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1911 Condor Construction Corp - Performance BondrJh:;�hai irHLJ;'= SEilrt40i [:0lli:% = � °ps)PPTROL LER Bond No.: CMGP0001060 (:�ERN;c ( Y 2ri1gii29342 SECTION 00605 Premium: $13,465.00 n:Er_:ii`,° IhdG FEE'S 11-9ci`5C, PERFORMANCE BOND Executed in Two (2) Originals (100% of Contract Price) KNOW ALL MEN BY THESE PRESENTS that: Condor Construction, Corp. (Name of CONTRACTOR) 1800 Pembrook Drive, Suite 313, Orlando, FL 32810 (Address of CONTRACTOR) CONTRACTOR's Telephone Number: 407-895-2598 a Corporation (, (Corporation, Partnership, or Individual) hereinafter called "Principal", and Argonaut Insurance Company (Name of Surety) C/o CMGIA 20335 Ventura Blvd. Suite 426, Woodland Hills, CA 91364 (Address of Surety) Surety's Telephone Number: 866-363-2642 hereinafter called "Surety", are held and firmly bound unto CITY OF SANFORD, 300 N. Park Ave, Sanford, Florida 32771, hereinafter called "CITY", in the sum of Five Hundred Thirty Four Thousand Two Hundred Ninety Four and 96/100 DOLLARS ($ 534,294.96 ) in lawful money of the United States, for the payment of which sum well and truly to be made, we 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. CITY's telephone number is (407) 688-5028. THE CONDITION OF THIS OBLIGATION�uch that whereas the Principal entered into a certain Agreement with CITY, dated the . day of 6�6rq!: - , 20 /P a copy of which is hereto attached and made a part hereof for the construction of: IFB 16/17-18 Terwilliger Trail The Project is located (Provide Legal Description. If in RNV, provide address or general location): General description of the Work: The CONTRACTOR is responsible for all labor, materials, equipment, coordination, and incidentals necessary for Terwilliger Trail, IFB 16/17-18 w i PERFORMANCE BOND IFB 16/17-18 Terwilliger Trail (100% of Contract Price) 00605-1 This Performance Bond is being entered into to satisfy the requirements of Section 255.05, Florida Statues, and the Agreement referenced above, as the same may be amended. NOW, THEREFORE, the condition of this obligation is such that if Principal: 1. Promptly and faithfully performs its duties, all the covenants, terms, conditions, and agreements of said Agreement including, but not limited, to the guaranty period and the warranty provisions, in the time and manner prescribed in the Agreement; and 2. Pays CITY all liquidated damages, losses, damages, delay damages, expenses, costs, and attorneys' fees, including costs and attorneys fees on appeal that CITY sustains resulting from any breach or default by Principal under the Agreement then this bond is void; otherwise it shall remain in full force and effect. The coverage of this Performance Bond is co -equal with each and every obligation of the Principal under the above referenced Agreement and the Contract Documents of which the Agreement is a part, except that the coverage of the Performance Bond is limited to one hundred percent (100%) of the Contract Price. In the event that the Principal shall fail to perform any of the terms, covenants, and conditions of the Agreement and the Contract Documents of which the Agreement is a part during the period in which this Performance Bond is in effect, the Surety shall remain liable to CITY for all such direct loss or damage (including reasonable attorneys' fees and costs and attorneys' fees and costs on appeal) resulting from any failure to perform, up to one hundred percent (100%) of the Contract Price and for indirect damages as determined by CITY up to an additional twenty percent (20%) over the adjusted Contract Price. In the event that the Surety fails to fulfill its obligations under this Performance Bond, then the Surety shall also indemnify and hold CITY harmless from any and all loss, damage, cost, and expense, including reasonable attorneys' fees and costs for all trial and appellate proceedings, resulting from the Surety's failure to fulfill its obligations hereunder up to one hundred percent (100%) of the Contract Price. The Surety stipulates and agrees that its obligation is to perform the Principal's work under the Agreement under this Performance Bond. The following preventative options by the Surety are encouraged; however, preventative options shall not be considered under this Performance Bond: (i) Surety's financing of the Principal to keep Principal from defaulting under the Contract Documents; and (ii) Surety's offers to CITY to buy back this Performance Bond. The Surety agrees that its obligation under this Performance Bond is to: (i) take over performance of the Principal's work and be the completing Surety even if performance of the Principal's work exceeds the adjusted Principal's Contract Price; or (ii) re -bid and re -let the Principal's work to a completing contractor with Surety remaining liable for the completing contractor's performance of the Principal's work and furnishing adequate funds to complete the work. The Surety acknowledges that its cost of completion upon default by the Principal may exceed the Contract PERFORMANCE BOND IFB 16/17-18 Terwilliger Trail (100% of Contract Price) 00605-2 Price. In any event, the Principal's Contract Time is of the essence and applicable delay damages are not waived by CITY. The Surety, for value received, hereby stipulates and agrees that its obligations hereunder shall be direct and immediate and not conditional or contingent upon CITY's pursuit of its remedies against Principal; however, such obligation shall only arise upon a declaration of default of the Principal and shall remain in full force and effect notwithstanding (i) amendments or modifications to the Agreement entered into by CITY and Principal without Surety's knowledge or consent; and (ii) the discharge of Principal as a result of any proceeding initiated under the Bankruptcy Code of 1978, as the same may be amended, or any similar State or Federal law, or any limitations of the liability of Principal or its estate as a result of any such proceeding. Any changes in or under the Agreement and Contract Documents and compliance or non- compliance with any formalities connected with the Agreement or the changes therein shall not affect Surety's obligations under this Performance Bond and Surety hereby waives notice of any such changes. However, in the event Change Orders (unilateral or directive change orders and bilateral change orders) or other modifications to the Agreement and Contract Documents are executed exceeding one hundred percent (100%) of the Contract Price, the Surety shall be notified by CITY of such increased by CITY, and the Principal shall be required to increase the sum of this Performance Bond to be commensurate with the increased Contract Price. The Surety's liability to CITY shall not be reduced should CITY directly purchase for the purpose for Sales Tax Recovery certain components and materials to be utilized in the work done by the Principal pursuant to his obligations under the Agreement. Specifically, the Surety shall remain fully liable and bound to CITY for the full compliance with the Contract Documents and full performance and function and all warranties of all components and materials, notwithstanding the fact that CITY may issue deductive Change Orders and directly purchase such items. This Performance Bond and the Payment Bond and the covered amounts of each are separate and distinct from each other. This Performance Bond is intended to comply with the requirements of Section 255.05, Florida Statutes, as amended, and additionally, to provide contract rights more expansive than as required by statute. IN WITNESS WHEREOF, this instrument is executed this 14th day of February , 20 18 ATTEST. �PRINCIP L/CONTRACTOR Condor Co strugi—on, Corp. ,::: � 4_4_� 0, 3 By: Secretary Typed Name of Secretary IFB 16/17-18 Terwilliger Trail PRINCIPAL / dOVJTRACTOR By: CONTRACTOR Signatory Authority _:F 6i) -,Do / p�_Cs) Typed Name and Title PERFORMANCE BOND (100% of Contract Price) 00605-3 n (CORPORATE Z—Q G k n ( A rr C) Type.. Name (Witness to CONTRACTOR) Typed Name IFB 16/17-18 Terwilliger Trail 1800 Pembrook Drive, Suite 313 Address Orlando, FL 32810 City, State, Zip 407-895-2598 407-895-2599 Telephone No. Facsimile No. (Surety Signature Page Follows) CIZIZIII�J PERFORMANCE BOND (100% of Contract Price) ATT T' uw,�,Ca,�, (SURETY) Secretary Typed or Printed Name r - Nitr<ess as t URE Y See-e�' ��-� i,+ Typed or Printed Name Witness as to SURETY Typed or Printed Name ,"y,r ntl:Ittl!,, SURETY ` Argonaut Insurance Company'}' SURETY ''rrrrtttt't° Stephanie Hope Shear Typed or Printed Name Attorney -in -Fact Title C/o CMGIA 20335 Ventura Blvd. Suite 426 Address Woodland Hills, CA 91364 City, State, Zip 866-363-2642 866-495-2510 Telephone No. Facsimile No. NOTE: Date of this Performance Bond must not be prior to date of the Agreement. If CONTRACTOR is a joint venture, all ventures shall execute this Performance Bond. If CONTRACTOR is a Partnership, all partners shall execute this Performance 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 CITY. All bonds shall be originals and issued or countersigned by a local producing agent who is authorized to operate in the State of Florida. Attorneys -in -fact who sign Bid Bonds or Performance/Payment Bonds must file with such bond a certified copy of their Power of Attorney to sign such Bond. Agents of surety companies must list their name, address, and telephone number on all Bonds. END OF SECTION Florida Surety Bonds, Inc. 620 N. Wymore Road Suite 200 Maitland, Florida 32751 (4c-1) 194--7-110 PERFORMANCE BOND IFB 16/17-18 Terwilliger Trail (100% of Contract Price) 00605-5 q-- CMGP0001060 Argonaut Insurance Company $13,465.00 Deliveries Only: 225 W. Washington, 24th Floor Chicago, IL 60606 United States Postal Service: P.O. Box 469011, San Antonio, TX 78246 POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the Argonaut Insurance Company, a Corporation duly organized and existing under the laws of the State of Illinois and having its principal office in the County of Cook, Illinois does hereby nominate, constitute and appoint: Gabriella Gradv, Shilo Lee Losing. Stephanie Hope Shear Their true and lawful agent(s) and attorney(s)-in-fact, each in their separate capacity if more than one is named above, to make, execute, seal and deliver for and on its behalf as surety, and as its act and deed any and all bonds, contracts, agreements of indemnity and other undertakings in suretyship provided, however, that the penal sum of any one such instrument executed hereunder shall not exceed the sum of: $10.000.000.00 This Power of Attorney is granted and is signed and sealed under and by the authority of the following Resolution adopted by the Board of Directors of Argonaut Insurance Company: "RESOLVED, That the President, Senior Vice President, Vice President, Assistant Vice President, Secretary, Treasurer and each of them hereby is authorized to execute powers of attorney, and such authority can be executed by use of facsimile signature, which may be attested or acknowledged by any officer or attorney, of the Company, qualifying the attorney or attorneys named in the given power of attorney, to execute in behalf of, and acknowledge as the act and deed of the Argonaut Insurance Company, all bond undertakings and contracts of suretyship, and to affix the corporate seal thereto." IN WITNESS WHEREOF, Argonaut Insurance Company has caused its official seal to be hereunto affixed and these presents to be signed by its duly authorized officer on the 8th day of May, 2017. Argonaut Insurance Company URA Us. rJEAL•i a '•44 rN015:• t: STATE OF TEXAS COUNTY OF HARRIS SS: Joshua C. Betz, Senior Vice President On this 8th day of May, 2017 A.D., before me, a Notary Public of the State of Texas, in and for the County of Harris, duly commissioned and qualified, came THE ABOVE OFFICER OF THE COMPANY, to me personally known to be the individual and officer described in, and who executed the preceding instrument, and he acknowledged the execution of same, and being by me duly sworn, deposed and said that lie is the officer of the said Company aforesaid, and that the seal affixed to the preceding instrument is the Corporate Seal of said Company, and the said Corporate Seal and his signature as officer were duly affixed and subscribed to the said instrument by the authority and direction of the said corporation, and that Resolution adopted by the Board of Directors of said Company, referred to in the preceding instrument is now in force. IN TESTIMONY WHEREOF, I have hereunto set my hand, and affixed my Official Seal at the County of Hams, the day and year first above written. r.-..-- 4�lw'ti`rn.`'YY�.�aJtn �,♦•�.Y_YV, K.".THLEEN N.. MEEKS p'•• ' ��,� Notary Public, State of Texas o: ••�"'° Comm. Exoiros 07-75-2027 (Notary Public) '' r°;,,,•• iJota:y 10 557902.6 I, the undersigned Officer of the Argonaut Insurance Company, Illinois Corporation, do hereby certify that the original POWER OF ATTORNEY ofwhich the foregoing is a full, true and correct copy is still in full force and effect and has not been revoked. IN WITNESS WHEREOF, I have hereunto set my hand, and affixed the Seal of said,GMpa4;'on the 14th day of February 2018 G Nil$ Q� s Z. r '`4LYO`s' r Sarah Heineman ',,'','/ ��r,l� to 41 `t�'••' �� ' VP -Underwriting Surety THIS DOCUMENT IS NOT VALID UNLESS THE WORDS ARGO POWER OF ATTORNEYARE IN BLUE. IF YOU HAVE QUESTIONS ON AUTHENTICITY OF THIS DOCUMENT CALL (210) 321 - 8400. q CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of LOS ANGELES On FEB 14 2016 before me, SHIRLEY GIGGLES, NOTARY PUBLIC Date Here Insert Name and Title of the Officer personally appeared STEPHANIE HOPE SHEAR Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. SHIRLEY GIGGLES Notary Public - California Los Angeles County z Commission # 2163817 My Comm. Expires Sep 7, 2020! I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature i �re of NotaryPublic Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Number of Pages: Signer(s) Document Date: Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: ©2014 National Notary Association - www.NationaiNotary.org - 1 -800 -US NOTARY (1-800-876-6827) Item #5907 C} SECTION 00610 PAYMENT BOND (100% of Contract Price) KNOW ALL MEN BY THESE PRESENTS that: Condor Construction, Corp. (Name of CONTRACTOR) 1800 Pembrook Drive, Suite 313, Orlando, FL 32810 (Address of CONTRACTOR) CONTRACTOR's Telephone Number: 407-895-2598 a Corporation (Corporation, Partnership, or Individual) hereinafter called "Principal", and Argonaut Insurance Company (Name of Surety) Bond No.: CMGP0001060 Premium: Included in the Performance Bond Executed in Two (2) Originals C/o CMGIA 20335 Ventura Blvd. Suite 426, Woodland Hills, CA 91364 (Address of Surety) Surety's Telephone Number: 866-363-2642 hereinafter called "Surety", are held and firmly bound unto CITY OF SANFORD, 300 N. Park Ave., Sanford, Florida 32771, hereinafter called "CITY", in the sum of Five Hundred Thirty Four Thousand Two Hundred Ninety Four and 96/100 DOLLARS ($ 534,294.96 ) in lawful money of the United States, for the payment of which sum well and truly to be made, we bind ourselves, successors, and assigns, jointly and severally, firmly by these presents. CITY's telephone number is (407) 688-5028. THE CONDITION OF THIS OBLIGATION is such that w,b2r9as, the Principal entered into a certain Agreement with CITY, dated the day day of r 20ffa copy of which is hereto attached and made a part hereof for the construction of: B 16/17-18 Terwilliger Trail The Project is located (Provide Legal Description. If in R/W, provide address or general location): General description of the Work: The CONTRACTOR is responsible for all labor, materials, equipment, coordination, and incidentals necessary for Terwilliger Trail, IFB 16/17-18. NOW, THEREFORE, the condition of this obligation is such that if Principal shall promptly make payments to all claimants as defined in Section 255.05(1), Florida Statutes, supplying Principal IFB 16/17-18 Terwilliger Trail 00610-1 PAYMENT BOND (100% of Contract Price) 4 with labor, materials, or supplies, used directly or indirectly by Principal 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 Payment Bond is furnished for the purpose of complying with the requirements of Section 255.05, Florida Statutes, as same may be amended. 2. It is a specific condition of this Payment Bond that a claimant's right of action on this Payment Bond is limited to the provisions of Section 255.05, Florida Statutes, including, but not limited to, the one (1) year time limitation within which suits may be brought. 3. This Payment Bond is conditioned that CONTRACTOR shall promptly make payments to all persons defined in Section 713.05, Florida Statutes, whose claims derive from the prosecution of the work provided for in the Agreement. Therefore, a claimant, except a laborer, who is not in privity with the CONTRACTOR shall, within forty-five (45) days after beginning to furnish labor, materials, or supplies for the prosecution of the work, furnish CONTRACTOR with a notice that (s)he may look to this Payment Bond for protection. A claimant who is not in privity with the CONTRACTOR and who has not received payment for his/her labor, materials, supplies, or rental equipment within ninety (90) days after final furnishing of the labor, services, materials, or equipment by claimant, deliver to 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 CONTRACTOR or the Surety on the bond after one (1) year from the performance of the labor or completion of the delivery of the materials or supplies. 4. Any changes in or under the Agreement or Contract Documents and compliance or non- compliance with any formalities connected with the Agreement or the changes therein shall not affect Surety's obligations under this Payment Bond and Surety hereby waives notice of any such changes. Further, Principal and Surety acknowledge that the sum of this Payment Bond shall increase or decrease in accordance with the Change Orders (unilateral or directive change orders and bilateral change orders) or other modifications to the Agreement or Contract Documents. This Payment Bond shall not cover any components or materials directly purchased and paid for by CITY pursuant to Sales Tax Recovery. 5. The Performance Bond and this Payment Bond and the covered amounts of each are separate and distinct from each other. This Payment Bond shall be construed as a statutory Payment Bond under Section 255.05, Florida Statutes, and not as a common law bond. IN WITNESS WHEREOF, this instrument is executed this 14th day of February 120 18 ATTEST. PRINCIPAL/CONTRACTOR CondorrCC�nstruction, Corp. PRINCIPAMCI' RACTOR IFB 16/17-18 Terwilliger Trail 00610-2 PAYMENT BOND (100% of Contract Price) a� By: SecretaryBy: CONTRACTOR Signatory Authority -}— ff Typed Name of Sear Typed Name and Title C) C7 1800 Pembrook Drive, Suite 313 Z O (CORPORATE SE a Address F 2015 P Orlando, FL 32810 (Witr%s to NIRA TO City, State, Zip 407-895-2598 407-895-2599 Typed me Telephone No. Facsimile No. (Witness to CONTRACTOR) Typed Name IFB 16/17-18 Terwilliger Trail (Surety Signature Page Follows) 00610-3 PAYMENT BOND (100% of Contract Price) c,. ATTEST.- (SURETY) TTEST: (SURETY) Secretary Typed or Printed Name W1 s as to, RET Typed or Printed Name Witness as to SURETY Typed or Printed Name SURETY 5ctat:t!rrtrrrr. Argonaut Insurance Company; '' i�.i 4• SURETY .: •'�� - St/hanie Hope Shear P P Typed or Printed Name Attorney -in -Fact Title C/o CMGIA 20335 Ventura Blvd. Suite 426 Address Woodland Hills, CA 91364 City, State, Zip 866-363-2642 866-495-2510 Telephone No. Facsimile No. NOTE: Date of this Payment Bond must not be prior to date of the Agreement. If CONTRACTOR is a joint venture, all ventures shall execute this Payment Bond. If CONTRACTOR is a Partnership, all partners shall execute this Payment 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 CITY. All bonds shall be originals and issued or countersigned by a local producing agent who is authorized to operate in the State of Florida. Attorneys -in -fact who sign Bid Bonds or Performance/Payment Bonds must file with such bond a certified copy of their Power of Attorney to sign such Bond. Agents of surety companies must list their name, address, and telephone number on all Bonds. IFB 16/17-18 Terwilliger Trail END OF SECTION 00610-4 Florida Surety Bonds, Inc. 620 N. Wymore Road Suite 200 Maitland, Florida 32751 (qo-1) -1&6--1-170 PAYMENT BOND (100% of Contract Price) CI CMGP0001060 $13,465.00 Argonaut Insurance Company Deliveries Only: 225 W. Washington, 24th Floor Chicago, IL 60606 United States Postal Service: P.O. Box 469011, San Antonio, TX 78246 POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the Argonaut Insurance Company, a Corporation duly organized and existing under the laws of the State of Illinois and having its principal office in the County of Cook, Illinois does hereby nominate, constitute and appoint: Gabriella Grady, Shilo Lee Losino, Stephanie Hope Shear Their true and lawful agent(s) and attomey(s)-in-fact, each in their separate capacity if more than one is named above, to make, execute, seal and deliver for and on its behalf as surety, and as its act and deed any and all bonds, contracts, agreements of indemnity and other undertakings in suretyship provided, however, that the penal sum of any one such instrument executed hereunder shall not exceed the sum of: $10,000,000.00 This Power of Attorney is granted and is signed and sealed under and by the authority of the following Resolution adopted by the Board of Directors of Argonaut Insurance Company: "RESOLVED, That the President, Senior Vice President, Vice President, Assistant Vice President, Secretary, Treasurer and each of them hereby is authorized to execute powers of attorney, and such authority can be executed by use of facsimile signature, which may be attested or acknowledged by any officer or attorney, of the Company, qualifying the attorney or attorneys named in the given power of attorney, to execute in behalf of, and acknowledge as the act and deed of the Argonaut Insurance Company, all bond undertakings and contracts of suretyship, and to affix the corporate seal thereto." IN WITNESS WHEREOF, Argonaut Insurance Company has caused its official seal to be hereunto affixed and these presents to be signed by its duly authorized officer on the 8th day of May, 2017. ,...111,,,,,,, Argonaut Insurance Company URA ;da: ,s4s by: rt«o1�: ' STATE OF TEXAS COUNTY OF HARRIS SS: Joshua C. Betz, Senior Vice President On this 8th day of May, 2017 A.D., before me, a Notary Public of the State of Texas, in and for the County of Harris, duly commissioned and qualified, came THE ABOVE OFFICER OF THE COMPANY, to me personally known to be the individual and officer described in, and who executed the preceding instrument, and he acknowledged the execution of same, and being by me duly sworn, deposed and said that he is the officer of the said Company aforesaid, and that the seal affixed to the preceding instrument is the Corporate Seal of said Company, and the said Corporate Seal and his signature as officer were duly affixed and subscribed to the said instrument by the authority and direction of the said corporation, and that Resolution adopted by the Board of Directors of said Company, referred to in the preceding instrument is now in force. IN TESTIMONY WHEREOF, I have hereunto set my hand, and affixed my Official Seal at the County of Hams, the day and year first above written. fin. 4-Y),uiA,3 KATHLEEN M. MEEKS 'Nolar; Pudic, State of Texas (Notary Public) F= Comm. ExnIron 07-15-2021 NomyID 557902.8 I, the undersigned Officer of the Argonaut Insurance Company, Illinois Corporation, do hereby certify that the original POWER OF ATTORNEY of which the foregoing is a full, true and convect copy is still in full force and effect and has not been revoked. IN WITNESS WHEREOF, I have hereunto set my hand, and affixed the Seal of said Company, on the 14th day of February 2018 THIS DOCUMENT IS NOT VALID UNLESS THE r. d' 1948 A,a Sarah Heineman , VP -Underwriting Surety WORDS ARGO POWER OF ATTORNEYARE IN BLUE. IF YOU HAVE QUESTIONS O AUTHENTICITY OF THIS DOCUMENT CALL (210) 321 - 8400. , CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 �.��r•.yess,�=�.Mac.�-r�;��.M.•�,�c,,�=��?�rs��:r�,�c�,�c�.��.c��c A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of LOS ANGELES On FEB 1 4.• 018 before me, SHIRLEY GIGGLES, NOTARY PUBLIC Date Here Insert Name and Title of the Officer personally appeared STEPHANIE HOPE SHEAR Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. SHIRLEY GIGGLES Notary Public - California Los Angeles County Z `r° : Commission # 2163817 My Comm. Expires Sep 7, 2020 Place Notary Seal Above I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature S ure of Notary Public OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Number of Pages: Signer(s) Document Date: Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual El Attorney in Fact 0 Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee it Guardian or Conservator ❑ Other: Signer Is Representing: ©2014 National Notary Association - www.NationalNotary.org • 1 -800 -US NOTARY (1-800-876-6827) Item #5907 c; Bond No.: CMGP0001060 SECTION 00615 Premium: Included in the Performance Bond MATERIAL AND WORKMANSHIP BOND Executed in Two (2) Originals (10% of Contract Price) KNOW ALL MEN BY THESE PRESENTS that: Condor Construction, Corp. (Name of CONTRACTOR) 1800 Pembrook Drive, Suite 313, Orlando, FL 32810 (Address of CONTRACTOR) CONTRACTOR's Telephone Number: 407-895-2598 a Corporation (Corporation, Partnership, or Individual) hereinafter called "Principal", and Argonaut Insurance Company (Name of Surety) C/o CMGIA 20335 Ventura Blvd. Suite 426, Woodland Hills, CA 91364 (Address of Surety) Surety's Telephone Number: 866-363-2642 hereinafter called Surety, are held and firmly bound unto CITY of SANFORD, 300 N. Park Ave., Sanford, Florida 32771, hereinafter called CITY, in the sum of ten percent (10%) of the Contract Price as adjusted under the Contract Documents Five Hundred Thirty Four * DOLLARS ($ 534,294.96 ) in lawful money of the United States, for the payment of which sum well and truly to be made, we bind ourselves, successors, and assigns, jointly and severally, firmly by these presents. CITY's telephone number is (407) 688-5028. THE CONDITION OF THIS OBLIGATION is such that ereas, the Principal ent ed into a certain Agreement with CITY, dated the day of 1 LCA a" 200, a copy of which is hereto attached and made a part hereof for the construction of: Terwilliger Trail, IFB 16/17-18. Principal is obligated to protect the CITY against any defects resulting from faulty Materials or Workmanship of said improvements for a period of two (2) years from the date of Final Completion under the Contract Documents. The conditions of this obligation are such that if Principal shall promptly and faithfully protect the CITY against any Defects resulting from faulty Materials and Workmanship of the aforesaid 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. * Thousand Two Hundred Ninety Four and 96/100 IFB 16/17-18 Terwilliger Trail 00615-1 MATERIAL AND WORKMANSHIP BOND (10% of Contract Price) C1 The CITY 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. 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 CITY, 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 cost. Should the Surety fail or refuse to correct said Defects, the CITY, 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 CITY 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 CITY should exercise and give effect to such right, the Principal and the Surety shall jointly and severally hereunder reimburse the CITY the total cost thereof, including, but not limited to, engineering, legal and contingent cost, together with any damages either direct or consequent which may be sustained on account of the failure of the Principal to correct said defects. IFB 16/17-18 Terwilliger Trail (Signature Pages Follow) 00615-2 MATERIAL AND WORKMANSHIP BOND (10% of Contract Price) �j IN WITNESS WHEREOF, this instrument is executed this 14th day of 20 18 ATTEST: By: Secretary uu�� P�'J'co(' Typed Name of Se (CORPORATE SEAL iii0Z�I.1111. a _ • Typed ame (Witness to CONTRACTOR) Typed Name February PRINCIPAL/CONTRACTOR Condor onstr�ction, Corp. \ PRIN IPAL / �t By: CONTR OOR Signatory Authority Typed Name and Title 1800 Pembrook Drive, Suite 313 Address Orlando, FL 32810 City, State, Zip 407-895-2598 407-895-2599 Telephone No. Facsimile No. (Surety Signature Page Follows) IFB 16/17-18 Terwilliger Trail MATERIAL AND WORKMANSHIP BOND (10% of Contract Price) 00615-3 ATTEST.- (SURETY) TTEST: (SURETY) Secretary Typed or Printed Name ne as to VIRETY Typed or Printed Name Witness as to SURETY Typed or Printed Name SURETY Argonaut Insurance Com�ar�}t ,.•• •••;:;• y ' SURETY Y 'I J1 Ste anie Hope Shear """"" Typed or Printed Name Attorney -in -Fact Title C/o CMGIA 20335 Ventura Blvd. Suite 426 Address Woodland Hills, CA 91364 City, State, Zip 866-363-2642 866-495-2510 Telephone No. Facsimile No. NOTE: Date of the Bond must not be prior to date of Agreement. If CONTRACTOR is a joint venture, all ventures shall execute the Bond. If CONTRACTOR is a Partnership, all partners shall execute the 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 CITY. All bonds shall be originals and issued or countersigned by a local producing agent who is authorized to operate in the State of Florida. Attorneys -in -fact who sign Bid Bonds or Performance/Payment Bonds must file with such bond a certified copy of their Power of Attorney to sign such Bond. Agents of Surety companies must list their name, address, and telephone number on all Bonds. Florida Surety Bonds, Inc END OF SECTION 620 N. Wymore Road Suite 200 Maitland, Florida 32751 (4cl) -7%6-"1-1'70 IFB 16/17-18 Terwilliger Trail MATERIAL AND WORKMANSHIP BOND (10% of Contract Price) 00615-4 CMGP0001060 $13,465.00 Argonaut Insurance Company Deliveries Only: 225 W. Washington, 24th Floor Chicago, IL 60606 United States Postal Service: P.O. Box 469011, San Antonio, TX 78246 POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the Argonaut Insurance Company, a Corporation duly organized and existing under the laws of the State of Illinois and having its principal office in the County of Cook, Illinois does hereby nominate, constitute and appoint: Gabriella Grady, Shilo Lee Losing, Stephanie Hope She Their true and lawful agent(s) and attorney(s)-in-fact, each in their separate capacity if more than one is named above, to make, execute, seal and deliver for and on its behalf as surety, and as its act and deed any and all bonds, contracts, agreements of indemnity and other undertakings in suretyship provided, however, that the penal sum of any one such instrument executed hereunder shall not exceed the sum of-. $10,000,000.00 This Power of Attorney is granted and is signed and sealed under and by the authority of the following Resolution adopted by the Board of Directors of Argonaut Insurance Company: "RESOLVED, That the President, Senior Vice President, Vice President, Assistant Vice President, Secretary, Treasurer and each of them hereby is authorized to execute powers of attorney, and such authority can be executed by use of facsimile signature, which may be attested or acknowledged by any officer or attorney, of the Company, qualifying the attorney or attorneys named in the given power of attorney, to execute in behalf of, and acknowledge as the act and deed of the Argonaut Insurance Company, all bond undertakings and contracts of suretyship, and to affix the corporate seal thereto." IN WITNESS WHEREOF, Argonaut Insurance Company has caused its official seal to be hereunto affixed and these presents to be signed by its duly authorized officer on the 8th day of May, 2017. Argonaut Insurance Company STATE OF TEXAS COUNTY OF HARRIS SS: Zi•. 1948b ••�4twots: : �,�� y: ......•..*....•• Joshua C. Betz, Senior Vice President On this 8th day of May, 2017 A.D., before me, a Notary Public of the State of Texas, in and for the County of Harris, duly commissioned and qualified, came THE ABOVE OFFICER OF THE COMPANY, to me personally known to be the individual and officer described in, and who executed the preceding instrument, and he acknowledged the execution of same, and being by me duly sworn, deposed and said that he is the officer of the said Company aforesaid, and that the seal affixed to the preceding instrument is the Corporate Seal of said Company, and the said Corporate Seal and his signature as officer were duly affixed and subscribed to the said instrument by the authority and direction of the said corporation, and that Resolution adopted by the Board of Directors of said Company, referred to in the preceding instrument is now in force. IN TESTIMONY WHEREOF, I have hereunto set my hand, and affixed my Official Seal at the County of Harris, the day and year first above written. �.igwr .•�^i�� KATHLEEN M. MEEKS --s• Notary Public, State of Texas (Notary Public) Comm. Expires 07-15-2021 Nate:y iD 557902-8 I, the undersigned Officer of the Argonaut Insurance Company, Illinois Corporation, do hereby certify that the original POWER OF ATTORNEY of which the foregoing is a full, true and correct copy is still in full force and effect and has not been revoked. IN WITNESS WHEREOF, I have hereunto set my hand, and affixed the Seal of said Company, on the 14th day of February 2018 •'�G��o`-k��fi�•�`. xis•: ;' _ ,,., Sarah Heineman , VP -Underwriting Surety r x�,� 4 ''' THIS DOCUMENT IS NOT VALID UNLESS THE WORDS ARGO POWER bF A-11TORNEYARE IN BLUE. IF YOU HAVE QUESTIONS f N� AUTHENTICITY OF THIS DOCUMENT CALL (210) 321 - 8400. l I CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of LOS ANGELES On `� — �� before me, SHIRLEY GIGGLES, NOTARY PUBLIC . bale Here Insert Name and Title of the Officer personally appeared STEPHANIE HOPE SHEAR Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature 4 Si , re of Notary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Number of Pages: Signer(s) Document Date: Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: .. 02014 National Notary Association • www.NationaiNotary.org • 1 -800 -US NOTARY (1-800-876-6827) Item #5907 �t" SHIRLEY GIGGLES Notary Public California Z County a _ = Los Angeles Commission # 2163817 my comm. Expires Se 7, 2020 I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature 4 Si , re of Notary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Number of Pages: Signer(s) Document Date: Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: .. 02014 National Notary Association • www.NationaiNotary.org • 1 -800 -US NOTARY (1-800-876-6827) Item #5907 �t" CIT\' O SANFORD FINANCE UEPAHIMENI INSURANCE REQUIREMENTS INSURANCE REQUIREMENTS OUTLINED BELOW APPLICABLE TO CONTRACTS FOR SERVICES WHEN THE CONTRACTOR PERFORMS ON OR OFF CITY PREMISES Outline of Requirements: Commercial General Liability shall include- Bodily injury liability, Property Damage liability; Personal Injury liability and Advertising injury liability Coverages shall include: Premises/ Operations; Products/Completed Operations; Contractual liability; Independent Contractors, Explosion; Collapse; Underground. When required by the City, coverage must be provided for sexual harassment, abuse and molestation aboo -000 -f 1'000•( Comprehensive Auto Liability, CSL, shall include "any auto" or shall include all of the following. owned, leased, hired, non -owned autos, and scheduled autos. $ 3,000,000 Per Occurrence $ 3,000,000 General Aggregate $ 1,000,000 Combined Single Limit $ 1,000,000 General $ 1,000,000 Per Occurrence $ 1,000,000 General Aggregate $ 1,000,000 Combined Single Limit $ 1,000,000 General $ 500,000 Per Occurrence $ 500,000 General Aggregate $ 500,000 Per Occurrence $ 500,000 General Aggregate Professional Liability (when required)` $ 1,000,000 I $ 1,000,000 $ 1,000,000 9V . A _ Minimum Minimum Minimum Builder's Risk (when required) shall include theft, sinkholes, off site storage, transit, installation and equipment breakdown. Permission to occupy shall be included and the policy shall be endorsed to cover the interest of all parties, including the City of Sanford, all contractors and subcontractors N.A. Garage Keepers (when required) �L A, Garage Liability (when required) IN. A 100% of completed value of additions and structures $3,000,000 Aggregate: No per vehicle maximum preferred $3,000,000 Combined Single Limit $3,000,000 General Aqqreqate 1 of 3 Insurance Requirements 100% of completed value of additions and structures $1,000,000 Aggregate: No per vehicle maximum preferred $1,000,000 Combined Single Limit $1,000,000 General Aaareaate 100% of completed value of additions and structures $500,000 Aggregate: No per vehicle maximum preferred $500,000 Combined Single Limit $500,000 General Aggregate Contract Contract does Contract does Workers' Compensation Exceeds not Exceed not Exceed $500,000, 180 $500,000, 180 $25,000, 30 days COVERAGE REQUIRED $ 1,000,000. $500,000 $ 500,000 compensation insurance days and days and no and no unusual unusual hazards unusual hazards exist exist hazards exist Commercial General Liability shall include- Bodily injury liability, Property Damage liability; Personal Injury liability and Advertising injury liability Coverages shall include: Premises/ Operations; Products/Completed Operations; Contractual liability; Independent Contractors, Explosion; Collapse; Underground. When required by the City, coverage must be provided for sexual harassment, abuse and molestation aboo -000 -f 1'000•( Comprehensive Auto Liability, CSL, shall include "any auto" or shall include all of the following. owned, leased, hired, non -owned autos, and scheduled autos. $ 3,000,000 Per Occurrence $ 3,000,000 General Aggregate $ 1,000,000 Combined Single Limit $ 1,000,000 General $ 1,000,000 Per Occurrence $ 1,000,000 General Aggregate $ 1,000,000 Combined Single Limit $ 1,000,000 General $ 500,000 Per Occurrence $ 500,000 General Aggregate $ 500,000 Per Occurrence $ 500,000 General Aggregate Professional Liability (when required)` $ 1,000,000 I $ 1,000,000 $ 1,000,000 9V . A _ Minimum Minimum Minimum Builder's Risk (when required) shall include theft, sinkholes, off site storage, transit, installation and equipment breakdown. Permission to occupy shall be included and the policy shall be endorsed to cover the interest of all parties, including the City of Sanford, all contractors and subcontractors N.A. Garage Keepers (when required) �L A, Garage Liability (when required) IN. A 100% of completed value of additions and structures $3,000,000 Aggregate: No per vehicle maximum preferred $3,000,000 Combined Single Limit $3,000,000 General Aqqreqate 1 of 3 Insurance Requirements 100% of completed value of additions and structures $1,000,000 Aggregate: No per vehicle maximum preferred $1,000,000 Combined Single Limit $1,000,000 General Aaareaate 100% of completed value of additions and structures $500,000 Aggregate: No per vehicle maximum preferred $500,000 Combined Single Limit $500,000 General Aggregate Employers Liability Employers Employers Workers' Compensation $1,000,000 - Liability $500,000 Liability $500,000 Each Accident Each Accident Each Accident *Certificates of exemption are not acceptable in lieu of workers $ 1,000,000. $500,000 $ 500,000 compensation insurance Disease Disease Disease $ 1,000,000 $500,000 1 $ 500,000 Commercial General Liability shall include- Bodily injury liability, Property Damage liability; Personal Injury liability and Advertising injury liability Coverages shall include: Premises/ Operations; Products/Completed Operations; Contractual liability; Independent Contractors, Explosion; Collapse; Underground. When required by the City, coverage must be provided for sexual harassment, abuse and molestation aboo -000 -f 1'000•( Comprehensive Auto Liability, CSL, shall include "any auto" or shall include all of the following. owned, leased, hired, non -owned autos, and scheduled autos. $ 3,000,000 Per Occurrence $ 3,000,000 General Aggregate $ 1,000,000 Combined Single Limit $ 1,000,000 General $ 1,000,000 Per Occurrence $ 1,000,000 General Aggregate $ 1,000,000 Combined Single Limit $ 1,000,000 General $ 500,000 Per Occurrence $ 500,000 General Aggregate $ 500,000 Per Occurrence $ 500,000 General Aggregate Professional Liability (when required)` $ 1,000,000 I $ 1,000,000 $ 1,000,000 9V . A _ Minimum Minimum Minimum Builder's Risk (when required) shall include theft, sinkholes, off site storage, transit, installation and equipment breakdown. Permission to occupy shall be included and the policy shall be endorsed to cover the interest of all parties, including the City of Sanford, all contractors and subcontractors N.A. Garage Keepers (when required) �L A, Garage Liability (when required) IN. A 100% of completed value of additions and structures $3,000,000 Aggregate: No per vehicle maximum preferred $3,000,000 Combined Single Limit $3,000,000 General Aqqreqate 1 of 3 Insurance Requirements 100% of completed value of additions and structures $1,000,000 Aggregate: No per vehicle maximum preferred $1,000,000 Combined Single Limit $1,000,000 General Aaareaate 100% of completed value of additions and structures $500,000 Aggregate: No per vehicle maximum preferred $500,000 Combined Single Limit $500,000 General Aggregate 1. It is noted that Professional Liability, builder's risk, garage keepers and garage liability is not required unless applicable conditions exist. If clarification is needed the CONTRACTOR must request clarification from the City of Sanford Purchasing Office. 11. Vendor, Contractor, bidder shall provide, to the City of Sanford "City," 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. III. 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. > Certification Terms and Conditions IV. It is noted that the City has a contractual relationship with the named vendor, contractor or provider (collectively referred hereinafter as 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 notwithstanding, the City will expect relief from the Contractor. a. The insurance limits indicated above and otherwise referenced are minimum limits acceptable to the City. Also, all contractor policies shall to be considered primary to City coverage and shall not contain co-insurance provisions. b. All policies, except for professional liability policies and workers compensation policies shall name the City of Sanford as Additional Insured. c. Professional Liability Coverage, when applicable, will be defined on a case by case basis. d. In the event that the insurance coverage expires prior to the completion of the project, a renewal certificate shall be issued 34 days prior to said, expiration date. e. All limits are per occurrence and must include Bodily Injury and Property Damage. f. All policies must be written on occurrence form, not on claims made Form, except for Professional Liability. g. Self -Insured retentions shall be allowed on any liability coverage. h. In the notification of cancellation: The City of Sanford shall be endorsed onto the policy as a cancellation notice recipient. Should any of the above described policies of Sanford in accordance with the policy provisions. L All insurers must have an A.M. rating of at least A -VII. 2 of 3 Insurance Requirements j. It is the responsibility of the Prime CONTRACTOR to ensure that all sub -contractors retained by the Prime CONTRACTOR shall provide coverage as defined here -in before and after and are the responsibility of said Prime CONTRACTOR in all respects. k. Any changes to the coverage requirements indicated above shall be approved by the City of Sanford, Risk Manager. I. Address of "Certificate Holder" is City of Sanford; P O Box 1788 (300 N. Park Avenue); Sanford, Florida 32771; Attention Purchasing Manager; Phone 407.688.5028/5030 Fax 407.688.5021. m. All certificates of insurance, notices etc. must be provided to the above address. Zdescription of the certificate of insurance please also add the tion number and project name. AFFIANT SIGNATURE Wis F. PivvzDn Typed Name of AFFIANT ;:)msrcAerx+ Title _ STATE OF COUNTY OF ( ``.4 ::7 �^ cf T e foregoing in trument was executed before,�e this*' �� day of F;1�1 0 I . , by ill1)7c i as l YC>'•C+C'i l'i of i1�CI,C! r CC�� who personally swore or affirmed that he/she is authorized to execute this document and thereby bind the Corporation, and who is personally known to me OR has produced as identification. — --- y LILANAA. RIVILLAS NOTARY PUBLIC STATE OF FLORIDA Comm#GG090876 NOTARY PUBLIC, State of (stamp) •`ppVCc Expires 415/2021 The City reserves the unilateral right to modify the insurance requirements set forth at any time. PLEASE COMPLETE AND SUBMIT Failure to submit this form may be grounds for disqualification of your submittal 3 of 3 Insurance Requirements Agency Code 12-0286-00 Policy Number 162322-78678242 COMMERCIAL GENERAL LIABILITY 55373 (1-07) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM. A. Under SECTION 11- WHO IS AN INSURED, the following is added: A person or organization is an Additional Insured, only with respect to liability arising out of "your work" for that Additional Insured by or for you: 1. If required in a written contract or agreement; or 2. If required by an oral contract or agreement only if a Certificate of Insurance was issued prior to the loss indicating that the person or organiza- tion was an Additional Insured. B. Under SECTION 111- LIMITS OF INSURANCE, the following is added: The limits of liability for the Additional Insured are those specked in the written contract or agreement between the insured and the owner, lessee or contractor or those specified in the Certificate of Insurance, if an oral contract or agreement, not to exceed the limits provided in this policy. These limits are inclusive of and not in addition to the limits of insurance shown in the Declarations. C. SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, is amended as follows: 1. The following provision is added to 4. Other Insurance: This insurance is primary for the Additional Insured, but only with respect to liability arising out of "your work" for that Additional Insured by or for you. Other insurance available to the Additional Insured will apply as excess insur- ance and not contribute as primary insurance to the insurance provided by this endorsement. 2. The following provision is added: Other Additional Insured Coverage Issued By Us If this policy provides coverage for the same loss to any Additional Insured specifically shown as an Additional Insured in another endorsement to this policy, our maximum limit of insurance under this endorsement and any other endorse- ment shall not exceed the limit of insurance in the written contract or agreement between the insured and the owner, lessee or contractor, or the limits provided in this policy, whichever is less. Our maximum limit of insurance arising out of an 'occurrence", shall not exceed the limit of insurance shown in the Declarations, regard- less of the number of insureds or Additional Insureds. All other policy terms and conditions apply. Includes copyrighted material of Insurance Services Office, Inc., with its permission. 55373 (1-07) Copyright Insurance Services Office, Inc., 1984, 2003. Page 1 of 1 Jout ern -Owners Page 1 Issued 07-07-2017 INSURANCE COMPANY 6101 ANACAPRI BLVD., LANSING, MI 48917-3999 AGENCY INSURANCE OFFICE OF AMERICA INC 12-0286-00 MKT TERR 123 904-448-9777 INSURED CONDOR CONSTRUCTION CORP ADDRESS 1800 PEMBROOK DR STE 313 ORLANDO FL 32810-6928 TAILORED PROTECTION POLICY DECLARATIONS Change Endorsement Effective 06-21-2017 POLICY NUMBER 162322-78678242-17 Company Use 78 -23 -FL -1604 Company Policy Term Bill 12:01 a.m. 12:01 a.m. to 04-01-2017 04-01-2018 Description of Change ADDED FORM 55373 - BLANKET ADDITIONAL INSURED INCLUDING - PRODUCTS - COMPLETED OPERATIONS Transaction Number: 002 Endorsement Premium: $554.00 ADDITIONAL (THIS IS NOT A BILL) 12-0286-00 INSURANCE OFFICE OF AMERICA INC 1 SLEIMAN PKWY STE 130 JACKSONVILLE FL 32216-8045 07-07-2017 CONDOR CONSTRUCTION CORP 1800 PEMBROOK DR STE 313 ORLANDO FL 32810-6928 RE: Policy 162322-78678242-17 59511 (7-15) INSURANCE LIFE - HOME - CAR - BUSINESS P.O. BOX 30660 - LANSING, MICHIGAN 48909-8160 Southern -Owners Insurance Company Remember, you can view your policy, pay your bili or change your paperless options any time online, at www.auto-owners.com. If you have not already enrolled your policy, you may do so using policy number 162322.78678242-17 and Personal ID Code (PID) 58G 8N3 RSP. Your agency's phone number is 904-448-9777. Thank you for selecting Auto -Owners Insurance Group to serve your insurance needs! Feel free to contact your independent Auto -Owners agent with questions you may have. Auto -Owners and its affiliate companies offer a variety of programs, each of which has its own eligibility requirements, coverages and rates. In addition, Auto -Owners also offers many billing options. Please take this opportunity to review your insurance needs with your Auto -Owners agent, and discuss which company, program, and billing option may be most appropriate for you. Auto -Owners Insurance Company was formed in 1916. The Auto -Owners Insurance Group is comprised of five property and casualty companies and a life insurance company. Our A++ (Superior) rating by A.M. Best Company signifies that we have the financial strength to provide the insurance protection you need. -- Serving Our Policyholders and Agents Since 1916 -- rnninrnnl_n9 rARcalniun CERTIFICATE OF LIABILITY INSURANCE DA 212(2018 (MMIDDIYYYY) 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 have ADDITIONAL INSURED provisions or 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 License # OE67768 co TACT Diana Carrion Insurance Office of America, Inc. 1 Sleiman Parkway Suite 130 A/C, w , Et): (904 394-3964 22120 ac, No :(904) 261-9960 hss: Diana.Carrion@ioausa.com Jacksonville, FL 32216 INSURERS AFFORDING COVERAGE NAIC # INSURER A: Southern -Owners Insurance Company 10190 INSURED INSURERB:Auto-Owners Insurance Company 18988 INSURER C Mestchester Fire Insurance Company 10030 Condor Construction, Corp. 1800 Pembrook Drive CLAIMS -MADE [ X] OCCUR Suite 313 INSURER D: INSURER E: Orlando, FL 32810 INSURER F: COVFRAGFS CERTIFICATE NUMBER: 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 T TYPE OF INSURANCE AODL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE_ $ 1,000,000 CLAIMS -MADE [ X] OCCUR X 78678242 04/01/2017 04/0112018 DAMAGE TO R(EaENTED ocourren $ 300,000 MED EXP (Any oneperson) $ 10'000 PERSONAL& ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS- COMP/OP AGG S 2,000,000 X POLICY ❑ PES LOC HIRED NON OWNED S 1,000,000 OTHER: B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT a nt S 1,000,000 BODILY INJURY Perperson) S X ANY AUTO 5070101500 04/25/2017 04/01/2018 BODILY INJURY Per accident S OWNED 'SCHEDULED AUTOS ONLY AUTOS j PROPERTY AMAGE Per. accident S UAUE N p D TOS ONLY ATOS ONLY X S25I�8red Mir X CGmp01C011 Ded 5 557,0D S A X UMBRELLA LIAR OCCUR EACH OCCURRENCE $ 5'000'000 AGGREGATE S 5,000,000 EXCESS LIAB CLAIMS -MADE 50678242 04/01/2017 04/01/2018 DED I X I RETENTIONS 10,000 S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPRO ECUTIVE IETggO PSOTH- LTL E.L. EACH ACCIDENT S vR R EXCLUDED? F] (Mandatory in N�) N/A �A _ E.L. DISEASE - EA EMPLOYEE S E.L. DISEASE - POLICY LIMIT S If yes, describe under DESCRIPTION OF OPERATIONS below C Contractor Pollution G28174305001 10/10/2017 04/01/2018 See Desc of Ops DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Contractors Pollution: $1,000,000 Each Occurrence, $2,000,000 General Aggregate. 520 AGREEMENT - IFB 16/17-18 Terwilliger Trail Certificte holder is listed as additional insured with respects to general liability on a primary and non contributory basis as per written contract for project listed above; City of Sanford POB 1788 (300 N. Park Avenue) Purchasing Manager SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE r ACORD 25 (2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AC'©RO�CERTIFICATE OF LIABILITY INSURANCE DA02/02/2o 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 have ADDITIONAL INSURED provisions or 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 Doug Jones c/oArtex Risk Solutions, Inc. 8840 E. Chaparral Rd.; Suite 275 CONTACT NAME: PHONE , (480) 951-4177Fvc No : (480) 951 4266 ADDRIESS: SDL.BSD.Certificates@artexrisk.com INSURERS AFFORDING COVERAGE NAIC # Scottsdale, AZ 85250 INSURERA: American Zurich Insurance Company 40142 INSURED Oasis Acquisition, Inc Alt. Emp: CONDOR CONSTRUCTION CORP 2054 Vista Parkway Suite 300 INSURER 8: INSURER C : INSURER D: West Palm Beach, FL 33411 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 1 7FLO75911802 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 LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MM/DON EFF POLICY EXP LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE 71 OCCUR DAMAGE 1-0 RENTE157- PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY ❑ PRO ❑ JECT LOC PRODUCTS -COMPlOPAGG $ $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident BODILY INJURY (Per person) $ ANYAUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per acddent) $ PROPERTY DAMAGE $ Per accident HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAR I OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETORlPARTNER/EXECUTIVE OFFICERIMEMBEREXCLUDED? F (Mandatory in NH) N/A WC 29-38-687-15 06/01/2017 06/01/2018 X PER OTH- STATUTE ER _ _ E.L. EACH ACCIDENT $ 1,000 000 E.L. DISEASE - EA EMPLOYE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 Location Coverage Period: 06/01/2017 06/01/2018 Client# 15445 -CORP DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Coverage is provided for CONDOR CONSTRUCTION CORP 520 AGREEMENT 9 p 1800 PEMBROOK DR STE 313 IFB 16/17-18 Terwilliger Trail only those co -employees of, but not subcontractors ORLANDO, FL 32810 to: Endorsements: 30 days written cancel notice (10 days for non payment of premium) rya:a�laL•�_��a;L�»��a: .. . . City of Sanford Attn: Purchasing Manager P.O. Box 1788 - 300 N. Park Avenue Sanford, FL 32771 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and loco are reaistered marks of ACORD Remittance Name 1U1 S F 1P' iN Z uq . Address 1'8C0 ®d K UE, SWITE ITE P.O. Box or Street Address City V RIL�'N DCS State FLOP -(DA - Zip '32 E5 (U • r Tel 40T t3 q5. 2S � F3 Fax: 32� 1 (9 • a•9 B 3 • Contact �-� 1 10 t6y2O N Email 1-ULtS. C�itZUP) GO(tcGp�p.uS Federal I.D. No. 8 1 ) Name on Checks - 2 5OC115) Social Security No. Required with all SSN Display Purchase Order Information Vendor Name CONDOR, CON SMUC—T'1 ori COO. Address l � PE44 00,00 K D R� VE � 5 U t TE 3n0 . P.O. Biuor Street Address City ©R -44-s )o State FLOP -t bA Zip aZg10 Country UC -IA • Tel `�o`T �(�." 5`� Fax 3:)-1 • a.l`e� - �°� Contact �uIS : ?tMr) Email �u�S� I1tl Ct�t1Y�rp. (d$ Web Address UJuuu3. Con 0fC©(P-QS (� Display Vendor Bid Information Vendor Name 1.:. mwp' 00"S muc i ol'i P . Address Is000 P6r 4B>7 ©CX 'Na VE , CiU ITE 2500- P.O. O0. P.O. Box or Street Address City 01UNDO State FLO0 PA Zip 32FS10 Tel 9 T7. Y J- 2, 5 012 Fax 3/24 - ZI CK• 261 W3 Contact I t,f..1 S 1111 0n Email address t W& • 1n20A C0nd0(C'0ep•U5 Web Address uaCk)(u • Wr1C(b{cpt�. US 0- Po- NOTE: ALL VENDORS MUST COMPLETE AND INCLUDE A W-9 FORM, COPY ATTACHED NOTE: COMPLETION INSTRUCTIONS: Clear copies, incomplete forms will not be accepted. Please complete these forms and return by either FAX or Mail to address or FAX number as instructed by the requesting individual: Fax No. Attention r------------------------------------------------------------------------------, FOR CITY OF SANFORD USE ONLY: MUST have signature and department! Requested By: Dept/Div Date ------------------------------------------------------------------------------- February 19, 2009 FOR CITY STAFF USE ONLY: DESCRIBE WHAT THIS VENDOR IS GOING TO BE USE FOR: PLEASE USE THE H.T.E. SYSTEM TO GET THE COMMODITIES AND SUB COMMODITIES WRITE THE NUMBERS BELOW THAT PERTAIN(S) TO THIS VENDOR. PLEASE SUBMIT THIS WITH YOUR VENDOR FORM. INCOMPLETE FORMS WILL BE FORWARDED TO THE APPRORIATE DEPARTMENTS. THANK YOU, PURCHASING DEPARTMENT. COMMODITY SUB -COMMODITY Forrnw-9 Request for Taxpayer Give form to the (Rev. November 2005) Identification Number and Certification requester. Do not Department of the Treasury send to the IRS. Imornal ncvmLc Service N Name (as shown on your income tax return) m C0 '�©t2. GOM-3TIZUC-Tz ON c 1`P. ca CL Business name, if different from above C 0 y m CL o Individual/ Check appropriate box: ❑ Sole proprietor +{ Corporation ❑ Partnership ❑ Other ► .................. Exempt from backup ❑ withholding 0 Address (number, street, and apt, or suite no.) Requester's name and address (optional) a = ll� `F�r�ijatiOo l� 712=4 vF '�v ("i'F_ 300 U City, state, and ZIP code 00P-LAniDO FLOP DA 2)28 10 - m List account number(s) here (optional) m Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on Line 1 to avoid Social security number backup withholding. For individuals, this is your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3. or Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose j Employer identification number number to enter. Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and 2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and 3. 1 am a U.S. person (including a U.S. resident alien). Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generall , pa ents other than interest and dividends, you are not required to sign the Certification, but you must provide your correct TIN. (See Ahe inst ction� 4.) SignI Signature of \\^^` Here U.S. person ► 1 / Date ►i3 Purpose of Form A person who is required to file an information return with the IRS, must obtain your correct taxpayer identification number (TIN) to report, for example, income paid to you, real estate transactions, mortgage interest you paid, acquisition or abandonment of secured property, cancellation of debt, or contributions you made to an IRA. U.S. person. Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN to the person requesting it (the requester) and, when applicable, to: 1. Certify that the TIN you are giving is correct (or you are waiting for a number to be issued), 2. Certify that you are not subject to backup withholding, or 3. Claim exemption from backup withholding if you are a U.S. exempt payee. In 3 above, if applicable, you are also certifying that as a U.S, person, your allocable share of any partnership income from a U.S, trade or business is not subject to the withholding tax on foreign partners' share of effectively connected income. Note. If a requester gives you a form other than Form W-9 to request your TIN, you must use the requester's form if it is substantially similar to this Form W-9. For federal tax purposes, you are considered a person if you are: • An individual who is a citizen or resident of the United States, • A partnership, corporation, company, or association created or organized in the United States or under the laws of the United States, or • Any estate (other than a foreign estate) or trust. See Regulations sections 301.7701-6(a) and 7(a) for additional information. Special rules for partnerships. Partnerships that conduct a trade or business in the United States are generally required to pay a withholding tax on any foreign partners' share of income from such business. Further, in certain cases where a Form W-9 has not been received, a partnership Is required to presume that a partner is a foreign person, and pay the withholding tax. Therefore, if you are a U.S. person that is a partner in a partnership conducting a trade or business in the United States, provide Form W-9 to the partnership to establish your U.S. status and avoid withholding on your share of partnership income. The person who gives Form W-9 to the partnership for purposes of establishing its U.S. status and avoiding withholding on its allocable share of net income from the partnership conducting a trade or business in the United States is in the following cases: • The U.S. owner of a disregarded entity and not the ne t Cat. No. 10231X Form Form W-9 (Rev. 11-2005) Page 2 • The U.S. grantor or other owner of a grantor trust and not the trust, and • The U.S. trust (other than a grantor trust) and not the beneficiaries of the trust. Foreign person. If you are a foreign person, do not use Form W-9. Instead, use the appropriate Form W-8 (see Publication 515, Withholding of Tax on Nonresident Aliens and Foreign Entities). Nonresident alien who becomes a resident alien. Generally, only a nonresident alien individual may use the terms of a tax treaty to reduce or eliminate U.S. tax on certain types of income. However, most tax treaties contain a provision known as a "saving clause." Exceptions specified in the saving clause may permit an exemption from tax to continue for certain types of income even after the recipient has otherwise become a U.S. resident alien for tax purposes. If you are a U.S. resident alien who is relying on an exception contained in the saving clause of a tax treaty to claim an exemption from U.S. tax on certain types of income, you must attach a statement to Form W-9 that specifies the following five items: 1. The treaty country. Generally, this must be the same treaty under which you claimed exemption from tax as a nonresident alien. 2. The treaty article addressing the income. 3. The article number (or location) in the tax treaty that contains the saving clause and its exceptions. 4. The type and amount of income that qualifies for the exemption from tax. 5. Sufficient facts to justify the exemption from tax under the terms of the treaty article. Example. Article 20 of the U.S.-China income tax treaty allows an exemption from tax for scholarship income received by a Chinese student temporarily present in the United States. Under U.S. law, this student will become a resident alien for tax purposes if his or her stay in the United States exceeds 5 calendar years. However, paragraph 2 of the first Protocol to the U.S.-China treaty (dated April 30, 1984) allows the provisions of Article 20 to continue to apply even after the Chinese student becomes a resident alien of the United States. A Chinese student who qualifies for this exception (under paragraph 2 of the first protocol) and is relying on this exception to claim an exemption from tax on his or her scholarship or fellowship income would attach to Form W-9 a statement that includes the information described above to support that exemption. If you are a nonresident alien or a foreign entity not subject to backup withholding, give the requester the appropriate completed Form W-8. What is backup withholding? Persons making certain payments to you must under certain conditions withhold and pay to the IRS 28% of such payments (after December 31, 2002). This is called "backup withholding." Payments that may be subject to backup withholding include interest, dividends, broker and barter exchange transactions, rents, royalties, nonemployee pay, and certain payments from fishing boat operators. Real estate transactions are not subject to backup withholding. You will not be subject to backup withholding on payments you receive if you give the requester your correct TIN, make the proper certifications, and report all your taxable interest and dividends on your tax return. Payments you receive will be subject to backup withholding if: 1. You do not furnish your TIN to the requester, 2. You do not certify your TIN when required (see the Part 11 instructions on page 4 for details), 3. The IRS tells the requester that you furnished an incorrect TIN, 4. The IRS tells you that you are subject to backup withholding because you did not report all your interest and dividends on your tax return (for reportable interest and dividends only), or 5. You do not certify to the requester that you are not subject to backup withholding under 4 above (for reportable interest and dividend accounts opened after 1983 only). Certain payees and payments are exempt from backup withholding. See the instructions below and the separate Instructions for the Requester of Form W-9. Also see Special rules regarding partnerships on page 1. Penalties Failure to furnish TIN. If you fail to furnish your correct TIN to a requester, you are subject to a penalty of $50 for each such failure unless your failure is due to reasonable cause and not to willful neglect. Civil penalty for false information with respect to withholding. If you make a false statement with no reasonable basis that results in no backup withholding, you are subject to a $500 penalty. Criminal penalty for falsifying information. Willfully falsifying certifications or affirmations may subject you to criminal penalties including fines and/or imprisonment. Misuse of TINs. If the requester discloses or uses TINs in violation of federal law, the requester may be subject to civil and criminal penalties. Specific Instructions Name If you are an individual, you must generally enter the name shown on your income tax return. However, if you have changed your last name, for instance, due to marriage without informing the Social Security Administration of the name change, enter your first name, the last name shown on your social security card, and your new last name. If the account is in joint names, list first, and then circle, the name of the person or entity whose number you entered in Part 1 of the form. Sole proprietor. Enter your individual name as shown on your income tax return on the "Name" line. You may enter your business, trade, or "doing business as (DBA)" name on the "Business name" line. Limited liability company (LLC). If you are a single -member LLC (including a foreign LLC with a domestic owner) that is disregarded as an entity separate from its owner under Treasury regulations section 301.7701-3, enter the owner's name on the "Name" line. Enter the LLC's name on the "Business name" line. Check the appropriate box for your filing status (sole proprietor, corporation, etc.), then check the box for "Other" and enter "LLC" in the space provided. Other entities. Enter your business name as shown on required federal tax documents on the "Name" line. This name should match the name shown on the charter or other legal document creating the entity. You may enter any business, trade, or DBA name on the "Business name" line. Note. You are requested to check the appropriate box for your status (individual/sole proprietor, corporation, etc.). Exempt From Backup Withholding If you are exempt, enter your name as described above and check the appropriate box for your status, then check the "Exempt from backup withholding" box in the line fol the business name, sign and date the form. Form W-9 (Rev. 11-2005) Page 3 Generally, individuals (including sole proprietors) are not exempt from backup withholding. Corporations are exempt from backup withholding for certain payments, such as interest and dividends. Note. If you are exempt from backup withholding, you should still complete this form to avoid possible erroneous backup withholding. Exempt payees. Backup withholding is not required on any payments made to the following payees: 1. An organization exempt from tax under section 501(a), any IRA, or a custodial account under section 403(b)(7) if the account satisfies the requirements of section 401(%2), 2. The United States or any of its agencies or instrumentalities, 3. A state, the District of Columbia, a possession of the United States, or any of their political subdivisions or Instrumentalities, 4. A foreign government or any of its political subdivisions, agencies, or instrumentalities, or 5. An international organization or any of its agencies or instrumentalities. Other payees that may be exempt from backup withholding include: 6. A corporation, 7. A foreign central bank of issue, 8. A dealer in securities or commodities required to register in the United States, the District of Columbia, or a possession of the United States, 9. A futures commission merchant registered with the Commodity Futures Trading Commission, 10. A real estate investment trust, 11. An entity registered at all times during the tax year under the Investment Company Act of 1940, 12. A common trust fund operated by a bank under section 584(a), 13. A financial institution, 14. A middleman known in the investment community as a nominee or custodian, or 15. A trust exempt from tax under section 664 or described in section 4947. The chart below shows types of payments that may be exempt from backup withholding. The chart applies to the exempt recipients listed above, 1 through 15. IF the payment is for ... THEN the payment is exempt for... Interest and dividend payments All exempt recipients except for 9 Broker transactions Exempt recipients 1 through 13. Also, a person registered under the Investment Advisers Act of 1940 who regularly acts as a broker Barter exchange transactions Exempt recipients 1 through 5 and patronage dividends Payments over $600 required Generally, exempt recipients to be reported and direct 1 through 7 sales over $5,000' 'See Form 1099-MISC, Miscellaneous Income, and its instructions. 2However, the following payments made to a corporation (including gross proceeds paid to an attorney under section 6045(f), even if the attorney is a corporation) and reportable on Form 1099-MISC are not exempt from backup withholding: medical and health care payments, attorneys' fees; and payments for services paid by a federal executive agency. Part I. Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. If you are a resident alien and you do not have and are not eligible to get an SSN, Iour TIN is your IRS individual taxpayer identification number TIN). Enter it in the social security number box. If you do not have an ITIN, see How to get a TIN below. If you are a sole proprietor and you have an EIN, you may enter either your SSN or EIN. However, the IRS prefers that you use your SSN. If you are a single -owner LLC that is disregarded as an entity separate from its owner (see Limited liability company (LLC) on page 2), enter your SSN (or EIN, if you have one). If the LLC is a corporation, partnership, etc., enter the entity's EIN. Note. See the chart on page 4 for further clarification of name and TIN combinations. How to get a TIN. If you do not have a TIN, apply for one immediately. To apply for an SSN, get Form SS -5, Application for a Social Security Card, from your local Social Security Administration office or get this form online at www.socialsecurity.gov. You may also get this form by calling 1-800-772-1213. Use Form W-7, Application for IRS Individual Taxpayer Identification Number, to apply for an ITIN, or Form SS -4, Application for Employer Identification Number, to apply for an EIN. You can apply for an EIN online by accessing the IRS website at www.irs.gov/businesses and clicking on Employer ID Numbers under Related Topics. You can get Forms W-7 and SS -4 from the IRS by visiting www.irs.gov or by calling 1 -800 -TAX -FORM (1-800-829-3676). If you are asked to complete Form W-9 but do not have a TIN, write "Applied For" in the space for the TIN, sign and date the form, and give it to the requester. For interest and dividend payments, and certain payments made with respect to readily tradable instruments, generally you will have 60 days to get a TIN and give it to the requester before you are subject to backup withholding on payments. The 60 -day rule does not apply to other types of payments. You will be subject to backup withholding on all such payments until you provide your TIN to the requester. Note. Writing "Applied For" means that you have already applied for a TIN or that you intend to apply for one soon. Caution: A disregarded domestic entity that has a foreign owner must use the appropriate Form W-8. Form W-9 (Rev. 11-2005) Part II. Certification To establish to the withholding agent that you are a U.S. person, or resident alien, sign Form W-9. You may be requested to sign by the withholding agent even if items 1, 4, and 5 below indicate otherwise. For a joint account, only the person whose TIN is shown in Part I should sign (when required). Exempt recipients, see Exempt From Backup Withholding on page 2. Signature requirements. Complete the certification as indicated in 1 through 5 below. 1. Interest, dividend, and barter exchange accounts opened before 1984 and broker accounts considered active during 1983. You must give your correct TIN, but you do not have to sign the certification. 2. Interest, dividend, broker, and barter exchange accounts opened after 1983 and broker accounts considered inactive during 1983. You must sign the certification or backup withholding will apply. If you are subject to backup withholding and you are merely providing your correct TIN to the requester, you must cross out item 2 in the certification before signing the form. 3. Real estate transactions. You must sign the certification. You may cross out item 2 of the certification. 4. Other payments. You must give your correct TIN, but you do not have to sign the certification unless you have been notified that you have previously given an incorrect TIN. "Other payments" include payments made in the course of the requester's trade or business for rents, royalties, goods (other than bills for merchandise), medical and health care services (including payments to corporations), payments to a nonemployee for services, payments to certain fishing boat crew members and fishermen, and gross proceeds paid to attorneys (including payments to corporations). 5. Mortgage interest paid by you, acquisition or abandonment of secured property, cancellation of debt, qualified tuition program payments (under section 529), IRA, Coverdell ESA, Archer MSA or HSA contributions or distributions, and pension distributions. You must give your correct TIN, but you do not have to sign the certification. Privacy Act Notice Page 4 What Name and Number To Give the Requester For this type of account: Give name and SSN of: 1. Individual The individual 2. Two or more individuals ijoint The actual owner of the account account) or, if combined funds, the first individual on the account' 3. Custodian account of a minor The minor (Uniform Gift to Minors Act) 4. a. The usual revocable The grantor -trustee' savings trust (grantor is also trustee) b. So-called trust account The actual owner' that is not a legal or valid trust under state law 5. Sole proprietorship or The owner' single -owner LLC For this type of account: Give name and EIN of: 6. Sole proprietorship or The owner' single -owner LLC 7. A valid trust, estate, or Legal entity ° pension trust 8. Corporate or LLC electing The corporation corporate status on Form 8832 9. Association, club, religious, The organization charitable, educational, or other tax-exempt organization 10. Partnership or multi -member The partnership LLC 11. A broker or registered The broker or nominee nominee 12. Account with the Department The public entity of Agriculture in the name of a public entity (such as a state or local government, school district, or prison) that receives agricultural program payments List first and circle the name of the person whose number you furnish. If only one person on a joint account has an SSN, that person's number must be furnished. Circle the minor's name and furnish the minor's SSN. a You must show your individual name and you may also enter your business or "DBA" name on the second name line. You may use either your SSN or EIN (if you have one). If you are a sole proprietor, IRS encourages you to use your SSN. List first and circle the name of the legal trust, estate. or pension trust. (Do not furnish the TIN of the personal representative or trustee unless the legal entity itself is not designated in the account title.) Also see Special rules regarding partnerships on page 1. Note. if no name is circled when more than one name is listed, the number will be considered to be that of the first name listed. Section 6109 of the Internal Revenue Code requires you to provide your correct TIN to persons who must file information returns with the IRS to report interest, dividends, and certain other income paid to you, mortgage interest you paid, the acquisition or abandonment of secured property, cancellation of debt, or contributions you made to an IRA, or Archer MSA or HSA. The IRS uses the numbers for identification purposes and to help verify the accuracy of your tax return. The IRS may also provide this information to the Department of Justice for civil and criminal litigation, and to cities, states, the District of Columbia, and U.S. possessions to carry out their tax laws. We may also disclose this information to other countries under a tax treaty, to federal and state agencies to enforce federal nontax criminal laws, or to federal law enforcement and intelligence agencies to combat terrorism. You must provide your TIN whether or not you are required to file a tax return. Payers must generally withhold 2806 o ab interest, dividend, and certain other payments to a payee who does not give a TIN to a payer. Certain penalties may Igo apply. "ARGO SURETY February 15, 2018 Re: Condor Construction, Corp Bond #CMGPO001060 - IFB 16/17-18 Terwilliger Trail To Whom it May Concern: Please accept this letter as approval and agreement from the surety, Argonaut Insurance Company to amend the bond date on the above referenced bonds to align with the construction contract date. Please provide us with a copy of the amended bonds. If you have any additional questions or changes that are required, please feel free to contact me at any time. 1y, ;. Argonaut Insurance Company PO Box 469011 San Antonio, TX 78246 c/o CMC,1A - 20335 Ventura Blvd.. Ste. 426. Woodland Hills. CA 91364