Okaloosa County BOCC — May 6, 2014 — Finalpmtdocs — reading text

Commissioners Attn: Sherri Williams County Purchasing 602-C North Pead Street Crestview, FL 32536 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Aon Risk Services Northeast, Inc. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD © 1988-2010 ACORD CORPORATION. All rights reservad. CONSENT OF SURETY TO FINAL PAYMENT AIA G707 Document Bond No. GSM28681 PROJECT: Foxwood Drainage Repairs, Phase 2, Crestview, FL, 32539 (Name, Address) ARCHITECT’S PROJECT NO: TO: (Owner) Okaloosa County Board of County Commissioners 302 N Wilson Street #203 Crestview, FL 32536 CONTRACT FOR: Construction CONTRACT DATE: Contractor: Gum Creek Farms, Inc. In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above, the (type the name of the surety) The Gray Insurance Company , SURETY, on bond of (type the name of the Contractor) Gum Creek Farms, Inc. » CONTRACTOR, hereby approves the final payment to the Contractor, and agrees that final payment to the Contractor shall not relieve the Surety Company of any of its obligations to (type Owner’s name) Okaloosa County Board of County Commissioners , OWNER as set forth in the said Surety’s bond. IN WITNESS WHEREOF, The Surety has hereunto set its hand this 20th day of | March, 2014. The Gray Insurance Company 4 ; (Surety) \ wine at Medttepas ota! Conwa Pamela L. Jarman, Attorney-In-Fact & FL Licensed Resident Agent ' Bond # GSM28681 “THE GRAY INSURANCE COMPANY THE GRAY CASUALTY & SURETY COMPANY 1 7 7 6 7 5 GENERAL POWER OF ATTORNEY ‘ KNOW ALL BY THESE PRESENTS, THAT The Gray Insurance Company and The Gray Casualty & Surety Company, corporations duly organized and existing under the Jaws of Louisiana, and having their principal offices in Metairie, Louisiana, do hereby make, constitute, and appoint Benjamin H. French, Clyde D. Hare, Rebekah Wolf, L. Dale Waldorff, K. Wayne Walker, Pamela L. Jarman and Paul A. Locascio of Fort Walton Beach, Florida jointly or severally on behalf of each of the Companies named above its true and lawful Attorney(s)-in-Fact, to make, execute, seal and deliver, for and on its behalf and as its deed, bonds, or other writings obligatory in the nature of a bond, as surety, contracts of suretyship as are or may be required or permitted by law, regulation, contract or otherwise, provided that no bond or undertaking or contract of suretyship executed under this authority shall exceed the amount of $10,000,000. - This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of Directors of both The Gray Insurance Company and The Gray Casualty & Surety Company.at meetings duly called and held on the 26" day of June, 2003. : “RESOLVED, that the President, Executive Vice President, any Vice President, or the Secretary be and cach or any of them hereby is authorized to execute a power of Attorney qualifying the attorney named in the given Power of Attomey to execute on behalf of the Company bonds, undertakings, and all contracts of surety, and that each or any of them is hereby authorized to attest to the execution of such Power of Attorney, and to attach the seal of the Company; and it is FURTHER RESOLVED, that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile, and any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal shall be binding upon the Company now and in the future when so affixed with regard to any bond, undertaking or contract of surety to which it is attached. IN WITNESS WHEREOEF, The Gray Insurance Company and The Gray Casualty & Surety Company have caused their official seals to be hereinto affixed, and these presents to be signed by their authorized officers this 12" day of September, 2011. Bheadad Lege” Mosby Mark S. Manguno Secretary, The Gray Insurance Company, The Gray Casualty & Surety Company Michael T. Gray President, The Gray Insurance Company and Vice President, The Gray Casualty & Surety Company State of Louisiana SS: Parish of Jefferson On this 12" day of September, 2011, before me, a Notary Public, personally appeared Michael T. Gray, President of The Gray Insurance Company and Vice President of The Gray Casualty & Surety Company, and Mark S. Manguno, Secretary of The Gray Insurance Company and The Gray Casualty & Surety Company, personally known to me, being duly sworn, acknowledged that they signed the above Power of Attorney and affixed the seals of the companies as officers of, and acknowledged said instrument to be the voluntary act and deed, of their companies. Lisa S. Millar, Notary Public, Parish of Orleans State of Louisiana My Commission is for Life sty ss ay oS. Mi, -]; Mark-S. Manguno, Secretary of The Gray Insurance Company and The Gray Casualty & Surety Company, do hereby certit'y that the above and forgoing is a true and correct copy of a Power of Attorney given by the companies, which is still in full force and effect. the seals of the Companies this 20th dayof March 2014 anpure Mark S. Manguno, Secretary The Gray Insurance Company The Gray Casualty & Surety Company Ne Seen aaaioin, f UI SSa INT OLINANLOW ION SULNa DOG SIMU uaGHOR UNINdOCOIN 7G Sy CEI Mf A sia aia / oe (CO LON SLINEIINOOC Silas ec A SAAN COUN Gum Creek Farms, inc. 1097 Hwy ~—83N, DeFuniak Springs, FL 32433, gives notice of completion of Foxwaod Drainage Repairs - Phase 2 and seis 4/11/2014 as the date of finat settlement, All persons and firms should file all claims for payment to the below address prier to the settlement date: Okaloosa County (Owner) ATIN: Contracts and Leases Coordinator 602-C North Pearl St Cresiview, FL 32536 By: Don Fife Vice President Pub: March 21, 28, 2074, April 4, 1472014 ent DAU RnmeeS eww. + AEN: =S Contracts | anid: Friday, | LEGAL ADVERTISING | fo s200- | Legal 5842 : ADVERTISEMENT. OF COMPLETION Gum Creek Farms;ino. 4097 8 Hwy oc 88N, |! DeFuniale ‘Springs, FL Leases Coordinator’ 802-C North Pearl St E 32536- Page 1oft 03/19/2014 15:37:07 Ad Number 34638564 Ad Key Order Number 34283979 Salesperson 104 - Angella Lewis PO Number Publication Northwest Florida Daily News Customer : 33865417 Gum Creek Farms, Inc. Section Classified 2008 Contact z Don Fife Sub Section Classified 2006 Addressi : 1097 Hwy 83 North Category 4100 Legal Advertising Address2 : Dates Run 03/21 /2014-04/4 1/2014 City St Zip DeFuniak Springs FL 32433 Days 4 Phone (850) 892-0291 Size 1 x 3.39, 32 lines Fax : (850) 892-6331 Words 83 Credit Card : SEEM ET OB, Ad Rate Legals Rate Printed By : Angeila Lewis Ad Price 208.52 Entered By Angella Lewis Amount Paid 208.52 Amount Due -0.00 Keywords 94478 ADVERTISEMENT OF COMPLETION Gum Creek Farm Notes Zones 94478 ADVERTISEMENT OF COMPLETION APPLICATION FOR PAYMENT PERIODIC ESTIMATE NO.: 3-frasmp: | PROJECTNO,;, C/Y- 2/9] Put WORK PERIOD BEGIN DATE:_2/z Z)iy END DATE: _ ah Git ROAD NAME: fiptarod Dartvngs Repains - Physe 2 ORIGINAL CONTRACT SUM oo $_ 257 %S84.08 NET CHANGE BY CHANGE ORDERS $_< 7, ope wa > CONTRACTSUMTODATE $_L52., § $0.00 ANALYSIS OF WORK PERFORMED 7 Value of original contract work performed previously: $ ZS. A 7& Joe 2. Work performed this month: . $_f ; Gov,2© 3. Total value of work performed to date: . $ Z 5 4, PS vo 4, Less: Amount retained at five (5%) percent: $ 00 ‘5. Net amount earned on contraci work io date: $ 25 28 $0.00 6, Less: Amount of previous payment: $Z 39 492.$0 ~ A ~ AMOUNT DUE THIS PAYMENT. we CERTIFICATION OF CONTRACTOR According fo the bes! of my knowledge and belief, | certify that all items and amounts shown on the face of the Periodic Estimate are correct; that all work has been performed and/or materials supplied in full aecosdance with the terms and conditions of the contract between Okaloosa County and , and that the items for which payment is requested have been paid and that there are no vendors-mechanics, or other liens or conditionaysal contracts ich should be satisfied or discharged before such payment is made. : Gum Chek Fryems Lae By: ug /) (Firm Name) (Namef Authorized Officer & Title) CERTIFICATION OF ENGINE! ! certify that | have verified this Periodic Estimate and that fo the best of my knowledge Project Manager’ Date: 4 Lofty Foxwood Drainage Repairs - Phase 2 App.ForPayment MI CONTRACTOR'S RELEASE OF LIENS Lo STATE OF: Monde county of: Widtanel Before me, the undersigned Nojary Public in and for the said County and State Pgrsonally appegred eA - Fepresenting the Contractor, Coun Cael, Dares tet who being duly swom according to law deposes and says that all labor, materials, and outstanding claims and indebtedness of whatever nature arising out of the performance of the Contract with OKA SOSA 14~Z16 al COUNTY BOARD OF ¢ UNTY CO, SSIONERS the Owner, for ret No. , have been paid in full and that for the final payment in the amount 441.50 - the Contractor releases and discharges the Owner and- er { Sworn to Gnd subscribed before me this LY__day of 2th 20t# = My Commission Expires: ({Nofary Public) Foxwood Drainage Repairs - Phase 2 - Release of Liens fe) NORTHWEST FLORIDA D News Published Daily Fort Walton Beach, Florida Distributed in Okaloosa, Santa Rosa & Walton Counties State of Florida, County of Okaloosa Before the undersigned authorized personally appeared Colleen. Cadogan 3 who on oath says that (s)he is Legal Advertising Clerk of the Northwest Florida Daily News, a daily newspaper published at Fort Walton Beach, in Okaloosa County, Florida; that the attached copy of advertisement, being a Leg: al__< in the matter of Notice AdNiartismant of Compution intel NO a\4 01a) County Court, was published in said newspaper in the issues of Maven 2\ 25426 Boal 4 M20) Affiant further says that the said Northwest Florida Daily News is a newspaper published at Fort Walton Beach, in said Okaloosa County, Florida, and that the said newspaper has heretofore been continuously published in said Okaloosa County, Florida, each day, and has been entered as second class mail matter at the post office in Fort Walton Beach, in said Okaloosa County, Florida, for a period of one year next preceding the first publication of the attached copy of advertisement; and affiant further says that (s)he has neither paid nor promised any person, firm or corporation any discount, rebate, commission or refund for the purpose of securing this advertisement for publication in the said newspaper. STATE OF FLORIDA COUNTY OF OKALOOSA ed) before me this SATII | LOWY (Date} /——., who is/are personally known to me or Subscribed and sworn t (y IA09 we has/have produced Personally Known Personally Known as identification. {Type of identification) Ea“ AL — Signature) Notary Public, Commission No. (Name of Notary typed, printed or stamped) ? ate of Florida 3 Jul 30, 2013 3 116319 wf Le Legal 5842 ADVERTISEMENT: oF COMPLETION : Gum Creek Farms, Ine: T0972 Hwy. 88N; BeFuniak:: Springs, FL 32433; gives:::notice of completion: of Foxwood Drainage 22 Repairs: Phase 2.--and: sets 4pt1/2014:"as the: date Offinal: settlement: : All persons. sand. ‘rms should «file: all claims. for. payment::-to.the “below. address: prior::: to the settlement date: Okaloosa County. (Qwnen) 2 ATTN: = Contracts and ‘Leases Coordinator 602.C:North Pearl St Crestview, FL 32536 °° By: Don Fife Vice President < -: Legal 5842 we March. °.21;: 28, 2014, : April. 4,11; 2014 Bond No. GSM28681 WARRANTY BOND KNOWN ALL BY THESE PRESENTS: That-we Gum Creek Farms, Inc:, as‘Contractor, and The Gray Insurance Company, as Surety, are held and firmly bound unto Okaloosa County Board of County Commissioners, as Obligee, in the total sum of | Two hundred