HomeMy WebLinkAboutRes.2725.11-05-20121.1aamk)19 IIRMS-s_'.
RESOLUTION NO. aqa?
A RESOLUTION AUTHORIZING THE CITY MANAGER TO
EXECUTE AN AGREEMENT WITH NIP KELLEY
EQUIPMENT COMPANY, INC, FOR PARKING LOT
IMPROVEMENTS AT BROADWAY AND MIDDLE STREET,
IN THE CITY OF CAPE GIRARDEAU, MISSOURI
BE IT RESOLVED BY THE COUNCIL OF THE CITY OF CAPE
GIRARDEAU, MISSOURI, AS FOLLOWS:
ARTICLE 1. The City Manager, for and on behalf of the City
of Cape Girardeau, Missouri, is hereby authorized to execute an
Agreement with Nip Kelley Equipment Company, Inc., for parking
lot improvements at Broadway and Middle Street, in the City of
Cape Girardeau, Missouri. A copy of said Agreement is attached
to this Resolution and made a part hereof.
PASSED AND ADOPTED THIS 0" DAY OF A % 2012.
Harry E. R dig r, Mayor
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CITY OF CAPE GIRARDEAU
PARKING LOT IMPROVEMENTS
AT
BROADWAY AND MIDDLE STREET
STANDARD FORM OF AGREEMENT
BETWEEN OWNER AND CONTRACTOR
ON THE BASIS OF A STIPULATED PRICE
THIS AGREEMENT is dated as of the ��Y .day of �,C�V Ennl�l'f_in the year
2012 by and between the City of Cape Girardeau, Missouri (hereinafter called OWNER)
and Nip Kellev Equipment Companv, Inc. (hereinafter called CONTRACTOR).
OWNER and CONTRACTOR, in consideration of the mutual covenants hereinafter set
forth, agree as follows:
Article 1. WORK.
CONTRACTOR shall complete all Work as specified or indicated in the Contract
Documents. The Work is generally described as follows: ,
The improvement will consist of gradinq, addinq base rock, and asphalt
pavinq the lot at the southwest corner of Broadwav and Middle Street.
Landscapinq areas shall be constructed on portions of the lot as shown on
the plans Liqhtinq shall also be provided along the landscaqed center aisle.
In addition improvements to the west sidewalk of Middle Street, from
Broadway to Themis will be incorporated into the proiect, includinq removal
and replacement of sidewalks curbs qutters and drivewavs, installation of a
green area befinreen the new curbs and sidewalks, and installation of ADA
compliant ramps at the corner of Middle and Themis.
Article 2. ENGINEER.
The City Engineer or his designee is to act as OWNER'S representative, assume all duties
and responsibilities and have the rights and authority assigned to ENGINEER in the
Contract Documents in connection with completion of the Work in accordance with the
Contract Documents.
Article 3. CONTRACT TIMES.
3.1 The work will be substantially completed within thi 30 calendar days after the date
when the Contract Times commence to run as provided in paragraph 2.3 of the General
Conditions, and completed and ready for final payment in accordance with paragraph
14.13 of the General Conditions by March 29, 2013.
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3.2 Liquidated Damages. OWNER and CONTRACTOR recognize that time is of the
essence of this Agreement and that OWNER will suffer financial loss if the Work is not
completed within the times specified in paragraph 3.1 above, plus any extensions thereof
allowed in accordance with Article 12 of the General Conditions. They also recognize the
delays, expense and difficulties involved in proving the actual loss suffered by OWNER if
the Work is not competed on time. Accordingly, instead of requiring any such proof,
OWNER and CONTRACTOR agree that as liquidated damages for delay (but not as a
penalty) CONTRACTOR shall pay OWNER two thousand dollars $2,000.00 for each
day that expires after the time specified in paragraph 3.1 for Substantial Completion until
the Work is substantially complete. After Substantial Completion, if CONTRACTOR sha�l
neglect, refuse or fail to complete the remaining Work within the time specified in
paragraph 3.1 for completion and readiness for final payment or any proper extension
thereof granted by OWNER, CONTRACTOR shall pay OWNER one thousand dollars
$1,000.00 for each day that expires after the time specified in paragraph 3.1 for
completion and readiness for final payment.
Article 4. CONTRACT PRICE.
OWNER shall pay CONTRACTOR for completion of the Work in accordance with the
Contract Documents an amount in current funds equal to the sum of the amounts
determined pursuant to paragraphs 4.1 and 4.2 below:
4.2 for all Unit Price Work, an amount equal to the sum of the established unit price for
each separately identified item of Unit Price Work times the estimated quantity of that item
as indicated in the bidding documents.
TOTAL OF ALL UNIT PRICES: One hundred seventeen thousand nine hundred eight
dollars and sixtv-eiqht cents ($ 117,908.68 )
As provided in paragraph 11.9 of the General Conditions estimated quantities are not
guaranteed, and determinations of actual quantities and classification are to be made by
ENGINEER as provided in paragraph 9.10 of the General Conditions. Unit prices have
been computed as provided in paragraph 11.9.2 of the General Conditions.
Article 5. PAYMENT PROCEDURES.
CONTRACTOR shall submit Applications for Payment in accordance with Article 14 of the
General Conditions. Applications for Payment will be processed by ENGINEER as
provided in the General Conditions.
5.1 Progress payments; Retainage. OWNER shall make progress payments on account
of the Contract Price on the basis of CONTRACTOR'S Application for Payment as
recommended by ENGINEER, on or about the 10th day of each month during construction
as provided in paragraphs 5.1.1 and 5.1.2 below. All such payments will be measured by
the schedule of values established in paragraph 2.9 of the General Conditions (and in the
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case of Unit Price Work based on the number of units completed) or, in the event there is
no schedule of values, as provided in the General Requirements.
5.1.1 Prior to Substantial Completion, progress payments will be made in an amount equal
to the percentage indicated below, but, in each case, less the aggregate of payments
previously made and less such amounts as ENGINEER shall determine, or OWNER may
withhold, in accordance with paragraph 14.7 of the General Conditions.
90% of Work completed (with the balance being retainage). If Work has
been 50%completed as determined by ENGINEER, and if the character and
progress of the Work have been satisfactory to OWNER and ENGINEER,
OWNER, on recommendation of ENGINEER, may determine that as long as
the character and progress of the Work remain satisfactory to them, there
will be no additional retainage on account of Work completed, in which case,
the remaining progress payments prior to Substantial Completion will be an
amount equal to 100% of the Work completed.
90% (with the balance being retainage) of materials and equipment not
incorporated in the Work (but delivered, suitably stored and accompanied by
documentations satisfactory to OWNER as provided in paragraph 14.2 of the
General Conditions).
5.1.2 Upon Substantial Com�letion, in an amount sufficient to increase total payments to
CONTRACTOR to 95%of the Contract Price (with the balance being retainage), less such
amounts as ENGINEER shall determine, or OWNER may withhold, in accordance with
paragraph 14.7 of the General Conditions.
5.2 Final Payment. Upon final completion and acceptance of the Work in accordance with
paragraph 14.13 of the General Conditions, OWNER shall pay the remainder of the
Contract Price as recommended by ENGINEER as provided in said paragraph 14.13.
Article 6. INTEREST.
All moneys not paid when due as provided in Article 14 of the General Conditions shall
bear interest at the maximum rate allowed by law at the place of the Project.
Article 7. CONTRACTOR'S REPRESENTATIONS.
In order to induce OWNER to enter into the Agreement, CONTRACTOR makes the
following representations:
7.1 CONTRACTOR has examined and carefully studied the Contract Documents
(including the Addenda listed in paragraph 8) and the other related data identified in the
Bidding Documents, including "technical data".
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7.2 CONTRACTOR has visited the site and become familiar with and is satisfied as to the
general, local and site conditions that may affect cost, progress, performance and
furnishing of the Work.
7.3 CONTRACTOR is familiar with and is satisfied as to all federal, state and local Laws
and Regulations that may affect cost, progress, performance and furnishing of the Work.
7.4 CONTRACTOR has carefully studied all reports of explorations and tests of
subsurface conditions at or contiguous to the site and all drawings of physical conditions in
or relating to existing surface or subsurface structures at or contiguous to the site (except
Underground Facilities) which have been identified. CONTRACTOR acknowledges that
such reports and drawings are not Contract Documents and may not be complete for
CONTRACTOR'S purposes. CONTRACTOR acknowledges that OWNER and ENGINEER
do not assume responsibility for the accuracy or completeness of information and data
shown or indicated in the Contract Documents with respect to Underground Facilities at or
contiguous to the site. CONTRACTOR has obtained and carefully studied (or assumes
responsibility for having done so) all such additional supplementary examinations,
investigations, explorations, tests, studies and data concerning conditions (surface,
subsurface and Underground Facilities)at or contiguous to the site or otherwise which may
affect cost, progress, performance or furnishing of the Work or which relate to any aspect
of the means, methods, techniques, sequences and procedures of construction to be
employed by CONTRACTOR and safety precautions and programs incident thereto.
CONTRACTOR does not consider that any additional examinations, investigations,
explorations, tests, studies or data are necessary for the performance and furnishing of the
Work at the Contract Price, within the Contract Times and in accordance with the other
terms and conditions of the Contract Documents.
7.5 CONTRACTOR is aware of the general nature of work to be performed by OWNER
and others at the site that relates to the Work as indicated in the Contract Documents.
7.6 CONTRACTOR has correlated the information known to CONTRACTOR, information
and observation obtained from visits to the site, reports and drawings identified in the
Contract documents and all additional examinations, investigations, explorations, tests,
studies and data with the Contract Documents.
7.7 CONTRACTOR has given ENGINEER written notice of all conflicts, errors, ambiguities
or discrepancies that CONTRACTOR has discovered in the Contract Documents and the
written resolution thereof by ENGINEER is acceptable to CONTRACTOR, and the Contract
Documents are generally sufficient to indicate and convey understanding of all terms and
conditions for perFormance and furnishing of the Work.
Article 8. CONTRACT DOCUMENTS.
The Contract Documents which comprise the entire agreement befinreen OWNER and
CONTRACTOR concerning the Work consist of the following:
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8.1 This Agreement (pages A-1 to A-7 inclusive).
8.2 Exhibits to this Agreement (pages BF- to BF- , inclusive).
8.3 Performance, Payment, and other Bonds, identified as exhibits and consisting of
pages.
8.4 Notice to Proceed.
8.5 General Conditions (pages 1 to 55 , inclusive). (EJCDC No. 1910-8 1990 Edition)
8.6 Supplementary Conditions (pages SC-1 to SC- 5 , inclusive).
8.7 Specifications bearing the title PARKING LOT IMPROVEMENTS AT BROADWAY
AND MIDDLE STREET.
8.8 Drawings.
8.9 Addenda numbers 1 to 2 , inclusive.
8.10 CONTRACTOR'S Bid (pages BF- 1 to BF- 9 , inclusive) marked exhibit A .
8.11 Pursuant to 285.530 R.S. Mo, the contractor must affirm its enrollment and
participation in a federal work authorization program with respect to the employees
proposed to work in connection with the services requested herein by 1) submitting a
completed, notarized copy of AFFIDAVIT OF WORK AUTHORIZATION and 2) providing
documentation affirming the bidder's enrollment and participation in a federal work
authorization program with respect to the employees proposed to work in connection with
the services requested herein.
8.12 Documentation submitted by CONTRACTOR prior to Notice of Award (pages _to
, inclusive).
8.13 The following which may be delivered or issued after the Effective Date of the
Agreement and are not attached hereto: All Written Amendments and other documents
amending, modifying or supplementing the Contract Documents pursuant to paragraphs
3.5 and 3.6 of the General Conditions.
The documents listed in paragraphs 8.2 et seq. above are attached to this Agreement
(except as expressly noted otherwise above).
There are no Contract Documents other than those listed above in the Article 8. The
Contract Documents may only be amended, modified or supplemented as provided in
paragraphs 3.5 and 3.6 of the General Conditions.
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Article 9. MISCELLANEOUS.
9.1 Terms used in this Agreement which are defined in Article 1 of the General Conditions
will have the meanings indicated in the General Conditions.
9.2 No assignment by a party hereto of any rights under or interests in the Contract
Documents will be binding on another party hereto without the written consent of the party
sought to be bound; and, specifically but without limitation, moneys that may become due
and moneys that are due may not be assigned without such consent (except to the extent
that the effect of this restriction may be limited by law), and unless specifically stated to the
contrary in any written consent to an assignment no assignment will release or discharge
the assignor from any duty or responsibility under the Contract Documents.
9.3 OWNER and CONTRACTOR each binds itself, its partners, successors, assigns and
legal representatives to the other party hereto, its partners, successors, assigns and legal
representatives in respect to all covenants, agreements and obligations contained in the
Contract Documents.
9.4 Any provision or part of the Contract Documents held to be void or unenforceable
under any Law or Regulation shall be deemed stricken, and all remaining provisions shall
continue to be valid and binding upon OWNER and CONTRACTOR, who agree that the
Contract Documents shall be reformed to replace such stricken provision or part thereof
with a valid and enforceable provision that comes as close as possible to expressing the
intention of the stricken provision.
9.5 Pursuant to 292.675, R.S. Mo, the contractor is informed that all contractors or
subcontractors doing work on this project to provide, and require its on-site employees to
complete, a ten (10) hour course in construction safety and health approved by the
Occupational Safety and Health Administration ("OSHA") or similar program approved by
the Missouri Department of Labor and Industrial Relations which is at least as stringent as
an approved OSHA program. The training must be completed within sixty(60)days of the
date work on the project commences. On-site employees found on the worksite without
documentation of the required training shall have finrenty (20) days to produce such
documentation.
9.6 The General Contractor shall provide to the City of Cape Girardeau City Engineer's
Office weekly certified payrolls from the General Contractor and all Subcontractors during
the course of the project. These must be provided on a weekly basis; if no work was done,
then a payroll stating "No Work Done" must be submitted.
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IN WITNESS WHEREOF, OWNER and CONTRACTOR have signed the Agreement in
multiple copies, One counterpart each has been delivered to CONTRACTOR and
ENGINEER and finro counterparts to the OWNER. All portions of the Contract Documents
have been signed, initialed or identified by OWNER and CONTRACTOR or identified by
ENGINEER on their behalf.
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This Agreement will be effective on %! 1;�=. � � , 201Z(anrh;�ch�fis���e ,
Effective Date of the Agreement). � ;;-��% f, "�,;
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OWNER Ci of e Girardeau CONTRACTOR rvi elle E ui �'�am a �� ' y;y
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Scott M er � M a er Vince Kelle , Presiden�� . s� - "
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By: y. ,, � .��,��� ,,..
[CORPORA SEA ] [ PO T AL]
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Attest Attest
Frank Myers
Address for giving notices Address for giving notices
401 Independence Street 41 N. Spriqq Street
Cape Girardeau, MO 63703 Cape Girardeau, MO 63701
(If OWNER is a public body, attach License No. � 8800
evidence of authority to sign and
resolution or other documents Agent for service of process:
authorizing execution of Agreement.
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� �' �� � '�`� attach evidence of authority to sign.)
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EXHIBIT A
CITY OF CAPE GIRARDEAU
PARK/NG LOT IMPROVEMENTS
AT
BROADWAYAND MIDDLE STREET
BID FORM
(EJCDC 1910-18) (1990)
PROJECT IDENTIFICATION:
The improvement will consist of gradingf adding base r�ck and asphalt
pavin_v the Iot at the southwest comer of Br�adway and Middle Street.
Landscapina areas shall be constructed on Qortions of the lot as shown on
the plans. Liahting shall a/so be prvvided along the landscaped centeraisle.
ln addition, imarovements to the west sidewalk of Middle Street. from
Broadwav to Themis. will be incorporated into the pruject, including r�emoval
and replacementofsidewa/ks. curbs,gutters, and driveways,installation ofa
green area beiween the new curbs and sidewalks, and installation of ADA
comaliant ramvs at the comer of Middle and Themis.
THIS BID IS SUBMITTED TQ� CITY OF CAPE GIRARDEAU, MO
4011NDEPENDENCE STREET
CAPE GIRARDEAU, MO 63703
1. The undersigned BIDDER pioposes and agrees, if the Bid is accepted, to enterinto an
agr�ement with OWNER in the f+�rm included in the Contract Documenfs to perform and
fumish all Work as specified or indicated in the Contract Documenfs for the Bid Price and
within the Bid rmes indicated in this Bid and in accordance with the other terms and
conditions of the Contract Documents.
2. BIDDER accepts all of the terms and conditions of the Adve�tisement or Invifation to Bid
and lnstrucfions to Bidders,including without limitation those dealing with the disposition of
Bid securify. This Bid will remain subject fo acceptance for sixiy days afler the day of Bid
opening. B/DDER will sign and deliver the r�equired number of counterpa►ts of the
Agreement with the Bonds and other documents required by the Bidding Requir�ments
within fifleen days after the date of OWNER'S notice of Awarcl.
3. ln submiifing this Bid, B/DDER represents, as more fully set forth in the Agreement,
that:
(a) 81DDER has examined and carefully studied the Bidding Documents and the
following:
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Addenda, receipt of all which is hereby acknowledged: �UstAddenda byAddendum Numberend Date)
Addendum #1 - October 24, 2012
Addendum #2 - October 26, 2012
(b) BIDDER has visited the site and become"familia�with and is safisfied as to the
general, local and site conditions that may affect cost, progr�ss, pe►formance and
fumishing of the Wor1�;
(c) BIDDER is familiar writh and is satisfied as to all federal, state and local Laws and
Regulations t�iat may atl`ect cost, progress, perfom►ance and fumishing of the Work.
(� BIDDER has car�efully studied alI reports of exp/orations and tests of subsurface
condifions at or contiguous to the site and all drawings of physical conditions in or relating
to exisfing surface or subsuiface structures at or configuous to the site (except
Undergruund Facilities) which have been identified. BIDDER acknowledges that such
reports and drawings a►e not Contract Documents and may not be complete forB1DDER'S
purposes. B/DDER acknowledges that OWNER and Engineer do not assume
responsibility for accuracy or comp/eteness of infoRnation and data shown or indicated in
the Bidding Documents with respect to Underground Facilities at orcontiguous to the site.
B/DDER has obtained and carefully studied(or assumes responsibility forhaving done so)
all such addifional or supplementary examinations, investigations, explora6ons, tests,
studies and data conceming conditions(surface, subsurface and Undeiground Facilities)at
or contiguous to the site or othervvise which may af�ect cost progress, perfonnance or
fumishing of the Work or which ielate to any aspect of the means, methods, techniques,
sequences and procedwes of construction to be employed by BIDDER and safety
precautions and piograms incident theieto. BIDDER does not consider that any addiitional
examinations, investigations, explorations, tests, studies or data are necessary for the
determination of fliis Bid fior performance and fumishing of the Wor�in accordance with the
times, price and other terms and conditions of the Contract Documents.
(e) BIDDER is aware of the general nature of Work to be performed by Owner and
others at the site that relates to Wo�for which this Bid is submiited as indicated in fhe
Contract Documents.
(� BIDDER has corrslated the infi�rmation known to BIDDER, information and
observations obtained from visits to the site, r�ports and drawings identi�ied in the Contract
Documents and all addifional examina�ons, investigations, explorations, tests, studies and
data with the Contract Documents.
(g) BIDDER has gi►ren Engineer wriiten no6ce of all conflicts, errors, ambiguities or
discrepancies that BIDDER has discovered in the Contract Documents and the wriiten
resolution thereof by ENG/NEER is acceptable to BIDDER, and the Contract Documenfs
� BF-2
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are generally sufficient to indicate and convey understanding of all terms and conditions for
performing and fumishing the Work for which this Bid is submifted.
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(h) This Bid is genuine and not made in the interest of or on behalf of any undisclosed
person, firm or corporation and is not submifted in conformity with any agreement or ru/es
of any group associa6on, oiganization or corporation;B/DDER has not directly orindirectly
induced or solicited any other Bidder to submit a fa/se or sham Bid; BIDDER has not
solicited or induced any person, fiim or corporation to refrain frvm bidding;and BIDDER
has not sought by collusion to obtain foritse/f any advantage overanyotherBidderorover
OWNER
(�) Pursuant to 285.530 RSMo, the biddermust atfirm its enrollment and paificipation in
a federal work authorization program with respecf to the emp/oyees proposed to wori�in
connection with the senrices rsquested herein by
• submifting a comp/eted, notaiized copy of AFFIDAVIT OF WORK
AUTHORIZATION and
• prr�viding documentation affrrming the bidders enr�llment and participation in a
federal wori�authorization program with respect to the employees proposed to wori�
in connection with the services requested herein.
• http://www.uscis.gov/portaUsite/uscis
(�) Bidders are informed that the Prt�ject is subject to the requirements of Sec6on �
292.675, R.S. Mo, which requires a/l contractors or subcontractors doing wori� on the
Prnject to provide, and require its on-site employees to complete, a ten(10)hourcourse in
construction safefy and health approved by the Occupational Safety and Health
Administration(°'OSHA'�or similar program approved by the Missouri Department of Labor
and Industrial Relations which is at least as stringent as an approved OSHA program. The
training must be complefed within sixiy (60) days of the date work on the Project ,
commences. On-site employees found on fhe worksite without documentation �of tl�e
r�quirsd training shall have twenty(20) days to produce such documentation.
4. BIDDER will complete the Work in accordance with the Contract Documents for the
following price(s):
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UNIT PRICE BID
NO ITEM UNIT EST. UNIT TOTAL
QTy PR10E EST. PRICE
1, Excavation/Grading LS ) $ ,�. � p,
2, Aggregate Base(6") SY 1,286 $ , � $
3, Tack Coat GAL 248 $ .�p3 $
4. 6"Bituminous Pavement TON 424 $_ ,,Q3 $ � a
Mixture (BP-2)
5. 2"Bituminous Pavement TON 132 $ � .�p� $ o � �
Mixture(BP-2) Overlay
6. Parking Stall Striping— EA 45 $ . $ , �
White(per sta/l)
7. Planting Soil CY 86 $ $ D �
8. Mu/ch CY 43 $ �D $ �
9. Liitle Henry Itea EA 15 $ T �•,3 $ ?�o- �j
10. Red Sprite Holly EA 12 $ . 9 $ 6 -�p$
11. Public Parking Sign EA 2 $_�Q� $ ' �,o �
12. Handicapped Parking Sign EA 2 $ p '^b� $ ,�
(R7�8)
13. Van Accessible Sign EA 1 $ �f Q,Q9 $ 0,a
(R7-8P)
14. 18'Pole and Base EA 2 $ $ ��j
Foundation
15. Light Fr�ctures and Arms EA 4 $ � � �
16. . E/ecfrical System LS 1 $ .(,� $ g,3 .0?7
17. Parking B/ocks EA 47 $ $ 9 rf .
18. Handicapped Stall Painting EA 2 $ , � $ ��. U
19. Concrete Patch SY 14 $ �J $ S . Q
20. Concrete Removal SY 36 $ $ �� - v
21, Remove and Replace � , $ ,�
Concrete Driveway SY 53
ADDENDUM Two BF-�4
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22. Remove and Rep/ace $ . (1 $ U . �
Concrete Sidewa/k SY 208
23. Remove and Rep/ace Curb $ .o� $ � • v
and Gutter LF 380
24. Upright Curb LF 105 $ ` $ �� `
25. Sing/e Curb Ramp with $ �p. $ � •��
Truncated Domes � 2
2B, Adjust Inlet � i $ . $ - 6 7 �v
27. Temporary Traffic Control LS 1 $ °' �$ Q"O�`�
28. Temporary Erosion Control LS 1 � o '� � '�
29. Add Soil, Seed, and Mulch LS 1 $ � �� ' '�
30. Truedwarf Boxwood � 36 $ _ .,/ $ �O•��
31. Installation of Owner LS 1 � � �' � � �� � "
Provided Piants
TOTAL BID FOR ALL UNIT PRICES $ � � � /�O� O'
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d � e u �1�� a� �,�j1��-1' I1�
a h p (Written figure) v
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(Total bid amount is to be shown in both words and figures. In case of discrepancy, the
amount shown in words will govem. Ir�case of error in extension,the unit and lump sum
prices under each Pay Item will be considered correct, and these sums when properly
extended, shall constitute the Bid.)
Unit Prices have been computed in accordance with paragraph 11.9.2 of the General
Conditions.
BIDDER acknowledges that quantities are not guaranteed and final payment will be based
on actual quantities determined as provided in the Contract Documents.
5. BIDDER agrees that the Work will be substantially complete within thi 30 calendar
days after the date when the Contract Times commences to run as provided in paragraph
2.3 of the General Conditions, and completed and ready for final payment in accordance
with paragraph 14.13 of the General Conditions by March 29. 2013.
BIDDER accepts the provisions of the Agreement as to liquidated damages in the event of
failure to complete the Work within the times specified in the Agreement.
6. The#ollowing documents are attached to and made a condition of this Bid:
ADDENDUM Two BF-5
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(b) Exhibit Affidavit of Work Authorization
(c) The E-Verify Program for Unemployment Verification Memorandum of
Understanding hftnJ/'www.uscis.vo�/f'"iles/nativedocuments/MOU pdf
(a� Exhibit Affidavit of OSHA Training
(e) Certfication Regarrling Debarment, Suspension and Other Responsibility Mafters
7. Bidderagrees to submit the following documents within three (3) business days afler
the opening of Bids if requested.•
(a) BIDDER'S Qual'rf'icafion Statement with supporting data.
8. Communica6ons conceming this Bid shall be addressed to:
Name Vince Kelley
Address 41 North Sprigg St. Cape Girardeau, MO 63701
(a) Performance and Payment Bonding Company
Name_ Merchants Bondinq Companv
Addr�ss21o0 Fleur Drive, Des Moines, IA 50321
AgenflPower ofAitomey Name('�f usea� Donald L. Wasoba
Address 22 Avocado Tree Circle, St. Peters, MO 63376
9. Terms used in the Bid which are defined in the Genera/conditions or lnstructions will
have tfie meanings indicated in the General Conditions or Instructions.
SUBMITTED on october 30 , 20 12
State Contracto�License No. 0 010 5 7 5
IF BIDDER is:
An lndividual
By (SEAL)
(Individual's Name)
doing business as
Business address: �
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Phone No.:
A Partnershia
By (SEAL)
(Firm 1Vame)
(General Partner�
Business address:
Phone No.:
A Cornoration �
By 1vi xelle E ui metnt Co. , Inc. (SEAL)
(Corpora on Name) �
;,;,t , : Missouri
.';`, : � (State f I ratio � .
' � ���ltilii(Il/fiJ/ .: .
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,,,✓�`�3� t_L,E;; ''''��nce Kelley (SEAL)
' �,= ,. C�,��.�`�; � (Name of Pers uthorized to Sign)
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�'�,.,��e�� ,��rank Myers .
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�:� �.,�,<<<�., � (Secr�'fa�Y)
Business addl�ss: 41 North Sprigg st.
Cape Girardeau, MO 63701 �
Phone No.: (573) 334-0553
Date of Qualifica6on to do business is January 1 974
A Joint Venture
By (SEAL)
(Name)
(Address)
By (SEAL)
(Name)
(Address) ".
Phone Number and Address for receipt of ofricial communications:
BF-7
r.
!
(Each joint venturermust sign. The mannerofsigning foreach individual,partnership and
co�poration that is a party to the joint venture should be in the manner indicated above.)
i
BF-8
.•
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BREAKDOWN OF WORK FORCE �Required):
The Contractor shal!be registered with the Missouri Secretary of State in orrler to work on
this project. .
B/DDER hereby states fhat he will perform fhe following items of wori� directly without
employment of subcontractors: �
All work exce�t as noter3 hal nw
If is anticipated that the following subcontractors will be employed for wori�on fhis project:
*SUBCONTRACTORS:
(Name of Company) �(Type of Wori�)
Jokerst Asphalt Pavincr
K & K Electric Electrical
�o����_���4�..> Lands capi ng
"All subcontractors sha/l be negistered with the Missouri Secretary of State in order ie wori�
on this pmject.
BF-9
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• (
EXHIBIT
AFFIDAVIT OF OSHA TRAIIVING
COMES NOW(Name) Vince Kelley ss (Office Hel� President
of(Company Name/Conttactor)Nip Kelley Equ�.pment co_ , Tnud first being duly swom, on
my oath,affitm in connection with the conttacted services related toParking Lot Improvement
at Broadway & Middle Stre t
(Pmject Name) for t�ie dutation of the contract,as follows:
1. Contractor shall provide a ten (10) hour Occupational Safety and Health
Administration (OSHA) construction safety program for all emplopees who will be on-site at the
Project The construction safety program shall include a course in construction safety and health
that is approved by OSHA or a similar program appioved by the Missowi Departtnent of Labor and
Industrial Relations which is at least as stringent as an approved OSHA progtam as requiued by
Section 292.675,RSMo.
2. Conttactor shall requixe its on-site employees to complete a construction safety
progra.m within sixty (60) daps after the date work on the Project commences,as required bp Section
292.675,RSMo. , '� -
3. Contcactor acknowledges a.nd agrees that any of Contcactor's employees found on
the Project site without documentation of the successful completion of a constcuction safety
progxam shall be required to produce such documentation within twenty(20) daps, or will be subject
to removal from the Project
4. Conttactor shall require all of its Subconttactors to comply with the requirements of
Section 292.675,RSMo. �
5. Conttactor acknowledges that pursuant to Section 292.675, RSMo., Contractor shall
forfeit to City as a penalty two thousand five hund.ted dollars ($2,500.000),plus one hundred dollaxs
(�100.00) for each on-site employee emploped by Contractor or its Subcontractor, for each calendar
day, or portion thexeof, such on-site employee is emploped without the construction safety training
required in Section 292.675, RSMo.
6. Contractor acknowledges that violations of Section 292.675, RSMo, and imposition
of the penalties described thexei.n shall be investigated and determined by the Missouri Depaznnent
of Labor and Industrial Relations.
7. Contractor acknowledges that in the event that the Missouri Department of Labor
and Industrial Relations ha.s determined that a violation of Section 292.675, RSMo., has occutted
i •
and that a penalty shall be assessed, the City shall withhold and retain all sums a.nd amounts due and
� owing when making payments to Contra.ctor under this Contract
FURTHER AFFIANT SATTH NOT.
IN AFFIRMATION THEREOF, the facts stated above are true and correct (the
uudersigned understands that false statements made in this fili.ng aze subject to the
penalties provided in Section 575.040,RSMo.)
Nip Ke ley Equipment Co. , Inc.
(name of c rporation)
By:
' (name of officer of corp on and tifle)
, ,_r�$,�,
Vince Kelle President
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STATE OF MISSOURI )
) ss.
COUNTY OF CAPE GIltARDEAU )
On rhis �day of Oc� . 20�-before me appeared ��E� ►`-e �
to me pers �y kno ,who,b ' by me duly swom,did say that he/she is the ✓eS 10 �L+'
of � ���a�Missowi Corporation, and that the seal affiged to the
forego ins ent is th seal of said Corporation, and that the said instrument was signed and
sealed in behalf of said Corporation by authority of its Board of Directors, and acknowledged said
instrument to be the free act and deed of said Corporation.
IN TESTIMONY WHEREOF, I have heseunto set my hand and affiged my official seal, at
my office in Cape Girardeau,Missouti,the dap and eat first above written.
�
Notary Public
My Commission F�pires:
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EXHIBIT
AFFIDAVIT OF WORS AUTHORIZATION
COMES NOW(Name) Vince Kellev as (OfficeHel� President
of(CompaayName/Con�ac�or) Nip Kelley Equipment Co. , I�3.first being duly swom, on
my oath,affirm as follows:
1. (Company Name/Coatractor) Nip Relley Equipment Co. , Inc.
is enrolled and will continue to participate in a federal work authorization program in respect to
emplopees that will work in connection with the contracted services related to (Project Name) Parking
& Middle Street
Lot Improvements at Broadway fo= the duration of the contta.ct in accordauce with RSMo
Chaptet 285.530(2).
2. I also affiim that(CompanyName/Conmactor�ip Kelley Equipment Codoeslnc.
not and will not knowingly employ a person who is an unauthorized alien in connection with the
contract services r��e�to�trojeict�am°ej ements at Broadway & Middle Street for
the duration of the contract
3. Attached hereto is documentation affirming Contractor's ensollment and
participation in a federal work authorization progtam with respect to the employees worl�ing in
connection with the.contracted services. �
FURTHER AFFIANT SATI'H NOT.
IN AFFIRMATION THEREOF, the facts stated above are true and conect (the
undersigned understands that false statements made in this filiug are subject to the
penalties provided in Section 575.040,RSMo.)
Nip Kelle Equipment Co. , Inc.
(name of coipora on)
By:
(name of o cer of coiporation tifle)
Vince Kelley, sident
,�;1T'I�S��;'. ::,:�'�' .
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,
_`.���'�ec�y`�o�otl�s;officer) Fr Myers
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STATE OF MISSOURI )
) ss.
COUNTY OF CAPE GIRARDEAU � )
On this �i�ay of l�L��►� , 20,�-before me appeated Y i✓1 � ��2
to m persona,lly kn�wn,who,b�in�,by�e duly swom,d'id say that he/she is the /p,s i �l�I.-f'
of � �'b'I- I;J -�`a`�I,ssouri Corporation, and that the seal affixed to the
forego' ins ent �s e seal of said Cozporation, and that the said instrument was signed and
sealed in behalf of said Corporation by authoritp of its Board of Directors, and acknowledged said
instrument to be the free act and deed of said Corporation.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my official seal, at
my office in Cape Gitardeau,Missowi,the dap and yeat first above written.
; — �
Notary Public
•;�p4�P�!%�r, STAqLPEPPIE
�i°.�iG�= My��
My Commission Egpires: :• •*= Feb�ary 9,2p13
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jj���`' C�mmheion#OA484211
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BBAL
Certification Regarding
Debarment, Suspension and Other Responsibility Matters
The con�actor hereby certifies to the best of its knowledge and belief and that it and its principals
and its subcontractors and their principals:
(a) Are not presently debarred, suspended,proposed for debarment, declared ineligible or
voluntarily excluded from covered transactions by any Federal or State department or agency;
(b) Have not within a three(3)yeaz period preceding this proposal been convicted of or had a
civil judgment rendered against them for commission of fraud or a criminal offense in
connection with obtai.ning, attempting to obtain or performi.ng a public(Federal, State or
Local)transaction or contract under a public transaction; violation of Federal or State antitrust
statutes or commission of embezzlement,theft,forgery,bribery,falsification or destruction of
records,making.false statements or receiving stolen property;
(c) Are not presently indicted for or otherwise criminally or civilly charged by a government
entity(Federal, State or Local)with commission of any of the offenses enumerated in
paragraph(1)(b)of tlus certification; and
(d) Have not within a three-yeaz period preceding this subcontract had one or more public
transactions(Federal, State or Local)terminated for cause or default.
I understand that a false statement on this certification may be grounds for rejection of this
contractor or termination of the contract In addition,under 18 USC Sec. 1001,a false
statement may result in a fine of np to$ 10,000 or imprisonment for up to five (�years or
both.
Vince K lley - President ,
Typed N e &Title Authorized Representative
��'��Z
Signa e of Authorized presentative Date
❑ I am unable to certify to the above statement. My explanation is attached.
. ' �
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1Y i-VBRIIY IS A 56R�•SCL 0!O6
Company ID Number.211168
THE E-VERIFY PROGRAM FOR EMPLOYMENT VERIFICATION
MEMORANDUM OF UNDERSTANDING
ARTICLE I
PURPOSE AND AUTHORITY
This Memorandum of Understanding (MOU) sets forth the points of agreement between the
Department of Homeland Security (DHS) and Nip Kellev Equipment Companv, Inc.
(Employer) regarding the Employer's participation in the Employment Eligibility Verification
. Program (E-Verify). This MOU explains certain features of the E-Verify program and
enumerates specific responsibilities of DHS, the Social Securit�r Administration (SSA), and the
Employer. E-Verify is a program that electronically confirms an employee's eligibility to work in
the United States after completion of the Employment Eligibility Verification Form (Form I-9).
For covered government contractors, E-Verify is used to verify the employment eligibility of all
newly hired employees and all existing employees assigned to Federal contracts. .
Authority for the E-Ver'ify program is found in Title IV, Subtitle A, of the Illegal Immigration .
Reform and Immigrant Responsibility Act of 1996 (IIRIRA), Pub. L:. �04-208, 110 Stat. 3009, as
amended (8 U.S.C. § 1324a note). Authority for use of the E-`✓erify program by Federal
contractors and subcontractors covered by the terms of Subpa�t 22.18, "Employment Eligibility �
Verification", of the Federal Acquisition Regulation (FAR) (hereinafter referred to in this MOU as
a "Federal cor�tractor") to verify the employment eiigibiliiy�of certai� employees working on
Federal contracts is also found in Subpart 22.18 and in Executive arder 12989, as amended.
ARTICLE II
FUNCTIONS TO BE PERFORMED
A. RESPONSIBILITlES OF SSA
1. SSA agrees to provide the Employer with available information that allows the Employer
to confirm the accuracy of Social Security Numbers provided by all employees verified under
this MOU and the employment authorization of U.S. citizens.
2. SSA agrees to provide to the Employer appropriate assistance with operational
problems that may arise during the Employer's participation in the E-Verify program. SSA
agrees to provide the Employer with names, titles, addresses, and telephone numbers of SSA
representatives to be contacted during the E-Ver'rfy process.
3. SSA agrees to safeguard the information provided by the Employer through the E-Verify
program procedures, and to limit access to such information, as is appropriate by law, to
individuals responsible for the verification of Social Security Numbers and for evaluation of the
E-Verify program or such other persons or entities who may be authorized by SSA as governed
by the Privacy Act (5 U.S.C. § 552a), the Social Security Act (42 U.S.C. 1306(a)), and SSA
regulations (20 CFR Part 401).
Page 1 af 13�E-Veai"ry tJiOU for Er,�pioyer�Revisic�Date t(li29�'OS .�:-�;�.:�s==,:::���.':; -;-.
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Company ID Number:211168 �
4. SSA agrees to provide a means of automated verification that is designed (in
conjunction with DHS's automated system if necessary) to provide confirmation or tentative
nonconfirmation of U.S. citizens' employment eligibility within 3 Federal Government work days
of the initial inquiry.
5. SSA agrees to provide a means of secondary verification (including updating SSA
records as may be necessary) for employees who contest SSA tentative nonconfirmations that
is designed to provide final confirmation or nonconfirmation of U.S. citizens' employment
eligibility and accuracy of SSA records for both citizens and aliens within 10 Federal
Government work days of the date of referral to SSA, unless SSA determines that more than 1Q
days may be necessary. In such cases, SSA will provide additional verification instructions.
B. RESPONSIBILITIES OF DHS
1. After SSA ver'rfies the accuracy of SSA records for aliens through E-Verify, DHS agrees
to provide the Employer access to selected data from DHS's database to enable the Employer
to conduct, to the extent authorized by this MOU:
• Automated verificatio.n checks on alien employees by electronic means, and
• Photo verification checks (when available) on employees.
. 2. DHS agrees to provitle to the Employer appropriate assistance with operational
. problems that may arise during the Employer's participation in the E-Verify �rogram. �DHS .
agrees to provide the Employer names, titles, addresses, and telephone��-numbers of DHS
representatives to be contacted during the E-Verify process. .
3. DHS agrees to provide to the Employer a manual (the E-Verify User Manual) containing
instructions on E-Veriiy policies, procedures and requirements for both SSA and DHS, including
restrictions on the use of E-Verify. DHS agrees to provide training materials on E-Verify.
4. DHS agrees to provide to the Employer a notice, which indicates the Employer's
participation in the E-Verify program. DHS also agrees to provide to the Employer anti-
discrimination notices issued by the Office of Special Counsel for Immigration-Related Unfair
Employment Practices (OSC), Civil Rights Division, U.S. Department of Justice.
5. DHS agrees to issue the Employer a user identification number and password that
permits the Employer to verify information provided by alien employees with DHS's database.
6. DHS agrees to safeguard the information provided to DHS by the Employer, and to limit
access to such information to individuals responsible for the verification of alien employment
eligibility and for evaluation of the E-Ver'rfy program, or to such other persons or entities as may
be authorized by applicable law. Information will be used only to verify the accuracy of Social
Security Numbers and employment eligibility, to enforce the Immigration and Nationality Act
(INA) and Federal criminal laws, and to administer Federal contracting requirements.
7. DHS agrees to provide a means of automated verification that is designed (in
conjunction with SSA verification procedures) to provide confirrnation or tentative
Page 2 of 13�E-Ve�"ry P11CU for Em�laye;�Re�ision�ate 1�i29J08 -;s.�.;::. ,;;;,;:. ;;;;;^.+:_.:�:_;;.-
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Company ID Number:211168
nonconfirmation of employees' employment eligibility within 3 Federal Government work days of
the initial inquiry.
8. DHS agrees to provide a means of secondary verification (including updating DHS
records as may be necessary) for employees who contest DHS tentative nonconfirmations and
photo non-match tentative nonconfirmations that is designed to provide final confirmation or
nonconfirmation of the employees' employment eligibility within 10 Federal Government work
days of the date of referral to DHS, unless DHS determines that more than 10 days may be
necessary. In such cases, DHS will provide additional verification instructions.
' C. RESPONSIBILITIES OF THE EMPLOYER
1. �The Employer agrees to display the notices supplied by DHS in a prominent place that is
clearly visible to prospective employees and all employees who are to be verified through the
system.
� 2. The Employer agrees to proyicle to the SSA and DHS the names, titles, addresses, and
telephone numbers of the Employer representatives to be contacted regarding E-Ver'rfy.
3. The Employer agrees to become familiar with and comply with the most recent version
� of the E-Verify User Manual. �
4. The Employer agrees that any Employer Representative who will perforrn employment
. � verification queries will complete the E-Verify Tutorial before that individual initiat�s any
' queries.
A. The Employer agrees that all Employer representatives will take ttie refresher
tutorials initiated by the E-Verify program as a condition of contiriued use of E-
Verify, including any tutorials for Federal contractors if the Employer is a Federal
contractor.
B. Failure to complete a refresher tutorial will prevent the Employer from continued
use of the program. � .
5. The Employer agrees to comply with current Form 1-9 procedures, with two exceptions:
• If an employee presents a "List B" identity document, the Emptoyer agrees to only
accept "List B" documents that contain a photo. (List B documents identified in 8 C.F.R.
§274a.2(b)(1)(B)) can be presented during the Form I-9 process to establish identity.) If
an employee objects to the photo requirement for religious reasons, the Employer
should contact E-Verify at 888-464-4218.
• If an employee presents a DHS Form I-551 (Permanent Resident Card) or Form I-766
(Employment Authorization Document)to complete the Form I-9, the Employer agrees to
make a photocopy of the document and to retain the photocopy with the employee's
Form I-9. The employer will use the photocopy to verify the photo and to assist DHS
with its review of photo non-matches that are contested by employees. Note that
employees retain the right to present any List A, or List B and List C, documentation to
complete the Form I-9. DHS may in the future designate other documents that activate
the photo screening tool.
Page 3 of 13�E-Veriip t�OU far EmployerjRevision Daie 1D!2o%08 ,:.-::_- � -�-_ _—: `�`� ' ..
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6. The Employer understands that participation in E-Verify does not exempt the Employer
from the responsibility to complete, retain, and make available for inspection Forms I-9 that
relate to its employees, or from other requirements of applicable regulations or laws, including
the obligation to comply with the antidiscrimination requirements of section 274B of the INA with
respect to Form I-9 procedures, except for the following mod'rfied requirements applicable by
reason of the Employer's participation in E-Verify: (1) identity documents must have photos, as
described in paragraph 5 above; (2) a rebuttable presumption is established that the Employer
has not violated section 274A(a)(1)(A) of the Immigration and Nationality Act (INA) with respect
to the hiring of any individual 'rf it obtains confirmation of the identity and employment eligibility of
the individual in compliance with the terms and conditions of E-Verify; (3) the Employer must
notify DHS if it continues to employ any employee after receiving a final nonconfirmation, and is
subject to a civil mor�ey penalty between $550 and $1,100 for each failure to notify DHS of
continued employment following a final nonconfirmation; (4) the Employer is subject to a
rebuttable presumption that it has knowingly employed an unauthorized alien in violation of
section 274A(a)(1)(A) ff the Employer continues to employ an employee after receiving a final
nonconfirmation; and (5) no person or entity participating in E-Ver'rfy is civilly or criminally liable
urider any law for any action taken in good faith based on information provided through the
confirmation system. DHS reserves the right to conduct Form I-9 compliance inspections during
the course of E-Verify, as well as to conduct any other enforcement activity authorized by law.
7. The Employer agrees to initiate E-Verify verification procedures for new employees
within 3 Employer business days after each employee has been hired (but after both sections 1 ..
and 2 of the Form I-9 have been completed), and to complete as many (but only as many) steps . .
of the E-Ver'rfy process as are necessary according ta the E-Verify User Manual. The Empleyer. � . .. .
is prohibited from initiating verification procedures before the employee has been hired ancl the �_�::.: -'
Form I-9 completed. If the automated system to:be queried is temporarily unavailable, the 3-day - .. .
fime period :is extended until it is again operational in order to accommodate the Employer's
attempting, in good faith, to make inquiries during the period of unavailability. In all•�cases, the
Employer must use the SSA verification procedures first, and use DHS verification procedures
and photo screening tool only after the SSA verification response has been given. Employers
may initiate verification by notating the Form I-9 in circumstances where the employee has
applied for a Social Security Number (SSN) from the SSA and is waiting to receive the SSN,
provided that the Employer performs an E-Verify employment ver'rfication query using the
employee's SSN as soon as the SSN becomes available.
8. The Employer agrees not to use E-Ver'rfy procedures for pre-employment screening af
job applicants, in support of any unlawful employment practice, or for any other use n�t
authorized by this MOU. Employers must use E-Verify for all new employees, unless an
Employer is a Federal contractor that qualifies for the exceptions described in Article II.D.1.c.
Except as provided in Article II.D, the Employer will not verify selectively and will not verify
employees hired before the effective date of this MOU. The Employer understands that if the
Employer uses E-Verify procedures for any purpose other than as authorized by this MOU, the
Employer may be subject to appropriate legal action and termination of its access to SSA and
DHS information pursuant to this MOU.
9. The Employer agrees to follow appropriate procedures (see Article III. below) regarding
tentative nonconfirmations, including notifying employees of the finding, providing writtee
referral instructions to employees, allowing employees to contest the finding, and not taking
Page 4 of 13�E-Verify MOU Por Em�loyar��evisio�Date 10/29l08 4�,rt,s�..��:�:,::_n-_., ,- --
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adverse action against empioyees if they choose to contest the finding. Further, when
employees contest a tentative nonconfirmation based upon a photo non-match, the Employer is
required to take affirmative steps (see Article III.B. below) to contact DHS with information
necessary to resotve the challenge.
10. The Employer agrees not to take any adverse action against an employee based upon
the employee's perceived employment eligibility status while SSA or DHS is processing the
verification request unless the Employer obtains knowledge (as defined in 8 C.F.R. § 274a.1(I))
that the employee is not work authorized. The Employer understands that an initial inability of
the SSA or DHS automated verification system to ver'rfy work authorization, a tentative
nonconfirmation, a case in continuance (indicating the need for additional time for the
govemment to r�solve a case), or the finding of a photo non-match, does not establish, and
should not be interpreted as evidence, that the employee is not work authorized. In any of the
cases listed above, the employee must be provided a full and fair opportunity to contest the
finding, and if he or she does so, the employee may not be terminated or suffer any adverse
employment consequences based upon the employee's perceived employment eligibility status
(including denying, reducing, or extending work hours, delaying or preventing training, requiring .
an employee to work in poorer conditions, refusing to assign the employee to a Federal contract
or other assignment, or otherwise subjecting an employee to any assumption that he or she is
unauthorized to work) until and unless secondary verification by SSA or DHS has been
completed and a final nonconfirmation has been issued. If the employee does not choose to
contest a tentative nonconfirmation or a photo non-match ar if a secondary verification is �
completed and a final nonconfirmation is issued, then the Employer can find the employee is not
work authorized and te.rminate the employee's employment. �: Einployers or employees with �
questions about a final nonconfirmation may call E-Veri#y at 1-888-464-4218 or OSC at�1-800- � '
255-8155 or.1�800-237-2515 (TDD). �
11. The Employer agrees to comply with Title VII of the Civil Rights Act of 1964 and section
274B of the INA by not discriminating unlawfully against any individual in hiring, firing, or
recruitment or referral practices because of his or her national origin or, in the case of a
protected individual as defined in section 274B(a)(3) of the INA, because of his or her
citizenship status. The Employer understands that such illegal practices can include selective
verification or use of E-Verify except as provided in part D below, or discharging or refusing to
hire employees because they appear or sound �foreign" or have received tentative
nonconfirrnations. The Employer further understands that any violation of the unfa'r
immigration-related employment practices provisions in section 274B of the INA could subject
the Employer to civil penalties, back pay awards, and other sanctions, and violations of Title VII
could subject the Employer to back pay awards, compensatory and punitive damages.
Volations of either section 2746 of the INA or Title VII may also lead to the termination of its
participation in E-Verify. If the Employer has any questions relating to the anti-discrimination
provision, it should contact OSC at 1-800-255-8155 or 1-800-237-2515 (TDD).
12. The Employer agrees to record the case verification number on the employee's Form I-9
or to print the screen containing the case ver'rfication number and attach it to the employee's
Form I-9.
13. The Employer agrees that it will use the information it receives from SSA or DHS
pursuant to E-Verify and this MOU only to confirm the employment eligibility of employees as
Page 5 af 13�E-Verify�IOU for Employer�Revisior�Oaie 10!29�08 >'��.�;��.��:� =_- _. ---
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authorized by this MOU. The Empioyer agrees that it will safeguard this inforrnation, and means
of access to it (such as PINS and passwords) to ensure that it is not used for any other purpose
and as necessary to protect its confidentiality, including ensuring that it is not disseminated to
any person other than employees of the Employer who are authorized to perform the
Employer's responsibilities under this MOU, except for such dissemination as may be
authorized in advance by SSA or DHS for legitimate purposes.
14. The Employer acknowledges that the information which it receives from SSA is
govemed by the Privacy Act (5 U.S.C. § 552a(i)(1) and (3)) and the Social Security Act (42
U.S.C. 1306(a)), and that any person who obtains this information under false pretenses or uses
it for any purpose other than as provided for in this MOU may be subject to criminal penalties.
15. The Employer agrees to cooperate with DHS and SSA in their compliance�monitoring
and evaluation of E-Verify, including by permitting DHS and SSA, upon reasonable notice, to
review Forms I-9 and other employment records and to intenriew it and its employees regarding
the Employer's use of E-Verify, and to respond in a timely and accurate manner to DHS
requests for information relating to their participation in E-Verify. .
D. RESPONSIBILITIES OF FEDERAL CONTRACTORS .
1. The Employer understands that if it is a Federal contractor subject to the �
employment verffication terms in Subpart 22.18 of the FAR it must ver'rfy the employmenl
_ eligibility of any "employee assigned to the contracY' (as defined in FAR 22.1801) in addition to
verifying the.employment eligibility of all other employees required•to be ver�ied under the FAR.
Once an employee has been�verified through E-Verify by the Employer, the.�Employ�r may noi •
reverify the employee through E-Ver'rfy. �
a. �Federal contractors not enrolled at the time of contract award: An Employer thai
is not enrolled in E-Verify as a Federal contractor at the time of a contract award must enroll as
a Federal contractor in the E-Verify program within 30 calendar days of contract award and,
within 90 days of enrollment, begin to use E-Ver'rfy to initiate verification of employment eligibility
of new hires of the Employer who are working in the United States, whether or not assigned to
the contract. Once the Employer begins verifying new hires, such ver'rfication of new hires musi
be initiated within 3 business days after the date of hire. Once enrolled in E-Verify as a Federal
contractor, the Employer must initiate verification of employees assigned to the contract within
90 calendar days after the date of enrollment or within 30 days of an employee's assignment to
the contract, whichever date is later.
b. Federal contractors already enrolled at the time of a contract award: Employers
enrolled in E-Verify as a Federal contractor for 90 days or more at the time of a contract award
must use E-Verify to initiate verification of employment eligibility for new hires of the Employer
who are working in the United States, whether or not assigned to the contract, within 3 business
days after the date of hire. If the Employer is enrolled in E-Verify as a Federal contractor for 90
calendar days or less at the time of contract award, the Employer must, within 90 days of
enrollment, begin to use E-Verify to initiate verification of new hires of the contractor who are
working in the United States, whether or not assigned to the contract. Such verification of new
hires must be initiated within 3 business days after the date of hire. An Employer enrolled as a
Federal contractor in E-Verify must initiate verification of each employee assigned to the
Page S af 13jEVeri"ry tJIOU for Employer�Revisior:Date 10/231p8 ?�:>:�4;..'��x:1 - ->..r.;s�?;=;;
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contract within 90 calendar days after date of contract award or within 30 days after assignmer�t
to the contract, whichever is later.
c. Institutions of higher education, State, local and tribal govemments and sureties:
Federal contractors that are institutions of higher education (as defined at 20 U.S.C. 1001(a)),
State or local governments, governments of Federally recognized Indian tribes, or sureties
performing under a takeover agreement entered into with a Federal agency pursuant to a
performance bond may choose to only verify new and existing employees assigned to the
Federal contract. Such Federal contractors may, however, elect to veriiy all new hires, and/or
all existing employees hired after November 6, 1986. The provisions of Article II.D, paragraphs
i.a and i.b of this MOU providing timeframes for initiating employment verification of employees
assigned to a contract apply to such institutions of higher education, State, local and tribal
governments, and sureties.
d. Verification of all employees: Upon enrollment, Employers who are Federal
contractors may elect to verify employment eligibility of all existing employees working in the
United States who were hired �fter November 6, 1986, instead of verifying only those
employees assigned to a covered Federal contrac�. After enrollment, Employers must elect to
do so only in the manner designated by DHS and initiate E-Verify verification of all existing .
employees within 180 days after the election.
e. Form I-9 procedures for Federal contractors: The Employer may use a
previously completed Form I-9 as the basis for initiating E-Verify verification of an employee
� assigned to a contract as long as that Form I-9 is complete (including the SSN), complies with
Article II.C.5, the employee's work authorization has not expired, and�the Employer has
reviewed the information reflected in the Form I-9 either in person or in communications-with the
employee to ensure that the employee's stated basis in section 1 of the Form I-9 for work
authorization has not changed (including, but not limited to, a lawful permanent resident alien
having become a naturalized U.S. citizen). If the Employer is unable to determine that the Form
1-9 complies with Article II.C.5, if the employee's basis for work authorization as attested in
section 1 has expired or changed, or if the Form I-9 contains no SSN or is otherwise incomplete,
the Employer shall�complete a new I-9 consistent with Article II.C.5, or update the previous I-9
to provide the necessary information. If section 1 of the Form I-9 is otherwise valid and up-to-
date and the form otherwise complies with Article II.C.5, but reflects documentation (such as a
U.S. passport or Form I-551) that expired subsequent to completion of the Form I-9, the
Employer shall not require the production of additional documentation, or use the photo
screening tool described in Article II.C.5, subject to any additional or superseding instructions
that may be provided on this subjeet in the E-Veriiy User Manual. Nothing in this section shall
be construed to require a second verification using E-Verify of any assigned employee who has
previously been verified as a newly hired employee under this MOU, or to authorize verification
of any existing employee by any Employer that is not a Federal contractor.
2. The Employer understands that'rf it is a Federal contractor, its compliance with this MOU
is a performance requirement under the terms of the Federal contract or subcontract, and the
Employer consents to the release of information relating to compliance with its verification
responsibilities under this MOU to contracting officers or other officials authorized to review the
Employer's compliance with Federal contracting requirements.
Page 7 af 13�E-Verify MOU for Employer�Revision Date 10l29�3 ���,��`��..�;�F�`:.:-•:`,: >
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ARTICLE 111
REFERRAL OF INDIVIDUALS TO SSA AND DHS
A. REFERRAL TO SSA
1. If the Employer receives a tentative nonconfirmation issued by SSA, the Employer must
print the tentative nonconfirmation notice as directed by the automated system and provide it to
the employee so that the employee may determine whether he or she will contest the tentative �
nonconfirmation.
2. The Employer will refer employees to SSA field offices only as directed by the �
automated system based on a tentative nonconfirmation, and only after the Employer records
the case verification number, reviews the input to detect any transaction errors, and determines
that the employee contests the tentative nonconfirmation. The Employer will transmit the Social
Security Number to SSA for verification again if this review indicates a need to do so. The
Employer will determine whether the employee contests the tentative nonconfirmation as soon
as possible after the Employer receives it.
3. If the employee contests an SSA tentative nonconfirmation, the Employer will provide
the employee with a system-generated referral letter and instruct the employee to visit an SSA
office.within 8 Federal Govemment work days. SSA will electronically transmit the result of the
referral to the Employer within 10 Federal Govemment work days of the referrai Unless�it. -. �
determines that more than 10 days is necessary..The Employer agrees to checic the�E-Verify �
system regularly for case updates. .
4. The Employer agrees not to ask the employee to obtain a printout from the Social
Security Number database (the Numident) or other written verification of the Social Security
Number from the SSA.
B. REFERRAL TO DHS
1. If the Employer receives a tentative nonconfirmation issued by DHS, the Employer must
print the tentative nonconfirmation notice as directed by the automated system and provide it to
the employee so that the employee may determine whether he or she will contest the tentative
nonconfirmation.
2. If the Employer finds a photo non-match for an employee who provides a document for
which the automated system has transmitted a photo, the employer must print the photo non-
match tentative nonconfirmation notice as directed by the automated system and provide it to
the employee so that the employee may determine whether he or she will contest the finding.
3. The Employer agrees to refer individuals to DHS only when the employee chooses to
contest a tentative nonconfirmation received from DHS automated verification process or when
the Employer issues a tentative nonconfirmation based upon a photo non-match. The Employer
will determine whether the employee contests the tentative nonconfirmation as soon as possible
Page 8 4f 13�E-Verify MOU for E+nployer�Revisicn Date 1D2�08 „-- y=-- �..-.. � , - _ •
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after the Employer receives it.
4. If the employee contests a tentative nonconfirmation issued by DHS, the Employer wil�
provide the employee with a referral letter and instruct the employee to contact DHS through its
toll-free hotline (as found on the referral letter) within 8 Federal Government work days.
5. If the employee contests a tentative nonconfirmation based upon a photo non-match, the
Employer will provide the employee with a referral letter to DHS. DHS will electronically transmit
the result of the referral to the Employer within 10 Federal Government work days of the referral
unless it determines that more than 10 days is necessary. The Employer agrees to check the E-
Ver'rfy system regularly for case updates.
6. The Employer agrees that if an employee contests a tentative nonconfirmation based .
upon a photo non-match, the Employer will send a copy of the employee's Form I-551 or Form
I-766 to DHS for review by:
• �Scanning and uploading the document, or .
• Sending a photocopy of the document by an express mail account (fumished and paid
for by DHS).
� � 7. The Employer understands that if it cannot determine whether there is a photo
match/non-match, the Employer is required to forward.tF�e employee's documentation to DHS by .
scanning and uploading, or by sending the document as described in the preceding paragraph,
and resolving the case as specified by the Immigration Services Verifier at DHS wno will • ��•
� determine the photo match or non-match. . � •
ARTICLE IV
SERVICE PROVISIONS
SSA and DHS will not charge the Employer for verification services performed under this MOU.
The Employer is responsible for providing equipment needed to make inquiries. To access the
E-Verify System, an Employer will need a personal computer with Internet access.
ARTICLE V
PARTIES
A. This MOU is effective upon the signature of all parties, and shall continue in effect for as
long as the SSA and DHS conduct the E-Verify program unless modified in writing by the mutual
consent of all parties, or terminated by any party upon 30 days prior written notice to the others.
Any and all system enhancements to the E-Ver'rfy program by DHS or SSA, including but not
limited to the E-Ver'rfy checking against additional data sources and instituting new verification
procedures, will be covered under this MOU and will not cause the need for a supplemental
MOU that outlines these changes. DHS agrees to train employers on all changes made to E-
Verify through the use of mandatory refresher tutorials and updates to the E-Verify User
Manual. Even without changes to E-Verify, DHS reserves the right to require employers to take
,_�::�..: :: �.._ :.-., :_
Page 9 af 13�E-Verify MOU for Empl�yer�Revisior?Date 1�129/OS .:- ...�_'�'�.�,-"."z=,�-=''�:.:�;
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mandatory refresher tutorials. An Employer that is a Federal contractor may terminate this
MOU when the Federal contract that requires its participation in E-Ver'rfy is terminated or
completed. In such a circumstance, the Federal contractor must provide written notice to DHS.
If an Employer that is a Federal contractor fails to provide such notice, that Employer will remain
a participant in the E-Ver'rfy program, will remain bound by the terms of this MOU that apply to
non-Federal contractor participants, and will be required to use the E-Verify procedures to verify
the employment eligibility of all newly hired employees.
B. Notwithstanding Article V, part A of this MOU, DHS may terminate this MOU if deemed
necessary because of the requirements of law or policy, or upon a determination by SSA or
DHS that there has been a breach of system integrity or security by the Employer, or a failure
on the part of the Employer tp comply with established procedures or legal requirements. The
Employer understands that if it is a Federal contractor, termination of this MOU by any party for
any reason may negatively affect its performance of its contractual responsibilities.
C. Some or all SSA and DHS responsibilities under this MOU may be performed by
contractor(s), and SSA and DHS may adjust verification responsibilities between each other as
they may determine necessary. By separate agreement with DHS, SSA has agreed to perform
its responsibilities as described in this MOU.
D. Nothing in this MOU is intended, or should be construed, to'create any right or bene#it,
substantive or procedural, enforceable at law by any third party against the United States, its
agencies, officers, or employees, or against the Employer, its agents, officers, or employees.
E. Each party shall be solely responsible for defending any claim or action against it arising �
out of or related to E-Ver'rfy or this MOU, whether civil or criminal, and for any liability
wherefrom, including (but not limited to) any dispute. between the Err�ployer and any other
person or entity regarding the applicability of Section 403(d) of IIRIRA to any action taken or
allegedly taken by the Employer.
F. The Employer understands that the fact of its participation in E-Verify is not confidential
information and may be disclosed as authorized or required by law and DHS or SSA policy,
including but not limited to, Congressional oversight, E-Verify publicity and media inquiries,
determinations of compliance with Federal contractual requirements, and responses to inquiries
under the Freedom of Information Act (FOIA).
G. The foregoing constitutes the full agreement on this subject between DHS and the
Employer.
H. The individuals whose signatures appear below represent that they are authorized to
enter into this MOU on behalf of the Employer and DHS respectively.
Page 10 af 13;E-Verify h�OU for Employer�Revisia�Date 10�'291�3 ;r;�,---r,;,��;z -
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To be accepted as a participant in E-Verify, you should only sign the Employer's Section
of the signature page. If you have any questions, contact E-Verify at 888-464-4218.
�I�yec �I�ip.Kelaey:Equip�en#.Company;titc. . .. .
Vinc� KelleY .
Name(P}ease Type or Prini) Title
. Eteclmnical�y Siyned 05/05120�9
Signature . . Qate
Department o#:Homeland Security-Verification�Division � . -
US��'�erff�cation`Division
Name(Please.Type or Print) Ti#le .
��ctr�rrical/y Signeo' .:: . � � 05/05i2049 . : =
Sigiiature ° _ . . . :. Dafe ,. .
Page it of 13�E-Verify MOU for Employer�Revision Date 10;29108 '.�'�.��k.kr� :_._:_;�:�:`::.-::r:�:,::;
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Company ID Number.211168
- � Infocmation-Required forthe E-Veriiy Program
Ir�formation.relating#o yaur'Compa�y:
Company Natne: Nip Keliey Equipment Gompany,fnc.
Campany Facility Address: 47 North Sprigg
� Cape Gi.rardeau;MO 63701
Company Af#�nate . _ -
_- .: �ddress�. -
Ca��ty`o:_Parish: GAPE GtRAR�E�t�U � �
Empioye�r id�ntification : - . - . :
, _ ;: .Number: 431086200. .
North American`)ndustry
Classifiicat[oii Systems : = .. � .
;,. , ,. .
. Code..237 ;�, . . ` . . .
Farent Company: Nip KeileyEquipmeM Company,(nc. _ . �
Num6er-af Emplayees: 2o ta 99 �
Nurnber of-Sites Verifiasf -
for: 1 - �
are you veriiy�r�g_for-more than 1 srte? 1#yes,please provide the riumber of sites verified for iq
each State:
. MISSOURI 1 � site(s)
Page i2 oi 13�E-Verify MUU forEmployer�Revision Date 1�� �=v-�^.°;,:-`;;- •.-d.i;�-;�c�-;:�--'
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lrrformation relating to the Program Administrator(s)for your Company on policy questions or
operational problems:
Name: Staci L Pepple
Telephone Number: (573)334-0553 Faz Number: (573)334-2025
�-mail Address: spepple�nipkelleyco.com
: Name: Vince L Kelley
� Te[ephA.ne Number� (573)334-0553 Fax I�umber. j573)334-2025
E-mail Address: vkelley�nipkelleyco.com ' ..
Page 13 of 13�E-Verify MOU for Employer�Revision�a�14'29�'OS -- . ..r ..-=�::=�°r"���:=:�:'�>:;
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OWN�8�7Ya�t��ta(ab�ess}: �
City of CaT�e C=irar�.
City Aa].I, 4Q1 Iad�e Stre� ..
Cape ixardeau, Ai0 63701 ,
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����xipt�iLe F�f'�. � .-,.
A. StimelT sh�.�eausa bs6e�to�Fns Bond��etieot aad
cfYCct'tve Pa►aq t+tA[iozsuY ev�tle3e�g t&a�ucbo�y of d�e�ec,
agcat at nprrs�ntive w�o exuuted i�as 8oad m betaif of Sus�ty
��4�at aad de1�,r�sssch B�d�bi�d thr Sutety��
t D. Ihes Bor�d ic ie�aded m c�Poim ta ai!a�p(ieabte sm�ry .
����S�aa d+��Cad ihff!6e deaoed e�f bc
includod ho�ea a�f f����g�. }��Y P�'o��afthe '
SJG'[]C IW.19t�BC[i8906ditiot►) $�-�
f
� � •
' � MERCHANT�S�
BONDING COMPANY,�
POWER OF ATTORNEY
Know All Persons By These Preserrts,that MERCHANTS BONDING COMPANY(MUTUAL)and MERCHANTS NATIONAL BONDING,
INC.,both being corporations duly organ¢ed under the laws of the State of lowa(herein collectively called the"Companies'),
and that the Companies do hereby make,constitute and appoirrt,individually,
Donald L Wasoba
of St Peters and State of MO their true and lawFul Attomey-in-Fact,with full power
and authority hereby conferred in their name,place and stead,to sign,execute,acknowledge and dei"iver in their behalf as surety
any and all bonds, undertaldngs,recognizances or other written obtigations in the nature thereof,subjed to the limitation that any
such instrument shall not exoeed the amouM of:
TR'O NIILLION(52,000,000.00)DOLLARS
and to bind the Companies thereby as fully and to the same extent as ff such bond or undertaking was signed by the duly
authorized officers of the Companies,and all the acts of said Attomey-in-Fact, pursuant to the authority herein given,are
hereby ratified and confirmed.
This Power-of-Attomey is made and executed pursuarrt to and by authority of the following By-Laws adopted by the Board of
Diredors of the Merchants Bonding Company(Mutual)on April 23,2011 and adopted by the Board of Directors of Merchants Nationai
Bonding,Inc.,on October 24,2011.
'The President,Secretary,Treasurer,or any Assistant Treasurer or any Assistant Secxetary or arry Vice Presiderrt shali have
power and authority to appoirrt Attomeysin-Fact,and to authorize them to exearte on behalf of the Company,and attach the
seal of the Company thereto,bonds and undertakings,recognizances,contrads of indemnity and other writings obligatory in
the nature thereof.
The signature of any authorized officer and the seal of the Company may be affoced by facsimile or eledronic transmission to
any Power of Attomey or Certfication thereof authorizing the execution and delivery of any bond,undertaking,recognizance,
or other suretyship obligations of the Company,and such signature and seal when so used shall have the same force and
effed as though manually fixed."
In Wrtness Whereof,the Companies have caused this instrumeM to be signed and sealed this 2nd day of Mat�ch , 20�2•
,, .�.N..
��.�. r�. ••��.�.���•
y,������;�,�o�� Q i �Dy►0�¢�Q�A1A9.• MERCHANTS BONDING COMPANY(MUTUAL)
�•�q�%�� qj;.:p: � 0:�0 9.��.y`� MERCHANTS NATIONAL BONDING,INC.
_�: � -0_ �`�;�_ :��_ -o- o' :
_ ,x'j= 2003 �n: ;y,, 1933 :�c:
• • � ��
-,,�'.�• .....•;�,`r�'�s .�.b�� .� .`1��.
STATE OF IOWA , •.,�••.�t �,,. •.� �•
COUNTY OF POLK ss. �����•"� ""� President
On this 2nd day of March � 2012,before me appeared Larry Taytor,to me personally known,who being by me duly swom did
say that he is Presiderrt of the MERCHANTS BONDING COMPANY(MUTUAL)and MERCHANTS NATIONAL BONDING,INC.;and
that the seals affaed to fhe foregoing instrumerrt is the Corporate Seals of the Companies;and that the said instrument was signed and
sealed in behalf of the Companies by authorily of their respedive Boards of Directors.
In Testimony Whereof,I have hereurrto set my hand and affixed my Oftiaal Seal at the City of Des Moines,lowa,ttie day and year
first above written.
�MARANDA GREENWALT �� �,�
�� Commissfon Number 770312
My Commisston Expfres
October 28,2014
Notary Public,Polk County,lowa
STATE OF IOWA
� COUNTY OF POLK ss.
I, William Wamer,Jr.,Secretary of the MERCHANTS BONDING COMPANY(MUTUAL)and MERCHANTS NATIONAL BONDING,INC.,
do hereby certify that the above and foregoing is a true and correct copy of the POWER-0E-ATTORNEY executed by sai¢,Companies,
which is stiil in full force and effed and has not been amended or revoked. :.h;;.,
in Wrtness Whereof,I have hereunto set m hand and affixed the seal of the Com anies on ''��'�+ +j�"'-�-
this 30� day of Odober , 2012 y P ,'�,ti�1� ��j/fi:•�,�;�:�
�NIM,� ��������� '�� ��� . ......, ' J �,s
�•�""' '"� • NG C • � � �'• �
,r,.�` *�1011,�� •.�, ;�p� O,�A, 'QO .'"�,p0;�.,�-. f��;i': ;.
r g?o��Rqr�p'�: :�'�c,O�P�9��►9Z,�: f������i J�"` �= °'`
'�:i�' o:�=' :�:_ -o- �^�_: _ ,:!:.C�v��� :,.F �=
=�; .,p- •G a .z; � . ��;- '� • � � �:
� 2043 '�� �s' t933 :c• :,��„seue����r:t�:3, ��. .= -►;
_�= ;.o; .yJ. :ti; ,. eu yJ. : .� :b�,-' � �
_ , �•b C� ;•>` :.� � �`
POA 0014 (11/11) -.,td'�+�.. , ..•;r�r�,rr •.;�lN''�'.•\1a� '�'�,l,'.�j�• "'v'• '.��,.'
�"ti+n..Y»��nµ"��� '•••..••' ,%'t°/•,,����ia,i�n�,n�•'``'
THE AMERICAN INSTITUTE OF ARCHITECTS
�
Bond No. MOC 67404
AfA Documer►t�1312
Performance Bond
Any si�ulaz reFerence to Contractor,Surety,Ownc�r or other pa►cy shatl be considered plural where appiicable.
CONTRACTOR(Name and Address): SURETY(Name and Principa!Place of Business):
Nip Kelley Equipment Company,Inc. Merchants Bonding Company(Mutual)
41 North Sprigg Street 2100 Fleur Drive
Cape Girardeau, MO 63701 Des Moines, IA 50321
Tel:515-243-8171
OWNER tName and Address):
City of Cape Girardeau .
401Independence
Cape Girazdeau,MO 63701
CONTSTRUCTION CONTRACT
Date: November '1 ,2012
Amount: $117,908.68
Des�ription(Name and Location): paz�g Lot Improvements at Broadway and Middle Street
BOND
Date(Not earl ier than Construction Contratt Date): November 1 ,2012
Amount: $117,908.68
Mod�ca6ons to thi¢Bond: � None 0 See Pa�e 3
� ,',,,,' ,,�f i ",���:.. -; �.
CONTRACTOR AS RINCIPAL SURETY �•�` w'�� ' '��'�
'`` �,�,�����Gom ny: {Corporate Seaq CompanY: 3 ��aq'••, �
` � L��ip�idyy Fqui nt Comp ,Inc. Merchants Bonding Company(Mutual) �? 4, ,,� ,r�
� �( . • , � Tel:51 43-8171 � ! J r �; ; a � '3 �
'�t �;;;��.�� Signature: cM,.o� c..� ��� . c�
,�, � .
«'''`�� .�larr��r1d��� Vinc elley .President Name and Title: Donald L.Wasoba ' 'f�t `ry�`i� . `s ,
',; R �,: �' � u, � : J � =: Attomey-In-Fact � ,A cQ' f ,•�,� �
' �� .f�C�� i(�n�t<'}addj�b��signatures appear on page 3) �nd Signed and Sealed this 6th day of �d��l�,�.�a�;�,
��•'�/ • �:� Bu ef
��'�% '�/ � ��.�jR!�V ° � AT10N ONLY—Name,Adrlress and Tefephone) r F
r '''<< �° • '�.L' OWNER'S REPRESENTATIVE(Archieect.Engineer or other
. E '�i��,;AG���fo�BROKER:
c�� P�Y1�
,', `Gateway Surety
22 Avocado Tree Circle
St.Peters, MO 63376 •
Tel:314374-0589
AIA DOCUMENT A31t•PERFORMANtE BOND ANp PAYMENT BflNO•DECEMBfR 1984 E�. •AIA A
THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W.,WASHINGTON,D.C. 20006 ��Z'�� �
1 The Contractor and the Surety,jointly and severally,bind .t After investigation, determine the amount for
themselves, their heirs, executors, administrators, which it may be liabie to the Owner and, as soon
successors and assigns to the Owner for the performance as practicable after the amount is determined,
of the Construction Contract, which is incorporated herein tender payment therefore to the Owner,or
by reference.
.2 Deny liability in whole or in part and notify the
2 If the Contractor performs the Construction Contract,the Owner citing reasons therefore.
Surety and the Contractor shall have no obtigation under 5 If the surety does not proceed as provided in Para-graph
this Bond,except to participate in conferences as provided 4 with reasonable promptness, the Surety shall be deemed
in Subparagraph 3.1. to be in default on this Bond fifteen days after receipt of
3 If there is no Owner Default, the Surety's obligation an additional written notice from the Owner to the Surety
demanding that the Surety perForm its obligations under this
under this Bond shall arise after. Bond, and the Owner shall be entitled to enforce any
3.1 The Owner has notified the ConVactor and the remedy available to the Owner. If the Surety proceeds as
Surety at its address described in Paragraph 10 provided in Subparagraph 4.4, and the Owner refuses the
below that the Owner is considering deGaring a payment tendered or the Surety had denied liability, in
Contrador Default and has requested and attempted whole or in part, without further notice the Owner shal� be
to arrange a conference with the Contractor and the entitled to e�foroe any remedy available to the Owner.
Surety to be held not later than fifteen days after
receipt of such notice to discuss methods of per- 6 After the Owner has terminated the Contractors right to
forming the Construction Contract. If the Owner, the �mplete the Construction Contract, and if the Surety
Contrador and the Surety agree, the Contractor shall elects to act under Subparagraph 4.1,4.2, or 4.3 above,
be allowed a reasonable time to perform the then the responsibilities of the Sunety to the Ovmer shall
Construdion Contrad, but such an agreement shall not be greater than those of the Contrador under the
not waive the Owner's right, if any, subsequently to Construction Contract, and the responsibilities of the
declar�e a Contractor Default;and Owner to the Surety shall not be greater than those of the
3.2 The Owner has deGared a Contractor Default and �er under the Construction Contract.To the limit of the
formally terminatsd the Contractor's right to complete amount of this Bond, but subject to commitrnent by the
the contract Such Contractor Defautt shall not be �ner of the Balance of the Contract Prioe to mitigation of
declared earlier than twenty days after the Contractor costs and damages on the Construction Contrad, the
and the Surety have received notice as provided in Surety is obligated without duplication for.
Subparagraph 3.1;and 6.1 The responsibilities of the Contrador for cor-
3.3 The Owner has agreed to pay the Balanoe of the r�ection of defective work and complefion of the Con-
Contract Price to the Surety in accorclance with the struction Contract;
terms of the Construction Contract or to a contrador
selected to perform the Construction Contract in 62 Additional legal, design professional and delay
acxordance with the terms of the contract with the costs resulting from the Contractor's Default, and
Owner. resulting from the actions or failure to act of the
4 When the Owner has satisfied the oonditions of Surety under Paragraph 4;and
Paragraph 3,the Surety shall promptly and at the Surety's 6.3 Liquidated damages, or if no liquidated damages
expense take one of the following adions: are speafied in the Construdion Corrtrad, actual
damages caused by delayed performance or non-
4.1 Arrange for the Contractor, with consent of the performance of the Contractor.
Owner, to perform and complete the Construdion
Contract;or 7 The Surety shall not be liable to the Owner or others for
obligations of the Contractor that are unrelated to the
4.2 Undertake to perform and complete the Con- Construction Contract, and the Balance of the Contract
strudion Contract itself, through its agents or through Price shall not be r�educed or set off on account of any
independent contractors;or such unrelated obligations. No right of adion shall accrue
4.3 Obtain bids or negotiated proposals from qualified on this Bond to any person or entity other than the Owner
contractors acceptable to the Owner for a contract for or its heirs,executors,administrators or sucoessors.
perfoRnance and completion of the Construction 8 The Surety hereby waives notice of any change, indu-
Contract, arrange for a contract to be prepared for ding changes of time, to the Construction Contract or to
execution by the Owner and the contrador selected related suboontracts, purchase orders and othe� obli-
with the Owner's concurrence, to be secured with gations.
performance and payment bonds executed by a
qualified surety equivalent to the bonds issued on the 9 Any proceeding, legal or equitable, under this Bond may
Construction Contract, and pay to the Owner the be instituted in any court of competent jurisdiction in the
amount of damages as described in Paragraph 6 in location in which the work or part of the work is located and
excess of the Balance of the Contract Price incurred shall be instituted within two years after Contractor Defauft
by the Owner resulting from the Contractor's default;or or within two years after the Contractor ceased working
4.4 Waive its right to perform and complete, amange or within two years after the Surety refuses or fails to
for completion, or obtain a new contractor and with Perform its obligations under this Bond, whichever occurs
ficst. If the provisions of this Paragraph are void or
reasonable promptness under the arcumstances: prohibited by law,the minimum period of limitation avail-
AIA DOCUMENT A312�PERFORMANCE BOND AND PAYMENT SOND�DECEMBER 1984 ED.�AIA ��_�� 2
THE AMERICAN INSTRUTE Of ARCHITECHT5,1735 NEW YORK AVE,N.W. WASHINGTON,D.C. 20006
abie to sureties as a defense in the jurisdiction of the suit have been made including aliowance to the
shall be applicable. Contractor of any amounts received or to be
received by the Owner in settlement of insurance or
10 Notice to the Surety,the Owner or the Contractor shall other claims for damages to which the Contractor is
be mailed or delivered to the address shown on the entitled, reduced by all valid and proper payments
signature page. made to or on be- half of the Contractor under the
Construction Contract.
11 When this Bond has been fumished to comply with a 12.2 Construction Contract:The agreement between
statutory or other legal requirement in the location where the Owner and the Contractor identified on the sig—
the construction was to be performed, any provision in nature page, including all Contract Documents and
this Bond conflicting with said statutory or legal changes thereto.
requirement shall be deemed deleted herefrom and 12.3 Contractor Default: Failure of the Contractor,
provisions conforming to such statutory or other legal
requirement shall be deemed incorporated herein. The which has neither been remedied nor waived, to
intent is that this Bond shall be construed as a statutory PerForm or otherwise to comply with the terms of the
bond and not as a common law bond. Construction Contrad.
12 DEFINITIONS 12,4 Owner Default: Failure of the Owner,which has
12.1 Balance of the Contract Price:The total amount neither been remedied nor waived, to pay the Con-
tractor as required by the Construction Contract or to
payable by the Owner to the Contractor under the perForm and complete or comply with the other terms
Construction Contract after all proper adjustments thereof.
MODIFICATIONS TO THIS BOND ARE AS FOLLOWS:
NONE
(Space is provided below for additional signatures of added parties,other than those appearing on the cover page.)
CONTRACTOR AS PRINCIPAL SURETY
Company: Company:
(Corporate Seal) (Corporate Seal)
Signature: Signature:
Name and Tdle: Name and Title:
Address: Address:
AIA DOCUMENT A312�PERFORMANCE BOND AND PAYMENT BOND�DECEMBER 1984 ED.�AIA� ��_�� 3
THE AMERICAN INSTITUTE OF ARCHfTEC15,1735 NEW YORK AVE,N.W. WASN�NGTON,D.C. 20006
THE AMERICAN INSTITUTE OF ARCH[TECTS
Bond No. MOC 67404
A!A Document A3 t 2
Payment Bond
Arry singular reference Do Contractor,Surety,Owneraother paRy shail be considered plural where appiicable.
CONTRACT{OR(Name and Address}: SURETY(Name and Principal Place of Business?:
Nip Kelley Equipment Company,Inc. Merchants Bonding Company(Mutual)
41 North Spngg Street 2100 Fleur Drive
Cape Girardeau, MO 63701 Des Moines, IA 50321
OWNER iName and Address): Tel: 515-243-8171
City of Cape Girardeau
401Independence
Cape Girardeau, MO 63701
CONTSTRUCTION CONTRACI'
Date: Novmber '� ,2012
Amount: $117,908.68
DeScription(Name and Location):Parking Lot Improvements at Broadway and Middle Street
BOND
Date iNot earlier than Construction Contract Datei: Novmber "7 ,2012
= Amouni: �117,908.68
„��.��.,>3��,
,.,� j�ations to this nd: � None � See Page b
r�., , ELL�., ;
�1 ,.� "�1�"�7�9�A5 PR CIPAL SURE7Y ;�;,�, � ,rrr{i;, , ,
_ ��*'�` f�ampari�yr' ' (CorporateSeal) Company: , ��te��'r�y
a � :��,� �Sl�lip�,�Bley�qaipme Company Merchants Bonding Company(Mutual) `��. .•��� � '? ,�`;
�,. C}�' ��,�. . ,:; _ , , Tel: 51 43-8171 �, � , �, � , y ,�"
•. �,; • . � � (�j f , 4i.
., ,�f ��`g����' '�' Signature: p f; f
�� ' Ndme and Title: Donald L.Wasoba � ; � � C► } . "
n , , �, •.4�at7�ev'��Aii�*'fiitle: ince Ke ley, Pre� ent j ; .-� ,cLp,,; �i� ,
��' `i� k7� � �'4..,. Attotney-In-Fact � ,,` 4� �","; : ,
��
� �� " (A`ny edditionai signatures appear on page 6} �nd signed and sealed this 6th day of�=.� �'t '.21��.�,,i'
but left undated at the r est of the : ���`"" � `���`
�,a;; r .�,�� �� ���u.���<<"`.,_
(FOR WFORMATlQN ONLY—Name,Add�ess and Telephone)
AGENT or BROKER: OWNER'S REPRESENTATIVE(Architect, Engineer or bther
Gateway Surety ����
22 Avocado Tree Circle
St.Peters, MO 63376
Tel:314-374-0589
AIA DOCUMENT A312 �PERFORMANCE BOND ANp PAYMEkT BOND• DECEMBEK 7984 ED.• hIA�
TiiE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, D.C. 20006 A��Z'��H� 4
1 The Contractor and the Surety, jointly and severally, 5 If a notice required by Paragraph 4 is given by the
bind themselves, their heirs, executors, administrator, Owner to the Contractor or to the Surety,that is sufficient
sucoessors and assigns to the Owner to pay for labor, compfiance.
materials and equipment fumished for use in the 6 When the Claimant has satisfied the conditions of
performance of the Construction Contract, which is paragraph 4,the Surety shall promptly and at the Surety's
incorporated herein by reference. expense take the following actions:
2 With respect to the Owner, this obligation shatl be null 6.1 Send an answer to the Claimant, with a copy to
and void if the Contrador. the Owner, within 45 days after receipt of the claim,
2.1 PrompUy makes payment, directly or indirectly, stating the amounts that are undisputed and the
for all sums due Claimants,and basis for challenging any amounts that are disputed.
2.2 Defends, indemnities, and holds harmless the 6.2 Pay or arrange for payment of any undisputed
Owner from all claims,demands, liens or suits by any amounts.
person or errtity who fumished labor, materials or
equipment for use in the performance of the 7 The Surety's total obligation shall not exceed the
Construction Contract, provided the Owner has amount of this Bond,and the amount of this Bond shall be
promptly notified the Contractor and the Surety (at ��d�ed for any payments made in good faith by the
the address described in Paragraph 12) of any Surety.
claims,demands, liens or suits and tendered defense 8 Amounts owed by the Owner to the Contractor under
of such Gaims, demands, liens or suits to the the Construction Contract shall be used for the
Contrador and the Surety, and provided there is no performance of the Construc6on Contrad and to satisfy
Owner Default. claims,if any, under any Construction Performance Bond.
By the Contractor fumishing and the Owner accepting this
3 With resped to Claimants, this obligation shall be null Bond, they agree that all funds eamed by the Contractor
and void if the Contrector promptly makes payment, �n the performance of the Construction Contract are
diredly or indirectly,for all sums due. dedicated to satisfy obligations of the Contractor and the
Surety under this Bond, subject to the Owner's p�ority to
4 The Surety shall have no obligation to Claimants under use the funds for the completion of the woric.
this Bond until:
4.1 Claimants who are employed by or have a direct 9 The Surety shall not be liable to the Owner, Claimants
contract with the Contractor have given notice to the or others for obligations of the Contractor that are
Surety (at the address described in Paragraph 12) unrelated to the Construction Contract. The Owner shall
and sent a copy, or notice thereof, to the Owner, not be liable for payment of any costs or expenses of any
stating that a Gaim is being made under this Bond Claimant under this Bond,and shall have under this Bond
and, with substantial accuracy, the amount of the no obligations to make payments to, give notices on
Gaim. behalf of, or otherwise have obligations to Claimants
4.2 Claimants who do not have a direct contract with under this Bond.
the Contractor. 10 The Surety hereby waives notice of any change,
.1 Have fumished written notice to the Contractor including changes of time,to the Construction Contract or
and sent a copy, or notice thereof, to the to related subcontracts, purchase orders and other
Owner, within 90 days after having last per- obligations.
formed labor or last fumished materials or
equipment included in the claim stating, with 11 No suit or action shall be commenced by a Claimant
substantial accuracy, the amount of the Gaim under this Bond other than in a court of competent juris-
and the name of the party to whom the mater- diction in the location in which the work or part of the worlc
iafs were fumished or supplied or for whom is located or after the expiration of one year from the date
the labor was done or perfortned; and (1) on which the Claimant gave the notice requined by
Subparagraph 4.1 or Clause 4.2.3, or(2) on which the
.2 Have either received a rejection in whole or in last labor or service was performed by anyone or the last
part from the Contractor,or not received within materials or equipment were fumished by anyone under
30 days of fumishing the above notice any the Construction Contract, whichever of(1) or(2) first
communication from the Contractor by which occurs. If the provisions of this Paragraph are void or
the Contractor has indicated the claim will be prohibited by law, the minimum period of limitation
paid directly or indirectly;and available to sureties as a defense in the jurisdiction of the
.3 Not having been paid within the above 30 days, suit shall be applicable.
have sent a written notice to the Surety(at the �2 Notice to the Surety,the Owner or the Contractor shafl
address described in Paragraph 12) and sent � mailed or delivered to the address shown on the
a copy, or notice thereof, to the Owner, stating signature page. Actual receipt of notice by Surety, the
that a ctaim is being made under this Bond and Owner or the Contractor, however acxomplished,shall be
enclosing a copy of the previous written notice sufficient compliance as of the date received at the
fumished to the Contractor. address shown on the signature page.
AIA DOCUMENT A312�PERFORMANCE BOND AND PAYMENT BOND�DECEMBER 1984 ED.�AIA� ��_�� 5
THE AMERICAN INSTITUTE OF ARCHITECT5,1735 NEW YORK AVE,N.W.WASNINGTON,D.C. 20008
. ,
13 When this Bond has been furnished to comply with a The intent of this Bond shall be to include without
statutory or other legal requirement in the location where limitation in the terms"labor, materials or equipmenY'
the construction was to be performed, any provision in that part of water, gas, power, light, heat, oil,
this Bond conflicting with said statutory or legal gasoline,telephone service or rental equipment used
requirement shall be deemed deleted herefrom and in the Construction Contract, architedural and
provisions conforming to such statutory or other legal engineering services required for performance of the
requirement shall be deemed incorporated herein. The work of the Contractor and the Contractor's
intent is that this Bond shall be construed as a statutory subcontractors, and all other items for which a
bond and not as a common law bond. mechanic's lien may be asserted in the jurisdiction
where the labor, materials or equipment were
14 Upon request by any person or entity appearing to be fumished.
a potential beneficiary of this Bond, the Contractor shall �5.2 Construction Contract: The agreement between
promptly furnish a copy of this Bond or shall permit a copy the Owner and the Contractor identified on the
to be made. signature page, including all Contract
Documents and cha�ges thereto.
15 DEFINITIONS
15.3 Owner Default: Failure of the Owner,which has
15.1 Claimant:An individual or entity having a direct neither been remedied nor waived, to pay the
contract with the Contractor or with a subcontractor of Contractor as required by the Construction Contract
the Contractor to fumish labor, materials or or to perform and complete or comply with the other
equipment for use in the performance of the Contract. terms thereof.
MODIFICATIONS TO THIS BOND ARE AS FOLLOWS:
Section 6 is modified by adding section 6.3.
6.3 The Surety's failure to discharge its obligations under this Section 6 shall not be deemed to constitute a waiver of
defenses the Surety or Contractor may have or acquire as to a claim. However, if the Surety fails to discharge its
obligations under this Section 6,the Surety sha11 indemnify the Claimant for the reasonable attorney's fees the Claimant
incurs to recover any sums found to be due and owing to the Claimant
NONE.
(Space is provided below for additional signatures of added parties,other than those appearing on the cover page.)
CONTRACTOR AS PRINCIPAL SURETY
Company: Company:
(Corporate Sea{) (Corporate Seaq
Signature: Signature:
Name and Title: Name and TiBe:
Address: Address:
AIA DOCUMEM A312�PERFORMANCE BOND AND PAYMENT BOND�DECEMBER 1984 ED.�AIA�
THE AMERICAN INSTITUTE Of ARCNITECT5,1735 NEW YORK AVE, N.W.WASHINCaTON,D.C. 20006 ����� s
. ,
MERCHAI�TTS �
BONDING COMPANYn
POWER OF ATTORNEY
Know All Persons By These Presents,that MERCHANTS BONDING COMPANY(MUTUAL)and MERCHANTS NATIONAL BONDING,
INC.,both being corporations duy organized under the laws of the State of lowa(herein collectively called the"Companies"),
and that the Companies do hereby make,constitute and appoint,individually,
Donald L Wasoba
of St Peters and State of MO their true and lawful Attomey-in-Fact,with full power
and authority hereby conferred in their name,place and stead,to sign,execute,acknowledge and deliver in their behalf as surety
any and all bonds,undertakings, recognizances or other written obligaGons in the nature thereof,subjed to the limitation that any
such instrumerrt shail not exceed the amount of:
TWO MILLION($2,000,000.00)DOLLARS
and to bind the Companies thereby as fully and to the same extent as'rf such bond or undertaking was signed by the duly
authorized officers of the Companies,and all the acts of said Attorney-in-Fact, pursuant to the authority herein given,are
hereby ratified and confirmed.
This Power-of-Attomey is made and executed pursuant to and by authority of the following By-Laws adopted by the Board of
Diredors of the Merchants Bonding Company(Mutual)on April 23,2011 and adopted by the Board of Directors of Merchants National
Bonding,Inc.,on October 24,2011.
'The President,Secretary,Treasurer,or any Assistant Treasurer or any Assistant Secretary or any Vice President shall have
power and authority to appoint Attomeys-in-Fad,and to authorize them to execute on behalf of the Company,and attach the
seai of the Company thereto,bonds and undertakings,recognizances,contrads of indemnity and other writings obligatory in
the nature thereof.
The signature of any authorized officer and the seal of the Company may be affixed by facsimile or electronic transmission to
any Power of Attomey or Certification thereof authorizing the execution and delivery of any bond,undertaking,recognizance,
or other suretyship obiigations of the Company,and such signature and seal when so used shall have the same force and
etfect as though manualiy fixed."
In Wdness Whereof,the Companies have caused this instrument to be signed and sealed this 2nd day of March � 20�2•
5��•��i1Nf��N�. •����.��•
,,,����.a*-��Qlj,,�••,,,, :����iG.COM'.o; MERCHANTS BONDING COMPANY(MUTUAL)
;�p��:40��Rq���': ;0��O�P�9q'9y� MERCHANTS NATIONAL BONDING,INC.
•� � ��": 'y=2 �;�•
��� -0_ t� •F-. -O- �:3•
:�: �2:' •
.a' 1933 :c: ��
=:v= 2�03 :.�= .y�. • ,,. sy
. �.��� . ...•;��r r' �•,�6'oi�•......•`:�a�;.
STATE OF IOWA ,•'il��+h qre.4n�������,,'� •��'��'�• President
COUNTY OF POLK ss.
On this 2nd day of March , 2012,before me appeared Larry Taylor,to me personally known,who being by me duly swom did
say that he is President of the MERCHANTS BONDING COMPANY(MUTUAL)and MERCHANTS NATIONAL BONDING,INC.;and
that the seals affixed to the foregoing instrument is the Corporate Seals of the Companies;and that the said instrument was signed and
sealed in behaff of the Companies by authority of their respedive Boards of Directors.
In Testimony Whereof,I have hereunto set my hand and affixed my Offiaal Seal at the City of Des Moines,lowa,the day and year
first above written.
+��MARANDA GREENWALT � �� � �
Commission Number 770312
' My Commission Expires
O11 October 28,2014
Notary Public,Polk County,lowa
STATE OF IOWA
COUNTY OF POLK ss.
I, Wiliiam Wamer,Jr.,Secretary of the MERCHANTS BONDING COMPANY(MUTUAL)and MERCHANTS NATIONAL BONDING,INC.,
do hereby certify that the above and foregoing is a Vue and correct copy of the POWER-OF-ATTORNEY executed by said Companies,
which is still in fuli force and effect and has not been amended or revoked.
in Witness Whereof,I have hereunto set my hand and affixed the seal of the Companies on .;,
t�11S d8)/Of , , .:�4Yarrr�y :�-
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Power of Attorney `����,�"�IOf�,j.''%y' ;'p`NG �0�••, ,��� ,�;*.E C��A
Attached to bond ,,.• �*,�o�< �..` ;�O?ORPOqq.'O9Z. N� �pgn� �-..�'�<
thi s 6th day of ?,�g:'�,o '��;.:o?�=: :y;i ;.�; !/,��G�,;'� �������. '�:
November, 2012, '�:= ,.o- �:�: :ii— -O �:3� 's�r'` �� ,-� � -
but left undated :v;. ZC�3 ;.�r; :yv.. 1933 :•y: . `��� ;��� �._-
at the request of : � =i� ; '. 6 'ac' -'���" .• ,-
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A`oRo CERTIFICATE OF LIABILITY INSURANCE 11i6�Zo1a �
;
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATtON ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS g
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES I
BELpW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITtJTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED I
REPRESENTATNE OR PRODUCER,AND THE CERTIFICATE HOLDER. '
IMPQRTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(fes)must be endorsed. If SUBROGATION IS WAIVED,subject to ;
the terms and conditions of the policy,ce�tain policies may require an endorsement. A statement on this certlficate does not confer rights to the I
certiflcate holder in lieu of such endorsement(s). ;
PRODUCER . TOZ3 Fi�cher '
Capital Insureace & Associates PH°NE . (573)335-2300 F� .1573)335-0117 �
326 South Broadview E'�� .taraf@cayitaliaaagency.com �
P.O. SOX 1 I7 9 INSURER S AFPORDING COVERAGE NAIC�f
Cape GirarSeau MO 63703 INSURERA:AMCO Iasuraace C aa 9100 �
INSURED INSURERB:N8t10IIW1CI6 Mutal Ina Co 3787 3
NIP KELLY EQIIIPD�+NT CO INC uisuReRc;Allied Insurance j
PO BOX 33 iruur�Ro:Missouri lo ers �utual '
. INSURERE:Ti36 Hartford Co�nercial rt �
CAPS GIRA.RDEAII MO 63702-0033 INSURERF: t
COVERAGES CERTIFICATE NUMBER:�ester 2012/2013 REVISION NUMBER: r
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THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD x
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. 'r
INSR 7YpE OF INSURANCE � B POIICY NUMBER ��plpY EFF P�ppY EXP ��MRs
LTR
GENERAL UABIUTY EACH OCCURRENCE 5 1�OOO�000 I
X COMMERCWL GENERAL 11ABILITY PR MI E E c rcen . E 100,OOU f
A CLAIMS-MADE ❑X OCCUR CPGI.A07152738259 /Z3/2012 /23/2013 MED EXP(An one person) E 5,000
PERSONAL&ADVINJURY S 1�000�000
GENERALAGGREGATE S Z�OOO�OOO �
GEN'L AGGREGATE UMIT APPUES PER PRODUCTS-COMPIOP AGG S 2�000,000 E
X POLICY PRO- LOC S I
AUTOMOBILELIABILITY EaaBa t iN 1 000 000 �
X ANY AUTO BODILY INJURY(Per personj E �
B ALLOWNED SCHEDULED PBA7152738259 /23/2013 /93/2013 gODILYINJURY(Peraaident) 5 i
AUTOS NON-0WNED PROPERTY DAMAGE j i
X HIRED AUTOS X AUTOS Per iden �
][ �g Uni�suredmotwistcombined a 100 000 i
X UMBRELLALIAB X p�CUR EACHOCCURRENCE 5 4�000�000 t
`. EXCESS LIAB CLAIMS-AAADE AGGREGATE S 4�OOO�OOO j
DED � RETENTIONS 10,00 PCAA7151738259 /13/201Z /23/2013 y E
D WORKERS COMPENSATiON WC STATU- OTH-
AND EMPLOYERS'LIABILITY i
ANY PROPRIETOWPARTNEWEXECUTIVE YrN E.L.EACHACCIDENT S 1 OOO 000 +
OFFICER/MEMBEREXCLUDED9 � N�A 0509977-09 /6/2012 /6/2013
(Mandatory In NH) E.L.DISEASE-EA EMPLOYE S 1 000 000 _
If yes,tlescribeunder E.L.DISEASE-POLICYLIMIT 5 1 0�0 �00
DESCRIPTION OF OPERAIIONS below
E Leased/Rented Squipment 4MSIII6365 /Z9/2012 /29/2013 $ 300�00�
(
DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 107,Addttlonal Remarks Schedule,If more space Is requlred) �
B
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CERTIFICATE HOLDER CANCELLATION �
339-6302 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE t
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELNERED IN
C�ty of Cape Girardeau ACCORDANCE WITH THE P�UCY PROVISIONS. `
Project: Parking Lot �rovements �
8t Broadway & Middle AUTHORIZED REPRESENTATNE i
3
401 Iadepeadeace Street �
Cape GirsrBeau, MO 63701
Chris Oross/TARA �'-"� � —'�'"""�
ACORD 25{2010/05) 01988-2010 ACORD CORPORATION. All rights reserved. �
INS025(20�0o5).oi The ACORD name and iogo are registered marks of ACORD �
• . �
�
A`�p� CERTIFICATE OF LIABILITY INSURANCE ii�e�aoia� `
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS ;
CERTIFICATE DOES NOT AFFIRMATNELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES j
BEIOW. THIS CERTIFICATE OF INSURANC� 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 pol(cy(fes)must be endorsad. If SUBROGATION IS WANED,subject to i
the terms and conditions of the policy,certain policies may require an endorsemeM. A statement on this certiflcate does not confer rights to the �
certificate holder in lieu of such endorsement(s. ;
PRODUCER A Taxa Fisahar i
Capital Insuraace & Associates PHONE . (573)335-2300 F� .(573)335-0117 {
326 South Sroadview .taraf�cayitalinsagency.com �
P.O. SOX 17 7 9 INSURER 5 AFFOROING COVERAGE NIUC M i
Cape Girardeau MO 63703 iNsur�Rn:Nationwide Mutal Ias Co 3787 j
INSURED IN9URER 8: �
CI'PY OF CAPE GIRXRA�'AU INSURER C:
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P� B�X 3 3 INSURER D: S.
INSURER E: t
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CAPE GIRARDEAU MO 63702-0033 INSURERF: �
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COVERAGES CERTIFICATE NUMBER:OCP t�aster 2012/2013 REVISION NUMBER: 't
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD E
INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS f
CER7IFICATE MAY BE 15SUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, !
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIM�TS SHOWN MAY HAVE BEEN REDUCED 8Y PAID CLAIMS. `
INSR 7ypE OF INSURANCE �� POUCY NUMBER MOLICY EFF POLICY EXP LIMRS �
L7R
G�NERALLIABILITY EACH OCCURRENCE S 3�000,000 k
X COMMERCIAL GENERAL LIABILITY MtS n S �
A CLAIMS-MADE �OCCUR PGL07134119085 /14/2012 /i4/2013 MED EXP one rson E �
OWII9x"S & COAti'30tOx'8 PERSONAI 8 ADV INJURY E ��.
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Liability GENERALAGGREGATE 5 3,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS•COMP/OP AGG E
X POLICY PRO- LOC s �
AUTOMOBILE LIABILJTY COM8INED SINGLE LIMIT
Ea ac i nl
BODILY INJURY(Per persan) S i
ANY AUTO �
ALL OWNED SCHEDUIED BODILY INJURY(Per acsidenl) S
AUTOS AUTOS
NONAWNED PROPERTY DAMAGE S i
HIRED AUTOS qUTpg Per acci n �
S
UMBRELLA LIAB OCCUR EACH OCCURRENCE E �
E%CE33 4A6 CLAIMS•MADE AGGREGATE E �
DED RETENTION S s �
WORKERS COMPENSATION WC STATU- OTH- �
ANO EMPLOYERS'UABILITY
ANY PROPRIETOR/PARTNEfLEXECUTIVE Y�N E.l.EACH ACCIDENT S
OFFICER/MEMBER EXCLUDE09 � N�A �
(Mandatory In NH) E.L.DISEASE•EA EMPLOYE S f
Kyes,dascribe under t
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S �
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DESCRIPTION OF OPERATIONS/LOCATIONS I VENICLES (Atmch ACORD 101,Addldonal Remarko Scheduls,H more cpaca l4 requlred) i�
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CERTIFICATE HOLDER CANCELLATION �
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339-6302 SHOULD ANY OF THE ABOVE DESCRIBEO POLICIES BE CANCELLED BEFORE 4
THE EXPIRATION DAFE THEREOF, NOTICE WILL BE DELIVERED IN
City of Cape Girardeau ACCORDANCE WITH THE POUCY PROVISIONS. �
Project: Parkinq Lot �rovemeats '�
3t Broadway & MiBdle AUTHORIZED REPRESENTATNE �
401 Independeace Street `
Cape GirarBesu, MO 63701
Chris Oross/TARA �""� �'�'��'s �
ACORD 25(2010/05) �1988-2010 ACORD CORPORATION. All rights reserved. �.
INS025(zo�oos�.oi The ACORD name and logo are registered marks of ACORD �
�
. �
;
COMMERCIAL GENERAL LIABILITY •
CG 71 57 09 10
THIS ENDORSEMENT CHANGES THE POUCY. PLEASE READ IT CAREFULLY. �
;
ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS i
AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION CONTRACT f
PRIMARY AND NON-CONTRIBUTORY !
�
This endorsement modifies insurance provided under the following: '
i
�
COMMERCIAL GENERAL LIABILITY COVERAGE PART i
A. Section II — Who Is An Insured is amended to a. The preparing, approving, or failing to pre- t
include as an additional insured any person or or- pare or approve, maps, shop drawings, opi- ;
ganization for whom you are performing operations nions, reports, surveys, field orders, change "
when you and such person or organization have orders or drawings and specifications;or �
agreed in a written contract that such person or b. Supervisory, inspection, architectural or }
organization be added as an additional insured on engineering activities. �
your policy. Such person or organization is an ad- 2, ��godily injury" or "property damage" occurring +
ditional insured only with respect to liability for"bo- �
dily injury", "property damage" or "personal and after: �
advertising injury" arising out of, in whole or in part, a. All work, including materials, parts or �
bY: equipment furnished in connection with �
such work, on the project (other than ser- ,
1. Your acts or omissions;or ;
vice, maintenance or repairs) to be per-
2. The acts or omissions of those acting on your formed by or on behalf of the additional in- ':
behalf; sured(s) at the location of the covered
in the performance of your ongoing operations operations has been completed;or
for the additivnal insured. b. That portion of "your work" out of which the
A person's or organization's status as an addi- injury or damage arises has been put to its �
tional insured under this endorsement ends intended use by any person or organization '
when your operations for that additional in- other than another contractor or subcontrac- �,
sured are completed. tor engaged in performing operations for a ;
No such person or organization is an additional principal as a part of the same project. ;
insured for liability arising out of the "products- D. With respect to the insurance afforded to these €
completed operations hazard". additional insureds, Condition 4. Other Insurance ;
of Section IV — Commerciai General Liability
B.The following is added to SECTION III— LIMITS Conditions is replaced by the following: �
OF INSURANCE:
4. Other Insurance t
The limits of insurance applicable to the additional i
insured are those specified in the written contract a. Primary Insurance �
between you and the additional insured, or the lim- This insurance is primary if you have agreed �
its available under this policy, whichever are less. in a written contract or written agreement: s
These limits are part of and not in addition to the �1� That this insurance be primary. If other
limits of insurance under this policy. �
insurance is also primary, we will share
C. With respect to the insurance afforded to these with all that other insurance as de- ;
additional insureds, the following additional exclu- scribed in c.below;or i
sions apply: (2) The coverage afforded by this insur- �
This insurance does not apply to: ance is primary and non-contributory f
1. "Bodily injury", "property damage" or "personal with the additional insured's own insur- t
and advertising injury" arising out of the ren ance. ;
dering of, or the failure to render, any profes- '
sional architecturai, engineering or surveying ;
services,including:
CG 71 57 09 10 Includes copyrighted material of Insurance Services Office, Inc. Page 1 of 2 �
0
with its permission.
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i
CG 71 57 09 10 �
Paragraphs (1) and (2) do not apply to (2) When this insurance is excess, we will �
other insurance to which the additional have no duty under Coverages A or B �
insured has been added as an addi- to defend the additional insured against �
tional insured or to other insurance de- any"suit" if any other insurer has a duty `
scribed in paragraph b. below. to defend the additional insured against �
b. Excess Insurance that "suiY'. If no other insurer defends,
we will undertake to do so, but we will i
This insurance is excess over: be entitled to the additional insured's �
(1) Any of the other insurance, whether rights against all those other insurers. �
primary, excess, contingent or on any �3) When this insurance is excess over '•
other basis: other insurance, we will pay only our {
(a) That is Fire, Extended Coverage, share of the amount of the loss, if any,
Builder's Risk, Installation Risk or that exceeds the sum of: �
similar coverage for"your work"; (a)The total amount that all such other !
(b) That is fire, lightning, or explosion insurance would pay for the loss in �
insurance for premises rented to the absence of this insurance; and i
you or temporarily occupied by you (b) The total of all deductible and self- 3
with permission of the owner; insured amounts under all that other 1
(c) That is insurance purchased by you insurance. �
_ . to cover your liability as a tenant for �4) We will share the remaining loss, if any, j
"property damage" to premises with any other insurance that is not de-
rented to you or temporarily occu- scribed in this Excess Insurance provi-
pied by you with permission of the sion and was not bought specifically to �
owner;or j
apply in excess of the Limits of Insur-
(d) If the loss arises out of the mainten- ance shown in the Declarations of this ;
ance or use of aircraft, "autos" or Coverage Part. `
watercraft to the extent not subject c. Method Of Sharing �
to Excfusion g. of Section I — Cov- �
erage A—Bodily Injury And Properry If ail of the other insurance available to
Damage Liability the additional insured permits contribu-
(e) That is any other insurance availa- tion by equal shares, we will follow this i
ble to an ad'ditional insured under method also. Under this approach each
insurer contributes equal amounts until it �
this endorsement covering liability f
arising out of the premises or opera- ' has paid its applicable limit of insurance
tions, or products completed opera- or none of the loss remains, whichever '
tions, for which the additionai in- comes first. `
sured has been added as an If any of the other insurance available to +
additional insured by that other in- the additional insured does not permit
surance. contribution by equal shares, we will con-
tribute by limits. Under this method, each �
insurer's share is based on the ratio of its �
applicable limit of insurance to the total
applicable limits of insurance of all insur- �
ers. �
All terms and conditions of this pollcy apply unless modified by this endorsement. i
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Page 2 of 2 Includes copyrighted material of Insurance Services Office, Inc. CG 7'1 57 09 10 �
with its permission. �
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