HomeMy WebLinkAboutRes.2928.10-19-2015BILL NO. 15-193
RESOLUTION NO. l
A RESOLUTION AUTHORIZING THE CITY MANAGER TO
EXECUTE AN AGREEMENT WITH FISHER TANK
COMPANY, FOR THE LASALLE WATER STORAGE TANK,
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 Fisher Tank Company, for LaSalle Water
Storage Tank, in the City of Cape Girardeau. The Agreement
shall be in substantially the form attached hereto as Exhibit A,
which document is hereby approved by the City Council, and
incorporated herein by reference, with such changes therein as
shall be approved by the officers of the City executing the
same.
WI
PASSED AND ADOPTED THIS DAY OF 015.
ATTEST:
& 9 U &Iud
Gayle L. Conrad, City Clerk
H y E. Rediger, Mayor
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CITY OF CAPE GIRARDEAU
LASALLE WATER TANK
Project No. 6172
STANDARD FORM OF AGREEMENT
BETWEEN OWNER AND CONTRACTOR
ON THE BASIS OF A STIPULATED PRICE
THIS AGREEMENT is dated as of the ��day of /ut��irJ�i� in the year
2015 by and between the City of Cape Girardeau, Missouri (hereinafter called OWNER)
and Fisher Tank Companv (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:
This project consists of the construction of a nominal 750,000 gallon welded steel ground
storage water tank on a one-acre site south of LaSalle Avenue including, but not limited to,
electrical, site clearing, grading, gravel drive,fence, instrumentation, telemetry, piping and
all appurtenances as indicated in the Project Plans and Specifications prepared by Horner
& Shifrin, Inc. and dated September 4, 2015 for the City of Cape Girardeau, Missouri.
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 330 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 within 360 days after the date when the Contract Times
commence to run.
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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 One Thousand One Hundred dollars
1 100.00 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 shall 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
One Hundred dollars 1 100.00 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 equa� to the sum of the amount
determined pursuant to paragraph 4.1 below:
4.1 for Lump Sum Amount.
LUMP SUM CONTRACT AMOUNT One Million Ninetv-nine Thousand
Dollars and Zero Cents ($ 1,099,000.00)
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
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.
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95% 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.
95% (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 Completion, in an amount sufficient to increase total payments to
CONTRACTOR to 98%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 Fina/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".
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
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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:
8.1 This Agreement (pages A-1 to A-7 inclusive).
8.2 Exhibits to this Agreement (pages to , inclusive).
8.3 Performance, Payment, and other Bonds, identified as exhibits and consisting of
pages.
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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 LaSalle Water Tank.
8.8 Drawings.
8.9 Addenda numbers 1 to 1 , inclusive.
8.10 CONTRACTOR'S Bid (pages BF-1 to BF-7 , 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.
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
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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 twenty (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 two 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.
This Agreement will be effective on l'l`a��C/h.f��R.. � , 2015 (which is the
Effective Date of the Agreement).
OWNER Citv of Cape Girardeau CONTRACTOR_ Fisher Tank Companv
Scott Meyer�, C' ana er L� • ��'�ir1 �.l��;S /4S�-Sr'C/�7�✓
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By� - - By: �
OR T [CORPORATE SFr4L] a
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Attest Attest � �� �-l�� C:.,�,,,�('C�L.,
Address for giving notices Address for giving notices
401 Independence Street ; ����Q /��'c�'Y-�i7 ��. S ��,�� � /�
Cape Girardeau, MO 63703 �-��'D��� �� , h�°L ��SLyS'�
(If OWNER is a public body, attach License No. ,/�1 ,//�
evidence of authority to sign and
resvlution or other documents �nt for servic�2�f process:
authorizing execution of Agreement. , --
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(If CONTRACTOR is corporation,
�� attach evidence of authority to sign.)
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EXHIBIT "A"
CITY OF CAPE GIRARDEAU
LASALLE WATER TANK
Project No. 6172
BID FORM
(EJCDC 1910-18) (1990)
PROJEeT IDENTIFICATION: The improvements consist of:
_ T�tis proje�t consists of the construction of a nomina1750,000 gallon welded steel ground
storag�water tank on a one-acre site south of LaSalle Avenue including, but not limited to,
eiectrical, site clearing, grading, gravel drive,fence, instrumentation,telemetry, piping and
all a{�purtenances as indicated in the Project Plans and Specfications prepared by Homer
� Shifrin, Inc. and dated September 4, 2015 for the City of Cape Girardeau, Missouri.
THIS BID IS SUBMITTED TO: CITY oF CAPE GIRARDEAU, MO
401 INDEPENDENCE STREET
CAPE GIRARDEAU, MO 63703
1. The undersigned BIDDER proposes and agrees, if the Bid is accepted, to enter into an
agreement with OWNER in the form included in the Contract Documents to perform and
fumish all Work as specified or indicated in the Contract Documents for the Bid Price and
within the Bid Times indicated in this Bid and in accordance with the other terms and
conditions of the Contract Documents.
2. BI DDER accepts all of the terms and conditions of the Advertisement or Invitation to Bid
and Instructions to Bidders, including without limitation those dealing with the disposition of
Bid security. This Bid will remain subject to acceptance for sixty days after the day of Bid
_ opening. BIDDER will sign and deliver the required number of counterparts of the
Agreement with the Bonds and other documents required by the Bidding Requirements
within fifteen days after the date of OWNER'S notice of Award.
3. In submitting this Bid, BIDDER represents; as more fully set forth in the Agreement,
that:
(a) BIDDER has examined and carefully studied the Bidding Documents and the
following:
BF-1
Add tada, r ce' t o all IIICII IS Il@f@��/aCECIIOWIeC�9@CJ: �List Addenda by Addendum Number and Date)
. C�. �y�,b�e�' �S ��I�
(b) BIDDER 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 "
fumishing of the Work;
(c) BIDDER 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.
(d) BIDDER 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. BIDDER acknowledges that such
reports and drawings are not Contract Documents and may not be complete for BIDDER'S
purposes. BIDDER acknowledges that OWNER and Engineer do not assume
responsibility for accuracy or completeness of information and data shown or indicated in
the Bidding Documents with respect to Underground Facilities at or contiguous to the site.
BIDDER has obtained and carefully studied (or assumes responsibility for having done so)
all such additionat or supplementary examinations, investigations, explorations, tests,
studies and data conceming conditions(surface,subsurface and Underground Facilities)at
or contiguous to the site or otherwise which may affect cost progress, performance or
fumishing of the Work or which relate to any aspect of the means, methods, techniques,
sequences and procedures of construction to be employed by BIDDER and safety
precautions and programs incident thereto. BIDDER does not consider that any additional
examinations, investigations, explorations, tests, studies or data are necessary for the
determination of this Bid for perFormance and fumishing of the Work 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 Work for which this Bid is submitted as indicated in the
Contract Documents.
(fl BIDDER has correlated the information known to BIDDER, information and
observations 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.
(g) BIDDER has given Engineer written notice of all conflicts, errors, ambiguities or
disc�epancies that BIDDER has discovered in the Contract Documents and the written
resolution thereof by ENGINEER is acceptable to BIDDER, and the Contract
Documents are generally sufficient to indicate and convey understanding of all terms
and conditions for performing and fumishing the Work for which this Bid is submitted.
BF-2
Any questions, comments, or concems regarding the design of this project should be
addressed to Tim Richmond Project Manaqer City of Cape Girardeau at 573-339-
6327.
(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 submitted in conformity with any agreement or rules
of any group association, organization or corporation; BIDDER has not directly or indirectly
induced or solicited any other Bidder to submit a false or sham Bid; BIDDER has not
solicited or induced any person, firm or corporation to refrain from bidding; and BIDDER
has not sought by collusion to obtain for itself any advantage over any other Bidder or over
OWNER.
(i) Pursuant to 285.530 RSMo,the bidder must aff rm 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
• submitting a completed, notarized copy of AFFIDAVIT OF WORK
AUTHORIZATION and
• 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.
(j) Bidders are informed that the Project is subject to the requirements of Section
292.675, R.S. Mo, which requires all contractors or subcontractors doing work on the
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.
BF-3
4. BIDDER wiii compiete the Work in accordance with the Contract Documents for the
foliowing price(s):
750,000 Gallon Welded Steel Ground Storage Water Tank
Lump Sum Contract Bid Price
� �
(To I in numefic figures)
'�1Y� I�i��io n ��i�l E�•i J�.���n� � I19CI��.Y.��1 �C�i2s t�2�� �%('�n7�S
(Total in Wntten Words)
(Total bid amount is#o be shown in both words and figures. In case of discrepancy,
the amount shown in words will govern.)
5. BIDDER agrees that the Work will be substantially complete within 330 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 within 360 calendar days after the date when
the Contract Times commences to run.
BIDDER accepts the provisions of the Agreement as to liquidated damages in the event of
failure to complete the Work within the times spec�ed in the Agreement.
6. The following documents are attached to and made a condition of this Bid:
(a) Required Bid Security in the form of bid bond or cashiers check.
(b) Acknowledgement of any addenda issued.
(c) Exhibit Affidavit of Work Authorization
(d) Exhibit Affidavit of Excessive Unemployment (if applicable)
(e) The E-Verify Program for Unemployment Verification Memorandum of
Understanding http:/lwww.uscis.gov/e-verifv
(fl Exhibit Affidavit of OSHA Training
(g) Certification Regarding Debarment, Suspension and Other Responsibility Matters
7. Bidder agrees to submit the following documents within three (3) business days after
the opening of Bids if requested:
(a) BIDDER'S Qualification Statement with supporting data.
BF-4
8. Communications concerning this Bid shall be addressed to:
Name _ ��• ���i n �G�1/I �S
Address �t��Q 1 ' 1 G��.�;ri �v� . �. �1-1 iTE �c� ����L'f� �L-- ��'��
-� s
(a) Performance and Payment Bonding Company
Name N�� �i �k ��.f'I/I C�S — ��'S�"�'`n -`�`�Cl'�7��l
Add�ess� �' � � G'c -C' ��t�� G� �C �f.�i C��� �r'� 1.���'�
Agent\Power of Attorney Name (if used)
Address
9. Terms used in the Bid which are defined in the General conditions or Instructions will
have the meanings indicated in the General Conditions or Instructions.
SUBMITTED on �C�b��- l� , ZoI�
State Contractor License No. /� �
IF BIDDER is:
An Individual
By
(Individual's Name)
doing business as
Business address:
Phone No.:
A Partnership
BY (SEAL)
(Firm Name)
(General Partner)
Business address: -
Phone No.:
BF-5
A Corporation
BY �5���' r i'1� ?/yi
(� oration f�ame) ��—
T7 ) l.� iC�
State ion)
,By
- Name o�Pe on Authori ed to Sign) � �' ��rt � tv�"s
4','S`�G�-r�� �_C�''e �
- - ' , (Title)
`(GQ�rp.orate Seal)
A�test '�` /�l' ,Q�t_-
" , '` � ' � ` (Secret ` } _/ )
Business address: ; ,QC� (.�.r'�/? �,�'��T-�c7`'�, �� �'�-�/�
� r�a.ot,�/�/l � l� L3.sc-�s�
Phone No.: a�S � - f �'
Date of Qualification to do business is /��r�C�
A Joint Venture
By (SEAL)
(Name)
(Address)
By (SEAL)
(Name)
(Address)
Phone Number and Address for receipt of official communications:
(Each joint venturer must sign. The manner of signing for each individual, partnership and
corporation that is a parly to the joint venture should be in the manner indicated above.)
BF-6
BREAKDOWN OF WORK FORCE (Required):
The Contractor shall be registered with the Missouri Secretary of State in order to work on
this project.
BIDDER hereby states that he will perform the following items of work directly without
employment of subcontractors:
l`�1.Gc:��-�' i C� `� � �.�- � £5��
�' ' Gl.�rL a-/l
It is anticipated that the following subcontractors will be employed for work on this project:
*SUBCONTRACTORS:
(Name of Company) (Type of Work)
' �..i �e � ,��..n� ��. �i�-. ��� �u�c�c�i'��
*All subcontractors shall be registered with the Missouri Secretary of State in orderto work
on this project.
BF-7
BID BOND
KNOW ALL MEN BY THESE P�2ESENTS, that we, the undersigned
FISHER TANK COMPANY as Principai,and
W ESTERN SURETY COMPANY as Surety,are hereby held and firmly bound
unto CITY OF CAPE GIRARDEAU MISSOURI �
CITY in the p�na1 sum pf Five percent of amount bid.,5%of Amount Bid .
for the payment of which,well and truly to be made,we hereby jointty and severally bind ourselves successors
and assigns.
Signed this 6th �y o{October _, 20 15
The Condition of the above obligation is such that whereas the Principal has submitted to
CITY OF CAPE GIRARDEAU,MISSOURI a certain BID, attached hereto and hereby
made a part thereof to euter into a contract in writing for the
LaSalle Water Tank,Project No.6172
NOW THEREFORE,
(a) If said BID shall be rejected,or
(b) Ff said BID shall be accepted aad the Principal shaIl execute aad deliver a contract in the Form
of Contract attached hereto {properly completed in accordance with said Bidj and shall furnish
a BOND for his faithful performance of said contract, and for the payment of all persons
performing]abor or fiarnishing mateiials in persoas performiug labor or furnishing materials in
connection therewith, and shall in all other respects perform the ag�eement create@ by the
acceptance of said BID, then this obligation shall be void, otherwise the same shali rP**�a�*+ in
farce and effec�It being espressly understood and agreed that the iiability of the Suretp far any
and all claims hereunder shaIl, in no evcnt, exceed the penal amount �f this obligation as
herein.stated.
The Sure#y, for value received, hereby stipztlates and agrees that the obligations of said Surety and its BOND
shall be in no way impaired or affected by any extensifln of the time witbin which the CTTY may accept such
BID; and said S�rety does hereby waive nohce of any such eatension.
IN WITNESS WFiEREOF, the Principal and the Surety have hereunto set their hands and seals, and such of
them as are corporations have caused their eorporate seais to be hereto affixed and these presents to be
signed lry their proper officer , the dayJyear set forth above.
F�SH K C N
� � (L.S.) WESTE N SURETY'COMPANY
Principal �•_�0���-� �::°iS�f\�-Sltre.7�:-� S�u�
.� ,, . �'
ATTES'T:�'-_ `-t��'� lG�(.i._.: -�'�� �1.���''L-- Elizabe Marrero,Attorney In Fact
�� ; ��1.G`-+l C�G�:�.��=�CY,t�I.::-� �-T�E SS �`'�
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� Western Surety Company �
POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY-IN-FACT
Kriow All Men By These Presents,That WESTERN SURET'Y COMPANY,a South Dakota cotporation,is a duly organized and existing corporation
having its principal office in the City of Sioux Falls,and State of South Dakota,and that it dces by virtue of the signature and seal herein affixed hereby
make,constitute and appoint
Douglas R Wheeler, Wayne G Mc Vaugh, Jaquanda Long, Elizabeth Marrero, Maureen
Mc Neill,Marina Tapia,Individually
of Philadelphia,PA,its true and lawful Attomey(s}in-Fact with full power and authority hereby conferred to sign,seal and execute for and on its behalf
bonds,undertakings and other obligatory instruments of similar natu�
-In Unlimited Amounts -
and to bind i[thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of the corporation and all the acts of said
Attomey,pursuant to the suthority hereby given,are hereby ratified and confirmed.
This Power of Attomey is made and executed pursuant to and by authority of the By-Law printed on the reverse hereof,duly adopte�as indicated,by
the shareholders of the corporatioa
In Wi�ess Whereof,WESTERN SURETY COMPANY has caused these Presents to be signed by its Vice President and its corporate seai to be
hereto affixed on dus 22nd day of October,2013.
!?��co WESTERN . SURETY COMPANY
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aul T.Bruflat,Vice President
State of South Dakota 1
T ss
County of Minnehaha J
On this 22nd day of October,2013,before me personaliy came Paui T.Bruflat,to me lmown,who,being by me duly swom,did depose and say: that
he resides in the City of Sioux Falls,State of South Dakota;that he is the Vice President of WEST'ERN SURETY COMPANY described in and which
executed the above instrument;that he knows the seal of said corporadon;that the seal affixed to the said instrument is such corporate seal;that it was so
afFixed pursuant to authority given by the Board of Directots of said corporation and that he signed his name thereto pursuant to like authority, and
aclmowledges same to be the act and deed of said corporaaon.
My commission expires + *
j J.MOHR f
June 23,2015 i SF�1 NOTARY PUBUC�
,r SOUTH DAKOTA
i + `��7 V✓
J.Mohr,Notary Public
CERTIFICATE
I,L.Nelson,Assistant Secretary of WESTERN SURETY COMPANY do hereby certif�+,�that,the Power of Attorney hereinabove set forth is still in
force,and further certify that the By-Law of the corpotation p nte�on the reverse hereof�is`�ttkl xi�#o�e;�.In testimony whereo�have hereunro subscribed
� �_
my name and afhxed the seal of the said corporation this �� day of ����� 'k°':J":�� �4�1�,
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y''"f'� WyES7"E.Ri'�1' SITRETY COMPANY
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_ L.Nelson,Assistant Secretary
Form F4280-7-2012
Authorizing By-Law
ADOP'TED BY THE SHAREHOLDERS OF WESTERN SURETY COMPANY
This Power of Attomey is made and executed pursuant to and by authority of the following By-Law duly adopted by the shareholders
of the Company.
Section 7. All bonds, policies, undertaldngs, Powers of Attorney, or other obligations of the corporation shall be ezecuted in the
corporate name of the Company by the President, Secretary, and Assistant Secretary>Treasurer, or any Vice President,or by such other
officers as the Board of D'uectors may authorize. The President,any Vice President, Secretary, any Assistant Secretary,or the Treasurer
may appoint Attomeys in Fact or agents who shall have authority to issue bonds,policies, or undertakings in the name of the Company.
The corporate seal is not necessary for the validity of any bonds, policies,undertakings,Powers of Attomey or other obligations of the
corporation. The signature of any such officer and the cocporate seal may be printed by facsimile.
��
WESTERN SURETY COMPANY
Siong Fa1Ls,South Dakota
Statement of Net Admitted Assets and I,iabilities
December 31,2014
ASSETS
Bonds $1,824,951,414
St�cks 23,975,582
Cash, cash equivalents, and short-term invesiments � 51,536,164
Investment income due and accrued 22,267,675
Premiums and considerations 41,696,249
Amounts recovera.ble from reinsurers (11,221,508)
Federal and foreign income taxes recoverable 7,401,709
Net deferred tax asset 20,261,713
Receivable from parent, subsidiaries, and affiliates 17,380,167
Other assets 3,799
Total Assets $1,998,252,964
LIABILITIESAND SURPLUS
Losses $302,997,505
Reinsurance payable on paid losses and loss adjustment expenses (15,267,712)
Loss adjustment expense 64,134,995
Contingent and other commissions payable 6,099,306
Unearned premiums 259,011,845
Advance premiums 5,321,610
Payable to parent, subsidiaries and affiliates 107,843
Other liabilities 7,821,458
Total Liabilities $630,226,850
Surplus Account:
Capita.l paid up $4,000,000
Gzoss paid in and contributed surplus 280,071,837
Unassigned funds 1,083,954,277
Surplus as regards policyholders $1,368,026,114
� Tota.l Liabilities and Capital $1,998,252,964
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I;��,bc�, �t Vice President of Westem Surety Company hereby certify that the above is an
a� S�e repres�i�at� of the financial statement of the Company dated December 31, 2014, as filed
���h�vari �s I�t�.uce Departments and is a true and correct statement of the condition of Westem
St��•�'o�p�y�that date.
��'`'�`�����`'+�'°� Western Sure ompany
By
Assistant ice Presiden
Subscribed and sworn to me this 19th day of March ,2015
My COIT1Il115S10I1 eXplT@S: YOLAN�A JIMENEZ
OFFICIAL SEAL +
Notary Public,State of Iilinols
My Commission Expires No Pu lic
Saptember 24,2017
��IT
AFFIDAVI'I' OF WORgAUTHORI7.ATION
coMEs Now��� G,�ebi��t�is��o�x� l�ss��- ��r��v
of(Compauy Name/Coat�or) r��'1�,�dn.� �3��and fitst being duty swom, on
my oath,affirna as foIlaws: .
1. �c��N��c��r� 1-i s�t- I a�. �n't��n..1/
is eurolled and w�]. cont�nue to partici}�ate in a federal work anthoriza.tion pmgra�n in respect to
.etnplopees that w�1t work in connection wrth the contracted setvices related to(Project Name)
J ,, C �, fl ( ,l�,_� J V
�-G( �(�-F I C Lt�Gt�e6 I�,/1.1� far the dutation of the contract in accordance.with RSMo
Chapter 285_530(2).
2. �:..I also affi�m that C �`1
. ( ompaup Nam�/Co�actor) �I�Pl���.!U\ l��Qn V does
not and w�71 not knowingly employ a petson who is an unautho�ized alien in connection�vith the
contta.ct setvices related bo(PmjectName) �-�[.��l� � l�l�C� ��-/L� for
thc dutation of the conrtact
3. Atfached hereto is docamentation affimning Contxacto�'s enmllment and
patticipation in a federal work authorization pmg�am �vith respect to the emplopees worlang �n
connection with the conna.cted setvices.
FIJR1��AFF][ANT SATI�i NOT. �
IN AF�7t7�rA'I'ION THEREOF, the fiacts stated abrn►e are ttue and correct (the
unde=signed vaderstands that faLse statements made in this filing are subject to the
pe.�alties provided in Section 575.040,RSMo.) � .
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On ti�is ��'E'da,p of� {`���,� � 20�before me appeared�': /�v�J�jl !�`-i,1;'S
to me petsonaIlp known,who,being by me dul��vPorn,di.d sap that he/she is the ;fls<,T-5t�•�.��-���
of�i sh er'��fc.�t;� j'�/h.f,r�i _, a A�e� Cotporaiion, and that the seal affi�ed to the
foregoing insmiment is the s�l of said Carporation, and. that the said instrument was signed and
sealed in beha].f of said Cozporation by authoritp of its Board of Directors, and ac�noW�dged said
inst�ument to,�e the free act and deed of said Corporation.
1N TF-ST'IMONY WI-�REOF,I have hereunto set mp hand and aff�ed.my official seal,at
. my office in Cape Guardea�l�ssouti,the dap aud peat first above written. ,.:f.:':;�::
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Online Resaurces I Tutorial I Home�Contact Us I Extt
�-��r��C. �m��c�yment Elic�r`bilit,�l��rif�ca�i�n
case qdministration Com�any Information
inirlal ver�flcarion Company Name: Flsher Tank Company View/Edit
v�ew Cases Lompany ID Number: 296912
User Administrallon
Change Password Physical Location: Malling Address:
Pwd Challenge Q&A Address 1: 313:West Fourth Street Adc�ress 1:
Chanae Proftle Address 2: Address 2:
CFty: Chester City:
Site Administration �re: Pp State:
ndd User �p Code: 19G33-1822 Zip Code:
Vlew Users County: DEIAWARE
Maintain Company
7erminate tompa�y Employer ldentification Number:231384852
Participat�on Total Number of Employees: S00 io 499
Reports Corporate/Parent Company:
View Reporta
Organization Designation:
Emplc+yer Cat�gory: None of these categories apply
NAICS Code: 332-FABR:CATED METAL PRODUCT MANUFACTURING Vew/Edit
Totaf Hirinp Sites: 3 ViEW/Edlt
Tota!Poirtts of Contact: 1 VeW(Edlt
�.Denartment af Homeland Securltr� U•S•CItlzensAio�nd Imm��orntion Services Download Viewers
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THE E VERIFY PROGRAM FOR ENIPLOYMENT VERIFICATION
MEMORANDUM OF UNDERSTANDING
ARTICLE 1
PURPOSE AND AUTHORITY , .
This Memorandum of Understanding (MOU) sets forth the points of agreement between the
Departmerrt of Homeland Security (DHS� and ��Tctn,�''��rn�,�(Employer)
regarding the �Employer's participation in the Employmerrt Eligibility Ve fication Program (E-
Verify). This MOU explains.certain features of the E-Verify program and enumerates specific
responsibilities of DHS,the Social Security Administration (SSA), and the Employer. E-Verify is
a program that electronicalfy confirms an employee's eligibility to work in the United States after
completion of the Employment Eligibi(ity 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 coritracts.
Authority fo� the E-Verify program is found in T�le IV, Subtitle A, of the Illegal Immigration
Reform and Immigrarrt Responsibility Act of 1996 (IIRIRA), Pub. L. 104-208, 110 Stat 3009, as
. amended (8 U.S.C. § 1324a note). Authority for use of the E-Verify program by Federal
contractors arnd subcontractors covered by the terms of Subpart 22.18, "Employment Eligibility
Verification", of the Federal Acquisition Regul�tion (�AR) (hereinafter referred to in this MOU as
a "Federal contracto� to verify the employment eligibility of certain employees worlcing on
Federal cormacts is also found in Subpart 22.18 and in Executive Order 12989,as amended.
ARTICLE II
FUNCTIONS TO BE PERFORMED
A. RESPONSIBILITIES 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-Verify 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
ind'nriduals responsible for the verification of 5ocial Security Numbers and for evaluation of the
- E-Verify program or such other persons or errtities who may be authorized by SSA as govemed
by the Privacy Act (5 U.S.C. § 552a), the Social Security Act (42 U.S.C. 1306(a)), and SSA
regufations (20 CFR Part 401). �
Page!of t2�E-Verify MOU for EmployerjRevision Date 10129lOS� www.dhs.govlE-Verify
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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 tentadve
nonconfirmation of U.S. citizens' employment eligibility within 3 Federal Governmerrt work days
of the initia! inquiry. .
5. SSA agrees to provide a means of secondary verification (inciuding updating SSA
records as may be necessary) for employees who contest SSA tentative nonco�"irmations 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
Govemment work days of the date of refeiral tp SSA, unless SSA determines that more than 10
days may be necessary. In such cases, SSA will provide additional verification instructions.
B. RESPONSIBILITIES OF DHS
1. After SSA verifies 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 verification checks on alien employees by electronic means, and
� Photo verification checks (when available)on employees.
2. DHS agrees to provide to the Employer appropriate assistance with operational
problems that may arise during the Employer's participation in the E-Verify program. DHS
agrees to provide the Employer names, titles, addresses, and telephone numbers of DHS
represerrtatives 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-Verify policies, procedures and requiremerrts for both SSA and DHS, incfuding
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 nodce, which indiptes the Employer's
participation in the E-Verify program. DHS afso 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 iderrtification 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 responsibie for the verification of alien employment
eligibility and for evaluation of the E-Verify program, or to such other persons or eritities as may
be authorized by applicabte law. Information will be used only to verify the accuracy of Social
Security Numbers and employment eligibility, to enforce the Immigration and Nationafity Act
(1NA) and Federal criminal laws, and to administer Federal corrtracting requirements.
7. DHS agrees to provide a means of automated verification that is designed (in
conjunction with SSA verification procedures) to provide confirmation or terrtative
nonconfirmation of employees' employmerrt eligibility within 3 Federal Govemmerrt work days of
the ini�al inquiry. ,
Page 2 oi 12�E-Veri(y MOU for Employerj{2evision DatE 10/'29/OSI VIfWW.dhs.gov/E-Verify
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� 8. DHS agrees to provide a means of secondary verification {including updating DHS
recorcls as..may be necessary) for employees who contest DHS tentative nonconfirmadons and
photo non-match tentative nonconfirmations that is designed to provide final confirmation or
nonconfirmation of the employees' employment eligibility within 10 Federal Govemment work
days of the date of referrai 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 nodces supplied by DHS in a prominent place that is
clearly visible to prospective employees and atl employees who are to be verified through the
system.
2. The Employer agrees to provide to the SSA and DHS the na►nes, titles, addresses, and
telephone numbers of the Employer representatives to be contacted regarding E-Verifjr.
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 Represerrtative who will perform employmerrt
verification queries will complete the E-Verify Tutorial before that individual initiates any
queries. . .
A. The Employer agrees that all Employer representatives will take the refresher
tutorials initiated by the E-Verify program as a condition of continued 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 preverrt the Employer from continued
use of the program.
5. The Employer agrees to comply with currerrt Form I-9 procedures,with two exceptions:
• If an employee presents a "List B" identity document, the Employer agrees to only
accept "List B"documents that contain a photo. (List B documents identified in 8 C.F.R.
§ 274a.2(b)(�)(B)) can be preserrted 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 888-464-421 S.
• If an employee preser� a DHS Form I-551 (Permanerrt Resident Car� or Form 1-766
(Employmerrt Authorization Document)to complete the Form 1-9,the Employer agrees to
make a photocopy of the documerrt and to retain the photocopy with the empioyee'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 corrtested by employees. Note that
employees retain the right to preserrt any List A, or List B and List C, documerrtation to
complete the Form I-9. DHS may in the future designate other documerrts that activate
the photo screening tool.
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 requiremerrts of applicable regulations or laws, including
Page 3 of 12�E-VeriFy MOU for EmployeijRevision Date 10l29/08� MVWW.dhS.gov/E-Verity
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the obligation to compiy with the antidiscrimination requirements of section 274B of the INA with
respect to Form I-9 procedures, except for the following modified 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 Aat (INA) with respect
to the hiring of any individual if 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 corrtinues to employ any employee after receiving a final nonconfirmation, and is
subject to a civil money penalty between $550 and $1,100 for each failure to notify DHS of
continued employmerrt following a final nonconfirmation; (4) the Empfoyer is subject to a
rebuttable presumption that it has knowingly employed an unauthorized alien in violation of
section 274A(a){1)(A) if the Employer continues to employ an employee after receiving a final
nonconfirmation; and (5) no person or entity participating in E-Verify is civilly or criminally liable
under any law for any action taken in good faith based on.informadon 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 employePS
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-Verify process as are necessary according to the E-Verify User Manual. The Employer
is prohibited from initiating verification procedures.before the employee has been hired and the
Form I-9 completed. If the automated system to be queried is temporarily unavailable,the 3-day
time 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 af unavailabil'ity. 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 SSIV,
pravided that the Employer performs an E-Verify employment verification query using the
employee's SSN as soon as the SSN becomes available.
8. The Employer agrees not to use E-Verify procedures for pre-employment screening of
job applicants, in support of any unlawful employment practice, or for any other use not
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
Er�ployer 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 pursuarrt 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 written
referral instructions to employees, allowing employees to corrtest the finding, and not taking
adverse action against employees if they choose to corrtest the finding. Further, when
employees corrtest a terrtative nonconfrrmation 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 resolve the cfiallenge. �
Page 4 of 12�E-Veri(y MOU for Empfoyer�Revision Date 10/29/O8� www dhs.gov/E Verify
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10. The Employer agrees not to take any adverse action against an employee based upon
the employee's perceiyed 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.i(1))
that the empioyee is not work authorized. The Employer understands that an inidal inability of
the SSA or DHS automated verification system to verify work authorization. a tentative -
nonconfirmation, a case in continuance (indicating the need for additional time for the
government to resolve 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 adve�se
employment consequences based upon the employee's perceived employmerrt eligibiliry status
(incfuding denying, reducing, or extending work hours, delaying or preveriting training, requiring
an employee to work in poorer conditions, refusing to assign the employee to a Federal contract
or other assignment, or othenivise 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 nan-match or if a secondary verification is
completed and a final nonconfirmation is issued, then the Employer can find the employee is not
worlc authorized and terminate the employee's employment. Employers or employees with
questions about a final nonconfirmation may call E-Verify at 1-888-464-4218 or OSC at 1-500-
255-8155 or 1-800-237-2515 (TDD). �
11. The Employer agrees to comply with Ti�e VII of the Civil Rights Act of 1964 and section
2746 of the INA by not discximinating unlawfully against any indnridual 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 sectian 2748(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
nonconfirmations. The Employer further understands that any violation of the unfair
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 Tttle VII
could subject the Employer to back pay awards, corrjpensatory and punitive damages.
Violations of either section 274B of the INA or Titte VII may also lead to the termination of its
participation in E-Verify. If the Employer has any questions relating to the anti-discrimination
�rovision, it should contact OSC at 1-800-255-81�55 or 1-800-237-2515 (TDD).
l2. The Employer agrees to record the case verification number on the employee's Form I-9
or to print the screen containing the case verfication number and attach it to the empioyee'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 employmerrt eligibility of employees as �
authorized by this MOU. The Employer agrees that it will safeguard this information, and means
of access to it(sucfi as PINS and passwords) to ensure that it is not used for arry other purpose
and as necessary to protect its confideritiality, including ensuring that it is not disseminated to
any person other than employees of the Employer who are authorized to perform the
Employer's responsibili�es under this MOU, except for such dissemination as may be
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authorized in advance by SSA or DHS for legitimate purposes.
14. The Employer acknowledges that the information which it receives from SSA is
� governed 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 fafse pretenses or uses
it for any purpose other than as provided for in this MOU may be subject to criminal penalties.
�5. 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 interview it and its employees regarding
the Employers 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. RESPONSIBlLITIES OF FEDERAL CONTRACTORS
1. The Employer understands that if it is a Federal contractor subject to the
employment verification terms in Subpart 22.18 of the FAR it must verify the employmerrt
efigibility of any "employee assigned to the contract" (as�defined in FAR 22.1801) in addition to .
verifjring the employment eligibility of all other employees required to be verified under the FAR.
Once an employee has been verified through E-Verify by the Employer, the Employer may not
reverify the employee through E-Verify,
a. Federal coritractors not enrolled at the�ime of contract award: An Employer that
is not enrolled in E-Verify as a Federal cor�tractor 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 enrollmerrt, begin to use E-Verify to initiate verification of employmerit eligibility
of new hires of the Employer who are working in the United States, whether or not assigned ta
the contract. Once the Employer begins verifying new hires, such verification of new hires must
. 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 ihe date of enrollment or within 30 days of an employee's assignment to
the contract,whicFiever date is later.
b. Federal contractors already enrolled at the time of a contract award: Employers
enrolled in E-Verify as a Federa! contractor for 90 days or more at the tirrie of a coritract award
must use E-Verify to initiate verification of employmerrt 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 Federa� corrtractor for 90
calendar days or less at the time of contract award, the Employer must, within 90 days of
enroHmer�t, begin to use E-Verify to initiate verification of new hires of the contractor wha are
working in the United States, whether or not assigned to the cormact 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
, coritract within 90 calendar days after date of contract award or within 30 days after assignment
to the corrtract,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 govemments, govemmerrts of Federally recognized Indian tribes, or sureties
Page 6 of 12�E-Yerify MOU for EmpioyerjRevision Date 10129/08I www.dhs.gov/E Yerify
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pertorming under a takeover agreemerrt entered into with a Federal agency pursuant to a
performance bond may ehoose to only verify new and existing employees assigned to the
Federal contract. Such Federai contractors may, however, elect to verify all new hires, and/or --
ail existing employees hired after November 6, 1986. The provisions of Article II.D, paragraphs
1.a and 1.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 � �
govemments, and sureties. �
d. Verification of all employees: Upon enrollment, Employers who are Federal
� . contractors may elect to verify employment eligibifity of all existing employees working in the .
United States who were hired after November 6, 1986, instead of verifying only those
employees assigned to a covered Federal contra�t. After enrollment, Employers must elect to
� do so only in the manner designa#ed by DHS and initiate E-Verify verification of all existing
employees within 180 days after the election. � �
- e. Form f-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 1-9 is complete (including the SSN), complies with
Articfe II.C.S, the employee's work authorization has not expired, and the Employer has
reviewed the information reflected in the Form 1-9 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 permanerit residerrt 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.S, if the �employee's basis for work authorization as attested in .
section 1 has expired or changed, or if the Form 1-9 contains no SSN or is otherwise incomplete,
tk�e 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 othervvise complies with Article iI.C.5; but reflects documeritation (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 additionaf documerrtation, or use the photo
screening tool des�rib�d in Article I1.C.5, subject to any additional or superseding instructions
that may be provided on this subject in the E-Verify User Manual. Nothing in this secdon shall
be construed tp require a second.verification using E-Verify of any assigned employee who has
previously been ver�ed as a newfy hired employee under this MOU, or to authorize verification
of any existing employee by any Employer that is not a Federal cor�actor.
. 2. The Empioyer understands that if it is.a FederaF contractor, its compliance with this MOU
is a pertormance requiremerrt under ihe terms of the Federal corrtract or subcontract, and the �
Employer�consents to �the release of information relating to compliance with its�verifieation
responsibiiities under this MOU to contracting officers or other officials auttiorized to review the
Employer's comptiance with Federal cor�tracting requirements. �
, ARTICLE III
REFERRAL OF INDNIDUALS TO SSA AND DHS
A. REF�RRAL TO SSA �
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1. If the Employer receives a tent�tive 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 corrtest ttie tentative
nonconfirmation.
2. The Employer will refer employees to SSA field offices only as directed by the
automated system based on a terrtative noncorrfirmation, and only after the Empfoyer records
the case verification number, reviews the input to detect any transaction errors, and determines
that the empioyee contests the terrtative nonconfirmation. The Employer wiil transmit the Social
Security Number to SSA for verifcation again if this review indicates a need to do so. The
Employer will determine whether the employee corrtests the tentative nonconfirmatian as soon �
as possible after the Employer receives it. �
3. If the employee cor�tests 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 Government work days. SSA will electronically transmit ihe result of the
referra!to the Employer within 10 Federal Govemmerrt work days of the refieRal unless it
determines that more than 10 days is necessary.-The Employer.agrees to check the E-Verify
system regularly for case updates.
4. The Employer agrees not to ask the emptoyee to obtain a prirrtout from the Social
Security Number database (the Numident) or other written verification of the Social Security
Number from the SSA.
B. REFERRAL TO DHS �
l. If the Employer receives a terrtative nonconfirmation issued by DHS,the Employer must
print the teritative 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 documerrt for
which the automated system has transmitted a photo, the employer must prirrt the photo non-
match terrtative 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 corrtest the findi�g.
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 teritative nonconfirmadon based upon a photo non-matcfi. The Employer �
will�detemnine whether the employee contests the tentative nonconfirmation as soo� as possible
after the Employer receives it
4. If the employee contests a tentative nonconfirmation issued by DHS, the Employer will
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 terrtative nonconfirmation based upon a photo non-match,the
Employer will provide the employee with a referral letter to DHS. DHS will electronicaffy transmit
Page 8 of 12�E-Verify MOU for Empbyer�Revision Date 10/29/08� WWW.dhS.gov/E-Verify
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the result of the referrai to the Emplflyer within 10 Federal Govemment work days of the referral
unless it determines that more than 10 days is necessary. The Employer agrees to check the E-
Verify system regularly for case updates. "
�
6. The Employer agrees that if an employee corrtests a terrtative nonconfirmation based
upon a photo non-match, the Employer will send a copy of the employee's Form I-551 or Form
i-766 ta DHS for review by:
• Scanning and upioading the document, or
• Sending a photocopy of the document by an express mail account (furnished and paid
for by DHS). .
7. The Empioyer understands that if it cannot� determine whether there is a photo
match/non-match,the Employer is required to forvvard the 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 who 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 equipmerrt needed to make inquiries. To access the
E-Verify System, an Employer will need a personal computer with Irrtemet 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
conse�t 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-Verify program by DHS or SSA, including but not
limited to the E-Verify checking against additional data sources and instituting new verfication
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
mandatory refresher tutorials. An Employer that is a Federal contractor may terminate this �
MOU when the Federal corrtract that requires its participation in E-Verify is terminated or
completed. In such a circumst�nce, the Federal contractor must provide written notice to DHS.
If an Employer that is a Federal coniractor fails to provide such notice, that Employer will remain
a parbciparrt in the E-Verify program, will remain bound by the terms of this MOU that apply to
non-Federal contractor participarrts, and will be required to use the E-Verify procedures to verify
the employmerrt 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 requiremerrts of law�or policy, or upon a determination by SSA or
Page 9 of 12�E-Verify MOU for Employer�Revisio�Date 10f29/08� WWNf.dhs.gov/E Verify
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DHS that there has been a breach of system integrity or security by the Employer, or a failure
on the part of the Empioyer to comply with established procedures or legal requirements. The
Employer understands that if it is a Federal contractor, termination of ihis MOU by any party t'or
any reason may negatively affect its perFormance of its contractual responsibilities.
C. Some or ail 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 irrtended, or should be construed, to create any right or benefrt,
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-Verify or this MOU, whether civil or criminal, and for any liability
wherefrom, including (but not limited to) any dispute between the Employer and any other
person or errtity 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 r•equired by law and DHS or 5SA poliry,
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 irrto this MOU on behalf of the Employer and DHS respectively.
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, confiact E-Verify at 888-4644218.
Emptoyer .
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Department of Homeland Security—Verification Division
Name{Pl�se Type or Print) �
Slgnature �
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E-YENIfT 6�SRVKE Of WS.WO SL�
Company ID Number. ��L� /-�
� tnfoRnation Required for the E-Verify Prograin
Information relating to your Company: .
�
_/` !L -�'
Company Name: � ,�j �� �� '
Company Facility Address: r �/ � l �(,�- ��''/1 �>t'\'�C'�
�'',� ��f�� �'fl l�'���
Company Alternate
Address: .
County or Parish: � {,(�a,{� � j�(� ,
Employer lden Number. o� 3 -�- 1 �`,��g�c�
North American industry
Classfication S�stems � � ���
Code: .
Parent Company:
Number of Empioyees: ��Q
Number of Sites Verified
for.
_ �..
Are you verifying for more than 1 site?If yes,please provide the number of sites verified for in
- each State: ,
S te Number of sites Site s
� es �
�es � �
� � �
Page 11 of 12�E-Veiity MOU for EmployerJRevision DaGe 10(29/O8� WWW.dhs.gov/E Verify
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Company ID Number._ � /�7��
Infortnation relating tc the Program Administrator(s)for your Company on policy
questions or operational problems:
. Name: �l 'E U. ��n ��
Telephone Number. ����� �c72��— � �f�
Fax Number.����� �� �'— ��i7C�'
E-mail Address: I f l�-i�1 li�1�. �J—I t%l/���Q.A'1�C. �r7/Yl
Name:
, Telephone Number.
Fax Number. •
E-mai(Address:
Page 12 of 12�E-Verify MOU for Emp(oy�Revision Date 10/29l08� www.dhs.90V1E-VEt1fy
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� AFFIDAVI'I'OF OSHA TRAIlVING
COMES NOW(rr�)1.��-�i n��'i 5 as (O�x�L��'�-��C.-1���i!
of(Compaapxame/Co�actor) f 1�+'lf�.��_a-ril�` l.?��'l�l'c� i/ and first being dnly swom, on .
my oath,affima in connec.-tion with.the contracted setv�es rclated to�� ���f�- 11.7✓`��
��,� (P=oject Name)for the du�ation of the conttac�as follaws:
1. Contractor shall pravide a teu (1� hont Occapational Safetp and. Health
Administra.ti.on (OSHA) constroction safetY Pr°gram far aIl emplopees �cho w�Il be on-site at the
Project The �n safetY Pm� shall inciude a arutse in construction safety and health
tha.t is a.ppmved bp OSHA or a simiilu pmgratn appmved by t�e Mlssouri Deparime.at of Iabor and
Tnrin�trial R.rlations which is at lea.st as strtngent as an appmved OSHA�pmg�n as reYmred bY
Section 292675,RSMo_
2_ Contrachor shall require ifs on-site eao�ployees to completE a wnsttnction safety
Pr°g�n w�in s�tY�60) days aftet the datE work on.the Pmject comnneuces,as�ir�bp S�n
292675,RSMo. ,
3. Con�or ac.�nowledges and ag�rxs that any of Con�racto='s etnpIopees found on
the Projec# si�e without docamentatioa of the snccessfnl completion of a co�.strnction safetp
Pmgratn shaIl be required t�prodnce such documentatio�a withm.tc�entY(2� daYs,or w�be subject
tn re�oval fiom the Project �
4. Contractior shall requite aIl of ifs Subcon� to comp�y wi$i the�eqIIizem.ents of
Sectinn 292675,RSMo.
5. Contractor acknawledges that p,,,�,�*,t to Section 292.675,RSMo.,Conttactnr shaII
foifeit to Citp as a penalty two thonsand five hnndt�ed dollais (�2,500.000�,plvs on�hundred doIlars
($100_0� far each on site emPl°Yee emPl°Yed bY Contractat or its Subcontracbo�far each c�lendar
dap, or pottion theteo� such on-si�e eem�lopee is eeu�loyed�vithout t$e r�,*,�t++,�+;.,r, Safet��a�m$
se�ed in�Sxtion 292675,RSMo.
6. Conttac�= acknawledg�es that violations of Section 292675,RSMo, and�raposifioa
of the penaltics descnbed therein shall be iuvestiga�6ed and.dche�min,e.d bp the l�ssomi D�,-�*�,P*,+
ofLabor and�ndnstxial RPtaricm�, .
7. Conttactar acknowledges that sn the evmt t�at the Mtssouii Depatt�t of Iaboi
and in�sr�;at g�� has dete�nined that a vi�olation of Section 292675, RSMo., has occr�ed �
� �
aud that a peualty shaIl be assessed, the Cii�shall withhold aad retain all sums and amotmts due and
°�������c���r� co�
FURT��R 1S�FFIANT SATl�i NOT:
IN AFFf7tMATION THFREOF, the facts stated above are tcQe aud cotrect (the
uadetslg7led undetstaads that false st�.tesne�ts made in this filing are subject to the
pe�ies provided in Section 575.040,RSMo.) . .
. �S� f��-,. �
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� f officct of m=poatioa,�a t�i3c)
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ATTEST: �
�
.�'�ip�or oti�es o$crr)h
i
- ' �'S �'�' ' . .. ,
y� �1_ ;�(SEA�:'OFCORPORATIOl�
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On this f.��+dap of(3/ `,�=���.t 20� before me appeared �'. �2��f h �t{:Ji�
tio me�onally�nawa,who,hemg bY me�lY,,�,swom,did say t�at hr/she is th� t�-.Ss�.Sc'C���y .
of r`�iS�z!L•T,L' ��,:���ir��•� , a A�ti Corporation, and that the seal affr�ed. to the
fo�cgomg 3„�rr,,,,,K,r is the seat of said Corporarioa, and that the sa�d instti�raent�vas signed and
sraled in behalf of said Co�porarian bp a�ority of i�s Board of I�tors,and ac�nowledged said,
instrIImeat to bc thc free act and deed of said Cospo*a++�,r,-
IN TEST�l�tONY WHmEOF,I have hereanto set mp band and affis�d mg o.f�Csat se�at ;
1ap o$ce in Cape C��issou�,��,y�y�fiist above�. � -
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r,t�i'Zfi " ' L�1l�t,�'� : �
• Notary Pnblic , "'
My Commissi�ori F.�a}vres: . " .
I����l�l�✓�l � �-=���'
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CITY �� CAPE
G 1 R A R D E A U
Certification Regarding
Debarment, Suspension and Other Responsibility Matters
The contractor hereby certifies to the best of its lrnowledge and belief and that it and its pri.ncipals
and its subcontractors and their principals: .
�a) Are not presently debarred,suspended,proposed for debamient, declared ineligible or
voluntarily excluded from covered hansactions by any Federal or Sta.te 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 cri.minal offense in.
connection with obtaining,attempting to obtain or performing a public(Federal, State or
Local)transaction or conhact under a public transaction;violation of Federal or State antitrust
statutes or commission of embezTlement,thef�,forgery,bribery,falsification or destruction of
records,making false statements or receiving stolen property;
(c) Are not presenfly indicted for or otherwise crimi.nally or civilly charged by a government
e�tity(Federal, State or Local)with commission of any of the offenses enumerated in
paragraph(1)(b)of this certification; and
(d) Have not within a three-year period preceding this subcontract had one or more public
transactions (Federal, State or Local)tPrminatP.� 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,nnder 18 USC Sec. 1001,a false
statement may resnit in a fine of np to$ 10,OOQ or imprisonment for up to five (�years or
both
�- , flh i� -v i
T N rt1e of A ' rized R,�presentative
� • V` ��� � Q�l�� i �
Si�e of Authorized Representative Date
❑ I am unable to certify to the above statement My explana.tion is attached.
r
11��IITTES QF THE SPECIAL MEET�Ir
O�T�IE
�$�i��i, O�t'uIREC'i�RS
OF THE
k'ISI3E�t'I'�Ni�COMPANX
n s�::cia: rr,aeti.�g oi the B�ru c;�ir�e�o►� was hztd st 73J .:.'v:. �;ST �n u5e twElf;
day of December, 2014 at thz office of the company, 104 Fisher Tank Drive, Leesviiie, South
�sr�lira 2�s7U.
:�ere�.�ere rreser:t�=oi�o«in�Uirecters:
P.Michaet Szelak,Chairman
Robert M.Sorst
John A.Fisher
James).Miller
C.Adams Moore
Jack E.Whitiow
Paut A.Windham
constituting all members of the Board of D'uectars.
T}i��tl2iT3t-!S�i^atCt�i:t3�t�l�.�il:j�flSp'Oi�'S2 7lv�ilit�Wa5 tQ GStu�3iiS�'i nlii35Gi ifiJ LA uJ4�Is't6
bonds a.�d contracts for the corporation. Accordingly,the following resotution was presented for
vote:
RESOLVED: "That P.Michael Szelak President and Chief Executive Officer,Scot M.
F.�w:r3s,'Trrasu:e:a.-td C�r.tr�:�e.;lar.zes:t."t�Iil:er,�°ice Uresadea�.:n�Sec:e ar�;�zcic�.
Whitlow and Pa41 A. Windham, Slice Fresi�en�; Bradisy C. Anderson, Johnny M.
Bro-�xn, G. itobEn L'av:s, Stevar. F. Jsckson, ttonnie ��'. M�tt.hews, Jar.�es P. Pasternack,
Ronald F. Quail and Frederik A. Ruinen, Assistant Secretaries, are hereby authorized to
execute, in name and in behalf of ttsis corpor�tion, bonds and contracts involving the
. ecnstnsction or cepair of ste:l storage tanks, substanti2lly in me form corrli-non to the
business of tha Corporztion,so l�ng as they shail be employed by�e Co:poration."
Up�n crotion the resQivuor.was duly sr�ade,sec�nded and ur.animous!y carried.
Ar'ter fir�-her generzl eis..�ssioa, ihe followi�g resoiution was resolved, sec�r.ded and
voted u�cn favorably:
Ra,SC��,`'��: "Th�i i�i�C�n►�ar.} �au���rizea t� sign a�;� submit the b�d or�,r��sai
o:�i:e �er�craticn ana �y su:,missicn o:�.'r,is bid cr pro�sal, �lie C�rporaii�n certi ies
and affirms as follows:
(aj This bid or proposaI has been intlepen�ently arrived a*without collusion with any
other bidder or with any competitor or potential competitor.
(b) i his i;id ur prap�si�i has noi been knowingly disclosed, prior to the openiag of
bids or nroposal for this project, to any other bidder, Gompetiter or potential
competitor.
(c) No attempt has been or will be made to induce any other person,partnership, or
c:,rp�,—��r,ta sabm;t a bid�r proposal.
(d) The person signing this bid or proposat certifies that he or she has fully informed
himself or herseli regarding the accaracy of the satements conffiined in this
certification, and under penalties of perjury, affirms the truth thereof, such
penalties being appiicable t� the birlder as we:l as te :he person signing in its
��h3!f„
There being no furth�r business on the agenda,the meeting, upon motion was adjourned
at 8:10 A.M.EST.
Respectfully submitted,
/r�.�,�.
Ja es J.Mi31' cretary J �
;�^ _
� y�er' Pd to be e and c ct
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FIS�R TANI��COlV�PANY
ItEFEREl�TC�LI5TING
C�TS'�O�iER CONTACT LOCA�'ION CI�PA�I'€'Y I3�NSIONS
INFORPr�ATIQ�N
SAR.ATOGA WATER MAI.CULhi PIRNIE MALT:�NY SMMG 90'0"DIA.X 105'6"
AUTHORI'I'Y 855 ROUTE 146 HIGH
$3,087,7?6 CLIF'fON PA.RK,NY 12065
2010 TODD I�fIIdEHARDT
(518)250-7300
AQUA PA I GANNETT.FLEMING,INC. BRISTOL TO WNSHIP, 7r1�II�iG 102'DI 1.X 32'HIGH
$866,400 P.O.BOX 80794 PA
201a YA;..LEY FORGE,PA 194&4
( THOMAS M ICIELY
(610)650-8101 EXT.7122
HAZLETON SITE SCHtJMACf�R ENGINE�I2ING HAZLETON,PA 2MNIG 60'0"DIA.X 98'0"
CONTRACTORS 55130RTH CONAHAN DRiVE HIGH
51,207,000 Hr1Zi ETON,PA 18201
2011 (570)�55-9407
i.TNiVER3ITY OF UNIVERSITY OF STORRS,CT ?.C?vfMG 45'0"DIA X 85'3"
CONNECPICUT CONNEGTIC[PT HJGH
$1,�8,759.50 31 LeDOYT ROAD
2�i3 STOR.RS,�I'06269
JOHN WARNER
86Q .486-3682
TOWN GF BdUN7'UN i SUBURBAN Ct7NSUi.TIIdG BOC}NTOi1,Nr' � 750MG 70'0"DiA.X 27'0"HIGA
$$53,245.�; � Et`GfNF.ERS I
2Q11 � 1W VAI.LEYROAD ,
� � SLTTE 20� t
MT.ARLINGTON,IVJ 07856
ANDREW HOLT
973 348-1776 . .
CITY OF FALL FAY,SPIFFORI?& , FAL?.RIVER,iv1A 1 i�IIbiG 5�}'0"DA X 7E'U"
RNF.R THORNDIKE HIGH
$1,535,700 5 BURLINGT'02�WOO�S
2012 BURLINGTON,}dIA 01803 ( �
GINA BR1TI'flN '
(?3.1)221-1266 _
Tt7t�TSHIF'OF ' LEE T.PURCELI. ROCKAWAY,NJ 350A?i; -i4'DIA X 32'SL7'cT
ROCK4WnY CONSUL'CIidG
$655,100 353C ROUTE 46 W. �
2013 SUPI'E 240
FA.7RFIEI.D,NJ 07004 �
30FIN BLACK �
973 227-7"�lXi �
Nt_��4JATER MAINE WATER C('SMPAN'Y CP.MDEN,1� R65i.�tG 35'DIP_.X l02';CURT
COR+t,°?��JY 855 ItOCKLAN�STRE�I' �
$76l,Oi5 � ROCICRIRI',N1E
?Jl"s S'['N:VE COX
� (2L�'n 236-5�.:S
IdIP KELiEY' HO1tIdER&SH�RLJ CA�DE GIRA�EAU,MJ f 1;vII��[G I 48'D;r�Y 85'7"K'�JRT
EQL"IFh3E2v'T GG. �2Cn�OAKLAIV�AVE?d(IE i
�92i,4�.�0 S7'.LOUIS,MO 631 J 0 I I �
2614 L:SA FEPdNEWr11.D � I
----� (314)531-4321 _ -- �
k
.
�ISH�� '1'AN#�C C�IWIPANY
��� .�`�n,,�lvyee (�wne�
CUSTOMER: CiTY OF CAPE GIRARDEAU �ATE: 9./5/201�
LOCA7101V: CAPE GIRHRDEAU, MO DRAWING NUf1lIBER 15445-501 RO
SPACIFIC GRAVITY: 1
TAN.K CAPACITY: 760,400 DESIGN STRESS:
DESIGN CODE: AWWA SECIION 14 DESIpV PRESSURE(WC): 0
E�JrPTY WEIGHT(LB): 217,4'11 DESIGiV VACUUM(WC): 0
JOINT EFFIGENCY: 100
ST4UCTURAL ATTACHMENTS VNIND: 90 MPH
�AGED LADDER CORROSION ALLOWANCE(in}
INTERMEDlATE REST PLATFORM ROOF: 0
LADDER- S7RAIGt-fT SHELL: 0
SAFETY CLIMB DEVICE(TS-STRAIGi�iT) 807TOM: 0
SAF�TI'CUMB HARNES(T5) STRi1CTURE: 0
ANTENNA SUPPORTS ANNULAR RING: NONE
OUTSIDE PAINTERS LUGS ANCHORAGE: YES
CABLE SUPPORTS
FITTING LIST ./A�--0.25"
2-36"SHELL MANWAY W/HINGE ��
1 - 12" BOTTOM INLET W/CHECK VALVE-S.S.
1 - 12"X 50' RI SER Pl PE
1 -6" BOTTOM CONC. (DRAIf� q�-0.25"
1 - 12"ST11B OVERFLO'W W/CONICAL .
1 - 12" U/ERFLO'W PIPE X 70'
1 -3/4"SHELL COUPl.ING W/FREEIE A36-0.25"
2-36"X 42"ROOF MAMNAYS
1 - 16''FF N�ISHROOi1A VENT A36-0.25'
A36-0.25"
1 -S:3��RBEE GS-9 MIXING SYSTEM �-0.25' 72,0"
2-,Lf GHT SLlPPOErTS
A36-�.3125"
A3E-0.375"
A36M-0.5'
A573-70-0.75"
43'0"
A36--�25"
TOP ANGLE: 3�Cixl/4
P.00F?YPE: l�3SRELiA ROOF
ROOF 1NELD: DOUBLE tAP LVELDE� �OF
BOTTOFJI WELD: SENGLE LAP WELDEQ SOTTt�tA
VIiEl..DING:AI�`JS Fc.4DIOGRAPH!G INS?ECTlON PEP.CODE
HYDRO TEST: BY FI SHER �..,�;ti ��;�
FOUNDATiOiV BY N1P KELLY ��;,,s -`�'a � a�'
����: �„�����
:��,/s � TM _
=-_ Document A312 2010
Performance Bond Bond No.929607024
CONTRACTOR: SURETY:
(Name, le al status and address) (Name, legal status and principal place
FISHER T�NK COMPANY of business)
3600 S.Martin Street,Suite 12
Cropweli,AL 35054 WESTERN SURETY COMPANY
101 South Phillips Avenue This document has important legal
Sioux Falls, SD 57104 consequences.Consultation with
OWNER: an attomey is encouraged with
ame, le al status and address respect to its completion or
� S � modification.
CITY OF CAPE GIRARDEAU, MISSOURI
401 Independence Street Any singular reference to
Cape Girardeau, MO 63703 Contrador,Surety,Owner or
other party shall be considered
CONSTRUCTION CONTRACT plural where applicable.
AIA Document A312-2010
Date: N�j`i�rn��� �(j� �[��l.J-� combinestwo separate bonds,a
�o�:One Million Ninety Nine Thousand and 00/100 Dollars Performance Bond and a
($1,099,000.00) Payment Bond,into one form.
DeSCri hon: This is not a single combined
p Pertormance and Payment Bond.
(Name and location)
LaSalle Water Tank,Project No.6172
BOND
Date: �AV.�lI71��i� �G �C��'SJ
(Not earlier than Construction Con�ract Date)
One Million Ninety Nine Thousand and 00/100 Dollars
Amount:(�1,099,000.00)
Modif'ications to this Bond: �None ❑ See Section 16
CONTRACTOR AS PRINCIPAL SURETY �
Company: (Corporate Seal) Company: (Corpo e eal) ___ - -
FISHER TANK CO PA WESTERN TY COMPANY -_ �
� � � �-__
st�lla�lll'0: � \ slg17c1tLll'E: ' - " -
Name ��,�` L�����1 1�q �,e��� Name Elizabeth M rrero,Attorney-in- act
and Title: ������ . J(-(.;k'�<�.� `� and Title:
(Any additional signatures appear on the last page of this Performance Bond.)
(FOR INFORMATION ONLY—Name, address and telephone)
AGENT or BROKER: OWNER'S REPRESENTATIVE:
Aon Risk Services Central, Inc. (Architect,Engineer or other party:)
One Liberty Place, 1650 Market Street
Philadelphia, PA 19103
215-255-2000
AIA Document A312TM'-2010.The American Institute of Architeds.
1
§1 The Contractor and Surety,joinfly and severally,bind themselves,their heirs,executors,administrators,successors
and assigns to the Owner for the perforn�ance of the Constniction Contract,which is incorporated herein by reference.
§2 If the Contractor performs the Constiuction Contract,the Surety and the Contractor shall have no obligation under
this Bond,except when applicable to participate in a conference as provided in Section 3.
§3 If there is no Owner Default under the Construction Contract,the Surety's obligation under this Bond shall arise
after
.1 the Owner first pmvides notice to the Contractor and the Surety that the Owner is considering declaring
a Contractor Default. Such notice shall indicate whether the Owner is requesting a conference among
the Owner,Contractor and Surety to discuss the Contractor's perforniance.If the Owner does�t
request a conference,the Surety may,within five(5)busi�ss days after receipt of the Owner's�tice,
request such a conference.If the Surety timely requests a conference,the Owner shall atteixi.Unless
the Owner agrees otherwise,arry conference requested under this Section 3.1 shall be held within ten
(10)business days of the Surety's receipt of the Owner's notice.If the Owner,the Contractor and the
Surety agree,the Contractor shall be allowed a reasonable time to perform the Construction Contract,
but such an agreement sl�all not waive the Owner's right,if any,subsequenfly to declare a Contractor
Default;
.2 the Owner declares a Contractor Default,terminates the Construction Contract and notif'ies the Surety;
and
.3 the Owner has agreed to pay the Balance of the Contract Price in accordance with the terms of the
Construction Contract to the Surety or to a contractor selected to perform the Construction Contract.
§4 Failure on the part of the Owner to comply with the notice requirement in Section 3.1 shall not constitute a failure
to comply with a condition precedent to the Surety's obligations,or release the Surety from its obligations,except to
the extent the Surety demonstrates actual prejudice.
§5 When the Owner has satisfied the conditions of Section 3,the Surety shall prompfly and at the Surety's expense
take one of the following actions:
§5.1 Arrange for the Contractor,with the consent of the Owner,to perform and complete the Construction Contract;
§5.2 U�ertake to perform and complete the Construction Contract itself,through its agents or independent
conlractors;
§5.3 Obtain bids or negotiated proposals from qualif'ied contractors acceptable to the Owner for a contract for
performance and completion of the Conshucrion Contract,amange for a contract to be prepared for execution by the
Owner and a contractor selected with the Owner's concurrence,to be secured with performance and payment bonds
executed by a qualified surety equivalent to the bonds issued on the Construction Contract,and pay to the Owner the
amourn of damages as described in Section 7 in excess of the Balance of the Contract Price incurred by the Owner as
a result of the Contractor Default;or
§5.4 Waive its right to perform and complete,arrange for completion,or obtain a new contractor and with reasonable
promptness under the circumstances:
.1 After im�estigation,deternune the amount for which it may be liable to the Owner and,as soon as
pracricable after the amount is deternuned,make payment to the Owner;or
.2 Deny liability in whole or in part and notify the Owner,citing the reasons for denial.
§6 If the Surety does not proceed as provided in Section 5 with reasonable prompiness,the Surety shall be deemed to
be in default on this Bond seven days after receipt of an additional written notice from the Owner to the Surety
demanding that the Surety perform its obligations under this Bond,and the Owner shall be enritled to enforce any
remedy a�ailable to the Owner.If the Surety proceeds as provided in Section 5.4,and the Owner refuses the payment
or the Surety has denied liability,in whole or in part,without further notice the Owner shall be entitled to enforce any
remedy available to the Owner.
AIA Document A312TM'—2010.The American Institute of Architects.
2
§7 If the Surety elects to act under Section 5.1,5.2 or 5.3,then the responsibilities of the Surety to the Owner shall not
be greater than those of the Contractor under the Construction Contract,and the responsibilities of the Owner to the
Surety shall not be greater than those of the Owner under the Construction Contract. Subject to the commitment by the
Owner to pay the Balance of the Contract Price,the Surety is obligated,without duplication,for
.1 the responsibilities of the Contractor for correction of defective work and completion of the
Construction Contract;
.2 addirional legal,design professional and delay costs resulting from the Contractor's Default,and
resulting from the actions or failure to act of the Surety under Section 5;and
.3 liquidated damages,or if no liquidated damages are specified in the Constiuction Contract,actual
damages caused by delayed performance or non-perforn�ance of the Contractor.
§8 If the Surety elects to act under Section 5.1,5.3 or 5.4,the Surety's liability is limited to the amount of this Bond.
§9 The Surety shall not be liable to the Owner or others for obligations of the Contractor that are unrelated to the
Construction Contract,and the Balance of the Contract Price shall not be reduced or set off on account of any such
unrelated obligations.No right of action shall accrue on this Bond to any person or entity other than the Own�er or its
heirs,executors,administrators,successors and assigns.
§10 The Surety hereby waives notice of any change,including changes of rime,to the Construction Contract or to
related subcontracts,purchase orders and other obligations.
§11 t�ny proceeding,legal or equitable,under this Bond may be instituted in any court of competent jurisdiction in
the location in which the work or part of the work is located and shall be instituted within two years after a declaration
of Contractor Default or within two years after the Contractor ceased working or within two years after the Surety
refuses or fails to perform its obligations under this Bond,whichever occurs first. If the provisions of this Paragraph
are void or prohibited by law,the minimum period of limitation available to suredes as a defense in the jurisdiction of
the suit shall be applicable.
§12 Notice to the Surety,the Owner or the Contractor shall be mailed or delivered to the address shown on the page
on which their signature appears.
§13 When this Bond has been furnished to comply with a statutory or other legal requirement in the location where
the construction was to be performed,any provision in this Bond conflicting with said statutory or legal requirement
shall be deemed deleted herefrom and pmvisions conforming to such statutory or other legal requirement shall be
deemed incorporated herein.When so furnished,the intent is that this Bond shall be conshued as a statutory bond and
not as a common law bond.
§14 Definitions
§14.1 Balance of the Contract Price.The total amount payable by the Owner to the Contractor under the Construction
Contract after all proper adjustments have been made,including allowance to the Contractor of any amounts received
or to be received by the Owner in settlement of insurance or other claims for damages to which the Contractor is
entitled,reduced by all valid and pmper payments made to or on behalf of the Contractor under the Construction
Contract.
§14.2 Construction Contract.'The agreement between the Owner and Contractor identified on the cover page,
including all Contract Documents and changes made to the agreement and the Contract Documents.
§14.3 Contractor Default.Failure of the Contractor,which has not been remedied or waived,to perform or otherwise to
comply with a material term of the Construcfion Contract.
§14.4 Owner Default.Failure of the Owner,which l�as not been remedied or waived,to pay the Contractor as required
under the Construction Contract or to perform and complete or comply with the other material terms of the
Construction Contract.
§14.5 Contract Documents.All the documents that comprise the agreement between the Owner and Contractor.
§15 If this Bond is issued for an agreement between a Contractor and subcontractor,the term Contractor in this Bond
shall be deemed to be Subcontractor and the term Owner shall be deemed to be Contractor.
AIA Document A312TM'—2010.The American Institute of Architects.
3
§16 Modifications to this bond are as follows:
(Space is provided below for additional signatures of added parties, other than those appearing on the cover page.)
CONTRACTOR AS PRINCIPAL SURETY
Company: (Corporate Seal) Company: (Corporate Seal)
Signature: Signature:
Name and Title: , Name and Tifle: ,qttorney-in-Fact
Address: Address:
AIA Document A312'""—2010.The American Institute of Architects.
4
— �
'�� Doc u ment A312 TM — 2010
, ,:
-._
Payment Bond Bond No.929607024
CONTRACTOR: SURETY:
(Name, legal status and address) (Name, legal status and principal place
FISHER TANK COMPANY of business)
3600 S.Martin Street,Suite 12
Cropwell,AL 35054 WESTERN SURETY COMPANY
101 South Phillips Avenue This document has important legal
Sioux Falls, SD 57104 consequences.ConsuRation with
an attomey is encouraged with
OWNER: respect to its completion or
(Name, legal status and address) modification.
CITY OF CAPE GIRARDEAU, MISSOURI
401 IndependenCe Street Any singular reference to
Cape Girardeau, MO 63703 Contractor,Surety,Owner or
other party shall be considered
CONSTRUCTION CONTRACT plural where applicable.
Date: �/ ,�� �' � � AIA Document A312-2010
/V D✓L��7J j3�,� G� combines two separate bonds,a
Amount: One Million Ninety Nine Thousand and 00/100 Dollars Pertormance Bond and a
($1,099,000.00) Payment Bond,into one form.
DeSCTi hon: This is not a single combined
P Performance and Payment Bond.
(Name and location)
LaSalle Water Tank,Project No.6172
BOND
���1��p✓�'�i��'�. -�- ���5l
ot ear ier than onstruction Cod�iract Date
One Million Ninety Nine Thousand and 00/100 Dollars
Amount:($1,099,000.00)
Modifications to this Bond: bD None ❑ See Section 18
CONTRACTORAS PRINCIPAL SURETY
Company: (Corporate Seal) Compan : " (Cor r te Seal)
FISHER'iANKCOM ANY WESTER �YCOMPAN`� �
S1�1C1LlIFY;: .gT1al71I� - - � -
Name >- . E )�:� �✓�S Name Elizabet� rrero,Attorney-in-Fact -
anri Tifle: I�•� S�,{- �t tr'��-� and Title:
(Any additional signatures appear on the last page of this Payment Bond.) - - "
(FOR INFORMATION ONLY—Name, address and telephone)
AGENT or BROKER: OWNER'S REPRESENTATIVE:
Aon Risk Services Central, Inc. (Architect,Engineer or other party:)
One Liberty Place, 1650 Market Street
Philadelphia, PA 19103
215-255-2000
AIA Document A312TM'—2010.The American Institute of Architeds.
5
§1 The Contractor and Surety,jointly a�severally,bind themselves,their heirs,executors,administrators,successors
and assigns to the Owner to pay for labor,materials and equipment furnished for use in the perfomiance of the
Construction Contract,which is incorporated herein by reference,subject to the following terms.
§2 If the Contractor prompfly makes payment of all sums due to Claimants,and defends,i�emnifies and holds
l�arn�less the Owner from claims,demands,liens or suits by any person or entity seeking payment for labor,materials
or equipment furnished for use in the perfonnance of the Construction Contract,then the Surety and the Contractor
shall have no obligation under this Bond.
§3 If there is no Owner Default under the Construction Contract,the Surety's obligation to the Owner under this Bond
shall arise after the Owner has promptly notified the Contractor and the Surety(at the address described in Section 13)
of claims,demands,liens or suits against the Owner or the Owner's pmperty by any person or entity seeking payment
for labor,materials or equipment furnished for use in the performance of the Construction Contract and tendered
defense of such claims,demands,liens or suits to the Contractor and the Surety.
§4 When the Owner has satisfied the conditions in Section 3,the Surety shall promptly and at the Surety's expense
defend,indemnify and hold hannless the Owner against a duly tendered claim,demand,lien or suit.
§5 The Surety's obligations to a Claimant under this Bond shall arise after the following:
§5.1 Claimants,who do not have a direct contract with the Contractor,
.1 ha�e furnished a written notice of non-payment to the Contractor,stating with substantial accuracy the
amount claimed and the name of the party to whom the materials were,or equipment was,furnished or
supplied or for whom the labor was done or performed,within ninety(90)days after having last
performed labor or last fumished materials or equipment included in the Claim;and
.2 have sent a Claim to the Surety(at the address described in Section 13).
§5.2 Claimants,who are employed by or have a direct contract with the Contractor,have sent a Claim to the Surety(at
the address described in Section 13).
§6 If a norice of non-payment required by Section 5.1.1 is given by the Owner to the Contractor,that is sufficient to
sarisfy a Claimant's obligarion to furnish a written notice of non-payment under Section 51.1.
§7 When a Claimant has saiisfied the conditions of Sections 5.1 or 5.2,whichever is applicable,the Surety shall
prompfly and at the Surety's expense take the following actions:
§7.1 Send an answer to the Claimant,with a copy to the Owner,within sixty(60)days after receipt of the Claim,
stating the amounts that are undisputed and the basis for challenging any amounts that are disputed;and
§7.2 Pay or amange for payment of any undisputed amounts.
§7.3 The Surety's failure to discharge its obligations under Section 7.1 or Section 7.2 shall not be dee�d to
constitute a waiver of defenses the Surety or Contractor may ha�e or acquire as to a Claim,except as to undisputed
amounts for which the Surety and Claimant have reached agreement.If,however,the Surety fails to discharge its
obligations under Section 7.1 or Section 72,the Surety shall indemnify the Claimant for the reasonable attomey's
fees the Claimant incurs thereafter to recover any sums found to be due and owing to the Claimant.
§8 The Surety's total obligation shall not exceed the amount of this Bond,plus the amount of reasonable attorney's
fees pmvided under Section 7.3,and the amouirt of this Bond shall be credited for any payments made in good faith
by the Surety.
§9 Amounts owed by the Owner to the Contractor under the Construction Contract shall be used for the performance
of the Construction Contract and to satisfy claims,if any,under any construction perforn�ance bond.By the
Contractor furnishing and the Owner accepdng this Bond,they agree that all funds earned by the Contractor in the
performance of the Construction Contract are dedicated to satisfy obligations of the Contractor and Surety under this
Bond,subject to the Owner's priority to use the funds for the completion of the work.
AIA Document A312TM'—2010.The American Institute of Architects.
s
§10 The Surety shall not be liable to the Owner,Claimants or others for obligations of the Contractor tbat are
unrelated to the Construction Contract.The Owner shall not be liable for the payment of any costs or expenses of any
Claimant under this Bond,and shall have under this Bond no obligation to make payments to,or give notice on behalf
of,Claimants or othenvise have any obligations to Claimants under this Bond.
§11 The Surety hereby waives norice of any change,including cl�anges of time,to the Construction Contract or to
related subcontracts,purchase orders and other obligations.
§12 No suit or action shall be commenced by a Claimant under this Bond other than in a court of competent
jurisdiction in the state in which the project that is the subject of the Construction Contract is located or after the
expiration of one yeaz from the date(1)on which the Claimant sent a Claim to the Surety pursuant to
Section 5.1.2 or 5.2,or(2)on which the last labor or service was performed by anyone or the last materials or
equipment were furnished by anyone under the Construction Contract,whichever of(1)or(2)first occurs.If the
pmvisions of this Paragraph are void or prohibited by law,the minimum period of limitarion available to sureties as a
defense in the jurisdiction of the suit shall be applicable.
§13 Notice and Claims to the Surety,the Owner or the Coniractor sl�all be mailed or delivered to the address shown
on the page on wluch their signature appeais.Actual receipt of notice or Claims,however accomplished,shall be
sufficient compliance as of the date received.
§14 When this Bond has been furnished to comply with a statutory or other legal requirement in the location where
the construction was to be performed,any provision in this Bond conflicting with said statutory or legal requirement
shall be deemed deleted herefrom and provisions confornung to such statutory or other legal requirement shall be
deemed incorporated herein.When so fiunished,the intent is that this Bond shall be construed as a statutory bond and
not as a common law bond.
§15 Upon request by any person or entity appearing to be a potential beneficiary of this Bond,the Contractor and
Owner shall prompfly furnish a copy of this Bond or shall pernut a copy to be made.
§16 Definitions
§16.1 Claim.A written statement by the Claimant including at a minimum:
.1 the name of the Claimant;
.2 the name of the person for whom the labor was done,or materials or equipment furnished;
.3 a copy of the agreemeirt or purchase order pursuant to which labor,materials or equipment was
furnished for use in the performance of the Construction Contract;
.4 a brief description of the labor,materials or equipment furnished;
.5 the date on which the Claimant last performed labor or last furnished materials or equipment for use in
the performance of the Construction Contract;
.6 the total amount earned by the Claimant for labor,materials or equipment fiunished as of the date of
the Claim;
.7 the total amount of previous payments received by the Claimant;and
.8 the total amount due and unpaid to the Claimant for labor,materials or equipment furnished as of the
date of the Claim.
§16.2 Claimant.An individual or entity ha�ing a direct contract with the Contractor or with a subcontractor of the
Contractor to furnish labor,materials or equipment for use in the performance of the Construction Contract.The term
Claimant also includes any individual or enrity that has rightfully asserted a claim under an applicable mechanic's lien
or similaz statute against the real property upon which the Project is located.The intent of this Bond shall be to
include without limitation in the terms"labor,materials or equipment"that part of water,gas,power,light,heat,oil,
gasoline,telephone service or rental equipment used in the Construction Contract,architectural and engineering
services required for perforn�ance of the work of the Contractor and the Contractor's subcontractors,and all other
items for which a mechanic's lien may be asserted in the jurisdiction where the labor,materials or equipment were
furnished.
§16.3 Construction Contract�The agreement between the Owner and Contractor identif'ied on the cover page,
including all Contract Documents and all changes made to the agreement and the Contract Documents.
AIA Document A312TM'—2010.The American Institute of Architects.
7
§16.4 Owner Defaul�Failure of the Owner,which has not been remedied or waived,to pay the Contractor as required
under the Construction Contract or to perform and complete or comply with the other material terms of the
Construction Contract.
§16.5 Contract Documents.All the documents that comprise the agreement between the Owner a�Contractor.
§17 If this Bond is issued for an agreement between a Contractor and subcontractor,tl�term Contractor in this Bond
shall be deemed to be Subcontractor and the term Owner shall be deemed to be Contractor.
§18 Modif'ications to this bond are as follows:
(Space is provided below for additional signatures of added parties, other than those appearing on the cover page.)
CONTRACTORAS PRINCIPAL SURETY
Company: (Corporate Seal) Company: (Corporate Seal)
Signature: Signature:
Name and Title: , Name and Tifle: ,Attorney-in-Fact
Address: Address:
AIA Document A312TM'—2010.The American Institute of Architects.
$
. � � Western Surety Company
POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY-IN-FACT
Know All Men By These Presents,That WESTERN SURETY COMPANY,a South Dakota corporation,is a duly organized and existing corporation
having its principal office in the City of Sioux Falls,and State of South Dakota,and that it does by virtue of the signature and seal herein affixed hereby
make,constitute and appoint
Douglas R Wheeler, Wayne G Mc Vaugh, Jaquanda Long, Elizabeth Marrero, Maureen
Mc Neill,Marina Tapia,Individually
of Philadelphia,PA, its true and lawful Attomey(s)-in-Fact with full power and authority hereby confened to sign, seal and execute for and on its behalf
bonds,undertakings a�d other obligatory instruments of similaz nature
- In Unlimited Amounts -
and to bind it thereby as fully and to the same extent as if such instruments were signed by a duly authorized oFficer of the corporation and all the acts of said
Attorney,pursuant to the authority hereby given,are hereby ratified and confirmed.
This Power of Attorney is made and executed pursuant to and by authority of the By-Law printed on the reverse hereof,duly adopted,as indicated,by
the shareholders of the corporation.
In Witness Whereof, WESTERN SURETY COMPANY has caused these presents to be signed by its Vice President and its corporate seal to be
hereto affixed on this 22nd day of October,2013.
�„�ET� WESTERN SURETY COMPANY
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aul T.Bruflat,Vice President
State of South Dakota l
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County of Minnehaha J
On this 22nd day of October,2013,before me personally came Paul T.Bruflat,to me known,who,being by me duly sworn,did depose and say: that
he resides in the City of Sioux Falls, Sta[e of South Dakota;that he is the Vice President of WESTERN SURETY COMPANY described in and which
executed the above instrument;that he knows the seal of said corporation;that the seal affixed to the said instrument is such corporate seal;that it was so
affixed pursuant to authority given by the Board of Directors of said corporation and that he signed his name thereto pursuant to like authority, and
acknowledges same to be the act and deed of said corporation.
My commission expires +""' �
J.MOHR f
� SEn� NOTARY PUBLIC S^�� � .
June 23,2015 f SOUTH DAKOTA �
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L Mohr,Notary Public
CERTIFICATE
I,L. Nelson,Assistant Secretary of WESTERN SURETY COMPANY do hereby certify that the Power of Attorney hereinabove set forth is still in
force,and further certify that the By-Law of the corporation printed on the reverse hereof is still in force. In testimony whereof I have her.uato subs�ribed
my name and affixed the seal of the said corporation this�day of /U�J i���G� ,�
�""�„`ETY , WESTERN SURETY COA� PA�1Y
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L.Nelson,Assistant Secretary
Form F4280-7-2012
Authorizing By-Law
ADOPTED BY THE SHAREHOLDERS OF WESTERN SURETY COMPANY
This Power of Attorney is made and executed pursuant to and by authority of the following By-Law duly adopted by the shareholders
of the Company.
Section 7. All bonds, policies, undertakings, Powers of Attorney, or other obligations of the corporation shall be executed in the
corporate name of the Company by the President, Secretary, and Assistant Secretary, Treasurer, or any Vice President, or by such other
officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer
may appoint Attorneys in Fact or agents who shall have authority to issue bonds, policies, or undertakings in the name of the Company.
The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the
corporation. The signature of any such officer and the corporate seal may be printed by facsimile.
WESTERN SURETY COMPANY
Sioux Falls,South Dakota
Statement of Net Admitted Assets and Liabilities
December 31,2014
ASSETS
Bonds $1,824,951,414
Stocks 23,975,582
Cash, cash equivalents, and short-term investments 51,536,164
Investment income due and accrued 22,267,675
Premiums and considerations 41,696,249
Amounts recoverable from reinsurers (11,221,508)
Federal and foreign income taxes recoverable 7,401,709
Net deferred tax asset 20,261,713
Receivable from parent, subsidiaries, and affiliates 17,380,167
Other assets 3,799
Total Assets $1,998,252,964
LIABILITIESAND SURPLUS
Losses $302,997,505
Reinsurance payable on paid losses and loss adjustment expenses (15,267,712)
Loss adjustment expense 64,134,995
Contingent and other commissions payable 6,099,306
Unearned premiums 259,011,845
Advance premiums 5,321,610
Payable to parent, subsidiaxies and affiliates 107,843
Other liabilities 7,821,458
Total Liabilities $630,226,850
Surplus Account:
Capital paid up $4,000,000
Gross paid in and contributed surplus 280,071,837
Unassigned funds 1,083,954,277
Surplus as regards policyholders $1,368,026,114
Total Liabilities and Capital $1,998,252,964
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I�,��oc�y, �t Vice President of Western Surety Company hereby certify that the above is an
a� '� represe�itai�� of the financial statement of the Company dated December 31, 2014, as filed
���h�ario�s I��.nce Departments and is a ixue and correct statement of the condition of Western
Si��•�"o�itp�y - that date.
r�,�s`e�����y��������.�
e�te�e�����g��a� Western Sure ompany
By
Assistant ice Presiden
Subscribed and sworn to me this 19th day of March , 2015
My COTT1T111SS1011 OX�ll'0S: YOLANDA JIMENEZ
� OFFiCIAL SEAL i i
Notary Public,State of Illinofs
My Commission Expires NO2 Pll I1C
September 24,2017