Backup Documents 10/11/2011 Item #16A1ORIGINAL DOCUMENTS CHECKLIST &ROUTING SLIP 16A ',
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper. Attach to original document. Original documents should be hand delivered to the Board Office. The completed routing slip and original
documents are to be forwarded to the Board Office only after the Board has taken action on the item.)
ROUTING SLIP
Complete routing lines #1 through #4 as appropriate for additional signatures, dates, and/or information needed. ff the document is already complete with the
exception of the Chairman's signature, draw a line through routing lines #1 through #4, complete the checklist, and forward to Sue Filson (line #5).
Route to Addressee(s)
(List in routing order
Office
Initials
Date
1. Judy Puig
GMD Planning &
Regulation/Operations
(Initial)
I
2.
10 /11 /11
Agenda Item Number
16al
3.
signed by the Chairman, with the exception of most letters, must be reviewed and signed
4.
Contract Bond & Rider
Number of Original
1
5. Ian Mitchell, Supervisor,
BCC Office
Board of County Commissioners
I Documents Attached
j t
6. Minutes and Records
Clerk of Court's Office
PRIMARY CONTACT INFORMATION
(The primary contact is the holder of the original document pending BCC approval. 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 above, including Sue Filson, need to contact staff for additional or missing
information All original documents needing the BCC Chairman's signature are to be delivered to the BCC office only after the BCC has acted to approve the
item.)
Name of Primary Staff
Laurie Beard
Phone Number
252 -5782
Contact
appropriate.
(Initial)
Applicable)
Agenda Date Item was
10 /11 /11
Agenda Item Number
16al
Approved by the BCC
signed by the Chairman, with the exception of most letters, must be reviewed and signed
Type of Document
Contract Bond & Rider
Number of Original
1
Attached
I
I Documents Attached
INSTRUCTIONS & CHECKLIST
I: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip W WS Original 9.03.04, Revised 1.26.05, Revised 2.24.05
Initial the Yes column or mark "N /A" m the Not Applicable column, whichever is
Yes
N/A (Not
appropriate.
(Initial)
Applicable)
1.
Original document has been signed/mitialed for legal sufficiency. (All documents to be
signed by the Chairman, with the exception of most letters, must be reviewed and signed
by the Office of the County Attorney. This includes signature pages from ordinances,
resolutions, etc. signed by the County Attorney's Office and signature pages from
contracts, agreements, etc. that have been fully executed by all parties except the BCC
Chairman and Clerk to the Board and possibly State Officials.
2.
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
P
3.
The Chairman's signature line date has been entered as the date of BCC approval of the
document or the final negotiated contract date whichever is applicable.
lE)
4.
"Sign here" tabs are placed on the appropriate pages indicating where the Chairman's
u1b
signature and initials are required.
5.
In most cases (some contracts are an exception), the original document and this routing slip
should be provided to Sue Filson in the BCC office within 24 hours of BCC approval.
Some documents are time sensitive and require forwarding to Tallahassee within a certain
time frame or the BCC's actions are nullified. Be aware of your deadlines!
6.
document was approved by the BCC on 10-11-11 (enter date) and all changes
1The
made during the meeting have been incorporated in the attached document. The
g
County Attorney's Office has reviewed the changes, if applicable.
I: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip W WS Original 9.03.04, Revised 1.26.05, Revised 2.24.05
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
CONTRACT BOND
16A I
Bond No. 929536597
375 -020-27
CONTRACTS ADMINISTRATION
OGC - 04/11
Page 1 of 2
Ronald Benderson and David H. Baldauf as Trustees under a Trust Agreement
KNOW ALL MEN BY THESE PRESENTS: That we, dated September 22, 1993 known as the Randall Benderson 1993 -1 Trust as to
an undivided 85 % interest as a tenant in common and WR -1 Associates, Ltd., as to an undivided 15% interest as a tenant in common.
(Entity Name) having its principal place of business at 570 Delaware Avenue, Buffalo, NY 14202
716 - 886 -0211 (Bidding Office Street Address, City, State, Zip and Phone #)
(hereinafter called Principal or Contractor) and Western Surety Company
hereinafter called Surety), duly authorized to do business in the State of Florida, pursuant to the laws of the State of Florida,
having its principal place of business a 333 S. Wabash Avenue, 41st Floor, Chicago, IL 60604
(City, State, Zip) are held and firmly bound unto the State of Florida, in the full and just sum of
Thirty Two Thousand and 00/100
DOLLARS ( $32,000.00 ), lawful money of the United States of America, to be paid to the Florida Department
of Transportation, to which payment well and truly be made we bind ourselves, our heirs, executors, administrators,
successors and assigns, jointly and severally and firmly by these presents; WHEREAS, the above -bound Principal has
subscribed to a contract with the State of Florida Department of Transportation (hereinafter called the Department), to
bear the date of , for constructing or otherwise improving a road(s), bridge(s),
and building(s) To close the access cut on Davis Boulevard turning left onto Joyrose upon occurrence of one of the closure
triggers
in Collier County(ies)
particularly known as Federal Aid Project No(s).:
Financial Project No(s).:
Contract No.
(hereinafter called the Contract), upon certain terms and conditions in the Contract more particularly mentioned; and
WHEREAS, it was one of the conditions of the Contract that these presents shall be executed; NOW, THEREFORE, the
conditions of this obligation are such that if the above- bound Principal in all respects shall comply with Section
337.18(1), Florida Statutes, and shall promptly, faithfully, efficiently, and fully perform the Contract according to plans and
specifications as therein referred to and made a part thereof, and any alterations as may be made in said plans and
specifications as provided for therein, and within the time period specified, and further, shall remedy any errors in partial
or final estimates and any defects which may exist, appear, occur or result in or from said work within a period of two (2)
years from the date of final acceptance of the work under the Contract and further if the Contractor shall promptly make
payment to all persons furnishing labor, material, equipment, and supplies, and all persons defined in Section 713.01,
Florida Statutes, whose claims derive directly or indirectly from the prosecution of the work provided for in the Contract
(See Section 337.18(1) (a) -(f), F.S., for specific "claim" notice and time limitation requirements), and shall promptly pay
all State Workers' Compensation and Unemployment Compensation taxes incurred in the performance of the Contract,
and shall be liable to the State in a civil action instituted by the Department or any officer of the State authorized in such
cases for double any amount in money or property the State may lose or be overcharged or otherwise defrauded of, by
reason of any wrongful or criminal act, if any, of the Contractor, its agents, and employees, and should the Contractor not
be declared to be in default under the Contract then the bond shall be deemed void. In the event of default by the
Contactor, the Surety shall pay the Department in addition to the above obligations, all liquidated damages and
disincentives assessed against the Contractor because of the default which were not withheld from Contract proceeds
and if the Department at its sole option demands that the Surety take over the project and provided further that should
the Department elect to have the Surety to take over the project, then in such event, the Surety may not select the
Contractor or any affiliate of the Contractor to complete the project for and on behalf of the Surety without the
Department's express written consent and, finally, if the subject Contract required contractor qualification, under Section
337.14, Florida Statutes, or otherwise, the Surety must use a qualified contractor, who is approved by the Department, to
perform the work. It is further covenanted and agreed that any alterations or additions made under this Contract or in the
work to be performed therein or the granting of any extension of time for the performance of the Contract or any other
forbearance by or on the part of either the Department or the Principal shall not in any way release the Principal and the
Surety or either of them, their respective heirs, executors, administrators, successors, or assigns, from any liability
hereunder. Notice to the Surety of such alterations, extension, or forbearance is hereby specifically waived. Under this
bond, the surety, pursuant to Section 337.11(9)(a), F.S. shall be fully liable under such surety bond to the full extent of
any modified contract amount up to and including 25 percent over the original contract amount and without regard to the
fact that the surety was not aware of or did not approve such modifications. However, if modifications of the original
contract amount cumulatively result in modifications of the contract amount in excess of 25 percent of the
16A 1
375 - 020 -27
CONTRACTS ADMINISTRATION
OGC - 04/11
Page 2 of 2
original contract amount, the surety's approval shall be required to bind the surety under the bond on that portion in
excess of 25 percent of the original contract amount. This obligation shall remain in full force and effect until the full
performance of all covenants, terms, and conditions herein stipulated. Failure by the Surety to perform its obligations
under the terms of this bond may result in the Surety being disqualified from issuing bonds for future Department
contracts.
WITNESS the signature of the principal (Contractor) and the signature of the Surety by Jessica Jean Fischer its
Attorney -in -Fact (Agent or Attorney -in -Fact) with the seals of said Principal and Surety
hereunto affixed this 6th day of September 2011
complete me
Entity Name: See Attached Signature Page
Authorized Signature:
'Signature:
as
Name & Title (Print):
Name & Title (Print):
(Seal)
-in the event OT a vartnersnip ootn signature ana printed name of 2 partners must be affixed.
Organized and existing under the laws of the State of South Dakota and authorized to do business in the State of Florida, pursuant to
the laws of the State of Florida.
Countersigned:
Florida Licensed Insurance Agent Surety Company Name (Print) (Seal)
Print information below (Florida Licensed Insurance Agent; whether in By. QL;7_�'ilL..-
Attorney -in -Fact or Countersignature role): "Florida 1_66nsed Inps�urance A_gFec�nt�t or Attorney -in -Fact (Surety)
® Above * leg, Fisc ter, Ft ffiRiicensed Insurance Agent (check if
Name: US[ Insurance Services LLC g ry Is a so a on
applicable and complete business name, address and telephone number
Business Address: 630 W. Germantown Pike, Ste. 200, Plymouth Meeting, PA 19462 block; if not, have such an agent countersign and complete block)
Telephone: 484 - 351 -4639 NOTE: Power of Attorney showing authority of Surety's Agent or
Attomey -in -Fact is to be attached.
Contractor shall record this bond in the official records of the Clerk of Court of the county where the improvement is located prior to commencing the work in accordance with
Section 337.18(1)(b), Florida Statutes.
Send "Notices to Owner" to:
16A 1
Legal Entity Name:
Ronald Benderson and David H. Baldauf as Trustees under a Trust Agreement dated September
22, 1993 known as the Randall Benderson 1993 -1 Trust as to an undivided 85% interest as a
tenant in common and WR -I Associates, Ltd as to an undivided 15% interest as
a tenant in common
Signature Blocks:
Randall enderson 1993 -1 T st
By:
David H. Baldauf, Ti stee
WR -I Associates, Ltd
By: BG The Village, LLC
General Partner
By: kA� A74=-
David H. Baldauf, Manager
Western Surety Company 16A
POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY -IN -FACT
Know All Men By These Presents, That WESTERN SURETY COMPANY, a South Dakota corporation, is a duly organized and existing corporation
having its principal office in the City of Sioux Falls, and State of South Dakota, and that it does by virtue of the signature and seal herein affixed hereby
make, constitute and appoint
Donald L Roberts Jr, Jessica Jean Fischer, Benedict Tockarshewsky, Francis M Mc Ginley,
Lisa M Mc Kernan, Individually
of Plymouth Meeting, PA, its true and lawful Attomey(s) -in -Fact with full power and authority hereby conferred to sign, seal and execute for and on its
behalf bonds, undertakings and other obligatory instruments of similar nature
- In Unlimited Amounts -
and to bind it thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of the corporation and all the acts of said
Attorney, pursuant to the authority hereby given, are hereby ratified and confirmed.
This Power of Attorney is made and executed pursuant to and by authority of the By -Law printed on the reverse hereof, duly adopted, as indicated, by
the shareholders of the corporation.
In Witness Whereof, WESTERN SURETY COMPANY has caused these presents to be signed by its Senior Vice President and its corporate seal to
be hereto affixed on this 18th day of March, 2011.
a OWEST ERN SURETY COMPANY
Paul . Bruflat, Senior Vice President
State of South Dakota
ss
County of Minnehaha
On this 18th day of March, 2011, before me personally came Paul T. Bruflat, to me known, who, being by me duly sworn, did depose and say: that he
resides in the City of Sioux Falls, State of South Dakota; that he is the Senior Vice President of WESTERN SURETY COMPANY described in and which
executed the above instrument; that he knows the seal of said corporation; that the seal affixed to the said instrument is such corporate seal; that it was so
affixed pursuant to authority given by the Board of Directors of said corporation and that he signed his name thereto pursuant to like authority, and
acknowledges same to be the act and deed of said corporation.
My commission expires j~~`' •""'"''"'''''�'"+'+'+`+ +'+ +'+�� +
r D. KRELL i
November 30, 2012 r SEAL NOTARY PUBLIC 8 i
a SOUTH DAKOTA r
t
+Y4hti ti4�444ti4�a44btih4Sg4ti {+
Public
CERTIFICATE D. Krell, No
I, L. Nelson, Assistant Secretary of WESTERN SURETY COMPANY do hereby certify that the Power of Attorney hereinabove set forth is still in
force, and further certify that the By -Law of the corporation printed on the reverse hereof is still in force. In testimony whereof I have hereunto subscribed
my name and affixed the seal of the said corporation this +12A day of v.
.
WESTERN SURETY COMPANY
>M ppK� p
Form F4280 -09 -06
L. Nelson, Assistant Secretary
I
16 A 1, -
Authorizing By -Law
ADOPTED BY THE SHAREHOLDERS OF WESTERN SURETY COMPANY
This Power of Attorney is made and executed pursuant to and by authority of the following By -Law duly adopted by the shareholders
of the Company.
Section 7. All bonds, policies, undertakings, Powers of Attorney, or other obligations of the corporation shall be executed in the
corporate name of the Company by the President, Secretary, and Assistant Secretary, Treasurer, or any Vice President, or by such other
officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer
may appoint Attorneys in Fact or agents who shall have authority to issue bonds, policies, or undertakings in the name of the Company.
The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the
corporation. The signature of any such officer and the corporate seal may be printed by facsimile.
16A 1
WESTERN SURETY COMPANY
333 S. Wabash Avenue
41" Floor
Chicago, IL 60604
DUAL OBLIGEE RIDER
To be attached to and form a part of contract bond number 929536597 issued by the
Western Surety Company
on behalf of Ronald Benderson and David H Baldauf as Trustees under a Trust Agreement dated September 22, 1993 known
as the Randall Benderson 1993 -1 Trust as to an undivided 85% interest as a tenant in common and WR -1 Associates. Ltd., as to
an undivided 15% interest as a tenant in common.
in the amount of Thirty Two Thousand and 00 /100 Dollars ($32,000.00 ) and dated September 6. 2011 in favor of Florida
Department of Transportation
In consideration of the sum of One Dollar ($1.00) each and other good and valuable consideration receipt of which is hereby
acknowledged, the Undersigned hereby agree as follows:
1. The Collier County, Florida is hereby added to said bond as an additional obligee.
2. The Surety shall not be liable under this bond to the Obligee, or any of them unless the said Obligees, or any of them, shall
make payments to the Principal strictly in accordance with the terms of the said contract as to payments, and shall perform all
other obligations to be performed under said contract at the time and in the manner therein set forth.
3. No suit, action or proceeding by reason of any default whatever shall be brought on this bond after two (2) years from the
day on which the final payment under said construction contract falls due.
4. Aggregate liability of Surety hereunder to Obligees is limited to the penal sum above stated and Surety, upon making
payment hereunder, shall be subrogated to, and shall be entitled to an assignment of all rights of the payee with respect to the
particular obligation discharged by the payment, either against principal or against any other party liable to the payee on the
discharged obligation.
Signed, Sealed and Dated this 6th day of a [ember, 2011
Randall Benderson 1993 -1 Trust. Florida Department of Transportation
BY:/
David H. Baldauf, Trustee
WR -I Associates, Ltd.
By: BG the Village, LLC
General Partner
BY: 1W r'
David H. Baldauf, Manaber
ATTEST:' "
D rfT 'AM QGY CLERK
0
Ap$royed:�'s to %t`m
egal su,
a j�,_-
Steven T. Williams
Assistant County Attorney
ClYI
BOARD OF COUNTY CONBUSSIONERS
COLL CO , FLORIDA
By: .
FRED W. COYLE, C o k
Western Surety Company
BY: l2 �e- '- F.c
Jessi Jean Mscher, Attorney -in -Fact
16A 1
WESTERN SURETY COMPAI"'
333 S. Wabash Avenue
41" Floor
Chicago, IL 60604
DUAL OBLIGEE RIDER
To be attached to and form a part of contract bond number 929536597 issued by the
Western Surety Comnanv
on behalf of Ronald Benderson and David i•l. Baldauf as Trustees under a Trust Agreement dated September 221. 1993 known
as the Randall Benderson 1993 -1 Trust as to an undivided 85% interest as a tenant in common and WR -I Associates Ltd.. as to
an undivided 15% interest as a tenant in common.
in the amount of Thirtv Two Thousand and 001100 Dollars ($32,000.00) and dated Member 6.2011 in favor of Florida
Dwartment of Transportation
In consideration of the sum of One Dollar ($1.00) each and otter good and valuable consideration receipt of which is hereby
acknowledged, the Undersigned hereby agree as follows:
1. The Collier County. Florida is hereby added to said bond as an additional obligec.
2. The Surety shall not be liable under this bond to the Obligee. or any of them unless the said Obligees, or any of them, shall
make payments to the Principal strictly in accordance with the uxms of the said contract as to payments, and shall perform all
other obligations to be performed under said contract at the time and in the manner therein set forth.
3. No suit. action or proceeding by reason of any default whatever shall be brought on this bond after two (2) years from the
day on which the final payment under said construction contract falls due.
4. Aggregate liability of Surety hereunder to Obligees is limited to the penal sum above stated and Surety, upon making
payment hereunder. shall be subrogated w, and shall be entitled to an assignment of all rights of the payee with respect to the
particular obligation discharged by the payment. either against principal or against any other party liable to the payee on the
discharged obligation.
Signed. Sealed and Dated this 6th day of September. 2011
Randall Benderson 1993 -1 Trust.
BY: /�
David H. Baldauf, Trustee
WR -i Associates. Ltd.
By BG the Village. LLC
General Partner
BY: 1 W
David H. Baldauf. Manahker
Florida Department of Transportation
BY: /PX A'bsG%'—
Collier County. Florida
BY:
Western Surety Company
JessicWjean Hischer. Attornev -in -Fact