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1656 TB Landmark Construction IFB 13/14-02 . t , oiii `r- I Monday, March 31, 2014 Uo$ -4 C Z PURCHASING DEPARTMENT :X: SIVillTrAL MEMORANDUM To: City Clerk RE: Sanford Reclaimed Water Interconnect with Volusia County IFB 13/14-02 f P' L ,Pena.rk- l rS-kru c '-ib rl The item(s) noted below is/are attached and forwarded to your office for the following action(s): 1 Development Order I Mayor's signature Final Plat(original mylars) I' Recording I Letter of Credit U ' - •en I Maintenance Bond M Safe k:eping Ordinance • i-.i ity Manager Performance Bond Payment Bond Resolution City Manager Signature City Clerk Attest/Signature Once completed,please: I I Return originals to Purchasing t F tti ' _201.4 F'`' Return copies Df D Special Instructions: M cwiho-L O rdo-v��z From Date T:\Dept_forms\City Clerk Transmittal Memo-2009.doc SWO1th vpRtp Monday, March 31, 2014 PURCHASING DEPARTMENT TRANSMITTAL MEMORANDUM To: City Clerk RE: Sanford Reclaimed Water Interconnect with Volusia County IFB 13/14-02 7 t2 1.4.,n6tkyark- Cor ,E kLd ibr, inc. The item(s) noted below is/are attached and forwarded to your office for the following action(s): ❑ Development Order n Mayor's signature ❑ Final Plat(original mylars) I Recording ❑ Letter of Credit ❑ Rendering Maintenance Bond ❑ Safe keeping (Vault) ❑ Ordinance ❑ Deputy City Manager ❑ Performance Bond ❑ Payment Bond ❑ Resolution ❑ City Manager Signature ❑ ❑ City Clerk Attest/Signature Once completed, please: ❑ Return originals to Purchasing ❑ Return copies Special Instructions: Ma-i-iho-L Oro o-e z From Date T:\Dept_forms\City Clerk Transmittal Memo-2009.doc SN101kD 18777- DOCUMENT APPROVAL 3/31 /2014 1 1 :38 AM Contract Agreement Name: Sanford Reclaimed Water Interconnect with Volusia County IFB 13/14-0 ` r8,,ecernd-- - / P. ''ing Manag? Date Ck � it Sc 313 I� Finance Director Date 11144 OAT c/ ity At orney / Date 4 ) 14‘ 114 Lksak.4 cArk R-R-c-e"e0( -e )(\ (Ark. ( L(_ ceikA'Str'O-Of otoe04414311- v-. P1 i AirW ►'ki Letter Of Transmittal 500 West Fulton Street Sanford,FL 32771 Phone:407.322.6841 Fax:407.330.0639 Date: March 27, 2014 To: Marisol Ordonez City of Sanford Purchasing Dept. Re: Sanford Reclaimed Water Interconnect With Volusia Co. (IFB 13/14-2) CPH Job No. S0696.02 WE ARE SENDING YOU THE ATTACHED ITEM(S): NO. OF COPIES DESCRIPTION 1 Notice of Award - Fully Executed Copy for the City's Records 2 Agreement Executed by T B Landmark Construction, Inc. 2 Performance Bond and Payment Bond (Originals) - Agreement Date to be Filled in by the City (Note: Once the Bonds Have been dated, please scan and send a PDF copy) 2 Certificate of Insurance (General /Auto / Umbrella /Workers' Comp.) 2 Insurance Endorsements 2 City Required Insurance Certification (Section 00618 Executed by Thad Con) 2 Section 00620 Insurance Certification (Executed by Zurich American Insurance Co.) THESE ITEMS ARE TRANSMITTED AS INDICATED BELOW: X For Your Use For Review and Comment As Requested For Bids Due REMARKS: Once the Agreement has been executed by the City one original needs to be returned to T B Landmark (we would also like to receive a scanned copy for our records). COPY TO: SIGNED: KATRIINA BOWMAN, P.E. If enclosures are not as noted,kindly notify us at once. NOTICE OF AWARD To: T B Landmark Construction, Inc. 11220 New Berlin Rd. Jacksonville, Florida 32114 Project Name: Sanford Reclaimed Water Interconnect With Volusia Co. Bid No.: IFB 13/14-2 The OWNER has considered the BID submitted by you, received on January 14, 2014 for the above described WORK in response to the Invitation for Bids and Information for Bidders. You are hereby notified that your BID has been accepted for BID items in the amount of $994,739.00. You are required by the Instructions to Bidder to execute the Agreement and furnish the required CONTRACTOR's Performance Bond, Payment Bond, and certificates of insurance within fourteen (14) calendar days from the date of this Notice to you. If you fail to execute said Agreement and to furnish said Bonds and insurance within fourteen (14) calendar days from receipt of this Notice, said OWNER will be entitled to consider all your rights arising out of the OWNER's acceptance of your BID as abandoned and as a forfeiture of your BID BOND. The OWNER will be entitled to such other rights as may be granted by law. You are required to return an acknowledged copy of this NOTICE OF AWARD to the OWNER. Dated this STtf day of /n ;" re" OWNER: Cit of Sanford (Na I =f OWNE`1 �.11iii/, By(Signat ►re).r----`" - nWe-roN .N, & t!4 f',A2& si - (Printed Name and Title) ACCEPTANCE OF NOTICE Receipt and acceptance of the above NOTICE OF AWARD is hereby acknowledged by T B Landmark Construction, Inc. thi _ ' of MGVC� , 20 I . By Martin Adams, Manager Printed Name and Title Sanford Reclaimed Water Interconnect With Volusia Co. NOTICE OF AWARD Page 1 of 1 SECTION 00520 AGREEMENT FORM PART 1 GENERAL (1 1.01 THIS AGREEMENT, made and entered into the � r day of p l'1 I , 2J0 by and between the City of Sanford, Florida, 300 North Park Avenue, Sanford, Florida 32771, a municipal corporation of the State of Florida, holding tax exempt status, hereinafter referred to as the "CITY" (also referred to as "OWNER") and T B Landmark Construction, Inc., whose principal and local address is 11220 New Berlin Rd., Jacksonville, Florida 32114, hereinafter referred to as to as the "CONTRACTOR". The CITY and the CONTRACTOR are collectively referred to herein as the Parties. 1.02 The Owner and Contractor Agree as Follows: A. The Contract Documents include the Agreement, Addenda (which pertain to the Contract Documents), Contractor's Bid, Notice to Proceed, the Bonds, the General Conditions, the Supplementary Conditions, the Specifications listed in the Index to the Project Manual, any technical specifications as incorporated by the Project Manual; the Drawings as listed in the Project Manual, all Written Amendments, Change Orders, Work Change Directives, Field Orders, Engineer's written interpretations and clarifications issued on or after the Effective Date of this Agreement, and all documents which are fully a part of the Contract with the City are identified by title and number as set forth below and are available for review at and downloading from the City's Web site (site in full) and all documents are agreed to be incorporated into the Contract as if physically attached to the Contract and are, further, agreed to be incorporated into the Contract as if fully set forth therein verbatim. The Contract Documents include: 1. Executed, Section 00520 - Agreement Form. 2. The Project Manual. Note the Index (starting on page number 00010-1 of the Project Manual) includes all instructions, terms, general and supplemental conditions, bid documents, plans, prints and specifications pertaining to the Project. 3. Addenda Applicable to the Bid 4. Contractor's Bid, 00410. 5. Performance Bond, 00605. 6. Payment Bond, 00610 7. Material and Workmanship Bond, 00615. 8. Trench Safety (Executed Form), 00430 9. Non Collusion Affidavit, 00432 10. Conflict of Interest Affidavit, 00434 11. Public Entities Crime Affidavit, 00436 12. Compliance With the Public Records Law Affidavit, 00438 13. Certification Of Non-Segregated Facilities (Executed Form), 00450 14. Disputes Disclosure (Executed Form), 00452 Sanford Reclaimed Water Interconnect With Volusia Co. AGREEMENT FORM 00520-1 15. Drug Free Workplace (Executed Form), 00454 16. Unauthorized (Illegal) Alien Workers Affidavit, 00456 17. E-Verify Compliance Affidavit, 00458 18. Americans With Disabilities Act Affidavit, 00460 19. Insurance Certificate(s) 20. Notice of Award, 00510 21. Criminal Background Check Requirements, 00525 22. Notice to Proceed, 00530. 23. Consent of Surety to Final Payment (Executed Form), 00617. 24. Contractor's Application for Payment (Executed Forms), 00625. 25. Certificate of Substantial Completion, 00626. 26. Certificate of Final Completion, 00627. 27. Contractor's Partial Release of Lien (Executed Forms), 00640. 28. Subcontractor's Final Release of Lien (Executed Form), 00641. 29. Subcontractor's Partial Release of Lien (Executed Forms), 00644. 30. Contractor's Release of Lien (Executed Form), 00645. 31. Project Field Order(Executed Form), 00940. 32. Work Directive Change (Executed Form), 00945. 33. Change Order(Executed), 00950. 34. Additional document(s) that are not specifically listed in Paragraph 1.02.A.1 through 1.02.A.36, but which are included in the Project Manual and any additional documents agreed upon by the Parties shall be included as a part of the Contract. These documents form the Contract and all are as fully a part of the Contract as if attached to this Agreement or repeated herein. As the documents indicated above are executed, the date of final execution and initials of the individual who received the executed document(s) is to be added to the blank next to the listed document(s) when processed and made a part of the City's official set of Contract Documents. B. Scope of Work The Contractor shall perform all work required by the Contract Documents for the construction of the Sanford Reclaimed Water Interconnect With Volusia Co. (IFB 13/14-2). C. Contract Time The Contractor shall begin work after the issuance of a written Notice to Proceed from Owner and shall substantially complete the work within the Contract Time identified in Paragraphs 1.02.C.5 of the Bid Form, which is 120 Calendar Days. The work shall be finally complete, ready for Final Payment in accordance with the General Conditions, within 30 calendar days from the actual date of substantial completion. D. Liquidated Damages Sanford Reclaimed Water Interconnect With Volusia Co. AGREEMENT FORM 00520-2 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 substantially complete within the time specified in Paragraph C above, plus any extensions thereof allowed in accordance with the General Conditions. They also recognize the delays, expense and difficulties involved in proving in a legal arbitration proceeding the actual loss suffered by OWNER if the Work is not substantially complete 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 $1000 for each calendar day that expires after the time specified in Paragraph C for substantial completion until the work is substantially complete. It is agreed that if this Work is not Finally completed in accordance with the Contract Documents, the CONTRACTOR shall pay the OWNER as liquidated damages for delay, and not as penalty, one-fourth ('/) of the rate set forth above. E. Contract Price Unit Price Contract The Owner will pay the Contractor in current funds for the performance of the work, subject to additions and deductions by Change Order and subject to the Measurement and Payment Provisions, and subject to actual constructed quantities; the Total Contract Price of Nine hundred ninety-four thousand seven hundred thirty-nine and 00/100 Dollars ($994,739.00). Payments will be made to the Contractor on the basis of the Schedule of Unit Prices included as a part of his Bid, which shall be as fully a part of the Contract as if attached or repeated herein. F. City of Sanford Tax Recovery The CONTRACTOR shall cooperate with the CITY in the implementation of the CITY's tax recovery program and, to that end, the CITY may make purchases directly under its purchase order processes relative to various materials, supplies and equipment that may be part of the services provided under this Agreement. The CONTRACTOR hereby recognizes the right of the CITY to engage in tax recovery/savings through direct purchases. G. Payments The Owner will make payments as provided in the General Conditions and Supplementary Conditions. H. Retainage In accordance with the provisions of the State of Florida Local Government Prompt Payment Act, the value of each application for payment shall be equal to the total value of the Work performed to date, less an amount retained, and less payments previously made and amounts withheld in accordance with the General Sanford Reclaimed Water Interconnect With Volusia Co. AGREEMENT FORM 00520-3 Conditions and Supplementary Conditions. Retainage for this project is 10%, to be held by Owner as collateral security to ensure completion of Work. When the Work is 50 percent complete, defined as being 50 percent complete based on the construction progress schedule as updated during construction, and expenditure of at least 50 percent of the total updated construction cost, retainage shall be reduced in accordance with State law. Engineer The Project has been designed by CPH, Inc., referred to in the documents as the Engineer. J. Additional Terms and Conditions 1. The CONTRACTOR hereby warrants and represents to the CITY that it is competent and otherwise able to provide professional and high quality goods and/or services to the CITY by means of employees who are neat in appearance and of polite demeanor. 2. All submissions submitted by the CONTRACTOR in the proposals/bid submitted to the CITY are hereby incorporated herein to the extent not inconsistent with the terms and conditions as set forth herein. 3. The CONTRACTOR acknowledges that the CITY may retain other goods and/or service providers to provide the same goods and/or services for CITY projects. The CONTRACTOR acknowledges that the CITY, at the CITY's option, may request proposals from the CONTRACTOR and the other goods and/or service providers for CITY projects. The CITY reserves the right to select which goods and/or services provider shall provide goods and/or services for the CITY's projects. 4. The CONTRACTOR agrees to provide and ensure coordination between goods/services providers. 5. Each party hereto represents to the other that it has undertaken all necessary actions to execute this Agreement, and that it has the legal authority to enter into this Agreement and to undertake all obligations imposed on it. The person(s) executing this Agreement for the CONTRACTOR certify that he/she/they is/are authorized to bind the CONTRACTOR fully to the terms of this Agreement. 6. The CONTRACTOR hereby guarantees the CITY that all materials, supplies, services and equipment as listed on a Purchase Order meet the requirements, specifications and standards as provided for under the Federal Occupations Safety and Health Act of 1970, from time to time amended and in force on the date hereof. Sanford Reclaimed Water Interconnect With Volusia Co. AGREEMENT FORM 00520-4 7. It is agreed that nothing herein contained is intended or should be construed as in any manner creating or establishing a relationship of co- partners between the parties, or as constituting the CONTRACTOR (including, but not limited to, its officers, employees, and agents) the agent, representative, or employee of the CITY for any purpose, or in any manner, whatsoever. The CONTRACTOR is to be and shall remain forever an independent contractor with respect to all services performed under this Agreement. 8. Persons employed by the CONTRACTOR in the provision and performance of the goods and/or services and functions pursuant to this Agreement shall have no claim to pension, workers' compensation, unemployment compensation, civil service or other employee rights or privileges granted to the CITY's officers and employees either by operation of law or by the CITY. 9. No claim for goods and/or services furnished by the CONTRACTOR not specifically provided for herein shall be honored by the CITY. 10. Execution of this Agreement by the CONTRACTOR is a representation that the CONTRACTOR is familiar with the goods and/or services to be provided and/or performed and with local conditions. The CONTRACTOR shall make no claim for additional time or money based upon its failure to comply with this Agreement. The CONTRACTOR has informed the CITY, and hereby represents to the CITY, that it has extensive experience in performing and providing the services and/or goods described in this Agreement and that it is well acquainted with the components that are properly and customarily included within such projects and the requirements of laws, ordinance, rules, regulations or orders of any public authority or licensing entity having jurisdiction over the CITY's Projects. 11. Quality, Professional Standards, and Security Requirements a. Under this paragraph 11, the term "CONTRACTOR'S employees" shall include CONTRACTOR'S agents, employees and SUBCONTRACTORS extending to SUBCONTRACTORS agents and employees. b. The CONTRACTOR shall be responsible for the professional quality, accepted standards, technical accuracy, neatness of appearance of employees, employee conduct, safety, and the coordination of all services furnished by the CONTRACTOR under any Agreement resulting from this solicitation. The City reserves the right to require all CONTRACTOR employees, when on City property or work sites, to wear identification badges at all times which, at a minimum, provides the name of the employee and the CONTRACTOR. Sanford Reclaimed Water Interconnect With Volusia Co. AGREEMENT FORM 00520-5 c. The CITY reserves the right to require the CONTRACTOR to provide to the CITY a list of employees working on the project. Also, the list shall include employee working days, times and assignments within forty-eight (48) hours of the CITY's written request for such information. This information will be reviewed, screened and verified by the CITY, prior to the employees of the CONTRACTOR entering the CITY's premises and/or work sites. d. The CONTRACTOR shall comply with Section 2-67 of the Sanford City Code as it relates to security screenings of private contractors and employees of private contractors. The CONTRACTOR shall cause each person found by the City Commission to be functioning in a position critical to the security and/or public safety of the CITY by reason of access to any publicly owned or operated facility to undergo the following inquiries and procedures conducted by the City of Sanford: 1) Fingerprinting in accordance with the CITY's pre-employment procedures; 2) Submission of the fingerprints to the Florida Department of Law Enforcement for state criminal history evaluation; and 3) Submission of the fingerprints to the Federal Bureau of Investigation for a national criminal history evaluation. e. Such confidential information shall be used by the CITY to determine a person's eligibility to function in such critical employment position(s) as described. Additionally, the CITY may request and the CONTRACTOR shall provide the name, address and social security number and licenses (driver's, commercial drivers license or CDL, or other operator's license) for employees of the CONTRACTOR and/or SUBCONTRACTORS that may work on the CITY's premises in positions found by the City Commission to be critical to the security and/or public safety of the CITY by reason of access to any publicly owned or operated facility. The CONTRACTOR shall release such information upon approval of the affected employees. If an employee refuses to authorize the release of their address, social security number and/or licenses they shall not be allowed to work or continue to work in such critical positions. f. The CONTRACTOR shall work closely with the CITY on all aspects of the provision of the goods and/or services. With respect to services, the CONTRACTOR shall be responsible for the professional quality, technical accuracy, competence, methodology, accuracy and the coordination of all of the following which are listed for illustration purposes and not as a limitation: documents, analysis, reports, data, plans, plats, maps, surveys, Sanford Reclaimed Water Interconnect With Volusia Co. AGREEMENT FORM 00520-6 specifications, and any and all other services of whatever type or nature furnished by the CONTRACTOR under this Agreement. The CONTRACTOR shall, without additional compensation, correct or revise any errors or deficiencies in his/her/its plans, analysis, data, reports, designs, drawings, specifications, and any and all other services of whatever type or nature. The CONTRACTOR's submissions in response to the subject bid or procurement processes are incorporated herein by this reference thereto. 12. Neither the CITY's review, approval or acceptance of, nor payment for, any of the goods and/or services required shall be construed to operate as a waiver of any rights under this Agreement or of any cause of action arising out of the performance of this Agreement and the CONTRACTOR shall be and remain liable to the CITY in accordance with applicable law for all damages to the CITY caused by the CONTRACTOR negligent or improper performance or failure to perform any of the goods and/or services furnished under this Agreement. 13. The rights and remedies of the CITY, provided for under this Agreement, are in addition to any other rights and remedies provided by law. 14. Time is of the essence in the performance of all goods and/or services provided by the CONTRACTOR under the terms of this Agreement. 15. Invoices, which are in an acceptable form to the CITY and without disputable items, which are received by the CITY, will be processed for payment within thirty (30) days of receipt by the CITY. 16. The CONTRACTOR will be notified of any disputable items contained in invoices submitted by the CONTRACTOR within fifteen (15) days of receipt by the CITY with an explanation of the deficiencies. 17. The CITY and the CONTRACTOR will make every effort to resolve all disputable items contained in the CONTRACTOR's invoices. 18. Each invoice shall reference this Agreement, the appropriate billing period. 19. The Florida Prompt Payment Act shall apply when applicable. A billing period represents the dates in which the CONTRACTOR completed goods and/or services referenced in an invoice. 20. Invoices are to be forwarded directly the City's designated CEI representative, as identifed at the preconstruction meeting, for review and processing. Sanford Reclaimed Water Interconnect With Volusia Co. AGREEMENT FORM 00520-7 21. CITY designates the City Manager or his/her designated representative, to represent the CITY in all matters pertaining to and arising from the work and the performance of this Agreement. 22. The City Manager, or his/her designated representative, shall have the following responsibilities: a. Examination of all work and rendering, in writing, decisions indicating the CITY's approval or disapproval within a reasonable time so as not to materially delay the work of the CONTRACTOR; b. Transmission of instructions, receipt of information, and interpretation and definition of CITY's policies and decisions with respect to design, materials, and other matters pertinent to the work covered by this Agreement; c. Giving prompt written notice to the CONTRACTOR whenever the CITY official representative knows of a defect or change necessary in the project; and d. Coordinating and managing the CONTRACTOR's preparation of any necessary applications to governmental bodies, to arrange for submission of such applications. 23. Until further notice from the City Manager the designated representative for this Agreement is: Paul Moore, P.E. Utility Director City of Sanford P.O. Box 1788 Sanford, Florida 32772 24. CITY may terminate this Agreement for convenience at any time or for any one (1) or more of the reasons as follows: a. If, in the CITY's opinion, adequate progress is not being made by the CONTRACTOR due to the CONTRACTOR 's failure to perform; or b. If, in the CITY's opinion, the quality of the goods and/or services provided by the CONTRACTOR is/are not in conformance with commonly accepted professional standards, standards of the CITY, and the requirements of Federal and/or State regulatory agencies, and the CONTRACTOR has not corrected such deficiencies in a timely manner as reasonably determined by the CITY; or c. The CONTRACTOR, or any employee or agent of the CONTRACTOR, is indicted or has a direct charge issued against him for any crime arising out of or in conjunction with any work that has been performed by the CONTRACTOR; or Sanford Reclaimed Water Interconnect With Volusia Co. AGREEMENT FORM 00520-8 d. The CONTRACTOR becomes involved in either voluntary or involuntary bankruptcy proceedings, or makes an assignment for the benefit of creditors; or e. The CONTRACTOR violates the Standards of Conduct provisions herein or any provision of Federal, State or local law or any provision of the CITY's Code of Conduct. 25. In the event of any of the causes of termination, the CITY's designated representative may send a certified letter to the CONTRACTOR requesting that the CONTRACTOR show cause why the Agreement should not be terminated. If assurance satisfactory to the CITY of corrective measures to be made within a reasonable time is not given to the CITY within seven (7) calendar days of the date of the letter, the CITY may consider the CONTRACTOR to be in default, and may then immediately terminate this Agreement. 26. In the event that this Agreement is terminated for cause and it is later determined that the cause does not exist, then this Agreement or the Purchase/Work Order shall be deemed terminated for convenience by the CITY and the CITY shall have the right to so terminate this Agreement without any recourse by the CONTRACTOR. 27. The CONTRACTOR may terminate this Agreement only if the CITY fails to pay the CONTRACTOR in accordance with this Agreement. 28. Notwithstanding any other provision of this Agreement, the CITY shall have the right at any time to terminate this Agreement in its entirely without cause, if such termination is deemed by the CITY to be in the public interest, in writing of deficiencies or default in the performance of its duties under the Agreement and the CONTRACTOR shall have ten (10) days to correct same or to request, in writing, a hearing. Failure of the CONTRACTOR to remedy said specified items of deficiency or default in the notice by either the CITY's designated representative within ten (10) days of receipt of such notice of such decisions, shall result in the termination of the Agreement, and the CITY shall be relieved of any and all responsibilities and liabilities under the terms and provisions of the Agreement. 29. The CITY shall have the right to terminate this Agreement without cause with a sixty (60) day written notice to the other party. The CITY reserves the right to terminate any Agreement for cause with a five (5) day written notice to the CONTRACTOR. Notice shall be served to the parties as specified in the Agreement. 30. In the event that this Agreement is terminated, the CITY shall identify any specific work to be continued to completion pursuant to the provisions of this Agreement. Sanford Reclaimed Water Interconnect With Volusia Co. AGREEMENT FORM 00520-9 31. In the event that after the CITY termination for cause for failure of the CONTRACTOR to fulfill its obligations under this Agreement it is found that the CONTRACTOR has not so failed, the termination shall be deemed to have been for convenience and without cause. 32. In the event this Agreement is terminated or canceled prior to final completion without cause, payment for the unpaid portion of the services provided by the CONTRACTOR to the date of termination and any additional services shall be paid to the CONTRACTOR. 33. Upon receipt of notice of termination, given by either party, the terminated party shall promptly discontinue the provision of all goods and/or services, unless the notice provides otherwise. 34. The performance or provision of the CONTRACTOR's goods and/or services under this Agreement may be suspended by the CITY at any time. 35. In the event the CITY suspends the performance or provision of the CONTRACTOR services hereunder, the CITY shall so notify the CONTRACTOR in writing, such suspension becoming effective within seven (7) days from the date of mailing, and the CITY shall pay to the CONTRACTOR within thirty (30) days all compensation which has become due to and payable to the CONTRACTOR to the effective date of such suspension. The CITY shall thereafter have no further obligation for payment to the CONTRACTOR for the suspended provision of goods and/or services unless and until the CITY's designated representative notifies the CONTRACTOR in writing that the provision of the goods and/or services of the CONTRACTOR called for hereunder are to be resumed by the CONTRACTOR. 36. Upon receipt of written notice from the CITY that the CONTRACTOR's provision of goods and/or services hereunder are to be resumed, the CONTRACTOR shall continue to provide the services to the CITY. 37. The CONTRACTOR agrees that it will not discriminate against any employee or applicant for employment for work under this Agreement because of race, color, religion, sex, age, national origin or disability and will take affirmative steps to ensure that applicants are employed and employees are treated during employment without regard to race, color, religion, sex, age, national origin or disability. This provision shall include, but not be limited to, the following: employment, upgrading, demotion or transfer; recruitment advertising; layoff or termination; rates of pay or their forms or compensation; and selection for training, including apprenticeship. The CONTRACTOR, moreover, shall comply with all the requirements as imposed by the Americans with Disability Act, the regulations of the Federal government issued thereunder, and any and all requirements of Federal or State law related thereto. Sanford Reclaimed Water Interconnect With Volusia Co. AGREEMENT FORM 00520-10 38. Indemnity and Insurance a. To the fullest extent permitted by law, the CONTRACTOR shall indemnify, hold harmless and defend the CITY, its agents, servants, officers, officials and employees, or any of them, from and against any and all claims, damages, losses, and expenses including, but not limited to, attorney's fees and other legal costs such as those for paralegal, investigative, and legal support services, and the actual costs incurred for expert witness testimony, arising out of or resulting from the performance or provision of services required under this Agreement, provided that same is caused in whole or in part by the error, omission, negligent act, failure to act, breach of contract obligation, malfeasance, officers, officials, employees, or subCONTRACTORs. Additionally, the CONTRACTOR accepts responsibility for all damages resulting in any way related to the performance of work. In no event, shall either party be responsible or liable to the other for any incidental, consequential, or indirect damages, whether arising by contract or tort. b. In accordance with Section 725.06, Florida Statutes, adequate consideration has been provided to the CONTRACTOR for this obligation, the receipt and sufficiency of which is hereby specifically acknowledged. c. Nothing herein shall be deemed to affect the rights, privileges, and immunities of the CITY as set forth in Section 768.28, Florida Statutes. d. In claims against any person or entity, indemnification under this Section by an employee of the CONTRACTOR or its agents or subCONTRACTORs, anyone directly or indirectly employed by them or anyone for whose acts they may be liable, the indemnification obligation under this Section shall not be limited by a limitation on amount or type of damages, compensation, or benefits payable by or for the CONTRACTOR or its agents or subCONTRACTORs, under Workers Compensation acts, disability benefits acts, or other employee benefit acts. e. The execution of this Agreement by the CONTRACTOR shall obligate the CONTRACTOR to comply with the indemnification provision of this Agreement; provided, however, that the CONTRACTOR must also comply with the provisions of this Agreement relating to insurance coverage. f. The CONTRACTOR shall submit a report to the CITY within twenty-four (24) hours of the date of any incident resulting in Sanford Reclaimed Water Interconnect With Volusia Co. AGREEMENT FORM 00520-11 damage or which is reasonably likely to result in a claim of damage. 39. The CONTRACTOR shall obtain or possess and continuously maintain the insurance coverage as set forth and required in the bid documents. 40. All insurance other than Workers Compensation and Professional Liability that must be maintained by the CONTRACTOR shall specifically include the CITY as an additional insured. 41. The CONTRACTOR shall provide Certificates of Insurance to the CITY evidencing that all such insurance is in effect prior to the issuance of the first Purchase/Work Order under this Agreement from the CITY. These Certificates of Insurance shall become part of this Agreement. Neither approval by the CITY nor failure to disapprove the insurance furnished by a CONTRACTOR shall relieve the CONTRACTOR of the CONTRACTOR's full responsibility for performance of any obligation including the CONTRACTOR's indemnification of the CITY under this Agreement. If, during the period which an insurance company is providing the insurance coverage required by this Agreement, an insurance company shall: (1) lose its Certificate of Authority, (2) no longer comply with Section 440.57, Florida Statutes, or (3) fail to maintain the requisite Best's Rating and Financial Size Category, the CONTRACTOR shall, as soon as the CONTRACTOR has knowledge of any such circumstance, immediately notify the CITY and immediately replace the insurance coverage provided by the insurance company with a different insurance company meeting the requirements of this Agreement. Until such time as the CONTRACTOR has replaced the unacceptable insurer with insurance acceptable to the CITY, the CONTRACTOR shall be deemed to be in default of this Agreement. 42. The insurance coverage shall contain a provision that requires that prior to any changes in the coverage, except increases in aggregate coverage, thirty (30) days prior notice will be given to the CITY by submission of a new Certificate of Insurance. 43. The CONTRACTOR shall furnish Certificates of Insurance directly to the CITY's Designated Representative. The certificates shall clearly indicate that the CONTRACTOR has obtained insurance of the type, amount and classification required by this Agreement. 44. Nothing in this Agreement or any action relating to this Agreement shall be construed as the CITY's waiver of sovereign immunity beyond the limits set forth in Section 768.28, Florida Statutes. 45. The CITY shall not be obligated or liable under the terms of this Agreement to any party other than the CONTRACTOR. There are no third party beneficiaries to this Agreement. Sanford Reclaimed Water Interconnect With Volusia Co. AGREEMENT FORM 00520-12 46. The CONTRACTOR is an independent contractor and not an agent, representative, or employee of the CITY. The CITY shall have no liability except as specifically provided in this Agreement. 47. All insurance shall be primary to, and not contribute with, any insurance or self-insurance maintained by the CITY. 48. The CONTRACTOR warrants that it has not employed or retained any company or person, other than a bona fide employee working solely for the CONTRACTOR, to solicit or secure this Agreement and that the CONTRACTOR has not paid or agreed to pay any person, company, corporation, individual or firm other than a bona fide employee working solely for the CONTRACTOR, any fee, commission, percentage, gift, or any other consideration, contingent upon or resulting from the award of making this Agreement. 49. The CONTRACTOR shall not discriminate on the grounds of race, color, religion, sex, or national origin in the performance of work under this Agreement or violate any laws pertaining to civil rights, equal protection or discrimination. 50. The CONTRACTOR hereby certifies that no undisclosed (in writing) conflict of interest exists with respect to the Agreement, including, but not limited to, any conflicts that may be due to representation of other clients, customers or vendees, other contractual relationships of the CONTRACTOR, or any interest in property that the CONTRACTOR may have. The CONTRACTOR further certifies that any conflict of interest that arises during the term of this Agreement shall be immediately disclosed in writing to the CITY. Violation of this Section shall be considered as justification for immediate termination of this Agreement. 51. The CONTRACTOR shall ensure that all taxes due from the CONTRACTOR are paid in a timely and complete manner including, but not limited to, occupational license tax. 52. If the CITY determines that any employee or representative of the CONTRACTOR is not satisfactorily performing his/her assigned duties or is demonstrating improper conduct pursuant to any assignment or work performed under this Agreement, the CITY shall so notify the CONTRACTOR, in writing. The CONTRACTOR shall immediately remove such employee or representative of the CONTRACTOR from such assignment. 53. The CONTRACTOR shall not publish any documents or release information regarding this Agreement to the media without prior approval of the CITY. Sanford Reclaimed Water Interconnect With Volusia Co. AGREEMENT FORM 00520-13 54. The CONTRACTOR shall certify, upon request by the CITY, that the CONTRACTOR maintains a drug free workplace policy in accordance with Section 287.0878, Florida Statutes. Failure to submit this certification may result in termination. 55. If the CONTRACTOR or an affiliate is placed on the convicted vendor list following a conviction for a public entity crime, such action may result in termination by the CITY. The CONTRACTOR shall provide a certification of compliance regarding the public crime requirements set forth in State law upon request by the CITY. 56. The CITY reserves the right to unilaterally terminate this Agreement if the CONTRACTOR refuses to allow public access to all documents, papers, letters, or other materials subject to provisions of Chapter 119, Florida Statutes, and other applicable law, and made or received by the CONTRACTOR in conjunction, in any way, with this Agreement. 57. The CONTRACTOR shall comply with the requirements of the Americans with Disabilities Act (ADA), and any and all related Federal or State laws which prohibits discrimination by public and private entities on the basis of disability. 58. The CITY will not intentionally award publicly-funded contracts to any contractor who knowingly employs unauthorized alien workers, constituting a violation of the employment provisions contained in 8 U.S.C. Section 1324a(e) Section 274A(e) of the Immigration and Nationally Act (INA). The CITY shall consider the employment by the CONTRACTOR of unauthorized aliens, a violation of Section 274A(e) of the INA. Such violation by the CONTRACTOR of the employment provisions contained in Section 274A(e) of the INA shall be grounds for immediate termination of this Agreement by the CITY. 59. The CONTRACTOR agrees to comply with Federal, State, and local environmental, health, and safety laws and regulations applicable to the goods and/or services provided to the CITY. The CONTRACTOR agrees that any program or initiative involving the work that could adversely affect any personnel involved, citizens, residents, users, neighbors or the surrounding environment will ensure compliance with any and all employment safety, environmental and health laws. 60. The CONTRACTOR shall ensure that all goods and/or services are provided to the CITY after the CONTRACTOR has obtained, at its sole and exclusive expense, any and all permits, licenses, permissions, approvals or similar consents. 61. If applicable, in accordance with Section 216.347, Florida Statutes, the CONTRACTOR shall not use funds provided by this Agreement for the purpose of lobbying the Legislature, the judicial branch or State agency. Sanford Reclaimed Water Interconnect With Volusia Co. AGREEMENT FORM 00520-14 f 62. The CONTRACTOR shall advise the CITY in writing of it who has been placed on a discriminatory vendor list, may not submit a bid on a contract to provide goods or services to a public entity, or may not transact business with any public entity. 63. The CONTRACTOR shall not engage in any action that would create a conflict of interest in the performance of that actions of any CITY employee or other person during the course of performance of, or otherwise related to, this Agreement or which would violate or cause others to violate the provisions of Part III, Chapter 112, Florida Statutes, relating to ethics in government. 64. The CONTRACTOR shall maintain books, records, documents, time and costs accounts and other evidence directly related to its provision or performance of services under this Agreement. All time records and cost data shall be maintained in accordance with generally accepted accounting principles. 65. The CONTRACTOR shall maintain and allow access to the records required under this Section for a minimum period of five (5) years after the completion of the provision or performance goods and/or services under this Agreement and date of final payment for said goods and/or services, or date of termination of this Agreement. 66. The CITY may perform, or cause to have performed, an audit of the records of the CONTRACTOR before or after final payment to support final payment under any Purchase/Work Order issued hereunder. This audit shall be performed at a time mutually agreeable to the CONTRACTOR and the CITY subsequent to the close of the final fiscal period in which goods and/or services are provided or performed. Total compensation to the CONTRACTOR may be determined subsequent to an audit as provided for in this Section, and the total compensation so determined shall be used to calculate final payment to the CONTRACTOR. Conduct of this audit shall not delay final payment as required by this Section. 67. In addition to the above, if Federal, State, County, or other entity funds are used for any goods and/or services under this Agreement, the Comptroller General of the United States or the Chief Financial Officer of the State of Florida, or the County of Seminole, or any representatives, shall have access to any books, documents, papers, and records of the CONTRACTOR which are directly pertinent to goods and/or services provided or performed under this Agreement for purposes of making audit, examination, excerpts, and transcriptions. 68. In the event of any audit or inspection conducted reveals any overpayment by the CITY under the terms of the Agreement, the Sanford Reclaimed Water Interconnect With Volusia Co. AGREEMENT FORM 00520-15 CONTRACTOR shall refund such overpayment to the CITY within thirty (30) days of notice by the CITY of the request for the refund. 69. The CONTRACTOR agrees to fully comply with all State laws relating to public records. 70. The CONTRACTOR agrees that if any litigation, claim, or audit is started before the expiration of the record retention period established above, the records shall be retained until all litigation, claims or audit findings involving the records have been resolved and final action taken. 71. The CONTRACTOR shall not sublet, assign or transfer any interest in this Agreement, or claims for the money due or to become due out of this Agreement to a bank, trust company, or other financial institution without written CITY approval. When approved by the CITY, written notice of such assignment or transfer shall be furnished promptly to the CITY. 72. Any CONTRACTOR proposed subcontractors shall be submitted to the CITY for written approval prior to the CONTRACTOR entering into a subcontract. Subcontractor information shall include, but not be limited to, State registrations, business address, occupational license tax proof of payment, and insurance certifications. 73. The CONTRACTOR shall coordinate the provision of goods and/or services and work product of any CITY approved subcontractors, and remain fully responsible for such goods and/or services and work under the terms of this Agreement. 74. Any subcontract shall be in writing and shall incorporate this Agreement and require the subcontractor to assume performance of the CONTRACTOR's duties commensurately with the CONTRACTOR's duties to the CITY under this Agreement, it being understood that nothing herein shall in any way relieve the CONTRACTOR from any of its duties under this Agreement. The CONTRACTOR shall provide the CITY with executed copies of all subcontracts. 75. The CONTRACTOR shall reasonably cooperate at all times with the CITY and other CITY contractors and professionals. 76. This Agreement is to be governed by the laws of the State of Florida. 77. Venue for any legal proceeding related to this Agreement shall be in the Eighteenth Judicial Circuit Court in and for Seminole County, Florida. 78. This Agreement is the result of bona fide arms length negotiations between the CITY and the CONTRACTOR and all parties have contributed substantially and materially to the preparation of the Contract. Sanford Reclaimed Water Interconnect With Volusia Co. AGREEMENT FORM 00520-16 Accordingly, this Agreement shall not be construed or interpreted more strictly against any one party than against any other party. 79. Neither party shall be considered in default in performance of its obligations hereunder to the extent that performance of such obligations, or any of them, is delayed or prevented by Force Majeure. Force Majeure shall include, but not be limited to, hostility, terrorism, revolution, civil commotion, strike, epidemic, fire, flood, wind, earthquake, explosion, any law, proclamation, regulation, or ordinance or other act of government, or any act of God or any cause whether of the same or different nature, existing or future; provided that the cause whether or not enumerated in this Section is beyond the control and without the fault or negligence of the party seeking relief under this Section. 80. This Agreement, together with the exhibit(s), if any, constitutes the entire integrated Agreement between the CITY and the CONTRACTOR and supersedes all prior written or oral understandings in connection therewith. This Agreement, and all the terms and provisions contained 9 p herein, including without limitation the exhibits hereto, constitute the full and complete agreement between the parties hereto to the date hereof, and supersedes and controls over any and all prior agreements, understandings, representations, correspondence and statements whether written or oral. 81. This Agreement may only be amended, supplemented or modified by a formal written amendment. 82. Any alterations, amendments, deletions, or waivers of the provisions of this Agreement shall be valid only when expressed in writing and duly signed by the parties. 83. Written notice requirements of this Agreement shall be strictly construed and such requirements are a condition precedent to pursuing any rights or remedies hereunder. The CONTRACTOR agrees not to claim any waiver by CITY of such notice requirements based upon CITY having actual knowledge, implied, verbal or constructive notice, lack of prejudice or any other grounds as a substitute for the failure of the CONTRACTOR to comply with the express written notice requirements herein. Computer notification (e-mails and message boards) shall not constitute proper written notice under the terms of the Agreement. 84. The failure of the CITY to insist in any instance upon the strict performance of any provision of this Agreement, or to exercise any right or privilege granted to the CITY hereunder shall not constitute or be construed as a waiver of any such provision or right and the same shall continue in force. Sanford Reclaimed Water Interconnect With Volusia Co. AGREEMENT FORM 00520-17 85. In no event shall any obligation of the CITY under this Agreement be or constitute a general obligation or indebtedness of the CITY, a pledge of the ad valorem taxing power of the CITY or a general obligation or indebtedness of the CITY within the meaning of the Constitution of the State of Florida or any other applicable laws, but shall be payable solely from legally available revenues and funds. 86. The CONTRACTOR shall not have the right to compel the exercise of the ad valorem taxing power of the CITY. 87. Each exhibit referred to and attached to this Agreement is an essential part of this Agreement. The exhibits and any amendments or revisions thereto, even if not physically attached hereto, shall be treated as if they are part of this Agreement. 88. The Section headings and captions of this Agreement are for convenience and reference only and in no way define, limit, describe the scope or intent of this Agreement or any part thereof, or in any way affect this Agreement or construe any provision of this Agreement. 89. If any term, provision or condition contained in this Agreement shall, to any extent, be held invalid or unenforceable, the remainder of this Agreement, or the application of such term, provision or condition to persons or circumstances other than those in respect of which it is invalid or unenforceable, shall not be affected thereby, and each term, provision and condition of this Agreement shall be valid and enforceable to the fullest extent permitted by law when consistent with equity and the public interest. 90. All provisions of this Agreement shall be read and applied in para materia with all other provisions hereof. 91. In the event of a dispute related to any performance or payment obligation arising under this Agreement, the parties agree to exhaust any alternative dispute resolution procedures reasonably imposed by the CITY prior to filing suit or otherwise pursuing legal remedies. 92. The CONTRACTOR agrees that it will file no suit or otherwise pursue legal remedies based on facts or evidentiary materials that were not presented for consideration to the CITY in alternative dispute resolution procedures or which the CONTRACTOR had knowledge and failed to present during the CITY procedures. 93. In the event that CITY procedures are exhausted and a suit is filed or legal remedies are otherwise pursued, the parties shall exercise best efforts to resolve disputes through voluntary mediation. Mediator selection and the procedures to be employed in voluntary mediation shall Sanford Reclaimed Water Interconnect With Volusia Co. AGREEMENT FORM 00520-18 be mutually acceptable to the parties. Costs of voluntary mediation shall be shared equally among the parties participating in the mediation. 94. This Agreement may be executed in any number of counterparts, each of which shall be deemed an original, but all of which, taken together, shall constitute one and the same document. Sanford Reclaimed Water Interconnect With Volusia Co. AGREEMENT FORM 00520-19 IN WITNESS WHEREOF, the parties hereto have executed this Agreement the day and year first above written. CONTRACTOR: T B Landmark Construction, Inc. Name of Firm s/((-11Y By (Sig ature) Date (SEAL) Martin Adams, Manager Printed Name and Title ATTEST: 3R111-1 B (Signa ) Date \110 Y\ ( —Al'o\Q ks%\tkAk- Printed Name and Title J OWNER: City of Sanford Name of Owner Air AI By (Signature Date (SEAL) ' 1 ' Jeff Triplett, Mayo Printed Name and Title ATTEST: 0 - —( (f By (Sign tureyy) Date Qo ?ttV Printed Name and Title Approved as to form and leg. y .ter 416 , 0 L. CC;TIbqt Date 1 ity Attorney )41 ' ; ' T' to Az A Sanford Reclaimed Water Interconnect With Volusia Co. AGREEMENT FORM 00520-20 ACO® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) ‘■■■---- 3/24/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS • CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Mary Burns, CIC, CRM NAME: y Kuykendall Gardner 12.70.Extl: (407)894-5431 (AIC.No): (407)629-6378 1560 Orange Ave Ste 750 ADORess:mburns @kgbroker.com INSURER(S)AFFORDING COVERAGE NAIC# Winter Park FL 32789 INSURERA:Zurich American Insurance Co INSURED INSURER B:NOrth River Ins Co 21105 TB Landmark Construction, Inc. INSURERC:Bridgefield Employers Ins Co 10701 11220 New Berlin Road INSURER D:Federal Ins Co 20281 INSURER E: Jacksonville FL 32226 INSURERF: COVERAGES CERTIFICATE NUMBER:13-14 Master COI REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER (MM/DD/YYYY) (MMIDD/YYYY) GENERAL LIABILITY EACH OCCURRENCE $ 1,0 0 0,0 0 0 • DAMAGE TO RENTED 300,000 X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ A CLAIMS-MADE X OCCUR GL0655826305 11/2.3/201311/23/2014 MEDEXP(Anyoneperson) $ 10,000 PERSONAL&ADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 -1 POLICY X PEP- X LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ A ALL OWNED SCHEDULED 5AP655826405 11/23/201311/23/2014 BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS X AUTOS (Per accident) PIP-Basic $ 10,000 UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000 B X EXCESS LIAB CLAIMS-MADE _AGGREGATE $ 10,000,000 DED RETENTIONS 5821014465 11/23/2013 11/23/2014 $ C WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY TORY I IMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A 083046525 11/23/2013 11/23/2014 (Mandatory in NH) 08304 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,0 0 0 D Leased/Rented or Borrowed 6691538 11/23/201311/23/2014 Limit of Insurance 400,000 Contractors Equipment Deductible/Theft Deductible 5,000/10,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Re: Sanford Reclaimed Water Interconnect With Volusia Co. City of Sanford and CPH, Inc. is reflected as additional insured as respects general, auto and umbrella liability, if required by written contract, for work performed by or on behalf of the named insured. Coverage is primary and non contributory. Waiver of subrogation applies in favor of additional insureds if required by written contract. Explosion; Collapse; Underground (XCU) Coverage in included under the general liabilty policy. GL endorsement GL-1175-F CW applies and is attached. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Sanford ACCORDANCE WITH THE POLICY PROVISIONS. Purchasing Manager 300 N. Park Avenue AUTHORIZED REPRESENTATIVE Sanford, FL 32771 Andrew Sobo/CIG1c? % ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 romnns m The Arf1Rr1 name anr7 Innn arcs renictereri marlrc of At f1Rrl ADDITIONAL COVERAGES Ref# Description Coverage Code Form No. Edition Date Employee Benefits EBLIA Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 1,000,000 2,000,000. 1,000 Per Claim Ref# Description Coverage Code Form No. Edition Date Limited Jobsite Pollution Coverage Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 1,000,000 2,000,000 5,000 Flat Ref# Description Coverage Code Form No. Edition Date Medical payments MEDPM Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 5,000 Ref# Description Coverage Code Form No. Edition Date Uninsured motorist Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 1,000,000 Ref# Description Coverage Code Form No. Edition Date Terrorism Coverage TERR Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium $893.36 Ref# Description Coverage Code Form No. Edition Date Premium discount PDIS Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium -$20,067.18 Ref# Description Coverage Code Form No. Edition Date WC& Employer's liability WCEL Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 1,000,000 1,000,000 1,000,000 Ref# Description Coverage Code Form No. Edition Date Drug Free Credit DRUGF Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium -$10,843.89 Ref# Description Coverage Code Form No. Edition Date Experience Mod Factor 1 EXPO1 Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium $18,543.04 Ref# Description Coverage Code Form No. Edition Date Safety Program SAFTY Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium -$4,426.08 Ref# Description Coverage Code Form No. Edition Date Expense constant EXCNT Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium $200.00 OFADTLCV Copyright 2001,AMS Services,Inc. A`°RO® CERTIFICATE OF LIABILITY INSURANCE YY) 3A26/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Mary Burns, CIC, CRM NAME: y Kuykendall Gardner r2Nlv.EXtt: (407)894-5431 (AIC.No): (407)629-6378 1560 Orange Ave Ste 750 nooaess:mburns @kgbroker.com INSURER(S)AFFORDING COVERAGE NAIC 8 Winter Park FL 32789 INSURERA:Zurich American Insurance Co INSURED INSURER B:NOrth River Ins Co 21105 TB Landmark Construction, Inc. INSURERC:Bridgefield Employers Ins Co 10701 11220 New Berlin Road INSURER D:Federal Ins Co 20281 INSURER E: Jacksonville FL 32226 INSURERF: COVERAGES CERTIFICATE NUMBER:13-14 Master COI REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DDIYYYY) GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 300,000 X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ A CLAIMS-MADE X OCCUR GL0655826305 11/23/201311/23/2014 MEDEXP(Anyoneperson) $ 10,000 PERSONAL&ADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY X PRO X LOC $ JF(:T AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 A X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BAP655826405 11/23/2013 11/23/2014 BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE _ AUTOS (Per accident) _ PIP-Basic $ 10,000 UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000 B x EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,000 DED RETENTION$ 5821014465 11/23/2013 11/23/2014 $ C WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A 11/23/2013 11/23/2014 (Mandatory in NH) 083046525 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,0 0 0,0 00 D Leased/Rented or Borrowed 6691538 11/23/201311/23/2014 Limit of Insurance 400,000 Contractors. Equipment Deductible/Theft Deductible 5,000/10,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Re: Sanford Reclaimed Water Interconnect With Volusia Co. City of Sanford and CPH, Inc. is reflected as additional insured as respects general, auto and umbrella liability, if required by written contract, for work performed by or on behalf of the named insured. Coverage is primary and non contributory. Waiver of subrogation applies in favor of additional insureds if required by written contract. Explosion; Collapse; Underground (XCU) Coverage in included under the general liabilty policy. GL endorsement GL-1175-F CW applies and is attached. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. CPH Inc P.O. Box 2808 Sanford, FL 32772 AUTHORIZED REPRESENTATIVE Andrew Sobo/CIG 11 2 ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 mmnns m The.ArflRll name.and Innn arta re.ni¢fe.re.rl m,rlre of Ar r1Rr1 ADDITIONAL COVERAGES Ref# Description Coverage Code Form No. Edition Date Employee Benefits EBLIA Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 1,000,000 2,000,000 1,000 Per Claim Ref# Description Coverage Code Form No. Edition Date Limited Jobsite Pollution Coverage Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 1,000,000 2,000,000 5,000 Flat Ref# Description Coverage Code Form No. Edition Date Medical payments MEDPM Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 5,000 Ref# Description Coverage Code Form No. Edition Date Uninsured motorist Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 1,000,000 Ref# Description Coverage Code Form No. Edition Date Terrorism Coverage TERR Limit 1 ' . Limit 2 Limit 3 Deductible Amount Deductible Type Premium $893.36 Ref# Description Coverage Code Form No. Edition Date Premium discount PDIS I Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium -$20,067.18 Ref# Description Coverage Code Form No. Edition Date WC& Employer's liability WCEL Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 1,000,000 1,000,000 1,000,000 Ref# Description Coverage Code Form No. Edition Date Drug Free Credit DRUGF Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium -$10,843.89 Ref# Description Coverage Code Form No. Edition Date Experience Mod Factor 1 EXPO1 Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium $18,543.04 Ref# Description Coverage Code Form No. Edition Date Safety Program SAFTY Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium -$4,426.08 Ref# Description Coverage Code Form No. Edition Date Expense constant EXCNT Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium $200.00 OFADTLCV Copyright 2001,AMS Services,Inc. Waiver Of Subrogation (Blanket) Endorsement Policy No. Eff. Date of Pol. Exp. Date of Pol. Eff.Date of End. Producer Addl.Preen Return Prem. 11/23/13 11/23/14 11/23/13 Kuykendal $ Incl . $ GL0655826305 Gardner LLC THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Conunencial General Liability Coverage Part The following is added to the Transfer Of Rights Of Recovery Against Others To Us Condition: If you are required by a written contract or agreement, which is executed before a loss, to waive your rights of recovery from others, we agree to waive our rights of recovery. This waiver of rights shall not be construed to be a waiver with respect to any other operations in which the insured has no contractual interest. U-GL-925-B CW(12/01) Insured Copy Page 1 of 1 • Additional Insured - Automatic - Owners, Lessees Or ZURICH Contractors - Products-Completed Operations Liability Amendment Policy No. Eff. Date of Pd. Exp. Date of Pol. Eff. Date of End. Producer No. Add'I. Prem Return Prem. 11/23/13 11/23/14 11/23/13 Kuykendal1 Incl . I I I I GL0655826305 Gardner, LLC THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAFEFULLY. Named Insured: Address(including ZIP Code): This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part A. Section II —Who Is An Insured is amended to include as an insured any person or organization who you are required to add as an additional insured on this policy under a written contract or written agreement. B. The insurance provided to the additional insured person or organization applies only to 'bodily injury", "property damage" or "personal and advertising injury" covered under Section I — Coverage A — Bodily Injury And Property Damage Liability and Section I — Coverage B — Personal And Advertising Injury Liability, but only with respect to liability for "bodily injury", "property damage"or "personal and advertising injury"caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf, and resulting directly from your ongoing operations or'your work"as included in the"products-completed operations hazard", which is the subject of the written contract or written agreement. C. However, regardless of the provisions of Paragraphs A. and B.above: 1. We will not extend any insurance coverage to any additional insured person or organization: a. That is not provided to you in this policy; or b. That is any broader coverage than you are required to provide to the additional insured person or organization in the written contract or written agreement; and c. Subject to Paragraphs 1.a. and 1.b. above and solely as respects "products-completed operations hazard" coverage, unless a claim or "suit" for damages is presented to us no later than one year from the "products- completed operations hazard" completion date deemed applicable to 'your work" from which the loss originates if no time requirement for reporting a claim or "suit"for damages is stipulated in the written contract or written agreement; and 2. We will not provide Limits of Insurance to any additional insured person or organization that exceed the lower of: a. The Limits of Insurance provided to you in this policy; or b. The Limits of Insurance you are required to provide in the written contract or written agreement. D. The insurance provided to the additional insured person or organization does not apply to: "Bodily injury", "property damage" or "personal and advertising injury"arising out of the rendering or failure to render any professional architectural, engineering or surveying services including: u-GL-1461-B Cw(10111) Page 1 of 2 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Insured Copy 1. The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and 2. Supervisory, inspection, architectural or engineering activities. E. The additional insured must see to it that: 1. We are notified as soon as practicable of an "occurrence"or offense that may result in a claim; 2. We receive written notice of a claim or "suit"as soon as practicable; and 3. A request for defense and indemnity of the claim or "suit"will promptly be brought against any policy issued by another insurer under which the additional insured may be an insured in any capacity. This provision does not apply to insurance on which the additional insured is a Named Insured, if the written contract or written agreement requires that this coverage be primary and non-contributory. F. For the coverage provided by this endorsement: 1. The following paragraph is added to Paragraph 4.a. of the Other Insurance Condition of Section IV—Commercial General Liability Conditions This insurance is primary insurance as respects our coverage to the additional insured person or organization, where the written contract or written agreement requires that this insurance be primary and non-contributory with respect to any other policy upon which the additional insured is a Named Insured. In that event, we will not seek contribution from any other such insurance policy available to the additional insured on which the additional insured person or organization is a Named Insured. 2. The following paragraph is added to Paragraph 4.b. of the Other Insurance Condition of Section IV—Commercial General Liability Conditions This insurance is excess over: Any of the other insurance, whether primary, excess, contingent or on any other basis, available to an additional insured, in which the additional insured on our policy is also covered as an additional insured on another policy providing coverage for the same "occurrence", offense, claim or "suit". This provision does not apply to any policy in which the additional insured is a Named Insured on such other policy and where our policy is required by written contract or written agreement to provide coverage to the additional insured on a primary and non- contributory basis. G. This endorsement does not apply to an additional insured which has been added to this policy by an endorsement showing the additional insured in a Schedule of additional insureds, and which endorsement applies specifically to that identified additional insured. All other terms and conditions of this policy remain unchanged. U-GL-1461-B CW(10/11) Page 2 of 2 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Insured Copy • Additional Insured - Automatic - Owners, Lessees Or ZURICH Contractors Policy No. Eff. Date of Poi. Exp. Date of Pol. Elf.Date of End. Producer No. Addl.Prem Return Prem. GL0655826305 11/23/2013 11/23/2014 11/23/2013 TI115 ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Named Insured:T.B. LANDMARK CONSTRUCT ION, INC. Address(including ZiP Code): This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part A. Section H —Who Is An Insured is amended to include as an additional insured any person or organization whom you are required to add as an additional insured on this policy under a written contract or written agreement. Such person or organization is an additional insured only with respect to liability for"bodily injury", "property damage" or"personal and advertising injury"caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf, in the performance of your ongoing operations or "your work" as included in the "products-completed operations hazard",which is the subject of the written contract or written agreement. However,the insurance afforded to such additional insured: 1. Only applies to the extent permitted by law;and 2. Will not be broader than that which you are required by the written contract or written agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to: "Bodily injury", "property damage" or"personal and advertising injury"arising out of the rendering of, or failure to render, any professional architectural,engineering or surveying services including: a. The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b. Supervisory, inspection,architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional architectural, engineering or surveying services, U-GL-1 175-F CW(04/13) Page 1of2 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. C. The following is added to Paragraph 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit of Section IV— Coninercial General Liability Conditions: The additional insured must see to it that: 1. We are notified as soon as practicable of an "occurrence" or offense that may result in a claim; 2. We receive written notice of a claim or"suit"as soon as practicable;and 3. A request for defense and indemnity of the claim or "suit" will promptly be brought against any policy issued by another insurer under which the additional insured may be an insured in any capacity. This provision does not apply to insurance on which the additional insured is a Named Insured if the written contract or written agreement requires that this coverage be primary and non-contributory. D. For the purposes of the coverage provided by this endorsement: 1. The following is added to the Other Insurance Condition of Section iV—Commercial General Liability Conditions: Primary and Noncontributory insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured provided that: a. The additional insured is a Named Insured under such other insurance;and b. You are required by written contract or written agreement that this insurance be primary and not seek contribution from any other insurance available to the additional insured. 2, The following paragraph is added to Paragraph 4.b.of the Other Insurance Condition of Section IV--Commercial General Liability Conditions: This insurance is excess over: Any of the other insurance, whether primary, excess, contingent or on any other basis, available to an additional insured, in which the additional insured on our policy is also covered as an additional insured on another policy providing coverage for the same "occurrence", offense, claim or "suit". This provision does not apply to any policy in which the additional insured is a Named Insured on such other policy and where our policy is required by a written contract or written agreement to provide coverage to the additional insured on a primary and non- contributory basis. E. This endorsement does not apply to an additional insured which has been added to this policy by an endorsement showing the additional insured in a Schedule of additional insureds, and which endorsement applies specifically to that identified additional insured. F. With respect to the insurance afforded to the additional insureds under this endorsement, the following is added to Section IA—Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the written contract or written agreement referenced in Paragraph A.of this endorsement; or 2. Available under the applicable Limits of Insurance shown in the Declarations, whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. All other terms and conditions of this policy remain unchanged. U-GL-1175-F Cw(04/13) Page 2 of 2 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. SECTION 00618 INSURANCE REQUIREMENTS (CITY OF SANFORD) The following insurance requirements are required to be met, in addition to requirements defined in Sections 00700 (General Conditions) and 00800 (Supplementary Conditions). Any conflict between the requirements contained in this section and any other section, it is hereby noted that the requirements of this section as amended shall prevail. 1. The successful bidder will be required to provide, to the City of Sanford and the Engineer, prior to commencing any work, a Certificate of Insurance which verifies coverage in compliance with the requirements outlined below. Any work initiated without completion of this requirement shall be unauthorized and the City will not be responsible. 2. The City reserves the right, as conditions warrant, to modify or increase insurance requirements outlined below as may be determined by the project, conditions and exposure. 3. The insurance limits indicated below and otherwise referenced are minimum limits acceptable to the City. Such policies shall be endorsed to provide primary and non- contributory coverage to the City and all of the Additional Insureds in relation to any and all other liability insurance. 4. All policies are to be provide a Waiver of Subrogation endorsement in favor of the City and all of the Additional Insureds. 5. All policies are to be endorsed to include the City of Sanford and the Engineer as Additional Insured, except for professional liability policies and workers compensation policies. 6. Professional Liability Coverage, when applicable, will be defined on a case by case basis. 7. Builder's Risk ("All Risk") insurance is required for all projects that include above grade construction, installation of structures, pipeline installation, and for all projects where the Contractor proposes to be paid for stored material. 8. In the event that the insurance coverage expires prior to the completion of the project, a renewal certificate shall be issued 30 days prior to said expiration date. 9. All limits are per occurrence and must include Bodily Injury and Property Damage. 10. All policies must be written on occurrence form, not on claims made form, except for Professional Liability. 11. Self insured retentions shall not be allowed on any liability coverage. Sanford Reclaimed Water Interconnect With Volusia Co. INSURANCE REQUIREMENTS (CITY OF SANFORD) 00618-1 19. Certification: A. It is noted that the City has a contractual relationship with the named Contractor, applicable to a purchase order, work order, contract or other form of commitment by the City of Sanford, whether in writing or not and has no such contractual relationship with the Contractor's insurance carrier. Therefore, the onus is on the Contractor to insure that they have the insurance coverage specified by the City to meet all contractual obligations and expectations of the City. Further, as the Contractor's insurance coverage is a matter between the vendor and its insurance carrier, the City will turn to the Contractor for relief as a result of any damages or alleged damages for which the Contractor is responsible to indemnify and hold the City harmless. It is understood that the Contractor may satisfy relief to the City for such damages either directly or through its insurance coverage; exclusions by the insurance carrier not withstanding, the City will expect relief from the Contractor. B. The Undersigned accepts and agrees to meet all of the insurance coverage requirements, terms, conditions and certification(s) stated herein before and after and further agrees to maintain and provide the designated coverage during the life of the identified document. Also, when the coverage requirements stated herein before and after are specifically referenced by applicable solicitation, purchase order or contract document, those terms, conditions and coverage requirements are incorporated into that document as if fully set forth in verbatim. Certified By: T B Landmark Construction, Inc. Name of Contractor 11220 New Berlin Rd. Jacksonville, Florida 32114 Address City State Zip Code Signature Martin Adams, Manager Printed Name and Title END OF SECTION Sanford Reclaimed Water Interconnect With Volusia Co. INSURANCE REQUIREMENTS (CITY OF SANFORD) 00618-3 SECTION 00620 INSURANCE CERTIFICATION Name of Project: Sanford Reclaimed Water Interconnect With Volusia Co. (IFB 13/14-2) Owner: City of Sanford 300 North Park Avenue Sanford, FL 32771-1244 Engineer: CPH, Inc. P.O. Box 2808 Sanford, Florida 32772 Ph. 407-322-6841 THIS IS TO CERTIFY that the numbered policies identified by the attached Certificates of Insurance have been issued by the below stated company in conformance with the limits and requirements as set forth in the General Conditions and Supplementary Conditions. The insurance company hereby waives its rights of subrogation against the additional insured. TB Landmark Construction, Inc. Named Insured Zurich American Insurance Co. Insurance Company 495 N. Keller Road, Suite 500, Maitland, FL 32751 Address< City State Zip By: Si. at re .f A fizzed Representative Mary H. Burns , Printed or Typed Name of Authorized Representative (Attach Acknowledgment) (Make additional copies of this form if more than one insurance company provides contract required insurance). Sanford Reclaimed Water Interconnect With Volusia Co. INSURANCE CERTIFICATION 00620-1 '4�°® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 3/24/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Mary Burns, CIC, CRM NAME: y Kuykendall Gardner (a°No Ext): (407)894-5431 AC,No):(407)629-6378 1560 Orange Ave Ste 750 ADORess:mburns @kgbroker.com INSURER(S)AFFORDING COVERAGE NAIC# Winter Park FL 32789 INSURERA:Zurich American Insurance Co INSURED INSURER B:North River Ins Co 21105 TB Landmark Construction, Inc. INsuRERC:Bridgefield Employers Ins Co ,10701 11220 New Berlin Road INSURERD:Federal Ins Co 20281 INSURER E: Jacksonville FL 32226 INSURERF: COVERAGES CERTIFICATE NUMBER:13-14 Master COI REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP W MI LIMITS LTR INSR VD POLICY NUMBER (MM/DD/YYYY) (MDD/YYYY) GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 300,000 X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ A CLAIMS-MADE X OCCUR GL0655826305 11/23/201311/23/2014 MEDEXP(Anyoneperson) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 7 POLICY X PRO X LOC $ 'JECT AUTOMOBILE LIABILITY . COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ A ALL OWNED SCHEDULED BAP655826405 11/23/2013 11/23/2014 BODILY INJURY(Per accident) $ AUTOS AUTOS X X NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS _ AUTOS (Per accident) PIP-Basic $ 10,000 UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000 B X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,000 DED RETENTION$ 5821014465 11/23/2013 11/23/2014 $ C WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A 083046525 11/23/2013 11/23/2014 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 D Leased/Rented or Borrowed 6691538 11/23/201311/23/2014 Limitoflnsurance 400,000 Contractors Equipment Deductible/Theft Deductible 5,000/10,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Re: Sanford Reclaimed Water Interconnect With Volusia Co. City of Sanford and CPH, Inc. is reflected as additional insured as respects general, auto and umbrella liability, if required by written contract, for work performed by or on behalf of the named insured. Coverage is primary and non contributory. Waiver of subrogation applies in favor of additional insureds if required by written contract. Explosion; Collapse; Underground (XCU) Coverage in included under the general liabilty policy. GL endorsement GL-1175-F CW applies and is attached. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Sanford ACCORDANCE WITH THE POLICY PROVISIONS. Purchasing Manager 300 N. Park Avenue AUTHORIZED REPRESENTATIVE Sanford, FL 32771 Andrew Sobo/CIGc� ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025l2mnns/m The AC(1Rrl name and Innn arc rcnicfcrcrl marlec of ArfPr1 ADDITIONAL COVERAGES Ref# Description Coverage Code Form No. Edition Date Employee Benefits EBLIA Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 1,000,000 2,000,000 1,000 Per Claim Ref# Description Coverage Code Form No. Edition Date Limited Jobsite Pollution Coverage Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 1,000,000 2,000,000 5,000 Flat Ref# Description Coverage Code Form No. Edition Date Medical payments MEDPM Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 5,000 Ref# Description Coverage Code Form No. Edition Date Uninsured motorist Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 1,000,000 Ref# Description Coverage Code Form No. Edition Date Terrorism Coverage TERR Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium $893.36 Ref# Description Coverage Code Form No. Edition Date Premium discount PDIS Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium -$20,067.18 Ref# Description Coverage Code Form No. Edition Date WC & Employer's liability WCEL Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 1,000,000 1,000,000 1,000,000 Ref# Description Coverage Code Form No. Edition Date Drug Free Credit DRUGF Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium -$10,843.89 Ref# Description Coverage Code Form No. Edition Date p 9 Experience Mod Factor 1 EXPO1 Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium $18,543.04 Ref# Description Coverage Code Form No. Edition Date Safety Program SAFTY Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium -$4,426.08 Ref# Description Coverage Code Form No. Edition Date Expense constant EXCNT Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium $200.00 OFADTLCV Copyright 2001,AMS Services,Inc. 1 AC RD CERTIFICATE OF LIABILITY INSURANCE 3/26/2014YY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Mary Burns, CIC, CRM NAME: y Kuykendall Gardner PHONE FXt): (407)894-5431 (A/C.No): (407)629-6378 1560 Orange Ave Ste 750 ADORIess:mburns @kgbroker.com INSURER(S)AFFORDING COVERAGE NAIC# Winter Park FL 32789 INSURERA:Zurich American Insurance Co INSURED INSURER B:NOrth River Ins Co 21105 TB Landmark Construction, Inc. INSURERC:Bridgefield Employers Ins Co 10701 11220 New Berlin Road INSURERD:Federal Ins Co 20281 ' INSURER E: Jacksonville FL 32226 INSURERF: COVERAGES CERTIFICATE NUMBER:13-14 Master Coi REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 300,000 X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ A CLAIMS-MADE X OCCUR GL0655826305 11/23/201311/23/2014 MEDEXP(Anyoneperson) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 7 POLICY X TA-PRO X LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ A ALL OWNED SCHEDULED BAP655826405 11/23/2013 11/23/2014 BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X N PROPERTY DAMAGE $ - (Per accident) AUTON OWNED OS PIP-Basic $ 10,000 UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000 B X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,000 DED RETENTION$ 5821014465 11/23/2013 11/23/2014 $ C WORKERS COMPENSATION .. WC STATU- 0TH- AND EMPLOYERS'LIABILITY TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT $ 1,000,000 (Mandatory OFFICER/MEMBER EXCLUDED? N/A 083046525 11/23/201311/23/2014 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If Yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 D Leased/Rented or Borrowed 6691538 11/23/201311/23/2014 LimitofInsurance 400,000 Contractors Equipment Deductible/Theft Deductible 5,000/10,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Re: Sanford Reclaimed Water Interconnect With Volusia Co. City of Sanford and CPH, Inc. is reflected as additional insured as respects general, auto and umbrella liability, if required by written contract, for work performed by or on behalf of the named insured. Coverage is primary and non contributory. Waiver of subrogation applies in favor of additional insureds if required by written contract. Explosion; Collapse; Underground (XCU) Coverage in included under the general liabilty policy. GL endorsement GL-1175-F CW applies and is attached. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. CPH Inc P.O. Box 2808 Sanford, FL 32772 AUTHORIZED REPRESENTATIVE Andrew Sobo/CIG „1-7 V ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 romnr r m ` The.Ar'r1Rn name.and Inns ara re.nicfe.rsrd mark of ArfPr1 ADDITIONAL COVERAGES Ref# Description Coverage Code Form No. Edition Date Employee Benefits EBLIA Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 1,000,000 2,000,000 1,000 Per Claim Ref# Description Coverage Code Form No. Edition Date Limited Jobsite Pollution Coverage Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 1,000,000 2,000,000 5,000 Flat Ref# Description Coverage Code Form No. Edition Date Medical payments MEDPM Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 5,000 Ref# Description Coverage Code Form No. Edition Date Uninsured motorist Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 1,000,000 Ref# Description Coverage Code Form No. Edition Date Terrorism Coverage TERR Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium $893.36 Ref# Description Coverage Code Form No. Edition Date Premium discount PDIS Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium -$20,067.18 Ref# Description Coverage Code Form No. Edition Date WC& Employer's liability WCEL Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium 1,000,000 1,000,000 1,000,000 Ref# Description Coverage Code Form No. Edition Date Drug Free Credit DRUGF Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium -$10,843.89 Ref# Description Coverage Code Form No. Edition Date Experience Mod Factor 1 EXPO1 Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium $18,543.04 Ref# Description Coverage Code Form No. Edition Date Safety Program SAFTY Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium -$4,426.08 Ref# Description Coverage Code Form No. Edition Date Expense constant EXCNT Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium $200.00 OFADTLCV Copyright 2001,AMS Services,Inc. Waiver Of Subrogation (Blanket) Endorsement Policy No. Eff. Date of Pol. Exp. Date of Pol. Eff.Date of End. Producer Add'I.Preen Return Prem. 11/23/13 11/23/14 11/23/13 Kuykendal $ Incl . $ GL0655826305 Gardner LLC THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part The following is added to the Transfer Of Rights Of Recovery Against Others To Us Condition If you are required by a written contract or agreement, which is executed before a loss, to waive your rights of recovery from others, we agree to waive our rights of recovery. This waiver of rights shall not be construed to be a waiver with respect to any other operations in which the insured has no contractual interest. U-GL-925-B CW(12/0I) Insured Copy Page l of 1 rµ:r Additional Insured - Automatic - Owners, Lessees Or ZURICH Contractors - Products-Completed Operations Liability Amendment Policy No. Eff. Date of Pol. Exp. Date of Pd. Eff. Date of End. Producer No. Add'I. Prem Return Prem. 11/23/13 11/23/14 11/23/13 KuykendalL Incl . GL0655826305 Gardner, LLC THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Named Insured: Address(including ZIP Code): This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part A. Section II —Who Is An Insured is amended to include as an insured any person or organization who you are required to add as an additional insured on this policy under a written contract or written agreement. B. The insurance provided to the additional insured person or organization applies only to "bodily injury", "property damage" or "personal and advertising injury" covered under Section I — Coverage A — Bodily Injury And Property Damage Liability and Section I — Coverage B — Personal And Advertising Injury Liability, but only with respect to liability for "bodily injury", "property damage"or "personal and advertising injury"caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf, and resulting directly from your ongoing operations or'your work"as included in the"products-completed operations hazard", which is the subject of the written contract or written agreement. C. However, regardless of the provisions of Paragraphs A. and B.above: 1. We will not extend any insurance coverage to any additional insured person or organization: a. That is not provided to you in this policy; or b. That is any broader coverage than you are required to provide to the additional insured person or organization in the written contract or written agreement; and c. Subject to Paragraphs 1.a. and 1.b. above and solely as respects "products-completed operations hazard" coverage, unless a claim or "suit" for damages is presented to us no later than one year from the "products- completed operations hazard" completion date deemed applicable to 'your work" from which the loss originates if no time requirement for reporting a claim or "suit"for damages is stipulated in the written contract or written agreement; and 2. We will not provide Limits of Insurance to any additional insured person or organization that exceed the lower of: a. The Limits of Insurance provided to you in this policy; or b. The Limits of Insurance you are required to provide in the written contract or written agreement. D. The insurance provided to the additional insured person or organization does not apply to: "Bodily injury", "property damage" or "personal and advertising injury"arising out of the rendering or failure to render any professional architectural, engineering or surveying services including: 1J-GL-1461-B Cw(10/11) Page 1 of 2 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Insured Copy 1. The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and 2. Supervisory, inspection, architectural or engineering activities. E. The additional insured must see to it that: 1. We are notified as soon as practicable of an "occurrence"or offense that may result in a claim; 2. We receive written notice of a claim or "suit"as soon as practicable;and 3. A request for defense and indemnity of the claim or "suit"will promptly be brought against any policy issued by another insurer under which the additional insured may be an insured in any capacity. This provision does not apply to insurance on which the additional insured is a Named Insured, if the written contract or written agreement requires that this coverage be primary and non-contributory. F. For the coverage provided by this endorsement: 1. The following paragraph is added to Paragraph 4.a. of the Other Insurance Condition of Section IV—Commercial General Liability Conditions This insurance is primary insurance as respects our coverage to the additional insured person or organization, where the written contract or written agreement requires that this insurance be primary and non-contributory with respect to any other policy upon which the additional insured is a Named Insured. In that event, we will not seek contribution from any other such insurance policy available to the additional insured on which the additional insured person or organization is a Named Insured. 2. The following paragraph is added to Paragraph 4.b. of the Other Insurance Condition of Section IV—Commercial General Liability Conditions This insurance is excess over: Any of the other insurance, whether primary, excess, contingent or on any other basis, available to an additional insured, in which the additional insured on our policy is also covered as an additional insured on another policy providing coverage for the same "occurrence", offense, claim or "suit". This provision does not apply to any policy in which the additional insured is a Named Insured on such other policy and where our policy is required by written contract or written agreement to provide coverage to the additional insured on a primary and non- contributory basis. G. This endorsement does not apply to an additional insured which has been added to this policy by an endorsement showing the additional insured in a Schedule of additional insureds, and which endorsement applies specifically to that identified additional insured. All other terms and conditions of this policy remain unchanged. U-GL-1461-B CW(10/11) Page 2 of 2 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Insured Copy Additional Insured - Automatic - Owners, Lessees Or ZURIC9 H Contractors Policy No. Eff. Date of Pol. Exp. Date of Pol. Eff.Date of End. Producer No. Addl.Prem Return Prem. GL0655826305 11/23/2013 11/23/2014 11/23/2013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Named Insured:T.13. LANDMARK CONSTRUCTION, INC. Address(including ZIP Code): This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part A. Section H —Who Is An Insured is amended to include as an additional insured any person or organization whom you are required to add as an additional insured on this policy under a written contract or written agreement. Such person or organization is an additional insured only with respect to liability for'bodily injury", "property damage"or"personal and advertising injury"caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf, in the performance of your ongoing operations or "your work" as included in the 'products-completed operations hazard",which is the subject of the written contract or written agreement. However,the insurance afforded to such additional insured: 1. Only applies to the extent permitted by law;and 2. Will not be broader than that which you are required by the written contract or written agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to: "Bodily injury", "property damage" or"personal and advertising injury"arising out of the rendering of, or failure to render,any professional architectural,engineering or surveying services including: a. The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b. Supervisory, inspection,architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional architectural, engineering or surveying services. U-GL-1175-F CW(04/13) Page 1 of 2 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. C. The following is added to Paragraph 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit of Section IV— Comrnercial General Liability Conditions: The additional insured must see to it that: 1. We are notified as soon as practicable of an "occurrence" or offense that may result in a claim; 2. We receive written notice of a claim or"suit"as soon as practicable;and 3. A request for defense and indemnity of the claim or "suit" will promptly be brought against any policy issued by another insurer under which the additional insured may be an insured in any capacity. This provision does not apply to insurance on which the additional insured is a Named Insured if the written contract or written agreement requires that this coverage be primary and non-contributory. D. For the purposes of the coverage provided by this endorsement: 1. The following is added to the Other Insurance Condition of Section iV—Commercial General Liability Conditions: Primary and Noncontributory insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured provided that: a. The additional insured is a Named Insured under such other insurance;and b. You are required by written contract or written agreement that this insurance be primary and not seek contribution from any other insurance available to the additional insured. 2. The following paragraph is added to Paragraph 4.b.of the Other Insurance Condition of Section IV—Commercial General Liability Conditions This insurance is excess over: Any of the other insurance, whether primary, excess, contingent or on any other basis, available to an additional insured, in which the additional insured on our policy is also covered as an additional insured on another policy providing coverage for the same "occurrence", offense, claim or "suit'. This provision does not apply to any policy in which the additional insured is a Named insured on such other policy and where our policy is required by a written contract or written agreement to provide coverage to the additional insured on a primary and non- contributory basis. E. This endorsement does not apply to an additional insured which has been added to this policy by an endorsement showing the additional insured in a Schedule of additional insureds, and which endorsement applies specifically to that identified additional insured. F. With respect to the insurance afforded to the additional insureds under this endorsement, the following is added to Section Iii—Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the written contract or written agreement referenced in Paragraph A.of this endorsement; or 2. Available under the applicable Limits of Insurance shown in the Declarations, whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. All other terms and conditions of this policy remain unchanged. U-GL-1175-F CW(04/13) Page 2 of 2 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. SECTION 00618 INSURANCE REQUIREMENTS (CITY OF SANFORD) The following insurance requirements are required to be met, in addition to requirements defined in Sections 00700 (General Conditions) and 00800 (Supplementary Conditions). Any conflict between the requirements contained in this section and any other section, it is hereby noted that the requirements of this section as amended shall prevail. 1. The successful bidder will be required to provide, to the City of Sanford and the Engineer, prior to commencing any work, a Certificate of Insurance which verifies coverage in compliance with the requirements outlined below. Any work initiated without completion of this requirement shall be unauthorized and the City will not be responsible. 2. The City reserves the right, as conditions warrant, to modify or increase insurance requirements outlined below as may be determined by the project, conditions and exposure. 3. The insurance limits indicated below and otherwise referenced are minimum limits acceptable to the City. Such policies shall be endorsed to provide primary and non- contributory coverage to the City and all of the Additional Insureds in relation to any and all other liability insurance. 4. All policies are to be provide a Waiver of Subrogation endorsement in favor of the City and all of the Additional Insureds. 5. All policies are to be endorsed to include the City of Sanford and the Engineer as Additional Insured, except for professional liability policies and workers compensation policies. 6. Professional Liability Coverage, when applicable, will be defined on a case by case basis. 7. Builder's Risk ("All Risk") insurance is required for all projects that include above grade construction, installation of structures, pipeline installation, and for all projects where the Contractor proposes to be paid for stored material. 8. In the event that the insurance coverage expires prior to the completion of the project, a renewal certificate shall be issued 30 days prior to said expiration date. 9. All limits are per occurrence and must include Bodily Injury and Property Damage. 10. All policies must be written on occurrence form, not on claims made form, except for Professional Liability. 11. Self insured retentions shall not be allowed on any liability coverage. Sanford Reclaimed Water Interconnect With Volusia Co. INSURANCE REQUIREMENTS (CITY OF SANFORD) 00618-1 12. In the notification of cancellation: The City of Sanford and the Engineer shall be endorsed onto the policy as a cancellation notice recipient. Should any of the above described policies be cancelled before the expiration date thereof, notice shall be delivered to the City of Sanford in accordance with the policy provisions. 13. All insurers must have an A.M. Best rating of at least A-VII. 14. It is the responsibility of the Contractor to responsible to ensure that all Subcontractors retained by the Prime Contractor shall provide coverage as defined herein before and after and are the responsibility of said Prime Contractor in all respects. 15. Any changes to the coverage requirements indicated above shall be approved by the City of Sanford Risk Manager. 16. Address of "Certificate Holder" is: City of Sanford; Attention: Purchasing Manager; 300 N. Park Avenue); Sanford, FL 32771 Phone: 407-688.5028; Fax: 407-688-5021; CPH, Inc., P.O. Box 2808, Sanford, FL 32772. 17. All certificates of insurance, notices, etc. must be provided to the above addresses. 18. Insurance requirements are as follows: A. For construction projects where the total construction cost is $500,000 or higher: Coverage Required Minimum Policy Limits Workers' Compensation Employers Liability$ 1,000,000 *Certificates of exemption are not acceptable in lieu of Each Accident $ 1,000,000 workers compensation insurance Disease $ 1,000,000 Commercial General Liability shall include- Bodily injury liability, Property Damage liability; Personal Injury liability and Advertising injury liability Coverages shall $ 3,000,000 Per Occurrence include: Premises/Operations; Products/Completed $ 3,000,000 General Aggregate Operations; Contractual liability; Independent Contractors, Explosion; Collapse; Underground Comprehensive Auto Liability, CSL, shall include "any $ 1,000,000 Combined Single Limit auto" or shall include all of the following: owned, $ 1,000,000 General Aggregate leased, hired, non-owned autos, and scheduled autos. Professional Liability(when required) Not required for this project Builder's Risk (when required)shall include theft, sinkholes, off site storage, transit, installation and equipment breakdown. Permission to occupy shall be 100% of completed value of additions included and the policy shall be endorsed to cover the and structures interest of all parties, including the City of Sanford, all contractors and subcontractors Garage Keepers (when required) Not required for this project Garage Liability(when required) Not required for this project Sanford Reclaimed Water Interconnect With Volusia Co. INSURANCE REQUIREMENTS (CITY OF SANFORD) 00618-2 19. Certification: A. It is noted that the City has a contractual relationship with the named Contractor, applicable to a purchase order, work order, contract or other form of commitment by the City of Sanford, whether in writing or not and has no such contractual relationship with the Contractor's insurance carrier. Therefore, the onus is on the Contractor to insure that they have the insurance coverage specified by the City to meet all contractual obligations and expectations of the City. Further, as the Contractor's insurance coverage is a matter between the vendor and its insurance carrier, the City will turn to the Contractor for relief as a result of any damages or alleged damages for which the Contractor is responsible to indemnify and hold the City harmless. It is understood that the Contractor may satisfy relief to the City for such damages either directly or through its insurance coverage; exclusions by the insurance carrier not withstanding, the City will expect relief from the Contractor. B. The Undersigned accepts and agrees to meet all of the insurance coverage requirements, terms, conditions and certification(s) stated herein before and after and further agrees to maintain and provide the designated coverage during the life of the identified document. Also, when the coverage requirements stated herein before and after are specifically referenced by applicable solicitation, purchase order or contract document, those terms, conditions and coverage requirements are incorporated into that document as if fully set forth in verbatim. Certified By: T B Landmark Construction, Inc. Name of Contractor 11220 New Berlin Rd. Jacksonville, Florida 32114 Address / City State Zip Code J. Signature Martin Adams, Manager Printed Name and Title END OF SECTION Sanford Reclaimed Water Interconnect With Volusia Co. INSURANCE REQUIREMENTS (CITY OF SANFORD) 00618-3 SECTION 00620 4ISURANCE CERTIFICATION Name of Project: Sanford Reclaimed Water Interconnect With Volusia Co.IIFB 13/14-2) Owner: City of Sanford 300 North Park Avenue Sanford, FL 32771-1244 Engineer: CPH, Inc. P.O. Box 2808 Sanford, Florida 32772 Ph. 407-322-6841 THIS IS TO CERTIFY that the numbered policies identified by the attached Certificates of Insurance have been issued by the below stated company in conformance with the limits and requirements as set forth in the General Conditions and Supplementary Conditions. The insurance company hereby•waives its rights of subrogation against the additional insured. TB Landmark Construction, Inc. Named Insured Federal Insurance Co. Insurance Company 200 .Hall ' s Mill Road, Whitehouse Station, NJ 08889 Address City State Zip By Signs e • •u •-. Re resentative Mary H. Bu Printed or Typed Name of Authorized Representative (Attach Acknowledgment) (Make additional copies of this form if more than one insurance company provides contract required insurance). Sanford Reclaimed Water Interconnect With Volusia Co. INSURANCE CERTIFICATION 00620-1 ORIGINAL SECTION 00410 BID SUBMITTAL FORM PER ADDENDUM NO. 1 PART 1 GENERAL 1.01 Description The following Bid, for the Sanford Reclaimed Water Interconnect With Volusia Co. (IFB 13/14- a is hereby made to City of Sanford, hereafter called the Owner. This Bid is submitted by(1) T B Landmark Construction, Inc. 11220 New Berlin Road Jacksonville, FL 32226 tthigpen(atblandmark.com 904-751-1016 (1)Name,address,e-mail address,and telephone number of Bidder 1.02 The Undersigned: A. Acknowledges receipt of: 1. Project Manual and Drawings identified within the Project Manual. 2. Addenda: Number 1 Dated 12/30/13 Number Dated Number Dated Number Dated Number Dated B. Has examined the site and all Bidding Documents and understands that in submitting his Bid, he waives all right to plead any misunderstanding regarding the same. C. Agrees: 1. To hold this Bid open for 90 calendar days after the bid opening date. 2. To accept the provisions of the Instructions to Bidders regarding disposition of Bid Security. 3. To enter into and execute a contract with the Owner, if awarded on the basis of this Bid, and to furnish a Performance Bond and a Labor and Material Payment Bond in accordance with the Instructions to Bidders. 4. To accomplish the work in accordance with the Contract Documents. Sanford Reclaimed Water Interconnect With Volusia Co. BID FORM NAME OF BIDDER: T B Landmark Construction. Inc. Rev. Bid Submittal Form Per Add.No. 1 12/30/13 00410-1 5. To begin work not later than 10 days after the issuance of a Notice to Proceed, unless otherwise provided, and substantially complete the work within 120 calendar days of the date of the Notice to Proceed. 6. To accept the provisions of the Agreement as to liquidated damages in the event of failure to complete the work on time. 1.03 Bid Schedule The Bidder hereby agrees to perform all work as required by the Contract Documents for the following Unit Prices. All work required to be performed by the Contract Documents is to be included within the following Pay Items, inclusive of furnishing all manpower, equipment, materials and performance of all operations relative to construction of the project. Work for which there is not a Pay Item will be considered incidental to the Contract and no additional compensation will be allowed. (This area left blank intentionally) Sanford Reclaimed Water Interconnect With Volusia Co. BID FORM NAME OF BIDDER:T B T.andmark Constnictinn,Jnc. Rev. Bid Submittal Form Per Add. No. 1 12/30/13 00410-2 O O O O o w 0 g 0 - �. � 0 o 0 o M . V. o p � � _ o a �� g0 '.� 0(fiCV a b'w .)- � 1 W O `e . 'o 0 0�a d .3 ° M o o a �v • O a °. • ` ' nm F" won� s�' — Ys 3 M, �Q M >- p � m 0) o ti Z c- '- X- X- co .- N U) 1- X- X- i- — I- U) N N OD O Q N U) Z a 13 Q y 0 Cl) U) V) co co LL U) U) Z LL u_ u_ U) co Cl) U) U) < W W uc >- > LL J J •• J J _J J I— J J J J J J J J W LLJ UJ LU cn cn O D M To p O o N E Tr U >,it c6 c ' 0 as c = O a) t a`) = a Z d as co E a) of U- `' — a) " v ca 2 c U U �o ` c a) m m 0-m c o a) w as >, a) N Q r a co _.., Y 0 .0 N Q N •( J y--• j •� o O U) W a) a c0 ' a) -c o c O N >., a) i a) °- o as N CU v) U� Y a 7 7 c tl) •U a a) > V c a) o ( •C CD _.� U U Ui CU o c c U C V �� U c m c U 13 to > R a. C n n `) c W c>o a) � Q c m .X .c a) > O O - a) a, U > m dw ca m � o u) c > > 6- i a) U p o 4-0 as U o a) ca � � N o � � a) cct ca — 'E m a) c 3 a) — . c W aa) _ Q � � N > ) 73 :n - U � a 0 U Y ccct Z a) a to o Q c) aci a) o `m o g a) 0 0 2 2 .� . c 0 c ai via •- c n) a) .) �0 3 wP� 0 c ca) � � 13 -o � � •� ca ND � aoio > -t 0EIJ „sQ >, > aaa)) �H Q. 0 c 2 c O o o p m TD) a) W N vi o '_ > °- c W Z 3 't 't > (,) U) R m c u = c rn rn " fr x c 0) t, � U 13 .,-(0 >, a o a) cdZ a) a) a � � w U N N c O a) .c c u) W > c a ctU) 2 > c 5 is U p U) c O u_ L c c) - d E ._> 3 > 3 a) Y E a) c m m U c aci a)) p v w n) a) W o m o - a) a) 00 o v a) 'x a) m c m = .0 03 a) C CO.5 0 0 O o- m a) CO 0 2 2 a W U) U U LL. cV NDW Z > a) ZmO JCQ E > N cV Q UOm x0 L. w E W O 0 ,- cV CO - U) c0 N- CO 0) O 1— N cc6 Q F Z ' N CO U) co N- co 0 ,- ,- ,- ,- r- (NJ N N V) Z D Uo 0 'Ci c?- q a s• rn. .5 o • o r0 � a} s cc,o m�,M ''e „;"*(fi5-40 ,5' Nzp w 0 QQ U °. o o a ° p �V1 n iNi CI r ~ m Z M ' N N M CO M CO �Y CO Z D a d a rn 4 Qi E I-- co VJ W W ` Z (n J J J co n Nt. is P O r E i a 0 a3 c0 7 0 m a d C p CO W m f6 N (U d re n. - I m I CO O O V O U iii a) .r LL N a) , N U < a) �C LL 6 (a t6 �^ viYO' c m ° c a) >, (C O c ai J '� ca D CO U -,--. Y m6 co U Z .c o > E 1,-, N t6 m y a.N .� O i N co 'p § O co c- c' ccou) V Ed 1-..)L.) - o a) co .0 (i) E % E to' c� w 7 X 'X ■ 3 7 m c cf C O 'O O W W E c U E = > 'a "C U .Q Q O w a„ co co co d 5 d C cd Z O co a) a) c c 6 N a O EQ - . • • 0 >>a/ a) •� �W 0- aS as as w w ai ,1 m o d U U > > > > > Z Z -a c W p 0 0 0 0 0 - - a) — 0 C W a) E E E E E ... Y o= Q 0 0 a) a) a) v) O Q co m ° 0wwww � E (n (n m a' u. J '0 0 H � � w 0 co - LL) () c- co 6) co N 0 t03 Q I— Z N N N N N N N c'') c') M I— U) Z 1.04 Miscellaneous Requirements and Affirmations A. Proposals (Bids) must be on the Bid Form. B. I have attached the following required fully executed forms to this Bid: 1. Bid Security complying with the requirements of the Bidding Documents. 2. Trench Safety Statement- Section 00430 3. Non Collusion Affidavit- Section 00432 4. Conflict of Interest Affidavit- Section 00434 5. Florida Statutes on Public Entity Crimes Affidavit- Section 00436 6. Compliance With the Public Records Law Affidavit-Section 00438 1.05 RESPECTFULLY SUBMITTED, signed and sealed this 13 day of January , 2014 T B Landmark Construction, Inc. Contra tor' ` 1/13/14 By Signature) Date Martin Adams, Manager Printed Name and Title 11220 New Berlin Road Business Address Jacksonville FL 32226 (CORPORATE SEAL) City State Zip Code 904-751-1016 904-751-4125 Telephone No. Facsimile No. tthiguen(a)tblandmark.com E-Mail Address ATTEST. / 1/13/14 By ignature) Date Robin R. Thigpen, Secretary Printed Name and Title END OF SECTION Sanford Reclaimed Water Interconnect With Volusia Co. BID FORM NAME OF BIDDER: T B Landmark Construction, Inc. Rev.Bid Submittal Form Per Add.No. 1 12/30/13 00410-5 SECTION 00420 BID BOND FORM KNOW ALL MEN BY THESE PRESENT, that we, the undersigned, (1) T B Landmark Construction, Inc. , as Principal, and (2) Travelers Casualty and Surety Company of America , as Surety, are hereby and firmly bound unto (3) City of Sanford , as Owner, in the penal sum of(4) Five Percent of Amount Bid Dollars ($ 5% ) for the payment of which, well and truly to be made, we hereby jointly and severally bind ourselves, our heirs, executors, administrators, successors, and assigns. The condition of the above obligation is such that whereas the Principal has submitted to (3) City of Sanford a certain Bid for(5) Sanford Reclaimed Water Interconnect with Volusia Co. , attached hereto and hereby made a part hereof. 1) Bidder 2) Surety 3) Owner 4) Amount of Bond as Required in the Instructions to Bidders 5) Name of Project as Shown in Invitation for Bids NOW, THEREFORE, A. If said Bidder shall be in rejected, or in the alternate, B. If said Bid shall be accepted and the Principal shall execute and deliver the Agreement (properly completed in accordance with the Bidding Documents), and shall furnish a bond for his faithful performance of said contract, and for the payment of all persons performing labor or furnishing materials in connection therewith, and shall in all other respects perform the agreement created by the acceptance of said Bid, then this obligation shall be void, otherwise the same shall remain in force and effect; it being expressly understood and agreed that the liability of the Surety for any and all claims hereunder shall, in no event, exceed the penal amount of this obligation as herein stated. The Surety, for value received, hereby stipulates and agrees that the obligations of said Surety and its bond shall be in no way impaired or affected by any extension of the time within which the Owner may accept such Bid; and said Surety does hereby give waive notice of any such extension. Sanford Reclaimed Water Interconnect With Volusia Co. BID BOND FORM 00420-1 IN WITNESS WHEREOF, the Principal and the Surety have hereunto set their hands and seals, and such of them as are corporations have caused their corporate seals to be hereto affixed and these presents to be signed by their proper officers. Signed and sealed this 14th day of January , 2014 T B Landmark Construction, Inc. ATTEST: Principal iO ,i By (Principa office' By (Signature of Officer) • a..% I o r 0 Martin Adams. Manager Typed Name and Titl= Typed Name and Title 11220 New Berlin Road (CORPORATE SEAL) Address Jacksonville, FL 32226 City, State, Zip Travelers Casualty and Surety Company of America ( Sure al It I By: By Attorney-in-Fact Tina Montanez,Witness Robert T.Theus,Attorney-In-Fact Typed Name and Title Typed Name and Title 219 N.Newnan Street (SEAL) Address Jacksonville,FL 32202 City, State, Zip (904)353-3181 (904)353-5722 Telephone No. Facsimile No. END OF SECTION Sanford Reclaimed Water Interconnect With Volusia Co. BID BOND FORM 00420-2 WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER AA. POWER OF ATTORNEY TRAVELERSJ Farmington Casualty Company St.Paul Mercury Insurance Company Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company Fidelity and Guaranty Insurance Underwriters,Inc. Travelers Casualty and Surety Company of America St.Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company St.Paul Guardian Insurance Company Attorney-In Fact No. 224800 Certificate No. 005621521 KNOW ALL MEN BY THESE PRESENTS: That Farmington Casualty Company,St. Paul Fire and Marine Insurance Company,St. Paul Guardian Insurance Company,St.Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers Casualty and Surety Company of America,and United States Fidelity and Guaranty Company are corporations duly organized under the laws of the State of Connecticut,that Fidelity and Guaranty Insurance Company is a corporation duly organized under the laws of the State of Iowa,and that Fidelity and Guaranty Insurance Underwriters,Inc.,is a corporation duly organized under the laws of the State of Wisconsin(herein collectively called the"Companies"),and that the Companies do hereby make,constitute and appoint Fitzhugh K.Powell Jr.,Robert T.Theus,Roger R.Hurst,Susan W.Jordan,Walter N.Myers,and Benjamin Powell of the City of Jacksonville ,State of Florida ,their true and lawful Attorney(s)-in-Fact, each in their separate capacity if more than one is named above,to sign,execute,seal and acknowledge any and all bonds,recognizances,conditional undertakings and other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons,guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. IN WITNESS WHEREOF,the Companies have caused this instrument to be signed and their corporate seals to be hereto affixed,this 30th day of August 2013 Farmington Casualty Company St.Paul Mercury Insurance Company Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company Fidelity and Guaranty Insurance Underwriters,Inc. Travelers Casualty and Surety Company of America St.Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company St.Paul Guardian Insurance Company U AS4 a1 1`� .��. 1'l l• ��• "ova 6 4to y e�0:T•P.O XA .9s �lJ�,r.�.•...-.0.',.}qp, p d r P IY p a 9co itaiN a. 0 Y l y 197 1951 AL 1:SELLD „NCE` S `tt a f ot• .14n Atti c v State of Connecticut By: City of Hartford ss. Robert L.Raney, enior Vice President On this the 30th day of August 2013 before me personally appeared Robert L.Raney,who acknowledged himself to be the Senior Vice President of Farmington Casualty Company, Fidelity and Guaranty Insurance Company,Fidelity and Guaranty Insurance Underwriters,Inc.,St.Paul Fire and Marine Insurance Company,St.Paul Guardian Insurance Company,St.Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers Casualty and Surety Company of America,and United States Fidelity and Guaranty Company,and that he,as such,being authorized so to do,executed the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. to.lerN In Witness Whereof,I hereunto set my hand and official seal. MR Q4Jl' C My Commission expires the 30th day of June,2016. � 441.0 * `�1Marie C.Tetreault,Notary Public + CCU$ 58440-8-12 Printed in U.S.A. WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER SECTION 00430 TRENCH SAFETY STATEMENT FORM Bidder acknowledges that included in the various items of the proposal contained on the Bid Form are costs for complying with the Florida Trench Safety Act (FS 553.60-553.64). The Bidder further identifies the cost of compliance with the applicable trench safety standards for the project as follows (Bidder to attach additional sheets as necessary to identify all costs): Trench Safety Measure Units of Measure Unit Unit Cost Extended (Description) (LF, SF, SY) Quantity Cost A Trench Box LF 1550 5.00 7,750.00 B C D E F TOTAL $ 7,750.00 The total cost shown herein is already included in the various items on the Bid Form and is not additional to the pricing shown on the Bid Form. Bidder, by signature below, assures that the contractor performing trench excavating will comply with the applicable Trench Safety Standards. Submitted, signed and sealed this 13 day of January , 2014 T B Landmark Construction Inc. Bidder pE--j6L____ Si ature Martin Adams, Manager Printed Name and Title ATTES • 1/13/14 Signature Date (SEAL) END OF SECTION Sanford Reclaimed Water Interconnect With Volusia Co. TRENCH SAFETY STATEMENT FORM 00430-1 SECTION 00432 NON COLLUSION AFFIDAVIT The undersigned, by signing this document hereby certifies that the company named below hereby is or does: 1. States that the entity named below and the individual signing this document has submitted the attached bid or proposal: 2. He is fully informed respecting the preparation and contents of the attached proposal and of all pertinent circumstances respecting such proposal; 3. Said bid or proposal is genuine and is not a collusive or sham bid or proposal; 4. Neither the said bidder or proposer nor any of its officers, partners, owners, agents, representatives, employees or parties in interest, including this affiant, has in any way colluded, conspired, connived or agreed, directly or indirectly with any other bidder, proposer, firm or person to submit a collusive or sham bid or proposal in connection with the Contract for which the attached bid or proposal has been submitted or to refrain from bidding or proposing in connection with such Contract, or has in any manner, directly or indirectly, sought by agreement or collusion or communications or conference with any other bidder, proposer, firm or person to fix the price or prices in the attached bid or proposal or of any other bidder of proposer, or to fix any overhead, profit or cost element of the bid or proposal price or the bid or proposal price of any other bidder or proposer, or to secure through any collusion, conspiracy, connivance or unlawful agreement any advantage against the City of Sanford or any person interested in the proposed Contract. 5. The price or prices quoted in the attached bid or proposal are fair and proper and are not tainted by any collusion, conspiracy, connivance or unlawful agreement on the part of the bidder or proposer or any of its agents, representatives, owners, employees, or parties in interest, including the individual signing this document. T B Landmark Construction Inc. Bidder 1/13/14 Sign ture of Authorized Representative (Affiant) Date Martin Adams,Manager Printed or Typed Name and Title of Authorized Representative (Affiant) COUNTY OF Duval STATE OF FLORIDA Sanford Reclaimed Water Interconnect With Volusia Co. NON COLLUSION AFFIDAVIT 00432-1 On this 13 day of January , 20 14 , before me, the undersigned Notary Public of the State of Florida, personally appeared Martin Adams whose name(s) is/are subscribed to the within instrument, and he/she/they acknowledge that he/she/they executed it. WITNESS my hand and official seal. He/She is personally known to me or has produced , as if;:..,,:*`^ VICTORIA AMRHEIN ii + MY COMMISSION N EE852030 ' . EXPIRES November 15,2016 (Notary Pu lic in and for the County and State Aforementioned) 1407);96-0153 FbneallotaryService corn SEAL My commission expires: 11/15/16 END OF SECTION Sanford Reclaimed Water Interconnect With Volusia Co. NON COLLUSION AFFIDAVIT 00432-2 SECTION 00434 CONFLICT OF INTEREST AFFIDAVIT Project Name: Sanford Reclaimed Water Interconnect With Volusia Co. Bid No.: IFB 13/14-2 The Affiant identified below deposes and states that: 1. The below named Bidder is submitting an Expression of Interest for the City of Sanford project named above. 2. The Affiant has made diligent inquiry and provides the information contained in this Affidavit based upon his own knowledge. 3. The Affiant states that only one submittal for the above project is being submitted and that the below named Bidder has no financial interest in other entities submitting proposals for the same project. 4. Neither the Affiant nor the below named Bidder has directly or indirectly entered into any agreement, participated in any collusion, or otherwise taken any action in restraint of free competitive pricing in connection with the Bidder's submittal for the above project. This statement restricts the discussion of pricing data until the completion of negotiations and execution of the Agreement for this project 5. Neither the Bidder nor its affiliates, nor any one associated with them, is presently suspended or otherwise ineligible from participating in contract lettings by any local, state, or federal agency. 6. Neither the Bidder, nor its affiliates, nor any one associated with them have any potential conflict of interest due to any other clients, contracts, or property interests for this project. 7. I certify that no member of the Bidder's ownership, management, or staff has a vested interest in any aspect of or Department of the City of Sanford. 8. I certify that no member of the Bidder's ownership or management is presently applying for an employee position or actively seeking an elected position with City of Sanford. 9. In the event that a conflict of interest is identified in the provision of services, I, on behalf of the below named Bidder, will immediately notify the City of Sanford in writing. Sanford Reclaimed Water Interconnect With Volusia Co. CONFLICT OF INTEREST AFFIDAVIT 00434-1 T B Landmark Construction, Inc. Bidder 1/13/14 Signature of Authorized Representative (Affiant) Date Martin Adams, Manager Printed or Typed Name and Title of Authorized Representative (Affiant) COUNTY OF Duval STATE OF FLORIDA On this 13 day of January , 20 14 , before me, the undersigned Notary Public of the State of Florida, personally appeared Martin Adams whose name(s) is/are subscribed to the within instrument, and he/she/they acknowledge that he/she/they executed it. WITNESS my hand and official seal. He/She is personally known to me o has produced as identification. oiikhk VICTORIA AMRHEIN MY COMMISSION#EE852030 fik t, EXPIRES November 15,2018 (Notary PR is in and for the County and State Aforementioned) 1_407_)_A-0153 Fb dallota ServIce cam � SEAL My commission expires: 11/15/16 END OF SECTION Sanford Reclaimed Water Interconnect With Volusia Co. CONFLICT OF INTEREST AFFIDAVIT 00434-2 SECTION 00436 FLORIDA STATUTES ON PUBLIC ENTITY CRIMES AFFIDAVIT Project Name: Sanford Reclaimed Water Interconnect With Volusia Co. Bid No.: IFB 13/14-2 The Affiant identified below attests to the following: 1. I understand that a "public entity crime" as defined in Section 287.133(1)(g), Florida Statutes, means a violation of any State or Federal law by a person with respect to and directly related to the transaction of business with any public entity or with an agency or political subdivision of any other state or with the United States, including, but not limited to, any bid or contract for goods or services to be provided to any public entity or an agency or political subdivision of any other state or of the United States and involving antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy, or material misrepresentation. 2. I understand that "convicted" or "conviction" as defined in Paragraph 287.133(1)(b), Florida Statutes, means a finding of guilt or a conviction of a public entity crimes, with or without an adjudication of guilt, in any Federal or state trial court of record relating to charges brought by indictment or information after July 1, 1989, as a result of a jury verdict, non-jury trial, or entry of a plea of guilty or nolo contendere. 3. I understand that an "affiliate" as defined in Section 287.133(1)(a), Florida Statutes, means: A predecessor or successor of a person convicted of a public entity crime: or an entity under the control of any natural person who is active in the management of the entity and how has been convicted of a public entity crime. The term "affiliate" includes those officers, directors, executives, partners, shareholders, employees, members, and agents who are active in the management of an affiliate. The ownership by one (1) person of shares constituting a controlling interest in another person, or a pooling of equipment or income among persons when not for fair market value under an arm's length agreement, shall be a prima facie case that one person controls another person. A person who knowingly enters into a joint venture with a person who has been convicted of a public entity crime in Florida during the preceding thirty-six (36) months shall be considered an affiliate. 4. I understand that a "person" as defined in Section 287.133(1)(e), Florida Statutes, means any natural person or entity organized under the laws of any state or of the United States with the legal power to enter into a binding contract and which bids or applies to bid on contracts for the provision of goods or services let by a public entity, or which otherwise transacts or applies to transact business with a public entity. The term "person" includes those officers, directors, executives, partners, shareholders, employees, members, and agents who are active in management of an entity. Sanford Reclaimed Water Interconnect With Volusia Co. FLORIDA STATUTES ON PUBLIC ENTITY CRIMES AFFIDAVIT 00436-1 5. Based on information and belief, the statement which I have marked below is true in relation to the entity submitting this sworn statement. (Note: indicate which of the below statements apply) XXX Neither the entity submitting this sworn statement, nor any officers, directors, executives, partners, shareholders, employees, members, or agents who are active in management of the entity, nor the affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. The entity submitting this sworn statement, or one or more of the officers, directors, executives, partners, shareholders, employees, members or agent who are active in management of the entity, or an affiliate of the entity, has been charged with and convicted of a public entity crime subsequent to July 1, 1989. The entity submitting this sworn statement, or one or more of the officers, directors, executives, partners, shareholders, employees, members or agents who are active in management of the entity, or an affiliate of the entity, has been charged with and convicted of a public entity crime subsequent to July 1, 1989. However, there has been a subsequent proceeding before an Administrative Law Jury of the State of Florida, Division of Administrative Hearings and the Final Order entered by the Administrative Law Jury determined that it was not in the public interest to place the entity submitting this sworn statement on the convicted vendor list. (You must attach a copy of the final order.) I understand that the submission of this form to the City of Sanford is for the City only and, that this form is valid through December 31, of the calendar year in which it is filed. I also understand that i am required to inform the City prior to entering in to a contract in excess of the threshold amount provided in section 287.017, Florida Statues, for category two of any change in the information contained in this form. T B Landmark Construction, Inc. 59-3607816 Bidder FEIN No. 1/13/14 Signature of Authorized Representative (Affiant) Date Martin Adams,Manager Printed or Typed Name and Title of Authorized Representative (Affiant) COUNTY OF Duval STATE OF FLORIDA On this 13 day of January , 2014 , before me, the undersigned Notary Public of the State of Florida, personally appeared Martin Adams whose name(s) is/are subscribed to the within instrument, and he/she/they acknowledge that he/she/they executed it. WITNESS my hand and official seal. He/She is Sanford Reclaimed Water Interconnect With Volusia Co. FLORIDA STATUTES ON PUBLIC ENTITY CRIMES AFFIDAVIT 00436-2 personally known to me or has produced , as identification. ;;:44• VICTORIA AMRHEIN MY COMMISSION$EE252030 (No ry Publ c In and for the County and State Aforementioned) r. '•., EXPIRES November 15,2016 �4U7)l9b-0153 f{y, trLoir ric°co. My commission expires: 11/15/16 END OF SECTION Sanford Reclaimed Water Interconnect With Volusia Co. FLORIDA STATUTES ON PUBLIC ENTITY CRIMES AFFIDAVIT 00436-3 SECTION 00438 COMPLIANCE WITH THE PUBLIC RECORDS LAW AFFIDAVIT Upon award recommendation or ten (10) days after opening, submittals become "public records" and shall be subject to public disclosure consistent with Chapter 119, Florida Statutes. Proposers/Bidders must invoke the exemptions to disclosure provided by law as applicable to the response to the solicitation, must identify the data or other materials to be protected, and must state the reasons why such exclusion from public disclosure is necessary. The submission of a proposal authorizes release of your firm's credit data to the City of Sanford. If the Bidder submits information exempt from public disclosure, the Bidder must identify with specificity which pages/paragraphs of their bid/proposal package are exempt from the Public Records Act, identifying the specific exemption section that applies to each. The protected information must be submitted to the City in a separate envelope marked accordingly. By submitting a response to this solicitation, the Bidder agrees to defend, indemnify and hold the City harmless in the event we are forced to litigate the public records status of the Bidders documents. T B Landmark Constructio , Inc. Bidder 1/13/14 Signature of Authorized Representative (Affiant) Date Martin Adams, Manager Printed or Typed Name and Title of Authorized Representative (Affiant) COUNTY OF Duval STATE OF FLORIDA On this 13 day of January , 20 14 , before me, the undersigned Notary Public of the State of Florida, personally appeared Martin Adams whose name(s) is/are subscribed to the within instrument, and he/she/they acknowledge that he/she/thy executed it. WITNESS my hand and official seal. He/She is personally known to me or as produced , as ic1 11f dliur Y VICTORIA MARHEIN MY COMMISSION#EE852030 EXPIRES November 15,2016 (N tary Public in and for the County and State Aforementioned) `i4O1 198-0153 FbrWaNOtaryServke own SEAL My commission expires: 11/15/16 END OF SECTION Sanford Reclaimed Water Interconnect With Volusia Co. COMPLIANCE WITH THE PUBLIC RECORDS LAW AFFIDAVIT 00438-1 SECTION 00440 BIDDER QUALIFICATION AFFIDAVIT State the true, exact, correct and complete name of the company, partnership, corporation, trade or fictitious name under which the Bidder does business and the address of the place of business. T B Landmark Construction, Inc. Name of Bidder 11220 New Berlin Rd. Jacksonville, FL 32226; 904-751-1016; vthigpen@tblandmark.com Address of Bidder - it Phone No. of Bidder Bidder E-Mail Address Bidder's Contractor's License No(s). CGC060694, CUC057226 (As issued by the Florida Dept. Of Business and Professional Regulation Construction Industry Licensing Board) The Bidder is (check one of the following): ( )An Individual ( )A Partnership (x)A Corporation Principal Office Address: 11220 New Berlin Road Jacksonville, FL 32226 1. If Bidder is a corporation, answer the following: Date of Incorporation: 11/10/99 State of Incorporation: Florida President's Name: Robin R. Thigpen Vice President's Name: Timothy C. Beasley 2. If Bidder is an individual or a partnership, answer the following: Date of Organization: Name, Address and Ownership Units of all Partners: State whether general or limited partnership: Sanford Reclaimed Water Interconnect With Volusia Co. BIDDER QUALIFICATION AFFIDAVIT 00440-1 3. If Bidder is other than an individual, corporation or partnership, describe the organization and give the name and address of principals: N/A 4. If Bidder is operation under a fictitious name, submit evidence of compliance with the Florida Fictitious Name Statute. Information attached: Yes N/A N/A 5. How many years has the Bidder been in business as a Contractor under its present name? 14 years 6. Under what other former names has the Bidder operated? N/A 7. How many years experience in construction work has the Bidder had as a Prime Contractor? 14 years 8. List below information concerning projects the Bidder has completed in the last five (5) years as a Prime Contractor for the type of work required for this project (attach additional sheets as necessary). It is noted that the experience claimed here must be associated with the Bidder named above. The City of Sanford reserves the right to require additional information and to conduct any investigation deemed necessary to evaluate the Bidder. Name of Project Name of Owner Owner Contact Construction Major Construction Name and Contract Items Phone No. Amount Please see attached project history. Sanford Reclaimed Water Interconnect With Volusia Co. BIDDER QUALIFICATION AFFIDAVIT 00440-2 Name of Project Name of Owner Owner Contact Construction Major Construction Name and Contract Items Phone No. Amount Sanford Reclaimed Water Interconnect With Volusia Co. BIDDER QUALIFICATION AFFIDAVIT 00440-3 T B Landmark Construction, Inc. Scope of Work Completed Projects & References 1. Utility Main Ext from Ridaught to Mid Clay,Clay County Utility Authority TB Landmark installed 577 linear feet of 2" PVC water main, 143 linear feet of 16" PVC force main, 10,314 linear feet of 18" PVC reclaimed water main, 10,900 linear feet of 18"PVC force main,6,360 linear feet of 24" PVC reclaimed water main, 107 linear feet of 30" Steel Casing and 193 linear feet of 36" Steel Casing.All were installed via open cut method. Contract Amoun Location Job Start/End Owner Contact $ 2,369,000.00 Clay County, FL July 2012 Clay County Utility Authority January 2013 3176 Old Jennings Road Middleburg, FL 32068 Jeremy Johnston(904)213-2477 jjohnston@ccua.org 2. San Jose WWTP Phase Out,Jacksonville Electric Authority TB Landmark installed 2,000 LF of 16 Inch DR 25 PVC sewer force main and all appurtenances from the existing Lavista Pump Station to the existing San Clerc Pump station on Sanchez Road. All installed by open cut. Contract Amoun Location Job Start/End Owner Contact $ 362,876.85 Jacksonville, FL May 2012 Jacksonville Electric Authority December 2012 21 West Church Street Jacksonville, FL 32202 Beth DiMeo(904) 665-8139 dimeea @jea.com 3. University Blvd WM Replacement,Jacksonville Electric Authority TB Landmark installed a water main replacement consisting of a new 6-inch and 8-inch diameter water main from Stetson Rd to St. Augustine Rd. along University Blvd. The route was entirely in the FDOT Right -of-way and it consisting of 2,000 LF of 6-inch DR18 Fusible PVC (FPVC) via Horizontal Directional Drill (HDD), 740 LF of 8-inch of DR18 FPVC via HDD, 145 LF of 8-inch DR18 PVC and 90 LF of 8-inch Ductile Iron Pipe (DIP) via the open cut method. The purpose was to replace the aging and undersized existing 4-inch AC water main. The new water main was connected to an existing 6-inch line at Stetson Rd and to an existing 8-inch line at St Augustine Road. Tied-in to the existing distribution mains on Colgate Rd,Temple Rd, Suwannee Rd and Graywood Rd. Contract Amoun Location Job Start/End Owner Contact $ 457,975.98 Jacksonville,FL June 2012 Jacksonville Electric Authority December 2012 21 West Church Street Jacksonville, FL 32202 Carlos Marina(904) 665-4498 maricj @jea.com T B Landmark Construction, Inc. Scope of Work Completed Projects & References 4. SW 35th Terrace Pump Station, City of Gainesville,FL T B Landmark is responsible for the construction of a pumping system necessary to lower the water level in an existing storm water retention basin in the SW Industrial Park prior to major storms to help reduce the likelihood of the basin overtopping and flooding the nearby properties. The work generally consists of providing a pumping platform, submersible pump with a mobile power unit, and the directional drilling of a 6"HDPE discharge pipe 2,090 LF in length. Contract Amoun Location Job Start/End Owner Contact $ 180,749.00 City of Gainesville, FL November 2011 City of Gainesville April 2012 PO Box 490 Station 58 Gainesville,FL 32602 John Veilleux(352)393-8418 veilleuxj@cityofgainesville.org 5. City of Jasper CDBG Gas Main Extension,Jasper, FL T B Landmark is responsible for the construction of approximately 5 miles of 6" HDPE gas pipe via open lay and directional drilling methods. This project also includes the construction of a natural gas odorization system and a regulator station. Contract Amoun Location Job Start/End Owner Contact $ 513,425.53 City of Jasper November 2011 City of Jasper April 2012 208 Hatley Road Jasper, FL 32052 Greg Bailey(386) 752-4675 6. Royal Lakes Booster Pump Station,Jacksonville,FL T B Landmark is responsible for providing all labor and materials to construct a wastewater booster pump station at the Royal Lakes WWTP and install the approximately 1,200LF 24" PVC influent and effluent force mains within the Royal Lakes WWTF site boundary. Contract Amoun Location Job Start/End Owner Contact $ 1,045,705.5( Jacksonville,FL January 2012 Jacksonville Electric Authority May 2012 21 West Church Street Jacksonville,FL 32202 Carlos Marina(904) 665-4498 maricj @jea.com T B Landmark Construction, Inc. Scope of Work Completed Projects & References 7. Town of Callahan,FL T B Landmark furnished all labor, materials and equipment for the replacement of two existing lift stations and the construction of a new lift station. A 16" steel casing jack and bore was performed under a CSX railroad with 8" DIP gravity sewer carrier pipe running through. This job included a directional drill of approximately 525 LF of 8" HDPE force main and open lay of 460LF of 8" and 6" PVC gravity sewer with 4 manholes. There was 2,212 LF of 8" VCP gravity sewer that was replaced by pipe bursting with 10" HDPE. 130 LF of existing 8" CIP gravity sewer was replaced with 8" DIP inside an existing 18" steel casing under US Hwy 1. T B Landmark made all connections to existing pipes and manholes, installed the valves and fittings, completed the restoration and completed the lift stations to full and working order. Contract Amoun Location Job Start/End Owner Contact $ 822,435.00 Town of Callahan, FL April 2011 Town of Callahan, FL November 2011 PO Box 5016 Callahan,FL 32234 Micheal Williams(904)879-3801 pwd@townofcallahan-fl.gov 8. Bal Harbour Village, FL T B Landmark provided all labor, materials and equipment necessary for constructing a new sanitary sewer forcemain for Bal Harbour Village. This job included extensive MOT and dewatering throughout the job which stretched over three municipalities, Bal Harbour, Surfside and Miami Beach. 11,000 LF of 16" HDPE and 450 LF of 12" HDPE sanitary forcemain were installed via directional drill. 750 LF of 16" DIP sanitary forcemain was installed by open lay methods. The new sanitary forcemain was connected to an existing lift station and to an existing 36" CIP forcemain. Most of this job was installed down the middle of Collins Avenue in a high traffic area. T B Landmark completed all restoration to return the area to original or better condition. Contract Amoun Location Job Start/End Owner Contact $ 2,692,000.00 Bal Harbour Village, FL August 2011 Bal Harbour Village October 2011 655 96th Street Bal Harbour, FL 33154 Peter Kunen(954) 815-9038 plcunen@craigasmith.com 9. St.John's County, FL T B Landmark provided all labor, materials and equipment necessary for constructing approximately 2,400 LF of 6" PVC water main. There was 170 LF of 6" PVC installed by directional drilling methods and 507 LF of 4" PVC water main installed by open cut. This job included ninety-eight 1" PVC services in the right of way of the streets within the Maderia Heights Subdivision in St. John's County. The work also included clearing, dewatering, trenching,backfilling, grading, sodding, erosion control measures and all other incidental work to complete a potable water system. All work was performed in accordance with the St. John's County Utility Department Standards. T B Landmark Construction, Inc. Scope of Work Completed Projects & References Contract Amoun Location Job Start/End Owner Contact $ 176,000.00 St. Johns County, FL June 2011 St. John's County October 2011 1205 SR 16 St. Augustine, FL 32084 Rob Zammataro (904)209-2604 rammataro@sjcfl.us 10. City of Atlantic Beach, FL The work performed was the construction of a new raw wastewater force main that will be used to transfer wastewater from the Buccaneer WWTP to the Main WWTP. The total length of the force main is approximately 12,380 if of 12" and 18" pipelines of various materials. Approximately 5,500 if pP Y p p of 18" was installed via open cut and 930 if installed via HDD. Approximate 650 if of 12" was installed via open cut and 5,300 if installed via HDD. The new force main was connected to existing system as well as a 120 if jack/bore crossing of Mayport Rd(SR-AlA). Contract Amoun Location Job Start/End Owner Contact $ 1,509,000.00 City of Atlantic Beach, Fl January 2011 City of Atlantic Beach, FL July 2011 800 Seminole Rd. Atlantic Beach, FL 32233 Donna Kaluzniak(904)270-2535 dkaluzniak@coab.us 11. City of Port Wentworth, GA T B Landmark installed 1,080 LF of 16" FPVC Casing under I-95 at SR-24 via HDD and pulled 1,120 LF of 12" FPVC inside the casing with casing spacers. We installed 120 LF of 12" FPVC under business entrance via HDD to keep the disturbance to the area minimal. This job required a tie in to 2 existing lift stations by open laying 440 LF PVC. TB Landmark was responsible for furnishing and installing all material,pressure testing and finalizing the line by tie-ins. Contract Amoun Location Job Start/End Owner Contact $ 228,278.00 Port Wentworth, GA April 2011 City of Port Wentworth June 2011 305 S. Coastal Hwy Port Wentworth. GA 31407 Pat Burke (912) 927-1484 pburk@pcdg-savannah.com T B Landmark Construction, Inc. Scope of Work Completed Projects & References 12. City of Daytona Beach,FL T B Landmark furnished all necessary labor, materials, equipment and expertise to complete the work in the contract for installation of approximately 1,320 linear feet of 20" sanitary force main system and 1, 950 linear feet of 4" Schedule 80 PVC conduit by subaqueous horizontal directional drill and open trench excavation. The work included all pipe, fittings, valves, pull boxes connections to the existing sanitary force main system and empty PVC conduit systems, site work, final dressing, pavement restoration,traffic signal system restoration and maintenance of traffic. Contract Amoun Location Job Start/End Owner Contact $ 356,000.00 Daytona Beach,FL December 2010 City of Daytona Beach, FL May 2011 125 Basin Street, Ste. 130 Daytona Beach, FL 32114 Frank Van Pelt(386) 671-8813 VanPeltF @codb.us 13. Orange County Utilities This project consisted of the construction of approximately one thousand one hundred fifty (1,150) linear feet of twelve inch (12") PVC force main and approximately two hundred seventy five (275) linear feet of eight inch (8") PVC force main along Ranchero Street from Redditt Road to Dalton Avenue; construction of approximately four hundred sixty (460) linear feet of eight inch (8") PVC force main along the east right of way of Dalton A venue from Ranchero Street to Charlin Parkway; and the construction of approximately one thousand one hundred sixty five (1,165) linear feet of eight inch (8") PVC force main along the south right of way of Chari in Parkway from Dalton A venue to Goldenrod Road all by open cut method of construction. Along the west right of way of Goldenrod Road, construction consisted of approximately one thousand two hundred (1,200) linear feet of eight inch (8") HDPE (DR 17) force main by directional drill construction method and connection to an existing eight inch (8") force main. Construction of the force mains included associated fittings, plug valves, and air release valves. Due to the maturity of the area, removal and replacement of curbing, sidewalks, concrete driveways, asphalt pavement, and landscaping as a result of the new pipe installations was required. This project also involved the removal of approximately one thousand four hundred twenty (1,420) linear feet of existing abandoned 8" Asbestos Cement (AC) water main, including fittings, valves, and associated appurtenances in the north right of way of Ranchero Street. Contract Amoun Location Job Start/End Owner Contact $ 354,000.00 Orlando,FL Sept 2010 Orange County Utilities March 2011 400 E South St Orlando, FL 32801 Kent Veech(407) 381-2192 kent.veech @woolpert.com T B Landmark Construction, Inc. Scope of Work Completed Projects & References 14.Teco Gas Daytona Division,FL This project falls under our Teco Blanket Contract for the Daytona Beach area. For this particular job we installed 6,960 LF of 6" plastic pipe via HDD and 4,930 LF of 6" plastic pipe via open cut for a gas line. We also installed a 4" plastic gas line with 4,410 LF installed via HDD and 2,213 LF installed via open cut. T B Landmark was responsible for replacing the sod that was disturbed and restoring the area back to its original look. Contract Amoun Location Job Start/End Owner Contact $ 254,000.00 Daytona Beach,FL January 2011 Teco Gas-Daytona Division March 2011 1722 Ridgewood Ave Holly Hill, FL 32117 Bill Williams (352)267-3578 trbrw @tecoenergy.com 15.Florida Inland Navigation District T B Landmark installed 3,800 LF of 36" HDPE pipe for a discharge line going through the D-Dot Ranch property in Jacksonville, FL. The discharge line included 15 manholes that were thoroughly tested to meet the specifications. Helical Anchors were used to anchor down the pipe to ensure it won't move from its original position. There was also clearing, hay and seeding and trench excavation included in this job. Contract Amoun Location Job Start/End Owner Contact $ 480,000.00 Jacksonville, FL June 2010 Florida Inland Navigation District Dec 2010 1314 Marcinski Road Jupiter, FL 33477 Renee Robertson(904)731-7040 r robertson @taylorengine ering.corn 16. Teco Gas—Tampa Division T B Landmark installed approximately 131,000 feet (24.8 miles) of 16 inch O.D., API-5L, Grade X- 70, steel line pipe, complete with jack & bore or open cut road and driveway crossings, open cut stream crossings, test lead installations, zinc ribbon installation and HDD tie-ins, as well as pipeline appurtenances. Pipeline alignment was primarily along power. Pipeline construction is situated within Clay, St. Johns, and Duval Counties,Florida. TB Landmark fabricated and installed three (3) Mainline Valve settings and all associated appurtenances. We installed two (2) isolation valves, one on each side of the Seaboard Coastline Railroad located in Clay County, Florida. One(1) isolation valve was installed, approximately 974 feet west of the FEC Railroad located in Duval County, Florida. All tie —ins with the HDD's were completed according to specs. Pipe was extensively hydrotested after all the tie-ins were completed. The work included all activities necessary or incident to the fabrication and installation, all in accordance with the Contract. T B Landmark Construction, Inc. Scope of Work Completed Projects & References Contract Amoun Location Job Start/End Owner Contact $ 18,000,000.00 Green Cove Springs, FL April 2010 Teco Gas -Tampa Division October 2010 702 N Franklin Street Tampa, FL 33601 Bill Greer(904) 529-5119 wjgreerl @aol.coin 17. Jacksonville Electric Authority(JEA) T B Landmark constructed a 20" water main in North Jacksonville consisting of: 3,932LF of 20" PVC installed by open cut and 2,055LF of 20" Ductile Iron installed via open cut. 850LF of 20" Steel Pipe installed via HDD and 1,941LF of 24" HDPE installed via HDD. This job also had a 165LF 36" steel casing jack and bore, 2 16"x16" taps, 4 fire hydrants, MOT and restoration of the jobsite. The entire open-cut portion was installed in FEC and FDOT right of way behind concrete barricades. Contract Amoun Location Job Start/End Owner Contact $ 1,015,000.00 Jacksonville, FL Sept 2009 Jacksonville Electric Authority June 2010 21 West Church Street Jacksonville, FL 32202 Beth DiMeo (904) 665-8139 dimeea @jea.com 9. Has the Bidder ever failed to complete any work awarded to it? If so, state when, where and why (attach additional sheets as necessary). No 10. Has any officer or partner of your organization ever been an officer or partner of some other organization that failed to complete a construction contract? If so, state name of individual, name of other organization, and reason therefore (attach additional sheets as necessary). No 11. State the names, addresses and the type of business of all firms that are partially or wholly owned by the Bidder(attach additional sheets as necessary): N/A 12. What is the Bidder's bonding capacity? 20,000,000/40,000,000 13. What amount of the Bidder's bonding capacity has been used as of the date of this bid? 12,700,000 14. State the name of the Surety Company which will be providing the Performance and Payment Bond, and name and address of the Agent: Travelers Casualty and Surety Company of America Cecil W. Powell &Co. 219 N Newnan St. Jacksonville, FL 32202 15. Has the Bidder been in disputes or litigations in the last five (5) years over construction projects which are completed or still pending for completion? If so, describe the nature of the disputes or litigations and state the Owner's Name, Address, Telephone, and amount of disputes or litigations (attach additional sheets as necessary). No Sanford Reclaimed Water Interconnect With Volusia Co. BIDDER QUALIFICATION AFFIDAVIT 00440-4 The Bidder acknowledges and understands that the information contained in response to this qualifications form shall be relied upon by the City in awarding the contract and such information is warranted by Bidder to be true. The discovery of any omission or misstatement that materially affects the Bidder's qualifications to perform under the contract shall cause the City to reject the bid or proposal, and if after the award to cancel and terminate the award and/or contract. T B Landmark Construction, Inc. Name of Bidder L 1/13/14 Signature of A orized Representative (Affiant) Date Martin Adams, Manager Printed or Typed Name and Title of Authorized Representative (Affiant) COUNTY OF Duval STATE OF FLORIDA On this 13 day of January , 20 14 , before me, the undersigned Notary Public of the State of Florida, personally appeared Martin Adams whose name(s) is/are subscribed to the within instrument, and he/she/they acknowledge that he/she/they executed it. WITNESS my hand and official seal. He/She is personally known to me o has produced , as idcntifioation. VICTORIA AMRHEIN ,., "= MY COMMISSION#EE852030 r/� ;.1 EXPIRES November 15,2016 (N tary is in and for the County and State Aforementioned) 1407)198-0163 F1oHCallol Swvl000an SEAL My commission expires: 11/15/16 END OF SECTION Sanford Reclaimed Water Interconnect With Volusia Co. BIDDER QUALIFICATION AFFIDAVIT 00440-5 SECTION 00450 CERTIFICATION OF NON-SEGREGATED FACILITIES FORM The Contractor certifies that no segregated facilities are maintained and will not be maintained during the execution of this contract at any of its establishments. The Contractor further certifies that none of its employees are permitted to perform their services at any location under the Contractor's control during the life of this contract where segregated facilities are maintained. The Contractor certifies further that it will not maintain or provide for its employees any segregated facilities at any of its establishments, and that he will not permit his employees to perform their services at any location, under his control, where segregated facilities are maintained. As used in this certification, the term "segregated facilities" means any waiting rooms, work area, rest rooms and wash rooms, restaurants and other eating areas, time clocks, locker rooms and other storage or dre ss i ng areas, parking lots, drinking fountains, recreation or entertainment areas, transportation, and housing facilities provided for employees which are segregated by explicit directive or are in fact segregated on the basis of race, creed, color or national origin, because of habit, local custom, or otherwise. The Contractor agrees that (except where it has obtained identical certification from proposed subcontractors for specific time periods) it will obtain identical certifications from proposed subcontractors prior to the award of subcontract exceeding $10,000 and that it will retain such certifications in its files. T B Landmark Construction, Inc. Contract',r gf 1/13/14 Signatu'e of Authorized Representative Date Martin Adams, Manager Printed or Typed Name and Title of Authorized Representative END OF SECTION Sanford Reclaimed Water Interconnect With Volusia Co. CERTIFICATION OF NON-SEGREGATED FACILITIES FORM 00450-1 SECTION 00452 DISPUTES DISCLOSURE FORM Answer the following questions by answering "YES" or "NO". If you answer "YES", please explain in the space provided, please add a page(s) if additional space is needed. 1. Has your firm, or any of its officers, received a reprimand of any nature or been Y Y P Y suspended by the Department of Professional Regulation or any other regulatory agency or professional association within the last five (5) years? No (Y/N) 2. Has your firm, or any member of your firm, been declared in default, terminated or removed from a contract or job related to the services your firm provides in the regular course of business within the last five (5) years? No (Y/N) 3. Has your firm had filed against it or filed any requests for equitable adjustment, contract claims or litigation in the past five (5) years that is related to the services your firm provides in the regular course of business? No (Y/N) Note: If yes, the explanation must state the nature of the request for equitable adjustment, contract claim or litigation, a brief description of the case, the outcome or status of suit and the monetary amounts or extended contract time involved. I hereby certify that all statements made are true and agree and understand that any misstatement or misrepresentation or falsification of facts shall be cause for forfeiture of rights for further consideration of the project identified. T B Landmark Consturction, Inc. Firm 1/13/14 Signatur of Authorized Representative Date Martin Adams,Manager Printed or Typed Name and Title of Authorized Representative END OF SECTION Sanford Reclaimed Water Interconnect With Volusia Co. DISPUTES DISCLOSURE FORM 00452-1 SECTION 00454 DRUG FREE WORKPLACE FORM The undersigned, in accordance with Florida Statute 287.087 hereby certifies that the company named below does: 1. Publish a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the workplace and specifying the actions that will be taken against employees for violations of such prohibition. 2. Inform employees about the dangers of drug abuse in the workplace, the business's policy of maintaining a drug-free workplace, any available drug counseling, rehabilitation, and Employee assistance programs, and the penalties that may be imposed upon employees for drug abuse violations. 3. Give each employee engaged in providing the commodities or contractual services that are proposed a copy of the statement specified in item 1. 4. In the statement specified in item 1, notify the employees that, as a condition of working on the commodities or contractual services that are under bid, the employee will abide by the terms of the statement and will notify the employer of any conviction of, or plea of guilty or nolo contendere to, any violation of Chapter 893 or of any controlled substance law of the United States or any state, for a violation occurring in the workplace no later than five (5) days after such conviction. 5. Impose a sanction on, or require the satisfactory participation in a drug abuse assistance or rehabilitation program if such is available in the employee's community, by any employee who is so convicted. 6. Make a good faith effort to continue to maintain a drug-free workplace through implementation of this section. T B Landmark Construction, Inc. Firm 1/13/14 Signatur of Authorized Representative Date Martin Adams, Manager Printed or Typed Name and Title of Authorized Representative END OF SECTION Sanford Reclaimed Water Interconnect With Volusia Co. DRUG FREE WORKPLACE FORM 00454-1 SECTION 00456 UNAUTHORIZED (ILLEGAL) ALIEN WORKERS AFFIDAVIT The City of Sanford will not intentionally award publicly-funded contracts to any Contractor who knowingly employs unauthorized alien workers, constituting a violation of the employment provisions contained in 8 U.S.C. Section 1324a(e) Section 274A(e) of the Immigration and Nationally Act (INA). The City of Sanford shall consider the employment by the Contractor of unauthorized aliens, a violation of Section 274A(e) of the INA. Such violation by the Contractor of the employment provisions contained in Section 274A(e) of the INA shall be grounds for immediate termination of this Agreement by the City of Sanford. The Affiant identified below deposes and states that: 1. The below identified Contractor does not and will not during the performance of any contract resulting from the solicitation identified below employ illegal alien workers or otherwise violate the provisions of the federal Immigration Reform and Control Act of 1986. 2. Upon request of the City, it will provide copies of Immigration Form 1-9 for each person associated with the above named company who has been or is present at the designated jobsite associated with any work or project resulting from this solicitation. T B Landmark Construction, Inc. /tit-- Contractor ce 1/13/14 Signature of Authorized Representative (Affiant) Date Martin Adams, Manager Printed or Typed Name and Title of Authorized Representative (Affiant) COUNTY OF Duval STATE OF FLORIDA On this 13 day of January , 20 14 , before me, the undersigned Notary Public of the State of Florida, personally appeared Martin Adams whose name(s) is/are subscribed to the within instrument, and he/she/they acknowledge that he/she/they executed it. WITNESS my hand and official seal. He/She is personally known to me f has produced , as .0:*-„.. VIClf ac*ARHEIN •"c MY COMMISSION#EE652030 l/./) -f- . *r,; EXPIRES November 15,2016 (N tary Publi in and for the County and State Aforementioned) ,407)398-0153 FtorldalloW( •tom SEAL My commission expires: 11/15/16 END OF SECTION Sanford Reclaimed Water Interconnect With Volusia Co. UNAUTHORIZED(ILLEGAL) ALIEN WORKERS AFFIDAVIT 00456-1 SECTION 00458 E-VERIFY COMPLIANCE AFFIDAVIT Project Name: Sanford Reclaimed Water Interconnect With Volusia Co. Bid No.: IFB 13/14-2 The Affiant identified below attests to the following: 9 1. That the Contractor is currently in compliance with and throughout the term of the above identified project and will remain in compliance with Executive Order 11-02, issued by the Office of the Governor, State of Florida, requiring the use of the Department of Homeland Security's Status Verification ("E-Verify") System to ensure that all employees of the Contract and the Contractor's subcontractors performing work under the above- listed Contract are legally permitted to work in the United States. 2. Each Contractor that performs work under the Project referenced above shall provide the City of Sanford, Florida, a copy of the "Edit Company Profile" screen indicating enrollment in the E-Verify Program. 3. The Contractor will register and participate in the work status verification for all newly hired employees of the contractor and for all subcontractors performing work on the above-listed Contract. 4. The Contractor agrees to maintain records of its compliance with the verification requirements as outlined in this Affidavit and, upon request of the any Authority having jurisdiction over the Project, including, but not limited to, the State of Florida, agrees to provide a copy of each such verification to that Authority. 5. That all persons assigned by the Contractor or its subcontractors to perform work under the above identified project will meet the employment eligibility requirements as established by the Federal Government and the government of the State of Florida. 6. That the Contractor understands and agrees that its failure to comply with the verification requirements as set forth herein or its failure to ensure that all employees and subcontracts performing work under the above identified project are legally authorized to work in the United States and the State of Florida constitute a breach of contract for which the City of Sanford may immediately terminate the Contract without notice and without penalty. Contractor further understands and agrees that in the event of such termination, the Contractor shall be liable to the City for any costs incurred by the City as a result of the Contractor's breach. 7. That for the purposes of this Affidavit, the following definitions apply: "Employee"—Any person who is hired to perform work in the State of Florida. Sanford Reclaimed Water Interconnect With Volusia Co. E-VERIFY COMPLIANCE AFFIDAVIT 00458-1 "Status Verification System" — the procedures developed under the Illegal Immigration Reform and Immigration Responsibility Act of 1996, operated by the Department of Homeland Security and known as the "E-Verify Program", or any successor electronic verification system that may replace the E-Verify Program. T B Landmark Construction, Inc. Contractor 1/13/14 Signature of Authorized Repre 'ent'tiv- A ffiant) Date Martin Adams,Manager Printed or Typed Name and Title of Authorized Representative (Affiant) COUNTY OF Duval STATE OF FLORIDA On this 13 day of January , 2014 , before me, the undersigned Notary Public of the State of Florida, personally appeared Martin Adams whose name(s) is/are subscribed to the within instrument, and he/she/they acknowledge that he/she/t ey executed it. WITNESS my hand and official seal. He/She is personally known to me o has produced , as iripntifiratinn _ 1T- *: VICTORIA AMRHEIN ; •'_ MY COMMISSION#EE852030 EXPIRES November 15,2016 (Notary Pu:' in and for the County and State Aforementioned) 14071398.0153 FlatWONattrySerelco tom SEAL My commission expires: 11/15/16 END OF SECTION Sanford Reclaimed Water Interconnect With Volusia Co. E-VERIFY COMPLIANCE AFFIDAVIT 00458-2 SECTION 00460 AMERICANS WITH DISABILITIES ACT AFFIDAVIT By executing this Certification, the undersigned Contractor certifies that the information herein contained is true and correct and that none of the information supplied was for the purpose of defrauding the City of Sanford. The Contractor will not discriminate against any employee or applicant for employment because of physical or mental handicap in regard to any position for which the employee or applicant for employment is qualified. The Contractor agrees to comply with the rules, regulations and relevant orders issued pursuant to the Americans with Disabilities Act (ADA), 42 USC s. 12101 et seq. It is understood that in no event shall the City of Sanford be held liable for the actions or omissions of the Contractor or any other party or parties to the Agreement for failure to comply with the ADA. The Contractor agrees to hold harmless and indemnify the City of Sanford, its agents, officers or employees from any and all claims, demands, debts, liabilities or causes of action of every kind or character, whether in law or equity, resulting from the Contractor's acts or omissions in connection with the ADA. T B Landmark Construction, Inc. Contractor 1/13/14 Signature of Authorized Representative (Affiant) Date Martin Adams, Manager Printed or Typed Name and Title of Authorized Representative (Affiant) COUNTY OF Duval STATE OF FLORIDA On this 13 day of January , 20 14 , before me, the undersigned Notary Public of the State of Florida, personally appeared Martin Adams whose name(s) is/are subscribed to the within instrument, and he/she/they acknowledge that he/she/they executed it. WITNESS my hand and official seal. He/She is personally known to me of has •roduced , as .„;;;!..,:;i4zi, VICTORIA AMRHEIN .•. MY COMMISSION#EE652030 (N tary '•lblic in and for the County and State Aforementioned) .: EXPIRES November 15,2016 My commission expires: END OF SECTION Sanford Reclaimed Water Interconnect With Volusia Co. AMERICANS WITH DISABILITIES ACT AFFIDAVIT 00460-1 STATE OF FLORIDA 1:43:;-% DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ' 11 ': CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395• 1940 NORTH MONROE STREET �c_oc`'� TALLAHASSEE FL 32399-0783 THIGPEN, ROBIN RODNEY T B LANDMARK CONSTRUCTION INC 11220 NEW BERLIN ROAD JACKSONVILLE FL 32226 . Congratulations! With this license you become one of the nearly one million I '• ' STATE OF FLORIDA AC# 6 25868 DEPARTMENT OF BUSINESS AND Floridians licensed by the Department of Business and Professional Regulation. ! e PROFESSIONAL REGULATION Our professionals and businesses range from architects to yacht brokers,from I — boxers to barbeque restaurants,and they keep Florida's economy strong. CGC060694 • 10.8/09/12 12700737: Every day we work to improve the way we do business in order to serve you better. - For information about our services,please log onto www.myfloridalicense.com. f CERTIFIED. GENERAL CONTRACTOR There you can find more information about our divisions and the regulations that E THIGPEN, ROBIN RODNEY impact you,subscribe to department newsletters and learn more about the T B LANDMARK CONSTRUCTION INC Department's initiatives. Our mission at the Department is:License Efficiently, Regulate Fairly.We constantly strive to serve you better so that you can serve your customers. IS CBRTIFIBD under the provieious of ch.489 P Thank you for doing business in Florida,and congratulations on your new license!: Expiration date, AUG 31, 2019 L12080901993 DETACH HERE • ,.� . ..�.. ,• Ciitl;R0UNL1;:.14ICRQ!?li 4 4 . ,.;�� .7.'-12r �. AC# 6258681 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD SEQ#L12080901993 DATE BATCH NUMBER LICENSE NBR 08/09/2012 127007371 CGC060694 The GENERAL CONTRACTOR • Named below IS CERTIFIBD Under the P rovisions of Chapter 489 FS. •Expiration date: AUG 31, 2014 . . . THIGPEN, ROBIN RODNEY • T B LANDMARK CONSTRUCTION INC 11220 NEW BERLIN ROAD JACKSONVILLE FL 32226 RICK SCOTT KEN LAWSON GOVERNOR SECRETARY DISPLAY AS REQUIRED BY LAW STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION Y_ CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 • 1940 NORTH MONROE STREET c 1 ..' '� TALLAHASSEE FL 32399-0783 THIGPEN, ROBIN RODNEY T B LANDMARK CONSTRUCTION INC 11220 NEW BERLIN ROAD JACKSONVILLE FL 32226 ...Lk_ AC# 6 2 588 5 Congratulations! With this license you become one of the nearly one million ; : g STATE OF FLORIDA, DEPARTMENT OF BUSINESS AND Floridians licensed by the Department of Business and Professional Regulation. ‘, PROFESSIONAL REGULATION Our professionals and businesses range from architects to yacht brokers,from - boxers to barbeque restaurants,and they keep Florida's economy strong. CUC057226 08/49./12 12700737] Every day we work to improve the way we do business in order to serve you better For information about our services,please log onto www.myfloridalicense.com. CERT UNDERGROUND & EXCAV CNTR There you can find more information about our divisions and the regulations that THIGPEN, ROBIN RODNEY impact you,subscribe to department newsletters and learn more about the T B LANDMARK CONSTRUCTION INC Department's initiatives. Our mission at the Department is:License Efficiently,Regulate Fairly.We constantly strive to serve you better so that you can serve your customers. Is CERTIFIED under the Thank you for doing business in Florida,and congratulations on your new license!! d 1 p=oviei of ch. { tzpiration ata: AUG 31, 2014 L12080902168 s 8 DETACH HERE ;'17:7 `ti.`: 'zt-IHIS.DoCUMENTHAS:A COLOREDHAG(GROUNDI.. RORRINti.iit ,gVE]10171#t#C°,:P14 DPAPgRAT w,1A': 3 st_ d:r AC# 6258856 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD SEQ#L12080902168 DATE BATCH NUMBER LICENSE NBR • I .. 08/09/2012 127007371 CUC057226_ The UNDERGROUND UTILITY & EXCAVATION CO Named below IS CERTIFIED Under the provisions of Chapter: 489-14i.. Expiration date: AUG 31, 2014 THIGPEN, ROBIN RODNEY T B LANDMARK CONSTRUCTION INC 11220 NEW BERLIN ROAD JACKSONVILLE FL 32226 RICK SCOTT KEN LAWSON GOVERNOR SECRETARY DISPLAY AS REQUIRED BY LAW s �l STATE OF FLORIDA . DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION "1"0"%- CONSTRUCTION INDUSTRY LICENSING BOARD ' °.c,• 1940 NORTH MONROE STREET (850) 487-1395 TALLAHASSEE FL 32399-0783 THIGPEN, ROBIN RODNEY T B LANDMARK CONSTRUCTION INC 11220 NEW BERLIN ROAD JACKSONVILLE FL 32226 STATE OF FLORIDA AC# p 2 S8 4 4 Congratulations! With this license you become one of the nearly one million 3: DEPARTMENT OF BUSINESS AND Floridians licensed by the Department of Business and Professional Regulation. ! . PROFESSIONAL REGULATION Our professionals and businesses range from architects to yacht brokers,from I r boxers to barbeque restaurants,and they keep Florida's economy strong. ! ! CFC1425930 08/49/12 12700737: Every day we work to improve the way we do business in order to serve you better. For information about our services,please log onto www.myfloridalicense.com. • CERTIFIED PLUMBING CONTRACTOR There you can find more information about our divisions and the regulations that , THIGPEN, ROBIN RODNEY impact you,subscribe to department newsletters and learn more about the T B LANDMARK CONSTRUCTION INC Department's initiatives. Our mission at the Department is:License Efficiently,Regulate Fairly.We constantly strive to serve you better so that you can serve your customers. ! Thank you for doing business in Florida,and congratulations on your new license!! IS CERTIFIED under the provisions of C P rzpiration data: AUG 31, 2014 L12080901750175 4 DETACH HERE THIS DOCUMENT,NASA COLORED ACKGR0UND NAVA:COLOHEat AaGROUPPI,IINCROPROOMVANEMAIWPATENT EDPAPER j AC# 6258442 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD SEQ#L12080901754 DATE BATCH NUMBER LICENSE NBR 08/09/2012 127007371 CFC1425930 The PLUMBING CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 F$ Expiration date: AUG 31, 2014 i THIGPEN, ROBIN RODNEY T B LANDMARK CONSTRUCTION INC 11220 NEW BERLIN ROAD JACKSONVILLE FL 32226 RICK SCOTT KEN LAWSON GOVERNOR SECRETARY ___. DISPLAY AS REQUIRED BY LAW �! ��` : .� STATE OF FLORIDA : �,, �,�. DEPARTMENT OF BIISINESS AND PROFESSIONAL REGULATION v **-- s'r CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 ',ter' 1940 NORTH MONROE STREET w __ate. TALLAHASSEE FL 32399-0783 THIGPEN, ROBIN RODNEY T B LANDMARK CONSTRUCTION INC 11220 NEW BERLIN ROAD JACKSONVILLE FL 32226 I ' '" STATE OF FLORIDA AC# 6 2 58 7 is Congratulations! With this license you become one of the nearly one million A DEPARTMENT OF BIISINESS AND Floridians licensed by the Department of Business and Professional Regulation. I «' PROFESSIONAL REGULATION Our professionals and businesses range from architects to yacht brokers,from boxers to barbeque restaurants,and they keep Florida's economy strong. CMC1249354. 08/09/12 12700737] Every day we work to improve the way we do business in order to serve you better For information about our services,please log onto www.myfloridalicense.com. CERTIFIED MECHANICAL CONTRACTOR There you can find more information about our divisions and the regulations that THIGPEN, ROBIN RODNEY impact you,subscribe to department newsletters and learn more about the T B LANDMARK CONSTRUCTION INC Department's initiatives. Our mission at the Department is: License Efficiently,Regulate Fairly.We constantly strive to serve you better so that you can serve your customers. , Thank you for doing business in Florida,and congratulations on your new license! IS CERTIFIED under the provisions of ch.489 r lbcpiratioa data. AUG 31, 2014 L12080902055 DETACH HERE : ' A =x s4- 4'TRISDOCUMENT.HAS'iktoLoRED1A`C.KGAAU$.tovi tCltOpf 1NTl$Q.il.INEMARI04.:VATENTED RAPER-`,' :`z ,_:r;°7 '" 'T ''' v AC# 6258743 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD SEQ#L1208o902055 DATE BATCH NUMBER LICENSE NBR. 08/09/2012 127007371 CMC1249354' The MECHANICAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 - B. . Expiration date: AUG 31, 2014 _ THIGPEN, ROBIN RODNEY T B LANDMARK CONSTRUCTION INC 11220 NEW BERLIN ROAD JACKSONVILLE FL 32226 I RICK SCOTT KEN LAWSON GOVERNOR SECRETARY DISPLAY AS RFC1IIRFn RY I Aw I LIMITED POWER OF ATTORNEY Known all men by these presents, TB Landmark Construction, Inc. ("TB Landmark"), a Florida Corporation with principal offices at 11220 New Berlin Road, Jacksonville, Florida 32226 does hereby irrevocably constitute, nominate, appoint and authorize, Martin Adams, who presently resides at Gail lore. 0/R 32413 and who is presently employed by TB Landmark holding the position of 0.7E 1'-- , as its true and lawful attorney-in-fact, to do in its name and on its behalf, all such a ts, deeds and things as are necessary or required in connection with or incidental to submission of its bid for the proposed project, including but not limited to signing and submission of all bids, and other documents and writings, participating in bidders and other conferences, providing information/responses, representing it in all matters relating to the bidding process, signing and execution of all contracts and undertakings consequent to acceptance of its bid, and generally dealing with the necessary parties in all matters in connection with or relating to or arising out of its bid for the proposed project and/or upon award thereof to TB Landmark. And TB Landmark hereby agrees to ratify and confirm, and does hereby ratify and confirm all acts, deeds and things lawfully done or caused to be done by its said attorney-in-fact pursuant to and in exercise of the powers conferred by this limited power of attorney, and that all acts, deeds, and things done by its said attorney-in-fact in exercise of the powers hereby conferred shall and shall always be deemed to have been done by TB Landmark. In witness whereof, Robin Thigpen, on behalf of TB Landmark as its President, has executed this power of attorney on this 01-day of December, 2012. . Rosin Thigpen,President TB Landmark Construction, Inc. I accept. Martin Adams 1 STATE OF FLORIDA COUNTY OF DUVAL Sworn to and subscribed before me this ja 'day of December, 2012 by Robin Thigpen. sYR� CHRISTINE STRANG GOSS[u c `�` tJ �� ,S MY COMMISSION*D0982276 Notary Public Iplike EXPIRES May 17,2014 Print Name: ,>t r;t a k t' S II 4 t • t o7)$.6.153 FlockleNotawy6orviocoan My Commission Expires: 51111?---L)►4- Personally Known ✓ OR Produced Identification J/A Type of Identification Produced Ma, STATE OF FLORIDA COUNTY OF DUVAL Sworn to and subscribed before me this lam day of December, 2012 by Martin Adams. yi►►!r•' CHRISTINE STRANG GOSSELL ' •'i MY COMMIS&ON#D0982278 ��--//�� EXPIRES May 17,2014 Notary Public/� c — / +'t (407)398-0153 Print Name: Lam(uVT5'f]yl.Qi c rl(�� (1�yJ. - My Commission Expires: 5 j 11 j Te l-{- Personally Known V OR Produced Identification tJ JA Type of Identification Produced , JA SECTION 00525 CRIMINAL BACKGROUND CHECK REQUIREMENTS AND AFFIDAVIT The Affiant identified below agrees to the following: 1. The Contractor shall be responsible for the accepted standards, appearance, conduct, and safety of its employees, subcontractors, agents, and any other person caused by the Contractor to have access to any facility under the authority of the City. 2. Contractors who have access to City owned and/or operated facilities and utilities which are designated by the City to be critical to security of public safety, shall comply with the security measures as described herein. 3. Contractors and each of their employees shall, as and when required by the City, wear an identification badge which provides the name of the employee and the contractor. 4. Contractors shall provide within forty-eight (48) hours of the City's request, a list of employees and subcontractors who will have access to City sites and/or facilities, their working days, times and assignments. Additionally, the City reserves the right to require the inclusion of individual addresses, social security numbers and driver's license numbers including state of issuance for employees and subcontractors identified above. Such confidential information shall be used by the City to determine a person's eligibility to function in such critical employment position(s) as described. 5. The Contractor shall cause each employee and subcontractor deemed by the City to be functioning in a position critical to the security and/or public safety of the City to comply with procedures outlined below by submitting their fingerprints to the Florida Department of Law Enforcement for state criminal history evaluation. 6. The Contractor, applicable to each Contractor's and Subcontractor's employee identified by the City, shall submit a fingerprint card which includes the ORI/Account Number provided by the City along with a check for$24.00 for each fingerprint card to the Florida Department of Law Enforcement. In addition, if the Police or Sheriffs Department processing the fingerprint cards charges a fee (cash only) for that service, the contractor shall be responsible for that charge. 7. The fingerprint request shall include the subject's name, sex, race and date of birth and other information such as DL and SS. 8. Fingerprint cards may be processed by any Florida Police Department or Sheriff's Department. If the Contractor is "out-of-state," the fingerprint cards may be processed by any PD, etc. and sent to the address below for processing. The ORI No. assigned to the City of Sanford is FL759053Z this number must be used. The City will provide the forms. 9. Sanford Police Department fingerprinting time schedule are only Monday, Wednesday and Friday from 9:00 AM-12:00 Noon. Sanford Reclaimed Water Interconnect With Volusia Co. CRIMINAL BACKGROUND CHECK REQUIREMENTS AND AFFIDAVIT 00525-1 10. Fingerprint cards shall be sent to: Criminal Justice Information Services Post Office Box 1489 Tallahassee, Florida 32302-1489 11. The ORI number directs the report to be returned to the City of Sanford. The Contractor shall not request the report to be returned to the Contractor. Only the fingerprint card(s) and the indicated payment are to be placed in the envelope. No cover letter or other instructions are to be included. Only a report(s) sent directly to the City of Sanford by the FDLE will be accepted as valid. 12. If a contractor or contractor's employee refuses to authorize the release of their address, social security number, licenses and/or to participate in the criminal history record checks when required by the City, they shall not be allowed to work or continue to work in or on such critical position(s) or project(s). Reports which reflect incidents in an individual's back ground will be addressed and resolved on a case by case basis. T B Landmark Construction, Inc. Cony ac r ilA 1/21/14 Signature of Authorized Representative (Affiant) Date Martin Adams,Manager Printed or Typed Name and Title of Authorized Representative (Affiant) COUNTY OF Duval STATE OF FLORIDA On this 21 day of January , 20 14 , before me, the undersigned Notary Public of the State of Florida, personally appeared Martin Adams whose name(s) is/are subscribed to the within instrument, and he/she/they acknowledge that he/she/they executed it. WITNESS my hand and official seal. He/She is personally known to me rhas pr duced , as identification. ` (!Notary Pu c in and for the County and State Aforementioned) SEAL My commission expires: 11/15/16 _4,441; VICTORIA AMRHEIN MY COMMISSION#EE852030 END OF SECTION EXPIRES November 15,2016 14071 s9E-0153 FbrMsNotarySwvico corn Sanford Reclaimed Water Interconnect With Volusia Co. CRIMINAL BACKGROUND CHECK REQUIREMENTS AND AFFIDAVIT 00525-2 1 CI .,-1 g CI cd - • f� ■ 'v y o ca d b O F'' � x co) Li 0 5 a a o O.,W � W p CA CI= = A v1 v1 O O CI a H 0 „. . yin 0 CS! 1.:$ ,. i.+ ,... O O •F•, • v o V E o F a c cd °a . 6 01 b ee o 6 MM I-1"11., ?� p 0 -0 ty 4) CP d ;Ea 0.4 C/) o 0 oa, � H w ›, as O w 0 Martin E. Adams 6042 Antigua Court Orange Park,Florida 32003 (904)269-7381 /(904)228-5504 Professional Summary: • I am an extremely professional,dedicated and hard working individual who is a self starter and career driven. I am able to make skilled decisions,work under pressure and time restraints. I enjoy negotiating,and being a leader. I respect others and strive to get the best out of everyone around me. Expertise: • As Senior Project Manager responsible for overseeing all aspects of the Estimating and Project Management Depai tinent. Highly successful in developing relationships to bring projects to completion on time and under budget. Skilled negotiator with strong leadership,organization,and communication skills. • Responsible for generating new business,review all billing and preparing monthly reports that were given to the VP and Owner. Played a major role in increasing repeat and referral business by projecting a friendly,positive, and professional image. • Worked with engineers,architects,general contractors and owners in developing and administering cost changes,work orders and other pertinent information. Responsible for estimating projects,negotiating contracts,and knowledgeable in specification of materials and standard practices. • As Estimator/Project Manager provided bids on city and private roadway and utility projects ranging up to$20 Million dollars. Submit schedules and shop drawings,prepared purchase orders,and created Schedule of Values. Reviewed contracts,implemented sub-contracts and oversaw all project coordination. Provided necessary permits and worked with superintendents, sub-contractors and vendors scheduling estimated work time and delivery dates. • Installed water,sewer,and drainage in new subdivisions,commercial parcels and city rehab work. Built headwalls and box culvert for road crossings. Installed various water lines,such as PVC,HDPE,fiberglass,stainless steel and ductile iron pipe in a mechanical plant. Operated backhoe,trenches,bull-dozers,directional boring equipment and miscellaneous equipment. Accomplishments: In 2003,Baptist Medical Center facility in Downtown Jacksonville,Florida had a large addition put on the building along with a new parking garage. This addition was being built right over the existing water,sewer and drainage system. All of these utilities had to be rerouted in order to start the new structure. I personally worked with the engineer to change the conflict structure and phasing plan which allowed us to by-pass the sewer system,the drainage system, and maintain water,electric,gas and all communication to the hospital. This eliminated three weeks of phasing and the builder was able to start almost one month earlier. They started a difficult project saving money and time. This generated a lot of repeat business and a great reference. Tara L. Thigpen 7547 Yellow Fin Dr.,Apt 202 Jacksonville,FL 32256 904.718.6462 OBJECTIVE: To apply and further develop my proven administrative, analytical and management skills to provide consistent and dependable service in an upbeat organizational culture that promotes personal and professional growth EXPERIENCE: T B Landmark Construction,Inc.,Jacksonville,Florida Project Manager/Estimator, January 2013-Present • Communicate directly with clients,government entities,and field superintendents to provide exceptional service for all projects • Communicate directly with clients,government entities,and field superintendents to provide exceptional service for all projects • Use project management concepts,as well as project specification and drawing expertise,to collaborate with superintendents to keep projects on schedule and within budget • Provide client damage control and solutions when changes or unforeseen issues arose during projects • Coordinate subcontractors and vendors to operate on specific schedules in order to increase productivity and avoid delays • Take-off and estimate projects in bid status HDR Architecture,Inc.,Alexandria,Virginia Executive Section Coordinator, October 2009—January 2013 • Work with Client,Contractor,and Project Architect to provide Construction Administration services that exceed client expectations on high profile projects,some in excess of$2 Billion • Manage the processing, logging,reporting,and tracking of all submittals,RFI's,CPR's,CO's,AS1, etc.on multiple projects simultaneously • Coordinate with expansive,nationwide project teams of engineers and architects to provide reviews prior to scheduled completion dates • Act as quality control on Construction Administration documents prior to submitting to the client • Develop, write,and train teams on Construction Administration Processing Procedures for each project to ensure a smooth project flow • Collaborate with CA Team to develop and implement overall local office minimum requirement procedures for Construction Administration Phase • Serve as Chair of the Employee of the Month Program on TSO Committee • Received Corporate Pathfinder Award of Excellence in Process Improvement 2012 T B Landmark Construction,Inc.,Jacksonville,Florida Project Coordinator, February 2006-July 2009 • Communicated directly with clients,government entities,and field superintendents to provide exceptional service for all projects • Used project management concepts,as well as project specification and drawing expertise,to collaborate with superintendents to keep projects on schedule and within budget • Provided client damage control and solutions when changes or unforeseen issues arose during projects • Coordinated subcontractors and vendors to operate on specific schedules in order to increase productivity and avoid delays • Completed all contract and insurance documentation associated with the projects. • Handled damage claims EDUCATION: Jacksonville University • Pursuing BS in Business Management Palatka High School,Palatka,FL • Graduated with High Honors BRIAN HICKOX QUALIFICATIONS I have been in the civil construction and underground utility construction field for the last fourteen years. I have worked in the field as an operator, foreman and general superintendent. I have knowledge for every step of the construction process as those levels. PROFESSIONAL EXPERIENCE 2004-Present TB Landmark Construction, Inc. Jacksonville,Florida Superintendent • Oversee all aspects of management for Water, Sewer and Gas divisions. Responsible for scheduling and completing all jobs in a safe,timely manner. Construction of gas mains and services, and HDPE water mains up to 36" in diameter. In addition to these responsibilities, I have overseen the timely completion of several major projects listed below: - Holly Hill-740LF of 30"DIPS HDPE via HDD—26'below Creek Crossing - Phillips Highway- Greenland Road—567LF of 30"IPS via HDD - Phelps Street—4301LF of 20" HDPE via HDD 2000-2004 HD Zachary Construction San Antonio,TX Civil General Foreman • Responsible for running all underground piping, chiller piping for the Northside Power Plant in Jacksonville, Florida. Also, civil foreman responsible for building ammonia containment area and piping in power plant at SCGE in Goose Creek,South Carolina 1995 -2000 Milestone Construction Jacksonville,FL Heavy Equipment Operator • Operated heavy equipment for underground utilities. Started out as an equipment operator and progreesed to foreman for construction of water and sewer mains. Was responsible for running crews to complete jobs per specifications in a safe and timely manner PERSONAL INFORMATION Education: Florida Community College at Jacksonville,Florida Class of 1995 Marital Status: Married with Three Children Oe< T B Landmark CONSTRUCTION,Ike. Subcontractor Listing 1. Lafleur Nurseries & Garden Center—Trees and Bushes 6275 W SR 46 Sanford, FL 32771 (407) 956-8117 2. Riley&Company Inc.—RTU and Electrical 5491 Benchmark Ln. Sanford, FL 32773 (407) 265-9963 We are still awaiting responses from potential subcontractors and will notify the city as soon as possible once we receive confirmation. Contractor's Project Experience Project name and location: Pendola Point Reclaim Water&Force Main Bid amount: 2,496,701.90 Final Contract amount: 2,779,744.19 Contract time: 240 days Completion time: 210 days Year completed: 2/13 - 10/13 Description of work: Installed 16,500LF of 12" reclaimed water line and 8" wastewater force main from the City of Tampa's Howard F. Current WWTP to the NexLube facility on Pendola Point. The job included a wire lined 2,770LF 30" subaqueous drill under the Port Sutton Channel. Explanation of any time extensions and/or changes in contact amount:+283,042.29 Increase was caused by quantity adjustments and scope change from original design. Name, address, and telephone number of owner reference: Tampa Port Authority 1101 Channelside Drive Tampa, FL 33602 Dan Abbitt,(813) 905-5013, dabbitt(a,tampaport.com Name, address, and telephone number of architect or engineer: Halcrow 1101 Channelside Drive, Suite 200S Tampa, FL 33602 Karen Somerder, (813) 386-1990 Contractor's Project Experience Project name and location: San Sebastian River Drill, St. Augustine, FL Bid amount: 288,102.94 Final Contract amount: 321,624.40 Contract time: 144 days Completion time: 120 days Year completed: 11/11 - 3/12 Description of work: Completed a 1,400LF 12" HDPE wire line guided drill under the San Sebastian River in one shot. Drill was performed in clay ground. Explanation of any time extensions and/or changes in contact amount: 33,521.46 Increase in amount due to additional work requested by owner. Name, address, and telephone number of owner reference: City of St. Augustine 75 King Street St. Augustine, FL 32084 Bill Mendez(904)209-4274,bmendez@citystaug.com Name, address, and telephone number of architect or engineer: Owner design Contractor's Project Experience Project name and location: Intracoastal Waterway Force Main Replacement Project Bid amount: 512,751.00 Final Contract amount: N/A Contract time: 150 days Completion time: days Year completed: 10/13 -2/14 Description of work: T B Landmark Construction installed a new 14" FPVC force main via a wire-lined HDD across the Intracoastal Waterway. This job also included the abandoning the existing force mains and installing a new 4" force main. Explanation of any time extensions and/or changes in contact amount: N/A Name, address, and telephone number of owner reference: City of Venice 401 W. Venice Ave. Venice, FL Mickey Healy (941) 486-2788 ext. 229 Name, address, and telephone number of architect or engineer: Same as owner. Contractor's Project Experience Project name and location: AT&T Bridge of Lions Drill, St. Augustine, FL Bid amount: 452,317.00 Final Contract amount: 452,317.00 Contract time: days Completion time: 41 days Year completed: 2/13 -4/13 Description of work: Completed a 2,400LF 6" PVC wire line guided drill across the Matanzas River. Drill was completed in clay ground conditions. Explanation of any time extensions and/or changes in contact amount:None Name, address, and telephone number of owner reference: AT&T 900 North Nova Rd. Daytona Beach, FL 32117 Earl Beck(386) 257-7994 Name, address, and telephone number of architect or engineer: Design-Build Project with Applied Technology&Management, Inc. e T B LANDMARK CONSTRUCTION, INC. Financial Statements October 31, 2012 and 2011 b T U 1 11 3l J 1 1 11 .1 Conner, Hubbard & Company, LLC JCertified Public Accountants Orange Park, Florida J J 11 T B LANDMARK CONSTRUCTION, INC. TABLE OF CONTENTS PAGE I 11 INDEPENDENT ACCOUNTANTS' REPORT 1 FINANCIAL STATEMENTS Balance Sheets 2 Statements of Income and Retained Earnings 3 Statements of Cash Flows 4 Notes to Financial Statements 6 SUPPLEMENTAL INFORMATION aj Schedules of Cost of Revenues Earned 15 I 1 Schedules of Selling and Administrative Expenses 16 } Schedule of Contracts in Progress 17 11 .1 J j J . J II �' CONNER, HUBBARD & COMPANY, LLC 17.. •I I Certified Public Accountants ii Taxation,Accounting, Pension Planning, and Business Counseling 11 INDEPENDENT AUDITORS'REPORT . To the Board of Directors T B Landmark Construction,Inc. Jacksonville, Florida We have audited the accompanying balance sheets of T B Landmark Construction, Inc. as of October 31, 2012 and 2011, and the related statements of income and retained earnings and cash flows for the years ii then ended. These financial statements are the responsibility of the Company's management. Our responsibility is to express an opinion on these financial statements based on our audit. We conducted our audit in accordance with generally accepted auditing standards. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of material misstatement. An audit includes examining, on a test basis, evidence supporting the amounts and disclosures in the financial statements. An audit also includes assessing the accounting principles used and significant estimates made by management, as well as evaluating the overall financial statement presentation. We believe that our audit provides a reasonable basis for our jopinion. In our opinion, the financial statements referred to above present fairly in all material respects the ilfinancial position of T B Landmark Construction, Inc. as of October 31, 2012 and 2011, and the results of its operations and its cash flows for the years then ended in conformity with accounting principles generally accepted in the United States of America. I} Our audit was conducted for the purpose of forming an opinion on the basic financial statements taken as a whole. The accompanying Schedules of Cost of Revenues Earned, Selling and Administrative Expenses and Contracts in Progress are presented for. purposes of additional analysis and are not a required part of the basic financial statements. Such information has been subjected to the auditing i procedures applied in the audit of the basic financial statements and, in our opinion, is fairly stated in all material respects in relation to the basic financial statements taken as a whole. LI £ , gJLi a L �e • i CONNER,HUBBARD&COMPANY,LLC Certified Public Accountants February 13,2013 ..] Jwebsite:www.connerhubbard.com e-mail:firm @connerhubbard.com Please respond to the office at: 1106 Park Avenue ❑ 212 North Davis Street Orange Park,Florida 32073 Nashville,Georgia 31639 j (904)278-1040;Fax(904)278-9444 (229)686-9419 T B LANDMARK CONSTRUCTION,INC. Balance Sheets October 31, 2012 and 2011 2012 2011 CURRENT ASSETS Cash $ 4,096,811 $ 1,018,954 Accounts receivable 4,266,942 3,023,993 Costs and estimated earnings in excess of billings on uncompleted contracts 361,915 14,395 Other assets 104,591 129,731 11 Total Current Assets 8,830,259 4 187 073 iiEQUIPMENT,NET 3,945,868 1,490,574 TOTAL ASSETS $ 12,776,127 $ 5,677,647 II II CURRENT LIABILITIES Accounts payable and accrued expenses $ 1,614,867 $ 1,370,147 Billings in excess of costs and estimated } ` earnings on uncompleted contracts 271,789 145,728 Current portion -Long-term debt 725,914 425,567 IITotal Current Liabilities 2,612,570 1,941,442 LONG-TERM DEBT 1,607,278 482,444 Total Liabilities 4,219,848 2,423,886 .I SHAREHOLDERS'EQUITY Common Stock, $1 par value, 100 shares authorized, issued iland outstanding 100 100 Paid-in capital 110,333 110,333 IlRetained earnings 8,445,846 3,143,328 Total Equity 8,556,279 3,253,761 _I TOTAL LIABILITIES AND SHAREHOLDERS'EQUITY $ 12,776,127 $ 5,677,647 j The accompanying notes are an integral part of these financial statements. J -2- _1 I T B LANDMARK CONSTRUCTION, INC. Statements of Income and Retained Earnings Years ended October 31, 2012 and 2011 2012 2011 CONTRACT REVENUE EARNED $ 26,704,788 $ 14,025,317 COST OF REVENUE EARNED 17,997,521 11,628,285 II' Gross Profit 8,707,267 2 397 032 SELLING AND ADMINISTRATIVE EXPENSES 1,256,216 1,566,754 OPERATING INCOME 7,451,051 830,278 OTHER INCOME (EXPENSE) Other 21,584 (24,518) Total Other Income 21,584 (24,518) NET INCOME 7,472,635 805,760 � DISTRIBUTIONS TO SHAREHOLDERS (2,170,117) (2,271,058) RETAINED EARNINGS - BEGINNING OF PERIOD 3,143,328 4,608,626 RETAINED EARNINGS - END OF PERIOD $ 8,445,846 $ 3,143,328 [I LI Ij The accompanying notes are an integral part of these financial statements. J - 3 - .J 1 T B LANDMARK CONSTRUCTION, INC. Statements of Cash Flows Years ended October 31, 2012 and 2011 2012 2011 di CASH FLOWS FROM OPERATING ACTIVITIES: Net Income $ 7,472,635 $ 805,760 Adjustments to reconcile net income to net cash used by operating activities: Depreciation 376,804 453,714 (Gain) loss on fixed asset disposal - 38,481 (Increase) decrease in: Accounts receivable (1,242,949) (367,511) Costs and estimated earnings in excess of billings on uncompleted contracts (347,520) 98,060 Other assets 25,137 10,395 Increase (decrease) in: Accounts payable and accrued expenses 244,720 1,005,497 Billings in excess of costs and estimated earnings on uncompleted contracts 126,061 (561,925) ii Net Cash Provided By Operating Activities 6,654,888 1,482,471 CASH FLOWS FROM INVESTING ACTIVITIES I] Proceeds from sale of assets - - Purchases of vehicles and equipment (2,832,098) (185,540) 11 Net Cash Used By Investing Activities (2,832,098) (185,540) Ii , ,J The accompanying notes are an integral part of these financial statements. -4 - J T B LANDMARK CONSTRUCTION, INC. Statements of Cash Flows (Continued) Years ended October 31, 2012 and 2011 2012 2011 CASH FLOWS FROM FINANCING ACTIVITIES: Line of credit,net New borrowings 2,622,350 164,519 Payments on debt (1,197,166) (497,701) in Distributions to shareholders (2,170,117) (2,271,058) Net Cash Used by Financing Activities (744,933) (2,604,240) NET DECREASE IN CASH 3,077,857 (1,307,309) CASH AT BEGINNING OF YEAR 1,018,954 2,326,263 4 3 CASH AT END OF YEAR $ 4,096,811 $ 1,018,954 SUPPLEMENTAL INFORMATION: INTEREST PAID $ 65,132 $ 79,778 11 TAXES PAID Hj j j The accompanying notes are an integral part of these financial statements. J _ 5 _ T B LANDMARK CONSTRUCTION,INC. Notes to Financial Statements October 31, 2012 and 2011 A. SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES 1) Business Activities The Company was incorporated on November 10, 1999 and is engaged primarily in the business of underground utility line installation throughout Florida. • 2) Cash and Cash Equivalents For balance sheet classification and reporting cash flows, the Company considers all highly liquid investments with maturities of three months or less when purchased to be cash equivalents. 3) Equipment Equipment is stated at cost less accumulative depreciation. Depreciation is calculated on the straight-line method over the expected useful lives of the assets which range from .five to ten years. 4) Revenue Recognition Revenues under long-term contracts are recorded on the percentage-of-completion method, measured by the percentage of costs incurred to date to estimated total cost for each contract. Under the percentage-of-completion method, costs and estimated earnings in excess of progress billings are shown as a current asset. Progress billings in excess of costs and estimated earnings incurred on long-term contracts are shown as a current liability. Income from short-term contracts and service and repair are recorded on the accrual basis of accounting. �J Ii - 6 - _.1 T B LANDMARK CONSTRUCTION,INC. Notes to Financial Statements October 31, 2012 and 2011 A. SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Continued) 5) Income Taxes The Company is an S corporation on for federal and state income tax purposes. Accordingly, income taxes are the responsibility of the stockholders and no provision for income taxes is reflected in the financial statements. 6) Use of Estimates The preparation of financial statements in conformity with generally accepted accounting principles requires management to make estimates and assumptions. This could affect the reported amounts of assets and liabilities, disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. These estimates involve judgments with respect to the various items including future economic factors that are difficult to predict and are beyond the control of the Company. Therefore, actual results could differ from these estimates. B. CONTRACT RECEIVABLES 2012 2011 Accounts Receivable $ 2,819,850 $ 2,456,859 Retention 1,851,607 971,652 4,671,457 3,428,511 Less: Allowance for doubtful accounts (404,515) (404,518) $ 4,266,942 $ 3,023,993 U I ) 4 J _ 7 _ J j T B LANDMARK CONSTRUCTION,INC. Notes to Financial Statements October 31, 2012 and 2011 C. COSTS AND ESTIMATED EARNINGS ON UNCOMPLETED CONTRACTS As of October 31, 2012 and 2011, the costs and estimated earnings on uncompleted contracts were as follows: 2012 2011 Costs incurred on uncompleted contracts $ 10,060,031 $ 4,470,802 Estimated earnings 7,479,115 612,228 17,539,146 5,083,030 Less: Billings to date 17,449,020 5,214,363 $ 90,126 $ (131,333) Included in the accompanying balance sheet under the following captions: 1 2012 2011 Costs and estimated earnings in excess of billings on uncompleted contracts $ 361,915 $ 14,395 Billings in excess of costs and estimated earnings on uncompleted contracts (271,789) (145,728) $ 90,126 $ (131,333) L1 - 8 - J J e T 13 LANDMARK CONSTRUCTION,INC. Notes to Financial Statements October 31, 2012 and 2011 D. EQUIPMENT Equipment consists of the following: 2012 2011 Leasehold improvements $ 6,538 $ 6,538 Office furniture and equipment 35,280 35,280 Machinery and equipment 6,060,217 3,514,363 Trucks and vehicles 2,090,312 1,842,278 8,192,347 5,398,459 Less: Accumulated depreciation 4,246,479 3,907,885 $ 3,945,868 $ 1,490,574 1 E. ACCOUNTS PAYABLE AND ACCRUED EXPENSES < � 2012 2011 11 Accounts payable $ 1,428,694 $ 1,291,633 Accrued job losses 94,781 0 Other 91,391 78,513 $ 1,614,866 $ 1,370,146 F. LONG-TERM DEBT 2012 2011 [I Note P a Y monthly able in monthl installments of $2,901 including interest at 9.37%, secured by heavy equipment. Final payment due August 2011. $ 2,337 U - 9 - oT B LANDMARK CONSTRUCTION,INC. Notes to Financial Statements October 31, 2012 and 2011 ElF. LONG-TERM DEBT(Continued) 2012 2011 Note payable in monthly installments of $1,711 with interest at 7.75%, secured by heavy equipment. Final payment due May 2012. 3,300 Note payable in monthly installments of $13,235 including interest at 7.0%, secured by heavy equipment. Final payment due July 2012. 117,720 Note payable in monthly installments of$916 including interest at 0.0%, secured by equipment. Final payment due October 2012. 11,912 11 Note payable in monthly installments of $1,428 =Z including interest at 7.84%, secured by a vehicle. Final payment due January 2014. $ 21,199 36,116 Note payable in monthly installments of $2,876 including interest at 8.99%, secured by equipment. Final payment due February 2013. 43,240 72,422 1 Note payable in monthly installments of $10,286 Iincluding interest at 6.00%, secured by heavy Iequipment. Final payment due February 2015. 268,126 372,059 Note payable in monthly installments of $2,775 including interest at 6.40%, secured by a vehicle. Final payment due March 2013. 16,049 47,409 Note payable in monthly installments of$700 including interest at 7.98%, secured by a vehicle. Final payment due April 2013. 4,099 11,829 J - 10- J e 11 T B LANDMARK CONSTRUCTION,INC. Notes to Financial Statements October 31, 2012 and 2011 F. LONG-TERM DEBT(Continued) 2012 2011 Note payable in monthly installments of$940 including interest at 7.84%, secured by a vehicle. Final payment due June 2013. 7,101 17,452 Note payable in monthly installments of $2,496 including interest at 4.99%, secured by a vehicle. Final payment due July 2014. 50,103 76,832 Note payable in monthly installments of $1,072 including interest at 7.49%, secured by a vehicle. Final payment due August 2013. 9,380 21,051 II Note payable in monthly installments of $3,199 • including interest at 5.25%, secured by equipment. Final payment due November 2013. 40,343 75,600 Note payable in monthly installments of $1,825 including interest at 7.84%, secured by a vehicle. Final payment due November 2013. 22,681 41,972 Note payable in monthly installments of $1,045 including interest at 4.84%, secured by a vehicle. Final payment due February 2015. 27,478 111 Note payable in monthly installments of$810 including interest at 5.74%, secured by a vehicle. Final payment due February 2015. 22,589 - Note payable in monthly installments of$810 including interest at 5.74%, secured by a vehicle. Final payment due February 2015. 21,865 j - 11 - J .J II T B LANDMARK CONSTRUCTION,INC. Notes to Financial Statements October 31, 2012 and 2011 F. LONG-TERM DEBT(Continued) 2012 2011 Note payable in monthly installments of $1,758 including interest at 5.74%, secured by a vehicle. Final payment due February 2015. 49,745 Note payable in monthly installments of $7,230 including interest at 4.40%, secured by a equipment. 11 • Final payment due May 2016. 287,156 - Note payable in monthly installments of $3,793 including interest at 0.99%, secured by equipment. Final payment due June 2016. 117,876 Note payable in monthly installments of $1,180 including interest at 5.74%, secured by a vehicle. Final 9 payment due September 2019. 38,005 - Note payable in monthly installments of $1,206 including interest at 5.64%, secured by a vehicle. Final payment due October 2015. 39,842 Note payable in monthly installments of $20,022 including interest at 3.0%, secured by equipment. Final payment due October 2017. 1,100,600 Note payable in monthly installments of $1,874 including interest at 5.99%, secured by a vehicle. Final payment due November 2015. 61,470 i ' I j - 12- j T B LANDMARK CONSTRUCTION,INC. Notes to Financial Statements October 31, 2012 and 2011 F. LONG-TERM DEBT(Continued) 2012 2011 1 installments of $2 497 Note payable in monthly , including interest at 0.00%, secured by equipment. Final payment due September 2015. 84,245 Total debt 2,333,192 908,011 Less: Current portion 725,914 425,567 $ 1,607,278 $ 482,444 Maturities of long-term debt are as follows: Year ending October 31, - 2013 $ 725,914 2014 623,563 2015 468,532 2016 279,415 2017 235,768 Total $ 2,333,192 I IG. CONCENTRATIONS A major customer comprised approximately 59% of revenue earned in 2012 26% of revenue earned in 2011. • I LI - 13 - j J T B LANDMARK CONSTRUCTION,INC. Notes to Financial Statements October 31, 2012 and 2011 H. RELATED PARTIES The Company leases warehouse and office space from its shareholders under a verbal month-to• month lease. Rental payments totaled $90,997 in 2012 and $85,280 in 2011. I. SUBSEQUENT EVENTS Subsequent events have been evaluated through February 13, 2013, the date the financial statements were available to be issued. p U 1.1 U - 14 - j J SUPPLEMENTAL INFORMATION si 1J i� IJ J 11 T B LANDMARK CONSTRUCTION, INC. Schedules of Cost of Revenues Earned Years ended October 31, 2012 and 2011 11 2012 2011 Material $ 3,991,066 $ 3,763,965 Subcontractors 2,721,941 2,341,026 Labor 4,395,596 2,170,430 11 Equipment expense 4,798,456 1,885,155 Depreciation 376,804 445,000 Other direct overhead 1,713,658 1,022,709 $ 17,997,521 $ 11,628,285 El i j Ii U U U See Independent Auditors' Report. - 15 J El PT B LANDMARK CONSTRUCTION, INC. Schedules of Selling and Administrative Expenses 0 Years ended October 31, 2012 and 2011 fl2012 2011 Advertising $ 8,871 $ 1,700 Interest expense 65,132 79,778 Office expense 68,199 63,842 Q Officer salaries 119,600 119,600 Depreciation 8,714 Employee benefits 152,561 153,667 Bad debt - 406,115 Utilities 20,610 23,880 III n Telephone 71,179 57,047 il 11 Other 149,440 124,165 Professional fees 19,760 13,319 Rent 90,997 90,997 Salaries 381,647 310,338 Taxes and licenses 108,220 113,592 $ 1,256,216 $ 1,566,754 ii Ii 1 LI ti LI J iSee Independent Auditors' Report. - 16 - J U VD CC' 7- VIv •0 O y wr O N vl Q\ vl O\ f C aV+ b0 y .-. .-.c7 cR C U •_•„ CV O N b H E L N N en O y O C sA N O rn 0000. 0• cO VD N O O, 00 0 h 0 00 C 0 V O 7 N _ K N q 69 69 7 M 00 M co 7 cc-1 h co t� u-∎ 00 'O N 00 h cr. O N en h M b ON N '0 '0 C' V V i� C p C 000 N Oh "" O N 00 ti N N N L L U (s, w h 69 69 I 00 h N N --• 00 l0 vi ‘D V T, -N. CO 0 7'0 en Oh h 7 00 O\ •--• .u+ O 'fl 7 7 00".•:00 N b N N '0- Ol E V O 000 M en ^■ ' V N N N h E t L -.cri r CO wow • so 69 ii O h b ' N N N 0N. 7 N U N CO OO N N ^• 000 c M O O z •--+ N 00 00 O N" . O vi O\ V H '0 N .0. CA lD N 7 _ O en M v■ 0 M 7 z n o q a O U 0 11 U 0 69 so c4 L. w `� I. V O O O O O O O O O O N C4 CD C v Nrr -. a viin n V E'+ N E -. o; '0 CP; 00' '0 c4 v 00 0 6. of cr. 0oVD7 0000 d h „c.j Z cLV M 0.. V � O a 0 ' U U -0 Q\ 0l vl 00 0 VD '.0 o N rn 7 0 .! n "'� 4-� O M 00 O 7 N O M Ol O 0 0 ° '0 I- M 00 0 O 00 v■ O M N VD 0 C. y O .V+ •n vi N 7 vi O v t: . 'D C- U E '' 00 M en 00 O� CO O CAN'0- vl E A t H U eu U UP Q v) 69 69 :flt M. v1 OA N OD O O� M ^■ U VD M ' R E,y '0 ct C- O M O 7 N VI C� Si cd y OD 00 M N O 00 C� C� O 00 vl ty 7 h vl O vl M VI \D N N E i G O O '0 O Cn 7 N h y E '0 00 7 0l M 7 :: V O M J 69 69 7 O M ON O h M Ol M M — 7 0 ON O O O N vl O 7 en .V+ h vl 7 7 0 0 00 N M o A m O h 7 0 0 0 CA 00 l'D 7 00 CD- +7' O A N M N 7 M ^ OO M O U F ° o LI 69 69 7 h 'O N N N O N ^. h D\ � N b O O\ O '0 vl C' \O Vl V'1 �D O\ -• h a0 vl 00 0 O vi,D M N O M N vi 00 O cC ini 7 O\ - N 0 N - en OD V - N N N 69 6A L9 V E C U ` V W 00 .'7 4 CI ti .7 W v] Z ,l Send Result Report Ce KYOCER2 MFP 04/15/2014 15:26 Firmware Version 2N4_2000.003.032 2014.01.16 [2N4_1000.002.001] [2N4_1100.001.002] [2N4_7000.003.032] • Job No.: 000356 Total Time: -°--'--" Page: 074 Complete Document: doc00035620140415152445 No. Date and Time Destination Times Type Result Resolution/ECM 001 04/15/14 15:24 MarisolOrdonez -°--'--" E-mail OK 300x300/- , 1 [ LA73Z01052 ] Performance and ayment Bond Public Work Surety Bond No.: 106064635 d As to the Contractor/Principal: Name: TB Landmark Construction, Inc. Principal Business Address: 11220 New Berlin Road, Jacksonville, FL 32226 g, Telephone: (904) 751-1016 As to the Surety: Name: Travelers Casualty and Surety Company of America CIG Principal Business Address: 1 Tower Square, Hartford, CT 06183 Telephone: (800) 842-8496 As to the Owner of the Property/Contracting Public Entity: 0 Name: City of Sanford Principal Business Address: 300 N Park Ave, Sanford, FL 32701 Telephone: ( ) z Project Description: Sanford Reclaimed Water Interconnect with Volusia County IFB 13/14-2 Legal Description of Project: Sanford Reclaimed Water Interconnect with Volusia County IFB 13/14-2 C This bond has been furnished to comply with the requirements of F.S.A. 255.05. This bond is hereby amended such that All provisions and limitations, including conditions, notice and time limitations of F.S.A. 255.05 are incorporated herein by reference. Any provisions of this bond which conflicts with or purports to grant broader or more expanded coverage in excess of the minimum requirements of the applicable statute shall be deemed herefrom. This bond is a statutory bond, not a common law bond. N This is the front page of the performance/payment bond(s)regardless of preprinted numbers on the other pages issued in rn compliance with Florida Statute 255.05 IRYANNE NOW E, SFMD*ILl-: COUNTY CLERK OF CIRCUIT COURT & COMPTROLLER BK 08245 Pis 0815 - 828; (14pgs) FILE NUM 2014041 775 ! El iIDU) 04/16/2014 02:40:23 PM I EC iR[)DN6 FEES 120.50 REUIRDED BY J Eckenrath(all) b co Bond No. 106064635 rs- PERFORMANCE BOND - - C) KNOW ALL MEN BY THESE PRESENTS: that T B Landmark Construction, Inc. clo (Name of CONTRACTOR) 11220 New Berlin Rd. Jacksonville. Florida 32114 904-751-1016 (Address of CONTRACTOR) (Phone No. of CONTRACTOR) a Corporation , hereinafter called (Corporation, Partnership or Individual) CONTRACTOR, 0 and Travelers Casualty and Surety Company of America (Name of SURETY) I Tower Square,Hartford,CT 06183 (800)842-8496 (Address of SURETY) (Phone No. of SURETY) hereinafter called SURETY, are held and firmly bound unto: the City of Sanford, the OWNER, whose address is 300 North Park Avenue, Sanford, Florida C 32771; in the full and just Sum of Nine hundred ninety-four thousand seven hundred thirty-nine and 00/100 DOLLARS ($994.739.00) in lawful money of the United States, for the payment of which o sum well and truly to be made, we, the CONTRACTOR and SURETY, bind ourselves, successors, and assigns, jointly and severally, firmly by these presents. The sum shall not be less than one hundred percent (100%) of the Contract Price. >� THE CONDITION OF THIS OBLIGATION is such that whereas, the CONTRACTOR entered a c into a certain Agreement (including all associated contract documents relating thereto and as the PAgreement may be amended from time-to-time) with the OWNER, dated the ri - day of sp okt L , .Pp151- a copy of which may be hereto attached, but, in to any event, is maintained in the records of the OWNER, said Agreement being hereby made a part hereof by this reference thereto as if fully set forth herein verbatim, said Agreement being o entered generally for the construction of: Sanford Reclaimed Water Interconnect With Volusia Co. (IFB 13/14-2) (Name of Project) (Contract No.) The Project is briefly described as: New reclaimed water main starting at Wayside Park in Seminole Co. and ending near the Lake Monroe Park entrance in Volusia Co. The reclaimed water main will be 20" D.I. open cut Sanford Reclaimed Water Interconnect With Volusia Co. PERFORMANCE BOND Page 1 of 5 construction along a 1400-ft (+1-) portion of the route, plus approximately 1350-ft of new 24" HDPE directional bore construction, the majority of which will be the crossing of the St. Johns River. The construction also includes a new above grade valve and antenna in Wayside Park and new above grade interconnect (including a meter, control panels, and antenna) in Volusia Co. This Bond is being entered into to, at a minimum, satisfy the requirements of Section 255.05, Florida Statutes, and to satisfy the terms and conditions the Agreement. The SURETY shall be bound by any and all alternative dispute resolution awards and settlements to the same extent as CONTRACTOR is bound. NOW, THEREFORE, the condition of this obligation is such that if CONTRACTOR: 1. Promptly and faithfully performs all of its duties and responsibilities as well as all of the covenants, terms, conditions, and agreements of said Agreement in its totality, in the time and manner prescribed in the Agreement to the satisfaction of the OWNER, and 2. Pays OWNER all such sums as will be sufficient to satisfy all losses, damages, delay damages (liquidated or actual), expenses, costs and attorneys' fees (including, but not limited to, costs and attorney's fees on appeal that OWNER sustains resulting directly or indirectly from any breach or default by CONTRACTOR under the Agreement), and 3. Satisfies all claims and demands incurred under the Agreement, and fully indemnifies and holds harmless the OWNER from all costs and damages which it may suffer by reason or failure to do so, then this Bond is able to be voided upon demand of the SURETY; otherwise it shall remain in full force and effect. The coverage of this Bond is co-equal with each and every obligation of the CONTRACTOR under the Agreement. In the event that the CONTRACTOR fails to perform any of the terms, covenants or conditions of the Agreement before this Bond is released by the OWNER, the SURETY shall remain liable to the OWNER for all such loss or damage. The SURETY shall also indemnify and hold the OWNER harmless from any and all loss, damage, cost and expenses enumerated herein with respect to the CONTRACTOR, resulting directly or indirectly from the SURETY's failure to fulfill its obligations hereunder. This subsection shall survive the termination or cancellation of this Bond. The SURETY stipulates and agrees that its obligation under this Bond is to perform the CONTRACTOR's work under the Agreement. The following shall not be considered performance under any circumstance or in any context: (i) SURETY's financing of the CONTRACTOR under the Bond to keep CONTRACTOR from defaulting under the Agreement, or (ii) SURETY's offers to OWNER to buy back the Bond. SURETY's election to do nothing under the Bond shall be construed as a material breach of the Bond and bad faith by the Sanford Reclaimed Water Interconnect With Volusia Co. PERFORMANCE BOND Page 2 of 5 SURETY. The SURETY agrees that its obligation under the Bond is to: (i) fully take over performance of the CONTRACTOR's work under the Agreement in a plenary manner and be the completing surety even if performance of the CONTRACTOR's work exceeds the CONTRACTOR's contract price under the Agreement, or (ii) re-bid and re-let the CONTRACTOR's work to a completing contractor with SURETY remaining liable for the completing contractor's performance of the CONTRACTOR's work and furnishing adequate and full funds to complete the work in the required plenary manner. The SURETY acknowledges that its cost of completion upon default by the CONTRACTOR may exceed the contract price set forth in the Agreement. In any event, the CONTRACTOR l's Contract Time is of the essence and applicable delay damages are not waived by OWNER. The SURETY, for value received, hereby stipulates and agrees that its obligations hereunder shall be direct and immediate and not conditional or contingent upon OWNER's pursuit of its remedies against CONTRACTOR, shall remain in full force and effect notwithstanding (i) amendments or modifications to the Agreement entered into by OWNER and CONTRACTOR without the SURETY's knowledge or consent (ii) waivers of compliance with or nay default under the Agreement granted by OWNER to CONTRACTOR without the SURETY's knowledge or consent, or (iii) the discharge of CONTRACTOR from its obligations under the Agreement as a result of any proceeding initiated under the bankruptcy laws of the United States of America, as the same may be amended, or any similar State or Federal law, or any limitation of the liability or CONTRACTOR or its estate as a result of any such proceeding. Any changes in or under the Agreement and compliance or noncompliance with any formalities connected with the Agreement or the changes therein shall not affect SURETY's obligations under this Bond and SURETY hereby waives notice of any such changes. Further, CONTRACTOR and SURETY acknowledge that the Sum of this Bond shall increase or decrease in accordance with change orders (unilateral and bilateral) or other modifications to the Agreement. The CONTRACTOR may have obligations to the SURETY, but the failure of the CONTRACTOR to perform, comply with or accomplish any such obligation, in whole or part, shall not, in any way or to any extent, limit or interfere with the rights and benefits of the OWNER under this Bond. This Bond and any other bond, or similar document, and the covered amounts of each, are separate and distinct from each other and the OWNER shall be entitled to the totality of rights and benefits from all such documents. This Bond is intended to comply, at a minimu+li, with the requirements of Section 255.05, Florida Statutes, as amended, and additionally, to provide common law rights more expansive than as required by statute; provided, however, that the OWNER shall be entitled to all such common law rights notwithstanding the language used herein. The SURETY agrees that this Bond shall be construed as a common law bond when such construction will benefit the OWNER. The undersigned signatories represent to the OWNER that they are authorized, permitted and empowered to execute this document and bind the entity or person for which they are executing this document and recognize that the OWNER is relying, to its detriment, upon the signature set forth below and the representations, promises, covenants, guarantees and assurances made herein. City of Sanford/Volusia County-Reclaimed Water Interconnect PERFORMANCE BOND Page 3 of 5 IN WITNESS WHEREOF, this instrument is executed this the day of ATTEST: T B Landmark Construction, Inc. CONT AC OR Aiv %.---,L--- '.-ii.' CONTRACTOR A ttesting Authority By: CONTRACTOR Signatory Authority ,400,„,,,.I.,,,,,,-;,, V;••••'�•••`' GA 1 11 li •• i Martin Adams, Manager _' �1- Co •.' esd Name Typed Name and Title ti,‘ f`► , c =.. -`9,y '--P - _ 11220 New Berlin Rd. :0', `F '' PORATE SEAL) Address -4, ��-01Am„,s, Jacksonville, Florida 32114 '4'!11iti RStfoll ( fitness ONTRACTOR) City, State, Zip VI( 0. )0n 904-751-1016 904-751-4125 Typed Name Telephone No. Facsimile No. ATTES SURETY i 1 ,- Travelers Casualty and Surety Company of America Air RETY) Secr- ary f SURETY 'Walt r`N.. °rs 4 yT,, etl Name '1#64 ------ 'e��.•`••.••-•1PP43R,ATE SEAL) Attorney-in-Fact f: ; (, 6 'L 7 Robert T. Theus > s s to.SURETY �� Typed Name 4.,••••1ina.lblontanez 219 N.Newnan Street Typed Name Address Jacksonville,FL 32202 City, State, Zip (904)353-3181 (904)353-5722 Telephone No. Facsimile No. NOTE: Date of the Bond must not be prior to date of Agreement. If CONTRACTOR is a joint venture, all venturers shall execute the Bond. If CONTRACTOR is partnership, all partners shall execute the Bond. The SURETY's obligations run as to all such parties. City of Sanford/Volusia County—Reclaimed Water Interconnect PERFORMANCE BOND Page 4 of 5 IMPORTANT: Surety companies executing bonds must appear on the Treasury Department's most current list (Circular 570 as amended) and be authorized to transact business in the State of Florida, unless otherwise specifically approved in writing by OWNER. ATTACH a certified Power-of-Attorney appointing individual Attorney-in-Fact for execution of Bond on behalf of SURETY. City of Sanford/Volusia County—Reclaimed Water Interconnect PERFORMANCE BOND Page 5 of 5 WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER I, POWER OF ATTORNEY J TRAVELERS Farmington Casualty Company St.Paul Mercury Insurance Company Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company Fidelity and Guaranty Insurance Underwriters,Inc. Travelers Casualty and Surety Company of America St.Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company St.Paul Guardian Insurance Company Attorney-In Fact No. 224800 Certificate No. 005621584 KNOW ALL MEN BY THESE PRESENTS: That Farmington Casualty Company, St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance Company,St.Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers Casualty and Surety Company of America,and United States Fidelity and Guaranty Company are corporations duly organized under the laws of the State of Connecticut,that Fidelity and Guaranty Insurance Company is a corporation duly organized under the laws of the State of Iowa,and that Fidelity and Guaranty Insurance Underwriters,Inc.,is a corporation duly organized under the laws of the State of Wisconsin(herein collectively called the"Companies"),and that the Companies do hereby make,constitute and appoint Fitzhugh K.Powell Jr.,Robert T.Theus,Roger R.Hurst,Susan W.Jordan,Walter N.Myers,and Benjamin Powell II of the City of Jacksonville ,State of Florida ,their true and lawful Attomey(s)-in-Fact, each in their separate capacity if more than one is named above,to sign,execute,seal and acknowledge any and all bonds,recognizances,conditional undertakings and other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons,guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. IN WITNESS WHEREOF,the Companies have caused this instrument to be signed and their corporate seals to be hereto affixed,this 30th ffi day of August 2013 Farmington Casualty Company St.Paul Mercury Insurance Company Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company Fidelity and Guaranty Insurance Underwriters,Inc. Travelers Casualty and Surety Company of America St.Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company St.Paul Guardian Insurance Company G �4r p,P�2• .44' eV 4 y \1.N..LNSG .„..,n„,,,...t P,,Tr aao we �ytY40 02 oerayr',- °w F G P 1,p it!�: :! 4J.:.........9y q PJ SL ,� fly �\� C u* o ° r�O 91CDRPDRATED w T °",�4 1 W,;�pkPORA;—n� �` m 3� '`�\ 1982 0 t --R,. ,. _._ 1,-,1 a �W„ a „,,„,„„,,,,A 977 - a: a HARTFORD, t �RTFORD,t Z qy�• S ; 1951 . ,s. - •S E A L!” �' ° "' cowN. '� coRn. 2 u+ 1896 �y �a > ';a + •'o' �`., ro o"SEAL:D W i 1t f ry �� i *eta o .,yr��•N ,, INN v.•... :`a ''s 4a .f• `yse %) �A' 1 State of Connecticut By: // ..,:e.-/ City of Hartford ss. Robert L.Raney, e or Vice President On this the 30th day of August 2013 before me y personally appeared Robert L.Raney,who acknowledged himself to be the Senior Vice President of Farmington Casualty Company, Fidelity and Guaranty Insurance Company,Fidelity and Guaranty Insurance Underwriters,Inc.,St.Paul Fire and Marine Insurance Company,St.Paul Guardian Insurance Company,St.Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers Casualty and Surety Company of America,and United States Fidelity and Guaranty Company,and that he,as such,being authorized so to do,executed the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. GTE In Witness Whereof,I hereunto set my hand and official seal. *Or V\.600(14. C . My Commission expires the 30th day of June,2016. *+ 'Domo * Marie C.Tetreault.N t\r\ P5:hlic C 58440-8-12 Printed in U.S.A. 1 A, : a e .. Z v • WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER �� •• yti •\ *P.i ,, r l;R -ond No. 106064635 PAYMENT BOND KNOW ALL MEN BY THESE PRESENTS: that T B Landmark Construction. Inc. (Name of CONTRACTOR) 11220 New Berlin Rd. Jacksonville, Florida 32114 904-751-1016 (Address of CONTRACTOR) (Phone No. of CONTRACTOR) a Corporation , hereinafter called (Corporation, Partnership or Individual) CONTRACTOR, and Travelers Casualty and Surety Company of America (Name of SURETY) 1 Tower Square,Hartford,CT 06183 (800)842-8496 (Address of SURETY) (Phone No. of SURETY) hereinafter called SURETY, are held and firmly bound unto: the City of Sanford, the OWNER, whose address is 300 North Park Avenue, Sanford, Florida 32771; in the full and just Sum of Nine hundred ninety-four thousand seven hundred thirty-nine and 00/100 DOLLARS ($994,739.00) in lawful money of the United States, for the payment of which sum well and truly to be made, we, the CONTRACTOR and SURETY, bind ourselves, successors, and assigns, jointly and severally, firmly by these presents. The sum shall not be less than one hundred percent (100%) of the Contract Price. THE CONDITION OF THIS OBLIGATION is such that whereas, the CONTRACTOR entered into a certain Agreement (including all associated contract documents relating theto and as the Agreecnent may be amended from time-to-time) with the OWNER, dated the day of 12.4 L , c2014 a copy of which may be hereto attached, but, in any event, is maintained in the records of the OWNER, said Agreement being hereby made a part hereof by this reference thereto as if fully set forth herein verbatim, said Agreement being entered generally for the construction of: Sanford Reclaimed Water Interconnect With Volusia Co. IFB 13/14-2 (Name of Project) (Contract No.) The Project is briefly described as: Sanford Reclaimed Water Interconnect With Volusia Co. PAYMENT BOND Page 1 of 4 New reclaimed water main starting at Wayside Park in Seminole Co. and ending near the Lake Monroe Park entrance in Volusia Co. The reclaimed water main will be 20" D.I. open cut construction along a 1400-ft (+/-) portion of the route, plus approximately 1350-ft of new 24" HDPE directional bore construction, the majority of which will be the crossing of the St. Johns River. The construction also includes a new above grade valve and antenna in Wayside Park and new above grade interconnect (including a meter, control panels, and antenna) in Volusia Co. The SURETY shall be bound by any and all alternative dispute resolution awards and settlements to the same extent as CONTRACTOR is bound. NOW, THEREFORE, the condition of this obligation is such that if CONTRACTOR shall promptly make payments to all claimants as defined in Sections 255.05 and 713.01, Florida Statutes, supplying CONTRACTOR with labor, materials, or supplies, used directly or indirectly by CONTRACTOR in the prosecution of the Work provided for in the Agreement, then this obligation shall be void; otherwise, it shall remain in full force and effect subject, however, to the following conditions: 1. This Bond is furnished for the purpose of complying with the requirements of Section 255.05, Florida Statutes, as amended as well as for other intents and purposes for the benefit of the OWNER. 2. Any action instituted by a claimant under this bond for payment must be in accordance with the notice and time limitation provisions in Sections 713.23 and 713.18, Florida Statutes. 3. Therefore, a claimant, except a laborer, who is not in privity with the CONTRACTOR shall, before commencing to furnish labor, materials, or supplies for the prosecution of the work, or not later than 45 days after commencing to furnish labor, materials, or supplies for the prosecution of the work, furnish the CONTRACTOR with a notice that he or she intends to look to this Bond for protection. A claimant who is not in privity with the CONTRACTOR and who has not received payment for his or her labor, materials, or supplies shall deliver to the CONTRACTOR and to the SURETY written notice of the performance of the labor or delivery of the materials or supplies and of the nonpayment. The notice of nonpayment may be served at any time during the progress of the work or thereafter but not before 45 days after the first furnishing of labor, servic s, or materials, and not later than 90 days after the final furnishing of the labor, services, or materials by the claimant or, with respect to rental equipment, not later than 90 days after the date that the rental equipment was last on the job site available for use. Claimant shall deliver to the CONTRACTOR and to the SURETY written notice of the performance of the labor or delivery of the materials or supplies and of the nonpayment. No action for the labor, materials or supplies may be instituted against the CONTRACTOR or the SURETY on the bond after one year from the performance of the labor or completion of the delivery of the materials or supplies. Sanford Reclaimed Water Interconnect With Volusia Co. PAYMENT BOND Page 2 of 4 4. The SURETY, for value received, hereby stipulates and agrees that its obligations hereunder shall be direct and immediate and not conditional or contingent upon OWNER's pursuit of its remedies against CONTRACTOR, shall remain in full force and effect notwithstanding (i) amendments or modifications to the Agreement entered into by OWNER and CONTRACTOR without the SURETY's knowledge or consent (ii) waivers of compliance with or nay default under the Agreement granted by OWNER to CONTRACTOR without the SURETY's knowledge or consent, or (iii) the discharge of CONTRACTOR from its obligations under the Agreement as a result of any proceeding initiated under the bankruptcy laws of the United States of America, as the same may be amended, or any similar State or Federal law, or any limitation of the liability or CONTRACTOR or its estate as a result of any such proceeding. 5. Any changes in or under the Agreement and compliance or noncompliance with any formalities connected with the Agreement or the changes therein shall not affect SURETY's obligations under this Bond and SURETY hereby waives notice of any such changes. Further, CONTRACTOR and SURETY acknowledge that the Sum of this Bond shall increase or decrease in accordance with change orders (unilateral and bilateral) or other modifications to the Agreement. The CONTRACTOR may have obligations to the SURETY, but the failure of the CONTRACTOR to perform, comply with or accomplish any such obligation, in whole or part, shall not, in any way or to any extent, limit or interfere with the rights and benefits of the OWNER under this Bond. 6. This Bond and any other bond, or similar document, and the covered amounts of each, are separate and distinct from each other and the OWNER shall be entitled to the totality of rights and benefits from all such ldooccuments. IN WITH SS WHEREOF, this instrument is executed this the / day of fee,/ ATTEST: T B Landmark Construction, Inc. CONTRACT R g !• A _- ,,,,„,,C7 TRACTOR A esting Authority By: CONTRACTOR Signatory Authority ,.� .• , p n ?j•1\nid 11 - _ I Martin Adams, Manager •. :.tt� Gi^•% ._I yped Name J Typed Name and Title rvi - , to 1 - 11220 New Berlin Rd. --.OJ . i.a.(c E'PORATE SEAL) Address 'sy 74".,9 . ',ttr-r-3',. ii4 Jacksonville, Florida 32114 (Witness o ONTRACTOR) City, State, Zip ■0 Y Qk ) 1(v\\-v1.tIi 904-751-1016 904-751-4125 yped Name Telephone No. Facsimile No. Sanford Reclaimed Water Interconnect With Volusia Co. PAYMENT BOND Page 3 of 4 • A EST SURETY / / �` _ Travelers Casualty and Surety Company of America #'URE Y) Secret-ry SURETY Walter N.hers (800)842-8496 Typed Nam Telephone No. Facsimile No. t41/ /et 41E SEAL\J fat ,( v �(,� t By • f." ' tness at to SURETY Attorney-in-Fact Tana Montanez Robert T.Theus Typ -Name Typed Name �/y� 219 N.Newnan Street `_..tNitness as to SURETY Address Annette Evans Jacksonville,FL 32202 Typed Name City, State, Zip (904)353-3181 (904)353-5722 Telephone No. Facsimile No. NOTE: Date of the Bond must not be prior to date of Agreement. If CONTRACTOR is a joint venture, all venturers shall execute the Bond. If CONTRACTOR is partnership, all partners shall execute the Bond. The SURETY's obligations run as to all such parties. IMPORTANT: Surety companies executing bonds must appear on the Treasury Department's most current list (Circular 570 as amended) and be authorized to transact business in the State of Florida, unless otherwise specifically approved in writing by OWNER. ATTACH a certified Power-of-Attorney appointing individual Attorney-in-Fact for execution of Bond on behalf of SURETY. Sanford Reclaimed Water Interconnect With Volusia Co. PAYMENT BOND Page 4 of 4 • ' WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER .A► POWER OF ATTORNEY TRAVELERS.1 Farmington Casualty Company St.Paul Mercury Insurance Company Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company Fidelity and Guaranty Insurance Underwriters,Inc. Travelers Casualty and Surety Company of America St.Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company St.Paul Guardian Insurance Company Attorney-In Fact No. 224800 Certificate No. 0 05621585 KNOW ALL MEN BY THESE PRESENTS: That Farmington Casualty Company, St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance Company,St.Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers Casualty and Surety Company of America,and United States Fidelity and Guaranty Company are corporations duly organized under the laws of the State of Connecticut,that Fidelity and Guaranty Insurance Company is a corporation duly organized under the laws of the State of Iowa,and that Fidelity and Guaranty Insurance Underwriters,Inc.,is a corporation duly organized under the laws of the State of Wisconsin(herein collectively called the"Companies"),and that the Companies do hereby make,constitute and appoint Fitzhugh K.Powell Jr.,Robert T.Theus,Roger R.Hurst,Susan W.Jordan,Walter N.Myers,and Benjamin Powell of the City of Jacksonville ,State of Florida ,their true and lawful Attomey(s)-in-Fact, each in their separate capacity if more than one is named above,to sign,execute,seal and acknowledge any and all bonds,recognizances,conditional undertakings and other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons,guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. IN WITNESS WHEREOF,the Companies have caused this instrument to be signed and their corporate seals to be hereto affixed,this 30th day of August 2013 Farmington Casualty Company St.Paul Mercury Insurance Company Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company Fidelity and Guaranty Insurance Underwriters,Inc. Travelers Casualty and Surety Company of America St.Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company St.Paul Guardian Insurance Company �ttTY I ,CI,SU,A�r : /In"ti \i.N....9s* xaj' ,,"*NO wpE 0YA� ct o,0.°<4 O:' J:................... J s ... fY I-8 S C1 ° INCORFDRATED _ T aIZoRPwR4ff + Wr�0aP0eA ff`^',c o' 9 `�'J \\� Ixc Z�19.82� O ',977 _ 4.�' soi Z -._ • ;o; W HARTFORD, La•HARTFORD,�.4 a DO t_ crt,_ f 1951 t J:SEAL i6'l 1."S °i CONN. 5�DONN.i e3 1896 a '" , y o. �• tee:,SEAL ;, o i` f o bey. ti� i 1`� 7„ es',,44CC° �'4?:AN3ar l°'.r......:re yt • 0,ai \J'••-:+ .(4P0 AN, State of Connecticut By: /� �'� City of Hartford ss. Robert L.Raney, e Ai for Vice President On this the 30th day of August 2013 before me personally appeared Robert L.Raney,who acknowledged himself to be the Senior Vice President of Farmington Casualty Company, Fidelity and Guaranty Insurance Company,Fidelity and Guaranty Insurance Underwriters,Inc.,St.Paul Fire and Marine Insurance Company,St.Paul Guardian Insurance Company,St.Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers Casualty and Surety Company of America,and United States Fidelity and Guaranty Company,and that he,as such,being authorized so to do,executed the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. to.Terk . r. • In Witness Whereof,I hereunto set my hand and official seal. IAA Git01 CZ, : • v•- My Commission expires the 30th day of June,2016. * *1G * Marie C.Tetrrul1,Nor ublo 1.• %t,, ....... 4 ?a 58440-8-12 Printed in U.S.A. .,,0 #1$18 _^ WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER