Okaloosa County BOCC — March 1, 2016 — TanglewoodCloseout — reading text

advertisement for publication in the said newspapet. Subscribed a/@uo before me this _/ 2 2y C _ / ,AMHJ Whois pélsonally known to me and has produced identification. g [L/(,uz‘c/ (K_,,,,, v@etfiy Signature) SHERRIE TAYLOR . Commisalon # FF 210763 i Expires March 16, 2019 ree BO0-355.7019 Bandad T Trey Fala lnguia (Scal) POBox9 15199 Hwy 331 Business Freeport, FL 32439 January 26, 2016 RE: Tanglewood / Overbrook Stormwater Management Project Okaloosa County Board of County Commissioners 101 East James Lee Boulevard Crestview, Florida 32536 Gentlemen: This letter is to confirm that H&T Contractors, L.L.C. will maintain certificates of insurance for two (2) years concerning the aforementioned project. Respectfully submitted, John B. Irvin, IV, CFO H&T Contractors, L.L.C. johnbirvin@hotmail.com CGC 1517436 Office: 850.835.0231 Fax: 850.835.5123 ACORD" S CERTIFICATE OF LIABILITY INSURANCE 2«”5( OATE (MM/DD/YYYY) 3/19/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING (NSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy{les) must be endorsed. It SUBROGATION IS WAIVED, subject to the terms and conditlons of the pollcy, certain policles may requite an endorsement. A statement on this certiflcate does not confer rights to the cartiflcate holder in lleu of such orsement(s). PRODUCER [SRMECT_ Daniels Commercial Insurance, LLG DA, SOMMaroks inerance; LLG PHONE . o 850-308-7710 | A% noy. 850-308-7716 Pensacola FL 32501 AhiEes, service@dclnslic.com INSUHER(S) AFFORDING COVERAGE NAIC ¥ nsuren A :BITCO General Insurance Corporation 20095 INSURED H&TCONT-01 insuRen B :Great American Insurance Company 16691 H&T Contractors, LLC nsurer ¢ :Federal Insurance Company 20281 P.O.Box 9 Freepon FL 32439-0009 INSURER D ; INSURER E : INSURERF ; a E C UMBER: 860236032 ISIO ER; THIS 1S TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TEARM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IR TYPE OF INSURANCE RS0 [va | POLICY NUMBER OO oy UmTS A | x | COMMERCIAL GENERAL LIABILITY Y | v [cLP3s17300 B/10/2016 [3/10/2016 EACH OCCURRENGE $1,000,000 | cLams wane Izl OccuUn PREMISES (Fa occuitence) _| $300,000 B ) MED EXP {Ary ona porson) | $10,000 || PERSONAL & ADV INJURY | $1,000,000 | GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY i 52 LOC PRODUCTS - COMP/OP AGG | $2,000,000 OTHER: $ A~ | AuronmoniL UABILITY Y | Y [cApssizant BI02016 PH0/2016 | oReREDaNGLE LT[ 000 00 X | anvauto BODILY INJURY (Per parson) | $ | ALkQymED LED BODILY INJURY (Per accidert) | § X | Hinep AuTos A REOWNED mmme s X |pip $ B [X [umBRELLALAB | X | occun Y [sBU 0256847 03 B/10/2015 P/10/2016 | EACH OCGURRENCE $1,000,000 _{ EXCESS LIAB CLAIMS MADE AGGREGATE $1,000,000 vep [X | nerenmion 10,000 - A | WORKERS COMPENSATION - y |wcasi7302 or102016 por2016 | X [ERe | (S8 B ANYPROPRIETORPARINEREXECUTIVE NTA E.L EACH ACCIDENT $1,000,000 N (Mandatory In NH) £.L. DISEASE - EA EMPLOYEE] $1,000,000 D TIOn OF SPERATIONS below E.L DISEASE - POLICY LIMIT | $1,000,000 41 C |Leased/Rented Equpment 4546-83-72 3/10/2015 B/10/2016 Limit of Liability $300,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additlonal Remarks Schedule, may be allached it more space is required) Tanglewood/Overbrook Stormwater Management Improvements Grant. Centificate Holder Is an Additional Insured as respects General Llabllity & Automobille Liabllity if required by written contract. Walver of Subrogation applies In favor of the Centificate Holder as respects General Liability, Automobile Liability, Umbrella & Workers Compensatlon if required by writlen contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Okaloosa County ACCORDANCE WITH THE POLICY PROVISIONS. 602-C North Peatrl Street Crestvlew FL 32536 AUTHORIZED REPRESENTATIVE e s, N R 2 TR (asearwe ¥ - ‘M‘N\" W ACORD 25 (2014/01) © 1908-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CONSENT OF SURETY OWNER O TO FINAL PAYMENT égi}l?:fggon g AIA Document G707 s 0 Bond No. NFL 1096 OTHER O TO OWNER: ARCHITECT'S PROJECT NO.: (Name and address) Okaloosa County Board of County Commissioners 101 East James Lee Boulevard Crestview, FL 32536 PROJECT: CONTRACT DATED: (Name and address) CONTRACT FOR: Tanglewood/Overbrook Stormwater Grant Project In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above, the (Insert nane and address of Surety) Merchants National Bonding, Inc. P.O. Box 14498 Des Moines, IA 50306 - 3498 , SURETY, on bond of (Insent name emd address of Contractor) H&T Contractors, L.L.C. 15199 Hwy. 331 Business Freeport, FL 32439 , CONTRACTOR, hereby approves of the final payment to the Contractor, and agrees that final payment to the Contractor shall not relieve the Surety of any of its obligations 1o (Insert name and address of Owner) Okaloosa County Board of County Commissioners 101 East James Lee Boulevard Crestview, FL 32536 , OWNER, as set forth in said Surety’s bond. IN WITNESS WHEREOF, the Surety has hereunto set its hand on this date: November 5, 2015 (Inser! in wpiting the month foliowed by the muneric date and year.) Merchants National Bonding, Inc. (Sarety) M gt (Signature of authorized yepresentative) gfi; QRIY\M»-L.. y O Evondia H. Woessner Attorney-in-Fact o -~ A (Printed e and tide) G707-1994 MERCHANTS S BONDING COMPANY- POWER OF ATTORNEY Know All Persons By These Presents, that MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., both being corporations of the State of lowa (herein collectively called the “Companies”) do hereby make, constitute and appoint, individually, Alisa B Ferris; Evondia H Woessner; Jeffrey M Wilson; Mark W Edwards Il; R E Daniels; Robert R Freel; Ronald B Giadrosich; Shelby E Daniels their true and lawful Attorney(s)-in-Fact, to make, execute, seal and deliver on behalf of the Companies, as Surety, bonds, undertakings and other written obligations in the nature thereof, subject to the limitation that any such instrument shall not exceed the amount of: EIGHT MILLION ($8,000,000.00) DOLLARS This Power-of-Attorney is granted and is signed and sealed by facsimile under and by authority of the following By-Laws adopted by the Board of Directors of 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 connection with obligations in favor of the Florida Department of Transportation only, it is agreed that the power and authority hereby given to the Attomey-in-Fact includes any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts required by the State of Florida Department of Transportation. 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 connection with obligations in favor of the Kentucky Department of Highways only, it is agreed that the power and authority hereby given to the Attomey-in-Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner- Department of Highways of the Commonwealth of Kentucky at least thirty (30) days prior to the modification or revocation. In Witness Whereof, the Companies have caused this instrument to be signed and sealed this 15th day of August , 2015 ROTTILU T e, MERCHANTS BONDING COMPANY (MUTUAL) & ks 3 e, ‘\? % MERCHANTS NATIONAL BONDING, INC. £ 'a,‘ * W STATE OF IOWA ey g COUNTY OF Dallas SS. President On this 15th day of August . 2015 , before me appeared Larry Taylor, to me personally known, who being by me sworn did 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 are 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. ) WENDY WOODY 9 S Commission Number 784654 DL T My Commiss on Expires Tyt June 20, 2017 Notary Publid; County, lowa (Expiration of notary’s commission does not invalidate this instrument) I, 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 5th day of November ,2015 RIRLUTTH ° Q“'wl "'i,"’ Tod P G ; ’o S8 0, o ONE Cogns, *."_.....,,_. -, 'Q." PO -..- ; ¥ ' o oM O S ; °°,"<,°“ KR %‘w/ %?“M% ., , $ IATE WL s ™ ¢ 5 ESIE . LY (B -0 gt Secretary £ iZIE 1w o %-:". 23 Jof o % Q o < 3 ST o V. DNND e T N X ";" ‘4/ tesaas? ."J\“|\“\ '.:911’ - \'}l.. “*r, W ®acge® 3 ity POA 0014 (6/15) McGRIFF, SEIBELS & WILLIAMS, INC. INSURANCE & BONDS January 26, 2016 Okazloosa County Board of County Commissioners 101 East James Lee Boulevard Crestview, FL 32536 Re: H&T Contractors, L.L.C. Bond No. NFL 1096 with Merchants National Bonding, Inc. To Whom it May Concern: Boud NFL 1096 in the amount of $401,621.50 was a legal instrument foliowing the Contract for all work in association with the Tanglewood/Overbrook Stormwater Grant Project. A “Consent of Surety to Final Payment” was issued on November 5, 2015, giviag our consent to close the bond and release the final payment to the contractor. The contract allows for a one-year warranty period. The warranty period will run from December 10, 2015 to Decerber 10, 2016. Singerely, . = . . i T ) Mot r— Evendia H. Woessner Aftorney-in-Fact 2211 7th Avenue South / Birmingham, Alabama 35233 P.O. Box 10265 / Birmingham, Alabama 35202-0265 TEL—~205) 252-9871 Fax—(205) 581-9463 MERCHANTS BONDING COMPANY-. POWER OF ATTORNEY Know All Persons By These Presents, that MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., both being corporations of the State of lowa (herein collectively called the “Companies”) do hereby make,