HomeMy WebLinkAboutHi-Lite Marking, Inc.MOF
HOME OF PELICAN ISLAND
1225 Main Street
Sebastian, FL 32958
(772) 388-8214
April 17, 2013
Hi -Lite Markings, Inc.
18249 Hi -Lite Drive
Adams Center, NY 13606
RE: Release of Performance Bond for Sebastian Municipal Airport Runway Marking in
the amount of $41,055.00 — Bond # 41266439
To Whom It May Concern:
In accordance with a request from City of Sebastian Community Development Director, Joe
Griffin and assurance that all required work has been completed, I am releasing bond
#41266439. The Performance Bond was issued by Platte River Insurance Company in the
amount of $41,055.00 to the City of Sebastian for runway marking at the Sebastian Municipal
Airport.
Sinc y,
Sally A. Mai MC
City Clerk
Attachment: Original Bond #41266439
Copy of Contractor Certificate of Project Completion
cc: City Manager
City Attomey
Community Development Director
Public Works Director
Date Accepted:
Project Name & #:
Contractor Name:
CRY of
So.
,1in
HOME Of PELICAN HAND
CERTIFICATE OF PROJECT COMPLETION
4- !i- 13
• Runway Markings
Purchase Order #: 6890 Final Contract Price
2&. 3U -
Project Location: Municipal Airport
Pursuant to the above captioned contract and in compliance of same, we the undersigned do
hereby certify that this project is complete.
Issuance of this certificate releases the contractor from any further responsibility except as
stipulated in the contract as is relates to bond performance, payment of subcontractors, release or
liens, maintenance and indemnity. All contractual obligations as to warranty, insurance,
indemnification and patents, shall remain in full effect for the contractually stipulated period of
time. In no way does the issuing of this certificate release the Contractor from all legal
obligations as stipulated in Chapter 713 of the Florida Statutes.
Therefore, having reviewed the contract and inspected the work, the undersigned to hereby accept
the segment s b g compl e.
Proie ad2er Date
Engineering C, odsultant, Michael Baker
ifi fid
Public Works Director
Date
Date
Date
-/.2- 13
Date
- / S/,3
Date
416-b
DAte
Date
Date
Bond No. 41266439
AIA Document A312 TM .2010
Performance Bond
CONTRACTOR:
(Name, legal status and address)
Hi -Lite Markings, Inc.
18249 Hi -Lite Drive
Adams Center, NY 13606
OWNER:
(1Vame, legal status and address)
City of Sebastian
1225 Main Street
Sebastian, FL 32958
CONSTRUCTION CONTRACT
Date: November 7, 2012
SURETY:
(Name, legal status and principal place
of business)
Platte River Insurance Company
115 Glastonbury Blvd., Suite 5
Glastonbury, CT 06033
Amount: Forty ,One Thousand Fifty -Five and 00/100 Dollars
($41,055.00)
Description:
(Name and location) 2012 Runway Markings at the Sebastian
Municipal Airport
BOND
Date: November 7. 2012
(Not earlier than Construction Contract Date)
Amount: Forty One Thousand Fifty -Five and 00/100 Dollars
Modifications to this Bond: ® None ❑ See Section 16 ($41,055.00)
CONTRACTOR AS PRINCIPAL SURETY
Company: (Cojporate Seal) Company• (Corporate Seal)
WW rkings, Plate Insuran e
�, •'Q,p �9rd,;h Si ature: /
afie �:t�s M • N e ctoria L. es
- SE
Title: ?G>';crL_-P;,.a,s:an ttle: Attorney -In-
1991§ny addU nal signatures appear on the last page of this Performance Boncl)
FUI Y R Ill( VRAMTION ONLY— Name, address and telephone)
��'�i •'•' SAGE �r BROKER: OWNER'S REPRESENTATIVE:
well s��i igot%grurance Services USA, Inc. (Architect, Engineer or other party:)
7 Giralda Farms, 2nd Floor
Madison, NJ 07940
(973) 437-2300
Inst. AIA Document MUM — 2010. The American Institute of Architects.
This document has important legal
consequences. Consultation with
an attorney is encouraged with
respect to its completion or
modification.
Any singular reference to
Contractor, Surety, Owner or
other party shall be considered
plural where applicable.
AIA Document A312-2010
combines two separate bonds, a
Performance Bond and a
Payment Bond, Into one form.
This is not a single combined
Performance and Payment Bond.
061110
9
§ 1 The Contractor and 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 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 provides 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 performance. If the Owner does not
request a conference, the Surety may, within five (5) business days after receipt of the Owner's notice,
request such a conference. If the Surety timely requests a conference, the Owner shall attend. Unless
the Owner agrees otherwise, any 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 shall not waive the Owner's right, if any, subsequently to declare a Contractor
Default;
.2 the Owner declares a Contractor Default, terminates the Construction Contract and notifies 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 promptly 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 Undertake to perform and complete the Construction Contract itself, through its agents or independent
contractors;
§ 5.3 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 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
amount 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 investigation, determine the amount for which it may be liable to the Owner and, as soon as
practicable after the amount is determined, 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 promptness, 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 perforni 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 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.
Inst. AIA Document A312M— 2010. The American Institute of Architects.
§ 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 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 Section 5; and
.3 liquidated damages, or if no liquidated damages are specified in the Construction Contract, actual
damages caused by delayed performance or non-performance 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 Owner or its
heirs, executors, administrators, successors and assigns.
§ 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 Any proceeding, legal or equitable, tinder 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 sureties 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 provisions conforming to such statutory or other legal requirement shall be
deemed incorporated herein. When so furnished, the intent is that this Bond shall be construed as a statutory bond and
not as a common law bond.
§ 14 Definitions
§ 14.1 Balance of the Contract Price. Tile total amount payable by the Owner to the Contractor under die 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 proper 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 Construction Contract.
§ 14.4 Owner Default. 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.
§ 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 tern Owner shall be deemed to be Contractor.
Intt. AIA Document A312*" — 2010. The American Institute of Architects.
§ 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:
Name and Title:
Address
Signature:
Name and Title:
Address
CAUTION: You should sign an original AIA Contract Document, on which this text appears in RED. An original assures that
changes will not be obscured.
Init. AIA Document A312TN — 2010. The American institute of Architects.
Corporate Acknowledgement
STATE OF New York,
COUNTY OF Jefferson
On this 7th day of November
Sa,!►.Vy �.l�r ,
appeared
2012, before me
NOTARY PUBLIC personally
personally known to me (or proved to me on the basis of satisfactory evidence) to be the person
who executed the within instrument as president (or secretary)or on behalf of the corporation
therein named and acknowledged to me that the corporation executed it.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed my Official Seal, the day
and year first above written.
My Commission expires
Notary Public, r siding at
Nlarkrn,
Z. v
SEAL =
1990
r �
r �
SALLY W DALY
NOTARY PUBLIC -STATE OF NEW YORK
No.01DA6242984
Qualified In Jefferson County
My Commission Expires June 13, 2015
ACKNOWLEDGEMENT OF SURETY
State of New Jersey
County of Morris
City of Madison
On this 7th day of _November in the year 2012 _ before me personally
Came Victoria L. Ernest to me known, who, being by me duly sworn, did
depose and say that he resides in Madison. NJ ; that he is
the Attorney -In -Fact for Platte River Insurance Company the
corporation described in and which executed the attached instrument; that he knows
the seal of the said corporation; that the seal affixed to the said instrument is such
corporate seal; and that it was so affixed by Order of the Board of Directors of the said
corporation, and that he signed his name thereto by like order.
n,lam
Notary Public
ROBYN ROST
NOTARY PUBLIC, STATE OF NEW JERSEY
NO.2372977
COMMISSION EXPIRES APRIL. -8, 2013
11011 ,S�/ f,/11'�/+i�I 4, `Y1 �i���+i. �1 �, • I, •{ .t.,'. •\ r?'•: ,••i•.�A,• e.,. �' 1 4',�i�, lri�1✓is1y�V �''j ii
�. !,1'II �, /1 H./f ,// If l.f/t ! ,111 f♦ir+ii �/1f ,tii•: CO l�,oitir. �t �l1 jft 4f if�r: CO l�iiiti /l if ilii �0 l�iif li '/ ilrilI�� re1{i*/���:, tr
it � r5i/1-.� Ih�il+ ��� l�lt a ,1 1�.'�: "81411"o-' 11!11 � 4H,4, 4 i/t1/1 �• � 11,!tt � it1!11 � Ir,.{/4.+tt111.�11tf11 �'� i�/ �•N�f
t�' . !,<.I,tx�i •.lF,+l1.F.x.•' lttli. �:Fiftttl. r►tfii3},• � 1!,41.x;.} istt}+4' {�1�1t} iii}Lt e}ti}.F}.. t{ftFc+ iilscll .=IF►IH� ii[,,, n}It«•,.►F'F:►'�,._ {1 1a
PLATTE RIVER INSURANCE COMPANY 41266439
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS, That the PLATTE RiVER INSURANCE COMPANY, a corporation of the State of Nebraska, having its
principal offices in the City of Middleton. Wisconsin, does make, constitute and appoint
ROBYN ROST; VICTORIA L. ERNEST
its true and lawful Attorney(s)-in-fact, to make, execute, seal and deliver for and on its behalf, as surety, and as its act and deed, any and all bonds,
undertakings and contracts of suretyship, provided that no bond or undertaking or contract of suretyship executed under this authority shall exceed in
amount the sum of
_-------------- _----- _------- ALL WRITTEN INSTRUMENTS IN AN AMOUNT NOT TO EXCEL -D: $5,000,000------------.________
This Power of Attorney is granted and is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board
of Directors of PLATTE RIVER INSURANCE COMPANY at a meeting duly called and held on the 8th day of January. 2002.
"RESOLVED, that the President, and Vice -President, the Secretary or Treasurer, acting individually or otherwise, be and they hereby are granted the
power and authorization to appoint by a Power of Attorney for the purposes only of executing and attesting bonds and undertakings and other writings
obligatory in the nature thereof, one or more vice-presidents, assistant secretaries and attorney(s)-in-fact, each appointee to have the powers and duties
usual to such offices to (lie business of (lie Corporation: the signature of such officers and the seal of the Corporation may be affixed to such power of
attorney or to any certificate relating thereto by facsimile, and any such power of attorney or certificate bearing such facsimile signatures or facsimile
seal shall be valid and binding upon the Corporation in the future with respect to any bond or undertaking or other writing obligatory in the nature
thereof to which it is attached. Any such appointment may be revoked, for cause, or without cause, by any of said officers, at any time."
IN WITNESS WHEREOF, the PLATTE RIVER INSURANCE COMPANY has caused these presents to be signed by its officer undersigned and its
corporate seal to be hereto affixed duly attested, this 2nd day of. May, 2011.
Attest:PLATTERIVER INSURANCE COMPANY
L J `\�;�1NGtltkl!NDfl:71.n�/yi,
37
CpRPOfltTE
Richard W. Allen III V David F. Pauly �Tl*
> 1
ya' AL {
President z 1311CEO &President
Surety & Fidelity Operations
STATE OF WISCONSINS.S.: /""`?•',yrr"ERASY�u�ca„�����`��:
COUNTY OF DANE I "I'll
On the 2nd day of May, 2011 before me personally came David F. Pauly, to me known, who being by me duly sworn, did depose and say: that he resides
in the County of Dane, State of Wisconsin; that he is President of PLATTE RIVER INSURANCE COMPANY. the corporation described herein and
which executed the above instrument: that he knows the seal of the said corporation; that the seal affixed to said instrument is such corporate seal; that
it was so affixed by order of the Board of Directors of said corporation and that he signed his name thereto by like order.
DANEL
•' W. . ,.
t, KRUEGER
_ Daniel W. Krueger
STATE OF WISCONSIN S.S.: Notary Public, Dane Co., WI
s,bww.", .
COUNTY OF DANE CERTIFICATE My Commission Is Permanent
1, the undersigned duly elected to the office stated below, now the incumbent in PLACI'E RIVER INSURANCE COMPANY. a Nebraska Corporation,
authorized to make this certificate, DO HEREBY CERTIFY that the foregoing attached Power of Attorney remains in full force and has not been
revoked; and furthermore, that the Resolution of the Board of Directors. set forth in the Power of Attorney is now in force.
Signed and sealed at the City of Middleton, State of Wisconsin this 7th day of Noyemht?r , 2 012
SEAL) <`
_ Alan S. Ogilvie
. ,. Secretary
THIS DOCUMENT IS NOT VALID UNLESS PRINTED ON GREEN SHADED BACKGROUND WITH A RED SERIAL NUMBER IN THE UPPER
RiGHT HAND CORNER. IF YOU HAVE ANY QUESTIONS CONCERNING THE AUTHENTICITY OF THIS DOCUMENT CALL 800-475-4450.
PR -POA (5-11)
rl..�rrr. RIVER INSURANCE COMPANY
BALANCE SHEET
December 31, 2011
Admitted Assets
2011
Cash and in%csied assn p.:
Bonds
589,138.249
Common .locks
16.000,620
Cash. each equivalents and shon•renn investments
7.334,264
Total cash and invested assctc
112.673.133
Investment income dtre and Seemed
496.684
Uncollected premiums and agents' balances in course of eolkelion
719,477
Deferred premiums. agems' balances and installments booked but deferred and not yet due
3.133.393
Cutrcat federal and foreign income tax recoverable and interest thereon
399,79E
Nei deferred tax asset
1,139.379
Receivables from parent. subsidiaries and al7ilistes
3,721,831
Other admitted assets
10,481
Total admitted assets
S 122,299.176•
Liabilities and Surplus as Regards Policyholders
Liabilities:
Losses
522,321.475
Reinsurance payable on paid losses and loss adjustment expenses
941,390
Loss adjustment expenses
3,985,S40
Commissions payable contingent commissions and other similar charges
613,430
Other expenses (excluding taxes. licenses and fees)
653.499
Taxes. licenses and fccs (excluding federal and foreign income taxes)
244.151
Unearned prernivaus
10.295.003
Ceded reinsurance premiums payable (net of ceding commissions)
4,362.793
Amounts withheld or retained by company for account of others
40,000.643
Remittances and items not allocated
64,379
Other liabilities
559.437
Tota) liabilities
84.241.986
Surplus as rcYards policyholders:
Common capital stock
4,800,000
Gross paid in and contributed surplus
30.739,907
Unassigned funds (surplusl
2,5l7,2E3
Surplus as regards policyholders
3E,07.190
Total liabilities and capital and surplus
$122.299.176
1, David Pauly, CEO and President of Platte River lascran c Company do hereby eerdfy thal to the best of my knowledge and belief, the
foregoing Ia a full and true statutory Statement of Admitted Assets end Lltbllittts, Csplral and Surplus or the Operadon at December 31,
2011, prepared In conformity "Uh the accounting practices prest:fted by the Insurance Department of the State of Ncbmska. IN
WITNESS WHEREOF, ! have set my bind and aMud the seal of the Corporation at Middleton. Wisconsin.
David Pauly
CEO & President _ z"rssar.
Bond No. 41266439
All
DocumentA312TM .2010
Payment Bona
CONTRACTOR:
(Name, legal status and address)
Hi -Lite Markings, Inc.
18249 Hi -Lite Drive.
Adams Center, NY 13606
OWNER:
(Name, legal status and address)
City of Sebastian
1225 Main Street
Sebastian, FL 32958
SURETY:
(Name, legal status and principal place
of business)
Platte River Insurance Company
115 Glastonbury Blvd., Suite 5
Glastonbury, CT 06033
CONSTRUCTION CONTRACT
Date: November 7.. 2012
Amount: Forty One Thousand Fifty -Five and 00/100 Dollars
($41,055.00)
Description:
(Name and location) 2012 Runway Markings at the Sebastian
Municipal Airport
BOND
Date: November 7, 2012
(Not earlier than Construction Contract Date)
Amount: Forty One Thousand Fifty -Five and 00/100 Dollars
($41,055.00)
Modifications to this Bond: ❑ None ❑ See Section IS
CONTRACTOR AS PRINCIPAL SURETY
Company:/ (Corporate Seal) Company; l/ (Corporate Seal)
\\\`qa �c te,���gs, P1 a lnsur7 e t
.0
p ings� Si atur
VOA
Nat{t ; f& N e i oris L. esti
SES Tine: 5 La- d-Attorney—In Fact
1 9961ny additeanal signatures appear on the last page of this PaymenrBond)
r � �
••'-•!li�cW Y .R IN4pRMATION ONLY—Name, address and telephone)
��'�•, ••••• AdENt\,Sr BROKER: OWNER'S REPRESENTATIVE:
Weli'§ri,FK�9,,\IX)jurance Services USA, Inc .(Architect, Engineer or other party:)
7 Giralda Farms, 2nd Floor
Madison, NJ 07940
(973) 437-2300
Init. AIA Document A312T" — 2010. The American Institute of Architects.
This document has important legal
consequences. Consultation with
an attorney is encouraged with
respect to Its completion or
modification.
Any singular reference to
Contractor, Surety, Owner or
other party shall be considered
plural where applicable.
AIA Document A312-2010
combines tiro separate bonds, a
Performance Bond and a
Payment Bond, Into one form.
This is not a single combined
Performance and Payment Bond.
051110
5
§ 1 The Contractor and 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, subject to the following terms.
§ 2 If the Contractor promptly makes payment of all sums due to Claimants, and defends, indemnifies and holds
harmless 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 performance 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 property 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 harmless 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 have 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 furnished 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 notice of non-payment required by Section 5.1.1 is given by the Owner to the Contractor, that is sufficient to
satisfy a Claimant's obligation to furnish a written notice of non-payment under Section 5.1.1.
§ 7 When a Claimant has satisfied the conditions of Sections 5.1 or 5.2, whichever is applicable, the Surety shall
promptly 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 arrange 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 deemed to
constitute a waiver of defenses the Surety or Contractor may have 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 7.2, the Surety shall indemnify the Claimant for the reasonable attorney'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 provided under Section 7.3, and the amount 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 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 Surety under this
Bond, subject to the Owner's priority to use the funds for the completion of the work.
tntt. AIA Document A312Tu — 2010. The American Institute of Architects.
§ 10 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 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 otherwise have any obligations to Claimants under this Bond.
§ 11 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.
§ 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 year 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 , • ; • ; • , ;
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.
§ 13 Notice and Claims 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. 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 lierefrom and provisions conforming to such statutory or other legal requirement shall be
deemed incorporated herein. When so furnished, 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 promptly furnish a copy of this Bond or shall permit 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 agreement 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 furnished 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 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 Construction Contract. The term
Claimant also includes any individual or entity that has rightfully asserted a claim under an applicable mechanic's lien
or similar statute against the real property upon which the Project is located. The intent of this Bond shall be to
include without limitation in the terns "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 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.
§ 16.3 Construction Contract. The agreement between the Owner and Contractor identified on the cover page,
including all Contract Documents and all changes made to the agreement and the Contract Documents.
[nit. AIA Document A312T" — 2010. The American Institute of Architects.
7
§ 96.4 Owner Default. 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 ten -ns of the
Construction Contract.
§ 96.5 Contract Documents. All the documents that comprise the agreement between the Owner and Contractor.
§ 97 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.
§ 18 Modifications to this bond are as follows:
(Space is provided below for additional signatures of added parties, other than those appearing on the corer page.)
CONTRACTOR AS PRINCIPAL SURETY
Company: (Corporate Seal) Company: (Corporate Seal)
Signature:
Name and Title:
Address
Signature:
Name and Title:
Address
CAUTION: You should sign an original AIA Contract Document, on which this text appears In RED. An original assures that
changes will not be obscured.
Init. AIA Document A312Tm — 2010. The American Institute of Architects.
Corporate Acknowledgement
STATE OF New York,
COUNTY OF Jefferson
On this 7th day of November.
appeared R� 1•k . V-J�>,3ecsr
2012_, before me
NOTARY PUBLIC personally
personally known to me (or proved to me on the basis of satisfactory evidence) to be the person
who executed the within instrument as president (or secretary)or on behalf of the corporation
therein named and acknowledged to me that the corporation executed it.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed my Official Seal, the day
and year first above written.
t
My Commission expires
Notary Public, residing at
itiiiir�r�>>�
��\�� larkin9s too,,
%N�..•'OR...z i
SEALS'
1
1990
�ftt
SALLY W DALY
NOTARY PUBLIC -STATE OF NEW YORK
NO.OIDA6242984
Qualified In Jefferson County
My Commission Expires June 13, 2016
ACKNOWLEDGEMENT OF SURETY
State of New .jersey
County of Morris
City of Madison
On this 7th day of _November in the year 2012 _ before me personally
Came Victoria L. Ernest to me known, who, being by me duly sworn, did
depose and say that he resides in Madison, N] ; that he is
the Attorney -In -Fact for Platte River Insurance Company the
corporation described in and which executed the attached instrument; that he knows
the seal of the said corporation; that the seal affixed to the said instrument is such
corporate seal; and that it was so affixed by Order of the Board of Directors of the said
corporation, and that he signed his name thereto by like order.
Notary Public
ROBYN ROST
NOTARY PUBLIC, STATE OF NEW JERSEY
NO. 2372977'
COMMISSION EXPIRES APR128, 2013
/ .� v-'• J.' \ 11., f f\\Il \ ), l\I�• 1 ill• fll.\ fl II\ 11[I 1 / 1• 1 f f f ^. i
-J-�I�I�I�, �u� .,: i �� z ,wtrl ►1► s ►� ut�t t:;tt �:�tttlt' 4 i� i:i� gut s. \
PLATTE RIVER INSURANCE COMPANY 412 6 6 4 4 0
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS, That the PLATTE RIVER INSURANCE COMPANY, a corporation of the State of Nebraska, having its _ -�'•'t
S. principal offices in the City of Middleton. Wisconsin, does make, constitute and appoint,;
_ -- --- —ROBYN ROST; VICTORIA L. ERNEST-----------------------•---•—
its true and lawful Attorneys) -in -fact, to make, execute, seal and deliver for and on its behalf; as surety, and as its act and deed, any and all bonds,
undertakings and contracts of suretyship, provided that no bond or undertaking or contract of suretyship executed under this authority shall exceed in
amount the sum of
\' == ------ ALL WRITTEN INSTRUMENTS IN AN AMOUNT NOT TO EXCEED: $5,000,000—
This Power of Attorney is granted and is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board
of Directors of PLATTE RIVER INSURANCE COMPANY at a meeting duly called and held on the 8th day of January: 2002.`,1
., "RESOLVED, that the President, and Vice -['resident, the Secretary or Treasurer, acting individually or otherwise, be and they hereby are granted thei
power and authorization to appoint by a Power of Attorney for the purposes only of executing and attesting bonds and undertakings and other writings
il. obligatory in the nature thereof, one or more vice-presidents, assistant secretaries and attorney(s)-in-fact, each appointee to have the powers and duties -fti'y
usual to such offices to the business of the Corporation; the signature of such officers and the seal of the Corporation may be affixed to such power of
attorney or to any certificate relating thereto by facsimile, and any such power of attorney or certificate bearing such facsimile signatures or facsimile
seal shall be valid and binding upon the Corporation in the future with respect to any bond or undertaking or other writing obligatory in the nature
r r:' thereof to which it is attached. Any such appointment may be revoked, for cause, or without cause, by any of said officers, at any time." i
IN WITNESS WHEREOF, the PLATTE RIVER INSURANCE COMPANY has caused these presents to be signed by its officer undersigned and its
corporate seal to be hereto affixed duly attested, this 2nd day of May, 2011.
Attest: PLATTE RiVER INSURANCE COMPANY
Richard W. Allen III rnJ `{`�` David F. Pauly'
President I� SEAL ,I j! CEO & President "<
�wq Surety & Fidelity Operations
�r STATE OF WISCONSIN ' krsKnsx�'au` '�
' COUNTY OF DANE } S.S.7rx;�uanitiarii
On the 2nd d� of May, 2011 before me personally came David F. Pauly. to me known, who being b me duly sworn, did depose and say: that he resides
s. day Y p Y Y b y Y• p Y
in the County of Dane, State of Wisconsin: that he is President of PLATTE RIVER INSURANCE COMPANY, the corporation described herein and
which executed the above instrument; that he knows the seal of the said corporation; that the seal affixed to said instrument is such corporate seal; that
it was so affixed by order of the Board of Directors of said corporation and that he signed his name thereto by like order.
DANELw
} KRUEGER ^�
Daniel W. Krueger �r
• STATE OF WISCONSIN S.S.: *': ° Notary Public. Dane Co., WI
�...-�
r� COUNTY OF DANE CERTIFICATE My Commission Is Permanent
1, the undersigned duly elected to the off ice stated below, now the incumbent in PLA17E RIVER INSURANCE COMPANY. a Nebraska Corporation,
authorized to make this certificate. DO HEREBY CER'I•IfFY that the foregoing attached Power of Attorney remains in full force and has not been
revoked; and furthermore, that the Resolution of the Board of Directors, set forth in the Power of Attorney is now in force.
Signed and sealed at the Cit of Middleton, State of Wisconsin this �— day of Nnyemher 2 012
s Y
> SEAL
Alan S. Ogilvie
Secretary
THIS DOCUMENT IS NOT VALID UNLESS PRINTED ON GREEN SHADED BACKcJROUND WITH A RED SERIAL NUMBER IN THE UPPER r.
RIGHT HAND CORNER. IF YOU HAVE ANY QUESTIONS CONCERNING _THF A J�'HENTiCITl' OF THIS DOCUMENT CALL 800-475-4450.
PR -POA 0-11) ~'
%`�T�;\�,sWfr/�.�';,{^/,'\�CS�rr3''.���i\�`a�:•Y \�"s=`�r.`L f:,'�.'�.�•.� •y ?�`/" •�. ''\'-. _c, ^ �- '�'�`ary`� '�-,-'''^�.t..i%� `i -ns /`., \'�`g+� �:�\tc�r
in.,\'I"rt RIVER INS1,111ANCE COMPANY
BALANCE SIIEET
December 31, 2011
Adntllied Assets
1011
Cash and in, esied asset>:
Bands
$89,138.249
Cnmsroa clocks
16.000,620
Cash. cash equivalcmc and short-term invemments
7,534,264
Total casts and immstcd assets
112.673.133
Investment income due and Scensed
496.684
Uncollected premiums and agents' balances in course oreolleelion
719,477
Deferred premiums. agents' balances and Installments booked but deterred and not yet due
3.138.393
Current federal and foreign income to.% recoverable and interest thereon
3",792
Net deferred tax asset
1,139.379
Receivables from parent. subsidiaries and altiliates
3,721.831
Other admitted assets
10.481
Total admitted assets
f 122.299,176 '
Liabilities and Surplus as Regards Policyholders
Liabilities:
Lasses
522,321.473
Reinsurance payable on paid tosses and loss adjustment expenses
941.390
Loss adjustment expenses
3,985.540
Commissions payable. contingent commissions and other similar charges
613.450
Other expenses (excluding taxes. licenses and fees)
633.499
Taxes. licenses and fees (excluding federal and foreign income taxes)
244.131
Unearned presniusus
10.295.005
Celled reinsurance premiums payable tact *reeding commissions)
4,562.795
Amounts withheld or retained by company liar account orothcrs
40,000,645
Remittances and items not alkwated
64,579
Other liabilities
559.457
Total liabilities
84.241,986
Surplus as regards policyholden:
Common capital stuck
4,800,000
Oross paid in and contributed surplus
30.739,907
Unassigned funds (surplus)
2,517.283
Surplus as regards noticyholden
38,057.190
Total liabilities and capital and surplus
s i 22,299.176
1, David Pauli, CEO and President of Plane River Insurance Company do hereby eerdry that to the best of my knowledge and better, the
foregolrtg Is a fedi and true statutory Statetatnt of Admixed Assets and Uab[ilttes, Capital and Surplus or the Operation at December 31.
20111, prepared to conformity with the accounting practices pretcrfbed by the lnstinnoe Deportment of the state of Nebraska. IN
WITNESS WHBRSOF, l have set my hand and afted tate seal of the Corporation at Mlddleton. Wisconsin.
David Pauly
CEO di President _-marratr,