HomeMy WebLinkAbout18-20 RESOLUTIONF FAYETT
gRKANS PSPS
113 West Mountain Street
Fayetteville, AR 72701
(479)575-8323
Resolution: 18-20
File Number: 2019-0902
EMERGENCY VEHICLE SPECIALISTS, INC. BOND PROJECT:
A RESOLUTION TO APPROVE THE PURCHASE OF A 2020 PIERCE IMPEL FIRE ENGINE
APPARATUS FROM EMERGENCY VEHICLE SPECIALISTS, INC. IN THE AMOUNT OF
$629,244.00 PLUS A PERFORMANCE AND PAYMENT BOND AT A COST OF $1,790.00,
PURSUANT TO A HOUSTON-GALVESTON AREA COUNCIL COOPERATIVE PURCHASING
CONTRACT, TO APPROVE A PROJECT CONTINGENCY IN THE AMOUNT OF $65,000.00, AND TO
APPROVE A BUDGET ADJUSTMENT
WHEREAS, the Fire Department needs to replace Unit 33, a 2004 E-1 Cyclone II Ladder Apparatus,
based on the recommendation of the Fleet Division; and
WHEREAS, the City will receive a pre -pay discount of $20,771.00 in exchange for the purchase of a
performance and payment bond at a cost of $1,790.00 and a good customer discount of $9,163.69 which
will allow the City to receive a net total discount of $28,144.69.00; and
WHEREAS, the Fire Department recommends the purchase of a 2020 Pierce Impel Fire Engine
Apparatus from Emergency Vehicle Specialists, Inc.
NOW, THEREFORE BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF
FAYETTEVILLE, ARKANSAS:
Section 1: That the City Council of the City of Fayetteville, Arkansas hereby approves the purchase of
a 2020 Pierce Impel Fire Engine Apparatus from Emergency Vehicle Specialists, Inc. in the amount of
$629,244.00 plus a performance and payment bond at a cost of $1,790.00 pursuant to a Houston -
Galveston Area Council cooperative purchasing contract, approves a project contingency in the amount of
$65,000.00, and authorizes Mayor Jordan to sign any contract or other document to
Page 1 Printed on 119120
File Number. 2019-0902
Resolution 18-20
execute and pay for this approved contract.
Section 2: That the City Council of the City of Fayetteville, Arkansas hereby approves a budget
adjustment, a copy of which is attached to this Resolution.
PASSED and APPROVED on 1/7/2020
Attest:
%VER K
����.• UTVO�•9J;
Kara Paxton, City Clerk Treast �_
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Page 2 Printed on 119120
OFF�P/'Y`'E TTS of
Arkansas
Text FileFile
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Agenda Date: 1/7/2020
Version: 1
113 West Mountain Street
Fayetteville, AR 72701
(479) 575-8323
Status: Passed
In Control: City Council Meeting File Type: Resolution
Agenda Number: C. 2
EMERGENCY VEHICLE SPECIALISTS, INC. BOND PROJECT:
A RESOLUTION TO APPROVE THE PURCHASE OF A 2020 PIERCE IMPEL FIRE ENGINE
APPARATUS FROM EMERGENCY VEHICLE SPECIALISTS, INC. IN THE AMOUNT OF
$629,244.00 PLUS A PERFORMANCE AND PAYMENT BOND AT A COST OF $1,790.00,
PURSUANT TO A HOUSTON-GALVESTON AREA COUNCIL COOPERATIVE PURCHASING
CONTRACT, TO APPROVE A PROJECT CONTINGENCY IN THE AMOUNT OF $65,000.00, AND
TO APPROVE A BUDGET ADJUSTMENT
WHEREAS, the Fire Department needs to replace Unit 33, a 2004 E-1 Cyclone II Ladder Apparatus, based
on the recommendation of the Fleet Division; and
WHEREAS, the City will receive a pre -pay discount' of $20,771.00 in exchange . for the purchase of a
performance and payment bond at a cost of $1,790.00 and a good customer discount of $9,163.69 which will
allow the City to receive a net total discount of $28,144.69.00; and
WHEREAS, the Fire Department recommends the purchase of a 2020 Pierce Impel Fire Engine Apparatus
from Emergency Vehicle Specialists, Inc.
NOW, THEREFORE BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF
FAYETTEVILLE, ARKANSAS:
Section 1: That the City Council of the City of Fayetteville, Arkansas hereby approves the purchase of a 2020
Pierce Impel Fire Engine Apparatus from Emergency Vehicle Specialists, Inc. in the amount of $629,244.00
plus a performance and payment bond at a cost of $1,790.00 pursuant to a Houston -Galveston Area Council
cooperative purchasing contract, approves a project contingency in the amount of $65,000.00, and authorizes
Mayor Jordan to sign any contract or other document to execute and pay for this approved contract.
Section 2: That the City Council of the City of Fayetteville, Arkansas hereby approves a budget adjustment, a
copy of which is attached to this Resolution.
City of Fayetteville, Arkansas Page 1 Printed on 1/8/2020
City of Fayetteville Staff Review Form
2019-0902
Legistar File ID
1/7/2020
City Council Meeting Date - Agenda Item Only
N/A for Non -Agenda Item
Brad Hardin 12/11/2019 FIRE (300)
Submitted By Submitted Date Division / Department
Action Recommendation:
Approval of a resolution to purchase a new engine fire apparatus for use by the Fayetteville Fire Department from
G & W Diesel/EVS through the Houston -Galveston Area Council (HGAC) Contract # FS12-19 Member #14-3975. The
purchase amount will be $629,244.00 plus the performance and payment bond cost of $1,790.00 for a total of
$631,034.00 using the bonded pre -pay net discount; Approval of a Contingency in the amount of $65,000; And
Approval of a Budget Adjustment.
4610.860.7150-5802.00
Account Number
46100.7150.6200
Project Number
Budgeted Item? Yes
Does item have a cost? Yes
Budget Adjustment Attached? Yes
Budget Impact:
Fire Project 2019 Bond
Fund
Fire Project 2019 Bonds - Fire Apparatus, Engine
6
Project Title
Current Budget
Funds Obligated
Current Balance
Item Cost
Budget Adjustment
Remaining Budget
$ 10,588,135.00
$ 612,203.18
$ 9,975,931.82
$ 696,034.00
$ 9,279,897.82
V20180321
Purchase Order Number: Previous Ordinance or Resolution #
Change Order Number: Approval Date:
Original Contract Number:
Comments: With approval of contingency funds of $65,000, the total funds needed will be $696,034. Bond Funds will be utilized for the
purchase. The Budget Adjustment will allocate the funds within the Fund of $696,034.
�"� CITY OF
WFAYETTEVILLE
4WARKANSAS
MEETING OF JANUARY 7, 2020
TO: Mayor and City Council
FROM: Brad Hardin, Fire Chief
DATE: December 11, 2019
CITY COUNCIL N'ENO
SUBJECT: Approval of a resolution to purchase a new engine fire apparatus for use by
the Fayetteville Fire Department; Approval of a Contingency in the amount of $65,000;
And Approval of a Budget Adjustment
RECOMMENDATION:
Approval of a resolution to purchase a new engine fire apparatus for use by the Fayetteville Fire
Department from G & W Diesel/EVS through the Houston -Galveston Area Council (HGAC)
Contract # FS12-19 Member #14-3975. The purchase amount will be $629,244.00 plus the
performance and payment bond cost of $1,790.00 for a total of $631,034.00 using the bonded
pre -pay net discount; Approval of a Contingency in the amount of $65,000; And Approval of a
Budget Adjustment.
BACKGROUND:
We will be replacing (fleet recommendation) unit #33, a 2004 E -One Cyclone II Apparatus. The
replacement will be a 2020 Pierce Impel Fire Engine Apparatus. The Fire Department's internal
equipment committee has spent almost a year in developing specifications to customize fire
trucks for Fayetteville's unique features such as narrow streets and mountainous terrain. This
makes it the best buy for the City. They have chosen this unit from Pierce Manufacturing
through G&W Diesel/EVS.
DISCUSSION:
The unit proposed for purchase is a 2020 Pierce Engine Apparatus. The truck is designed and
built to National Fire Protection Association (NFPA) 1901, Standard for Fire Apparatus. By
adhering to these standards, the Fire Department is assured of getting the necessary required
equipment.
Mailing Address:
113 W. Mountain Street www.fayetteville-ar.gov
Fayetteville, AR 72701
BUDGET/STAFF IMPACT:
The quote from G&W Diesel/EVS through the HGAC Contract # FS12-19 is for one Pierce Impel
Fire Engine Apparatus for $650,015.00 with pre -payment discount of $20,771.00 minus the cost
of $1,790.00 for the Performance and Payment Bond. This makes the amount $631,034.00.
With approval of contingency funds of $65,000, the total funds needed will be $696,034.00. The
Budget Adjustment will allow for funds in Fire Project 2019 Bonds—Fire Apparatus, Engine 6
46100.7150.6200. The approval of the Budget Adjustment will utilize Bond proceeds funding.
and allow for the purchase of the new fire apparatus in January to receive the discount price
before the February apparatus price increase. This will enable the discounted purchase to
occur.
ATTACHMENTS:
Purchasing Documentation; Budget Adjustment
2
Oshkosh Corporation Classification - Restricted.
CONTRACT PRICING WORKSHEET
InKaw For MOTOR VEHICLES Only
Contractj
No.: FS12-19
Date t
Prepared: 11/20/19
This Worksheet is prepared by Contractor and given to End User. If a PO is issued, both documents
MUST be faxed to H -GAC @ 713-993-4548. Therefore please type or print legibly.
Buying 1City of Fayetteville, Fire Dept
Agency:
y
contractor: :Emergency Vehicle Specilists
Contact :Willie Watts
Person: i.
Prepared JScott Jones
By: e
Phone: 1479-675-8365
Phone: '479-422-6800
Fax: i
Fax: t
Email: =wwatts(ZDfayeffMdRgtgLgov
.��: Wones gwevs.com
Product . FS19VC07
Code: i
Descr]ption: ; Pierce Enforcer, 4 Door Full Tilt Alum Cab, Alum Body, Single Axle, 1250 GPM Pump
. Product Item Base Unit Price Per Contractor's H -GAC Contract: $492,768.0
B. Published Options - Itemize below - Attach additional sheet(s) if necessary - Include Option Code in description if applicable.
(Note: Published Options are options which were submitted and priced in Contractor's bid.)
Description Cost Description 4 Cost
102 Add frame liner custom 1 $1,814.00 167 mirrors change to bus style cab comer $3,125.0
105 upgrade to 22800# front axle $2,175.00 175 Electric windows $2,093.0
109 Tak 4 Suspension $16,965.00 188 upgrade SCBA bracket to hands free x : $3,068.0
117 Tire Chains rear Axle $4,368.00 192 cab windows factory tint $504.00
128 Wheel chocks and mounts pgimpel r p ' $19,843.0
$96600 199 Upgrade enforcer to
.
129 Disc brakes front $1,247.00 208 Spare 12 volt power x 8 $952.00
140 Cummins L9 400h to 450h L9 - i $2,103.00 209 Radio Weatherband --- ,
P P $1 070.0
15l Aggressive Down Shift $143.00 212 Install customer MDT $1,041.0
i
159 Add Extended bumper $2,335.00 215 Install customer radio ¢ $947.0
:
164 Bumper equipment tray ' $2,135.00 222 camera system sides and rear $4,032.0
166 Linex bumper coating _ $417.00 Subtotal From Additional Sheet(s): 11 $84,963.0
174 Mounting plate on engine tunnel $505.00 Subtotal B: 1 $156,811.0
C. Unpublished Options - Itemize below / attach additional sheet(s) if necessary.
Description ! Cost Description = Cost
Subtotal From Additional Sheets . $0.0
i Subtotal C: $0.0
Check: Total cost of Unpublished Options (C) cannot exceed 25% of the total of the Base Unit'. For this transaction the percentage is:
Price plus Published Options (A+B).
O0
D. Total Cost Before Any Applicable Trade -In / Other Allowances / Discounts (A+B+C) 1
Quantity Ordered: 1 X Subtotal of A + B + C: 649579 11 IF -Subtotal D: 3 $_649,579.0
E. H -GAC Order Processing Charge (Amount Per Current Policy) .014778325 Subtotal E:: $9,599.6
F. Trade -Ins / Other Allowances / Special Discounts / Freight / Installation
----- -------- - -
Description i CostDescription ? Cost
Performance Bond _ $1,790.00 Aerial Pre -Payment Discount i
100% Pre -Payment Discount -$20,771.00 Good Customer Discount i -$9,163.69
1 Subtotal F._]_ -$28,144.69
Delivery Date: G. Total Purchase Price (D+E+F): 15631,034.00
PROPOSAL FOR FURNISHING FIRE APPARATUS
November 14, 2019
City of Fayetteville, AR Fire Department
The undersigned is prepared to manufacture for you, upon an order being placed by you, for final
acceptance by Emergency Vehicle Specialists, at its home office in Memphis, Tennessee, the apparatus and
equipment herein named and for the following prices:
One (1) Pierce Customer Pumper Impel Chassis Per Our Proposal $ 650,015.00
Prepay Discount (20,771.00)
Performance Bond 1,790.00
This price includes $60,000.00 In Loose Equipment or Truck Changes
Total Due With Check By 1-27-2020 Total $ 631,034.00
Said apparatus and equipment are to be built and shipped in accordance with the specifications hereto
attached, delays due to strikes, war, or intentional conflict, failures to obtain chassis, materials, or other causes
beyond our control not preventing, within about 9 months after receipt of this order and the acceptance thereof
at our office at Memphis,Tennessee, and to be delivered to you at 303 W Center St, Fayetteville, AR.
The specifications herein contained shall form a part of the final contract, and are subject to changes
desired by the purchaser, provided such alterations are interlined prior to the acceptance by the company of the
order to purchase, and provided such alterations do not materially affect the cost of the construction of the
apparatus.
The proposal for fire apparatus conforms with all Federal Department of Transportation (DOT) rules
and regulations in effect at the time of bid, and with all National Fire Protection Association (NFPA) Guidelines
for Automotive Fire Apparatus as published at the time of bid, except as modified by customer specifications.
Any increased costs incurred by first party because of future changes in or additions to said DOT or NFPA
standards will be passed along to the customers as an addition to the price set forth above.
Unless accepted within 60 days from date, the right is reserved to withdraw this proposition.
Emergency Vehicle Specialists, Inc.
By:
AUTHORIZED SALES REPRESENTATIVE
Scott Jones
EMERGENCY VEHICLE SPECIALISTS
1397
City of Fayetteville, Arkansas - Budget Adjustment Form (Legistar)
Budget Year Division Adjustment Number
/0rg2 FIRE (300)
2020 (BY)
Requestor: Kevin Springer
BUDGET ADJUSTMENT DESCRIPTION / JUSTIFICATION:
Approval of a resolution to purchase a new engine fire apparatus for use by the Fayetteville Fire Department from G &
W Diesel/EVS through the Houston -Galveston Area Council (HGAC) Contract # FS12-19 Member #14-3975. The purchase
amount will be $629,244.00 plus the performance and payment bond cost of $1,790.00 for a total of $631,034.00 using
the bonded pre -pay net discount; Approval of a Contingency in the amount of $65,000; And Approval of a Budget
Adjustment.
ICOUNCIL DATE: 1/7/2020
LEGISTAR FILE ID#: 2019-0902
KevLwSpr►.n#er
12/11/2019 3:36 PM
Budget Director Date
TYPE: D - (City Council)
JOURNAL #:
1/7/2020
RESOLUTION/ORDINANCE
I
GLDATE:
CHKD/POSTED:
TOTAL
Account Number
- -
Increase / (Decrease)
Expense Revenue
Proiect.Sub#
Project Sub.Detl AT
v.20191211
Account Name
4610.860.7150-5802.00
631,034 -
46100
7150.6200 EX
Vehicles & Equipment - base
4610.860.7150-5911.99
4610.860.7999-5899.00
65,000 -
(696,034) -
46100
46100
7150.6200 EX
7999 EX
Contingency - Capital Project
Unallocated - Budget
H:\Budget Adjustments\2020_Budget\City Council\01-07-2020\BA20 - 2019-0902 Fire Apparatus Bond.xlsm 1 of 1
Bond No. 9341111
Fidelity and Deposit Company of Maryland
HOME OFFICE
3910 KESWICK ROAD BALTIMORE, MARYLAND 21211
PERFORMANCE AND PAYMENT BOND
KNOW ALL MEN BY THESE PRESENTS, THAT, G & W Diesel Services, Inc. dba Emergency Vehicle Specialists
892 Kansas Memphis, TN 38106
Fidelity an epos)Company of Maryland
(hereinafter called Principal), as Principal and 1299 Zurich Way, 5th Floor, Schaumburg' IL 60196-1056
a corporation organized and existing under the laws of the State of IL with its principaloffice in the City of
Schaumburg, IL , (hereinafter called Surety) as Surety are held and firmly bound unto
City of Fayetteville
(hereinafter called the Owner) and to all persons who furnish labor or material directly to the Principal for use in
the prosecution of the work hereinafter named, in the just and full sum of Six Hundred Fifty Thousand
Fifteen Dollars and 00/100 Dollars (50,015.00 )
to the payment of which sum well and truly to be made, the said Principal and Surety bind themselves, and their
respective heirs, administrators, executors, successors and assigns, jointly and severally, firmly by these presents.
WHEREAS, the Principal has entered into a certain written contract with the Owner, dated the
day of , for One (1) Pierce Impel Pumper
which contract is hereby referred to and made a part hereof as fully and to the same extent as if copied at length
herein.
NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, that if the said Principal
shall fully indemnify the Owner from and against any failure on his/her part faithfully to perform the obligations
imposed upon him/her under the terms of said contract free and clear of all liens arising out of claims for labor
and material entering into the work, and if the said Principal shall pay all persons who shall have furnished labor
or material directly to the Principal for use in the prosecution of the aforesaid work, each of which said persons
shalt have a direct right of action on this instrument in his/her own name and for his/her own benefit, subject,
however, to the Owner's priority, then this obligation to be void; otherwise to remain in full force and effect.
PROVIDED, HOWEVER, that no action, suit or proceeding shall be had or maintained against the Surety on
this instrument unless the same be brought or instituted and process served upon the Surety within two years
after completion of the work mentioned in said contract, whether such work be completed by the Principal,
Surety or Owner; but if there is any maintenance or warranty period provided in the contract for which said
Surety is liable, an action for such maintenance or warranty may be brought within two years from the expiration
of said maintenance or warranty period, but not afterwards.
IN WITNESS SS WHEREOF the said Principal and Surety have signed and sealed this instrument this / ry
day of1_,
G & W Diesel Services, Inc. dba Emergency Vehicle Specialists
iW tness: Principal
*gyp OEPO
Klv� 0 ideli and Deposit Company of Maryland
Witness: Chthy Hutson— 0 Surety
ra.. b
lE9f} ; '
Sarah E. DeYoung Atto a In -Fact
a..
Bond Number 9341111
Obligee City of Fayetteville
ZURICH AMERICAN INSURANCE COMPANY
COLONIAL AMERICAN CASUALTY AND SURETY COMPANY
FIDELITY AND DEPOSIT COMPANY OF MARYLAND
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS: That the ZURICH AMERICAN INSURANCE COMPANY, a corporation of the State of New
York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the State of Illinois, and the FIDELITY
AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Illinois (herein collectively called the "Companies"), by
Robert D. Murray, Vice President, in pursuance of authority granted by Article V, Section 8, of the By -Laws of said Companies, which are
set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof, do hereby nominate, constitute,
and appoint Sarah E. DeYoung 'its true and lawful agent and Attomey-in-Fact, to make, execute,
seal and deliver, for, and on its behalf as surety, and as its act and deed: any and all bonds and undertakings, and the execution of such
bonds or undertakings in pursuance of these presents, shall be as binding upon said Companies, as fully and amply, to all intents and
purposes, as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE
COMPANY at its office in New York, New York., the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND
SURETY COMPANY at its office in Owings Mills, Maryland., and the regularly elected officers of the FIDELITY AND DEPOSIT
COMPANY OF MARYLAND at its office in Owings Mills, Maryland., in their own proper persons.
The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V, Section 8, of
the By -Laws of said Companies, and is now in force.
IN WITNESS WHEREOF, the said Vice -President has hereunto subscribed his/her names and affixed the Corporate Seals of the said
ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and
FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 19th day of June, A.D. 2019.
ATTEST:
ZURICH AMERICAN INSURANCE COMPANY
COLONIAL AMERICAN CASUALTY AND SURETY COMPANY
FIDELITY AND DEPOSIT COMPANY OF MARYLAND
SEAL
7
By: Robert D. Murray ���,d'
Vice President
By: Dawn E. Brown
Secretary
State of Maryland
County of Baltimore
On this 19th day of June, A.D. 2019, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, Robert D.
Murray, Vice President and Dawn E. Brown, Secretary of the Companies, to me personally known to be the individuals and officers described in and who
executed the preceding instrument, and acknowledged the execution of same, and being by me duly sworn, deposeth and saith, that he/she is the said officer of
the Company aforesaid, and that the seals affixed to the preceding instrument are the Corporate Seals of said Companies, and that the said Corporate Seals and
the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporations.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above written.
rU lLt`'✓'�?�;
Constance A. Dunn, Notary Public
'4,�'%i,•�x;;ps�.\�
My Commission Expires: July 9, 2023
I WA9;TAO&24Is]�j&'Ew_\Y&Ke]At: I*Eel 12_li1I*�
"Article V, Section 8, Attorneys -in -Fact. The Chief Executive Officer, the President, or any Executive Vice President or Vice President
may, by written instrument under the attested corporate seal, appoint attorneys -in -fact with authority to execute bonds, policies,
recognizances, stipulations, undertakings, or other like instruments on behalf of the Company, and may authorize any officer or any such
attomey-in-fact to affix the corporate seal thereto; and may with or without cause modify of revoke any such appointment or authority at any
time."
CERTIFICATE
I, the undersigned, Vice President of the ZURICH AMERICAN INSURANCE COMPANY, the COLONIAL AMERICAN
CASUALTY AND SURETY COMPANY, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, do hereby certify that the
foregoing Power of Attorney is still in full force and effect on the date of this certificate; and I do further certify that Article V, Section 8, of
the By -Laws of the Companies is still in force.
This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of
Directors of the ZURICH AMERICAN INSURANCE COMPANY at a meeting duly called and held on the 15th day of December 1998.
RESOLVED: "That the signature of the President or a Vice President and the attesting signature of a Secretary or an Assistant Secretary
and the Seal of the Company may be affixed by facsimile on any Power of Attorney ... Any such Power or any certificate thereof bearing such
facsimile signature and seal shall be valid and binding on the Company."
This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of
Directors of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held on the 5th day of
May, 1994, and the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a
meeting duly called and held on the 10th day of May, 1990.
RESOLVED: "That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature
of any Vice -President, Secretary, or Assistant Secretary of the Company, whether made heretofore or hereafter, wherever appearing upon a
certified copy of any power of attorney issued by the Company, shall be valid and binding upon the Company with the same force and effect
as though manually affixed.
IN TESTIMONY WHEREOF, I have hereunto subscribed my name and affixed the corporate seals of the said Companies,
this day of
04
SEAL
OAK
Brian M. Hodges, Vice President
TO REPORT A CLAIM WITH REGARD TO A SURETY BOND, PLEASE SUBMIT A COMPLETE DESCRIPTION
OF THE CLAIM INCLUDING THE PRINCIPAL ON THE BOND, THE BOND NUMBER, AND YOUR CONTACT
INFORMATION TO:
Zurich Surety Claims
1299 Zurich Way
Schaumburg, IL 60196-1056
www.ret)ortsfclaims(@.zurichna.com
800-626-4577