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Home My WebLink About2025-4247CONTRACT DOCUMENTS 2025 40th Avenue U lity lmprovements City of Colu a Heights Columbia hts, MN rfrr eoLror.lU A MENK Real People. Real Solutions. Bolton-Menk.com CONTRACT #2025-4247 CTRTIFICATIONS PAGE PRO.JECT MANUAT FOR 2025 4OTH AVENUE UTILITY IMPROVEMENTS CITY OF COTUMBIA HEIGHTS COI.UMBIA HEIGHTS, MN I hereby certity that this plan, specification, or report was prepared by me or under my direct supervision, and that I am a duly Licensed Professional Engineer under the laws of the State of Minnesota. Signature: Typed or Printed Namel Date: 5l3O/2O25 Lingl, P.E License Number: 56344 city of columbia Heights - 24x.135228 June 2025 O 8.lron & Menk,lnc 2025, A I Righti Ret./v€d CERTIFICATIONS PAGE PAGE 00 01 05-1 Zet/' TAELE OF CONTENTS 2025 40th Avenue Utility lmprovements City of Columbia Heights This Project Manual incorporates, either in full or in part, various EJCDC copyrighted documents. Documents incorporated in full are subject to the copyright notice in the EiCDC document footnotes. For those EJCDC documents excerpted, modified, or incorporated in part, those portions of the text that originated in copyrighted EICDC documents remain subject to the EjCDC license and copyright. Copyright @ 2018 National Society of Professional Engineers, American Council of Engineering Companies, and American Society of Civil Engineers. All rights reserved. CONTRACT DOCUMENTST PRO,IECT MANUAL: lntroductory lnformation, 00 0105 00 01 10 00 11 13 00 21 13 00 41 00 00 43 13 00 45 11 00 51 00 00 51 11 00 s2 00 00 55 00 00 61 13.13 00 61 13.16 00 51 13.19 00 72 00 00 73 00 Bidding Requirements, Contract Forms and Conditions of Contract CERTIFICATIONS PAGE TABLE OF CONTENTS ADVERTISEMENT FOR BIDS INSTRUCTIONS TO BIDDERS BID FORMS BID SECURITY FORM RESPONSIBLE CONTRACTOR VERIFICATION AND CERTIFICATION OF COMPLIANCE NOTICE OF AWARD ADDITIONAL SUBCONTRACTORS LIST AGREEMENT FORMS NOTICE TO PROCEED PERFORMANCE BOND FORM PAYMENT BOND FORM WARRANTY BOND FORM C.7OO 2018 STANDARD GENERAL CONDITIONS OF lHE CONSTRUCTION CONTRACT C-8OO 2018 SUPPLEMENTARY CONDITIONS OF THE CONSTRUCTION CONTRACT 01 1100 01 21 16 01 29 00 01 31 00 0131 19 01 32 15 0133 00 014100 or 4t 26 01 42 1.3 07 42 79 01 45 00 01 55 17 01 55 26 01 57 13 01 71 13 07 7l-23 FEDERAT WAGE DETERMINATION REQU IREM ENTS STATE WAGE DETERM INATION REQUIREMENTS TRUCK RENTAL RATE REQU IREMENTS DISADVANTAGED BUISINESS ENTERPRISE (DBE) GOOD FAITH EFFORTS BUILD AMERICA, BUY AMERICA (BABA) ACT REQUIREMENTS SUMMARY OF WORK CONTINGENCY ALTOWANCES PAYMENT PROCEDURES PROJECT MANAGEMENT AND COORDINATION PROJECT MEETINGS CONSTRUCTION PROGRESS SCHEDULE SUBIVITTAL PROCEDU RES REGULATORY REQUIREMENTS PERMIT REQUIREMENTS ABBREVIATIONS AND ACRONYMS REFERENCE STANDARDS QUALITY CONTROT HAUL ROUTES AND TEMPORARY ACCESS TRAFFIC CONTROL TEMPORARY EROSION AND SEDIMENT CONTROL (LESS THAN ONE ACRE DISTURBANCE) MOBITIZATION FIELD ENGINEERING City of Columbia Heights - 24X.13S228 June 2025 @ 30ro^ & Menk, r.. ro25, ArR;gnE Res.,v€d TAEtE OF CONTENTS PAGE 00 01 10-1 07 77 02 47 3101 31 11 3L 20 31 23 3123 32 72 32 17 32 91 32 92 33 01 33 05 33 74 33 31 33 42 00 13 21 00 00 13 01 23 19.13 00 30.85 06 00 00 00s CLOSEOUT PROCEDU RES SELECTIVE SITE DEMOLITION APPLICATION OF WATER CTEARING AND GRU BBING EARTH MOVING SUBGRADE PREPARATION DEWATERING AGGREGATE BASE COURSES FLEXIBLE PAVEMENT PATCHING PAVEMENT MARKINGS TOP5OIL PLACEMENT AND GRADING TURF AND GRASSES MANHOLE RIM AD]USTMENT TRENCHING AND BACKFILLING WATER UTILITY TRANSMISSION AND DISTRIBUTION SANITARY SEWERAGE PIPING STORMWATER CONVEYANCE APPENDIX: BRAUN TNTETEC BORTNG LOGS DATED 3/19/2025 CITY SPECIAL PROVISIONS TO THE CEAM STANDARD SPECIFICATIONS DRAWINGS (UNDER SEPARATE COVER}: asheets numbered l through I inclusive, dated 513E2925 and with each sheet bearing the followinE general titler 2025 40th Avenue Utility Improvements City of Columbia Heights ****END OF SECTTON**** City of Columbia Hei8hts - 24X.135228 .lune 2025 e aono^ & Menk,r^. 2025,a Rghts R€+ry.d TABLE OF CONTENTS PAGE 00 01 10 2 ADVERTIS€MENT FOR BIDS 2025 4OT'T AVENUE UTILITY IMPROVEMENTS CITY OF COLUMBIA HEIGHTS COLUMBIA H EIGHIS, MN RECEIPT AND OPENING OF PROPOSATS: Proposals for the work described below will be received online through QuestCDN.com until 1O:OO AM on June 20, 2025, at which time the bids [ill be opened and publicly read through Microsoft Teams. Please us the below link or call-in number/conference lD to see and/or hear the bid opening results: 1. Microsoft Teams Link: httos://bit.lvl4othAveBidOpen 2. Call:612-42A-87 78lconference lD: 777 O8O 64i DESCRIPTION Of WORK: The work includes the construction of a pproximately 3,970 SQ YD REMOVE ROADWAY PAVEMENT 4 EACH HYDRANT LEADS 360 LIN FT l" WATER SERVICE68 VFT SANITARY SEWER MANHOLES 26 VFT SANITARY SEWER OUISIDE DROP 720 TONS BITUMINOUS ROADWAY PATCHING 1,300 LIN FT 8" WATERMAIN 5OO SQ YD TURF ESTABLISHM ENT together with numerous related items of work, all in accordance with Plans and Specifications. This project is subject to prevailing Wage Rates, Truck Rentals Rates, Disadvantaged Business Enterprise Goals, the provisions of the Build America, Buy America (BABA)Act, and Responsible Contractor Certification, COMPLETION Of WORX: Substantial Completion of the contrccl.is lOl15l2O25. All work under the Contract must be complete and ready for final payment by 1'0/3112025. pt-AN HOLDERS LIST, ADDENDUMS AND BID TABUTATION: The plan holders list, addendums and bid tabulations will be avaalable for download on-line at www.questcdn.com or www.bolton-menk.com. TO OBTAIN 8lO DOCUMENTS: Complete digital project bidding documents are available at www.questcdn.com or www.bolton-menk.com. You may view the digita I plan documents for free by entering Quest project ,9716853 on the website's Project Search page. Documents may be downloaded for S50.00. Please contact QuestcDN.com at 952-233-1632 or info@questcdn.com for assistance in free membership registration, viewing, downloading, and working with this digital projed information. BID SUBMITTAI-: Abidshall be submitted online no late r tha n the date a nd tim e prescribed. For this project, the Owner will only be accepting on line electronic bids through QuestCDN. Toaccessthe eledronic bid form, downloadthe project document and click the online bidding button at the top of the advertisement. Prospective bidders must be on the plan holders list through QuestcDN for bids to be accepted. BID SECURITY: A Proposal Bond in the amount of not less than 5 percent of the total amount bid, drawn in favor of City of columbia Heights shall accompany each bid. OWNER'S RIGHTS RTSERVED: The Owner reserves the right to reject any or all bids and to waive any irregularities and informalities therein and to award the Contract to other than the lowest bidder if, in their discretion, the interest of the Owner would be best served thereby. DATEDi 5/2812025 /S/ Kevin Hansen City Enginee. I Public Works Director Published: www.columbiahejqhtsmn.gov LIFE (abbreviated): QuestCDN: r***END OF SECT|ONT*1i May 30,2025 lune 5, 2025, and June 13,2025 June 6, 2025 city of columbia HeiShts - 24x.135228 June 2025 O8.ton& M..k,tnc 2025,Ar ighc Re*ryed ADVERTISEMENT FOR BIDS PAGE 00 11 13-1 INSTRUCTIONS TO BIDDERS . Page ARTICLE 1- Defined Terms 2 ARTICLE 2 - Bidding Documents 2 ARTICLE 3 - Qualifications Of Bidders 3 ARTICLE 4 - Pre-Bid Conference 3 ARTICLE 5 - Site and Other Areas; Existing Site Conditions; Examination of Sitei Owne/s Safety Program; Other Work at the Site 3 ARTICLE 6 - Bidder's Representations and Certifications 4 ARTICLE 7 - lnterpretations and Addenda 4 ARTICLE 8 - Bid Security 5 ARTICLE 9 - Contract Times 5 ARTICLE 10 - Substitute and Or-Equal ltems s ARTICLE 11 - Subcontractors, Suppliers, and Others 6 ARTICLE 12 - Preparation of Bid 6 ARTICLE 13 - Basis of Bid 7 ARTICLE 14 - Submittal of Bid 7 ARTICLE 15 -Modification and Withdrawal of Bid I ARTICLE 15 - Opening of Bids 8 ARTICLE 17 - Bids to Remain Subject to Acceptance 8 ARTICLE 18 - Evaluation of Bids and Award of Contract 8 ARTICLE 19 - Bonds and lnsurance 9 ARTICLE 20 - Signing of Agreement 9 ARTICLE 21 - Sales and Use Taxes 9 ARTICLE 22 - Contracts to Be Assigned 9 This document i5 a MoDIFIED version of EJcDc'C-200,NSPE, ACEC, and ASCE. All rights reserved City of Columbia Hei8hts - 24X.135228 June 2025 ght@ 2018 by INSTRUCTIONS TO BIDDERS PAGE 00 21 13-1 ARTICTE 1_DEFINED TERMS 1.01 Terms used in these lnstructions to Bidders have the meanings indicated in the General Conditions and Supplementary Conditions. Additional terms used in these lnstructions to Bidders have the meaninBs indicated below: A. lssuing Office-The office from which the Bidding Documents are to be issued, and which registers plan holders. ARTICTE 2_BIDDING DOCUMENTS 2.0L Bidder shall obtain a complete set of Bidding Requirements and proposed Contract Documents (together, the Bidding Documents). See the Agreement for a list of the Contract Documents. lt is Bidder's responsibility to determine that it is using a complete set of docu ments in the preparation of a Bid. Bidder assumes sole responsibility for errors or misinterpretations resulting from the use of incomplete documents, by Bidder itself or by its prospective Subcontractors and Suppliers. 2.O2 Bidding Documents are made available for the sole purpose of obtaining Bids for completion of the Project and permission to download or distribution of the Bidding Documents does not confer a license or grant permission or authorization for any other use. Authorization to download documents, or other distribution, includes the right for plan holders to print documents solely for their use, and the use of their prospective Subcontractors and Suppliers, provided the plan holder pays all costs associated with printing or reproduction. Printed documents maY not be re-sold under any circumstances. 2.03 Bidder may register as a plan holder and obtain complete sets of Bidding Documents, in the number and format stated in the Advertisement or invitation to bid. Bidders may rely that sets of Bidding Documents obtained in this manner are complete unless an omission is blatant. Registered plan holders will receive Addenda issued by Owner. 2.O4 Owner is not responsible for omissions in Bidding Documents or other documents obtained from plan rooms or other sources, or for a Bidder's failu re to obtain Addenda if they a re not a registered plan holder. 2.05 Electronic Documents A. When the Bidding Requirements indicate that electronic (digital) copies of the Bidding Documents are available, such documents will be made available to the Bidders as Electronic Documents in the manner sPecified. 1. Bidding Documents will be provided in Adobe PDF {Ponable Document Format) (.pdf) that is readable by Adobe Acrobat Reader. lt is the intent of the Engineer and Owner that such Electronic Documents are to be exactly representative of the paper copies of the documents. However, because the Owner and Engineer cannot totally control the transmission and receipt of Electronic Documents nor the Contractor's means of reproduction of such documents, the Owner and Engineer cannot and do not guarantee that Electronic Documents and reproductions prepared from those versions are identical in every manner to the paper copies. B. Unless otherwise stated in the Bidding Documents, the Bidder may use and rely upon complete sets of Electronic Documents ofthe Bidding Documents, described in Paragraph 2.05.A above. However, Bidder assumes all risks associated with differences arising from transmission/receipt of Electronic Documents versions of Bidding Documents and reproductions prepared from those versions and, further, assumes all risks, costs, and responsibility associated with use of the Electronic Documents versions to derive information that is not explicitly contained in printed paper versions of the documents, and for Bidder's reliance upon such derived information. This document is a MODIFIED version of EJCDC. C-2OO by NSPE, ACEC, and ASCE. All right5 reserved City of Columbia Heights - 24X.135228 INSTRUCTIONS TO BIDDERS June 2025 , CopyrightO 2018 PAGE 00 21 13-2 ARTICtE 3-QUAUFTCATTONS OF BTDDERS 3.01 This Article is not used- ARTICLE 4-PRE-BID CONFERENCE 4.Ol A pre-bid conference will not be conducted for this Project. ARTICtE 5-SITE AND OTHER AREAS; ExISTING SITE CONDITIONS; EXAMINATION OF SITE; OWNER'S SAFEw PROGRAM; OTHER WORK AT THE SITE 5.01 Site ond Other Areds The Site is identified in the Bidding Documents. By definition, the Site includes rights-of-way, easements, and other lands furnished by Owner for the use of the Contractor. Any additional lands required for temporary construction facilities, construction equipment, or storage of materials and equipment, and any access needed for such additional lands, are to be obtained and paid for by Contractor. 5.O2 Existing Site Conditions A. Subsurface and Physical Conditions; Hazardous Environmental Conditions 1. The Su pple menta ry Cond ition s identify th e following rega rd ing exist ing cond ition s at or adjacent to the Site: a. Those reports of explorations and tests of subsurface conditions at or adjacent to the Site that contain Technical Data. b. Those drawings known to Owner of existing physical conditions at or ad.iacent to the Site, including those drawings depicting existing surface or subsurface structures at or adjacent to the Site (except Underground Facilities), that contain Technical Data. c. Reports and drawings known to Owner relating to Hazardous Environmental Conditions that have been identified at or adjacent to the Site. 1) Technical Data contained in such reports and drawings. .2. Owner will make copies of reports and drawings referenced above available to any Bidder on request. These reports and drawings are not part ofthe Contract Documents, but the Technical Data contained therein upon whose accuracy Bidder is entitled to rely, as provided in the General Conditions, has been identified and established in the Supplementary Conditions. Bidder is responsible for any interpretation or conclusion Bidder draws from any Technical Data or any other data, interpretations, opinions, or information contained in such reports or shown or indicated in such drawings. 3. lf the Supplementary Conditions do not identify Technical Data, the default definition of Technical Data set forth in Article 1 of the General Conditions will apply. B. lJnderground Focilities: Underground Facilities are shown or indicated on the Drawings, pursuant to Paragraph 5.05 of the Genera I Conditions, and not in the drawinBs referred to in Paragraph 5.02.A of these lnstructions to Bidders. lnformation and data regarding the presence or location of Underground Facillties are not intended to be categorized, identified, or defined as Technical Data. Othe r Site -related Docume nts A. tn addition to the documents regarding existing Site conditions referred to in Paragraph 5.02.A, the following other documents relating to conditions at or ad.iacent to the Site are known to Owner and made available to Bidders for reference: This document is a MoDIFIED version ot EJcDc'c-200, copyrigh NSPE, ACEC, and ASCE. All riBhts reserved City of Columbia Heights - 24x.135228 lune 2025 5.03 tO 2018 by INSTRUCTIONS TO BIDDERS PAGE 00 21 13-3 1. No other site related documents are available. 5.04 Site Visit ond Testing by Bidders A. Bidder is required to visit the Site and conduct a thorough visual examination of the Site and adjacent areas. During the visit, the Bidder must not disturb any ongoing operations at the Site. B. Bidder shall conduct the required Site visit during normal working hours. C. Bidder is not required to conduct any subsurface testing, or exhaustive investigations of Site conditions. D. On request, and to the extent Owner has control over the Site, and schedule permitting, the Owner will provide Bidder general access to the Site to conduct such additional examinations, investigations, explorations, tests, and studies as Bidder deems necessary for preparing and submitting a successful Bid. Owner will not have any obligation to grant such access if doing so is not practical because of existing operations, security or safety concerns, or restraints on Owne/s authority regarding the Site. Bidder is responsible for establishing access needed to reach specific selected test sites. E. Bidder must comply with all applicable Laws and Regulations regarding excavation and location of utilities, obtain all permits, and comply with all terms and conditions established by Owner or by property owners or other entities controlling the Site with respect to schedule, access, existing operations, security, Iiability insurance, and applicable safety programs. F. Bidder must fill all holes and clean up and restore the Site to its former condition upon completion of such explorations, investigations, tests, and studies. 5.05 Owner's SoIety Progrom A. site visits and work at the Site may be governed by an Owner safety program. lf an Owner safety program exists, it will be noted in the Suppiementary Conditions. 5.06 Other Work ot the Site A. Reference is made to Article I of the Supplementary Conditions for the identification of the general nature of other work of which Owner is aware (if anylthat is to be performed at the Site by Owner or others (such as utilities and other prime contractors) and relates to the Work contemplated by these Bidding Documents. lf Owner is party to a written contract for such other work, then on request, Owner will provide to each Bidder access to examine such contracts (other than portions thereof related to price and other confidential matters), if any. ARTICTE 6_BIDDER'S REPRESENTATIONS AND CERTIFICATIONS 6.01 Express Representations and Certifications in Bid Form, Agreement A. The Bid Form that each Bidder will submit contains express representations regarding the Bidder's examination of Project documentation, Site visit, and preparation of the Bid, and certifications regarding lack of collusion or fraud in connection with the Bid. Bidder should review these representations and certifications and assure that Bidder can make the representations and certifications in good faith, before executing and submitting its Bid. B. lf Bidder is awarded the Contract, Bidder (as Contractor) will make similar express representations and certifications when it executes the Agreement. ARTICTE 7_INTERPRETATIONS AND ADDENDA 7.O7 Owner on its own initiative may issue Addenda to clarify, correct, supplement, or change the Bidding Documents. This document is a MODIFIE0 version of EJCDC. C-2OO SPE, ACEC, and ASCE. All rights reserved June 2025 , copyrightO 2018 by N PAGE 00 21 13 4 City of Colum bia Heights - 24X.13S228 INSTRUCTIONS TO B DDERS 7.O2 Bidder shall submit all questions about the meaning or intent of the Bidding Documents to Engineer rn writing to the lssuing Office. Contact information and submittal procedures for such questions are as follows: 7533 Sunwood Drive NW, Suite 206, Ramsey, MN 55303, (763) 433-2851 7.O3 lnterpretations or clarifications considered necessary by Engineer in response to such questions will be issued by Addenda delivered to all registered plan holders. Questions received less than seven days prior to the date for opening of Bids may not be answered. 7.O4 Only responses set forth in an Addendum will be binding. Oral and other interpretations or clarifications will be without legal effect. Responses to questions are not part of the Contract Documents unless set forth in an Addendum that expressly modifies or supplements the Contract Documents. ARTICLE 8_BID SECURITY 8.01 A Bid must be accompanied by Bid security made payable to Owner in an amount of 5 percent of Bidder's maximum 8id price (determined by adding the base bid and all alternates) and in the form of a Bid bond issued by a surety meeting the requirements of Paragraph 6.01. of the General Conditions. Such Bid bond will be issued in the form included in the Bidding Documents or the unmodified EJCDCversion ofthe same form. 8.02 The Bid security of the apparent Successful Bidder will be retained until Owner awards the contract to such Bidder, and such Bidder has executed the Contract, furnished the required Contract security, and met the other conditions of the Notice of Award, whereupon the Bid security will be released. lf the Successful Bidder fails to execute and deliver the Contract and furnish the required Contract security within 15 days after the Notice of Award, Owner may consider Bidder to be in default, annul the Notice of Award, and the Bid security of that Bidder will be forfeited, in whole in the case of a penal sum bid bond, and to the extent of Owner's damages in the case of a damages-form bond. Such forfeiture will be Owner's exclusive remedy if Bidder defaults- 8.03 The Bid security of other Bidders that Owner believes to have a reasonable chance of receiving the award may be retained by Owner until the earlier of 7 days after the Effective Date of the Contract or 61 days after the Bid opening, whereupon Bid security furnished by such Bidders will be released. 8.04 Bid security of other Bidders that Owner believes do not have a reasonable chance of receiving the award will be released within 7 days after the Bid opening- ARTICTE 9-CONTRACT TIMES 9.01 The number of days within which, or the dates by which, the Work is to be (a) substantially completed and (b) ready for final payment, and (c) Milestones (if any) are to be achieved, are set forth in the Agree ment. 9.02 Provisions for liquidated damages, if any, for failure to timely attain a Milestone, Substantial Completion, or completion of the Work in readiness for final payment, are set forth in the Agreement. ARTICLE 10_SUBSTITUTE AND "OR EQUAI." ITEMS 10.01 The Contract for the Work, as awarded, will be on the basis of materials and equipment specified or described in the Bidding Documents without consideration during the bidding and Contract award process of possible substitute or "or-equal" items. ln cases in which the Contract allows the Contractor to request that Engineer authorize the use of a substitute or "or-equal" item of material or equipment, application for such acceptance may not be made to and will not be considered by Engineer until after the Effective Date of the Contract. Thi5 document is a MODIFIED version of EJCDC' C-200, Copyrighto 2018 by NSPE, ACEC, and ASCE. All riShts reserved City of Columbia Heights - 24X.135228 lune 2025 INSTRUCTIONS TO BIDDERS PAGE 00 21 13 5 10.02 The Contract for the Work, as awarded, will be on the basis of materials and equipment specified or described in the Bidding Documents, and those "or-equal" or substitute or materials and equipment subsequently approved by Engineer prior to the submittal of Bids and identified by Addendum. No item of material or equipment will be considered by Engineer as an "or equal" or substitute unless written request for approval has been submitted by Bidder and has been received by Engineer within 10 days of the issuance of the Advertisement for Bids or invitation to Bidders. Each such request must comply with the requirements of Paragraphs 7.05 and 7.06 of the General Conditions, and the review of the request will be governed by the principles in those paragraphs. The bu rden of proof of the merit of the proposed item is upon Bidder. Engineer's decision of approval or disapproval of a proposed item will be final. lf Engineer approves any such proposed item, such approval will be set forth in an Addendum issued to all registered Eidders. Bidders cannot rely upon approvals made in any other manner. 10.03 All prices that Bidder sets forth in its Bid will be based on the presumption that the Contractor will furnish the materials and equipment specified or described in the Bidding Documents, as supplemented by Addenda. Any assumptions regarding the possibility of post-Bid approvals of "or-equal" or substitution requests are made at Bidder's sole risk. ARTICLE 11_SUBCONTRACTORS, SUPPTIERS, AND OTHERS 11.01 A Bidder must be prepared to retain specific Subcontractors and Suppliers for the performance of the Work if required to do so by the Bidd ing Documents or in the Specifications. lf a prospective Bidder objects to retaining any such Subcontractor or Su pplier and the concern is not relieved by an Addend um, then the prospective Bidder should refrain from submitting a Bid. 11.02 The apparent Successful Bidder, and any other Bidder so requested, must submit to Owner a list of the Subcontractors or Suppliers proposed for the following portions of the Work within five days after Bid opening: A. There are no key categories of work. 11.03 If requested by Owner, such list must be accompanied by an experience statement with pertinent information regarding similar projects and other evidence of qualification for each such Subcontractor or Supplier. lf Owner or Engineer, after due investigation, has reasonable objection to any proposed Subcontractor or Supplier, Owner may, before the Notice of Award is given, request apparent Successful Bidder to submit an acceptable substitute, in which case apparent Successful Bidder will submit a substitute, Bidder's Bid price will be increased (or decreased) by the difference in cost occasioned by such substitution, and Owner may consider such price adjustment in evaluating Bids and making the Contract award. 11.04 lf apparent Successful Bidder declines to make any such substitution, Owner may award the Contract to the next lowest Bidder that proposes to use acceptable Subcontractors and Suppliers. Declining to make requested substitutions will constitute grounds for forfeiture of the Bid security of any Bidder. Any Subcontractor or Supplier, so listed a nd against which Owner or Engineer makes no written objection prior to the giving of the Notice of Award will be deemed acceptable to Owner and Engineer subject to subsequent revocation ofsuch acceptance as provided in Paragraph 7.07 ofthe GeneralConditions. ARTICTE 12_PREPARATION OF BID 12.01 The Bid Form is included with the Bidding Documents. A. All blanks on the Bid Form must be completed. B. Paper bids, if applicable, must be completed in ink and the Bid Form signed in ink. Erasures or alterations must be initialed in ink by the person signing the Bid Form. This document is a MODtFtED version of EJCDCo C y NSPE, ACEC, and ASCE. A rights reserved City of Columbia Heights - 24X.135228 INSTRUCTIONS TO BIDDERS June 2025 -200, CopyrightO 2018 b PAGE 00 21 13-6 12.o2 12.03 12.04 12.05 C. A Bid price must be indicated for each section, bid item, alternate, adjustment unit price item, and unit price item listed therein. D. lf the Bid Form expressly indicates that submitting pricing on a specific alternate item is optional, and Bidder elects to not furnish pricing for such optional alternate item, then Bidder may enter the words "No Bid" or "Not Applicable." When submitting a paper bid, if Bidder has obtained the Bidding Documents as Electronic Documents, then Bidder shall prepare its Bid on a paper copy of the Bid Form printed from the Electronic Documents version of the Bidding Documents. The printed copy of the Bid Form must be clearly legible, printed on 8% inch by 11-inch paper and as closely identica I in appearance to the Electronic Docu ment version of the Bid Form as may be practical. The Owner reserves the right to accept Bid Forms which nominally vary in appearance from the original paper version of the Bid Form, providing that all required information and submittals are included with the Bid. A Bid by a corporation must be executed in the corporate name by a corporate officer (whose title must appear under the si8nature), accompanied by evidence of authority to sign. The corporate address and state of incorporation must be shown. A Bid by a partnership must be executed in the partnership name and signed by a partner (whose title must appear under the signature), accompanied by evidence of authority to sign. The official address of the partnership must be shown. A Bid by a limited liability company must be executed in the name of the firm by a member or other authorized person and accompanied by evidence of authority to sign. The state of formation of the firm and the official address of the firm must b€ shown. A Bid by an individual must show the Bidder's name and official address. A Bid by a.ioint venture must be executed by an authorized representative of each joint venturer in the manner indicated on the Bid Form. The .ioint venture must have been formally established prior to submittal of a Bid, and the official address of the joint venture must be shown. When submitting a paper bid, all names must be printed in ink below the signatures. The Bid must contain an acknowledgment of receipt of all Addenda, the numbers of which must be filled in on the Bid Form. Postal and e mail addresses and telephone number for communications regarding the Bid must be shown. The Bid must contain evidence of Bidder's authority to do business in the state where the Project is located, or Bidder must certify in writing that it will obtain such authority within the time for acceptance of Bids and attach such certification to the Bid. 72.06 1,2.O7 12.08 12.09 12.r0 12.1,1, 12.12 lf Bidder is required to be licensed to submit a Bid or perform the Work in the state where the Project is Iocated, the Bid must contain evidence of Bidder's licensure, or Bidder must certify in writing that it will obtain such licensure within the time for acceptance of Bids and attach such certification to the Bid. Bidder's state contractor license number, if any, must also be shown on the Bid Form. ARTICTE 13-BASIS OF BID ARTICLE 14_SUBMITTAT OF BID 14.01 The Bid Form is to be completed and submitted with the Bid security and the other documents required to be submitted under the terms of Article 2 of the Bid Form. 14.02 A Bid must be received no later than the date and time prescribed and at the place indicated in the Advertisement or invitation to bid. Paper bids, if applicable, must be enclosed in a plainly marked package This document is a MODIFIED version of EICDc! C-200, Copyrigh NSPE, ACEC, and ASCE. All riShts reserved City of Columbia Heights - 24x.135228 June 2025 t@ 2018 by INSTRUCTIONS TO BIDDERS PAGE 00 21 13-7 14.03 with the Project title, and, if applicable, the designated portion of the Project for which the Bid is submitted, the name and address of Bidder, and must be accompanied by the Bid security and other required documents. lf a Bid is sent by mail or other delivery system, the sealed envelope containlng the Bid must be enclosed in a separate package plainly marked on the outside with the notation "BlD ENCLOSED." A mailed Bid must be addressed to the location designated in the Advertisement. Bids received after the date and time prescribed for the opening of bids, or not submitted at the correct location or in the designated manner, will not be accepted. Paper bids that are not accepted will be returned to the Bidder unopened. ARTICI-E 15_MODIFICATION AND WITHDRAWAT OF BID 15.01 An unopened Bid may be withdrawn by an appropriate document duly executed in the same manner that a Bid must be executed and delivered to the place where Bids are to be submitted prior to the date and time for the open ing of Bids. Upon receipt of such notice, the u nopened Bid will be returned to the Bidder. 15.02 lf a Bidder wishes to modify its Bid prior to Bid opening, Bidder must withdraw its initial Bid in the manner specified in Paragraph 15.O1 and submit a new Bid prior to the date and time for the opening of Bids. 15.03 tf within 24 hours after Bids are opened any Bidder files a duly signed written notice with Owner and promptly thereafter demonstrates to the reasonable satisfaction of Owner that there was a material and substantial mistake in the preparation of its Bid, the Bidder may withdraw its Bid, and the Bid security will be returned. Thereafter, if the Work is rebid, the Bidder will be disqualified from further bidding on the Work. ARTICTE 16_OPENING OF BIDS 16.01 Bids will be opened at the time and place indicated in the advertisement or invitation to bid and, unless obviously non-responsive, read aloud publicly. A tabulation of the total amounts of the base Bids and major alternates, if any, will be made available to Bidders after the opening of Bids. ARTICTE 17_BIDS TO REMAIN SUBJECT TO ACCEPTANCE 17.01 All Bids will remain subject to acceptance for the period of time stated in the Bid Form, but Owner may, in its sole discretion, release a ny Bid a nd return the Bid secu rity prior to the end of this period. ARTICI-E 18_EVATUATION OF BIDS AND AWARD OF CONTRACT 18.01 Owner reserves the right to re.ject any or all Bids, including without limitation, nonconforming, nonresponsive, unbalanced, or conditional Bids. Owner also reserves the right to waive all minor Bid informalities not involving price, time, or changes in the Work. 18.02 Owner will reject the Bid of any Bidder that Owner finds, after reasonable inquiry and evaluation, to not be responsible. 18.03 lf Bidder purports to add terms or conditions to its Bid, takes exception to any provision of the Bidding Docu ments, or attem pts to a lter the contents of the Contract Documents for purposes of the Bid, whether in the Bid itself or in a separate communication to Owner or Engineer, then Owner wil! reject the Bid as nonresponsive. 18.04 lf Owner awards the contract for the Work, such award will be to the responsible Bidder submitting the lowest responsive Bid. 18.05 Evoludtion of Bids A. ln evaluating Bids, Owner will consider whether the Bids comply with the prescribed requirements, and such alternates, unit prices, and other data, as may be requested in the Bid Form or prior to the Notice of Award. This document is a MODIFIED version of EJCDC6 C-2OO by NSPE, ACEC, and ASCE. All rights reserved June 2025 , Copyrighto 2018 PAGE 00 21 13-8 City of Columbia Heights 24X.135228 INSTRUCTIONS TO BIDDERS B. For the determination of the apparent low Bidder(s) when alternate(s) are submitted, Bids will be compared on the basis of the sum of the base bid and the alternate(s) selected by the Owner for award. C. For determination of the apparent low Bidde(s) when sectional bids are submitted, Bids will be compared on the basis of the aggregate of the Bids for separate sections and the Bids for combined sections that result in the lowest total a mount for a ll of the Work. D. For the determination of the apparent low Bidder when unit price bids are submitted, Bids will be compared on the basis of the total of the products of the estimated quantity of each item and unit price Bid for that item, together with any lump sum items. E. For the determination of the apparent low Bidder when cost-plus-fee bids are submitted, Bids will be compared on the basis of the Guaranteed Maximum Price set forth by Bidder on the Bid Form. 18.05 ln evaluating whether a Bidder is responsible, Owner will consider the qualifications of the Bidder and may consider the qualifications and experience of Subcontractors and Suppliers proposed for those portions of the Work for which the identity of Subcontractors and Suppliers must be submitted as provided in the Bidding Documents. 18.07 Owner may conduct such investigations as Owner deems necessary to establish the responsibility, qualifications, and financial ability of Bidders and any proposed Subcontractors or Suppliers. ARTICTE 19_BONDS AND INSURANCE 19.01 Article 6 of the General Conditions, as may be modified by the Supplementary Conditions, sets forth Owner's requirements as to performance and payment bonds, other required bonds (if any), and insurance. When the Successful Bidder delivers the executed Agreement to Owner, it must be accompanied by required bonds and insurance documentation. 19.02 A4icle 8, Bid Security, of these lnstructions, addresses any requirements for providing bid bonds as part of the bidding process. ARTICTE 2O_SIGNING OF AGREEMENT 20.01 When Owner issues a Notice of Award to the Successful Bidder, itwill be accompanied bythe unexecuted counterparts ofthe Agreement along with the other Contract Documents as identified in the Agreement. Within 15 days thereafter, Successful Bidder must execute and deliver the required number of counterparts ofthe Agreement and any bonds and insurance documentation required to be delivered by the Contract Documents to Owner. Within 10 days thereafter, Owner will deliver one fully executed counterpart of the Agreement to Successful Bidder, together with printed and electronic copies of the Contract Documents as stated in Paragraph 2.02 ofthe GeneralConditions. ARTICTE 21_SAtES AND USE TAXES 21.01 Sales tax is to be included in the Bid. ARTICLE 22-CONTRACTS TO BE ASSIGNED ARTICLE 23_22.01 NO SUPPTEMENTARY CONDITIONS IN THIS ARTICLE. This document is a MODIFIED version of EJcDCo C-200, Copyrighto 2018 by NSPE, ACEC, and ASCE. All riShts reserved City of Columbia Heights - 24x.135228 June 2025 INSTRUCTIONS TO BIDDERS PAGE 00 21 13 9 Items to Be Submitted with the Bid for 2025 40th Avenue Utility Improvements City of Columbia Heights Columbia Heights, MN BID FORMS 2025 4oth Avenue Utility lmprovements The terms used in this Bid with initial capital letters have the meanings stated in the lnstructions to Bidders, the General Conditions, and the Conditions. ARTICTE 1_OWNER AND BIDDER 1.01 This Bid is submitted to: City of Columbia Heights, 3989 Central Avenue NE, Columbia Heights, MN 55421. Refer to the Advertisement for Bids for submittal location, format, and deadline for consideration. 7.02 This bid form is provided for Bidders reference. The Bid must be submitted to City of Columbia Heights electronically through QuestCDN. 1.03 The undersigned Bidder proposes and agrees, if this Bid is accepted, to enter into an Agreement with Owner in the form included in the Bidding Documents to perform all Work as specified or indicated in the Bidding Documents for the prices and within the times indicated in this Bid and in accordance with the other terms and conditions of the Bidding Documents. ARTICTE 2_ATTACHMENTS TO THIS BID 2.Ot The following documents are submitted with and made a condition of this Bid: A. Required Bid security; B. Section 00 45 11 Responsible Contractor Verification and Certiflcation of Compliance Prime Contractor Bid Form Attachment of this Project Manual. ARTICLE 3-BA5IS OF BID ARTICIE 4-TIME OF COMPTETION 4.O1 Bidder agrees that the Work will be substantlally complete and will be completed and ready for final payment in accordance with Paragraph 15.06 of the ceneral Conditions on or before the dates or wlthin the number of calendar days indicated in the Agreement. ARTICTE 5-BIDDER'S AC(NOWT€DGEMENTS: ACCETTANCE PERIOD, IN5TRUCTIONS, ANO RECEIPT OF ADDENDA 5.01 Bid Acceptance Period A. This Bid will remain subject to acceptance for 61 days after the Bid opening, or for such longer period of time that Bidder may agree to in writing upon request of Owner. 5.02 lnstructions to Bidders A. Bidder accepts all of the terms and conditions of the lnstructions to Bidders, includinB without limitation those dealing with the disposition of Bid security. 5.03 Receipt of Addenda A. Bidde r hereby acknowledges receipt of the following Adde nda: Addendum Number Addendum Date This docurnent is a MODIFIED version of ETCDC6 C ACEC, and ASCE. All rlghts reserved City of Columbia Heights ' 24X.135228 June 2025 -410, Copyricht@ 2018 by NsPE, BID FORMS PAGE 00 41 00 1 ARTICTE 5_BIDDER'S REPRESENTATIONS AND CERTIFICATIONS 6.01 Bidder'sRepresentations A. ln submitting this Bid, Bidder represents the following 1. Bidder has examined and carefully studied the Bidding Documents, including Addenda. 2. Bidder has visited the Site, conducted a thorough visual examination of the Site and adjacent areas, and become familiar with the general, local, and Site conditions that may affect cost, progress, and performance of the Work. 3. Bidder is familiar with all Laws and Regulations that may affect cost, progress, and performance of the Work. 4. Bidder has carefully studied the reports of explorations and tests of subsurface conditions at or adjacent to the site and the drawings of physical conditions relating to existing surface or subsurface structures at the Site that have been identified in the Supplementary Conditions, with respect to the Technical Data in such reports and drawings. 5. Bidder has carefully studied the reports and drawings relating to Hazardous Envlronmental Conditions, if any, at or adjacent to the site that have been identified in the Supplementary conditions, with respect to Technical Data in such reports and drawings. 6. Eidder has considered the information known to Bidder itself; information commonly known to contractors doing business in the locality of the Site; information and observations obtained from visits to the Slte; the Bidding Documents; and the Technical Data identified in the Supplementary conditions or by definition, with respect to the effect of such information, observations, and Technical Data on (a) the cost, progress, and performance of the Work; (b)the means, methods, techniques, sequences, and procedures of construction to be employed by Bidder, if selected as Contractor; and (c) Bidder's (Contractor's) safety precautions and programs. 7. Based on the information and observations referred to in the preceding paragraph, Bidder agrees that no further examinations, investigations, explorations, tests, studies, or data are necessary for the performance ofthe Work at the Contract Price, within the Contract Times, and in accordance wlth the other terms and conditions of the Contract. 8. Bidder 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 Bidding Documents. 9. Bidder has given Engineer written notice of all conflicts, errors, ambiguities, or discrepancies that Bidder has discovered in the gidding Documents, and of discrepancies between Site conditions and the Contract oocuments, and the written resolution thereof by Engineer is acceptable to Contractor. 10. The Bidding Documents are generally sufficient to indicate and convey understanding of allterms and conditions for performance and furnishing of the Work. This document is a MODIFIED version of EJCDCo C-410 and A5CE. All rights reserved. June 2025 , Copyrisht@ 2 018 by NSPE, ACEC, PAGE 00 4100-2 City of Columbia Heights - 24X.135228 8lD FOR[4S 6.O2 11. The submission ofthis Bid constitutesan incontrovertible representation by Bldderthat without exception the Bid and all prices in the Bid are premised upon performing and furnishing the Work required by the Bidding Documents. Bidder's Certlf ications A. The Bidder certifies the following: 1. This Bid is genuine and not made in the interest of or on behalf of any undisclosed individual or entity and is not submltted in conformity with any collusive agreement or rules of any group, association, organization, or corporation. 2. Bidder has not directly or indirectly lnduced or solicited any other Bidder to submit a false or sham Bid. 3. Bidder has not solicited or induced any individual or entity to refrain from bidding. 4. Bidder has not engaged in corrupt, fraudulent, collusive, or coercive practices in competing for the Contract. For the purposes of this Paragraph 6.02.A: a. Corrupt practice means the offering, giving, receiving, or soliciting of anything of value likely to influence the action of a public official in the bidding process. b. Fraudulent practice means an intentional misrepresentation of facts made (a)to influence the biddinB process to the detriment of Owner, {b) to establish bid prices at artificial non-competitive levels, or (c)to deprive Owner of the benefits of free and open competition. c. Collusive practice means a scheme or arrangement between two or more Bidders, with or without the knowledBe of Owner, a purpose of which is to establish bid prices at artificial, non-competitive levels. d. Coercive practice means harming or threatening to harm, directly or indirectly, persons or their property to influence their participation in the bidding process or affect the execution of the Contract. This document is a MODIFIEO version of EJCOC' C'410, copY.iEhtO 2018 by hts reserved City of Columbia Heights - 24X.135228 June 2025 NSPE, ACEC, and ASCE. AII ri8 BID FORMS PAGE 00 4100-3 I BIDDER hereby submits thls 8id as set forth above Bldder: A-1 Excavating LLC 8y: (typed ot p.ln?ed ndm. oJoryonl,ollon) ( ind lvlduol's slgnotwe ) Name: Charles M Storing (typed o. p.inted) Title: Secretary (typed ot p nted) oate: 6/20125 (typ.d o. print.d) It Bidder is o corporotion, o portnership, or o ioint venture, ottach evldence oJ authority to sign. Attest; signoture) Name:Jennifer Ber8eman (typed ot p nted) Title:Notary Ityped or prlnted) Date 6/2ol2s (typed ot prlnled) PO Box 90, Bloomer Wl 54724 Bidde/s Contact: Name:Charles M Storing (typed ot p hted) Title:Secretary (Wed ot printed) 715-558-4141Phone: Email: Address: estimating@alexcavating.com PO Box 90, Bloomer Wl 54724 Bidde/s Contractor License No.: (lf applicable) Thls document ls a MOOItIED verslon of EJCOC'c-410, copyrishto 2018 by NSPE. ACEC,and ASC€. All rirhts reserved. City of Columbia Heights - 24X.135228 .lune 2025 BIO FORMS PAGE 00 410e.4 Address for giving not!ces: n/a BIDDING SCXEDUTE 2025 4OIH AVINUI UIUW IMPSOVEMENTS CIrY OT COLUMBIA HEIGHTS. MN 8Mt PAOJICTNO 24X11522A0{n 6o0an r3dt lo ,.rio.m .ll ol rhe @ d€5.db!d ln th. aONTiaCr ooauMaNls lor th. tollslna lnlt odej NOIE:3105 rt ll lidtd.t.Lr tar.nd all.pDll@bL r.rer..d a€er. 3l00ai ou3r,illln unlt o.kcr In num.Qh, Eale.nenrl@ ro,.a.h it ri, a.d lot.l. c1 (Lv) ' clbL Yads, loose vollm. CY (c1) . cubi. Y.rds, compact.d vol(h. li,Laru..d in pr.e) lPl.+!inn.d quntitv B.ns or M..sur.ohr NOTE9 2 3 5 6 9 10 1l 12 l, rs t6 Ll u t9 27 21 7' 2S !5 11 7t 29 ,0 !l !2 202r.sol 2lol.so, 2r01.502 2101.502 2 ro4 502 2ro{,503 rt(}1,s03 21I,a.503 2lo4.t1a 210a.s02 210a.903 250t 601 2S03.602 2S03.603 2t06,60I 2121.610 11t1.507 llllso? ,211.604 2535.S03 2503.503 2403.s03 2t03,s03 210!.602 coNslRucroN 5ulvaYrN6 CLTAR r,l6 Al{O citBsal6 {5HnUA) fl .MOVT SAJIIIAAY MANHOII sAWCUT BmJMN qr5 PAVI MINT (tU rt Ot Ptlt) 9AWCUI CONCiEIE PAV€M'I{I IRITI OEPIH' R€M(VEPrPrsrwrRstsAN[ ftYl 5ALVA6 t ANO RaftSTAlt t]AltoSCAPa 0LOaX NTMOV' CUNO ANO GUTIER AEMOr'' COI{CRETI PAWMEI{I SEMOVE vAwr AJ.D 8Ot RTMOVI H'ORANI 5avl5t aN0 REllsrat 3tof,M alwtn PrPt ItMronArySyPASs PUMPIXG {5AI|ITARY) .- -ii, cor{NEcrro rxErrN6 sroRM sEwE[ srRucluk ] . conl{ECTTOrxrsflIqsroRMsEwtiflpt :. l, AOjUST fnAME ilN6 & CA5rNG. ' I. slnEal swtEPri (wmr flcruP siootr) acGirGATE 6r$ l.V) CLtiS 9- a6cna6^rf 6a5€lcvlcLAss5,sbtwalrp rcH n { SP 125 wEA{al6 COUis€ M0( ll;C} WPt SP 12SWEAnftG COURS€ MAlr;q sloawAfi PAr.tr D'PVC PIPE SEWTR SOR 25 r ouc1lLt tf,ot't PrpE sEwER cL 52 13" PVC PrPl SEWfn SOR 26 Colll{EcI TO TXISIING WATENMAIN 1.ro 80 I 2 7 5 10 l:r0 30 500 20 10 9 toN CA'II BID FORMS 00 41 00 2 z 3 .. " 2,820| :'I:- . lro 500- 119 BIODING SCHEDUTE 2025 40IH AVENUT UTI LIIY I MPROVEMENTS CITY O' COLUMBIA HEIGHTS, MN aMt PSoJECI NO. 24X135228000 BlooEn aSEe! to ,.,lorh all ol rh. po d.r.rab.d ln lh! COtlIRAcr oOcUMtt{Ts aor tlt ldkryllt urrl pri..i: NoTE: alo5 sh.llh.lude s.leet.r.nd al r o9[.r!r. tare. . ^d fe.i. BlooEn nunfil in unlr pric! ln.6..a1r, h.k..n.nrbn lor...h il n,..drol.l. CY (tV, ' Cubk Y..dt tGe volvm cY ((vl " cuuc Y.dt, conp.d.d volumc lr'rt rluEd ln Prrcl {p).pr.n.ed auntnyBari! ol McaruEnehl a, ,s l5 ,8 39 45 aa 50 5l 52 t! NOTIS: I 2 2503.503 2503.503 1504.602 2504.@2 2504.604 l5o{.601 2504.6!2 ?50{.603 2s03_602 2505.502 2r06502 2575,000 2s6r60r 2573,r0? 012116 s0 1,3@ ll !,180 6' WATEfiMA]N OICAI. riorr Ct 52 3' WATaiMAtt{ OrrCTlU tfiON Ct 52 OUclM NON FllTNGs TEMPORANYWAT'i5[NVT( t" wpa ( coPP€i WAT€R *RVrt 2'WAT ERMAIN INSU IATION COI{NtCI TO TIEIII{G SANIIARY SEWER @i6rnucTS N|TAAY stwt8 MAt{HOfr co[smucr 3' ouTsro€ DnoP coMrvo{ Toploll 8oiRow (N FI ta5 3 'go sEiD, rERlltr2ER, AND HYDIT UTIC MUtCr.] M^rii( ' A5 OMECIED 3Y IHt [I{6INEER 5TONM DR^IN INTET PiOTTC[IQN !" oorrSrt sorD ur{t MULI colliP mrtow) 1 13 utlT stD IEM tNCtUDE5 ftftO VEnrrcArONOfAIPtPESrZ(!6 a MArtfltAt5 r]Y CONnNrOSPA(a ENTnY 8lo roRrr,4s 00 a1 00 A-I EXCAVATING, LLC CONSENT OF SECRETARY PURSUANT TO CHAPTER I83 OF THE WISCONSIN UNIFORM LIMITED LIABILITY COMPANY LAW The undersigned, being the Secretary of A-l EXCAVATING, LLC, a Wisconsin limited liability company (the "Company"), acting pursuant to Chapter 183 of the Wisconsin Unilorm Lirnited Liability Company Law, does hercby certify that the following resolutions were duly adopted by written consent oi the sole member of said Company effective as oflhe Dn day of Attgu*.2023, and that said cons€nt is in accordance with the operating agreement of said Company and lhat said resolutions have not been amended or revoked and are in full force and effect: RESOLVED, that Charles M. Storing, Terry Pecha and/or Paul Mumm, as officels of the Company, are hereby authorized to execute and deliver, on behalf of the Con)pany, thefollowing: Bids and bid documents pertaining to contracts and subcontracts foljobs and projects to be performed by the Company; Contlacts and subcontracts forjobs and prcjects to be pelformed by the Company; Bond and bond applications for contmcts and subcontracts for' jobs and projects to be pcrformed by the Company; and Miscellaneous documents relating to the foregoing items. 2 3 4 RESOLVED, that thid palties dealing with the Company may rely upon a certified copy of the foregoing resolulions as evidence of the authorities granted by such resolutiorls. Any third palty receivirlg such a cerlified copy rnay completely rely r:pon such certified copy without any fulther duty of inquiry or the need to obtain any consent, approval, ot signature from the Company as to such matters. [Signante pa ge fol lows] IN WITNESS \ HEREOF, the undelsigned l]as executed this Consent to be filed as part ofthe minutes ofthe Company as ofAugust 22,2023. Alberto de Cardenas, Secretary Bldder Name: A-1 Excavating LLC Address (prlnclpol place of business): 8237 State Hr,r/y 64 Bloomer, W 54724 Surety Name: Tr$/.te,s Ca3ualty end Surety Compary of Ariarlca Address (princlpol ploce of buslness): One Tower Square Hartford, CT 06 1 83 Owner Name: city of Columbia Heights Addtess (pinctpol ploce of bustnest)i 3989 CentralAvenue NE Columbia Heights, MN 55421 Btd Ptolect lnom. ond toco oo)i 2025 4fth Avenue Utllity lmprovements - Columbla Heights, MN June 20th, 2025Date:Bid Bond PenalSum: Five Percent ofAmount Bid (50/6 ofAmount Bid) Date of Bond: June sth, 2O2S na Bd dderI Intend betoSurety bo nU hed reng sub ect tto eh tee8allv rms foset rth thnbyj Bis d nBo d do caeach eUS ht 5 B Bd toond dbe u executed na tiautho ollized rcely reorby e ntativeagent,pres Surety By: Name Name: or?yped)(Prlnted ot typed) Title;Title: Attest:Attest: Name Name: lPtlnted ot (Ptinted ot typ.d) Title: 8y lslgnotut )ol seol)nomelo.mol ol (cotporotrSurcA) Nolcs: 17) Note: Addrcttes ote lo & used lor gt"lng ony tequircd noti.e. (2) Ptorlde .xrualon by ohy oddltiotwl ponies, such os loint venturctt t necestory. BID SECURITY FORM Thls do.ument lr a MOOIFI€O version of ErCDC' C-430, Copyrltht@ 2018 by NSPE, ACEC, and ASCE. All rltht5 re!.rved. CiW of Columbla HeiShts - 24X.135228 June 2025 BID SECURITY FORM PAGE 00 43 13-1 L. Bidder and Surety, jointly and severally, bind themselves, their heirs, executors, administrators, successors, and assigns to pay to Owner upon default of Bidder the penal su m set forth on the face of this Bond. Payment of the penal sum is the extent of Bidder's and Surety's liability. Recovery of such penal sum under the terms of this Bond will be owner's sole and exclusive remedy upon default of Bidder. 2. Default of Bidder occurs upon the failure of Eidder to deliver within the time required by the Bidding Documents (or any extension thereof agreed to in writing by Owner) the executed Agreement required bV the Bidding Documents and any performance and payment bonds required by the BiddinB Documents. 3. This obligation will be null and void if: 3.1. owner accepts Bidder's Bid and Bidder delivers within the time required by the Bidding Documents (or any extension thereof agreed to in writing by Owner) the executed Agreement required by the Bidding Documents and any performance and payment bonds required by the Bidding Documents, or 3.2. All Bids are rejected by Owner, or 3.3. Owner fails to issue a Notice of Award to Bidder within the time specified in the Bidding Documents (or any extension thereof agreed to in writing by Bidder and, if applicable, consented to by surety when required by Paragraph 5 hereof). 4. Payment under this Bond will be due and payable upon default of Bidder and within 30 calendar days after receipt by Bidder and Surety of written notice of default from Owner, which notice will be given with reasonable promptness, identifying this Bond and the Project and including a statement of the amount due. 5. Surety waives notice of any and all defenses based on or arising out of any time extension to issue Notice of Award agreed to in writing by owner and Bidder. provided that the total time for issuing Notice of Award including extensions does not in the aggregate exceed 120 days from the 8id due date without surety's written consent. 6. No suit or action will be commenced under this Bond prior to 30 calendar days after the notice of default required in Paragraph 4 above is received by Bidder and surety, and in no case later than one year after the Bid due date. 7. Any suit or action und er this Bo nd will be co m menced on ly in a court of co mpetent jurisdiction located in the state in v,/hich the Project is located. 8. Notices required hereunder must be in writing and sent to Bidder and Surety at their respective addresses shown on the face of this Bond. Such notices may be sent by personal delivery, commercial courier, or by United States Postal Service registered or certified mail, return receipt requested, postage pre-paid, and will be deemed to be effective upon receipt by the party concerned. 9. Surety shall cause to be attached to this Bond a current and effective Power of Attorney evidencing the authority of the officer, agent, or representative who executed this Bond on behalf of Surety to execute, seal, and deliver such Bond and bind the Surety thereby. 10. This Bond is intended to conform to all applicable statutory requirements. Any applicable requirement of any applicable statute that has been omitted from this Bond will be deemed to be included herein as if set forth at length. lf any provision of this Bond conflicts with any applicable statute, then the provision of said statute governs and the remainder of this Bond that is not in conflict therewith continues in full force and effect., 11. The term "Bid" as used herein includes a Bid, offer, or proposal as applicable. This document is a MODIFIED verslon of EJCDCS C"430, Copyright@ 2018 by NSPE, ACEC, and ASCE. All rights reserved City of columbra Heights - 24X.135228 June 2025 8ID SECURITY FORM PAGE 00 43 13-2 .-. TRAYETERSJ Travelerg Casualty and Surety Company of Am€rica Travelers Casualty and Surety Company St. Paul Fire and Marine lnsuranc€ Company POWER OF ATTORT{EY K'{OW AII tlEX BY THESE PREEE T8: Thal Travslor. Ca.lalty and Su.oly Cornpa.ry ol Amorka, Trotrsle6 Ce3u.lty snd Swety Company, aM St. Paul Fk6 aad Ma.lna lnsuanco Cohprny are corporallon! duly o.glnlz€d undo, tha laws ol lho Stalc of Connec{cl, (h6acln collGctvBly calod the 'Compsnlo3'), Allanla and lhrt lho do hereby mek6. conslllut€ 6nd appolnl Carille M. Cruz ol lheir true end lawful Altorney(!)-in'Foct to sign, execut6, soal and ecknowlodge eny and all bonds. rccognizanct'!, cordruonal undorlsklng! and othd wr in08 obllgatoy in ths nafuro thdoot on behall of lho Corllftar{s3 ln lh6h busln*8 ol guarardoehg lh€ ,idelty ot paraorE. guerantc6lng th. p€.lamanco of conlracla and o)6drlhO or grrarantedrE bond! and und€,tatlnCs roqukld or pormltlad ln any eclicB or procoodlngt alof,od by law. lN wlTI{E9s WHEREOF, sle Compados halE c€usod thls ln3trumenl to b6 rEn6d. and thdr corpo..to !6rk lobo h€.olo dfir6d,lhl. 21.t day ol Aprll, 20?1. St8te ot Connoclhut City d Haritord es.Robert aney, S6nior Vice Pr€sident On lhis lho 2l.t day ol Aprll. 2021, before m6 p6r.onall, .pp6ered Robort L. Rrn.y. who acknowledged hllrtsslf to bs lh6 S€nlor Vlc6 P.6ld€nt of oach d the Compenlg€, 8nd thal ho, as !udr, belng authorized 80 lo do, ex€cutod lhe fq€going lnstruflEnl fo. the purposes lhereh co. ained by signlnC on behalt ol s.ld Co.ryranles by himself e. e duly 6ulhodzcd oflker. lN W|TNESS WHEREOF, I h€r€unto set my hand and oflicial ssal My Comml$lon expkes the 30th day of Juno. 2028 Anna F. Nowik, Notary Public Thb Po{rer of Altornoy i! gaedLd under aid by tho euthorily of lhe fdlowlng r€aolutloars sdoptod by tho Boaad! otr Diretora ol eedt a, the Colnpenie3. whldl r6olrllorB 8r€ norv ln full f6c€ snd offgcl. roadlng 8! follovJ3: RESOIVED, lhal tho Chatman. lh6 Prosldort, any Mce Chairman, any Ereculive Vlc€ Prosid€r[ .ny Ssdor Vlco Prcildert. any Vk€ P.€sldsnt, any Seco.d Vlce Presid6t{, the Treg3uro., any Assislanl T.ealurer, lhe Cqponls Socretary or any Asslrtant Secrgtary may sppolnt Atlor.Ey!-ln-F.ct and Agont3 to act for 8nd otl brhalf of the Compsny end may Olvo such .ppolntoa 6uch guthorily 83 hls or h6r o€,tmcalo ot aulhorily may proscrhe lo slgn wlth lho Compt.[rrs name .id goal wlth the Comprnfs so6l boMs, ,6cognlz.nc€s, contracb d lndomnity, end othor wrfllrE! oblhrto.y ln th6 n.turo ot e bond, r€coonllar|ce, fi coMltlonal uad€rlrking. and sny of sdd ofllc€rs o, lhE Bosrd ot Oroctds el any tltng may rsmolB any sudl appoinloo end revoke the power glwn him or hor; and ll 13 FURTHER RESOLVED, that lho Chalrm.n, tho P.66ldanl, .ny Vlco Chal man. .ny Er€culiv€ Vlco Pr6ldor{, .ny S6,!0. Vha Pr"st ont or .ny Vic€ Pr85ld€.l1 m8y dologal6 a[ or .ny p.rt ol the fdegolnC adhodly lo or€ o. moro ofice.s or employo66 d thl! Company, p.o(dod lhrt oach such dolog.tlon i! h rvrilln0 rnd e copy lhe.sof ls fll€d h lh6 oafice ol th€ S€crelary; aM ll ls FURTHER RESOLVEO,lhet any bo.d. rocognllanco, co.rlr.ct ot lndomntly, o, wrillng obllgetory ln lh6 nalu.o of a bond, recognlzence, or conditional unde.lstlng lhall be wlld 8nd blndlng upon lh6 Company wh6n (s) Blgnod by tho Pr€sldert any Vlc6 Chdm.n. sny Exocutlr,B Vio. Pr6.ld€nt, any s€nid Vlcg Prclldeni o( any Vlce Pa6ld6nt, any s6cond Vice Prelkt6nt, th6 Trc.3u€r, any Alllllaltt Tr6aurs, lha Coryorate Secretery o, any A5El8t.nt Serslary and duly sttsltod and loalod with lho Comp.ny'r leal by r S€c.Et.ry or Alsbtr S6cr.dg y; o. (b) duly exEcut€d (under seal. it r€quked) by ono or moro AtlomoyS-lr}Frct and Agenta puEuanl to he porv6a pa€acdbed h hk o, hea c€rtificste q thsir cortr.'Icetos d authorlly or by one or more Company offcer8 pu,su8nt lo 8 wrtlton doleoallql ol authorfty; and lt b FURTHER RESOLVED, that ths slgnature ot oach ol the fdlo lng ottlc6rs: Pr63ldeit. any Exeouuve Vioe Pr6ld6nl, .ny S.nlor Vice Presldenl, any Vice Presidcnt, any ASSlrtanl Vice Prg8Honl. any Secro(ary, any Asal8lanl S6cr6lary, and lho 6sal of tha Company may bB rflixad by lacalmlle to any Pow6r of Allomey o. to any c6rullc8le .elatlng thereto gppolnung Resldont Vlqo P(6ldontB, R..ldenl A.!lst8r{ S€crctslo3 o, Attornoys-ln-Facl fd purp663 or y oi sxrcr nO 8rd rtb3llng bords Bnd urdo(aklngs and othor wrltingr obllgatory ln lho nsturo lh6raar, and arry luarr Powo, ot Altomoy or cdmcato boaalrE auch facalmlle BlCnalurc or tacslrhflo soal lhall bo valid and blndlno upon tho Compsny and any sudl po*oa 80 axecuted aM corliflod by su{h facEknilo shnaturo and facslmlh s6al rhall be vald and blndlng on lho Company ln the fuluro vdlh r€6p€cl to eny bond o. uodo.strndln€ to vrl dr it b elbchod. l, K.vln E. Hughe., lhe unde.Blgnod, A!.btsnl SecrotEry d oach of ttrs Comp.nlo6, do horoby co.llfy lh.t lho abow ond fasgdng lE a l.u€ ond cor.ect copy of lh6 Poxa, oI Aloaney orecutrd by !8id Compar e!, whlch r€mailtl h fuI foaca ard €ffecl. oateo trt -{- oay ot June 2025 /*. { /4a.-a Ksvln E. Hughos:Asslstanl Secrotary fo varlly ah. eullrchllclay ol thla Power o, Aalomey, plarae c.ll u, .l 1-800-121-3880- Ple.sa relet to rha abore-ntmad ALomay(a)-tn-Fact enat lhe atotalk ot the bood ao whlch ahls Powar ol Allomoy l3 ataachaal. o(,qdl ^-,TRAYELERSJ SUREW BOND ELECTRONIC SIGNATURE & SEAL ADDENDUM TRAVELERS CASUALW AND SURETY COMPANY OF AMERICA Travelers Casualty and Surety Company of Am€rica CTravelersl has authorized its Attomeys-in-Fact to utilize an electronlc, facslmile, or dlgltal slgnature (each an "Ehcuonlc Slgnature') to execute bonds on behalF of Travelers and has further authorized its Attorneys-in-Fact to attach this Addendum to any such bonds. Travelers hereby acknowledges ard agrees that the attached bond executed by the Attorney-in-Fact on behalf of Travelers with an Electronic Signature shall have the same force and effect as if executed by the Attorney-in-Fact with a wet ink signature. Travelers also hereby agrees that the seal below shall be deemed affixed to the attached bond to the same extent as lf Travelers' ralsed corporate seal was physically afrixed to the face of the bond. Dated this 22nd day of September, 2020. Travelers casualty and surety companv of America By Robe.t L. Ranoy, Seni Presidenl H CONN. RESPONSIBTE CONTRACTOR VERIFICATION AND CERTIFICATION OF COMPLIANCE PRIME CONTRACTOR BID FORM ATTACHMENT BMI PROJECT NUMBER: 24X.135228 This form includes changes by statutory references from the Laws of Minnesota 2015, chapter 64, sections 1-9. This form must be submitted with the bid form submitted for this project. A bid form received without this form, may be rejected. lhir document isa M0DlFlE0 velsion ofthe [4nDOT le Contractor V€ rifkation and certificatlon of compliance torm Minn. Stat. 5 16C.285, Subd. 7. IMPIEMCNTATION. ... any prime contractor or subcontractor or motor carrier that does not meet the minimum criteria in subdivision 3 or fails to verify that it meets those criteria is not a responsible contractor and is not eligible to be awarded a construction contract for the project or to perform work on the project... Minn. Stat. $ 16C.285, Subd. 3. R€SPONSIBIE CONTRACTOR, MINIMUM CRITERIA. "Responsible contractor" means a contractor that conforms to the responsibility requirements in the solicitation document for its portion of the work on the project and verifies that it meets the following minimum criteria: (1)The Contractor: (i) is in compliance with workers' compensation and unemployment insurance requirements; (ii) is in compliance with Department of Revenue and 0epartment of Employment and Economic Development registration requirements if it has employees; (iii) has a valid federal tax identification number or a valid Social Security number if an individual; and (lv) has filed a certificate of authorlty to transact business in Minnesota with the Secretary of State if a foreign corporation or cooPerative, l2j The contractor or related entity is in compliance with and, during the three-year period before submitting the verification, has not violated section 777 .24, 777 .25, 777 .471o f77.44, LBt.03, 181.101, 181.13, !87.74, or L87.722, and has not violated U nited States Code, title 29, sections 201 to 219, or United states Code, title 40, sections 3141to 3148. For purposes ofthis clause, a violation occurs when a contractor or related entity: {i) repeatedly fails to pay statutorily required wages or penalties on one or more separate projects for a total underpayment of $25,000 or more within the three-year period, provided that a failure to pay is "repeated" only if it involves two or more separate and distinct occurrences of underpayment during the three-year period; (ii) has been issued an order to comply by the commissioner of Labor and lndustry that has become final; (iii) has been issued at least two determination letters within the three-year period by the Department of Transportation finding an underpayment by the contractor or related entity to its own employees; (iv) has been found by the commissioner of Labor and lndustry to have repeatedly or willfully violated any of the sections referenced in this clause pursuant to section 177.27; (v) has been issued a ruling or findings of underpayment by the administrator of the Wage and Hour Division of the United States Oepartment of Labor that have become final or have been upheld by an administrative Iaw judge or the Administrative Review Board; or (vi) has been found liable for underpayment of wages or penalties or misrepresenting a construction worker as an independent contractor in an action brought in a court having jurisdiction. Provided that, if the contractor or related entity contests a determination of underpayment by the Department of Transportation in a contested case proceeding, a violation does not occur until the contested case proceeding has concluded with a determination that the contractor or related entity underpaid wages or penalties;* City of Columbia Hei8hts' 24X.135228 RESPONSIBLE CONTRACTOR VERIFICATION AND CERTIFICATION OT COMPLIANCE PAGE 00 45 11-1.lune 2025 vr2:91r O soltM & M.nh le 2015,alni3hBR.nd.d (3)The contractor or related entity is in compliance with and, during the three-year period be verification, has not violated section 181.723 or chapter 3268. For purposes of this clause, a violation occurs fore subm itting the when a contractor or reJated ent has been issued a final administrative or licensin order;* (4)The contractor or related entity has not, more than twice during the three-year period before submitting the office of Administratlve Hearings or was not a led to the office;* (s)The contractor or related entity has not received a final determination assesslng a monetary sanction from t Department of Administration or Transportation for failure to meet targeted group business, disadvantaged business enterprise, or veteran-owned business goals, due to a lack of good faith effort, more than once during he the three'year eriod before submittin the verification;* *Any violations, suspensions, revocations, or sanctions, as defined in clauses {2) to (5), occurring prior to Ju 2014, shall not be considered in determinin whether a contractor or related entit lv r, meets the minimum criteria (6)The contractor or related entity is not currently suspended or debarred by the federal Sovernment or the state of Minnesota or any of its departments, commissions, agencies, or political subdivisions that have authority to debar a ccntractor; and llt All subcontractors and motor carriers that the contractor intends to use to perform proiect wor the contractor through a signed statement under oath by an owner or officer that they meet the minimum k have verified to criteria listed in clauses (1 to 6 Minn. Stat. S 16(:.285, 5ubd. 5. SUBCONTRACTOR VERIFICATION A prime contractor or subcontractor shall include in its verification of compliance under subdivision 4 a list of all of its first-tier subcontractors that it intends to retain for work on the project. Prior to execution of a construction contract, and as a condition precedent to the execution of a construction contract, the apparent successful prime contractor shall submit to the contracting authority a supplemental verification under oath confirming compliance with subdivision 3, clause (7). Each contractor or subcontractor shall obtain from all subcontractors with which it will have a direct contractual relationship a signed statement under oath by an owner or officer verifylng that they meet all of the minimum criteria in subdivision 3 prior to execution of a construction contract with each subcontractor. lf a prime contractor or any subcontractor retains additional subcontractors on the project after submitting its verification of compliance, the prime contractor or subcontractor shall obtain verifications of compliance from each additional subcontractor with which it has a direct contractual relationship and shall submit a supplemental verification confirming compliance with subdivision 3, clause (7), within 14 days of retainlng the additional subcontractors. A prime contractor shall submit to the contractlng authority upon request copies of the signed verifications of compliance from all subcontractors of any tier pursuant to subdivision 3, clause (7). A prime contractor and subcontractors shall not be responsible for the false statements of any subcontractor with which they do not have a direct contractual relationship. A prime contractor and subcontractors shall be responsible for false statements by their first-tier subcontractors with which they have a direct contractual relationship on ly if they accept the verification of compliance with actual knowledge that it contains a false statement. Subd. 5a. Motor carrier verification. A prime contractor or subcontractor shall obtain annually from all motor carriers with which it will have a direct contractual relationship a signed statement under oath by an owner or officer verifying that they meet all of the minimum crlteria in subdivision 3 prior to execution of a construction contract with each motor carrier. A prime contractor or subcontractor shall require each such motor carrier to provide it with immediate written notification in the event that the motor carrier no longer meets one or more of the minimum criteria in subdivision 3 after submitting its annual verification. A motor carrier shall be ineligible to perform work on a project covered by this section if it does not meet all the minimum criteria in subdivision 3. Upon request, a prime contractor or subcontractor shall submit to the contracting authority the signed verifications of compliance from all motor carriers provjding for-hire transportation of materials, equipment, or supplies for a project. Thisdocumenr is a MOD|F|EOversion ofthe MnDOI Responsibl€ Conra(tor Verlllcat ion and Certificatlon of Co mpllance ,orm City of Columbia Heights - 24X.135228 RESPONSIBIE CONTRACTOR VERIFICATION AN D CERTIF'CATION OF COMPTIANCE PAGE 00 4s 11-2 June 2025 Vl2292l O Aoho. & M..1, tm.2O2t,lltRthrt x.r.a.d verification, had a certificate of compliance under section 363A.36 revoked or suspended based on the provisions of section 363A.36, with the revocation or suspension becoming final because it was upheld by the Minn. Stat. 5 16C.285,Subd. 4. VERIFICATION OFCOMPLIANCE. A contractor respondlng to a solicitation document of a contracting authority shall submit to the contracting authority a signed statement under oath by an owner or offlcer vedfolng compllance with each of the minimum criteria ln subdivislon 3, with the exceptlon of clause (7), at the tlme that lt responds to the solicitation document. A contracting authority may accept a signed statement under oath as sufficient to demonstrate that a contractor is a responsible contractor and shall not be held liable for awarding a contract in reasonable reliance on that statement. A prime contractor, subcontractor, or motor carrier that fails to verify compliance wlth any one of the requlred minimum criteria or makes a false statement under oath ln a verification of compliance shall be ineligible to be awarded a construction contract on the proiect for which the verification was submitted. A false statem€nt under oath verifying compliance with any ofthe minimum criteria may result in termination of a construction contract that has already been awarded to a prime contractor or subcontrador or motor canier that submits a false statement. A contracting authority shall not be liable for declining to award a contract or terminating a contract based on a reasonable determinatlon that the contractor failed to verify compliance with the minimum criteria or falsely stated that it meets the minimum criteria. A verification of compliance need not be notarized. An electronic verification of compliance made and submitted as part of an electronic bid shall be an acceptable verification of compliance under this section provided that it contains an electronlc signature as deffned in sectlon 32S1.02, paragraph (h). CERTIFICATION 8y slgnlnt thls document I certlfy that I am an owner or offlcer of the company, and I certlfy under oath that: l) My company meets each of the Mlnimum Crlterla to b€ a responslble contractor as deflned hereln and ls ln compllance wlth Mlnn, Stat. S 15C.2E5, and 2) lf my company ls awarded a contract, I wlll submit Attachment A-1 prlor to contract execution, and 3l if my company is awarded a contract, I wlll also submlt Attachment A-Z as requlred. Authorized Signature of Owner or Officer: t Printed Name: Trt6:- -U Secretary Date 6l20/?s Company Name: A-1 Excavating Ll-C NOTE: Minn. Stat, 5 15C.285, Subd. 2, (c) lf only one prlme contractor responds to a sollcltatlon document, a contractlng authority may award a construction contract to the responding prime contractor even if the minimum crlterla ln suMivision 3 are not met. ....ENO Ot SECTIONT'.' rhb do.ulrr€llt h. MOO|FIE0v?rron of th€ MnooT R.spo lbleConlra.to.V.rlfl(allon .nd C€nlrlcatloo of Compllance form City of Columbia Heights - 24X.135228 RESPONSIBIE CONTRACTOR VERIf ICATION AND lune 2025 vl2rt, ! li !.lrd I lrh.\ k( lor5, lll ntha iffia CERTIFICATION OF COMPUANCE PAGE 00 45 11-3 r0,,\Charles M Storins Items to Be Executed After Bid Opening for 2025 4}th Avenue Utility lmprovements City of Columbia Heights Columbia Heights, MN Datc of lssuance: June 24, 2025 Own:r: CiW of Columbia HeiShts Owner's Proiect No.: Englncer: Bohon & Menk, lnc. En8inee/s Proiect No.: 24X.135228 Prolect: 2025 40th Avenue Utility lmprov.ments Bidder: A-1 Excavatlnt, Ll-C Bidde/s Address: P.O. Box 90, Bloomet,Wl 54724 You are notified that Owner has accepted your Bid dated June 20, 2025, for the above Contract, and that you are the Successful Bidder and are awarded a Contract for: . Sewer and Water Replacements The Contract Price of the awarded Contract is 5848,&48.00. Contract Price is subrect to ad.lustment based on the provisions of the Contract, including but not limited to those governing changes, Unlt Price Work, and Work performed on a cost-plus-fee basis, as applicable. Three [3] unexecuted counterparts of the Agreement accompany this Notice of Award, and one copy of the Contract Documents accompanies this Notice of Award or has been transmitted or made available to Eidder electronically. E Drawings will be delivered separately from the other Contract Documents. You must comply with the following conditions precedent within 15 days of the date of receipt of this Notice of Award: 1. Deliver to Owner [3] counterparts of the Agreement, signed by Bidder (as Contractor]. 2. Deliver wlth the signed Agreement(s) the Contract security (such as required performance and payment bonds) and insurance documentation, as specified in the lnstructions to Bidders and in the General Conditions, Articles 2 and 5. 3. Deliver to Owner executed Section 00 51 U 'ADDITIOI{AL SUBCONTRACTORS tlsT" in accordance with Minn. Stat. 15C.285 subd.3 Subclauses (1) to (7). Delivery is a condition precedent to execution of this contract and failure to submit this form shall be cause for the Owner to cancel Award of Contract and declare your Bid sacurity forfeited. 4. Other conditions precedent: DBE 6ood F.lth Efforts Documentatlon Fallure to comply with these conditions within the time specified will entitle Owner to consider you in default, annul this Notice of Award, and declare your Bid security forfeited. Within 10 days after you comply with the above conditions, Owner will return to you one fully signed counterpart of the Agreement, together with any additional copies of the Contract Documents as indicated in Paragraph 2.OZ of the General Conditions. City of Columbia Heights Kr-r;* y{a-""* Owner: By bignoturc): Name (printed): Title: Copy: Engineer Kevin Hansen City Engineer /Public Works Director Thii docurnent is a MODIFIED version of AC[C, and ASCE. All rilhts,eseNcd .iune 2025 EJCDC' C-510, Copyritht O 2018 by NSPE, PAGE OO 51 OG1 NOTICE OF AWARD NOTICE OF AWARD city of columbia Heithrs - 24x.135228 o.Qo' a6t25t2425 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMAIIVELY OR NEGATIVELY AIIE D, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF II{SURAI{CE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S}, AUTHORIZED REPRESENTAIIVE OR PROOUCER, A OTHE CERTIFICATE HOLOER. IMPORTANT: lf th€ ce ificate holder is an ADDITIO'{AL INSUREO, the policylies) must have AOOITIONAL INSURED provisions or be endorsed. It SUBROGATION IS WAIVEO, subjecl lo the terms and conditions ol the policy, ce(ain policies may require an endoEemeri. A statemenl on this cenificate does not conter rights to the certiticate holder in lieu of such endorsement(s). PRODUCER MARSH USA LLC, TwO ALLIANCE CENTER 3560 LENOX ROAD SUITE 21OO AILANTA, GA 30326 Attn l\,lastec.cens@marsh.com c! 1!402!qcsqqcA!412415 NSUREO Al Excavating LIC MasTec Noflh Amedca. lnc, 8237 Stale HYy 64 Bloomer W 51724 PHONE I&c, Nq.En):liA/c![o) INSU BER(SI4:FO!qINGIqVE!!GE ACt Americai hsllltrce oqnpall lldem!Lu lns lla Olla!1h A!-er ca rcE Fitqll ndeldileG lnsur!trce Catnpaiy x4 INSURERJ INSURERE tNsuRES C INST'REED INSURER E INST'RER F 22E1 43511 207!4 COVERAGES CERTIFICATE HOLDER CERTIFICATE OF LIABILITY INSURANCE CERTIFICATE NUMBER CANCELLATION REVISION NUMBER: s @ 1988-2016 ACORO CORPORATION. All rights reserved THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAIVED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWTHSTANOING ANY REQUIRE[,lENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER oOCUMENT WTH RESPECT TO wHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN THE INSURANCE AFFORDED BY THE POLICIES DESCRIAED HEREIN IS SUBJECI TO ALL THE TERIVS. EXCLUSIONS AND CONDITIONS OF SUCI,I POLICIES. LIMITS SHOVVN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LIMITSPOUCY EFF POLICYEXP EACHOCCI]RRENCE DAMAGE TO RENIEO !R EMlsES lEa oE!!en!9l MED ExP (any one p€6on) PERSONAL &ADVINJURY GE NERAL AGGREGATE EXCLUDED -ooo,om 200 9Ory 6.000 000 n sX s PRODUCTS. COMP/OP AGG $ OTHER S s @t1512024 09115t2425y y xS1G48924803o!x COITIiIERCIAL GENERAL LIABIUTY CLA|MS-MAD€ x occuR srR, $2.000 000 GEN L AGGREGATE LIMIT A]PLIES PER x PoLrcY i#i Loc !,000,qm 500 000 owuEo HIRED AUTOS ONLY S s $ y y ISA H 108,461 10 09t1s12024 a9n5t2025 BOOILY NJ!RY (Perperson) SCHEOULED AUTOS NON-OM/NEO AUTOS ONLY A alloMoatLE LtAaLlw BODILY INJURY (Pera@d6l) (per a@d6tl UI{BFELLA LIAB EXCESSUAB OED REIENTION EACri OCCUrlRENCE AGGREGATE SOCCUR CLAIMS.IIAOE tvoRKERS COt PENSAIOiTi AND EMPLOYERS'UABILIrY ANYPROPRIETOR/PARTNER'EXECUTIVE OF'ICER/MEMBEREXCLUOEO' y W1RC72603716 (A0S) w1RC72603783 (AZ r,rA) scFc72603825 (WD @t15D024 49t1512024 w1512024 09t'1512025 09t15t2425 0911512425 EL rEL EL EACHACCIO€NT OISEASE . EA EMPLOYE E DSEASE - POLICY LIMIT 2.o!ryq 2 000 000 2 000,0m C c x T UTEs OESCRIPTION OF OPERATIONS / LOCATIoI{S / VEHICLES (ACORO 1 01, Addition.l R.rud(s Sch€dul., tuy b. .tt ch€d it moE .p.c. ir r€qulEd) Re ' 2025 40TrlAVE UI llTY IMPROVEMENIS conditoos ol lhe policies, SHOULD ANY OF THE ABOVE OESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRANON OATE IHEREOF. I{OTICE WLL AE DELIVEREO ItI ACCORDANCE WTH THE POLICY PROVISIONS. AUTHORIZEO REPRESENTA]IVE ?7C4.-Z ZIS:'< -.z-.{Ct ACORD 25 (2016/03)The ACORD name and logo are registered marks of ACORO I r,r CITY OF COLUMgIA HEIGI-TS 3g8S CENTRAL AVE NF COLUMEIA I]EIGHTS. MN 55421 AGENCY cUSToMER lo: CN102902330 LoC #: Atlanta ADDITIONAL REMARKS SCHEDULE ?age 2 ot 2 ADDITIONAL REMARKS @ 2oo8 AcoRD cORPoRATION. All rights reserved. MARSH USA LLC,A1 Excavaling LLC MasIec No ' Ameica ,nc 8237 Stale H*y 6.{ Bloorcr. W 5,+721 THIS AODITIONAL REiIARKS FORM IS A SCHEOULE TO ACORD FORIU, FORM U[{BER: 25 rOnU ltLe:Certificate of Liability lnsuranc€ Excess Worte,s Compefl saton Cariei ACE Ameican lnsurance Company Poky: WCUC72603862 (CA FL GA, NC, IX) EflecUve: 09152024 Etriralron: 0E152025 Limits: E.L. Each Ac.idenL t2,000,000 E.L. oiseas&Each Emrloyee 52.000 000 E.L. oi*asePolicy Limit S2,0m 000 ACORD 101 (2008101) The ACORD name and logo are registered marks of ACORD 25 ADDITIONAL INSURED - OWI{ERS, LESSEES OR CONTRACTORS - COTXPLETED OPERATIOiIS hDd THIS EiIDORSEXEI\IT CHAITGES THE POLICY. PLEASE READ IT CARER'LLY. Thb Endor:cment modlfior imunncr prwldtd undr the following: EXCESS OOIHERCIAL GE]IEML LIABIUTY POLIGY SCHEDULE Xrlm (XAddluon l lll3ulrd P.Eon(3) & Omnntsrton(s):Locatlon And Dercrlptlon Of CompleEd Ope4{!o4q Any paEon or oriErfza0on rhom ypu har/€ sol€ed b hrdudo as an addl0onal hrr€d urxler a vrlttan conra4 pluru€d srcfi conrad ura8 oEolbd Flor b fio dab of bss All locatiom wher€ you porform sofi br exfi afiiuofial hur€d Flrcuent b any such wdtten contsa.l. lntoma Cl rEouircd b comolote this SdEdule, if rDt shcn n above, will bo sh.ltxn in fr€ Dodgrations. A. S-ffon ll - Who b An hrlutod b amonded b include N an additional insur€d the penon(s) or olganiz+ tion(s) sho{,n h t|e Sctedule, tut only wlfi rqec-t b lebltty lbr 'bodlly lntr4a or 'p.openy ddriagc" caueed, h whole or in part, by 'yoLr urorlf at the location designated ald describod ln th6 Schedule ol &ls endorse- ment perfiomed br hel additional insured end induded in tlre 'productsdryrpteteO operatlons nzad'. llou,rE'var: l. The insurance afiordod to such addilional insurEd or{y agplles to tho cxbnt p6rmltt6d by lafi ard 2. lf covcrago Ptwidcd to lha additional lnalJrd iB rquirod by a c.onlE t a aglrrmGnt, th. insuranoaffi6d to sudt additiond imurod wll not be broador thEn Utat $,hicrr you ar€ requimd by lhe oonbact or agr€om€nt b provlde hi sudt addtbnsl hsur€d. B. St! t"!!!d to the insurancs afrrdgd to theee additronal in8urds, h€ tbllowing h added b Sec{lon lll -Llmlt Of lNur.nc. And R6tdn d Llmlt: f cowrage Piurired h the eddilb{al insurBd b required by 8 coobect or agr€emen( the most we will pry on behe[ ofthe addithnal inEu]€d ls the amount of insurance: 1. Requled by the contac.t or agrr.rn€nq or 2. Ayaihble under he appllSb Limlts of lrt3urance stbwn in the Deda?tiorB; whidowr is less. This ondorEollEnt sha[ nd incraa8c th€ apflkxtic Umib of Insuranco sfiorwr h tha Dec]aratixrs. AuthorizDd Ropr€s€ntativo F.iq-m€nt l{umbc. M8Tac, lnc. hlqtPr 09 I 1 512024 r o 091 1 512025 Ellldilr Ot df Endd-nad 09t15t2024 Poey qrltd xsL P*ry ?arnba G48924803 @ ACE Am€rican lnEurancs company x921 I 64€ (04fi 3) lmlu&s copyrighlsd triittrial of lnsu,snra Seilicet ofrce, lrE , with ilB pofidssirn. pago , ol 1 33 ADDMONAL IT{SURED. OWHERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATIOil Th.b fr$.d 'ti..qr.r't b fi. pllpeEtirr THIS ENDORITETEI{T CHAiGES THE POLICY. PLEASE READ 1T CAREFULLY. Thlc Endoltemcnt modm.. lfturrnG. ptuvllcd undr the followlng: EXCESS COTilERCIAL OENEIIAL LUTBIUTY POIJCY SCHEDULE r. Of Addltionr! ]n$r.d htton(3) Or Onnnizrtbn(rl:[.ocaton{3) Of Coycred Opentlors Any p€r$n or oalqizeton whonr ]Jou lravE agt€ed to lndude c an additirnal hetrcd l.rld€r I writbn dlaact proylded Eu{fi conhad ryar fl€cuH p.ia to the date of l6s. All l-ocdms wherc you erE p€rfEnnhg ongoing op€iathnE for Bucfi addition.l imurod FrBUEnt to any eICfi writbn ooEH. lnbmation required b compleE his S.fiedule, if not sho,vn above, will be sho\ rn in the D€claralions A. Srcdon ll - Who lr An lrrurud b lmcrid.d b incudc s .n addltional inar]ld th. pc(&n(t) or ollaniz+ [on(s) lhown h the Schodule, tut only wlth ]Epoct to li*ility for 'bodily injuf, 'prop€{ty darnsgB' q "peasonal aId ad\rqtking hjur!' ceured, in lvholo or h part by: l. Your acb or omissims; ot 2. Thc 8Et3 or oflrixims of tho.e actitg on your bGhalt h th€ perfumdtce ol yorr ongoing operalions fc the additonal imur€d(s) at the locaffon(s) d€sign ted abov6. H(,talovor: l. The lmurance affu{.d b sudi addluonat insrltd ofily apdios to th€ 6,(blt po{tnitt6d by hw; and 2. lf cowrage prwid€d b t|o additoml in$r€d is rsquilrd by a csttrad or agr€ornont _ths in8uranc. 8furd6d to Eird ddltimal lnsurrd will mt b€ broeder thsn that whicir you arg rcquircd by the oonlrecl or agroamgnt b plot U€ for $lcfi tdditonal irBur€d. B. Wh reeped b the insuranB afurdsd to tlFs€ addtlidl.l lnsursds, tha fiClowing addtional exclusiond apCf ThiE insurrnco do.E no{ apdy to 'bodly injun/ or 'p.op.tty damago' oc-cuning afui: l. Ai yuo[t(, lndudhg ffiterl8b, perl3 or equipment fumbhod in cdtnecton wltt erch vfllq on the pa,ect (other than eewid, malnh6ance or rspaie) b b€ perlbnn€d by or on behalf of the additlonal in$t€d(s) 8t the hcadon of the cowrEd operatlons hr been comple!6d; or X$2llSSe (04/13) Copyrtgfir! lrrrrficc Scnixe ofi8, l'lc , m12 Pq' 1 sl2 ta.mld llnnld MasT*, lnc- ErdqEmer l'lumb.r Pbr'ry qflt(l xsL Pdo, fffi$r G48924803 P.a.t Hod Ogl 1 5 I 2024 rc 09 I 1 512025 Eftdiv. D.t ol En&6mcrt 09115t2024 llr!.d Ay o{adre of lnau6nc. Colrrpsry) AGE Anerican lnswanca Conp y 2. That porti,l of .}urtflo.l( dd d whlcfi th6 Iniury or darEgp ariEr. h* bc6n Brt b ih lnbnd6d tJ!6 by any pcllon or organlzatbn othor than anothar contrac{or or suboontracior €ngagcd in P€rforming op€ratons fur a FirKipal {s a Prt of t B sama projrct G. Wrh rcped to tho insuranco affodsd to th€se addltonal lnsu]ld8, lhe follcwing iE eddod to Scction - Limlts Ol lnrurrtc. Arld R.tin d Umlt lf coverage provlded ro fte additonal insured b ,equi'ld by e conbact or agrE€ment, the rnost wE will pay on betlalf d fie addilionel insurEd b the arutnt of insuElroe: l. Requhed hy te oontrd or agr€sment a 2. Aveleble under the +pllcaHe LlmiB of ln$rance sfio'tfln ln the Dedaratons; wtrichcver ia le*. This endoGement shal mt incre$e the apdi:aue Umil3 of lns{Izlce shown in the Dedaretbm. AJthoraed RegeGentetivE x921 1 68a (04/1 3)Coprrighrt, lrErrn€r S€wi63 Ofpa, lIE., 20'12 Pqi2dl2 A lI re cancd this Polcy trior b ib ogiration ttalc by nc{ice to you or tho ffi ilarted h6ur€d lor any rHson dl6r than nonpaym€nt of promlum, wa wlll ondoavor b sond writbn notice of carc.llation, to thc pG|sons or oEadzatlons li8t6d in fto 8cfi€dd€ lhat you or yolf r€pEs.ntathro crEat or rnaintain (the 'S.fi.dulo') by allowing your rsprEsentativ€ to Eond sudr notico b Eudr persons or organEalbns. Thls no0co will be ,n e&tthn b our rdlca b ),ou or tho fl]lt Nam.d lnaulEd, and any oft€r party whom wE ara rEqdrsd b notify by stafut€ and in accodanco wtth tho cancolhtbn prtn isbns of tt|e PolEy. B' Th€ tEtbe qf cancelhtion, as provid€d by !.our llpnsofltatiy8, h htlrdcd orly to bo a oourtGy rptmcaton to the pqson(s) or oryanization(s) nam6d h the Schedde ln lho cv€nt of a psnding cancolhtion of oov€age. We have no legal obligation of any kind b any sudr psrson(s) or organization{s}. Tho faiLrru b provile advanco notification of canccllation to tttc peeon(s) or oqanization(s) Ehor n in tho Scfi.dLde rvill impo6s no obligstim or lhbility of any kind upon [l8, oul agenb or roprustnhtives, will mt exbnd rry Poliry cancolatjon dab and wil not negab any cancollation d tto Policy. C. W6 at€ not 'Bponsbh tur v6rifyhg any lnhflxation in any Sdedulo, nor a.o w! rasponslbb fur any lncored lnbrmation that you or l,our lEpfsontatiw rnay uso. D. W€ wll fily b€ rrspondble br sonding 6u(,l noli€o lo your npn8€ntathre, d ),our r€pFsenhtir/€ will in tum Eendlhe notico to the pemons or organizations [strd in tho Schodub at least 30 daya prnr to tho cano6llalion dsl6 aPPlkabls E tt€ Polkiy. Yott will cooprato with us h Eovldirg lh€ Schedulc, or in causitg your rcprsonbtivr to provid! t lc Sr*Edule. E. The prwisions of hb noti). do nqt.pply in tho .v6r!t that ]rqr cancd th6 pof,sy. POLICY NUMBER: ISAH'108461 1 0 EHLJEEI' HOTICE TO OTHERS - SCHEDULE NOTICE BY INSURED'S REPRESEIITATTVE NOTICE TO POLICYHOLDERS ALL-34275 (10/11)Pag€ I of 1 POLICY NUMBER: XSL G48924803 EHIJEIEI" NOTICE TO POLIGYHOLDERS ilOTICE TO OTHERS - SCHEDULE NOTICE BY INSURED'S REPRESEiITAT]VE A. lf rre cancol this Po[cy prior b ib oeiraton datB by ncfba fo ],ou or tho ffrt tlam€d in€ur€d for any raason olhar than nonpaym6nt of pilmlum, v,o will endoavor b s6nd wrttbn notc. of cacdlaton, lo th. pctsont or olgantsathm lid€d in t|6 BcfEdd6 lhst yor or yur r€p(6ntativ! crs.b or mlnlah (the 'S#ul€') by allowing your r€pEs.fltativ€ tD Ernd sf,rdr no[c. b Eu.fi p€rto.E or orggntrEllon3. Thb nolico wlll be ,n e&ltoi to our ndc. b you or tho flrtt Namcd lnsulDd, ard any olhor party whom ryo a[r lequir€d to mtfy by Etafub and in aocotdanco with tho cancallation pmvisbnr of tho Polkl. B. Tho notice ol cancdhtion, as prDtr,ldsd by ysur r€pns€nta1iv8, is inbndad only to bo a ooutt€sy notification to tho p*son(e) or orlsnizatkm(s) narnad h fio Sch€dd€ in thc Gver of a pending cancdhtion of corcragp. Wo h8v€ no tcgat oUBaion of any kind b any s rh p6rson(8) a organlzation{t}. Th€ faihr€ to provkle advano notification of canc.llation to tho pceon(s) or orgnnization(s) shorvn in the Schodul. will impose no oblbation or liab ity of any kind upon ua, our agenb or ropnqrontativ€s, will rpt axbnd my Polky cancolatjon dab and will not nogab any cancellation of th. Policy. C. W6 are not rEspontbb for vadrylE any lnfunnation in any Sdredule, nor arr w! rssponslbb hr any inconed inbmation that you or y.rur rcprEontathre mey uso. D. W€ wil 6rly b€ Esponsible br s€nding sudr nolicc 1o your EpEs€ntativE, ad }!ur rDpGsentdit o will in tum send th6 noti6 lo the porlons or orlEnizalions [stEd in sro Schrdub at leest 30 da}! prnr to the cancellalim dab appllcabb b tr€ Pdkry. You will coogerate wilh us in prwHing lhe Sch€dul6, or in caushg ywr ropr€Esntativr 1o govid€ tho Sdrdulo. E, Tho prcn isions of hb ndix do not apply in tho 6v€nt that ]tou cancd th€ Poncy. ALL-34275 (1011 1 )Pegb I of 1 EndoG6mont Numbarilrt.dllErtd MASTEC. tt{C. EOO DOUGI.AS ROAD PENTHOUSE COML GAELES FL 3!tI34 Pofc, ilmD.r Syntot WLR it Ytbor C72603746 Pdlq Piiod o9t15t2i24 TO o9ll q2025 Ellkir! DatE d ErdoBemGd 0911y,2024 bq&d By (tlm. o llErr!.to Corry.Ily) lNDErrNlTY lNS. CO. OF l.lORTH AITERICA [ut th. Polcy nxib-- lh6 lr.trlnda! of th. ffio.lirioh bbEootrDl 'nta crtrtorarctlt clEig..lhc pdlry b rttldi I b d.ohGd.d b dft.lir! on hG d.a. b3lcd lrlc.. othcrxfrc d.f.d. Worl(Et3' Compomrtlon lnd EnlP Lhbt Pol NOTICE TO OTHERS ENDORSEIIEIIIT - SCHEDULE A. lf tre cancd this Policy prbr to iG expiralion date by notlce to you or the flrsl Named insured {br any lBi}Bon other lhan nonpsynEr d premium, we will Endga\rior, aG s6t out belon, b send utritbn noti@ of canc6llatrcn, vla suci el€.ironic or Elher fiorm of ndr'ficaton a3 we de0ermine, to the persom or organizalions lided in the sdtodule thal you or your Eplssentathn prwide or harc govided b us (tho 'Schedule). You or your r€prEsentatiE must provito us with tho physixl and/or email eddlBss of sudr psrons or org€niatirns, and we wlll utilize such e-mail addrtsE or physlcal addrese thal you or your ropresentative prwlded to us on such Scfiedule. B. The Sctedule must bo initially Ewlded to us wlthin 15 da)rs aft.r: i. Ttre beginning d th€ Polkry period, if thh endoGement is efiactire as crf such daE; or ll. Tlis ondofsdnent hee been addod b th6 Pdiry, if thb endorsomonl ie efiec*ive eftsr tle Pdicy perbd comm6ncot. G. Thb endorsement mllst be ln an elecfmlc lbrmat that F acceptsHe t lI3; and mu$ bo ec. tatB. D, Our ddlvery of lhc notitcaton as describ€d in Paragraph A. of this endors€flEnt will be bscd m th6 Erost tEcsnt S.rEdule in our records s of the date the notoe ol canodlation b mailed or deltuered to lhe filst NarrEd lnsured. E. We will endeavor b sond or d€liwr sudr rpthe to the e-mail addrasE or physlcal addrcss mnespondirg to eacfr person or organizalion indicated in the Schedule at leasl 30 days prbr to tho cancelatlon date appllcable b th6 Poltcy. F. The notics rsftr€ncad in thb ondor8emcnt is intond.d only b bc a courtesy notification to th6 porson(8) or organlzaton(s) named ln tio Schcdule ln the c\,cnl of a pcndlng cancelaton of correrage. We haw no hgal oblfation of any kind b any such person(s) or organization(s). Ovr fallure to Fwide advance nolifioalion of cancalHion to the persc{s) or orgsnization(s) shown in thc Sdl€dul€ shall impose no obligation or lhbility of any ldnd upon us, our qpnts or ropresentatvgs, will not $(bnd any Pdicy cancslhtion date and will not nEg€b ary canodhbn of the Polkry. G. We are not rcsponsible fur verifiing arry info.rnation p.ovided to us in any Schedule, noi arc we iEspondble for any inoonsc't infurmation hat pu or yulr reprEenhtive Plovue b us. lf you or your rcprBsentau\re does not providc us with e Schedule, we have no responsibility br taHng any acton under this endoGement. ln addition, if nellher you nor yqJr rEpr€sentauw proMdes u8 with €-rnan and physical addlrss infomalion vyilh ro8pod b a particuhr porson or o/ganizali6, th€n w6 shall haE no rEponsibility for taking aclion wih r€gad to sudr p€rson or entity under his endorrornonl H. We mey anams with your reprgssntgtiw b s€nd sudr notice in tho avmt d aIIy sud| cancellatbn. l. Yc[l will cooperate with us in providing the Sctredule, or in causing pur reprosentat\re to po\rido ths Scfiodul€. J. Thie endoEomont fuB nor apply ln thc ev6nt that yDU cenel the Policy. Al dler tems and condl0ons of t{s Policy remaln unchanged. rvc s G, 704 (08112)Pags 1 ol2 AufiorLad RePIslonbdve wc 9s 03 7(rA (0E/t2) P8oe2 ol2 ACORif EVIDENCE OF PROPERTY INSURANCE 47t02t2025 IHIS EMOENCE OF PROPERIY INSURANCE IS ISSUEO AS A MATTER OF INFORMANON AOOITIONAL INTEREST NAMED EELOW' THIS EVIDENCE DOES NOT AFFIRMATIVEIY OR COVERAGE AFFORDEO 8Y IHE POLICIES BELOW, IHIS EVIOENCE OF INSURANCE OOES ISSUING INSURER{S), AUTHORIZEO REPRESENTATIVE OR PROOUCER, AND THEAOONONAL INTEREST, ONLY AND CONFERS NO RIGHTS UPON NEGATIVELY AMEND, EXTENO OR ALTER NOI CONSNTUTE A CONTRACT BETWEEN THE THE THE Aon Risk services Northeast, Inc Boslon MA Offi ce5l State street sui te 2201 Boston MA 02109 usA Markel A,reri can Ins Co (E00) r6l 0r05 5 70000085 /78 A*1 Excavati ng LLc Maslec North Ameri ca, Inc 8237 State Hwy 64 B loomer wI 54724 usA 09/15/2024 ; a ALL RISK- su RE: Project Name / Location: Utility Tmprovements, 2025 4oth Ave LOCAI ON/DESCR PION TI]E POLICIES OF INSURANCE LISTEO BELOW HAVE EEEN NOTWTHSTANOING ANY REQUIREMENT TERM OR CONOIIION OF PROPERry INSURANCE MAY BE ISSUEO OR MAY PERTAIN THE ISSUED IO IHE INSUR€D NAMEO ABOVE FOR THE POLICY PERIOD INDICATED ANY CONTRACI OR OIHER OOCUMENT IMTH R€SPECT IO \i1,tIICH THIS EVIOENCE OF INSURANCE AFFORO'O BY THE POLJCIES DESCRIBEO HEREIN IS SUBJECT TO AI! THE rctES L t\4TERMAND CONDLT]BEEN RE Commercial Property Coverage Bl kt Real & personal $ 10,000,000 $ 50,000 IETIffiI ttr REMARKS lncludi A'll risk of direct physical loss or danaqe !o insured Droexclusions, and deductibles of poli(y. rimits and deduitiListing City of columbia Heiqhts and Bolron and yenk rnc.policy provisions of the property policy with respect tocontract. rty subject to policy terms, conditions,es subject to policy terms and conditions.re included as Loss pavee in accordance with thee above refe.enced location as requjred by wri!ten pe bt a th ADDINONAL It{TEREST -r iE =T<-.1il+=lrH =.i-l =-atrfi-)H*, -I ci ty of columbia Heights 3989 cent.al Ave, NE columbia Heights MN 55421 usA LENDERS LOSS PAYABLE AL AOR 7ED REPRESENTATNE .M.@./9**J&,4&-f* O 1993-2015 aCORD CORPORATION All rights r€ssrved Tho AcoRD n.me.nd logo are r€gktered merk otAcoRD SHOUIDAI{Y OF THE ABOVE OESCRIBEO POIICIES BE CANCELLED BEFORE THE EXPIRATION OAIE IHEREOF, NONCE WLL BE OEIIVERED IN ACCOROANGE WITH THE POLICY PROVISIONS. ACORD 27 (2015/03) o9/15/zozs I l-..'*** MKLM1rM0000215 I I DECLARATIONS - EXCESS GENERAL LIABILITY POLICY - Page 2 XSL G48924803 POLICY IDENTIFICATION FORMS ANO ENDORSEMENTS FORMS AND ENDORSEMENTS ATTACHED TO THIS POLICY AT INCEPTION Form No SCHEDULE OF NOTICES Description A1123445b0713 A114X070796 A112Y31c032020 A11208871006 A11223680607 tLN1751 1 1 1 ALL301 520710 ALL7X47 aozoo 1D37041 10823 ALL2Y8'10514 A11512200918 ALL2U78b0206 41134275101 ',l ALL34277 10',| I ALL342771011 At1342771011 A1t34277 101 1 Policyholder Notice Commercial Lines Deregulation New York An lmportant Notice To Our Alaska Policyholders Arkansas Notice To Policyholders Chubb Producer Compensation Praclices & Policies Colorado Fraud Statement lllinois Notice To Policyholders Regarding The Religious Freedom Protection And Civil Union Act lmportant lnformation To ldaho Policyholders Regarding Your lnsurance lmportant lnformation To Virginia Policyholders Regarding Your lnsurance lmportant Notice For Policyholders Notice Of Occurrence, Offense' Claim Or Suit lndiana Notice To Policyholders Missouri Disclaimer Notice Commercial Lines Deregulation Notice To All Oklahoma Policyholders Notice To Others - Schedule Notice By lnsured's Representative Notice To Others - SPeciflc Partles Notice To Others - Specific Parties Notice To Others - SPecific Parties Notice To Others - Specific Parties xS-6U88e (06/10) Page 2 ol 28 Form No Description Notice To Others - Speciflc Parties Notice To Others - Specific Parties Notice To Others - Specific Parties Notice To Others - Speciflc Parties Notice To Others - Specific Parties Notice To Our Florida Property And Casualty Policyholders Guidelines For Loss Control Plans Pennsylvania Notice Policyholder Notice - Ohio Ouestions About Your lnsurance? Risk Control Services For Texas Policyholders Texas Notice lnformation And Complaints U.S. Treasury Department's Office Of Foreign Assets Control ("OFAC") Advisory Notice To Policyholders Wisconsin Notice To Policyholders SCHEDULE OF COVERAGE FORMS Description Excess Commercial General Liability Policy SCHEDULE OF ENDORSEMENTS Description Notice To Others Endorsement - Specific Parties Notice To Others Endorsement - Specific Parties Notice To Others Endorsement - Specific Parties Notice To Others Endorsement - Specific Parties Notice To Others Endorsement - Specific parties Notice To Others Endorsement - Specific parties Non-Contributory Endorsement For Additional lnsureds Non-Contributory Endorsement For Additional lnsureds Non-Contributory Endorsement For Additional lnsureds Non-Contributory Endorsement For Additional lnsureds Non-Contributory Endorsement For Additional lnsureds Non-Contributory Endorsement For Additional lnsureds Non-Contrjbutory Endorsement For Additional lnsureds Non-Contributory Endorsement For Additional lnsureds Non-Contributory Endorsement For Additional lnsureds Non-Contributory Endorsement For Additional lnsureds Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Conlractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations 4LL34277 101 1 4LL342771011 4LL342771011 4LL34277 101 1 4LL342771011 A11398220413 Endt. No t109100702 A115W060795 ALL5X451 196 ALL'l 1 559e0716 ALL4Y30g0520 t1P0010104 ALL5X5'1a0206 Form No. XS6U9le1218 A11326880'1 '11 A11326880111 A113268801'11 A11326880111 41132688011 1 4113268801'11 XS20288a05'14 XS20288a0514 XS20288a0514 XS20288a0514 XS20288a0514 XS20288a0514 XS20288a0514 XS20288a0514 XS20288a0514 XS20288a0514 xs211641106 XS21'164a0413 XS21164a04'13 ,l 4 5 6 7 8 I 10 11 12 13 14 15 16 17 '18 19 20 xS-6U88e (06/10) XS21164a0413 Page 3 of 28 Form No Form No. XS21 '164aO413 XS21 164a04'13 XS21 164a0413 XS2'l '164a0413 XS21164a0413 XS21164a0413 XS21 164a0413 XS21164a0413 XS21 164a0413 XS21 164aM13 XS21164a04'13 XS21 164a0413 XS2 l 164a0413 XS21 164a0413 XS21164a0413 XS21 164aP413 XS21 164a04'13 XS21 '168a0413 XS21164a0413 XS21 164a0413 XS21164a0413 XS21 168a0413 XS21 168a0413 xs2'1167b0413 xs21167b0413 Description Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Conlractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees or Contractors - completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners. Lessees Or Contraclors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - owners, Lessees or Contractors - Scheduled Person Or Organization Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations xS-6U88e (06i 10) Page 4 ol 28 Endt. No. 2'l 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 Form No. xs21 167b0413 xs21 167b0413 xs21167b0413 xs21 167b0413 xs21 167b0413 xs21167b0413 xs21'167b0413 xs21 167b0413 xs21 167b0413 xs2't167b0413 xs21 167b0413 xs21167b0413 xs21 167b0413 xs21'1681106 XS21 164a0413 XS21164a0413 XS21164a0413 XS21 '168a0413 XS21 168a0413 XS21 168a0413 XS21 168a0413 XS21168a0413 XS21 '168a0413 XS21168a04'13 XS21 168a0413 Description Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured . State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Addilional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizalions Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional Insured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional Insured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional Insured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization xS-6U88e (06/10)Page 5 of 28 Endt. No. 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 bJ 64 65 66 67 68 69 70 Form No. XS21 168a04'13 XS21 168a0413 xS21 168a041 3 XS21 168a0413 XS21 168a0413 XS21 168a04'13 XS2'1168a0413 XS21168a0413 XS21 168a04'13 XS21 168a04'13 Description Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners. Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners. Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners. Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Designated Person Or Organization Additional lnsured - Designated Person Or Organization Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Otherc To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Contractual Liability - Railroads Waiver Of Transfer Of Rights Of Recovery Against Others To Us Additional lnsured - Vendors Additional lnsured - Lessor Of Leased Equipment - Automatic Status When Required ln Lease Agreement With You Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Non-Contributory Endorsement For Additional lnsureds Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - State Or Polilical Subdivisions - Permits Or Authorizations 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 xs6w25b041 3 xs6w25b0413 XSOW34a0220 X56W34a0220 xSOW34a0220 XSOW34a0220 XS6W34a0220 XS6W34a0220 XS6W34a0220 XSOW34a0220 XS6W34a0220 XS6W34a0220 XS6W34a0220 XS6W34a0220 XS6W34a0220 XSOW34a0220 XS20723a0510 XS6W34a0220 XS6W31c0217 xs6w29b02 t 7 XS21168a04'13 XS20288a0514 XS21168a0413 101 102 103 104 XS-6U88e (06/10) xs21167b04'13 Page 6 of 28 Endt. No. 7',t. 72 73 74 75 76 77 78 79 80 Endt. No Form No Description Kentucky Local Government Premium Tax Schedule Surcharge Schedule Signatures Additional lnsured - Designated Person Or Organization Additional lnsured - Designated Person Or Organization Additional lnsured - Designated Person Or Organization Additional lnsured - Designated Person Or Organization Additional lnsured - Designated Person Or Organization Additional lnsured - Designated Person Or Organization Additional lnsured - Designated Person Or Organization Additional lnsured - Designated Person Or Organization Additional lnsured - Designated Person Or Organization Additional lnsured - Designated Person Or Organization Additional lnsured - Designated Person Or Organization Additional lnsured - Designated Person Or Organization Additional lnsured - Designated Person Or Organization Additional lnsured - Designated Person Or Organization Additional lnsured - Designated Person Or Organization Additional lnsured - Designated Person Or Organization Additional lnsured - Designated Person Or Organization Additional lnsured - Designated Person Or Organization Additional lnsured - Designated Person Or Organization Additional lnsured - Designated Person Or Organization Additional lnsured - Designated Person Or Organization Additional lnsured - Designated Person Or Organization Additional lnsured - Designated Person Or Organization Additional lnsured - Designated Person Or Organization Additional lnsured - Designated Person Or Organization Additional lnsured - Designated Person Or Organization Additional lnsured - Designated Person Or Organization Additional lnsured - Designated Person Or Organization Additional lnsured - Designated Person Or Organization Additional lnsured - Designated Person Or Organization Additional lnsured - Designated Person Or Organization Additional lnsured - Designaled Person Or Organization Additional lnsured - Designated Person Or Organization Additional lnsured - Designated Person Or Organization Additional lnsured - Designated Person Or Organization Additional lnsured - Designated Person Or Organization Additional lnsured - Oesignated Person Or Organization Additional lnsured - Designated Person Or Organization Additional lnsured - Designated Person Or Organization Additional lnsured - Designated Person Or Organization Additional lnsured - Designated Person Or Organization 105 106 107 108 109 110 1',|'l 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 ,IM 145 146 147 148 XS-6U88e (06/10) ALL32677aO4'12 4LL224211011 cc1K11kO422 xs6w25b0413 xs6w25b0413 xs6w25b0413 xs6w25b0413 xs6w25b0413 xs6w25b0413 xs6w25b0413 xs6w25b0413 xs6w25b0413 xs6w25b0413 xs6w25b0413 xs6w25b0413 xs6w25b0413 xs6w25b0413 xs6w25b0413 xs6w25b0413 xs6w25b0413 xs6w25b0413 xs6w25b0413 xs6w25b0413 xs6w25b0413 xs6w25b0413 xs6w25b04'13 xs6w25b0413 xs6w25b0413 xs6w25b04'13 xs6w25b0413 xs6w25b0413 xs6w25b0413 xs6w25b0413 xs6w25b0413 xs6w25b0413 xs6w25b0413 xs6w25b0413 xs6w25b0413 xs6w25b0413 xs6w25b0413 xs6w25b0413 xs6w25b0413 xs6w25b0413 xs6w25b0413 Page 7 ol28 149 '150 151 '152 153 154 155 156 157 xs6w25b0413 xs6w25b0413 xs6w290995 XS6W30a0217 XS6W30a0217 XS6W30a0217 XS6W30a0217 X521170a0413 xs211641106 Endt. No 158 160 161 162 tt)J 164 165 166 167 168 '169 170 171 172 '173 174 175 176 177 Form No xs21 1641 106 xs211641106 xs21 1641 106 xs211641106 xs21 1641 106 XS21 164a04'13 XS21164a0413 XS21164a04'13 XS21164a0413 XS2'1 164a04'13 XS21 164a04'13 X521'164a0413 XS21 164a0413 XS21164a0413 XS21164a0413 Description Additional lnsured - Designated Person Or Organization Additional lnsured - Designated Person Or Organization Additional lnsured - Lessor Of Leased Equipment Additional lnsured - Managers Or Lessors Of Premises Additional lnsured - Managers Or Lessors Of Premises Additional lnsured - Managers Or Lessors Of Premises Additional lnsured - Managers Or Lessors Of Premises Additional lnsured - Mortgagee, Assignee, Or Receiver Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Compleled Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additionat lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners. Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations XS-6U88e (06i 10) XS21 164a041 3 Page 8 of 28 xs21 1641 106 xs21 1641 106 XS2'1 164a041 3 159 xs211641106 Endt. No 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 '196 197 '198 199 200 201 202 Form No. XS21 164a0413 XS21 164a0413 XS21 164a0413 XS21164a0413 XS21 164a04'13 XS21 164a0413 XS21164a0413 XS2 l 164a04'13 XS21 164a0413 XS21164a0413 XS21164a04'13 XS2 l 164a0413 XS21 164a0413 XS2'1164a04'13 XS2'l 164a0413 XS21164a0413 XS21164a0413 XS21 164a0413 XS21 164a0413 XS21164a0413 XS21 164a0413 XS21164a0413 XS21'164a0413 XS21164a04'13 Description Addilional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operalions Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contraclors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Compleled Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations XS-6U88e (06/10) XS21 164a0413 Page 9 of 28 Endt. No 203 2M 205 206 207 208 209 210 211 212 213 214 215 216 217 218 ?19 220 221 222 223 224 225 226 227 Form No. XS21164a04'13 XS21 164a0413 XS21 164a0413 XS21 164a041 3 XS21 164a0413 XS21 164a0413 XS21 164a041 3 X521164a0413 XS21 '164a0413 XS21 164a0413 XS21 164a04 13 XS21 164a0413 XS21 164a0413 XS21164a0413 XS21164a0413 XS21164a0413 XSz1 164a0413 XS21164a0413 XS21 164a0413 XS21 164a04'13 XS21 164a0413 XS21164a0413 XS21 164a0413 XS21164a0413 XS21'164a0413 Description Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - owners, Lessees Or Contractors - completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations xS-6U88e (06/10)Page 10 of 28 Endt. No. 228 229 230 231 232 233 234 235 236 237 234 239 240 t 241 24? 243 244 245 246 247 248 249 250 251 252 Form No. XS21164ab413 XS21 164a0413 XS21 164a0413 XS21 164a0413 XS21 164a0413 XS2 l 164a0413 XS21164a0413 XS21164a0413 XS21164a0413 XS21164a0413 XS21 164a0413 XS21164a0413 XS21 164a0413 XS21164a04'13 X521164a0413 XS21 164a0413 XS21164a0413 XS21164a0413 XS21 't64a0413 XS2'1 164a0413 XS2'1164a0413 XS21 164a0413 XS21 164a0413 XS21'164a04'13 XS21 164a0413 Description Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional Insured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Compleled Operations Additjonal lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations XS-6U88e (06/10)Page 11of28 Endt. No 253 254 255 256 257 258 259 260 261 262 263 264 26s 266 267 268 269 270 271 272 273 274 275 276 277 Form No. XS21 '164a0413 XS21164a0413 xS21 164a0413 XS21 164a0413 XS21 164a0413 xS21 '164a0413 XS21 '164a0413 XS21164a0413 XS21164a04'13 XS21164a0413 Xs21 '164a0413 XS21164a04'13 XS21164a0413 XS21 164a0413 XS21 164a0413 XS21 164a0413 XS2'1164a0413 XS21'164a04'13 XS21 164a04'13 XS2'1164a0413 XS21164a0413 XS21 '164a0413 XS21164a0413 XS21 164a0413 XS21 164a0413 Description Additional lnsured - Owners, Operations Additional lnsured - Owners, Operations Additional lnsured - Owners, Operations Additional lnsured - Owners, Operations Additional lnsured - Owners, Operations Additional lnsured - Owners, Operations Additional lnsured - Owners, Operations Additional lnsured - Owners, Operations Additional lnsured - Owners, Operations Additional lnsured - Owners, Operations Additional lnsured - Owners. Operations Additional lnsured - Owners, Operations Additional lnsured - Owners, Operations Additional lnsured - Owners, Operations Additional lnsured - Owners, Operations Additional lnsured - Owners, Operations Additional lnsured - Owners, Operations Additional lnsured - Owners, Operations Additional lnsured - Owners, Operations Additional lnsured - Owners, Operations Additional Insured - Owners. Operations Additional lnsured - Owners. Operations Additional lnsured - Owners, Operations Additional lnsured - Owners. Operations Additional lnsured - Owners, Operations Lessees Or Contractors - Completed Lessees Or Contractors - Completed Lessees Or Contractors - completed Lessees Or Contractors - Completed Lessees Or Contractors - Completed Lessees Or Contractors - Completed Lessees Or Contractors - Completed Lessees Or Contractors - Completed Lessees Or Contractors - Completed Lessees Or Contractors - Completed Lessees Or Contractors - Completed Lessees Or Contractors - Completed Lessees Or Contractors - Completed Lessees Or Contractors - Completed Lessees Or Contractors - Completed Lessees Or Contractors - Completed Lessees Or Contractors - Completed Lessees Or Contractors - Completed Lessees Or Contractors - Completed Lessees Or Contractors - Completed Lessees Or Contractors - Completed Lessees Or Contractors - Completed Lessees Or Contractors - Completed Lessees Or Contractors - Completed Lessees Or Contractors - Completed x5-6U88e (06/10)Page 12 of 28 Endt. No 278 279 280 281 282 283 284 285 286 287 288 289 290 291 292 293 294 295 296 297 298 299 300 301 302 Form No. XS21 164a0413 XS21164a0413 XS21 164a04'13 XS21 164a0413 XS2'1'164a0413 X521164a04'13 XS21 164a0413 XS21'164a0413 XS21 164a0413 xs21164a04'13 XS21 '164a0413 XS2'l 164a0413 XS21 164a0413 XS21 164a0413 XS21'164a0413 XS21 164a04'13 XS21 164a0413 xs211681106 xsz1 1681 106 xs21 1681 106 xs211681 106 xs21 168'1106 xs211681106 xs21 1681 106 xs21 1681 106 Description Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners. Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners. Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization XS-6U88e (06/10)Page 13 of 28 Endt. No 303 304 305 306 307 308 309 310 311 312 313 314 315 316 317 318 319 320 321 322 323 324 325 326 327 Form No. xs21 1681 106 xs21 1681106 XS21 168a04'13 XS21 168a0413 XS21 168a0413 XS21 168a0413 XS21 168a0413 XS21 168a04 13 XS21 168a0413 XS21168a0413 XS21 168a0413 XSz1 168a0413 XS21 168a04'13 xS21 168a04'13 XS21 168a0413 XS21 168a04'13 XS21 168a0413 XS21 168a0413 XS21 168a0413 XS21 168a0413 XS21168a0413 XS2'1 168a0413 XS21 168a0413 XS21 168a0413 xS21 168a0413 Description Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners. Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners. Lessees Or Contractors - Scheduled Person Or Organizalion Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additionai lnsured - Owners. Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization xS-6U88e (06/10)Page 14 ol28 340 341 342 343 344 345 346 347 349 350 351 352 Form No. XS21168a0413 X52't 168a0413 XS2'1168a0413 XS21 168a0413 XS21 168a0413 XS21 168a0413 XS21 168a0413 XS2'1 168a0413 XS21 168a04'13 XS21 168a0413 X521168a0413 XS21 168a0413 XS2'1 168a04'13 XS21 168aM13 XS21168a0413 XS21168a0413 XS21 168a0413 XS2'1 168a0413 XS21 168a0413 XS2'l 168a0413 XS21 '168a04'13 XS21 168a0413 XS2'l 168a04't3 XS21 168a0413 X521168a0413 348 Description Additional lnsUred - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Conlractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors _ Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors _ Scheduled Person Or Organization xS-6U88e (06/10) Page 15 of 28 Endt. No. 328 329 330 331 332 333 334 335 336 337 338 339 Endt. No 353 354 355 356 357 358 359 360 361 362 363 364 365 366 367 368 369 370 371 372 373 374 375 376 377 Form No. XS21 '168a0413 XS21 168a0413 XS21168a0413 XS2'1168a0413 XS21 168a0413 XS21 168a0413 XS21 168aM13 XS2'l 168a04 13 XS21 168a0413 XS21168a0413 XS2 l 168a0413 XS21 168a0413 XS21 168a0413 XS21 168a0413 XS21 168a0413 XS2'1 168a0413 xS21 168a0413 XS21 168a0413 XS21 168a04'13 XS21 '168a0413 XS21 '168a0413 XS21 168a0413 XS2'l 168a0413 XS21168a04'13 xS21 168a0413 Description Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Addilional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contradors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners. Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Addilional lnsured - Owners. Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization XS-6U88e (06/10)Page 16 of 28 Endt. No 378 379 380 381 382 383 384 38s 386 387 388 389 390 391 392 393 394 395 396 397 398 399 400 401 402 Form No. XS21 168a0413 XS2'1 168a04'13 XS21 168a0413 XS21 168a0413 XS21 168a0413 XS21 168aM13 XS2'l 168a0413 XS2 1 168a04'13 XS21 '168a0413 XS2'1 168a0413 XS21 168a0413 XS21 168a0413 XS21 168a0413 XS21 168a0413 XS2l 168a0413 XS21'168a0413 XS2'l 168a0413 XS21 168a0413 XS21 168a0413 XS21 168a0413 XS21 '168a0413 XS21 168a0413 XS21 168a0413 XS21 168a0413 XS21168a0413 Description Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners. Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Pe6on Or Organization Additional lnsured - Owners. Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person qr Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organizalion Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization xS-6U88e (06/10)Page 17 o'128 Endt. No 403 404 405 406 407 408 409 410 411 412 413 414 415 416 417 418 419 420 421 422 424 425 426 427 Form No. XS21168a0413 XS21 168a0413 XS21 168a0413 XS2'l 168a0413 XS21168a0413 XS21168a0413 XS21'168a0413 XS2'1168a0413 xs21168a0413 XS21 168a0413 XS21 168a0413 xS21 168a0413 xS21 168a0413 xS2'1 168a0413 XS21168a0413 XSz1168a0413 XS21168a04'13 XS2l '168a0413 XS21168a0413 XS21168a0413 XS21 168a0413 XS21168a0413 XS21168a0413 xS21168a0413 XS21 168a0413 Description Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners. Lessees Or Conlractors - Scheduled Person 0r Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners. Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Conlraclors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organizalion Additional lnsured - Owners, Lessees or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organazation Additional lnsured - Owners. Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organizalion Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or organization Additional lnsured - Owners. Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or organization xS-6U88e (06/10)Page 18 of 28 Form No. XS21 168a0413 XS21 168a0413 XS21'168a0413 XS21 '168a0413 XS21 '168a0413 XS2'1168a0413 XS2'l 168a0413 XS21 168a0413 XS21168a04'13 XS2'1168a0413 XS21 168a0413 XS21 168a0413 XS21 168a0413 XS21 168a0413 XS21168a0413 XS21168a0413 XS21168a0413 XS21168a0413 XS21168a0413 XS21 168a0413 XS21168a0413 XS2 1 '168a0413 XS21 168a0413 XS21 168a0413 XS21 168a0413 Description Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Orqanization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Pe6on Or Organization Additional lnsured - Owners. Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners. Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners. Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization xS-6U88e (06/10)Page 19 of 28 Endt. No. 42A 429 430 43'l 432 433 434 435 436 437 438 439 440 441 442 443 444 445 446 447 448 449 450 451 452 Endt. No 453 454 455 456 457 458 459 460 461 462 463 464 465 466 467 468 469 470 471 472 473 474 475 476 477 Form No. XS21168a0413 XS21 '168a0413 XS21168a0413 XS21 168a0413 XS21 168a0413 XS21 168a0413 XS21168a0413 XS21168a0413 xs21167b0413 xs21167b04'13 xs21 167b0413 xs2't 167b04'13 xs21 167b0413 xs21167b0413 xs21 167b04'13 xs21 167b0413 xs21 167b0413 xs21167b0413 xs21'167b0413 xs21 167b0413 xs21167b0413 xs21'167b0413 xs21 167b0413 xs21 167b0413 xs21 167b0413 Description Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners. Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners. Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners. Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - State Or Politacal Subdivisions - Permits Or Authorizations Additional Insured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Polilical Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations XS-6U88e (06/10)Page 20 of 28 Endt. No 478 479 480 481 482 483 4U 485 486 487 488 489 490 491 492 493 494 495 496 497 498 499 500 501 502 Form No. xs21 167b0413 xs21 167b0413 xs2'1167b0413 xs21 167b0413 xs21 167b0413 xs21167b0413 xs21167b04'13 xs21167b0413 xs21167b0413 xs21 167b0413 xs21 167b04'13 xs21 167b0413 xs21'167b0413 xs21 167b0413 xs21167b0413 xs21 167b0413 xs21167b0413 xs21167b0413 xs21 167b0413 xs21 167b0413 xs21'167b0413 xs21167b0413 xs21 167b0413 xs21 167b0413 xs21167b0413 Description Additional lnsured - State Or Polilical Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Aulhorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations XS-6U88e (06/10)Page 21 ol 28 Endt. No 503 504 505 506 507 508 509 510 511 532 533 534 535 536 537 538 XS-6U88e (06/10) Form No. xs2'l 167b0413 xs21 167b0413 xs2 1 167b0413 xs21167b0413 xs2'l 167b0413 xs21167b0413 xs21167b04'13 xs21 167b0413 xs21 167b0413 xs21 1591 106 xs21 159l 106 xs21 1 591 106 xs298920510 A1110617b0614 xs34258101 1 512 513 514 515 516 517 518 519 520 52'l 522 523 5?4 525 526 527 528 529 530 531 LD6X25 XS20722aO51O XS 18355a0610 1D202830606 xs21 '1601 106 xs202900606 1D202820606 1D202820606 1D202820606 A1123684a0115 XS20723a0510 XS20723a05'10 XS20723a0510 XS20723a0510 XS20723a0510 XS20723a0510 XS20723a0510 XS20723a0510 XS20723a0510 xs3858890524 Descriptaon Additional lnsured - State Or Political Subdivisions - Permits Or Authorizalions Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Additional lnsured - State or Political Subdivisions - Permits Or Authorizations Additional lnsured - State Or Political Subdivisions - Permits Or Authorizations Aircraft Products - Completed Operations Exclusion Alienated Premises Endorsement Amendment Of Conditions Amendment Of Duties ln The Event Of Occurrence Boats Broad Form Named lnsured Cancellation - Notice To Additional lnterests Cancellation - Notice To Additional lnterests Cancellation - Notice To Additional lnterests Cap On Losses From Certified Acts Of Terrorism Conlractual Liability - Railroads Contractual Liability - Railroads Contractual Liability - Railroads Contractual Liability - Railroads Contractual Liability - Railroads Contractual Liability - Railroads Contractual Liability - Railroads Contractual Liability - Railroads Contractual Liability - Railroads Cyber lncident Liability Coverage Subject To Each Cyber lncident Occurrence And Aggregate Limits Designated Construction Prolect(s) General Aggregate Limit Designated Conslruction Project(s) General Aggregate Limit Designated Construction Project(s) General Aggregate Limit Designated Location(s) - Aggregate Limit Earlier Notice Of Cancellation And Non-Renewal Endorsement Employee Benefits Liability Coverage Allocated Loss Ad.iustment Expense Erodes The Retained Limit, Deductible And Policy Limit Exclusion - Contractors - Professional Liabilityxs21 1621 106 Page 22 ol 28 Endt. No Form No Description Exclusion - Violation Of Laws Addressing Data Privacy Exclusion Of Liability lnsurance Afforded Under Another Policy Fellow Employee Coverage Fire, Explosion, Smoke And Water Damage Legal Liability Fungi Or Bacteria Exclusion Gulf Of lvlexico Extension Endorsement ln Rem lncidental Medical Malpractice Liability Coverage Lead lvlaterials Limited Electronic Data Loss Coverage - Access, Collection, Release, Disclosure, Limited Bodily lnjury And Property Damage Non-Contributory Endorsement For Additional lnsureds Non-Contributory Endorsement For Additional lnsureds Non-Contributory Endorsement For Additional lnsureds Non-Contributory Endorsement For Additional lnsureds Non-Contributory Endorsement For Additional lnsureds Non-Contributory Endorsement For Additional lnsureds Non-Contributory Endorsement For Additional lnsureds Non-Contributory Endorsement For Additional lnsureds Non-Contributory Endorsement For Additional lnsureds Non-Contributory Endorsement For Additional lnsureds Non-Contributory Endorsement For Additional lnsureds Non-Contributory Endorsement For Additional lnsureds Non-Contributory Endorsement For Additional lnsureds Non-Contributory Endorsement For Additional lnsureds Non-Contributory Endorsement For Additional lnsureds Non-Contributory Endorsement For Additional lnsureds Non-Contributory Endorsemenl For Additional lnsureds Non-Contributory Endorsement For Additional lnsureds Non-Contributory Endorsement For Additional Insureds Non-Contributory Endorsement For Additional lnsureds Non-Contributory Endo6ement For Additional lnsureds Non-Contributory Endorsement For Additional lnsureds Non-Contributory Endorsement For Additional lnsureds Non-Contributory Endorsement For Additional lnsureds Non-Contributory Endorsement For Additional Insureds Non-Contributory Endorsement For Additional lnsureds Non-Contributory Endorsement For Additional lnsureds Non-Owned Watercraft Exception Notice To Others Endorsement - Specific Parties Notice To Others Endorsement - Specific Parties Notice To Others Endorsement - Specific Parties Notice To Others Endorsement - Speciflc Parties Notice To Others Endorsement - Specific Parties 540 541 542 543 544 545 546 547 548 549 550 551 552 553 554 555 556 557 558 559 560 561 562 563 564 565 566 567 568 569 570 571 572 574 575 576 577 578 579 580 581 XS20288a0514 XS20288a05'14 XS20288a0514 XS20288a05'14 XS20288a0514 XS20288a0514 XS20288a0514 XS20288a0514 XS20288a0514 XS20288a0514 XS20288a0514 XS20288a0514 XS20288a0514 XS20288a0514 XS20288a0514 XS20288a05'14 XS20288a0514 XS20288a0514 XS20288a0514 XS20288a0514 XS20288a0514 XS20288a0514 XS20288a0514 XS20288a0514 XS20288a0514 XS20288a0514 XS20288a0514 1D466861015 A1132688011 1 A11326880111 A113268801 11 A11326880111 A1132688011 1 XS-6U88e (06/'10)Page 23 of 28 xs3618161223 1D246740308 xs212251106 XS'18357a0610 xs182250405 1D459220615 1D202840606 LD200360206 XSOW33a1202 XS46599a'1 115 Endt. No 582 583 584 585 586 587 588 589 590 59'l 592 593 594 595 596 597 598 599 600 601 602 603 604 605 606 607 608 609 610 61'l 612 613 6'14 615 616 617 618 619 620 621 622 623 A113268801 11 A113268801 11 A113268801 11 A1L3268801 11 41132688011 1 ALL326880',ll 1 A1132688011 1 A11326880'r l 1 A1132688011 1 A11326880111 A11326880111 A11326880111 A113268801 11 A113268801 11 A11326880111 A113268801'11 A11326880111 41132688011 1 A1132688011 1 A11326880111 A11326880111 A1132688011 1 A11326880'111 A113268801 11 A11326880111 A113268801 1't A113268801'l 1 A1132688011 1 A1132688011 1 A11326880111 A1L326880111 A11326880111 A113268801 11 A11326880111 A1132688011 1 A11326880111 A11326880111 A113268801 11 A1132688011 1 A11180571211 XS18356a06'10 Form No Description Notice To Others Endorsement - Specific Parties Notice To Others Endorsement - Specific Parties Notice To Others Endorsement - Speciric Parties Notice To Others Endorsement - Specific Parties Notice To Others Endorsement - Specific Parties Notice To Others Endorsement - Specilic Parties Notice To Others Endorsement - Specific Parties Notice To Others Endorsement - Specific Parties Notice To Others Endorsement - Specific Parties Notice To Others Endorsement - Specific Parties Notice To Others Endorsement - Specific Parties Notice To Others Endorsemenl - Specific Parties Notice To Others Endorsement - Speciflc Parties Notice To Others Endorsement - Specific Parties Notice To Others Endorsement - Specific Parties Notice To Others Endorsement - Specific Parties Notice To Others Endorsement - Specific Parties Notice To Others Endorsement - Specific Parties Notice To Others Endorsement - Specific Parties Notice To Others Endorsement - Specific Parties Notice To Others Endorsement - Specific Parties Notice To Others Endorsement - Specific Parties Notice To Others Endorsement - Specific Parties Notice To Others Endorsement - Speciflc Parties Notice To Others Endorsement - Specific Parties Notice To Others Endorsement - Speciflc Parties Notice To Others Endorsement - Specific Parties Notice To Others Endorsement - Specific Parties Notice To Others Endorsement - Specific Parties Notice To Others Endorsement - Specific Parties Notice To Others Endorsement - Speciflc Parties Notice To Others Endorsement - Speciflc Parties Notice To Others Endorsement - Speciflc Parties Notice To Others Endorsement - Specific Parties Notice To Others Endorsement - Specilic Parties Notice To Others Endorsement - Specilic Parties Notice To Olhers Endorsement - Specific Parties Notice To Others Endorsement - Speciflc Parties Notice To Others Endorsement - Specific Parties Notification Of Premium Adjustment Partnership, Joint Venture Or Limited Liability Company Coverage - Named lnsured's lnterest Personal & Advertising lnjury Liability Contractual Exclusion Deletion xS-6U88e (06/10) XS21228a0510 Page 24 ol 28 624 625 626 627 628 629 630 631 632 633 634 635 636 637 638 639 640 641 642 643 644 645 646 647 648 649 650 651 652 653 554 655 656 657 658 659 660 661 662 bbJ 664 665 666 Form No XS6W35a0817 A11218580207 xs298870510 Description A11442990215 xs182240405 41121101'1'106 xs4367910'14 1D2X62a0408 XS6W34a0220 XS6W34a0220 XS6W34a0220 XS6W34a0220 XS6W34a0220 XSOW34a0220 XSOW34a0220 XS6W34a0220 XS6W34a0220 XSOW34a0220 XS6W34a0220 XS6W34a0220 XS6W34a0220 XSOW34a0220 XS6W34a0220 XSOW34a0220 X56W34a0220 XS6W34a0220 XS6W34a0220 XS6W34a0220 XSOW34a0220 XS6W34a0220 XS6W34a0220 X56W34a0220 XS6W34a0220 XS6W34a0220 XS6W34a0220 XSOW34a0220 XSOW34a0220 XSOW34a0220 XS6W34a0220 XS6W34a0220 XS6W3a0220 XS6W34a0220 XS6W34a0220 xS-6U88e (06h0)Page 25 ol 28 Endt. No. Pollution Exclusion - Hostile Fire Exception Port Authority Of New York And New Jersey Endorsement Reimbursement Of Deductible Endorsement Allocated Loss Adjustment Expense ("ALAE") lncluded ln The Oeductible Amount Reporting Of Data On Claims Within A Retention Silica Or Silica-Related Dust Exclusion Trade Or Economic Sanctions Endorsement Underlying Coverage Erodes Retention Endorsement Unintentional Failure To Disclose Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Othe6 To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To LJs Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Ot Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Form No Description Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer Of Rights Of Recovery Against Others To Us Waiver Of Transfer of Rights Of Recovery Against others To Us Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Additional lnsured - Owners, Lessees Or Contractors Additional lnsured - Owners, Lessees Or Contractors - (Form B) Additional lnsured - Owners, Lessees Or Contractors - (Form B) Additional lnsured - Owners, Lessees Or Contractors - Completed Operations Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or organization Additional lnsured - Owners, Lessees Or Contractors - Scheduled Person Or Organization Allocated Loss Adjustment Expense Erodes Retained Limit And Erodes Policy Limit Definition Of Occunence Employee Professional Services Liability Coverage 667 668 669 670 671 672 673 674 675 b/b 678 679 680 681 682 683 684 68s 686 687 688 689 690 691 692 693 694 695 696 697 XS6W34a0220 XS6W34a0220 XS6W34a0220 XS6W34a0220 XS6W34a0220 XS6W34a0220 XSOW34a0220 XS6W34a0220 XS6W34a0220 XS6W34a0220 XS6W34a0220 XS6W34a0220 XS6W34a0220 XS6W34a0220 XS6W34a0220 XS6W34a0220 XS6W34a0220 XS6W34a0220 XSOW34a0220 XSOW34a0220 XSoW34a0220 XS6W34a0220 XS6W34a0220 XS6W34a0220 XS6W34a0220 XS6W34a0220 XSOW34a0220 XSOW34a0220 XS6W34a0220 XS6W34a0220 tlts5698305'17 698 699 700 701 703 704 705 706 MS32829010921 M535710221222 MS36398410923 M5357 1021 '1222 t\,4 s32829020921 M535710231222 MS32829090921 t\rs3405551022 MS36398421223 xS-6U88e (06/10)Page 26 of 28 Endt. No. 702 707 708 709 710 711 712 713 714 r\,rs32829010092'1 |v|s32829040921 t\,4s32829070921 r\.4s32829080921 M541255',t 123 M53572031222 r\,rs3201560224 t\,ts32829050921 Endt. No 715 716 717 7',18 719 720 721 722 724 725 726 727 728 729 730 731 732 733 734 735 736 737 738 739 740 74'l 742 743 744 745 746 747 748 Description Excess Wrap-Up And Joint Venture Coverage Forest Fire Suppression Costs Endorsement Joint Venture Endorsement Limited Pollution Coverage Endorsement - Work Site Medical Payments Coverage Named lnsured Reimbursement - Scheduled Policy Stop Gap - Employers Liability Coverage Endorsement - Puerto Rico & US Virgin lslands Allocated Loss Adjustment Expense Erodes The Retained Limit, Deductible And Policy Limit USVI Location Schedule West Virginia Deliberate lntent Coverage Disclosure Pursuant To Terrorism Risk lnsurance Act Alaska Changes - Attorneys Fees Alaska Changes - Cancellation And Nonrenewal Arizona Changes - Cancellation And Nonrenewal Arkansas Changes - Cancellation And Nonrenewal California Changes - Cancellation And Nonrenewal Colorado Changes - Cancellation And Nonrenewal Connecticut Changes - Cancellation And Nonrenewal Delaware Changes - Cancellation And Nonrenewal District Of Columbia Changes - Cancellation And Nonrenewal Florida Changes - Cancellation And Nonrenewal Georgia Changes - Cancellation And Nonrenewal Hawaii Changes - Cancellation And Nonrenewal ldaho Changes - Cancellation And Nonrenewal lllinois Changes - Cancellation And Nonrenewal lndiana Changes - Cancellation And Nonrenewal lowa Changes - Cancellation And Nonrenewal Kansas Changes - Cancellation And Nonrenewal Kentucky Changes - Cancellation And Nonrenewal Louisiana Changes - Cancellation And Nonrenewal Maine Changes - Cancellation And Nonrenewal Maryland Changes - Cancellation And Nonrenewal Michigan Changes - Cancellalion And Nonrenewal l\,rinnesota Changes - Cancellation And Nonrenewal Minnesota Changes Endorsement Mississippi Changes - Cancellation And Nonrenewal Missouri Changes - Cancellation And Nonrenewal Montana Amendatory Endorsement Nebraska - Cancellation And Nonrenewal Nevada Changes - Cancellation And Nonrenewal New Hampshire - Cancellation And Nonrenewal New Jersey Changes - Cancellation And Nonrenewal MS32829060921 MS330390924 t109851220 ALL5X26bl I I 1 1D2S50b0201 LD2S51c12'14 1D2S52b0801 1D2S53d0811 1D2S54a0201 1D2S550392 1D3S08b0612 1D2S56a0201 1D2S57b0201 xs1v18b0215 1O2S59a0201 1D2S60c0311 LD2S6't a0201 1D2S62a0201 1D2S630392 1D2S64a0201 1D2S65a0201 1D2S66c0801 1D2S67a0201 1D2S68c0516 LD2S69e0417 1D2S70a0201 xs223600607 1D2S71a0201 1D2S72c0805 1D2S73e0407 LD2S7 4a020'l LD3507a0201 1D2S75b0201 LD2S76 XS-6U88e (06/10)Page 27 ol 28 Form No. Endt. No 749 750 75'l 752 753 754 755 756 757 758 759 760 761 762 763 764 765 766 767 768 769 770 1D 10247a0515 LO2577c0201 1D2S78b0201 LD2S79d081 1 LD2S80c0706 1D2S81c1006 1D2S82a0201 1D2S83a0201 1D2S85b0201 LD2S86b08't 0 1D2S87b0902 1D2S88a0201 1D2S89a0201 1D2S90b0201 1D2S910392 xs31659081 1 1D2S92d1215 1D2S930392 xs38020'1 1 13 1D2S94a0201 1D2S95a0201 1D2S96a0201 Description New Mexico Changes - Cancellation And Nonrenewal New York Changes - Cancellation And Nonrenewal North Carolina - Cancellation And Nonrenewal North Dakota Changes - Cancellalion And Nonrenewal Ohio Changes - Cancellation And Nonrenewal Oklahoma Changes - Cancellation And Nonrenewal Oregon Changes - Cancellation And Nonrenewal Pennsylvania Changes - cancellation And Nonrenewal Rhode lsland Changes - Cancellation And Nonrenewal South Carolina changes - cancellation, Nonrenewal South Dakota Changes - Cancellation And Nonrenewal Tennessee Changes - Cancellation And Nonrenewal Texas Changes - Cancellation And Nonrenewal Provisions For Casualty Lines And Commercial Package Policies Utah Changes - Cancellation And Nonrenewal Vermont Changes - Cancellation And Nonrenewal Vermont Changes - Pollution Virginia Changes - Cancellation And Nonrenewal Washington Changes - Cancellation And Nonrenewal Washington Changes - Oefense Costs West Virginia Changes - Cancellation And Nonrenewal Wisconsin Changes - Cancellation And Nonrenewal Wyoming Changes - Cancellation And Nonrenewal This declaration and the coverage form(s) and endorsements, if any, listed above and attached, completes the above numbered policy. THE TOTAL AMOUNT DUE INCLUDES A PREMIUM SURCHARGE PURSUANT TO SECTION 'I36.392 OF THE KENTUCKY REVISED STATUTES. XS-6U88e (06/10)Page 28 of 28 Form No. RESPONSIBTE CONTRACTOR VERIFICATIOIT AND CERNFICATION OF COMPUANCT AITACHMENT A-1 FIRST-TIER SUBCOI{TRACTORS LIST SUBM]T PRIOR TO EXECUNON OF A CONSTRUCNO COUTRACT 8Ml PROJECI NUMBER: 24X.135228 Minn. Stat. 5 16C.285, Subd. 5. A prime contractor or subcontractor shall include in its verification of compliance under subdivision 4 a list of all of its first-tier subcontractors that it intends to retain for work on the proiect. Prior to execution of a construction contract, and as a condition precedent to the execution of a construction contract, the apparent successful prime contractor shall submit to the contracting authority a supplemental verification under oath confirming compliance with subdivislon 3, clause (7). Each contractor or subcontractor shall obtain from all subcontractors with which it will have a direct contractual relationship a signed statement under oath by an owner or officer verifyint that they meet all ofthe minimum criteria in subdivision 3 prior to execution of a construdion contract with each subcontractor. FIRST TIER SUECOI{TRACTOR NAMES' (Legal nam€ of company as registered with the Secretary of statel Name of city where company home otfice is located Eituminous Roadways lnc Mendota HeiBhts, MN Hugo's Tree Care lnc Hugo, MN Rainor a^ntra.tino H'ri-hin.^^ irN Sir tines-A-Lot Edina, MN Safety Signs LIC Lakeville, MN 'Attach additional sheets as needed for submission of all first-tier subcontractors. This document is a MOD|F|Eoverion olth€ MnDOT flesron sibl€ Contractor Vedtication .nd C€rtificarlon of Comol SUPPLEMENTAL CERTIFICATION FOR ATTACHMENT A.1 gy signing this document I certify that I am an owner or officer of the company, and I certify under oath that: All first-tier subcontractors listed on attachment A-1 have verified through a signed statement under oath by an owner or officer that they meet the minimum criteria to be a responsible contractor as defined ln Minn. stat.516C.285. Owner or Officer:Printed Name: Charles M Storing Title \-, Secretary Date; 6/25/25 Company Name: A-1 ExcavatinS LLC Caty of Columbia Heights - 24X.135228 June 2025 ADDITIONAL SUBCONTRACTORS LIST PAGE m 51 11-1 ADOITIONAL SUECONTRACTORS TIST ATTACHMETTT A.2 ADDITIONAL SUBCONTRACTORS TIST AODITIONAT SUBCONTRACTOR NAME5. (Legal name of company as reSlste.ed wlth the Secretary of statel Name of city where companY home offlce is located unknown at this time rAttach additional sheets as needed for submlsslon of all additional subcontractors. Thi3 doi:ument is e MOOlflEOve.slon ofthe MnDOT and certificatlfi ot complian.€ torm SUPPLEMENTAL CERTIFICATION FOR ATTACHMENT A-2 By sitnint this document I certlfy that I am an owner or officer ol the company, and I cenify under oath that: All additional subcontractors llsted on Attachment A-2 have verified throu8h a slSned statement under oath by an owner or officer that they meet the minimum criteria to be a responsible contractor as defined in Minn. Stat. 0 16C.285. Printed Name: Charles M Storing Owner or Officer: /rl. Date: 6/2sl2sSecretary Company Name: A-1 Excavating LLC city of Columbia HeiShts - 24X.135228 June 2025 R.3ponslble Contractor Ver.licatlon ADDITIONAT SUECONTRACTORS USI PAGE 00 51 11-2 PRIME CONINACTOT TO SUBM]T AS SUBCONTRACTORS ARE ADOED TO THE PROJECT PROJECT UMBERT 24X.135224 This form must be submitted to the Proiect Mana8er or individual as ldentified in the solicitation document. Minn. Stat. 5 16C.285, 5ubd. 5. lf a prime contractor or any subcontractor retains additional subcontradors on the proiect after submitting its verification of compliance, the prime contractor or subcontractor shall obtain verifications of compliance from each additional subcontractor with which it has a direct conractual relationship and shall submit a supplemental verification confirming compllance with subdivision 3, clause (7), within 14 days of retainint the additional subcontractors. Title: This document is a MODIFII0 version oI EICOC. C-520. Copyrighto 2018 by NSP[. ACEC, and ASCE. All rights resarved. City ot Columbia Heights - 24X.135228 June 2025 AGREEMENT TORMS PAGE OO 52 OGl AGREEMENT FORMS This ASreement is by and between City of Columbia Heithts ("Ownet-) and A-1 Excavatint, Ll-C ('Contractor"). Terms used in this Agreement have the meanings stated in the General Conditions and the Supplementary Condltions. Owner and contractor hereby agree as follows: AtTrcu l-woRx 1.01 Contractor shall complete all Work as specifled or indicated ln the Contract Documents. The Work is generally described as follows: . Project: 2025 40th Avenue Utility lmprovements ARITICLE Z-THE PROJECT z.o\ The Project, of which the Work under the Contract Documents ls a part, ls Benerally described as follows: . Sewer and Water Replacements ARTICLE 3-ENGIT{EER 3.01 The Owner has retained linsert name of Owner's representative] ("Engineer") to act as Owne/s representative, assume all duties and responsibilities of Engineer, and have the rights and authority assigned to Engineer in the Contract. 3.02 The part of the Proiect that pertalns to the Work has been desiSned by Bolton & Menk, lnc. ARIIClf, 4-CONTRACT TIMES 4.01 Time ls ofThe Essence A. All time limlts for Milestones, lf any, Substantial Completion, and completion and readlness for final payment as stated in the Contract Documents are of the essence of the Contract. 4.O2 SubstantialCompletion A. Substantial completion shall be defined as; l. The date when construction is sufficiently completed so that the owner can occupy or use the improvement for the intended purpose. 2. For streets, highways, and bridges, the date when construction-related traffic devices and ongoing inspections are no longer required. 3. The Contractor acknowledges that on8oing inspections are required until the conditlons of all construction permits for thls proiect are met and specilically during the following work activities: €xcavation, backfilling, underground utilities including water, sanitary, and storm sewer, compaction, aggregate base, paving, and removal of all traffic control signage and erosion control temporary best management practices. 4.03 Contract Times: Dates A. The work shall be substantlally completed on or before ,:0l,s1m25, and completed and ready for final payment in accordance with ParaSraph 15.05 of section 0O 72 00 "General Conditions" of this Proiect Manual on ot betote LO|3,.|2OZS. 4.O4 LiquidatedDamages A. Contractor and Owner recognize that time is of the essence as stated in Paragraph 4.01 above and that Owner will suffer financiai and other losses if the Work is not completed and Milestones not achieved within the contract Times, as duly modified. The parties also recognize the delaYs, exp€nse, and difficulties involved ln proving, in a legal or arbitration proceedin8, the actual loss suffered by Owner ifthe Work is not completed on time. AccordinSly, instead of requiring any such proof, Owner and Contractor agree that as liquidated damages for delay (but not as a penalty): 1. Substantial Completion; Contractor shall pay Owner $ 1,0O0.00 for each day that expires after the time (as duly adrusted pursuant to the Contract) sp€cified above for Substantlal Completion, untilthe Work is substantially complete. 2. Completion of Remaining Work: After Substantial Completion, if Contractor shall neglect, refuse, or fail to complete the remaining Work within the Contract Times (as duly adjusted pursuant to the Contract) for completion and readiness for final payment, Contractor shall pay Owner S 500.00 for each day that expires after such time until the Work is completed and ready for final payment. 3. Liquidated damages for fuiling to timely attain completion are not additive and will not be imposed concurrently. B. lf Owner recovers liquidated damages for a delay in completion by Contractor, then such liquidated damages are Owner's sole and exclusive remedy for such delay, and Owner ls precluded from recovering any other damages, whether actual, direct, excess, or consequentlal, for such delay, except for special damages (if any) specified in this Agreement. ARNOE s-CONTRACT PRICE 5.Ol Owner shall pay Contractor for completion of the Work in accordance with the Contract Documents, the amounts that follow, subject to adjustment under the Contract: A. For all Unit Price Work, an amount equal to the sum of the extended prices (establlshed for each separately identified item of Unit Price Wo* by multiplying the unit price times the actual quantity of that item). B. The extended prices for Unit Price Work set forth as of the Effective Date of the Contract are based on estimated quantities. tu provided in ParaSraph 13.03 of the General Conditions, estimated quantities are not guaranteed, and determinatlons of actual quantities and classlfications are to be made by Engineer. C. For all awarded Work, at the prices stated in Contracto/s Bid, attached hereto as an exhibit. D. The Work awarded shall include: 1. Base Bid ARNGE FPAYMENT PROCEDURES 6.01 Submittal and Processing of Payments A. Applications for Payment shall be submitted and processed in accordance with Article 15 of th€ General Conditlons or as modified by the Supplemental Conditions. 6.02 Progress Payments; Retalnage A. Owner shall make progress payments during performance of the work on the basis of Contractor's Applications for Paym€nt dated on or about the 25th day of each month of the Work as provided in paragraph 6.02.A.1 below, provided that such Applications for Payment have been submitted in a This document is a MODIFIE0 version of ErC0C' C-520 NSPt, ACEC, and ASCE. All riShts reserved. City of Columbia HeiShts - 24X.135228 iune 202S , copyrlghto 2018 by AGREEMENT FORMS PAGE OO 52 OG2 6.03 5.04 timely manner and otherwise meet the requirements of the Contract. All such payments will be measured by the Schedule of Values established as provided in the General Conditaons (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 elsewhere in the Contract. 1. Prior to Substantial Completion, progress payments will be made in an amount equal to the percentage indicated below but, in each case, less the aggregate of payments previously made and less such amounts as Owner may withhold, including but not limited to liquidated damages, in accordance with the Contract. a. 95% percent of the value of the Work completed (with the balance being retainage). b. 95% percent of cost of materials and equipment not incorporated in the Work (with the balance bein8 retainage). B. Within 60 days of the date of Substantial Completion, Owner shall pay an amount sufficient to increase total payments to Contractor to 99 percent of the Work completed, less such amounts set off by Owner pursuant to Paragraph 15.01.E of the General Conditions, and less 250 percent of EnSineer's estimate of the value of Work to be completed or corrected as shown on the punch list of items to be completed or corrected prior to final payment and all final paperwork is completed. Final paperwork is defined as documents required by the contract which may include but are not limited to: 1. Operations Manuals, record documents, and submittals required by the contract documents, and 2. Payroll documents for projects with prevailing wag€ requlrements, and 3. lC 134, and 4. Lien Releases, if required. a. Mn Department of Commerce Form 40.5.1. b. http://www.commerce.state.mn.us/UCB/40.5.1.pdf or equal. Progress Payment to Subcontractors A. For contracts within the State of Minnesota, MN Statute 471.425 Subd. 4a. shall apply. MN Statute 471.425 Subd. 4a. requires: 1. The prime contractor shall pay any subcontractor within ten days of the prime contractor's receipt of payment for undisputed services provided by the subcontractor. 2. The prime contractor shall pay interest of 1-1/2 percent per month or any part of a month to the subcontractor on any undisputed amount not paid on time to the subcontractor. 3. The minimum monthly interest penalty payment for an unpaid balance of 5100 or more is S10. For an unpaid balance of less than 5100, the prime contractor shall pay the actual penalty due to the subcontractor. 4. A subcontractor who prevalls in a civilaction to collect interest penalties from a prime contractor must be awarded its costs and disbursements, including attorney's fees, incurred in bringing the action." Final Payment A. Upon final completion and acceptance of the Work, Owner shall pay the remainder of the Contract Price in accordance with Paragraph 15.06 of the General Conditions. Thi5 document is a MOoIFIED version of EJCOC. C E, AC€C,.nd ASCE. All ri8hts reserved. Clty of Columbia HeiBhts -.24X.135228 .lune 2025 -520, CopyriSht@ 2018 bv NSP AGREEMENT FORMS PAGE OO 52 OG3 6.05 Consent of Surety A. Owner will not make final payment or return or release retainage at Substantial Completion or any other time, unless Contractor submits written consent of the surety to such payment, retum, or release- 6.05 lnterest A. All amounts not paid when due will bear interest at the rate of 1.5 percent per month. ARNclT'-GOMTNACT DOCUMENTS 7.Ol Contents A. Ihe Contract Documents conslst of all the following: 1. This Agreement. 2. Bonds; a. Performance bond (to8ether with power of attorneyl. b. Payment bond (toSether with power of attorney). 3. General Conditions. 4. SupplementaryConditions. 5. Sp€cifications as listed in the table of contents of the project manual (copy of list attachedr. 6. Drawings as listed in the table of contents of the project manual (copy of list attached. ) 7. Addenda (N/A). 8. Exhibits to this Agreement (enumerated as follows): a. Contractor's Bid (pates m 41 o0-1to 00 45 U'3, inclusive|. 9. The following which may be delivered or issued on or after the Effective Oate of the Contract and are not attached hereto: a. Notice to Proceed. b. work change Directives. c. Chante Orde6. d. Field Orders. e. Warranty Bond, if any. B. The Contract Documents listed in Paragraph 7.01.A are attached to this Agreement (except as expressly noted otherwise above). C. There are no Contract Documents other than those listed above in this Article 7. D. The Contract Documents may only be amended, modified, or supplemented as provided ln the Contract. ANNGLE 8_NEPRESENTATIOiIS, CENTI'ICATIOiIS, A D STIPUIANONS 8.01 Contractor'sRepresentations A. ln order to induce Owner to enter lnto this Crntract, Contractor makes the followlng representations: 1. Contractor has examined and carefully studied the Contract Documents, including Addenda. This do.ument ls a MOoIFIED version ot EJCDC' C-520, CopyriShto 2018 by NSPE, ACEC,end ASCE. All raShts reserved Clty ot Columbla Heightt - 24X.135228 .lune 2025 AGREEMENT FORMS PAG€ 00 52 004 8.02 2. Contractor has visited the Site, conducted a thorough visual examination of the Site and adjacent areas, and become familiar with the general, local, and Site conditions that may affect cost, progress, and performance of the Work. 3. Contractor ls familiar with all Laws and Regulatlons that may aff€ct cost, progress, and performance of the Work. 4. Contractor has carefully studied the reports of explorations and tests of subsurface conditions at or adjacent to the Site and the drawinBs of physical conditions relating to existing surface or subsurface structures at the Sate that have been identified in the Supplementary Conditions, with resp€ct to the Technical Data in such reports and drawings. 5. Contractor has carefully studied the reports and drawin8s relating to Hazardous Environmental Conditions, if any, at or adjacent to the Site that have been identified in the Supplementary Conditions, with respect to Technical Data in such reports and drawings. 6. Contractor has considered the information known to Contractor itself; information commonly known to contractors doing business in the locality of the Site; information and observations obtained from visits to the Site; the Contract Oocuments; and the Technical Data identified in the Supplementary Conditions or by definition, with respect to the effect of such information, observations, and Technical Data on (a) the cost, progress, and performance of the Work; (b) the means, methods, techniques, sequences, and procedures of construction to be employed by Contractor; and (clContractor's safety precautions and protrams. 7. Eased on the information and observations referred to in the preceding paragraph, Contractor aSrees that no further examinations, investigations, explorations, tests, studies, or data are necessary for the performance of the Work at the Contract Prlce, wlthin the Contract Times, and in accordance with the other terms and conditions ofthe Contract. 8. 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. 9- Contractor has given Engineer written notice ofallconflicts, errors, ambiguities, or discrepancies that Contractor has discovered in the Contract Documents, and of discrepancies between Site conditions and the Contract Documents, and the written resolution thereof by Engineer is acceptable to Contractor. 10. The Contract Documents are generally sufficient to indicate and convey understanding of all terms and conditions for performance and furnishing of thb Work. 11. Contractor's entry into this Contract constitutes an incontrovertible representation by Contractor that without exception all pric€s in the Agreement are premised upon performing and furnishing the Work required by the Contract oocuments. Contractor's Certifications A. Contractor certifies that it has not enga8ed in corrupt, fraudulent, collusive, or coercive practices in competing for or in executing the Contract. For the purposes of this Paragraph 8.02: 1. "corrupt practice" means the offering, giving, receivinS, or soliciting of anythinS of value likely to influence the action of a public official in the bidding process or in the Contract execution; 2. "fraudulent practice" means an intentional misrepresentation of facts made (a) to influence the bidding process or the execution of the Contract to the detriment of Owner, (b) to establlsh 8id or Contract prices at artificial non-competitive levels, or (c) to deprive Owner of the benefits of free and open competition; Thls document is a MODIFIE0 version ot EJCOCT C-520,2018 by NSP[, ACEC, and ASCE. All rights res.rved. Clty of Columbla HeiShts - 24X.135228 June 202S AGREEMENT FORMs PAGE 00 52 00-5 8.03 3. 'collusive practice" means a scheme or arrang€ment between two or more Bldders, with or without the knowledge of Owner, a purpose of which is to establish Bid prices at artificial, non- competitive levels; and 4. "coercive practice" means harming or threatening to harm, directly or indirectly, persons or their property to influence their participation in the bidding process or affect the execution of the Contract. Standard General Conditions A. Owner stipulates that if the General Conditions that are made a part of this Contract are EICDCo C 7OO, Standard General Conditlons for the Construction Contract (20181, published by the Engineers Joint Contract Oocuments committee, and if owner is the party that has furnished said General conditions, then ownei has plainly shown all modifications to the standard wording of such published document to the Conractor, through a process such as highliShting or "track changes" (redline/strikeout), or in the Supplementary Conditions. This document ls a MODIFIE0 version of EJCDC' C-S20, Copyrishto 2018 by NSPE. ACEC, and ASCE. All rights reserved. City of Columbia Heights - 24X.135228 June 2025 AGREEMENT FORMS PAGE 00 52 00-6 lN WITNESS WHEREOF, Owner and Contractor have signed this Agreement. This Agreement will b€ effective on J!!92L2925 (which is the Effective Date ofthe Contract). OWNER: CONTRACTOR: City of Columbia Heights A-1 ExcavatinB, LLC (lyped or prihted nome o, o.gontzot-lon)(typed ot prlnEd orgon)rotion) By: By: By: By: By: Amiida Md ue, Simula, Ma ot pinted) Date: (dote sign.d) Name: (typed or ptinted) Title: printed) lj ContmcTot it o corporction, o pottne5hip, ot o joiAt Entute, ottoch evidence ol oulhotity to stgn) Attest: Title: (tycedot gat d) Address for giving notices: P.O. Box 90 2E Aaron Chirpich, City Man aSer (lyped ot prlnred) Attest: Title: City Clerk Ity*d o' Drht dl Addr€ss for giving notices: 3989 CentralAvenue NE Columbia Heights, MN 55421 Eloomer wt 54724 Designated Re Name Title: Designated Representative (typed or tu++Name: Title: (typed or Nintedl C tU€nor^rr.^flrt, nA*r. _!@ ot printe4l v t@ ot pttnted) Address Add A ,! Thir document is a MOolFlE0version of UCDC'C-520, Copyrithto 2018 bv NSP[, ACEC, and ASCE. Allrithts re5€rved City of columbia Heights - 24X.135228 June 2025 AGREEMENT FORMS PAGE 00 52 00-7 (ayped ,!,,- Columble H.l8rrts, Cllyor 2025 4oit A/!nu.lrllllty lmp.ovam,n3 2/v1135228Iten68$l Oirl6.: City or Columbl. H.tghls Soucltor: Sdloi A X..r. hc. 06/2U2025 t0:@ Ar! COI 2011.601 2021.501 2101.501 2101.!,02 2101.s02 21{r.502 2104.503 21lX.5Gt 2104.s(xl 2104.5& 21oa 210.5r} 210a.s18 2104.504 210il.slx| 210..5& 210t_503 2104 25q!.601 2503.502 2ro3.603 2506.602 21.:t3.61 z.tt.507 221t.507 Zit.@1 2231.604 2535.503 2503.503 250:t.50:l 2503.503 2503.a)2 2503.stx) 2503 503 2504.502 2504.a)2 250a.602 2504.608 2504.601 ?lo1.q2 2504.502 25rX.603 25tX.6oa 250:t.602 2506.502 2506.50? 2506.603 b14.507 257S 256it.601 2573.502 2542.503 S*l5n lln &|a iar B 8€85 I 2 3 a 5 6 7 8 0 t0 l! E 1lt t4 ,6 16 77 1l l0 a) 21 2 z! A 25 26 27 aa $ 31 u 3l 3a 35 $ tt 36s ao at 12 a3 4 rs a6 o {8 /E 60 s1 52 CONSIR-,CION SU8I,/EUT]G xoSruz^mN CI"EARING AIO Gru8BIM} ISIINUBI CTEARING GNUBA]TG B€XOVE SA}IIIAFY IIANIIOIE s wclrT 8[uiiNous P vEr.rErrI (Frx"r- DIPIHI s u/clJr coNcRm PAVEXENT (frar o€PDl) Rflro/E PiPC s€$rEf,s (sr}{l^sYl REr{OVr 80 0r\r YPAVE|.IEM S l-V GEAr,lO R€ltlST ll- LANDSC PE BLOCr i€,1o\'E CUiA A}IO GTJIIEF REHOVE gOEWAL( iE OVE CONCRm PAVET{INI rsr(,vEv LvE AM) 80x REHOI'E TM}NANT iEl,rovt w TERHA}I SALVAGE AXO N€NSIAI STORH SEWES PIPE rErPoMnY EYPASS PUTaPING {S I IAIY) co r{Ecrro [rBIl Gsronl{ sfwEs srnucruRE COI{N€GT TO EnSNNG SIONT SEII/ER PIPE lDttriTFi HE RING I ClSnirG srREEr sr{ErpER ll.nlH ncxuP BRoox) AGGaEGIT: B SE (C14 CT.ASS 5 AGGnEG TE SISE (c14 Cr"lSS S - $DA.r L(P TCH mESP 125WE ENG COUiSE m( (3:Cl TYPE SP r2.5 WEAfIiIG COUBSE HX (3;Cl . slD€U,At( PAICH 8|TUXNOUSCUiE I' Plrc PIPE S€WER SDB 26 8' IXTCTIIE lloll PIPE SEllr€8 CL 52 IE- ryC HPE SEWEA SDR 26 cot{NEcT ro &snNG w rtirlrN 6'W TEil,,l lN DUCIIIE nON Ct 52 8'W IERI',I ltl OUcnLf noN CL s2 6',GITEV tVE & 80X 8'6ATEV t VEe 80X tm)RAt{r OUCNU NON FTIINGS ,IEMFONAXYWATEN SERVIC! I'COSPOS Ttoil STOP 1'CUnSSIoPt 80r 1' IYPE ( COFPEN WAIER S€RvlCE 2'W rE8r.lAtir lNst ullotr @NNECI TO EXSTTI{G STN|TAAY SEII\'ER c sTrNG ASSEITELY coxsTRucr sAtll^nY sErr/ER rl NHoLt coNSInucT 0' ot IstoE Df,oP @HHOI TOPSO - S(HROnr SEED, FENNUZE8, AXD TM)BAULrc t4l,LCH I'AIRIX Ii FF|C COiaIROt sroEH oS lN tl{tfr P8orrcnoN 4' oou8LE SOLID UNE MULTI COr.iP (YELLOW) LUHP 5UI,I Llr P sur{ SQ YD ErcH EACH EACH UN 'TUN FT TJI.I FI SQYT) UN FI LN FT sQrI SQ YD Elcrl EACTI UN FT uN Ft IUHPSUl.l EACH EICH EACH HOUR CU YD CU YD TOr{ TOt{ [N FT LIT Fr Ufl Fr [N FI EICH tIN FT tlll Fr EACH tcH EICH L8S LUr49 SUl. Elcti EICH LIN EI SQ YO ETCB EACH LIN FI UT FT CUYD SQ YD LUHPSUH EACH UN FT 1 I 20 2 2 3 2820 130 7t) 3970 a5 500 170 20 t3 1380 8l) t 2 2 r5 10 Erc !o 6eo 30 $ox 4 10 I 80 1300 4 11 t28l) 1 9 I so 30 6 3 €8 26 60 s00 1 t! 1580 |1&c.v.d{ UC Qr.n0t t,nll Prlc. t6.000.00 t€7,qr.m le.0o a50o.0o !500.m azsm.m t3.00 t7.OO tI.oo t5.m l70.00 18.00 tz00 120.00 $0o.m t{i02.m t10.00 tlm.oo 325,ooo.oo a2,0qr.m 12,000.00 4600.00 t150.00 t&.00 3so.m t128.00 t2&.00 31r.oo to31.00 azzLoo t333.00 t2,500.00 $,7.00 t92.00 te7m.00 tJ,700-00 t6,90O.00 118.00 l9.o@.00 a,oo.m 1650.0O t73.00 t?5.m 32,s00.00 31.200.q) 4r.500.00 41.190.00 t80.00 t'oo lt1, .rx) 35o.oo t1.50 tIl.r!6lon 4838.l.&m 16,mo.oo 197,000.q) $r0.00 41,@O.O 11,000.@ t7,500.00 a8,a€0.@ tg1o.m 42,100.m t19,850.m l3.rso.u) 44,6.00 33a0.00 taoo.oo i!,gm.m aeros.m $3,8m.m ia.ooo.m !?3,(x)O.m ia.oo.m aa,m0.@ 13,000.m 31,500.@ tl26.aoo.@ i3.600.0 a80.3ro.m $,a00_00 i5.5oo.oo ta,6:lo.0o t0.860.ln $.330.m 122.s00.00 i7.760.@ t1t9,600-m alo.Eoo.oo ..0,7110-00 u7,600_m 423,0.0.00 t9,000.q) 13,800.00 ,5,ESo.m t26,280.00 ,750-00 315,000.m G,600.m tr02,@0.m 130,s40.m 14,600.@ !3,s00.m 111.5OO.m a65o.0o t2,370.00 l1o,oo0.m t10.qro.m t8.8,848.00 fD(ED 8... Bid Totrl 53 0121 16 T.ANoSCAPE ALLOI/ANCE UNIT 10000 i100 Owner: Engineer: Contractor: Project: NOT]CE TO PROCEED City of Columbia Hei Bolton & Menk, lnc. A-1 Excavating, LLC 2025 4fth Avenue Utility lmprovements Owner's Project No.: Engineer's Project No.: Contractor's Pro.iect No. : 24X.135228 Effective Date of Contract: 6/2412025 Owner hereby notifies Contractor that the Contract Times under the above Contract will commence to run on June 24,2025 pursuant to 5C-4.01 of the Supplementary Conditions. On that date, Contractor shall start performing its obligations under the Contract Documents. No Work will be done at the Site prior to such date. The Substantial Completion and Final Completion must be achieved in accordance with the requirements of the Agreement. Before starting any Work at the Site, Contractor must comply with the following: . Provide notification to notice to Owner/Engineer as stated within the pro.ject specifications; . Obtain submittal reviews prescribed by the Engineer; and o Secure required permits as stated within the project specifications. Owner:City of Columbia Hei ghts Kevin Hansen By (signoture)i Name (printed): Title: Date lssued: Copy: Engineer City Engineer/Public Works Director This do.ument is a MODIFIED version of EJCDCo C-550, Co thto 2018 by NSPE, ACEC, and ASCE. All riShts reserved City of Columbia Heights - 24X.135228 June 2025 NOTICE TO PROCEED PAGE 00 55 00-1 PERFORMANCE BOND FORM Contrect Descfiplion (nome ond locotion): 2025 4&h Avenue Utllity lmprovements - Columbia Heaghts, MN ContractPrice: 5848,848.00 Effective Date of Convac.: 612412025 SuretyContractor as Principal A-'l By: Name: Title: Attest: Name: Title: Amert (Signoturc)(Attoch e: Michael Galarza Witness ,T By: Name: Title: Attest: I - Nam Title Notes: (1) Ptovide supplementol execution by ony oddittonol pofties, such as joint vehture4. (2) Any tingulor reletence to Controctor, Surcty, OwneL or oah.t pofty it contidepd plutolwhe4 opplboble. This documenl rs e MODIFIEO version of EICOC. C-610,and AStE. All rights reserved Contractor Name: A- l Excavatin& LIC Address (principot ptoce ol busi,/,est)i P.O. Box 90 Bloomer, Wl t4724 Surety Name: Travcbl! C€ruslty and SuEty Company o, Anto.ice Ndfess lvln iryt ploce ol busin.ss)l One Tower Square Hartford, CT 06183 Ownai Name: City of Columbia Heights Mailing address /pr,, cipol ploce ol butin.ss) 3989 CentralAvenue NE Columbia Heights, MN 55421 Bond Bond Amount: $84E,848.00 oate of Bond: June 26th, 2025 lDotc ol aond connot be codi.t thon Efredi,t Dola ol Co,!troct) Modiflcations to this Bond form: E None U See Paragraph 15 Surety and Contractor, intending to be legally bound hereby, subject to the terms set forth in this Performance Bond, do each cause this Performance Bond to be duly executed by an authorized officer, agent, or representative. .-& city of columbia Hei8hts - 24x.135228 June 2025 2018 by NSPE , ACEC, PERFORMANCE BOND FORM PACE 00 61 11.13-1 Travelers --l 1 2 l The Contractor and Surety. jointly and severally, bind themselves, their heirs, executors, administrators, successors, and assigns to the Owner for the performance of the Construction Contract, which is incorporated herein by reference. lf the Contractor performs the Construction Contract, the Surety and the Contractor shall have no obligation under this Bond, except when applicable to participate in a conference as provided in Paragraph 3. lf there is no Owner Default under the Construction Contract, the Surety's obligation under this Bond will arise after: 3.1. The Owner first provides notice to th€ Contractor and the Surety that the Owner is considering declaring a Contractor oefault. Such notice may indicate whether the Owner is requesting a conference among the Owner, Contrador, and Surety to discuss the Contractor's performance. lf the Owner does not r€quest a conference, the Surety may, within five (5) business days after receipt of the Owne/s notice, request such a conference. lf the Surety timely requests a conference, the Owner shall attend. Unless the Owner agrees otherwise, any conference requested under this Paragraph 3.1 will be held within ten (10) business days of the Surevs receipt of the Owher's notice. lf the Owner, the Contractor, and the Surety agree, the Contractor shall be allowed a reasonable time to perform the Construction Contract, but such an agreement does not waive the Owner's right, if any, subsequently to declare a Contractor Default; 3.2. The Owner declares a Contractor Oefault, terminates the Construction Contract, and notifies the Surety; and 3.3. The Owner has agreed to pay the Balance of the Contract Price in accordance with the terms of the Construction Contract to the Surety or to a contractor selected to perform the Construction Contract. 4. Failure on the part of the Owner to comply with the notice requirement in Paragraph 3.1 does not constitute a failure to comply with a condition precedent to the Surety's obligations, or release the Surety from its obligations, except to the extent the Surety demonstrates actual prejudice. 5. When the Owner has satisfied the conditions of Paragraph 3, the Surety shall promptly and at the Surety's expense take one of the following actions: 5.1. Arrange for the Contractor, with the consent of the Owner, to perform and complete the Construction Contract; 5.2. Undertake to perform and complete the Construction Contract itself, through its agents or independent contractors; 5.3. Obtain bids or negotiated proposals from qualified contractors acceptable to the Owner for a contract for performance and completion of the Construction Contract, arrange for a contract to be prepared for execution by the Owner and a contractor selected with the Owners concurence, to be secured with performance and payment bonds executed by a qualified surety equivalent to the bonds issued on the Construction Contract, and pay to the Owner the amount of damaSes as descrlbed in Paragraph 7 in excess of the Balance of the Contract Price incurred by the Owner as a result of the Conttactor Default; or 5,4. Waive its right to perform and complete, arrange for completion, or obtain a new contractor, and with reasonable promptness under the circumstances: This documenl is a MOD|FlEDversion of EJCOC'C-510,@ 2018 by NSPE, ACEC, end ASCE All rithE reserv€d. City of Columbia Heights - 24X.135228 .lune 2025 PERFORMANCT BOND FORM PAGE 00 61 13.13-2 5.4.1 After investigation, determine the amount for which it may be liable to ttle Owner and, as soon as practicable after the amount is determined, make payment to the Owner; or 5.4.2 Deny liability in whole or in part and notify the Owner, citint the reasons for denial. 6. lf the Surety does not proceed as provided in Paragraph 5 with reasonable promptness, the Surety shall be deemed to be in default on this Bond seven days after receipt of an additional written notice from the Owner to the Surety demanding that the Surety p€rform its obligations under this Bond, and the Owner shall be entitled to enforce any remedy available to the Owner. lf the Surety proceeds as provided in Paragraph 5.4, and the Owner retuses the payment, or the Surety has denied liability, in whole or in part, without further notice, the owner shall be entitled to enforce any remedy available to the Owner. 7. lf the Surety elects to act under Paragraph 5.1, 5.2, or 5.3, then the responsibilities of the Surety to the Owner will not be greater than those of the Contractor under the Construction Contract, and the responsibilities of the Owner to the Suretywill not be greater than those ofthe Owner underthe Construction Contract. Subject to the commitment by the Owner to pay the Balance of the Contract Price, the surety is obliSated, without duplication for: 7.1. the responsibilities of the Contractor for correction of defective work and completion of the Construction Contract; 7.2. addational legal, design professional, and delay €osts resulting from the Contracto/s Detault, and resultinB from the actions or failure to act of the Surety under ParaSraph 5; and 7.3. liquidated damages, or if no liquidated damages are specified in the Construction Contract, actual damages caused by delayed performance or non-performance of the Contractor. 8. lf the Surety elects to act under Paragraph 5.1, S.3, or 5.4, the Surety's liability is limited to the amount ot this Bond. 9. The Surety shall not be liable to the Owner or others for obligations of the Contractor that are unrelated to the Construction Contract, and the Ealance of the Contract Price will not be reduced or set off on account of any such unrelated obligations. No right of action will accrue on this Eond to any person or entity other than the Owner or its heirs, executors, administrators, successors, and assiSns. 10. The Surety hereby waives notice of any change, including changes of time, to the Construction Contract or to related subcontracts, purchase orders, and other obligations. 11. Any proceeding, letal or equitable, underthis Bond mustbe instituted in any court of com petent jurisdiction an the Iocation in which the work or part of the work is located and must be instituted within two years after a declaration of Contractor Default or within two years after the Contractor ceased working or within two years after the Surety refuses or fails to perform its obligations under this Bond, whichever occurs first. lf the provisions of this paragraph are void or prohibited by law, the minimum periods of limitations available to sureties as a defense in the jurisdiction of the suit will be applicable. 12. Notice to the Surety, the Owner, or the Contractor must be mailed or delivered to the address shown on th€ page on which their signature appears. 13. When this Bond has been furnished to comply with a statutory or other legal requirement in the location where the construction was to be performed, any provision in this Eond conflicting with said statutory or legal requirement will be deemed deleted therefrom and provisions conformint to such statutory or other leSal requirement will be deemed incorporated herein- When so furnished, the intent is that this Bond will be construed as a statutory bond and not as a common law bond. 14. Definitions Thi5 doc!ment rs a MODIFIED verlion of €ICDC' C-610, Copyrishto 2018 bY 9E, AC[C, and ASCE. All rithtt City of Columbia HeiShts - 24X.135228 June 2025 PERFORMANCE BOND fORM PAGE 00 61 13.13-3 14.1. Ealance of the Contract Price-The total amount payable by the Owner to the Contractor under the Construction Contract after all proper adjustments have been made including allowance for the Contractor for any amounts received or to be receaved by the Owner in settlement of insurance or other claims for damages to which the Contractor is entitled, reduced bv all valid and proper payments made to or on behalf of the Contractor under the Construction Contract. 14.2. Construction Contract-The aSreement between the Owner and Contractor identified on the cover page, including all Contract Oocuments and changes made to the agreement and the Contract Documents. 14.3. Contractor Default-Failure of the Contractor, which has not been remedied or waived, to perform or otherwise to comply with a material term of the Construction Contract. 14.4. Owner Default-tailure of the Owner, which has not been remedied or waived, to pay the Contractor as required under the Construction Contract or to perform and complete or comply with the other materaal terms of the Consiruction Contract. 14.5. Contract Documents-All the documents that comprise the agreement between the Owner and Contractor. 15. lf this Eond is issued for an agreement between a contractor and subcontractor, the term Contractor in this Eond will be deemed to be Subcontractor and the term Owner will be deemed to be Contractor. 16. Modlflcations to this Bond are as follows: None Thrs documeht rs a MODltltD versron of tlCDC. C,6 2018 by NSP[, ACEC, and ASCI. All City of Columbia Hei8hts - 24X.135228 June 2025 10, PERFORMANCE BOND FORM PAGE 00 61 13.13-4 -.TRAYELERSJ Travelers Casuslty and Surety Company of America Travelers casualty and Surety Company St. Paul Fire and Marine Insurance Company POVYER OF A'TORTEY Kilow aLL xE]{ BY THESE PRE8EUTS: That TrsvsloG Ca3ualty and Su.ety Company of America, TraveleG Casualty and suroty company, and sl under the lrws ol lhe Stale ol Conneclicul (herein colleclively colled lhePall Fire ard "Comparues'), Marine Inaur ard that enco co.noeny are co.po.atron6 duly dgenizGd do hereby mete, corEtrlute and eppolnt Carmlle M. Cruz lhoir fuo elld lsrvful Attsnoy(s)-in-FacI to stn. e)€cuto. 6srl ard ackno*ledge any and all bonds rocogniranc€s, cordilionel urdortekings and oth€r \iriling! obligaldy in lh€ halure lhoreot on bohalf d the Co lhe fide{ily d porsorig. ouarants€rno the peddnarte of cooaact! and exedring or guaranlo€lng boods arld hpaniea in lheh bLrshess ol gueranleehg undortatings required or pelmdlod ln any actioas d proc6€din!6 elorsd by levi tlt w|Tt|ESS WHeREOf. tho Compsd6 hrv€ caur€d lhi! inlbumorit lo bc !ion6d, trd th6k corporate.eals to b€ hereto aflixed, thb 2ln day of Aprll. m21. Staie oI Conneclicut Cily of Hartfo.d ss By Roberl aney, Senior Vbe Pre3idenl On this the 213t day ol Apdl. ar21. befo.6 me personally apgeared Rob.rt L. Ranoy. who &tnowledgsd himself lo be lhe Seorcr Vice Pre6donl ot eech ot the conpanie!, and lhst he. a3 !udl. b€ino authorized so to do. exgculed the fo.€going rnslrument td the puQces therein cootained by signrng on behalf of saicl Companies by hims€lt as a cluly authorized oflicet lN WTTNESS WHEREOF. I hereunlo sel my hand and offrctal seal. My Commi3sion expires the 30th day of Juno, 2026 Anna P Nowrk Notary Public This Power of Altomoy is 0ranted under and by lhe authority ol lhe fdlorving r6}oMior6 adopted by lh6 Boerds ot olr€dor8 c, each d lhe companies, *Ndr r€soltiorB are now in full tqce and droct. roedino as fdlori,s: RESOLVED. that tho Chahmon. the Pr€aid6r,t. eny Vic€ Chairman, ,ny Ex€cuuv6 Mcs Pr9gid€nl, any Senior Vico Pr6idert. eny Mce Prs!|ident. any S6cond Vtc6 Pr6sld6nl, lho Tr6e3ul6r, any Alr6tanl Tle'guler. the Co.porale Soc.elery or any Assislanl S€crstary may atpdnt AttorneF_in-Facl and Ag6nts to act tor and on bohstt ol the Company and msy giw suafi appoinlee sudr arrlhorily as hi3 o, her c€rlificate ot aulhority may pr6cribg to sign wrth ths Codpan/r narne ar|d seat y.ith he Company/B 66slbords, r6co0ni2anc6. coltt acls of indamniy. 8nd otlt€r wnlinC! abliost(y in the nalure d a bond. reco€ntzance. oa conditional undo.taking. and any of srid omc€rs or th6 Board d Dirrclo6 at any time may .amove any ludl appoinlee 3rd r6\oke the power gavtll him o. het; and it i5 FURTHER RESOLVEO. lhat lhc Chdrmen, the Prolideit, ,ny Vice Cnetrmen, any Execuliv€ Vic€ Presideol, 6ny Sono. Vice Pr€silknl oa any Vice Presidenl may d€tegals sll q any part of lh6 fdogoin! authority to one or more ofiic€.s d employ€€s ot this Company. providod lhal gach such delegatlon .r in wrilhg ,ncl a copy thoroof 13 filed in the dfice of tho S€crolty: and rt is FURTHER RESOLVED, thd eny bor6. rocognizanc€. contrecl c indomnity, or wriing obligato.y h lhe nalu.e of e boid. recogniaance. or cood,lonal underlaking shall b€ \6lid and bindinO Lpon lho Cdnpany when (a) 6rgn€d by tho F'rasid6nt, any Vice ChekmSn, any Ereclrtive Vice P.6denl, any Senior Vice President o. any Vic6 Prosident. any Second Vica Pr€3fir€nl, lhe Trea6urcr. sny Assaslanl Treasurq. the CoDorate Secr€l8ry or any Assistar Sdotery and duly .t!B.ted a.d lealed with lhe Companyb soal by a S€cr6l{y or tusbtant Serglary: or (b) duly ereculed (undor seal. it required) by one or mo.e Anomoy6-k-F&1 end Agonls pur$Ient to tha pow6r prescribGd in hi6 or he. c€,lifcale or thair c€nilicats of authonly or by one or mor6 Company oflic6{a puGuant to r wrilten deleOation d sulhorityi and it is FURTHER RESOLVED. thet th6 sttmtur6 of sach o, tho tollowno oflicsIs: Pro6rdenl, any Erecdlve Vice Pr6idenl, any Senior Mc€ Pre3ident. any Vice Pr6sidsn(, any asslstar{ Mc6 Prosid€nl, any S€crotery. eny Assisl$l Secrelary, ard lhe seal of the Company may be altxad b, facamtle to any Powor oa Attomoy o. to any co.dllcde rehtng theroto appolnllng Recldont Vice Prosidenta, R€8iden[ Assistar S*rste.ie6 or Allo.noya-in-Fact lor ptrpGoa only of 6x6culing and att€aling bonds ani underletinoa end other wriling3 obligatory i. th€ noluro tharcd. and eny such Powor ot Alifney o. c€rttfcae boaring auch faGimile 6i0ndurc or facsimile seal lhall be vald and bindlng upon lhe Company fd any sudr porvet 90 sxocutod and cert,fied by sudr fs3in 16 signEturE and tacsimile !6al shall be veld and binding on lhe Codrpany in lhe tuture with rcap€ct to 8ny bond (r udeBtaflding lo 'rhici il i6 attachsd. l, Klvln E. Hugho!. lhe undersroned. As66ta Sec,otary of 6eh oa th€ Companiss, do heBby cortify that tho abow arx, f(regoin0 i6 a lrue .rrd cqted copy o, lhe Pow6r of Aio.ney executed by rtid Companies. wiilch remahs in tull fdce end atfact o"t"c tt o 2ffi o"y ot June m25 , l(evin E H(4h Assastant Secrelary @ @ fo vcrity the .ulhenticiay o, lhis Pot tor o, Adomey, Plerao call ut at 1-800-121-3880. Prerse rotsr to t 16 ,Dovenamed Allomey(a)-in-F.cl aad lhe atatara ol the boad ao which lhia Power ol Altofiey ia .tLched. Bond Bond Amount; $8218,&t8.00 Oate of Bond: June 26th, 2025 (Ootc ol Bohd connot bc ca i.t thon tllcctive Dota ol Contrc.?) Modmcations to this Bond ,orm: E None O see Pa 18 ctor as Principal PAYMENT BOND FORM Contract Description Aorre dnd locdtionrj 2025 40th Avenue Utility lmprovements - Columbia Heithts, MN ContractPrice: 5848,848.00 Effective Date of Contract: 5/24/2025 Surety (Fu lormol node ol Suretyl lcotp.ote By, Name: 6s61116 g gr* (Printed or typedl By: Name: Title: Attest: Name: Title: nted or Title: Attest: Name: Title; ure) latza {Printed or Notes: (1) P@vAe supplemenlol execution by ony oddltionol Wfties, such os ioint venturers. (2) Any singulor relerence to Conttodor, Surcty. Owner, ot other gotv is conside.ed plurol wherc owlicoble. This document is a MODIFIED veriion of EJCDCT C-515,2018 by NSPE, ACEC, and AScE. All ri8hts rererved Contractor Namei A-1 Excavatin& LLC Mdress (pdncipal ploce oJ business)'. P.O. Box 90 Bloomer, Wl 54724 Surety Name: T.avsh6 Casurlty and SuEty Co6p.ny ol Amsri= Address lgrincipol ptoce of businessl'. One Tor/er Square Hartford, CT 06183 otrrner Name: City of Columbia HeiShts Mailing address /pr,n cipot ptoce ol business): 3989 Central Avenue NE Columbia Heights, MN 55421 Surety and Contractor, intendint to be legally bound hereby, subject to the terms set fonh in this Payment Bond, do each cause this Payment Bond to be duly executed by an authorized officer, agent, or representative. Y) City of Columbia Heights - 24X.135228 lune 2025 PAYMENT BOND FORM PAGE 00 61 13.16-1 1 2 3 4 5 6 7 The Contractor and Surety, jointly and severally, bind themselves, their heirs, executors, administrators, successors, and assiSns to the Owner to pay for labor, materials, and equipment furnished for use in the performance of the Construction Contract, which is incorporated herein by reference, sub.ied to the following terms. tf the Contractor promptly makes payment of all sums due to claimants, and defends, indemnifies, and holds harmless the Owner from claims, demands, liens, or suits by anY person or entity seeking payment for labor, materials, or equipment furnished for use in the performance of the Construction Contract, then the Surety and the Contractor shall have no obligation under this Bond. lf there is no Owner Oefault under the Construction Contract, the Surety's obliSation to the Owner under this Bond will arise after the Owner has promptly notified the Contractor and the Surety (at the address described in Paragraph 13) of claims, demands, liens, or suits against the owner or the owner's property by any person or entity seeking payment for labor, materials, or equipment furnished for use in the performance of the Construction Contract, and tendered defense of such claims, demands, liens, or suits to the Contractor and the Surety. When the Owner has satasfied the conditions in Paragraph 3, the Surety shall promptly and at the Surety's expense defend, indemnify, and hold harmless the Owner aSainst a duly tendered claim, demand, lien, or suit. The surety's obligations to a claimant under this Bond will arise after the followinS: 5.1. Claimants who do not have a direct contract with the Contrador 5.1.1. have furnished a written notice of non-payment to the Contractor, statinS with substantial accuracy the amount claimed and the name of the party to whom the materials were, or equipment was, fumished or supplied or for whom the labor was done or performed, within ninety (90) days after having last performed labor or last furnished materials or equipment included in the Claim; and 5.1.2- have sent a Claim to the Surety {at the address described in ParaBraph 13}. 5.2. Claimants who are employed by or have a direct contract with the Contractor have sent a Claim to the Surety (at the address described in Paragraph 13). lf a notice of non-paymeQt required by Paragraph 5.1.1 is Siven by the Owner to the Contractor, that is sufficient to satisfy a Claimant's oblitation to furnish a written notice of non-payment under Paragraph 5.1 1 When a Claimant has satisfied the conditions of Paragraph 5.1 or 5.2, whichever is applicable, the surety shall promptly and at the Surety's expense take the following actions: 7.1. Send an answer to the Claimant, with a copy to the Owner, within sixty (60) days after receipt of the Claim, stating the amounts that are undisputed and the basis for challenSing any amounts that are disputed; and 7.2. Pay or arranSe for payment of any undisputed amounts. 7.3. The Surety's failure to discharge its obliSations under Paragraph 7 .7 or 7.2 will not be deemed to constitute a waiver of defenses the Surety or Contractor may have or acquire as to a Claim, except as to undisputed amounts for which the Surety and Claimant have reached agreement. lf, however, the Surety fails to discharge its obllgations under Paragraph 7.! or 7.2, the Surety shall indemnify the Claimant for the reasonable attorney's fees the Claimant incurs thereafter to recover any sums found to be due and owing to the claimant. City of Columbia Heithts - 24X.135228 June 2025 Allrlthts reserved- _ PAYMENT BOND FORM PAGE 00 61 13.16-2 Thls document ii a MOOIFIEO version of IICDC'C-515, CopYtiShto 2018 bYNSPE, ACEC, and ASCE. Thrs document rt a MODIFIEO version of EJCDC. C-615 by NSPE, ACEC, and ASCI. All ri8hts reserved City of Columbia HeiShtr - 24X.135228 lune 2O2S , CopvrightO 2018 PAYM€NT BOND FORM PAGE 00 61 13.15-3 8. The Surety's total obligation will not exceed the amount of this Bond, plus the amount of reasonable attorney's fees provided under Paragraph 7.3, and the amount of this Bond will be credited for any payments made in good faith by the Surety. 9. Amounts owed bY the Owner to the Contractor under the Construction Contract will be used for the performance of the Construction Contract and to satisfy claims, if any, under any construction performance bond. By the Contractor furnishing and the Owner accepting this Bond, they agree that all funds earned by the Contractor in the performance ofthe Construction Contract are dedicated to satisfyint obliBations ofthe Contractor and Surety under this Bond, subject to the Owner's priority to use the funds for the completion of the work. 10. The Surety shall not be liable to the Owner, Claimants, or others for obliSations of the Contractor that are unrelated to the Construction Contract. The Owner shall not be liable for the payment of any costs or expenses of any Claimant under this Bond and shall have under this Bond no obligation to make payments to or Sive notice on behalf of Claimants, or otherwise have any obligations to Claimants under this Bond. 11. The Surety hereby waives notice of any change, including changes of time, to the Construction Contract or to related subcontracts, purchase orders, and other obligations. 12. No suit or action will be commenced by a Claimant under this Bond oth€r than in a court of competent iurisdiction in the state in which the project that is the subject of the Construction Contract is located or after the expiration of one year from the date (1) on which the Claimant sent a Claim to the Surety pursuant to Paragraph 5.1.2 or 5.2, or (2) on which the last labor or service was performed by anyone or the last materials or equipment were furnished by anyone under the Construction Contract, whichever of (1) or (2) first occurs. lf the provisions of this para8raph are void or prohibited by law, the minimum period of limitation available to sureties as a defense in the jurisdiction of the suit will be applicable. 13. Notice and Claims to the Surety, the Owner, or the Contractor must be mailed or delivered to the address shown on the page on which their signature appears. Actual receipt of notice or Claims, however accomplished, will be sufficient compliance as of the date re€eived. 14. When this Bond has been furnished to comply with a statutory or other legal requirement in the location where the construction was to be performed, any provision in this Bond conflicting with said statutory or legal requirement will be deemed deleted here from and provisions conforming to such statutory or other legal requirement will be deemed incorporated herein. When so furnished, the intent is that this Bond will be construed as a statutory bond and not as a common law bond. 15. Upon requests by any person or entity appearing to be a potential benefaciary of this Bond, the Contractor and Owner shall promptly furnish a copy of this Bond or shall permit a copy to be made. 15. Definitions 16.1. Claim-A written statement by the Claimant including at a minimum: 16.1.1. The name ofthe Claimant; 16.1.2. The name of the person for whom the labor was done, or materials or equipment furnished; 15.1.3. A copy of the agreement or purchase order pursuant to which labor, materials, or equipment was furnished for use in the performance of the Construction Contract; 16.1.4, A brief description ofthe labor, materials, or equipment furnished; 17 18 16.1.5. The date on which the Claimant last performed labor or last furnished materials or equipment for use in the performance of the Construction Contract; 16.1,6. The total amount earned bY the Claimant for labor, materials, or equipment furnished as of the date of the Claim; 16.1.7. The total amount of previous payments received bytheClaimant; and 16.1.8. The totalamount due and unpaid to the Claimant for labor, materials, or equipment furnished as of the date of the claim, 16.2. Clalmant-An individual or entity having a direct contract with the Contractor or with a subcontractor of the Contractor to furnish labor, materials, or equipment for use in the performance of the Construction Contract. The term Claimant also includes any individual or entity that has rightfully asserted a claim under an applicable mechanic's lien or similar statute a8ainst the real property upon which the Proiect is located. The intent of this Bond is to include without limitation in the terms of 'labor, materials, or equipment" that part of the water, 8as, power, li8ht, heat, oil, Sasoline, telephone service, or rental equipment used in the Construction Contract, architectural and enSineering services required for performance of the work of the Contractor and the Contractot's subcontractors, and all other items for which a mechanic's lien may be asserted in the jurisdiction where the labor, materials, or equipment were furnished. 16.3. Construction Contract-The agreement between the Owner and Contractor identified on the cover page, including all Contract Oocuments and all changes made to the agreement and the contract Documents. 15.4. Owner Defauh-Failure of the Owner, which has not been remedied or waived, to pay the Contractor as required under the Construction Contract or to perform and complete or comply with the other material terms of the Construction Contract. 16.5. Contract Documents-All the documents that comprise the agreement between the Owner and Contractor. lf this Bond is issued for an agreement between a contractor and subcontractor, the term Contractor in this Bond will be deemed to be Subcontractor and the term Owner will be deemed to be Contractor. Modifications to this Bond are as follows: l{one This document rs a MODIFIED version of EICDC' C-615, C ht@ 2018 by NSPt, ACtC, and ASCE. All riShts reserved City of Columbia HeiShts - 24X.135228 lune 2025 PAYMENT BOND FORM PAGE 00 61 13.16-4 .-, TRAYETERSJ Trayelers Casualty and Surety Company of America Travelers Casualty and Surety Company St. Paul Fire and Marine Insurance Company K'{OW ALL llE { 8Y THESE PRESEiITS Thst Travelers POWER OF ATTORI{EY Ca3uany aad Slr€ty Company of Amerba. Trsvdol! C6udty and Surety Corrpany, 8nd St PaJl Fare and MEdne ln3urance Compeny a.e corp orations duly oaganized under lh€ laws ol th6 State ot Conn@licut (hor€in cotloctivsty csttort lho 'ColrDern€6') Atlanla th€ Comoa Georqra nies do h€r6by make. corEtitlrt€ ard appoht lhsr lrue and lawful Attorney(6)-in-Fsct lo 6Dn, 6xocute. s6d ard actnowtedgo any aod att bonds, ard lhal Carmlle M Cruz recognizenceS. condilional underlakings and olher writing! ouoatfiy in tha nelura th6r6o, on bohatf d tho Compa 6s in their bus,n66s of gusI.ntso g the fid€lity of p€.sons. guarante€rng the perfo.marce d confacts and ercqrting ol guarame€iog bond6 and uidgnekings .equked or p€rmilt€d in eny ectiorE r proc€€dings elowed by law lil WITiIESS WHEREOF. lhe Compenics have ca6ed th.6 lnstrumeni lo be signod. eM thear c@poaate soals lo be heroto effixod. this 21!l day of Apill. 2021. Stdg o, Conn€clicut Crty of Ha.tford $. By Roberl , Sonior Vic€ Pr6denl lN W]TNESS YVIIEREOF, I hereunlo sel my hand and officEt seat My Commlsrlon cxpirca the 3oth day of JunG, Z126 Anna P. Nowik, Notry Public FURTHER RESOLVEO. lhd any bond. recognizance, contracl of indemnily, o. wriling obllCalo.y h lh6 nalur€ ol s bond. r6co0r zanc€. or cqtltional l"ndslakim shall be volid ard Undhg r4o.r tho Coanpany \rhen (s) 6ign€d by lhs Pr€.idort, any Vrc6 Chaiman. any Exoculi\re Vrce Presid6nl, any SGr oa Vico Ft€sidgnl o. any Vic€ Pr6aadonl. any Socond Vlco Presadenl, tho Treasuler. any Agsiltant Trea6urr, the Coryorate Secretary or sny Assistant S€crela,y ard duly attBted 8nd sotl€d with the Companyl 6eal by a Seretaay o. Arsidanl Secr€taryi or (b) duly erecutod (und€a Beat. if required) by ooe or mo(e Aiomey!-in-Facl and Agonts ptnsuanl lo h€ poNaa pr€acribad in hig or hor clrtificate or lhah 66rt'ficalos of tuthonty or by one oa more Company dcss pu.suanl to s writlon dslegation oa autho.ity: and it is FURTHER REEOLVEO. that lho signsture ot eeh ot th6 following ollic.lsr Prosll€nl. sny Execdive Vace Pr6ider{. any S6nior Vic€ Pr6.id€nt, any Vrca Presrdern. afiy As$stant Vic6 Prcsdent. arry Secr6tary. any Assi6trlt S6crela.y. ard lhe lcd d the Comps.y may be alfired by facrm o to any Pow€. oa Allo,ney ( lo any corlificslo rslating lh€roto sppointing Ro6id6nt Mce Pr6aidontB, R€aidenl Assistant Sec.€lari6s or Atlo.noy8-in-Fecl faprfpc6 only of oEaulirg ard attostiig bon& and und6rlsling6 and ofEr wrilinls obfigatory in ths naturs thersd, ard any sudl Porver ot Auqney or cedificdg baaring 8(rch lacaimile signaluro or fecsimile Bgal 6118ll bo valid ard binding upon lh6 Cornpany and eny audr powsr 5o €xgcutod and cortiried by sudr facaimile sionatuto anal l.E6imiie soal shall be v8[d ard bindhg on lha Cornpeny in ths firturo wilh respecl to eny bond or wdoGtanding lo whidr it k afiacJ|Ed. l, Kgvh E. Hughea. lh6 undsr6igned. Asaistafll Secratary of 6ach oa lho Companies. do horeby c€riily thal lh€ abo\6 and to€going 6 a trus and ccrect copy ol th€ Posror of Altdnoy €rccuted by said Comp6ni6. which romein3 in tull to.E€ ard df61. od€d thb th d., d June 2025 Thi6 PoNer ot Atlornoy l8 granled under and by lhe aulhority ot the followlnC resolutiorB adopted by lhe Boards ot oheclorE of oacfi o{ lhe Comprnt€s, whidr resobliorE are noi in tullldco and €ffecl, rrading as fdlo s: RESOLVEO. th3l the Chaiman. lhe Pr€sider{, any Vias Chairman, any ExocutNe Vice Pr6sident. any Sedor Mce Pr6idoit. any Vtc€ presadont, any Socond Mce P.esidsnt, lhe Troaa6er.iny As3iSlanl Treasuror, the Cuporate Sedetary or any ASsistant S,ecretary nay appoint Attorn€F-in-Facl and AOonts lo ad ro. and oo bohalf of tho Compeny and may giv€ 6r.E,1 eppont6e sudr aulhdity e6 hb o her cqtifraie d;titiority may pnitcriue to srgn tuth the CorYpgn),r6 ntrne srd 6oal wlh th€ Cornpan)/s seal borus, r6cognizsnc66. conlGcls d hdomnity, 6nd cih€r wntngs dligatoai in lhe nature o{ a tond, recogdzenc€, or condilional undeatrking, and any of sekJ dfic€rs q lhe Board ot Dtrecto.s al any lime may remols ant suart appointee and ro\ole lho pow6r giv€i hiln or her; and il is FTRTHER RESOLVED, thrl lhO Chriman, th6 Pr63id6rn. any Vics C,heirmen. rny Erecuthre Vice presideri, any Senior Vic6 pr6airOnt or eny Vlce Pr€8k gnl may delegato all r sny parl otthe fo.egoino suthority to on€ or mds offics6 o. omployo€6 dthis Company, providod lhsl sach such delegalion 19 in witing arld a copy tho(eo, is fiH in the olfice ol the S€crota.yi and it is lo vedly the arahen clu ol thla Powar ol Aftomay, please call us st ,-8M121-3880. Plo.e. rd..lothc .bov..n. e.t Aflomey(s)-ln-Fzcl tnd lhe.t tals d dro boad to whtch thL Power ol Attomey ls tttache<t O,nlhas lhe 21 day ofAprll,2021. befo.e m€ peraon€lly appoered Robe L. Raney, who acknowledg€d himselfto be lhe S6nro. Vice prssdent ot each of tho Conpani€s. end lhel ho, as 8udt, being autho.rzsd so to do. ex6cuted the f;egoing tnslrument ld the purpGes lherein cmtained by signing on beheff ot said Compeniss by himsdf 6 a duly suthorEed offc€r. /*' {, Kovin E Hughes:Asshltrl S€cretsry GT