Backup Documents 12/10/2019 Item #16C 8 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 1 t p
V C 8
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper. Attach to original document. The completed routing slip and original documents arc 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. — - —
3. County Attorney Office County Attorney Office
iiiit/
4. BCC Office Board of County 49159):4)
,)14/5) I—Ill_Z
5. Minutes and Records Clerk of Court's Office � I ���a0 0).!CDOn
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 ,K,L rCry' Phone Number col)
Contact/ Department ��`"'� 4f507'41?33
Agenda Date Item was /240//q
„ /'D// Agenda Item Number ( ,^
Approved by the BCC 2/ ttl
Type of Documenty� Number of Original /
Attached A �'k_ =lbw Documents Attached
PO number or account
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?
2. Does the document need to be sent to another agency for additional signatures? If yes, It/L
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
signed by the Chairman,with the exception of most letters,must be reviewed and signed l/ '
by the Office of the County Attorney. (�
4. All handwritten strike-through and revisions have been initialed by the County Attorney's n.
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
document or the final negotiated contract date whichever is applicable. O
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's
signature and initials are required. CPbr
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 CPir
time frame or the BCC's actions are nullified. Beaare of your deadlines!
8. The document was approved by the BCC on ('L lD Renter date)and all changes made
during the meeting have been incorporated in the attached document. The County
Attorney's Office has reviewed the changes,if applicable.
9. Initials of attorney verifying that the attached document is the version approved by the
BCC,all changes directed by the BCC have been made,and the document is ready for the ,
Chairman's signature.
l: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
1 6 C 8
MEMORANDUM
Date: January 15, 2020
To: Corinne Trtan, Project Manager
PU Engineering & Project Management
From: Teresa Cannon, Deputy Clerk
Minutes & Records Department
Re: Work Order for #14-6213-134 w/Haskins, Inc.
Attached for your record is a copy of the item referenced above, (Agenda Item
#16C8) adopted by the Board of County Commissioners Tuesday, December 10,
2019.
If you have any questions, please call me at 252-8411.
Thank you.
Attachment (1)
16 C8
MEMORANDUM
Date: January 15, 2020
To: Ana Reynoso,
Procurement Services
From: Teresa Cannon, Sr. Deputy Clerk
Minutes & Records Department
Re: Work Order to Contract #14-6213-134 "Village Walk
Wastewater System Modifications"
Contractor: Haskins, Inc.
Attached for your records is an original of the referenced document above,
(Item #16C8) adopted by the Board of County Commissioners on Tuesday,
December 10, 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
16C8
WORK ORDDO/PURCHASE ORDER
Contract 14-6213-13 E`Underground Utility Contr ctors"
Contract Expiration Date: July 7, 202U
This Work Order is for professional underground utility services for work known as:
V
Project Name: Village Walk Wastewater System Modifications
Project No: 70250
The work is specified in the proposal dated October 8,2019 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: Haskins, Inc.
Scope of Work: As detailed in the attached proposal and the following:
* Task I Mobilization/Demobilization/
* Task II Force Main Piping/
* Task III Pump Station 152.02 Upgrades
* Task IV Allowance
Schedule of Work: Complete work within 365 days from the date of the Notice to Proceed which is
accompanying this Work Order. The Veydor agrees that any Work Order that extends beyond the
expiration date of Agreement #14-621f-134 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 reenced above, the County will compensate the
Firm in accordance with following method(s): ®Negotiated 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 $ 12,700.00 LSV
Task II $ 116,700.00 LSA
Task III $ 542,265.00 LS/
Task IV $ 37,000.00 LS/T&M,tnit Price
TOTAL FEE $708,665.00
PREPARED BY: /D/z/oZig
Corinne Trtan, Project Manager Date j
( i
age1 of 3
�t�o
1 6 C8
APPROVED BY: 1 1/5/2019
Craig Pajer,Principal Project Manager Date
APPROVED BY:
To hmelik,EPMD Director Date
APPROVED BY:- r///a//
Beth Johns ,Wastewater Director Date
1
APPROVED BY: r ?
Jos: Be(one,,•perations Support Director Date
APPROVED BY: °'� r'1 (�(� /I
D eorge Yilm z,Department Head 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: Haskins, c.
10/25/2019
R n cPhee,Vice President Date
(Remainder of page intentionally left blank)
Page 2 of 3
CAO
16C8
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 CO .N Y COMMISSIONERS
Crystal K. Kinzel,Clerk COLLIER CO bir • • •A
11110,40
W/liam L. McDaniel,Jr., Chairman
Dated 1 °_
' *as to Chairman's
•� cattare only.
•
Haskins,Inc.
By _ , , .
First Wit ess re
Ryan zT ac thee,Vice President
Mabel Lego tType/print signature and thief
t. ype/print witness namet
'ec•nd Witns
Aaliyah Ott
TType/print witness name
• .proved a to ' . m d Legality:
I
County Attorney
/ Il a ._
int ame
Item# 132Q1?)
DDate da ��to)r I
Date I I �s� $
Ree
/ , Page 3 of 3
Deputy( e rk
16CR
Collier County Solicitation 14-6213-134
Date: September 19th, 2019
From: Patrick Boyle, Operations Analyst ►/Cfltjr County
239-252-8941, Telephone Number
Patrick,Royle4co..iercoutttyfl-.grty Y `'
Public Utilities Department
Engineering and Project Management Division
To: Potential Quoters
REQUEST FOR QUOTATIONS FOR MULTIPLE PROJECTS UNDER CONTRACT
14-6213"Undersround Utilit Contractors'
Selected Vendors:
Mitchell & Stark Construction Co., Inc. Kyle Construction, Inc.
Douglas N. Higgins Inc, Haskins, Inc.
Quality Enterprises USA, Inc. Southwest Utility Systems, Inc.
As provided in the referenced contract, the County Division is soliciting
quotes for the referenced project.
Project
RFQ 14-6213-134
VILLAGE WALK WASTEWATER SYSTEM MODIFICATIONS
RFQ Due Date: Tuesday, October 8th, 2019 at 3:00 PM
Q&A Deadline: Friday, October 4th, 2019 at 5:00 PM
Non-Mandatory Pre-Bid Meeting
Pre-Bid Meeting Tuesday October 1St, 2019 at 10:00AM
Number of Days to Final Completion: 330 days to substantial 365 days to final completion
Scope Provided
-...__ Yes
Plans and Specs: Yes
Liquidated Damages: $1260.00.00 per day
Payment & Performance Bonds If over$200,000.00
Your quotation response for this project is due electronically to the Email address listed above no later
than the date and time specified above.We will not accept any quotation responses later than the noted
time and date. If your firm is unable to respond electronically, your quotation must be received in the
office of the Public Utilities Engineer& Project Management at the below referenced address no later
than the time and date specified. We look forward to your participation in this request for
information/quotation process.
Haskins Inc.
Firm's Complete Legal Name
239-947-184 1239-947-3857
Tele. .rig ber/Fax Number
lirgn.- et
Vice President
Title
Ryan MacPhee 10/08/19
Print Name Date
cc: Corrine Trtan, Project Manager
Public Utilities Engineering&Project Management Division•3339 Tamiami Trail East,Suite 303 Naples,Florida 34112
9/20/2019 1:38 PM p•4
1 6 C8
Cote County
Public Utilities Department
Engineering & Project Management Division
BID ADDENDUM NUMBER ONE
for
VILLAGE WALK WASTEWATER SYSTEM MODIFICATIONS
Solicitation No. RFQ 14-6213-134
ISSUE DATE: Wednesday, October 2, 2019
The following, changes, additions, deletions and/or clarifications are made to the Contract
Documents and Specifications for the above referenced project:
BIDDERS' QUESTIONS
Question #1: Is there sufficient spacing for the discharge piping? Also, can the new
pumps sit properly on the existing bench within the wet well?
Answer#1: Plan sheets C07, C08 and C09 have been updated to reflect 40"
minimum spacing center to center of the discharge piping. In
addition, a new bench, new base elbow and new base are required
for the new pumps.
Question #2: What are the existing flows to Lift Stations 152.02 and 152.00.
Answer#2: Lift Station 152.02 has an average influent rate of 58 GPM with a
peak hour influent rate of 140 GPM. Lift Station 152.00 has an
average influent rate of 59 GPM with a peak hour influent rate of
150 GPM.
Attachments: Revised Plan Sheet Nos.: C07, CO8, and C09
G4�1.„
)
Pub c Ut flies Engineering&Project Management U v sion*3339 Tamiami Trail Easl,Suite 303*Naples,Florida 34112-5361*239-252.4285*FAX 239.252-5378 t,}
CO
C.)
0 0 0 0 0 0 0 O 0 0
-
0 0 00 0
0 0 0 0 O
00 00 0
COCD 0 o 00
N N 0 O
Areal N N f0 C.5 N N r r N CO
Cr R M
U) u7
W W W W
o U U U
E a Fe ire
a a a a.
o 0 0 0
w w w w
O 0 0 0
z z z z
Cu
is
1 u) u) xenw W u) u) i;:, u) t»
¢ o Q o Q
Q Q z
o ;(...0
- o F' ui N- r
Or m On m N m m
.- ':
U m C a 0 0
U h U { N U (W.1 ..
2 2
Ft a a O a O na
I-
2 U Z 0 Z 0 z 0 -
C Cl) I.)
J • G d N
F -i F -1 F F .-. LL O)
c c j
C E c
f;• 2o m g
)
.- .- � .- N J u)
w w w w c
o Ii
`o y O
m
C
V
N 6
m a U)
E
E °
a 3 a
E „, J m
c N
x o m
g -6- .` 7)
-a o d E
m 2 Z 6, (''223
O w O O
P F F m
P N 4)°/ c
a CO a a a °
E o
U 0 0 U F Q
W u" W W W J O 0)
o C o O ,1,' O o v -2
D
w
W io T. 8 'EL o .
J N ta C U N L`.
a l0 N O y
p a N 3
0
2 E c Ei o u u u .° 3
U a ato
Q a Z-=
N o a c c c`c
CI 'm .2 U o o
mU c
(n N R Q
c O ° x °
Caoil
0
F cn ,81FW
W 0
F
J- E 0
.0 j
F- '0.4",
D N 0 N a'
U >, r
:,04'.::::::,,,,,,e
�7 a
m ma� a
va 3 Z N p C) U v
_ w 2 a a
U Z CO w U U)
�M 0 u. "...Id
o
c a- i4 C%i d4
i
J- Q) 2 222
J t6 g C.) g U g CF.) g
OU > m COIll W
U) LIJ
h ILI
00
NO IAMM
r. ( 3 m
t o
z
544111210
VIENM C
0
u
mown 0
Fah m
o=o 0
V z
3
, O 00
OO OO OO O
- \ - 00OOO Op
O O O
Mft*.,
Sc CC 0000 PP Vt
g I- n O O O O N N V
pt� , C Vr V) 'f-2 ',-° V V Vt N W
V1 VT V1 Vl VY
1O..
C
C 'D
O O NO NO O 0
M OOOOOO
�` i . OO 000 OO
"; N O O O O N n O O 0N
*magi ., riv , r; W
, NN Olm OO M , Ln
,w-,:.,,,, , NVrlN V)lLVn1V1VT ,r-sr.,
�
r
0 O o O O o 0 0
a 0
- ,- o o O o 0 0 o O -
CC0 o LriLri o o Lri
O O N O N N O O tO
V ti ff ,..6 ,s5 T.-1 ,1 f- N 00
7 L.2 `,2).
V/ VT Ln Ln of VT N
Vl V1 VT en VY
Y
• 2
O O O Vl 00
O- ' WO 1.OO
O
OO Jet OO
p ' NiNnh00 tO
0. P. P. vn 00 NN O
=„ 0 t m
„ 1 VVNVl ti V1 7) ViV?
W
3
qr,r d
$ 1. _
co
O
O O 7.
m
m m
y H in H
_ C Al .,. M [T
z o z z
0 < O O
- en
0c6 G G
z = 00 w 00
N
O
a 0 m2 z
A'a " c Ln e:i F.. v
v o z < z
C3
m o O ' O
G
H 0,
o ° obi a
C
E w j
O c c N
',- 44611i111110 'Ai '
m m
u L^ 3
I6C8
FRONT PAGE OF PUBLIC PAYMENT & PERFORMANCE BOND
In compliance with F.S. Chapter 255.05(1)(a)
Bond No.: 30074183
Contractor Name: Haskins, Inc.
Contractor Address: 10956 Enterprise Avenue,Bonita Springs, FL 34135
Contractor Phone No: (239) 947-1846
Surety Company Name: Western Surety Company
Surety Company Address: P.O. Box 5001, Westfield Center, OH 44251-5001
Surety Company Phone No: 330-887-0101
Agent Name: Waldorff Insurance & Bonding, Inc.
Agent Address: 1110 NW 6th' Street
Gainesville, FL 32601
Agent Phone No: (352) 374-7779
Obligee Name: Collier County
Obligee Address: 3327 Tamiami Trail E., FL 34112
Obligee Phone No:
Bond Amount: $708,665.00
Contract No: (if applicable)70046.22.3
Description of Work: Village Walk Wastewater System Modification
Project Address: FL
FRONT PAGE
All other bond page(s)are deemed subsequent to this page regardless of any page number(s)that may be pre-printed thereon.
.4
Bond No. 30074183
16C8
Li this exhibit is not applicable
EXHIBIT C-2
PUBLIC PERFORMANCE BOND
Bond No. 30074183
Contract No. 14-6213-134
KNOW ALL MEN BY THESE PRESENTS: That Haskins, Inc.
, as Principal, and Western Surety Company
as Surety, located at P.O. Box 5001, Westfield Center, OH 44251-5001 (Business Address)
are held and firmly bound to Collier County, FL _, as Oblige in the sum of
Seven hundred eight thousand six hundred sixty five and 00/100 dollars ($ 708,665, 0 )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 8th day of October
2019 , with Oblige for #70046.22.3 Village Walk Wastewater System Modification
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.
0
Bond No. 30074183 1 6 C R
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 17th day
of December , 20 19 , the name of each party being affixed and these presents duly signed by its
undersigned representative, pursuant to authority of its governing body.
Sig ed, sealed and delivered
ill s n o.:, ,, PRINCIPAL:
4 3 Haskins, Inc. ,,
\. T
By. ei
—_
Witnesses o Principal Name: to
Its: ( bJ tV
STATE OF
COUNTY OF Lu..
The fozggoing ins``tr�`u� ment was acknowledged before me this 1 i "day of Q,Ertct itLf
20� by t iG.A. F� kJ , as Vac_ 1 i ie-i�t_t �� of 1-1‘15,161c4 T .
a -Ft _ \ orporation, on behalf of the corporation.
�jg/She is rs
peonally known to me OR has produced as identification and
did (did not) take oath.
My Commission Expires: 02-43 '20?& Lam- 7)r`'
(Signatur of Notary)
1 -
Name: kl l ti
(Legibly Printed)
(AFFIX OFFICIAL SEAL) r
Notary Public, State of t0(� &.)77'�
4 ,.t�pr'd a•.. MABEL LAGO ( & V V
I i.R , '- Notary Public State of Florida I Commission No.: Gj '�
1;'� A; Commission#GG 269100
Iii
•1'S pel My Comm.Expires Feb 13,2023 I
'•
4 Bonded through National Notary Assn.
Bond No. 30074183 1 6 C 8
ATTEST: SURETY:
Western Surety Company
(Printed Name)
Western Surety Company
P.O. Box 5001
Westfield Center, OH 44251-5001
(Business Address)
(Authorized Signature)
Witness as to Surety
(Printed Name)
OR
r-- As Attorney in Fact & FL Resident Agent
(Attach Power of Attorney)
Witnesses
Waldorff Insurance & Bonding
1110 NW 6th Street
Gainesville, FL 32601
(Business Address)
Benjamin H. French
(Printed Name)
352-374-7779
(Telephone Number)
STATE OF Florida
COUNTY OF Alachua
The foregoing instrument was acknowledged before me this 17th day of December 2019 by
Benjamin H. French , as Attorney-in-Fact of Western Surety Company
, Surety, on behalf of Surety. He/She is personally known fo me OR has produced
personally known as identification and who did (did not) take an oath.
My Commission Expires: 12/17/22 • d6''t-'
(Signature of Notary)
Name: Trava Ridlon
(Legibly Printed)
(AFFIX OFFICIAL SEAL)
Notary Public, State of Florida
TRAVA RIDLON
NOTARY PUBLIC Commission No.: GG284959
STATE OF FLORIDA
NO.GG284959
MY COMMISSION EXPIRES DEC.17,2022
Bond No. 30074183 1 6
C
8
Exhibit C-1
this exhibit is not applicable
PUBLIC PAYMENT BOND
Bond No. 30074183
Contract No. 14-6213-134
KNOW ALL MEN BY THESE PRESENTS: That Haskins, Inc. as
Principal, and Western Surety Company , as Surety, located at
P.O. Box 5001, Westfield Center, OH 44251-5001 (Business Address) are held and firmly bound to
Collier County, FL as Oblige in the sum ofSeven hundred eight thousand six hundred sixty five and 00/100
($ 708,665.00 ) 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 the8th day of October , 20 19
with Oblige for#70046.22.3 Village Walk Wastewater System Modification
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 17th day of
December , 2019 , the name of under-signed representative, pursuant to authority of its governing
body.
c:uo
Bond No. 30074183I ` ^ Q
Signed, sealed and delivered
in the •re nce : PRINCIPAL:
t I._
� Haskins, Inc. , '
, By: e- r&,,„,
Witness-s7. to Principal Name: .�.� r'
Its: ( (QSti . P •
STATE OF Yl--
COUNTY OF LQf,
Th regoing instrunnnt was acknowledg l before ne this f .,.J2R.�yc 20 t‘:), by .
?tt , as \) i rVS i D-4C.1 of t- tg0.4tc 'ti<-- , a .-- 111-14-1.2
corporattm, on behalf of the corporation. Jig/she is personally known to me OR has produced `jt4--
as identification and did (did not),,t,ake an oath.
My • fission Ex•ires: OZ'JIa/UR- LL
MASEL LAGO (Signature of Notary)
o� e
Notary Public-State of Florida t
P Commission#GG 269100 Name: `i` ��
My Comm.Expires Feb 13,2023
Bonded through National NotaryAssn. (Legibly Printed)
(AFFIX OFFICIAL SEAL) Notary Public, State of 106 Q
Commission No.: 1=t.61-'1 i 0
ATTEST: SURETY:
Western Surety Company
(Printed Name)
Western Surety Company
P.O. Box 5001
Westfield Center, OH 44251-5001
(Business Address)
(Authorized Signature)
Witness as to Surety
(Printed Name)
OR
�C'AU
Bond No. 30074183 1 6
C 8
(ea)/ 'e .ent
`�----� �---- , As Aff� -yin Fact• sl gent
' .,- i✓{ c:(t'-�J (Attach Power of Attorney)
Witnesses
Waldorff Insurance & Bonding
1110 NW 6th Street
Gainesville, FL 32601 _
(Business Address)
Benjamin H. French
(Printed Name)
352-374-7779
(Telephone Number)
STATE OF Florida
COUNTY OF Alachua
The foregoing instrument was acknowledged before me this 17th of December 2019 , by
Benjamin H. French , as Attorney-in-Fact
of Western Surety Company , Surety, on behalf of Surety. He/She is personally known to
me OR has produced personally known as identification and who did (did not) take an oath.
My Commission Expires: 12/17/22 ��'�°�`
(Signature of Notary)
Name: Trava Ridlon
(Legibly Printed)
(AFFIX OFFICIAL SEAL)
Notary Public, State of Florida
TRAVA RIDLON Commission No.: GG284959
NOTARY PUBLIC
STATE OF FLORIDA
NO.GG284959
MY COMMISSION EXPIRES DEC,17,2022
CA O
Bond No. 30074183 1 6 C s
Western Surety Company
POWER OF ATTORNEY APPOLY CLNG INDIVIDUAL ATTORNEY-IN-FACT
Kuuw All Men By These Presents,That WESTERN SURETY COMPANY.a South Dakota corporation.is a duly organized and cwsbnR eutporatiun
laving 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,constittnc and appoint
L. Dale WaldortT Benjamin H French, Pamela L. Jarman, Paul A Locascio, K. Wayne
Walker, Rebekah C Wolf,Clyde I) [fare, Individually
Of Fort Walton Reach.FL,its tete and lawful Attonuy(s)-hr-Fact with 11t11 power and authority hereby conferred to sign,seal and execute for and on its
behalf builds,undertakings and other obligatory instruments of similar nature
- In Unlimited Amounts-
Ink('to bind it thereby as fully and to the sauce extent us if such instruments were signed by u duly authorized office] of the imputation and all the acts of said
Attorney,pursuant to the authority hereby given.arc hereby ratified and confirmed.
This Power of Attorney is made and executed puratant 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 Vice President and its corporate seal to be
hereto affixed on this 29th day of December,2015.
ysaac
WESTERN SURETY COMPANY
c
+tisk A�^• �
�tM.AN0 .GS C.�L_.......—
w.,. 'ant T.BMW,Vice President
State of south Dakota J
SS
County of Minneltahu
On this 29th day of December,2015,before ins personally crane Paul T.Bnulat,to me known,who,being by nae duly swum,did depose and say: that
he resides in the City of Sioux Falls,State of South Dakota;that he is the Vice President of WESTERN SUitE'1'Y COMPANY described in and which
executed the above itstmment;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 namc thereto pursuant to like authority,and
acknowledgas sae to he the act and deed of said corporation.
My commission expires J.MOt1R
rrornvr�u l , .1().772/)4-11
June 23,2021 t�ran aNw /
J.Mohr,Notary Public
CERTIFICATE
I, L.Nelson, Assistant.Secretary of WESTERN SURETY COMPANY do hereby certity that the Power of Attorney hereinabove set forth is still in
force,and thither certify tinct;due Hy-Law of the corporation printed on the reverse hereof is still in force. In testimony whereof I have hereunto subscribed
my name and atfixedthe cal oh'he said corporation this17th day of December, 2019.
WESTERN SURETY COMPANY
or AN,
• L.Nelson,Assistant Secretary
Form F4280.7.2012
C