Backup Documents 04/25/2017 Item #16C3 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL I)OCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office
at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later
than Monday preceding the Board meeting.
**NEW** ROUTING SLIP
Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already complete with the
evcclxion of the Chairman's sign;tture,draw a line thtetigh routing Imes#1 through tt2,complete the.hecklist,and forward to the Ctxmnty Attorney Office.
Route to Addressee(s)(List in routing order) Office Initials Date
1.
4
r,,
2.
3. County Attorney Office County Attorney Office - it 11
4. BCC Office Board of County ',
Commissioners ,. / \k \—\._.
5. Minutes and Records Clerk of Court's Office , ,. ...
! `..
Tirn '" 171
PRIMARY CONTACT INFORMATION
Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the
addressees:Moe,nma',need to contact staff for ttddibonul or:cussing information.
Name of Primary Staff Phone Number 1,-
Contact
Contact I Department Alicia Abb,6tt _ 239-252-5.44 -
Agenda Date Item was if Agenda Item Number v
Approved by the BCC 4/25/17 ' 16C3
Type of Document Number of Original
Attached Work Order _ Documents Attached 1 ;,
PO number or account
number if document is
to be recorded 70085.17.6 -.4
.4.......
INSTRUCTIONS & CHECKLIST
I Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes
appropriate. (Initial) Applicable)N/A(Not
A licable)
1 Does the document require the chairman's original signature? = -_-:;),---7
2 Does the document need to be sent to another agency for additional signatures? If yes, ,,"
provide the Contact Information(Name;Agency;Address; Phone)on an attached sheet. N/A ;;
3. Original document has been signed/initialed for legal sufficiency, (All documents to be ,�,.�-�
signed by the Chairman,with the exception of most letters,must be reviewed and signed \y - ,
by the Office of the County Attorney.
4. All handwritten strike-through and revisions have been initialed by the County Attorney's
Office and all other parties except the BCC Chairman and the Clerk to the Board `-.)
5 The Chairman's signature line date has been entered as the date of BCC approval of the -------••‘-i-
document or the final negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's 1`ti
t
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip
should be provided to the County Attorney Office at the time the item is input into SIRE.
Some documents are time sensitive and require forwarding to Tallahassee within a certain <3
it
time frame or the BCC's actions are nullified. Be aware of your deadlines!
S. The document was approved by the BCC on 4/25/17 and all changes made during NIA is not
the meeting have been incorporated in the attached document. The County r ivi an option for
Attorney's Office has reviewed the changes,if applicable. this line.
9. Initials of attorney verifying that the attached document is the version approved by the N/A is not
BCC,all changes directed by the BCC have been made,and the document is ready for the an option,for
Chairman's signature. — as this lune.
I.forms!County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05;Revised 11/30/12
16C3
WORK ERJPURCHASE ORDER
Contract 14-6 3 "Underground Utili Contracting"
Contract Expiration Date: Jul , 2018
This Work Order is for professional Underground Utility Contracting services for work known as:
Project Name: SRO Wellfield Flow Meter Replacement RFQ 14-6213-84
Project No:70085.17.6✓
The work is specified in the proposal dated December 2, which is attached hereto and made a part of
this Work Order. In accordance wi4Terms and Conditions of the Agreement referenced above and
Request for Quotation # 14-621Y.84, this Work Order/Purchase Order is assigned to: Quality
Enterprises USA, Inc.
Scope of Work: As detailed in the attached proposal and the following:
> Task I: Perform all work as described in the request for quote (RFQ I4-6"LI3-84), and as listed
on the attached quote form.
> Task II: Allowance.
Schedule of Work: Complete work within 2'!0 days from the date of the Notice to Proceed which is
accompanying this Work Order. The Cpfisultant agrees that any Work Order that extends beyond the
expiration date of Agreement# 14-6243 will survive and remain subject to the terms and conditions
of that Agreement until the completion or termination of this Work Order.
Compensation: In accordance with the Agreement referenced above, the County will compensate the
Firm in accordance with following method(s): ONeg6tiated Lump Sum (NLS) ❑Lump Sum Plus
Reimbursable Costs (LS+RC) ®Time & Material (T&M) (established hourly rate-Schedule A) ❑
Cost Plus Fixed Fee (CPFF), (define which method will be used for which tasks) as provided in the
attached proposal. //
Task I $ 198,025.19 NL'S//
Task II $ 15,000.00 T&IVI
TOTAL FEE $213,025.19 NLS &T&M
PREPARED BY: Jti,-X,VC CK C�k l l NkC)Y6\c:\\'aG Cl
Alicia Abbott,Project Manager Date
Engineerriin &Project Management Division
APPROVED BY: C..-V(.1( ::11-kLLC:-.
.g aii?
Oscar Martinez, . ., Principal P . -c_t'atanager Date
Engineering& Project M• ..4:it t Division
Page 1 of 3
16C3
i
APPROVED BY: (197a444 //. 3 - 9 - 1
P. Libby, Watt P'stri. tion Manager Date
APPROVED BY: it 1 q
e T essner, # ater Director D.,e
APPROVED BY: AL 3 9
To Chmelik, P.E., Director s ate 0- eering& Project Management Division
A//* 3 /Wan
APPROVED BY: /%%Aitr[1.
J ell e ne, Ut' i f�Operations Support Director Date
APPROVED BY: i ,
i' / 3 - Kt - /-7
i .n Hall, 'rocurement Strategist Date
APPROVED BY. •. - it �y /1 It,
G rge Yil az, Public Utilities Administrator Date
By the signature below, the Firm (including employees, officers and/or agents) certifies, and hereby
discloses, that, to the best of their knowledge and belief, all relevant facts concerning past, present, or
currently planned interest or activity (financial, contractual, organizational, or otherwise) which
relates to the proposed work; and bear on whether the Firm has a potential conflict have been fully
disclosed.
Additionally, the Firm agrees to notify the Procurement Director, in writing within 48 hours of
learning of any actual or potential conflict of interest that arises during the Work Order and/or project
duration.
ACCEPTED BY: Quality Enterprises USA, Inc.
411'' �� 3W17Name & Title o Authorized Officer Date
Stacey L. Murrell, Corporate Secretary
(Remainder of page intentionally left blank)
Page 2 of 3
16C3 4
IN WITNESS WHEREOF,the parties hereto, have each, respectively, by an authorized person or
agent, have executed this Work Order on the date and year first written below.
ATTEST: BOARD OF COUNTY COMMISSIONERS
Dwight E. Brock,;Clerk of Courts COLLIE 40 TY, FLORIDA
By: ( , By: //
,�.� Penny Tayl(Chairman
Dated: '5 "3
,(SEAL)
Attest as to Ct airman's Name of Firm: Quality Enterprises USA, Inc.
signaatturee only.
�u C. ;LCZ By: w• _ / �G%� �
First Witness Signature
Stacey L. Murrell , Cnrpnrate Secretary
Marcie Cohen TType/print signature and titleT
TT/ype/print witness nameT
Second W. less
Margarita Negron
TType/print witness nameT
A ov d to s a d Ler:,
Zasi::;County Attorney
� c_0g
Print Name item# IL
AgendaL.l.,"'
Date -�-6a' }- -
Date
Recd
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Page 3 of 3
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16C3
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EXHIBIT A 16 C3
PUBLIC PAYMENT BOND
Bond No. 9243743
Contract No. 14-6213-84
KNOW ALL MEN BY THESE PRESENTS: ThatQuality Enterprises USA,Inc.
Fidelity and Deposit Company of Maryland as Principal, and
IL 60196 as Surety, located at 1299 Zurich Way,Schaumburg
(Business Address)are held and firmly bound to Board of County Commissions,Collier
County,FL as Oblige in the sum of Two Hundred Thirteen Thousand Twenty Five Dollars
we bind ourselves, our heirs, executors, personal representatives, successor19H00s and assigns,jointly and19
) for theseveral paymy t wwhereof
WHEREAS, Principal has entered into a contract dated as of the 21st day of April , 2017,with Oblige for
SRO Wel�eld Flow Meter Replacement,Phase 1
in accordance with
drawings and specifications, which contract is incorporated by reference and made a part hereof, and is referred to as the
Contract.
THE CONDITION OF THIS BOND is that if Principal:
Promptly makes payment to all claimants as defined in Section 255.05(1), Florida Statutes, supplying Principal with labor,
materials or supplies, used directly or indirectly by Principal in the prosecution of the work provided for in the contract,
then this bond is void; otherwise it remains in full force.
Any changes in or under the Contract and compliance or noncompliance with any formalities connected with the Contract
or the changes do not affect sureties obligation under this Bond.
The provisions of this bond are subject to the time limitations of Section 255.0592. In no event will the Surety be liable in
the aggregate to claimants for more than the penal sum of this Payment Bond, regardless of the number of suits that may
be filed by claimants.
IN WITNESS WHEREOF, the above parties have executed this instrument this 21st day of April , 20 17 , the
name of under-signed representative, pursuant to authority of its governing body.
Signed, sealed and delivered
in th- aresence of: PRINCIPAL:
6 i2eaix Quality Entet i es USA,Inc.
rprWitnesses as to Principal Na. ,
p Name: .o
rd Murrell
Its: •resid-nt
STATE OF Florida
COUNTY OF Collier
The foregoing instrument was acknowledged before me this 21st of April 20 17by Howard J. Murrell
as President of Quality Enterprises TVirginia corporation, on
behalf of the corporation. He/she is personally known to me OR has produced N/A Known
as identification and did (did not)take an'oath.
My Commission Expires: 2/11/18 (Signature of Notary)
Name: Marcie L. Cohen
(Legibly Printed) •
(AFFIX OFFICIAL SEAL) Notary Public, State of Florida
Commission No.: FF 070688
Page-12-
ATTEST: 16C3
SURETY:
(Printed Name)
(Business Address)
(Authorized Signature)
Witness as to Surety
(Printed Name)
OR Fidelity and Deposit Company of Maryland
As Attorney in Fact Ta my A.Ward
(Attach Power of Attorney
Witnesses athryn nei
1299 Zurich Way
Schaumburg,IL 60196
(Business Address)
Tammy A.Ward
(Printed Name)
757-491-1100
(Telephone Number)
STATE OF Virginia
COUNTY OF Virginia Beach
The foregoing instrument was acknowledged before me this 21st day of April
2017 , by Tammy A.Ward , as Attorney-in-Fact
of Fidelity and Deposit Company of Maryland , Surety, on behalf of Surety. He/She is personally known to me
OR has produced as identification an
d
who did(did not)take an oath.
My Commission Expires: September 30,2018 /i C
(Signature of Notar))
Name: Terri K.Strawhand
(Legibly Printed)
(AFFIX OFFICIAL SEAL)
` ____ Notary Public, State of Virginia
TERRI K.STRAWHAND 1 Commission No.: 247448
Notary Public
Commonwealth of Virginia
Reg.#247448
My Commission Expires 9/30/2018
Page-13-
1 6 C3
EXHIBIT A-2
PUBLIC PERFORMANCE BOND
Bond No. 9243743
Contract No. 14-6213-84
KNOW ALL MEN BY THESE PRESENTS: That Quality Enterprises USA,Inc.
, as Principal, and Fidelity and Deposit Company of Maryland
, as Surety, located at 1299 Zurich Way,Schaumburg,IL 60196
(Business Address) are held and firmly bound to Board of County Commissioners
Collier County,FL , as Oblige in the sum of Two Hundred Thirteen Thousand Twenty Five Dollars
and 19/100 ($ 213,025.19 ) for the payment whereof we bond ourselves, our heirs,
executors. personal representatives, successors and assigns,jointly and severally.
WHEREAS, Principal has entered into a contract dated as of the 21st day of April , 20 17 ,
with Oblige for SRO Wellfield Flow Meter Replacement,Phase 1
in accordance with drawings and specifications, which contractor is incorporated by reference and made a pat
hereof, and is referred to as the Contract.
THE CONDITION OF THIS BOND is that if Principal:
1. Performs the Contract at the times and in the manner prescribed in the Contract, and
2. Pays Oblige any and all losses, damages, costs and attorneys'fees that Oblige sustains because of
any default by Principal under the Contract, including, but not limited to, all delay damages,whether
liquidated or actual, incurred by Oblige; and
3. Performs the guarantee of all work and materials furnished under the Contract for the time specified
in the Contract, then this bond is void; otherwise it remains in full force. Any changes in or under
the Contract and compliance or noncompliance with any formalities connected with the Contract or
the changes do not affect Sureties obligation under this bond.
The Surety, for value received, hereby stipulates and agrees that no changes, extensions of time, alterations or
additions to the terms of the Contract or other work to be performed hereunder, or the specifications referred to
therein shall in anywise affect its obligations under this bond, and it does hereby waive notice of any such
changes, extensions of time, alternations or additions to the terms of the Contract or to work or to the
specifications.
Page-14-
16C3
This instrument shall be construed in all respects as a common law bond. It is expressly understood that the
time provisions and statute of limitations under Section 255.05, Florida Statutes, shall not apply to this bond.
In no event will the Surety be liable in the aggregate to Oblige for more than the penal sum of this Performance
bond regardless of the number of suits that may be filed by Oblige.
IN WITNESS WHEREOF, the above parties have executed this instrument this 21st day of April
, 2017 , the name of each party being affixed and these presents duly signed by its undersigned
representative, pursuant to authority of its governing body.
Signed, sealed and delivered
in the presence of: PRINCIPAL:
Quality En7s USA c.
r By;
Witnesses as to Principal Name:
nwar .T. Murrell
Its: Prpsidpnt
STATE OF Florida
COUNTY OF Collier
The foregoing instrument was acknowledged before me this 21st day of April
201 7 , by Howard J. Murrell , as President
USA. of Quality EnterprisPS
Inc. a Virginia corporation, on behalf of the corporation.
He/She is personally known to me OR has produced N/A Known
did (did not) take an oath. as identification and
en
My Commission Expires: 2/11/18 i� t
MAR IE L.WHEN —i-t (Signature of Notary)
F,Y COMMISSICINI#rF 070688
EXPIRES:February 11,2018 Name:
dThruNotary PuMicUndercniiers Marcie L. Cohen
Bonde
(AFFIX OFFICIAL SEAL) (Legibly Printed)
Notary Public, State of Florida
Commission No.: FF 070688
Page-15-
16C3
ATTEST: SURETY:
(Printed Name)
(Business Address)
(Authorized Signature)
Witness as to Surety
(Printed Name)
Fidelity and Deposit Company of Maryland
As Attorney in Fact my A-Ward
(Attach Power of Attorney)
Witnesses Kath n Snell
11(
1299 Zurich Way
Schaumburg,IL 60196
(Business Address)
Tammy A.Ward
(Printed Name)
757-491-1100
(Telephone Number)
STATE OF Virginia
COUNTY OF Virginia Beach
The foregoing instrument was acknowledged before me this 21st day of April , 2017 , by
Tammy A.Ward , as Attorney-in-Fact Of Fidelity and Deposit Company of
Maryland , Surety, on behalf of Surety. He/She is personally known to me OR has produced
as identification and who did (did not)take an oath.
My Commission Expires: September 30,2018 . GhCC/
(Signature of Notar0
Name: Terri K.Strawhand
(Legibly Printed)
(AFFIX OFFICIAL SEAL)
Notary Public, State of Virginia
TERRI K.STRAWHAND
Notary Public
Commonwealth of Virginia Commission No.: 247448
Rey.#247446
My Commission Expires 9/3012018
Page-16-
! 6C3
ZURICH AMERICAN INSURANCE COMPANY
COLONIAL AMERICAN CASUALTY AND SURETY COMPANY
FIDELITY AND DEPOSIT COMPANY OF MARYLAND
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS:That the ZURICH AMERICAN INSURANCE COMPANY,a corporation of the State of New
York,the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY,a corporation of the State of Maryland,and the FIDELITY
AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Maryland (herein collectively called the "Companies"), by
MICHAEL BOND,Vice President,in pursuance of authority granted by Article V, Section 8,of the By-Laws of said Companies,which
are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof, do hereby nominate,
constitute, and appoint Mark C. BUNDY,Tammy A. WARD,Terri K. STRAWHAND and Kathryn SNELL,all of Virginia Beach,
Virginia, EACH its true and lawful agent and Attorney-in-Fact,to make,execute,seal and deliver,for,and on its behalf as surety,and as
its act and deed:any and all bonds and undertakings,and the execution of such bonds or undertakings in pursuance of these presents,shall
be as binding upon said Companies,as fully and amply,to all intents and purposes,as if they had been duly executed and acknowledged by
the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York,New York.,the regularly
elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills,Maryland.,and the
regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland.,in their
own proper persons.
The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V,Section 8,of
the By-Laws of said Companies,and is now in force.
IN WITNESS WHEREOF,the said Vice-President has hereunto subscribed his/her names and affixed the Corporate Seals of the said
ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and
FIDELITY AND DEPOSIT COMPANY OF MARYLAND,this 21st day of April,A.D.2016.
ATTEST:
ZURICH AMERICAN INSURANCE COMPANY
COLONIAL AMERICAN CASUALTY AND SURETY COMPANY
FIDELITY AND DEPOSIT COMPANY OF MARYLAND
usai °Duos,.
SEAL a
s int
xKt� o
Secretary Vice President
Eric D.Barnes Michael Bond
State of MarylandFOR YOUR PROTECTION,
County of Baltimore LOOK FOR THE ZURICH WATERMARK
On this 21st day of April,A.D.2016,before the subscriber,a Notary Public of the State of Maryland,duly commissioned and qualified,MICHAEL
BOND,Vice President,and ERIC D.BARNES,Secretary,of the Companies,to me personally known to be the individuals and officers described in and
who executed the preceding instrument,and acknowledged the execution of same,and being by me duly sworn,deposeth and saith,that he/she is the said
officer of the Company aforesaid,and that the seals affixed to the preceding instrument are the Corporate Seals of said Companies,and that the said Corporate
Seals and the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporations.
IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed my Official Seal the day and year first above written.
hllilir(�i4
97ta At;,,
t
I'll/lll"
Maria D.Adamski,Notary Public
My Commission Expires:July 8,2019
POA-F 176-3814A
EXTRACT FROM BY-LAWS OF THE COMPANIES 1 6 C 3
"Article V,Section 8,Attorneys-in-Fact. The Chief Executive Officer,the President,or any Executive Vice President or Vice President
may, by written instrument under the attested corporate seal, appoint attorneys-in-fact with authority to execute bonds, policies,
recognizances, stipulations,undertakings, or other like instruments on behalf of the Company, and may authorize any officer or any such
attorney-in-fact to affix the corporate seal thereto;and may with or without cause modify of revoke any such appointment or authority at any
time."
CERTIFICATE
I, the undersigned, Vice President of the ZURICH AMERICAN INSURANCE COMPANY, the COLONIAL AMERICAN
CASUALTY AND SURETY COMPANY,and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, do hereby certify that the
foregoing Power of Attorney is still in full force and effect on the date of this certificate;and I do further certify that Article V,Section 8,of
the By-Laws of the Companies is still in force.
This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of
Directors of the ZURICH AMERICAN INSURANCE COMPANY at a meeting duly called and held on the 15th day of December 1998.
RESOLVED: "That the signature of the President or a Vice President and the attesting signature of a Secretary or an Assistant Secretary
and the Seal of the Company may be affixed by facsimile on any Power of Attorney...Any such Power or any certificate thereof bearing such
facsimile signature and seal shall be valid and binding on the Company."
This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of
Directors of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held on the 5th day of
May, 1994, and the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a
meeting duly called and held on the 10th day of May, 1990.
RESOLVED: "That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature
of any Vice-President, Secretary,or Assistant Secretary of the Company,whether made heretofore or hereafter, wherever appearing upon a
certified copy of any power of attorney issued by the Company,shall be valid and binding upon the Company with the same force and effect
as though manually affixed.
TESTIMO Y WHEREOF,I have helunto subscribed my name and affixed the corporate seals of the said Companies,
tin's)t day of ,20 7
0.0 nu
1 =
:EALv
"ft.*ow. CIAO
Gerald F.Haley,Vice President
TO REPORT A CLAIM WITH REGARD TO A SURETY BOND,PLEASE SUBMIT ALL REQUIRED
INFORMATION TO:
Zurich American Insurance Co.
Attn: Surety Claims
1299 Zurich Way
Schaumburg,IL 60196-1056