Clove Excavators
TOWN OF WAPPINGER
UNITED WAPPINGER WATER DISTRICT
ROUTE 9 WATER MAIN LOOP
CONTRACT NO.13-010
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 03 03 2014 ,
(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 Route 9 Water Main
Loop, Town of Wappinger, as required by and in strict accordance with the plans,
specifications and all other documents relating to Contract No. 13-010, for the prices
stipulated and as shown on this bid form.
Name of Bidder:
(Individual, Partnership, orpora io r LLC)''
"Circle applicab
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 SIGN TUK
r
ADDENDUM NO. 1 03/21/2014
ADDENDUM NO. 2 ~~~
ADDENDUM NO. 3
ADDENDUM N0.4
Clove Excavators, Inc.
200 01
e:ldocumerrtsH weppinperle ~/1008h/.tl)BD2 carted voapp vvatarNw20802.12 r„eadow Aa9 IooPS filtraNonbpacslroute 9 lpoptgenere~div 200.doc
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 Vllappinger, as evidenced
by issuance of a Notice of Award by the Owner, and mailed by registered
mail with retum 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 quantifies 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
performance 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 specked 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.
(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 02
r.~documentsu weppingene v~r2008WJ20802 untied wapp watar1w2p802.12 rtwedow_ne9 Ioope flnrationmPersvowe 9 IooplgeneralWiv 200.doc
(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 tabor and materials to be furnished for the completion of this
contract, and that his/her information was secured by personal investigation
and research.
o //~~°°°---.m'0.
In the event of a laws it, th~i~d ..-~id s it shall be filed in the
same county as the cation of the pr ~
MAR 81 1014
BID FOR CONTRACT WORK:
. TOWN °F w~p~r
Base Brd ¢ -~,T~~IN CL~~N~~~
'~ '='~ ~(
Install water distribution improvements and related items~n accordance with the Contract
Documents. 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
13-010, agrees to accept (unless modified pursuant to the terms of the General Conditions)
a total, final and fixed contract price not to exceed:
$ One million, four hundred seventy three hundred sixty five dollars and zero cent
(Words)
$ ~ 1 470 365.00
(Figures)
200 03
e:WoamentsV N'ePP~~N ~~'~P waterW~20802.12 meadow Ae9loopt filUetion\apea\route 91oop\pararalldiv 200.doc
Also made a part of this bid is the attach ocu nta ' n per Division 100, Article C.3.
Sign Bid Here
AU ORI SIGNATURE
Print Name Marc Vumbico
Title PrPeiiivn
Official Company Name Clove Excavators Inc.
(individual, Partnership Corporation LLC)'`
Circle applicable wo
Company 11 Raymond Avenue Suite 23
Mailing Address
STREET
_ Poughkeepsie, NY 12603
CITY STATE ZIP CODE
Federal Employer
Identification No.
Telephone No.
80-0116085
845-452-5030
a~c~~adr~o
MARS 1 2014
I TOWN OF WAPPINGER
TOWN CLERK
200 ~4
e:ldocumentslt wappingerla w20081w20802 unRed vaapp watertw20802.12 meadow rte9 loops fiftration~specslroute 9
looplgeneralldiv 200.doc
(If bidder is a corporation, fill in the following blanks.)
Organized under the laws of the State of: New York
Name and Address of President: Marc Vumbico- 32 Catskill Avenue Pou~lilceepsie, NY 12603
Name and Address of Secretary: n/a
Name and Address of Treasurer: n/a
(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 05
e~~doa~rtiernslt weppinpeM w2008~w20802 txiited wepp weterlw20802.12 meedow_rte9 loops flltrsliwilspeesYOUte 9 boplpenerelktiv 200.doc
STATE OF NEW YORK )
COUNTY OF Dutchess )
ss:
On the 31st day of March , 2014 ~fp~ ~, ~
undersigned, a Notary Public in and for said State, personally appeared Marc Vumbico
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.
~M W d~-~
NOTARY PUBLIC
_.
LISA M WOOD
Notary Public, State of Nevi work
No. 01 W06' 7871 ~
Gluallffed in Dutr~:~°~>~ss Caunty
Commission Expir~,:~@Q tQ 882!
200 06
e:ldocurnerNslt wappingerla w2008Wd20802 urrited weep waterVv20602.12 meatlow rte9 loops fitUafionkpaceYOUle 9 IooptgeneraMiv 200.doC
O
r
O
M
U
r C
W ~
WV
_ ~
N Q
~ ~
J
m O
N ~~
m 47
D
J m
O U O O' O O O O ~ O O O C O O O O O O
~~ O O p
O
O O
O O O O O
O ~
O O
O O
O ~
N O O
O ~
~ O
O ~ O
O
0.. ~ O
O O O O
O O
~ O
~ ~ ~ ~ ~ ~ O
C ~ N ~ ~ opp
6R ~ 69 ff3 6NR ~ ~ 69 ~ ~ 0
{~ ~
69 ~
~ N
V9 ~
~ M
b9 M
fA ~
W
~
~ ~
O ~ p O O
O O
O O
O
O O
O
_
u- O
C O
p C
O
O O
O
O O
~ ~
O C
O O
O O
C O
O O
O O
p O
O O
O O
O
O
O
O..
D
Z
~
~ O
~ O.
~ O
~ O
O ~
~ O
~ O
O C
~
N
N C
~ o0
~ O
C O
M O
O
m ~ 69 ~ E!9 EA ~ ~ ~ ~ ~ 69 y'ng ~ 69 5ry ~ ~ ~
W
~ ~
a.
F" ~
y N
G p C O
N O .d
~
d
~ C
'd
.d
`n G
'ey ti
G p
d ~
G
Z ~
~
~ N
.d N
,d
b b
O
~
y
.~
~ eJ
>
t ^ t
Oft N
V N
.d N
V
S`
Q b
q ~
G ~
~ N
`~ ~
~ ~
L
.b O
b L G
O y ,^
C b
G ~'
G d
~+ 'b
Lam' ~`
O N ~
~ N
b
~ b
'° :~
b
'd ~
w b
~ b
~ > O
b~ b
c O
~ N
~~ y
~ ~
~ O
~~, G
td
b G
`~
W o=
,ya ~
m 'V b '° ~`~ y
=c ~ ~~
~ `~~ ~
'
b
G abiG b`3
p 'dc a'diy
' ~ °~
y U
w° O
s c0
° p
ctl
~ h
0 y N
00 JY" V
° t ,~
p
° 7
°~ O d
s" {
y
'O V
~o '~ V
~` N
~O .d' U
~° ~ V
~` O
'b .~ C
v
N
~+ ~' ~
S
°
~
L
La+'
N
~
N o
i
..~. G
0 ~~
O. ~ d
L a~
N N~
.d L N
N L N y N
b L.' ~~
C L
.d
'v~~ G
[L-°
'
=
° y O .b
F
~ 0
F°~
F~o G N
3'° ~
°° .>.
cr.~ y
Ga N .d
O~ G
O~
H G
Zv L
[-
~ [ F
- w F~ ' k
~ p
W W W W
~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ W W W W
Z ~ ~ ~ ~ ~ ~ > > ~
lA ~
fA tWi I
Wi tWi lWi IWi tWi uW. ~
W I_ (A (A !A (/7 fn fn fl! to
~ ~ ~ ~ ~ e
~ ~ Q W W W Q
~
~
2
2
~
~
~ W W
LLi W
a
J z z z z z z z z
J .1 J J J J J J J J J J J J J J J
H- ~ Q Q Q Q Q Q Q Q Q Q ~ ~ ti c0 c~ O M
W~
Z
Z
Z
Z
Z
Z
Z
Z
Z
Z
N
N
M
d'
C7
•-
M co
C_
' C
• ~
C ~
~ ~ a •L
m
O C o
. 0 o
~ L
m ,`
m ~
m E
~
D_ m ~ ~
~ c co ca ~ a o
° .. •- m
~
°
U ° c o ~ m
` m °
~ ~° `o m ~ m
W
~ c ~
r U aU 0 0
c""v o
m o ~
o0 ° ~
°
~
O ~ m
p ~ U c
o U
_ t _ N C Q C H Y
O
Z ~
N V =' m
rn ~
~ ` N
o
m ~
m~ ~
O c ~
p ~ L
p~ C_
co c
ca m e co •
v, m . c
i ° cu
W O O y
~ m
d °
t 3
N m m
F- ~ t0
~ O m
~
~ .~
r F-' p p O ~O C
''" d O p -
CO _
oD
F- ~ [~ .,
p (n J () r r ~
Q m U
~ O
~ W
~ IL
~ U'
~ _
~
~ -i Q OD U D W LL. C~ 2
v
N
~_
m
m
N
f0
m
O
m
m
c
m
C7
d
Q
O
O
O
N
O
M
U
V
W ~
W_U
N C
~ ~
m J
C
~ ~
C0 d
J m
~~ O p p O O O ~ O O O O ~ O
d. G O O O
p ~ ~ O O ~ C
O
~ O
' O
~p C p
p
00 ~
,~ ~
G
~ ~p
vi ~
~ N ~
~ O
vl
~ V
1
~
N h
r ~
N
b9 6N9 ~ d9 69 fA Cf3 ~ ~ 69 b9 V`3 6R ~
W
lr
O
~
O
O O
O O
O O
~
O
Z O O O ~ O O ~ O O O ~ O
~ O C
~
m ~ ~
~ v';,
~ p 00 O ~ N ~C .~. ~ O ~:. O
W ~ ~ ~ ~ ~ ~ ~ 69 fA ~ ~ ~
U ti
d
~
.b
O y
aCi
p
.`3 O
N
C
b
~
~ ~ N
C ~y N O O
~ O~ C
Z
~ O
`~ ~
O
~ N
b V ~
p ~
N
O ~ W N
~'O
~ L Y
N
Q
b L
C
O O
> O O
W ~ ~
~ ~
b ~
~ p
~ C
~ y pp
C ~d
['
' W v
O ~
O
W '
c
~ b ~ v « •° o ~ `" J y
~ ~ b
~ ~
•o" d
a•°i c b
~ ~ b ~
- y
V ctl ~
C ro O
v b
''~' b ~
~ Y O
V O O
b O c~ 'O
p '~ O 'J b
t v O
C
I C ~ ~ ~ ~ O y b ~ O ctl O
"~ ~ ~
w
w N y'' wy'' ~c ~y
L 3c
F- ~ ~o
• ~•°
ro
~L. ~ H •n ii ro 'w w ~ y i,,, i,,, $ ~n
ti ia.~
Z = _ _ = LWL LWL = W W ~ ~ Q ~ _
w~
~ ~ v
~ v
~ v
~ v
w ~
w ~
w v
~ ~
~ ~
~ a
~ ~
~ ~ a
~ Q
w
u u u u m
d Z Z Z
J Z
J J J U J
J J
1- ~-
Cfl O .- GO
N O
N O
N ~
e' O
~ O
Oi to
J fn
i «~
~ (n
J ~
W U' ~ ~ ..
.a
~ ~ 3 ~ tyQ
O N ~ c>o U~ c>o c m m ~
n.
aN a > > m o
d
~ o N
cn m
x i
°' I
°~
c
o m I
rn I
rn °
°' c Q
m~ ~
~
vUi cn
>
m
om c
•°-
'
•o'cma
' t1? ~
~m c
a
' c
a
' ~
m ~
~ m ~a
m o
'
x
w
w ~ n. a m c m o. a 'Z o> o ~
~
a o
v ~° a a ~ •
O °,~,
m m
.. ~ ~, m rn
> c
n• .
~ m o
rn
a> c
a
a
rn ~ m
~ o 0
rn. ~
Z Ur O
C~ ~ O OJ
U
~ O N
U O>
Uc O qi '
~ O y
U O y
U C
N ~
- ,•y. C L
w
' p
a
~
W
~
co ~
2 a
A NU m
~ .
~ j vo
~
U ~
`~Q ~
`~Q
~ a
c~ o
~ ~
~ x
W
F
.. Q (A I ~ U m
Q,~ m Q Q m V D LtJ ti ~ ~ o
c
W
O
O
O
N
0
O
M
~4~+
U
r
W
W
2
N
_p
Ln
W
N
m
U
n
0
0
J
C
.~
t4
N
O
0
m O
O O
j
Q
~, W ~ O v
~
i- a ° °O °O c ~
o
„~ 00 oc o
~ ~ ~
~ ~
W
w a
~ ~ O ' mm
o 0 0 0 ~
o Z ~
~ ~
~ ~
~ ~
~ o
~
m
W
U
a Z U
L
r ~ C
V ~
Z Q ~ o N
c
c
G O N C
Q ~ G C
{{{W
7 ,b p
y U '~ C
.~' V ~ 'd
r ~ O
N ~ O
~ ~
~
W
~ ~~ o ~
p p p p ~
W ~ ~ ~
~ } ~
~Z ~ U U U U a
Q= m m m m ~
d. > > > > J
"U U U U
F- ~-
~
'
O
~ O
N O
~
W
U' J
C
Z 7
~
~ ~ _ ~ ~
u_
~>,
LL -
~~
m m m a~
~
~
cn ~
cn p
cn
m ~ c
o
w ~~ m~ mt9 ai ~° a
Z ~ ~ L ~~ ~ C
l0 ~ j Q
...
~ ~ QU QU Q o QN ~
Q Q
~- m
r U
r p
0
v
e,
m
r
m
m
m
m
0
N
U
m
O
O
O
N
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 07
e kioaxnentsU weppinyer~s v2008tw20802 united vvapp vralerlva2o802. t 2 meadow_Aa9 loops fitlrationlspecslrnule 9 foop~generaMiv ZOO.doc
BID BOND
KNOW ALL MEN BY THESE PRESENTS: that
Clove Excavators, Inc.
* 11 Raymond Avenue, Suite 23, Poughkeepsie, NY 12603 as Principal; and
Selective Insurance Company. of America
** 40 Wantaae Avenuga Branchvi l l ga NJ 07890 as Surety, are hereby
held and fitrnly bound unto the Town Board, Town of Wappinger, New York in the amount
Of: Five Percent of the Attached Bid (tR~(X>~ ( 5~S of Bid---------------------------)
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 Zd 14 .
WHEREAS, the condition of the above obligation is such that, whereas the Principal has
submitted to the Town Board acertain-bid, atfached hereto and hereby made a part hereof,
to enter into a contract in writing for the Water .Main Extension to Route 9 Water Main. Loop
for the Town of Wappinger,. New York, as shown and specified in Contract Na. 13-010..
NOW THEREFORE,
(a) If said Bid shall be rejected,. or in the alternate
(b) If said Bid shall be accepted and the Principe! 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:,. there this obligation shall. be void.
Otherwise,. the same ;steal( remain in force and effect,. ~ being: expressly
understood and agreed that the (lability of the Surety for any and all claims
hereunder shall, in no event; exceed the amount of this obligation as .herein
stated.
The Surety,. far value received., hereby stipulates and agrees that the obligations of said
Surety and its bored shalt in no way be impaired or affected by any extension of the time
within which the Principal may wept such bid; acid said. Surety tlo$~ hereby waive notice
of any such extension. ,
IN 1IUITNE'SS WHEF~EOF, the Principal and the Surety have hereuntoset their hands and
seals, and such of them as are Corporations have caused their Corporate seals to be
hereto affixed: and these presents to be signed by their proper officers,. the day and year
first set'forth above.
(SEAL) Clove Excavators, Lnc
PRINCIPAL
Insert Bidder's Name 11 Raymond Ave Suit 3 eepsi e, NY 12603
"""Insert Surety's Name By
rc m ,President
7~d ~$.
s;~tt ~ ~ ui1~A:wtwpp w~uMaQL~B02 12 mtndow qs9 bops fiaretlontsdita`g bq}i}pemerandnr ZOC doc
Signed, sealed and d
in the presence of
~iL--~
(Corporate seal of Contractor
if a corporation) Clove Excavators 1 nc.
11 Raymond Avenue Suite 23
Pou4hkee~sie NY 12603
Contractor
By
Marc Vumbico P esident
Selective Insurance Comoanv of America
y
Fra k S. Marant , Jr., (True Of ~ffi+cer) Attorney-in-Fact
fCcarpt~t'~te seal of
:S~retyj Attest
act
200 09
e:WodxrverrtsYwappiepept+~l0U81w2~R2unihd'.wapp.vih~W24hff2.t2'rtiiitf6.w_+~61c~opsftMiotiop~ikbL-a;91cop1genaHlWiv2Qitiiloc.
STATE OF NEW YORK )
} ss:
COUNTY OF ~utchess )
On the 31st day of March 2014 before me, the
undersigned, a Notary Public in and for said State, personally appeared Marc yumb; co
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.
KATHLEEN LOMUSCIO
Notary Public, State of New York
Residing to Dutchess County
Reg. No. 01L06274233
Commission Expires December 31.20,
.r
ZflO 7 0
e:ldocuments~t wappin~erla v~ObdhM20Bi12 un~ed wapp water~twZt}$g2.12 meac~nr r4e9 iaaps-filtr8ttontspecsi~oute 9
loopktenersldnr 2AO;doc
;..
~:• 4,
' 1$r,'; ~'~ _ ,
STATE OF
SS:
COUNTY OF
On this day of before me personally a with whom I
am personally acquainted, who, being by me duly swo epose and say:
That (s)he resides at that (s)he is he'" of the the corporation described m and
which executed the foregoing in ent; that he knows the corporate seal of said corporation;
that the seal thereto affixed.' such corporate seal; that it is so affixed by order of the Board of
Directors, and that h~.~igned his name thereto by like order.
Notary Public
County
STATE OF New York
SS:
COUNTY OF Dutchess
On this 31st day of March, 2014 ,before me personally appeared Frank S. Maranto, Jr.
with whom I am personally acquainted, who, being by me duly sworn, did depose and say:
That (s)he resides at Hyde Park, NY that (s)he is the Attorney-In-Fact of the Selective Insurance
Company of America the corporation described in and which executed the foregoing instrument;
that he knows the corporate seal of said corporation; that the seal thereto affixed is such
corporate seal; that it is so affixed by order of the Board of Directors, and that he signed his
name thereto by like order.
Notary Public
County
KATHLEEN LOMUSCIO
Notary Public, State of New York
Residing in Dutchess County
Reg. No. 01 L06274233 /
Commission Expires December 31,20 tP
r
SELECTIVE °
Selective Insurance Company of America
40 Wantage Avenue
Branchville, New Jersey 07890 BondNo.B 1142993
973-948-3000
POWER OF ATTORNEY
P~mle Bla
SELECTIVE INSURANCE COMPANY OF AMERICA, a New Jersey corporation having its principal office at 40
Wantage Avenue, in Branchville, State of New Jersey ("SICA"), pursuant to Article VII, Section 1 of its By-Laws, which
state in pertinent part:
The Chairman of the Board, President, Chief Executive Officer, any Executive Vice President,
any Senior Vice President or any Corporate Secretary may, from time to time, appoint attorneys
in fact, and agents to act for and on behalf of the Corporation and they may give such appointee
such authority, as his/her certificate of authority may prescribe, to sign with the Corporation's
name and seal with the Corporation'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 may, at any time, remove any such appointee and revoke the power and
authority given him/her.
off.,
O
Q
w
F~
W
U
does hereby appoint Frank Maranto
its true and lawful attorney(s)-in-fact, full authority to execute on SICA's behalf fidelity and surety bonds or undertakings
and other documents of a similar character issued by SICA in the course of its business, and to bind SICA thereby as fully
as if such instruments had been duly executed by SICA's regularly elected officers at its principal office, in amounts or
penalties not exceeding the sum of: One Million Five Hundred Thousand Dollars ($1,500,000.00)
Signed this 31st
day of March 2014
SELECTIVE INSURANCE CO PANY O f
p~:~
By: ~ ~~ i
Ttmothy archio ~;;,,
Its VP, Bond Department ~~ ,~ i926
STATE OF NEW JERSEY
:ss. Branchville
COUNTY OF SUSSEX
On this 31st day of March 2014 before me, the undersigned of~oer~ Spnally
appeared Timothy A. Marchio, who acknowledged himself to be the Vice President of SICA, and that ~``~ ~J ~''•
:Is
Vice President, being authorized so to do, executed the foregoing instrument for the purposes therein csi~ ed,Ib sigi
the name of the corporation by himself as Senior Vice President an h t the same was his free act an$' ~ed ~ .Cree:act
and deed of SICA. ~ ~ ,,~~l,,~~""__!
I;ona~tB~414299J
+_. Notary Public ,=,, ~,,~ 5~~•'
The power of attorney is signed and sealed by facsimile under and by the authority of the following Resolution adopted by
the Board of Directors of SICA at a meeting duly called and held on the 6th of February 1987, to wit:
"RESOLVED, the Board of Directors of Selective Insurance Company of America authorizes and approves the use of a
facsimile corporate seal, facsimile signatures of corporate officers and notarial acknowledgements thereof on powers of
attorney for the execution of bonds, recognizances, contracts of indemnity and other writing obligatory in the nature of a
bond, recognizance or conditional undertaking."
CERTIFICATION
Signed this 31st day of March 2014 .
I do hereby certify as SICA's Corporate Secretary that the foregoing extract of SICA's By-Laws
force and effect and this Power of Attorney issued pursuant to and in accordance with the By-La
H. Lanza, SICA
Important Notice: If the bond number embedded within the Notary Seal does not match the number in the upper
right-hand comer of this Power of Attorney, contact us at 973-948-3000.
SEAL
1928
B91 (12-i1)
~' Selective Insurance Company of America
SELECTIVE ® 40 Wantage Avenue BondNo.B 1142993
Branchville, New Jersey 07890
973-948-3000
STATEMENT OF FINANCIAL CONDITION Public Bid
1 hereby certify that the following information is contained in the Annual Statement of Selective Insurance Company of
America ("SICA") to the New Jersey Department of Banking and Insurance as of December 31, 2013:
ADMITTED ASSETS (in thousands) LIABILITIES AND SURPLUS (in thousands)
Bonds $ 1,223,024 Reserve for losses and loss expenses $ 895,187
Preferred stocks at convention value 0 Reserve for unearned premiums 293,169
Provision for unauthorized
Common stocks at convention values 1.30,174 reinsurance 853
Subsidiary common stock at Commissions payable and
convention values 0 contingent commissions 20,314
Short-term investments 82,666 Other accrued expenses 1.9,390
Mortgage loans on real estate
(including collateral loans) 36,721 Other liabilities 258.668
Other invested assets 77,505 Total. liabilities 1,487,581
Interest and dividends due or accrued 12,795
Premiums receivable 277,559 Surplus as regards policyholders 463,438
Other admitted assets 1.10,575
Total liabilities and surplus as
Total admitted assets ~-1~1~o 1~ regards policyholders ~-~-~~
1 further certify that the following is a true and exact excerpt from Article VII, Section 1 of the By-Laws of SICA, which is
still. valid and existing.
The Chairman of the Board, President, Chief Executive Officer, any Executive Vice President,
any Senior Vice President or any Corporate Secretary may, from time to time, appoint attorneys
in fact, and. agents to act for anal on behalf of the Corporation and they may give such. appointee
such authority, as his/her certificate of authority may prescribe, to sign with the Corporation's
name and seal with the Corporation'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 may, at any time, remove any such appointee and revoke the power and
authority given him/her.
IN WITNESS WHEREOF, I hereunto subscribe my name and
STATE OF NEW JERSEY
ss. Branchville
COUNTY OF SUSSEX ~"`~~""' ti ~ ~ ~ ~ ~ < <,
~`~`~EN~ ~'`~,
On this day of fC~,2014, before me, the undersigned officer, personally appeared Michael H. Lanza, oQ`~ , ~ • ~ ~ - ,hi,,~',
acknowledged himself to be the Corporate Secretary of SICA, and t e, as such Corporate Secretary, being.~'iorized o ' `?~
to do, executed the foregoing instrument for the purposes therein nta' , by signing the name of t corparatidn b~~ ~'~~~ ~ :gym
himself as Corporate Secretary. ~ ~" ~!`/~ ~ '- - --
Chari~e ftim ,; ~F~,~, J ER `~ ,,. ~.
My Commission Expires: NOtdryPubGCOfNewJet98y '"' ~ ~ ~ ~ t~`~
My C~mm'~ssicn Elcpites 617J2016
CERTIFICATION OF NON-COLLUSION BY BIDDER
No bid will be considered unless this Cert~cation 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 agenc~+ 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 pe of p rjury.
BIDDER'S SIGNATURE:
Marc ~ bico; Preside~~
zoo»
DATE: 03/31/2014
e:ldocumentsll wappingerla w20081w20802 united wapp water1W20802.12 meadow rte9 loops filtraGonlspecslroute 9
Ioopk~eneralldiv 200.doc