1530* Killebrew (2)xin%IN
UTILITY DEPARTME1N r
TRANSMITTAL MEMORANDUM
TO: Bill Smith, Purchasing
FROM: Migdalia Hernandez
RE: Final Pay Request for Large Meters Replacement
L'
n;
�y I:^yil
4wT�
The item(s) noted below is /are attached and forwarded to your office for the following action(s):
❑ Development Order ❑ Mayor's signature
❑ Final Plat (original mylars) ® Recording
❑ Letter of Credit Renderi, g
® Maintenance Bond Lfe �(Vault ❑ Ordinance ❑
®
Performance Bond
❑
Resolution
❑
Final Lien Releases
Once completed, please:
❑ Return original
® Return copy
❑ Return Original Change Orders to Process Final Payment
Special Instructions:
Bill /Marisol
Attached the following documentations for signature and proper recording:
1. Large Meters — Final Change Order Reconciliation Deduct (3 originals)
2. Final Lien Release from Killebrew
3. Original Consent of Surety to Final Payment
4. Original Material and Workmanship Bond
Please advise if you have any questions regarding the above final pay request documentation.
Thank you!
DATE: 01/02/13
PURCHASING OFFICE: 407.688.5030
ACCOUNTS PAYABLE: 407.688.5020
FACSIMILE: 407.688.5021
VENDOR NO.: 11849
TO:
KILLEBREW, INC
PO BOX 6258
LAKELAND, FL
I all SoN am F.34 N Owl 1 '1
CITY OF SANFORD
P.O. BOX 1788
(300 NORTH PARK AVENUE)
SANFORD, FLORIDA 32772
FLORIDA TAX EXEMPT NO.: 858012621681C -8
PO NUMBER 033224
CHANGE #: 6
DATE CHG: 04/02/13
SUBMIT INVOICES TO: ACCOUNTS PAYABLE
FINANCE DEPT.
P.O. BOX 1788
SANFORD, FL 32772
SHIP TO:
CITY OF SANFORD
300 N. PARK AVENUE
33807 -6258 SANFORD, FL 32771
DELIVER BY
TERMS
F.O.B. DESTINATION
BID OR QUOTATION NO.
REQUISITION NO.
UNLESS OTHERWISE INDICATED
09/30/13
NET /30
ACCOUNT NO.: SEE BELOW PROJECT NO.:
NO DEVIATION FROM THIS PURCHASE ORDER WILL BE ALLOWED UNLESS AUTHORIZED BY THE PURCHASING MANAGER - CITY OF SANFORD
ITEM NO.
DESCRIPTION
QUANTITY
OF
UNITE
ISSUE
UNIT COST
EXTENDED COST
*
* CHANGE ORDER
*
*** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
1
METER REPLACEMENTS AT THE
.00
.00
.00
FOLLOWING LOCATIONS:
PAGE SCHOOL, MARINER VILLAGE AND
TWO METERS
ON SEMINOLE COUNTY BLDG AND MED
ART BLDG
STATE REVOLVING LOAN DW159120
2
SEE LINE ITEM NO.1 FOR DETAILS
32620.00
NA
1.00
32620.00
CHANGE ACCT CODE
3
WATER QUALITY IMPROVEMENT
.00
.00
.00
PROJECT
RFQ 11/12 -02; LARGE METER
INSTALLATION FOR
VARIOUS LOCATIONS; 1 AT MARINER
VILLAGE, 3 AT
SEMINOLE COUNTY BUILDING, AND 1 AT
MEDICAL ART
BUILDING ... DW1103;'SRF DW590120
CHANGE ORDER NO 1 ATTACHED
SEE LINE ITEM 3 FOR DETAILS
4
SEE LINE 3 FOR DETAILS CHANGED
.00
.00
.00
ACCT CODE
APPROVED BY:
APPROVED BY: IJ45nh 4l_
CITY PrANAGER
ALL PACKAGES AND INVOICES ASSOCIATED WITH THIS P.O. MUST BEAR THIS PURCHASE ORDER NUMBER. THE VENDOR IS RESPONSIBLE TO CAREFULLY
READ AND COMPLY WITH ALL OF THE STANDARD TERMS AND CONDITIONS PROVIDED ON THE REVERSE SIDE OF THIS PURCHASE ORDER
AND AT HTTP: //WWW.SANFORDFL.GOVI DEPARTMENTS /PURCHASE/TERMS.HTML
COPIES TO: VENDOR ORIGINATING DEPARTMENT PURCHASING
DATE: 01/02/13
PURCHASING OFFICE: 407.688.5030
ACCOUNTS PAYABLE: 407.688.5020
FACSIMILE: 407.688.5021
VENDOR NO.: 11849
TO:
KILLEBREW, INC
PO BOX 6258
LAKELAND, FL
CITY OF SANFORD
P.O. BOX 1788
(300 NORTH PARK AVENUE)
SANFORD, FLORIDA 32772
FLORIDA TAX EXEMPT NO.: 858012621681C -8
PO NUMBER 033224
CHANGE 4: 6
DATE CHG: 04/02/13
SUBMIT INVOICES TO: ACCOUNTS PAYABLE
FINANCE DEPT.
P.O. BOX 1788
SANFORD, FL 32772
SHIP TO:
CITY OF SANFORD
300 N. PARK AVENUE
33807 -6258 SANFORD, FL 32771
DELIVER BY
TERMS
F.O.B. DESTINATION
BID OR QUOTATION NO.
REQUISITION NO.
UNLESS OTHERWISE INDICATED
09/30/13
NET /30
ACCOUNT NO.: SEE BELOW PROJECT NO.:
NO DEVIATION FROM THIS PURCHASE ORDER WILL BE ALLOWED UNLESS AUTHORIZED BY THE PURCHASING MANAGER - CITY OF SANFORD
ITEM NO.
DESCRIPTION
QUANTITY
UNIT E
OF
ISSUE
UNIT COST
EXTENDED COST
* t�r* k: k' kYit�cisk�cFickic *F *ickirk�cic9c�c'kF4rk4ci:
* CHANGE ORDER
5
CHANGE PROJECT CODE
208184.00
NA
1.00
208184.00
6
SANFORD CENTRAL FL REGIONAL
102128.00
NA
1.00
102128.00
HOSPITAL METER REPLACE
MENT,
Change Order 2 Reduce PO of
$ -7=300 and included
additional days to contract 303
days total of
423 days... entire project (MH)
10.14.14
SUB
TOTAL
342932.00
TOTAL
342932.00
EQ /ACCT DATE REQ. BY
-------
- - - --
PROJECT
- - - - - --
-- - - - - --
AMOUNT
---------------------------- - - - - --
000063577 12/18/12 MIGDALIA H
----- - - - - --
RNANDEZ
- - - --
DW
- - - - - --
103
-- - - - - --
.00
5245305366300
3577 04/02/13 RYAN OSSOW
KI
DW
103
2620.00
5245305366303
1---------------------------------------
000064083 11/19/13 M HERNANDE
DW
103
.00
5245305366300
4083 11/26/13 RYAN OSSOW
KI
DW
103
.00
5245305366303
4083 12/10/13 PETER /RYIUI
DW
102 2(8184.00
5245305366303
000064209 03/13/14 M HERNANDEJ
DW
102 1(2128.00
5245305366303
APPROVED BY:
PURCHASING AGENT
APPROVED BY:
CITY MANAGER
ALL PACKAGES AND INVOICES ASSOCIATED WITH THIS P.O. MUST BEAR THIS PURCHASE ORDER NUMBER. THE VENDOR IS RESPONSIBLE TO CAREFULLY
READ AND COMPLY WITH ALL OF THE STANDARD TERMS AND CONDITIONS PROVIDED ON THE REVERSE SIDE OF THIS PURCHASE ORDER
AND AT HTTP: //WWW.SANFORDFL.GOV/ DEPARTMENTS /PURCHASE/TERMS.HTML
COPIES TO: VENDOR ORIGINATING DEPARTMENT PURCHASING
PROJECT NO. IFB 10/11 -10
SECTION 00850
CHANGE ORDER FORM
Change Order No. 1 /,i
Project Title Water Quality Improvement Proiect (Sanford Meter Replacement -- First
Five Meters)
Bid No. RFQ 11/12 -02, PO 033224, Requisition No. 63577
Owner: City of Sanford
Contractor: Killebrew, Inc.
Agreement Date: January 2, 2013
This Change Order is necessary to cover changes in the work to be
performed under this Agreement. The GENERAL CONDITIONS,
SUPPLEMENTARY CONDITIONS, and STANDARD SPECIFICATIONS
apply to and govern all work under this Change Order.
THE FOLLOWING CHANGES ARE MADE TO THE CONTRACT DOCUMENTS:
(1) Original Contract Price
(2) Current Contract Price (Adjusted by Previous Change Orders)
(3) Total Proposed Change in Contract Price
(4) New Contract Price (Item 2 + Item 3)
(5) Original Contract Time
(6) Current Contract Time (Adjusted by Previous Change Orders)
(7) Total Proposed Change in Contract Time
(8) New Contract Time (Item 6 + Item 7)
(9) Original Contract Substantial Completion Date
(10) New Contract Substantial Completion Date
00850 -1
$113,675
$127,129
$(7,300)
$119,829
120 Days
120 Days
303 Days
423 Days
May 2, 2013
March 1, 2014
PROJECT NO. IFB 10/11 -10
CHANGES ORDERED
ITEM 1
Description of Change: Reconcile final contract amount for close out purposes.
Reason for Change: Project is complete
Change in Contract Price: ($7,300)
Change in Contract Time:
CHANGE ORDER SUMMARY
No.
Description
Change in
Contract Price
Change in
Contract Time
1
Final Reconciliation Deduct
($7,300)
0
TOTAL
1 ($7,300)
1 0
WAIVER This Change Order constitutes full and mutual accord and satisfaction for the
adjustment of the Contract Price and Contract Time as a result of increases or decreases in
cost and time of performance caused directly and indirectly from the change. Acceptance of
this Waiver constitutes an agreement between OWNER and CONTRACTOR that the Change
Order represents an equitable adjustment to the Agreement and that CONTRACTOR shall
waive all rights to file a Contract Claim or claim of any nature on this Change Order. Execution
of this Change Order shall constitute CONTRACTOR's complete acceptance and satisfaction
that it is entitled to no more costs or time (direct, indirect, impact, etc.) pursuant to this Change
Order.
APPROVAL AND CHANGE ORDER AUTHORIZATION
00850 -2
PROJECT NO. IFB 10/11 -10
ACKNOWLEDGMENTS
The aforementioned change, and work affected thereby, is subject to all provisions of the
original Agreement and specifically changed by this Change Order; and It is expressly
understood and agreed that the approval of the Change Order shall have no effect on the
original Agreement other than matters expressly provided herein.
IVY c��
L ly—L 4
(Secretar )
_q�I'1 1q
Date ,
(Corporate Seal)
UVEM M
(Signs ure)
( v — t a. --- i '-f
Date
(Seal)
Vi , k1-e 6't-e,L'-); ( f-, ('
Contractor
Ctrs , t � � C, m Cr vt�r a S, l y e-
Printed Name and Title of O er
By (Signature
Date
Owner
Printed Name and Title
By (Si ature)
Zq
Date
END OF SECTION
00850 -3
PROJECT NO. RFQ 11/12-02
SECTION 00644
SUBCONTRACTOR'S RELEASE OF LIEN (FINAL AND COMPLETE)
Before me, the undersigned authority in said County and State, appeared Cindy Q. Adamson
who, being first duly sworn, deposes and says that he is
Vice- President of Killebrew. Inc. a
company and/or corporation authorized to do business in the State of Florida, and is a
SLIBCONTRACTOR/VENDOR/LIENOR in a contract entered into between the CONTRACTOR,
1) Killebrew, Inc, and the City of Sanford for the Project
known as 2) Water Quality Improvement Projects, RFQ 11/12-02, located in Seminole County,
Florida under an Agreement with the CITY OF SANFORD the date of said Agreement which is
31 12/20/13
1) Name of Contractor 2) Name of Project identified in Instructions to Bidders 3) Date of Referenced Agreement
Let it be known that the undersigned SubcontractorNendor/Lienor is duly authorized to make
this affidavit in consideration of the final payment in the amount of 4) $109.428.00 , and
hereby waives all rights to claim a lien for labor, services, equipment, or materials furnished to
the CONTRACTOR on the project and property identified herein before.
4) Amount of Final Payment 5) Address and Identification of the Property
IN WITNESS WHEREOF, 1 /we have executed this instrument under seal this 16th day of
Sept 2014
Authorized Rdpresentative (Signature)
v
Cindy D. Adamson (SEAL)
Printed Name and Title
STATE OF Florida
COUNTY OF Polk
The foregoing instrument was acknowledged before me this 16th day of sepi
2014 by Cindv D. Adamson
-1 1 — Of
Killebrew. Inc. — (corporation), on behalf of the corporation, who is
personally known to me or has produced (Type
of Identification) as identification and who did (did not) take an oath.
Sworn to and subscribed to before me this 16th day of September
2014
Aa IZ-
(Signature)
Denise Henderson
(Print name) Notary Public in and for the County and State Aforementioned
My Commission Expires: 12/25/17
END OF SECTION
DENISE HENDERSON
MY COMMISSION #FF078917
006" EXPIRES December 25, 2017
(407) 398-0153 RoridallotarySeMG(-1.001T1
BOND NO.: 54- 192177
Owner: City of Sanford
Project Name: Water Quality Improvement Project
Contractor: Killebrew, Inc. PROJECT NO. RFQ 11/12 -02
SECTION 00617
CONSENT OF SURETY TO FINAL PAYMENT
WE, the United Fire & Casualty Company , having heretofore
executed Performance and Payment Bonds for P.O. # 033224 Sanford Meter Replacements Only
in the sum of Two Hundred Fifty Two Thousand One Hundred Eighty Two and 70/100
Dollars ($ 252, 182 .70 ------- -- --------------- );- hereby agree that the OWNER may make full payment of
the final estimate, including the retained percentage, to said CONTRACTOR. The Surety
concurs that full payment to the CONTRACTOR is appropriate and the Surety expressly
releases the OWNER from all liability to Surety resulting from full payment to CONTRACTOR. It
is fully understood that the granting of the right to the OWNER to make payment of the final
estimate to said contractor and /or his assigns, shall in no way relieve this surety company of its
obligations under its bond, as set forth in the specifications, contract and bond pertaining to the
above project.
IN WITNESS WHEREOF, the United Fire & Casualty Company has
caused this instrument to be executed on its behalf by its Representative
and its duly authorized attorney in fact, and its corporate seal to be
hereunto affixed, all on this 5th day of September 2014
United Fire & Casualty Company
Surety Attorney -in -Fact Teresa L. Durham
& FL Licensed Resident Agent (407) 786 -7770
(Power of Attorney must be attached if executed by Attorney in Fact)
STATE OF Florida .
COUNTY OF Orange
The foregoing instrument was acknowledged before me this 5th day of September
2014 by Teresa L. Durham of _
United Fire & Casualty Company (corporation), on behalf of the corporation, who is
personally known to me or has produced N (Type
of Identification) as identification and who did (did not) take an oath.
Sworn to and subscribed to before me this 5th day of September 2014
.S�6'.�rf.sct6.i!ad �. • ,/at�tu.e��i.-�t�
(Signature)
Patricia L. Slaughter
(Print name) Notary Public in and for the County and State Aforementioned
My Commission Expires: 3/31/17
END OF SECTION
00617.1 RHEI ic State of Florida laughtersion EE 868174
1 /2017
INDIVIDUALLY of MAITLAND FL
their true and lawful Attorneys) -in,-Fact with power and authority hereby conferred to sign, seal and execute in its behalf all lawful'bouds, undertakings
and other obligatory instruments of similar nature provided that no single obligation shall exceed $35, 000, 000.00
and to bind the Companies thereby as fully and to the same extent as if such instruments were signed by the duty authorized officers of the Companies
and all of' the ,acts of said Attorney, pursuant to the authority, hereby 'given and hereby ratified and confirmed.
The Authority hereby granted is continuous and shall remain in full force and effect until revoked by UNITED FIRE & CASUALTY COMPANY,
UNITED FIRE '& INDEMNITY COMPANY, AND FINANCIAL PACIFIC INSURANCE COMPANY.
This Power of Attorney is made and executed' pursuant to and by authority of the following bylaw duly adopted of May 15, 2013, by the Boards of
Directors of UNITED FIRE & CASUALTY COMPANY, UNITED FIRE & INDEMNITY COMPANY, and FINANCIAL PACIFIC INSURANCE
COMPANY. "Article VI – Surety Bonds and Undertakings"
Section ?, Appointment of Attomey -in -Fact. "The President or any Vice President, or any other officer of the Companies may, from time to
time, appoint by written certificates attorneys -in -fact to act in behalf of the Companies in the execution of policies of 'insurance, bonds,
undertakings and other obligatory instruments of like nature. The signature of any officer authorized hereby, and the Corporate seal, may be
affixed by facsimile to any power of attorney or special power of attorney or certification of either authorized hereby; such signature "and seal,
when soused, being adopted by the Companies as the original signature of such officer and the original seal of the Companies, to be valid and
binding upon the Companies with the same force and effect as though manually affixed. Such attorneys -in -fact, subject to the limitations set
forth in their: respective certificates of authority shall have full power to bind the Companies by their signature and execution of any:such
instruments and to attach the seal of the Companies thereto. The President or any Vice President, the Board of Directors or any other officer of
the Companies may at any time revoke all power and authority previously given to any attorney -in -fact.
CAS °u„ /., a 1., + +IIII,II IN WITNESS WHEREOF the COMPANIES have each caused these presents to be signed by its
Qk�Qy, {,c�4 ;� gWDE1yy /ji4 `O��" \G INSU lid /+(' o
° . k g o \,QPG� oPPOt I4"" ,w vice president and its corporate seal to be hereto affixed this 11 t h day of October, 2013
CORPORATE CORPORATE �'..,, = �v, 2G 'FO c7
t _ � _ > z _ auLr zz, . = UNITED FIRE &CASUALTY COMPANY
i:z 4 P SEAL 3\P� �? SEAL Y Z, �, 1986 .aa, UNITED FIRE &INDEMNITY COMPANY
FINANCIAL PACIFIC INSURANCE COMPANY
/KAeip ��0' 69,Zy, D`� . a' ,UFOP
// /111
B
'' V
y:
State of Iowa,. County of Linn, ss: Vice President
On llth day 'of October, 2013, before me personally came Dennis J. Richmann
to me known; who being by me duly sworn, did depose and say; that he resides in Cedar'Rapids,.State'of Iowa; thathe is a Vice President of UNITED
FIRE & CASUALTY COMPANY, a Vice President of UNITED FIRE & INDEMNITY COMPANY, and a Vice President of FINANCIAL PACIFIC
:INSURANCE COMPANY the.corporations described hi and which executed the above instrument; that he knows the seal of said corporations. that the
seal affixed to the said instrument is such corporate seal; that it was so affixed pursuant to authority given by the Board of Directors of said corporations
and that he sighed his name thereto pursuant to like authority, and acknowledges same to be the act and deed of said corporations.
%110 Iowa Notarial Seal H Notary Public
Judith A. Davis commission number 173041 My commission expires: 4'/23/2015
My Commission Expires 4/23/2015
said originals, and that the said Power of Attorney has not been revoked and is r
In testa— no y,whereof I have hereunto subscribed my name and affxec
this day of i 20
G111NSU
�q14 }ao `qPG \pAPOiJq �C..:
CORD: E dY�y gip/ CORPORATE. y U..�G DULY 2,� 0
:a K 5` SEAL t 6 1966 ,e
SEAL c 5
RIII Il' \` / of i /11 \\ ` II /Iy(Ill lllitll \ \�� `
:BPOA0044 0913
Assistant Secretary, OF &I /FPIC
Bond No. 54-201999 PROJECT NAME: Water Quality Improvement Project
Effective Dates: 8/26/14 — 8/26/16 P.O. # 033224
Executed in 1 Counterpart
SECTION 00615
MATERIAL AND WORKMANSHIP BOND
KNOW ALL MEN BY THESE PRESENTS:
THAT WE, Killebrew, Inc., hereinafter referred to as "Principal" and United Fire &
Casualty Company, hereinafter referred to as "Surety" are held and firmly bound unto the (1)
City of Sanford, hereinafter referred to as the OWNER in the sum of ten percent (10%) of the
110% Contract Price of $252,182.70, as adjusted under the Contract Documents which equals
Twenty Five Thousand Two Hundred Eighteen and 27/100 Dollars $25,218.27 is for the
payment of which we bind ourselves, heirs, executors, successors and assigns, jointly and
severally, firmly by these presents.
WHEREAS, Principal has constructed certain improvements, including roadways,
utilities, curbs, storm drains and other appurtenances in that certain Project described as the (2)
Water Quality Improvement Project, (P.O. #033224 — Sanford Meter Replacements Only), and
WHEREAS, the aforesaid improvements were made pursuant to an Agreement dated
September 18th, 2012 and filed with the Purchasing Office of OWNER; and
WHEREAS, the Principal warrants and guarantees to the OWNER that all work, labor,
materials, equipment and services furnished and performed has been done in a good and
workmanlike manner and is of the highest quality, free from defects; and
WHEREAS, Principal is obligated to protect the OWNER against any defects resulting
from faulty Materials or Workmanship of said improvements and to maintain said improvements
for a period of two (2) years from the date of Final Completion under the Contract Documents.
NOW THEREFORE, the conditions of this obligation is such that if Principal shall
promptly and faithfully protect the OWNER against any Defects resulting from faulty Materials
and Workmanship of the aforesaid improvements and maintain said improvements for a period
of two (2) years from the date of Final completion, then this obligation shall be null and void,
otherwise it shall remain in full force and effect.
1) Name of Owner- City of Sanford
2) Name of Project identified in Instructions to Bidders - Water Quality Improvement Proiect,
(P.O. #033224 — Sanford Meter Replacements Only)
The OWNER shall notify the Principal in writing of any Defect for which the Principal is
responsible and shall specify in said notice a reasonable period of time within which Principal
shall have to correct said Defect.
00615-1
Bond No. 54- 201999 PROJECT NAME: Water Quality Improvement Project
Effective Dates: 8/26114-8/26/16 P.O. # 033224
Executed in 1 Counterpart
The Surety unconditionally covenants and agrees that if the Principal fails to perform, within the
time specified, the Surety, upon thirty (30) days written notice from OWNER, or its authorized
agent or officer, of the failure to perform will correct such Defect or Defects and pay the cost
thereof, including, but not limited to engineering, legal and contingent costs. Should the
Surety fail or refuse to correct said Defects, the OWNER, in view of the public interest, health,
safety, welfare and factors involved, shall have the right to resort to any and all legal remedies
against the Principal and Surety and either, both at law and in equity, including specifically,
specific performance to which the Principal and Surety unconditionally agree.
The Principal and Surety further jointly and severally agree that the OWNER at its option, shall
have the right to correct said Defects resulting from faulty Materials or Workmanship, or,
pursuant to public advertisement and receipt of Bids, cause to be corrected any Defects or said
Defects in case the Principal shall fail or refuse to do so, and in the event the OWNER should
exercise and give effect to such right, the Principal and the Surety shall jointly and severally
hereunder reimburse the OWNER the total cost thereof, including, but not limited to,
engineering, legal and contingent costs, together with any damages either direct or consequent
which may be sustained on account of the failure of the Principal to correct said defects.
IN WITNESS WHEREOF, this instrument is executed this the 5th day of September, 2014.
ATTEST:
Secretary (Principal)
Typed, Ntame
(CORf?ORATE SEAL)
. v.
(,Witness to Principal) i
Typed Name
00615 -2
Killebrew. Inc.
Principal (Contractor)
By (Signat e)
Typed Name and Title
2830 Winter Lake Road
Address
Lakeland FL 33803
City, State, Zip
(863) 701 -0273 (863) 701 -9204
Telephone No. Facsimile No.
Bond No. 54- 201999 PROJECT NAME: Water Quality Improvement Project
Effective Dates: 8/26114 — 8/26/16 P.O. # 033224
Executed in 1 Counterpart
ATTEST:
United Fire & Casualty Company
(Surety) Secretary Surety
Susan L. Reich
Typed Name
(CORPORATE SEAL)
Witness as to Suret
Patricia L. Slaughter
Typed Name
Witness as to Surety
Lisa Roseland
Typed Name
(319) 399 -5700 (319) 399 -5425
Telephone No. Facsimile No.
By: 0t,600-tv
Attorney- in- Fact/FL Licensed Resident Agent
Teresa L. Durham
Typed Name
PO Box 73909
Address
Cedar Rapids, IA 52407 -3909
City, State, Zip
(319) 399 -5700 (319) 399 -5425
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 Bond.
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
Performance Bond on behalf of Surety.
END OF SECTION
00615 -3
L SLAUGHTER, OR GLORIA A RICHARDS, OR OR`:DON BRAMLAGE, OR LISA,ROSELAND, O,R'CHERYL FOLEY, ALL
INDIVIDUALLY of MAITLAND FL
their true and lawful Attorneys) -in -Fact with power and authority hereby conferred to sign, seal and execute in its behalf all lawful bonds, undertakings
and other obligatory instruments of similar nature provided that no single obligation shall exceed $35,000,000.00
and to bind the Companies thereby as fully and to the same extent as if such instruments were signed by the duly authorized officers of the Companies
and all of theacts of said Attorney, pursuant to the authority hereby given and hereby ratified and confirmed.
The Authority , hereby granted is continuous and shall remain in full force and effect until revoked by UNITEDTIRE'& CASUALTY COMPANY,
UNITED FIRE & INDEMNITY COMPANY, AND F INANCIAL 1NSUI2ANCE COMPANY.
This Power of Attorney is made and executed pursuant to and by authority of the following bylaw duly adopted on May 15, 2013, by the Boards ofs.
Directors of UNITED FIRE & CASUALTY COMPANY, UNITED FIRE & INDEMNITY COMPANY, and FINANCIAL PACIFIC INSURANCE
COMPANY. "Article VI - Surety Bonds and Undertakings"
Section, 2, Appointment of Attorney -in -Fact. "The President or any Vice President, or any other officer of the Companies may,, from time to
time, appoint by written certificates attorneys -in -fact to act in behalf of the Companies in the execution of policies of insurance, bonds,
undertakings and other obligatory instruments of like nature. The signature of any officer authorized hereby, and the Corporate seal, may be
affixed 'by,facsimile to any power of attorney or special power of attorney or certification of either authorized hereby; such signature'and seal,
when soused, being adopted by the Companies as the original signature of such officer and the original seal of the Companies, to be valid and
binding upon the Companies with the same force and effect as though manually affixed. Such attorneys -in -fact, subject to the limitations set
forth in their respective certificates of authority shall have full power to bind the Companies by their signature and execution of any, such
instruments and to attach the seal of the Companies thereto. The President'or any Vice President, the Board of Directors or any other officer of
the Companies may at any time revoke all power and authority previously given to any attorney -in -fact.
IN WITNESS WHEREOF, the COMPANIES have each caused these presents to be signed by its
k Co aks� �o ,,, PC�F.•PPO R ?y� vice president and its corporate seal to be hereto affixed this 11 t h day of October , 2013
CORP°RliTE k G O ^' a 4;�,0Ojj'•.,tc`
1�
_� COOR ;= q; 2 �'°-
Z ;, % UNITED FIRE & CASUALTY COMPANY
aULY 2,�
senL r - — — z = = Z = UNITED FIRE &INDEMNITY COMPANY
SEAL 't'b a s. 1906 , a`
,' 4„ F FINANCIAL PACIFIIC INSURANCE COMPANY
aa,nmUO �nnmmw „U",• /"mot [i
State of Iowa, County of Linn, ss:
On 11th f October, 2013 before me Vice President
y personally came Dennis J. Richmann
to me known, who being by me duly sworn, did depose and say; that lie resides in Cedar Rapids,. State' of Iowa; that lie is a Vice President of UNITED
FIRE & CASUALTY COMPANY, a Vice President of UNITED FIRE & INDEMNITY COMPANY, and a Vice President of FINANCIAL PACIFIC
INSURANCE COMPANY the corporations described in and which executed the above instrument; that he.knows the seal of said corporations; that the
seal affixed to the said instrument is such corporate seal; that it was so affixed pursuant to authority given by the Board of Directors of said corporations
and that he signed his name thereto pursuant to like authority, and acknowledges same to be the act and deed of said corporations.
't g Judith K Davis
z Iowa Notarial seal Notary Public
Commission number 173041 My com4m ssion expires: 4•/23/2015
ow►. My Commission Expires 4/23/2015