HomeMy WebLinkAboutContract 1615Contractor's Business Name:
Individual's Name:
Fax No:
BID FORM
PROJECT IDENTIFICATION: REMOVAL / DEMOLITION OF
THREE SINGLE FAMILY UNITS & GARAGES
BIDS TO BE OPENED: 2:00 P.M. - WEDNESDAY, AUGUST 8TM , 2001
This bid is snbmitted to:
CITY OF COLUMBIA HEIGHTS
637 38TM AVENUE NE
COLUMBIA HEIGHTS, MN 55421
The undersigned BIDDER proposes and agrees, if this Bid is accepted, to enter into an agreement with
OWNER in the form included in the Contract Documents to perform and furnish all Work as specified or
indicated in the Contract Documents for the Contract Price and within the Contract time indicated in this bid
and in accordance with the other terms and conditions of the Contract Document.
BIDDER '~ccepts all of the terms and conditions of the Notice or Invitation to Bid and Instruction to Bidders.
This Bid will remain subject to acceptance for forty-five (45) days after the day of Bid opening. BIDDER
will sign and submit the Agreement with the Bonds and other documents required by the Bidding
Requirements within Ten (10) days after the date of O'~5%'ER'S NOTICE OF AWARD.
In submitting this bid, BIDDER represents, as more fldly set forth in the Agreement, that:
(a)
Date
/
BIDDER has examined copies of all the Bidding Documents and of the following Addenda
(receipt of all of which is hereby acknowledged):
Number
~-.~ .-~/
(b)
(c)
(d)
BIDDER has familiarized itself with the nature and extent of the Contract Documents,
Work, site, locality, and all local conditions and laws and regulations that in any manner
may affect cost, progress, performance or furnishing of the Materials.
Omitted.
Omitted.
10
(e)
(0
(g)
(h)
(i)
No additional examination, investigations, explorations, texts?reports or similar
information or &3ta in respect of said Underground Facilities are or will be required by
BIDDER in order to perform and furnish the Work at the Contract Price, within the
contract Time and in accordance with the other terms and conditions of the Contract
Doeuments):
BIDDER has correlated the results of all such observations, examinations, investigations,
explorations, tests, reports and studies with the terms and conditions of the Contract
Documents.
BIDDER has given ENGINEER written notice of all conflicts, errors, discrepancies that
it has discovered in the Contract Documents and the ~vritten resolution thereof by
ENGINEER is acceptable to BIDDER.
This Bid is genuine and not made in the interest of or on behalf of any undisclosed
person, f'n-m or corp0rati~)n and is not submitted in conformity with any agreement or
roles of any group, association, organization or corporation; BIDDER has not directly or
indirectly induced or solicited any other BIDDER to submit a false or sham Bid;
BIDDER has not solicited or induced any person, firm or corporation to refrain from
bidding; and BIDDER has not sought by collusion to obtain for itself any advantage over
any other BIDDER or over OV~2NER.
Any other representation as required by Laws and Regulations.
4. BIDDER WILL COMPLETE THE WORK FOR THE FOLLOWING UNIT PRICES:
CITY OF COLUMBIA HEIGHTS
REMOVAL / DEMOLITION OF 3 SINGLE FAMILY UNITS AND GARAGES
Part 'A': DEMOLITION (payment to Contractor)
Part 'B': REMOVAL (payment to City)
BID Part A. Demolition of the following structures:
Description Quantity Unit
Demolish 1307 42nd Avenue single family unit LS 1
Demolish 4542 Washington Street single family unit LS 1
Demolish 4358 Third Street single family unit LS 1
Demolish 1307 42nd Avenue garage LS 1
Demolish 4542 Washington Street garage LS 1
Total:
$ 7z'oo. oO
$ 5'o0, oO
s
$
TOTAL BASE BID DEMOLITION: $O~/~/ q/~, ~)O
Total Demolition Base Bid Written in Words
11
Bid Part B:
' Description ~ ~"
Remove 1307 42nd Avenue single family unit
Remove 4542 Washington Street single family unit
Remove 4358 Third Street single family unit
Remove 1307 42na Avenue garage
Remove 4542 Washington Street garage
Removal of the following structures:
OuantiW
LS'
LS
LS
LS
LS
Unit
1
1
1
1
1
.Total:
TOTAL BASE BID REMOVAL:
Total Removal Base Bid Written in Words
The following information shall be provided by the Contractor for completion of the work:
1. Time required after Contract Documents are executed to start ~vork: 7
2. Time required from commencement to completion (working days only): ! 5'
days.
days.
5. BIDDER agrees that the Work will be completed as follows:
All work must be completed ~vithin 45 days of the date of City Council Award, or
September 26, 2001.
· . BIDDER accepts the provisions of the Agreement as to liquidated damages in the event
of failure to complete the work on time.
The following documents are attached to and made a condition of the BID.
(a)
(b)
(c)
A tabulation of Subcontractors, Suppliers, and other persons and organizations
required to be identified in this Bid.
Affidavit of Non-Collusion.
OSHA Compliance form.
Communications concerning this BID shall be addressed to the address of BIDDER indicated
below.
SUBMITTED ON: ~ ~ 2
,2001.
12
If BIDDER is:
AN INDIVIDUAL
By
(Individual's Name)
(SEAL)
Doing Business As
Telephone No:
A PARTNERSHIP
By
/ (Firm Name)
(SEAL)
Business Address:
(General Partner)
Telephone No.
A CORPORATION
(Corporation Name)
(State of Incorporation)
~ ~, ~
(Name of Per'on Authorized to'~i~
(Title)
ATTEST: >~--~-~
·
Business Address:
Telephone No. ~
13
(SEAL)
A JOINT ~ENTURE
By~
(Name)
(Address)
By
(Name)
(Address)
Mailing Address:
TelephoneNo.
Each joint venturer must sign. The manner of signing for each individual, partnership and
corporation that is a party to the joint venture should be in the manner indicated above.
14
LIST OF SUBCONTRACTORS
Bidders must list subcontractors tentatively scheduled to work on this project.
All changes must be submitted to the City Engineer.
BIDDER'S REFERENCES (same or similar type work)
NAME
TELEPHONE NO.
15
STATE OF
COUNTY OF
AFFIDAVIT OF NON-COLLUSION:
That I am the BIDDER (if the bidder is an individual), a partner in the. BIDDER (if the
bidder is a parmership) of an officer or employee of the BIDDER corporation having
authority to sign on its behalf (if the BIDDER is a corporation;
(2)
That the attached bid or bids have been arrived at by the BIDDER individually and have
been submitted without collusion with, and without any agreement, understanding or
planned common course of action with any vendor of materials, supplies, equipment or
services described in the invitation to bid designed to limit individual bidding or
competition;
(3)
That the contents of the bid or bids have not been communicated by the BIDDER, or its
employees or agents, to any person not any employee or agent of the BIDDER, or its
surety, on any bond furnished with the bid or bids, and will not be communicated to any
person, prior to any official opening of the bids, or bids; and;
(4)
That I have fully informed myself regarding the accuracy of the statements made in this
affidavit.
BIDDER
FIRbI MAKING BIDS
Subscribed and sworn tp~before.~;~
this ~ day of ~,/~J(5~.~ ,2001.
/ N~NIE ~'~
OFFICIAL TITLE
16
EJCDC
STANDARD FORM OF AGREEMENT
BETWEEN OWNER AND CONTRACTOR
ON THE BASIS OF STIPULATED PRICE
THIS AGREEMENT is by and between the
MINNESOTA, (hereinafter called OWNER) and
(Hereinafter called CONTRACTOR).
CITY OF COLUMBIA HEIGHTS,
OWNER and CONTRACTOR, in consideration of the mutual covenants hereinafter set
forth, agree as follows:
ARTICLE 1 - WORK
1.01 CONTRACTOR shall complete all Work as specified or indicated in the Contract
Documents. The Work is generally described as follows:
Demolition or moving of three (3) residential structures and garages.
ARTICLE 2 - THE PROJECT
2.01 The Project for which the Work under the Contract Documents may be the whole or only
a part is generally described as follows:
REMOVAL / DEMOLITION OF THREE SINGLE FAMILY UNITS &
GARAGES:
CITY PROJECT NO.s
0005,0017 & 0018
ARTICLE 3 - ENGINEER
3.01 The Project has been designed by the CITY OF COLUMBIA HEIGHTS'
ENGINEERING DEPARTMENT, who is hereinafter called ENGINEER and who is to act as
OWNER's representative, assume all duties and responsibilities, and have the rights and
authority assigned to ENGINEER in the Contract Documents in connection with the completion
of the Work in accordance with the Contract Documents.
17
ARTICLE 4 - CONTRACT TIMES
4.01 Tinge of the Esset~.ce
A. All time limits for Milestones, if any, Substantial Completion, and completion and
readiness for final payment as stated in the Contract Documents are of the essence of the
Contract.
4.02 Dates for Substantial Completion and Final Payment
A. The Work will be substantially completed on or before September 26, 2001, and
completed and ready for final payment in accordance with paragaph 14.07 of the
General Conditions.
4.03 Liquidated Damages
A. CONTRACTOR and OWNER recognize that time is of the essence of this
Ageement and that OWNER ~vill suffer financial loss if the Work is not completed
within the times specified in paragraph 4.02 above, plus any extensions thereof allowed
in accordance with Article 12 of the General Conditions. The parties also recognize the
delays, expense, and difficulties involved in proving in a legal or arbitration proceeding
the actual loss suffered by OWNER if the Work is not completed on time. Accordingly,
instead of requiring any such proof, OWNER and CONTRACTOR agree that as
liquidated damages for delay (but not as a penalty), CONTRACTOR shall pay OWNER
$250.00 for each day that expires after the time specified in paragraph 4.02 for
Substantial Completion until the Work is substantially complete. After Substantial
Completion, if CONTRACTOR shall neglect, refuse, or fail to complete the remaining
Work within the Contract Time or any proper extension thereof granted by OWNER,
CONTRACTOR shall pay OYVNER $250.00 for each day that expires after the time
specified in paragraph 4.02 for completion and readiness for final payment until the
Work is completed and ready for final payment.
ARTICLE 5 - CONTRACT PRICE
5.01 OWNER shall pay CONTRACTOR for completion of the Work in accordance with the
Contract Documents an amount in current funds equal to the sum of the amounts determined
pursuant to paragraphs below:
For all Work, at the prices stated in CONTRACTOR's Bid, attached hereto as an Exhibit
A.
As provided in paragraph 11.03 of the General Conditions, estimated quantities are not
guaranteed, and determinations of actual quantities and classifications are to be made by
ENGINEER as provided in paragraph 9.08 of the General Conditions. Unit prices have
been computed as provided in paragraph 11.03 of the General Conditions.
18
ARTICLE 6 - PAYMENT PROCEDURES
6.01 Sub)nitta! and Pr, ocessing of Payments
A. CONTRACTOR shall submit Applications for Payment in accordance with Article
14 of the General Conditions. Applications for Payment will be processed by
ENGINEER as provided in the General Conditions.
6.02 Progress Payments; Retainage
A. OYVNER shall make progress payments on account of the Contract Price on the
basis of CONTRACTOR's Applications for Payment on or about the fifteenth day of
each month during performance of the Work as provided in paragraphs 6.02.A. 1 and
6.02.A.2 below. All such payments will be measured by the schedule of values
established in paragraph 2.07.A of the General Conditions (and in the case of Unit Price
Work based on the number of units completed) or, in the event there is no schedule of
values, as provided in the General Requirements:
1. Prior to Substantial Completion, progress payments will be made in an
amount equal to the percentage indicated belo~v but, in each case, less the aggregate
of payments previously made and less such amounts as ENGINEER may determine
or OWNER may withhold, in accordance with paragraph 14.02 of the General
Conditions:
a. 95% of Work completed (with the balance being retainage). If the
Work has been 50% completed as determined by ENGINEER, and if the
character and progress of the Work have been satisfactory to OYVNER and
ENGINEER, OWNER, on recommendation of ENGINEER, may determine
that as long as the character and progress of the Work remain satisfactory to
them, there will be no retainage on account of Work subsequently completed,
in which case the remaining progress payments prior to Substantial Completion
will be in an amount equal to 100% of the Work completed less the aggregate
of payment previously made; and
b. 95% of cost of materials and equipment not incorporated in the Work
(with the balance being retainage).
2. Upon Substantial Completion, OWNER shall pay an amount sufficient to
increase total payments to CONTRACTOR to 98% of the Work completed, less
such amounts as ENGINEER shall determine in accordance with paragraph
14.02.B.5 of the General Conditions and less 5% of ENGINEER's estimate of the
value of Work to be completed or corrected as shown on the tentative list of items
to be completed or corrected attached to the certificate of Substantial Completion.
19
6.03
Fin a l Paym en t
A. Upon final completion and acceptance of the Work in accordance with paragraph
14.07 of the GenEral Conditions, OWNER shall pay the remainder of the Contract Price
as recommended by ENGINEER as provided in said paragraph 14.07.
ARTICLE 7 - INTEREST
7.01 All moneys not paid when due as provided in Article 14 of the General Conditions shall
bear interest at the rate of 6% per annum.
ARTICLE 8 - CONTRACTOR'S REPRESENTATIONS
8.01 In order to induce OWNER to enter this A~eement CONTRACTOR makes the
follo;ving representations:
A. CONTRACTOR has examined and carefully studied the Contract Documents and
the other related data identified in the Bidding Documents.
B. CONTRACTOR has visited the Site and become familiar with and is satisfied as to
the general, local, and Site conditions that may affect cost, progress, and performance of
the Work.
C. CONTRACTOR is familiar with and is satisfied as to all federal, state, and local
La~vs and Regulations that may affect cost, progress, and performance of the Work.
D. CONTRACTOR has carefully studied all: (1) reports of explorations and tests of
substirface conditions at or contiguous to the Site and all dra~vings of physical conditions
in or relating to existing surface or subsurface structures at or contiguous to the Site
(except Underground Facilities) which have been identified in the Supplementary
Conditions as provided in paragraph 4.02 of the General Conditions and (2) reports and
dra~vings of a Hazardous Enviro~mental Condition, if any, at the Site which has been
identified in the Supplementary Conditions as provided in paragraph 4.06 of the General
Conditions.
E. CONTRACTOR has obtained and carefully studied (or assumes responsibility for
having done so) all additional or supplementary examinations, investigations,
explorations, tests, studies, and data concerning conditions (surface, subsurface, and
Underground Facilities) at or contiguous to the Site which may affect cost, pro~ess, or
perforn~ance of the Work or which relate to any aspect of the means, methods,
techniques, sequences, and procedures of construction to be employed by
CONTRACTOR, including applying the specific means, methods, techniques,
sequences, and procedures of construction, if any, expressly required by the Contract
Documents to be employed by CONTRACTOR, and safety precautions and programs
incident thereto.
20
F. CONTRACTOR does not consider that any further examinations, investigations,
explorations, tests, s,tudies, or data are necessary for the performance of the Work at the
Contract Price, within the Contract Times, and in accordance with the other terms and
coriditions of th~.Contract Documents.
G. CONTRACTOR is aware of the general nature of work to be performed by
OWNER and others at the Site that relates to the Work as indicated in the Contract
Documents.
H. CONTRACTOR has correlated the information known to CONTRACTOR,
information and observations obtained from visits to the Site, reports and dra~vings
identified in the Contract Documents, and all additional examinations, investigations,
explorations, tests, studies, and data with the Contract Documents.
I. CONTRACTOR has given ENGINEER written notice of all conflicts, errors,
ambiguities, or discrepancies that CONTRACTOR has discovered in the Contract
Documents, and the written resolution thereof by ENGINEER is acceptable to
CONTRACTOR.
J. The Contract Documents are generally sufficient to indicate and convey
understanding of all terms and conditions for performance and fitrnishing of the Work.
ARTICLE 9 CONTRACT DOCUMENTS
9.01 Contents
A. The Contract Documents consist of the following:
'1.
2.
3.
4.
5.
6.
7.
8.
9.
This Agreement (pages __ to __
Performance Bond (pages __ to __
Payment Bond (pages __ to __
Other Bonds (pages __ to __
General Conditions (pages to __
Supplementary Conditions (pages __
inclusive);
inclusive);
inclusive);
inclusive);
., inclusive);
to __., inclusive);
Specifications as listed in the table of contents of the Project Manual;
Drawings consisting of none.
Addenda (nulnbers __ to __, inclusive);
21
Exhibits to this Agreement (enumerated as follows):
mo
Notice to Proceed (pages to __., inclusive);
CONTRACTOR's Bid (pages __ to __, inclusive);
Documentation submitted by CONTRACTOR prior to Notice
of Award (pages__ to __, inclusive);
;
11.
The following which may be delivered or issued on or after the Effective
Date of the Ageement and are not attached hereto:
Written Amendments;
Work Change Directives;
Change Order(s).
The documents listed in paragraph 9.01 .A are attached to this Ageement (except
as expressly noted otherwise above).
There are no Contract Documents other than those listed above in this Article 9.
The Contract Documents may only be amended, modified, or supplemented as
provided in paragraph 3.05 of the General Conditions.
ARTICLE 10 - MISCELLANEOUS
10.01 Terms
A. Terms used in this Agreement will have the meanings indicated in the General
Conditions.
10.02
Assignment of Contract
A. No assignment by a party hereto of any fights under or interests in the Contract will
be binding on another party hereto without the xvritten consent of the party sought to be
bound; and, specifically but without limitation, moneys that may become due and
moneys that are due may not be assigned without such consent (except to the extent that
the effect of this restriction may be limited by law), and unless specifically stated to the
contrary in any written consent to an assignment, no assigrm~ent will release or discharge
the assignor from any duty or responsibility under the Contract Documents.
22
10.03
Successors and Assigns
A. OWNER and CONTRACTOR each binds itself, its partners, successors, assigns,
and legal represe, atatives to the other party hereto, its partners, successors, assigns, and
legal representatives in respect to all covenants, agreements, and obligations contained in
the Contract Documents.
10.04
10.05
Severability
A. Any provision or part of the Contract Documents held to be void or unenforceable
under any Law or Regulation shall be deemed stricken, and all remaining provisions shall
continue to be valid and binding upon OWNER and CONTRACTOR, who agree that the
Contract Documents shall be reformed to replace such stricken provision or part thereof
with a valid and enforceable provision that comes as close as possible to expressing the
intention of the stricken provision.
Other Provisions (if applicable).
23
IN WITNESS WHEREOF, OWNER and CONTRACTOR have sig-ned this A=oTeement in
duplicate. One counterpart each has been delivered to OWNER and CONTRACTOR. All portions of the
Contract Documents have been sig-ned or identified by OWNER and CONTRACTOR or on their behalf.
This Agreement will be ~'ffective on t~ ~ /r~, 2001 (which is the Effective Date of the
Agreement).
O%~%'ER: /2
~---Gary/Peterson, Mayor
[CORPO1L&TE SEAL HERE]
Attest
Address for giving notices:
CONTtLa~CTOR:
z3 - s
..z",,¢' c
[CORPORATE SEAL HERE]
Attes _ ~ __
Address for givin= notices:
License No.
(Where applicable)
(If OWNER is a corporation, attach evidence
of authority to sign. If OWNER is a public
body, attach evidence of authority to sign and
resolution or other documents authorizing
execution of O~VNER-CONTRACTOR
Agreement).
Agent for service of process:
(If CONTRACTOR is a corporation or a
partnership, attach evidence of authority to
sign.)
Designated Representative: / Designated Representative:
~1 , · ' · i) '
Facsimile: 7~ 3/7¢ ~ -- $ ¢¢ /
Phone: /.~'"/- ¢4 ¢- 6 t"//V~
Facsimile: 0~"/
24
08/21/01 14:05 FA~ 612 376 4299 BERKLEY RISK ~002
i CERTIFICA~ON OF WORKERS' COMPENSATION iNSURANCE
C~y of Columbia
637 - 38m Ave N~
Columbia Heights. MN
Project ¢01-132
Jay Brothers, Inc. Fax: 651~64-1704
PO BOX 70O
Forest Lake, MN 55025
~e named insured has be~n ~e~insured s~n~e 10/2~1998
,: .......... ~ , · .... , ..... ,., ........... .~,~:~:,~,4~,,~ ~.,;~,~.,~:~::~.~,~,. v ,, , ~ .... "- .......... :: ............... {~' ~:~:~i:l'~', ~ '
EEP Worke~' Compensation Fund
As a member, the named insured is author~ed by the 74 - 38
State of Minnesota to self-insure its workers'
~mpensation I~abilities ...........................................
10122/2000 10/2~2001
Wo~em' Compensation .. Statoto~
Employem' Liability:
Each Accident $ 2,000,000
Policy Limit- $ 2,000,000
F~ch Employee for Disease $ 2,000,000
Ber~ey Risk Administratom Company, LLC ff this authority is revoked or ~e nam~ selNinsured
920 Sscond Avenue South, Suite 700 entity withdraws from the plan, B~C will endeavor to
Minneapolis, MN 55402~023 provide 30 days w~en noUce of such revocation or
612-376~200 withdrawal. However, failure to do so shall impose no
obligation or liabil~ o[ any kind upon
Dale Haug (612) 28~2729
p~ ~ Account Manager
8/21/01
THIS INFORMATION IS BEING PRODDED FOR INFOR~T]ONAL PURPOSES ONLY,
~ger~ey Risk Admlnis~tors Oompany, ~O 2000 rac
'" ~ BOND NO. GRMN18865A
Performance Bond
Any sing, ilar re}eronc~,to Coat~actor, Surety, Owner or other parry shall b~ cormidcrcd plural where applicable.
CONTRACTOR (Name and Addr~):
Jay Bros ·, Inc.
9218 Lake Dr. NE, P.O. Box 700
Forest Lake, MN 55025
OWNER (Name and Address);
City of Columbia_Heights
637 - 38th Ave. N.E.
Columbia Heights, MN 55421
CONTRACT
Da~e: August 13, 2001
SURBq~(N~c~d Addr~sofPr~C~M
of B~es~:
Granite Re, Inc.
10804 Quail Plaza Drive
Ste. 200
Oklahoma City, OK 73120
Thousand Nine Hundred and 00/1~0
(3) Residential
& 0018
Thousand Nine Hundred and 00/100
Amount: ($24,900.00) Twenty Four
D~cription(NmneandLocafion): Demolition or Moving of Three
Columbia Heights, Minnesota
City P~oject No's. 0005, 0017
BOND
Dam0WoccaHier ~anCon~ract Date): August 20, 2001
Amount: ($24,900.00) Twenty Four
ModiHcations ~ ~s Bond Form: None
Structures & Garages
Suzety and Contractor, intending to be legally bound hereby, subject to the terms printed on the reverse side hereof, do each cause
th~s Performance Bond to be duly executed on its b~half by its authorized officer, agent or representative.
CONTRACTOR AS PRINCIPAL
Company: Jay Bros., Inc.(Corp. Seal)
Signature:
Name and Title: -
SURETY
Comps.ny: ~~
Gr ' Re, Inc. (Corp. Seal)
Signature: ,
Name an~'e~ - Jonathan Pate
(At~ach ?ewer of Attorney) Attorney-in-Fact
(Space is provided below for signatures of additional parties, if required.)
CONTRACTOR AS PRINCIPAL
C~mpany:
SURETY
(Corp. Seal) Company: (Corp. Seal)
Signature: Signature:
Name and Title: Name and Title:
EJCDC No. 1910-28-A (1996 F. dRion)
Originally prcpar~ through the joint cfi'om or' the Scu'ety Association of America. Engineers Joint ¢onrrac~ Documents Commim:,,, the Associated
Contractors of America, and th~ American Irafituta of Architects.
00610-1
State of
County of
On this
come(s)
ACKNOWLEDGMENT OF PRINCIPAL (Individual)
day of
, in the year : before me personally
to me known and known to me to be the person(s) who (is) (are) described in and executed the foregoing instrument,
and acknowledge(s) to me that he executed the same.
State of
County of
On this
come(s)
Notary Public
ACKNOWLEDGMENT OF PRINCIPAL (Partnership)
day of , in the year
, before me personally
a member of the co-partnership of
to me known and known to me to be the person who is described in and executed the foregoing instrument, and
acknowledges to me that he executed the same as for the act and deed of the said co-partnership.
Notary Public
ACKNOWLEDGMENT OF PRINCIPAL (Corporation)
State of
County of
On this
come(s)
day of /-~;/¢~' , in the year ¢ ! , before me personally
to me known, who, being duly sworn, deposes and says that he resides in the City of L,/~z),~z5 //",¢_¢¢~_
that he is the ~J~ of the ~ ~/ ~/~- //v~
the corporation described in and which executed the foregoing instrument; that he knows the seal of the said corporation;
the seal affixed to the said instrument is such corporate seal; that it was so affixed by the order of the Board of Directors
of said corporation, and that he signed his name thereto by like order.
Publi~-~lnne~ot~ ~
ACKNOWLEDGMENT OF SURETY
State of Minnesota
County of Dakota
On this 20 th
come(s) Jonathan Pate
Granite Re, Inc.
day of August , in the year 2001, before me personally
. Attorney(s)-in-Fact of
with whom I am personally acquainted, and who, being by me duly sworn, says
that he reside(s) in Inver Grove Heights, MN that he is (are) the Attorney(s)-in-Fact of Gra.nlte Re, Inc.
company described in and which executed the within instrument; that he know(s) the corpolate seal of such
Command
that seal affixed to the within instrument is such corporate seal and that it was affixed by or(~er of the Board~D~ectors!of
sa d company, and tba;U~.e s,g~:~e~!_..~,s..a.!:d :!~..s.__.~,.~_~:~,~ ~s.._.~,~Attorney(s)- n-Fact of the sa d Compal~y by ke order. ~k,~ '
GRANITE RE, INC.
GENERAL POWER OF A'I-I-ORNEY
Know all Men by these Presents:
That GRANITE RE, INC., a corporation organized and existing under the laws of the State of OKLAHOMA and having its principal
office at the City of OKLAHOMA CITY in the State of OKLAHOMA does hereby constitute and appoint:
JONATHAN PATE, WANDA ESPE, TOM LAHL its true and lawful Attorney-in-Fact(s) for the following purposes, to wit:
To sign its name as surety to, and to execute, seal and acknowledge any and all bonds, and to respectively do and perform any
and all acts and things set forth in the resolution of the Board of Directors of the said GRANITE RE, INC. a certified copy of which is hereto
annexed and made a part of this Power of Attorney; and the said GRANITE RE, INC. through us, its Board of Directors, hereby ratifies and
confirms all and whatsoever the said:
JONATHAN PATE, WANDA ESPE, TOM LAHL
may lawfully do in the premises by virtue of these presents.
In Witness Whereof, the said GRANITE RE, INC. has caused this instrument to be sealed with its corporate seal, duly attested by
the signatures of its Vice President and Secretary/Treasurer, this 14~ day of May, 1998.
STATE OF OKLAHOMA )
)
COUNTY OF OKLAHOMA )
SS:
R. Dar-ryl Fish~r~ [~r~id~n~
Rodm~n A. Frates, Secretary/Treasurer
On this 14th day of May 1998, before me personally came R. Darryl Fisher, Vice President of the GRANITE RE, INC. Company and
Rodman A. Frates, Secretary/Treasurer of said Company, with both of whom I am personally acquainted, who being by me severally duly
sworn, said, that they, the said R. Darryl Fisher and Rodman A. Frates were respectively the Vice President and the Secretary/Treasurer of
the GRANITE RE, INC., the corporation described in and which executed the foregoing Power of Attorney; that they each knew the seal of
said corporation; that the seal affixed to said Power of attorney was such corporate seal, that it was so fixed by order of the Board of
Directors of said corporation, and that they signed their name thereto by like order as Vice President and Secretary/Treasurer, respectively,
of the Company.
My Commission Expires:
May 9, 2004
GRANITE RE, INC.
Certificate
THE UNDERSIGNED, being the duly elected and acting Secretary/Treasurer of Granite Re, Inc., an Oklahoma Corporation, HEREBY
CERTIFIES that the following resolution is a true and correct excerpt from the July 15, 1987, minutes of the meeting of the Board of
Directors of Granite Re, Inc.
"RESOLVED, that the President, any Vice President, the Secretary, and any Assistant Vice President shall each have authority to
appoint individuals as attorneys-in-fact or under other appropriate titles with authority to execute on behalf of the company
fidelity and surety bonds and other documents of similar character issued by the Company in the course of its business. On any
instrument making or evidencing such appointment, the signatures may be affixed by facsimile. On any instrument conferring
such authority or on any bond or undertaking of the Company, the seal, or a facsimile thereof, may be impressed or affixed or in
any other manner reproduced; provided, however, that the seal shall not be necessary to the validity of any such instrument or
undertaking.'
IN WITNESS WHEREOF, the undersigned has subscribed this Certificate and affixed the corporate seal of the Corporation this
20th day of August ,2001. ~ -~.--~.-~~ ,-- ~
R~man A. Frates, Secretary/Treasurer
" ; BOND NO. GRMN18865A
,. Payment Bond
Any singular reference to Contractor, Surety, Owner or other party shall be considered plural where applicable.
CONTRACTOR (Name and Addre~): Jay Bros., Inc.
9218 Lake Dr. NE, P.O. Box 700
Forest Lake, MN 55025
OWNER (Name and Address):
City of Col-mhia Heights
637 - 38th Ave. N.E.
Col-mhia Heights; MN 55421
CONTRACT
Date: August 13, 2001
Amount: ($24,900.00) Twenty Four
Description (Name and Location):
SURETY (Name and Address of Principal Place
of Business):
Granite Re, Inc.
10804 QUail Plaza Drive
Ste. 200
Oklahoma City, OK 73120
Thousand Nine Hundred and 00/100
Demolition or Moving of Three (3) Residential
Columbia Heights, Minnesota
City Project No's. 0005, 0017 & 0018
Structures & Garages
BOND
Date (Not earlier than Contract Date): August 20, 2001
Amount: ($24,900.00) Twenty Four Thousand Nine Hundred and 00/100
Medifieafions to this Bond Form: None
Surety and Contractor, intending to be legally bound hereby, subject ~o the terms printed on thc reverse side hereof, do each cause this
Payment Bond to be duly executed on its lmhalf by its authorized officer, agent, or representative.
CONTRACTOR AS PRINCIPAL
Company: Jay Bros., Inc.
Name and Title: ~' ~
(Corp.
SURETY
Name anj~fI~'tl~: Jonathan Pate
(A~acb/Power of ARo~ney) Attorney-in-Fact
(Space is provided below for signatures of additional parties, if required.)
CONTRACTOR AS PRINCIPAL
Company:
(CoT. ScM) Company: (Corp. Sea)
Signature: Signature:
Name and Title: Name and Title:
FJCDC No. 1910-28-B (1996 Fxlition)
Ofiglnally pr~parefl through the joint efform of the Surety Associatitm of America. Engineers Joint Confiner Doea~ments Cou~rnlttee, thc As.~oeiated General Conwac~0rs
of America, thc American Institute of Architect. the American Subcontractors Association, and m~ Associated ~pecial~y Contractors.
00620- I
State of
County of
On this
come(s)
ACKNOWLEDGMENT OF PRINCIPAL (Individual)
day of , in the year , before me personally
to me known and known to me to be the person(s) who (is) (are) described in and executed the foregoing instrument,
and acknowledge(s) to me that he executed the same.
State of
County of
On this.
come(s)
Notary Public
ACKNOWLEDGMENT OF PRINCIPAL (Partnership)
day of , in the year
, before me personally
a member of the co-partnership of
to me known and known to me to be the person who is described in and executed the foregoing instrument, and
acknowledges to me that he executed the same as for the act and deed of the said co-partnership.
Notary Public
ACKNOWLEDGMENT OF PRINCIPAL (Corporation)
State of
County of ~/'Z~P~/~I,.~ '--f
On this Z-- c-/, .,~.f. day of , in the year ~ ~" , before me personally
come(s) ,/~,~/zd~ ik~ J~-f ,
to me known, who, being duly sworn, deposes and says that he resides in the City of
that he is the ~T---tc'-Ci of the --//'g--/ ~'~/~_b~'
the corporation described in and which executed the foregoing instrument; that he knows the seal of the said corporation;
the seal affixed to the said instrument is such corporate seal; that it was so affixed by the order of the Board of Directors
of said corporation, and that he signed his name thereto by like order.
State of Minnesota
County of Dakota
On this 20 th
come(s) Jonathan Pate
day of August
, in the year 2001, before me personally
Attorney(s)-in-Fact of
Granite Re, Inc. with whom I am personally acquainted, and wh~O, being by me duly sworn, says
that he reside(s) in Inver Grove Heights. MN that he is (are) the Attorney(s)-in-Fact of Granite Re, Inc.
company described in and which executed the within instrument; that he know(s) the corporate seal of such Cox~pa~ and
that seal affixed to the within instrument is such corp,~orate seal and that it was affixed by ord~er of the So~[~rector~ of
said company, a~d'~~~~(Attorney(s)-in-Fact of the said Compa~ by like or~er. ~
~ '~;¥;','};?i:~L'. ........ ~'_i~.i] ,....-~,_~L; ......... ~;~ Nota~ Public
GRANITE RE, INC.
GENERAL POWER OF ATTORNEY
Know all Men by these Presents:
That GRANITE RE, INC., a corporation organized and existing under the laws of the State of OKLAHOMA and having its principal
office at the City of OKLAHOMA CITY in the State of OKLAHOMA does hereby constitute and appoint:
JONATHAN PATE, WANDA ESPE, TOM LAHL its true and lawful Attorney-in-Fact(s) for the following purposes, to wit:
To sign its name as surety to, and to execute, seal and acknowledge any and all bonds, and to respectively do and perform any
and all acts and things set forth in the resolution of the Board of Directors of the said GRANITE RE, INC. a certified copy of which is hereto
annexed and made a part of this Power of Attorney; and the said GRANITE RE, INC. through us, its Board of Directors, hereby ratifies and
confirms all and whatsoever the said:
JONATHAN PATE, WANDA ESPE, TOM LAHL
may lawfully do in the premises by virtue of these presents.
In Witness Whereof, the said GRANITE RE, INC. has caused this instrument to be sealed with its corporate seal, duly attested by
the signatures of its Vice President and Secretary/Treasurer, this 14th day of May, 1998.
STATE OF OKLAHOMA )
)
COUNTY OF OKLAHOMA )
SS:
R. Dar-ryl Fish~r;~ [~r~id~n~
Rodman A. Frates, Secretary/Treasurer
On this 14th dayof May 1998, before me personally came R. Darryl Fisher, Vice President of the GRANITE RE, INC. Company and
Rodman A. Frates, Secretary/Treasurer of said Company, with both of whom I am personally acquainted, who being by me severally duly
sworn, said, that they, the said R. Darryl Fisher and Rodman A. Frates were respectively the Vice President and the Secretary/Treasurer of
the GRANITE RE, INC., the corporation described in and which executed the foregoing Power of Attorney; that'they each knew the seal of
said corporation; that the seal affixed to said Power of attorney was such corporate seal, that it was so fixed by order of the Board of
Directors of said corporation, and that they signed their name thereto by like order as Vice President and Secretary/Treasurer, respectively,
of the Company.
My Commission Expires: May 9, 2004
GRANITE RE~ INC.
Certificate
THE UNDERSIGNED, being the duly elected and acting Secretary/Treasurer of Granite Re, Inc., an Oklahoma Corporation, HEREBY
CERTIFIES that the following resolution is a true and correct excerpt from the July 15, 1987, minutes of the meeting of the Board of
Directors of Granite Re, Inc.
"RESOLVED, that the President, any Vice President, the Secretary, and any Assistant Vice President shall each have authority to
appoint individuals as' attorneys-in-fact or under other appropriate titles with authority to execute on behalf of the company
fidelity and surety bonds and other documents of similar character issued by the Company in the course of its business. On any
instrument making or evidencing such appointment, the signatures may be affixed by facsimile. On any instrument conferring
such authority or on any bond or undertaking of the Company, the seal, or a facsimile thereof, may be impressed or affixed or in
any other manner reproduced; provided, however, that the seal shall not be necessary to the validity of any such instrument or
undertaking."
IN WITNESS WHEREOF, the undersigned has subscribed this Certificate and affixed the corporate seal of the Corporation this
20th day of Au[~ust ,2001.
oRo~'/dd man A.~ Frates, S~'~ecretary/Treas u rer
FROM :~ADUANTAGE 1 INSURANCE PHONE NO. : 520252?536 Aug. 21 2001 04:27AM P2
DA"I ~ (MM/DD/YY)
CERTIFICATE' OF LIABILITY INSURANCE
PRODUCER JTHIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION oNLY AND
ADVANTAGE t INSURANCE AGENCY, INC. ICONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE
3801 N, 3RD STREETSUITE # 101 JDOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
ST CLOUD MN 56303 IPOLIClES BELOW.
PHONE: 320-2~;2-6050
FAX.' 320~252-7536 COMPANIES AFFORDING COVERAGE
INSURED ICOMPANY A: BITUMINOUS CASUALTY CORP.
JAY BROS., INC. J.~P,~N-~.' "
9218 LAKE DRIVE N.E. I~OMP~---'~--~.'
FOREST LAKE MN 55025 I~AN~/~.'
THIS IS TO c~[,-~' THAT THE POLICIES OF INSURANCE; J~/SYED'BELQW HAVE BEEN 13._e~F_=D TO THE IN,SUR~D NAMED ABOV~ FOR; THE POU~;¥PERIOD INDICATED,
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOOUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY I~E I~UED
O1~ MAY PERTAIN, THE IN..~URANCE AFFORDED BY THE; POLICIES DESCRJBED HE.~EIN IS SUBJECT TO ALLTHE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.
LIMITS ..~HOWN MAY HAVE BEEN REDUCED BY PAID Ct, AIMS.
INI~R 'rYP~ OF IN~,URANCE POLICY NUMBER eOblCY EFFECTIVE PQUCY EXPII~4.Y~
,-r~ ~, PATE/MM/h~/v¥~ DA-ri=/1~ Mh-W3,Wy3
DEaF-RAt. UAI~IUTY CLP 3 t't0 343 APR 1 01 APR 1 0Z F-ACH OCCURPJ;NOE ~ 1,000, ,00~
X COM~ERCIAL~.3 GENERAl.i_:._. ILIA~ILITY F~'~I~ DAMAGS'-~(~y One Fire) $ So
'~ Ct. AIMS MADE JX'j OCCUR MED. EXP (Any One P.,~) $ 5,000~_
m PER~3NAI. &_,ADV INJURY $ '~,000,000
GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPt, IES PEI~ PRODUC'I:S--COMPIOP AG~. $ 2~,000,000
AtrrO~Ol~[.~ [,~J~JLrrY CAP 3 t'10 34,2 APR 1 01 APR t 02 COUE~INED SINd~LE LlUIT
(~ ;¢~ent) $ 't,O00,O00
~ ANY AUTO
ALL OWNED AUTO~ BODILY INJURY
~CHEDULEO AUTOS (Pe~' person)
HIRED AUTO~ BODILY INJURY
NON-OWNED AUTOS (Pet ;~c~idr-nt)
PROPERTY DAMAGE, $
GARAGE I. IAI~ILITY ' AUTO ONLY-'EA ACCi0~NT $
ANYAUrro OTHER THAN F--A ACC $
AUTO ONLY; AGG $
E~CESS UA~Lr~ CUP 2 529 208 APR ~ 0't APR 1 02 F-.ACH OC~URRENC~ t, 1,000~000
A $
J Dc:DUCTIBLE $
RETENTION $ $
EMPLOYERS' UA~ILITY 'TC~Y '_';.:.~;
E.L. EACH .~..,CIDENT .S ....
E,L, DISEASE-FA EMPLOYEE $
E.L DISEASE-POLICY LIMIT
OTHER: INSTALL.~TION FLOATER CLP 3 'PI0 343 ~J~R 1 01 APR 1 02 $500,000 '
A
RENTED OR LEASED $'tO0oOO0
E(~¥1PMENT
DESCRIPTION OF OPE~TIONS/LOCATION$/VEHICLES/SPECIAL ITEMS PROJECT #01-13Z
REMOVAL/DEMOLITION OF THREE SINGLE FAMILY uNrrs & GARAGES
CERTIFICATE HOLDER
Attention:
ACORD 25-.';; {'[~gl)
I I ADDI'r[ONAL INSURED; INSU_RER ~LE'I'I~r.~ ANC~tl ATl~q ,,
SHOULD ANY OF THE A~VE DE~RiB~ POUCI~ BE C~CE~EO BEFO~
~UT FAILU~ TO MAI 3U~ NOTC~ ~ IMP~E NO OBLI~TION OR L~lt~
OF ANY ~ND U~N THE COMPS,
CITY OF COLUMBIA HEIGHTS
637 38TH AVE NE
COLUMBIA HEIGHTS, MN ,~4;Z1-3801