HomeMy WebLinkAboutAPAC Southeast, Inc. Pavement Overlaymr��r
SEBASTIAN
Q �aw�
HOME OF PELICAN ISLAND
1225 Main Street
Sebastian, FL 32958
(772)388-8215 Phone
May 18, 2017
APAC- SOUTHEAST, INC.
2710 Michigan Avenue
Kissimmee, FL 34744
RE: Release of Payment & Performance Bond for City of Sebastian 2010 Pavement
Overlay—Bond # 8220-22-87.
To Whom It May Concern:
I am releasing payment and performance bonds #8220-22-87 issued by Federal Insurance
Company in the amount of $381,841.29 to the City of Sebastian for 2010 Pavement Overlay.
iette Williams, MMC
Clerk
Attachment: Original Bonds #8220-22-87
THE AMERICAN INSTITUTE OF ARCHITECTS
BOND NO. 8220-22-87
AIA Document A312
Performance Bond
Any singular reference to Contractor, Surety, Owner or other party shall be considered plural where applicable.
CONTRACTOR (Name and Address):
APAC - SOUTHEAST, INC.
2710 MICHIGAN AVENUE
KISSIMMEE, FL 34744
OWNER (Name and Address):
CITY OF SEBASTIAN
1225 MAIN STREET
SEBASTIAN, FL 32958
CONSTRUCTION .CONTRACT
Date: AUGUST 17, 2010
Amount: $381,841,29
SURETY (Name and Principal Place of Business):
FEDERAL INSURANCE COMPANY
15 MOUNTAIN VIEW RD.
WARREN, NJ 07061
Description (Name and Location): CITY OF SEBASTIAN 2010 PAVEMENT OVERLAY
BOND
Date (Not earlier than Construction Contract Date): AUGUST 24, 2010
Amount: $381,841.29
Modifications to this Bond:
CONTRACTOR AS PRINCIPAL
Company: (Corporate Seal)
APAC - SOUTHEAST, INC.
Signature.
Name and Title: �� 1►i r P���r
(Any additional signatures appear on page 3)
❑ See Page 3
SURETY
Company: (Corporate Seal)
FEDERAL INSU ANCE COMPANY
Siature:
Nam A DAVIS,
Attorney -In -Fac
(FOR INFORMATION ONLY - Name, Address and Telephone)
AGENT .or BROKER: 801-533-3600 OWNER'S REPRESENTATIVE (Architect, Engineer or
Marsh or
Risk & Insurance Services other party):
15 W. South Temple, Ste. 700
Salt Lake City, UT 84101
AIA DOCUMENT A312 • PERFORMANCE BOND AND PAYMENT BOND • DECEMBER 1984 ED. • AIA
THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, D.C. 20006 A312-1984
THIRD PRINTING • MARCH 1987
1 The Contractor and the Surety, jointly and severally, bind
themselves, their heirs, executors, administrators,
successors and assigns to the Owner for the performance
of the Construction Contract, which is incorporated herein
by reference.
2 If the Contractor performs the Construction Contract, the
Surety and the Contractor shall have no obligation under
this Bond, except to participate in conferences as provided
in Subparagraph 3.1.
3 If there is no Owner Default, the Surety's obligation
under this Bond shall arise after:
3.1 The Owner has notified the Contractor and the
Surety at its address described in Paragraph 10 below
that the Owner is considering declaring a Contractor
Default and has requested and attempted to arrange a
conference with the Contractor and the Surety to be
held not later than fifteen days after receipt of such
notice to discuss methods of performing the
Construction Contract. 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 shall not waive the Owner's
right, if any, subsequently to declare a Contractor
Default; and
3.2 The Owner has declared a Contractor Default and
formally terminated the Contractor's right to complete
the contract. Such Contractor Default shall not be
declared earlier than twenty days after the Contractor
and the Surety have received notice as provided in
Subparagraph 3.1; and
3.3 The Owner has agreed to pay the Balance of the
Contract Price to the Surety in accordance with the
terms of the Construction Contract or to a contractor
selected to perform the Construction Contract in
accordance with the terms of the contract with the
Owner.
4 When the Owner has satisfied the conditions of
Paragraph 3, the Surety shall promptly and at the Surety's
expense take one of the following actions:
4.1 Arrange for the Contractor, with consent of the
Owner, to perform and complete the Construction
Contract; or
4.2 Undertake to perform and complete the
Construction Contract itself, through its agents or
through independent contractors; or
4.3 Obtain bids or negotiated proposals from qualified
contractors acceptable to the Owner for a contract for
performance and completion of the Construction
Contract, arrange for a contract to be prepared for
execution by the Owner and the 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
amount of damages as described in Paragraph 6 in
excess of the Balance. of the Contract Price incurred
by the Owner resulting from the Contractor's default;
or
4.4 Waive its right to perform and complete, arrange
for completion, or obtain a new contractor and with
reasonable promptness under the circumstances:
.1 After investigation, determine the amount for
which it may be liable to the Owner and, as
soon as practicable after the amount is
determined, tender payment therefor to the
Owner; or `'
.2 Deny liability in whole or in part and notify the
Owner citing reasons therefor.
5 If the Surety does not proceed as provided in Paragraph
4 with reasonable promptness, the Surety shall be deemed
to be in default on this Bond fifteen 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 entitled to enforce any
remedy available to the Owner. If the surety proceeds as
provided in Subparagraph 4.4, and the Owner refuses the
payment tendered 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.
6 After the Owner has terminated the Contractor's right to
complete the Construction Contract, and if the Surety
elects to act under Subparagraph 4.1, 4.2, or 4.3 above,
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. To the limit of the
amount of this Bond, but subject to commitment by the
Owner of the Balance of the Contract Price to mitigation of
costs and damages on the Construction Contract, the
Surety is obligated without duplication for:
6.1 The responsibilities of the Contractor for correction
of defective work and completion of the Construction
Contract;
6.2 Additional 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 Paragraph 4; and
6.3 Liquidated damages, or if not liquidated damages
are specified in the Construction Contract, actual
damages caused by delayed performance or non-
performance of the Contractor.
7 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 Owner
or its heirs, executors, administrators or successors.
8 The Surety hereby waives notice of any change,
including changes of time, to the Construction Contract or
to related subcontracts, purchase orders and other
obligations.
9 Any 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 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 sureties
as a defense in the jurisdiction of the suit shall be
applicable.
AIA DOCUMENT A312 . PERFORMANCE BOND AND PAYMENT BOND • DECEMBER 1984 ED. • AIA
THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, D.C. 20006 A312-1984
THIRD PRINTING • MARCH 1987
0
10 Notice to the Surety, the Owner or the Contractor shall
be mailed or delivered to the address shown on the
signature page.
11 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
conforming to such statutory or other legal requirement
shall be deemed incorporated herein. The intent is that
this Bond shall be construed as a statutory bond and not
as a common law bond.
12 DEFINITIONS
12.1 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
MODIFICATIONS TO THIS BOND ARE AS FOLLOWS:
by the Owner in settlement of insurance or other
claims for damages to which the Contractor is entitled,
reduced by all valid and proper payments made to or
on behalf of the Contractor under the Construction
Contract.
12.2 Construction Contract: The agreement betwen
the Owner and the Contractor identified on the
signature page, including all Contract Documents and
changes thereto.
12.3 Contractor Default: Failure of the Contractor,
which has neither been remedied nor waived, to
perform or otherwise to comply with the terms of the
Construction Contract.
12.4 Owner Default: Failure of the Owner, which has
neither been remedied nor waived, to pay the
Contractor as required by the Construction Contract or
to perform and complete or comply with the other
terms thereof.
(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:
Name and Title:
Address:
Signature:
Name and Title:
Address:
AIA DOCUMENT A312 • PERFORMANCE BOND AND PAYMENT BOND • DECEMBER 1984 ED. • AIA
THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, D.C. 20006 A312-1984 3
THIRD PRINTING • MARCH 1987
THE AMERICAN INSTITUTE OF ARCHITECTS
BOND NO. 8220-22-87
AIA Document A312
Payment Bond
Any singular reference to Contractor, Surety, Owner or other party shall be considered plural where applicable.
CONTRACTOR (Name and Address):
APAC - SOUTHEAST, INC.
2710 MICHIGAN AVENUE
KISSIMMEE, FL 34744
OWNER (Name and Address):
CITY OF SEBASTIAN
1225 MAIN STREET
SEBASTIAN, FL 32958
SURETY (Name and Principal Place of Business):
FEDERAL INSURANCE COMPANY
15 MOUNTAIN VIEW ROAD
WARREN, NJ 07061
CONSTRUCTION CONTRACT
Date: AUGUST 17, 2010
Amount: $381,841.29
Description (Name and Location): CITY OF SEBASTIAN 2010 PAVEMENT OVERLAY
BOND 9// //o
Date (Not earlier than Construction Contract Date): AUGUST 24, 2010
Amount: $381,841.29
Modifications to this Bond:
CONTRACTOR AS PRINCIPAL
Company: (Corporate Seal)
APAC - SOUTHEAST, INC.
Signature:
Name and Title:
(Any additional signatures appear on page 6)
❑ None
® See Page 6
SURETY
Company: (Corporate Seal)
A
INS RNCE COMPANY
iA
eand
DAVIS,
- n -Fact
(FOR INFORMATION ONLY- Name, Address and Telephone)
AGENT or BROKER: 801-533-3600 OWNER'S REPRESENTATIVE (Architect, Engineer
Marsh USA Risk & Insurance Services or other party):
15 W. South Temple, Ste. 700
Salt Lake City, UT 84101
AIA DOCUMENT A312 • PERFORMANCE BOND AND PAYMENT BOND • DECEMBER 1984 ED. • AIA
THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, D.C. 20006 A312-1984
THIRD PRINTING • MARCH 1987
I The Contractor and the Surety, jointly and 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
performance of the Construction Contract, which is
incorporated herein by reference.
2 With respect to the Owner, this obligation shall be null
and void if the Contractor:
2.1 Promptly makes payment, directly or indirectly, for
all sums due Claimants, and
2.2 Defends, indemnifies and holds harmless the
Owner from claims, demands, liens or suits by any
person or entity whose claim, demand, lien or suit is for
the payment for labor, materials or equipment furnished
for use in the performance of the Construction Contract,
provided the Owner has promptly notified the
Contractor and the Surety (at the address described in
Paragraph 12) of any claims, demands, liens or suits
and tendered defense of such claims, demands, liens
or suits to the Contractor and the Surety, and provided
there is no Owner Default.
3 With respect to Claimants, this obligation shall be null
and void if the Contractor promptly makes payment,
directly or indirectly, for all sums due.
4. The Surety shall have no obligation to Claimants under
this Bond until:
4.1 Claimants who are employed by or have a direct
contract with the Contractor have given notice to the
Surety (at the address described in Paragraph 12) and
sent a copy, or notice thereof, to the Owner, stating
that a claim is being made under this Bond and, with
substantial accuracy, the amount of the claim.
4.2 Claimants who do not have a direct contract with
the Contractor:
.1 Have furnished written notice to the Contractor
and sent a copy, or notice thereof, to the
Owner, within 90 days after having last
performed labor or last furnished materials or
equipment included in the claim stating, with
substantial accuracy, the amount of the claim
and the name of the party to whom the
materials were furnished or supplied or for
whom the labor was done or performed; and
6 When the Claimant has satisfied the conditions of
Paragraph 4, the Surety shall promptly and at the Surety*s
expense take the following actions:
6.1 Send an answer to the Claimant, with a copy to the
Owner, within 45 days after receipt of the claim, stating
the amounts that are undisputed and the basis for
challenging any amounts that are disputed.
6.2 Pay or arrange for payment of any undisputed
amounts.
7 The Surety's total obligation shall not exceed the amount
of this Bond, and the amount of this Bond shall be credited
for any payments made in good faith by the Surety.
8 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 Performance Bond. By the Contractor
furnishing and the Owner accepting 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 the Surety under this
Bond, subject to the Owner's priority to use the funds for the
completion of the work.
9 The Surety shall not be liable to the Owner, Claimants or
others for obligations of the Contractor that are unrelated to
the Construction Contract. The Owner shall not be liable for
payment of any costs or expenses of any Claimant under
this Bond, and shall have under this Bond no obligations to
make payments to, give notices on behalf of, or otherwise
have obligations to Claimants under this Bond.
10 The Surety hereby waives notice of any change,
including changes of time, to the Construction Contract or to
related subcontracts, purchase orders and other obligations.
11 No suit or action shall be commenced by a Claimant
under this Bond other than in a court of competent
jurisdiction in the location in which the work or part of the
work is located or after the expiration of one year from the
date (1) on which the Claimant gave the notice required by
Subparagraph 4.1 or Clause 4.2.3, 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 provisions of this Paragraph are void or prohibited by
law, the minimum period of limitation available to sureties as
a defense in the jurisdiction of the suit shall be applicable.
.2 Have either received a rejection in whole or in 12 Notice to the Surety, the Owner or the Contractor shall
part from the Contractor, or not received within be mailed or delivered to the address shown on the
30 days of furnishing the above notice any signature page. Actual receipt of notice by Surety, the
communication from the Contractor by which Owner or the Contractor, however accomplished, shall be
the Contractor has indicated the claim will be sufficient compliance as of the date received at the address
paid directly or indirectly; and shown on the signature page.
.3 Not having been paid within the above 30 13 When this Bond has been furnished to comply with a
days, have sent a written notice to the Surety statutory or other legal requirement in the location where the
(at the address described in Paragraph 12) construction was to be performed, any provision in this Bond
and sent a copy, or notice thereof, to the conflicting with said statutory or legal requirements shall be
Owner, stating that a claim is being made deemed deleted herefrom and provisions conforming to
under this Bond and enclosing a copy of the such statutory or other legal requirement shall be deemed
previous written notice furnished to the incorporated herein. The intent is that this
Contractor.
5 If a notice required by Paragraph 4 is given by the
Owner to the Contractor or to the Surety, that is sufficient
compliance.
AIA DOCUMENT A312 • PERFORMANCE BOND AND PAYMENT BOND • DECEMBER 1984 ED. • AIA
THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, D.C. 20006 A312-1984
THIRD PRINTING • MARCH 1987
Bond shall be construed as a statutory bond and not as a
common law bond.
14 Upon request by any person or entity appearing to be a
potential beneficiary of this Bond, the Contractor shall
promptly furnish a copy of this Bond or shall permit a copy
to be made.
15 DEFINITIONS
15.1 Claimant: An individual or entity having 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 Contract. 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
MODIFICATIONS TO THIS BOND ARE AS FOLLOWS:
Paragraph 4 is amended to insert sub -paragraph 4.3 which states:
in the Construction Contract, architectural and
engineering services required for performance 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.
15.2 Construction Contract: The agreement between
the Owner and the Contractor identified on the
signature page, including all Contract Documents and
changes thereto.
15.3 Owner Default: Failure of the Owner, which has
neither been remedied nor waived, to pay the
Contractor as required by the Construction Contract or
to perform and complete or comply with the other
terms thereof.
4.3 Claimant has furnished to Surety proof of claim duly swom to by Claimant with adequate supporting documentation proving the amount
claimed is due and payable.
Paragraph 5 is revised to read, in its entirety, as follows:
5. If a notice required by Paragraph 4 is given by the Owner to the Contractor and to the Surety, that is sufficient compliance.
Paragraph 6 and its sub paragraphs 6.1 and 6.2 shall be deleted in their entirety.
(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:
Name and Title:
Address:
Signature:
Name and Title:
Address:
AIA DOCUMENT A312 • PERFORMANCE BOND AND PAYMENT BOND • DECEMBER 1984 ED. • AIA
THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVE., N.W., WASHINGTON, D.C. 20006 A312-1984
SURETY ACKNOWLEDGMENT
STATE OF UTAH }
COUNTY OF SALT LAIC } SS
On this 24TH day of AUGUST, 2010, before me personally came TINA DAVIS to
me known, who, being by me duly sworn, did depose and say that she is an
Attorney -In -Fact of FEDERAL INSURANCE COMPANY the corporation
described in and which executed the within instrument; that she knows the
corporate seal of said corporation, that the seal affixed to the within instrument is
such corporate seal, and that she signed the said instrument and affixed the said seal
as Attorney -In -Fact of the Board of Directors of said corporation and by authority
of this office under the Standing Resolutions thereof.
Public
LINDSEYAG TES
Notary Public - State of Utah
Commission Number: 576343
lyOg My Commission Expires Oct. 15, 2012
t r
luChubb POWER Federal Insurance Company Attn: Surety Department
OF Vigilant Insurance Company 15 Mountain View Road
Surety ATTORNEY Pacific Indemnity Company Warren, NJ 07059
Know All by These Presents, That FEDERAL INSURANCE COMPANY, an Indiana corporation, VIGILANT INSURANCE
COMPANY, a New York corporation, and PACIFIC INDEMNITY COMPANY, a Wisconsin corporation, do each hereby constitute and
a point Tina Davis, Marcinda Drysdale and Jeanna Romero of Salt Lake City, Utah and Mary E. Strait of Tulsa,
OklaholtlN.N....-.a"..
each as their true and lawful Attorney- in- Fact to execute under such designation In their names and to affix their corporate seals to and deliver for and on their behalf as surety
thereon or otherwise, bonds and undertakings and other writings obligatory In the nature thereof (other than bail bonds) given or executed In the course of buslness, and any
Instruments amending or altering the same, and consents to the modification or alteration of any Instrument referred to in said bonds or obligations.
In Witness Whereat said FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY have each executed and attested
these presents and affixed their corporate seals on this 20th day of November, 2009.
Kenneth C. Wendel, Assistant Secretary Davl onls. Jr., Vice Presld
STATE OF NEW JERSEY
ss.
County of Somerset
On this 20th day of November, 2009 before me, a Notary Public of New Jersey. personally came Kenneth C. Wendel, to me
known to be Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY, the companies which
executed the foregoing Power of Attorney, and the said Kenneth C. Wendel. being by me duly swom, did depose and say that he Is Assistant Secretary of FEDERAL
INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY and knows the corporate seals thereof, that the seals affixed to the
foregoing Power of Attorney are such corporate seals and were thereto affixed by authority of the By Laws of said Companies; and that he signed said Power of Attorney as
Assistant Secretary of said Companies by like authority; and that he Is acquainted with David B. Norris, Jr., and knows him to be Vice President of said Companies; and that the
signature of David B. Norris, Jr., subscribed to said Power of Attorney is In the genuine handwriting of David B. Norris, Jr.. and was thereto subscribed by authority of said By-
Laws
yLaws and in deponent's presence.
Notarla STEPM 0.OP"
No" Public, SheAat NOW
j3 ARV NIL 2321W
Com olon E*ku Gd, 26, 2014
� 1,pUB0 Notary
Public
JET
CERTIFICATION
Extract from the By- Laws of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY:
"Ail powers of attorney for and on behalf of the Company may and shall be executed In the name and on behalf of the Company, either by the Chairman or the
President or a Vice President or an Assistant Vice President, jointly with the Secretary or an Assistant Secretary, under their respective designations. The
signature of such officers may be engraved. printed or lithographed. The signature of each of the following officers: Chairman, President, any Vice President, any
Assistant Vice President. any Secretary, any Assistant Secretary and the' seal of the Company may be affixed by facsimile to any power of attorney or to any
certificate relating thereto appointing Assistant Secretaries or Attorneys- In- Fact for purposes only of executing and attesting bonds and undertakings and other
writings obligatory in the nature thereof. and any such power of attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding
upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding upon the Company
with respect to any bond or undertaking to which it is attached
1, Kenneth C. Wendel, Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY
(the 'Companies') do hereby certify that
(I) the foregoing extract of the By Laws of the Companies Is true and conea
(i) the Companies are duly licensed and authorized to transact surety business in all 50 of the United States of America and the District of Columbia and are
authorized by the U.S. Treasury Department; further, Federal and Vigilant are licensed in Puerto Rico and the U.S. Virgin Islands. and Federal Is licensed In
American Samoa, Guam, and each of the Provinces of Canada except Prince Edward island; and
(Iii) the foregoing Power of Attorney is true, correct and in full force and effect.
Given under my hand and seals of said Companies at Warren. NJ this AUGUST 24, 2010
00,
+ /
Kenneth C. Wend I. Assistant Secretary
IN THE EVENT YOU WISH TO NOTIFY US OF A CLAIM, VERIFY THE AUTHENTICITY OF THIS BOND OR NOTIFY US OF ANY OTHER
MATTER, PLEASE CONTACT US AT ADDRESS LISTED ABOVE, OR BY Telephone (908)903-3493 Fax (908)903- 3656
e-mail: surety@chubb.com
Form 15-10- 02258- U (Ed. 5- 03) CONSENT