Backup Documents 11/12/2019 Item #16A17 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 16 A 17
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
exception of the Chairman's signature,draw a line through routing_lines#1 through#2,complete the checklist,and forward to the County Attorney Office.
Route to Addressee(s) (List in routing order) Office Initials Date
1.
2.
3. County Attorney Office County Attorney Office SRT •9
• 1Z\\.(aXx
4. BCC Office Board of County '`
Commissioners \r\ (:—D/ \Z.Vc\f\
5. Minutes and Records Clerk of Court's Office 1210111 311 i
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 above,may need to contact staff for additional or missing information.
Name of Primary Staff Julio Ordonez/GMD-Traffic perations Contact Information 239-252-5722
_ Contact/Department
Agenda Date Item was November 12, 2019 Agenda Item Number 16A17
Approved by the BCC ///(////
12G3Type of Work Order to Ajax Paving Industries of Number of Original
Document Attached FL, LLC, for construction of the Documents Attached
"Everglades Boulevard North Shoulder
Improvements—Segment I"project, in the
amount of$620,373.28(Project 60237.1)
PO number or account N/A
number if document is
to be recorded
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A" in the Not Applicable column, whichever is Yes N/A (Not
appropriate. (Initial) Applicable)
1. Does the document require the chairman's original signature STAMP OK JO
2. Does the document need to be sent to another agency for additional signatures? If yes, JO
provide the Contact Information (Name; Agency; Address; Phone)on an attached sheet.
3. Original document has been signed/initialed for legal sufficiency. (All documents to be JO
signed by the Chairman,with the exception of most letters, must be reviewed and signed
by the Office of the County Attorney.
4. All handwritten strike-through and revisions have been initialed by the County Attorney's JO
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 JO
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 JO
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip JO
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
time frame or the BCC's actions are nullified. Be aware of your deadlines!
8. The document was approved by the BCC on 11/12/2019 and all changes made during JO N/A is not
the meeting have been incorporated in the attached document. The County 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. this line.
16A17
MEMORANDUM
Date: December 19, 2019
To: Julio Ordonez, Project Manager
Traffic Operations
From: Teresa Cannon, Sr. Deputy Clerk
Minutes & Records Department
Re: Work Order for Contract #16-6663 "Everglades Boulevard
North Shoulder Improvements — Segment I"
Contractor: Ajax Paving Industries of FL., LLC
Attached for your records is a scanned copy of the original as referenced
document above, (Item #16A17) adopted by the Board of County Commissioners
on Tuesday, November 12, 2019.
The Board's Minutes & Records Department has kept an original as part of
the Board's Official Records.
If you have any questions, please feel free to contact me at 252-8411.
Thank you.
Attachment
16A17
WORK ORDER/PURCHASE ORDER
Contract# 16-6663 "Roadway Contractors"
Contract Expiration Date: Marchi 2021
This Work Order is for roadway construction services for work known as:
Project Name: Everglades Boulevard North Shoulder Improvements—Segment I
Project No: 60237.1
The work is specified in the proposal dated September 13,2019, which is attached hereto and made a
part of this Work Order. In accordance with Terms and Conditions of the Agreement referenced above,
this Work Order/Purchase Order is assigned to: Ajax Paving Industries of FL,LLC.
Scope of Work: As detailed in the attached proposal and the following:
Task I: Everglades Boulevard North Shoulder Improvements—Segment I
Schedule of Work: Complete work within 120 days from the date of the Notice to Proceed which is
accompanying this Work Order. The Consultant agrees that any Work Order that extends beyond the
expiration date of Agreement# 16-6663 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: ® Negotiated Lump Sum (NLS) as provided in the
attached Bid Schedule.
Task I: Shoulders Improvement $ 620,373.28
TOTAL FEE $ 620,373.28
Adir
PREPARED B 011 "ye _ . Zo /9
Ju o '� , - , error �� *'� �er to
. 1 •' • en-E : neermg Division
APPROVED BY: . 9/2/0
J (Ahmad, PE, i vision Dire or,
Tran.p.rtation Tngineering Di i 'on
_ _31\a_
APPROVED BY: ri tI II `' Si
Thaddeus ohen,Departm- t Head ate
Growth Management Department
Page 1 of 3
16A17
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 duri1Ihe Work Order and/or project duration.
,,.00°0%6R/pS''%
ACCEPTED BY• • 'a Paving Industrie .f FL, Lt. ••' ;-(f-gip p •. o,�; p_ ' /
Q
►tstie • varo 7 stant Secret Date
•
: a• 2008
•
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.
Page 2 of 3
1 6 A 1 7
ATTEST;1,,' .1371,10 0� BOARD OF COUNTY COMMISSIONERS
:41' °''. Ser�C t�f Courts COLLIER CO ' i; = : ' DA
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By: ...aging'''. tilir►
• 1 1 q` Willia j L. McDaniel,Jr.
Dated: Chairman
(SEAL)
Attest as to Chairman's Ajax Paving Industries of FL,LLC.
signature only.
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Fust Witness By- i �l `: T p0 -
Signature =>: SEA I r
44epi /1 •:.. F.
oo '• 2008 -iii£ o�o(pi •
(1 5 Christie Alvaro,Assistant Sec t ,<C '-P,h
tT e/print witn s nameT %'}'d'••o ho? �'t .�'�
A I '``,,...7 111,00'
,0 0'
PM Chigi
Second Witness
i)4NIL 54it4041bi
tType/print witness nameT
A ro ed Wo Fp an Le ality:
Wei*,
Assistiy*County Attorney
rt41/
.�C4)i 7 — L_-
Print Name
I A ; da
D;te )\` I
L1
Ret' ,21,.,1 19
Rec'd
S.:
Deputy :ark
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Page 3 of 3 0
16A17
EXHIBIT B
PUBLIC PAYMENT BOND
Bond No. 013130343
Contract No. 16-6663
KNOW ALL MEN BY THESE PRESENTS: That Ajax Paving Industries of Florida, LLC. , as
Principal, and Liberty Mutual Insurance Company
, as Surety, located at
ezk, lcy Street . Bo.tcn, MA 02116 (Business Addresa) are held, and firmly bogad
♦p ; tvr nounty 'a rl s ,%eery +.,eloinni,mnr, Six t1i,:vlrr E enty Thuetaneu! Three Hundred event?- &
11 as Oblige in the sum of,e„ ,;
($ h.tO.33'28 ) for the payment whereof we bind ourselves, our heirs, executors, personal
representatives, successors and assigns, jointly and severally.
WHEREAS, Principal has entered into a contract dated as of the 24t.r, day of °=c'tate•,'Lot20 15
with Oblige for Everglades Boulevard Nortn Shoulder Improvements Segment I - Protect No. 60717.1
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 9' day of
October , 20 1s , the name of under-signed representative, pursuant to authority of its governing
body.
Page 16 of 29
#168663'ROADWAY CONTRACTORS'
Ajax Paving Industries of Flodde,LLC
)
1 6 A 1 7
Signed, sealed and delivered
in tt e resenc- of) PRINCIPAL:
0 du
d2d
pav: i rndust.:-ies of 1`lrUt'"fr1�Ida.,:'1,41,C q--
Wit asses as to Prin:I Name.— Christie 't varo ' -" -
Its: Asst. Cor• . O ,t.
STATE OF Florida
COUNTY OF Sarasota
The fgregoing instrument was acknowledged before me this 14th of Oct . 2019 , by
Christie Alvaro as Asst . Corp. Secof Ajax Paving Ind a Florida
corporation, on behalf of the corporation. He/she is perlially koawn to me OR has produced n/a
personally knWidentificatlon and did (did not tak a oath. —'
My C ►.ties —
1rnu'w, 0 IANARAHE dieeldliaAgL
S' nature of Nota
�' 1 Notary Public-State of Florida g Notary)
i� r " Commission f GG 227176
'+'?'or'r. My Comm.Expires Jun 19,2022 Name.
Bonded through National Notary Assn.
!I_ _ „_ _ _ , .....-
1
(Legibly Printed)
(AFFIX OFFICIAL SEAL) Notary Public, State of
Commission No.:
ATTEST SURETY:
Liberty Mutual tnourance Company
(Printed Name)
(Business Address)
(Authorized Signature)
Witness as to Surety
(Printed Name)
OR
Page 17 of 29
#1646663"ROADWAY CONTRACTORS'
AJax Paving Industries of Florida,LLC 7re'l''
16A17
As Attorney in Fa { ____
Nick Ashburn, Surety Account Manager __ (Attach Power of Attorney)
Witnesses
175 Berkeley Street
Boston, MA 02116
(Business Address)
Holly Nichols, Attorney-in-fact
(Printed Name)
(248) 519-1400
(Telephone Number)
STATE OF Michigan
COUNTY OF Oakland
The foregoing instrument was acknowledged before me this 9th day of October
2019 , by HO,.t N1chuls as Attorney-in-fact
of i:tbetty Miltu,l1 rnsztr;,nce 70rt17 „y , Surety, on behalf of Surety, He/She is personally known
to me OR has produced N/A as identification and who did (did not)take an oath.
My Commission Expires: 05/25/2020 'Et-t<- y 1 1 )t .-�
(Signature of Notary)
Name: Jill 0. Moore
(AFFIX OFFICIAL SEAL) (Legibly Printed)
Notary Public, State of Michigan —
Commission No.: NiA
JILL E MOORE
Notary Public-State of Michigan
County of Oakland
My Commission Expires§.26-
Acting in the County of L) [, 1-) 71/
Page lB of 29
016-8883"ROADWAY CONTRACTORS' r'r'
Ajax Paving Industries of Florida,LIC ( ;„
16A17
EXHIBIT B-2
PUBLIC PERFORMANCE BOND
Bond Na. 33I3131/343
Contract No. 16-6663
KNOW ALL MEN BY THESE PRESENTS: That Ajax Paving Industries of Florida, LLC.
, as Principal, and Liberty Mutual Insurance Company
as Surety, located at 175 Berkeley Street, Boston, MA 02115
(Business Address) are held and firmly bound to Collier- County Board
of County C:ommtSe1oner5 , as Oblige in the sum of six Hundred Twenty ThousaiW Thr.- Kurr1rn l;everlty-three
and 29.'100 ,',2(1,31+..'w
($ ) 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 24th day of sopC.rtrl ,cr
2019 , with Oblige for Everglades Boulevard North Shoulder Improvements - Segment I - Pxo ect Net.
in accordance with drawings and specIficatlons, 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 19 of 29
*16-6663'ROADWAY CONTRACTORS'
Ajax Paving Industries of Florida, LLC
f n�
16A17
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 9th day of October
, 20 19 , the name of each party being affixed and these presents duly signed by itsundfersigned.
representative, pursuant to authority of its governing body, •' ' ..•
Signed, sealed and delivered
in the • esence o // ia PRINCIPAL:
__ _L. .4 �� ��/� Ajar Ya�Inq Industries of Fltir�itia1.t'
t,, —
' lr�
. • .4- By: _ .1 L. ..
A,, AAA ;.-
Witnesses as to 'rinci:�I' Name:
rit: e ' varp r ,,
Its: Asst. Corp. Secretary_'"
STATE OF Florida
COUNTY OF Sarasota
2019 The for�Poir fore-Poing instrument was acknowledgbefore a this 14 day of October
2U6 , by r ie Alvaro , as /Asst. Corp. set;. of Ajax raving inn
a Florida corporation, on behalf of the corporation.
He/She is p sally known to me OR has produced n/a (personally knowr1 Identification and
did (did not)ttiT<e an oa ,
My Commission Expires. a10 ,'b ,,...4........ _ .... _ / --
-ignature of Notary)
Name:
(Legibly Printed)
(AFFIX OFFICIAL SEAL)
•�+�. — - Notary Public, State of
4:..iu'•., ADRIANA RAHE
, ;�'' 1y''` Notary Public-State of Florida
` Commission#GG 227176 Commission No.:
\:!:.o'r: My Comm.Expires Jun 19,2022
Bonded through National Notary Assn.
Page 20 of 29
M16-8663'ROADWAY CONTRACTORS"
Ajax Paving Industries of Florida,LLC
16A17
ATTEST: SURETY:
Liberty Mutual Insurance company
(Printed Name)
(Business Address)
(Authorized Signature)
Witness as to Surety -----
(Printed Name)
x t._ • OR
As Attorney in Fact
Nick Ashburn, Surety Account Manager (Attach Power of Attorney)
Witnesses
115 SerkeTey'ffitreet "
Roston, MA 02116
(Business Address)
Holly Nichols, Attorney-in-fact
(Printed Name)
(248) 519-1400
(Telephone Number)
STATE OF Michigan
COUNTY OF Oakland
The foregoing instrument was acknowledged before me this 91-h day of October ZO 19 by
Holly Nichols
as Attorney-in-fact of Liberty Mutual Insurance
Company , Surety, on behalf of Surety. He/She is personally known to me OR has produced
N/A as Identification and who did (did not)take an oath.
My Commission Expires: 05/25/2020 .C( t( )Jai,(
(Signature of Notary)
Name: Jill E. Moore
(Legibly Printed)
(AFFIX OFFICIAL SEAL)
Notary Public, State of Michigan
Commission No.: N/A
AL E MOCME
NotaryMichigan
County of Oaldand
My Commission Esq 5.25--2020
Acting In the County of t' i t 117 rid
Page 21 of 29
018.9883'ROADWAY CONTRACTORS'
Ajax Paving InduetNes of Florida,LLC
161417
.w This Power of Attorney limits the acts of those named herein,end they have no authority to
r bind the Company except In the manner and to the extent herein stated,
aV.4 e, L.,,i I)€I t, ,
OpLiberty Mutual Insurance Company
tu. The Ohio Casualty Insurance Company Certificate No:8198083-013068
West American Insurance Company
SURETY
POWER OF ATTORNEY
KNOWN ALL PERSONS BY THESE PRESENTS:That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire,that
Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts,and West Amencan Insurance Company is a corporation duly organized
under the laws of the State of Indiana(herein collectively called the'Compan es"j,pursuant to and by authority herein set forth,does hereby name,constitute and appoint, Nicholas
Ashburn.Anne Ilurick,Robert I) Ileuer;Paul M I lurlr),Michael I) Lrchncr,Mark Madden,Richard S McGre or !lolly Nichols,Jason Rose's
all of the city of_ frog state of MI each individuallys W
it there be more than one named de and lawful at orne-in-fact to make,
execute,seal,acknowtedga and deliver.for and on its behalf as surety and as its act and deed,any and all undertakings,bonds,recognizances and other surety obligations,in pursuance
of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper
persons
IN WITNESS WHEREOF,this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed
thereto this 311th day of Nrrtcmt it 201 II
Liberty Mutual Insurance Company
4`.INstri,, �4'' INs°R t, 1t+s(R. The Ohio Casualty Insurance Company
J41*oo n i4, �� ..e.011'" 4P ry°10°'Ysa4'.. West American Insurance Company
� Y1912hn a 1919 f : ?i
O ea !O IaA YS `nn, ,,,/// �1 C_
a) e7T . 0 3,yt . 0 �,it . 0 By:
E David M Carey.Assistant Secretary _•. W
State of PFNNSYLVANIA
$al
o County of MONTGOMERY ss ,
E • c
V tb On this 30th day of Nuvitncer , 2018 before me personally appeared David M Carey,who acknowledged himself lobe the Assistant Secretary of Liberty Mutual Insurance 0
Oro Company,The Ohio Casualty Company,and West American Insurance Company,and that he.as such,being authorized so to do,execute the foregoing instrument for the purposes=
N > therein contained by signing on behalf of the corporations by himself as a duly authorized officer L�W
v
N IN WITNESS WHEREOF,I have hereunto subscribed my name and affixed my notarial seal at King of Prussia,Pennsylvania,on the day and year first above written r a
co ` , -7-.:: ^,. COMMONWEALTH OF PENNSYLVANIA .�f �t
'r l Notarial Seal FI.14.0
/1 a
j({�{ el O Trues.Pastoila Notary PublicOCO 0 t 1 ; upper Mcron rwp,Mmtgomory County By: > pr45re
C lt1 t� t, ,r/ My Can,misflon Expres March 2a.2021E
di ��,:��.._-Vi..',, M.rm.r v.drnyuian,aawosrm,M N'ane PaStella Notary Public a.co
N,...(1-1er.'. to 0,..:
C44) This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company,Liberty Mutual ig u'
FInsurance Company,and West American Insurance Company which resolutions are now in full force and effect reading as follows j
ami ARTICLE IV-OFFICERS:Section 12 Power of Attorney ',A
0 m Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President,and subject to such limitation as the Chairman or the ,q,
:12 President may prescribe,shall appoint such attorneys-in-fact,as may be necessary to act in behall of the Corporation to make.execute,seal,acknowledge and deliver as surety >o
i c any and all undertakings,bonds,recognizances and other surety obligations Such attorneys-in-fact,subject to the limitations set forth in their respective powers of attorney,shall g N
have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation When so executed,such a?
Z v instruments shall be as binding as if signed by the President and attested to by the Secretary Any power or authority grantedrepresentative or aorney- PI
to any ttin•fact under the C
provisions of this article may be revoked at any time by the Board,the Chairman,the President or by the officer or officers granting such power or authority
ARTICLE XIII-Execution of Contracts:Section 5 Surety Bonds and Undertakings "�
Any officer of the Company authorized for that purpose in writing by the chairman or the president,and subject to such limitations as the chairman or the president may prescribe, -.
shall appoint such attorneys•in•fact,as may be necessary to act in behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings,
bonds,recognizances and other surety obligations Such attorneys-in-fact subject to the limitations set forth in their respective powers of attorney,shall have full power to bind the
Company by their signature and execution of any such instruments and to attach thereto the seal of the Company When so executed such instruments shall be as binding as if
signed by the president and attested by the secretary
Certificate of Designation-The President of the Company,acting pursuant to the Bylaws of the Company,authorizes David M Carey,Assistant Secretary to appoint such attorneys-in-
fact as may be necessary to act on behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety
obligations
Authorization-By unanimous consent of the Company's Board of Directors,the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the
Company,wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds,shall be valid and binding upon the Company with
the same force and effect as though manually affixed
I.Renee C Llewellyn,the undersigned,Assistant Secretary.The Ohio Casualty Insurance Company,Liberty Mutual Insurance Company,and West American Insurance Compenv do
hereby certify that the original power of attorney of which the foregoing is a full,true and correct copy of the Power of Attorney executed by said Companies,is in full face and e(od and
has not been revoked
IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this 9th day of October 2019
s tH8U4. �ZY INa a tNstrR
f°M°r+1R�0'*�rn ,f ovwpa� n `LP�Qoroe,'44. ��JJ /
4 a 1912 ^ o° 0 1919' s f 1991�� n O. C144,t4P'.,-
a s° ((rr _
r3�,?c�u''*.,iv 0��.1'441011 rig Oi *iia By Renee C.Llewellyn Assistant Secrete:17— —
R
l MS•r2873).MIC OCIC WAIC MUD Co_0137,018