HomeMy WebLinkAboutContract 49332 PHILADELPHIA CCrarNMC O...
LjINSURANCE COMPANIES
A Member of the Toklo Marine Group
DUAL OBLIGEE RIDER OFFICIAL,RECORD
(To be attached to Bund at time of issuance I CIT ■ 31C�wRY
FT. WORTH,Tx
TO BF, ATTACHED TO AND FORM PART OF Bond No. PB02183700051. dated cont I
this Rider,by Philadelphia indemnity Insurance Company,as Surety,on behalfof_AMX Constru
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Services, LP,2351 W Northwest Hwy Ste 2118, Dallas,TX 75220, r
Q q�CFN N
as Principal,and in favor of-City of Fort Worth 1,
and Hudson Insurance Company, as Obligees. CIT ,
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B
IT IS HEREBY UNDERSTOOD AND AGREED that the attached Bond is hereby amended to h ving:
Notwithstanding anything contained herein to the contrary. there shall be no liability on the part of the Principal or Surety
under this Bond to the Obligees, or either of them, unless the Obligees, or either of them, shall make payments to the Principal,
or to the Surety in case it arranges for completion of the Contract upon default of the Principal. strictly in accordance with the
terms of said Contract as to payments, and shall perform all the other obligations required to be performed under said Contract
at the time and in the manner therein set forth.
In no event shall the liability of the Principal and the Surety to the Oblige, or either of them, in the aggregate.exceed the penal
sum stated in the attached Bond.
IT IS FURTHER UNDERSTOOD AND AGREED that nothing contained in this Rider shall be held to change, alter or %ary
the terms of the attached Bond except as set forth hereinabove. In the event of a conflict between the Bond and this Rider. the
parties agree that this Rider shall govern and control. All references to the Bond, either in the Bond or in this Rider. Shall
include and refer to the Bond as supplemented and amendcd by this Rider. Except as provided by this Rider. all other terms
and conditions of the Bond remain in full force and effect.
This Rider may be executed in two or more counterparts, each of which shall be deemed all original. but which together shall
constitute one and some instrument.
SIGNED,SEALED AND DATED this_29th day ofJune 20 17
PRINCIPAL:AMX Construction &Specialty Services, LP SURETY: Philarlelphia Indemnity Insurance Compan«
To
e
Signature. - '�=�'.`" Signature:
Alltll IVl -111-haCl SteAhercQuig art j
Name and Fide-P!w1 4'oD D7'. rX1J
Agreed to and accepted by:
OBLIGEE: City of Fort Worth OBLIGEE: Hudson %t r nc Company
Signature. �"�-�� Signature: G T
F rp y
Name and Title" zS� Ct A& � �� and l'itle:� C L_
.6t
APPROVED AS TO FORM AN &4A b
Ct1YATrORNEY S J. iee, City Secretary
; i
AIA Document A312T'" - 2010
Bond No. PB02183700051
Performance Bond
SURETY:
CONTRACTOR: (Name, legal status and principal place f
(Name, legal status and address) of business)
AMX Construction & Specialty Services,
LP Philadelphia Indemnity Insurance Company
2351 W Northwest Hwy Ste 2118 One Bala Plaza Suite 100 s
Dallas, TX 75220 Bala Cynwyd, PA 19004 ,
i
OWNER: This document has important legal
(Name, legal status and address) consequences.Consultation with
an attorney is encouraged with
Hudson Insurance Company respect to its completion or
3301 Windy Ridge Parkway SE modification.
Atlanta, GA 30339
Any singular reference to
Contractor,Surety.Owner or
other party shall be
CONSTRUCTION CONTRACT considered plural where
Date: 6/16/2017 applicable.
AIA Document A312-201 0
Amount: $1,746.580.00 combines two separate bonds,a
(Name and Location Performance Bond and a Payment
Bond,into one form.This is not a
single combined Performance and
Payment Bond
Description:
Interior Finish-Out Completion City Project No C00130 i
Victory Forest Recreation Center, 3427 Hemphill St, Ft Worth, TX 47432
(Name and location)
BOND
Date: June 29,2017
(Not earlier than Construction Contract Date)
Amount: $1,746,580.00
Modifications to this Bond: ❑ None X See Section 16
CONTRACTOR AS PRINCIPAL SURETY
Company: A onstr ctio &S ialty Services, LP Company: P del hia I de ity Insurance
(Corporate C:. al) Company (Corporate Seal)
Signature: Signature:
Name and Title a, a Name And TilIALSt hen fXcQ ney-in-Fact
(Any additional signatures a pear on the last page df this Performance Bond)
(FOR INFORMATION ONLY—Name, address and telephone)
AGENT or BROKER: OWNER'S REPRESENTATION:
(Architect, Engineer or other party:
ASSURANCE BROKERS LTD
95 N Research Dr Ste 100
Edwardsville, IL 62025
AIA Document A312'"'—2010.The American Institute of Architects.
§ 1 The Contractor and Surety,jointly and severally, bind themselves, their heirs, executors, administrators, successors
and assigns to the Owner for the performance of the Construction Contract, which is incorporated herein by reference.
§ 2 If the Contractor performs the Construction Contract, the Surety and the Contractor shall have no obligation under
this Bond, except when applicable to participate in a conference as provided in Section 3.
§ 3 If there is no Owner Default under the Construction Contract, the Surety's obligation under this Bond shall arise
after
.1 the Owner first provides notice to the Contractor and the Surety that the Owner is considering declaring
a Contractor Default. Such notice shall indicate whether the Owner is requesting a conference among the
Owner, Contractor and Surety to discuss the Contractor's performance. If the Owner does not request a
conference, the Surety may, within five(5) business days after receipt of the Owner's notice, request such a
conference. lithe Surety timely requests a conference, the Owner shall attend. Unless the Owner agrees
otherwise, any conference requested under this Section 3.1 shall be held within ten (10) business days of
the Surety's receipt of the Owner's notice. If the Owner, the Contractor and the Surety agree, the
Contractor shall be allowed a reasonable time to perform the Construction Contract, but such an agreement
shall not waive the Owner's right, if any, subsequently to declare a Contractor Default;
.2 the Owner declares a Contractor Default, terminates the Construction Contract and notifies the Surety;
and
.3 the Owner has agreed to pay the Balance of the Contract Price in accordance with the terms of the
Construction Contract to the Surety or to a contractor selected to perform the Construction Contract.
§ 4 Failure on the part of the Owner to comply with the notice requirement in Section 3.1 shall not constitute a failure to comply
with a condition precedent to the Surety's obligations, or release the Surety from its obligations, except to the extent the Surety
demonstrates actual prejudice.
§ 5 When the Owner has satisfied the conditions of Section 3, the Surety shall promptly and at the Surety's expense take one of
the following actions:
§ 5.1 Arrange for the Contractor, with the consent of the Owner, to perform and complete the Construction Contract;
§ 5.2 Undertake to perform and complete the Construction Contract itself, through its agents or independent contractors;
§ 5.3 Obtain bids or negotiated proposals from qualified contractors acceptable to the Owner for a contract for performance and
completion of the Construction Contract, arrange for a contract to be prepared for execution by the Owner and a contractor
selected with the Owner's concurrence, to be secured with performance and payment bonds executed by a qualified surety
equivalent to the bonds issued on the Construction Contract, and pay to the Owner the amount of damages as described in Section
7 in excess of the Balance of the Contract Price incurred by the Owner as a result of the Contractor Default; or
§ 5.4 Waive its right to perform and complete, arrange for completion, or obtain a new contractor and with reasonable promptness
under the circumstances:
.1 After investigation, determine the amount for which it may be liable to the Owner and, as soon as
practicable after the amount is determined, make payment to the Owner; or
.2 Deny liability in whole or in part and notify the Owner, citing the reasons for denial.
§ 6 If the Surety does not proceed as provided in Section 5 with reasonable promptness, the Surety shall be deemed to be in default on this
Bond seven days after receipt of an additional written notice from the Owner to the Surety demanding that the Surety perform its obligations
under this Bond, and the Owner shall be entitled to enforce any remedy available to the Owner. If the Surety proceeds as provided in Section
5.4, and the Owner refuses the payment or the Surety has denied liability, in whole or in part, without further notice the Owner shall be
entitled to enforce any remedy available to the Owner.
AIA Document A312--2010.The American Institute of Architects 2
§7 If the Surety elects to act under Section 5.1, 5.2 or 5.3, then the responsibilities of the Surety to the Owner shall not be greater than
those of the Contractor under the Construction Contract, and the responsibilities of the Owner to the Surety shall not be greater than those
of the Owner under the Construction Contract. Subject to the commitment by the Owner to pay the Balance of the Contract Price, the Surety
is obligated, without duplication, for
1 the responsibilities of the Contractor for correction of defective work and completion of the
Construction Contract:
.2 additional legal, design professional and delay costs resulting from the Contractor's Default, and
resulting from the actions or failure to act of the Surety under Section 5; and
.3 liquidated damages, or if no liquidated damages are specified in the Construction Contract, actual
damages caused by delayed performance or non-performance of the Contractor.
§8 If the Surety elects to act under Section 5.1, 5.3 or 5.4, the Surety's liability is limited to the amount of this Bond.
§9 The Surety shall not be liable to the Owner or others for obligations of the Contractor that are unrelated to the Construction Contract,
and the Balance of the Contract Price shall not be reduced or set off on account of any such unrelated obligations. No right of action
shall accrue on this Bond to any person or entity other than the Owner or its heirs, executors, administrators, successors and assigns.
§ 10 the Surety hereby waives notice of any change, including changes of time, to the Construction Contract or to related
subcontracts, purchase orders and other obligations.
§ 11 Any proceeding, legal or equitable, under this Bond may be instituted in any court of competent jurisdiction in the location in
which the work or part of the work is located and shall be instituted within two years after a declaration of Contractor Default or within
two years after the Contractor ceased working or within two years after the Surety refuses or fails to perform its obligations under
this Bond, whichever occurs first. If the provisions of this Paragraph are void or prohibited by law, the minimum period of limitation
available to sureties as a defense in the jurisdiction of the suit shall be applicable.
§ 12 Notice to the Surety, the Owner or the Contractor shall be mailed or delivered to the address shown on the page on which their
signature appears.
§ 13 When this Bond has been furnished to comply with a statutory or other legal requirement in the location where the construction
was to be performed, any provision in this Bond conflicting with said statutory or legal requirement shall be deemed deleted herefrom
and provisions conforming to such statutory or other legal requirement shall be deemed incorporated herein. When so furnished, the
intent is that this Bond shall be construed as a statutory bond and not as a common law bond.
§14 Definitions
§14.1 Balance of the Contract Price.The total amount payable by the Owner to the Contractor under the Construction Contract after all
proper adjustments have been made, including allowance to the Contractor of any amounts received or to be received by the Owner in
settlement of insurance or other claims for damages to which the Contractor is entitled, reduced by all valid and proper payments
made to or on behalf of the Contractor under the Construction Contract.
§14.2 Construction Contract.The agreement between the Owner and Contractor identified on the cover page, including all
Contract Documents and changes made to the agreement and the Contract Documents.
§ 14.3 Contractor Default.Failure of the Contractor, which has not been remedied or waived, to perform or otherwise to comply with a
material term of the Construction Contract.
§14.4 Owner Default.Failure of the Owner, which has not been remedied or waived, to pay the Contractor as required under the
Construction Contract or to perform and complete or comply with the other material terms of the Construction Contract.
§ 14.5 Contract Documents.All the documents that comprise the agreement between the Owner and Contractor.
§ 15 If this Bond is issued for an agreement between a Contractor and subcontractor, the term Contractor in this Bond shall be deemed to be
Subcontractor and the term Owner shall be deemed to be Contractor
AIA Document A312--2010.The American Institute of Architects. 3
§ 16 Modifications to this bond are as follows: If any conflict or inconsistency exists between the Surety's obligations or undertakings
as described in the terms of this bond and as described in the Contract,Subcontracts,Contract Documents, or any other
underlying documents,then the terms of this bond shall prevail.
(Space is provided below for additional signatures of addedparties, other than those appearing on the cover page.)
CONTRACTOR AS PRINCIPAL SURETY
Company: (Corporate Seal Company: (Corporate Seal
Signature: Signature:
Name and Title: Name and Title:
Address: Address:
Caution: You should sign an original AIA Contract Document,on which this text appears in RED. An original assures that
Chan es will be not be obscured.
AIA Document A312—"—2010.The American Institute of Architects 4
Document A312 TM
AIA
- 2010
Bond No. PB02183700051
Payment Bond
SURETY:
CONTRACTOR: (Name, legal status and principal place
(Name, legal status and address) of business)
LMX Construction & Specialty Services,
Philadelphia Indemnity Insurance Company
2351 W Northwest Hwy Ste 2118 One Bala Plaza Suite 100
Dallas, TX 75220 Bala Cynwyd, PA 19004
OWNER: This document has important legal
(Name, legal status and address) consequences.Consultation with
an attorney is encouraged with
Hudson Insurance Company respect to its completion or
3301 Windy Ridge Parkway SE modification
Atlanta, GA 30339
Any singular reference to
Contractor,Surety,Owner or
other party shall be
CONSTRUCTION CONTRACT considered plural where
Date: 6/16/2017 applicable.
AIA Document A312-201 0
Amount: $1,746,580.00 combines two separate bonds,a
(Name and Location Performance Bond and a Payment
Bond,into one form.This is not a
single combined Performance and
Payment Bond
Description:
Interior Finish-Out Completion City Project No C00130
Victory Forest Recreation Center, 3427 Hemphill St, Ft Worth,TX 47432
(Name and location)
BOND
Date: June 29,2017
(Not earlier than Construction Contract Date)
Amount: $1,746,580.00
Modifications to this Bond: ❑ None X See Section 16
CONTRACTOR AS PRINCIPAL SURETY
Company: ,A uction &Specialty Services, LP Company: Phil d I is Indemni Insurance
(Corporate S al)_ Company orporate Seal)
Signature:_ Signature:
Name and Title: t. Name And Title: a en c ITwlol�
y-in-Fact
(Any additional signatures lappear on the last paA of this Performance Bond)
(FOR INFORMATION ONLY—Name, address and telephone)
AGENT or BROKER: OWNER'S REPRESENTATION:
(Architect, Engineer or other party:
ASSURANCE BROKERS LTD
95 N Research Dr Ste 100
Edwardsville, IL 62025
AIA Document A312"—2010.The American Institute of Architects. 5
§ I The Contractor and Surety,jointly and severally, bind themselves,their heirs,executors,administrators, successors and assigns to the
Owner to pay for labor, materials and equipment furnished for use in the performance of the Construction Contract,which is
incorporated herein by reference,subject to the following terms.
§ 2 If the Contractor promptly makes payment of all sums due to Claimants, and defends, indemnifies and holds harmless the Owner
from claims, demands, liens or suits by any person or entity seeking payment for labor, materials or equipment furnished for use in the
performance of the Construction Contract, then the Surety and the Contractor shall have no obligation under this Bond.
§ 3 If there is no Owner Default under the Construction Contract, the Surety's obligation to the Owner under this Bond shall arise after the
Owner has promptly notified the Contractor and the Surety (at the address described in Section 13) of claims, demands, liens or suits
against the Owner or the Owner's property by any person or entity seeking payment for labor, materials or equipment furnished for use
in the performance of the Construction Contract and tendered
defense of such claims,demands, liens or suits to the Contractor and the Surety.
§4 When the Owner has satisfied the conditions in Section 3,the Surety shall promptly and at the Surety's expense defend, indemnify
and hold harmless the Owner against a duly tendered claim, demand, lien or suit.
§5 The Surety's obligations to a Claimant under this Bond shall arise after the following:
§ 5.1 Claimants,who do not have a direct contract with the Contractor,
have furnished a written notice of non-payment to the Contractor,stating with substantial accuracy the
amount claimed and the name of the party to whom the materials were,or equipment was, furnished or supplied or for
whom the labor was done or performed, within ninety (90)days after having last performed labor or last furnished
materials or equipment included in the Claim;and
2 have sent a Claim to the Surety(at the address described in Section 13).
§ 5.2 Claimants,who are employed by or have a direct contract with the Contractor, have sent a Claim to the Surety(at the address
described in Section 13).
§6 If a notice of non-payment required by Section 5.1.1 is given by the Owner to the Contractor,that is sufficient to satisfy a Claimant's
obligation to furnish a written notice of non-payment under Section 5.1.1.
§7 When a Claimant has satisfied the conditions of Sections 5.1 or 5.2.whichever is applicable,the Surety shall promptly and at the
Surety's expense take the following actions:
§7.1 Send an answer to the Claimant,with a copy to the Owner,within sixty(60)days after receipt of the Claim, stating the amounts
that are undisputed and the basis for challenging any amounts that are disputed;and
§ 7.2 Pay or arrange for payment of any undisputed amounts.
§ 7.3 The Surety's failure to discharge its obligations under Section 7.1 or Section 7.2 shall not be deemed to constitute a waiver of
defenses the Surety or Contractor may have or acquire as to a Claim,except as to undisputed amounts for which the Surety and Claimant
have reached agreement. If,however,the Surety fails to discharge its obligations under Section 7.1 or Section 7.2, the Surety shall
indemnify the Claimant for the reasonable attorney's fees the Claimant incurs thereafter to recover any sums found to be due and
owing to the Claimant.
§ 8 The Surety's total obligation shall not exceed the amount of this Bond,plus the amount of reasonable attorney's fees provided under
Section 7.3,and the amount of this Bond shall be credited for any payments made in good faith by the Surety.
§ 9 Amounts owed by the Owner to the Contractor under the Construction Contract shall be used for the performance of the
Construction Contract and to satisfy claims, if any, under any construction performance bond. By the Contractor furnishing and the
Owner accepting this Bond,they agree that all funds earned by the Contractor in the performance of the Construction Contract are
dedicated to satisfy obligations of the Contractor and Surety under this Bond,subject to the Owner's priority to use the funds for the
completion of the work.
AIA Document A312"'—2010.The American Institute of Architects. 6
§ 10 The Surety shall not be liable to the Owner. Claimants or others for obligations of the Contractor that are unrelated to the
Construction Contract.The Owner shall not be liable for the payment of any costs or expenses of any Claimant under this Bond, and shall
have under this Bond no obligation to make payments to,or give notice on behalf of. Claimants or otherwise have any obligations to
Claimants under this Bond.
§ 11 fhe Surety hereby waives notice ofany change, including changes of time,to the Construction Contract or to related subcontracts.
Purchase orders and other obligations.
§ 12 No suit or action shall be commenced by a Claimant under this Bond other than in it court of competent jurisdiction in the state
in which the project that is the subject of the Construction Contract is located or after the expiration of one year from the date(I)on
which the Claimant sent a Claim to the Surety pursuant to
Section 5.1.2 or 5.2. or (2)on which the last labor or service was performcd by anyone or the last materials or equipment were
furnished by anyone under the Construction Contract, whichever of( 1)or(2) first occurs. If the provisions of this Paragraph are void or
prohibited by law,the minimum period of limitation available to sureties as a defense in thejurisdiction of the suit shall he applicable.
§ 13 Notice and Claims to the Surety. the Owner or the Contractor shall be mailed or delivered to the address shown on the page on
which their signature appears. Actual receipt of notice or Claims. however accomplished.shall be sufficient compliance as of the date
received.
§ 14 When this Bond has been furnished to comply with a statutory or other legal requirement in the location where the construction
was to be performed, any provision in this Bond conflicting with said statutory or legal requirement shall be deemed deleted herefrom
and provisions conforming to such statutory or other legal requirement shall be deemed incorporated herein. When so furnished. the
intent is that this Bond shall be construed as a statutory bond and not as a common law bond.
§ 15 Upon request by any person or entity appearing to be a potential beneficiary of this Bond.the Contractor and(honer shall
promptly furnish a copy of this Bond or shall permit a copy to be made.
§16 Definitions
§16.1 Claim. A written statement by the Claimant including at a minimum:
.1 the name of the Claimant.
.2 the name of the person for whom the labor was done.or materials or equipment furnished:
3 a copy of the agreement or purchase order pursuant to which labor, materials or equipment oras
furnished for use in the performance of the Construction Contract:
.4 a brief description of the labor,materials or equipment furnished:
.5 the date on which the Claimant last performed labor or last furnished materials or equipment for use in
the performance of the Construction Contract;
.6 the total amount earned by the Claimant for labor, materials or equipment furnished as of the data,of
the Claim_
.7 the total amount of previous payments received by the Claimant: and
.8 the total amount due and unpaid to the Claimant for labor. materials or equipment furnished as of the
date of the Claim.
§ 16.2 Claimant.An individual or entity having it direct contract with the Contractor or with a subcontractor of the Contractor to furnish
labor,materials or equipment for use in the performance of the Construction Contract. The term Claimant also includes any individual of
entity that has rightfully asserted a claim under an applicable mechanic's lien or similar statute against the real property upon which
the Project is located. The intent of this Bond shall he to include without limitation in the terms "labor, materials or equipment" that part
of water,gas, power, light,heat,oil.gasoline, telephone service or rental equipment used in the Construction Contract. architectural
and engineering services required for performance of the work of the Contractor and the Contractor's subcontractors. and all other
items for which a mechanic's lien may be asserted in thejurisdiction where the labor, materials or equipment were furnished_
§16.3 Construction Contract,The agreement betlNeen the Owner and Contractor identified on the cover page. including all Contract
Documents and all changes made to the agreement and the Contract Documents.
AIA Document A312--2010 The American Institute of Architects. 7
§ 16.4 Owner Default. Failure of the Owner, which has not been remedied or waived,to pay the Contractor as required under the
Construction Contract or to perform and complete or comply with the other material terms of the Construction Contract.
§ 16.5 Contract Documents. All the documents that comprise the agreement between the Owner and Contractor.
§ 17 If this Bond is issued for an agreement between a Contractor and subcontractor,the term Contractor in this Bond shall be deemed
to be Subcontractor and the term Owner shall be deemed to be Contractor.
§ 18 Modifications to this bond are as follows: If any conflict or inconsistency exists between the Surety's obligations or
undertakings as described in the terms of this bond and as described in the Contract,Subcontracts,Contract Documents,or any
other underlying documents,then the terms of this bond shall prevail.
(Space is provided below for additional signatures of addedparties, other than those appearing on the cover page.)
CONTRACTOR AS PRINCIPAL SURETY
Company: (Corporate Seal Company: (Corporate Seal
Signature: Si nature:
Name and Title: Name and Title:
Address: Address:
Caution: You should sign an original AIA Contract Document, on which this text appears in RED. An original assures that
changes will be not be obscured.
AIA Document A312'"—2010.The American Institute of Archaects 8
164
PHILADELPHIA INDEMNITY INSURANCE COMPANY
One Bala Plaza,Suite 100
Bala Cynwyd,PA 19004-0950
Power of Attorney
KNOW ALL PERSONS BY THESE PRESENTS:That PHILADELPHIA INDEMNITY INSURANCE COMPANY(the Company),a corporation organized and
existing under the laws of the Commonwealth of Pennsylvania, does hereby constitute and appoint Holly Johnson,Jared Frank Lindsay Offermann, Raluh
McOuieean,Robert Green and Steuhen MCOuiaean of Assurance Brokers,Ltd.,its true and lawful Attomey-in-fact with full authority to execute on its behalf
bonds,undertakings,recognizances and other contracts of indemnity and writings obligatory in the nature thereof,issued in the course of its business and to bind the
Company thereby,in an amount not to exceed$25,000,000.00.
This Power of Attorney is granted and is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of
PHILADELPHIA INDEMNITY INSURANCE COMPANY on the 14"ofNovember,2016.
RESOLVED: That the Board of Directors hereby authorizes the President or any Vice President of the
Company: (1) Appoint Attomey(s) in Fact and authorize the Attorney(s) in Fact to
execute on behalf of the Company bonds and undertakings,contracts of indemnity and
other writings obligatory in the nature thereof and to attach the seal of the Company
thereto; and (2) to remove, at any time, any such Attorney-in-Fact and revoke the
authority given. And,be it
FURTHER
RESOLVED: That the signatures of such officers and the seal of the Company may be affixed to any
such Power of Attorney or certificate relating thereto by facsimile,and any such Power of
Attorney so executed and certified by facsimile signatures and facsimile seal shall be
valid and binding upon the Company in the future with respect to any bond or
undertaking to which it is attached.
IN TESTIMONY WHEREOF, PHILADELPHIA INDEMNITY INSURANCE COMPANY HAS CAUSED THIS INSTRUMENT TO BE SIGNED AND
ITS CORPORATE SEALTO BE AFFIXED BY ITS AUTHORIZED OFFICE THIS 14Th DAY OF NOVEMBER,2016.
U
(Seal) �q
Robert D.O'Leary Jr.,President&CEO
Philadelphia Indemnity Insurance Company
On this 14'h day of November,2016,before me came the individual who executed the preceding instrument,to me personally known,and being by me duly sworn said
that he is the therein described and authorized officer of the PHILADELPHIA INDEMNITY INSURANCE COMPANY;that the seal affixed to said instrument is
the Corporate seal of said Company;that the said Corporate Seal and his signature were duly affixed.
COMMOMW t TM w-ONS1tym
NotarW Fa
NC+a Yoward,Notary Pubft
!rQ4el V1.r.O..Mont;—M Cwaty
MY Co tWm Eayro Jan.6.2010
Notary Public:
residing at: Bala Cynwyd,PA
(Notary Seal)
My commission expires: January 8,2018
1,Edward Sayago,Corporate Secretary of PHILADELPHIA INDEMNITY INSURANCE COMPANY,do hereby certify that the foregoing resolution of the Board of
Directors and this Power of Attorney issued pursuant thereto on this 14'"day of November,2016 are true and correct and are still in full force and effect.I do further
certify that Robert D.O'Leary Jr.,who executed the Power of Attorney as President,was on the date of execution of the attached Power of Attorney the duly elected
President of PHILADELPHIA INDEMNITY INSURANCE COMPANY,
In Testimony Whereof I have subscribed my name and affixed the facsimile seal of each Company this 2.9 day of ju n A 2017
Edward Sayago,Corporate Secretary
PHILADELPHIA INDEMNITY INSURANCE COMPANY
State of Illinois
County of Madison
On this 29`h day of June, 2017, before me, Holly V. Johnson, a Notary Public within and for the above
mentioned county, personally appeared Stephen McQuiggan, to me personally known, who being by the
duly sworn he is an Attorney-In-Fact of.
Allegheny Casualty Company
AMCO Insurance Company
American Contractors Indemnity Company
Bond Safeguard Insurance Company
Contractors Bonding and Insurance Company
Fidelity and Deposit Company of Maryland
First National Insurance Company of America
Granite Re,Inc.
Hartford Casualty Insurance Company
Lexon Insurance Company
Merchants Bonding Company (Mutual)
Nationwide Mutual Insurance Company
Old Republic Surety Company
Pekin Insurance Company
Philadelphia Indemnity Insurance Company
Plaza Insurance Company
Star Insurance Company
State Auto Insurance Company
The Ohio Casualty Insurance Company
Travelers Casualty and Surety Company ofAmerica
US Specialty Insurance Company
Westchester Fire Insurance Company
Western Surety Company
the corporation named in the foregoing instrument, and that the seal affixed to the said instrument
is the corporate seal of the said corporation, and that the said instrument was signed and sealed
on behalf of the said corporation,by authority of its Board of Directors, and the said
Stephen: McQuiggan, acknowledged the said instrument to be the free act and deed of the
said corporation.
Oficial Seal By: Nolly Johnson
Holly V.Johnson Notary ITu6fic
Notary Public,State of Illinois
My Commission Expires January 30,2021
Victory Forest Recreation Center
Dual Obligee Rider
(Dated 29 June 2017)
Contract Compliance Manager:
By signing I acknowledge that I am the person responsible
for the monitoring and administration of this contract,including
ensuring all performance and reporting requirements.
Name of Empioyee/Signature
Title
This form is N/A as No City Funds are associated with this Contract
Brian R.Glass AIA
Printed Name Signature