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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.
1804 W. 4th Street, 207 Lafayette Street, 208 Sunnyside Avenue, and 637 Ankeny Street.
Total "lump sum" bid: $ 25 4 eb
The correct summation of the actual bid tabulation figures will supersede the listed total.
Submitting Firm: 6 te` AWN
Address: IL, k- �-w•.v�• u - �'`
City: AteC.•aits A- State: I e iZip: Saorok
Authorized Representative (print) WS-
Authorized Representative Signature
Date: Email: oat-1 cc -aSoa e-Q ywsei. caw.. .
Phone: 3'tt, -'1 e - /Py$t Fax:
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:
X 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
C✓1lCv - stA5- C_t,45
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: AB-2023-02-04P: 1804 W 4th St, 207 Lafayette St, 208 Sunnyside Av, and 637 Ankeny St
Page 9 of 10
Our "not to exceed" bid price for each property is:
1804 E. 4th Street
207 Lafayette Street
208 Sunnyside Avenue
PO
e rya
el 1 Ez-L
637 Ankeny Street
Soo
Total
� o0
31 -4-ido
RFB FOR ASBESTOS ABATEMENT SERVICES: Contract: AB-2023-02-04P: 1804 \V 4'h St, 207 Lafayette St, 208 Sunnyside AV, and 637 Ankeny St
Page 10 of 10
CONTRACTOR:
(Name, legal status and address)
Site Services, Inc
1621 E. Commercial St.
Algona, IA 50511
OWNER:
(Name, legal status and address)
City Of Waterloo
715 Mulberry St.
Waterloo, IA 50703
BOND AMOUNT: $ 5 Percent of Bond
BID BOND
Bid# ZA42704
SURETY:
(Name, legal status and principal place of business)
Arch Insurance Company
Jersey City, New Jersey
PROJECT:
(Name, location or address, and Project number, if any)
Four Locations in city of Waterloo, IA. 1804 E 4th St., 207 Lafayette St, 208 Sunnyside Ave., 637 Anckeny St.
The Contractor and Surety are bound to the Owner in the amount set forth above, for the payment of which the
Contractor and Surety 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 prompt payment 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.
The Company executing this bond vouches that this document conforms to American Institute of Architects Document A310, 2010 edition
1
Signed and sealed this 27th day of December, 2022
(Witness)
Site Services, Inc.
(Contr,
(Title)
Arch Insurance Company
(Surety)
ka
,*
(Seal)
ig-Z---c---,--e--„
(Title) Michael Rice, as Attorney in Fact
The Company executing this bond vouches that this document conforms to American Institute of Architects Document A310, 2010 edition
2
Individual Acknowledgement
State of
County of
On this day of , 20 , before me personally came
to me known and known to me to be the individual(s) who executed the foregoing instrument, and acknowledged that he/she
executed same.
Notary Public
My commission expires
Partnership Acknowledgement
State of
County of
On this day of , 20 , before me personally came
a member of the co -partnership of to me known and known to me to be the person
who is described in and who executed the foregoing instrument and acknowledges to me that he/she executed the same as and
for the act and deed of the said co -partnership.
Notary Public
My commission expires
Corporate Acknowledgement
State of
County of
On this day of 20 , before me personally came
to me known, who being by me duly sworn, did depose and say that he/she resides in that
he/she is the of the , the
corporation described in and which executed the foregoing instrument, and that he/she signed his/her name thereto by order of
the Board of Directors of said corporation.
State of NY
County of Cortland
Notary Public
My commission expires
Surety Acknowledgement
On this 27th day of December 20 22, before me personally came MichaelMRice to me known, who being by me duly sworn, did
depose and say that he/she resides in Cortland that he/she is the Attorney -in -Fact of Arch Insurance Company, the corporation
described in and which executed the foregoing instrument; that he/she knows the Seal of said corporation; that one of the Seals
affixed to the foregoing instrument is such Seal; that it was so affixed by order of the Board of Directors of said corporation; and
that he/she signed his/her name thereto by like order.
knyta M Lyori
Notary Public, State of New York
Registration no. ()I0/6372835
Qualified in Tompkins County
Cuuilllt§4l4lll F pima March 26, 202,ip
My comm( ion expires
2(9, 2O2(a
Notary Public
AIC 0000384538
This Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in the manner and to the extent herein staled.
Not valid for Note, Loan, Letter of Credit, Currency Rate, Interest Rate or Residential Value Guarantees.
POWER OF ATTORNEY
Know All Persons I3y 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 Ill, Karen O'Connell, Michael Rice, Olga Garza, Pauline Perlongo and William A. Ballay of Orland Park, IL (EACH)
its true and lawful Attomey(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 One Hundred and Fifty Million Dollars (150,000,000.00).
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 frilly
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 August 31, 2022, tnte and
accurate copies of which are hereinafter set forth and are hereby certified to by the undersigned Secretary as being in frill 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 August 31, 2022:
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 August 31, 2022, 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 24'h day of October, 2022
Attested and Certified Arch Insurance Company
Regan A. Shulman, Secretary
STATE OF PENNSYLVANIA SS
COUNTY OF PHILADELPIIIA 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
purposes therein set forth.
Stephen C. Ruschak, Executive Vice President
CERTIFICATION
I, Regan A. Shulman , Secretary of the Arch Insurance Company, do hereby certify that the attached Power of Attorney dated October 24, 2022 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.
IN TESTIMONY WHEREOF, I have hereunto subscribed my name and affixed the corporate seal of the Arch Insurance Company on this
20
Commonwealth of Pennsylvania • Notary Seal
MICHELE TRIPOD), Notary Public
Philadelphia County
My Commission Expires July 31, 2025
Commission Number 1168622
Michele Tripodi, Notary Public
My commission expires 07/31/2025
This Power of Attorney limits the acts of those named therein to the bonds and
except in the manner and to the extent herein stated.
PLEASE SEND ALL CLAIM INQUIRIES RELATING TO THIS BOND
Arch Insurance — Surety Division
3 Parkway, Suite 1500
Philadelphia, PA 19102
day of
,
Regan A. Shulman, Secretary
undertakings specifically narned therein and they have no authority to bind the Company
ante
TO THE FOLLOWING ADDRESS:
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.
AICP0A08312022 Printed in U.S.A.