HomeMy WebLinkAboutLodge ConstructionFORM OF BID OR PROPOSAL
F.Y. 2018 SINK CREEK CHANNEL CLEANOUT AND SHAPING
CONTRACT NO. 924
CITY OF WATERLOO, IOWA
Honorable Mayor and City Council
Waterloo, Iowa
Gentlemen:
1. The undersigned, being a Corporation existing under the laws of the State of Tf
a Partnership consisting of the following partners:
having familiarized (himself) (themselves) (itself) with the existing conditions on the project area
affecting the cost of the work, and with all the contract documents listed in the Table of Contents and
Addenda (if any), as prepared by AECOM now on file in the office of the City Clerk, City Hall,
Waterloo, Iowa, hereby proposes to furnish all supervision, technical personnel, labor, materials,
machinery, tools, appurtenances, equipment, and services, including utility and transportation
services required to construct and complete this F.Y. 2018 SINK CREEK CHANNEL CLEANOUT
AND SHAPING, CONTRACT NO. 924, all in accordance with the above -listed documents and for
the unit prices for work in place for the following items and quantities:
F.Y. 2017 SINK CREEK CHANNEL CLEANOUT AND SHAPING
CONTRACT O. 924
Item '
No.
Description
'.
Unit.
Est. Qty.
Unit Bid Price
Total Bid Price
1
Clearing and Grubbing
ACRE
2.5
Oct
$ 4 0 5-0
$ 7 i'
C/e
$ 1 6a C, "--
as)
$ 1V) 000 ±—
/g,
2
Excavation, Class 10, Channel
CY
2000.0
3
Topsoil, Strip, Salvage and Spread
CY
1000.0
$ q i-
$ 000 p"�
et--°
$ /1 000 '�
$ 6 [rjs; I
)
4
Topsoil, Furnish and Spread
CY
500.0
$ n '/ 2
5
Stabilized Construction Areas, Class A Crushed
Stone
TON
350.0
$ l 0 0
I l
6
Aprons, Concrete, 18 -In. Dia.
EACH
1.0
4
$ Roo ---6"
foo 'y
Storm Sewer Gravity Main, Trenched, Reinforced
Concrete Pipe (RCP), 2000D (Class III), 18 -In.
LF
138.0
$ S" %
$ COO
$ to 330
U
$ SO
8
RCP Apron Section Footing
EACH
1.0
9
Engineering Fabric
SY
IF
1150.0
150.0
$ 3 ✓
$ // r
$ 3)1/ —O ' '
$ 662j 0
10
Fence, Field
11
Gate, Field Fence, 16 -Ft
EACH
1.0
$ /2 000 £
$ / fiat e
12
Removal of Fence, Field
LF
150.0
$ 9._5%
ov
$ 375-
FORM OF 81D
AECOM #60485896
CONTRACT NO. 924
FB -1 of 3
FY 2018 -Sink Creek Channel Cleanout & Shaping
Item
No.
Description
Unit
Est. Qty.
Unit Bid Price
Total Bid Price
13
Mobilization
LS
1.0
$ 7J$--00 ""'-
$ 7, S-061
14
Seeding and Fertilizing (Urban)
ACRE
3.5
$ ya00 a o�
�
$ � UO
if / 7 ''!
15
Slope and Channel Protection, Wood Excelsior Mat
SQ
935.0
$ 7/
$ �0), ci�'.�r'
TOTAL BASE BID
00
$ terJ 365
ALTERNATE BID ITEMS
16
Turf Reinforcement Mat, Type 2
SQ
426.0
$ 3q -ft—
$ / 4, /fv-'
TOTAL ALTERNATE BID
$ / 6) 6 /1/ c,°
TOTAL BASE BID + ALTERNATE BID
00
$7Q(,l) 9 79
2. It is the City of Waterloo's intention to evaluate the bids, reviewing both the Base Bid and the
Alternate Bid. The City of Waterloo reserves the right to award the contract based on the Base Bid
only or the Base Bid plus Alternate Bid.
3. It is understood that the quantities set forth are approximate only and subject to variation and that the
unit bid price for the work done shall govern in the actual payment to Contractor.
4. In submitting this bid, the bidder understands that the right is reserved by the City of Waterloo, Iowa,
to reject any or all bids. If written notice of the acceptance of this bid is mailed, telegraphed, or
delivered to the undersigned within thirty (30) days after the opening thereof, or at any time thereafter
before this bid is withdrawn, the undersigned agrees to execute and deliver an agreement in the
prescribed form and furnish the required bond and certificate of the insurance within ten (10) days
after the agreement is presented to him for signature, and start work within ten (10) days after
"Notice to Proceed" is issued.
CYO
5. Security in the sum of
($ ) in the form of 13c. k et -
accordance with the INSTRUCTIONS TO BIDDERS.
6. Attached hereto is a Non -Collusion Affidavit of Prime Contractor.
Dollars
is submitted herewith in
7. Attached hereto is a Resident Bidder Certification ( ) or Non -Resident Bidder Certification
(.,..____). (Mark one.)
8. iihe bidder is prepared to submit a financial and experience statement upon request.
9. The Prime Contractor and Subcontractor(s), which have performed an aggregate of $10,000.00 in
work for the City in the current calendar year, are prepared to submit an MP or Update and an
EOC, within ten (10) days of notification that the bid submitted is lowest and acceptable.
10. The bidder has received the following Addendum or Addenda:
Addendum No.
Date /2-5_ 77
FORM OF BID CONTRACT NO. 924 FB -2 of 3
AECOM 1160485896 FY 201 B -Sink Creek Channel Cleanout & Shaping
11. The bidder shall list the MBENUBE subcontractor(s), amount of subcontracts and bid items on the
City of Waterloo Minority and/or Women Business Pre-bid Contact Information Form submitted with
this Form of Bid or Proposal. The apparent low Bidder shall submit a list of all other Subcontractor(s)
to be used on this Project to the City of Waterloo by 5:00 p.m. the business day following the day
Bids on this Project are due along with the Non -Collusion Affidavits of All Subcontractor(s).
The Contractor shall submit information on subcontractors on "SUBCONTRACTOR REQUEST AND
APPROVAL" Form to be provided by City prior to approval of contract.
The subcontractors listed on this proposal and/or submitted to the Contract Compliance Officer
cannot be changed except for the following reasons:
1) The City of Waterloo does not approve the subcontractors.
2) The subcontractors submit in writing that they cannot fulfill their subcontracts.
12. The bidder has filled in all blanks on this proposal. Those blanks not applicable are marked "none"
or "NA".
13. The bidder has attached all applicable forms.
14. The Owner reserves the right to select alternates, delete line items, and/or to reduce quantities prior
to the award of a contract due to budgetary limitations,
Lod? Cow.cla,c.-1-tcw t /a— ,' ` �7
(Name of Bidder
BY:
(Date)
) ( )
fficial Address: (Including Zip Code):
pa. gG?. Ks --t
Title.5-6//"--1'c
c7 -c (6., /c � I o&(9
I.R.S. No. «7-&fe789
FORM OF BID CONTRACT NO. 924 FB -3 of 3
AECOM #60485896 FY 2018 -Sink Creek Channel Cleanout & Shaping
NON -COLLUSION AFFIDAVIT OF PRIME BIDDER
State of
/ )ss
County of 13/"C is �� ` Y`)
Se ktt
1. He is Owner Partner Office
CoHs� e i e� .4 the Bidder that has su
, being first duly sworn, deposes and says that:
r�Aent , of /46L9
resentativ
in e.
the attached Bid;
2. He is fully informed respecting the preparation and contents of the attached Bid and of all
pertinent circumstances respecting such Bid;
3. Such Bid is genuine and is not a collusive or sham Bid;
4. Neither the said Bidder nor any of its officers, partners, owners, agents, representatives,
employees, or parties in interest, including this affiant, has in any way colluded, conspired,
connived or agreed, directly or indirectly, with any other Bidder, firm or person to submit a
collusive or sham Bid in connection with the Contract for which the attached Bid has been
submitted or to refrain from bidding in connection with such Contract, or has in any manner,
directly or indirectly, sought by agreement or collusion or communication or conference with any
other Bidder, firm or person to fix the price or prices in the attached Bid or of any other Bidder, or,
to fix any overhead, profit or cost element of the bid price or the bid price of any other Bidder, or to
secure through any collusion, conspiracy, connivance, or unlawful agreement any advantage
against the City of Waterloo, Iowa, or any person interested in the Proposed Contract; and
5. The price or prices quoted in the attached Bid are fair and proper and are not tainted by any
collusion, conspiracy, connivance or unlawful agreement on the part of the Bidder or any of its
agents, representatives, owners,employees, oror parti -st, including this aff'-nt.
(Signe.
Title
Subscribed and sworn to before me this 4/ , day of &/. w�✓ , 2017.
My commission expires , & h/5; ,282,17
Title
r ;.. .r
S3NIdX3 NOISSIWWOO,I{N w
209909 'ON NOISSIWWOO
NN3SNVONII
NON -COLLUSION AFFIDAVIT CONTRACT NO. 924 NCA -1 of 2
AECOM #60485898 FY 2018 Sink Creek Channel Cleanout & Shaping
EQUAL OPPORTUNITY CLAUSE
(As provided in Executive Order No. 11246)
All contractors, subcontractors, vendors and suppliers of goods and services doing business with the City
and value of said business equals or exceeds ten thousand dollars ($10,000.00) annually agree as
follows:
1. The contractors, subcontractor, vendor and supplier of goods and services will not discriminate
against any employee or applicant for employment because of race, color, creed, sex, national
origin, economic status, age, mental or physical handicap, political opinions or affiliations. The
contractor, subcontractor, vendor and supplier will develop an Affirmative Action program to
ensure that applicants are employed and that employees are treated during employment without
regard to their race, creed, color, sex, national origin, religion, economic status, age, mental or
physical disability, political opinions or affiliations. Such actions shall include but not be limited to
the following:
a. Employment
b. Upgrading
c. Demotion or Transfer
d. Recruitment and Advertising
e. Layoff or Termination
f. Rates of Pay or Other Forms of Compensation
g. Selection for Training Including Apprenticeship
2. The contractor, subcontractor, vendor and supplier of goods and services will, in all solicitations
or advertisements for employees, state that all qualified applicants will receive consideration for
employment without regard to race, creed, color, sex, national origin, religion, economic status,
age, mental or physical disabilities, political opinion or affiliations.
3. The contractor, subcontractor, vendor and supplier or his/her collective bargaining representative
will send to each labor union or representative of workers which he/she has a collective
bargaining agreement or other contract or understanding, a notice advising said labor union or
workers' representative of the contractor's commitment under this section.
4. The contractor, subcontractor, vendor and supplier of goods and services will comply with all
published rules, regulations, directives, and order of the City of Waterloo Affirmative Action
Program Contract Compliance Provisions.
5. The contractor, subcontractor, vendor and supplier of goods and services will furnish and file
compliance reports within such time and upon such forms as provided by the Affirmative Action
Officer. Said forms will elicit information as to the policies, procedures, patterns, and practices of
each subcontractor as well as the contractor himself/herself and said contractor, subcontractor,
vendor and supplier will permit access to his/her employment books, records and accounts to the
City's Affirmative Action Officer, for the purpose of investigation to ascertain compliance with this
contract and with rules and regulations of the City's Affirmative Action Program—Contract
Compliance Provisions relative to Resolution No. 24664.
6. In the event of the contractor's non-compliance with the non-discrimination clauses of this
contract or with any of such rules, regulations and orders, this contract may be canceled,
terminated or suspended in whole or in part and the contractor may be declared ineligible for
further contracts in accordance with procedures authorized by the City Council.
7. The contractor, subcontractor, vendor and supplier of goods and services will include, or
incorporate by reference, the provisions of the non-discrimination clause in every contract,
EQUAL OPPORTUNITY CLAUSE CONTRACT NO. 924 EOC-1 of 2
AECOM #60485898 FY 2018 -Sink Creek Channel Cleanout & Shaping
CONTRACT NO.:
PROJECT NAME:
DATE OF LETTING:
NON-RESIDENT BIDDER CERTIFICATION
90261
F% 0a0/e 5,4K
cdee-�l
C lernk ob4
/O-/S—l7
I hereby certify that I am an Iowa non-resident bidder.
COMPANY NAME: 2-424e- (c (^C—
CORPORATE OFFICER:
TITLE: "-K a t
'`leve 20 e.
DATE: /o
STATE/COUNTRY OF RESIDENCY:
Stated below are the preference(s) to resident bidders in the state/country of
(Preference to bidders, labor force, or other preferential treatment to bidders or laborers, etc.
RESIDENT BIDDER CONTRACT NO. 924 RB -3 of 3
AECOM #60485896 FY 2015SInk Creek Channel Cleanout 8 Shaping
Revised February 2003
CONTRACTOR'S OR SUBCONTRACTOR'S AFFIRMATIVE ACTION PROGRAM
Check box that applies to party completing program:
( ) General Contractor
( ) Subcontractor
Section A to be completed by GENERAL CONTRACTORS only:
A.
Name of Company L&d e Cc-vtyln o l �c.w
Address of Company Pa go) f'S-t O-/& 4 IC50 it iZip S U y q
Telephone Number ( ) 3 Ii ,;231-05270
Federal ID
Number (iff��� Federal ID Number, Owner/President's Social Security Number)
Name of Project F/ 7? 511
.1i K
Project Contract Number ' 6.701 -
CYeed- C I es, i o v+
Estimated Construction Work Dates - / //`/'/7 1/
Start Finish
Section B to be completed by SUBCONTRACTORS only:
B.
Name of General or Prime Contractor Lciye CP( -,--c e -fav
Name of Subcontractor P *- . , 4- o (
Subcontractor's Address OS- w/t9e:lt Th,65 Zip &(,,d 307 lo,0),,//4o5-69 S`/damwy.
Subcontractor's Telephone Number (‘ ) 1/711— 6/c9-0
Subcontractor's Federal ID Number (if no Federal ID Number Owner/President's Social Security
Number) /
Name of Equal Employment Officer I3 sye-,v"L-
C. Remainder of program to be completed by party completing program, either Prime or
Subcontractor.
1. The Owners and/or Principals of your company:
-1-
Ethnic
Name Address Position Sex Origin
S-Ikut, L..'.. Po, P6/ ez-Wet PI Vit
c (-1 ko it icy
2. Other Areas of Interest:
If your company has branches or subsidiaries, or if your company is a branch or
subsidiary of a parent organization, give the following information:
Type of
Name Address Affiliation Degree
II. EMPLOYER'S POLICY (Please read carefully.)
A. We, the undersigned, recognize that we are morally and legally committed to
nondiscrimination in employment. Any person who applies for employment with our
company will not be discriminated against because of race, color, creed, sex, national
origin, economic status, age, mental or physical handicap.
B. The employment policies and practices of the undersigned are to recruit and hire
employees without discrimination, and to treat them equally with respect to compensation
and opportunities for advancement, including training, upgrading, promotion, and
transfer. However, we realize the inequities associated with employment training,
upgrading, contracting and subcontracting for minorities and women and we will direct
our efforts to correcting any deficiencies to the maximum extent possible. The same will
be required of our SUBCONTRACTORS and suppliers.
C. We submit this program to assure compliance with Executive Order 11246, as amended,
and other subsequent orders that may pertain to equal employment opportunity and merit
employment policies, fully realizing that our qualification and/or merit system should be
evaluated and revised, if necessary.
D. We agree to put forth the maximum effort to achieve full employment and utilization of
capabilities and productivity of all our citizens without regard to race, creed, color, sex,
national origin,ri/economic status, age, and mental or physical handicap.
E. Le r CG &Is --/A-6.44.-/ will give training
(Name of Company)
and employment opportunities to local residents of Waterloo, Iowa, to the greatest extent
feasible.
III. AFFIRMATIVE ACTION
A. L 04(5 recognizes that the
(Name of Company)
_2_
effective application of a policy of merit employment involves more than just a policy
statement, and A(LC rt. ."-.41-.41,"-^--
(Name
-.41-ch ^-(Name of Company)
will, therefore, re-evaluate our Affirmative Action Program to ensure that equal
employment opportunities are available on the basis of individual merit, and to actively
encourage minorities, women and local residents to seek employment with our company
on this basis.
B. .4-4 c. rev, s -c C will undertake the
(Name of Company)
following six (6) steps to improve our Affirmative Action Program:
1. Minority Recruitment and Employment;
2. Local Recruitment and Employment;
3. Disabled Veteran and Vietnam Era Veteran Recruitment and Employment;
4. Handicapped Recruitment and Employment;
5. Female Recruitment and Employment; and
6. Training, Upgrading and Promotional Opportunities.
C. Zc Z- r- will take
(Name of Company)
whatever steps are necessary to ensure that our total work force has adequate minority,
female, and local representation. We will utilize the following methods in our recruitment
attempts:
1. Local advertising media (newspapers, radio, TV);
2. Community organizations (churches, clubs, schools);
3. Public and private institutions in the area (UNI, Hawkeye Community College);
4. Job Service of Iowa; and
5. Other.
D. ! C; -v ; -,&-e k, 1 .-` will seek qualified minority,
(Name of Company)
female, and local group applicants for all job categories and will make asserted efforts to
increase minority, female and group representation in occupations at the higher levels or
skill and responsibility.
E. All sources of employment used shall be aware that we are an Equal Employment
Opportunity Employer. Labor organizations representing our employees will be notified
of our Equal Employment Opportunity Policy and Affirmative Action Program.
F. Training, upgrading, promotion and transfer activities at all levels will be monitored to
ensure that full consideration has been given to qualified minority, female, and local
group employees.
c<)$ %D vs-tn c v L t
(Name of Company)
companies with whom we are associated and/or do business, to do the same and we will
assist them in their efforts.
H. 2e,1 5 -e has taken the following
(Name of Company)
Affirmative Action to ensure that minority, female, local contractors and/or suppliers were
provided opportunities to negotiate and/or bid on this project: (if none, write "NONE")
G.
will encourage other
1. C
-3-
J.
2. S
As a result of the above efforts, we have involved minority, female, and local contractors
and/or suppliers in the following areas of subcontracting: (if none, write "NONE")
///M/ L-
2,
`ails c'_ c ccrS-f we -{-s-, will require approved
(Name of Company)
Affirmative Action Programs from all nonexempt contractors who propose to work on this
project and will take whatever steps are necessary to ensure that non -minority
contractors have adequate representation of minority, female and local persons in their
total work force.
K. In further accordance with rules and guidelines Issued pursuant to Executive Order
11246 as amended, we establish the goals for our company, based on parity
percentages supplied by the City, and we realize these goals will be reviewed on an
annual basis.
L. /c,eise C"ccvs-En-c4"`- ` ` C will keep records of
(Name of Company)
specific actions relative to recruitment, employment, training, upgrading and promotion
and will provide the City of Waterloo with any information relative to same, including
activities of our SUBCONTRACTORS and suppliers as necessary or when requested.
M. Parity figures for companies located in Waterloo are as follows:
Minority Parity = .08 (8%)
N. /-r-cCf6 Ce“ -s 71-c. Affirmative Action
(Name of Company)
Employment Goals:
The definition of Affirmative Action Goals is as follows: "Goals may not be rigid and
inflexible quotas which must be met, but must be targets, reasonably attainable by means
of applying every good faith effort to make all aspects of the entire Affirmative Action
Program work."
For the year 2017, please submit percentage targets for employing minorities and
women. If you already have reached your target for hiring minorities and women, please
submit that percentage.
"Goals for Minorities:
Goals for Women:
"Your affirmative action goals should be between 1% and 10% or more for minorities and
1% and 5% or more for women.
Please be advised that the goals or targets are purely your estimation of how many
women and minorities your company can reasonably expect to hire in 201_. Note, that
none of the goals are rigid or inflexible. They are targets that your company calculates as
reasonably attainable. This will help the City in its monitoring procedures as required by
City of Waterloo Resolution No. 1984-142(4).
-4-
CONTRACTOR'S TOTAL WORK FORCE
(WATERLOO)
NAME AND ADDRESS
JOB CATEGORY
R`A��CE
SEX
HOURLY
WAGE
(1 D
Jr -Lk ,, S L ut 4-,
. _ ,,
w
Pi
—
sue bets C1
��L//S,1I/U
4C4Ie44
vL-
ag-
/ J LS c ti
J/�j/�e „,,(,�, 6,-,
op e-f�1.4-"(
L✓
//1
J (/
a //�
p
/"'( iC Renievt-
O L'tcr''�1pc
ct€.0
£,U-
w
J4
0'?
229_
sale„ v,— ygwe/t r
A,
ictlia-< e .
In/
t"t
/1
/3-e4+
44..tece.(
w
a7
/r
INDICATE:
DISABLED VETERAN: DV
VIETNAM ERA VETERAN: W
HANDICAPPED: H
We hereby certify that we are in compliance with all City and Federal Affirmative Action
Regulations and agree to accept all liability for failure to comply.
Respectfully submitted,
By: Skin le -d3 >
Company Executive
By:
Date
Equal Employment
Opportunity Officer
/oi .- ,' - 17
Date
City of Waterloo Affirmative Action Officer
Approved
Disapproved Reason:
By:
Date:
-6-
MBE)WBE BUSINESS ENTERPRISE
PRE-BID CONTACT INFORMATIONTI/F/ORM
Prime Contractor Name:1° 4- , Coc S-f-�c-f vcn t h Project: 7�r Letting Date: /6 —(69- —/ —7
NO MBE/WBE SUBCONTRACTORS: If you are NOT using any MBE/WBE subcontractors to complete this project, sign below. Attach a brief
explanation as to why subcontracting was not feasible with this project. If any MBEIWBE subcontractors will be used, please use the bottom
portion of this form.
Contractor Signature: Title:
Date: %) — 42 '/
SUBCONTRAC • APPLICABLE: You are required, in order for your bid to be considered responsive, to provide the information on this form
showing of your MBEANBE subcontractor contacts made for your bid submission. This information is subject to verification. Any questions
should be directed to Contract Compliance Office 319-291-4429.
You are required, in order for your bid to be considered responsive, to provide the information on this Form showing your MBEM/BE Business
Enterprise contacts made prior to your bid submission. This information is subject to verifications and confirmation.
If you are unable to identify MBEfWBE firms to perform portions of the work, please contact Louis Starks, Contract Compliance Officer, for
assistance at (319) 291-4429.
In the event it is determined that the MBE/WBE Business Enterprise goals are not met, then before awarding the contract the City of Waterloo will
make a determination as to whether or not the apparent successful low bidder made good faith efforts to meet the goals.
TABLE OF INFORMATION SHOWING BIDDER'S PRE-BID
MBE/WBE BUSINESS ENTERPRISE CONTACTS
Quotes Received Quotation used in bid
MBE/WBE
Subcontractors
Dates
Contacted
Yes/No
Dates
Contacted
Yes/No
Dollar Amount Proposed to
be Subcontracted
+ /V rs err
/e -6-17
ytgS
// -4a-)7
N°
Na+- 10,4, .6,s , U.c.
l/-7
l�/e7
/o—//-17
p/O
oi/a-1- Iv"- Lid or r u"
—T
If
104,,_ 'kc5izi.-, cci,Y(Cz/°1'
(Form CCO-4) Rev. 06-20-02
MBENUBE PARTICIPATION
AECOM 460485896
CONTRACT NO. 924
M-6 of 6
FY 2018 -Sink Creek Channel Cleanout & Shaping
JIB
BID BOND
KNOW ALL MEN BY THESE PRESENTS, that we, Lodge Construction, Inc.
as Principal, and North American Specialty Insurance Company
as Surety are held and firmly bound unto the CITY OF WATERLOO , Iowa, hereinafter called
"OWNER." In the penal sum ---Five Percent of the Bid Submitted ---
Dollars ($ ---5%--- ) lawful money of the United States, for the payment
of which sum will and truly be made, we bind ourselves, our heirs, executors, administrators, and
successors, jointly and severally, firmly by these presents. The condition of this obligation is such that
whereas the Principal has submitted the accompanying bid dated the 12th day of October
, 2017 , for FY 2018 Sink Creek Channel Cleanout and Shaping in the City of Waterloo, IA - Contract
No. 924
NOW, THEREFORE,
(a) If said Bid shall be rejected, or in the altemate,
(b) If said Bid shall be accepted and the Principal shall execute and deliver a contract in the form specified
and shall fumish a bond for his faithful performance of said contract, and for the payment of all persons
performing labor or furnishing materials in connection therewith, and shall in all other respects perform the
agreement created by the acceptance of said Bid,
Then this obligation shall be void, otherwise the same shall remain in force and effect; it being expressly
understood and agreed chat the liability of the Surety for any and all claims hereunder shall, in no event,
exceed the penal amount of this obligation as herein stated.
By virtue of statutory authority, the full amount of this bid bond shall be forfeited to the Owner in liquidation of
damages sustained in the event that the Principal fails to execute the contract and provide the bond as
provided in the specifications or by law.
The Surety, for value received, hereby stipulates and agrees that the obligations of said Surety and its bond
shall be in no way, impaired or affected by any extension of the time within which the Owner may accept
such Bid or execute such contract; and said Surety does hereby waive notice of any such extension.
IN WITNESS WHEREOF, the Principal and the Surety, have hereunto set their hands and seals, and such
of them as are corporations, have caused their corporate seals to be hereto affixed and these presents to be
signed by their proper officers this 3rd day of October , A.D. 2017
40
Lodge Construction, Inc. (Seal)
Principal
By
North A Aiarn Specialty surance Compan eat
ifirAprijei
;t
torney-in-fact Anne Crowner
(Title)
SWISS RE CORPORATE SOLUTIONS
NORTH AMERICAN SPECIALTY INSURANCE COMPANY
WASHINGTON INTERNATIONAL INSURANCE COMPANY
WESTPORT INSURANCE CORPORATION
GENERAL POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS, THAT North American Specialty Insurance Company, a corporation duly organized and existing under
laws of the State of New Hampshire, and having its principal office in the City of Overland Park, Kansas and Washington International Insurance
Company a corporation organized and existing under the laws of the State of New Hampshire and having its principal office in the City of Overland
Park, Kansas, and Westport Insurance Corporation, organized under the laws of the State of Missouri, and having its principal office in the City of
Overland Park, Kansas each does hereby make, constitute and appoint:
JAY D. FREIERMTJTH, CRAIG E. IIANSEN, BRIAN M. DEIMERLY, SHIRLEY S. BARTENHAGEN, CINDY BENNETT, ANNE CROWN ER,
TEM McCULLOH„ STACY VENN, DIONE R. YOUNG, and WENDY ANN CASEY JOINTLY OR SEVERALLY
Its true and lawful Attorney(s)-in-Fact, to make, execute, seal and deliver, for and on its behalf and as its act and deed, bonds or other writings
obligatory in the nature of a bond on behalf of each of said Companies, as surety, on contracts of suretyship as are or may be required or permitted by
law, regulation, contract or otherwise, provided that no bond or undertaking or contract or suretyship executed under this authority shall exceed the
amount of: ONE IIUNDRED TWENTY FIVE MILLION ($125,000,000.00) DOLLARS
This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of
Directors of North American Specialty Insurance Company and Washington International Insurance Company at meetings duly called and held
on March 24, 2000 and Westport Insurance Corporation by written consent of its Executive Committee dated July 18, 2011.
"RESOLVED, that any two of the President, any Senior Vice President, any Vice President, any Assistant Vice President,
the Secretary or any Assistant Secretary be, and each or any of then hereby is authorized to execute a Power of Attorney qualifying the attorney named
in the given Power of Attorney to execute on behalf of the Company bonds, undertakings and all contracts of surety, and that each or any of them
hereby is authorized to attest to the execution of any such Power of Attorney and to attach therein the seal of the Company; and itis
FURTHER RESOLVED, that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any
certificate relating thereto by facsimile, and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be
binding upon the Company when so affixed and in the future with regard to any bond, undertaking or contract of surety to which it is attached."
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SEAL cz =
re:WA% 1973 4,; o
VOX hAMP`�`P:o
By
Steven P. Anderson, Sensor Vsce President of Washington international Insurance Company
& Senior Vice President of North American Specialty Insurance Company
& Senior Vice President of Westport Insurance Corporation
By
Alike A. Ito, Senior Vice President of W:uhinglon International Insurance Company
& Senior Vice President of North American Specialty hisurnne Company
& Senior Vice President of Westport Insurance Corporation
IN WITNESS WHEREOF, North American Specialty Insurance Company, Washington International Insurance Company and Westport
Insurance Corporation have caused their official seals to be hereunto affixed, and these presents to be signed by their authorized officers this
this 17 day of August 20 17
State of Illinois
County of Cook
On this 17 day of
ss:
August
North American Specialty Insurance Company
Washington International insurance Company
Westport Insurance Corporation
20 17, before me, a Notary Public personally appeared Steven P. Anderson , Senior Vice President of
Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and Senior Vice President of
Westport Insurance Corporation and Michael A. Ito Senior Vice President of Washington International Insurance Company and Senior Vice President
of Nath American Specialty Insurance Company and Senior Vice President of Westport Insurance Corporation, personally known to me, who
being by me duly sworn, acknowledged that they signed the above Power of Attorney as officers of and acknowledged said instrument to be the
voluntary act and deed of their respective companies.
OFFICIAL SEAL
M KENNY
NOTARY PUBUC, STATE OF I WNOIS
MY COMMISSION EXPIRES 1210412017
-M(Th �ti: its
M. Kenny, Notary Public
I, Jeffrey Goldberg , the duly elected Vice President and Assistant Secretary of North American Specialty Insurance Company, Washington
International Insurance Company and Westport Insurance Corporation do hereby certify that the above and foregoing is a true and correct copy of a
Power of Attorney given by said North American Specialty Insurance Company, Washington International Insurance Company and Westport Insurance
Corporation which is still in full force and effect.
IN WITNESS WHEREOF, I have set my hand and affixed the seals of the Companies this 3rd day of October , 2017
Jeffrey Qoldherg, Vice President & Assistant Secretary of Washington International insmmme Company &
North American Specialty Insurance Company & Vice President & Assistant Secretary of Westport Insurance Corporation
P.O. BOX 459 1 CLARKSVILLE, Lk 50619
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