Legacy Supply~~~~1 '_ ~
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
SEPTEMBER 2013
REVISED FEBRUARY 2014
MA#: W21215.11
2QQ 01
L
TOWN OF WAPPINGER
UNITED WAPPINGER WATER DISTRICT
WATER MAIN EXTENSION TO CHELSEA HAMLET
CONTRACT NO. 13-006
BID FORM
l
THE TOWN RESERVES THE RIGHT TO REJECT ANY OR ALL BIDS. EACH BID FORM
SHALL BE ACCOMPANIEb 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 D3 C~3 ~ D ~
(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:
(f d vid al, Partnership, Corporation or LLC)~
* Circle applicable word
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:
ADDENDUM NO. 1
ADDENDUM NO. 2
ADDENDUM NO. 3
ADDENDUM N0.4
DATE
~ I
3) a~
200 02
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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 ACCOMPANIE6 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 D3 D3 ~- ~~~
(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:
(I d vid al, Partnership, Corporation or LLC)~
* Circle applicable word
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:
ADDENDUM NO. 1
ADDENDUM NO. 2
ADDENDUM NO. 3
ADDENDUM NO.4
DATE
-~-{ °'~-F-~--
3 ~ a~ i~
200 02
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THE 70WN RESERVES THE RIGHT TO REJECT ANY OR ALL BIDS. EACH BID FORM
SHALL BE ACCOMPANIE6 BY BID SECURITY (AS DESCRIBED IN THE INSTRUCTION
TO BIDDERS).
BID FORM
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 D3 D3 ,_~,
(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:
TOWN OF WAPPINGER
UNITED WAPPINGER WATER DISTRICT
.WATER MAIN EXTENSION TO CHELSEA HAMLET
CONTRACT NO. 13-006
(Ir~dlvid~al, Partnership, Corporation or LLC)~
* Circle applicable word
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:
ADDENDUM NO. 1
ADDENDUM NO. 2
ADDENDUM NO. 3
ADDENDUM NO.4
DATE
a I
3I a~ i
200 02
1
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In consideration of, and to induce the award of this contract to him/her, the bidder
represents and warrants that:
(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 accordance 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 shalt become interested directly or indirectly as a contracting
party, partner, stockholder, surety or otherwise in this bid or in the
pe~t:formance 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.
(fl All work shall be completed within the ti contrla tedocuments, amailedct edhe
the Notice to Proceed or set by the
undersigned by registered mail with return receipt requested to the legal
address of the bidder as indicated on his/her bid.
(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
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(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
w. 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:
$~ov~r ~~ 0~1 ~~ ~~ ~~5v~~~ C ~ ~~~ ~~ ~~`~SA, ~'-~'P_ ~1~ 1'~ a~a~S cl~~ 2Qro G~~IS
(Wo s)
~.
"` (Figures) ll~1~~~~ D
V ~~
t
'"' MAR 31 2014
TOWN OF WAPPINGER
~'OV1iN CLERK
200 04 ~ ._ ~~~~ -
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:
$ F ~ ~ il-e u.IS q ~ ~ re ~ G~1~,` s ~~ 2 r ~ ~ S
. (Words)
$ S `l S n ~ , oa
(Figures)
Add Alternate 2 Bid
For Add Alternate 2: Electrical Service for Pressure Reducing Vault, 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:
(Words)
(Figures)
Also made a part of this bid is the attached do umentation per Division 100, Article C.3.
Sign Bid Here
,,,,, AU ORIZED IG TURE
MAR 31T~fl~
TOWN OF W,~rg~~pany Name S
TOWN CLERK (Indivi al, Partne s ip, orporation LLC)
'` Circle applicable word
Company
Mailing Address I'~-~ i~~~ ~ ~~~~~ ~~'f1~~°
STREET
Va~~~~ NUJ io~9~
CITY STATE ZIP CODE
Federal Employer
Identification No. ~- 55~~31~~1L
Telephone No. ~~~~~ c~Q~- 0~0 ~-~
200 05
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(If bidder is a corporation, fill in the following blanks.)
Organized under the laws of the State of:
Name and Address of President:
Name and Address of Secretary:
Name and Address of Treasurer:
(If bidder is a Limited Liability Company, fill in the following blanks.)
Organized under the laws of the State of: I~P~~V ~~~~~
Name of Manager or Managing Member: ~.l (7Y1 s° CQSS I r
Agent for Service of Process:
Address for Service of Process: I `~ R(;t.t ~ ~~~ ~ ,~~~-~ ~-~ ~~ ~ y I ~~ ~°
G°~C~C~~OdCD
MAR 31 214
TOWN OF WAPPINGER
T®UVN CLERK
200 06
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~"""' STATE OF NEW YORK )
COUNTY OF ~J ~~~ ~~'~ ~-e~
ss: ~`t~ ~~~ b~ ~ ~.~~,~.~~~,
On the ~g ~h day of M as ~~, ~~.. 0\~- ,before me, the
undersigned, a Notary Public in and for said State, personally appeared ~~Sa. ~- o~'1s- ~asS~~~
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.
scow t~ iFlUaou '
'~ Notary Public, State ~ New York
No. 01 FI6083628
(qualified in Westchester County
Commission f=xpires November 18, 20\4
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NOTARY PUBLIC
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B Dt BOND
KNOW ALL MEN BY THESE PRESENTS: that
~ Legacy Supply, LLC. as Principal; and
** Travelers Casualty and Surety Company of America aS Surety, are hereby
held and firmly bound unto the Town Board, Town of Wappinger, New York in~the amount
Of: Five Percent of Amount Bid .Dollars $ (5%)
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 31st
day of March
20 14
WHEREAS, the condition of the above obligation is such that, whereas the Principa[ has
submitted to the Town Board a certain bid, attached hereto and hereby made a part hereof,
to enter into a contract in writing far 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 sha0 execute and deliver a
contract in the Form of an Agreement attached hereto (properly completed in
accordance with said Bid) and sha11 in all respects perform the agreement
cxeated 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 obfigafion 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 notices
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 oft+icers, the day and year
first set forth above.
(S~) Legacy Supply, LLC.
/~ PRIN AL /~_
''insert Bidder's'Name ~~L+~ /1-~( t'~/~"~I
**lnsert Sure#y's Name gy Travelers~~ualty and Surety gompany of America
n-Fact -
09
Signed, sealed and delivered
in the presence of
{Corporate seal of Contractor
if a corporation)
(Corporate seal of
.Surety)
Legacy Supply, LLC.
Contractor
~-,~~~ ~--~~nS' a..~~~~~ p~(oPS'
(Title of Officer)
200 f7'1-0
Travelers Casualty and Surety Company of America
STATE OF NEW YORK )
~ ss: ~~~~ ~ ~, ti-~ ~ ~1~,~11 ~.
couNTY of ~, ~~ ~~ ~.~ ~ ~ ,~ ~
On the ~ ~ ~ St day of ~ GS ~~ , ~. ~ ~ ~ ,before me, the
undersigned, a Notary Public in and for said State, personally appeared ~ ~ ~n s - ~~<_ s ~
ersonaliy known to me or proved to me on the basis of satisfactory evidence to be the
P
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.
~.~
SCOTT L FltJZZOLA
Notary Public, State of New York NOTARY PUBLIC
No. 01 F16083828
Qualified in Westchester Coin
Commission F.xpin~s November 1 , 20 ~ h-
a
i
BID BOND
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.
200 08
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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 faid 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 enalty f perjury.
BIDDER'S SIGNATURE: ~ DATE: ~ ~~
~0 fi2
THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED
.A- POWER OF ATTORNEY
TRAVELERS J Farmington Casualty Company St. Paul Mercury Insurance Company
Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company
Fidelity and Guaranty Insurance Underwriters, Inc. Travelers Casualty and Surety Company of America
St. Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company
St. Paul Guardian Insurance Company
Attorney-In Fact No. 215496 Certificate No. ~ ~ ~ ~ 8 8
KNOW ALL MEN BY THESE PRESENTS: That Farmington Casualty Company, St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance
Company, St. Paul Mercury Insurance Company, Travelers Casualty and Surety Company, Travelers Casualty and Surety Company of America, and United States
Fidelity and Guaranty Company are corporations duly organized under the laws of the State of Connecticut, that Fidelity and Guaranty Insurance Company is a
cotporation duly organized under the laws of the State of Iowa, and that Fidelity and Guaranty Insurance Underwriters, Inc., is a corporation duly organized under the
laws of the State of Wisconsin (herein collectively called the "Companies"), and that the Companies do hereby make, constitute and appoint
Christopher J. Como, Patricia M. Como, and Jane Quinn
of the City of MOC1I00 ,State of COI1n0Ct1CUt ,their true and lawful Attorney(s)-in-Fact,
each in their separate capacity if more than one is named above, to sign, execute, seal and acknowledge any and all bonds, recognizances, conditional undertakings and
other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of
contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law.
IN WITNESS WHEREOF, the Companies have caused this instrument o be signed and their corporate seals to be hereto affixed, this
day of August 2013
Farmington Casualty Company
Fidelity and Guaranty Insurance Company
Fidelity and Guaranty Insurance Underwriters, Inc.
St. Paul Fire and Marine Insurance Company
St. Paul Guardian Insurance Company
6th
St. Paul Mercury Insurance Company
Travelers Casualty and Surety Company
Travelers Casualty and Surety Company of America
United States Fidelity and Guaranty Company
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State of Connecticut
City of Hartford ss.
/'
By:
Robert L. Raney, enior Vice President
On this the 6th da of August 2013
Y ,before me personally appeared Robert L. Raney, who acknowledged himself to
be the Senior Vice President of Farmington Casualty Company, Fidelity and Guaranty Insurance Company, Fidelity and Guaranty Insurance Underwriters, [nc., St. Paul
Fire and Marine Insurance Company, St. Paul Guardian Insurance Company, St. Paul Mercury Insurance Company, Travelers Casualty and Surety Company, Travelers
Casualty and Surety Company of America, and United States Fidelity and Guaranty Company, and that he, as such, being authorized so to do, executed the foregoing
instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer.
~G.T~
In Witness Whereof, I hereunto set my hand and official seal. ~
My Commission expires the 30th day of June, 2016. ~'0t/BL~G~`
58440-8-12 Printed in U.S.A.
`('(~ ciyu.~ C . ~
Marie C. Tetreault, Notary Public
ING: THIS POWER OF ATTORNEY IS INVALID
OF ATTORNEY IS INVALID WITHOUT THE RED BORDER
This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of Farmington Casualty Company, Fidelity
and Guaranty Insurance Company, Fidelity and Guazanty Insurance Underwriters, Inc., St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance
Company, St. Paul Mercury Insurance Company, Travelers Casualty and Surety Company, Travelers Casualty and Surety Company of America, and United States
Fidelity and Guaranty Company, which resolutions are now in full force and effect, reading as follows:
RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President, any Vice President, any Second Vice
President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint Attorneys-in-Fact and Agents to act for and on behalf
of the Company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the
Company's seal bonds, recognizances, contracts of indemnity, and other writings obligatory in the nature of a bond, recognizance, or conditional undertaking, and any
of said officers or the Boazd of Directors at any time may remove any such appointee and revoke the power given him or her; and it is
FURTHER RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President may
delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided that each such delegation is in writing and a copy
thereof is filed in the office of the Secretary; and it is
FURTHER RESOLVED, that any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance, or conditional undertaking
shall be valid and binding upon the Company when (a) signed by the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice
President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the
Company's seal by a Secretary or Assistant Secretazy; or (b) duly executed (under seal, if required) by one or more Attorneys-in-Fact and Agents pursuant to the power
prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority; and it is
FURTHER RESOLVED, that the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President, any Vice President,
any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to any Power of Attorney or to any
certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attorneys-in-Fact for purposes only of executing and attesting bonds
and undertakings and other writings obligatory in the nature thereof, and any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal
shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding on
the Company in the future with respect to any bond or understanding to which it is attached.
I, Kevin E. Hughes, the undersigned, Assistant Secretary, of Farmington Casualty Company, Fidelity and Guazanty Insurance Company, Fidelity and Guazanty Insurance
Underwriters, Inc., St. Paul Fire and Mazine Insurance Company, St. Paul Guardian Insurance Company, St. Paul Mercury Insurance Company, Travelers Casualty and
Surety Company, Travelers Casualty and Surety Company of America, and United States Fidelity and Guaranty Company do hereby certify that the above and foregoing
is a true and correct copy of the Power of Attorney executed by said Companies., which 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 said Companies this 31St day of MerCh , 2q~.
1<i/''
Kevin E. Hughes, Assistant Sec tazy
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To verify the authenticity of this Power of Attorney, call 1-800-421-3880 or contact us at www.travelersbond.com. Please refer to the Attorney-In-Fact number, the
above-named individuals and the details of the bond to which the power is attached.
WARNING: THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER