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HomeMy WebLinkAboutC-2556I i co - %0 IFOg, it AMENDMENT NO. 3 TO THE 2010/2011 ELECTRICAL SERVICES & PREVENTATIVE MAINTENANCE CONTRACT \Unity of 00 BY AND BETWEEN THE CITY OF ARCADIA AND D &J FOOTHILL ELECTRICAL CONTRACTORS, INC. This Amendment No. 3 ( "Amendment No. 3 ") is hereby entered into this ` day of , 2013 by and between the City of Arcadia, a municipal corporation of the St to of C lifornia, and D &J Foothill Electrical Contractors, Inc., with respect to that certain Agreement between the parties dated August 31, 2010 ( "Agreement'), and further amended by Amendment No. 1 dated September 7, 2011, and further amended by Amendment No. 2 dated November 20, 2012. The parties agree as follows: Section 3.3.4 of the Contract, is amended by extending the term from August 31, 2013 to August 31, 2014 ( "Extended Term "). 2. All of the remaining terms and provisions of the Contract are hereby reaffirmed. In witness whereof the parties have executed this Amendment No. 3 on the date set forth below. CITY OF ARCADIA Domin c Lazzarett City Manager Dated: `i (SEAL) TTE . I it erk i APPROVED AS TO FORM a� Stephen P. Deitsch City Attorney D &J FOOTHILL ELECTRICAL CONTRACTORS, INC. B David Larrmlens Title: President Dated: 08/22/2013 By: Title: Dated: CONCUR: 1 Tom Tait Public Works Services Director RVFUB\DR0\562370 CITY OF ARCADIA ELECTRICAL SERVICES & PREVENTATIVE MAINTENANCE CONTRACT PART "F" 'PERFORMANCE BOND GB - STATE & LOM (610) (7 ) PREMIUM FOR CONTRACT TERM AND IS SUBJECT TO ADJUSTMENT BASED ON FINAL CONTRACT PRICE PERFORMANCE BOND Bond 4391430 Premium: $2,694.00 Issued in Three Original Counterparts WHI;KLA5 the CITY OF ARCADIA (also herein "Obligee ") has awarded to DAJ ELECTRICAL CONTRACTORS, INC. (hereinafter "Contractor"), a contract for work consisting of but not limited to, furnishing all labor, materials, tools, equipment, services, and incidentals for the construction of ELECTRICAL SERVICES & PREVENTATIVE MAINTENANCE CONTRACT and all other required structures and facilities within the rights -of -way, easements and permits; WHEREAS, the Work to be performed by the Contractor is more particularly set forth in that certain contract for the said Public Work dated August 31 2010, as amended by Amendment No. 1 dated September 7, 2011 and further amended by Amendment No. 2 dated November 20, 2012 and further amended by Amendment No. 3 dated August 16th, 2013 (hereinafter the "Public Work Contract"); and WHEREAS, the Contractor is required by said Public Work Contract to perform the terms thereof and to provide a bond both for the performance and guaranty thereof, NOW, THEREFORE, we D &J Foothill Electrical Contractors, Inc. , the undersigned Contractor, as Principal, and SureTec Insurance Company a corporation organized and existing under the laws of the State of Texas , and duly authorized to transact business under the laws of the State of California, as Surety, are held and firmly bound unto the CITY OF ARCADIA in the sum of ONE HUNDRED TWELVE THOUSAND, NINE HUNDRED TEN DOLLARS AND NO CENTS, ($112,910.00), said sum being not less than 100% of the total amount payable by the said Obligee under the terms of the said Public Work Contract, for which payment well and truly to be made, we bind ourselves, our heirs, executors and administrators, successors and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH, that if the Principal, his or its heirs, executors, administrators, successors or assigns, shall in all things stand to and abide by, and well and truly keep and perform the covenants, conditions and agreements in the said Public Work Contract and any alteration thereof made as therein provided, on his or their part, to be kept and performed at the time and in the manner therein specified, and in all respects according to their Intent and meaning; and shall faithfully fulfill the one -year guarantee of all materials and workmanship; and indemnify and save harmless the Obligee, its officers and agents, as stipulated in the said Public Work Contract, then this obligation shall become null and void; otherwise it shall be and remain in full force and effect. In the event legal action is required to enforce the provisions of this agreement, the prevailing party shall be entitled to recover reasonable attomeys' fees in addition to court costs, necessary disbursements, and other damages. In case legal action is required to enforce the provisions of this bond, the prevailing party shall be entitled to recover reasonable attomeys' fees in addition to court costs, necessary disbursements and other consequential damages. RvPuBmRM6n70 PERFORMANCE BOND - 1 GB- STAn8: LOCAL (610) (7n4MQ) The said Surety, for value received, hereby stipulates and agrees that no change, extensions of time, alteration or addition to the terms of the Public Work Contract or to the Work to be performed there under, or the specifications accompanying the some shall in any way affect its obligations on this bond, and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the Contract, or to the Work or to Specifications. IN WITNESS WHEREOF, we have hereto set our hands and seals this 16th day on August , 2013 D &J Foothill lectrical Contractors Inc. Principal/ tractor By: President SureTec Insurance Company Surety By: �� -Cr��► J Attomey -in°Fact Shaunna Burchfiel The rate of premium on this bond is *** per thousand. The total amount of premium charged, $ 2,694.00 (The above must be filled in by corporate surety.) ""`$25.00 per thousand for the first $100,000 of contract amount. $15.00 per thousand for the next $400,000. RvpuBZRD%562370 PERFORMANCE BOND - 2 GB- STATE R LOCAL (610)(7/24M) State of California County of Orange On August 16th, 2013 ACKNOWLEDGMENT before me, Traci Larson, Notary Public (insert name and title of the officer) personally appeared Shaunna Burchfiel, Attorney -In -Fact who proved to me on the basis of satisfactory evidence to be the person(f4 whose name(a),ris!'are subs _Qribed to the within instrument and acknowledgedlo me that he /s /they executed the same in his6Eje their authorized capacity(ies), and that by hig /h' /their signatureA on the instrument the person�j, or the entity upon behalf of which the person(s5 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 hand and official seal, Signature (Seal) 40N4N0444040N4N4H04444 `>A4444444+F444 g ` T R 'Ci L RSON D m *`<t� ,r1A 71 4 ; Y .a ;r` ,:-a ;n.,`1, 2s44A.44 �4e+wi i�iw.s�+Naaoarrc444s�44+�:aea CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT State of California / County of Z-- ��t -GL-rS CIVIL CODE § 1189 On / 1"J}/' 22r 3betore me, ` Date Here Insert Name and Title of the Officer personally appeared 0,ft vll2 L A4WI' -e A-) S Name(s) of Signer(s) who proved to me on the basis of satisf y evidence to be the person(.) whose name( is/ e GORDON M. ANDERSON subscribed to the within instrument and acknowle ged Commission # 1888196 Z to me that ( e/ he/they executed the same in -d Notary Public - California Z Z ' = > is er /their authorized ca acit io6 and that b Z Los Angeles County p y( ) y My Comm. Expires May 3, 2014' I er /their signature(*) on the instrument the person(*), or the entity upon behalf of which the person(ill) 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 hand and official seal. Signature: (�, , , Place Notary Seal Above Signat If, otary Pubic 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 Docu ent Title or Type of Document: M-6h1 -C ✓ iv�, f �rrr e.�7� %�� 5 Document Date: L��L— Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: _ W Corporate Officer -- Title(s): _ -_ 7 Pte= ❑ Individual ❑ Partner - Ej Limited U Attorney in Fact O Trustee General Top of thumb here ❑ Guardian or Conservator L Other: Signer Is Representing: Signer's Name: ❑ Corporate Officer - Title(s): I-A Individual C 1 Partner - ❑ Limited ❑ General Top of thumb here ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing 0 2010 National Notary Association • NalionalNolary.org • 1- 800 -US NOTARY (1.600.876-6827) Item 05907 CITY OF ARCADIA ELECTRICAL SERVICES & PREVENTATIVE MAINTENANCE CONTRACT PART "G" PAYMENT BOND RVR3\DRM7D026 GB - STATB do LOCAL (620) (7R4/M ,PREMIUM FOR CONTRACT TERM AND IS SUBJECT TO ADJUSTMENT BASED ON FINAL CONTRACT PRICE PAYMENT (MATERIAL & LABOR) BOND Bond 4391430 Premium Included in Performance Bond Issued in Three Original Counterparts WHEREAS the CITY OF ARCADIA (hereinafter "Obligee ") has awarded to D &J ELECTRICAL CONTRACTORS, INC. (hereinafter "Contractor"), a contract for work consisting of but not limited to, furnishing all labor, materials, tools, equipment, services, and incidentals for the construction of the ELECTRICAL SERVICES & PREVENTATIVE MAINTENANCE CONTRACT and all other required structures and facilities within the rights-of-way, easements and permits; WHEREAS, the Work to be performed by the Contractor is more particularly set forth In that certain contract for the said Public Work dated August 31, 2010, as amended by Amendment No. 1 dated September 7, 2011 and further amended by Amendment No. 2 dated November 20, 2012 and further amended by Amendment No. 3 dated August 16th, 2013 (hereinafter the "Public Work Contract "); and WHEREAS, said Contractor is required to furnish a bond in connection with said Public Work Contract providing that if said Contractor or any of his or its subcontractors shall fall to pay for any materials, provisions, or other supplies, or terms used in, upon, for or about the performance of the Work contracted to be done, or for any work or labor done thereon of any kind, or for amounts due under the provisions of 3248 of the California Civil Code, with respect to such work or labor, that the Surety on this bond will pay the same together with a reasonable attorney's fee in case suit is brought on the bond. NOW, THEREFORE, We D &J Foothill Electrical Contractors, Inc. , the undersigned Contractor, as Principal and SureTec Insurance Compaq I a corporation organized and existing under the laws of the State of Texas and duly authorized to transact business under the laws of the State of California, as Surety, are held and firmly bound unto the CITY OF ARCADIA and to any and all material men, persons, companies or corporations furnishing materials, provisions, and other supplies used in, upon, for or about the performance of the said Public Work, and all persons, companies or corporations renting or hiring teams, or implements or machinery, for or contributing to said Public Work to be done, and all persons performing work or labor upon the same and all persons supplying both work and materials as aforesaid excepting the said Contractor, the sum of ONE HUNDRED TWELVE THOUSAND, NINE HUNDRED TEN DOLLARS AND NO CENTS, ($112,910.00), said sum being not less than 100% of the total amount payable by said Obligee under the terms of the said Public Work Contract, for which payment well and truly to be made, we bind ourselves, our heirs, executors and administrators, successors and assigns jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH that if the Principal, his or its subcontractors, heirs, executors, administrators, successors, or assigns, shall fail to pay for any materials, provisions, or other supplies or machinery used in, upon, for or about the performance of the Work contracted to be done, or for work or labor thereon of any kind, or fail to pay any of the persons named in California Civil Code Section 3181, or amounts due RVPUB FZI57=6 PAYMENT BOND - 1 GH• STATE & LOCAL (620) (7f24W under the Unemployment Insurance Code with respect to work or labor performed by any such claimant, or for any amounts required to be deducted, withheld, and paid over to the Employment Development Department from the wages of employees of the contractor and his subcontractors pursuant to Section 13020 of the Unemployment Insurance Code with respect to such work and labor, and all other applicable laws of the State of California and rules and regulations of its agencies, then said Surety will pay the same in or to an amount not exceeding the sum specified herein. In case legal action is required to enforce the provisions of this bond, the prevailing party shall be entitled to recover reasonable attorneys' fees in addition to court costs, necessary disbursements and other consequential damages. In addition to the provisions hereinabove, it is agreed that this bond will inure to the benefit of any and all persons, companies and corporations entitled to make claims under Sections 3110, 3111, 3112 and 3181 of the California Civil Code, so as to give a right of action to them or their assigns in any suit brought upon this bond. The said Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration or additions to the terms of the said Public Work Contract or to the Work to be performed thereunder or the specification accompanying the same shall in any way affect its obligations on this bond, and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the Contract or to the Work or to the Specifications. IN WITNESS WHEREOF, we have hereto set our hands and seals this 16th day on August , 2013 . D &J Foothill Qlectrical Contractors, Inc. PrincipahC retractor By: President SureTec Insurance Company Surety By: Attorney -in -Fact Shaunna Bur hfiel RYPU8MRW7M6 PAYMENT BOND - 2 ce - STATE & LOCAL (620) (inA=) ACKNOWLEDGMENT State of California County of Orange ) On August 16th, 2013 before me, Traci Larson, Notary Public (insert name and title of the officer) personally appeared Shaunna Burchfiel, Attorney -In -Fact who proved to me on the basis of satisfactory evidence to be the person(,] whose nameXj'�kare subs�riibed to the within instrument and ackncwledgedl q me that he /, /they executed the same in his, hefltheir authorized capacity(ie` ), and that by hi;; /ho /their signatureA on the instrument the personas), or the entity upon behalf of which the pers6n(,s5 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. ��q.►wn4w4 �p04444 WITNESS my hand and official seal. �; �u "° m lU\\ `t � �;�° �u ;;.rnmus•ai t, r..::1, 2014 a Signature (Seal) CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 State of California / County of Z_6 rS On �J� ��r 3before me, !�% '�a> /11, / ��-"� R C Date Here Insert Name and Title of the Officer personally appeared 12A-111D , h i L°rU S Name(s) of Signer(s) who proved to me on the basis of satisf Paged y evidence to be the person(; whose name( ie subscribed to the within instrument and acknowle to me that e/ he /they executed the same in GORDON M. ANDERSON Is er /their authorized capacity(ies), and that by < `s Commission # 1888196 Z I er /their signature(*) on the instrument the i = Notary Public - California Z Los Angeles County D person(*), or the entity upon behalf of which the My Comm. Expires May 3, 2014 + 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 hand official seal. Signature: 1-� /;P'& �-_ 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 Docu ent 2 �/z10�V Title or Type of Document: Mfh/i -G ✓ iv M 1%4 Document Date: _/_47�V_ _ tom. P_ � Number of Pages: . Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ____ W Corporate Officer — Title(s): - ❑ Individual [] Partner — u Limited ': 7 General Top of thump here LJ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Signer's Name: ❑ Corporate Officer — Title(s): L Individual C 1 Partner — ❑ Limited Cl General Top of thumb here ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing 0 2010 National Notary Association - NaiionalNotary.org - 1.800 -US NOTARY (1- 800 - 876-6827) Item 05907 PoA #: 510026 SureTec Insurance Company LIMITED POWER OF ATTORNEY Know All Men by These Presents, That SURETEC INSURANCE COMPANY (the "Company "), a corporation duly organized and existing under the laws of the State of Texas, and having its principal office in Houston, Harris County, Texas, does by these presents make, constitute and appoint George Burchfiel, Shaunna Burchfiel its true and lawful Attorney -in -fact, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings or other instruments or contracts of suretyship to include waivers to the conditions of contracts and consents of surety for: Five Million and 00/100 Dollars ($5,000,000.00) and to bind the Company thereby as fully and to the same extent as if such bond were signed by the President, sealed with the corporate seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attomey -in -Fact may do in the premises. Said appointment shall continue in force until 10/31/2015 and is made under and by authority of the following resolutions of the Board of Directors of the SureTec Insurance Company: Be it Resolved, that the President, any Vice - President, any Assistant Vice - President, any Secretary or any Assistant Secretary shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attomey(s) -in -Fact to represent and act for and on behalf of the Company subject to the following provisions: Attorney -in -Fact may be given full power and authority for and in the name of and of behalf of the Company, to execute, acknowledge and deliver, any and all bonds, recognizances, contracts, agreements or indemnity and other conditional or obligatory undertakings and any and all notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such Attorney -in -Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary. Be it Resolved, that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached. (Adopted at a meeting held on 2e of April, 1999) In Witness Whereof, SURETEC INSURANCE COMPANY has caused these presents to be signed by its President, and its corporate seal to be hereto affixed this 21st day of March, A.D. 2013. �M,pN4111tlWW,,,, SURETEC INSURANCE COMPANY SVRANC�wti C, o By. % V-1 w w °` John I'inox Jr:,r resident State of Texas ss: ��;• 1 . ,rya County of Harris •• .... tl� PIN On this 21st day of March, A.D. 2013 before me personally came John Knox Jr., to me known, who, being by me duly sworn, did depose and say, that he resides in Houston, Texas, that he is President of SURETEC INSURANCE COMPANY, the company described in and which executed the: above instrument; that he knows the seal of said Company; that the seal affixed to said instrument is such corporate seal; that it was so affixed by order of the Board of Directors of said Company; and that he signed his name thereto by like order. ,ip "ArPUA� JACQUELYN MALDONADO f �\ �/ ( U Notary Public State of Texas My Comm. Exp. 5118/2017 Jacq elyn Maldonado, Notary Public My commission expires May 18, 2017 1, M. Brent Beaty, Assistant Secretary of SURETEC INSURANCE COMPANY, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said Company, which is still in full force and effect; and furthermore, the resolutions of the Board of Directors, set out in the Power of Attorney are in full force and effect. Given under my hand and the seal of said Company at Houston, Texas this 1(� day of r , Q10 i 'A.D. A. Bre t Beaty, Assistant ecretary Any instrument issued in excess of the penalty stated above is totally void and without any validity. For verification of the authority of this power you may call (713) 812 -0800 any business day between 8:00 am and 5:00 pm CST. AMENDMENT NO. 2 TO THE 2010/2011 ELECTRICAL SERVICES & PREVENTATIVE MAINTENANCE CONTRACT BY AND BETWEEN THE CITY OF ARCADIA AND D &J FOOTHILL ELECTRICAL CONTRACTORS, INC. This Amendment No. 2 ( "Amendment No. 2 ") is hereby entered into this Mh day of 2012 by and between the City of Arcadia, a municipal corporation of the State of California, and D &J Foothill Electrical Contractors, Inc., with respect to that certain Agreement between the parties dated August 31, 2010 ( "Agreement "), and further amended by Amendment No. 1 dated September 7, 2011. The parties agree as follows: Pursuant to Section 3.3.4 of the Contract, the term is extended to and including August 31, 2013. 2. Pursuant to Section 3.3.2 of the Contract, the total compensation is not to exceed ONE HUNDRED TWELVE THOUSAND NINE HUNDRED AND TEN DOLLARS AND NO CENTS ($112,910.00). 3. All terms and provisions of the Contract not amended by this Amendment No. 2 are hereby reaffirmed. In witness whereof the parties have executed this Amendment No. 2 on the date set forth below. CITY OF ARCADIA gy: Dominic Lazza etto City Manager Dated: st + 4L Stephen P. Deitsch City Attorney D &J F00711ILL ELECTRICAL CONTRACTORS, INC. By: David Lammens President Dated: WAGrems 7 Tom Tait, Public Works Services Director PREMIUM FOR CONTRACT TERM AND IS SUBJECT TO ADJUSTMENT BASED ON FINAL CONTRACT PRICE PERFORMANCE BOND Bond No. 4384046 Premium: $2,694.00 Issued in three original counterparts WHEREAS the CITY OF ARCADIA (also herein "Obligee ") has awarded to D &J ELECTRICAL CONTRACTORS. INC. (hereinafter "Contractor "), a contract for work consisting of but not limited to, furnishing all labor, materials, tools, equipment, services, and incidentals for the construction -of ELECTRICAL. SERVICES & PREVENTATIVE MAINTENANCE CONTRACT and all other required structures and facilities within the rights -of -way, easements and permits; WHEREAS, the Work to be performed by the Contractor is more particularly set forth In that certain contract for the said Public Work dated August 31, 2090, as amended by Amendment No. 1 dated September 7, 2011 and further amended by Amendment No. 2 dated , i _ (hereinafter the "Public Work Contract "); and WHEREAS, the Contractor is required by said Public Work Contract to Perform the terms thereof and to provide a bond both for the performance and guaranty thereof, NOW, THEREFORE, we D &J Foothill Electrical Contractors, Inc. the undersigned Contractor, as Principal, and SureTec Insurance Company , a corporation organized and existing under the laws of the State of Texas , and duly authorized to transact business under the laws of the State of California, as Surety, are held and firmly bound unto the CITY OF ARCADIA in the sum of CITY OF ARCADIA in the sum of ONE HUNDRED TWELVE THOUSAND, NINE HUNDRED TEN DOLLARS AND NO CENTS, ($112,910.00), said sum being not less than 100% of the total amount payable by the said Obligee under the terms of the said Public Work Contract, for which payment well and truly to be made, we bind ourselves, our heirs, executors and administrators, successors and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH, that if the principal, his or its heirs, executors, administrators, successors or assigns, shall in all things stand to and abide by, and well and truly keep and perform the covenants, conditions and agreements in the said Public Work Contract and any alteration thereof made as therein provided, on his or their part, to be kept and performed at the time and in the manner therein specified, and in all respects according to their intent and meaning; and shall faithfully fulfill the one -year guarantee of all materials and workmanship; and indemnify and save harmless the Obllgee, its officers and agents, as stipulated in the said Public Work Contract, then this obligation shall become null and void, otherwise it shall be and remain in full force and effect. In the event legal action is required to enforce the provisions of this agreement, the prevailing party shall be entitled to recover reasonable attorneys' fees in addition to court costs, necessary disbursements, and other damages. In case legal action is required to enforce the provisions of this bond, the prevailing party shall be entitled to recover reasonable attorneys' fees in addition to court costs, necessary disbursements and other consequential damages, RVNIMORM562370 PERFORMANCE BOND - 1 OB- STATE & LOCAL (610)(7124 /00) The said Surety, for value received, hereby stipulates and agrees that no change, extensions of time, alteration or addition to the terms of the Public Work Contract or to the Work to be performed there under, or the specifications accompanying the same shall in any way affect its obligations on this bond, and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the Contract, or to the Work or to Specifications. IN WITNESS WHEREOF, we have hereto set our hands and seals this 7th day on August '2012 . D &J Foothill f lectrical Contractors, Inc. PrincipallC ar By. resident SureTec Insurance Company Surety Attorney -in -Fact Shaunna Burc fief The rate of premium on this bond is * ** per thousand. The total amount of premium charged, $2,694.00 (The above must be filled in by corporate surety.) X* *$25.00 per thousand for the first $100,000 of contract amount. $15.00 per thousand for the next $400,000. RVE RDRM67a7n PERFORMANCP MOND - 2 k�P-J1H11.&LUI,AL(6 {U)(' /f/AJVV) State of California CIVIL CODE § 1188 County of ./ On I/ 2— before me, GGQ� Yr del— l/ti�i t cis/ ,t/u (%� 9 / -c IZ11t Date ����--�� Here Insert Name and Title of the Officer personally appeared /__.__-� 6 V/ /D Z—G-(- l-Y? �-r) E—k? _ Name(s) of Signer(s) t PAMELA VENAWN Commission # f 8554()3 "A,` Notary Public - California z Z Z Los Angeles County il My Comm. Expires Jul 21, 2013 Place Notary Seal Above who proved to me on the basis of satisfactory evidence to be the persons)' whose nameWCi;�are subscribed to the within instrument and acknowledged to me that (t0he/they executed the same in a /her /their authorized capacity(io), and that by Sher /their signature} on the instrument the person(4, 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, and nd official seal. Signature: 7' 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: t q Ee to e-,. t J -S 3 pa- UImEtix% Document Date: 3O .� f 2, Number of Pages: Signer(s) Other Than Named bove: Capacity(ies) Claimed by Signer(s) Signer's Name: {'Corporate Officer — Title(s): ❑ Individual ❑ Partner — ❑ Limited ❑ General Top of thumb here ❑ Attorney in Fact ❑ Trustee Cj Guardian or Conservator ❑ Other: Signer Is Representing: Signer's Name: ❑ Corporate Officer — Title(s): Cl Individual L-1 Partner —= Limited Ll General Top of thumb here ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing D c 2010 National Notary Association • NationalNotary.org • 1- 800 -US NOTARY (1- 800 - 676.6827) Item #5907 LW State of California County of Orange } 072 August 7th, 2012 before me, Traci Larson, Notary Public (insert name and title of the officer) personally appeared Shaunna Burchfiel, Attorney -In -Fact who proved tome on the basis of satisfactory evidence to be the person(4 whose name are subscribed to the within instrument and acknowledged o me that he /6 /they executed the same in his6e,rA`their authorized capacity ice), and that by hisllh /their signature,} on the instrument the person*, or the entity upon behalf of which the person(o') 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 hand and official seal, PREMIUM FOR CONTRACT TERM Bond No. 4384046 AND IS SUBJECT TO ADJUSTMENT Premium included in Performance Bonc BASED ON FINAL CONTRACT PRICE Issued in three original counterparts PAYMENT (MATERIAL & LABOR) BOND WHEREAS the CITY OF ARCADIA (hereinafter "Obligee") has awarded to D &J ELECTRICAL CONTRACTORS, INC. (hereinafter "Contractor "), a contract for work consisting of but not limited to, furnishing all labor, materials, tools, equipment, services, and incidentals for the construction of the ELECTRICAL SERVICES & PREVENTATIVE MAINTENANCE CONTRACT and all other required structures and facilities within the rights -of-way, easements and permits; WHEREAS, the Work to be performed bythe Contractor is more particularly set forth in that certain contract for the said Public Work dated August 31 2010 as amended by Amendment No. 1 dated September 7, 2011 and further amended by Amendment No. 2 dated (hereinafter the "Public Work Contract"); and WHEREAS, said Contractor is required to furnish a bond in connection with said Public Work Contract providing that if said Contractor or any of his or its subcontractors shall fail to pay for any materials, provisions, or other supplies, or terms used in, upon, for or about the performance of the Work contracted to be done, or for any work or labor done thereon of any kind, or for amounts due under the provisions of 3248 of the California Civil Code, with respect to such work or labor, that the Surety on this bond will pay the same together with a reasonable attorney's fee in case suit is brought on the bond. NOW, THEREFORE, We D &J Foothill Electrical Contractors, Inc. , the undersigned Contractor, as Principal and SureTec Insurance Companv I a corporation organized and existing under the laws of the State of Texas and duly authorized to transact business under the laws of the State of California, as Surety, are held and firmly bound unto the CITY OF ARCADIA and to any and all material men, persons, companies or corporations tumishing materials, provisions, and other supplies used in, upon, for or about the performance of the said Public Work, and all persons, companies or corporations renting or hiring teams, or implements or machinery, for or contributing to said Public Work to be done, and all persons performing work or labor upon the same and all persons supplying both work and materials as aforesaid excepting the said Contractor, the sum of ONE HUNDRED TWELVE THOUSAND, NINE HUNDRED TEN DOLLARS AND NO CENTS, ($112,910.00), said sum being not less than 100% of the total amount payable by said Obligee under the terms of the said Public Work Contract, for which payment well and truly to be made, we bind ourselves, our heirs, executors and administrators, successors and assigns jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH that if the Principal, his or its subcontractors, heirs, executors, administrators, successors, or assigns, shall fail to pay for any materials, provisions, orother supplies or machinery used in, upon, for or aboutthe performance of the Work contracted to be done, or for work or labor thereon of any kind, or fail to pay any of the persons named in California Civil Code Section 3181, or amounts due under the Unemployment Insurance Code with respect to work or labor performed by any &vru)MDRDW0026 PAYMENT BOND - 1 GB - STATE kL,OGA,L(620)(7/24NO) such claimant, or for any amounts required to be deducted, withheld, and paid over to the Employment Development Department from the wages of employees of the contractor and his subcontractors pursuant to Section 13020 of the Unemployment Insurance Code with respect to such work and labor, and all other applicable laws of the State of California and rules and regulations of its agencies, then said Surety will pay the same in or to an amount not exceeding the sum specified herein. In case legal action is required to enforce the provisions of this bond, the prevailing party shall be entitled to recover reasonable attorneys' fees in addition to court costs, necessary disbursements and other consequential damages. In addition to the provisions hereinabove, it is agreed that this bond will inure to the benefit of any and all persons, companies and corporations entitled to make claims under Sections 3110, 3111, 3112 and 3181 of the California Civil Code, so as to give a right of action to them or their assigns in any suit brought upon this bond. The said Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration or additions to the terms of the said Public Work Contract or to the Work to be performed thereunder or the specification accompanying the same shall in any way affect its obligations on this bond, and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the Contractor to the Work or to the Specifications. IN WITNESS WHEREOF, we have hereto set our hands and seals this 7th day on August 2012 . D &J Foothill EI'ctrical Contractors Inc. Principal /Con ractur By, President SureTec Insurance Compan Surety Attorney -in -Fact Shaunna Burchiel RvpU8\DRM570026 PAYMENT BOND e 2 cs -wars & LOCAL (620) (7/24/00) State of California CIVIL CODE § 1189 County of On 2- before me, j6— 6 C /elCtus� �, �t/� !�f Date Here Insert Name and Title of the Officer personally appeared —J V� - >n e-o C Name(s) of Signer(s) s PAMELA VENAWN ,...- Commission # 1855403 Notary Public - California z Z Los Angeles County x, My COmm. Expires Jul 21, 2013 Place Notary Seal Above who proved to me on the basis of satisfactory evidence to be the person(s)' whose nameoT(' is�are subscribed to the within instrument and acknowledged to me that 0he /they executed the same in QW /her /their authorized capacity(ip6), and that by ai�/her /their signature on the instrument the person, 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 a and official se Signature: 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 l 1 F.-(Z. �? P-j Title or Type of Document: � (k � R 4-!! e- t n �. i S _'3 Pct. A m ct 1> Dno 1) S , Fj v t, D Document Date: .?� fv Number of Pages: Signer(s) Other Than Named bove: Capacity(ies) Claimed by Signer(s) Signer's Name: P--Corporate Officer — Title(s): 0 Individual Partner — u Limited O Attorney in Fact ❑ Trustee D General Top of thumb here El Guardian or Conservator ❑ Other: Signer Is Representing: Signer's Name: 0 Corporate Officer — Title(s): ❑ Individual i Partner — [-� Limited ❑ Attorney in Fact 1 Trustee 11:11M ilk go] lhillilu .11 El General Imajutrumn Top of thumb hero L, Guardian or Conservator O Other: Signer Is Representing © 2010 National Notary Association • NationalNotary.org • 1. 800 -US NOTARY (1 -600 -876 -6827) Item #5907 State of California County of Orange On August 7th, 2012 before me, Traci Larson, Notary Public (insert name and title of the officer) personally appeared Shaunna Burchfiel, Attorney -In -Fact who proved to me on the basis of satisfactory evidence to be the person(4 whose nameX../,Rare subscribed to the within instrument and acknowledged_ o me that he /63h/they executed the same in his i ltheir authorized capacity�i `s }, and that by hid /h /their signature} on the instrument the person�0'1 or the entity upon behalf of which the person(o 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 hand and official seal. Signature (Seal) POA #: 510026 Insurance SureTec Company, LIMITED POWER OF ATTORNEY Know All Men by These Presents, That SURETEC INSURANCE COMPANY (the "Company "), a corporation duly organized and existing under the laws of the State of Texas, and having its principal office in Houston, Harris County, Texas, does by these presents make, constitute and appoint George Burchfiel, Shaunna Burchfiel its true and lawful Attorney -in -fact, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings or other instruments or contracts of suretyship to include waivers to the conditions of contracts and consents of surety for: Five Million and 00/100 Dollars ($5,000,000.00) and to bind the Company thereby as fully and to the same extent as if such bond were signed by the President, sealed with the corporate seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney -in -Fact may do in the premises. Said appointment shall continue in force.until 10/3.1/2013 and is made under and by authority of the following resolutions of the Board of Directors of the SureTec Insurance Company: Be it Resolved, that the President, any Vice - President, any Assistant Vice - President, any Secretary or any Assistant Secretary shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attomey(s) -in -Fact to represent and act for and on behalf of the Company subject to the following provisions: Attorney -in -Fact may be given full power and authority for and in the name of and of behalf of the Company, to execute, acknowledge and deliver, any and all bonds, recognizances, contracts, agreements or indemnity and other conditional or obligatory undertakings and any and all notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such Attorney -in -Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary. Be it Resolved, that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached. (Adopted at a meeting held on 20 °i of April, 1 999) In W .+ness l✓hereof; SURETEC INSURANCE COMPANY has caused these presents to be signed by its President, and its corporate seal to be hereto affixed this 3rd day of September, A.D. 2010. �ux.,nuu� SURETEC IN E CQMPANY \�SURANCF��e �GI• X q By: _ _--- W i W ) D= John I o Jr., resident State of Texas ss: County of Harris On this 3rd day of September, A.D. 2010 before me personally came John Knox Jr., to me known, who, being by me duly sworn, did depose and say, that he resides in Houston, Texas, that he is President of SURETEC INSURANCE COMPANY, the company described in and which executed the above instrument; that he knows the seal of said Company; that the seal affixed to said instrument is such corporate seal; that it was so affixed by order of the Board of Directors of said Company; and that he signed his name thereto by like order. JACQUELYN MALDQNADO --- '` °` Notary Public, State of Texas My Commission Expires acq wely aldo ado, Notary Public O� May 18, 2013 y colnm lion ex es May 18, 2013 I, M. Brent Beaty, Assistant Secretary of SURETEC INSURANCE COMPANY, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said Company, which is still in full force and effect; and furthermore, the resolutions of the Board of Directors, set out in the Power of Attorney are in full force and effect. • Given under my hand and the seal of said Company at Houston, Texas this -4A day of tl �, A D M. Brent Beaty, Assistant Secretary Any instrument issued in excess of the penalty stated above is totally void and without any validity. For verification of the authority of this power you may call (713) 812 -0800 any business day between 8:00 am and 5:00 pm CST. 1161) V, - go AMENDMENT NO. 1 TO THE 2010/2011 ELECTRICAL SERVICES & PREVENTATIVE MAINTENANCE CONTRACT BY AND BETWEEN THE CITY OF ARCADIA AND D &J FOOTHILL ELECTRICAL CONTRACTORS, INC. This Amendment No. 1 ( "Amendment No. 1 ") is hereby entered into this �1 h day of nber 2011 by and between the City of Arcadia, a municipal corporation of the St to of California, and D &J Foothill Electrical Contractors, Inc., with respect to that certain Agreement between the parties dated August 31, 2010 ( "Agreement "). The parties agree as follows: Pursuant to Section 3.3.4 of the Contract, the term is extended to and including August 31, 2012. 2. Pursuant to Section 3.3.2 of the Contract, the total compensation is not to exceed ONE HUNDRED TWELVE THOUSAND NINE HUNDRED AND TEN DOLLARS AND NO CENTS ($112,910.00). 3. All terms and provisions of the Contract not amended by this Amendment No. 1 are hereby reaffirmed. In witness whereof the parties have executed this Amendment No. 1 on the date set forth below. CITY OF ARCADIA By: Donald Penman City Manager Dated: 9/ 7 /act, ATTEST: City erk APPROVED AS TO FORM: &eq� P f)�-&� Steph n P. Deitsch City Attorney D &J FOOTHILL ELECTRICAL CONTRA ORS INC. By avid Lammens President Dated: I /2 // CONCUR: Tom Tait, Public Works Services Director Page 1 of 1 llDO-$ d (PROJECT NO. ELECTRICAL SERVICES) CONTRACT FOR THE CITY OF ARCADIA ELECTRICAL SERVICES AND PREVENTATIVE MAINTENACE 1. PARTIES AND DATE. This Contract is made and entered into this 5� day of IL 24 2010, by and between the CITY OF ARCADIA (hereinafter called the "City ") and D &J F HILL ELECTRICAL CONTRACTOS, INC. (hereinafter called the "Contractor "). 2. RECITALS. 2.1 The City is a charter City organized under the laws of the State of California, with power to contract for services necessary to achieve its purpose; 2.2 Contractor, in response to a Notice Inviting Bids issued by City on JULY 12, 2010, has submitted a bid proposal for ELECTRICAL SERVICES AND PREVENTATIVE MAINTENANCE described in the Contract. 2.3 City has duly opened and considered the Contractor's bid proposal, and duly awarded the bid to Contractor in accordance with the Notice Inviting Bids and the other Bid Documents, and has given written notice to Contractor on AUGUST 20, 2010. 2.4 Contractor has obtained, and delivers concurrently herewith, Performance and Payment Bonds and evidences of insurance coverage as required by the Contract. 3. TERMS. 3.1 Incorporation of Documents. This Contract includes and hereby incorporates in full by reference the following documents, including all exhibits, drawings, specifications and documents therein, and attachments and addenda thereto: a. Notice Inviting Bids b. Instructions to Bidders C. Contract Bid Forms d. Contract e. Contract Appendix Part "A" - General Conditions Part "B" - Supplementary General Conditions Part "C" - Special Provisions Part "D" - Specifications Part "E" - Drawings RVPUB\DRD \570015 CONTRACT-1 GB - STATE & LOCAL (505/507/660) (7/24/00) (PROJECT NO. ELECTRICAL SERVICES) Part "F" - Performance Bond Part "G" - Payment Bond The above documents, including the General Conditions, are an integral part of the Contract Documents. In addition to signing this Contract, Contractor shall initial this paragraph immediately below acknowledging that he or she has read, understood and agrees with all of the terms of the Contract Documents, including, but not limited to, provisions of the General Conditions relating to indemnification, insurance, standards of performance, termination, compensation and time of the essence performance. Contractor shall not disclaim knowledge of the meaning and effect of any term or provision of the Contract Documents, and agrees to strictly abide by their meaning and intent. In the event that Contractor fails to initial below, the City shall have the right to declare the Contract unexecuted and to award the Contract to another contractor in accordance with state law. 0 Contractor, s Initials 3.2 Contractor's Basic Obligation. Contractor promises and agrees, at its own cost and expense, to furnish to the City all labor, materials, tools, equipment, services, and incidental and customary work for the construction of BID SCHEDULE I and BID SCHEDULE II necessary to fully and adequately complete ELECTRICAL SERVCIES AND PREVENTATIVE MAINTENANCE CONTRACT, including any alternates selected by the City, and all structures and facilities described in the Contract (hereinafter the "Work "), for a total of ONE HUNDRED TWELVE THOUSAND, NINE HUNDRED TEN DOLLARS AND NO CENTS, ($112,910.00), as specified in the-Contract Bid Forms submitted by the Contractor in response to the above referenced Notice Inviting Bids. Such amount shall be subject to adjustment in accordance with the applicable terms of this Contract. All Work shall be subject to, and performed in accordance with the above referenced documents. 3.3 Standard of Performance. Contractor shall perform all Work under this Contract in a skillful and workmanlike manner, and consistent with the standards generally recognized as being employed by professionals in the same discipline in the State of California. Contractor represents and maintains that it is skilled in the professional calling necessary to perform the Work. Contractor warrants that all employees and subcontractors shall have sufficient skill and experience to perform the Work assigned to them. Finally, Contractor further represents that it, its employees and subcontractors have all licenses, permits, qualifications and approvals of whatever nature that are legally required to perform the Work, and that such licenses and approvals shall be maintained throughout the term of this Contract. 3.4 Period of Performance. The term of this Contract shall be for one (1) year starting from the contract date of execution, unless earlier terminated as provided herein. Contractor shall complete the Services within the term of this Contract, and shall meet any other established schedules and deadlines. Moreover, Contractor shall perform its Work in strict accordance with any completion schedule, construction schedule or project milestones developed pursuant to provisions of the Contract, including but not limited the Project Schedule located in the Specifications. RVPUBDRD \570015 CONTRACT-2 GB - STATE & LOCAL (505/507/660) (7/24/00) (PROJECT NO. ELECTRICAL SERVICES) Contractor agrees that if such Work is not completed within the aforementioned period and /or pursuant to any such completion schedule, construction schedule or project milestones developed pursuant to provisions of the Contract, including but not limited to the Project Schedule located in the Specifications, it is understood, acknowledged and agreed that the City will suffer damage. Pursuant to Government Code Section 53069.85, Contractor shall pay to the City as fixed and liquidated damages the sum of FIVE HUNDRED DOLLARS AND NO CENTS, ($500.00) PER DAY as provided by the applicable provisions of the General Conditions, found in Part "B" of the Contract Appendix. 3.5 City's Basic Obligation. City agrees to engage and does hereby engage Contractor as an independent contractor to furnish all materials and to perform all Work according to the terms and conditions herein contained for the sum set forth above. Except as otherwise provided in the Contract, the City shall pay to Contractor, as full consideration for the satisfactory performance by the Contractor of the services and obligations required by this Contract, the above referenced compensation in accordance with compensation provisions set forth in the Contract. 3.6 Contractor's Labor Certification. Contractor maintains that he is aware of the provisions of Section 3700 of the California Labor Code which require every employer to be insured against liability for Worker's Compensation or to undertake self- insurance in accordance with the provisions of that Code, and agrees to comply with such provisions before commencing the performance of the Work. A certification form for this purpose is attached hereto as Exhibit "A" and incorporated herein by reference, and shall be executed simultaneously with this Contract. 3.7 Attorneys' Fees. If either party commences an action against the other party, either legal, administrative or otherwise, arising out of or in connection with this Contract, the prevailing party in such action shall be entitled to have and recover from the losing party reasonable attorneys' fees and all other costs of such action. 3.8 Successors. The parties do for themselves, their heirs, executors, administrators, successors, and assigns agree to the full performance of all of the provisions contained in this Contract. Contractor may not either voluntarily or by action of law, assign any obligation assumed by Contractor hereunder without the prior written consent of the City. RVPUB\DRD \570015 CONTRACT - 3 GB - STATE & LOCAL (505/507/660) (7/24/00) (PROJECT NO. ELECTRICAL SERVICES) 3.9 Notices. All notices hereunder and communications regarding interpretation of the terms of the Agreement or changes thereto shall be provided by the mailing thereof by registered or certified mail, return receipt requested, postage prepaid and addressed as follows: Contractor D &J Foothill Electrical Contractors, Inc. 2451 First Street La Verne, CA 91570 Attn: David Lammens, President City City of Arcadia 240 W. Huntington Drive P.O. Box 60021 Arcadia, CA 91066 -6021 Attn: Dave McVey, General Services Superintendent Any notice so given shall be considered received by the other party three (3) days after deposit in the U.S. Mail, first class postage prepaid, addressed to the party at the above address. Actual notice shall be deemed adequate notice on the date actual notice occurred, regardless of the method of service. CITY OF ARCADIA By: J . pclvvv.' � Donald Penman City Manager ATTES By: , A 0 �, CiyCek Approved as to Form: By: / , t1 Stephen P. Deitsch City Attorney CONTRACTO By: A&— David Lammens President (PROJECT NO. ELECTRICAL SERVICES) EXHIBIT "A" CERTIFICATION LABOR CODE - SECTION 1861 I, the undersigned Contractor, am aware of the provisions of Section 3700 et seq. of the California Labor Code which require every employer to be insured against liability for Worker's Compensation or to undertake self - insurance in accordance with the provisions of the Code. I agree to and will comply with such provisions before commencing the Work governed by this Contract. CONTRACTOR: D & J Foothill Electrical Name of Contractor: contractors, Inc. By: Signature David Lammens Name President Title August 30, 2010 Date RVPUB\DRD \570015 CONTRACT (EXHIBIT A) GR - RTATF R, 7 rN' n t CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT State of California / County of L0 5 e e S 3o /U before 0I-A P"(rOn g c� D to Here Insert Name and Title of the Officer ' personally appeared /Ja2 I/!JD Z-4- k1-1 1-k7 551/L) S Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person' whose name(pr' are subscribed to the within instrument and acknowledged to me that (2)she/they executed the same in i her /their authorized capacity(, and that by i her /their signature (73 on the instrument the PAMELA VEHAWN person, or the entitupon behalf of which the Commission # 1855403 I person(acted, executed the instrument. -s Notary Public - California zZ Z Los Angeles County I certify under PENALTY OF PERJURY under the M Comm. Expires Jul 21, 2013 laws of the State of California that the foregoing paragraph is true and correct. _ WITNESS my_baadand official seal. Signature: Place Notary Seal and /or Stamp 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 n Title or Type of Document: coN7J_Qc�1�� -�f hten f- �/ud- AeX_7vR hAa_fue- ,Btrlds Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Corporate Officer — Title(s): ❑ Individual ❑ Partner — ❑ Limited ❑ General I Top of thumb here Number of Pages: Signer's Name: ❑ Corporate Officer— Title(s): ❑ Individual ❑ Partner — ❑ Limited ❑ General Top of thumb here ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: ­­o National Notary Association - 93bu ue `;oto Ave., P.O. Box 2402 - Chatsworth, CA 91313 -2402 - www.NationalNotary.org Item #5907 Reorder: Call Toll -Free 1 -800- 876 -6827