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2011-88
CONTRACTOR AGREEMENT THIS AGREEMENT, made and entered into thisc2U, day of /1)e_fx b.a.,j 2011, A.D., by and between the City of Clermont 685 West Montrose Street, Clermont, Florida (hereinafter referred to as "OWNER "), and TB LANDMARK CONSTRUCTION, INC. 1120 New Berlin Road, Jacksonville, FL 32226 (hereinafter referred to as "CONTRACTOR "). 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 described in the bid documents and specifications entitled: RFB NO. 12 -004 Directional Bore Drills of City's Service Areas as prepared by Owner and its agents and shall do everything required by this Contract and the Contract Documents as defined herein and all drawings, maps and specifications referred to therein, which are all made a part of this Contract. The work to be performed hereunder shall be separated by streets as set forth in RFB No. 12 -004. Each street project shall commence upon issuance of an authorized Notice to Proceed from OWNER. ARTICLE II - THE CONTRACT SUM The OWNER 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. 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 specified 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 OWNER 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 OWNER than against the CONTRACTOR and his Surety Any ambiguity or uncertainty in the Plans, Drawings or Specifications shall be interpreted and construed by the OWNERS Public Services 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 OWNER 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 OWNER of stnct compliance with the terms of this Contract and/or the Drawings and Specifications covering said work; and the OWNER 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 OWNER, 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 to the OWNER for all damages, loss and expense caused to the OWNER 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 OWNER must be submitted to the OWNER 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 OWNER 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 OWNER, and shall be considered not as a penalty, but in liquidation of damages sustained. Contractor shall pay the liquidated damages amount contained herein to Owner within fifteen (15) days of receipt of OWNER'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 Contract Documents, and subject to additions and deductions as provided, CONTRACTOR shall submit a request for payment for services performed as authorized by an issued Notice to Proceed within thirty (30) days of completion of the work performed in the applicable Notice to Proceed. Upon OWNER's acceptance of the work performed, OWNER shall make payment to the CONTRACTOR, within thirty (30) calendar days of the duly certified and approved payment invoice. As a condition precedent to payment hereunder, CONTRACTOR shall submit evidence satisfactory to the OWNER 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 that all guarantees that may be required in the Specifications have been furnished and are found acceptable to OWNER 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 OWNER 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 OWNER to do so, furnish additional bonds, in such form and amounts, and with such Sureties as shall be satisfactory to the OWNER. 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 OWNER. 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 Owner 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 m 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 Owner, for the protection of employees not otherwise protected. 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 Coverages, Bodily Injury Occurrence, & Property Damage Combined Single Limit (b) Automobile Liability Coverages, $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. Owner's and Contractor's Protective Liability Insurance - The Owner shall procure and furnish an Owner'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 Coverages. 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 (a) To cover to the fullest extent permitted by law, the Contractor shall indemnify and hold harmless the Owner 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, abndge, 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 Owner 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 Owner for the indemnification provided herein. 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: TB Landmark Construction, Inc. 1120 New Berlin Road Jacksonville, FL 32262 Attn. Robert Thigpen, President OWNER: City of Clermont Attn: Wayne Saunders, City Manager 685 W. Montrose Street Clermont, FL 34711 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. 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. Engineer's Drawings and Specifications 3 Notice to Proceed 4. All documents contained in RFP No.: 12 -004 — Directional Bore Drills of City's Service Areas and CONTRACTOR's November 2, 2011 response thereto, including any all addenda or amendments thereto. 5. Instructions to Bidders 6. Payment and Performance Bonds IN WITNESS WHEREOF, the parties hereto have executed this Agreement on this kday of Not) er n be ( • 2011. City of C - •.. s it . S. Turville, Jr., Mayor Attest: Tracy Ac Td, City Clerk TB Landmark Construction, Inc. By: i �' i .Thigpen, Presi ent Attest: Corporate Secretary Roby. - Eh (ter (Name Printed or Typ) EXHIBIT A SECTION — C PRICE SCHEDULE ; 2:4. Description City / Unit Unit ice 12"' Street (Lake Minneola Shores) — 4 Borings 1 / Job 24,904.00 2 West Avenue and West Mineola Avenue —1 Boring 1 / Job 7,238.00 3 8 Street and West Minneola Avenue — 2 Borings 1 / Job 17 648.00 4 7 Street and West Minneola Avenue —1 Boring 1 / Job 3 653.00 5 Johns Lake Road and Eagle Lake Drive —1 Boring 1 1 Job 7 050.00 Final Completion Lump Sum Price 60, 393.00 Contractor's Days to Final Completion: 30 Working Days. Not to exceed: Sixty (60) Working Days from Notice To Proceed. By signing below, the respondent agrees to all terms, conditions, and apacifications as stated in this solicitation, and Is ailing in an authorized capacity to execute this response. The respondent also certifies that it can and will provide and make available, at a minimum, the items set forth In this solldtatton. Respondent infarnlatiort and Signature Company Name (print): TB Landmark Construction, Inc. Street Address: 11/2n Nam Rrbrlin Rawl 7aolrwnnv4lla, Fr, 32226 Mailing Address (if different): 11220 Now Rprl i n Road Jacknonvi 1 i p. FL 32226 Telephone: 904- 751 -1016 Fax: 904-751-4125 Emafl: cgossellaitblandmark. cost Payment Terms: 96 days, net 30 FEIN: 59 - 36 7816 Professional. License No.: CGC060694, Ct7CO57226 Signature: Date: 11/02/2011 Print Name: Robin R. Thigpen Title: president Does the respondent accept payment using the City's MASTERCARD? ❑ Yes Ij No END OF SECTION — C RFB No: 12 -004 Page 11 of 38 ' Ac o ® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) `../-- 11/4/2011 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 Mary Burns, CIC CRM Kuykendall Gardner (A/C. Fol. (407) 894 -5431 1 A/C.NoI. (407)629 -6378 1560 Orange Ave Ste 750 ADDARESS. @kgbroker. com INSURER(S) AFFORDING COVERAGE NAIC 8 Winter Park FL 32789 INSURERA Zurich N America INSURED INSURER B North River Ins Co 21105 TB Landmark Construction, Inc. INSURER C Bridgefmeld Employers Ins Co 10701 11220 New Berlin Road INSURERD INSURER E Jacksonville FL 32226 INSURERF COVERAGES CERTIFICATE NUMBER 10 -11 Master w /incr limit 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 SUBR POLICY EFF POLICY EXP LIMITS LTR , SR WVD POLICY NUMBER (MMIDDIYYYY) (MM /DD/YYYY) GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE ( aENTED PREMISES (Ea occurrence) $ 300,000 A I CLAIMS -MADE X OCCUR Y Y GL0655826301 11/23/2010 11/23/2011 MED EXP (Any one person) $ 10,000 PERSONAL &ADVINJURY $ 1,000,000 GENERAL AGGREGATE _ $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP /OP AGG $ 2,000,000 X 7 POLICY I I .TR [1 LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 A X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BAP655826402 11/23/201011/23 /2011 BODILYINJURY(Peraccident) $ AUTOS AUTOS NON -OWNED PROPERTY DAMAGE X HIRED AUTOS x AUTOS (Per accident) $ PIP -Basic $ 10,000 - X UMBRELLA LIAB X OCCUR EACH OCCURRENCE _ $ 5,000,000 B EXCESS LIAB CLAIMS -MADE AGGREGATE $ 5,000,000 DED RETENTION$ 5520148893 11/23/201011/23 /2011 $ C WORKERS COMPENSATION X I WC I AM U- I I ER AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT $ 1,000 (Mandatory In NH) EXCLUDED © NIA 083046525 11/23/2010 11/23/2011 E L DISEASE - EA EMPLOYEE $ 1,000,000 If DESCRIPTION under IPTION OF OPERATIONS below E L DISEASE - POLICY LIMIT $ 1,000,000 DSIPTION DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) City of Clermont is reflected as additional insured as respects general liability, if required by written contract, for work performed by or on behalf of the named insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ' THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Clermont ACCORDANCE WITH THE POLICY PROVISIONS. 685 W. Montrose Street Clermont, FL 34711 AUTHORIZED REPRESENTATIVE /yam Andrew Sobo /MAB . ? ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. INS025 (2mnnsl m That Arnim name and Inns aro ranicthrari marlrc of Arnim 1\ • Form W -9 Request for Taxpayer Give Form to the (Rev January 2011) requester. Do not Department of the Treasury Identification Number and Certification send to the IRS. Internal Revenue Service Name (as shown on your income tax retum) TB Landmark Construction, Inc. Business name/disregarded entity name, if different from above rn a Check appropnate box for federal tax 0 classification (required) ❑ Individual/sole proprietor ❑ C Corporation A S Corporation ❑ Partnership ❑ Trust/estate a Pr g IJ Limited liability company Enter the tax classification (C =C corporation, S =S corporation, P =partnership) • S ❑ Exempt payee o & 2 [ c o. ❑ Other (see instructions) • v 6 Address (number, street, and apt or suite no) Requester's name and address (optional) 11220 New Berlin Road City, state, and ZIP code r S Jacksonville, FL 32226 List account number(s) here (optional) Part I Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box The TIN provided must match the name given on the "Name" line I Social security number to avoid backup withholding. For individuals, this is your social secunty number (SSN) However, for a 1 I resident alien, sole propnetor, or disregarded entity, see the Part I instructions on page 3. For other I I - I I entitles, it is your employer identification number (EIN) If you do not have a number, see How to get a TIN on page 3. Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose I Employer Identification number number to enter 5 9 -3 6I 0I7[9I1I6 Part II Certification Under penalties of perjury, I certify that 1 The number shown on this form is my correct taxpayer identification number (or I am wafting for a number to be issued to me), and 2 I am not subject to backup withholding because. (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and 3 I am a U S citizen or other U S person (defined below) Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax retum. For real estate transactions, item 2 does not apply For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contnbutions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions on page 4 Sign Signature of Here u s. person • Date ► (/IS/ I General Instructions Note. If a requester gives you a form other than Form W -9 to request your TIN, you must use the requester's form if it is substantially similar Section references are to the Internal Revenue Code unless otherwise noted to this Form W -9 Definition of a U.S. person. For federal tax purposes, you are Purpose of Form considered a U S person if you are A person who is required to file an information retum with the IRS must • An individual who is a U S citizen or U S resident alien, obtain your correct taxpayer identification number (TIN) to report, for • A partnership, corporation, company, or association created or example, income paid to you, real estate transactions, mortgage interest organized in the United States or under the laws of the Unrted States, you paid, acquisition or abandonment of secured property, cancellation of debt, or contnbutions you made to an IRA. • An estate (other than a foreign estate), or • A domestic trust (as defined in Regulations section 301 7701 -7). Use Form W -9 only if you are a U S person (including a resident alien), to provide your correct TIN to the person requesting it (the Special rules for partnerships. Partnerships that conduct a trade or requester) and, when applicable, to business in the United States are generally required to pay a withholding 1 Certify that the TIN you are giving is correct (or you are waiting for a tax on any foreign partners' share of income from such business. number to be issued), Further, in certain cases where a Form W -9 has not been received, a 2 Certify that you are not subject to backup withholding, partnership is required to presume that a partner is a foreign person, 9. or and pay the withholding tax Therefore, if you are a U S person that is a 3 Claim exemption from backup withholding if you are a U S. exempt Partner in a partnership conducting a trade or business in the United payee If applicable, you are also certifying that as a U S person, your States, provide Form W -9 to the partnership to establish your U S. allocable share of any partnership income from a U S trade or business status and avoid withholding on your share of partnership income. is not subject to the withholding tax on foreign partners' share of effectively connected income Cat No 10231X Form W -9 (Rev 1 -2011) Form W -9 (Rev 1 -2011) Page 2 The person who gives Form W -9 to the partnership for purposes of Certain payees and payments are exempt from backup withholding. establishing its U S status and avoiding withholding on its allocable See the instructions below and the separate Instructions for the ■ share of net income from the partnership conducting a trade or business Requester of Form W -9 in the United States is in the following cases. Also see Special rules for partnerships on page 1 • The U S owner of a disregarded entity and not the entity, Updating Your Information • The U S. grantor or other owner of a grantor trust and not the trust, and You must provide updated information to any person to whom you • The U S trust (other than a grantor trust) and not the beneficiaries of claimed to be an exempt payee if you are no longer an exempt payee the trust and anticipate receiving reportable payments in the future from this Foreign person. If you are a foreign person For example, you may need to provide updated information if 9 P Y g person, do not use Form W -9 you are a C corporation that elects to be an S corporation, or if you no Instead, use the appropnate Form W -8 (see Publication 515, longer are tax exempt In addition, you must furnish a new Form W -9 if Withholding of Tax on Nonresident Aliens and Foreign Entities). the name or TIN changes for the account, for example, rf the grantor of a Nonresident alien who becomes a resident alien. Generally, only a grantor trust dies nonresident alien individual may use the terms of a tax treaty to reduce Penalties or eliminate U S tax on certain types of income. However, most tax treaties contain a provision known as a "saving clause." Exceptions Failure to fumish TIN. If you fail to furnish your correct TIN to a specified in the saving clause may permit an exemption from tax to requester, you are subject to a penalty of $50 for each such failure continue for certain types of income even after the payee has otherwise unless your failure is due to reasonable cause and not to willful neglect. become a U S resident alien for tax purposes. Civil penalty for false information with respect to withholding. If you If you are a U S resident alien who is relying on an exception make a false statement with no reasonable basis that results in no contained in the saving clause of a tax treaty to claim an exemption backup withholding, you are subject to a $500 penalty. from U S tax on certain types of income, you must attach a statement to Form W -9 that specifies the following five items. Criminal penalty for falsifying information. Willfully falsifying certifications or affirmations may subject you to cnminal penalties 1 The treaty country Generally, this must be the same treaty under including fines and/or impnsonment which you claimed exemption from tax as a nonresident alien 2. The treaty article addressing the income Misuse of TINs. If the requester discloses or uses TINs in violation of federal law, the requester may be subject to civil and cnminal penalties 3 The article number (or location) in the tax treaty that contains the saving clause and its exceptions Specific Instructions 4 The type and amount of income that qualifies for the exemption Name from tax 5 Sufficient facts to justify the exemption from tax under the terms of If you are an individual, you must generally enter the name shown on the treaty article. your income tax retum However, if you have changed your last name, Example. Article 20 of the U S. China income tax treaty for instance, due to mamage without informing the Social Secunty eaty allows an Administration of the name change, enter your first name, the last name exemption Exa pl from tax for scholarship S.- income income received x by a Chinese student temporanly present in the United States. Under U S. law, this shown on your social security card, and your new last name. student will become a resident alien for tax purposes if his or her stay in If the account is in joint names, list first, and then circle, the name of the United States exceeds 5 calendar years However, paragraph 2 of the person or entity whose number you entered in Part I of the form. the first Protocol to the U S -China treaty (dated Apnl 30, 1984) allows Sole proprietor. Enter your individual name as shown on your income the provisions of Article 20 to continue to apply even after the Chinese tax retum on the "Name" line. You may enter your business, trade, or student becomes a resident alien of the United States A Chinese "doing business as (DBA)" name on the "Business name /disregarded student who qualifies for this exception (under paragraph 2 of the first entity name" line. protocol) and is relying on this exception to claim an exemption from tax Partnership, C Corporation, or S Corporation. Enter the entity's name on his or her scholarship or fellowship income would attach to Form on the "Name" line and any business, trade, or "doing business as W -9 a statement that includes the information descnbed above to (DBA) name" on the "Business name/disregarded entity name" line support that exemption eg ty If you are a nonresident alien or a foreign entity not subject to backup Disregarded entity. Enter the owner's name on the "Name" line The withholding, give the requester the appropnate completed Form W -8 dame of the entity entered on the "Name" Tine should never be a disregarded entity The name on the "Name" line must be the name What is backup withholding? Persons making certain payments to you shown on the income tax retum on which the income will be reported. must under certain conditions withhold and pay to the IRS a percentage For example, if a foreign LLC that is treated as a disregarded entity for of such payments This is called "backup withholding " Payments that U S federal tax purposes has a domestic owner, the domestic owner's may be subject to backup withholding include interest, tax- exempt name is required to be provided on the "Name" line If the direct owner interest, dividends, broker and barter exchange transactions, rents, of the entity is also a disregarded entrty, enter the first owner that is not royalties, nonemployee pay, and certain payments from fishing boat disregarded for federal tax purposes Enter the disregarded entity's operators Real estate transactions are not subject to backup name on the "Business name/disregarded entity name" line If the owner withholding of the disregarded entity is a foreign person, you must complete an You will not be subject to backup withholding on payments you appropnate Form W -8 receive if you give the requester your correct TIN, make the proper Note. Check the appropnate box for the federal tax classification of the certifications, and report all your taxable interest and dividends on your person whose name is entered on the "Name" line (IndividuaVsole tax retum propnetor, Partnership, C Corporation, S Corporation, Trust/estate) Payments you receive will be subject to backup Limited Liability Company (LLC). If the person identified on the withholding if: "Name° line is an LLC, check the "Limited liability company" box only and enter the appropnate code for the tax classification in the space 1 You do not furnish your TIN to the requester, 2 You do not certi provided If you are an LLC that is treated as a partnership for federal fy your TIN when required (see the Part II tax purposes, enter "P" for partnership If you are an LLC that has filed a instructions on page 3 for details), Form 8832 or a Form 2553 to be taxed as a corporation, enter "C" for 3 The IRS tells the requester that you furnished an incorrect TIN, C corporation or "S" for S corporation. If you are an LLC that is 4 The IRS tells you that you are subject to backup withholding disregarded as an entity separate from its owner under Regulation because you did not report all your interest and dividends on your tax section 301 7701 -3 (except for employment and excise tax), do not retum (for reportable interest and dividends only), or check the LLC box unless the owner of the LLC (required to be identified on the "Name" line) is another LLC that is not disregarded for 5 You do not certify to the requester that you are not subject to federal tax purposes If the LLC is disregarded as an entity separate backup withholding under 4 above (for reportable interest and dividend from its owner, enter the appropnate tax classification of the owner accounts opened after 1983 only) identified on the "Name" line. j . Form W -9 (Rev 1 -2011) Page 3 Other entities. Enter your business name as shown on required federal Part I. Taxpayer Identification Number (TIN) tax documents,on the "Name" line This name should match the name shown on the charter or other legal document creating the entity You Enter your TIN in the appropriate box. If you are a resident alien and may enter any business, trade, or DBA name on the "Business name/ you do not have and are not eligible to get an SSN, your TIN is your IRS disregarded entity name" line. individual taxpayer identification number (ITIN). Enter it in the social security number box If you do not have an ITIN, see How to get a TIN Exempt Payee below If you are exempt from backup withholding, enter your name as If you are a sole proprietor and you have an EIN, you may enter either described above and check the appropnate box for your status, then your SSN or EIN. However, the IRS prefers that you use your SSN check the "Exempt payee" box in the line following the "Business name/ If you are a single- member LLC that is disregarded as an entity disregarded entity name," sign and date the form separate from Its owner (see Limited Liabih Company tY p Y (LLC) on page 2), Generally, individuals (including sole propnetors) are not exempt from enter the owner's SSN (or EIN, if the owner has one) Do not enter the backup withholding Corporations are exempt from backup withholding disregarded entity's EIN If the LLC is classified as a corporation or for certain payments, such as interest and dividends. Partnership, enter the entity's EIN. Note. If you are exempt from backup withholding, you should still Note.'See the chart on page 4 for further clarification of name and TIN complete this form to avoid possible erroneous backup withholding. combinations. The following payees are exempt from backup withholding How to get a TIN. If you do not have a TIN, apply for one immediately 1 An organization exempt from tax under section 501(a), any IRA, or a To apply for an SSN, get Form SS -5, Application for a Social Security custodial account under section tax Cana, from your local Social Security Administration office or get this 403(b)(7) if the account satisfies the form online at www ssagov You ma get by g requirements of section 401(1)(2), t 9 y also et this form b calling 1 -800 -772 -1213. Use Form W -7, Application for IRS Individual Taxpayer 2 The United States or any of its agencies or instrumentalities, Identification Number, to apply for an ITIN, or Form SS-4, Application for 3 A state, the Distnct of Columbia, a possession of the United States, Employer Identification Number, to apply for an EIN You can apply for or any of their political subdivisions or instrumentalities, an EIN online by accessing the IRS website at www irs gov /businesses 4 A foreign government or any of its political subdivisions, agencies, and clicking on Employer Identification Number (EIN) under Starting a or instrumentalities, or Business. You can get Forms W-7 and SS -4 from the IRS by visiting IRS gov or by calling 1- 800 -TAX -FORM (1- 800 - 829 -3678) 5 An international organization or any of its agencies or If you are asked to complete Form W -9 but do not have a TIN, wnte instrumentalities "Applied For" in the space for the TIN, sign and date the form, and give Other payees that may be exempt from backup withholding include it to the requester For interest and dividend payments, and certain 6 A corporation, payments made with respect to readily tradable instruments, generally 7 A foreign central bank of issue, you will have 80 days to get a TIN and give it to the requester before you are subject to backup withholding on payments. The 60 -day rule does 8 A dealer in securities or commodities required to register in the not apply to other types of payments. You will be subject to backup United States, the District of Columbia, or a possession of the United withholding on all such payments until you provide your TIN to the States, requester. 9 A futures commission merchant registered with the Commodity Note. Entenng "Applied For" means that you have already applied for a Futures Trading Commission, TIN or that you intend to apply for one soon. 10 A real estate investment trust, Caution: A disregarded domestic entity that has a foreign owner must 11- An entity registered at all times dunng the tax year under the use the appropnate Form W -8. Investment Company Act of 1940, Part II. Certification 12 A common trust fund operated by a bank under section 584(a), To establish to the withholding agent that you are a U S person, or 13 A financial institution, resident alien, sign Form W -9 You may be requested to sign by the 14 A middleman known in the investment community as a nominee or withholding agent even if item 1, below, and items 4 and 5 on page 4 custodian, or indicate otherwise. 15 A trust exempt from tax under section 864 or described in section For a joint account, only the person whose TIN is shown in Part I 4947 should sign (when required) In the case of a disregarded entity, the Person identified on the "Name" line must sign Exempt payees, see The following chart shows types of payments that may be exempt from backup withholding The chart applies to the exempt payees listed Exempt Payee on page 3 above, 1 through 15. Signature requirements. Complete the certification as indicated in items 1 through 3, below, and items 4 and 5 on page 4 IF the payment is for ... THEN the payment is exempt 1. Interest, dividend, and barter exchange accounts opened for ... before 1984 and broker accounts considered active during 1983. Interest and dividend payments All exempt payees except You must give your correct TIN, but you do not have to sign the for 9 certification. Broker transactions Exempt payees 1 through 5 and 7 2. Interest, dividend, broker, and barter exchange accounts P y g opened after 1983 and broker accounts considered inactive during through 13 Also, C corporations 1983. You must sign the certification or backup withholding will apply. If Barter exchange transactions and Exempt payees 1 through 5 you are subject to backup withholding and you are merely providing patronage dividends your correct TIN to the requester, you must cross out item 2 in the certification before signing the form Payments over $600 required to be Generally, exempt payees 3. Real estate transactions. You must sign the certification You may reported and direct sales over 1 through 72 cross out item 2 of the certification - $5,000 ' See Form 1099 -MISC, Miscellaneous Income, and its instructions 2 However, the following payments made to a corporation and reportable on Form 1099 -MISC are not exempt from backup withholding medical and health care payments, attomeys' fees, gross proceeds paid to an attomey, and payments for services paid by a federal executive agency Form W -9 (Rev 1 -2011) Page 4 4. Other payments. You must give your correct TIN, but you do not Note. If no name is circled when more than one name is listed, the have to sign the certification unless you have been notified that you number will be considered to be that of the first name listed. have previously given an incorrect TIN "Other payments" include payments made in the course of the requester's trade or business for Secure Your Tax Records from Identity Theft rents, royalties, goods (other than bills for merchandise), medical and Identity theft occurs when someone uses your personal information health care services (including payments to corporations), payments to such as your name, social secunty number (SSN), or other identifyin a nonemployee for services, payments to certain fishing boat crew g information, without your permission, to commit fraud or other trines members and fishermen, and gross proceeds paid to attorneys An identity thief may use your SSN to get a job or may file a tax return (including payments to corporations) using your SSN to receive a refund. 5. Mortgage interest paid by you, acquisition or abandonment of To reduce your nsk. secured property, cancellation of debt, qualified tuition program ' payments (under section 529), IRA, Coverdell ESA, Archer MSA or • Protect your SSN, HSA contributions or distnbutions, and pension distributions. You • Ensure your employer is protecting your SSN, and must give your correct TIN, but you do not have to sign the certification • Be careful when choosing a tax preparer What Name and Number To Give the Requester If your tax records are affected by identity theft and you receive a notice from the IRS, respond nght away to the name and phone number For this type of account Give name and SSN of: punted on the IRS notice or letter 1 Individual The individual If your tax records are not currently affected by identrty theft but you think you are at nsk due to a lost or stolen purse or wallet, questionable 2 Two or more individuals aoim The actual owner of the account or, account) if combined funds, the first credit card activity or credit report, contact the IRS Identity Theft Hotline individual on the account ' at 1- 800 - 908 -4490 or submit Form 14039 3 Custodian account of a minor The minor ` For more information, see Publication 4535, Identity Theft Prevention (Uniform Gift to Minors Act) and Victim Assistance. 4 a The usual revocable savings The grantor - trustee ' Victims of identity theft who are expenencing economic harm or a trust (grantor is also trustee) system problem, or are seeking help in resolving tax problems that have b So called trust account that is The actual owner' not been resolved through normal channels, may be eligible for not a legal or valid trust under Taxpayer Advocate Service (TAS) assistance You can reach TAS by state law calling the TAS toll -free case intake line at 1- 877 - 777 -4778 or TTY/TDD 5 Sole propnetorship or disregarded The owner' 1 - 800 - 829 - 4059. entity owned by an individual 6 Grantor trust filing under optional The grantor Protect yourself from suspicious emails or phishing schemes Form 1099 Fling Method 1 (see phishing is the creation and use of email and websites designed to Regulation section 1 671 4(b)(2)()(A)) mimic legitimate business emails and websites. The most common act For this type of account Give name and EIN of is sending an email to a user falsely claiming to be an established 7 Disregarded entity not owned by an The owner legitimate enterpnse in an attempt to scam the user into surrendering individual pnvate information that will be used for identity theft. 8 A valid trust, estate, or pension trust Legal entity' The IRS does not initiate contacts with taxpayers via emails. Also, the 9 Corporation or LLC electing The corporation IRS does not request personal detailed information through email or ask corporate status on Form 8832 or taxpayers for the PIN numbers, passwords, or similar secret access Form 2553 information for their credit card, bank, or other financial accounts 10 Association, club, religious, The organization If you receive an unsolicited email claiming to be from the IRS, chantable, educational, or other forward this message to phishing @rrs gov You may also report misuse tax exempt organization of the IRS name, logo, or other IRS property to the Treasury Inspector 11 Partnership or multi member LLC The partnership General for Tax Administration at 1- 800 -366 -4484 You can forward 12 A broker or registered nominee The broker or nominee suspicious emails to the Federal Trade Commission at spam @uce gov or contact them at www ftc gov /idtheft or 1- 877 - IDTHEFT 13 Account with the Department of The public entity Agnculture in the name of a public (1 - 877 - 438 - 4338). entity (such as a state or local Visit IRS gov to leam more about identi theft and how to reduce govemment, school distnct, or your nsk ty prison) that receives agricultural program payments 14 Grantor trust filing under the Form The trust 1041 Filing Method or the Optional Form 1099 Fling Method 2 (see Regulation section 1 671- 4(b)(2)(i)(B)) ' List first and circle the name of the person whose number you furnish If only one person on a Joint account has an SSN. that person's number must be furnished 2 Circle the minor's name and furnish the min's SSN ' You must show your indmdual name and you may also enter your business or 'DEW name on the "Business name/disregarded entity" name line You may use erther your SSN or EIN (d you have one). but the IRS encourages you to use your SSN Lust first and circle the name of the trust. estate. cr pension trust (Do not furnish the TIN of the personal representative or trustee unless the legal entity itself is not designated in the account title) Also see Special rules for partnerships on page 1 'Note. Grantor also must provide a Form W -9 to trustee of trust Privacy Act Notice Section 6109 of the Internal Revenue Code requires you to provide your correct TIN to persons (including federal agencies) who are required to file information returns with the IRS to report interest, dividends, or certain other income paid to you, mortgage interest you paid, the acquisition or abandonment of secured property, the cancellation of debt, or contnbutions you made to an IRA, Archer MSA, or HSA The person collecting this form uses the information on the form to file information returns with the IRS, reporting the above information Routine uses of this information include giving it to the Department of Justice for civil and cnminal litigation and to cities, states, the District of Columbia, and U S possessions for use in administenng their laws The information also may be disclosed to other countnes under a treaty, to federal and state agencies to enforce civil and cnminal laws, or to federal law enforcement and intelligence agencies to combat terronsm You must provide your TIN whether or not you are required to file a tax retum Under section 3406, payers must generally withhold a percentage of taxable interest, dividend, and certain other payments to a payee who does not give a TIN to the payer Certain penalties may also apply for providing false or fraudulent information • Performance and Payment Bond Public Work Surety Bond No.: 80069796 As to the Contractor /Principal. Name TB Landmark Construction, Inc. Principal Business Address 11220 New Berlin Road, Jacksonville, FL 32226 Telephone: (904) 751 -1016 As to the Surety. Name The Guarantee Company of North America USA Principal Business Address 25800 Northwestern Highway, Suite 720, Southfield, MI 48075 Telephone (248) 281 -0281 As to the Owner of the Property /Contracting Public Entity Name' City of Clermont Principal Business Address 685 West Montrose St, Clermont, FL 34712 Telephone ( 352) 394 -4081 Project Description: RFB 12 -004 Directional Bore Drills of City's Service Areas Legal Description of Project: RFB 12 -004 Directional Bore Drills of City's Service Areas This bond has been furnished to comply with the requirements of F S A 255 05 This bond is hereby amended such that All provisions and limitations, including conditions, notice and time limitations of F S A 255 05 are incorporated herein by reference Any provisions of this bond which conflicts with or purports to grant broader or more expanded coverage in excess of the minimum requirements of the applicable statute shall be deemed herefrom This bond is a statutory bond, not a common law bond This is the front page of the performance/ payment bond(s) regardless of preprinted numbers on the other pages issued in compliance with Florida Statute 255.05 , • City of Clermont Bid 12 -004 SECTION — L BONDS PERFORMANCE BOND THIS BOND IS ISSUED SIMULTANEOUSLY WITH LABOR AND MATERIAL PAYMENT BOND IN FAVOR OF THE OWNER CONDITIONED ON THE FULL AND FAITHFUL PERFORMANCE OF THE CONTRACT. Bond #80069796 KNOW ALL MEN BY THESE PRESENTS TB Landmark Construction, Inc , 11220 New Berlin Road, Jacksonville, FL 32226 (Full name and address or legal title of CONTRACTOR) as Principal, hereinafter called CONTRACTOR, and The Guarantee Company of North Amenca USA 25800 Northwestern Highway, Suite 720, Southfield, MI 48075 (Full name and address or legal title of Surety) as Surety, hereinafter called Surety, are held and firmly bound unto the City of Clermont, as Obligee, hereinafter called OWNER, in the amount of Sixty Thousand Three Hundred Ninety Three and 00 /100 (Dollar Amount in Words) ($ 60,393 00 ) (Dollar Amount in Numbers) (Sum equal to 100 percent of Contract amount) for the payment whereof CONTRACTOR and Surety bind themselves, their heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, CONTRACTOR has by written Agreement dated , entered into a Contract with OWNER for:Directional Bore Dnlls of City's Service Areas in accordance with Drawings and Specifications prepared by for the OWNER, which contract is by reference made a part hereof, and is hereinafter referred to as the Contract. NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION is such that, if CONTRACTOR shall promptly and faithfully perform said Contract, then this obligation shall be null and void; otherwise it shall remain in full force and effect. The Surety hereby waives notice of any alteration or extension of time made by the OWNER Whenever CONTRACTOR shall be, and declared by OWNER to be in default under the Contract, the OWNER having performed OWNER'S obligations thereunder, the Surety may RFB No 12 -004 Page 32 of 38 Oct 24, 2011 8 45 02 PM EDT p 35 City of Clermont Bid 12 -004 SECTION — L BONDS promptly remedy the default, in accordance with Section 255 05, Florida Statutes, or shall promptly, 1.) Complete the Contract in accordance with its terms and conditions or within sixty (60) calendar days. 2.) Obtain a bid or bids for completing the Contract in accordance with its terms and conditions, and upon determination by Surety of the lowest responsible bidder, or if the OWNER elects, upon determination by the OWNER and the Surety jointly of the lowest responsible bidder, arrange for a contract between such bidder and OWNER, and make available as work progresses (even though there should be a default or a succession of defaults under the Contract or Contracts of completion arranged under this paragraph) sufficient funds to pay the cost of completion less the balance of the Contract price, but not exceeding, including other costs and damages for which the Surety may be liable hereunder, the amount set forth in the first paragraph hereof. The term "balance of the Contract price," as used in this paragraph, shall mean the total amount payable by OWNER to CONTRACTOR under the Contract and any amendments thereto, Tess the amount properly paid by OWNER to CONTRACTOR. 3.) Upon termination of the Contract by the OWNER due to the CONTRACTOR'S failure to perform under the conditions herein set forth in the Contract, the OWNER may without prejudice to any right or remedy and after giving the CONTRACTOR and his Surety if any, seven (7) days written notice, terminate the employment of the CONTRACTOR, and take possession of the site and all of the materials, equipment, tools, construction equipment, and machinery thereon owned by the CONTRACTOR and may finish the work by whatever method he may deem expedient. In such case the CONTRACTOR shall not be entitled to receive any further payment until the work is finished. 4.) A claimant, except a laborer, who is not in privity with the Principal and who has not received payment for his labor, materials or supplies shall, within 45 days after beginning to furnish labor, materials or supplies for the prosecution of the work, furnish the Principal with a notice that he intends to look to the bond for protection, and 5) A claimant who is not in privity with the Principal and who has not received payment for his labor, materials, or supplies shall, within 90 days after performance of the labor or after complete delivery of materials or supplies, deliver to the Principal and to the Surety written notice of the performance of the labor or delivery of the materials or supplies and of the nonpayment. 6.) Other than a suit by OWNER, no action shall be instituted against the Principal or the Surety on the bond after one (1) year from the performance of the labor or completion of delivery of the materials or supplies. No right of action shall accrue on this bond to or for the use of any person or corporation other than the OWNER named herein or the heirs, executors, administrators or successors of the OWNER. RFB No 12 -004 Page 33 of 38 Oct 24, 2011 8 45 02 PM EDT p 36 • • City of Clermont Bid 12-004 SECTION - L BONDS THE FOREGOING PERFORMANCE BOND WAS SIGNED AND SEALED THIS DAY OF 2010. w.- " •-r. ,c? TB Landmark Construction, Inc (Principal) (Seal) A IL.Q,9. Q.l..A"--/ 4 • (Witness) By (Manual Signature) (Title) The Guarantee Company of North Amenca USA dUkOt (Surety) (Seal) (Witness) b(16475(1911 By. a (Manual Signature) , Robert T Theus, Attorney-In-Fact - (Title 1.—kYtT e-- 1 e dua (Re ident Agent as Attomey-in-Fact) co": Robert T Theus, FL Licensed Resident Age ilxid„, -VV - (Witness) oF 219 N Newnan Street (Address) Jacksonville, FL 32202 (904) 353-3181 (Telephone Number) Power of Attorney attached hereon RFB No 12-004 Page 34 of 38 Oct 24, 2011 8 45 02 PM EDT p 37 • City of Clermont Bid 12 -004 SECTION — L BONDS LABOR AND MATERIAL PAYMENT BOND THIS BOND IS ISSUED SIMULTANEOUSLY WITH THE PERFORMANCE BOND IN FAVOR OF THE OWNER CONDITIONED ON THE FULL AND FAITHFUL PERFORMANCE OF THE CONTRACT. Bond #80069796 KNOW ALL MEN BY THESE PRESENTS That TB Landmark Construction, Inc , 11220 New Berlin Road, Jacksonville, FL 32226 (Full name and address or legal title of CONTRACTOR) as Principal, hereinafter called CONTRACTOR, and The Guarantee Company of North America USA 25800 Northwestern Highway, Suite 720, Southfield, MI 48075 (Full name and address or legal title of Surety) as Surety, hereinafter called Surety, are held and firmly bound unto the City of Clermont as Obligee, hereinafter called OWNER, in the amount of: Sixty Thousand Three Hundred Ninety Three and 00 /100 (Dollar Amount in Words) ($ 60,393 00 ) (Dollar Amount in Numbers) (Sum equal to 100 percent of Contract amount) for the payment whereof CONTRACTOR and Surety bind themselves, their heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents WHEREAS, Principal has by written Agreement dated , entered into a Contract with OWNER for the construction of Dlrectlonal Bore Drills of City's Service Area accordance with Drawings and Specifications prepared by for the OWNER, which contract is hereinafter referred to as the Contract. NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION is such that, if Principal shall promptly make payment to all claimants as hereinafter defined, for all labor and materials used or reasonably required for use in the performance of the Contract, then this obligation shall be void; otherwise it shall remain in full force and effect, subject, however to the following conditions in accordance with Section 255.05, Florida Statutes 1.) A claimant is defined as one having a direct contract with the Principal or with a subcontractor of the Principal for labor, material, or both, used or reasonably required for use in the performance of the Contract, labor and material being construed to include that part of water, gas, power, Tight, heat, oil, gasoline, telephone service or rental of equipment directly applicable to the Contract RFB No 12 -004 Page 35 of 38 Oct 24, 2011 8 45 02 PM EDT p 36 City of Clermont Bid 12 -004 r• SECTION — L BONDS 2.) The above -named Principal and Surety hereby jointly and severally agree with the OWNER that every claimant as herein defined, who has not been paid in full before the expiration of a period of ninety (90) days after the date on which he last of such claimant's work or labor was done or performed, or materials were furnished by such claimant, may sue on this bond for the use of such claimant, prosecute the suit to final judgment for such sum or sums as may be justly due claimant, and have execution thereon. The OWNER shall not be liable for the payment of any costs or expenses of any such suit. 3.) Other than the OWNER, no suit or action shall be commenced hereunder by any claimant: a.) Unless claimant, other than one having a direct contract with the Principal shall have given written notice to any two of the following: The Principal, the OWNER, or the Surety above named, within ninety (90) days after such claimant did or performed the last of the work or labor, or furnished the last of the materials for which said claim is made, stating with substantial accuracy the amount claimed and the name of the party to whom the materials were furnished, or for whom the work or labor was done or performed. Such notice shall be served by mailing the same by registered mail or certified mail, postage prepaid, in an envelope addressed to the Principal, OWNER or Surety, at any place where an office is regularly maintained for the transaction of business, or served in any manner in which legal process may be served in the state in which the aforesaid project is located, save that such service need not be made by a public officer. b.) After the expiration of one (1) year following the date on which Principal ceased work on said Contract, it being understood, however, that if any limitation embodied in this bond is prohibited by any law controlling the construction hereof such limitation shall be deemed to be amended so as to be equal to the minimum period of limitation permitted by such law. c.) Other than in a state court of competent jurisdiction in and for the county or other political subdivision of the state in which the project, or any part thereof, is situated, or in the United States District Court for the district in which the Project, or any part thereof, is situated, and not elsewhere. d.) A claimant, except a laborer, who is not in privity with the Principal and who has not received payment for his labor, materials or supplies shall, within 45 days after beginning to furnish labor, materials or supplies for the prosecution of the work, furnish the Principal with a notice that he intends to look to the bond for protection, and e.) A claimant who is not in privity with the Principal and who has not received payment for his labor, materials or supplies shall, within 90 days after performance of the labor or after complete delivery of materials or supplies, RFB No 12 -004 Page 36 of 38 Oct 24, 2011 8 45 02 PM EDT p 39 • ` City of Clermont Bid 12 -004 SECTION - L BONDS deliver to the Principal and to the Surety written notice of the performance of the labor or delivery of the materials or supplies and of the nonpayment. f.) No action shall be instituted against the Principal or the Surety on the bond after one (1) year from the performance of the labor or completion of delivery of the materials or supplies. The amount of this bond shall be reduced by and to the extent of a payment or payments made In good faith hereunder, inclusive of the payment by Surety of mechanics' liens which may be filed or record against said improvement whether or not claim for the amount of such lien be presented under and against this bond THE FOREGOING LABOR AND MATERIAL PAYMENT BOND WAS SIGNED AND SEALED . THIS DAY OF 2010 =` � ,r:.,- „r� -• . ' TB Landmark Construction, Inc 4 ,®► .. v`! � 1 (Principal) (Seal) '� �i 4 : ° l`� .I 4 .f__`yam•∎ j � r tr d f • (Witness) .� � j f •.� �4 ��> By: I / . r �Q (Ma al Si nature) nn�attuure) �4 1,,,qu itltltte‘ (Title) The Guarantee Company of North Amenca USA (Surety) (Seal) (' ` w O ,Lr '$ (Witness) ry ;• v� B y tA111111111111kt 11� y a ( anual Signature) R Z. I ) ; we Ro T Theus, Attorne -In -Fact a ` ' (Ti + ,.Tf, (R- ident Agent as Attorney -in -Fact) Oetk& A, Robert T Theus, FL Licensed Resident Agent (Witness) 219 N Newnan Street Jacksonville, FL 32202 (Address) Power of Attorney attached hereon: RFB No 12 -004 Page 37 of 38 Oct 24, 2011 8 45 02 PM EDT p 40 0 0 • THr GOARA,NFF '.. E THE GUARANTEE COMPANY OF NORTH AMERICA USA MEANS OF Min U AMERICA Southfield, Michigan NA 1411 POWER OF ATTORNEY KNOW ALL BY THESE PRESENTS That THE GUARANTEE COMPANY OF NORTH AMERICA USA, a corporation organized and existing under the laws of the State of Michigan, having its principal office in Southfield, Michigan, does hereby constitute and appoint Fitzhugh K. Powell, Jr., Robert T. Theus, Roger R. Hurst, Walter Myers, Susan W. Jordan Cecil W. Powell & Company its true and lawful attorney(s) -in -fact to execute, seal and deliver for and on its behalf as surety, any and all bonds and undertakings, contracts of indemnity and other writings obligatory in the nature thereof, which are or may be allowed, required or permitted by law, statute, rule, regulation, contract or otherwise The execution of such instrument(s) in pursuance of these presents, shall be as binding upon THE GUARANTEE COMPANY OF NORTH AMERICA USA as fully and amply, to all intents and purposes, as if the same had been duly executed and acknowledged by its regularly elected officers at the principal office The Power of Attomey is executed and may be certified so, and may be revoked, pursuant to and by authority of Article IX, Section 9 03 of the By -Laws adopted by the Board of Directors of THE GUARANTEE COMPANY OF NORTH AMERICA USA at a meeting held on the 31 day of December, 2003 The President, or any Vice President, acting with any Secretary or Assistant Secretary, shall have power and authority 1 To appoint Attorney(s) -in -fact, and to authorize them to execute on behalf of the Company, and attach the Seal of the Company thereto, bonds and undertakings, contracts of indemnity and other writings obligatory in the nature thereof, and 2 To revoke, at any time, any such Attorney -in -fact and revoke the authority given, except as provided below 3 In connection with obligations in favor of the Kentucky Department of Highways only, it is agreed that the power and authonty hereby given to the Attorney -in -Fact cannot be modified or revoked unless prior wntten personal notice of such intent has been given to the Commissioner — Department of Highways of the Commonwealth of Kentucky at least thirty (30) days pnor to the modification or revocation Further, this Power of Attorney is signed and sealed by facsimile pursuant to resolution of the Board of Directors of the Company adopted at a meeting duly called and held on the 31 day of December 2003, of which the following is a true excerpt RESOLVED that the signature of any authorized officer and the seal of the Company may be affixed by facsimile to any Power of Attorney or certification thereof authorizing the execution and delivery of any bond, undertaking, contracts of indemnity and other wntings obligatory in the nature thereof, and such signature and seal when so used shall have the same force and effect as though manually affixed IN WITNESS WHEREOF, THE GUARANTEE COMPANY OF NORTH AMERICA USA has caused this instrument to be signed and its corporate seal to be affixed by its authorized officer, this 18th day o J * ANT Ee ° of March, 2011 THE GUARANTEE COMPANY OF NORTH AMERICA USA 3 ,c y O,91, 7'I AMEa` otic4, STATE OF MICHIGAN Stephen C. Ruschak, Vice President Randall Musselman, Secretary County of Oakland On this 18th day of March, 2011 before me came the individuals who executed the preceding instrument, to me personally known, and being by me duly sworn, said that each is the herein described and authorized officer of The Guarantee Company of North Amenca USA, that the seal affixed to said instrument is the Corporate Seal of said Company, that the Corporate Seal and each signature were duly affixed by order of the Board of Directors of said Company Cynthia A Takai IN WITNESS WHEREOF, I have hereunto set my hand at The Guarantee Notary Public, State of Michigan Company of North Amenca USA offices the day and year above written County of Oakland `� My Commission Expires February 27, 2012 • t ,� Acting in Oakland County i a • � 1, Randall Musselman, Secretary of THE GUARANTEE COMPANY OF NORTH AMERICA USA, do hereby certify that the above and foregoing is a true and correctcopy - of a Power of Attorney executed by THE GUARANTEE COMPANY OF NORTH AMERICA USA, which is still in full force and effect -T -.IN WITI}JESS WHEREOF, I have thereunto set my hand and attached the seal of said Company this day of Randall Musselman, Secretary ° o. 1 ` • • 4 THE GUARANTEE COMPANY OF NORTH AMERICA USA TERRORISM RIDER NOTICE OF TERRORISM COVERAGE AND DISCLOSURE OF PREMIUM Any loss applicable to a peril covered under this bond that is caused by a certified act of terrorism pursuant to the Terrorism Risk Insurance Act of 2002 (the "Act ") will be partially reimbursed by the United States under a formula established by federal law. Under this formula, the United States pays 90% of covered terrorism losses exceeding a statutorily established deductible to the insurance company providing this bond. The portion of your annual premium attributable to certified acts of terrorism under this bond is $1.00. The cost of terrorism coverage is subject to change on any bond for which an annual premium is charged. Payment for a loss will not exceed the limit of liability under this bond. This bond will not pay for any portion of certified terrorism loss beyond any applicable annual liability cap set forth in the Act. The terms of this rider do not provide coverage for any loss that would otherwise be excluded by the terms of this bond. FRONT PAGE OF PUBLIC PAYMENT BOND Florida Statute 255 05 BOND NO. 11- 08393 -PP CONTRACTOR: Allstate Paving, Inc 5284 Patch Road Orlando, FL 32822 407 - 277 -5247 SURETY: First Sealord Surety, Inc 789 E Lancaster Avenue Villanova, PA 19805 610- 664 -2259 AGENT: Nielson, Wojtowicz, Neu & Associates, Inc 1126 Central Avenue, Suite 200 St. Petersburg, FL 33705 727 - 209 -1803 OBLIGEE: City of Clermont 685 W Montrose Street Clermont, FL 34711 352- 241 -7386 , PROJECT: RFB No.11 -023 — Disston Avenue Stormwater Improvements; Disston Avenue I between East Minnehaha Avenue and East Lakeshore Drive _ i • vt ".j ti r � . _ J City of Clermont 3•d 11-023 SECTION — L BONDS Bond # 11-08393-PP PERFORMANCE BOND THIS BOND IS ISSUED SIMULTANEOUSLY WITH LABOR AND MATERIAL PAYMENT BOND IN FAVOR OF THE OWNER CONDITIONED ON THE FULL AND FAITHFUL PERFORMANCE OF THE CONTRACT KNOW ALL MEN BY THESE PRESENTS: Allstate Paving, Inc , 5284 Patch Road, Orlando, FL 32822 (Full name and address or legal title of CONTRACTOR) as Principal, hereinafter called CONTRACTOR, and First Sealord Surety, Inc , 789 E Lancaster Avenue, Villanova, PA 19805 (Full name and address or legal title of Surety) as Surety, hereinafter called Surety, are held and firmly bound unto the City of Clermont, as Obligee, hereinafter called OWNER, in the amount of: Five Rundrpd Ninety Nine Thnusand One Hundred Ten and 00 /100 Dollars (Dollar Amount in Words) ($ 599,110 00 (Dollar Amount in Numbers) (Sum equal to 100 percent of Contract amount) for the payment whereof CONTRACTOR and Surety bind themselves, their_ heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents WHEREAS, CONTRACTOR has by written Agreement dated , entered into a Contract with OWNER for st OmDTOeme°rs in accordance with Drawings and Specifications prepared by for the OWNER, which contract is by reference made a part hereof, and is hereinafter referred to as the Contract NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION is such that, if CONTRACTOR shall promptly and faithfully perform said Contract, then this obligation shall be null and void; otherwise it shall remain in full force and effect The Surety hereby waives notice of any alteration or extension of time made by the OWNER. Whenever CONTRACTOR shall be, and declared by OWNER to be in default under the Contract, the OWNER having performed OWNER'S obligations thereunder, the Surety may RFB No. 11 -023 ?age 32 of 41 Ct i of Clermont gw 112 323 SECTION — L BONDS promptly remedy the default, in accordance with Section 255 05, Florida Statutes, or shall promptly, 1.) Complete the Contract in accordance with its terms and conditions or within sixty (60) calendar days 2) Obtain a bid or bids for completing the Contract in accordance with its terms and conditions, and upon determination by Surety of the lowest responsible bidder, or if the OWNER elects, upon determination by the OWNER and the Surety jointly of the lowest responsible bidder, arrange for a contract between such bidder and OWNER, and make available as work progresses (even though there should be a default or a succession of defaults under the Contract or Contracts of completion arranged under this paragraph) sufficient funds to pay the cost of completion Tess the balance of the Contract price, but not exceeding, including other costs and damages for which the Surety may be liable hereunder, the amount set forth in the first paragraph hereof The term "balance of the Contract price," as used in this paragraph, shall mean the total amount payable by OWNER to CONTRACTOR under the Contract and any amendments thereto, less the amount properly paid by OWNER to CONTRACTOR 3.) Upon termination of the Contract by the OWNER due to the CONTRACTOR'S failure to perform under the conditions herein set forth in the Contract, the OWNER may without prejudice to any right or remedy and after giving the CONTRACTOR and his Surety if any, seven (7) days written notice, terminate the employment of the CONTRACTOR, and take possession of the site and all of the materials, equipment, tools, construction equipment, and machinery thereon owned by the CONTRACTOR and may finish the work by whatever method he may deem expedient In such case the CONTRACTOR shall not be entitled to receive any further payment until the work is finished. 4) A claimant, except a laborer, who is not in privity with the Principal and who has not received payment for his labor, materials or supplies shall, within 45 days after beginning to furnish labor, materials or supplies for the prosecution of the work, furnish the Principal with a notice that he intends to look to the bond for protection, and 5) A claimant who is not in privity with the Principal and who has not received payment for his labor, materials, or supplies shall, within 90 days after performance of the labor or after complete delivery of materials or supplies, deliver to the Principal and to the Surety written notice of the performance of the labor or delivery of the materials or supplies and of the nonpayment 6) Other than a suit by OWNER, no action shall be instituted against the Principal or the Surety on the bond after one (1) year from the performance of the labor or completion of delivery of the materials or supplies No right of action shall accrue on this bond to or for the use of any person or corporation other than the OWNER named herein or the heirs, executors, administrators or successors of the OWNER RFS No. 11 -023 Page Page 33 f ,, JJ Vl "1 1 C ■ty of Clermont $d 11 -022 SECTION — L BONDS THE FOREGOING PERFORMANCE BOND WAS SIGNED AND SEALED THIS DAY OF 2010. Allstate Paving, Inc ( Pnncipal) (Seal) (Witness. By: 71 S1 ture) nn lita(05 _ (Title) First Sealord Surety, Inc (Surety) (S (Wit wirer ke By (Manual Signature Kevin Wo towlcz. Attorney -in -Fart - (Title) N/A _ f (Resident Agent as Attorney -in -Fact) (Witness) Jennifer p rw 789 E Lancaster Ave (Address) Villanova, PA 19805 610- 664 -2259 (Telephone Number) Power of Attorney attached hereon November 7, 2011 RFB No 11 -023 Page 34 of 41 fm o ff 1 c -t D 11.023 SECTION — L BONDS Bond #11- 08393 -PP LABOR AND MATERIAL PAYMENT BOND THIS BOND IS ISSUED SIMULTANEOUSLY WITH THE PERFORMANCE BOND IN FAVOR OF THE OWNER CONDITIONED ON THE FULL AND FAITHFUL PERFORMANCE OF THE CONTRACT KNOW ALL MEN BY THESE PRESENTS That Al lstate Paving. Inc'., 5284 Patch Road, Orlando, FL 32822 (Full name and address or legal title of CONTRACTOR) as Principal, hereinafter called CONTRACTOR, and First Sealord Surety, Inc , 789 E Lancaster Avenue, Villanova, PA 19805 (Full name and address or legal title of Surety) as Surety, hereinafter called Surety, are held and firmly bound unto the City of Clermont as Obligee, hereinafter called OWNER, in the amount of: Five Hundred Ninety Nine Thousand One Hundred Ten and 00 /100 Dollars (Dollar Amount in Words) ($ 599,110 00 (Dollar Amount in Numbers) (Sum equal to 100 percent of Contract amount) for the payment whereof CONTRACTOR and Surety bind themselves, their heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents WHEREAS, Principal has by written Agreement dated , entered into a Contract with RFB 0- Dzton er � lle aCCOrdance with Drawings and OWNER for the construction of Gtnrm c.ratar 11- Tmnr Av , in II Specifications prepared by for the OWNER, which contract is hereinafter referred to as the Contract, NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION is such that, if Principal shall promptly make payment to all claimants as hereinafter defined, for all labor and materials used or reasonably required for use in the performance of the Contract, then this obligation shall be void, otherwise it shall remain in full force and effect, subject, however to the following conditions in accordance with Section 255.05, Florida Statutes' 1 ) A claimant is defined as one having a direct contract with the Principal or with a subcontractor of the Principal for labor, material, or both, used or reasonably required for use in the performance of the Contract, labor and material being construed to include th p of water, gas, power, light, heat, oil, gasoline, telephone service or rental of equipment directly applicable to the Contract RFB No 11 -023 Pa,,, 35 of 41 CA) of Clermont B 11-023 SECTION — L BONDS 2.) The above -named Principal and Surety hereby jointly and severally agree with the OWNER that every claimant as herein defined, who has not been paid in full before the expiration of a period of ninety (90) days after the date on which he last of such claimant's work or labor was done or performed, or materials were furnished by such claimant, may sue on this bond for the use of such claimant, prosecute the suit to final judgment for such sum or sums as may be justly due claimant, and have execution thereon The OWNER shall not be liable for the payment of any costs or expenses of any such suit 3) Other than the OWNER, no suit or action shall be commenced hereunder by any claimant a) Unless claimant, other than one having a direct contract with the Principal shall have given written notice to any two of the following: The Principal, the OWNER, or the Surety above named, within ninety (90) days after such claimant did or performed the last of the work or labor, or furnished the last of the materials for which said claim is made, stating with substantial accuracy the amount claimed and the name of the party to whom the materials were furnished, or for whom the work or labor was done or performed Such notice shall be served by mailing the same by registered mail or certified mail, postage prepaid, in an envelope addressed to the Principal, OWNER or Surety, at any place where an office is regularly maintained for the transaction of business, or served in any manner in which legal process may be served in the state in which the aforesaid project is located, save that such service need not be made by a public officer. b) After the expiration of one (1) year following the date on which Principal ceased work on said Contract, it being understood, however, that if any limitation embodied in this bond is prohibited by any law controlling the construction hereof such limitation shall be deemed to be amended so as to be equal to the minimum period of limitation permitted by such law. c) Other than in a state court of competent jurisdiction in and for the county or other political subdivision of the state in which the project, or any part thereof, is situated, or in the United States District Court for the district in which the Project, or any part thereof, is situated, and not elsewhere d A crahmant, excepra laborer, who is not in privity with the Principal and who has not received payment for his labor, materials or supplies shall, within 45 days after beginning to furnish labor, materials or supplies for the prosecution of the work, furnish the Principal with a notice that he intends to look to the bond for protection, and e) A clamant who is not in privity with the Principal and who has not received payment for his labor, materials or supplies shall, within 90 clays after performance of the labor or after cornplete delivery of materials or supplies, RFB No 11 -023 Page 36 of 41 • C y of riermnnt Prri 11 -023 SECTION — L BONDS deliver to the Principal and to the Surety written notice of the performance of the labor or delivery of the materials or supplies and of the nonpayment f) No action shall be instituted against the Principal or the Surety on the bond after one (1) year from the performance of the labor or completion of delivery of the materials or supplies The amount of this bond shall be reduced by and to the extent of a payment or payments made in good faith hereunder, inclusive of the payment by Surety of mechanics' liens which may be filed or record against said improvement whether or not claim for the amount of such lien be presented under and against this bond. THE FOREGOING LABOR AND MATERIAL PAYMENT BOND WAS SIGNED AND SEALED THIS DAY OF 2010 ‘4 C— Allstate Paving, Inc (Principal) (Seal) _ (Witness) , I ..0 ) taps 5 (Title) Ir P1rat Saalnrrl Surer . Inc. (Surety) (Se• (Wltn_�4I� • , Il■ By. i (Manual Signature) xa,nn Wn3 tnw1 C•z _pttDrney -, n - Pant ( - Title) N/A i (Resident Agent as Attorney -in -Fact) (Witness) Jen r Spur 789 E Lancaster Ave, Villanova, PA 19805 (Aaaress) Power of Attorney attached hereon November 7, 2011 RFB No 11 -023 Page 37 of 41 First Sealord Surety, Inc. Power No: MCO- 0138 -11 -12552 Power of Attorney KNOW ALL MEN BY THESE PRESENTS: That First Sealord Surety, Inc , a corporation of the Commonwealth of Pennsylvania, (hereinafter the "Company ") has made, constituted and appointed, and by these presents does make, constitute and appoint Glenn Arvanitis, Jack Neu and/or Kevin Woitowicz all of St Petersburg, Flonda its true and lawful Attorney -in -Fact, to make, execute and deliver on its behalf insurance policies, surety bonds, undertakings and other instruments of a similar nature as follows * **** Not To Exceed Five Million Dollars-------- _----- ------ - ---- -- ($5,000,000.00) * * * *** * **" Such insurance policies, surety bonds, undertakings and instruments for said purposes, when duly executed by the aforesaid Attorney -in -Fact, shall be binding upon the said Corporation as fully and to the same extent as if signed by the duly authorized officers of the Corporation and sealed with its corporate seal, and all the acts of said Attorney -in -Fact, pursuant to the authority hereby given, are hereby ratified and confirmed This appointment is made pursuant to the following By -Laws which were duly adopted by the Board of Directors of the said Corporation on April 7, 2003 with all Amendments thereto and are still in full force and effect "Article XII Policies, Bonds, Recognitions, Stipulations, Consents of Surety, Underwriting Undertakings, and Instruments Relating Thereto Section 12 -1. Insurance policies, bonds, recognitions, stipulations, consents of surety and underwriting undertakings of the Corporation, and releases, agreements and other writings relating in any way thereto or to any claim or loss thereunder, shall be signed in the name and on behalf of the Corporation a) by the Chairman of the Board, the President or a Vice President, and by the Secretary or an Assistant Secretary, or b) by an Attorney - in -Fact for the Corporation appointed and authorized by the Chairman of the Board, the President, or a Vice President to make such signature, or c) by such other officers or representatives as the Board may from time to time determine The seal of the Corporation shall if appropriate be affixed thereto by any such officer, Attorney -in -Fact or representative The authority of such Attorney -in -Fact and Agents shall be as prescribed in the instrument evidencing their appointment Any such appointment and all authority granted thereby may be revoked at any time by the Board of Directors or by any person empowered to make such appointment " IN WITNESS WHEREOF, First Sealord Surety, Inc has caused these presents to be duly signed and its corporate seal to be hereunto affixed and duly attested this 20th day of January, 2004 Attest /3,7,43'1"N First Sealord Surety, Inc. �Yi 199i {t ti (Seal) c / 0/ By � `=zsrn�} Gary L Bragg, Secretary Joel D Cooperman, Vice President Commonwealth of Pennsylvania County of Montgomery On this 22 day of April, 2010, before me personally appeared Joel D Cooperman, Vice President of First Sealord Surety, Inc , satisfactorily proven to be the person whose name is subscribed to this instrument (driver's license), who, being by me duly sworn, said that he resides in the Commonwealth of Pennsylvania, that he is Vice President of First Sealord Surety, Inc , the corporation described in and which executed the foregoing instrument, that he knows the corporate seal of the said Corporation, that the seal affixed to said instrument is such corpnrob. coal Mfi +n fhaf if woe en affiva,f by nrofar of *ha Board of Directar''6Y aid Corporation, and that he signed his name thereto as Vice President of saic y f, brAnitaill.V `ttate of P enn §Jvania ' J County of pefawarq >tti `NOT' SE- J Notary No t r Pbl R TN H AFyF,,.'.Y. County - • (, c • . ' c .. . .Tip., Y���ounty .7: __ Se a!) �- , ; Y on Expires June23, 2012 �, CE RTIFICATE I; th:tfidersigned Sep ot Sealord Surety, Inc do hereby certify that the original Power of ,,..v,"ay v, ..,,,..,, .,,c ,v,oy.,,,,y to a ,V,,, ,,,.c a,,., correct bdpyos in flint fore anti effect on the date of this Certificate and I do further certify that the Officer who executed the said Power of Attorney was one ofte Officefs butflonzsd by the Board of Directors to appoint an Attorney -in -Fact as provided in Section 12 -1 of the By -Laws of First Sealord Surety, Inc) •Thts Certificate may be signed and sealed by facsimile under and by authority of the following provisions of the By -Laws of First Sealord Surety, Inc - "Section 12 -2. The use of a pnnted facsimile of the corporate seal of the Corporation and of the signature of the Secretary or an Assistant Secretary on any certification of the correctness of a copy of an instrument executed by an authorized person pursuant to Article XII, Section 12 -1 of the By -Laws appointing and authorizing an Attorney -in -Fact to sign in the name and on behalf of the Corporation surety bonds, underwnting undertakings, or other instruments described in said Section 12 -1, with like effect as if such seal and such signature had been manually affixed and made " In Witness Whereof, I have hereunto set my hand and affixed the corporate seal of the Corporation to these presents this day of , 20_ This power of attorney is void unless the Bond number is inserted in this paragraph (insert Bond # here 1 PP ), the bond number is the same number as on the original bond, d the bond number has been inserted by an officer or employee of the Company or by the agent (seal) 7 Ga L Bragg, ecretary First_Sealord_Surety_POA doc (Ed 01/20/2004) .1