Sun Up EnterprisesTOWN OF WAPPINGER ROBINSON LANE BASEBALL FIELD
11412.07 BID FORM 00310-1
Bid
BIDDER Name SUN UP ENTERPRISES, INC.
Address SUN UP ENTERPRISES, INC
9607 Route 376
Waggingers Falls NY 9259
Phone and Fax ~~FS-4(oa- I goo gds''-ti~a-~37
Date -rY1.e~~~, 3 , ~ G ~ y
PROJECT: Town of Wappinger
Robinson Lane Baseball Field ~~~~~~~®
Community Development Block Grant
OWNER: Town of Wa in er MAR 0 5,014
pp~ g
20 Middlebush Road TOWN OF WAPPINGER
Wappingers Falls, NY 12590 _TO_ WN CLERK
1.01 The undersigned BIDDER proposes and agrees, if this Bid is acce ted, to enter into an
p
agreement with the OWNER in the form included in the Contract Documents to perform
and furnish all work as specified or indicated in the Contract Documents for the Contract
'~°' price and within the Contract Time indicated in this Bid and in accordance with the other
terms and conditions of the Contract Documents.
~ 2.01 BIDDER accepts all of the terms and conditions of the Invitation to Bid and Instructions to
BIDDERs. This Bid will remain subject to acceptance for sixty (60) days after the day of
Bid opening. BIDDER will sign and submit the Agreement and other documents required
by the Bidding Requirements within seven days after the date of the OWNER's Notice of
Award.
01 I
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hi
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id, BIDDER represents, as more fully set forth in the Agreement, that:
A. BIDDER has examined and carefully studied copies of all the Bidding Documents,
the oth
l
t
d d
t
id
ifi
d i
er re
a
e
a
a
ent
e
n the Bidding Documents, and the following Ad-
denda (receipt of all which is hereby acknowledged):
Date ~ - a y -l ~/ Number ~
Date ~ - a 6 - I y Number ~.
Date Number
Date Number
B. BIDDER has familiarized itself with the nature and extent of the Contract Docu-
ments, work site, locality, and all local conditions and Laws and Regulations that in
any manner may affect cost, progress, performance, or finishing of the work.
^~
00310-1
TOWN OF WAPPINGER
ROBINSON LANE BASEBALL FIELD
11412.07 BID FORM 00310-2
C. BIDDER has obtained and carefully studied (or assumes responsibility for obtain-
ing and carefully studying) all such examinations, investigations, explorations, tests
and studies which pertain to the physical conditions at the site or otherwise may af-
fect the cost, progress, performance or furnishing of the work as BIDDER
considers necessary for the performance or furnishing of the work at the Contract
Price, within the Contract Time, and in accordance with the other terms and condi-
tions of the Contract Documents, including specifically the provisions of Paragraph
4.02 of the General Conditions (and reports or drawings of Hazardous Environ-
mental Conditions, if any, as provided in paragraph 4.06 of the General
Conditions); and no additional examinations, investigations, explorations, tests, re-
ports, or similar information or data are or will be required by BIDDER for such
purposes.
D. Contract Time and Liquidated Damages
The Contract Time commences to run as provided in paragraph 2.03 of the Gen-
eral Conditions and completed and ready for final payment in accordance with
paragraph 14.07 of the General Conditions as specified in the Agreement.
CONTRACTOR shall pay OWNER as specified in the Agreement for each calen-
dar day that expires after the time specified in Agreement for milestones and for
completion and readiness for final payment.
E. BIDDER has reviewed and checked all information and data shown or indicated on
the Contract Documents with respect to existing Underground Facilities at or con-
tiguous to the site and assumes responsibility for the accurate location of said
Underground Facilities. No additional examinations, investigations, explorations,
tests, reports, or similar information or data in respect of said Underground Facili-
ties are or will be required by BIDDER in order to perform and furnish the work at
the Contract Price, within the Contract Time, and in accordance with the other
terms and conditions of the Contract Documents, including specifically the provi-
sions of Paragraph 4.04 of the General Conditions.
F. BIDDER has correlated the results of all such observations, examinations, investi-
gations, explorations, tests, reports, and studies with the terms and conditions of
the Contract Documents.
G. BIDDER has given ENGINEER written notice of all conflicts, errors, or discrepan-
cies that it has discovered in the Contract Documents and the written resolution
thereof by ENGINEER is acceptable to BIDDER.
H. This Bid is genuine and not made in the interest of or on behalf of any undisclosed
person, firm, or corporation and is not submitted in conformity with any agreement
or rules of any group, association, organization, or corporation; BIDDER has not di-
rectly or indirectly induced or solicited any other BIDDER to submit a false or sham
Bid; BIDDER has not solicited or induced any person, firm, or corporation to refrain
from bidding; and BIDDER has not sought by collusion to obtain for itself any ad-
vantage over any other BIDDER or over OWNER.
00310-2
TOWN OF WAPPINGER ROBINSON LANE BASEBALL FIELD
BID FORM 00310-3
11412.07
Non-Payment Of Contract Items
BIDDER understands and agrees to provisions for non-payment of monies as out-
lined in the Special Conditions for failure to complete a temporary erosion control
measures, dust control, and/or maintenance and protection of traffic. This non-
payment will be a permanent deduction from the total monies paid under this con-
tract.
J. BIDDER understands and agrees to pay OWNER one hundred dollars ($100) for
each calendar day that expires after the notification and time specified in the
Agreement for completion of restoration and/or, temporary erosion control
measures.
4.01 The BIDDER understands and agrees that the estimated quantities for unit Bid prices, if
any, are to be considered as approximate only. The OWNER does not expressly or by im-
plication agree that the actual quantities will correspond therewith and reserves the right to
increase or decrease any quantity or to eliminate any quantity as he may deem necessary.
Neither the OWNER nor the BIDDER will be entitled to any adjustments in a unit Bid price
as a result of any change in quantity unless that change exceeds 15% of the estimated
quantity and equals or exceeds $25,000, and BIDDER agrees to accept the aforesaid unit
Bid prices as complete and total compensation for any additions or deductions caused by
a variation in quantities as a result of more accurate measurement, or by any changes or
alterations in the Work ordered by the OWNER, and for use in computing the value of the
Work performed for progress payments for changes that vary within the adjustment limits
stated above.
The undersigned further understands that there will be a review and negotiation of the unit
Bid price whenever the actual quantity for that particular unit price Item varies by more
than 15% from the Bid quantity, or by $25,000 or greater.
5.01 BIDDER further agrees that the OWNER has the right to delete Bid items and/or Bid Sec-
tions and may add Alternate(s) prior to or after award if the OWNER deems this to be in
the OWNER'S best interest.
6.01 BIDDER agrees to entire dollar amount, even if it is zero ($0), for each Alternate. (Do not
leave an alternate bid amount blank.)
7.01 BIDDER also agrees that the OWNER reserves the right to award this project to the
lowest responsible BIDDER on the basis of the sum of the Base Bid, and any, all, or
none of the Alternates listed in the Bid (if Alternates are applicable). The Town has ap-
proximately $25,000 available to fund this project and intends to award the base bid
and as many of the alternates in the order listed totaling less than the available
funds.
8.01 BIDDER will complete the work for the following price(s) as stated in the attached Bid Pro-
posal.
00310-3
TOWN OF WAPPINGER ROBINSON LANE BASEBALL FIELC
11412.07 BID FORM 00310-
9.01 The Town of Wappinger has been and will continue to be an equal opportunity organize
tion. All qualified Minority and Women-Owned Business Enterprises (MWBE) supplier;
contractors and/or businesses will be afforded equal opportunity without discrimination bE
cause of race, color, religion, national origin, sex, age, disability, sexual preference c
Vietnam. Era Veterans status. The BIDDER shall comply with the material specification
and the Standard Clauses for NYS Contracts, Clauses Required by Office of Parks, Rec
reation and Historic Preservation and Equal Employment Opportunity Policy Statemer
appended to the specifications.
10.01 The project is in part funded by a Community Development Block Grant administered b~
the Dutchess County Department of Planning.
00310-4
ebruary 24, 2014
Prospective Bidders
Re: Addendum #1
Town of Wappinger - CDBG
Robinson Park Challenger Field Electrical
Job # 11412.07
Dear Prospective Bidders:
Clark Patterson Lee
DESIGN PROFESSIONALS
This letter is being written as Addendum Number 1. The purpose of this Addendum is
document pertinent discussions during the pre-bid meeting on February 20, 2014 and address any
questions which have arose to date. The contents of this Addendum are made part of the
Contract Documents for the above referenced contract and include the following:
Clarifications
1. All excavation is in grass areas, requiring top soil, seed and mulch as restoration. Watering
following completion of work is not a requirement.
2. The power pedestal cut sheet provided in the specification is intended to establish a standard
of intent. Products that meet the intent will be allowed if determined to be "an equal". The
night light is not a required feature.
3. The bid is based on a spare electrical conduit existing between from the electrical room to the
pull box.
4. Attached are photos of the electrical room. The spare conduits and the electrical box are both
on the southwest wall of the building.
5. The exact location of the power pedestal will be marked in the field by the Tawn's Engineer
to correspond to the cord from the portable restroom.
This concludes Addendum Number 1.
Questions regarding this bid shall be submitted in writing.
Sincerely,
Clark Patterson Lee
~•
Gre W: Bolner P.E.
g
Principal Associate
cc: Ralph Holt, Chairman of Recreation Committee soo Corporate aoulevara
Audra Murray, DC Department of Planning Newburgh, NY 12550
clarkpatterson.com
800.274.9000 TES
845.567.9614 FAx
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February 26, 2014
Prospective Bidders
Re: Addendum #2
Town of Wappinger - CDBG
Robinson Park Challenger Field Electrical
Job # 11412.07
Dear Prospective Bidders:
Clark Patterson Lee
DESIGN PROFESSIONALS
This letter is being written as Addendum Number 2. The purpose of this
Addendum is address questions which have arose to date. The contents of this
Addendum are made part of the Contract Documents for the above referenced contract
and include the following:
Corrections/Clarifications
1. The contractor is responsible for marking out the existing underground electrical as
necessary to avoid damage to these existing utilities. There is no water, sewer or
other underground utilities which will require markout.
2. To minimize disturbance in the grass areas, the contractor will be allowed to use a
trencher to reduce the width of the trench for the installation of the electrical conduit.
3. Alternate Bid item A-2 has been added for the installation of addition linear feet of
new trench and 2" schedule 40 PVC conduit should it be found that the existing spare
conduit is not able to be used.
This concludes Addendum Number 2.
Questions regarding this bid shall be submitted in writing.
Sincerely,
Clark Patterson Lee
,~1 ~ `W l8a-Qirl.Qrl,
Greg W. Bolner, P.E.
Principal Associate
cc: Ralph Holt, Chairman of Recreation Committee
Audra Murray, DC Department of Planning
900 Corporate Boulevard
Newburgh, NY 12550
clarkpatterson.com
800.274-9000 ~L
845.567.9614 anx
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Non-Collusive Bidding Certificate
In accordance with the provisions of Section 103-d of the General Municipal Law as amended, the
following "Non-Collusive Bidding Certificate" is and shall become a part of this proposal: (a) 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 organizations 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 by law, the prices which have been quoted in this bid
have not been knowingly disclosed by the BIDDER and will not knowingly be disclosed by the
BIDDER prior to opening, directly or indirectly, to any other BIDDER or to any competitor; and (3)
no attempt has been made or will be made by the BIDDER Fr~duc any other person, partner-
ship, or corporation to submit or not to ,sub a bid forth urpose of res fiction of competition."
o~Q~~
Signature ar,d Title
In accordance with the provisions of Section 103-a of the General Municipal Law the following
clause is hereby inserted to provide:
"That upon the refusal of a person, when called before a grand jury to testify concerning any
transaction or contract had with the State, any political subdivision thereof, a public authority or
with any pubic department, agency, or official of the State or of a public authority, to sign a waiver
of immunity against subsequent criminal prosecution or to answer any relevant question concern-
ing such transaction or contract, (a) such person, and any firm, partnership, or corporation of
which he is a member, partner, director or officer shall be disqualified from thereafter selling to or
submitting bids to or receiving awards from or entering into any contracts with any municipal cor-
poration or any public department, agency, or official thereof, for goods, work, or services, for a
period of five years after such refusal, and to provide also that (b) any and all contracts made with
any municipal corporation or any public department, agency, or official thereof, since the effective
date of this law, by such person, and by any firm, partnership, or corporation of which he is a
member, partner, director, or officer may be canceled or terminated by the municipal corporation
without incurring any penalty or damages on account of such cancellation or termination, but any
monies owing by the municipal corporation for goods delivered or work done prior to the cancella-
tion or termination, but any monies owing by the municipal corporation for goods delivered or work
done prior to cancellation or termination shall be paid."
00310-6
Ci
If BIDDER is:
An Individual
gy (SEAL)
(Individual's Name)
doing business as
Business Address:
Phone Number:
A Partnership
gy (SEAL) -
(Firm's Name)
(general partner)
Business Address:
Phone Number:
A Corporation
SUN UP ENTERPRISES, INC,
By (SEAL)
(Corporation Name)
7
~ (S to of Incorporation)
ar-o / c ~ ~~r' (Name of Person Authorized to Sign)
c~ Qom! ~ [~ .P~'i"'i '.
(Titlel
(Corpr.,rate Seal)
Attest_ ____.__
Business Addreas:
Phone Number:
Wappingers Falls, NY 12590
A Joint Venture
By
(Name)
(Address)
BY
(Name)
(Address)
(Each joint venturer must sign. The manner of signing for each individual, partnership, and corporation that is a party to the
joint venture should be in the m anner indicated above).
SUN UP ~~~~~3~~8~~~ ~ ~~~ o
Rigging • Drainage • Site Work • Excavating • Waterlines
Asphalt Paving • Concrete Work • Sanitary Sewers
CERTIFIED CORPORATE RESOLUTION
RESOLVED THAT Harold W. Buchner be authorized to sign and submit
the bid or proposal of this corporation for and to include in such bid of proposal the
certificate as to anon-collusion required by section one hundred three-d (103-d) of the
general municipal law as to the act and deed of such corporation, and for any
inaccuracies or mis-statements in such certificate this corporate bidder shall be liable
under the penalties of perjury.
The foregoing is a true and correct copy of the resolution and adopted by
Sun Up Enterprises, Inc. at a meeting of its board of directors held on the
4th Day of February , 2014
Secretary
Signed and sworn before me this
_~i~day of ~l~'1~''~, 2014
_ ~`
Notary Pubic
(~ln±ary P~,~:'oll;;, `•3~.. i~: ! !°w York
Ccmi ~ ~,,, ' ~ ~~ ~ _~ ;,,',7
~~_<< ~ 7
C(JITI171~:rSlv:l c.t,~ut,~ ~I~~Uy 1 /, Z~
1607 ROUTE 376 WAPPINGERS FALLS. NEW YORK 12590 TELEPHONE845-462-1800 FAX 845-462-8375
c-~
,~Qb.. ®u~~t ~3~ OTM ~ 1910
~sd ~®nd
KNOW ALL 1V1EN BY THESE PRESENTS, that we
(Here insert full name and address or legal title of Contractor)
Sun Up Enterprises Inc
1607 Route 376
Wappingers Falls, NY 12590
as Principal, hereinafter called the Principal, and
(Here insert full name and address or legal title of Surety)
Travelers Casualty and Surety Company of America
300 Windsor Street
Hartford, CT 06120
a corporation duly organized under the laws of the State of CT as Surety, hereinafter
called the Surety, are held and firmly bound unto
(Here insert full name and address or legal title of Owner)
Town cf Wappinger
1.0 Middlebush' Road
Wappingers Falls, NY 12590
as Obligee, hereinafter called the Obligee, in the sum of 5~ ($ 5~a ), for the payment of
which sum well and truly to be made, the said Principal and the said Surety, bind
ourselves, our heirs, executors, administrators, successors and assigns, jointly and
severally; firmly by these presents.
WHEREAS, the Principal has submitted a bid for
(Here insertfull name, address and description of project)
Robinson Park -Challenger Field Electrical
Robinson Lane Baseball Field -Electrical Services
NOW, TI-3EI2EFORE, if the Obligee shall accept the bid of the Principal and the
Principal shall enter into a Contract with the Obligee in accordance with the terms of
such bid, and give such bond or bonds as maybe specified in the bidding or Contract
Documents with good and sufficient surety for the faithful performance of such Contract
and for the prompt payment of Labor and material furnished in the prosecution thereof, or
in the event of the failure of the Principal to enter such Contract and give such bond or
bonds, if the Principal shall pay to the Obligee the difference not to exceed the penalty
hereof between the ai«otrnt specified in said bid and such .larger amount for which the
Obligee may in good faith contract with another party to perform the Work covered by
said bid, then this obligation shall be null and void, otherwise to remain infiill force and
effect.
ADDITIONS AND DELETIt)N5:
The author of this document has
added information needed for its
completion. The author may also
have revised the text of the original
AlA standard form. An Additions and
Deletions Report that notes added
information as well as revisions to
the standard form text is available
from the author and should be
reviewed. A vertical line in the left
margin of Phis document indicates
where the author has added
necessary Information and where
the author has added to or deleted
from the original AIA text.
This document has important legal
consequences, Consultation with an
attorney is encouraged with respect
to its.completion or modification.
AfA Document A310T" - 197D, Copyright ~ 1963 arrd 1970 by The American Inslitula o1 Architects. Afl riyhts reserved. N/ARIVING: This AIA® Document
is protected by U.S. Copyright Law and International Treaties, Unauthorized reproduction or distribution of this AIA° Document, or any portion of it,
may result in severe civil and criminal penalties, and will be prosecuted fo the maximum extent possible under the law. This dorumenl was produced
by AIA software at 11:32:13 on 10/302006 under Order No.1000240782 1 which expires on 5/3D/2D07, and is no[ for resale. (2844403059)
User t4otes:
Signed and sealed this 30th day of January, 2014
Sun Up Enterprises Inc
(Principal) (Seal)
(Title) H old Buc esi dent
Travelers Casualt and Suet Com an of America
U rep) r' /
W ~
(Title) arme a rasst (Seal)
Attorney-in-Fact
AlA Document A370T~~ - 7970. Copyright Q 1963 and 1970 by The American Institute of Architects. All rights reserved OWARNING: Thts AIA~ Document
'ss protected by U.S. Copyright La~v and International Treaties. Unauthorized reproduction or distribution of this AtA Document, or any portion of ii,
may rosult in savere civil and criminal penalties, and will be prosecuted to the maximum extent possible under the law. This document was produced
by AIA seRware at 11:32a3 on t 0/30/2006 under Ordor No.1000240782_t which expires nn 513012007, and is not for resale. (28444D3059)
User Nofes:
NOTARIAL JURAT
INDIVIDUAL ACKNOWLEDGMENT
State of }
County of }
On this day of - ,before me personally came
to me known and known to me to be the individual(s) who executed the foregoing instrument and
acknowledge to me that he/she/they executed the same.
Notary Public
PARTNERSHIP ACKNOWLEDGMENT
State of }
County of }
On this day of ,before me personally came
to me known and known to me to be a member of the partnership of
acknowledged that he/she executed the foregoing instrument as the
act of the said partnership.
Notary Public
CORPORATION ACKNOWLEDGMENT
State of New York }
County of Dutchess
On this day ofi
Harold Buchner
0) ~ ,before me personally came
to me known, who, being by me duly sworn, did depose and say that he/she resides in Poughkeepsie, NY
;that he/she is the President o#the Sun Up Enterprises Inc
the corporation which executed the foregoing instrument; that he/she
knows the seal of said corporation; that the seal affixed to the said instrument is such corporate seal; that is
was so affixed by order of the Board of Directors of the said corporation, and that he/she signed his/her name
to the instrument by like order.
Notary ublic
SURETY ACKNOWLEDGMENT
~,
Rln+ar~~ 1~~:~~:,-.:~~ .. i'~~w York
CorCr~ . ~, _, ~ ~ i, y ~ T,12G~
State of New York ~
County of Dutchess }
On this 3otn day of January 2014 ,before me personally came Carmella M. C,rassi
to me known, who being by me duly sworn, did depose and say: that he/she resides in the City of Kingston
that he/she is Attorney-in-Fact of the above signed surety, the corporation described in and which executed
the foregoing instrument; that he/she knows the corporate seal of said corporation; that the seal affixed to
Scid inSti umcnt IS such c~~rporate goal; that it wag en affjxed hjy order of tt-~e ~naer; r,f i7irarfprg of chid
corporation; and that he/she signed his/her name thereto by like order.
IVaTHLEEN A BROWN ~~~ - / ~-~
Notary Public, State of New York
Qualified in Ulster County ary Public
Reg. No. 4719731
Commission Expires Dec. 31, 20
OF
WITHOUT
.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. 224598 Certificate No. O O 4 v 1 H U~ O
KNOW ALL MEN BY THESE PRESENTS: That St. Pau] Fire and Marine Insurance Company, S[. Paul Guardian Insurance Company and St. Paul Mercury Insurance
Company are corporations duly organized under the laws of the State of Minnesota, that Farmington Casualty Company, Travelers Casualty and Surety Company, and
Travelers Casualty and Surety Company of America are corporations duly organized under the laws of [he State of Connecticut, that United States Fidelity and Guaranty
Company is a corporation duly organized under the laws of the State of Maryland, that Fidelity and Guaranty Insurance Company is a corporation 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
Frank S. Maranto Jr., Kevin A. Viana, Mary Ann Szczypca, Timothy Rychcik, Susan Provost, Kathleen A. Brown, Carmella M. Grassi, and Eleanor
Menges
of the City of ,State of_ 1~Pw Ynrk ,their ttue and lawful Attorney(s)-in-Fact,
each in their separate capacity i 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 to be signed and their corporate seals to be hereto affixed, this 25th
day of May 2012
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
St. Paul Mercury Insurance Company
Travelers Casualty and Surety Company
Travelers Casualty and Surety Company of America
United States Fidelity and Guaranty Company
°ASoUnq~ TY tFE 6 N ~N `""~""'•¢, 1
r O~y-'Yr )'L ~A J ,y' Q\~`,..... .;r(/9 JPi ~NSUg9r, 9JP~TY Ah0 ~ Ha ~y 4~Y,4_
U, 5 ~ (1 i ~~7/ / ~ in rEOP VryR~>' S Q:' °' f,P '- ~ Y. 41
1982 0 ~APORATED m ~1 ftm ;rm:poNeoRgtf.,,,,t ~ ,~
~ ~ S --- ~ ° : W HARTFORD, < ~ HARIFORq ~ a
i crw' a ~ 1951 ~ ~`'• S E A L ;o ! ' ~ ` ° ~ CONN. ° Y,A~OOHH a ~, 1896 -~
b~ N~ ~ ~ by'as c° os'... ; if ~`:,SSAL:'D W o O~
y . ti ! t~ .wy`FANLC ~r fS..... N;1L_ o.~•.... d 's a'~ ~~.... ~~ `~I
~ Mre
.,,,~
State of Connecticut
City of Hartford ss.
By:
Georg Thmnpson, enior ice President
On this the 25th day of May 2012 ,before me personally appeared George W. Thompson, who acknowledged
himself to be the Senior Vice President of 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, 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 pwposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer.
~f G.T~~
In Witness Whereof, 1 hereunto set my hand and official seal. ~
My Commission expires the 30th day of June. 2016. ~'OiIBU~
~~
58440-6-11 Printed in U.S.A.
WARNING: THIS POWER OF ATTORNEY
`C'(~ c~nc.~ C .
Marie C Tatreauh. Notary Public
THE RED
7RAVFIEP,S Cr\SUP+LTY AND SURETY CDMPi:NY DF Af4ERICA
HARTFORD, COtJtJECTIGUT 06183
FINANCIAL STATEMENTAS OF DECEMBER 31, 2012
AS FILED IN THE STATE OF NEW YORK
CAPITAL STOCK 5 6,4E0,D0p
CASH AND INVESTED CASH
20NDS $ 15,936,791
INVESTFdENT INCOME DUE AND ACCRUED 3,713,171,015
OTHER INVESTED ASSE75 .50,798,732
PREMIUM BALANCES 280,730,697
NET DEFERRED 7AX ASSET 184,842,508
REINSURkh1CE FiECOVERASLE 63,274,378
5ECURffIES LENDING P,EINVESTED COLLATtRAL ASSETS 12,410,524
RECEIVABLES FROM PARENT, SUBSIDIARIES AND'AFFIlIATES 7,769,155
11,060
470
UNDISTRIBUTED PAYMENTS ,
OTHER ASSETS (1,439.585)
884,093
TOTAL ASSETS 3 4.339.558.778
UNEARNED PP,EMIUMS
LOSSES $ 783,409 692
REIIVSURANCE PAYABLE ON PAID LOSSES 8 LCSSADJ
EXPENSES 9D1,058,710
.
LOSS ADJUSTMENT EXPENSES 1,446,021
COMMISSIONS 534,37D,660
TAXES, LICENSES AND FEES 29,2x1,779
OTHER EXPENSES 66,762,694
FUNDS HELD UNDER REINSURANCE TP,EATtES 35.5xE,957
CURRENT FEDERAL AfJD FOREIGN INCOME TAXES gq.449 544
REAIITTANCES AND- ITEM S NOT ALLOCATED 60,675,573
AMOUIJT$ WITHHELD /RETAINED FiY COMPANY-FOR OTHEP
S" 19,2.70,931
7
.
RETROACTIVE REINSURANCE RESERVE kSSUN,ED 9,084,606
PDLICYHOLDER DIVIDENDS 3,163,164
PROVISION FOR REINSURANCE 6,730,121
ADVANCE. PREMIUM 5,314,325
PAYABLE FOR'SECURITIES LENDING 726,098
CEDED REINSURANCE NETPREANIUMS PAYABLE 7,7fi9,155
ESCf-fEATLIABfLITY (74,803,744)
OTHER ACCP,UED EXPENSES RND LIABIUTIE3 5?.5,399
TDTALUABILmES 2x4462
s 2.55s.1D6,ss7
CAPITAL STOGK 5 6
4x0
040
PAID IN 5UP.PLUS ,
,
OTHER SURPLUS 433,603,764
TOTAL SURPLUS TO POLICYHOLDERS 1,3eo,ise.o61
3_ 1,784,451.821
TOTAL LIABILITIES: if SURPLUS' S 4,339 55x.778
STATE OF CONNECTICUT )
COUiVTY OF HAPTFORD ) SS.
CITY OF HAl'tT"rORD t
MICHAEL J. DOODY, BEING DULY SWORN, .SAYS THAT FiE tS SECOND VICE PRESIDE!T, OF TP.AVELEP.S CASUALTY AND SUP.ETY COMPANY OF AMERICA,
AND THAT TO THE BEST OF HIS KWOWLEDGE AND BELIEF, THE FOREGOING f5 A TRUE AND CORP,ECT STATEMENT OF THE FINANCIAL CONDITION OF SAID
COIJIPANY AS OF THE 31 ST DAY OF DECEMBER, 2012,.
SUBSCRIBED AND SN/ORN TO l;EFOR-.~ ME THIS
2D T H DRY OF MA.;=+CH, 2v^13
7
yr. p
SECOND VICE PRESIDENT ,f
CC r~ '..
NOTARY PU31.IC "~
st?snrr na. \x~:ts5tr.vrR
r\'nrary PuLlic
ti~jp ( 0Itl1A7XCtr»I rt7n>•2e ~'yrmr•rp(,rr i0• ,~, (71