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FORM OF BID OR PROPOSAL
F.Y. 2016 NORTHEAST INDUSTRIAL PARK SANITARY SEWER
AND WATER MAIN EXTENSION
CONTRACT NO. 900
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
,27.14.314 , 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 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 F.Y. 2016 NORTHEAST INDUSTRIAL PARK SANITARY SEWER
AND WATER MAIN EXTENSION, Contract No. 900, 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. 2016 NORTHEAST INDUSTRIAL PARK SANITARY SEWER
AND WATER MAIN EXTENSION
CONTRACT NO. 900
ITEM ITEM CODE ITEM DESCRIPTION UNIT ESTIMATED UNIT TOTAL
NO. QUANTITY PRICE PRICE
1 2533-4980005 MOBILIZATION LS 1 aDdlerd 64 aO
2 2528-8445110 TRAFFIC CONTROL LS 1 yoap Oe y,ono.Oo
STORM WATER POLLUTION
3 2599-9999010 PREVENTION PLAN LS 1
IMPLEMENTATION 4/5-00•ou 1Soo, 0p
4 2602-0000020 SILT FENCE _ LF 7,750 4,00 01,500, OD
5 2602-0010010 MOBILIZATION, EROSION CONTROL EA 3 c S`0. op 7So,00
6 2510 6745850 REMOVAL OF PAVEMENT, PORTLAND
CEMENT CONCRETE 7-INCH SY 150 do.00 3000- 0o
7 2599-9999009 REMOVAL OF STORM SEWER PIPE LF 40 fO 0 4
FROM EXISTING DETENTION POND c7(o.00 +w��� ,.y
FORM OF BID CONTRACT NO. 900-ADDENDUM #1 Page 1 of 4
REMOVE STORM SEWER PIPE LESS
8 2503-0200036 THAN OR EQUAL TO 36-INCH DIA.W/ IF 280 a(o,pp 7a80.00
APRON
9 2599-9999005 REMOVE EXISTING STORM SEWER EA 1
STRUCTURE b6b.00 (taco
10 2599 9999010 REMOVE EXISTING TREES AND LS 1
STUMPS Sob0.00 5000,00
11 2105-8425015 TOPSOIL,STRIP AND SALVAGE CY 2,665 7 9 AA?.73
12 2102-2710070 EXCAVATION,CLASS 10, ROADWAY CY 11,210
AND BORROW c?r'�S ? p7. ' &'
SANITARY SEWER GRAVITY MAIN,
13 2504-0114010 BORED,SINGLE-WALL PVC PIPE, 24- LF 400
INCH,W/36-INCH STEEL CASING PIPE 3'&O f y`7,000
SANITARY SEWER GRAVITY MAIN,
14 2504-0114010 TRENCHED,CORRUGATED PVC PIPE, IF 2,850 ?a 00 .40AI am ,
24-INCH
15 2435 0130148 MANHOLE,SANITARY SEWER,SW- EA 8
301,48-INCH DIA. (0000.00 r-f%pep, ••
16 2435-0130160 MANHOLE,SANITARY SEWER,SW- EA 1
301,60-INCH DIA. 7000-oG 7opt7. op
MANHOLE,SANITARY SEWER, SW-
17 2435-0130184 301,84-INCH DIA. EA 1 /o 0oD,C0 /O/000.Cr
18 2504-0200406 SANITARY SEWER SERVICE STUB, LF 430
PVC,6-INCH ?too Age.0.
TAPPING SLEEVE,VALVE,AND BOX
19 2554-0208012EA 1
16-INCH X 16-INCH ((p 000.00 I(p, o..i 0
WATERMAIN, BORED, DIP, 16-INCH
20 2599-9999009 DIA.WI 24-INCH DIA.STEEL CASING LF 460
PIPE a2fg6 /,/, Sfd
21 2554-0112012 WATERMAIN,TRENCHED, DIP, 16- If 3,620
INCH DIA. q0.00 arg grit),r.i
22 2554-0202200 FITTINGS BY COUNT, DUCTILE IRON EA 6 Opp.tan (pram.o0
23 2554-0207012 VALVE,GATE,DIP, 16-INCH DIA. EA 12 SSOD•OC Kerr. 0
24 2599 9999005 WATERMAIN TEE,MJ, 16-INCH x 6- EA 6
INCH t10O.0,0 60p, -r
25 2554-0210201 FIRE HYDRANT ASSEMBLY EA 6 V2oo-o0 ,7, A ,x,i
26 2554-0204120 WATER SERVICE STUB, DIP,6-INCH LF 430 9$,ob `/oiQ'SO,0+
27 2599 9999005 1-1/2-INCH FOAM INSULATION EA 6
BOARD,4'x 8'SHEET 13S.O(2 flo.OD
28 2435-0140160 MANHOLE,STORM SEWER,SW-401, EA 1
84-INCH DIA. ',Stt,0C gro0.04
STORM SEWER GRAVITY MAIN,
29 2503-0114236 TRENCHED, RCP,20000(CLASS III), LF 280 Ss 00 1
36-INCH DIA., USE EXISTING PIPE C)• 00
30 2416 0100036 APRONS,CONCRETE,36-INCH DIA. EA 1
W/2 JOINT TIES, USE EXISTING PIPE 050,04::7 /d,So,00
FORM OF BID CONTRACT NO. 900-ADDENDUM#1 Page 2 of 4
REPLACE STORM SEWER PIPE FROM
31 2599-9999009 EXISTING DETENTION POND, USE LF 40
EXISTING PIPE SS.o0 01,200.orr,
32 2502-8212206 SUBDRAIN, PERFORATED PLASTIC
PIPE, 6-INCH DIA. LF 1,300 jg"o b a31 Y12C OO
33 2435 0251218 INTAKE, SW-512, 18-INCH DIA.W/ EA 8
SOLID COVER igOo.0o /y,*V.c
STANDARD OR SLIP FORM PORTLAND
34 2301-1033070 CEMENT CONCRETE PAVEMENT, SY 150 DO a 7$d4YO
CLASS C,CLASS 2 DURABILITY,7-INCH
35 2105-8425005 TOPSOIL, FURNISH AND SPREAD CY 500 9.O o 9500 O'O
36 2599-9999001 TEMPORARY SEEDING AC 12
64,0.o4 71oD.ob
37 2601-2634100 MULCHING AC 12 75Q p0 100Dc a0
38 2601-2636044 SEEDING AND FERTILIZING(URBAN) AC 12
39 2599-9999010 2-YEAR MAINTENANCE BOND LS 1
30 aci100 oCYJ, o O
TOTAL CONSTRUCTION COST l
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.
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4. Security in the sum of V /q joykr_Sm_
Dollars ($ ) in the form o ;6L ,
is submitted herewith in accordance with the INSTRUCTIONS TO BIDDERS.
5. Attached hereto is a Non-Collusion Affidavit of Prime Contractor.
6. Attached hereto is a Resident Bidder Certification ( ), 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 810,000.00 in work for the City in the current calendar year, are prepared to
FORM OF BID CONTRACT NO. 900-ADDENDUM#1 Page 3 of 4
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. ( Date IA- IUD I3
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.
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.
CL G ,i-fq-i5
(Name of B' er) (Date)
BY: — Title c,
Official Add ess: (Including Zip Code):
20`7 E4 T c-ZiCocA.1 w/4/
,4a'1 tf5, r 4'q
I.R.S. No. 510 s' A%' 15555
FORM OF BID CONTRACT NO. 900—ADDENDUM#1 Page 4 of 4
f
t
° RESIDENT BIDDER CERTIFICATION
CONTRACT NO. ?co
is PROJECT NAME: ebtb tug L�.S L �A�! S9n).T11�J 5 J �w%t.t' mA),
DATE OF LETTING: i(-/7-15
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
t<. 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 J IL c.ei�r�;c
CORPORATE OFFICER I704- Q,f �i ` e
TITLE COd
DATE i(-1q—(g
i f-
(
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:
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,
ft. 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,
EQUAL OPPORTUNITY CLAUSE PAGE 1 OF 2 PAGES
it
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 wilt 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, subcontract or purchase order
unless exempted by the rules, regulations or orders of the City's
Affirmative Action Program, and will provide in•every subcontract, or
purchase order that said provisions will be binding upon each contractor,
subcontractor,or supplier.
8. We, the undersigned, recognize that we are morally and legally committed •
•
to non-discrimination in employment. Any person who applies for
employment with our company will not be discriminated against because
of race, creed, color, sex, national origin, economic status, a , mental or
physical disabilities.
(Signed)
propri e Icial)
COO
(Title)
IF11-I
(Date)
EQUAL OPPORTUNITY CLAUSE PAGE 2 OF 2 PAGES
,hn M Ail,�.):!:v i-'. .-. ..- Ae, l'� y. ...\ v f'1 n� !„� w� /'� _ —
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•
°' 3 MBENVBE BUSINESS ENTERPRISE
PRE-BID CONTACT INFORMATION FORM
Prime Contractor Name: ZI.6� ffse4 "-, C l� CL( Project' (fq,L gbe7 Letting Date: /(- /S
NO MBEIWBE SUBCONTRACTORS:If you are OT using any MBENVBE subcontractors to complete this project,sign below.Attach brief
explanation as to why subcontracting was r•, sible with this project.If any MBEfWBE subcontractors wit be used,please use the bottom
portion of this form.
• Contractor Signature: Ar Title: C' Date: I I--tf A-l S
SUBCONTRACTORS APPLICABLE:You a '•quired,in order for your bid to be considered responsive,to provide the information on this form
showing ALL of your MBENVBE subcontract.r 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 MBENVBE Business
Enterprise contacts made prior to your bid submission.This information is subject to verifications and confirmation.
If you are unable to identify MBENVBE 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 MBENVBE 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 Dates Yes/No Dates Yes/No Dollar Amount Proposed to
Subcontractors Contacted Contacted be Subcontracted
T
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(Form CCO-4)Rev.06-20-02
ttF $ z 55 5 oT A
To u S a� —7r1%S0C
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NON-COLLUSION AFFIDAVIT OF PRIME BIDDER
State of `�.J� )
_ )ss
County of 5 0ey
v jecepling .being first duly sworn,deposes and says that:
1. He is MI r ffer R ice nt reseative orA ,of
64
/rt it. � ,the Bidder that has submitted the attached Bid;
t 2. He is fully infed respecting the preparation and contents of the attached Bid and of all
pertinent circumstances respecting such Bid;
3. Such Bid is genuine and is note 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 ta'nted by
any collusion,conspiracy,connivance or unlawful reement on the part of the Bidder or
any of its agents,representatives,owners,ern yee ,or partte ' serest,including this
affiant.
(Signed)
• Tit e
Subscri d and sworn to before me this t4li dayof 4, commis ion Number R 75)45
NGE
, � FCdnmiseion 7�?>456
�1 Jr al ,2O1s • ow *
My ommLssipn Fxpireo
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Title
My commission expires id'02'1
J&K Contracting,LL.0
cf !`: " y
rc 1307 E. Lincoln Wa
• Ames, IA 50010
(.
Bond No. 1001048362-15
BID BOND
KNOW ALL MEN BY THESE PRESENTS,that we, J&K Contracting,LLC
American Contractors Indemnity Company
• as Principal,and
as Surety ere held and firmly bound unto the CITY OF WATERLOO Iowa,hereinafter called
"OWNER." In the penal sum 5% of total amount of bid not to exceed, One Hundred Eight Thousand and 00/100 Dollars
Dollars($ toa.o)o.c° )lawful money of the United States,for the payment
of which sum will and truly be made, we bind ourselves, out 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 ilia 'gt` day of Nc.er.,bsr
20 �5 ,for Waterloo NE Industrial Park Sanitary Sewer Water Main Extension,Waterloo,IA
•
NOW,THEREFORE,
(a)If said Bid shall be rejected, or In the alternate,
(b) If said Bid shell be accepted and the Principal shall execute and deliver a contract in the form specified'
and shell furnish e bond fur 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 forte end 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 falls 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 seats to be hereto affixed and these presents to be
signed by their proper officers this 19th day of November ,AO.2o1
J&K Contracting,LLC (Seal)
P ip
By I
Je reldmann,President (Title)
American Contractors Indemnity Company (Best)
with•
Surn
By
n sS Jer Crawl
Attorn -n-tact
r •
A14343
POWER OF ATTORNEY
AMERICAN CONTRACTORS INDEMNITY COMPANY TEXAS BONDING COMPANY
UNITED STATES SURETY COMPANY U.S.SPECIALTY INSURANCE COMPANY
KNOW ALL MEN BY THESE PRESENTS: That American Contractors Indemnity Company, a California corporation, Texas
Bonding Company, an assumed name of American Contractors Indemnity Company, United States Surety Company, a M aryland
corporation and U.S. Specialty Insurance Company, a Texas corporation(collectively,the"Companies"), do by these presents make,
constitute and appoint:
Jeremy Crawford,Michael D.Williams,William J.Nemec,Tanya Fukushima
or William Gerber of Golden Valley,Minnesota
its true and lawful Attorney(s)-in-fact, each in their separate capacity if more than one is nand above,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 to include riders, amendments, and-c asents of surety, providing the bond
penalty does not exceed ******Five Million*****w Dollars ($ **5,000,000.00** ).
This Power of Attorney shall expire without further action on December 20,2017. This Power of Attorney is granted under and by
authority of the following resolutions adopted by the Boards of Directors of the Companies:
Be it Resolved,that the President,any Vice-President,any Assistant Vice-President,any Secretary or any Assistant Secretary 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 object to the following __
provisions: - ____
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 or indemnity and other conditional or obligatory undertakings, including any and all consents for the release of retained
percentages and/or final estimates on engineering and construction contracts,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 binding upon the Company as if signed by the President and sealed and effected
by the Corporate Secretary.
Be Resolved,that the signature of any authorized officer and seal of the Company heretofore or hereafterafftxed to any power of attorney or any certificate relating
thereto by facsimile,and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be validand binding upon the Company with respect to
-any bond or undertaking to which it is attached.
IN WITNESS WHEREOF,The Companies have caused this instrument to be signed and their corporate seals to be hereto affixed,this
1st day of December,2014.
AMERICAN CONTRACTORS INDEMNITY COMPANY TEXAS BONDING COMPANY
Corporate Seals UNITED STATES SURETY COMPANY U.S.SPECIALTY INSURANCE COMPANY
„s0i111111, , R n — —
oRtR•Aci0lrgµ DES SU ' eo 5O)Je CO � iU d�caC —
ry W •
SEPT25 1990 M 9 Y < ') Y f-S `
:g . �s� Daniel P.Aguilar,Vice President
,
'.igUE0RN1ne� i�n000°" iieonOF
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the
document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. -
State of California --:
County of Los Angeles SS: -
On this 1st day of December,2014, before me,Maria G.Rodriguez-Wong,a notary public, personally appeared Dan P.Aguilar,Vice President of American
Contractors Indemnity Company,Texas Bonding Company,United States Surety Company and U.S.Specialty Insurance Company who proved to me on
the basis of satisfactory evidence to be the person whose name is-subscribed to the within instrument and acknowledged to me that he executed the same in
his authorized capacity,and that by his signature on the instrument the person,or the entity upon behalf of which the person acted,executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. _- --- -
WITNESS my hand and official seal.
a� MARIA G.RODRIGUEZ-WONG
t Commission N 2019771
Signature (0/
(Seal) i i �a Notary Public-California i
w'}! Los Angeles County s
- Comm.Ex kes Dee 20,2017
I,Michael Chalekson,Assistant Secretary of American Contractors Indemnity Company,Texas Bonding Company,United States Surety Company
and U.S.Specialty 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;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 f€need the seals of said Companies at Los Angeles,California this lgrh day
of November > 2015.'
Corporate Seals F'5.' s..........
RACiOky�yO P.�E �
-H .O Q ^J g] E1Y 10
"°p°"' Michael Chalekson,Assistant Secretary
Bond No. 1001048362-15 W ry � "
eErr x5 lsso o r :ate •c S .s
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Acknowledgment of Surety
State of Minnesota
County of Hennepin
On this 19th day of November, 2015 before me personally appeared Jeremy Crawford
who acknowledged that he or she is the attorney in fact who is authorized to sign on
behalf of American Contractors Indemnity Company (surety company), the foregoing
instrument, and he thereupon duly acknowledged to me that he executed the same.
Notary P is
'). MICHAEL E. KONZEN
Notary Public-Minnesota
�. /My Commission Expires Jen 31,2019