HomeMy WebLinkAboutBoulder Contracting, LLCBoulder Contracting, LLC
25789 N Ave
Grundy Center, IA 50638
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25789 N. Ave.
Grundy Center, IA 50638
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Revised Per Addendum No. 1 - 04/30/2018
FORM OF BID OR PROPOSAL
FY 2018 BRIDGE AND CULVERT REPAIRS
CONTRACT NO. 950
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 1;44,4
a Partnership consisting of the following partners:
/vA 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 the City Engineer of
the City of Waterloo 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 FY 2018 BRIDGE AND CULVERT REPAIRS, CONTRACT NO. 950, all
in accordance with the above -listed documents and for the unit prices for work in place for the
following items and quantities:
FY 2018 BRIDGE AND CULVERT REPAIRS
CONTRACT NO. 950
BID
ITEM
REF. NO.
DESCRIPTION
UNIT
EST.
QTY.
UNIT BID
PRICE
TOTAL BID
PRICE
1
2107-0425020
COMPACTING BACKFILL
ADJACENT TO BRIDGES,
CULVERTS OR STRUCTURES
CY
10.0
$
105-, op
$
1, vt". op
2
2301-0685550
BRIDGE APPROACH PAVEMENT,
AS PER PLAN
SY
107.0
$ /65.vU
$ 19,715".ov
3
2413-1100000
PREFORMED ELASTIC
NEOPRENE JOINT
LF
48.0
$ S,.moz,
$ a,ciao .az,
4
2413-1200100
NEOPRENE GLAND
INSTALLATION AND TESTING
LF
143.0
$
tgf.co
$ a7OS az,
5
2426-6772016
CONCRETE REPAIR
SF
33.0
$ 472rw,w
$ 6,4vo.ov
6
2426-6772020
PARTIAL DEPTH BRIDGE DECK
FINISH PATCH
SF
130.0
$ ISo, au
$ /9,Sun.ov
7
2511-7526004
SIDEWALK, P.C. CONCRETE, 4
IN.
SY
10.0
$
Metro
$ 1, b,w, on
8
2518-6910000
SAFETY CLOSURE
EACH
4.0
$ d74-,va
$ 1,1CO.0v
9
2528-8445110
TRAFFIC CONTROL
LS
1.0
$ 112,od,.on
$ 12,Deo ,(lb
10
2529-8200200
PRESSURE RELIEF JOINT, CF
LF
56.0
$ NS.ov
$ a,5"ao•ov
11
2533-4980005
MOBILIZATION
LS
1.0
$ Q5;voa.ovo
$ 2S,vm,.00
12
2599-9999005
HMA APPROACH REPAIRS
SY
50.0
$ 7G.az
$ 3,5oo.co
13
2599-9999005
REPAIR GUARDRAIL AND
TIMBER POSTS
LF
120.0
$ 7a .0-0
$ /t
$,LNo,0.0
Deleted
14
o Gno 994901G
�" '� w
• • ! _ !
AMD --POSTS
LS
1,9
$
$
FORM OF BID
AECOM #60569633
CONTRACT NO. 950
Page FB -1 of 3
FY 2018 Bridge and Culvert Repairs
Revised Per Addendum No. 1 - 04/30/2018
BID
ITEM
REF. NO.
DESCRIPTION
UNIT
EST.
QTY.
UNIT BID
PRICE
TOTAL BID
PRICE
15
2599-9999005
FURNISH AND INSTALL
EXPANSION JOINT CURB PLATE
EA
1.0
$ 1, �•�
$ w.v
1,O.o
16
2599-9999005
FURNISH AND INSTALL LIGHT
POST ACCESS COVER SCREWS
EA
10.0
$ IS.ev
$ ISo. ov
17
2599-9999005
REPAIR PEDESTRIAN PIPE
RAILINGS
LF
100.0
$
I?u.00
$
13000.00
TOTAL BID
$11f/757yo.oe
2. It is understood that the quantities set forth are approximate only and subject to variation and that the
unit bid price for the work done shall govern in the actual payment to Contractor.
3. In submitting this bid, the bidder understands that the right is reserved by the City of Waterloo, Iowa,
to reject any or all bids. If written notice of the acceptance of this bid is mailed, telegraphed, or
delivered to the undersigned within thirty (30) days after the opening thereof, or at any time thereafter
before this bid is withdrawn, the undersigned agrees to execute and deliver an agreement in the
prescribed form and furnish the required bond and certificate of the insurance within ten (10) days
after the agreement is presented to him for signature, and start work within ten (10) days after
"Notice to Proceed" is issued.
4. Security in the sum of So Dollars
($ ) in the form of Sao 6wo
with the INSTRUCTIONS TO BIDDERS.
is submitted herewith in accordance
5. Attached hereto is a Non -Collusion Affidavit of Prime Contractor.
6. Attached hereto is a Resident Bidder Certification ( X ) or Non -Resident Bidder Certification
( ). (Mark one.)
7. The bidder is prepared to submit a financial and experience statement upon request.
8. 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 AAP or Update and an
EOC, within ten (10) days of notification that the bid submitted is lowest and acceptable.
9. The bidder has received the following Addendum or Addenda:
Addendum No. 1 Date N S0 r6
2 SS?B
10. The bidder shall list the MBE/WBE 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.
FORM OF BID CONTRACT NO. 950 Page FB -2 of 3
AECOM #60569633 FY 2018 Bridge and Culvert Repairs
Revised Per Addendum No. 1 - 04/30/2018
11. The bidder has filled in all blanks on this proposal. Those blanks not applicable are marked "none"
or "NA".
12. The bidder has attached all applicable forms.
13. 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.
BY:
flow Oaf- CawMwc-2016, LCC.
(Name of Bidder)
Title P.iost-ovvr
Official Address: (Including Zip Code):
95789 b.. 4vea az
Ga...voY mss, LA 5o&38
I.R.S. No. )7.307avd3
FORM OF BID CONTRACT NO. 950 Page FB -3 of 3
AECOM #60569633 FY 2018 Bridge and Culvert Repairs
Revised Per Addendum No. 1 - 04/30/2018
FORM OF BID OR PROPOSAL
FY 2018 BRIDGE AND CULVERT REPAIRS
CONTRACT NO. 950
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 So wA
a Partnership consisting of the following partners:
NA 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 the City Engineer of
the City of Waterloo 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 FY 2018 BRIDGE AND CULVERT REPAIRS, CONTRACT NO. 950, all
in accordance with the above -listed documents and for the unit prices for work in place for the
following items and quantities:
FY 2018 BRIDGE AND CULVERT REPAIRS
CONTRACT NO. 950
BID
ITEM
REF. NO.
DESCRIPTION
UNIT
EST.
QTY.
UNIT BID
PRICE
TOTAL BID
PRICE
1
2107-0425020
COMPACTING BACKFILL
ADJACENT TO BRIDGES,
CULVERTS OR STRUCTURES
CY
10.0
$
r°Coo
$
/,.Soso
2
2301-0685550
BRIDGE APPROACH PAVEMENT,
AS PER PLAN
SY
107.0
$ /Ss. tar
$ 19,795.0b
3
2413-1100000
PREFORMED ELASTIC
NEOPRENE JOINT
LF
48.0
$ 50. el,
$ S,goo, az,
4
2413-1200100
NEOPRENE GLAND
INSTALLATION AND TESTING
LF
143.0
$
tgf.om
$ P7,665;vv
5
2426-6772016
CONCRETE REPAIR
SF
33.0
$ aa,00
$ G,LWtra
6
2426-6772020
PARTIAL DEPTH BRIDGE DECK
FINISH PATCH
SF
130.0
$ /fo,av
$ /9, Soo.on
7
2511-7526004
SIDEWALK, P.C. CONCRETE, 4
SY
10.0
$
IGovo
$ l,Gov,ov
8
2518-6910000
SAFETY CLOSURE
EACH
4.0
$ a7g,z,
$ /,/00,0n
9
2528-8445110
TRAFFIC CONTROL
LS
1.0
$ y, „0.o„
$ ya,COD ,vn
10
2529-8200200
PRESSURE RELIEF JOINT, CF
LF
56.0
$ Li 5.0v
$ a,no.on
11
2533-4980005
MOBILIZATION
LS
1.0
$ 25;000.ov
$ 05 oa,.00
12
2599-9999005
HMA APPROACH REPAIRS
SY
50.0
$ ?(,,op
$ 3,5".0.00
13
2599-9999005
REPAIR GUARDRAIL AND
LF
120.0
$
$its, 6No,0T)
De11e4ted
2599 9999005
gND__pg&g
L�
1.0
$
$
FORM OF BID
AECOM #60569633
CONTRACT NO. 950
Page FB -1 of 3
FY 2018 Bridge and Culvert Repairs
Revised Per Addendum No. 1 - 04/30/2018
BID
ITEM
REF. NO.
DESCRIPTION
UNIT
EST.
QTY.
UNIT BID
PRICE
TOTAL BID
PRICE
15
2599-9999005
FURNISH AND INSTALL
EXPANSION JOINT CURB PLATE
EA
1.0
$ /,tm•�
$
1,x•00
16
2599-9999005
FURNISH AND INSTALL LIGHT
POST ACCESS COVER SCREWS
EA
10.0
$
1 S. vo
$
I5o. ao
17
2599-9999005
REPAIR PEDESTRIAN PIPE
RAILINGS
LF
100.0
$ t go.
$
13, oao.�o
TOTAL BID
$4175, 79o.e6
2. It is understood that the quantities set forth are approximate only and subject to variation and that the
unit bid price for the work done shall govern in the actual payment to Contractor.
3. In submitting this bid, the bidder understands that the right is reserved by the City of Waterloo, Iowa,
to reject any or all bids. If written notice of the acceptance of this bid is mailed, telegraphed, or
delivered to the undersigned within thirty (30) days after the opening thereof, or at any time thereafter
before this bid is withdrawn, the undersigned agrees to execute and deliver an agreement in the
prescribed form and furnish the required bond and certificate of the insurance within ten (10) days
after the agreement is presented to him for signature, and start work within ten (10) days after
"Notice to Proceed" is issued.
4. Security in the sum of
($ ) in the form of Sao a.,..o
S'
with the INSTRUCTIONS TO BIDDERS.
Dollars
is submitted herewith in accordance
5. Attached hereto is a Non -Collusion Affidavit of Prime Contractor.
6. Attached hereto is a Resident Bidder Certification ( X ), or Non -Resident Bidder Certification
( ). (Mark one.)
7. The bidder is prepared to submit a financial and experience statement upon request.
8. 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 AAP or Update and an
EOC, within ten (10) days of notification that the bid submitted is lowest and acceptable.
9. The bidder has received the following Addendum or Addenda:
Addendum No. 1 Date N 5a re
2
8
10. The bidder shall list the MBE/WBE 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.
FORM OF BID CONTRACT NO. 950 Page FB -2 of 3
AECOM #60569633 FY 2018 Bridge and Culvert Repairs
Revised Per Addendum No. 1 - 04/30/2018
11. The bidder has filled in all blanks on this proposal. Those blanks not applicable are marked "none"
or "NA".
12. The bidder has attached all applicable forms.
13. 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.
foata, t tcyrzm-rvNG, LCC.
5/77,4
BY:
(Name of Bidder) (Date)
Title Patisu€wr
Official Address: (Including Zip Code):
95799 4'.. /4veNt.e
(avway CY.vhn, to soc.se
I.R.S. No. J9.3u�av83
FORM OF BID CONTRACT NO. 950 Page FB -3 of 3
AECOM #60569633 FY 2018 Bridge and Culvert Repairs
CONTRACT NO:
PROJECT NAME:
DATE OF LETTING:
RESIDENT BIDDER CERTIFICATION
q5o
avie (laco&i. r (uwrwr 4y'fl C(ZS
54/g
To be a qualified resident bidder, the bidder shall be a person or
entity authorized to transact business in this state and having a
business for at least three years prior to the date of the first
advertisement for the public improvement. If another state or
foreign country has a more stringent definition of a resident bidder,
the more stringent definition is applicable as to bidders from that
state or foreign country.
This qualification as resident bidder shall be maintained by the contractor and his
subcontractors at the work site until this project is completed.
I hereby certify that I am a resident bidder as defined above.
COMPANY NAME
guu.off2 OwMrt-e-1CYCn , LLC.
CORPORATE OFFICER AEA 6..«‘ knit J.0
TITLE ssn/r/
DATE 5-z/a
RESIDENT/NON-RESIDENT BIDDER
RESIDENT BIDDER:
In accordance with Section 73A.21 of the Iowa Code, all non -federal -aid public
improvement projects, which include road construction, shall be performed by a
qualified resident bidder. The resident bidder has been further defined as follows:
Resident Bidder:
A person or entity authorized to transact business in this state and
having a business for at least three years prior to the date of the
first advertisement for the public improvement. If another state or
foreign country has a more stringent definition of a resident bidder,
the more stringent definition is applicable as to bidders from that
state or foreign country.
The contractor shall provide the City with a certification that he is a qualified
resident bidder according to the above definition. The Certification shall be
submitted with the contractor's bid. A copy of the form of "Resident Bidder
Certification" is included in the Contract Documents. If it is determined that the
contractor does not meet this qualification after he begins work, a shutdown
notice shall be issued and the voiding of the contract shall begin unless the
contractor becomes qualified.
NON-RESIDENT BIDDER:
The contractor shall provide the City with a certification that he is a non-resident
bidder according to the above definition. The Certification shall be submitted with
the contractor's bid. A copy of the form of "Non -Resident Bidder Certification" is
included in the Contract Documents.
DJG
01/02/12
NON -COLLUSION AFFIDAVIT OF PRIME BIDDER
State of Tw a )
)ss
County of 6444NtY )
Lu,' kro i- being first duly sworn, deposes and says that:
1. He is (Owner, Partner, Officer, Representative, or Agent) of OFFCcE.-
the Bidder that has submitted 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, or parties in interest, including this affiant.
(Signed)
P,.bs w,Sn-r
Title
Subscribed and sworn to before me this 3'° day of p147 2018.
My commission expires ...5=16 -1020
at. e.A•S-41. eea._r
DAVID CAPSOPOULOS
Notarial Seal - Iowa
Commission Number 804393
My Co ' sion pi s1v}ag1 020
NON -COLLUSION AFFIDAVIT
AECOM #60569633
Peisa0 (%.LoAutes Rete -kr AMS
Title
CONTRACT NO. 950 Page NCA -1 of 2
FY 2018 Bridge and Culvert Repairs
Bidder Status Form
To be completed by all bidders Part A
Please answer "Yes" or "No" for each of the following:
Yes ❑ No
[� Yes ❑ No
Yes ❑ No
J Yes ❑ No
[] Yes ❑No
My company is authorized to transact business in Iowa.
(To help you determine if your company is authorized, please review the worksheet on the next page).
My company has an office to transact business in Iowa.
My company's office in Iowa is suitable for more than receiving mail, telephone calls, and e-mail.
My company has been conducting business in Iowa for at least 3 years prior to the first request for
bids on this project.
My company is not a subsidiary of another business entity or my company is a subsidiary of another
business entity that would qualify as a resident bidder in Iowa.
If you answered "Yes" for each question above, your company qualifies as a resident bidder. Please
complete Parts B and D of this form.
If you answered "No" to one or more questions above, your company is a nonresident bidder. Please
complete Parts C and D of this form.
To be completed by resident bidders Part B
My company has maintained offices in Iowa during the past 3 years at the following addresses:
Dates: t / i / iU to cylk.tru. / Address: as -799 fr. Mt"K..
City, State, Zip: on-Nwov C4w+t2, ik soon
Dates: / / to / / Address:
City, State, Zip:
Dates: / / to / / Address:
You may attach additional sheet(s) if needed. City, State, Zip'
To be completed by non-resident bidders Part C
1. Name of home state or foreign country reported to the Iowa Secretary of State:
2. Does your company's home state or foreign country offer preferences to resident bidders, resident labor
force preferences or any other type of preference to bidders or laborers? ❑ Yes ❑ No
3. If you answered "Yes" to question 2, identify each preference offered by your company's home state or foreign country
and the appropriate legal citation.
You may attach additional sheet(s) if needed.
To be completed by all bidders Part D
I certify that the statements made on this document are true and complete to the best of my knowledge and I know that my
failure to provide accurate and truthful information may be a reason to reject my bid.
Firm Name: 670.44a ( ,..1-cmwt,ctc
Signature:
Date: ,>ME
You must submit the completed form to the governmental body requesting bids per 875 Iowa Administrative Code
Chapter 156. This form has been approved by the Iowa Labor Commissioner.
309-6001 (09-15)
Worksheet: Authorization to Transact Business
This worksheet may be used to help complete Part A of the Resident Bidder Status form. If at least one of the following
describes your business, you are authorized to transact business in Iowa.
tp Yes ❑ No
❑ Yes gf No
❑ Yes (,] No
M Yes ❑ No
❑ Yes ® No
My business is currently registered as a contractor with the Iowa Division of Labor.
My business is a sole proprietorship and I am an Iowa resident for Iowa income tax purposes.
My business is a general partnership or joint venture. More than 50 percent of the general
partners or joint venture parties are residents of Iowa for Iowa income tax purposes.
My business is an active corporation with the Iowa Secretary of State and has paid all fees
required by the Secretary of State, has filed its most recent biennial report, and has not filed
articles of dissolution.
My business is a corporation whose articles of incorporation are filed in a state other than Iowa,
the corporation has received a certificate of authority from the Iowa secretary of state, has filed
its most recent biennial report with the secretary of state, and has neither received a certificate of
withdrawal from the secretary of state nor had its authority revoked.
❑ Yes ® No My business is a limited liability partnership which has filed a statement of qualification in this
state and the statement has not been canceled.
❑ Yes No My business is a limited liability partnership which has filed a statement of qualification in a
state other than Iowa, has filed a statement of foreign qualification in Iowa and a statement of
cancellation has not been filed.
❑ Yes tI No My business is a limited partnership or limited liability limited partnership which has filed a
certificate of limited partnership in this state, and has not filed a statement of termination.
❑ Yes 0 No My business is a limited partnership or a limited liability limited partnership whose certificate of
limited partnership is filed in a state other than Iowa, the limited partnership or limited liability
limited partnership has received notification from the Iowa secretary of state that the application
for certificate of authority has been approved and no notice of cancellation has been filed by the
limited partnership or the limited liability limited partnership.
❑ Yes ❑ No My business is a limited liability company whose certificate of organization is filed in Iowa and has
not filed a statement of termination.
❑ Yes 0 No My business is a limited liability company whose certificate of organization is filed in a state other
than Iowa, has received a certificate of authority to transact business in Iowa and the certificate
has not been revoked or canceled.
309-6001 (09-15)
BSF-2
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BID BOND
KNOW ALL MEN BY THESE PRESENTS, that we, Boulder Contracting, LLC
as Principal, and Westfield 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 Amount Bid
Dollars ($ 57° ) 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 3rd day of May
,20 18 , for FY 2018 Bridge and Culvert Repairs, Contract No. 950
NOW, THEREFORE,
(a) If said Bid shall be rejected, or in the alternate,
(b) If said Bid shall be accepted and the Principal shall execute and deliver a contract in the form
specified and shall furnish 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 that 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 pres-
ents to be signed by their proper officers this 3rd day of May , A.D. 2018_.
Boulder Contracting, LLC
Principal
Wi ess
W'ness
(Seal)
By
(Title)
Westfield Insurance Company
Surety
By
At yin fact Nancy D. Baltutat
(Seal)
BID BOND CONTRACT NO. 950 Page BB -1 of 1
AECOM #60569633 FY 2018 Bridge and Culvert Repairs
wn, rncv,4/w rw.Gf DCHnuav ,mJ aMMI
PnlVER # AND ISSUED PRIOR TO 06/07/16, FOR ANY PERSON OR PERSONS NAMED BELOW.
General
Power
of Attorney
CERTIFIED COPY
POWER NO. 1429172 00
Westfield Insurance Co.
Westfield National Insurance Co.
Ohio Farmers Insurance Co.
Westfield Center, Ohio
Know All Men by These Presents, That WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and 01110
FARMERS INSURANCE COMPANY, corporations, hereinafter referred to Individually as a "Company" and collectively as "Companies," duly
organized and existing under the laws of the State of Ohlo, and having its principal office In Westfield Center, Medina County, Ohio, do by these
presents make, constitute and appoint
MARK E. KEAIRNES, JOSEPH I. SCHMIT, JEFFREY R. BAKER, JILL SHAFFER, GREG T. LAMAIR, NANCY D. BALTUTAT,
PATRICK K. DUFF, CHRISTOPHER R. SEIBERLING, JOINTLY OR SEVERALLY
of WEST DES MOINES and State of IA its true and lawful Attorney(s)-In-Fact, with full power and authority hereby conferred in Its name,
place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings, or other instruments or contracts of
suretyship
LIMITATION: THIS POWER OF ATTORNEY CANNOT BE USED TO EXECUTE NOTE GUARANTEE, MORTGAGE DEFICIENCY, MORTGAGE
GUARANTEE, OR BANK DEPOSITORY BONDS.
and to bind any of the Companies thereby as fully and to the same extent as If such bonds were signed by the President, sealed with the corporate
seal of the applicable Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney(s)-in-Fact may do In
the premises. Said appointment is made under and by authority of the following resolution adopted by the Board of Directors of each of the
WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY:
"Be It Resolved, that the President, any Senior Executive, any Secretary or any Fidelity & Surety Operations Executive or other Executive shall
be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attorney(s)-in-Fact to represent and act for
and on behalf of the Company subject to the following provisions:
The Attorney -In -Fact, may be given full power and authority for and In the name of and on behalf of the Company, to execute, acknowledge and
deliver, any and all bonds, recognizances, contracts, agreements of Indemnity and other conditional or obligatory undertakings and any and all
notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such
Attorney -in -Fact shall be as binding upon the Company as If signed by the President and sealed and attested by the Corporate Secretary."
"Be it Further Resolved, that the signature of any such designated person and the seal of the Company heretofore or hereafter affixed to any
power of attorney or any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signatures or facsimile
seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached." (Each adopted at a meeting
held on February 8, 2000).
In Witness Whereof, WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE
COMPANY have caused these presents to be signed by their National Surety Leader and Senior Executive and their corporate seals to be hereto
affixed this 071h day of JUNE A.D. 2016 .
Corporate "'w 'µ�""��•
Seals P'\dyUN:9/0— ,
Affixed o W. '\ 0 ei
.I}
State of Ohlo
County of Medina ss.:
WESTFIELD INSURANCE COMPANY
WESTFIELD NATIONAL INSURANCE COMPANY
OHIO FARMERS INSURANCE COMPANY
•
By: J -.n
Dennis P. Baus, National Surety Leader and
Senior Executive
On this 07th day of JUNE A.D., 2016 , before me personally came Dennis P. Baus to me known, who, being by me duly sworn, did
depose and say, that he resides In Wooster, Ohio; that he Is National Surety Leader and Senior Executive of WESTFIELD INSURANCE
COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY, the companies described In and which
executed the above instrument; that he knows the seals of said Companies; that the seals affixed to said Instrument are such corporate seals; that
they were so affixed by order of the Boards of Directors of said Companies; and that he signed his name thereto by like order.
Notarial
Seal
Affixed
State of Ohio
County of Medina ss.:
David A. Kotnik, Attorney at Law, Notary Public
My Commission Does Not Expire (Sec. 147.03 Ohio Revised Code)
I, Frank A. Carrino, Secretary of WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS
INSURANCE COMPANY, do hereby certify that the above and foregoing Is a true and correct copy of a Power of Attorney, executed by said
Companies, which Is still in full force and effect; and furthermore, the resolutions of the Boards of Directors, set out in the Power of Attorney are
in full force and effect.
In Witness Whereof, I have hereunto set my hand and affixed the seals of said Companies at Westfield Center, Ohio, this 3rd day of
May 044 2018 .
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�fdJtf a s o /L '•.'f'
" e ct SEAL
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BPOAC2 (combined) (06-02)
d ..
Frank A. Carrino, Secretary
Secretary