Okaloosa County BOCC — September 3, 2013 — AirportRdFinalPayment — reading text

employee of the Department in connection with obtaining or performing said contract. 3. All amounts payable for labor, materials, or otherwise, in connection with said contract and work have been paid except for normal sub-contract retainages, which will be satisfied within 30 days after payment and/or release of retainage withheld under said contract. 4, There are no claims or suits pending against said Contractor or anyone in connection with the work done, materials furnished or otherwise, under said contract except as listed below. As to any such exception listed below, the Contractor has stated the name of the entity making the claim, the name of the entity against whom the claim is being made, and demonstrated below good cause as required by Section 337.11(11), Florida Statutes. Claiming Entity Claim Agent Nature of claim Good cause explanation Nila State of Florida A false statement or omission made in connection with this affidavit is E sufficient cause for suspension, revocation, or denial of qualification to bid, County of = sca rm %» 1p and a determination of non-responsibility, and may subject the person and/or entity making the false statement to any and all civil and criminal penalties Sworn to and subscribed before me this 2Y day available pursuant to applicable Federal and State Law. of QC7o BER, 20/3, by_BLaiR S. CRakF Qile,Coast FRALFIC ENGINEERS , Inc ‘i iani idavil Co tor (Pyint name of person signing Affidavit) Sidbd (Lobe. Cath E Lethe! f le — By Notary Public a eet TRESIDENT OU-10 14 Title Commission Expires Personally Known “OR Produced Identification Type of Identification Produced CATHERN E. RETHERFORD Notary Public - State of Florida My Comm. Expires Apr 10, 2014 Commission # DD 957292 STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION 700-050-21 Rule 14-24.001 F.A.C. Rute 470.008 FAG. CONTRACTOR’S AFFIDAVIT AND SURETY CONSENT pa (FORM 21-A) Pagpeale We, the Merchants Bonding Company (Mutual) duly authorized to do business under the laws of Florida, having (Type or print name of Surety) heretofore executed a performance and payment bond for the Contractor covering the contract described above, hereby consent the State of Florida Department of Transportation making full payment of the final estimate, including the retained percentage, to the Contractor. It is fully understood that consenting to the State of Florida Department of Transportation making payment of the final estimate to the Contractor and/or its assignee, shall not relieve this surety company of any of its obligations under its bond. IN WITNESS WHEREOF, the Merchants Bonding Company (Mutual) has caused this (Type or print name of surety) instrument to be executed by its President, Chief Executive Officer or duly authorized Attorney-In-Fact and its corporate seal to be hereto affixed, all on this 23rd day of October : 2013 Merchants Bonding Company (Mutual) SURETY COMPANY (AFFIX SEAL) BY: Cindy L. ‘a C1 Its Presidelt or Chief Executive Officer XI Its Attorney-In-Fact XX Florida Licensed Insurance Agent STATE OF Florida (Attach Power of Attorney) COUNTY OF __ Seminole Cindy L. Mirisola to me well known or who Before me, the undersigned Notary Public, personally appeared has produced _N/A - Personally Known as identification as the person described in and who executed the foregoing (Type of Identification) instrument in the name of _ Merchants Bonding Company (Mutual) and Cindy L. Mirisola acknowledged that he/she executed said instrument in the name of said surety as its Attorney-in-Fact & FL Resident Agent for the purposes therein expressed and that he/she has due and legal authority to execute the same on behalf of said surety. Sworn to and subscribed before me this _23rd day of October 2013 Nyy . eM, tL SHENSON Ge, % = 5 Sera 0, % My commission extives tary lw =F 20s . & . ; 3S ° H Notary Public, State of __ Florida 2 eo cE 17093 = S oe Ave gern OS MERCHANTS SS BONDING COMPANY. POWER OF ATTORNEY Know All Persons By These Presents, that MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., both being corporations duly organized under the laws of the State of lowa (herein collectively called the “Companies’), and that the Companies do hereby make, constitute and appoint, individually, Sarah Ann Lambert, Cindy L. Mirisola of Altamonte Springs and State of Florida their true and lawful Attorney-in-Fact, with full power and authority hereby conferred in their name, place and stead, to sign, execute, acknowledge and deliver in their behalf as surety any and all bonds, undertakings, recognizances or other written obligations in the nature thereof, subject to the limitation that any such instrument shall not exceed the amount of: THREE MILLION ($3,000,000.00) DOLLARS and to bind the Companies thereby as fully and to the same extent as if such bond or undertaking was signed by the duly authorized officers of the Companies, and all the acts of said Attorney-in-Fact, pursuant to the authority herein given, are hereby ratified and confirmed. This Power-of-Attorney is made and executed pursuant to and by authority of the following By-Laws adopted by the Board of Directors of the Merchants Bonding Company (Mutual) on April 23, 2011 and adopted by the Board of Directors of Merchants National Bonding, Inc., on October 24, 2011. "The President, Secretary, Treasurer, or any Assistant Treasurer or any Assistant Secretary or any Vice President shall have power and authority to appoint Attorneys-in-Fact, and to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto, bonds and undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof. The signature of any authorized officer and the seal of the Company may be affixed by facsimile or electronic transmission to any Power of Attorney or Certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the Company, and such signature and seal when so used shall have the same force and effect as though manually fixed." In Witness Whereof, the Companies have caused this instrument to be signed and sealed this 7th day of May , 2013 . tun, eterves TION A?” Q\NG Cos? oid Wf OMyise, MERCHANTS BONDING COMPANY (MUTUAL) fa ow ® 4g'%*, MERCHANTS NATIONAL BONDING, INC. AS Aah r=! -0- -o- Oi q OF By “a: Jy lo~ STATE OF IOWA ad te COUNTY OF POLK ss. “Mrs President 2013 , before me appeared Larry Taylor, to me personally known, who being by me duly sworn did Onthis 7th day of May ; say that he is President of the MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC.; and that the seals affixed to the foregoing instrument is the Corporate Seals of the Companies; and that the said instrument was signed and sealed in behalf of the Companies by authority of their respective Boards of Directors. In Testimony Whereof, | have hereunto set my hand and affixed my Official Seal at the City of Des Moines, lowa, the day and year first above written. 2, MARANDA GREENWALT 1 # Commission Number 770312 : My Commission Expires owe October 28, 2014 Notary Public, Polk County, lowa STATE OF IOWA COUNTY OF POLK ss. |, William Warner, Jr., Secretary of the MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., do hereby certify that the above and foregoing is a true and correct copy of the POWER-OF-ATTORNEY executed by said Companies, which is still in full force and effect and has not been amended or revoked. In Witness Whereof, | have hereunto set my hand and affixed the seal of the Companies on this 23rd day of October , 2013 enter, Secretary POA 0014 (11/11) MERCHANTS, BONDING COMPANY 2100 FLEUR DRIVE + DES MOINES, IOWA 50321-1158 (515) 243-8171 + (515) 243-3854 FAX MAINTENANCE BOND KNOW ALL PERSONS BY THESE PRESENTS: Bond No.__FLC 82538 __ That Gulf Coast Traffic Engineers, Inc. of Pensacola, Florida as Principal, and the MERCHANTS BONDING COMPANY (MUTUAL) of Des Moines, lowa as Surety are held and firmly bound unto the Okaloosa County Board of County Commissioners in the penal sum of One hundred forty three thousand four and 60/100 (143,004.60 ) DOLLARS, lawful money of the United States of America, for the payment of which, well and truly to be made, the Principal and Surety bind themselves, their and each of their heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. Signed and delivered this__23rd__ day of, October 2013 WHEREAS, the Principal entered into a certain contract, dated the _!8th__ day of June ; 2013 with the Okaloosa County Board of County Commissioners to furnish all the material and labor necessary for the construction of CR 188 (Airport Road) Safety Improvements LAP Project in conformity with certain specifications; and WHEREAS, a further condition of said contract is that the Principal should furnish a bond of indemnity, guaranteeing to remedy any defects in workmanship or materials that may develop in said work within a period of One (1) years from the date of acceptance of the work under said contract; and WHEREAS, the above work has been completed and accepted and if not accepted will be automatically accepted upon the filing of this maintenance bond; and WHEREAS, the MERCHANTS BONDING COMPANY (MUTUAL) of Des Moines, lowa for valuable consideration, has agreed to join with said Principal in such bond or guarantee, indemnifying said Okaloosa County Board of County Commissioners as aforesaid; NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, that if the said Principal does and shall, at the Principal's own cost and expense, remedy any and all defects that may develop in said work, within the period of One (1) years from the date of acceptance of the work under said contract, by reason of bad workmanship or poor material used in the construction of said work, and shall keep all work in continuous good repair during said period, and shall in all other respects, comply with all the terms and conditions of said contract with respect to maintenance and repair of said work, then this obligation to be null and void; otherwise to be and remain in full force and virtue in law. It is agreed that while the Principal shall be and remain liable for failure to adhere to the specifications which form the basis for the work, the Surety, inasmuch as the original work was not bonded, shall be obligated only to assure the maintenance of the work in the condition in which it existed at the time the work was accepted. Any obligation beyond this shall be that of only the Principal. Gulf Coast Traffic Engineers, Inc. of Maid Lorbe — Approved By MERCHANTS BONDING COMPANY (MUTUAL) By. Cody CON 0304 (7/10) Cindy L. Mirisola¥ Attorney-in-Fact MERCHANTS SSS _- BONDING COMPANY. POWER OF ATTORNEY Know All Persons By These Presents, that MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., both being corporations duly organized under the laws of the State of lowa (herein collectively called the "Companies’), and that the Companies do hereby make, constitute and appoint, individually, Sarah Ann Lambert, Cindy L. Mirisola of Altamonte Springs and State of Florida their true and lawful Attorney-in-Fact, with full power and authority hereby conferred in their name, place and stead, to sign, execute, acknowledge and deliver in their behalf as surety any and all bonds, undertakings, recognizances or other written obligations in the nature thereof, subject to the limitation that any such instrument shall not exceed the amount of: THREE MILLION ($3,000,000.00) DOLLARS and to bind the Companies thereby as fully and to the same extent as if such bond or undertaking was signed by the duly authorized officers of the Companies, and all the acts of said Attorney-in-Fact, pursuant to the authority herein given, are hereby ratified and