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REINBECK, IOWA 50669-0155
F.Y. 2016 Storm Sewer
Improvements
Contract NO.906
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City Hall 1st Floor
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Bid Date — 5-12-16
Bid Time — 1:00 PM CST
Bid Bond
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REINBECK, IOWA 50669-0155
CITY OF E
F.Y. 2016 Storm Sewer
Improvements
Contract NO.906
City Clerk City of Waterloo
City Hall 15t Floor
Bid Date — 5-12-16
Bid Time — 1:00 PM CST
Bid Proposal
FORM OF BID OR PROPOSAL
F.Y. 2016 STORM SEWER IMPROVEMENTS
CONTRACT NO. 906
CITY OF WATERLOO, IOWA
Honorable Mayor and City Council
Waterloo, Iowa
Gentlemen:
1. The undersigned, being a Corporation existing under the laws of the State of
Iowa , 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. 2016 STORM SEWER IMPROVEMENTS, Contract No. 906,
all in accordance with the above-listed documents and for the unit prices for work
in place for the following items and quantities:
F.Y. 2016 STORM SEWER IMPROVEMENTS
CONTRACT NO. 906
aro- bEsqvgwozi;:',.? 'UNIT EST.QTY. UNIT 13I0 1
ITEM DIVJTDNO UREET -7, PRICE
1 IRECYLED ASPHALT PAVING
TON 263 5 $ 17 . 50 $ 4 , 611 . 25
2 CLASS A CRUSHED STONE TON 1532 $ 20 . 00 $ 3 , 064 . 00
CONVENTIONAL SEEDING AND FERTILIZING,
3 TYPE 1 SEED MIX SY 3493 $ 2 . 00 698 . 60
4 RECP TYPE 2 SY 349 3 $ 2 . 00 698 . 60
5 'TOPSOIL, 4" SY 349.3 $ 6 . 00 2 , 095 . 80
6 DROP-IN INLET PROTECTION EACH 1.0 $ 250 . 00 $ 250 . 00
7 TRAFFIC CONTROL LS 1.0 $ 500 . 00 $ 500 . 00
8 STORM SEWER, 2000D, 15" LF 143 0 $ 57 . 50 $ 8, 222 . 50
SW-511 MODIFIED RECTANGULAR AREA
9 INLET EACH 1.0 $ 6 , 000 . 00$ 6 , 000 . 00
10 SW-401 CIRCULAR STORM SEWER MANHOLE EACH 1 0 $ 4 , 000 . 00 $ 4 , 000 . 00
11 MANHOLE, MINOR ADJUSTMENT EACH 1 0 $ 1, 500 . 00 $ 1, 500 . 00
FORM OF BID CONTRACT NO. 906 Page 1 of 5
'
`
' 12 CLASS1O EXCAVATION CY 451.5 $ 32 ' 50 $ I4 , 673 . 75
13 REM/REP 7.57HK8ADRIVEWAY @Y 258.3.* 85 . 0O $ 2I, 955 . 50
14 REM/REP 7°PCC44.5°HKNA COMPOSITE PATCH 8Y 35.8 $ I30 ' 00 $ 4 , 654 . 00 �
TOTAL DIVISION 1 72 , 924 . 00 ^ �
~
wl
1 RECYLEO ASPHALT PAVING TON 1�5 I7 5O |$ 2 , 896 . 25
` '^ ' /
CONVENTIONAL SEEDING AND FERTILIZING, ' `
2 TYPE 1 SEED MIX . 0Y 8027 �2 . 0O m I, 205 . 40
3 ,T{}P8Q|L. 4/' SY � 602.7 * 6 . 00 w 3 , 616 . 20
4 RECF, TYPE 2 _ SY OO2�7|* 2 ' 00 * 1, 205 . 40
~ ^
5 TRAFFIC CONTROL LG 1J0 $ 500 . 00 $ 500 . OO
-
6 STORM SEWER, 2O8OD. 12" ' LF , 151.0n 55 ' 00 $ 8, 305_ 00
7 CONCRETE COLLAR EACH �.O $ 7S0 . OO $ I, 500 . OO
^ . .
8 8VV-512CIRCULAR AREA INLET , EACH 2.0.$ 3 , 000 . 00 $ 6, 000 . 00
^ Q SVV-401 CIRCULAR STORM SEWER MANHOLE, EACH 1D $ 4 , 000 . 00 $ 4 , 000 . 00
10 CLASS1D_EXCAVATION CY 162.8 $ 3� , 5O $ 5, 29l . 00 �
� .
11 RE�/�EP4^ �� �Y 8.1 $ 62 . 00 00 $ 564 . 2O �
� � . �^ � .
12 REM/REPO'PCC/4.O°HK0A COMPOSITE PATCH SY 333 $ I20 . 08 $ 3 , 996 . 00
13 RAILROAD TIE REMOVALS � LS . 1.0 * 2 , 500 . 00 $ 2 , 500 . 00
14 ?LUG STORM SEWER _ � LG _ 1.0 $600 , 00 $600 , 00
'
TOTAL DIVISION 18 $ 42 , I79, 45 0A����
)c mkt
1 PAVEMENT REMOVAL SY 20,6 $ 7 . 00 $ 144 . 20
2 SAW CUT LF 178J0 $ I0 . 00 $ 1, 780 . 00
� REMOVE, SALVAGE AND RE-INSTALL STORM
3 SEWER, 2O0OQ. 18" LF 16.0 $ 67 . 00 $ 1, 072 . 00
,
4 STORM SEWER, 2000D. 18" LF 8.0 $ 56 . 50 $ 452 . 00
. .
5 SW-512C|RC AREA INTAKE EACH 1.01$ 3 , 000 . 00 $ 3 , 000 . 00
G 5'' PCC PAVEMENT, C-4 SY 12.3 $ 60 ' 00 _ ~$ 738 . O0
^
FORM DFBID CONTRACT NO. 9O0 Page 2of5
7 6" PCC PAVEMENT, C-4 SY 136.7 75 . 00 $ 10, 252 . 50
8 CLASS 10 EXCAVATION CY 65.1 $ 32 . 50 $ 2 , 115 . 75
REMOVE, SALVAGE AND RE-INSTALL
9 EROSION STONE SY 412 $ 15 . 00 $ 618 . 00
REMOVE AND RE-INSTALL OBJECT
10 MARKERS EACH 20 $ 100 . 00 $ 200 . 00
11 TRAFFIC CONTROL LS _ 1.0 $ 500 . 00 $ 500 . 00
1TOTAL DIVISION III 2 0, 872 .4 5 e4 egt\l‘-•
4541gr";:'' '!' §,1:5P:rtat''grAT-g!R-Rwqt ItcrAwirtp: 4
ITEM DIVISION Auk;liw,;:ro 444:
1 RECYLED ASPHALT PAVING TON 225.60 17 . 50 $ 3, 948 . 00
2 CLASS A CRUSHED STONE TON 32.30 $ 20 . 00 $ 646 . 00
3 CONVENTIONAL SEEDING, TYPE 1 SEED MIX SY 528.20 $ 2 . 00 $ 1, 056 . 40
4 RECP, TYPE 2 SY 528.20 $ 2 . 00 $ 1, 055 . 40
5 TOPSOIL, 4" SY 528.20 $ 6 . 0 0 $3 , 169 . 20
6 DROP-1N INLET PROTECTION EACH 200 $ 250 . 00 $ 500 . 00
7 TRAFFIC CONTROL LS 1.00 $ 500 . 00 $ 500 . 00
8 STORM SEWER, 2000D, 12" LF 134.00 $ 55 . 00 $ 7, 370 . 00
9 SW-501, TYPE Q CASTING EACH 2.00 4 , 500 . 00 $ 9, 000 . 00
10 COLLAR STRUCTURE OR PIPE EACH 1.00 $ 600 . 00 $600 . 00
11 CLASS 10 EXCAVATION CY 221.30 32 . 50 $ 7, 192 . 25
TOTAL DIVISION IV 35, 038 . 25
TOTAL ALL DIVISIONS $ 171, 014 . 15
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 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
FORM OF BID CONTRACT NO. 906 Page 3 of 5
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.
4. Security in the sum of 56
Dollars ($ 8 , 550 . 71 ) in the form of Bid Bond
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 Resident Bidder Certification ( x ), or Non-Resident
Bidder Certification ( ). (Mark one.)
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 EOC, 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
10. The bidder shall list the MBENVBE 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".
FORM OF BID CONTRACT NO. 906 Page 4 of 5
12. The bidder has attached all applicable forms.
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.
Peterson Contractors, Inc . 5-12-16
(Name of Bidder) (Date)
BY: C leshner Title Project Estimator / Manager
Official Address: (Including Zip Code):
104 Black Hawk St . , P .O. Box A
Reinbeck, IA 50669
I.R.S. No. 42-0921654
FORM OF BID CONTRACT NO. 906 Page 5 of 5
NON-COLLUSION AFFIDAVIT OF PRIME B|[][)ER
state of Iowa )
\ /K(�`�
Coun� of ���^^�ww\ > )go
. being first duly svvorn, deposes and says that:
1 He is (Owner, Pa�ner. Officer, Representative, orAgenU . of Peterson Cozztraotoro,
Inc . . �he 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 collusive or sham Bid;
4 Neither the said Bidder nor any of its oMicero, pertnera, ovvnare, agents, papremantativem,
ennp|oymeo, or parties in interest, including this affiont, has in any way oJUuded,
conspired, connived or mgreed, directly or indinect|y, with any other Biddor, fi[Ol or person
to submit ooUuak/e 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 Contnact, or
has in any manner, directly or indiraoUy, sought by agreement or collusion or
communication or conference with any other Bidder, finn or person to Mx the price or
prices in the attached Bid or of any other Bidder. or, to fix any uvmrhwad, profit or cost
element 0fthe bid price or the bid price of any other 8idder, or to secure through any
collusion, coosp|racy, 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 ool|uoion, oonspirany, connivance or unlawful agreement on the port of the Bidder or
any of its agents, representatives, nmmere employees, parties in interest, including this
efhant.
(Signed)
Project Estimator / y0azzaqer
Title
Subscribed and sworn to before nnmthis I2tb day of
May . 2016 .
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u Title
My commission expires
COmmission Expires
-- - January4, 2019
RESIDENT/NON-RESIDENT BIDDER
RESIDENT BIDDER:
In accordance with Section 73A.21 of the Iowa Code, all non-federal-aid public
improvement projects, which include road construction, shall be performed by a
qualified resident bidder. The resident bidder has been further defined as follows:
Resident Bidder:
A person or entity authorized to transact business in this state and
having a business for at least three years prior to the date of the
first advertisement for the public improvement. If another state or
foreign country has a more stringent definition of a resident bidder,
the more stringent definition is applicable as to bidders from that
state or foreign country.
The contractor shall provide the City with a certification that he is a qualified
resident bidder according to the above definition. The Certification shall be
submitted with the contractor's bid. A copy of the form of "Resident Bidder
Certification" is included in the Contract Documents. If it is determined that the
contractor does not meet this qualification after he begins work, a shutdown
notice shall be issued and the voiding of the contract shall begin unless the
contractor becomes qualified,
NON-RESIDENT BIDDER:
The contractor shall provide the City with a certification that he is a non-resident
bidder according to the above definition. The Certification shall be submitted with
the contractor's bid. A copy of the form of "Non-Resident Bidder Certification" is
included in the Contract Documents.
DJG
01/02/12
RESIDENT BIDDER CERTIFICATION
CONTRACT NO: No . 906
PROJECT NAME: F.Y. 2016 Storm Sewer Improvements
DATE OF LETTING: 5-12-16
To be a qualified resident bidder, the bidder shall be a person or
entity authorized to transact business in this state and having a
business for at least three years prior to the date of the first
advertisement for the public improvement. If another state or
foreign country has a more stringent definition of a resident bidder,
the more stringent definition is applicable as to bidders from that
state or foreign country.
This qualification as resident bidder shall be maintained by the contractor and his
subcontractors at the work site until this project is completed.
I hereby certify that I am a resident bidder as defined above.
COMPANY NAME Peterson Contractors, Inc .
CORPORATE OFFICER
OFFICER Jennife Locihart
TITLE Assistant Treasurer
DATE 5-12-16
. ,
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PETERSON CONTRACTORS, INC.
104 Blackhawk Street
P.O. BoxA
Reinbeck, Iowa 50669
www.petersoncontractors.corn Phone: 319-345-2713 Fax: 319-345-2991
QUOTE
PROPOSAL FOR: F.Y. 2016 Storm Sewer Improvements Waterloo
THE FOLLOWING ITEMS AND PRICES ARE QUOTED:
ITEM# DESCRIPTION UNIT TYPE QUANTITY UNIT PRICE TOTAL AMOUNT
1 RECYCLED ASHPALT PAVING TN 263.500 17.50 4,611.25
2 CLASS A CRUSHED STONE TN 153.200 20.00 3,064.00
3 CONVENTIONAL SEEDING & FERTILIZ SY 349.300 2.00 698.60
4 RECP TYPE 2 SY 349.300 2.00 698.60
5 4"TOPSOIL SY 349.300 6.00 2,095. 80
6 DROP-IN INLET PROTECTION EA 1.000 250.00 250.00
7 TRAFFIC CONTROL LS 1.000 500.00 500.00
8 15" RCP STORM SEWER LF 143.000 57.50 8,222.50
9 SW-511 MODIFIED RECTANGULAR ARE EA 1.000 6,000.00 6,000.00
10 SW-401 CIRCULAR STORM SEWER MAN EA 1.000 4,000.00 4,000.00
11 MINOR MANHOLE ADJUSTMENT EA 1.000 1, 500.00 1,500.00
12 CLASS 10 EXCAVATION CY 451.500 32.50 14,673. 75
13 REMOVE& REPLACE 75" HMA DRIVEW SY 258.300 85.00 21,955.50
14 REMOVE& REPLACE 7" PCC/4 1/2 SY 35.800 130.00 4,654.00
DIVISION I SUBTOTAL SUBTOTAL 72,924.00
101 RECYCLED ASPHALT PAVING TN 165.500 17.50 2,896.25
102 CONEVENTIONAL SEEDING & FERTILI SY 602.700 2.00 1,205.40
103 4"TOPSOIL SY 602.700 6.00 3,616.20
104 RECP TYPE 2 SY 602.700 2.00 1,205.40
105 TRAFFIC CONTROL LS 1.000 500.00 500.00
106 12" RCP STORM SEWER LF 151.000 55.00 8,305.00
107 CONCRETE COLLAR EA 2.000 750.00 1,500.00
108 SW-512 CIRCULAR AREA INLET EA 2.000 3,000.00 6,000.00
109 SW-401 CIRCULAR STORM SEWER MAN EA 1.000 4,000.00 4,000.00
110 CLASS 10 EXCAVATION CY 162.800 32.50 5,291.00
111 REMOVE & REPLACE 4" SIDEWALK SY 9. 100 62.00 564.20
112 REMOVE & REPLACE 6" PCC/4" HM SY 33.300 120.00 3,996.00
113 RAILROAD TIE REMOVALS LS 1.000 2,500.00 2,500.00
114 PLUG STORM SEWER LS 1.000 600.00 600.00
DIVISION II SUBTOTAL SUBTOTAL 42, 179.45
201 PAVEMENT REMOVAL SY 20.600 7.00 144.20
202 SAW CUT LF 178.000 10.00 1,780.00
203 18" RCP REMOVE SALVAGE & REINST LF 16.000 67.00 1,072.00
204 18" RCP STORM SEWER LF 8.000 56.50 452.00
205 SW-512 CIRCULAR AREA INTAKE EA 1.000 3,000.00 3,000.00
206 5" PCC PAVEMENT SY 12.300 60.00 738.00
207 6" PCC PAVEMENT SY 136.700 75.00 10,252.50
208 CLASS 10 EXCAVATION CY 65. 100 32.50 2, 115.75
209 REMOVE SALVAGE & REINSTALL EROS SY 41.200 15.00 618.00
210 REMOVE& REINSTALL OBJECT MARKE EA 2.000 100.00 200.00
211 TRAFFIC CONTROL LS 1.000 500.00 500.00
DIVISION III SUBTOTAL SUBTOTAL 20,872.45
301 RECYCLED ASPHALT PAVING TN 225.600 17.50 3,948.00
302 CLASS A CRUSHED STONE TN 32.300 20.00 646.00
PCI QUOTE ON F.Y. 2016 Storm Sewer Improvements Waterloo-Continued
ITEM# DESCRIPTION UNIT TYPE QUANTITY UNIT PRICE TOTAL AMOUNT
303 CONVENTIONAL SEEDING TYPE I SEE SY 528.200 2.00 1,056.40
304 RECP TYPE 2 SY 528.200 2.00 1,056.40
305 4"TOPSOIL SY 528.200 6.00 3, 169.20
306 DROP-IN INLET PROTECTION EA 2.000 250.00 500.00
307 TRAFFIC CONTROL LS 1.000 500.00 500.00
308 12" STORM SEWER LF 134.000 55.00 7,370.00
309 SW-501 TYPE Q CASTING EA 2.000 4,500.00 9,000.00
310 COLLAR STRUCTURE OR PIPE EA 1.000 600.00 600.00
311 CLASS 10 EXCAVATION CY 221.300 32.50 7, 192.25
DIVISION IV SUBTOTAL SUBTOTAL 35,038.25
TOTAL QUOTED AMOUNT: $ 171,014.15
PETERSON CONTRACTORS, INC.
CSAANW --
May 12,2016
BID BOND
KNOW ALL MEN BY THESE PRESENTS,that we, Peterson Contractors,Inc.
as Principal,and Travelers Casualty and Surety Company of America
as Surety are held and firmly bound unto the CITY OF WATERLOO ,Iowa,hereinafter called
"OWNER." In the penal sum ---Five Percent of Amount of Bid---
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 12th day of May
,20 16 ,for F.Y.2016 Storm Sewer Improvements in the City of
Waterloo,Iowa-Contract No.906
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 form specified
and shall furnish 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 Surely,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 6th day of May ,A.D.2016
Peters tractors,Inc. (Seal)
Pri cipal
By
`�cor elk. peterson1r7 -67--1,, , '� dent
�- t avelers C ty and Surety C p iy f America(Seal)
ss urety
itness Anne Crowner Attorn -in-f ione R.Young
WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER
AllIlk POWER OF ATTORNEY
TRAVELERS' Farmington Casualty Company St.Paul Mercury Insurance Company
Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company
Fidelity and Guaranty Insurance Underwriters,Inc. Travelers Casualty and Surety Company of America
St.Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company
St.Paul Guardian Insurance Company
Attorney-In Fact No. 226I03 Certificate No. 0 0 6674 282
KNOW ALL MEN BY THESE PRESENTS: That Farmington Casualty Company, St. Paul Fire and Marine Insurance Company, St.Paul Guardian Insurance
Company,St.Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers Casualty and Surety Company of America,and United States
Fidelity and Guaranty Company are corporations duly organized under the laws of the State of Connecticut,that Fidelity and Guaranty Insurance Company is a
corporation duly organized under the laws of the State of Iowa,and that Fidelity and Guaranty Insurance Underwriters,Inc.,is a corporation duly organized under the
laws of the State of Wisconsin(herein collectively called the"Companies"),and that the Companies do hereby make,constitute and appoint
Craig E.Hansen,Jay D.Freiermuth,Brian M.Deimerly,Cindy Bennett,Anne Crowner,Tim McCulloh,Stacy Venn,Lacey Cramblit, Shirley S.
Bartenhagen,and Dione R.Young
of the City of West Des Moines ,State of Iowa ,their true and lawful Attorney(s)-in-Fact,
each in their separate capacity if more than one is named above,to sign,execute,seal and acknowledge any and all bonds,recognizances,conditional undertakings and
other writings obligatory 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.
IN WITNESS WHEREOF,the Companies have caused this instrument to be signed and their corporate seals to be hereto affixed,this 26th
day of February 2016
Farmington Casualty Company St.Paul Mercury Insurance Company
Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company
Fidelity and Guaranty Insurance Underwriters,Inc. Travelers Casualty and Surety Company of America
St.Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company
St.Paul Guardian Insurance Company
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State of Connecticut By:
City of Hartford ss. Robert L.Raney, enior Vice President
On this the 26th day of February 2016 before me personally appeared Robert L.Raney,who acknowledged himself to
be the Senior Vice President of Farmington Casualty Company, Fidelity and Guaranty Insurance Company,Fidelity and Guaranty Insurance Underwriters,Inc.,St.Paul
Fire and Marine Insurance Company,St.Paul Guardian Insurance Company,St.Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers
Casualty and Surety Company of America,and United States Fidelity and Guaranty Company,and that he,as such,being authorized so to do,executed the foregoing
instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer.
G.T%
In Witness Whereof,I hereunto set my hand and official seal. �TAA t Q�(� C .
My Commission expires the 30th day of June,2016. * AMP * Marie C.Tetreault,Notary Public
NY
49/F GIP
58440-8-12 Printed in U.S.A.
WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER