Loading...
HomeMy WebLinkAboutAAA Budget Environmental, Inc.• S POST/AL SERVICETM 4 ro ro Pc 9 mtiN cu r 0 c 3 tu aim ln m Uf al A t4 cu RMLY TO SEAL ATTENTION - DELIVERY PERSONNEL SENDER HAS WAIVED SIGNATURE REQUIREMENT PLEASE DELIVER PER DMM M500.4.3 EXPRESS MAIL - WE DELIVER MAIL EXPRESS sac ice' seri Lan ras, rnutni ----...iui IuI11111111 PS10001000006 EF PRESS FIRMLY TO SEAL la, UNITED STATES POSTAL SERVICE® CUSTOMER USE ONLY PRIORITY MAIL EXPRESS® FROM: (PLEASE PRINT) PHONE ( ) AAA 3vrJef knvi rOtritntoi 11 toe. ICI r : Oirmnoigh MC4111l!°, ( A- qz&i DELIVERY OPTIONS (Customer Use Only) UN/ TED STATES POSTAL SERVICE m 1007 50703 PRIORITY MAIL EXPRESS FLAT RATE POSTAGE REQUIRED EJ 150 349 848 US PAYMENT BY ACCOUNT (if applicable) USPS® Corporate Acct. No. ORIGIN (POSTAL SERVICE USE ONLY) 1-Day ■ 2-Day U,S. POSTAGE PAID PME 1-Day MONTICELLO, IA 52310 AMOUNT21 $26.35 R2305K133090-03 Federal Agency Acct. No. or Postal Service'" Acct. No. ■ Military ■ DPO PO ZIP Code ■ SIGNATURE REQUIRED Note: The mailer must check the "Signature Required" box if the mailer: 1) Requires the addressee's signature; OR 2) Purchases additional Insurance; OR 3) Purchases COD service; OR 4) Purchases Return Receipt service. If the box is not checked, the Postal Service will leave the item in the addressee's mail receptacle or other secure location without attempting to obtain the addressee's signature on delivery. Delivery Options ■ ■ ■ No Saturday Delivery (delivered next business day) Sunday/Holiday Delivery Required (additional fee, where avallable`) 10:30 AM Delivery Required (additional fee, where available) *Refer to USPS.com® or local Post Office"' for avaitabilit . TO: (PLEASE PRINT) PHONE( ) 2_31kr Date Accepted (MM/DD/YY) Time Accepted q;49 14011 tibia Of -tic& 116 WItArlo-crni zWarrACtRisscSoL'A c) t7 Pe 3 Special Handling/Fragile Weight tat Rate lbs. ozs. Scheduled Delivery Date (MM/DDiYY) 3/0;/ Sche uled De ivery Time 10:30 AM ❑ 3:00 PM 12 NOON 10:30 AM Delivery Fee Sunday/Holiday Premium Fee Acceptance Employee Initials DELIVERY (POSTAI;;SERVICE USE ONLY) Delivery Attempt (MM/DD/YY) OI • For pickup or LISPS Trackingm, visit USPS.com or call 800-222-1811. ■ $100.00 insurance included. PEEL FROM THIS CORNER Delivery Attempt (MM/DD/YY) LABEL 11-B,MARCH 2019 Time ❑ AM ❑ PM Time ❑ AM ❑ PM Postage Insurance Fee Return Receipt Fee COD Fee Live Animal Transportation Fee Total Postage & Fees Employee Signature Employee Signature PSN 7690-02-000-9996 * Money Back Guarantee to U S., select APO/FPO/DPO, and select International destinations. See DMM and IMM at pe.usps.com for complete details. + Money Back Guarantee for U.S. destinations only. *For Domestic shipments, the maximum weight is 70 lbs. For International shipments, the maximum weight is 4 lbs. 1 www.usps,g" 2-•— v� 2-1 Q xto � W Q F w zits ag •2 O c'u 'a m c40 la 07 • - d • 131 t> iIgt to a Q.0 ru o G) >1b ge d Z 4Jo fit t0 m pi • AAA Budget Environmental, Inc. 121 East Grand Street Monticello, IA 52310 • SEALED RFB FOR ASBESTOS ABATEMENT SERVICES -# AB- 2021-03-08P 7 25 Glenwood Street 663 Kern Street 214 Cotta e Street409 Wellin Street 413 Wellin •ton Street. 915 Linden. Avenue 921 W. 2nd Street City Hall City Clerk's Office 715 Mulberry Street Waterloo, IA 50703 MAR/08/2021/MON 11:18 AM AAA_Budgetjnviro FAX rio, 319-465-3104 P, 001 EXHIBIT "A" SIGNATURE PAGE The undersigned Proposer/Bidder, having examined these documents and having full knowledge of the condition under which the work described herein must be performed, hereby proposes that they will fulfill the obligations contained herein in accordance with all instructions, terms conditions, and specifications set north; and that they will furnish all required services and pay all incidental costs in strict conformity with these documents for the stated process as payment in full, 725 Glenwood Street, 663 Kern Street, 214 Cottage Street, 409 Wellington Street, 413 Wellington Street, 915 Linden Avenue, 921 W. 2nd Street Total In written form; vuen-i� C lie hous&nd haw'ct cd "c(9Irf CO ur do !leis Theo n of the sdtt/al bid tabulatipn r cures will suaersede the listed total. Submitting Flrm: Nolzee &)ivv 40 sivvet ,~,k t~ Address: III id\-- G VCrOtA 6s City: ilf‘acic1t,p States aitelere• Zip; S {b Authorized Representative (print) C. C. ®�441-kkObt."--- Authorized Representative Signature Date: 31814 Phone: OIFV Klot JXbS Email: Gtct & be i n C ,9 m a i it cow? Fax: Sig 14(O5*3/0q EXCEPTIONS/DEVIATIONS to this Request for Proposal shall be listed in writ►ng on an attached document provided by the Bidder. Please be as specific as possible, Please check one; S Our company has no exceptions/deviations, Our company does have exceptions/deviations which are fisted on an attached document. GENERAL INFORMATION. Freight and/or delivery charges, if any, shall be included in the price. FIRM PRIMO. Offered prices shall remain firm for a minimum of sixty (60) days after the due date of this solicitation unless Indicated otherwise, Accepted prices shall remain firm for the duration of the contract ADDENDA (It is the Bidder's responsibility to check for issuance of any addenda). The authorized representative herby acknowledges receipt of the following addenda: Addenda Number Date livaadaal Addenda Number pate We choose not to bid. at this time but would like to be considered for future requests for bid PI13 EOfl ASBESTOS ABATEMENT SERWCES; # AB-2021-03-08P 725 Glenwood Street, 409 Wellington Street, 413 Wellington Street, 915 Linden Avenue, 921 West 2nd Street, 663 Kam Street, 214 Cottage Street • Page 10 of 11 rinn/ u0/ LULI/111VA 1U• lD xGl p,14 udgeC nb'1ro FAX No. 319-465-3104 P. 002 Our "not to exceed" bid price for each property is: 725 Glenwood Stree 663 Kern Street 'Po 214 Cottage Street 51102, 409 Wellington Street 413 Wellington Street 915 Linden Avenue 921 W. 2"" Street 85b I$17 Total $ cc/ RED FOR ASBESTOS ABATEMENT SERVICES: t AB-2021-03-08P 725 Glenwood Street, 409 Wellington Street, 413 Wellington Street, 915 Linden Avenue, 821 West 2nd Street, eoa Kern Street, 214 Cottage Street . Page 11 or 11 ACORES CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 03/08/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the po icy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER SKOGMAN CARLSON INSURANCE 1110 Dina Court Suite B Hiawatha IA 52233 CONTACT Kimberly Miller NAME: PHONE (319) 366-6288 (A/C No, Ext): E MAIL Kimberly@skogmanins.com ADDRESS: FAX () 319 364-7157 (A/C, No): INSURER(S) AFFORDING COVERAGE NAIC ft INSURER A: Swett Insurance Managers INSURED AAA Budget Environmental Inc /AAABE, Inc. Asbestos Inspections Testing & Training, Inc. 121 E. Grand Street Monticello IA 52310-1618 INSURER B : Western National INSURER C: INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER• 21-22 Cert Master REVISION NUMBER* THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLIC ES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR A X TYPE OF INSURANCE COMMERCIAL GENERAL LIABILITY X CLAIMS -MADE 1 OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: PRO- JECT X POLICY OTHER: LOC ADDL INSD Y SUBR WVD POLICY NUMBER 793-00-04-98-0007 POLICY EFF (MMIDD/YYYY) 02/04/2021 POLICY EXP (MM/DD/YYYY) 02/04/2022 EACH OCCURRENCE LIMITS $ 2,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) $ 50,000 $ 5,000 PERSONAL & ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 AU OMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY SCHEDULED _ AUTOS NON -OWNED _ AUTOS ONLY COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) B UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y/N N N/A WCV1024114 01/01/2021 01/01/2022 EACH OCCURRENCE AGGREGATE PER STATUTE OTH- ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 A Pollution Liability Professional Services 793-00-04-98-0007 02/04/2021 02/04/2022 Pollution Liability Limit Professional ServiceLimit 2,000,000 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be a tached if more space is required) CERTIFICATE HOLDER CANCELLATION City of Waterloo City Hall 715 Mulberry Street Waterloo IA 50703 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD A COI? Cr KIJILT2 OP ID: CS CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 03/08/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, If SUBROGATION IS WAIVED, subject to the terms and conditions this certificate does not confer rights to the certificate holder in lieu the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. of the policy, certain policies may require an endorsement. A statement on of such endorsement(s). PRODUCER Insurance Associates, Inc. 16133 Co. Rd. E-16 P.O. Box 617 Monticello, IA 52310 319-465-5431 com-ACT Cindy Stevenson NAME: PHONE 319-465-5431 (A/C, No, Ext): (A/c, Ne):319-465-5339 E-MAIL ADDRESS: cstevenson@laiowa.com INSURER(S) AFFORDING COVERAGE INSURER A : Nationwide Mutual Fire NAIC # 23787 mu KIJI LTD Asbestos Inspections, Testing & Training Inc AAA Budget Environmental 121 East Grand Street Monticello, IA 52310 INSURER B : INSURER C : INSURER D : INSURER E : INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR TYPE OF INSURANCE ADM_ SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS TRINSD VVVD (MM/DD/YYYY) (MM/DD/YYYYI COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS -MADE OCCUR PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PPOLICY JECT LOC PRODUCTS - COMP/OP AGG $ OTHER: $ A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) 1,000,000 $ X ANY AUTO X ACP3046425928 11/30/2020 11/30/2021 BODILY INJURY (Per person) $ OWNED AUTOS ONLY SCHEDULED AUTOS BODILY INJURY (Per accident) $ H AUTOS RED ONLY NON AUTOS -OWNED ONLY PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED RETENT ON $ $ WORKERS AND EMPLOYERS' COMPENSATION LIABILITY PER STATUTE j OTH- ER Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N / A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION WATERLI City of Waterloo City Hall City Clerk's Office 715 Mulberry Street (Waterloo, IA 50703 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Bond Number: 2457693 Init. Bid Bond CONTRACTOR: (Name, legal status and address) AAA Budget Environmental Inc 121 E Grand St Monticello, IA 52310-1618 OWNER: (Name legal status and address) City of Waterloo 715 Mulberry St Waterloo, IA 50703-5714 BOND AMOUNT: $ TM SURETY: (Name, legal status and principal place of business) West Bend Mutual Insurance Company PO Box 620976 Middleton, WI 53562 Five Percent of the Amount Bid PROJECT: (Name, location or address, and Project number; if any) Remove Asbestos materials. The Contractor and Surety are bound to the Owner in the amount set forth above, for the payment of which the Contractor and Suiety bind themselves, their heirs, executors, administrators, successors and assigns, jointly and severally, as provided herein. The conditions of this Bond are such that if the Owner accepts the bid of the Contractor within the time specified in the bid documents, or within such time period as may be agreed to by the Owner and Contractor, and the Contractor either (1) enters into a contract with the Owner in accordance with the terms of such bid, and gives such bond or bonds as may be specified in the bidding or Contract Documents, with a surety admitted in the jurisdiction of the Project and otherwise acceptable to the Owner, for the faithful performance of such Contract and for the promptpayment of labor and material furnished in the prosecution thereof; or (2) pays to the Owner the difference, not to exceed the amount of this Bond, between the amount specified in said bid and such larger amount for which the Owner may in good faith contract with another party to perform the work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. The Surety hereby waives any notice of an agreement between the Owner and Contractor to extend the time in which the Owner may accept the bid. Waiver of notice by the Surety shall not apply to any extension exceeding sixty (60) days in the aggregate beyond the time for acceptance of bids specified in the bid documents, and the Owner and Contractor shall obtain the Surety's consent for an extension beyond sixty (60) days. If this Bond is issued in connection with a subcontractor's bid to a Contractor, the term Contractor in this Bond shall be deemed to be Subcontractor and the term Owner shall be deemed to be Contractor. When this Bond has been furnished to comply with a statutory or other legal requirement in the. location of the Project any provision in this Bond conflicting with said statutory or legal requirement shall be deemed deleted herefrom and provisions conforming to such statutory or other legal requirement shall be deemed incorporated herein. When so furnished the intent is that this Bond shall be construed as a statutory bond and not as a common law bond. ADDITIONS AND DELETIONS: The author of this document has added information needed for its completion. The author may also have revised the text of the original AIA standard form. An Additions and Deletions Report that notes added information as well as revisions to the standard form text is available from the author and should be reviewed. A vertical line in the left margin of this document indicates where the author has added necessary information and where the author has added to or deleted from the original AIA text. This document has important legal consequences. Consultation with an attorney is encouraged with respect to its completion or modification. Any singular reference to Contractor, Surety, Owner or other party shall be considered plural where applicable. AIA Document A310TM —2010. Copyright © 1963, 1970 and 2010 by The American Institute of Architects. AU rights reserved. WARNING: This AIA® Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA® Document, or any portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under the law. This document was produced by AIA software at 08:24:00 ET on 02/17/2021 under Order No. 7809530746 which expires on 02/20/2022, and is not for resale. User Notes: (1496601206) Signed and sealed this 11 day of March , 2021 AAA Budget Environmental Inc (Contractor as Principal) (Seal) (Witness) (Title) Stephen Intlekofer President West Bend Mutual Insurance Company (Surety) (Witness) (Ti (Seal) Schultz , Attorney -In -Fact AIA Document A310TM —2010. Copyright ©1963, 1970 and 2010 by The American Institute of Architects. All rights reserved. WARNING: This AIA@ Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA® Document, or any portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under the law. This document was produced by AIA software at 08:24:00 ET on 02/17/2021 under Order No. 780953o746 which expires on 02/20/2022, and is not for resale. User Notes: (1496601206) A MUTUAL INSURANCE COMPANY" POWER OF ATTORNEY THE SILVER LINING® Bond No. 2457693 Know all men by these Presents, That West Bend Mutual Insurance Company, a corporation having its principal office in the City of West Bend, Wisconsin does make, constitute and appoint: James Schultz lawful Attorney(s)-in-fact, to make, execute, seal and deliver for and on its behalf as surety and as its act and deed any and all bonds, undertakings and contracts of suretyship, provided that no bond or undertaking or contract of suretyship executed under this authority shall exceed in amount the sum of. Ten Million Dollars ($10,000,000) This Power of Attorney is granted and is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of West Bend Mutual Insurance Company at a meeting duly called and held on the 21st day of December, 1999. Appointment of Attorney -In -Fact. The president or any vice president, or any other officer of West Bend Mutual Insurance Company may appoint by written certificate Attorneys -In -Fact to act on behalf of the company in the execution of and attesting of bonds and undertakings and other written obligatory instruments of like nature. The signature of any officer authorized hereby and the corporate seal may be affixed by facsimile to any such power of attorney or to any certificate relating therefore and any such power of attorney or certificate bearing such facsimile signatures or facsimile seal shall be valid and binding upon the company, and any such power so executed and certified by facsimile signatures and facsimile seal shall be valid and binding upon the company in the future with respect to any bond or undertaking or other writing obligatory in nature to which it is attached. Any such appointment may be revoked, for cause, or without cause, by any said officer at any time. In witness whereof, the West Bend Mutual Insurance Company has caused these presents to be signed by its president undersigned and its corporate seal to be hereto duly attested by its secretary this 22nd day of September, 2017. J� iri§:;. oORaoRATe 1-4 SEAL •: Attest CkI1 ctirma C. oat Christopher C. Z Secretary J1 gart • • State of Wisconsin • • County of Washington . �•-4---- Kevin A. Steiner Chief Executive Officer/President On the 22nd day of September, 2017, before me personally came Kevin A. Steiner, to me known being by duly sworn, did depose and say that he resides in the County of Washington State of Wisconsin; that he is the President of West Bend Mutual Insurance Company, the corporation described in and which executed the above instrument; that he knows the seal of the said corporation; that the seal affixed to said instrument is such corporate seal; that is was so affixed by order of the board of directors of said corporation and that he signed his name thereto by like order. JJ'N. BENea NOTARk'. .,mom'., PUBLIC ais�TF OF..... bat- Juli A nedum Senior orporate Attorney Notary Public, Washington Co., WI My Commission is Permanent The undersigned, duly elected to the office stated below, now the incumbent in West Bend Mutual Insurance Company, a Wisconsin corporation authorized to make this certificate Do Hereby Certify that the foregoing attached Power of Attorney remains in full force effect and has not been revoked and that the Resolution of the Board of Directors, set forth in the Power of Attorney is now in force. Signed and sealed at West Bend, Wisconsin this 1 lth day of March Notice: Any questions concerning this Mutual Insurance Company. GoRPORAre r : SEAL Power of Attorney may be directed to the Bond Manager at NSI, a division of West Bend 2021 • Heather Dunn Vice President - Chief Financial Officer 1900 S. 18th Ave. West Bend, WI 53095 I ph (262) 334-6430 ( 1-800-236-5004 ( fax (262) 338-5058 I www.thesilverlining.com