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Home My WebLink About4965 Contract Number: 4965 Vendor: JANSEN, INC. Subject: Wheaton Way /Schley Canyon Slope Repair Department: Engineering File Class: LEG 12 -1 Begin Date: 9/10/2010 End Date: 12/31/2010 Review Date: 12/1/2010 Vault Date: Comments: Change Order #1- 12/10; Notice of Completion 12/10/2010 AFFIDAVIT OF PUBLICATION Account #42742 AD #267618 (2010813 1) STATE OF WASHINGTON COUNTY OF KITSAP I, Laura Wessels, being first duly sworn on oath, deposes and says That she is now, and at all times embraced in the publication herein mentioned was the principal clerk of the printers and publishers of KITSAP SUN, that said newspaper has been approved as a legal newspaper by order of the Superior Court of the County of Kitsap, in which County it is published and is now and has been for more than six months prior to the date of the publication hereinafter referred to, published in the English language continually as a daily newspaper in Bremerton, Kitsap County, Washington, a weekly newspaper in Kitsap County, Washington and is now and during all of said time, was printed in an office maintained in the aforesaid place of publication of said newspaper, that the following is a true text of an advertisement as it was published in regular issues (and not in supplement form) of said newspaper on the following date, to wit And on December 10, 2010 such newspaper was regularly distributed to its subscribers during all of said period The full amount of the fee charged for the foregoing publication is the sum of $39 86 This amount has not been paid in full ___J YJJ'44 0 1 0 (Signature of Principal Clerk) Subscribed and sworn to before me this day of December 30, 2010 e_�v Notary Public in and for the State of Washington, Kitsap C my NOTICE OF COMPLETION TF 11OF Notice of Completion has been issued to Jansen, Inc, Protect No 10257 for the Wheaton Way /Schley Canyon Slope Repair Any parties having a claim for material, labor or damages related to this Contract have forty -five (45) days from the date of first publication of this notice to file a claim Carol Etgen City Clerk 345 6th Street, Suite 600 Bremerton, WA 98337 December 10, 2010 Ad #20108131 Contract Number: 4965 Vendor: JANSEN, INC. Subject: Wheaton Way /Schley Canyon Slope Repair Department: Engineering File Class: LEG 12 -1 Begin Date: 9/10/2010 End Date: 12/31/2010 Review Date: 12/1/2010 Vault Date: 1/1/2012 Comments: Change Order #1- 12/10; Notice of Completion 12/2010 ACCEPTANCE OF COMPENSATION & RELEASE OF ALL CLAIMS Wheaton Way /Schley Canyon Slope Repair Contract No. TA 3704 Jansen Inc. hereby indicates agreement with, and acceptance of, the final Progress Payment of $18,137.72, the total Contract Price of $230,721.50 including Washington State sales and/or use taxes, and the final Contract Time of 20 worldng days, as full and final compensation for all Work performed in connection with Contract No. TA 3704, and does hereby release the City of Bremerton from all claims, liens, liability, demands, damages and actions of any kind whatsoever, arising from performance of the Contract. Jansen Inc. By: '� Date: D Title, V i cr- pre - do' &-( Certificate of Notary Subscribed and sworn to before me this c�� slay of b t' , �v l /(,( 6, d0 NOTARY PUBLIC STATE OF WASHINGTON HEATHER M. RADKE nay Appointment Expires JUN 2, 2014 Washington State D p it nxnc of Department of Revenue eevenue W Box 47474 Olympia, WA 98504 -7474 600 039 614 Certificate of Payment of State Excise Taxes by Public Works Contractor JANSEN INC CITY OF BREMERTON 2110 BUCHANAN LOOP STE 1 EDUARDO ABAN FERNDALE WA 98248 9801 3027 OLYMPUS DR BREMERTON WA 98310 We hereby certify that taxes, increases and penalties due or to become due from the above -named contractor under Chapter 180, Laws of 1935, as amended, with respect to the following public works contract CITY OF BREMERTON TA 3704, WHEATON WAY / SCHLEY CANYON SLOPE REPAIR together with all other taxes, increases and penalties due from such contractor, have been paid in full or that they are, in the Department's opinion, readily collectible without recourse to the state's lien on the retained percentage This certificate is issued pursuant to the provision of Chapter 60 28 Revised Code of Washington for the sole purpose of informing the state, county, or municipal officer charged with the duty of disbursing or authorizing the payment of public funds to said contractor that the Department of Revenue hereby releases the state's lien on the retained percentage provided by this Chapter for excise taxes due from said contractor This certificate does not release said contractor from liability for additional tax that may be later determined to be due with respect to the above - mentioned contract or other activities Dated O 1126 f ( at Olympia, Washington, State of Washington Departm f Revenue Ceriifymg Officer For tax assistance, visit dor wa gov or call 1- 800- 647 -7706 To inquire about the availability of this document in an alternate format for the visually impaired , please call (360) 705 -6715 Teletype (TTY) users may call 1- 800 - 451 -7985 i REV 310028 (10- 01 -02) sTerF O� o � eY 18 BB STATE OF WASHINGTON DEPARTMENT OF LABOR AND INDUSTRS CITY OF BREMERTON rEB3 7 2 ] ATTN: EDUARDO ABAN PE 3027 OLYMPUS DRIVE ►0 ERIN.Cw1� BREMERTON WA 98310 Certificate of Release of the State's Lien on Public Works Contracts With this letter, the Washington State Department of Labor & Industries approves of your release or payment of the contract amount retained from the following contractor - -- JANSEN INC 282,491 -00 600 039 614 2110 BUCHANAN LOOP FERNDALE WA 98248 -9801 - -- related to the following public works contract: WHEATON WAY SCHLEY CANYON SLOPE REPAIR TA 3704 This approval is for workers' compensation insurance premiums only. L &I's prevailing wage section separately requires all contractors on the Project file an affidavit of wages paid. These affidavits must be approved before retainage can be released. In our opinion, all workers' compensation insurance premiums, increases, and penalties due to L &I from this contractor have been paid in full or are readily collectible without recourse to the state's lien on the retained percentage. ** This letter's sole purpose is to communicate our release of the state's lien to the public official responsible for paying or authorizing the payment of public funds to the contractor named above. If we later determine that the contractor owes additional premiums related to the above - mentioned contract or other activities, the contractor is still liable for payment. Dated February 14, 2011 at Olympia, Washington. ae#%, Co t c el ase pecialist PATRICIA MCLAIN 360 - 902 -5385 or MCLP235@LNI.WA.GOV ** Title 51 RCW authorizes L &I to collect workers' compensation insurance premiums, increases, and penalties. Chapter 60.28 RCW establishes L &I's priority regarding this lien. Chapter 39.12 RCW addresses L &I's requirement for affidavits of wages paid. .l ANNE , Employment Security Department WASHINGTON STATE CONTRACTOR JANSEN INC ) CERTIFICATE OF 2110 BUCHANAN LOOP STE 1 ) PAYMENT OF CONTRIBUTIONS FERNDALE, WA 98248 ) PENALTIES AND INTEREST ON PUBLIC WORKS CONTRACT ES Reference No 33806000 2 TO CITY OF BREMERTON 3027 OLYMPUS DR BREMERTON, WA 98310 p 4 The Employment Security Department hereby certifies those contributions, penalties and interest due from the above named contractor under the Employment Security Act have been paid in full or provided for with respect to the following public works contract TA 3704 The Employment Security Department hereby certifies that it has no claim pursuant to RCW 50 24 130 against the public body named above for tax attributable to service performed for said public body by the above named contractor on the above described contract The Employment Security Department releases its lien on the retained percentage, which is provided by RCW 60 28 040 for contributions, penalties and interest due from said contractor This certificate does not release said contractor from liability for additional contributions, penalties and interest which may be later determined to be due with respect to the above mentioned contract Dated at Olympia, Washington on February 4, 2011 CO MISSIONER EMPLO M ECURITY DEPA MENT By uthorized Represe tative) Original— Disbursing Officer Duplicate — Employer Triplicate -- Central Office Files EMS 8449 760 R3 -98 . r AFFIDAVIT OF PUBLICATION Account #42742 AD #267618 (2010813 1) STATE OF WASHINGTON COUNTY OF KITSAP I, Laura Wessels, being first duly sworn on oath, deposes and says That she is now, and at all times embraced in the publication herein mentioned was the principal clerk of the printers and publishers of KITSAP SUN, that said newspaper has been approved as a legal newspaper by order of the Superior Court of the County of Kitsap, in which County it is published and is now and has been for more than six months prior to the date of the publication hereinafter referred to, published in the English language continually as a daily newspaper in Bremerton, Kitsap County, Washington, a weekly newspaper in Kitsap County, Washington and is now and during all of said time, was printed in an office maintained in the aforesaid place of publication of said newspaper, that the following is a true text of an advertisement as it was published in regular issues (and not in supplement form) of said newspaper on the following date, to wit And on December 10, 2010 such newspaper was regularly distributed to its subscribers during all of said period The full amount of the fee charged for the foregoing publication is the sum of $39 86 This amount has not been paid in full (Signature of Principal Clerk) Subscribed and sworn to before me this day of December 30, 2010 MO FF /T�''��. .h ' c �� • ;'y am . Notary Public in and for the State of Washington, Kitsap Co my CC* NOTICE OF COMPLETION 0f:;�1P�•° Notice of Completion has been issued to Jansen, Inc, Project No 10257 for the Wheaton Way /Schley Canyon Slope Repair Any parties having a claim for material, labor or damages related to this Contract have forty -five (45) days from the date of first publication of this notice to file a claim Carol Etgen City Clerk 345 6th Street, Suite 600 Bremerton, WA 98337 December 10, 2010 Ad #20108131 i I I - I I i i Contract Number: 4965 Vendor: JANSEN, INC. Subject: Wheaton Way/Schley Canyon Slope Repair Department: Engineering File Class: LEG 12-1 Begin Date: 9/10/2010 End Date: 12/31/2010 Review Date: 12/1/2010 Vault Date: Comments: Change Order #1-12/10 MEMORANDUM ENGINEERING DIVISION TO: Mayor Patty Lent � FROM: Eduardo Aban DATE: December 2, 2010 SUBJ: Wheaton Way/Schley Canyon Slope Repair Change Order 1 Please see attached Change Order 1 for the Schley Canyon Slope Repair at Wheaton Way. The total increase is $6,087.31, which is 2.71 percent of the Contract amount. This increase was significantly influenced by the changes in the pavement removal and repaving. These changes were necessary because the pavement condition was worse when the removal was implemented in preparation for the repaving. More areas of cracking had developed in the pavement, and it � became necessary to replace the pavement in these areas. Please see attached drawing Because of the increase in the quantity of asphalt by more 25 %, I negotiated the original contract price of $347/ton down to $283.81/ton. This reduction in price is about 18.21%. , The revised Contract amount of $230,721.53 shown on the Change Order form is well below the total budget of $655,000.00. This is funded by FHWA, and the City's share for this additional cost is 13.5 percent of $6,08'7.31 which amounts to $821.79. Please let me know if you need additional information or further explanation to this change order. ' � CITY OF BREMERTON CHANGE ORDER CONTRACT CHANGE ORDER NO: 1 PROJECT NAME: Wheaton Way/Schley Canyon Slope Repair PROJECT NO: 10257 CONTRACTOR: Jansen, Inc. ORIGINAL CONTRACT AMOUNT: $224,634.22 DAYS: 20 PREVIOUSLY APPROVED CHANGES: $0.00 DAYS: THIS CHANGE: $6,087.31 DAYS: REVISED CONTRACT AMOUNT: $230,721.53 DAYS: This Change Order covers changes to the subject contract as described herein. The Contractor shail construct, furnish equipment and materials, and perform all work as necessary or required to compiete the Change Order Items. The increase or decrease in contract price shown below includes any applicable taxes. DESCRIPTION OF CHANGES INCREASE IN (DECREASE) IN CONTRACT ' CONTRACT CONTRACT TIME � � AMOUNT AMOUNT EXTENSION � � °' °—' ($) ($) (DAYS) > > � � X 1. Increase in Quantities Description These are Contract bid items where the estimated quantities increased, as follows: 1.1 Sawcutting The increase in quantity for this item was due to more broken asphalt pavement than estimated at the time of plan preparation that needed to be removed and replaced. The increase in quantity is from SO linear feet to 126 linear feet. - The additional cost is 761inear feet at $11.50/LF. $874.00 1.2 Remove Asphalt Concrete Pavement The increase in quantity is due to more broken asphalt pavement than estimated at the time of plan preparation within the shoulder area during construction. The increase in quantity is from 34 square yards to 94 square yards. The additional cost is 60 square yards at $42.25/SY. $2,535.00 1.3 HMA CL yz Inch, PG 64-22 The increase in quantity is due to the replacement of more broken asphalt pavement than estimated at the time of plan preparation within the shoulder area during construction. The increase in quantity is from 25 tons to 80.26 tons. The additional cost is 55.26 tons at $283.81/TON. $15,68337 1.4 Crushed Surfacing Base Course The increase on this item is not significant since this was only used on the area of the slide. The increase in quantity is from 30 tons to 33.14 tons. T'he additional cost is 3.14 tons at $73.05/TON. $229.38 1.5 Paint Line The increase in quantity is due to the repainting of the existing pavement lines that were already faded and do not meet MUTCD uidelines. T'he increase in uanti is from CONTRACT CHANGE ORDER NO: � PROJECT NAME: Wheaton Way/Schley Canyon Slope Repair 1501inear feet to 6731inear feet. The additional cost is 523 linear feet at $1.50/LF. $784.50 X 2. Decrease in Quantities Description These are Contract bid items where the estimated quantities decreased, as follows: 2.1 Structure Ezcavation Class A Including Haul T'he decrease in quantity is from 409 cubic yards to 300 cubic yards. The decrease in cost is 109 cubic yards at $28.90/CY. ($3,150.10) 2.2 Raised Pavement Marker Type 1 This item was not installed. T'he decrease in cost is 0.58 per hundred at $1,016.15/HLJND. ($589.37) 2.3 Corrugated HDPE Culvert Pipe, 3�Inch Diameter The decrease in quantity is from 301inear feet to 201inear feet. The decrease in cost is lO lineaz feet @$177.50/LF. ($1,775.00) , 2.4 Quarry Spalls The decrease in quantity is from 1,800 tons to 1,718.99 tons. The decrease in cost is 81.01 tons at $24.90/TON. ($2,017.15) 2.5 Gnbion Cribbing The decrease in quantity is from 239 cubic yards to 211 cubic yards. The decrease in cost is 28 cubic yards at $$211.10/CY. ($5,910.80) 2.6 Construction Geoteztile The decrease in quantity is from 61 square yards to 53.27 square yards. The decrease in cost is 7.73 square yards at $26.75/SY. ($206.78) 2.7 Eztruded Curb The decrease in quanrity is from 1501ineaz feet to 1381inear feet. The decrease in cost is 121inear feet at $8.90/LF ($106.80) 2.8 Raised Pavement Marker Type 2. The decrease in quantity is from 18 per hundred to 10 per hundred. The decrease in cost is 8/100 at $$3,274.30/HUND. ($261.94) 2.9 Minor Changes No work accounted as minor change. T'he decrease in cost is $1.00. ($1.00) NET CHANGE IN CONTRACT AMOUNT , $20,106.25 ($14,018.94) INCREASE OR (DECREASE) Contractor acknowledges and accepts that this Change Order constitutes final settlement of all claims of any kind or nature arising from or connected with any work either covered or affected by this Change Order, including, without limitation, claims related to contract time, on-site or home office overhead, or lost profits. Nothing in �this Change Order shall limit the City's right to bring a claim for past perFormance. The undersigned Contractor approves the foregoing Change Order as to the changes, if any, in the contract price specified for each item, including any and all supervision costs and other miscellaneous costs relating to the change in work, and as to the extension of time allowed, if any, for completion of the entire work due to said Change Order. Page 2 of 3 CONTRACT CHANGE ORDER NO: 1 PROJECT NAME: Wheaton Way/Schley Canyon Slope Repair This document will become a supplement of the contract and all provisions will apply hereto. It is understood that this Change Order shall be effective when approved by the City of Bremerton. The parties whose names appear below warrant that they are authorized to enter into a change order that is binding on the parties of this contract. In addition, Contractor warrants that it has or will inform the surety of this change, and shall take appropriate action to modify any bonds required under the contract to address this change. RECOMMENDED: �%`G3� C�i�--�' !///�/fi� PROJECT ENGINEER Date RECOMMENDED: ��i�?-�" `— ' � CITY ENGIN R/ DIRECTOR OF PUBLIC WORKS Date ACCEPTED: �1 3� )� CONTRAC R � Date APPROVED: lZ `' Z `� v MAYOR Date APPROVED AS TO FORM: ATTEST: ��/� � Bremerton City Attorney ity Clerk Page 3 of 3 . Contract Number: 4965 , Vendor: Subject: Department: File Class: Begin Date: End Date: Review Date: Vault Date: Jansen, Inc. Wheaton Way/Schley Canyon Slope Repair Engineering LEG 12-1 9/10/2010 12/31/2010 12/1/2010 Comments: � � � � � co�rr�c� CITY OF BRENNIEERTON, KITSAP COUNTY, WASHINGTON THIS AGREEMENT, made and entered into this j��i.. day of SP.��'• , 20 t D, between the City of Bremerton under and by virtue of Title 35 RCW (cities) as amended, and ,Tanseo, Inc. hereinafter called the Contractor. WITNESSETH: That in consideration of the terms and conditions contained herein and attached and made a part of this ageement, the parties hereto covenant and agree as follows: I. The Contractor shall do all work and furnish all tools materials and e ui ment for the � q P , Wheaton Way/Schley Canyon Slope Repair, in accordance with and as described in the attached Plans and Specifications, and the 2010 Standard Specifications of the Washington State Deparhnent of Transportation which are by this reference incorporated herein and made part hereof and shall perform any changes in the work in accord with the Contract Documents. The Contractor shall provide and bear the expense of all equipment, work, and labor, of any sort whatsoever that may be required for the transfer of materials and for constructing and completing the work provided for in these Contract Documents except those items mentioned therein to be furnished by the City of Bremerton. � II. The City of Bremerton hereby contracts with Contractor and Contractor hereby agrees � to provide the materials and to do and cause to be done the above described work and to complete and finish the same in accord with the attached Plans and Specifications and the terms and conditions herein contained and hereby Contracts to pay for the same according to the attached specifications and the schedule of unit or itemized prices at the time and in the manner and upon the conditions provided for in this Contract. ��`� � �� III. The Contractor is and shall be at all times acting as an independent contractor and not as an employee of the City. The Contractor shall secure at its expense, and shall be responsible for all payments of income tax, social security, state industrial insurance compensation, unemployment compensation, and all other payroll deductions for the Contractor, officer, agents, employees and sub-contractors. The Contractor shall also secure all applicable business licenses, if required, in connection with the contract services, including all required licenses for Contractor's officers, agents, employees and subcontractors. IV. The Contractor for himself/herself, and for his/her heirs, executors, administrators, successors, assigns, does hereby agree to the full performance of all the covenants herein contained upon the part of the Contractor. � V. It is further provided that no liability shall attach to the City of Bremerton by reason of entering into this Contract, except as provided herein. � City ofBremerton Wheaton Way/Schley Carryon Slope Repair LD-13 June 2010 , �` �' G �. � � � 1 t+ � r e !� r � , �. � � L! �. � :� �; !Q 1 �� VI. INDEMNg'ICATION. Contractor shall defend, indemnify and hold the City, its officers, officials, employees, agents and volunteers harmless from any and all claims, injuries, damages, losses or suits including all lega.l cost and attorney fees, azising out of or in connection with the performance of this agreement, except for injuries and damages solely caused by the City's negligence. • The City's inspection or acceptance of any of Contractor's work when completed shall not be grounds to avoid any of these covenants of indemnification. Should a court of competent jurisdiction determine that this agreement is subject to RCW 4.24.115, then, in the event of liability for damages azising out of bodily injury to persons or damages to property caused by or resulting from the concurrent negligence of the Contractor and the City, its officials, employees, agents and volunteers, the Contractor's liability hereunder shall be only to the extent of the Contractor's negligence. IT TS FUR'THER SPECIFICALLY AND EXPRESSLY LTNDERSTOOD THAT THIS INDEMNIFICATION CONSITUTES THE CONTRACTOR'S WAIVER OF TNIlViUNITY UNDER INDUSTRIAL INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSE OF THIS INDEMNIFICATION. TI-� PAR'TIES ACKNOWLEDGE THAT THEY HAVE MUTUALLY NEGOTIATED THIS WAIVER. The provisions of this section shall survive the expiration of termination of this agreement. IN WITNESS WE�REOF, the Contractor has executed this instrument, on the day and year fust below written and the Loca1 Agency Approving Authority has caused this instrument to be executed by and in the name of said City of Bremerton the day and year first above written. Y'h Executed by the Contractor this � day of � � 20 �� -�— �am��n 1�n� V. P. Contractor Executed by the Local Agency this _� day of ��►�'l �� 20�. (SEAL) City of Bremerton Wheaton Way/Schley Carryon Slope Repair � � O!� City of emerton Approving Authority C � City of Bremerton Attorney LD-14 June 2010 � Bond No. 20-SUR-208465 t ,l (: `, .�� ' `.'; �HA J[ �� A'!L' L�l�'J18H lll`C� RAA A{7�A �YJ� 9��IJ1d3J.11171 Vl'Y KNOW AI.I, MFN AY 'I'HESE PRTSENTS: 't'hat Jansen, Inc . , af Ferndale, Wa� . i n.g..t9sL_, as PI'lt]Clj)c��, all(� American Safetv Casualtv =m�urance com�any�: as Snrety, are�ou�tly and sevcral(y hcld and bound unto TI�IT: CT1'Y OF BREI�lEItTON, the pennl stun of Two Hundred *1�ollars ($2 24 . 6 3 4..2,�? , for the paymcnt ofwhich we jointly a��d severaliy bind ourselves, or heirs, execirtors, administrators, and assigns, and successors and assigns, finnly by tliesc presents. *Twenty Thousand Six Hundred Thirty and 22/100 The condition of this bond is such that 17VHEREAS, on the 2 nd ^__ day of Sepr,,.�,.IIikzer , A.D., 2010 , tiie said Jansen, Inc .__ __ , F'rincipal herein, exec��ted a certain Contract with the City ofBreinerton, by the terrns, eonditions and provisions ofwhieh Coutract the said Jans en , Inc . ,1'rincipal herewitli, agrees to fumish all m�terials a�id do certain wot�k, to-wit: That the said Principal herein wi11 undertake and complete the following described work:Wheaton Way/Schley Can�on Slo e Re��ir the Couuty of ICitsap, Washington, as per inaps, plans and specifications Tnade a pu�t of said Contract, which Contract as so executed is hereutitu attached, and is now refe�red to and by this refercnce is incorparated l�erein and rnade a}�art hereof as fiili for all purposes as if here set forth at length. NOW THER.�:1�OI2E, if the Principal herein shall faithfiiliy �nd tnrly observe and couaply �vith the tenns, conclitions aud �}rovisions of said Contract, u� alI respccts t�nd shall well and tnily and fully do and perfonn all matters and things by thc said 1'rincipai iurdertalcen tu be performed uncler said Cnntract, upon the terms proposed therei�a, and within the time prescribed therein, and until the same is accepted, a�id shall pay ali laborers, mechanics, subc.antractnrs and materialmen, a�id all persons who shatt s��pply such Contr�cior or sirbcontractor with provisions and supplies for the carrying on of sueh wark, and shal( in all respeets faithfully �erfnrm said Convact accoidir�g to law, then this obligation ta bc vaid, otherwise to remtin in full force ancl effect, WITNESSaurhandsthis 9th __dayofSegtem er ,201Q. Principal Jansen Inc . St�rety Cotn�any American Safety Casualty Insurance Company By: F3y: , � `- �� , �ri pz har Ki n�n � Attarney-in-fnct APPROV�D 11S TO FORM this Address of local office and agent of �urety Company: Propel Insurance 1201 Pacific Ave, Ste 1000 Tacoma, WA 98402 day af , 20 `� City af emerton Attorney City af Bt�enterton Wheaton WaylSchley Carryora Slope Repczir LD-I S June 2010 � � � nMrR�urs�rt�ru�s,u�� POWER OF ATTORNEY 20-SUR-208465 KNOW ALL MEN $X'f[�SE PRESEN'CS, that American Safety Caswnity [nsunnce Comparty has madc, constiwted and appointed, and by these preseats �es make, ---------- -_ -.-� —_ - - _ - -- - °-- - - - - - - -- - - - - -_ ;_- - �= -��-_ _=�= °`� - hr' ��t = h -_ =in. =ori- == == == ==�= ===-.� -_ =.- _-_ -. = -.� =_ =,-= _ =- = �=:= C is op er _y === === = � . - __ =__-==== == � = =:= --_- _ =-= °= _�__= =:__° _:____ === =_= �::= -==___ =�== _ _-___ = =:�a==� == - iu we and-�wfut attomey-in=fact; for it and �ts name, place; and stead:ta°execute on behal_f_of the-said Company as surety,_bon�,ynderla g and contract to be given to ' � � � =_ � � � � � ALL OBLIGBES, provided that no bond or undertaking or contract of suretys6ip executed under this authority shal! exceed 'm amount the sum of Two HundreA Twenty Fow Thousand S�x Hundred Thirty Four pollars and Twenty Two Cents ($224,634 20) This Power of Attorney-_is granted aad is signed and seated by_facsimile under.and by the authority of the-foliowing Resolution adopted by the Board of Bir�tors of the Company. 'on the Eigtett[ day of Septcmber; 2003, -- _ - _ - _ ` - = = -- =_ = _ - = - - ` - _ ` ' = _-- _ _ � _- - _-` °_' `_ °�_ °° i `�iSecre -ma a intattocne -in=factoc"a ents-witha"u{hori :as"definedorlirsut d' - or n: stan ta e te the in with Secr a Ass RFSOLVED,=that.the,Presid�t._conjnnction the etacy : ,Y =- _ _�Y_ FP� _YS -8_ _--- �Y inswmeat evidencing the appointment in each case, for aad�on behaCf"of the Company; to execuie`and deliver and affz"tt►e seal the Compaey to bonds, undertakings, recognizances, and suretyship obligadons of all kinds; and said officers may remove any such attozney-in-fact or agent and revoke any power of attomey previously granted to such persons. RESOLVED FURTSER. that any bond, undertaking, recognizaace, or suretyship ob[igaaon shall be valid and bindieg upoa the Company: (i) wben signed by the Psesident aa� any Vice-President and attested and sealed (if a seal be require� by any Secretary or Assistant Secretary or (ii) when signed by Ihe President or any Vice-Pmsident or Secretary or Assistant Secretary, and conntersigned and sealed (if a seal be required) by a duly suthorized attorney-in•fact or agent; or (iii) when duly executed and seated (if a seal be require� by one or rttore attorney-in-fact or agents pursuant to and within the limits of the authority evidenced by the power of attaney issued by the Company to such person or persons. -- - ___ _ __'- __ " _=_ °_ `_= .=` _ _ _ _ _ _ . ___ ______ _ " ____ ° _ = _=_ _' ___ _°_ YiFSpI,VgD_FZJRT$E$ that the signature of any authonzed officer and:the sea! of the Company roay be affixed by facsimik to any powtr of at[orney:ar certificaUOn theieof authoriziag the e�ceeuti� and deLvery of any bond, undertalung_ recogwzance, oi other suretyship obiigauons of ihe Compaay;_ and such signature_and seal when so used shall fiave the sairie foree and"affects as though manually°affixed.- - -=_ = _ " - _= _- _ __ = - _ — _= -, = _ �= IN WITIVESS I�PSEREOF, American Safety Casnalry Insurance Company has caused its official seal to be hereunto affixed, and these presents to be signed by its President and attested by its Secretazy this Eighth day of September, 2003. Attest: STATE Randolph L Hutto, Secretary .��5�� V�• Stephen R. Crim, President _ =- �= -� _ _ `=-= °-�>'' _==- _._ =_= _=.- .-- _ . -._ = _- -- -- - - - -- - o - _- - _ - -- - - °==`_ =___ =--_� - = •�..� __= =_ _ __ -° _== = _ =_== _�= `�_ == _—_ ___. _______ _ ___ _ _ __ r _ __ __ _ __ _ - �. __ _-_ _ _ -___" ___ 80:—_ ____ _ =_- c= "."=_:a �_ �-- =_:�___ _____: _"__' c—' �'-�=.3 = _ __" :`_`_' °-'-z � On this Eighth day of September, 2003, before me personally came Stephen R. Crim, to me known, who, being by me duly swom, did depose and say that he is the President of American Safety Casualty tosurance Company, the corporation described in and which executed the above instrument that he knows the seal of the said capora6on; that the seal afftxed w ttte said instrument is such corposate seal; that it was so affixed by order of the Boazd of Directors of said corpomtion and that he signed his name thereto by like order. � � � � I; the::yndeisigned,_ Secietary =of-American : Pawer of Attcifney remaens in fiitl"force and tias in fosce. Signed and Sealed at the City of Atlaata, in the Ctate of Georgia. __ -�- _ ° _ _ _�- � I — _ __°_ —� _—= - _"-- ___ --. : c ;4�MOlA�� `; y ; � _ ° MuG 'r ; ��MiW� " s '� ��yp `� ;_ _ Ruth . Bankston, Notary Public =_' .�---=- _- =: __ .->-== -._ _ _ ° "_ -:=_:6 '91r.uuntM�ac==� _ :z=�= ==s� _'_'-- �-- __- .�:= '_ `— =_==`z ._: '- e=_. oee Company an -0klahoma-'COt[J018t10R; DO=HEREBY_CERT7FY-thac=the=foFegoing'and a fiiritierm� that the°Resolution-of-the Board of_Directois, set forth iu=the satd-Power of_Attotoey, NUMBER Dated the !t� day of -fG'� �El•� j'fj , Z� "T � _===_°Ran _ h L. Huiro, Seotetary == - - = _ " _=: = _: - CIRIC;I:V�LL.SOFTIil.SYOii�EROF.-{TTORA'FF.4REYftIiVTEI) fl%ITHREU:\'L:IIERICALs�Z%:11BERC. ' UC'PLIC:l7'E.4SH.ILLH91�'7'HE'S:d:tiIEF'UKCE:IJ'U�Y�1�GC1'_-iS.�t.�"OKIGI.V.-tLO:\`L}'ttTiE:\`ISSt:"L'DINCUA'JL'�\'C%7C3:\7li-'1%'r�THEOKYCi,��II_