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Montesano~'1')o n~nc~ PROPOSAL FOR TOWN OF WAPPINGER UNITED WAPPINGER WATER DISTRICT WATER MAIN EXTENSION TO CHELSEA HAMLET CONTRACT NO. 13-006 DIVISION 200 BID FORM PREPARED BY: MORRIS ASSOCIATES ENGINEERING CONSULTANTS, PLLC 9 ELKS LANE POUGHKEEPSIE, NEW YORK 12601 l~tic2c.~,~ 3, av t ~" REVISED FEBRUARY 2014 MA#: W21215.11 2QQ. Q 1 hr ~" TOWN OF WAPPINGER UNITED WAPPINGER WATER DISTRICT WATER MAIN EXTENSION TO CHELSEA HAMLET CONTRACT NO. 13-006 BID FORM THE TOWN RESERVES THE RIGHT TO REJECT ANY OR ALL BIDS. EACH BID FORM SHALL BE ACCOMPANIED BY BID SECURITY (AS DESCRIBED IN THE INSTRUCTION TO BIDDERS). TO THE TOWN BOARD, TOWN OF WAPPINGER, NEW YORK Pursuant to and in compliance with your invitation to bid contained in the Notice to Contractors dated MA~t~I 3 ~ t~- , r•• (month) (day) (year) the undersigned hereby proposes to furnish all labor, machinery, equipment, facilities, tools, transportation, supplies, materials, insurances, permits, certificates, tests, guarantees, protection of equipment and property and life during construction; as well as competent and qualified supervision for all phases of the work, and other facilities and things necessary or proper for or incidental to, Town of Wappinger Water Main Extension to Chelsea Hamlet Project, Town of Wappinger, as required by and in strict accordance with the plans, specifications and all other documents relating to Contract No. 13-006, for the prices stipulated and as shown on this bid form. Name of Bidder: N~~ ~ic~5, i (Individual, Partnership Cor oral * Circle applicable word or LLC)'~ The undersigned declares that the bidding and contract documents have been carefully examined and that all things necessary for the completion of the work shall be provided. Receipt of the following addenda is hereby acknowledged: DATE SIGNATURE ADDENDUM NO. 1 MAr~~1 a~a~-~- ~~ ADDENDUM NO. 2 MARc_lJ o~5 aotA- ?/ '~ ADDENDUM NO. 3 ADDENDUM NO.4 200 02 r. • In consideration of, and to induce the award of this contract to him/her, the bidder represents and warrants that: +r. (a) If this bid is accepted by the Town Board, Town of Wappinger, as evidenced by issuance of a Notice of Award by the Owner, and mailed by registered mail with return receipt requested to the address of the bidder as indicated on his/her bid, the bidder will execute a contract on the form of agreement herein provided and will comply with all provisions of said Notice of Award. (b) This bid is made without any understanding, agreement or connection with any other person, firm or corporation making a bid for the same work, and that it is in all respect fair and without collusion or fraud. ~. (c) The bidder has carefully examined and fully understands all of the parts of the contract documents, and that the bidder will execute the contract and will completely perform it in strict acgordance with the provisions thereof for the sum set forth on the bid. Unit Prices have been computed in accordance with the Contract Documents. Bidder acknowledges that estimated quantities are not guaranteed, and are solely for the purpose of comparison of Bids, and final payment for all Unit Price Bid items will be based on actual quantities, determined as provided in the Contract Documents. (d) No officer or employee of the Town Board, Town of Wappinger, or any person whose salary is payable in whole or in part by the Town Board is, shall be, or shall become interested directly or indirectly as a contracting party, partner, stockholder, surety or otherwise in this bid or in the pe~ormance of the contract or in the supplies, materials or equipment, or to work or labor to which it relates, or in any portion of the profits thereof. ~ (e) The bidder is not in arrears to the Town Board upon debt or contract and is not a defaulter as surety, contractor, or otherwise upon any obligation to the Town Board, Town of Wappinger. (f) All work shall be completed within the time allotted, from the date specified in the Notice to Proceed or set by the contract documents, mailed to the ~,,, undersigned by registered mail with return receipt requested to the legal address of the bidder as indicated on his/her bid. a +~. (g) If the bid documents contain any unlawful provision not an essential part of the bid and which shall not appear to have been a controlling or material inducement to the making thereof, the same. shall be deemed of no effect and will upon notice by either the Owner or the bidder be deemed stricken from the bid documents without affecting the binding force of the remainder. 200 03 wr ~"' (h) Each and every provision of any law and clause required by law to be inserted in the bid documents shall be deemed to be inserted herein and the ~ bid documents shall be read and enforced as though it were included herein; and if through mistake or otherwise any such provision is not inserted or is not correctly inserted, then upon the application of either party, the bid documents shall forthwith be physically amended to make such insertion. (i) The bidder is financially solvent and sufficiently experienced and competent to perform the work. (j) The work can be performed as called for by the proposal and that the plans and specifications are in all respects suitable and adequate for the work. ,,, (k) The facts stated in his/her bid and the information given by him/her are true ~„ and correct in all respects. (I) The bidder is fully informed regarding all the conditions affecting the work to ~ be done and labor and materials to be furnished for the completion of this ,., contract, and that his/her information was secured by personal investigation and research. (m) In the event of a lawsuit, the bidder agrees that said suit shall be filed in the same county as the location of the project. BID FOR CONTRACT WORK: "~ Base Bid Install water distribution improvements and related items in accordance with the Contract j"' Documents, not including Bid Alternate 1. The signatory to this bid, for all work proposed, items furnished and strict compliance with all provisions of each and every Contract Document relating to Contract 13-006, agrees to accept (unless modified pursuant to the ""' terms of the General Conditions) a total, final and fixed contract price not to exceed: 1I~RE+E M1U..JpN NINE, I~vNO~..e'D rv~,vETY Nd~lE TNc~~S6^~ ~ Nin.C. NvNb~D C~6uty fX~-ZS ,~Ne 'Z£~© C~.n.TS (Words) "3.999.9 8t~e coo (Figures) ~~~~~d~~ Y' 200 04 MAC 81 2014 i TaWN qF WAPPINGER ~~W N CLERK w i~r+ Add Alternate 1 Bid For Add Alternate 1: Overlay paving of Entire Stenger Court, the signatory to this bid, for all work proposed, items furnished and strict compliance with all provisions of each and every Contract Document relating to Contract 13-006, agrees to accept (unless modified pursuant to the terms of the General Conditions) a total, final and fixed contract price not to exceed: -fW~Rrt`-~ SAX 7~Iov5+bNb I/~vE. NvN~j 1~~~ ~avr Dol-~25 $ q~ ~-E2o c~vTS (Words) 36; 5~~} ,oa (Figures) Also made a part of this bid is the attached documentation per Division 100, Article C.3. Sign Bid Here ~~ ~i~~~ AUTHORIZED SIGNATURE Print Name Cx~~ti~c.~ M~xv~:tiy Title pRC_5~~`~.'NT Official Company Name ~v+E`.:~ 1320 I~ (Individual, Partnership orporatio , LLC7* "Circle applicable word it Company Mailing Address ~?6~A~N /~~ STREET ~W prxb~'L1£ N`1 I c~d01 CITY STATE ZIP CODE Federal Employer Identification No. ~3` ~8c'~8671 Telephone No. 9ld- a3~~-~-~DO +~. 200 05 (If bidder is a corporation, fill in the following blanks.) Organized under the laws of the State of: lbw Yo ~~ Name and Address of President: ry~,,~-~~, ~/YavjC.~,i~yO ~IAVP ~ t~<~/ 1~1Rt' Name and Address of Secretary: _ 1Z~uaorzD N~~E~n.O ~! P,i~r~/. n Env .~?~ Name and Address of Treasurer._ ~R~n.~; ~kxvi~.ad~0 ~ 3R -tiARR-SoN ~ N`~% (If bidder is a Limited Liability Company, fill in the following blanks.) Organized under the laws of the State of: Name of Manager or Managing Member: Agent for Service of Process: Address for Service of Process: 200 06 ~... ~. r. STATE OF NEW YORK ) COUNTY OF -~iiCbJ~S-(Fr2 ) ss: On the d~3"~ day of ~r~a ~Iq- ,before me, the undersigned, a Notary Public in and for said State, personally appeared A~M~Ni~K ~~ personally known to me or proved to me on the basis of satisfactory evidence to be the individual whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his capacity, and that by his signature on the instrument, the individual, or the person upon behalf of which the individual acted, executed the instrument. CHRISTOPHER FRACASSA Notary Public, State of Newyork No.O1FR6173041 ~ualiffed In Dutchess County Commission Ex Tres Au ust ZO 2015 200 07 NOTARY PUBLIC ~/~ cN~2~5 ~-CA~S~', J ~ m ° orJ , Sqi+ ate- a • 0~o W ~ ~ ~ 4 'n. o M ,~ F% ~ ~ ~.O G ~ (~ ~.: W ~ ~ • ~ ~ po ~ ~ ~~ N ~. v' ~ M _ me..' 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'r V :.~c ~ W ~ ,.,t ~ ~/. ~.~ ~ ~ ~ .I c? v+ rC' _ r ~~ 0 +hT m '# W U q ~ y'. ,;, ~ Z ~~ K a ,~ ~ = w ~ ~ ~ ~ x_ A ~ N _ ~ ~ ~ ;. d ~ g ~ ~ ~- f W~ d~ a~ ~,~'~~~~" Q J J 'w~ a - L r ~ ~ ~. ~`r iiflFl _ ., °,' ': s ~~, ',_ ,* ~ N C L' ~ ~ Z O _ Q ~ V ~ ~`" _.. ;, .i.,~ .~ Q _ • V ~ 0 U (n L 0 . ,~ ~"'.d,'; r.. F -: . . a~ ~ ~ O Z ~ c ~ L W ~ r ~ ~ ~ ~ ~ ~ a . >+ V} = ~ ~ N C , ~ ~ ~ 0 Q ~ U O d L N .~ f6 .6 f~ a~ c (~ a~i a 0 .N ~ w tiw o~ 0 oz N m d m L U >N 0 .y d l1J 0 U } Z 'N N_ O N d m .a a c E U O w r. ~. ~"' BID BOND t`" If a bond is used, the form bound in this manual should be used. No other form may be used except with prior approval by the Owner after review by the Town Attorney which approval may be granted or withheld, in the Owner's discretion. v 200 08 r r BID BOND KNOW ALL MEN BY THESE PRESENTS: that * MONTESANO BROTHER as Principal; and «* LIBERTY MUTUAL INSURANC as Surety, are hereby held and firmly bound unto the Town BoDollars ~ of Wappinger, New York in the amount Of: FIVE PERCENT OF nTn nnrtnrrnTZ for the payment whereof Pnncipal and Surety bind ourselves, our heirs, executors, :administrators, successors and assigns, jointly and severally, firmly by these presents. Signed this z, ~T day of MARCH 2014 WHEREAS, the condition of the above obligation is such that, whereas the Principal has submitted to the Town Board a certain bid, attached hereto and hereby made a part hereof, 'to enter into a contract in writing for the Water Main Extension to Chelsea Hamlet for the Town of Wappinger, New York, as shown and specified in Contract No. 13-006. NOW THEREFORE, (a) If said Bid shall be rejected, or in the alternate (b) If said Bid shall be accepted and the Principal shall execute and deliver a :' contract in the Form of an Agreement attached hereto (properly completed in accordance with said Bid) and shall in all respects perform the agreement created by the acceptance of said Bid, then this obligation shall be void. Otherwise, the same sha11 remain in force and effect, it being expressly understood and agreed that the liability of the Surety for any and all claims hereunder shall, in no event, exceed the amount of this obligation as herein stated . The Surety, for value received, hereby stipulates and agrees that the obligations of said Surety and its bond shall in noway be impaired or affected by any extension of the time .within which the Principal may accept such bid; and said Surety does hereby waive notice of any such extension. IN WITNESS WHEREOF, the Principal and the Surety have hereunto set their hands and seals, and such of them as are Corporations have caused their Corporate seals to be hereto affixed and these presents to be signed by their proper officers, the day and year first set forth above. (SEAL) MONTESANO BROTHS TNC PRINCIPAL * ~ Mi'bJlr•CArt Ml Insert Bidder s Name C>,nn~NicY., **Insert Surety's Name BY !G~''- r 200 09 ;~: .~.. - -- z - ___ .:.. _ ____.. N r r e r r a t s 0 i a i i i Signed, sealed and delivered in the presence of (Corporate seal of Contractor if a corporation) ~~ESAI~ R0, ~ 1 NC Contractor By ~ ~• OQM1N~(.,f'. MDN~C<,;,~NO ~ P~2~`,IbE^~T - DENNIS M.: O' BRIEN ( itle of Officer) ATTORNEY-IN-FACT ..(Corporate seal of Surety) Attest WILLIAM D. xAAS (Title of Officer) ATTORNEY-IN-FACT - r• ~~~ Q I 0 LIBERTY MUTUAL INSURANC'R ~nMPANv -, ATE OF NEW YORK ST ) - ) ss: ..COUNTY OF I~"~c~~.r< } ~~ On the ~~ day of _ M,o(~ ~ ap ~~- ,before me, the undersigned, a Notary Public in and for said State, personalty appeared ~,N,c% M~,nE~.~~ personally known to me or proved to me on the basis of satisfactory evidence to be the individual whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his capacity, and that by his signature on the instrument, the individual, or the person upon behalf of which the individual acted, executed the instrument. CHRISTOPHER FRACASSA Notary Public, State of Nsw York No. 01 FR6173041 ~. ~ualHled In Dutchess County NOTARY PUBLIC Commission Ex res Au ust 20, 2015 CNR~S F~thc~55A ,, 200 11 ACKNO~`'LEDG~IENT BY SURETY COMPANY (Signed by Oue Authorized Person) STATE OT NE«' YORK ) )ss: COUNTY OF ) WESTCHESTER On this 31 st___day of __~ch 20 14 before me personally canle__ DENNIS h1. 0' BRIEN __ ___personally known and lalown to me to be _ ATTORNEY-IN-FACT of ~,Ig~Zy ~~~, INSURANCE COMPANY the Corporation described in and which executed the within instniment, who being by me duly swor-i1 did depose and say that he resides at _ NORTH NIERRTCK NFW YORK and that he/she is ATTORNEY-IN-FACT of said Corporation and knows the Corporate Seal of the said Corporation; that the seal affixed to the within instrument is such Corporate Seal and so affixed by order of the Board of Directors of said Corporation and that he/she signed his!her name thereto by like order; and that the said Corporation has received from the Superintendent of Insurance of the State of New York a Certificate of Solvency, and of its sufficiency as Surety or Guarantor, pursuant to Section 327 of the Insurance Law of the State of New York as amended, and that such Certificate has not been revoked. ~' "_iG/ ." ~L `ter /~1-.!`' l Signature~otary r'`~ v1y Commission Expires: ALICE McCARTHY NC+TARY PliBl.iC. Sze#F of lU~r, Ycr~<, QuaiifiAn ;n Outo#~ess County, Commission Expires ,I~ ne 02, 2015 ~i'-dr Lib~rrty ~UfU11, SUt?ETY Assets I.II3I:RTY MUTUAL INSUItANCI: COJiPAN~" FINA!~CIaL STATEbIENT-DECE~t1iER 31, 2012 Cash and Bank Ihposirs ............. ............ . y 903,711.69 *Bonds -- U.S Gotiernment .................................. . 1,16G,9?9,471 *Other Bonds ............... ..............,.. . 11.E 1 S, t 9,219 ~Stoc[~s ....................................... ... ........................ fi, l x.833.899 Real [state .......................................................... ?5,967.320 Agents' Balances or Uttcolleeted Premiums ......... 3,~3rS2.069.~53 Accrued Interest and Rents ................................... 1-1,016;763 Other Admitted Assess ........................................... 1-3.73?_633.45R Total Admitted Assets .................................. 5~4.24~ ~56.5?Z I,iabitities Unearned Premiums ........................................... .. ~-1.205 11 671 Reserve fir Claim; and Claims F:xp~nsc ............ , . .. 17,0i6,~2O,207 Funds held tinder Reinsurance Treaties ............ .. 1.315,062,091 Resenr for Ui~Tdends to Poiic)'holders,,,,,,,,,,,,,,,, 2,455,}11 Additional Statutory Reset-~~e ............................... . -19.763,995 Resen~e fi?r Commissions, Taxes and Other I_iabilities ............................................ . 3AG6.0~ 1~~37 Total .......... .............................. ........... ...... Special Surplus Funds ................ 560,621,497 . 535,69,899,915 Capital Stock ............................. 10.000.(100 Paid in Surplus .......................... 7.Fs99,471.R46 Unassigned Surplus .................... 5,996.373??y Surplus to Policyholders ..................... ... ..... 14.51Q,<t66 66~ Total Liabilities aad Surplus ............................. 544.~Q5 ~fi6 ZZ at ~"' S'JF Bonds are stated at amortized or in:esuvent ~alu~; Stocks at Ass<xiation ,Market ~'<tlu4s. s 1912 T'he foregoine financial information is taken from Liberty Mutual Insurance Company's financial at 9~~',~~~~~e statement filed frith the state of Massachusetts Department of Insurance. 1. TI~I JIIIiOLA)I4VSItii.:lssistant Secretan of Libcm Jfutual Insurance Company, do hereby certify that the foregoing is a trv~, and correct statentcnt of th:1sets and Liabilities of said Corinn-atior,. as of Deccarb~r ; 1, ?012, to the best of my kno~.cl~d_~e and belief: fA 66'IIIESS ~l'IIEREUf'. I have hereunto set my hand and aftised the seal of said ('orporation at Seattle. ~4'ashin~ton. this 2~th day of ;March. 2013. ~_ ~t~ ~ . Assistant Se~retar} S_~,~rum::~1,z ' This Power of Attomey limits the acts of those named herein, and they have no authority to bind the Company except in the manner and to the extent herein stated, Not valid for mortgage, note, loan, letter of credit, bank deposit, currency rate, Interest rate or residual value guarantees. To confirm the validity of this Power of Attorney tail 810.832.8240 between 9:00 am and 4:30 pm EST on any business day. American Fire and Casualty Company Liberty Mutual Insurance Company The Ohio Casualty Insurance Company West American Insurance Company POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS: That American Fire 8 Casualty Company and The Ohio Casualty Insurance Company are corporations duly organized under the laws of the State of New Hampshire, that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana (herein collecOvely cened the "Companies"), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, Dennis M. O'Brien of the city of W hlte P alns ,state of its true and lawful attomey-in-fact, with full power and authority hereby conferred to sign, execute and acknowledge the following surety bond: „ Principal Name: MONTESANO BROTHERS, INC. Obligee Name: TOWN OF WAPPINGER Surety Bond Number: Bid Bond Bond Amount: See Bond Form IN WITNESS WHEREOF, this Power of Attomey has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 18U day of November, 2013. ~PNO CASG ~,tNSUgr JP`SY INSI/,~ PNiNSt/q~ American Fire and Casualty Company zQ `acoRPORarQ9~~ ~Jti~~~oArog9f~r,^ `Pti `aootwogaro2~r+ F~~•~~ o/~r~ ~ The Ohio Casualty Insurance Company Liberty Mutual Insurance Company d ti 1906 ~ i ~ 1912 ~C^ ~ c 1919 a N 1991 a Wes merican Insurance Company '~~y~NAMP~paD ,v~y9s ri.` 2 ~'S-y``jY a~? 7s ~2 d *~ ) SACHUS p ~! HAMtfi ! /NOIAKP * * * * By. David .Carey, Assistant Secretary STATE OF PENNSYLVANIA ss COUNTY OF MONTGOMERY On this 18~^ day of November, 2013, before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Americen fire and Casualty Company, Liberty Mutual Insurance Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, exewte the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at Plymouth Meeting, Pennsylvania, on the day and year first above written. yp, PAST ~~Q.`~MONWE9`,1(y COMMONWEALTH OF PENNSYLVANIA Notarial Seal or: Teresa Pastella, Notary Pubilc BY~ ~P Plymouth Twp., Montgomery County Teresa Pastelia, otary Public ~k. NsvWP ~~, My Commission Expires March 28, 2017 Ate' PV0 Member Pennsylvania Association of Notaries This Power of Attorney-i ade and executed pursuant to and by authority of the following By-laws and Authorizations of American Fire and Casualty Company, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows: ARTICLE IV -OFFICERS -Section 12. Power of Attorney. Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the President may prescribe, shall appoint such attorneys-in-fact, as maybe necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety anyand all undertakings, bonds, recegn¢ances and other surety obligations. Such attorneys-in-fact, subject to the limitations sal forth in their respective powers of attorney, shall have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative orattorney- in-fact under the provisions of this article maybe revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority, ARTICLE X111-Execution of Contracts -SECTION 5. Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such Iimita0ons as the chairman or the president may prescribe, shall appoint such attorneys-in•fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and delNer as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attomeys•in-fact subject to the limitations set forth in their respective powers of attomey, shall have full power to bind the Company by their signature and execution of any such Instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation -The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assistant Secretary to appoint such attorneys• in-fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and delNer as surety any and all undertakings, bonds, recognizances and other surety obligations. Authorization - By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company, wherever appearing upon a certified copy of any power of attomey issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with the same force and effect as though manually affixed. I, Gregory w. Davenport, the undersigned, Assistant Secretary, of Amerian Fire and Casualty Company, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do hereby certify that the original power of attomey of which the foregoing is a Tull, true and correct copy of the Power of Attorney executed by said Companies, is in full force and effect and has not been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of sa(d Companies this 31st day of March 2014 , ~PNO CgSG ~,tNStrq P~T~ INS ~NtNSUggy 4\Q. `~LpRPOgr/,09~~ J,~J~°Rp ~l N~~ `PyJaL°avoggr'QV'L~T ~Q~y~~ ~`~r r~` ---1 1906 o F ~ o ° ~ o < ~ ~o By: 1912 ~ = 1919 3 ~ 1991 3 ~y ,~ ~ a o ~ ~ a Gregory W. Davenport, Assistant Secretary d~fYy yAMPS~*t~,D y~ ?i9SSACHVS~p= ~~'(y~HAM~'~`P!? Ti /NOIAN* t • * * # ~` BID BOND 5EE drt1A~~j KNOW ALL MEN BY THESE PRESENTS: that as Principal; and ** as Surety, are hereby held and firmly bound unto the Town Board, Town of Wappinger, New York in the amount of: Dollars $ for the payment whereof Principal and Surety bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. Signed this day of 20 WHEREAS, the condition of the above obligation is such that, whereas the Principal has submitted to the Town Board a certain bid, attached hereto and hereby made a part hereof,. to enter into a contract in writing for the Water Main Extension to Chelsea Hamlet for the Town of Wappinger, New York, as shown and specified in Contract No. 13-006. NOW THEREFORE, (a) If said Bid shall be rejected, or in the alternate (b) If said Bid shall be accepted and the Principal shall execute and deliver a contract in the Form of an Agreement attached hereto (properly completed in accordance with said Bid) and shall in all respects perform the agreement created by the acceptance of said Bid, then this obligation shall be void. Otherwise, the same shall remain in force and effect, it being expressly understood and agreed that the liability of the Surety for any and all claims hereunder shall, in no event, exceed the amount of this obligation as herein stated. The Surety, for value received, hereby stipulates and agrees that the obligations of said Surety and its bond shall in no way be impaired or affected by any extension of the time within which the Principal may accept such bid; and said Surety does hereby waive notice of any such extension. IN WITNESS WHEREOF, the Principal and the Surety have hereunto set their hands and seals, and such of them as are Corporations have caused their Corporate seals to be hereto affixed and these presents to be signed by their proper officers, the day and year first set forth above. (SEAL) PRINCIPAL *Insert Bidder's Name **lnsert Surety's Name By 200 09 ~ Signed, sealed and delivered in the presence of (Corporate seal of Contractor if a corporation) ~. .. Contractor By ~: BY (Title of Officer) (Corporate seal of Surety) Attest (Title of Officer) - - 200 Q10 i.. ~` STATE OF NEW YORK ) ss: COUNTY OF ) On the day of ,before me, the undersigned, a Notary Public in and for said State, personally appeared ±~. personally known to me or proved to me on the basis of satisfactory evidence to be the individual whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his capacity, and that by his signature on the instrument, the individual, or the person upon behalf of which the individual acted, executed the instrument. NOTARY PUBLIC i. 240 11 4 t CERTIFICATION OF NON-COLLUSION BY BIDDER No bid will be considered unless this Certification remains attached to and is submitted with the Bid By submission of this bid, each bidder and each person signing on behalf of any bidder certifies, and in the case of a joint bid each party thereto certifies as to its own organization, under penalty of perjury, that to the best of his knowledge and belief: (1) The prices in this bid have been arrived at independently, without collusion, consultation, communication, or agreement for the purpose of restricting competition as to any matter relating to such prices, with any other bidder or with any competitor. (2) Unless otherwise required bylaw the prices which have been quoted in this bid have not knowingly been disclosed by the bidder and will not knowingly be disclosed by the bidder, directly or indirectly, to any other bidder or to any competitor, before the time of the bid opening. (3) No attempt has been made or will be made by the bidder to induce any other person, partnership or corporation to submit or not to submit a bid for the purpose of restricting competition. A bid shall not be considered for award nor shall any award be made where (1) (2) and (3) above have not been complied with; provided however, that if in any case the bidder cannot make the foregoing certification, the bidder shall so state and shall furnish with the bid a signed statement which sets forth in detail the reasons therefore. Where (1) (2) and (3) above have not been complied with, the bid shall not be considered for award nor shall any award be made unless the head of the purchasing unit of the State, public department or agency to which the bid is made, or his designee, determines that such disclosure was not made for the purpose of restricting competition. (4) The fact that a bidder (a) has published price lists, rates, or tariffs, covering items being procured, (b) has informed prospective customers of proposed or pending publication of new or revised price lists for such items, or (c) has sold the same items to other customers at the same prices being bid, does not constitute, without more, a disclosure within the meaning of subparagraph (1 ). (5) Any bid hereafter made to any public authority or to any official of any public authority created by the State or any political subdivision, by a corporate bidder for work of services performed or to be performed or goods sold or to be sold where competitive bidding is required by statute, rule, regulation, or local law, and where such bid contains the certification referred to in the lead paragraph of this section, shall be deemed to have been authorized by the board of directors of the bidder and such authorization shall be deemed to include the signing and submission of the bid and the inclusion therein of the certificate as to non-collusion as the act and deed of the corporation. I affirm these statements under penalty ,of perjury. BIDDER'S SIGNATURE:" ]/yy~ ~?/? DATE: 3 S ~` ~~