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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.
Portion of 100 E 9th Street.
Total "lump sum" bid: $ I'i, 500.00 CF'ouKtl.%tN 11AoMsAIu0 AUI= NhirDAO 440 Yite�
Submitting Firm: PWpt4St\) L'NIIFghtinte1'A1. I .
Address: 2•63 9o,<'M 5T.
City: LJA't'tiMfib
State: TA Zip: 91/0 3
Authorized Representative (print) Klayseht. fAse
Authorized Representative Signature (1.-
Date: Mdi%•2l Email: M:1FNL'LitPwcr Afll/ANcemmDWUf.cser')
Phone: 3 l9.2$? 44447
Fax: Sei •29 7 • qWR
EXCEPTIONS/DEVIATIONS to this Request for Proposal shall be listed in writing on an attached document
provided by the Bidder. Please be as specific as possible. Please check one:
Our company has no exceptions/deviations.
Our company does have exceptions/deviations which are listed on an attached document.
GENERAL INFORMATION. Freight and/or delivery charges, if any, shall be included in the price.
FIRM PRICING. Offered prices shall remain firm for a minimum of sixty (60) days after the due date of this
solicitation unless indicated otherwise. Accepted prices shall remain firm for the duration of the contract.
ADDENDA (It is the Bidder's responsibility to check for issuance of any addenda). The authorized
representative herby acknowledges receipt of the following addenda:
Addenda Number Date Addenda Number Date
We choose not to bid at this time but would like to be considered for future requests for bid
BID BONE
KNOW: ALA. MEN BY THESE PRESENTS, that we, Advanced Environmental Testing and Abatement, Inc.
as i n d Merchants Bonding Company Mutual
r�hrt+�al� and ... g p— y _ — —
as u y-ark held and fi,o,nly .d-unto the _CITY OF kiy T t ; .... L, Iowa, hereinafter called
# W ER In the penat su ---Five Percent of the Bid Submittedm
Dollars ($:
_..50%0...
- .-_..-10411.. erna + f tho.. tlfted state for' t.paynt
. a'f' vvhich sum will and truly be made, e, 'We bind ourselves, our heirs, , xectA , administrators, and
suc ssors, jointly and severally, firmly by these presents. *The condition Of this obligation is such :that
_4th � November
* 2021 for whereas the Prn pat has submitted the accompanying bid dated the day of
Asbestos Removal at 100 E 9th Street, Waterloo, IA
•
:NOW, THE E
-CS) If said Bid shall be rejected, or in the alternate,
.(b) 1 Said Bid shall be: .acmpted and the Principal shall execute and deliver a contract in the f0.00 sp
:and shall furnish a bond for his faithful performance of said contract and for the payment- Of all petiOnt
perforrning labor or famishing materialni connection .h r%a s h a and shall in all other res a perform the
-Ogreementrniated by the acceptanceof said Bid,
Thee this obikiation shall be void otherwise the same shall remain in force and effect, `.`being expressly
understood ands.; gre . that . e liability of the Surety for any and _uit claims hereunder shall, In no event,.
exceedthe penal -.amou t of this obligatidh as herein stated, -
By. virtue of statutory a t ority1:t a fuji• artiount of this bld bond shall be forfeited tdaho Owner in liquidation of
(*mattes sustained in :the event. #hat Vele Principal :fails t ! execute the i ntrac . ' -probe :Oe bond as
provided in the specifications otosii
T - rev fpr value revived, -ereby stipulates and agrees that the Obligations of said Barely and its bared
:Shalt -be in: rt0 Warr, impaired p ad by any extension of the time within whit th.e Owner may acceM
,:Su Bid Or execute such contractand saki Surety does hereby waive notice of arty such eXtenslorL
ilk It s v oF{ the Principal and the Surety, have hereunto set their -hands and seats, andsuch
of them as are c moratons,. have caused their corporate seals:to be hereto affixed and these presents to be
29thOctober ,,, : 2021
signed by their proper Officere this day of O .�
Advanced Environmental Testing and Abatement, Inc. (Seal)
Principal
Witness:
Grace Rasmussen
By
-
Merchants Bonding Company (Mutual) (Seal)
Sur
Attomey¢
Jaimie Kangas
VIA;61:0v31/44--
(Title)
MERCHAN
BONDING COMPANYTU
POWER OF ATTORNEY
Know All Persons By These Presents, that MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC.,
both being corporations of the State of Iowa (herein collectively called the "Companies") do hereby make, constitute and appoint, individually,
Anne Crowner; Ashlea McCaughey; Ben Williams; Brian M Deimerly; Cameron M Burt; Cindy Bennett; Craig E Hansen; D Gregory Stitts; Dione R
Young; Donald E Appleby; Douglas Muth; Ginger Hoke; Grace Rasmussen; Greg Krier; Jaimie Kangas; Jay D Freiermuth; Jessica Jean Rini;
Kathleen Brewer; Mark R DeWitt; Mark Sweigart; Michelle R Gruis; Sarah C Brown; Seth D Rooker; Stacie Christensen; Stacy Venn; Tim McCulloh;
Todd Bengford; Wendy A Lewis
their true and lawful Attomey(s)-in-Fact, to sign its name as surety(ies) and to execute, seal and acknowledge any and all bonds, undertakings,
contracts and other written instruments in the nature thereof, on behalf of the Companies in their business of guaranteeing the fidelity of
persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions
or proceedings allowed by law.
This Power -of -Attorney is granted and is signed and sealed by facsimile under and by authority of the following By -Laws adopted by the Board
of Directors of Merchants Bonding Company (Mutual) on April 23, 2011 and amended August 14, 2015 and adopted by the Board of Directors of
Merchants National Bonding, Inc., on October 16, 2015.
"The President, Secretary, Treasurer, or any Assistant Treasurer or any Assistant Secretary or any Vice President shall have power and
authority to appoint Attorneys -in -Fact, and to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto,
bonds and undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof."
"The signature of any authorized officer and the seal of the Company may be affixed by facsimile or electronic transmission to any Power of Attorney
or Certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the
Company, and such signature and seal when so used shall have the same force and effect as though manually fixed."
In connection with obligations in favor of the Florida Department of Transportation only, it is agreed that the power and aut hority hereby given to the
Attorney -in -Fact includes any and all consents for the release of retained percentages and/or final estimates on engineering and construction
contracts required by the State of Florida Department of Transportation. It is fully understood that consenti ng to the State of Florida Department
of Transportation making payment of the final estimate to the Contractor and/or its assignee, shall not relieve this surety company of any of
its obligations under its bond.
In connection with obligations in favor of the Kentucky Department of Highways only, it is agreed that the power and authority hereby given
to the Attorney -in -Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner -
Department of Highways of the Commonwealth of Kentucky at least thirty (30) days prior to the modification or revocation.
In Witness Whereof, the Companies have caused this instrument to be signed and sealed this 2nd day of August , 2021
*** **t`ON •• •t••
. * 1% A4 .•
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St
et
-O-�AO a•
%Or 2003 : 0 .
STATE OF IOWA •+..,*.**,..*'
COUNTY OF DALLAS ss
n(� •�•
. FROlta
6- o; -•�
1933 ; :get
By
•
MERCHANTS BONDING COMPANY (MUTUAL)
MERCHANT$ NATIONAL BONDING, INC.
President
On this 2nd day of August 2021 , before me appeared Larry Taylor, to me personally known, who being by me duly sworn
did say that he is President of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC.; and that the
seals affixed to the foregoing instrument are the Corporate Seals of the Companies; and that the said instrument was signed and sealed in behalf
of the Companies by authority of their respective Boards of Directors.
low P
POLLY MASON
Commission Number 750576
My Commission Expires
January 07, 2023
•
MASS
Notary Public
(Expiration of notary's commission does not invalidate this instrument)
I, William Warner, Jr., Secretary of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., do hereby
certify that the above and foregoing is a true and correct copy of the POWER -OF -ATTORNEY executed by said Companies, which is still in full
force and effect and has not been amended or revoked.
In Witness Whereof, I have hereunto set my hand and affixed the seal of the Companies on this 29th day of October 2021
*P •••.•.
cQ; -ow o ri:
•
w0• 2003 :wow
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tit 4'
Secretary
POA 0018 (1/20)
ADVAENV-01
CWIGANT
D/YYYY)
DATE
ACORO
INSURANCE
CERTIFICATE
OF
LIABILITY
9/2/2
9/2/2021
THIS
NO RIGHTS
UPON THE CERTIFICATE
HOLDER
THIS
CERTIFICATE
IS
ISSUED AS A MATTER OF
INFORMATION ONLY AND CONFERS
NEGATIVELY
AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED
BY THE POLICIES
CERTIFICATE
BELOW.
THIS
DOES
CERTIFICATE
NOT
AFFIRMATIVELY
OR
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.
A statement on
If SUBROGATION
this certificate
does
IS WAIVED,
not confer
subject
rights
to the terms
to the certificate
and conditions of the policy certain
holder in lieu of such endorsement(s).
policies
may require an endorsement.
PRODUCER
Brummel
318
Cedar
Main
Falls,
Madsen
Street
Insurance
IA 50613
CONTACT
NAME:
Cathy
Wigant
PHONE
(A/C, No, Eat):
(319)
266-2644
(Arc,
Ne):(319)
277-2429
ADE-MAILDRESS:
cathyw@brummelmadsen.com
cath
w/�brummelmadsen.com
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A: Crum &
Forster Specialty
Insurance Company
44520
INSURED
Advanced
803 Ricker
Waterloo,
Environmental Testing & Abatement
Street
IA 50703
Inc
INSURER B :Western
National
Mutual
Insurance Company
15377
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
THIS
INDICATED.
CERTIFICATE
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH
MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLIC ES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
PAID CLAIMS.
EXCLUSIONS
AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY
INSR
TYPE OF INSURANCE
ADDL
INSR
SUBR
WVD
POLICY NUMBER
POLICY EFF
IMMIDDIYYYY)
POLICY EXP
(MMIDD/YYYYI
LIMITS
LTR
A
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 2'000'000
9/13/2021
9/13/2022
DAMAGE
PREMISE$
TO RENTED
IEa occurrence)
50,000
$
CLAIMS -MADE
X
OCCUR
EPK136883
MED EXP
(Any one person)
$ 5,000
x
Asbestos
PERSONAL & ADV INJURY
$ 2,000,000
X
Contractor
Pollution
GENERAL AGGREGATE
$ 5,000,000
GEN'LAGGREGATE
LIMIT APPLIES
PER:
PRODUCTS - COMP/OP AGG
$ 5,000,000
POLICY
X
PRO -CT
JE
LOC
TRANSPORTATION
$ 1,000,000
X
X
OTHER: Professional
Liability
B
AUTOMOBILE
LIABILITY
COMBINEaBi(E SINGLE LIMIT
S 1,000,000
2/28/2021
2/28/2022
BODILY
INJURY (Per person)
S
X
ANY AUTO
CPP 1013320
BODILY
INJURY (Per accident)
$
OWNED
SCHEDULED
AUTOS
ONLY
AUTOS
PROPERTY
Per
accident)
DAMAGE
S
HIRED
AUTOS ONLY
NON -OWNED
AUTOS ONLY
$
A
X
UMBRELLA LIAB
X
OCCUR
EACH OCCURRENCE
$
5,000,000
9/13/2021
9/13/2022
AGGREGATE
S
5,000,000
EXCESS LIAB
CLAIMS -MADE
EFX118804
$
DED ,
X,
RETENTION
$ 10,000
B
WORKERS
COMPENSATION
X
STATUTE
EORH
9/13/2021
9/13/2022
E.L.
EACH
ACCIDENT
1,000,000
$
AND
EMPLOYERS'
LIABILITY
Y / N
WCV 1001609
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER
EXCLUDED?
Y
N / A
E.L. DISEASE - EA EMPLOYEE
1,000,000
S
(Mandatory in NH)
If yes, describe under
OF OPERATIONS
below
EL. DISEASE -POLICY LIMIT
S 1,0001000
B
DESCRIPTION
Umbrella
Liab
(auto)
UMB
1016518
2/28/2021
2/28/2022
Ea Occ/ Aggregate
3,000,000
DESCRIPTION
OF OPERATIONS / LOCATIONS / VEHICLES
(ACORD
101, Additional Remarks Schedule, may be attached If more space is required)
CERTIFICATE
HOLDER
CANCELLATION
Insurance
of
policies
verification
and coverage
limits
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)
I
The
ACORD
name and
logo are registered
a
marks
1988-2015
of ACORD
ACORD CORPORATION.
All
rights reserved.