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2013-47 CONTRACTOR AGREEMENT FOR
TRAIL AND ROUNDABOUT CONSTRUCTION
THIS AGREEMENT, made and entered into this day of it (1.4 2013,
A.D., by and between the City of Clermont 685 West Montrose Street, Clont, Florida
(hereinafter referred to as "CITY"), and Commercial Industrial Corp. 11810 , Ocala, FL
34482 (hereinafter referred to as "CONTRACTOR").
WHEREAS, CONTRACTOR in response to a public bid prepared and issued by Lake
County (Lake County Bid No.: 13-0027) in accordance with an Interlocal Agreement
between CITY and Lake County related to construction improvements for the South Lake
Trail;
WHEREAS, based on CONTRACTOR's response, Lake County awarded a contract to
CONTRACTOR for the construction of the improvements to include the construction of
a roundabout to be paid for by CITY;
WHEREAS, CITY desires to utilize the CONTRACTOR's contract with Lake County
accordance with the referenced Interlocal and CITY's procurement policy; and
WHEREAS, CONTRACTOR desires to enter into a contract with CITY based on the
terms and conditions of the Lake County Bid No.: 13-0027 and CONTRACTOR's
response thereto.
WITNESSETH: That the parties hereto, for the consideration hereinafter set forth,
mutually agree as follows:
ARTICLE I - SCOPE OF WORK
The CONTRACTOR shall furnish all labor, materials, equipment, machinery, tools,
apparatus and transportation and perform all of the work as more particularly described in
Lake County Bid No.: 13-0027, which is incorporated herein in its entirety and as more
particularly described in Exhibit"A" attached hereto and incorporated herein and shall do
everything required by this Agreement and the other Agreement Documents contained in
the specifications,which are a part of these Documents.
ARTICLE II-THE CONTRACT SUM
The CITY shall pay to the CONTRACTOR, for the faithful performance of the Contract
as set forth in the contract documents and the unit Price Schedule, attached hereto and
incorporated herein as Exhibit "A", in lawful tender of the United States, the total
contract sum of TWO HUNDRED FORTY NINE THOUSAND SIX HUNDRED AND
76/100 ($249,600.76).
1
ARTICLE III - COMMENCEMENT AND COMPLETION OF WORK
1. The CONTRACTOR shall commence work within 10 calendar days after receipt
of(i) Notice to proceed, and (ii) receipt of all permits required to perform the work, and
the CONTRACTOR will substantially complete the same within the time period set forth
in the Notice to Proceed, unless the period for completion is extended otherwise by the
amendment or change order to the Contract. Substantial Completion as provided herein
shall be the day the project or designated portion thereof is certified and accepted by the
CITY as sufficiently complete, in accordance with the Contract Documents.
2. The CONTRACTOR shall prosecute the work with faithfulness and diligence.
3. The CONTRACTOR further declares he has examined the sites of the work and
that from personal knowledge and experience or that he has made sufficient
investigations to fully satisfy himself that such sites are correct and suitable for the work
and he assumes full responsibility therefore. The provisions of this Contract shall control
any inconsistent provisions contained in the specifications. All Drawings and
Specifications have been read and carefully considered by the CONTRACTOR, who
understands the same and agrees to their sufficiency for the work to be done. It is
expressly agreed that under no circumstances, conditions or situations shall this Contract
be more strongly construed against the CITY than against the CONTRACTOR and his
Surety.
Any ambiguity or uncertainty in the Plans, Drawings or Specifications shall be
interpreted and construed by the CITY'S project manager and his decision shall be final
and binding upon all parties.
It is distinctly understood and agreed that the passing, approval and/or acceptance of any
part of the work or material by the CITY or by any agent or representative as in
compliance with the terms of this Contract and/or of the Drawings, Plans and
Specifications covering said work shall not operate as a waiver by the CITY of strict
compliance with the terms of this Contract and/or the Drawings and Specifications
covering said work; and the CITY may require the CONTRACTOR and/or his Surety to
repair, replace, restore and/or make to comply strictly and in all things with this Contract
and the Drawings and Specifications any and all of said work and/or materials which
within a period of one year from and after the date of the passing, approval, and or
acceptance of any such work or material, are found to be defective or to fail and in any
way to comply with this Contract or with the Drawings and Specifications. This
provision shall not apply to materials or equipment normally expected to deteriorate or
wear out and become subject to normal repair and replacement before their condition is
discovered. The CONTRACTOR shall not be required to do normal maintenance work
under the guarantee provisions. Failure on the part of the CONTRACTOR and/or his
Surety, immediately after Notice to either, to repair or replace any such defective
materials and workmanship shall entitle the CITY, if it sees fit, to replace or repair the
same and recover the reasonable cost of such replacement and/or repair from the
CONTRACTOR and/or his Surety, who shall in any event be jointly and severally liable
2
to the CITY for all damages, loss and expense caused to the CITY by reason of the
CONTRACTOR'S breach of this Contract and/or his failure to comply strictly and in all
things with this Contract and/or his failure to comply strictly and in all things with this
Contract and with the Drawings and Specifications.
4. If required, As-built drawings and warranties acceptable to CITY must be
submitted to the CITY before final payment will be made to the CONTRACTOR.
ARTICLE IV- LIQUIDATED DAMAGES
1. It is mutually agreed that time is of the essence in regard to this Contract.
Therefore, notwithstanding any other provision contained in the Contract Documents,
should the CONTRACTOR fail to complete the work within the specified time as set by
the Notice to Proceed, or any authorized extension thereof, CONTRACTOR shall pay to
CITY the sum of FIVE HUNDRED DOLLARS ($500.00) per calendar day as fixed,
agreed and liquidated damages for each calendar day elapsing beyond the specified time
date; which sum shall represent the damages sustained by the CITY, and shall be
considered not as a penalty,but in liquidation of damages sustained. Contractor shall pay
the liquidated damages amount contained herein to CITY within fifteen (15) days of
receipt of CITY's written demand for such payment.
2. For the purposes of this Article, the day of final acceptance of the work shall be
considered a day of delay, and the scheduled day of completion of the work shall be
considered a day schedule for protection.
ARTICLE V- PARTIAL AND FINAL PAYMENTS
In accordance with the provisions fully set forth in the General Conditions, and subject to
additions and deductions as provided, the CITY shall pay the CONTRACTOR as
follows:
1. CONTRACTOR shall submit a progress payment request by the third (3rd) day of
each calendar month for work performed during the preceding calendar month. Upon
CONTRACTOR's signature accepting the PARTIAL PAYMENT AUTHORIZATION,
the CITY shall make a partial payment to the CONTRACTOR, within thirty (30)
calendar days, on the basis of a duly certified and approved payment invoice by the CITY
for work performed during the preceding calendar month under the Contract. To insure
proper performance of the Contract, the CITY shall retain ten percent (10%) of the
amount of each estimate until final completion and acceptance of all work covered by the
Contract.
2. Upon submission by the CONTRACTOR of evidence satisfactory to the CITY
that all payrolls, material bills and other costs incurred by the CONTRACTOR in
connection with the construction of the work have been paid in full, and also, after all
guarantees that may be required in the Specifications have been furnished and are found
acceptable by the CITY, final payment, including any retainage amount, on account of
3
this Contract shall be made within thirty (30) calendar days after completion of all work
by the CONTRACTOR covered by this Agreement and acceptance of such work by the
CITY.
ARTICLE VI -ADDITIONAL BONDS
It is further mutually agreed between the parties hereto that if, at any time after the
execution of this Agreement and the Surety Bonds hereto attached for its faithful
performance and payment of labor and materials, the CITY shall deem the Surety or
Sureties upon such bonds to be unsatisfactory, or if, for any reason, such bonds cease to
be adequate to cover the performance and payments of the work, the CONTRACTOR
shall, at his expense, and within seven (7) days after receipt of Notice from the CITY to
do so, furnish additional bonds, in such form and amounts, and with such Sureties as shall
be satisfactory to the CITY. In such event, no further payment to the CONTRACTOR
shall be deemed due under this Agreement until such new or additional security for the
faithful performance and for payment of labor and materials of the work shall be
furnished in manner and form satisfactory to the CITY.
ARTICLE VII—DISPUTE RESOLUTION- MEDIATION
1. Any claim, dispute or other matter in question arising out of or related to this
Agreement shall be subject to mediation as a condition precedent to voluntary arbitration
or the institution of legal or equitable proceedings by either party.
2. The CITY and Contractor shall endeavor to resolve claims, disputes and other
matters in question between them by mediation.
3. The parties shall share the mediator's fee and any filing fees equally. The
mediation shall be held in the place where the Project is located, unless another location
is mutually agreed upon. Agreements reached in mediation shall be enforceable as
settlement agreements in any court having jurisdiction thereof.
ARTICLE VIII—INSURANCE AND INDEMNIFICATION RIDER
1. Worker's Compensation Insurance The Contractor shall take out and maintain
during the life of this Agreement Worker's Compensation Insurance for all his employees
connected with the work of this Project and, in case any work is sublet, the Contractor
shall require the subcontractor similarly to provide Worker's Compensation Insurance for
all of the latter's employees unless such employees are covered by the protection afforded
by the Contractor. Such insurance shall comply with the Florida Worker's Compensation
Law. In case any class of employees engaged in hazardous work under this contract at
the site of the Project is not protected under the Worker's Compensation statute,
the Contractor shall provide adequate insurance, satisfactory to the CITY, for the
protection of employees not otherwise protected.
4
2. Contractor's Public Liability and Property Damage Insurance The Contactor
shall take out and maintain during the life of this Agreement Comprehensive General
Liability and Comprehensive Automobile Liability Insurance as shall protect it from
claims for damage for personal injury, including accidental death, as well as claims for
property damages which may arise from operating under this Agreement whether such
operations are by itself or by anyone directly or indirectly employed by it, and the amount
of such insurance shall be minimum limits as follows:
(a) Contractor's Comprehensive General, $1,000,000 Each ($2,000,000
aggregate) Liability Coverage's, Bodily Injury Occurrence, & Property
Damage Combined Single Limit
(b) Automobile Liability Coverage's, $1,000,000 Each Bodily Injury & Property
Damage Occurrence, Combined Single Limit
(c) Excess Liability, Umbrella Form $2,000,000 Each Occurrence, Combined
Single Limit
Insurance clause for both BODILY INJURY AND PROPERTY DAMAGE shall be
amended to provide coverage on an occurrence basis.
3. Subcontractor's Public Liability and Property Damage Insurance The Contractor
shall require each of his subcontractors to procure and maintain during the life of this
subcontract, insurance of the type specified above or insure the activities of his
subcontractors in his policy, as specified above.
4. CITY's and Contractor's Protective Liability Insurance The CITY shall procure
and furnish an CITY's and Contractor's Protective Liability Insurance Policy with the
following minimum limits:
(a) Bodily Injury Liability& $1,000,000 each ($2,000,000 aggregate)
Property Damage Liability Occurrence
Combined Single Limit
5. "XCU" (Explosion, Collapse, Underground Damage) The Contractor's
Liability Policy shall provide "XCU" coverage for those classifications in which they are
excluded.
6. Broad Form Property Damage Coverage, Products & Completed Operations
Coverages. The Contractor's Liability Policy shall include Broad Form Property Damage
Coverage, Products and Completed Operations Coverage's.
7. Contractual Liability Work Contracts The Contractor's Liability Policy shall
include Contractual Liability Coverage designed to protect the Contractor for contractual
liabilities assumed by the Contractor in the performance of this Agreement.
8. Indemnification Rider
5
(a) To cover to the fullest extent permitted by law, the Contractor shall
indemnify and hold harmless the CITY and its agents and employees from and against all
claims, damages, losses and expenses, including but not limited to attorney's fees, arising
out of or resulting from the performance of the Work, provided that any such claim,
damage, loss or expense (1) is attributable to bodily injury, sickness, disease or death, or
to injury to or destruction of tangible property (other than the Work itself) , and (2) is
caused in whole or in part by any negligent act or omission of the Contractor, any
subcontractor, anyone directly or indirectly employed by any of them or anyone for
whose acts any of them may be liable, regardless of whether or not it is caused in part by
a party indemnified hereunder. Such obligation shall not be construed to negate, abridge,
or otherwise reduce any other right to obligation of indemnity which would otherwise
exist as to any party or person described in this Article.
(b) In any and all claims against the CITY or any of its agents or employees
by any employee of the Contractor, any subcontractor, anyone directly or indirectly
employed by any of them or anyone for whose acts any of them may be liable, the
indemnification obligations under this Paragraph shall not be limited in any way by any
limitation on the amount or type of damages, compensation or benefits payable by or for
the Contractor or any subcontractor under workers' or workmen's compensation acts,
disability benefit acts or other employee benefit acts.
(c) The Contractor hereby acknowledges receipt of ten dollars and other good
and valuable consideration from the CITY for the indemnification provided herein.
9. Safety — At all times while performing the services contemplated herein
Contractor agrees to comply with CITY'S published safety standards. A copy of these
standards is attached hereto and incorporated herein as Exhibit `B". CONSULTANT
shall have full responsibility and assume all liability for the safety and supervision of its
employees while performing services provided hereunder.
ARTICLE IX-NOTICES
All notices shall be in writing and sent by United States mail, certified or registered, with
return receipt requested and postage prepaid, or by nationally recognized overnight
courier service to the address of the party set forth below. Any such notice shall be
deemed given when received by the party to whom it is intended.
CONTRACTOR: Commercial Industrial Corp.
11810 NW 115th Ave.
Reddick, FL 32686
Attn. Matt Rudnianyn, President
CITY: City of Clermont
Attn: Darren Gray, City Manager
685 W. Montrose Street
Clermont, FL 34711
6
ARTICLE X—MISCELLANEOUS
1. Attorneys' Fees. In the event a suit or action is instituted to enforce or interpret
any provision of this agreement, the prevailing party shall be entitled to recover such sum
as the Court may adjudge reasonable as attorneys' fees at trial or on any appeal, in
addition to all other sums provided by law.
2. Waiver. The waiver by city of breach of any provision of this agreement shall not
be construed or operate as a waiver of any subsequent breach of such provision or of such
provision itself and shall in no way affect the enforcement of any other provisions of this
agreement.
3. Severability. If any provision of this agreement or the application thereof to any
person or circumstance is to any extent invalid or unenforceable, such provision, or part
thereof, shall be deleted or modified in such a manner as to make the agreement valid and
enforceable under applicable law, the remainder of this agreement and the application of
such a provision to other persons or circumstances shall be unaffected, and this
agreement shall be valid and enforceable to the fullest extent permitted by applicable law.
4. Amendment. Except for as otherwise provided herein, this agreement may not be
modified or amended except by an agreement in writing signed by both parties.
5. Entire Agreement. This agreement including the documents incorporated by
reference contains the entire understanding of the parties hereto and supersedes all prior
and contemporaneous agreements between the parties with respect to the performance of
services by contractor.
6. Assignment. This agreement is personal to the parties hereto and may not be
assigned by contractor, in whole or in part,without the prior written consent of city.
7. Venue. The parties agree that the sole and exclusive venue for any cause of
action arising out of this agreement shall be Lake County, Florida.
8. Applicable Law. This agreement and any amendments hereto are executed and
delivered in the State of Florida and shall be governed, interpreted, construed and
enforced in accordance with the laws of the State of Florida.
9. Records. Contractor expressly understands and acknowledges that any and all
documents related to the services provided herein, may be considered records that are
subject to examination and production in accordance with Florida's Public Records Law.
Contractor expressly agrees that it will comply with all requirements related to said law
and that it will hold city harmless for any such disclosure related to Florida's Public
Records Law.
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ARTICLE XI - CONTRACT DOCUMENTS
The Contract Documents, as listed below are herein made fully a part of this Contract as
if herein repeated.
Document Precedence:
1. Contract Agreement
2. Technical Plan and Specifications
3. All documents contained in Lake County Bid No. 13-0027 and CONTRACTOR's
response thereto, including any all addenda or amendments thereto.
4. Payment and Performance Bonds
IN WITNESS WHEREOF, the parties hereto have executed this Agreement on
this 4 day of St i\ , 2013.
City of Clermont
arold S. Turville, Jr., Mayor
t I Attest:
Tracy Ackro d, ity Clerk
„.•Commercial Industria.Corp.
By:
Matt Rudnianyn, President
i
..............
r Q co>Cor etalte Secretary
ms 's ' �� � �'
' ' 'i ( cinlanj n I
w (
f'y+$ � nJame Printed or Typed)
8
EXHIBIT"A"
South Lake Trail Phase IIIA, Alternate B
Per construction plans and specifications public bid prepared and issued by Lake County
Bid No.: 13-0027 in accordance with an Interlocal Agreement between CITY and Lake
County related to construction improvements for the South Lake Trail.
9
Commercial Industrial Corp.
Alternate B: Trail and Roundabout UNIT QUANTITY UNIT PRICE AMOUNT
Construction
Pavement Milling 1 1/2" Deep SY 324.00 $ 3.47 $ 1,124.28
Pavers LF 2,825.00 $ 17.34 $ 48,985.50
Concrete, 6"Thk, 4,000 PSI, with fiber LF 276.00 $ 34.76 $ 9,593.76
mesh
Curb & Gutter, Type D LF 1,485.00 $ 9.82 $ 14,582.70
Curb & Gutter, Modified Type RA TN 263.00 $ 13.87 $ 3,647.81
Curb & Gutter, Modified Type F SY 776.00 $ 13.87 $ 10,763.12
Superpave Asphalt Concrete SY 371.00 $ 115.57 $ 42,876 47
Limerock, 10" SY 1,538.00 $ 13.40 $ 20,609.20
Limerock, 12" SY 255.00 $ 17.41 $ 4,439.55
Stabilized Subgrade, 12"Thk LF 1,238.00 $ 5.89 $ 7,291.82
Stabilized Shoulder, 6"Thk SY 246.00 $ 5.79 $ 1,424.34
6" PVC SF 302.00 $ 9.53 $ 2,878.06
Sod (Perimeter of EA 3,199.00 $ 2.28 $ 7,293.72
Roundabout/Landscaped Islands)
Truncated Dome Pavers EA 114.00 $ 86.68 $ 9,881.52
30"x 30" Roundabout Circulation (R6- EA 2.00 $ 231.14 $ 462.28
5P) Plaque
36" x 36"x 36" Construction Yield (R1- EA 5.00 $ 346.72 $ 1,733.60
2) Sign
48" x 24" Roundabout Directional (6- EA 3.00 $ 173 36 $ 520.08
4A) Sign
Existing Road Demolition (County LF 646.00 $ 5.05 $ 3,262.30
Road 561)
18" MES, Concrete, Round EA 1.00 $ 951.77 $ 951.77
Pipe Culvert, RCP, 18" LS 41.00 $ 40.00 $ 1,640.00
Inlet, Ditch Bottom, Type C EA 1.00 $ 1,940.25 $ 1,940.25
Pavement Markings, Yellow/White/Std EA 1.00 $ 5,778.62 $ 5,778.62
' Site Lighting Fixture and Pole, Type 9.00 $ 1,620.00 $ 14,580.00
EA SLA
Landscape Uplights, Type SLB LF 3.00 $ 907.00 $ 2,721 00
Electrical Pull Box EA 12.00 $ 115.00 $ 1,380 00
1" Conduits Below Grade with Branch EA 1,200.00 $ 8.09 $ 9,708.00
Circuit Wiring for LTG
Temporary Electrical Serivce with EA 1.00 $ 1,618.01 $ 1,618.01
Meter and Panel
Lighting Control Contactor EA 1.00 $ 6,356.00 $ 6,356.00
Relocation Tree EA 1.00 $ 11,557.00 $ 11,557.00
Drainage Flumes EA
MOT EA
Road Closed 30"x 48" EA
No Right Turn 24"x 24" EA
1 1/2" Milling SY
Total Lump Sum Bid Alternate B $ 249,600.76
Mathematical errors - Contractor has
$247,919 as total lump sum Bid Alternte B
I I
TABULATION OF ESTIMATED QUANTITIES
South Lake Trail Phase IIIA
Project No. 2013-03, Bid No. 13-0027
ITEM NO. PAY ITEM DESCRIPTION UNIT QUANTITY UNIT PRICE AMOUNT
I
Alternate B-Trail and Roundabout Construction.Ste 773+17 to Ste 786+76(Trail Alternate A and B Start to Trail Alternate A and B End)
1
1 PAVEMENT MILLING 1-1/2"DEEP SY 3)1 3 7 ( 1 )23, Y-4
2 PAVERS SF 24:1275 17 3 Li y/( ? 8y
3
CONCH RETE,6"THK,4,000 PSI,WITH FIBER SY n ��' 7� ����r I
4 CURB&GUTTER,TYPED LF 1 �O5 /t a i / S°O 11
r
5 CURB&GUTTER,MODIFIED TYPE RA LF 94,3 1 7 , DU 2 ;02 1/2
6 CURB&GUTTER,MODIFIED TYPE F LF 7 76 1 j r O 7 )4 76,2, /1
7 SUPERPAVE ASPHALT CONCRETE TN 371 i/ ,S? LI2 g7?, 5 C�
8 LIMEROCK,10" SY / C3C1 ) c 1/O 2, at 9-
9 LIMEROCK,12" SY 245 /7n 71 L/DP. 67
10 STABILIZED SUBGRADE,12"THK SY l2-38 S c O 0. 72_g", /9 ,
11 STABILIZED SHOULDER,6"THK SY )-.V6j 2�+ /1 73 j�/c ! / j.h
12 6"PVC LF 30 ` ft. 5.3 �p 77��
13 SOD(PERIMETER OF ROUNDABOUT/ SY „ M ��7 C.�n Q�
LANDSCAPED ISLANDS) 3/i? At ,z, 7
14 TRUNCATED DOME PAVERS
SF 1/ / �O r/) J J
/. .
30"x30"ROUNDABOUT CIRCULATION(R6-SP)
15 PLAQUE EA h nn
9-3l„y ya �
16 36"x36"x36"CONSTRUCTION YIELD(R1-2)
SIGN EA 5 /J/, 22- 733'52
/7(O
17 48"x24"ROUNDABOUT DIRECTIONAL(6-4A) 27^ ��`
SIGN EA .? �� "U
18 561)
EXISTING ROAD DEMOLITION(COUNTY ROAD SY 6VC ro3 1 n t
19 18"MES,CONCRETE,ROUND EA 'p, 1)7 S ^r')I `�
20 PIPE CULVERT,RCP,18" LF y 1 j�/� I>at/e) 1
21 INLET,DITCH BOTTOM,TYPE C EA 1 / 'O t��` /NO r.3 L.
22 PAVEMENT MARKINGS,YELLOW/WHITE,STD LS r S?7s,4_ O /2
ADDENDUM #4 W-8 05-03-2013
TABULATION OF ESTIMATED QUANTITIES
South Lake Trail Phase IIIA
Project No. 2013-03, Bid No. 13-0027
23 SITE LIGHTING FIXTURE AND POLE,TYPE SLA EA 7 /I)^O— 1 ( 5' '
24 LANDSCAPE UPLIGHTS,TYPE SLB EA 9C1?- --. 2-7/9--()
25 ELECTRICAL PULL BOX EA //,2_, 1 / s — j y Q 2 —
1"CONDUITS BELOW GRADE WITH BRANCH / I c�
28 CIRCUIT WIRING FOR LTG LF 70 O.D? ?7O e 0?
TEMPORARY ELECTRICAL SERVICE WITH
27 EA f
METER AND PANEL
1 /6/A10/ )�1 gr 0/
28 LIGHTING CONTROL CONTACTOR EA 1 6366 L3sr. '---
29 RELOCATION TREE EA I 1j,S7 ) 11 X5? —
(8)Alternate B Total Lump Sum: 1/'7 ( f9�•
/ T! 1
(A) Acceptance of Alternate A Trail Construction will include deletion of Original Trail Bid Work
Quantities from Sta 773+17 to Sta 785+35.
(B) Acceptance of Alternate B Trail and Roundabout Construction will include deletion of Original
Trail Bid Work Quantities from Sta 773+17 to Sta 785+35.
Work performed under this contract shall be based on a total lump sum base bid. Quantities shown
in this bid form and the construction plan are estimated for bidding purposes only and shall be ' 1
verified by the contractor. i
1
ADDENDUM #4 W-9 05-03-2013 1
i
TABULATION OF ESTIMATED QUANTITIES
South Lake Trail Phase IIIA
Project No. 2013-03, Bid No. 13-0027
The undersigned further agrees to execute the Contract within ten (10) calendar days after receipt of notice of
award, and within the time frame of Division X.
The undersigned further agrees to bear the full cost of maintaining all work until the final acceptance.
The undersigned further declares that his Bid is based on specifications as modified by the following Addenda:
Addendum No. I Dated 1. 1/ 3 Addendum No. y Dated 5/63/5
Addendum No. Dated Addendum No. Dated
Addendum No. Dated 471 Addendum No. Dated
The undersigned Contractpr's addre and principace of business is
v
11610 /\14 t IS Ij1, ii (& s2IoU69
If Contractor is a corporation list the names, titles, and business addresses of its President, Secretary and
Treasurer: nn� .. �++
1. PRESIDENT �AD?"k1VA(;11UC vit Address <«`{uNWI (S-4'
(Name) (1 eeld I plc, t=L 31L
2. SECRETARY Matt 1aft e(mtiA,Y:-/ter. Address I NV /%JW l (
(Name) U ,f2i e(d t tk, i=L- 32.ceg-
nn
3. TREASURER �CYI+ PIA n ct" 'Ys Address 11 lv.N� t
(Name) (J c(A u-k, i C 3 66
Reciprocal Vendor Preference
Vendors are advised the County has established, under Lake County Code, Chapter 2, Article VII, Sections 2-
221 and 2-222-(see below); a process under which a local vendor preference program applied by another
county may be applied in a reciprocal manner within Lake County. The following information is needed to
support application of the Code:
I2..CcAUkTJ
1. Primary business location of the responding vendor(city/state):
2. Does the responding vendor maintain a significant physical cation in Lake County at which employees are
located and business is regularly transacted: QYes KNo If "yes" is checked, provide supporting
detail:
ADDENDUM #4 W-10 05-03-2013
TABULATION OF ESTIMATED QUANTITIES
South Lake Trail Phase IIIA
Project No. 2013-03, Bid No. 13-0027
Said corporation is qualified to do business in the State of Florida.
COMMUC A OA " VrIkkAc-kivo_Lt
Corporate Name
By:
I _ .Aarti n , President
(Print ame)
***CORPORATE SEAL***
or Qualifying Agent
Contractor's Registration or Certification No.
If Contractor is not a corporation, list the name(s) and business address(es) of its owner(s),joint venturers or
partners:
1. Address
(Name)
2. Address
(Name)
3. Address
(Name)
The said compa or business entity is a sole proprietorship, partnership, or joint venture and is trading and
doing business as (Company Name).
By:
Na e of Firm or Qualifying Agent
Contractor's R- istration or Certification No.
ADDENDUM #4 W-I I 05-03-2013
TABULATION OF ESTIMATED QUANTITIES
South Lake Trail Phase IIIA I
Project No. 2013-03, Bid No. 13-0027
FLORIDA TRENCH SAFETY ACT CERTIFICATION AND DISCLOSURE STATEMENT
The undersigned acknowledges the requirements of the Florida Trench Safety Act (Section 553.60 et. seq.
Florida Statutes).
1
i
A. The Bidder further acknowledges that the Florida Trench Safety Act, (the Act) establishes the Federal
excavation safety standards set forth at 29 C.F.R. Section 1926.650 Subpart P, as the interim state standard
until such time as the State of Florida, through its Department of Labor and Employment Security, or any
successor agency, adopts, updates or revises said interim standard. This State of Florida standard may be
supplemented by special shoring requirements established by the State of Florida or any of its political 1
subdivisions.
1
B. The Bidder, as Contractor, shall comply with all applicable excavation/trench safety standards.
C. The Contractor shall consider the geotechnical data available from the County, if any, the Contractor's own
sources, and all other relevant information in its design of the trench safety system to be employed on the
subject Project. The Contractor acknowledges sole responsibilities for the selection of the data on which it
relies in designing the safety system, as well as for the system itself.
D. The amounts that the Bidder has set forth for pipe installation includes the following excavation/trench
safety measures and the linear feet of trench excavated under each safety measure. These units, costs, and
unit values shall be disclosed solely for the purpose of compliance with procedural requirements of the Act. No
adjustment to the Contract time or price shall be made for any difference in the actual number of linear feet of
trench excavation, except as may be otherwise provided in these Contract Documents.
Trench Safety Units of Unit Unit Cost Extended Cost
Measure Measure (Quantity)
(Description) (LF, SF)
A.' enc1- LA( LS l i►60 A. rird
B.
C.
D.
E.
F.
For Information Only, Not for Payment Purposes $ 1 t 00
Bidder may use additional sheets as necessary to extend this form.
ADDENDUM #4 W-12 05-03-2013
TABULATION OF ESTIMATED QUANTITIES
South Lake Trail Phase IIIA
Project No. 2013-03, Bid•No. 13-0027
Failure to complete the above may result in the bid being declared non-responsive.
E. The amount disclosed as the cost of compliance with the applicable trench safety requirements does not
constitute the extent of the Contractor's obligation to comply with said standards. The Contractor shall extend
additional sums at no additional cost to the County, if necessary, to comply with the Act (except as may
otherwise be provided).
.F. Acceptance of the bid to which this certification and disclosure applies in no way represents that the
County or its representative has evaluated and thereby determined that the above costs are adequate to
comply with the applicable trench safety requirements nor does it in any way relieve the Contractor of its sole
responsibility to comply with the applicable trench safety requirements.
C Or"1 (Yl�j( ire! .�L.�vl tASITIct ( c)Y 2 .
Company
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1 Name and Title
Address:
I k (r) N u■J 15 r61 Ve
O CAL 1—L 51L'f&
Telephone: 352 ) S L.(U —
ADDENDUM #4 W-13 05-03-2013
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COMMIND-02 MATERAT
A�OREY CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
6/28/2013
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 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 CONTACT
NAME
Insurance Office of America PHONE 800 243-6899 FAX (407)788-7933
P.O.BOX 162207 (A/C,No,Ext)( ) (A/C,No)
Altamonte Springs,FL 32716-2207 AD RIESS
INSURER(S)AFFORDING COVERAGE NAIC#
INSURER A Hartford Fire Insurance Company 19682
INSURED INSURER B Hartford Insurance Co of the Midwest 37478
Commercial Industrial Corp INSURER C Hartford Casualty Insurance Company 29424
11810 N.W.115th Avenue INSURER D Sentinel Insurance Company,Ltd. 11000
Reddick,FL 32686-4217 INSURER E Charter Oak Fire Insurance Company 25615
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
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 TYPE OF INSURANCE ADDL WVD POLICY NUMBER /YPOLICY EFF POLICY EXP LIMITS
(MM/DD/YYVY) (MM/DDYYY)
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
A X COMMERCIAL GENERAL LIABILITY FL-21UENQT2702 2/13/2013 2/13/2014 DAMAGES(RENTED 300,000
PREMISES(Ea occurrence) $
CLAIMS-MADE X OCCUR MED EXP(Any one person) $ 10,000
PERSONAL 8ADVINJURY $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 2,000,000
7 POLICY X IMF LOC 8
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
(Eaacudent) $ 1,000,000
B X ANY AUTO FL-21 UENQT2703 2/13/2013 2/13/2014 BODILY INJURY(Per person) $
ALL OWNED SCHEDULED BODILY INJURY(Per $
AUTOS AUTOS ( )
HIRED AUTOS NON-OWNED PROPERTY DAMAGE $
AUTOS APER ACCIDENT)
PIP $ 10,000
X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000
C EXCESS LIAB CLAIMS-MADE 21 RHUQT2704 2/13/2013 2/13/2014 AGGREGATE $ 5,000,000
DED X RETENTION$ 10,000 $
WORKERS COMPENSATION WC STATU- OTH-
AND EMPLOYERS'LIABILITY TORY LIMITS ER
D ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N FL-21 WBQT2701 2/13/2013 2/13/2014 E L EACH ACCIDENT $ 1,000,000
OFFICER/MEMBER EXCLUDED? N/A •
(Mandatory In NH) E L DISEASE-EA EMPLOYEE $ 1,000,000
If yes descnbe under
DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $ 1,000,000
E Equipment Floater QT6602B829401 2/13/2013 2/13/2014 Leased/Rented Equipt 400,000
E Installation/Build QT6602B829401 2/13/2013 2/13/2014 Installation Floater 75,000
DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space Is required)
City of Clermont is additional insured as respects to general liability as required under written contract
CERTIFICATE HOLDER CANCELLATION
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
City of Clermont --�
685 W.Montrose Street, � ��
(Clermont,FL 34711-0219
©1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD
POLICY NUMBER. 21 UEN QT2702
41
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - OPTION I
This endorsement modifies insurance provided under the following
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s) Designated Project(s) Or Location(s)
Or Organization(s): Of Covered Operations•
ALL 'ALL
Information required to complete this Schedule, if not shown above,will be shown in the Declarations
A. Subparagraph f., Any Other Party, under the 3. In connection with "your work" for the
Additional Insureds When Required By Written additional insured at the project(s) or
Contract, Written Agreement Or Permit location(s) designated in the Schedule and
Paragraph of Section II — Who Is An Insured is included within the "products-completed
replaced for any other person or organization not operations hazard", but only if
described under subparagraphs a. through e., but a. The written contract or agreement
- only with respect to the additional insured requires you to provide such coverage to
person(s) or organization(s) shown in the such additional insured at the project(s)or
Schedule above when you have agreed in a location(s) designated in the Schedule,
written contract or written agreement to provide and
insurance such as is afforded under this policy for
such person(s)or organization(s) b. This Coverage Part provides coverage for
"bodily injury" or "property damage"
This coverage is provided only with respect to included within the "products coin p
leted liabilit y for "bodily in j ur y", "property damage" or
operations hazard"
"personal and advertising injury" caused, in whole
or in part by your acts or omissions or the acts or B. The insurance afforded to the additional insured
omissions of those acting on your behalf shown in the Schedule applies only if the "bodily
injury" or "property damage" occurs, or the
1. In the performance of your ongoing operations "personal and advertising injury" offense is
for such additional insured at the project(s) or committed-
location(s)designated in the Schedule,
2 In connection with your premises owned by or 1 Dunng the policy penod, and
rented to you and shown in the Schedule; or 2. Subsequent to the execution of such written
contract or written agreement, and
Form HS 24 80 01 12 Page 1 of 2
© 2012, The Hartford
(Includes copyrighted material of Insurance Services Office, Inc , with its permission )
3. Prior to the expiration of the period of time that 1. The preparing, approving, or failing to prepare
the written contract or written agreement or approve maps, shop drawings, opinions,
requires such insurance be provided to the reports, surveys, field orders, change orders,
additional insured designs or specifications,or
C. With respect to the insurance afforded to the 2. Supervisory, inspection architectural or
person(s) or organizations(s) who are additional engineering activities
insureds under this endorsement, the following All other terms and conditions in the policy remain
additional exclusion applies unchanged
This insurance does not apply to "bodily injury",
"property damage" or "personal and advertising
injury" arising out of the rendering of, or the failure
to render, any professional architectural,
engineering or surveying services, including
Page 2 of 2 Form HS 24 80 01 12
FRONT PAGE OF PUBLIC PAYMENT & PERFORMANCE BOND
In compliance with F.S. Chapter 255.05(1)(a)
Bond No.: 016050115
Contractor Name: Commercial Industrial Corporation
Contractor Address: 11810 NW 115th Ave
Reddick, FL 32686
Contractor Phone No: 352-840-0161
Surety Company Name: Liberty Mutual Insurance Company
Surety Company Address: 175 Berkley Street
Boston, MA 02116
Surety Company Phone No: 617-357-9500
Agent Name: Waldorff Insurance & Bonding. Inc.
Agent Address: 5023 N.W 8th Ave, Suite B
Gainesville, FL 32605
Agent Phone No: 352-374-7779
County,Obligee Name: Lake Coun Florida
�1'
Obligee Address: PO Box 7800
Tavares, FL 32778
Obligee Phone No: 352-483-9000
Bond Amount: $3,122,735 13
Contract No: (if applicable)Project No. 2013-03
Description of Work: South Lake Trail, Phase 3A
Project Address:
Lake County, FL
FRONT PAGE
All other bond page(s)are deemed subsequent to this page regardless of any page number(s)that may be pre-pnnted thereon
•
DIVISION Y
BONDS
BOND NO. 016050115
PER FORE\LANCE B0ND
KNOW ALL MEN BY THESE PRESENTS: that We.
Contractor Commercial Industrial Corporation
Contractor Addiess 11810 NW 115th Aveenue
Contractor Address 2 Reddick, FL 32686
Contractor Telephone 352-840-0161
(heteinaltet called the -Principal.), whose principal business address and telephone number is as
stated above: and
Surety Liberty Mutual Insurance Company
Surety Address 175 Berkley Street
Surety Address 2 Boston, MA 02116
Surety Phone 617-357-9500
(hereinafter called the “Suietv''). whose principal addicss and telephone number is as stated
above. a surer; insurer chartered and existing under the law s of the State of
Massachusetts and authorized to do business in the State of Florida;
are held and firmly bound unto Lake County Boaid of County Conmtissioneis, Lake County.
Florida (hereinafter called the -Obligee"), whose pnncipal address is P.0 Box 7800, Tavares,
Florida 32778. and whose principal telephone number is(352)483-9000, in the sum of
Three Million,One Hundred Twenty-Two Thousand.Seven Hundred Thirty-Five Dollars and 13/100
($ 3,122 735 13 )
foi payment of which we bind ourselves, our heirs, our legal representatives, our successors and
our assignees.jointly and severally.
WHEREAS, Principal has entered into a contract with Obligee for South Lake Trail Phase IHA,
Project No 2013-03, Bid No. 13-0027, FPN: 422570-2-58-01, FAN: 8886-257-A in accordance
■Aith drawings and specifications, which contract is incorporated herein by reference and made a
part hereof, and is referred to as the Contract.
THE CONDITION OF THIS BOND is that if Principal:
1. Performs the Contract at the times and in the mannet prescribed in the Contract:
2 Pays Obligee any and all losses. damages_ costs and attorneys' fees, including appellate
proceedings,that Obligee sustains because of any default by Principal under the Contract.
including. but not limited to. all delay damages, whether liquidated or actual. incurred by
Obligee,
Y-1
BOND NO. 016050115
3 Perfotrns the guarantee of all ttoik and materials furnished under the Contract for the
time specified in the Contract. and
Promptly make all payments to all persons defined in Section 713.0]. flo►ula Statutes,
hose claims dense duectl) or indirectly from the prosecution of the \yolk p►ovided Ibr
in the Contract;
then this bond shall be void. othc► ise it remains in full force and effect.
Any changes in or under the Contract and compliance or noncompliance with any formalities
connected with the Contract or the changes do not affect Sin ely's obligation under this bond
The Surety. for value recen ed. hercb) stipulates and agrees that no changes. extensions of time,
alterations or additions to the terms of the Contract or other work to he performed hereunder, or
the specifications referred to therein shall in any way affect its obligation under this bond, and it
does hereby wait e notice of any such changes, extensions of time. alterations or additions to the
terms of the Contract or to work or to the specifications
This instrument shall be constu ued in all ►espects as a statutory bond. It is expressly understood
the time provisions and statute of limitation under Section 255.05. Florida Statutes, shall apply to
this bond.
By execution of this bond, the Surety acknottledges that it has read the Surety qualifications and
obligations imposed by the construction contract and hereby satisfies those conditions
IN WITNESS WHEREOF. the above bounded parties have executed this instrument
this loth day of_July . 2013 the name of each party
being. affixed and these presents duly slimed by its undeisigned representative. pursuant to
authority of its gosenting body.
Signed. sealed and delivered
in the presence of: PRINCIPAL-
Commercial Industiral Corporation
1 Company Name)
By:
' -ss to Principal ( ut 'zed Signature)
• PIP, • and
(Milted t a►
-ttn- s as to Principal \\ceesker
(Title)
11810 NW 115th Ave
Reddick. Fl 32686
(Business Address)
Y-2
BOND NO. 016050115
STATE OF Florida
COUNTY OF`TYVk y;p
The foigoim instrument was acknowledged before me
this WO- o2, by INalnlCtrn-f e(c}
of �o r t`,t a.Q., ` inCietr fi O.1
As-c-p . . a Corporation. on behalf
of the Corporation. He,`She is personally known to me or has produced
_as idcntifii i n and who did/did not take an oath.
1.thc KAREN R pox NOTARY: f
I'c Pi int Name:
MY COMMISSION.'EE 015112 mot)5L
EXPIRES Septenbei 17,2014 is Commission Number: �E l k
P Bonded Thm rift),Dubuc Undrron per_
i"
My Commission Expires. Q 17-o I`r
B}
Witness as to Surety (Authorized Signature)
Witness as to Surely (Printed Name)
(Title)
(Business Address)
Libe Mutual Insurance Company
OR
Witness as Attorney In Fact As Attorney In Fact An. r Po of Attorney)
(;,; r Pig`� Rebekah Wolf.Attorney-In-Fact&Fla Resident Agent
Witness as Attorney In Fact (Printed Name)
5023 N W 8th Ave Suite B
Gainesville FL 32605
(Business Address)
352-374-7779
(Telephone Number)
Y-3
•
BOND NO. 01605u 115
STATE OF Florida
COUNTY OF Alachua
The forgoing instrument \:as acknowledced before Mr
this 10th day of In
July,2013 by Rebekah Wolf.Attorney- -Fact
of Liberty Mutual Insurance Company
a Massachusetts Corporation. on behalf
of the Corporation. Hei She is personally known to me or has produced
Personally Known as identification and who did/did not take an oath.
NOTARY 47,� (--(
Print Name: /A //� /.mow,. s
1 HOLLY L ADAMS Commission Number( f 8 S' 3_5/ Z
NOTARY COMMISSION it EE853512 My Commission Expires- ///e �/4.
STATE OF EXPIRES NOV 25 2016
FLORIDA BONDED THROUGH
'0I,V. RU INSURANCE COMPANY
Y-4
BOND NO 016050115
PAYMENT BOND
KNOW ALL MEN BY THESE PRESENTS: that 1\'e_
Conti actor Commercial Industrial Corporation
Contractor Addiess 11810 NW 115th Aveenue
Contractor Address 2 Reddrek, FL 32686
Contractor Telephone 352-840-0161
(hereinafter called the"Principal"), hose principal business address and telephone number is as stated
above: and
Suretl Liberty Mutual Insurance Company
Surely Addiess 175 Berkley Street
Surety Address 2 Boston, MA 02116
Surety Phone 617,357-9500
(hereinafter called the "Surety-). whose principal addiess and telephone number is as stated above. a
surety insurer chartered and existing under the laws of the State of Massachusetts and authorized to
do business in the State of Florida;
aie held and firmly bound unto Lake County Board of County Commissioners. Lake County. Florida
(hereinafter called the'Obligee"),whose principal address is P.O Box 7800,Ta\ares, Flonda 32778,and
whose principal telephone number is(352)483-9000. in the sum of
Three Million,One Hundred Twenty-Two Thousand,Seven Hundred Thirty-Five Dollars and 13/100
(S 3,122 735 13 )
for pay merit of which «e bind ourselves, our heirs, our legal representatives, our successors and our
assignees..Jointly and sel,era 1ly
WHEREAS, Principal and Obligee hake reached a mutual agreement (hereinafter referred to as the
"Contract")for South Lake Trail Phase IIIA, Project No. 2013-03, Bid No. 13-0027, FPN: 422570-
2-58-01, FAN: 8886-257-A said Contract being made a part of this Bond by this reference.
THE CONDITION OF THIS BOND is that if Principal
1. Shall promptly make payments to all claunants as defined in section 255.05(1), Florida Statutes,
supplying the Principal Nt ith labor,materials or supplies, as used directly or indirectly by the Principal in
the prosecution of the Nk ark pros ided for in the Contract: and
2. Shall pay the Obligec for all losses,damages. expenses,costs and attorneys' fees,including those
resulting from appellate proceedings, that the Obligee sustains because of a default by the Principal in
contravention to the Conti act in regard to pa}ment for such labor. materials,or supplies furnished to the
Principal,
then this bond shall be void,other wise this Bond remains in full force and effect
v-5
BOND NO. 016050115
BE IT FURTHER KNOWN:
1. Any changes in or under the Conti act and compliance of noncompliance with an formalities
connected with the said Contract or alterations which may be made in the terms of the said Contract,or in
the work to be done under it,or the giving h) the Obligee of any extension of time for the perfoimar►ce of
the said Contract. or any other forbear,'nLe on the part of the Obligee or Principal to the other. shall not in
any way release the Principal and the Sureh. or either of them. their heirs. personal ►epresentatncs,
successors or assigns from liability hereunder, notice to the Surety of any such changes. alteration,.
extensions or forbearance being hereby waned.
2 Certain claimants seeking the protection of this Bond must timely comply with the strict
requirements set forth in Section 255 05. Florida Statutes,and as otherwise piovided by law.
3 The Pro\is►ons of this bond arc subjeLt to the limitations of Section 255 05(2). Florida Statutes
By execution of this bond, the Surety acknowledges that it has read the Surety qualifications and
obligations imposed by the construction contract and hereby satisfies those conditions.
THiS BOND DATED II-1E 10th DAY OF July 2013 (the date of issue
by the Surety or by the Surety's agent and the date of such agent's power-of-attorney)
Signed. sealed and dclkered in the presence of
PRINCIPAL.
Commercial Industrial Corporation
_ (Company Name)
itness as t ii ipal (Au r►zed Si,: anne)
0 Mr -
JOL ci
'line.s as to Principal P 'ned , e)
. �s�c .
(Title)
1m810 NW iicth Ave
-Redd4ckr.EL 32686 —
(Business Address)
STATE OF c\ f‘.6(3.,_
COUNTY ON- Y;p
TI e fotgoin, uisi ument vas acknoMedged before me this l O- cwt 1 �O\3_ by
. r a of
:. ►,k..t - �, . [ it .,G,a , a
Corporation, on behalf of the Corporation Hp, he is peiso►a -town to me or has produced
as identification and w+. . did n a - -n ,a, .
r,,... KARBJR.COX
NOTARY: it_: r '
_ , htVCQMMISSIONdEE015173 Print Name: - � P. t , OAK_
V.,........`,-. EXPIRES September17,2014 Commission Number. S t
,�9f ,. Bonded ThniNotary Pabe Underwriters
\,iy commission expires- a zo �}
Y-6
•
BOND NO. 016050115
By
Witness as to Surety (Authorized Signature)
Witness as to Surety (Printed Name)
(Title)
(Business Address)
OR
Liberty Mutual Insurance Company
L C r
/ ,
Witness as Attorney In Fact As Attorney En Fact(Attach Po vet of Attorney)
1''L. 0 y',,C i, l Rebekah Wolf Attonrey-In-Fact&Fla Resident Agent
Witness as Attorney In Fact (Printed Name)
co/3 N W 8th Pop., Sl oI*e B
Colne idle, rI 32C05
(Business Address)
352-374-7779
(Telephone Number)
STATE OF Florida
COUNTY OF Ala„h„a
The forgoing instrument was acknowledged before me
this 10th day of July, 2013 by Rebekah Wolf,Attorney-In-Fact
of Liberty Mutual Insurance Company -a
Massachusetts Corpoiation.on behalf of the Corporation. He/She is personally
known to me or has produced Personally Known as identification and who
did/did not take an oath.
NOTARY:c7 ;; c7
HOLLY I ADAMS Print Nam : /, //cam ✓WA. s
COMMISSION It EE853512 Commission Number: ff. 5 3 S/ 2
NOTARY My commission expires- 2 5'/i b
PUBIJC EXPIRES NOV 25 2016
STATE OF BONDED THROUGH
FLORIDA RU INSURANCE COMPANY
Y-7
THIS POWER OF ATTORNEY IS NOT VALID UNLESS IT IS PRINTED ON RED BACKGROUND.
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 stated
Certificate No 6111519
American Fire and Casualty Company Liberty Mutual Insurance Company
The Ohio Casualty Insurance Company West American Insurance Company
POWER OF ATTORNEY
KNOWN ALL PERSONS BY THESE PRESENTS.That American Fire&Casualty Company and The Ohio Casualty Insurance Company are corporations duly organized under the laws of
the State of New Hampshire,that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts,and West Amencan Insurance Company
is a corporation duly organized under the laws of the State of Indiana(herein collectively called the"Companies'),pursuant to and by authority herein set forth,does hereby name,constitute
and appoint, Benjamin H French.Paul A.Locascio.Rebekah Wolf
all of the city of Gainesville ,state of FL each individually if there be more than one named,its true and lawful attorney-in-fact to make,execute,seal,acknowledge
and deliver,for and on its behalf as surety and as Its act and deed,any and all undertakings,bonds,recognizances and other surety obligations,in pursuance of these presents and shall
be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons
IN WITNESS WHEREOF,this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed
thereto this 7th day of May , 2013
co
American Fire and Casualty Company
�„D CgS.y ,LSY 1 su,",! ` ,hSUr, .C`I'-`'„^u''ti.
F%�,= s, , ' �� ;x'.".15 w\ The Ohio Casualty Insurance Company to
1905 0 c/j)o r t l st 2 1-° ; T 99 i y Liberty Mutual Insurance Company =k = _ � ` West American Insurance Company -y
r x a By AO r�I
c STATE OF WASHINGTON ss Gregory Davenport,Assistant Secretary c
CCI
CO
a: COUNTY OF KING c
0
d On this 7th day of May , 2013 ,before me personally appeared Gregory W Davenport,who acknowledged himself to be the Assistant Secretary of Amencan v F—
ct y Are and Casualty Company,Liberty Mutual Insurance Company,The Ohio Casualty Company,and West American Insurance Company,and that he,as such,being authorized so to do, >,V)
6 3 execute the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authonzed officer m W
E
` >to
IN WITNESS WHEREOF,I have hereunto subscribed my name and affixed my notanal seal at Seattle,Washington,on the day and year first above written O O
y O.VI
C'`4k•4...c.,, )Vr_• 4
c 15
O i e 1 us!c KD Riley,Not Public d C
dO „OF,. _` 0E
.0. 0 IL fti
e This Power ofAttomey is made and executed pursuant to and by authority of the following By-laws and Authorizations of Amencan Fire and Casualty Company,The Ohlo Casualty Insurance to
of" Company,Liberty Mutual Insurance Company,and West American Insurance Company which resolutions are now in full force and effect reading as follows r o
CD` ARTICLE IV—OFFICERS—Section 12 Power of Attorney Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President,and subject O c
Cto such limitation as the Chairman or the President may prescribe,shall appoint such attorneys-fn-fact,as may be necessary to act in behalf of the Corporation to make,execute,seal, , .m
0 c acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety obligations Such attorneys-in-fact,subject to the limitations set forth in their respective '8
E of powers of attorney,shall have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation When so m ru
"-' executed,such instruments shall be as binding as if signed by the President and attested to by the Secretary Any power or authonty granted to any representative or attorney-In-fact under >.Q
O P.P• + the provisions of this article may be revoked at any time by the Board,the Chairman,the President or by the officer or officers granting such power or authority ,cr
�a c ARTICLE XIII—Execution of Contracts—SECTION 5 Surety Bonds and Undertakings Any officer of the Company authorized for that purpose In writing by the chairman or the president, c 0?
> ` and subject to such limitations as the chairman or the president may prescribe,shall appoint such attorneys-in-fact,as may be necessary to act in behalf of the Company to make,execute, C M
p 7 seal,acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety obligations Such attorneys-in-fact subject to the limitations set forth In their c o0
Z 0 respective powers of attorney,shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company When so O 0
executed such Instruments shall be as binding as if signed by the president and attested by the secretary - - C
CID
Certificate of Designation—The President of the Company,acting pursuant to the Bylaws of the Company,authorizes Gregory W.Davenport,Assistant Secretary to appoint such H
attorneys-In-fact as may be necessary to act on behalf of the Company to make,-execute,seal,acknowledge and deliver as surety any and all undertakings,bonds,recognizances and
other surety obligations .
Authorization—By unanimous consent of the Company's Board of Directors,the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the
Company,wherever appeanng upon a certified copy of any power of attorney issued by the Company in connection with surety bonds,shall be valid and binding upon the Company with
the same force and effect as though manually affixed -
I,David M Carey,the undersigned,Assistant Secretary,of Amencan Fire and Casualty Company,The Ohio Casualty Insurance Company,Liberty Mutual Insurance Company,and West
Amencan Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full,true and correct copy of the Power of Attorney executed by said Companies,
is in full force and effect and has not been revoked
IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this 1 f)t lay of Jill y ,20 1 1 -
Pha CA , cct INso ,11i5L{ aq,sNSUq,, dy
QV„,0-4,6`"9�� JP`roa;,A,r ',:::',,r-nt4'f 411 tiF��5,,0,14 ti ,,
1906 c e 1919 n' 1912 ° z 1991 K-t By
("< ° G ; \ 1 David M Care ;Assistant Secretary
e *. * t"
LMS 12873 092012 43 of 400