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Contract - Cutler Repaving, Inc. - 10/24/2024 BID _. ORIGINAL CITY OF ROUND ROCK TRANSPORTATION DEPARTMENT ROUND ROCK TEXAS Project Manual For: 2023 Arterial Street Maintenance Program August 2024 Prepared By: Matthew Bushak, P.E. '4EOF TEr�, st'1 ot APPROVED 13Y IAAITHEW BUSHAK CIT`( TTO N EY yI..t......9148 .... TBPE Firm Registration No BID BOND THE STATE OF TEXAS § § KNOW ALL BY THESE PRESENTS: COUNTY OF WILLIAMSON § That Cutler Repaving,Inc. of the City of Lawrence,KS County of Douglas State of Kansas as Principal, and Liberty Mutual Insurance Company authorized under the laws of the State of Texas to act as surety on bonds for principals,are held and firmly bound unto the CITY OF ROUND ROCK,TEXAS("Owner"), in the penal sum of Five Percent(5%)of the total amount of the Bid of the Principal submitted to the Owner, for the Work described below; for the payment whereof,well and truly to be made, and the said Principal and Surety do herby bind themselves and their heirs, administrators, executors, successors and assigns, jointly and severally,as follows: In no case shall the liability of the Surety hereunder exceed the sum of(Five Percent of Amount Bid Dollars(S 5% ). THE CONDITIONS OF THIS OBLIGATION ARE SUCH that,whereas,the Principal has submitted the above-referenced Bid to the Owner, for construction of the Work under the "Specifications for Construction of 2023 Arterial Street Maintenance Program )f for which Bids are to be opened at the office of Owner on the 17th day of September 12024 . NOW,THEREFORE,if the Principal is awarded the Contract,and within the time and manner required under the"Instructions to Bidders,"after the prescribed forms are presented to her/him for signature,enters into a written Agreement substantially in the form contained in the Bid Documents,in accordance with the Bid, and files the two (2) bonds with the Owner, one to guarantee faithful performance and the other to guarantee payment for labor and materials,then this obligation shall be null and void;otherwise,it shall be and remain in full force and effect. If, however, Principal fails to enter into a written Agreement with the Owner in accordance with the Bid or Principal and Surety fail to timely deliver to Owner the performance and payment bonds required by the Bid Documents, Surety within five(5)business days after receipt of a written demand from Owner shall pay to Owner the full penal sum of this Bid Bond,subject to the limitation described herein. In the event that suit is brought upon this Bond by the Owner and judgment is recovered, said Surety shall pay all costs incurred by the Owner in such suit, including a reasonable attorney's fee to be fixed by the Court. IN WITNESS WHEREOF, the said Principal and Surety have signed this instrument on this the 17th day of the month of September 2024 . Cutler Repaving, Inc. Liberty Mutual Insurance Company Principal Surety _Charles R.Veskerna Desiree E. Westmoreland Printed N• e Printed Name Title: President T tle: rney-i - c Address: 921 E. 27th St Address: 175 Berkeley Street _ Lawrence,KS 66046 Boston, MA 02116 00200 4-2020 Page I Bid Bond 00443638 Resident Agent of Surety: t e Non-Resident Agent: Desiree E. Westmoreland Printed Name 430 E. Douglas, Suite 400 Street Address Wichita, KS 67202 City, State,Zip Page 2 00200 4-2020 Bid Bond 00443638 This Power of Attorney limits the acts of those named herein,and they have no authority to bind the Company except in the manner and to the extent herein stated. Liber Liberty Mutual Insurance Company Mutual- The Ohio Casualty Insurance Company Certificate No: 8211287-674007 West American Insurance Company SURETY POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS:That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire,that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts,and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana(herein collectively called the"Companies"),pursuant to and by authority herein set forth,does hereby name,constitute and appoint, Desiree E. Westmoreland;Myriah A.Anderson;Timothy C.Smith;Todd Alan Rambo;Clara R.Navarro Abela;Alycia Marie Hoebener all of the city of Wichita state of KS each individually if there be more than one named,its true and lawful attorney-in-fact to make, execute,seal,acknowledge and deliver,for and on its behalf as surety and as its act and deed,any and all undertakings,bonds,recognizances and other surety obligations,in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF,this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 31st day of January , 2024 . Liberty Mutual Insurance Company INSUO V0 INS& 111� tNsuR The Ohio Casualty Insurance Company jPOR+rFoy�� �P6°1PORgro�m West American Insurance Company 1912y c a Z1919� a 1991 0 0 ~d�93'rACHU`•+�.da SO MA MPsa,aD 'ls �'t'DIAN�' 'Ab r N David M.Carey,Assistant Secretary `m State of PENNSYLVANIA :3 County of MONTGOMERY ss oOn this 31 st day of January 2024 before me personally appeared David M.Carey,who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance > Company,The Ohio Casualty Company,and West American Insurance Company,and that he,as such,being authorized so to do,execute the foregoing instrument for the purposes (_ therein contained by signing on behalf of the corporations by himself as a duly authorized officer. N IN WITNESS WHEREOF,I have hereunto subscribed my name and affixed my notarial seal at Plymouth Meeting,Pennsylvania,on the day and year first above written. Cu O Q-; M°Nyy 3TC` Commonwealth of Pennsylvania-Notary Seal !p °a' �(�, Teresa Pastella,Notary Public �� O ~ ° t 9 Montgomery County 0.2 CP My commission expires March 28,2025 B _ M P Commission number 1126044 y— •.. 0P��G Member,Pennsylvania Association of Notanes Teresa Pastella,Notary Public NV, V, RYP 4? This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company,Liberty Mutual Insurance O•� Company,and West American Insurance Company which resolutions are now in full force and effect reading as follows: E ARTICLE N—OFFICERS:Section 12.Power of Attorney. N o Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President,and subject to such limitation as the Chairman or the President i3 C may prescribe,shall appoint such attomeys-in-fact,as may be necessary to act in behalf of the Corporation to make,execute,seal,acknowledge and deliver as surety any and all W C undertakings,bonds,recognizances and other surety obligations.Such attomeys-in-fact,subject to the limitations set forth in their respective powers of attorney,shall have full o " power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation.When so executed,such instruments shall Z be as binding as if signed by the President and attested to by the Secretary.Any power or authority granted to any representative or attorney-in-fact under the provisions of this article may be revoked at any time by the Board,the Chairman,the President or by the officer or officers granting such power or authority. ARTICLE XIII—Execution of Contracts:Section 5.Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president,and subject to such limitations as the chairman or the president may prescribe, shall appoint such attorneys-in-fact,as may be necessary to act in behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings, bonds,recognizances and other surety obligations.Such attorneys-in-fact subject to the limitations set forth in their respective powers of attorney,shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company.When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation—The President of the Company,acting pursuant to the Bylaws of the Company,authorizes David M.Carey,Assistant Secretary to appoint such attomeys-in- fact as may be necessary to act on behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety obligations. Authorization—By unanimous consent of the Company's Board of Directors,the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company,wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds,shall be valid and binding upon the Company with the same force and effect as though manually affixed. I,Renee C.Llewellyn,the undersigned,Assistant Secretary,The Ohio Casualty Insurance Company,Liberty Mutual Insurance Company,and West American,Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full,true and correct copy of the Power of Attorney executed by said Companies,is in(hull force and effect and has not been revoked. ,1 IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this Ak day of S.e,p P�1NSuP I,( INS& d tNsliz °syr Zc+ yJ o°aP°"rrr PyZ `GQ fir 4 oOIL 0 H 41912 0 o _ 1919 0 'f 1991 d�4 CU9F'�.aa S0 HAMP �aO '� �A'DIANO• a3 By. g7� * Renee C.Llewellyn,Assistant Secretary LMS-12873 LMIC OCIC WAIC Multi Cc 02121 �O{ ,$iN gUR�T� Ok F'xt.,,,.� the Surety b Fidelity Association of America Resident Agent Countersignature Laws Have Been Eradicated and Violate the Law in Every U.S.State The purpose of this short white paper is to inform the reader that resident agent countersignature laws have been eradicated throughout the United States and its territories (with the exception of Guam,where it has not been challenged). Any bid, performance, or payment bond that requires a resident agent countersignature or a resident agent signature violates the law, as such requirements have been held unconstitutional by federal courts throughout the United States and have been repealed by state legislatures. Such requirements impermissibly favor licensed resident agents over licensed non-resident agents. It is not the countersignature requirement that is problematic; it is the requirement that the countersignature must be that of a resident agent that violates the law. The National Association of Surety Bond Producers (NASBP) and the Surety& Fidelity Association (SFAA)are aware that officials in some state and local agencies are not informed about the illegality of resident agent countersignature mandates.These officials will improperly reject a bid based on lack of a required resident agent countersignature or improperly refuse to accept performance and payment bonds based on lack of a required resident agent countersignature. NASBP and SFAA receive dozens of member requests each year to send comment letters to public agencies that have included the unlawful resident agent countersignature requirement in their surety bonds. Countersignature laws date back to the early twentieth century when states passed the laws as a consumer protection measure.The regulations requiring non-resident agents to receive sign-off by a local resident agent were originally intended to ensure compliance with local insurance laws.Those regulations also meant that out-of-state agents had to pay local agents for their signatures. By the 1990s,technology made the countersignature laws an anachronism of regulation. The movement to repeal countersignature laws began in the 1990s and ended in 2008 when the Ninth Circuit struck down Nevada's countersignature law. This movement was spearheaded by The Council of Insurance Agents& Brokers. One of the most well-known cases on this matter is Council of Insurance Agents and Brokers v. Tom Gallagher, 287 F. Supp. 2d 1302 (N.D. Fla. 2003), in which the U.S. District Court for the Northern District of Florida struck down a Florida statute that impermissibly favored resident agents.The district court determined that there was no rational basis for a distinction between properly licensed resident agents and non-resident agents and declared unconstitutional the Florida statute at issue that discriminated against Florida-licensed non-resident agents. Members may want to have the bond forms reviewed to ensure that the bonds do not contain an illegal resident agent signature or countersignature requirement.To clarify, it is permissible for bond forms to contain a licensed (resident OR non-resident)agent countersignature requirement,just not that it be a resident agent. Since an earlier version of this white paper was first released in October 2018, there has been confusion about the ambit of the term "resident agent" in this white paper.The term "resident agent" in this context refers to resident insurance agents--and NOT to resident agents for purposes of service of process. December 2019 Page 1 of 1 ALTERNATE BID Bid Approx. Item Description Item Quantity Unit and Written Unit Price Unit Price Amount AA=1 3.819 TON Pavement Repair, 12" Depth complete in place per TQ1 for One hundred fifty dollars and Seventy-five cents. 150.75 575,714.25 AA=2 147,244 51 In-Place Pavement Recycling complete in place per SY for Four dollars and Twenty-five cents. 4.25 625,787.00 AA=3 14.724 GAL Rejuvenator Agent complete in place per GAL for Four dollars and Ten cents. 4.10 60,368.40 A=4 147.244 SY Surface Mill, I" complete in place per SY for Two dollars and Sixty cents. 2.60 382,834.40 AA=5 8,098 TON Type D HMAC Surface Course, 1" complete in place per TON for One hundred twenty dollars and twenty-five cents. 120.25 973,784.50 A-6 100 SY Edge Mill complete in place per SY for Two dollars and Sixty cents. 2.60 260.00 A_7 2.350 LF Remove and Replace Curb and Gutter complete in place per LF for Seventy-six dollars and Sixteen cents. 76.16 178,976.00 00300-9-2015 Page 7 of 13 Bid Form ALTERNATE BID Bid Approx. Item Description Item Quantity Unit and Written Unit Price Unit Price Amount AA=8 12,395 LF Remove and Replace Sidewalk complete in place per LF for Twenty-one dollars and Twenty-eight cents. 21.28 263,765.60 A_9 4 EA Remove and Replace Ramps complete in place per EA for Five thousand forty dollars and no cents. 5,040.00 20,160.00 A-10 43 EA Valve Can Adjustment complete in place per EA for Fifty dollars and no cents. 50.00 2,150.00 A-11 59 EA Manhole Adjustment complete in place per EA for Fifty dollars and no cents. 50.00 2,950.00 A-12 5,787 SY Geogrid Base Reinforcement(INTERAX) complete in place per SSYY for Ten dollars and no cents. 10.00 57,870.00 A-13 4.760 LF REFL PAV MRK TY I (W) 6" (BRK)(100 MIL) complete in place per LF for no dollars and Ninety-two cents. 0.92 4,379.20 00300-9-2015 Page 8 of 13 Bid Form ALTERNATE BID Bid Approx. Item Description Item Quantity Unit and Written Unit Price Unit Price Amount A-14 13.504 LF REFL PAV MRK TY I (W) 6" (SLD)(100 MIL) complete in place per LE for No dollars and Eighty-three cents. 0.83 11,208.32 A-15 1.769 LF REFL PAV MRK TY I (W) 12" (SLD)(100 MIL) complete in place per LF for Five dollars and Sixty-one cents. 5.61 9,924.09 A-16 1.326 LF REFL PAV MRK TY I (W) 24" (SLD)(100 MIL) complete in place per LF for Twenty dollars and Ninety-six cents. 20.96 27,792.96 A-17 41.835 LF REFL PAV MRK TY I (Y)6" (SLD)(100 MIL) complete in place per LF for No dollars and Eighty-three cents. 0.83 34,723.05 A-18 3.850 LF REFL PAV MRK TY I (Y)6" (BRK)(100 MIL) complete in place per LF for No dollars and Ninety-two cents. 0.92 3,542.00 A-19 4.749 LF REFL PAV MRK TY I (W) 8" (SLD)(100 MIL) complete in place per LF for One dollars and Seventy-two cents. 1.72 8,168.28 00300-9-2015 Page 9 of 13 Bid Fonn ALTERNATE BID Bid Approx. Item Description Item Quantity Unit and Written Unit Price Unit Price Amount A-20 48 EA REFL PAV MRK TY I (W)(WORD ONLY)(100 MIL) complete in place per EA for Three hundred two dollars and Fifty cents. 302.50 14,520.00 A-21 8 EA REFL PAV MRK TY I (W) (BIKE LANE)(100 MIL) complete in place per EA for Seven hundred twenty-six dollars and No cents. 726.00 5,808.00 A-22 69 EA REFL PAV MRK TY I (W) (ARROW)(100 MIL) complete in place per EA for Two hundred seventy-five dollars and no cents. 275.00 18,975.00 A-23 45 EA TYPE II-B-B RPM (HYDRANTS) complete in place per EA for Thirty-three dollars and No cents. 33.00 1,485.00 A-24 1.045 EA TYPE II-A-A RPM complete in place per EA for Six dollars and Sixty cents. 6.60 6,897.00 A-25 250 EA TYPE I-C RPM complete in place per EA for Fifteen dollars and Thirty-five cents. 15.35 3,837.50 00300-9-2015 Page 10 of 13 Bid Form ALTERNATE BID Bid Approx. Item Description Item Quantity Unit and Written Unit Price Unit Price Amount A-26 5 MO Traffic Control complete in place per MO for Forty-eight thousand dollars and No cents. 48,000.00 240,000.00 TOTAL ALTERNATE BID(Items I dim A-26) $3,535,880.55 Materials: 1,062,760.00 All Other Charges: 2,473,120.55 * Total: 3,535,880.55 * Note: This total must be the same amount as shown above for"Total Alternate Bid" 00300-9-2015 Page 1 I of 13 Bid Form TOTAL BASE BID (Items 1 thru 24 ) Materials: All Other Charges: * Total: * Note: This total must be the same amount as shown above for "Total Base Bid" If this bid is accepted, the undersigned agrees to execute the Agreement and provide necessary bonds and insurance certification as per the Instructions to Bidders. The undersigned certifies that the bid prices contained in the bid have been carefully checked and are submitted as correct and final. The Owner reserves the right to reject any or all bids and may waive any informalities or technicalities. Resp ctfully Submitted, 921 East 27th St. Signature Charles R. Veskerna Lawrence, KS 66046 Print Name Address President 785-843-1524 Title Telephone Cutler Repaving, Inc. Name of Firm September 17, 2024 Date Secreta f Bid er is a Corporation + rIC. * .J c j ci 9t' J 00200-9-2015 Page 12 of 12 Bid Form Solicitation Requirements, Contract Forms & Conditions of Contract Statement of Bidder's Safety Experience Section 00410 Bidder must submit a signed Statement of Bidder's Safety Experience form with his Bid; failure to do so will constitute an incomplete Bid that may be rejected. In order to make a responsive Bid, Bidder must provide evidence that it meets minimum OSHA construction safety program requirements, has not been fined by OSHA for any willful safety violations in the past three years, and has a lost time injury rate that doesn't exceed the limits established below. All questions must be answered and data given must be clear and comprehensive. If necessary, questions may be answered on separate attached sheets. Company Name: Cutler Repaving, Inc. Address: 921 East 27th St. Lawrence, KS 66046 Phone: 785-843-1524 Completed by: Charles R. Veskerna Date: September 8,2024 1. Does the company have a written construction Safety program? ❑✓Yes ❑No 2. Does the company conduct construction safety inspections? ❑✓Yes ❑No 3. Does the company have an active construction safety-training program? ❑✓Yes ❑No 4. Has the company been fined by OSHA for any willful safety violations in the past [-]Yes ❑✓ No three years? 5. Does the company have a lost time injury rate of 7.8 for SIC 15,or 7.6 for SIC 16, [zYes I No or less over the past three years? Attach the company's OSHA 200/300 logs for the past three years. 6. Does the company or affected subcontractors have competent persons in the following Areas? A. Scaffolding El Yes ❑No ❑✓ N/A B. Excavation ❑Yes ❑No ✓❑N/A C. Cranes ❑Yes [:]No ✓❑N/A D. Electrical ❑Yes ❑No ❑✓ N/A E. Fall Protection ❑Yes ❑No ❑✓ N/A F. Confined Spaces ❑Yes ❑No O N/A I hereby certify that the above information is true and correct. Signature �� Title President Page 1 00410 8-2014 Statement of Bidder's Safety Experience 00090654 OSHA's Form 300A (Rev,0412004) Note:You can type input Into this form and save it. Year 20 Because the forms in this recordkeeping package are"fillable/writable" 23 PDF documents,you can type into the input form fields and — Summary of Work-Related Injuries and Illnesses then save your inputs using the free Adobe PDF Reader. U.S. Department of Labor Occupational safety and Hearth Administration ormappmvcd OMB no.1:1d-01'6 All establishments covered by Part 1904 must complete this Summary page,even if no work-related injunes or illnesses occurred during the year. Remember to review the Log to verify that the entries are complete and accurate before completing this summary. Using the Log,count the individual entries you made for each category. Then write the totals below,making sure youYe added the entries from every page of the Log.If you had no cases.write"0." Establishment information Employees,former employees,and their representatives have the fight to review the OSHA Form 300 in its entirety.They also have limited access to the OSHA Form 301 or its equivalent.See 29 CFR Part 1904.35,in OSHA's recordkeeping rule,for further details on the access provisions for yu„e.,t,br:hmentn.m. Cutler Repaving, Inc. these forms. _— succt 921 E 27th St Number of Cases city Lawrence state KS Zip 66046 Total number of Total number of Total number of cases Total number of deaths cast's with days with job transfer or other recordable industry description(e.R..Manufacture of motor truck trailers) away from work restriction cases 0 0 0 2 Asphalt Paving Contractor (G) (H) (q (J) North American Industrial Classification(NAICS),if known(e.g.,336212) 2137310 i Number of Days Employment information(pfyou don't have thesefigures,see the Total number of days Total number of days of If'orkrkcet on the nest page to evurnare.) away from work job transfer or restriction Annual average number of employees 245 0 0 (K) Total hours worked by all employees last year 293,580.00 (L) Sign here Injury and Illness Types Kuowiogly falsifying this document may result in a fine. Total number of... I certify that I have examined this document and that to the best of (M) 2 poisonings 0 y ow•lcdgc the es arc C,accurate,and complete. (f)Injuries (4) p (2)Skin disorders 0 (5) Hearing loss 0 Company executive Title (3)Respiratory conditions 0 (6) All other illnesses 0 Phone785-843-1524 Da1e01/08/2024 Post this Summary page from February 1 to April 30 of the year following the year covered by the form. Reset Nbl.npurt.g bmdcn tot this culkcuon ul mrutvunnu to eutittukd to avrnge 59 mi-tea per reaputue,inclmdmg time to tc—the uutructiotu,uM--b std gather the data needed.and cotnpkte ami rcecw the colkchop of mlomutwn.2'enonu ere rod rcquaed W respotd to the collucnon Uf mformawn mkaa d dupla),a--fly vand eNB-"I m­bet.If yuo h—Ny commctN about tFreuc canm.ua or my uNct upcctu of aty Aat,adkctiott u.otasc US Dcpumnm of tabot.OSHA Offmc of Stannical Analyau,Roum N-36”.200 Conswult-Mc—,NW, Wuhinitimt tX'202 tis.1).not uemd the cumpletod fumu to this offke OSHA's Form 300(Rau.o4P2oo4) Nate:You can type input into this form and""R Attention:This forth contains information relating to ■ Log of Work-Related Because the forms in this recordkeeping package are'fillableMnlable' employee health and must be used in a manner that PDF documents,you can type into the input rotor fields and protects the confidentiality of employees to the extent Year 20 22 then save your inputs using the free Adobe PDF Reader.In addition, possible while the information is being used for U.S.Department of Lab" Injuries and Illnesses he fors are programmed to auto-calculate as appropriate occupational safety and health purposes. o..up.aon.I S.r.y a.—,re-rn+<v.a-, Please Retard: ft rd lore: tarts appm,M(y.1H m.12111-01e6 1nlom don about every wwk-r I.W death aad aba.—y-A W.,,diV yw nk, ft,inrohes loss at •Cwnpktr an lniury and laness lnidW aepad(OSM Farm 301)w egaeaknt consUousmss,temated—,ka—lyw/ob hamster,daysa„ay ham wrk arWdirai veatmenr bly-dfint ail form breach lnryrywi(I..—mwdedon the tom.ifyouetwt—whethera E.cy.uy",.,en m. Cutler Repaving Inc. •Sgnificant work retired M)uMs andiltnausthatara lwpnwed bye vtY3ttlan wllonxd hedth rareprdaspnoA ms<hrKordobiecafly—kr .90511A.T-lwhdia WwkMwedM).niesaM ittnercts tlsatmM anyo/the spcefic rerwdingrdteria ksKdtn 29CFR Parr 19016 •Feethtt to ase two Imes lora tingle cose ilyoanree to. Lawrence esti. KS through 7900.I1. •Carnpkte the 5-p,Iw earl:case. Step 2.Describe the case Step 3.Classify the case (A) (B) (C) (D) (E) IFI Entr th.mrmbr of SeMct aew corumm: den N.In/arw w m Gu 6mpbyxe'r neax Job tlW Dar:oftutvey r,g d,<evrnt occurred [ff r4 ind or Vsub c,yuv of body war.er cure ,T. ea. (,q,rvrd«1 tot rr F.f+wJ�n{Jct.north rrW, ffeeth 1,J,,d) a,ubNocetWl '+•.':• .0 luve..< ntre<m t.)ar<a or n„a<per,onmkgg. a"r"•"'Id•t w'O^` tw.„ (eg..,10) Srrnnd bevy nv.m on rishl/rarrn/rv,�n on fob (M) I gg a...,.r„r r..rh1 twm �w�ri'.'rO°i:kue� .a.r.•"._ "'.'' n.nr> � � $' � 4 (G) (H) (1) (J) ((K) �r..IQ 2 < A Resat 1 Eberardo Diaz Operator 1 118 Plantation,FL Chest & ribs 0 0 0 0 13�@ �`) (a) t") (5) (6) — noe„aer —^-� — 000000 Rea« 2 Femando Cortez Operator 2 ,11 McAllen,TX Bump on the head 0 0 0 ®3 Brook Castleberry Tt Caned 6 3y Taos, NM Bruised back&legs 0 0 0 ®4 Jordan Nlcldow crew Hand 7 15 Orlando,FL Heat Stress 0 O 0 0 2 000000 Id% --- ®5 Guillermo Lopez Operator 7 12 Ruidoso,NM Strained lower back&leg 0 Q 0 0 19 _ 000000 -R;;W1 6 Nicholas Nicklow crew Hand 7 119 Orlando,FL Heat Stress 0 O 0 0 4 _„„ 000000 Reams 7 Rodrigo Garza Operator 88 13 Orlando,FL Heat Stress 0 O 0 0 4 _.„e 00000(Q i-R-w-i$ Joshua Crawford clew Hand 10,26 Ruidoso,NM Leg injury 0 0 0 0 3 ee„ —,„, 000000 — m—ane,re.r 0 0 0 O —. 1000000 0 0 0 0 _eM —a.„ 000000 ► 0 5 1 2 32 13 5 0 0 0 0 3 ----- m.7..ad m d.wllmion or nbmuum�a4,.rt eau'+Y,•rsmaar•OW OWs�vo. '�Ir n'+n.s<.nY r�am,a,.Aom ms es sun to eenubr Nese rote's ra aro Summerypge(Form 30aC)be(ae Ma—p—[ N.)4µ!Op CremuvwnvAtlmueA'4'. 'rpieym,nC talle.Da�oe:vJ Tetm�Inod forma aNn nRicn'��F� F <. (t) (2) (DELL (4) (5) (6) OSHA'S Form 300A (Rev 0412004; Mos.:You can type input into this form and save IL ■ Because the forms in this recordkeeang beckage am'fillablenvritable' Year 20 22 Summary of Work-Related Injuries and Illnesses PDF sa,m yodocumeur canWentotheo a form sad and o« U.S.Department of Labor t Lien save our m Is using the free Adobe PDF Beetle, „P,u,,,,r a.ny.r,a m..nA Aarar.tssae.s .. r��aowosa a+tx eo in was AN establishments covered by Ped 1900 must complete this Summarypage,even ifno work-related iryunes orilhesses occurred dung the year. Remember to review the Log to verily Mat the entries are complete andaccurate before completing this summary. Using the Log,courts ga individual anines you made Por each category.Then write the toasts below,making sure you*ve added the entries from every page of the Log.If you had no cases,write T.' Establishment Mint iedoin Employees,former employees,and their representatives have the right to review the OSHA Form 300 in 4s entirely.They also have limited access to the OSHA Form 301 or its equivalent See 29 CFR Part 1904.35,in OSHA's recoralkeeping rule,for further details on the access pmvisons for rw...mseenrra.a. Cutler Repaving Inc. these to"& Street 921 E 27th St NumberofCases city Lawrence we KS yip 66046 Total number of Total number of Total number of caul Total number of -- deaths cues with days with job transfer or other recordable lnduwy description(eg-MmWerne o/motor mark matters) away from work restriction cases 0 5 1 2 Asphalt Paving Contractor (G) `N) (1) (' North American Industrial Classifiwion(NAICS).ifkootm(e.g.,336112) 237310 NumberofDays Employment Information(If Hata don't ha.•e rkaefigurec see the Total number of days Total number of days of lFarkrAeer m Me nix page ro uamam.) away from work .Wb transfer or restriction 152 Annual average bomber of employee 32 13 Total hotus vrotkcd M all employees last year 376,940_00_ (K) (U Sign here Injury and Illness Types Knowingly falsifying this document may result in a fine. Total number of... I certify that I have examined this document and that to the best of (1)Injuries (4)Moonie my wledge the a 'u am we,accurate,and w tete (2)Skin disorders 0 (5)Hearing loss 0 y executive Tule (3)Respiratory condnrons 0 i6)All other illnesses 3 ph-e785-843-1524 D0e 1125/2022 Pose Mis Summary pap from February 1 so April 30 of rts year hollowing the year corded by the form. PUDLc rtmrtuta D,Wca far Ike mllRlam a(mkrmMRo r etanasa r�,.mac�I arauYs Fr Rgnac rrclueina tree a Rviw��m•nrctianf,raRD.M Nor rDc mm raa0ra,efd ceepkb ua Rvkv rR•eWcrm s(Wemvcn.Pmomnm�RWnJbr•-0oa1 rnas<o&.+uccrit mak,•:ai•pnr•. 4—9 obA•oeuo0meso.ityin r.e.q w Nor race more o ay cavi uperr of eru v�co0a;ro•,caa.n V,S V,,—n—V,,—n— OSII d& n(Ilnm. 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LAifr, J ;L2 ria -,• 0 9 0 0 000000 — — ---- Reset �_o+» _afw -��� _-- -- ------------ _ _ 0 0 0 000000 ®_ _ O O O O _- , 000000 Resat _ O O O 0 _. ..... 000000 Page ferns 0 O O O 0 0 O 0 0 0 0 0 0 Add aonnPage F — — — -- ramalmNr�dln.ip.Im ui nFmm+ne wuu•e4.grow,cwr.mi!v.AJ lata aawo:nr,wn lr y.+N,mr.mwtw, Ba foram rraneWrlrrose rotYsbita Sun�eABe(Form 3WASMbra You PON n. � [' ` a - (1) 12) (3) 14) IS) t8) City of Round Rock,Texas Contract Forms Standard Form of Agreement: Section 00500 City of Round Rock, Texas Standard Form of Agreement between Owner and Contractor AGREEMENT made as of the ( )day of ZhAbgr in the year 2024. BETWEEN the Owner: City of Round Rock,Texas(hereafter"Owner"or"City") 221 East Main Street Round Rock,Texas 78664 and the Contractor Cutler Repaving,Inc. ("Contractor") 921 E.27th St Lawrence,KS 66046 The Project is described as: 2023 Arterial Street Maintenance Program The Engineer is: Matthew Bushak,P.E. City of Round Rock mbushak a,roundrocktexas.gov 512-341-3318 For and in consideration of the mutual terms, conditions and covenants of this Agreement and all accompanying documents between Owner and Contractor, the receipt and sufficiency of which are hereby acknowledged,Owner and Contractor agree as follows: ARTICLE i THE CONTRACT DOCUMENTS The Contract Documents consist of this Agreement,Conditions of the Contract(General,Supplementary and other Conditions),Drawings,Specifications,Addenda issued prior to execution of this Agreement,other documents listed in this Agreement and Modifications issued after execution of this Agreement;these form the Contract,and are as fully a part of the Contract as if attached to this Agreement or repeated herein.The Contract represents the entire and integrated agreement between the parties hereto and supersedes prior negotiations,representations or agreements, either written or oral.An enumeration of the Contract Documents,other than Modifications,appears in Article 7. ARTICLE 2 THE WORK OF THIS CONTRACT Contractor shall fully execute the Work described in the Contract Documents,except to the extent specifically indicated in the Contract Documents to be the responsibility of others. 00500 42020 Page I of 5 Standard Form of Agrcement 00443647 ARTICLE 3 DATE OF COMMENCEMENT;DATE OF SUBSTANTIAL COMPLETION;DATE OF FINAL COMPLETION 3.1 The date of commencement of the Work shall be the date of this Agreement unless a different date is stated below or provision is made for the date to be fixed in a Notice to Proceed issued by Owner. 3.2 The Contract Time shall be measured from the date delineated in the Notice to Proceed. 3.3 Contractor shall commence Work within tenlam) calendar days from the date delineated in the Notice to Proceed. 3.4 Contractor shall achieve Substantial Completion of the items of Work listed on Attachment A to this Agreement no later than n/a ( n/a )calendar days from issuance by Owner of Notice to Proceed, and Contractor shall achieve Substantial Completion of the entire Work no later than one hundred twenty 1( 20 )calendar days from issuance by Owner of Notice to Proceed, subject to adjustments of this Contract Time as provided in the Contract Documents. 3.5 If Contractor fails to achieve Substantial Completion of the Work(or any portion thereof)on or before the date(s)specified for Substantial Completion in the Agreement,Contractor shall pay to Owner,as liquidated damages, the sum of one thousand and No/100 Dollars($ 1,000 ) for each calendar day that Substantial Completion is delayed after the date(s) specified for Substantial Completion. It is hereby agreed that the liquidated damages to which Owner is entitled hereunder are a reasonable forecast of just compensation for the harm that would be caused by Contractor's failure to achieve Substantial Completion of the Work(or any portion thereof)on or before the date(s)specified for Substantial Completion in the Agreement and is not a penalty. It is agreed that the harm that would be caused by such failure, which includes loss of expected use of the Project areas,provision of alternative storage facilities and rescheduling of moving and occupancy dates,is one that is incapable or very difficult of accurate estimation.It is hereby agreed that if Substantial Completion of the Work(or any portion thereof)is not achieved on or before thirty(30)days after the date(s) specified for Substantial Completion in the Agreement, the Owner shall have the option to either collect liquidated damages as set forth herein or to thereafter rely on its remedies under the Contract Documents and at law and in equity, including without limitation, the recovery of actual damages. The date(s) specified for Substantial Completion of the Work(or any portion thereof) in the Agreement shall be subject to adjustment as provided in the Contract Documents. 3.6 Contractor shall achieve Final Completion of the entire Work no later than one hundred fifty ( 150 )calendar days from issuance by Owner of Notice to Proceed. ARTICLE 4 CONTRACT SUM 4.1 Owner shall pay Contractor the Contract Sum in current funds for Contractor's full and complete performance of the Work and all of Contractor's obligations under this Agreement. The Contract Sum shall be Three million five hundred thirty-five thousand eight hundred eighty dollars and fifty-five cents ($3,535,880.55 ),subject to additions and deductions as provided in the Contract Documents. 4.2 Does the Contract Sum include alternates which are described in the Bid Form? No . Yes X .If yes,please provide details below: See Bid Form 00500 42020 Page 2 of 5 Standard Fonn of Ag ccmcnt 00443647 ARTICLE 5 PAYMENTS 5.1 PROGRESS PAYMENTS 5.1.1 Based upon Applications for Payment submitted to Engineer and Owner by Contractor,and Certificates for Payment issued by Engineer and not disputed by Owner and/or Owner's lender,Owner shall make progress payments on account of the Contract Sum to Contractor as provided below, in Article 14 of the General Conditions, and elsewhere in the Contract Documents. 5.1.2 The period covered by each Application for Payment shall be one calendar month ending on the last day of the month. 5.13 Provided that an Application for Payment is received by Engineer and Owner, and Engineer issues a Certificate of Payment not later than the tenth(10th) day of a month,Owner shall make payment to Contractor of amounts approved by the Owner not later than the tenth(10th)day of the next month.If an Application for Payment is received by Engineer and Owner after the application date fixed above,payment shall be made by Owner not later than one month after the Engineer issues a Certificate for Payment.The Owner shall not have any obligation to pay any amount covered by the Engineer's Certificate for Payment that is disputed by the Owner. 5.1.4 Each Application for Payment shall be based on the most recent schedule of values submitted by Contractor in accordance with the Contract Documents.The schedule of values shall allocate the entire Contract Sum among the various portions of the Work. The schedule of values shall be prepared in such form and supported by such data to substantiate its accuracy as Engineer and Owner may require.This schedule,unless objected to by Engineer or Owner, shall be used as a basis for reviewing Contractor's Applications for Payment. 5.1.5 Applications for Payment shall warrant the percentage of completion of each portion of the Work as of the end of the period covered by the Application for Payment. 5.1.6 Subject to other provisions of the Contract Documents, the amount of each progress payment shall be computed as provided in Article 14 of the General Conditions. 5.1.7 Except with Owner's prior written approval, Contractor shall not make advance payments to suppliers for materials or equipment which have not been delivered and stored at the site. 5.2 FINAL PAYMENT 5.2.1 Final payment, constituting the entire unpaid balance of the Contract Sum, shall be made by Owner to Contractor when: .1 Contractor has fully performed the Contract except for Contractor's responsibility to correct Work, and to satisfy other requirements,if any,which extend beyond final payment;and .2 a final Certificate for Payment has been issued by Engineer and approved by the Owner. 5.2.2 Owner's final payment to Contractor shall be made no later than thirty (30) days after the issuance of Engineer's final Certificate for Payment. In no event shall final payment be required to be made prior to thirty(30) days after all Work on the Contract has been fully performed.Defects in the Work discovered prior to final payment shall be treated as non-conforming Work and shall be corrected by Contractor prior to final payment,and shall not be treated as warranty items. ARTICLE 6 TERMINATION OR SUSPENSION 6.1 The Contract may be terminated by Owner or Contractor as provided in Article 15 of the General Conditions. 00500 42020 Page 3 of 5 Standard Form of Agrecmcnt 00443647 6.2 The Work may be suspended by Owner as provided in Article 15 of the General Conditions. ARTICLE 7 ENUMERATION OF CONTRACT DOCUMENTS 7.1 The Contract Documents,except for Modifications issued after execution of this Agreement,are enumerated as follows: 7.1.1 The Agreement is this executed version of the City of Round Rock, Texas Standard Form of Agreement between Owner and Contractor,as modified. 7.1.2 The General Conditions are the "City of Round Rock Contract Forms 00700," General Conditions, as modified. 7.1.3 The Supplementary,Special,and other Conditions of the Contract are those contained in the Project Manual dated August 2024 7.1.4 The Specifications are those contained in the Project Manual dated Auiust 2024 7.1.5 The Drawings,if any,are those contained in the Project Manual dated August 2024 7.1.6 The Insurance&Construction Bond Forms of the Contract are those contained in the Project Manual dated August 2024 7.1.7 The Notice to Bidders,Instructions to Bidders,Bid Form,and Addenda,if any,are those contained in the Project Manual dated August 2024 7.1.8 If this Agreement covers construction involving federal funds, thereby requiring inclusion of mandated contract clauses, such federally required clauses are those contained in the "City of Round Rock Contract Forms 03000,"Federally Required Contract Clauses,as modified. 7.1.9 Other documents,if any,forming part of the Contract Documents are as follows: All A ARTICLE 8 MISCELLANEOUS PROVISIONS 8.1 Where reference is made in this Agreement to a provision of any document, the reference refers to that provision as amended or supplemented by other provisions of the Contract Documents. 8.2 Owner's representative is: Reuben Ramirez,PMP City of Round Rock rramirez(a,)roundrocktexas.gov (512)218-7084 8.3 Contractor's representative is: Charles R.(Bob)Veskerna Cutler Repaving,Inc. bveskemana,cutlerrepaving.com 785-843-1524 8.4 Neither Owner's nor Contractor's representative shall be changed without ten(10)days'written notice to the other party. 00500 42020 Page 4 of 5 Standard Fonn of Agrccmcnt 00443647 8.5 Waiver of any breach of this Agreement shall not constitute waiver of any subsequent breach. 8.6 Owner agrees to pay Contractor from available funds for satisfactory performance of this Agreement in accordance with the bid or proposal submitted therefor,subject to proper additions and deductions,all as provided in the General Conditions, Supplemental Conditions,and Special Conditions of this Agreement, and Owner agrees to make payments on account thereof as provided therein. Lack of funds shall render this Agreement null and void to the extent funds are not available. This Agreement is a commitment of City of Round Rock's current revenues only. 8.7 Although this Agreement is drawn by Owner,both parties hereto expressly agree and assert that,in the event of any dispute over its meaning or application,this Agreement shall be interpreted reasonably and fairly,and neither more strongly for nor against either party. 8.8 This Agreement shall be enforceable in Round Rock,Texas,and if legal action is necessary by either party with respect to the enforcement of any or all of the terms or conditions herein,exclusive venue for same shall lie in Williamson County,Texas. This Agreement shall be governed by and construed in accordance with the laws and court decisions of the State of Texas. 8.9 Both parties hereby expressly agree that no claims or disputes between the parties arising out of or relating to this Agreement or a breach thereof shall be decided by an arbitration proceeding,including without limitation,any proceeding under the Federal Arbitration Act(9 USC Section 1-14)or any applicable state arbitration statute. 8.10 The parties, by execution of this Agreement, bind themselves, their heirs, successors, assigns, and legal representatives for the full and faithful performance of the terms and provisions hereof. This Agreement is entered into as of the day and year first written above and is executed in at least two(2) original copies,of which one is to be delivered to Owner. OWNER CONTRACTOR CITY ROUIJD ROC TEXAS Cutler Repaving,Inc. t o,� Printed N e: Printed Name:Charles R.Veskerna Title Title: President Date Signed: if La Date Signed: October 31,2024 ATT : 6" City Clerk FOR CIT APPROVED AS TO FORM: tt mey 00500 4-2020 Page 5 of 5 Standard Form of Agrccmcnt 00443647 Bond No. 674224593 PERFORMANCE BOND THE STATE OF TEXAS § § KNOW ALL BY THESE PRESENTS: COUNTY OF WILLIAMSON § That Cutler Repaving, Inc. , of the City of Lawrence , County of Douglas , and State of Kansas , as Principal, and Liberty Mutual Insurance Company authorized under the law of the State of Texas to act as surety on bonds for principals, are held and firmly bound unto the CITY OF ROUND ROCK,TEXAS (Owner), in the penal sum of Three million five hundred thirty-five thousand eight hundred eighty dollars and fifty-five cents Dollars ($3,535,880.55 ) for the payment whereof, well and truly to be made the said Principal and Surety bind themselves, and their heirs, administrators, executors, successors and assigns,jointly and severally,by these presents: WHEREAS, the Principal has entered into a certain written Agreement with the Owner dated the day of ,20X to which the Agreement is hereby referred to and made a part hereof as fully and to the same extent as if copied at length herein consisting of: 2023 Arterial Street Maintenance Program NOW, THEREFORE, THE CONDITIONS OF THIS OBLIGATION IS SUCH, that if the said Principal shall faithfully perform said Agreement and shall, in all respects, duly and faithfully observe and perform all and singular the covenants, conditions and agreements in and by said Agreement, agreed and covenanted by the Principal to be observed and performed, including but not limited to, the repair of any and all defects in said work occasioned by and resulting from defects in materials furnished by or workmanship of,the Principal in performing the Work covered by said Agreement and occurring within a period of twelve (12) months from the date of Final Completion and all other covenants and conditions, according to the true intent and meaning of said Agreement and the Plans and Specifications hereto annexed,then this obligation shall be void; otherwise to remain in full force and effect; PROVIDED, HOWEVER, that this bond is executed pursuant to the provisions of Chapter 2253, Texas Government Code, as amended, and all liabilities on this bond shall be determined in accordance with the provisions of said Chapter 2253 to the same extent as if it were copied at length herein. Page 1 00610 4-2020 Performance Bond 00443639 PERFORMANCE BOND (continued) Surety, for value received, stipulates and agrees that no change, extension of time, alteration or addition to the terms of the Agreement, or to the Work performed thereunder, or the Plans, Specifications, or drawings accompanying the same, shall in anywise affect its obligation on this bond,and it does hereby waive notice of any such change, extension of time,alteration or addition to the terms of the Agreement, or to the work to be performed thereunder. If Principal fails to faithfully perform said Agreement, Surety, after receipt of written notice of Principal's default,shall perform all of Principal's duties and obligations under the Agreement. If, within ten (10) days after receipt of such notice from Owner, Surety does not commence to complete the obligations of Principal with a contractor acceptable to Owner and diligently complete the performance of the Principal's duties and obligations, Owner shall have the right but not the obligation to have the duties and obligations of Principal performed. In such event, Surety shall pay to Owner,upon demand,all costs,expenses and damages sustained by Owner as a result of Principal's failure to perform its duties and obligations under the Agreement up to the $3,535,880.55 sum of this Performance Bond, plus all costs and expenses, including attorney's fees and expert and consultant fees incurred by Owner to enforce its rights under this Performance Bond. IN WITNESS WHEREOF, the said Principal and Surety have signed and sealed this instrument this 5+h day of NOV{►yt b(,1/ , 20 . Cutler Repaving,Inc. Liberty Mutual Insurance Company Principal Surety Charles R.Veskema Alycia Marie Hoebener Printed N e Printed Name By: By: Title: President Title: Att ey-in-Fact Address:921 E. 27th Street Address: 175 Berkeley Street Lawrence,KS 66046 Boston,MA Resident Agent of Surety: Signatu l Alycia Marie Hoebener Printed Name 430 E. Douglas Ave, Ste 400 Street Address Wichita,KS 67202 City, State&Zip Code Page 2 00610 4-2020 Performance Bond 00443639 Bond No. 674224593 PAYMENT BOND THE STATE OF TEXAS § § KNOW ALL MEN BY THESE PRESENTS: COUNTY OF WILLIAMSON § That Cutler Repaving,Inc , of the City of Lawrence , County of Douglas , and State of Kansas , as Principal, and Liberty Mutual Insurance Company authorized under the laws of the State of Texas to act as Surety on Bonds for Principals,are held and firmly bound unto the CITY OF ROUND ROCK, TEXAS (OWNER), and all subcontractors, workers, laborers, mechanics and suppliers as their interest may appear, all of whom shall have the right to sue upon this bond, in the penal sum of Three million five hundred thirty-five thousand eight hundred eighty dollars and fifty-five cents Dollars($ 3,535,880.55 )for the payment whereof,well and truly be made the said Principal and Surety bind themselves and their heirs, administrators, executors, successors, and assigns,jointly and severally,by these presents: WHEREAS,the Principal has entered into a certain written Agreement with the Owner,dated the (4:11- day of t)aRAdkg r , 20A to which Agreement is hereby referred to and made a part hereof as fully and to the same extent as if copied at length herein consisting o£ 2023 Arterial Street Maintenance Program NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, that if the said Principal shall well and truly pay all subcontractors, workers, laborers, mechanics, and suppliers, all monies to them owing by said Principals for subcontracts,work,labor,equipment, supplies and materials done and furnished for the construction of the improvements of said Agreement, then this obligation shall be and become null and void; otherwise to remain in full force and effect. PROVIDED, HOWEVER, that this bond is executed pursuant to the provisions of Chapter 2253, Texas Government Code, as amended, and all liabilities on this bond shall be determined in accordance with the provisions of said Chapter 2253 to the same extent as if it were copied at length herein. Page 1 00620 04-2020 Paymcnt Bond 00437699 PAYMENT BOND (continued) Surety, for value received, stipulates and agrees that no change, extension of time, alteration or addition to the terms of the Agreement, or to the Work performed thereunder, or the plans, specifications or drawings accompanying the same shall in anywise affect its obligation 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 to be performed thereunder. IN WITNESS WHEREOF, the said Principal and Surety have signed and sealed this Instrument this 5+'*, day of NU VQr be v- , 20Z4. Cutler Repaving,Inc. Liberty Mutual Insurance Company Principal Surety Charles R.Veskema Alycia Marie Hoebener Printed a Printed Name By: By: Title: president Title• tto y-id-"Fac t Address:921 E. 27th Street Address: 175 Berkeley Street Lawrence,KS 66046 Boston, MA 02116 _ Resident Agent of Surety: Signatur Alycia Marie Hoebener Printed Name 430 E. Douglas, Ste 400 Street Address Wichita, KS 67202 City, State&Zip Code Page 2 006201-2020 Payment Bond 00090656 This Power of Attorney limits the acts of those named herein,and they have no authority to bind the Company except in the manner and to the extent herein stated. Liberty Liberty Mutual Insurance Company Mutual. The Ohio Casualty Insurance Company Certificate No:8211287-674007 SURETY West American Insurance Company POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS:That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire,that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts,and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana(herein collectively called the"Companies'),pursuant to and by authority herein set forth,does hereby name,constitute and appoint, Desiree E. Westmoreland;Myriah A.Anderson;Timothy C.Smith,Todd Alan Rambo;Clara R.Navarro Abela;Alycia Marie Hoebener all of the city of Wichita state of KS each individually if there be more than one named,its true and lawful attorney-in-fact to make, execute,seal,acknowledge and deliver,for and on its behalf as surety and as its act and deed,any and all undertakings,bonds,recognizances and other surety obligations,in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF,this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 31 st day of January 2024 Liberty Mutual Insurance Company \Nsup qtr INS6 \Nsugq The Ohio Casualty Insurance Company AJp 4oavoRgr 92c yJP`oaPo2gr 9y Gp•�oNPokgr y° West American Insurance Company J = Fo fo Q = 1912 0 0 1919 0 1991 0 �//1 ° l/ d�SS4cNu5da ° �NAMPSt�da3 `!s �NOIANP aa� C ��� • >`� Hyl * �� ''M • l,� By: w David M.Carey,Assistant Secretary co State of PENNSYLVANIA Q@ g County of MONTGOMERY ss ttt555 On this 31 st day of January 2024 before me personally appeared David M.Carey,who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance Company,The Ohio Casualty Company,and West American Insurance Company,and that he,as such,being authorized so to do,execute the foregoing instrument for the purposes _ > therein contained by signing on behalf of the corporations by himself as a duly authorized officer. y� � t_7 IN WITNESS WHEREOF,I have hereunto subscribed my name and affixed my notarial seal at Plymouth Meeting,Pennsylvania,on the day and year first above written. •— o yp PAS, 4i MpN WF F< Commonwealth of Pennsylvania-Notary Seal N tiQ p9(i v Teresa Paslella,Notary Public Q N OF Montgomery County My commission expires March 28,2025 By Commission number 1126434 Qj L NgyINP \G Member,Pennsylvania Association of Notaries Teresa Pastella,Notary Public 0)to �ARy IPU�� M N o This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company,Liberty Mutual Insurance ECompany,and West American Insurance Company which resolutions are now in full force and effect reading as follows: "Y ARTICLE IV-OFFICERS:Section 12.Power of Attorney. Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President,and subject to such limitation as the Chairman or the President b 6 c may prescribe,shall appoint such attomeys-in-fact,as may be necessary to act in behalf of the Corporation to make,execute,seal,acknowledge and deliver as surety any and all CD > N undertakings,bonds,recognizances and other surety obligations.Such attomeys-in-fact,subject to the limitations set forth in their respective powers of attomey,shall have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation.When so executed,such instruments shall Z be as binding as if signed by the President and attested to by the Secretary.Any power or authority granted to any representative or attomey-in-fact under the provisions of this article may be revoked at any time by the Board,the Chairman,the President or by the officer or officers granting such power or authority. ARTICLE XIII-Execution of Contracts:Section 5.Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president,and subject to such limitations as the chairman or the pmsidant may pra:chbe, shall appoint such attorneys-in-fact,as may be necessary to act in behalf of the Company to make,execute,seal,acknowledge and deliver t;s sure;any and all undertakings, bonds,recognizances and other surety obligations.Such attomeys-in-fact subject to the limitations set forth in their respective powers of aCor Ry,shall have ft41 power to b?nd the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company.When so executed such instRrments shali be as biriding as if signed by the president and attested by the secretary. Certificate of Designation-The President of the Company,acting pursuant to the Bylaws of the Company,authorizes David M.Carey,Assistant Secretary to appoint such aeomeys-ir,- fact as may be necessary to act on behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings,bends,recognizznces omd other surety obligations. Authorization-By unanimous consent of the Company's Board of Directors,the Company consents that facsimile or mechanically reproduced signature of any assistant secreiary of the Company,wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds,shall be valid and binding upon the Company with the same force and effect as though manually affixed. I,Renee C.Llewellyn,the undersigned,Assistant Secretary,The Ohio Casualty Insurance Company,Liberty Mutual Insurance Company,and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full,true and correct copy of the Power of Attorney executed by said Companies,is in full force and effect and has not been revoked. }h IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this day of \NSU.0 "SY INS& \Ns1J,0 jP'40 P4Teyctn QJP'G&Pop,,r••qy� P40 OP4-r + 3 s 3 1912 0 1919 7u 1991 : ry p a 3B y �,�'sS4cNus��ds y° Mvsdam �S �NDIANP ,da Renee C.Llewellyn,Assistant Secretary LMS-12873 LMIC CCIC WAIC Multi Co 02/21 IMA CONSIDER IT DONE PLEASE NOTE: None of the attached bonds or powers-of-attorney have been dated as the contract copy provided did not contain a contract date. Once the contract has been dated, it is important that the same date be inserted onto each bond and each power of attorney wherever a date is requested. Please notify IMA of the contract date once known. Thank you. Alycia Marie Hoebener Surety Account Manager IMA Bond Department (316) 266-6343 P: 316.267.9221 IMA of Kansas, Inc. RISK MANAGEMENT, INSURANCE 8T F: 316.266.6254 P.O.Wichita 2992 IEMPLOYEE BENEFITS SOLUTIONS Wichita KS Kansa s www.imacorp.com dba IMA of Kansas Insu ro nce Services AFFILIATIONS:ASSUREX INTERSURE California Lic M OD28748 1/22/24,3:58 PM Sircon Platform OF I � 1 � a I P � � PXA General Lines Agent Qualification Effective Dates Property and Casualty 01/17/2024 ALYCIA MARIE HOEBENER NPN: 20762423 13300 W MACARTHUR RD WICHITA, KS 67227 is authorized to transact business as described above License No: 3121930 Issue Date: 01/17/2024 Expiration Date: 11/30/2026 Generated by Sircon 312850465 TEXAS J;41 oF� IS HEREBY AUTHORIZED TO TRANSACT BUSINESS IN ACCORDANCE TO THE LICENSE DESCRIPTION SHOWN BELOW: DEPARTMENT OF INSURANCE yy�� THIS IS TO CERTIFY THAT rex�s General Lines Agent ALYCIA MARIE HOEBENER Property and Casualty 13300 W MACARTHUR RD WICHITA,KS 67227 Issue Date:01/17/2024 Expiration Date:11/30/2026 LICENSE NUMBER:3121930 NPN:20762423 Generated by Sircon 312850465 https://platform.sircon.com/#/license-print 1/1 Liberty Mu_ tu,l SURETY TEXAS TEXAS IMPORTANT NOTICE AVISO IMPORTANTE To obtain information or make a complaint: Para obtener informacion o para someter una queja: You may call toll-free for information or to Usted puede llamar al numero de telefono gratis make a complaint at para informacion o para someter una queja al 1-877-751-2640 1-877-751-2640 You may also write to: Usted tambien puede escribir a: 2200 Renaissance Blvd., Ste.400 2200 Renaissance Blvd., Ste. 400 King of Prussia, PA 19406-2755 King of Prussia, PA 19406-2755 You may contact the Texas Department of Puede comunicarse con el Departamento de Insurance to obtain information on companies, Seguros de Texas para obtener informacion coverages,rights or complaints at acerca de companias, coberturas, derechos o 1-800-252-3439 quejas al 1-800-252-3439 You may write the Texas Department of Insurance Puede escribir al Departamento de Seguros Consumer Protection(111-1 A) de Texas Consumer Protection(111-1 A) P. O. Box 149091 P. O. Box 149091 Austin, TX 78714-9091 Austin,TX 78714-9091 FAX: (512)490-1007 FAX#(512)490-1007 Web: htty://www.tdi.texas.gov Web: htty://www.tdi.texas.gov E-mail: ConsumerProtection(a,tdi.texas.gov E-mail: ConsumerProtectionna,tdi.texas.gov PREMIUM OR CLAIM DISPUTES: DISPUTAS SOBRE PRIMAS O RECLAMOS: Should you have a dispute concerning your Si tiena una disputa concerniente a su prima o a premium or about a claim you should first contact un reclamo, debe comunicarse con el agente o the agent or call 1-800-843-6446. primero. Si no se resuelve la disputa, puede If the dispute is not resolved, you may contact the entonces comunicarse con el departamento (TDI) Texas Department of Insurance. ATTACH THIS NOTICE TO YOUR UNA ESTE AVISO A SU POLIZA: POLICY: This notice is for information only and does not Este aviso es solo para proposito de informacion y become a part or condition of the attached no se convierte en parte o condicion del document. documento adjunto. NP 70 68 09 01 LMS-15251 10115 IN so�T�. w p obd /r' The Surety S Fidelity FST 704' Association of America Resident Agent Countersignature Laws Have Been Eradicated and Violate the Law in Every U.S.State The purpose of this short white paper is to inform the reader that resident agent countersignature laws have been eradicated throughout the United States and its territories(with the exception of Guam, where it has not been challenged). Any bid, performance, or payment bond that requires a resident agent countersignature or a resident agent signature violates the law, as such requirements have been held unconstitutional by federal courts throughout the United States and have been repealed by state legislatures.Such requirements impermissibly favor licensed resident agents over licensed non-resident agents. It is not the countersignature requirement that is problematic; it is the requirement that the countersignature must be that of a resident agent that violates the law. The National Association of Surety Bond Producers(NASBP)and the Surety& Fidelity Association (SFAA) are aware that officials in some state and local agencies are not informed about the illegality of resident agent countersignature mandates.These officials will improperly reject a bid based on lack of a required resident agent countersignature or improperly refuse to accept performance and payment bonds based on lack of a required resident agent countersignature. NASBP and SFAA receive dozens of member requests each year to send comment letters to public agencies that have included the unlawful resident agent countersignature requirement in their surety bonds. Countersignature laws date back to the early twentieth century when states passed the laws as a consumer protection measure.The regulations requiring non-resident agents to receive sign-off by a local resident agent were originally intended to ensure compliance with local insurance laws.Those regulations also meant that out-of-state agents had to pay local agents for their signatures. By the 1990s,technology made the countersignature laws an anachronism of regulation.The movement to repeal countersignature laws began in the 1990s and ended in 2008 when the Ninth Circuit struck down Nevada's countersignature law.This movement was spearheaded by The Council of Insurance Agents& Brokers. One of the most well-known cases on this matter is Council of Insurance Agents and Brokers v. Tom Gallagher, 287 F. Supp. 2d 1302(N.D. Fla. 2003), in which the U.S. District Court for the Northern District of Florida struck down a Florida statute that impermissibly favored resident agents.The district court determined that there was no rational basis for a distinction between properly licensed resident agents and non-resident agents and declared unconstitutional the Florida statute at issue that discriminated against Florida-licensed non-resident agents. Members may want to have the bond forms reviewed to ensure that the bonds do not contain an illegal resident agent signature or countersignature requirement.To clarify, it is permissible for bond forms to contain a licensed (resident OR non-resident)agent countersignature requirement,just not that it be a resident agent. Since an earlier version of this white paper was first released in October 2018, there has been confusion about the ambit of the term "resident agent" in this white paper.The term "resident agent" in this context refers to resident insurance agents--and NOT to resident agents for purposes of service of process. December 2019 Page 1 of 1 __--104111 CUTLREP-02 MSTONE ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)10/31/2024 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 INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Johnston Fiss Insurance PHONE FAX 5225 W.75th Street,Suite 200 (AIC,No,Ext):(913)396-0800 (A/c, NNo):(913)396-0835 Shawnee Mission,KS 66208 E-MAIL .insurance@johnstonfiss.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Cincinnati Casualty Company 28665 INSURED INSURER B:WAYPOINT MUTUAL 13126 Cutler Repaving,Inc. INSURER C:Hartford Fire Insurance Company 19682 Attn: Bob Veskerna 921 E.27th Street INSURER D Lawrence,KS 6604 6-4 91 7 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS 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, TERM 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1'000'000 CLAIMS-MADE a OCCUR X EPP 0584980 8/1/2024 8/1/2025 DAMAGE TO RENTED 500,000 $ MED EXP(Any oneperson) $ 10'000 PERSONAL&ADV INJURY $ 1'000'000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY LX JECT F-1 LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ A COMBINED SINGLE LIMIT 1,000,000 AUTOMOBILE LIABILITY Ea acadent $ X ANY AUTO EPP 0584980 8/1/2024 8/1/2025 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY ASUTryOSyyNEp BODILY INJURY Per accident $ AUTOS ONLY ARa ONLY P�� Rd nt AMAGE $ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5'000'000 EXCESS LIAB CLAIMS-MADE EPP 0584980 8/1/2024 8/1/2025 AGGREGATE $ 5,000,000 DED I I RETENTION$ B WORKERS COMPENSATION X PEROTH- AND EMPLOYERS'LIABILITY ER WC100-0003848-2024A 8/1/2024 8/1/2025 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT $ QFFI d ry�n BES EXCLUDED9 NIA 1,000,000 (Mandato NH E.L.DISEASE-EA EMPLOYEE $ If es,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C Pollution 37CPIID5211 8/1/2024 8/1/2025 Limit 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Re:2023 Arterial Street Maintenance Program City of Round Rock is named as additional insured as respects liability and if required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Ci Of Round Rock THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City ACCORDANCE WITH THE POLICY PROVISIONS. 3400 Sunrise Road Round Rock,TX 78665 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD