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SITE SERVICES INC.
1621 East Commercial St.
Algona, IA 50511
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SITE SERVICES INC.
1621 East Commercial St.
Algona, IA 50511
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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 forth;
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.
200 Merriman Street, 1027 Sycamore Street, 325 W 13th Street, 321 W 6th Street, and 742 Grant
Avenue
Total in written form. '$X-s t-1 b tAtiND 1-liltsty\ sit ar
The correct summation of the actual bid tabulation figures will supersede the listed total,
Submitting Firm: '"\--S «- % lr •
Address: 1 to 2- k a Govwvv‘ issc.A-0u sw.
City:-t-crora.4 State: 1 0- Zip' Co G t 1
Authorized Representative (print) \Vra
Authorized Representative Signature LfJ,
r� J
Date: / 1.6 ✓j 2 ( Email. %kV-.se.rvtc ass\-?ek Q ctvw3‘ . Gown
Phone: *14.- 2-at cetee=• Fax: Sty✓ - 2ct S - lois,f3r5
EXCEPTIONS/DEVIATIONS to this Request for Proposal shall be listed in writing on an attached document
provided by the Bidder. Please be as specific as possible. Please check one:
)( Our company has no exceptions/deviations.
Our company does have exceptions/deviations which are listed on an attached document.
GENERAL INFORMATION. Freight and/or delivery charges, if any, shall be included in the price.
FIRM PRICING. 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 Addenda Number --" Date
We choose not to bid at this time but would like to be considered for future requests for bid
RFB FOR ASBESTOS ABATEMENT SERVICES: Contract: No. AB-2021-08-5P
200 Merriman Street, 1027 Sycamore Street, 325 W 13th Street, 321 W 6th Street, and 742 Grant Avenue
Page 9 of 10
Our "not to exceed" bid price for each property is:
200 Merriman
Street
$
t,1S®
1027 Sycamore
Street
$
Ah
0
325 W 13th Street
$
\
0
2,
o
321
W 6th
Street
Avenue
$
742
Grant
Total
$
CoI(
O
f
RFB FOR ASBESTOS ABA IEMENT SERVICES: Contract: No. AB-2021-08-5P
200 Merriman Street, 1027 Sycamore Street, 325 W 13th Street, 321 W 6th Street, and 742 Grant Avenue
Page 10 of 10
ACORD
CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DDIYYYY)
07/29/2021
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 policy, 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
Bonding & Insurance Specialists Agency, Inc.
BISA a McNeil Company, McNeil and Company, Inc. in CA dba
McNeil & Company Insurance Services Lic# 0B67313
13841 Southwest Highway, Orland Park IL 60462
INSURED
Site Services, Inc.
1621 East Commercial Street
Algona
IA 50511
CONTACT NAME: Karen O'Connell
PHONE 708-598-5355
(A/C, No, Ext)
E-MAIL lloconnemcneilandcom an
ADDRESS: k@ P Y•com
INSURER(S) AFFORDING COVERAGE
FAX
No): 708-598-6686
INSURERA: ARCH Specialists Insurance Company
INSURER B : American Interstate Insurance Company
INSURER C :
NAIC #
21199
24759
INSURER D :
INSURER E :
INSURER F :
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
LTR
TYPE OF INSURANCE
ADDL
INSD
SUBR
WVD
POLICY
NUMBER
POL
(MM/DD/YYYY)
CY EFF
(MM/DD/YYYY)
POL
CY
EXP
LIMITS
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 2,000,000
CLAIMS -MADE
X
OCCUR
DAMAGE S RENTED
SES (Ea occurrence)
PREMISES (
$ 100,000
A
X
Contractors Pollution
Liability
X
X
12EMP7187810
04/01/21
04/01/22
MED EXP (Any one person)
$ 5,000
X
Incl. Asbestos
Ops
PERSONAL & ADV INJURY
$ 2,000,000
GENERAL AGGREGATE
$ 2,000,000
GEN'L
AGGREGATE LIMIT APPLIES PER:
POLICY
X
PRO-
JECT
LOC
PRODUCTS - COMP/OP AGG
$ 2,000,000
OTHER:
Per
Claim
$ 2,000,000
COMBINED
SINGLE
LIMIT
$
AUTOMOBILE LIABILITY
(Ea accident)
ANY AUTO
BODILY INJURY (Per person)
$
OWNED
SCHEDULED
BODILY INJURY (Per accident)
$
AUTOS
AUTOS ONLY
HIRED
NON -OWNED
PROPERTY
DAMAGE
$
AUTOS ONLY
(Per accident)
AUTOS ONLY
$
04/01/21
04/01/22
2,000,000
A
UMBRELLA LIAB
X
OCCUR
X
X
12EMX2229402
EACH OCCURRENCE
$
X
EXCESS LIAB
CLAIMS -MADE
CGL (Inc
CPL/PL/Mold),
AGGREGATE
$ 2,000,000
Auto & Employers
Liability
DED
RETENTION
$
$
WORKERS
COMPENSATION
X
PER
EOTH
R
B
AND EMPLOYERS' LIABILITY Y / N
X
AVWCIA3011202021
08/01/21
08/01/22
ACCIDENT
$ 1,000,000
ANYPROPRIETOR/PARTNER/EXECUTIVE
E.L. EACH
OFFICER/MEMBEREXCLUDED?
Y
N /A
DISEASE EA EMPLOYEE
$ 1,000,000
(Mandatory in NH)
E.L. -
If
DESCRIPTION
yes, describe
under
OF
OPERATIONS
below
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
04/01/21
04/01/22
Per Occurrence
$2,000,000
A
Contractors
Ops-Claims
Professional
Pollution
Made
Liability
Liability
-Claims
-Mold
Made
X
X
12EMP7187810
Aggregate
$2,000,000
DESCRIPTION
OF OPERATIONS / LOCATIONS / VEHICLES
(ACORD
101, Additional Remarks Schedule, may be attached if more space is required)
CERTIFICATE HOLDER
CANCELLATION
FOR INFORMATION
AND
BIDDING PURPOSES
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
Karen O'Connell
ACORD 25 (2016/03)
1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
THE AMERICAN JNSTITUTE OF ARCHITECTS
AAA Document A310
QD Cia)]
ZA 42414
,,.� :Cz�10„7• .... .-__ -may.= zn.mt<-----
KNOW ALL MEN BY THESE PRESENTS, that we SITE SERVICES INC (Here insert full name and address or legal title of Contractor)
I O WA
as Principal, hereinafter called the Principal, and
ARCH INSURANCE COMPANY (Here insert full name and address or legal title of Surety)
3100 BROADWAY- KANSAS CITY, MO 64111
a corporation duly organized under the laws of the State of MISSOURI
as Surety, hereinafter called the Surety, are held and firmly bound unto
HHere insert full name and address or legal title of Owner)
CITY OF WATERLOO
I O WA
as Obligee, hereinafter called the Obligee, in the sum of
FIVE PERCENT OF THE BID AMOUNT Dollars ($ TBD },
for the payment of which sum well and truly to be made, the saki Principal and the said Surety, bind
ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by
these presents.
WHEREAS, the Principal has submitted a bid for
(Here insert full name, address and description of project) ..
ASBESTOS ABATEMENT- FOUR LOCATIONS IN WATERLOO, IA
NOW, THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enter into a Contract
with the Obligee in accordance with the terms of such bid, and give such bond or bonds as may be specified in the bidding
or Contract Documents with good and sufficient surety for the faithful performance of such Contract and for the prompt
payment of labor and material furnished in the prosecution thereof, or in the event of the failure of the Principal to enter
such Contract and give such bond or bonds, if the Principal shall pay to the Obligee the difference not to exceed the penalty
hereof between the amount specified in said bid and such larger amount for which the Obligee may in good faith contract
with another party to perform the Work covered by said bid, then this obligation shall be null and void, otherwis to remain
in full force and effect.
Signed and sealed this
(Witness)
23RD day of JULY
ARCH I SU
MARIA A GO
NESSIalaga
AIA DOCUMENT A310 • BID BOND • MA co• FEBRUARY 1970 ED • THE AMERICAN
INSTITUTE OF ARCHITECTS, 1735 N.Y, AVE., N.W., WASHINGTON, D. C, 20006
RW2.021
pail) (Seal)
.tz a
1
AI C 0000338747
This Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in the manner acid to the extent herein stated.
Not valid for Note, Loan, Letter of Credit, Currency Rate, Interest Rate or Residential Value Guarantees.
POWER OF ATTORNEY
Knoll All Persons By These Presents:
That the Arch Insurance Company, a corporation organized and existing under the laws of the State of Missouri, having its principal administrative office in Jersey City,
New Jersey (hereinafter referred to as the "Company") does hereby appoint:
Anne M. Barber, Daniel McNeil III, Maria A. Gonzalez, Olga Garza and William A. Ballay of Orland Park, IL (EACH)
its true and lawful Attorney(s)in-Fact, to make, execute, seal, and deliver from the date of issuance of this power for and on its behalf as surety, and as its act and deed:
Any and all bonds, undertakings, recognizances and other surety obligations, in the penal sum not exceeding Ninety Million Dollars ($90.000,000.00).
This authority does not permit the same obligation to be split into two or more bonds In order to bring each such bond within the dollar limit of authority as set forth
herein.
The execution of such bonds, undertakings, recognizances and other surety obligations in pursuance of these presents shall be as binding upon the said Company as
fully and amply to all intents and purposes, as if the same had been duly executed and acknowledged by its regularly elected officers at its principal administrative
office in Jersey City, New Jersey.
This Power of Attorney is executed by authority of resolutions adopted by unanimous consent of the Board of Directors of the Company on December 10, 2020, true
and accurate copies of which are hereinafter set forth and are hereby certified to by the undersigned Secretary as being in full force and effect:
"VOTED, That the Chairman of the Board, the President, or the Executive Vice President, or any Senior Vice President, of the Surety Business Division, or their
appointees designated in writing and filed with the Secretary, or the Secretary shall have the power and authority to appoint agents and attorneys -in -fact, and to
authorize them subject to the limitations set forth in their respective powers of attorney, to execute on behalf of the Company, and attach the seal of the Company
thereto, bonds, undertakings, recognizances and other surety obligations obligatory in the nature thereof, and any such officers of the Company may appoint agents for
acceptance of process."
This Power of Attorney is signed, sealed and certified by facsimile under and by authority of the following resolution adopted by the unanimous consent of the Board of
Directors of the Company on December 10, 2020:
VOTED, That the signature of the Chairman of the Board, the President, or the Executive Vice President, or any Senior Vice President, of the Surety Business
Division, or their appointees designated in writing and filed with the Secretary, and the signature of the Secretary, the seal of the Company, and certifications by the
Secretary, may be affixed by facsimile on any power of attorney or bond executed pursuant to the resolution adopted by the Board of Directors on December 10, 2020,
and any such power so executed, sealed and certified with respect to any bond or undertaking to which it is attached, shall continue to be valid and binding upon the
Company. In Testimony Whereof, the Company has caused this instrument to be signed and its corporate seal to be affixed by their authorized officers, this 27th day
of April, 2021.
Attested and Certified
4,1/4, kl.gestr,re
Regan` . Shulman, Secretary
STATE OF PENNSYLVANIA SS
COUNTY OF PHILADELPHIA SS
I, Michele Tripodi, a Notary Public, do hereby certify that Regan A. Shulman and Stephen C. Ruschak personally known to me to be the same persons whose names
are respectively as Secretary and Executive Vice President of the Arch Insurance Company, a Corporation organized and existing under the laws of the State of
Missouri, subscribed to the foregoing instrument, appeared before me this day in person and severally acknowledged that they being thereunto duly authorized signed,
sealed with the corporate seal and delivered the said instrument as the free and voluntary act of said corporation and as their own free and voluntary acts for the uses and
Arch Insurance Company
.t
Stephen C. Ruschak, Executive Vice President
purposes therein set forth.
COMMONWEALTH 09 PENNSYLVANIAors-a
towns. suit
hoot TA P001, Nouty Public
City of prillsdaphis. PhRi. Catinty
�y Catilakin Ekes July a1,Val
Miche podi, Notary Public
My commission expires 07/31/2021
zo
CERTIFICATION
I, Regan A. Shulman, Secretary of the Arch Insurance Company, do hereby certify that the attached Power of Attorney dated April 27, 2021 on behalf of the
person(s) as listed above is a true and correct copy and that the same has been in full force and effect since the date thereof and is in full force and effect on the date of
this certificate; and I do further certify that the said Stephen C. Ruschak, who executed the Power of Attorney as Executive Vice President, was on the date of execution
of the attached Power of Attorney the duly elected Executive Vice President of the Arch Insurance Company.
WHEREOF, I have hereunto subscribed m y name and affixed the corporate seal of the Arch Insurance Company on the - ay of J U t
IN TESTIMONY) p
20
getra Pit r
t
r,
Regf8rA A. Shulman, Secretary
This Power of Attorney limits the acts of those named therein to the bonds and undertakings specifically named therein and they have no authority to bind the Company
except in the manner and to the extent herein stated.
PLEASE SEND ALL CLAIM INQUIRIES RELATING TO THIS BOND TO THE FOLLOWING ADDRESS:
Arch Insurance — Surety Division
3 Parkway, Suite 1500
Philadelphia, PA 19102
To verify the authenticity of this Power of Attorney, please contact Arch Insurance Company at SuretyAuthentic@archinsurance.com
Please refer to the above named Attorney -in -Fact and the details of the bond to which the power is attached.
AICPOA040120 Printed in U.S.A.