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HomeMy WebLinkAbout20A - AA - PED COUNTDOWN HEADS AND PUSH BUTTONSREQUEST FOR COUNCIL ACTION CITY COUNCIL MEETING DATE: JANUARY 19, 2016 TITLE: AWARD CONTRACT FOR THE INSTALLATION OF PEDESTRIAN COUNTDOWN HEADS AND PUSH BUTTONS (PROJECT NOS. 15 -6830) (STRATEGIC PLAN NO. 61B, & 1G) d zli�t� CITY MANAGE RECOMMENDED ACTION CLERK OF COUNCIL USE ONLY: APPROVED ❑ As Recommended ❑ As Amended ❑ Ordinance on 1s` Reading ❑ Ordinance on 2nd Reading ❑ Implementing Resolution ❑ Set Public Hearing For CONTINUED TO FILE NUMBER 1. Authorize the City Manager and Clerk of the Council to award a contract to Siemens Industry, Inc., the lowest responsive bidder, in accordance with the bid in the amount of $596,076 for the installation of pedestrian countdown heads and push buttons throughout the city, and authorize the City Manager and Clerk of the Council to execute the contract, subject to non - substantive changes approved by the City Manager and City Attorney. 2. Approve an appropriation adjustment recognizing $101,822 from the Highway Safety Improvement Program funds into the Select Street Construction revenue account and appropriating the same to the Select Street Construction Expenditure account. 3. Approve the Project Cost Analysis for a total estimated project delivery cost of $745,096, which includes the contract base amount, administration, inspection, testing, and a 10 percent contractual contingency of $59,608, subject to non - substantive changes approved by the City Manager and City Attorney. DISCUSSION The recommended action will improve pedestrian safety and enhance compliance with the Americans with Disabilities Act. Traffic signals at selected intersections throughout the city (Exhibit 1) will be upgraded with pedestrian countdown heads using the latest technology to display a countdown of time remaining for pedestrians to complete crossing the roadway. In addition, pedestrian push buttons will be lowered so that they are more accessible to all pedestrians and easier to actuate. Once completed, these improvements will increase safety for pedestrians while promoting more walking and bicycling throughout the city. A Notice Inviting Bids was advertised on November 9 & 10, 2015, and bids were opened on December 1, 2015. The following is a summary of the bid invitations made and the bids received: 20A -1 Award Contract Installation of Pedestrian Countdown Heads & Push Buttons January 19, 2016 Page 2 Contractor Participation Data Santa Ana contractors receiving notices 1 Contractors requesting bidding documents 15 Bids received 6 Bids received from Santa Ana contractors 0 Bid Results Summary RANK BIDDER'S NAME LOCATION BID 1 Siemens Industry, Inc. Orange $596,076.00 2 Asplundh Construction Corp. Anaheim $653,011.00 3 PTM General Engineering Service, Inc. Riverside $674,041.00 4 California Professional Engineering, Inc. La Puente $732,630.00 5 St. Francis Electric, LLC Riverside $741,970.50 6 Steiny and Company, Inc. Baldwin Park $790,907.00 Six bids were received and all were deemed responsive. Siemens Industry, Inc., submitted the lowest responsive bid in the amount of $596,076. The Project Cost Analysis estimates the total project delivery cost to be $745,096 (Exhibit 2). That amount is less than the engineer's estimate of $827,820. Therefore, since there are sufficient funds to complete the project, staff recommends award of a contract to Siemens Industry, Inc. The construction contract incorporates the low bid and is ready for approval (Exhibit 3). In July 2014, funding award from the Federal Highway Safety Improvement Program (HSIP) was estimated at $989,700. In September 2015, the HSIP award was finalized at $1,091,522. The appropriation adjustment in this Council action will recognize the additional $101,822 for completion of this project. STRATEGIC PLAN ALIGNMENT Approval of this item supports the City's efforts to meet Goal #6 - Community Facilities & Infrastructure, Objective #1 (establish and maintain a Community Investment Plan for all City assets), Strategy B (equitably maintain existing streets and associated assets in a state of good repair so they are clean, safe and aesthetically pleasing for all users) and Strategy G (develop and implement the City's Capital Improvement Program in coordination with the Community Investment and Deferred Maintenance Plans). 20A -2 Award Contract Installation of Pedestrian Countdown Heads & Push Buttons January 19, 2016 Page 3 ENVIRONMENTAL IMPACT In accordance with the California Environmental Quality Act, the recommended actions are exempt from further review. Categorical Exemption Environmental Review No. 2014 -20 was filed for this project. FISCAL IMPACT The Project Cost Analysis estimates project expenditures to be $745,095.60, which includes construction, contract administration, inspection, testing, surveying, and contingencies. Funding is available in the Pedestrian Countdown Heads & ADA Push Button Upgrade project (No. 15- 6830) in the Federal Aid Safety Program Fund (Account No. 14717611 - 66220) and the Measure M2 Local Fair Share Fund (Account No. 03217662 - 66220) using the following spending plan: FY 2015 -16 FY 2016 -17 Federal Aid Safety Program Fund $335,293.02 $335.293.02 Measure M2 Local Fair Share Fund $37,254.78 $37,254.78 FY TOTAL $372,547.80 $372,547.80 PROJECT TOTAL $745,095.60 An appropriation adjustment will be processed to recognize $101,822 from the Highway Safety Improvement Program funds into the Select Street Construction revenue account (No. 14717002- 52001) and appropriating the same to the Select Street Construction Expenditure account (No. 14717611- 66220). Executive Director Public Works Agency FM /EWG/TC Exhibits: 1. Location Map 2. Cost Analysis 3. Construction Contract with Bid APPROVED AS/70 FUNDS AND ACCOUNTS: Executive Directt)f Finance & Management Services Agency 20A -3 20A -4 EXHIBIT 1 20A -5 20A -6 COST ANALYSIS PROJECT NO. 15 -6830: PEDESTRIAN COUNTDOWN HEADS AND PUSH BUTTONS Construction Contract $ 596,076.00 Contract Administration $ 41,694.00 Inspection and Testing $ 47,718.00 Survey $ 0.00 Contingencies $ 59,607.60 TOTAL ESTIMATED CONSTRUCTION COSTS $ 745,095.60 EXHIBIT 2 20A -7 20A -8 CITY OF SANTA ANA EXHIBIT 3 Construction Contract PROJECT NO. 15 -6830 PEDESTRAN COUNTDOWN HEADS AND PUSH BUTTONS This CONSTRUCTION CONTRACT is made and entered into this 19 day of January 2016, by and between the CITY OF SANTA ANA, CALIFORNIA, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California, hereinafter referred to as "CITY" and Siemens Industry, Inc., hereinafter referred to as "CONTRACTOR ". WITNESSETH: The CITY and the CONTRACTOR, for the consideration hereinafter named, mutually agree as follows; I. CONTRACTOR agrees to perform all the work and furnish all the materials at its own cost and expense necessary to construct and complete in a good and workmanlike manner and to the satisfaction of the City Engineer of the CITY, the Pedestrian Countdown Heads and Push Buttons, hereinafter referred to as the "Work of Improvement ", identified in and in accordance with the Contract Documents prepared by the City's Public Works Agency and approved by the City Council. 2. The complete Construction Contract consists of the "Contract Documents," as defined by the Standard Specifications for Public Works Construction and which include the following: • Notice Inviting Bids • Information to Bidders • Bid Proposal • Bid Bond • Contract Form • Contract Bonds • General Provisions • Special Provisions • Project Plans • Required Contract Provisions Federal -Aid Construction Contracts (Fonn FFIWA 1273) • Davis -Bacon Act and Wages • Appendices In case of conflict between the Contract Documents, the precedence of documents shall be as established in the Standard Specifications for Public Works Construction. 3. CITY agrees to pay and CONTRACTOR agrees to accept in full payment to complete the Work of Improvement the sum total ainomlt not to exceed $596,076.00, as set forth and identified in the BID PROPOSAL, which is attached hereto and incorporated herein as Exhibit "A ". The BID PROPOSAL contains a schedule of unit price(s) or lump sum(s) based on approximate quantities only, and the City does not expressly or by implication Page 1 of 20A -9 CITY OF SANTA ANA Construction Contract PROJECT NO. 15 -6830 PEDESTRAN COUNTDOWN HEADS AND PUSH BUTTONS agree that the actual amount of work will correspond therewith, but reserves the right to increase or decrease the amount of any class or portion of the work or to omit portions of the work as may be deemed necessary or advisable, 4. CONTRACTOR agrees to complete the Work of Improvement within the time specified in the Time for Completion of Improvements section of the BID PROPOSAL (Exhibit "A') including commencing construction within the timeframe therein specified after issuance of a Notice to Proceed. 5. The CONTRACTOR will pay, and will require all subcontractors to pay, all employees on the Work of Improvement a salary or wage at least equal to the prevailing salary or wage established for such work as set forth in the wage determinations for this work in accordance with applicable State and Federal law. 6. CONTRACTOR shall, after award of this Contract, furnish two bonds to be approved by the CITY, one in the amount of One Hundred Percent (100 %) of the Contract price, to guarantee the faithful performance of the work (Performance Bond), and one in the amount of One Hundred Percent (100 %) of the Contract price to guarantee payment of all claims for labor and materials furnished, (Payment Bond). This Contract shall not become effective until such bonds are supplied to and approved by the CITY. CONTRACTOR shall, prior to the release of the performance and payment bonds or the retention payment, furnish a warranty performance and payment bond equal to at Least ten (10 %) percent of the final Contract price or $1,000, whichever is greater (Warranty Bond). CONTRACTOR shall, upon project completion as a condition of project acceptance, furnish a Warranty Payment and Performance bond to be approved by the CITY, in the amount of Twenty -Five Percent (25 %) of the Contract price, to warrant the work done under said Contract Agreement against material or quality defects for a period of one year after acceptance by the AGENCY. s. CONTRACTOR shall, after award of this Contract, furnish Certificates of Liability Insurance and Worker's Compensation Insurance as outlined in the General Provisions, to be approved by the CITY. Page 2 of 3 20A -10 CITY OF SANTA ANA Construction Contract PROJECT NO. 15 -6830 PEDESTRAN COUNTDOWN HEADS AND PUSH BUTTONS IN WITNESS WHEREOF, the parties hereto have executed this Construction Contract on the day and year first above written. ATTEST: CITY OF SANTA ANA MARIA D, HUIZAR DAVID CAVAZOS Clerk of the Council City Manager APPROVED AS TO FORM: RECOMMENDED FOR APPROVAL: SONIA R. CARVALHO City Attorney BY To Sandoval Fred Mousavipour, P.E. C& f Assistant City Attorney Executive Director, Public Works Agency CONTRACTOR: Siemens Industry, Inc Page 3 of 3 20A -11 CITY OF SANTA ANA PROPOSAL PROJECT N0, 15 -6830: Pedestrian Countdown Heads and Push Buttons BID PROPOSAL TO: CITY COUNCIL OF THE CITY OF SANTA ANA FROM: SIC69GNS INDUSTRY, INC. REQUIREMENT: The undersigned bidder declares that they have carefully examined the location of the proposed work, that they have examined the Contract Documents in its entirety and hereby proposes to furnish all material and do all the work required to complete the said work in accordance with said plans (if any) and the specifications for the unit price(s) or lump sum(s) set forth in the following schedule: Project# 15 -6830 Item Description Qty Unit Unit Price Amount 1 Replace Pedestrian Head Assembly with 734 EA $ 00 .„ $ ? .]� Countdown Head •� ! 2 Replace Pedestrian Head Module with �7 EA $ t- f $ ),081 0" Countdown Head J� 3 Replace Pedestrian Push Button Assembly 948 EA $ po- $ } (y }(00vr 4 Replace Pedestrian Push Button 118 EA $ °I 5 Adjust Pedestrian Push Button Assembly to 831 EA 42 -inch Above Finished Grade 4y S _ �-. •�rV�.Oa 6 Install New Pedestrian Push Button 52 EA I ta2'i7� Assembly and Wiring c• ^,� Total Base Bid For Project: 15 -6830 $ _v `j-1 j t �� 1»t ilU.il`.1 The lowest responsible bidder shall be selected based on the total base bid. The City reserves the right to award the Base Bid, and any, all, or none of the add - alternate bid items (if any). * The quantity for this bid item is shown for bid comparison only. This bid item shall not be subject to the "25 %" limit as stated in Section 3 -2 of the Standard Specifications. The actual amount for this item will be dictated by the actual quantity used, and the Agency reserves the right to increase or decrease the quantity of this item accordingly. t This bid item is considered a Specialty Item per Section 2 -3.2 of the Standard Specifications. t3P -I 20A -12 CITY OF SANTA ANA PROPOSAL PROJECT NO. 15 -5830: Pedestrian Countdown Meads and Push Buttons TIME FOR COMPLETION OF IMPROVEMENTS AND LIQUIDATED DAMAGES The undersigned bidder hereby proposes to complete the Work for the total base bid amount shown above, within eighty (80) working days after the commencement date stated in the Notice to Proceed. The bidder also proposes to commence construction of the Work within ten (10) days after issuance of a Notice to Proceed, and to continue in a diligent and workman -like manner without interruption, and to complete the construction thereof within the time specified above. The liquidated damages amount in lieu of the amount specified in Subsection 6 -9 of the Standard Specifications, shall be $1,000 per calendar day. Name of Firm SIEMENS INDUSTRY, INC. Signature of BIDDER tmoj a Title t wrec: -Vol D2 ;Sej:\j�C:,E1 (if an individual, so state) J U" BP -2 20A -13 CITY OF SANTA ANA PROPOSAL PROJECT NO. 15 -6830: Pedestrian Countdown Heads and Push Buttons BIDDER'S STATEMENT BIDDER understands and agrees that this Bid Proposal, Contract Documents and subsequent Construction Contract Agreement shall constitute the entire agreement between BIDDER and the AGENCY only after it has been accepted by the City Council, endorsed by the Clerk of the Council with her signature and official seal noting hereon the action of approval of the Council, signed by the Public Works Agency Executive Director or his /her duly authorized agent, and signed by the City Attorney, denoting his approval of the form of this document, and its execution, and when it or an exact copy of it has been either delivered to BIDDER or deposited with the United States Postal Service properly addressed to the BIDDER with the correct postage affixed thereto. BIDDER further agrees that upon delivery (as defined above) of the accepted agreement he /she will furnish AGENCY all required bonds and certificate of liability insurance within ten (10) business days or the funds, check, draft, or BIDDERS bond substituted in lieu thereof accompanying this proposal shall become the property of the AGENCY and shall be considered as payment of damages due to the delay and other causes suffered by AGENCY because of the failure to furnish the necessary bonds and because it is distinctly agreed that the proof of damages actually suffered is difficult to ascertain; otherwise said funds, check, drafts, or BIDDER'S bond substituted in lieu thereof shall be returned to the undersigned. BIDDER understands that a bid is required for the entire work, the estimated quantities set forth in the bid schedule are solely for the purpose of comparing bids, and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. The BIDDER also certifies that the bid is a balanced bid. In accordance with Section 7028.15 of the California Business and Professions Code, the undersigned certifies under penalty of perjury that the foregoing is true and correct. Name of Firm SIEMENS INDUSTRY, INC. (CORPORATION) Signature of Title U1 re..r o-f- o� )ecd'tC,9 (if an individual, so state) (If a firm or co- partnership, state the firm name and give the names of all individual co- partners composing the firm. If a corporation, state legal name of corporation, and names of President, Secretary, Treasurer and Manager, thereof.) President: CEO, Kevin Riddeti Treasurer: CFO, Matthias Sehlelein Secretary: Communication Officer, Pranziska Wagner Address: 527 Mattison Ave, 8th floor, New York NY10022 BP-3 20A -14 Operations Manager: Michael Hutchens 2200 W Orangewood Ave, Oraage, CA 92868 CITY OF SANTA ANA PROPOSAL PROJECT NO. 15- 6830', Pedestrian Countdown Heads and Push Buttons CONTRACTOR'S LICENSING and REGISTRATION STATEMENT The undersigned contractor, or corporate officer, declares under penalty of perjury that he /she and all his /her subcontractors are registered with the State of California Department of Industrial Relations (DIR), and that the following is true and correct. Contractor's Name: SIGMGNS INDUSTRY INC Business Address: 2200 w Orangewood Ave, Orange, CA 92868 Business E -Mail MICHALL.HIJTCHCNS@SICMGNS.COM Address: 2200 w Orangewood Ave, Orange, CA 92868 Telephone: 714-448 -6943 State Contractor's License No, and Class: 758796, C- 10,C -20, C -16, B License Expiration Date: 02/28/2017 State Dept. of Industrial Relations (DIR) Registration NO,: 10001102447 State Dept. of Industrial Relations (DIR) Registration Expiration Date: 06/30/2016 Signed: Title: BP-4 20A -15 CITY OF SANTA ANA PROPOSAL PROJECT NO. 15 -6830: Pedestrian Countdown Beads and Push Buttons PREVAILING WAGE COMPLIANCE AND MONITORING STATEMENT Contractor is aware of the requirements of California Labor Code Section 1720, et seq., as well as California Code of Regulations, Title 8, Section 16,000, et seq., ( "Prevailing Wage Laws "), which require the payment of prevailing wage rates and the performance of other requirements on "public works" and "maintenance" projects. Since the services are being performed as part of an applicable "public works" or "maintenance" project, as defined by the Prevailing Wage Laws, and since the total compensation is $1,000 or more, Contractor agrees to fully comply with such Prevailing Wage Laws. City shall provide Contractor with a copy of the prevailing rates of per diem wages in effect at the commencement of this Agreement. Contractor shall make copies of the prevailing rates of per diem wages for each craft, classification or type of worker needed to execute the services available to interested parties upon request, and shall post copies at the Contractor's principal place of business and at the project site. Contractor shall defend, indemnify and hold the City, its elected officials, officers, employees and agents free and harmless from any claim or liability arising out of any failure or alleged failure to comply with the Prevailing Wage Laws. The undersigned certifies that the foregoing is true and correct. Name of Firm SIEMENS INDUSTRY, INC. Signature of BIDDER Title I ),[ (if an individual, so state) 13P -5 20A -16 CITY OF SANTA ANA PROPOSAL PROJECT NO. 156830: Pedestrian Countdown Beads and Push Buttons OWNERSHIP AFFIDAVIT STATE OF CALIFORNIA ) COUNTY OF ORANGE }ss: CITY OF SANTA ANA } ,being duty sworn, deposes and says: ❑INDIVIDUAL That he /she is the party making the foregoing proposal: ❑ PARTNERSHIP That he /she Is a member of the cc- partnership firm designated as: and who has been and is duly vested with the authority to make and execute Instruments for the co- partnership by: who constitute the other members of the co-partnership. PCI CORPORATION That he Is of: SIEMENS INDUSTRY, INC. a corporation which is making the foregoing proposal: ❑JOINTVENTURE That he is of: one of the parties making the foregoing proposal as a joint venture, and the he /she has been and is duly vested with the authority to execute instruments for an on behalf of the parties making said bid who are: that such a bid is genuine and not collusive or sham, and has not in any manner sought by collusion to secure any advantage against the City of Santa Ana or any person interested in the proposed contract, for himself or any other person. gnature f_ed erS"i 1J 1`. k(-IDIliter} -qr 4 rwia -° Subscribed and sworn to before me this day of _,/ 20 _ Signature of officer Administering Oath (N9arrPublic) PAC&Ci B P -6 20A -17 CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT STATE OF CALIFORNIA County of Orange ,___ On Q i , b6efore me, Candace Gallaher - Notary Public_ _ pate Here losert Name and ride of the officor personally appeared — _....__- Name(s) of Signar(s) who proved to me on the basis of satisfactory evidence to be the person (,s- )-whose nanne(s)-Is /are- subscrlbed to the �{ within instrument and acknowledged to me that he /sh&they- CANOACE GALLAHER [ Commission N 2117338 executed the same in his /her/their authorized capacity(ies), and that by hisibavAheir signature{sron the instrument the z v Notary Public • California person(&)', or the entity upon behalf of which the person(sr z Orange County J acted, executed the instrument. My Comm, Expires Jul 24, 2019 I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. Witness m ' and an official se I.iI Signature. =_ Place Notary Seal Above Signature of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: _..i._ Signer(s) Other Than Named Above: _ Capacity(les) Claimed by Signer(s) Signer's Name: ❑ Individual ❑ Corporate Officer —Tltle(s):__ ❑ Partner— ❑ Limited ❑ General ❑ Attorney In Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Top of thumb here Signer's Name:_„_. ❑ Individual ❑ Corporate Officer —Title(s):— ❑ Partner — ❑ Limited ❑ General ❑ Attorney In Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other; Signer is Representing: 20A -18 CITY OF SANTA ANA PROPOSAL PROJECT NO. 15.6830: Pedestrian Countdown Heads and Push Buttons KNOW ALL PRESENT that, ,as , as SURET , are held and firmly bound unto the CITY OF SANTA ANA, as AGENCY, in the penal s of _ Dollars ($ ), which is ten ercent (10 %) of the total amount bid by BIDDER to AGENCY for the above - stated project, fra the payment of which sum, BIDDER and SURETY agree to be bound, jointly and sever, Y, firmly by these presents. THE CONDITIONS OF THIS OBLIGATION ARE SUCH that, whereas BI DER is about to submit a bid to AGENCY for the above - stated project, if said bid is rejected // r if said bid is accepted and a contract is awarded and entered into by BIDDER in the man Zr and time specified, then this obligation shall be null and void, otherwise it shall remain j f full force and effect in favor of AGENCY. / IN WITNESS WHEREOF the parties hereto have set the" names, titles, hands, and seal this day of 20_. BIDDER* SURETY* Subscribed and sworn before me this day of , 20_, Signature: Nota/BIDDER/ and for the County of State of *Pro SURETY name, address, and telephone number and the name, title, address, and t umber of authorized representative. BP -7 20A -19 Document A310TM -2010 Conforms with The American Institute of Architects AIA Document 310 4�1 M CONTRACTOR: (Nmae, legal stunts and adeliess) Siemens Industry Inc. 2250 Business Way Riverside, CA 92501 OWNER: (Name, legal vanrs and address) City of Santa Ana 20 Civic Center Plaza Santa Ana, CA 92701 Bond Number: 79434433- CHU -15 -22 SURETY: (Name, legal srntas and principal place of business) Federal Insurance Company 15 Mountain View Rd. Warren, NJ 07061 -1615 State of Inc: Indiana BOND AMOUNT: Ten Percent of Amount Bid (10 %) This document has important legal consequences. Consultation with an attorney is encouraged with respect to its completion or modification. Any singular reference to Contractor, Surety, Owner or other party shall be considered plural where applicable. PROJECT: (Name, location or address, and Project number, lfarrv) Pedestrian Countdown Heads and Push Buttons Replacement of Countdown Pedestrian Heads and PPB's City Wide The Contractor and Surety are bound to the Owner in the amount set forth above, for the payment of which the Contractor and Surety bind themselves, their heirs, executors, administratm's, successm's and assigns, jointly and severally, as provided herein, The conditions of this Brad are such that if the Owner accepts the bid of the Contractor within the time specified in the bid documents, or within such time period as may be agreed to by the Owner and Contractor, and the Contractor either (1) enters into a contract with the Owner in accordance with the terms of such bid, and gives such bond or bonds as may be specified in the bidding or Contract Documents, with a surety admitted in the ,jurisdiction of the Project and otherwise acceptable to the Owner, for the faithful performance of such Contract and for the prompt payment of labor and material furnished in the prosecution thereof; or (2) pays to the Owner the difference, not to exceed the amount of this Bond, between the amount specified in said bid and such larger amount for which the Owner cony in good faith contract with another party to perform the work covered by said bid, then this obligation shall be unit and void, otherwise to remain in full force and effect. The Surety hereby waives any notice of an agreement between the Owner and Contractor to extend the time in which the Owner may accept the bid. Waiver of notice by the Surety shall not apply to any extension exceeding sixty (60) days in the aggregate beyond the time for acceptance of bids specified in the bid documents, and the Owner and Contractor shall obtain the Surety's consent for an extension beyond sixty (60) days. If this Bond is issued in connection with it subcontractor's bid to a Contractor, the term Contractor in this deemed to be Subcontractor and the term Owner shall be deemed to be Contractor. , When this Bond has been furnished to comply with it statutory or other legal requirement in the locat' any provision in this Bond conflicting with said statutory or legal requirement shall be deemed d A, provisions conforming to such statutory or other legal requirement shall be deemed incopo•aiu ham- furnished, the intent is that this Bond shall be construed as a statutory bond and not as a common la Signed and sealed this 01st rp"o ecem , 2015 _.✓ Siemens (Principal) (Witness- , (W(tnessJ�y L Johnson 20A -20 Sandra L. Ham, Attorney -In -Fact MS ACKNOWLEDGMENT BY SURETY OF Missouri City of St. Louis } SS, On this 01st appeared clay of December. Sandra L. Ham Federal Insurance Company 2015 , before me personally. , known to me to be die Auorncy -in -Fact of _ , Ole corporation drat executed the within instrument, and srckiioeiiedged to me that such corporation executed the same, IN WITNESS WIIEREOF, I haw hereunto set my hand and allixed my official scat, at lily ollicc: in the aforesaid County, the clay and year in this certificate first above written. My Commission Fxpires: September lfi, 2019 (Seal) Noto I'TTTA y D`Cy q y ublie, Notary Seal le SPat, of tvtlssottri '+ Commiss�ul 1County I% 18 MY Com miss ign Expires Setstbmet3 6, 20 h. S- 0230 /GEEF 2/98 20A -21 Brittany D. Clavin Notary Public in the State of Missouri County of St. Louis Commission # 15638336 rlChubb POWER Federal Insurance Company Attn: surety Department OF Vigilant Insurance Company 15 Mountain View Road Surety ATTORNEY Pacific Indemnity Company Warren, NJ 07059 Know All by These Presents, That FEDERAL INSURANCE COMPANY, an Indiana corporation, VIGILANT INSURANCE COMPANY, a New York corporation, and PACIFIC INDEMNITY COMPANY, a Wisconsin corporation, do each hereby constitute and appoint Pamela A. Realman, Cynthia L. Choren, Joann R. Frank, Sandra L, Ham, Nancy L. Johnson, Heidi A. Nothelsen, Karen L. Raider and Debra C, Schneider of St. Louis, Missouri – - – – -- --- -- – –^ - - °— w ^ – each as their two and lawful Adwney. in. Fact to execute under such dooignatton in their cares and to affix their corporate seals to and deliver for and on their behalf as surety theman or atherwRa, bands and Undertakings and other wrllings obligatory in the nature thereof (other than bell bonds) given or executed in the mdrsa of business, and any Instruments amending or uttering the Rome, end Consents to The ma7tricaUOn or arteTatlon of any Instrument referred to in said bonds or obligatlone In witness Whereof, said FEDERAL INSURANCE COM PAW, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY have each executed slid attesled these pmasms and affixed their corporate seals on this 21 Jay of May, 2014. ✓ e .€?aunB M Ch was. §§ sialsl secretary D oRia, Jc, Vice Pr+asl r 4PxNF Y STATE OF NEW JERSEY as. Courtly of Somerset On this 21'" day of May, 2014 before ore, a Notary Public of New Jersey, personally came Dawn M. Chloros, to ripe Im nt to be ASaislstlCSaC+Hkaryaf.FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY, the companleswhidh WOUTIdd me fon}gding Ppw uolAttorney, and the said Dawn M. Chloms, being by me duty ewom, did dePoo and Day That she is ADDTolont BWoury of FEDERAL MEURANCa COMPANY, VIGRANT INSURANCE COMPANY, and PACIFIC IN DEMNTTY COMPANY and knows the 001POrats seals thereof, Ural the seals affixed to the foregoing Power of Ahomey arc such corporate MID and were Thereto ar rrksd by authority of the By- Laws of bald Companies; and that she signed bald Power of Attorney as Assistant Ramsey of said Companies by like authority; and that she is acquainted an David S. Norris, Jr., and knows him to be Vice Prosideni of sold Companles; and that the signature of CavW a. Norris, Jr., subscribed Wand Powar ofAttorney TO In the genuine handwriting of David B. Noels, Jr., and vide thereto subscribed by authordy al said By- Laws and In deponents preservm. Notarial Seal IWTHEWNE A ADELhAR NOTAYTY FUNooR12Ca1 JERSEY Commission rD" July Ib, 2014 CERTIFICATION Extract Rom The Sy. Laws of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY: 'Art powers of attorney for and on bahaUOr the Compreq may and shall be exea8ed in the name and on behalf of the Company, tither by the Chairman or the Preaidert or a Yin Prestden( or an Assistant Virg Prosidenl, jointly with the Secretary or an Aasisim! Secretary, under their respective designations, The signature of such Ofimrs may be engraved, Printed or Inhographod, The signature of each of the following ofAcema; Chairman, President, any Vice Presoml, any Assistant Mee Rmidenl, any Secretary, any AsaiRlanl Seeetory and the seal of the Company may be affixed by facsimile to any Poorer of attorney or to any certificate ruleiing thereto eppolnUng Assistant SeOretanae or Attamay4- in•Fool for purposes only Of execulhg and attesting bonds and undertakings and other writings obligatory in the nature thereof, and any such power of atromey or ceriigeate bearing such tcsimile signature or fecsimlle met shall be valid and binding upon The Company and any such power so executed and sadines by such facsimile signature erW rucalmne seal shall be valid and binding upon the Company with respoot to any bond or undertaking to which II Is attached. - I, Dawn M. Choos, Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY (the "Companies') do hereby cerdN that (1) the foregoing eximat of tie ay- Laws 01 the Companies Is true and Correct, (fp the Companies are duly llcunmr! and authorized to Usheact surety buslnees In all ED of the United States or Ameriea and the District of Columbla and am outhodoed by the U.S. Treasury DeparUnard; further, Federal and Vigilant are IlCensed to Una U.S. Virgin Islands, and Federal Is licensed In American Samoa, GURm, Puerto RICO, and each afthe Provinces or Canada exmpt Pdnm Edward Inland; aril i nq the foregoing Power of Attorney Is we, correct and in full force and effect. Given under my hand and seals of said Companies at Warren, NJ this O1st day of December 2015. rr _ r7 60m0a,AsaietmtSooralary IN THE EVENTYOU WISH TO NOTIFY US OF A CLAIM, VERIFY THE AUTHENTICITY OF THIS BOND OR NOTIFY 08 OF PNY OTHER MATTER, PLEAOE CONTACT US AT ADDRESS Fars lSte- eZ2fi &ll GHN CONSEM hay. d2d4j 20A -22 Farm 16- 10- 0313A(Im9/19) 20A-23 _23 FEDERAL INSURANCE COMPANY STATEMENT OF ASSETS, LIABILITIES AND SURPLUS TO POLICYHOLDERS Statutory Basis DECEMBER 31, 2014 (in thousands of dollars) LIABILITIES AND ASSETS SURPLUS TO POLICYHOLDERS Cash and Short Term Investments ................ $ 110,484 Outstanding Losses and Loss Expenses..... $ 12,181,139 United States Government, State and Unearned Premiums ...... ............................... 3,654,861 Municipal Bonds .......... ............................... 10,245,402 Ceded Reinsurance Premiums Payable....,.. 339,486 Other Bonds ................... ............................... 4,927,443 Provision for Reinsurance ............................ 46,470 Stocks ............................ ............................... 1,066,355 Other Liabilities.............. ............................... 1,434,018 Other Invested Assets .... ............................... 1,365,367 TOTAL INVESTMENTS ............................... 17,715,051 TOTAL LIABILITIES..... ............................... 17,655,954 Investments In Afflllates: Chubb Investment Holdings, Inc..... ........... 3,565,038 Capital Stock................. ............................... 20,980 Pacific Indemnity Company .... 2,922,214 Paid -In Surplus-, .......................................... 3,106,809 Executive Risk Indemnity Inc ...................... 1,258,019 Unassigned Funds........ ...........................,,,, 11,700,594 Chubb Insurance Investment Holdings Ltd.... 1,162,709 CC Canada Holdings Ltd ............................ 652,660 Chubb Insurance Company of Australia Ltd. 480,068 SURPLUS TO POLICYHOLDERS .............. 14,828,383 Great Northern Insurance Company.,........ 476,969 Vigilant Insurance Company ....................... 292,313 Chubb European Investment Holdings SLP.. 287,633 Other Affillates ............. ............................... 517,330 Premiums Receivable .... ............................... 1,879,148 Other Assets .................. ............................... 1,474,965 TOTAL LIABILITIES AND SURPLUS TOTAL. ADMITTED ASSETS ...................... $ 32,484,337 TO POLICYHOLDERS ............................. $ 32,484,337 Investments are valued in accordance with requirements of the National Association of Insurance Commissioners, At December 31, 2014, Investments with a carrying value of $518,199,884 were deposited with government authorities as required by law. State, County & City of New York, — as: Yvonne Baker, Assistant Secretary of the Federal Insurance Company being duly sworn, deposes and says that the foregoing Statement of Assets, Liabilities and Surplus to Policyholders of said Federal Insurance Company on December 31, 2014 is true and correct and is a true abstract of the Annual Statement of said Company as filed with the Secretary of the Treasury of the United States for the 12 months ending December 31, 2014. Subscribed and sworn to before me this March 11, 2015. +tiG JEANETTE SHIPSEY Assistant Secretary Notary Public, State of Now York " Notary Public— No, 02SH5074142 Qualified In Nassau County Commission Expires March 10, 2019 Farm 16- 10- 0313A(Im9/19) 20A-23 _23 CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT STATE OF CALIFORNIA County of Orange On Y 1 " Lao [before me, Candace Gallaher - ag—j Public _ Date Hera hrsert Name and Title. of tha Officer personally appeared ACE GALLAHER 211733 Commission N 291733@ Notary Public - California n Orange County 777...... MX Comm, Ex Ireu Jut 24, 29t9w Place Notary Seal Above who proved to me on the basis of satisfactory evidence to be the persory(sYwhose name(s) is /are- subscribed to the within instrument and acknowledged to me that he%she /they- executed the same in his /her./.their-authorized capacity(ie* and that by his /her,/their signature(e)-on the instrument the persoro),, or the entity upon behalf of which the person(, - acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. Witness my, land a doff icial se I. Signature t Signature of-tiolary Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(les) Claimed by Signer(s) Signer's Name:—_.--___ ❑ Individual ❑ Corporate Officer — Tltle(s):__ ❑ Partner -- ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Top of thumb here Number of Pages: __ Signer's Name: ❑ Individual ❑ Corporate Officer— Title(s):_ ❑ Partner —❑ Limited ❑ General ❑ Attorney in Fact ❑ TrUSiee ❑ Guardian or Conservator Top of thumb here ❑ Omer: Signer Is Representing: 20A -24