HomeMy WebLinkAboutVieth Construction CorporationVieth Construction
Corporation
6419 Nordic Dr.
Cedar Falls, IA 50613
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Vieth Construction
Corporation
6419 Nordic Dr.
Cedar Falls, IA 50613
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FORM OF 11 OD OR PROPOSAO
`=EY. 2021 UPTON AVENUE, AND CAO-vROA E HOLI , DRU y TORWkJ1WAT
CONTRACT Na 1010
MY OF WAT
Honorable Mayor and City Council
Waterloo, Iowa
Gentlemen:
:7RLOO, IOWA
P1.OW ES
1. The undersigned, being a Corporation existing under the laws of the State of
i 0cAi 03/4. 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. 2021
UPTON AVENUE AND CARRIA HILL DRIVE STORMWATER IMPROVEMENTS, Contract
No. 1010, all in accordance with the above listed documents and for the unit prices for work in
place for the following items and quantities:
FY 2021
UPTON
AVENUE
at
CARRIAGE
-ILL
DRIVal
S
RMWATER
IMPROVEMENTS
C
O
N
RAC
T N. 1010
BID
SUDAS
TOTAL
UNIT
BID
TOTAL
BID
ITEM
SPECIFICATION
DESCRIPTION
UNIT
QTY
PRICE
PRICE
1
2010-1.08B
CLEARING
GRUBBING
AND
ACRE
2
$/00000
$ aotood
ON
-SITE
TOPSOIL,
STRIP,
SALVAGE,
2
2010-1.08D
AND
SPREAD
CY
2800
$
°
1
$ 30, gad
3
2010-1.08D
OFF
SPREAD
-SITE
TOPSOIL,
FURNISH
AND
CY
330
$
31
$
12, s4o
4
2010-1.08E
CLASS
10
EXCAVATION,
HAULED
CY
6300
$ 14295
-
$ in 750
5
2010-1.08E
EMBANKMENT
CONSTRUCTION
CY
455
$
lc
$ G/ $S
REMOVAL
OF
EXISTING
STORM
SEWER,
6
4020-1.08D
RCP,
12
IN
LF
30
$
40
$ l
REMOVAL
OF
EXISTING
STORM
SEWER,
d7do
7
4020-1.08D
RCP,
15
IN
LF
11
$
25
$
eUS
UNIT
BID
SUDAS
TOTAL
BID
TOTAL
BID
ITEM
SPECIFICATION
DESCRIPTION
UNIT
QTY
PRICE
PRICE
HIGH
DENSITY
POLYETHYLENE
PIPE
8
4020-2.01
30
51
F
(HOPE),
AASHTO
M
294,
8
IN
LF
174
$
$
no
HIGH
DENSITY
POLYETHYLENE
PIPE
9
4020-2.01
ti,
I
19, v73
F
(HDPE),
AASHTO
M 294,
15
IN
LF
353
$
$
FORM OF BID
of 4
CONTRACT NO. 1010
Page 1
HIGH
DENSITY
POLYETHYLENE
PIPE
24
IN
LF
120
$
5 g
$ G,
9&C)
10
4020-2.01F
(
HDPE),
AASHTO
M
294,
1400 0
3-I a o
11
4030-2.02
CONCRETE
PIPE
APRON,
15"
EACH
1
o
31SSd
$ 5, t
12
4030-2.02
CONCRETE
PIPE
APRON,
24"
EACH
2
$
oo
PERFORATED
SUBDRAIN,
TYPE
CORRUGATED
PE,
AASHTO
M
252,
LF
30
$ ga
$ 9ao
13
4040-2.02D
CP,
4
IN.
SEWER,
SW-401,
48
MANHOLE,
STORM
2
$
4'Qo0
$
g
14
6010-2.01
IN
EACH
r Q 00
SEWER,
SW-401,
60
MANHOLE,
STORM
1
$ 7So0
15
6010-2.01
IN
EACH
$75aa
60
IN
x
60
IN
AREA
INTAKE
STRUCUTRE,
1
$ 61606
$ '(0
16
6010-2.01
SW-513
EACH
00
72
IN
x
72
IN
AREA
INTAKE
STRUCUTRE,
2
$
$
13,000
17
6010-2.01
SW-513
EACH
L Soo
18
8030-1.08A
TRAFFIC
CONTROL
LS
1
$ 4,5
Se
$ 4 (SS0
SEEDING,
TYPE
1
(PERMANENT
LAWN
19
9010-2.02A
MIXTURE)
ACRE
3
$ (1-7%5
$ 36 ri5
20
9040-1.08N
SILT
FENCE
LF
1235
$ OS
$
3,114 .15
21
9040-1.08N
SILT
FENCE
REMOVAL
LF
1235
$
(o
$
I5.S. So
STABILIZED
CONSTRUCTION
22
9040-1.080
ENTRANCE,
EC-303
TONS
150
$ 36
$
4{Sd0
TURF
REINFORCEMENT
MATS
(TRM),
23
9040-1.08R
TYPE
II
SQ
62
$ 64
$ 3 tin-
TEMPORARY
ROLLED
EROSION
24
9040-2.052C
CONTROL
PRODUCT
(RECP),
TYPE
2.0
SY
7650
$ 1- 4 d
$ l a, 2 4o
25
9040-2.09D
RIP
RAP
(TYPE
EROSION
STONE)
TONS
70
$ 50
$ 1r 500
26
9040-3.02
SWPPP
MANAGEMENT
LS
1
$ 041646
$ eo D
i
27
11010-1.08A
CONSTRUCTION
SURVEY
LS
1
$ 9, SSo
$ Q, S$a
28
11020-1.08A
MOBILIZATION
LS
1
$ Ili Sob
$ I l,5o 0
*
CONSTRUCTION
FENCING
LF
4000
$ 3
$
13
29
SEE
DRAWINGS
cord
INLINE
DRAIN
BASIN
W/18
IN
GRATE
*
3
$
2
$
30
SEE
DRAWINGS
INTAKE
(NYLOPLAST
OR
EQUAL)
EACH
000
&toot
24
IN
INLINE
DRAIN
BASIN
W/
SOLID
TOP
*
1
5(
$
7St
31
SEE
DRAWINGS
(NYLOPLAST
OR
EQUAL)
EACH
$
150
5,
CONNECTION
OF
DOWNSPOUT
TILE
TO
150
14
$ S o0
NEW
STORM
LINE/STRUCTURES
EACH
$
(0
32
SEE
DRAWINGS*
,
FIELD
DRAIN
TILE
LINE
CONNECTION(S)
*
LS
1
$
Lf
$ t 00
33
SEE
DRAWINGS
TO
NORTH
INTAKE
STRUCTURE
Q-6
o
«
t
*See sheet
G04
of
the
design
drawings
for
estimate
reference
notes
covering
these
bid
items.
:-
, >
{,
gU IA. 75
°
ram;
i
.
$
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
FORM OF BID
of 4
CONTRACT NO. 1010 Page 2
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.
Security
in
the sum
5 6/0 am JD:a Dollars
of
in the form of rre1/4 60escK , 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 Bidder Status Form.
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
LOC, 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 401
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.
FORM OF BID
of 4
CONTRACT NO. 1010 Page 3
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.
Vieth Construction
Corporation
6419 Nordic Dr.
Ceda,r Fnlk IA 50613
(Name of bidder) (Date)
BY:
azum,
Official Address: (Including Zip Code):
Title ESP" a
Vieth Construction
Corporation
6419 Nordic Dr. r)
Cedar Falls,
I.R.S. No. ate sG 9057
FORM OF BID CONTRACT NO. 1010 Page 4
of 4
El o of d c, r
/I, 43 .4,
romp
To be completed by all!' bidders
s a r`
Please answer "Yes" or "No" for each of the following:
Dzi Yes
ri Yes
Li Yes
Yes
■
Yes
N o 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).
N o My company has an office to transact business in Iowa.
N o My company's office in Iowa is suitable for more than receiving mail, telephone calls, and email.
N o My company has been conducting business in Iowa for at least 3 years prior to the first request for
bids on this project.
N o 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
My company has maintained offices in Iowa during the past 3 years at the following addresses:
Dates:
Dates: l / to
Dates: l / to
You may attach additional sheet(s) if needed.
to pr-ce
gia" ` ' I Address:
City, State, Zip:
Address:
City, State, Zip:
Vieth Construction
Corporation
6419 Nordic Dr.
Cedar Falls, IA 50613
Address:
City, State, Zip:
To be completed by nonaresiderrit bidders
PartC
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?
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.
Yes [_ Na
You may attach additional sheet(s) if needed.
To be completed by all bidders
a
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: Wain Cont4-• corp.
Signature:
Date: G/3/'
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)
Worke�
'fleet), Authorllzatuon Transact Eiusiness
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.
Yes
QYes
0 Yes ONo
0 Yes
0 Yes
Yes
0 Yes
QYes
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.
My business is a limited liability partnership which has filed a statement of qualification in this
state and the statement has not been canceled.
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.
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.
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.
My business is a limited liability company whose certificate of organization is filed in Iowa and has
not filed a statement of termination.
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)
NON -COLLUSION AFFIDAVIT OF PRIME BIDDER
State of 10QJ0¼
)ss
County of 6 la c k PavAc
Arty Webs /
, being first duly sworn, deposes and says that:
1. He is (Owner, Partner, Officer, Representative, or Agent)1 , of VI:e44.1 C o n S- . C err.
, 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.
Subscribed and sworn to before me this
My commission expires
3 tSa-
(Signed) /
eShlMaf.✓
Title
•
day of
ci /Kra 2o/I
Mr3F1WBE BUSINESS ENTERPRISE
PRE -BID CONTACT INFORMATION FORM
Prime Contractor Name: V;e4In Goy, S4r tac Aton carp
Project: L On«eel- 1010
Letting Date:
NO MBE/JIBE 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 MBE/WBE
subcontractors will be used, please use the bottom portion of this form.
Contractor Signature:
Title: ksdkna
Date: 6/3 hi
SUBCONTRACTORS APPLICABLE: You are required, in order for your bid to be considered responsive, to provide
the information on this form showing ALL of your MBE/WBE subcontractor contacts made for your bid submission.
This information is subject to verification. Any questions may 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 MBE/WBE Business Enterprise contacts made prior to your bid submission. This information is subject to
verifications and confirmation.
If you are unable to identify MBE/WBE firms to perform portions of the work, please contact Rudy Jones, 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 BIDDFR'S PREBID
MBE/WBE BUSINESS ENTERPRISE CONTACTS
Quotes
Received
Quotation
used
in
bid
IV]BEIWBE
Dates
Dates
Dollar
Amount
Proposed
to
Contacted
Yes/No
Contacted
Yes/No
be
Subcontracted
Subcontractors
T:0--r Oofccre-4
5115
fe5
Sia
sce,5
S
4dvonea 4coint cd vkilt
i (5
No
U
0
(Form CCO-4) Rev. 06-20-02
BID BOND
KNOW ALL MEN BY THESE PRESENTS, that we, Vieth Construction Corporation
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 3rd day of June
• 2021 , for F.Y. 2021 Upton Avenue and Carriage Hill Drive Stormwater
Improvements, Contract No. 10101 Waterloo, Iowa
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 fomi 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 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 presents to be
signed by their proper officers this 28th day of May , A D. 2021
Vieth Construction Corporation (Seal)��
Principal
_ r
B y la-�'f ( /a/ le
.
ican Specialty Insurance CompartIseal)
Surety
ft-e-ae
) .
Atto e
t
fact Dione R. Young
(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 Kansas City, Missouri 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 Kansas
City, Missouri, and Westport Insurance Corporation, organized under the laws of the State of Missouri, and having its principal office in the City of
Kansas City, Missouri does hereby make, constitute and appoint:
JAY D. FREIERMUTH, CRAIG E HANSEN, BRIAN M. DEIMERLY, SHIRLEY S. BARTENHAGEN, CINDY BENNETT, ANNE CROWNER
TIM McCULLOH, STACY VENN, DIONE R. YOUNG, WENDY A. LEWIS, and STACIE CHRISTENSEN 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 HUNDRED 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 them 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 it is
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."
011I1III 00/1
ateOl.AUi g TY 1
4(42
=tiff' SEAL : n
W m—
:s 1973 a,MinimutO
1h001Wrx %,
: 01pN4Lhy
s 4,4sks,:ipkroltiso.ao
It ;c'=
•
la
I
tis\•A
• e.
Steven P. Anderson, Senior Vice President of Washington International Insurance Company
& Senior Vice President of North American Specialty Insurance Company
& Senior Vice President of Westport Insurance Corporation
By / 67,7l
Mike A. Ito, Senior Vice President of Washington International Insurance Company
& Senior Vice President of North American Specialty Insurance 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
,20 20
this 3RD day of DECEMBER
State of Illinois
County of Cook
On this 3RD day of DECEMBER , 20 20, 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 North 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.
ss:
North American Specialty Insurance Company
Washington International Insurance Company
Westport Insurance Corporation
OFFICIAL SEAL
M. KENNY
Notary "ublie State of 7Ii ;n:s
My Cornmissibn Expires
12,042021
•
1,k t r�
M. Kenny, Notary Public
1, 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 28thday of
May
2021 .
44), --re-- -7
•
Jeffrey Goldberg, Vice President & Assistant Secretary of Washington International Insurance Company &
North American Specialty Insurance Company & Vice President & Assistant Secretary of Westport Insurance Corporation