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Home My WebLink AboutPK11-208 - Original - Design Air, Ltd. - Corrections Facility Boiler Replacement - 06/16/2011 Records Mantigernet7ft& KENO Document WASXINGTOM y CONTRACT COVER SHEET This is to be completed by the Contract Manager prior to submission to City Clerks Office. All portions are to be completed. If you have questions, please contact City Clerk's Office. Vendor Name: Design Air, Ltd. Vendor Number: 33895 JD Edwards Number Contract Number: [ f— C910R This is assigned by City Clerk's Office Project Name: City of Kent Corrections Facility Boiler Replacement Description: ❑ Interlocal Agreement ❑ Change Order ❑ Amendment ® Contract ❑ Other: Contract Effective Date: 7/2011 Termination Date: 10/2011 Contract Renewal Notice (Days): 90 Number of days required notice for termination or renewal or amendment Contract Manager: Charlie Lindsey Department: Parks/Facilities Detail: (i.e. address, location, parcel number, tax id, etc.): 1230 S. Central S Public\RecordsManagement\Forms\ContractCover\adcc7832 1 11/08 CONTRACT THIS AGREEMENT, made in triplicate, is entered into between the CITY OF KENT, a Washington municipal corporation("City"). and Design Air. Ltd, organized under the laws of the State of—Washington , located and doing business at 8657 So 190`h St., Kent Washington 98031("Contractor"). WITNESS: In consideration of the terms and conditions contained herein and attached and made a part of this Agreement, the parties agree as follows: J 1. The Contractor shall do all work and furnish all tools, materials, and equipment for: Kent Corrections Boiler Replacement and Heating System Upgrades in accordance with and as described in the Contract and Bid Documents and shall perform any alterations in or additions to the work provided under the Contract Documents and every part thereof. The Contract Documents shall include all project specifications, provisions, and plans; the City's general and special conditions; the 2008/2009 Standard Specifications for Road, Bridge, and Municipal Construction, as prepared by the Washington State Department of Transportation and the Washington State Chapter of the American Public Works Association, including all published amendments issued by those organizations, if applicable ("Standard Specifications"); the City's bid documents; and the Contractor's response to the City's bid. Unless otherwise directed by the City, work shall start witiuncteen (10) days after the�City -6 4 issues its Notice to Proceed and be completed within endar dayss. I The Contractor shall provide and bear all expense of all equipment, work, and labor of any sort whatsoever that may be required for the transfer of materials and for constructing and completing the work provided for in the Contract Documents and every part thereof, except as mentioned in the specifications to be furnished by the City. 2. The City hereby promises and agrees with the Contractor to employ, and does employ, the Contractor to provide the materials and to do and cause to be done the above described work and to complete and finish the same according to the Contract Documents and the terms and conditions herein contained and hereby contracts to pay for the same according to the Contract Documents and the schedule of unit or itemized prices provided by Contractor in its response to the City's bid, at the time and in the manner and upon the conditions provided for in the Contract Documents. 3. The Contractor for itself, and for its heirs, executors, administrators, successors, and assigns, does hereby agree to the full performance of all covenants herein contained upon the part of the Contractor. 4. It is further provided that no liability shall attach to the City by reason of entering into this contract, except as expressly provided herein. 5. Contractor shall defend, indemnify, and hold the City, its officers, officials, employees, agents, volunteers and assigns harmless from any and all claims, injuries, damages, losses or suits, including all legal costs and attorney fees, arising out of or Project Name. City of Kent Corrections Facility Boiler Replacement Page 1 in connection with the performance of this contract, except for injuries and damages caused by the sole negligence of the City. The City's inspection or acceptance of any of Contractor's work when completed shall not be grounds to avoid any of these covenants of indemnification. Should a court of competent jurisdiction determine that this contract is subject to RCW 4.24.115, then, in the event of liability for damages arising out of bodily injury to persons or damages to property caused by or resulting from the concurrent negligence of the Contractor and the City, its officers, officials, employees, agents and volunteers, the Contractor's liability hereunder shall be only to the extent of the Contractor's negligence IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE CONTRACTOR'S WAIVER OF IMMUNITY UNDER INDUSTRIAL INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF THIS INDEMNIFICATION. THE PARTIES FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY NEGOTIATED THIS WAIVER. The provisions of this section shall survive the expiration or termination of this contract. 6 Contractor agrees, upon the City's written demand, to make all books and records available to the City for inspection, review, photocopying, and audit in the event of a contract related dispute, claim, modification, or other contract related action at reasonable times (not to exceed three (3) business days) and at places designated by the City. 7. The Contractor shall procure and maintain, during the term of construction and throughout the specified term of maintenance, insurance of the types and in the amounts described in Exhibit A attached and incorporated by this reference. 8. Contractor is responsible for locating any underground utilities affected by the work and is deemed to be an excavator for purposes of RCW Ch. 19.122, as amended. Contractor shall be responsible for compliance with RCW Ch. 19.122, including utilization of the "one call" locator service before commencing any excavation activities. 9. Contractor shall fully cover any and all loads of loose construction materials, including but not limited to sand, dirt, gravel, asphalt, excavated materials, construction debris, etc, to protect said materials from air exposure and to minimize emission of airborne particles to the ambient air environment within the City. IN WITNESS WHEREOF the parties hereto have caused this agreement to be executed the day and year first hereinabove written. Project Name:City of Kent Corrections Facility Boiler Replacement Paee• 2 CITY OF KENT BY: SU T COOKS, MAYOR DA ATTEST: BRENDA JACOBER, CItY CLERK APPROVED AS TO FORM: KE T LAW DEPARTMENT CONTRACTOR C S��R I�1 , `- A BYL�221 CL PRINT AME: t� G TITLE: C2S,Ae C\+ \1 DATE: 0 t Project Name- City of Kent Corrections Facility Boiler Replacement Nee 3 WITNESS, if INDIVIDUAL OR PARTNERSHIP: STATE OF WASHINGTON ) ) ss COUNTY OF KING ) 2011 On this day of -29iE�, before me personally appeared and to me known to be '?cP<\ae -� and of the corporation/individual that executed the within and foregoing instrument, and acknowledged said instrument to be free and voluntary act and deed of said corporation, for the uses and purposes therein mentioned, and on oath stated that they were authorized to execute said instrument and that the seal affixed is the corporate seal of said corporation. IN WITNESS WHEREOF, I have hereunto set my hand and official seal the day and year first above written. i ,^ {///i/fff4ci TA1r NOTARY PUBLIC, in and for the State of Washington, residing at `A-a'. My appointment expires L =�OciUt�S�'`��Itl t Project Name- City of Kent Corrections Facility Boiler Replacement Paee 4 BIDDER'SNAME Design Air, Ltd. CITY OF KENT KING COUNTY,WASHINGTON BID DOCUMENTS FOR City of Kent Corrections Facility—Boiler Replacement and Heating System Upgrades BIDS ACCEPTED UNTIL May 26,2011 2:00 P.M. BID OPENING May 26,2011 2:15 P.M. AT CITY OF KENT CITY HALL KENT,WASHINGTON Charles Lindsey Project Coordinator KENT WASHINGTON ORDER OF CONTENTS Invitation to Bid Project Description Declaration—City of Kent Equal Employment Opportunity Policy Administrative Policy 1.2—Minority and Women Contractors City of Kent Subcontractor List Contractor's Qualifications Statement Bid Form and Signature Sheet Bid Bond Form Performance Bond Form Combined Affidavit&Certification Form: Non-Collusion, Minimum Wage (Non-Federal Aid) Bidders Check List Sample Contract Sample Insurance Requirements Prevailing Wage Rates CITY OF KENT GENERAL CONDITIONS GENERAL SCOPE OF WORK ORDER OF CONTENTS FOR BIDDING AND CONTRACT REQUIREMENTS Invitation to Bid Project Descripton Declaration—City of Kent Equal Employment Opportunity Policy Administrative Policy 1.2—Minority and Women Contractors City of Kent Subcontractor List Contractor's Qualifications Statement Bid Form and Signature Sheet Bid Bond Form Performance Bond Form Combined Affidavit& Certification Form: Non-Collusion, Minimum Wage (Non-Federal Aid) Bidders Check List Sample Contract Sample Insurance Requirements Prevailing Wage Rates DECLARATION CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY The City of Kent is committed to conform to Federal and State laws regarding equal opportunity. As such all contractors, subcontractors and suppliers who perform work with relation to this contract shall comply with the regulations of the City's equal employment opportunity policies. The following questions specifically identify the requirements the City deems necessary for any contractor, subcontractor or supplier on this specific contract to adhere to. An affirmative response is required on all of the following questions for this contract to be valid and binding. If any contractor, subcontractor or supplier willfully misrepresents themselves with regard to the directives outlines, it will be considered a breach of contract and it will be at the City's sole determination regarding suspension or termination for all or part of the contract; The questions are as follows: 1. I have read the attached City of Kent administrative policy number 1.2. 2. During the time of this contract I will not discriminate in employment on the basis of sex, race, color, national origin, age, or the presence of all sensory,mental or physical disability. 3. During the time of this contract the prime contractor will provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer. 4. During the time of the contract 1, the prime contractor, will actively consider hiring and promotion of women and minorities. 5. Before acceptance of this contract, an adherence statement will be signed by me, the Prune Contractor, that the Prime Contractor complied with the requirements as set forth above. By signing below,I agree to fulfill the five requirements referenced above. Dated this 2 6 th day of May 2011 �) (Ronald A. Hagen For: Design Air, Ltd. Title. president & CEO Date: May 26, 2011 CITY OF KENT ADMINISTRATIVE POLICY NUMBER: 1.2 EFFECTIVE DATE: January 1, 1998 SUBJECT: MINORITY AND WOMEN SUPERSEDES: April 1, 1996 CONTRACTORS APPROVED BY Jim White,Mayor POLICY: Equal employment opportunity requirements for the City of Kent will conform to federal and state laws. All contractors, subcontractors, consultants and suppliers of the City must guarantee equal employment opportunity within their organization and, if holding contracts with the City amounting to $10,000 or more within any give year, must take the following affirmative steps: 1. Provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer. 2. Actively consider for promotion and advancement available minorities and women. Any contractor, subcontractor, consultant or supplier who willfully disregards the City's nondiscrimination and equal opportunity requirements shall be considered in breach of contract and subject to suspension or termination for all or part of the contract. Contract Compliance Officers will be appointed by the Directors of Planning, Parks, and Public Works Departments to assume the following duties for their respective departments. 1. Ensuring that contractors, subcontractors, consultants, and suppliers subject to these regulations are familiar with the regulations and the City's equal employment opportunity policy. 2. Monitoring to assure adherence to federal, state and local laws,policies and guidelines. CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE STATEMENT This form shall be filled out AFTER COMPLETION of this project by the Contractor awarded the Agreement. I,the undersigned, a duly represented agent of Company, hereby acknowledge and declare that the before-mentioned company was the prime contractor for the Agreement known as that was entered into on the_ (date) between the firm 1 represent and the City of Kent. I declare that I complied fully with all of the requirements and obligations as outlined in the City of Kent Administrative Policy 1.2 and the Declaration City of Kent Equal Employment Opportunity Policy that was part of the before-mentioned Agreement. Dated this day of 2011 By: For: Title: Date: Contractor's Compliance Statement (President Executive Order*11246) Date May 26 , 2011 This statement relates to a proposed contract with the City of Kent named City of Kent Correctional Facility Boiler Replacement and Heating System Upgrade I am the undersigned bidder or prospective contractor. I representative that I (please circle one response) have or have not, participated in a previous contract or subcontract subject to the President's Executive Order#11246 (regarding equal employment opportunity) or a preceding similar Executive Order. Bidder Design Air, Ltd. Company Name By: Ronald A. Hagen Contractor or Contractor's Representative Signature Its: President & CEO DATE May 26, 2011 ADDRESS. 8657 So . 190th Street Kent, WA 98031 For information about your previous contracts or subcontracts, consult htto tlenvirotext eh doe gov/datateas/iohnson/196509 24 html Contractor Compliance Statement t CITY OF KENT SUBCONTRACTOR LIST (Contracts over $100,000) List each subcontractor, from any tier of subcontractors, that shall perform subcontract work amounting to more than 10% of the total bid contract price. List each bid item to be performed by each designated subcontractor in numerical sequence. If no subcontractors will be performing 10% or more of the work, indicate this by writing "None" and signing this form at the bottom of the page. Failure to submit a fully completed and signed subcontractor list after the tune set for bid opening may disqualify your bid City of Kent Corrections Facility - Project Name: Boiler Replacement and Heating System Upgrades Project Number: Subcontractor Name None Item Numbers Subcontractor Name None Item Numbers Subcontractor Name None Item Numbers Subcontractor Name None Item Numbers Subcontractor Name None Item Numbers Subcontractor Name None Item Numbers CONTRACTOR'S SIGNATURE-1 �� CL �� CONTRACTOR'S QUALIFICATION STATEMENT (RCW 39.04.350) THE CITY WILL REVIEW THE CONTRACTOR'S RESPONSES TO THIS FORM TO DETERMINE WHETHER THE BIDDING CONTRACTOR IS RESPONSIBLE TO PERFORM THE CONTRACT WORK THIS FORM REQUIRES CRITERIA ESTABLISHED BY STATE LAW AS WELL AS SUPPLEMENTAL CRITERIA ESTABLISHED BY THE CITY THAT ARE APPLICABLE TO THIS PUBLIC WORKS PROJECT. THE BIDDER SHOULD READ AND RESPOND TO THIS FORM CAREFULLY. Indicia of contractor's responsibility inherently involve subjective determinations as to the contractor's ability to perform and complete the contract work responsibly and to the owner city's satisfaction. The city has an obligation and a duty to its citizens and its taxpayers to administer its budgets and complete its projects in a businesslike manner. Accordingly, it has a duty to exercise the type of inquiry and discretion a business would conduct when selecting a contractor who will be responsible to perform the contract work. The city's supplemental criteria are based, in large part, on the qualification statement form used by the American Institute of Architects. The city provides these criteria so as to provide the most objective framework possible within which the city will make its decision regarding the bidder's ability to be responsible to perform the contract work. These criteria, taken together, will form the basis for the city's decision that a bidder is or is not responsible to perform the contract work. Any bidder may make a formal written request to the city to modify the criteria set forth in this qualification statement, but that request may only be made within 48 hours of the date and time that the bidder first obtains the bid documents or three (3) business days prior to the scheduled bid opening date, whichever occurs first. If the city receives a modification request, it will consider any information submitted in the request and will respond before the bid submittal deadline. If the city's evaluation results in changed criteria, the city will issue an addendum establishmg the new or modified criteria. If the city determines that, based on the criteria established in this statement, a bidder is not responsible to perform the contract work, the city will provide written notice of its determination that will include the city's reason for its decision The bidder has 24 hours from the time the city delivers written notice to the bidder that the bidder is not responsible to perform the contract work to appeal the city's determination. No appeals will be received after the expiration of this 24 hour appeal period The city may deliver this notice by hand delivery, email, facsimile, or regular mail. In the event the city uses regular mail, the delivery will be deemed complete three days after being placed in the U.S. Mail. The bidder's right to appeal is limited to the single remedy of providing the city with additional information to be considered before the city issues a final determination Bidder acknowledges and understands that, as provided by RCW 39 04.350, no other appeal is allowed and no other remedy of any kind or nature is available to the bidding contractor if the City determines that the bidder is not responsible to perform the contract work If the bidder fails to request a modification within the time allowed, or fails to appeal a determination that the bidder is not responsible within the time allowed, the city will make its determination of bidder responsibility based on the information submitted. COMPLETE AND SIGN THIS FORMAS PART OF YOUR BID. FAILURE TO PROPERLY COMPLETE THIS FORM MAY ALSO RESULT IN DETERMINATION THAT YOUR BID IS NON-RESPONSIVE AND THEREFORE VOID. THIS DOCUMENT HAS IMPORTANT LEGAL CONSEQUENCES: CONSULTATION WITH AN ATTORNEY IS ENCOURAGED WITH RESPECT TO ITS COMPLETION OR MODIFICATION. The undersigned certifies under oath that the information provided herein is true and sufficiently complete so as not to be misleading SUBMITTEDBY: Design Air, Ltd. j NAME Ronald A. Hagen ADDRESS: 8657 So. 190th Street - Kent, WA 98031 PRINCIPAL OFFICE: Design Air, Ltd. ADDRESS: 8657 So. 190th Street Kent, WA 98031 PHONE: 253-854-2770 FAX: 253-854-6131 1. STATUTORY REQUIREMENTS 1.1 Provide a copy of your certificate of registration in compliance with chapter 18.27 RCW. Construction Contractor - DESIGL*212DG Electrical Contractor - DESIGAL905B5 Please see attached copies of certificate registration 1.2 Provide your current state unified business identifier number 600-314-241 1.3 Provide all applicable industrial insurance coverage for your employees working in Washington as required in Title 51 RCW, together with an employment security department number as required in Title 50 RCW, and a state excise tax registration number as required in Title 82 RCW. 402, 710-00 Please see attached copy of Washington State Industrial Insurance for all Employees 1.4 Provide a statement, signed by a person with authority to act and speak for your company, that your company, including any subsidiary companies or affiliated companies under majority ownership or under control by the owners of the bidder's company, are not and have not been in the past three (3) years, disqualified from bidding on any public works contract under RCW 39,06.010 or 39.12 065 (3). Please see attached "Disqualification from Bidding on any Public Works Contract" Statement 2. ORGANIZATION 2.1 How many years has your organization been in business as a Contractor9 3 2 Years 2.2 How many years has your organization been in business under its present business name? 32 Years 2.2.1 Under what other or former names has your organization operated?None 2.3 If your organization is a corporation, answer the following. 2.3.1 Date of incorporation: March 7, 197 9 2.3.2 State of incorporation Washington 2.3.3 President's name. Ronald A. Hagen 2.3.4 Vice-president's name(s): Kenneth R. Hagen 2.3.5 Secretary's name- Francis P. Donelan 2.3.6 Treasurer's name- N/A 2.4 If your organization is a partnership, answer the following: 2.4.1 Date of organization:N/A 2.4.2 Type of partnership (if applicable): N/A 2.4.3 Name(s) of general partner(s) N/A 2.5 If your organization is individually owned, answer the following: 2.5.1 Date of organization- N/A 2.5.2 Name of owner:N/A 2.6 If the form of your organization is other than those listed above, describe it and name the principals: N/A 3. LICENSING 3.1 List jurisdictions and trade categories in which your organization is legally qualified to do business and indicate license numbers, if applicable. DESIGL*2i2DG Washington Construction Contractor DE$IGpp,�,L905$5 Washingto.n Electr cal CQntragt r 3.2 Listjurisdictions in which your organizations partnership or trade name is foiled Construction Contractor and Electrical Contractor 4. EXPERIENCE 4.1 List the categories of work that your organization normally performs with its own forces. HVAC, Plumbing, and Piping - Mechanical General Contracting (Coordination and Supervision) 4.2 Claims and Suits. (If the answer to any of the questions below is yes, please attach details.) 4.2.1 Has your organization ever failed to complete any work awarded to it?No 4.2.2 Are there any judgments, claims, arbitration proceedings or suits pending or outstanding against your organization or its officers? No 4.2.3 Has your organization filed any law suits or requested arbitration with regard to construction contracts within the last five years? No 4.3 Within the last five years, has any officer or principal of your organization ever been an officer or principal of another organization when it failed to complete a construction contract? (If the answer is yes, please attach details)No 4.4 On a separate sheet, list major construction projects your organization has in progress, giving the name of project, owner. architect or design engineer, contract amount, percent complete and scheduled completion date. Please see attached "Current Major Project Listing" 4.4.1 State total worth of work in progress and under contract.$7, 5 0 0, 0 0 0 . 0 0 4.5 On a separate sheet, list the major projects your organization has completed in the past five years, giving the name of project, owner, architect or design engineer, contract amount, date of completion and percentage of the cost of the work performed with your own forces. Please see attached "Completed Major Project Listing° 4.5.1 State average annual amount of construction work performed during the past five years:$18 , 000, 000 . 00 4.6 On a separate sheet, list the construction experience and present commitments of the key individuals of your organization. Please see attached Resumes 4.7 On a separate sheet, list your major equipment. Please see attached "Shop Equipment Information" 5. REFERENCES King County DOT Mukilteo School District Contact: Jim Carlson Contact: Bob Miulli Phone: 206-384-2406 Phone: 425-356-1216 5.1 Trade References. Hargis Engineers City of Seattle Contact: Brian Boettcher Contact: Garrett Farrell 5.2 Bank References Phone: 206-448-3376 Phone: 206-233-7921 Harris Trust & Savings Bank 111 West Monroe - Chicago, IL 60690 5.3 Surety: Contact: Wes Frangul - Phone: 312-461-6174 5.3.1 Name of bonding company Travelers Casualty & surety Company of America Ann Risk Services 5.3.2 Name and address of agent:Richard F. Ferrucci & Associates, LLC. 1001 Franklin Ave. - Garden City, NY 11530 Contact: Rita Sagistano - Phone: 516-414-8900 6. FINANCING 6.1 Financial Statement. After bid opening,the City may require the following financial information from any of the three apparent low bidders If so required, the selected bidder(s) must respond with this financial information within 24 hours of the City's request for that information. The City's request for this information shall not be construed as an award or as an intent to award the contract. A bidder's failure or refusal to provide this information may result in rejection of that bidder's bid. 6.1.1 Attach a financial statement,preferably audited, including your organization's latest balance sheet and income statement showing the following items: Current Assets (e.g., cash,joint venture accounts, accounts receivable, notes receivable, accrued income, deposits, materials inventory and prepaid expenses); Net Fixed Assets; Other Assets; I Current Liabilities (e.g., accounts payable,notes payable, accrued expenses, provision for income taxes, advances, accrued salaries and accrued payroll taxes),Other Liabilities (e.g, capital, capital stock, authorized and outstanding shares par values, earned surplus and retained earnings). 6.1.2 Name and address of firm preparing attached financial statement, and date thereof. 6.1.3 Is the attached financial statement for the identical organization named on page one? 6.1.4 If not, explain the relationship and financial responsibility of the organization whose financial statement is provided (e.g.,parent-subsidiary). 6.2 Will the organization whose financial statement is attached act as guarantor of the contract for construction? 7. SIGNATURE 7.1 Dated at this 2 6 th day of May 2011. Name of Organization: Design Air, Ltd. cut Title: President & CEO 7.2 Ronald A. Hagen , being duly sworn, deposes and says that the information provided herein is true and sufficiently complete so as not to be misleading. y�,, Subscribed and swo efore me this day of. &4 2011. Notary Public: My Commission Expires: Zla Design Air, Ltd. 8657 South igov'Street Design Air Kent,Washington 98031 An EMCOR Company Phone: 253.854.2770 Fax: 253.854.6131 Certificate of Registration Construction Contractor (DESIGL*212DG) Business and Licensing Information Name DES]GIN AIR LTD IJBI No. 600314241 Phone 2536542770 Status Active Address 8657 South 190Th St License No. DESIGL'212DG Suite/Apt. License Type Construction Contractor City Kent Effective Date 317/1979 State WA Expiration Date 317/2012 Zip 98031 Suspend Date County King Specialty 1 General Business Type Corporation Specialty 2 Unused Parent Company Certificate of Registration Electrical Contractor (DESIGAL905B5) Business and Licensing Information Name DESIGN AIR LTD UBI No. 600314241 Phone 2538542770 Status Active Address 8657 So. 190Th Street License No. DESIGAL90595 Suite/Apt. License Type Electrical Contractor City Kent Effective Date 2/112010 State UAW Expiration Date 2/1/2012 Zip 95031 Suspend Date CouMy King Specialty 1 General Business Type Corporation Specialty 2 Unused Parent Company Current State Unified Business Identifier Number (600 314 241) Washington State Department of Revenue State Business Records Database Detail TAX REGISTRATION NO: 600314241 ACCOUNT OPENED: 02/22/1979 UBI: 600314241 ACCOUNT CLOSED. OPEN LEGAL ENTITY: DESIGN AIR LTD DOING BUSINESS AS: MAILING ADDRESS: BUSINESS LOCATION: 6657 S 190TH ST 8657 S 190TH ST KENT,WA 98031-1270 KENT,VIA 98031- OWNER TYPE: CORPORATION RESELLER PERMIT N0: A16 0989 11 NAICS CODE: 238220 PERMIT EFFECTIVE: 01,101/2011 PERMIT EXPIRES: 12/31/2011 Washington State Industrial Insurance for all Employees (4029710-00) Wasbington State Depardnent of ��,IT ,, Employer Liabil4ty Labor and Industries ; Certifuate C ar��tr y i i y J `0y. Department of Labor and Industries Employer Liability Certificate Date- 0412112011 UBI#: 600 314 241 Legal Business Name: DESIGN?IRLTD Account# 402,710-00 'Doing Business As'Name DESIGN AIR Estimated Workers Reported Quarter 4 of Year 2010"51 to 75 Workers" (See Description Below) Workers' Comp Premium Status. Account is current Firm has voluntarily reported and paid their premiums Licensed Contractor? Yes License Multiple Active Licenses AccountRepresentatzve T1 /JANBENTLEY(360)902-4652-Email STR0235 a@ ni wa gov Design Air,Ltd. Design Air 8657 South igot'Street Kent,Washington 98031 An EMCOR Company Phone: 253.854.2770 Fax: 253.854.6131 Disqualification from Bidding on any Public Works Contract Design Air, Ltd. and parent company EMCOR Group, Inc., including all subsidiary companies, are not and have not been in the past three (3)years, disqualified from bidding on any Public Works Contract under RCW 39.o6.o10 or 39.12.o65(3)• Design Air, Ltd., is not now, nor have we ever been disqualified or barred from bidding on any Public Works contract under RCW 39.o6.oio or 39.12.o65(3)• Throughout the thirty(30) plus years of operation, Design Air, Ltd. has at all times been a registered and licensed contractor. Design Air, Ltd. has in no way violated the requirements to pay the prevailing rate of wage. Date: May 26, 2oii 7 (Signature) C�c Ronald A. Hagen f President&CEO (Print Name and Title) Design Air, Ltd. 8657 So. igoth Street Kent, Washington 98031 Phone: 253-854-2770 Fax: 253-854-6131 Design Air, Ltd. Design Air 8657 South i9ot'Street Kent,Washington 98031 An EMCOR Company Phone: 253-854-2770 Fax: 253-854-6131 Current Major Project Listing Project: Renton Technical College - Miscellaneous Campus Mechanical and Electrical Improvements: Building'I' Controls and HVAC Work in Bldgs A,I,L and M Project No.: 2010-227H (1-2) Owner: Renton Technical College Architect: S.M. Stemper Architects P.L.L.C. Contract Amount: $543,000.00 Percent Complete: 8% Scheduled Completion Date: 8/25/11 Project: Lake Youngs Elementary School Heating System Replacement Owner: Kent School District No.415 Architect: Sierra-Martin Architects Engineer: Hargis Engineers Contract Amount: $1,237,995.00 Percent Complete: 4% Scheduled Completion Date: 8/26/11 Project: Pine Tree Elementary Heating System Replacement Owner: Kent School District No. 415 Architect: Sierra-Martin Architects Engineer: Hargis Engineers Contract Amount: $1,328,963.00 Percent Complete: 5% Scheduled Completion Date: 8/26/11 Project: Scenic Hill Elementary Classroom Univent HVAC Upgrades Owner: Kent School District No.415 Architect: Bogard Engineers PS Contract Amount: $1,009,600.00 Percent Complete: 5% Scheduled Completion Date: 8/26/11 Project: Green Lake Elementary 2011 Upgrades Phase I Owner: Seattle School District No. 1 Architect: Studio Meng Strazzara Contract Amount: $1,538,500.00 Percent Complete: 2% Scheduled Completion Date: 8/27/11 Project: Hawthorne Elementary School Mechanical Upgrades Owner: Seattle School District No. 1 Architect: Harthorne-Hagen Architects Contract Amount: $1,268,400.00 Percent Complete: 8% Scheduled Completion Date: 8/19/11 Project: Mechanical Upgrades at Lawton Elementary Owner: Seattle School District No.1 Architect: Harthorne-Hagen Architects Contract Amount: $887,665.00 Percent Complete: 5% Scheduled Completion Date: 8/19/11 Project: VA Seattle Seismic Renovation of Bldg. 31 Open MRI Owner: Department of Veterans Affairs Puget Sound Healthcare Architect: HDR Architecture Contract Amount: $665,463.00 Percent Complete: 30% Scheduled Completion Date: 10/28/11 Project: ADA Battalion Headquarters Owner: Department of Army JBLM Architect: ZGA Architects Contract Amount: $829,300.00 Percent Complete: 10% Scheduled Completion Date: 1/01/12 Project: Renovations at Rainier View Elementary Owner: Seattle School District No. 1 Architect: Freeman Fong Architecture Contract Amount: $532,000.00 Percent Complete: 50% Scheduled Completion Date: Project: Denny Middle School/Chief Sealth High School Phase II Owner: Seattle School District No. 1 Architect: Bassetti Architects Contract Amount: $8,798,811.00 Percent Complete: 99% Scheduled Completion Date: 5101AI Project: UW Hitchcock Hall Cooling Tower Upgrade Owner: University of Washington Architect: Wood Harbinger Mechanical and Electrical Engineers Contract Amount: $418,400.00 Percent Complete: 95% Scheduled Completion Date: 5101AI Project: TSB HVAC and Environmental Controls Upgrade at SWFPAC Owner: Lockheed Martin Corporate Space Systems Co. Architect: Lockheed Martin/U.S. Navy Contract Amount: $418,000.00 Percent Complete: 5% Scheduled Completion Date: 1/20/12 Project: Port of Seattle-Mechanical HVAC Seaport On Call 2011 Owner: Port of Seattle Seaport Architect: FSI Engineers Contract Amount: $300,000.00 Percent Complete: 1% Scheduled Completion Date: On going until all contract monies exhausted Project: Port of Seattle - Plumbing Open Order SW10-010 Owner: Port of Seattle Architect: FSI Engineers Contract Amount: $300,000.00 Percent Complete: 50% Scheduled Completion Date: On going until all contract monies exhausted =- Design Air, Ltd. Design Air 8657 South igoLh Street Kent,Washington 98031 An EMCOR Company Phone: 253-854-2770 Fax: 253-854-613. Completed Major Project Listing Project: Chief Sealth High School/Denny Middle School Phase Two Owner: Seattle School District No.1 Architect: Bassetti Architects Contract Amount: $8,798,811.00 Date Completed: 5125/11 Percent Completed by Design Air: 80% Project: King County Central Base Vehicle Exhaust System Upgrade &HVAC Systems Replacement Owner: King County Department of Transportation Architect: Tetra Tech/KCM Contract Amount: $4,700,361.00 Date Completed: 12/12/09 Percent Completed by Design Air: 85% Project: King County Youth Service Center HVAC Upgrade Owner: King County Procurement and Contract Services Engineer: Tres West Engineers Contract Amount: $1,421,569.00 ; I Date Completed: 4/13/08 Percent Completed by Design Air: 85% Project: King County Improvements to Ryerson Base Owner: King County Department of Transportation Architect: Tetra Tech Contract Amount: $2,783,712.00 Date Completed: IIA6109 Percent Completed by Design Air: 85% Project: Greenbridge Early Learning Center Owner: Puget Sound Educational Service District Architect: Miller Hayashi Architects Contract Amount: $2,599,436.00 , Date Completed: 2/26/10 f Percent Completed by Design Air: 90% I Project: Denny Middle School/Chief Sealth Phase One Owner: Seattle School District No. 1 Architect: Bassetti Architects Contract Amount: $2,043,000.00 Date Completed: 8/07/09 Percent Completed by Design Air: 95% Project: Steilacoom High School Modernization and Additions Owner: Steilacoom Historical School District Architect: DLR Group Contract Amount: $3,380,668.00 Date Completed: 5/24/09 Percent Completed by Design Air: 85% Project: MCON P-980 Reaction Force Auxiliary Support Complex Owner: Department of the Navy Architect: Mason &Hanger Architects Contract Amount: $1,144,330.00 Date Completed: 8107/09 Percent Completed by Design Air: 95% Project: City of Seattle Vehicle Maintenance Shop Owner: City of Seattle, Capital Programs Division Architect: KPG Engineers,Architects and Landscape Contract Amount: $720,000.00 Date Completed: 9/12/08 Percent Completed by Design Air: 80% Project: Beverly Elementary School HVAC Upgrades Owner: Edmonds School District Engineer: Hargis Engineers Contract Amount: $2,200,000.00 Date Completed: 8/12/08 Percent Completed by Design Air: 75% Project: Sno-Isle Tech Skill Center Bldg 2,3, 7,8 Mechanical &Electrical Upgrades Owner: Mukilteo School District Architect: McGranahan Architects Contract Amount: $1,618,440.00 Date Completed: 8/15/08 Percent Completed by Design Air: 75% Project: Highline Community College - Bldg 19 Aircraft Vent/Noise Reduction Phase 2 Owner: Highline Community College Architect: SM Stemper Architects Contract Amount: $705,000.00 Date Completed: 8/27/08 Percent Completed by Design Air: 79% Project: Frontier Bank Corporation New Administration Building Owner: Frontier Bank Architect: Botesch,Nash and Hall Architects Contract Amount: $806,250.00 Date Completed: 4/07/08 Percent Completed by Design Air: 85% Design Air, Ltd. 8657 South 1901h Street ,Design Air Kent, Washington 98031 F Phone: 253.854.2770 An EMCOR Company Fax: 253.854.6131 Ronald (Ron) A. Hagen POSITION President&CEO/Project Manager EDUCATION High school graduate, attended (2)years of Junior College Served as a Sheet Metal Apprentice Attended University of Washington HVAC fundamentals Attended various trade related continuing education and seminars EXPERIENCE 1979- Present Principle/General Manager, Design Air, Ltd. 1972-1979 General Manager of Sweeney Mechanical 1965-1972 Sheet Metal Mechanic, Foreman and on-site Superintendent Pancratz Co; Casper,WY Lents, Inc., Bremerton,WA Renton Sheet Metal, Renton ,WA ASSOCIATIONS Member of American Society of Heating, Air Conditioning, and Refrigeration Engineers Member of Sheet Metal Contractors Association Member of Kent Chamber of Commerce Member of Washington Thoroughbred Breeders Association SAMPLE • Seattle Fire Station#28-$1,022,838.00 (GC-Berschauer PROJECT Phillips Construction; Owner: City of Seattle Fleets and EXPERIENCE Facilities Department) • Aircraft Rescue & Fire Fighter Facility Upgrade- $287,754.00 (GC-MJ Takisaki, Inc.; Owner-City of Seattle Fleets and Facilities Department) • Boeing North Field Steam Repairs(Phase 1 &2) $54,099.00 (GC-Clements General Construction; Owner-The Boeing Company) • King County Improvements to Ryerson Base-$2,783,712.00 (GC-Ebenal General Inc; Owner-King County Metro) • King County Central Base Maintenance Building Vehicle Exhaust System and HVAC Systems Replacement- $4,700,361.00 (GC-Design Air; Owner-King County Metro) • Beverly Elementary School HVAC Upgrades-$2,175,000.00 (GC-Design Air; Owner-Edmonds School District) • Highline Community College Building 19 Aircraft Noise Reduction Phase 2 Ventilation-$705,000.00(GC-Western Ventures; Owner Highline Community College) • Sno-Isle Technical Skills Center Bldgs. 2, 3, 7 &8- Mechanical &Electrical Upgrades -$1,618,440.00 (GC- Design Air; Owner-Mukilteo School District) • Fairwood Elementary School HVAC Upgrades- $1,717,500.00(GC-Design Air; Owner-Kent School Dist) • Aquatic Facilities Upgrades @ Rogers HS-$1,237,000.00 (GC-Design Air; Owner-Puyallup School District) • James Monroe Elementary HVAC Upgrades-$720,350.00 (GC-Design Air; Owner-Everett School District) SAMPLE • King County Yesler Building HVAC Upgrades Phase 1 - PROJECT $512,500.00 (GC-Design Air; Owner-King County) EXPERIENCE . King County Yesler Building HVAC Upgrades Phase 2- CONTINUED $779,795.00 (GC-Design Air; Owner-King County) • UW HSC [-Wing-2 Level HVAC Upgrades-$1,167,119.00 (GC- CDK Construction; Owner-University of Washington) • Major HVAC Repairs at Pierce College-$587,305.00(GC- Design Air; Owner-Pierce College) • Mariner High School HVAC Upgrades Phase 1 &2- $968,500.00(GC-Design Air;Owner-Mukilteo School Dist) • City of Seattle Ballard Pool Mechanical Upgrades- $912,157.00(GC-Design Air; Owner-City of Seattle) REFERENCES Owner/General Contractor: King County Metro Contact: Ronald Quist Phone:206-263-4676 Cell: 206-684-1379 Owner/Owner Rep/General Contractor: Hargis Engineers Contact: Brian Boettcher Phone: 206-436-0404 Cell: 253-279-1855 Owner/Owner Rep/General Contractor: Hargis Engineers Contact:Terry Potvin Phone: 206-448-3376 Owner/General Contractor: Kent School District Contact: Fred Long Phone: 253-373-7144 Owner/Owner Rep/General Contractor: Bogard Engineering Contact: Lee Bogard Phone:425-415-6100 Cell: 206-972-6829 Owner/General Contractor: City of Seattle j Contact: Garrett Farrell Phone: 206-233-7921 Owner/General Contractor: King County Contact:Jim Carlson Phone:206-384-2406 Owner/General Contractor: Edmonds School District Contact: Matt Finch Phone:425-508-9344 Owner/General Contractor:Western Ventures Construction Contact: Steve Wagner Phone:425-640-5050 Owner/General Contractor. CDK Construction Contact Bill Satterthwaite Phone: 425-788-8441 CURRENT Ron will be available for this project as needed and on an WORK ongoing basis COMMITMENTS i i Design Air, Ltd. Qc 8657 South 190`h Street Design Air Kent, Washington 98031 Phone: 253.854.2770 An EMCOR Company Fax: 253.854.6131 Jerry Timbs POSITION Mechanical Superintendent EDUCATION SMACNA Code Revisions Classes SMACNA Foreman Training Certifications Asbestos Abatement/Awareness Training 15t Aid,CPR and Blood Borne Pathogens Certified Scaffold, Forklift,Aerial Reach Equipment,Articulated Booms Certification Fall Protection Certification Scissor Lift Certification Attended various trade related continuing education and SMACNA seminars Extensive safety training EXPERIENCE 2006-Current Mechanical Superintendent 2002-2007 Senior Foreman, Design Air, Ltd. 1995-2002 Field Foreman, Robert Lloyd Sheet Metal 1990-1994 Owner/Operator, Season Heating &Air Conditioning 1988-1989 General Manager, Spiro America 1984-1987 Project Manager/Estimator, Hermanson 1982-1983 General Manager, Rogue Valley Sheet Metal 1981 -1981 Head Sheet Metal Mechanic,Todd Shipyards 1979-1980 Sheet Metal Fabrication 767 Mock-Up-Boeing 1976-1979 United States Air Force-Crew Chief SAMPLE • Greenbridge Early Learning Center-$2,574,445.00 (GC- PROJECT Kassel Construction; Owner-Puget Sound Educational EXPERIENCE Service Dist.) • State Capital Museum and Outreach Center Boiler Replacement$53,527.00 (General Contractor: Design Air, Ltd.) Contact:Jeff Robison • Denny Middle School/Chief Sealth High School Project 2- Seattle,WA$7,539,000.00 (General Contractor: Absher Construction) Contact: David Becker • Steilacoom High School Modernization/Addition- Steilacoom, WA $3,103,389.00(General Contractor: John Korsmo Construction, Inc.) Contact John Mackenzie • Denny Middle School/Chief Sealth High School Project 1 - Seattle,WA$1,857,064.00(General Contractor: JV Constructors, Inc.) Contact:John Viger • Harborview Medical Center Lab Robotics-$589,500.00 (GC Western Ventures; Owner-Harborview Medical Center) • Forrest Park Swim Center-$978,000.00(GC-Design Air; Owner-City of Everett) • Whidbey Island Air Force Base Hangar No. 5 $1,364,735.00 (GC-Korte Construction; Owner- Department of the Navy) l f SAMPLE Winslow Wastewater Treatment Plant-$455,700.00 PROJECT (GC-Stan Palmer Construction; Owner-King County) EXPERIENCE . Pierce College Level 1 HVAC Repairs-$578,988.00 (GC- CONTINUED Design Air; Owner-Pierce College) • King County Ryerson Base Improvements-$2,783,712.00 (GC-Ebenal Construction; Owner-King County) • King County Central Base Maintenance Building Vehicle Exhaust System and HVAC Systems Replacement $4,700,361.00(GC-Design Air; Owner-King County) • King County Youth Service Center HVAC Upgrades- $1,281,144.00 (GC-DesignAir; Owner-King County) • Main Terminal AHU-8 Upgrade-$599,700.00 (GC-M D Moore Co.; Owner-Port of Seattle) • MCON P-980 Reaction Force Auxilairy Support Complex- $1,455,300.00 (GC-Triton Marine Construction; Owner Department of the Navy) • Beverly School Elementary Mechanical Upgrades- $2,175,000.00 (GC-Design Air; Owner-Edmonds School District) • Sno-Isle Technical Skills Center Bldgs. 2,3, 7&8- Mechanical & Electrical Upgrades-$1,618,440.00 (GC- Design Air; Owner-Mukilteo School District) • Central Link Light Rail-$4,500,000.00(GC-Kiewit Pacific Co.-Owner Central Puget Sound Regional Transit Authority • Snohomish County Courthouse-$689,000.00 (GC-M.A. Mortenson Construction; Owner-City of Everett) • Fairwood Elementary School HVAC Upgrades$1,717,500.00 (GC-Design Air; Owner-Kent School District) • Aquatic Facilities Upgrades @ Rogers HS-$1,237,000.00 (GC-Design Air; Owner Puyallup School District) • James Monroe Elementary HVAC Upgrades-$720,350.00 (GC Design Air; Owner-Everett School District) • Various University of Washington Projects-Seattle, WA • Various Camp Murray Projects-Tacoma, WA REFERENCES Owner/General Contractor: King County Contact: Jim Carlson Phone: 206-384-2406 Owner/General Contractor: City of Seattle Contact: Garrett Farrell Phone: 206-233-7921 Owner/Owner Rep/General Contractor: Hargis Engineers Contact: Brian Boettcher Phone: 206-436-0404 Cell: 253-279-1855 Owner/General Contractor. Kent School District Contact Fred Long Phone: 253-373-7144 I i Owner/Owner Rep/General Contractor: Bogard Engineering Contact: Lee Bogard Phone:425-415-6100 Cell: 206-972-6829 Owner/Owner Rep/General Contractor: HV Engineering Contact:Tom Harrylock Phone: 206-706-9669 QUALIFICATIONS Over 30 years experience in sheet metal trade. Expertise in supervision of overseeing projects workforce, subcontractors, scheduling, detailing,job progress, equipment and installation. Widespread experience of healthcare facilities,aquatic facilities, educational facilities, laboratories, clean rooms and Armed Forces major projects as well as convention centers. CURRENT Jerry will be available for this project as needed and on an WORK ongoing basis. COMMITMENTS Design Air, Ltd. 8657 South 1901h Street Design Air Kent, Washington 98031 Phone: 253.854.2770 An EMCOR Company Fax: 253.854.6131 Troy A. Berry POSITION Senior Foreman/Project Superintendent EDUCATION High School Graduate,Attended (2)years of Junior College Served five year sheet metal apprentice, attended various trade related continuing education and SMACNA seminars. Foreman's Training, Extensive Seismic Applications and Training, OSHA 30 Certified, Extensive Safety Training, Lead/Asbestos Certified, Competent Person for fall restraint and confined space certification, Member of SMW Local 66 EXPERIENCE 1994-Present Project Superintendent/Foreman, Design Air 1994-1994 Lead Journeyman, Mckinstry 1993-1994 Lead Journeyman/Apprentice, Design Air 1989-1993 Apprentice, Bicknell Fabricator SAMPLE Greenbridge Early Learning Center-$2,574,445.00 (GC- PROJECT Kassel Construction; Owner-Puget Sound Educational EXPERIENCE Service District) I4 • State Capital Museum and Outreach Center Boiler Replacement$53,527.00 (General Contractor: Design Air, Ltd.) Contact:Jeff Robison • Steilacoom High School Modernization/Addition- Steilacoom,WA$3,103,389.00 (General Contractor.John Korsmo Construction, Inc.) Contact:John Mackenzie • Denny Middle School/Chief Sealth High School Project 1 - Seattle,WA$1,857,064.00 (General Contractor:JV Constructors, Inc.) Contact:John Viger • King County Central Base Maintenance Building- $4,700,361.00(GC-Design Air; Owner-King County Dept of Transportation) • King County Ryerson Base Improvements-$2,783,712.00 (GC-Ebenal General, Inc.; Owner-King County Dept of Transportation) • UW HSC I-Wing 2-Level HVAC Upgrades-$1,167,119.00 (GC-CDK Construction; Owner-University of Washington) • Central Link Light Rail-$4,500,000.00 (GC-Kiewit Pack Co.-Owner Central Puget Sound Regional k Transit Authority) f • Bellevue Community College Bldg. `D'-$1,279,000.00 I (PCL Construction-Owner-Bellevue Community College) • King County Youth Services Center-$1,281,144.00 (GC- Design Air, Owner-King County) • McNeil Island OSHS Special Commitment Center- $5,244,000.00(GC-Absher Construction; Owner- Washington State Department of Corrections) SAMPLE . Communications Infrastructure Backbone System - PROJECT $1,200,000.00 (GC-Berschauer Phillips Construction EXPERIENCE Co.; Owner-Port of Seattle) CONTINUED . Bellevue Community College `R' Building-$545,780 (PCL Construction; Owner-Bellevue Community College) • Olympic College Business/Technology Buildings- $1,131,000.00(GC-Design Air; Owner-Olympic College) • Fairwood Elementary HVAC and Electrical Upgrade- $1,717,500.00 (GC-Design Air; Owner-Kent School District) • Kent Educational Support Building-$1,691,364.00 (GC- Design Air; Owner-Kent School District) • Bethel High School#3-$5,424,433.00 (GC-Wick Constructors, Inc.; Owner-Bethel School Dist) • University of Washington Villages-$725,000.00 (GC- Design Air; Owner-University of Washington) REFERENCES Owner/General Contractor: King County Metro Contact:Jim Carlson Phone: 206-384-2406 Owner/General Contractor: King County International Airport Contact: Milton Huertas Phone: 206-423-1233 Owner/General Contractor: Kiewit Pacific Co. Contact: Bill Kulas Phone: 206-938-6750 Owner/General Contractor: Kent School District Contact Fred Long Phone: 253-373-7144 Owner/General Contractor:Western Ventures Construction Contact: Steve Wagner Phone:425-640-5050 Owner/General Contractor. CDK Construction Contact Bill Satterthwaite Phone:425-788-8441 QUALIFICATIONS Extensive experience in supervision of all manpower, scheduling,detailing,coordination of job progress, equipment and installation. Extensive supervision of Subcontractors. Troy's history includes countless projects with University of Washington, Port of Seattle, King County, City of Seattle,The Boeing Company, major projects as well as healthcare facilities laboratories clean rooms, correctional facilities and learning facilities CURRENT Troy will be available for the entire duration of this project. WORK COMMITMENTS BID FORM Project: City of Kent Corrections Facility— Boiler Replacement and Heating System Upgrades 1230 Central Avenue South Kent, Washington 98032 Engineer: Engineering Economics,Inc. 1201 Western Ave., Suite 325 Seattle, Washington 98101 (206)622-1001 To the City of Kent Facilities Department, Having carefully examined the Project Manual prepared by Engineering Economics, Inc. dated May 12, 2011. UWE(name) Design Air, Ltd. have examined the site at 1230 Central Avenue South and understand the present conditions as well as the requirements of the Construction Contract, and propose to furnish all labor and materials for the City of Kent Corrections Facility—Boiler Replacement and Heating System Upgrades. In submitting this Bid,I agree: 1. To hold my Bid open until thirty (30) calendar days after the actual bid opening. 2. To enter into and execute a contract, if awarded on the basis of this bid, on City of Kent Public Works Agreement, and to fumish proof of insurance as required by the project document. 3. To complete the work in accordance with the Project Documents. 4. That the Owner has the right to waive any informalities in the bidding or to reject any or all bids. LUMP SUM BASE BID. For Base Bid as defined in specifications. The sum of (excluding WSST)the sum of: 'TvjWbV T kl'dj� 1�1�� " OJT�101' Jul) ff�N dollars(S'a`1 q50,05. PROPOSAL SIGNATURE PAGE The undersigned bidder hereby proposes and agrees to start construction work on the Contract, if awarded to him/her, on or before ten (10) calendar days from the date of the Notice to Proceed, and agrees to complete the Contract within 90 days after issuance of the City's Notice to Proceed. The undersigned bidder hereby agrees to submit all insurance documents, performance bonds, and signed contracts within ten (10) calendar days after City awards the Contract. The City anticipates issuance of the Notice to Proceed on the day of the preconstruction meeting. No bidder may withdraw his/her bid for a period of sixty (60) calendar days after the day of bid opening. The required bid security consisting of a bid bond, cashier's check or cash in an amount equal to 5% of the total amount is hereto attached. Notice of acceptance of this bid or request for additional information shall be addressed to the undersigned at the address stated below. Receipt of Addendum No.'s N/A, N/A , N/A , N/A, to the plans and/or specifications is hereby acknowledged Failure to acknowledge receipt of the addenda may be considered an irregularity in this proposal. By signing this Proposal Signature Page, the undersigned bidder agrees to be bound by all terms, requirements and representations listed in the bid documents whether set forth by the City or by the Bidder. DATE: May 26, 2011 Design Air, Ltd. NANE��BID)I��R BY: c^n4 Signature Ronald A. Hagen/President & CEO (Print Name and Title) 8657 So. 190th Street Address Kent, WA 98031 BID BOND FORM KNOW ALL MEN BY THESE PRESENTS: That we, Design Air, Ltd , 8657 South 190th Street, Kent, WA 98031 as Principal, and Travelers Casualty and Surety Company of America as Surety, Five Percent of Amount Bid are held and firmly bound unto the CITY OF KENT, as Obligee, in the penal sum of (,9%ofAmt Bid) Dollars, for the payment of which the Principal and the Surety bond themselves, their heirs, executors, administrators, successors and assigns,jointly and severally,by these presents. The condition of this obligation is such that if the Obligee shall make any award to the Principal for Kent Corrections Facility—Boiler Replacement and Heating System Upgrades According to the terms of the proposal or bid made by the Principal thereof, and the Principal shall duly make and enter into a contract with the Obligee in accordance with the terms of said proposal or bid and award and shall give bond for the faithful peifoimance thereof, with Surety or Sureties approved by the Obligee; or if the Principal shall, in case of failure so to do, pay and forfeit to the Obligee the penal amount of the deposit specified in the call for bids, then this obligation shall be null and void, otherwise it shall be and remain in full force and effect and the Surety shall forthwith pay and forfeit to the Obligee, as penalty and liquidated damaged, the amount of this bond SIGNED, SEALED AND DATED THIS 23rd DAY OF May 2011. Design Air, Ltd. PRINCIPAL Travelers Casualty and Surety Company of America SURETY 2011. Received return of deposit in the sum of$ I, i f IN WITNESS WHEREOF, the above bounden parties have executed this instrument under their separate seals. The name and corporate seal (if required by law) of each corporate party is hereto affixed and duly signed by its undersigned representatives pursuant to authority of its governing body. TWO WITNESSES: Design Air, Ltd PRINCIPA ante 'ncipal's nai a above) BY: Pi TITLE: Ae z\�C DATE: DATE: ( { — 1q- 2-L% CORPORATE SEAL: PRINT NANS Travelers Casualty and Surety Company of America DATE: Federal Insurance Company SURETY CORPORATE SEAL: BY:y ' DATE: June 22, 2011 A TITLE: Rita Sagistano,Attomey-In-Fact r ADDRESS:One Tower Square, Hartford, CT 06183(TR) 15 Mountain View Road, Warren, NJ 07059 (FE) CERTIFICATE AS TO CORPORATE SEAL ` t hereby certi that I am the(Assistant)Secretary y fy ( of the Corporation named as Principal is the within Bond;that ='a Who signed the said bond on behalf of the Principal r` • ., ,Af the said Corporation;that I know his signature thereto is genuine,and that said Bond was duly .,.'it. ,•- �- fined,sealed,and attested for and in behalf of said Corporation by authority of its governing body. SECRETARY OR ASSISTANT SECRETARY WARNING THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER Ate. POWER OF ATTORNEY F,TRAVELERSJ Farmington Casualty Company St.Paul Mercury Insurance Company Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company Fidelity and Guaranty Insurance Underwriters,Inc. Travelers Casualty and Surety Company of America St Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company St Paul Guardian Insurance Company Attorney-Ia Fact No. 222895 Certificate No. O O 4 1 4 7 7 8 i KNOW ALL MEN BY THESE PRESENTS That St Paul Fire and Marine Insurance Company,St Paul Guardian Insurance Company and St Paul Mercury Insurance Company are corporations duly organized under the laws of the State of Minnesota,that Farmington Casualty Company,Travelers Casualty and Surety Company,and i Travelers Casualty and Surety Company of America are corporations duly organized under the laws of the State of Connecticut,that United States Fidelity and Guaranty Company is a corporation duly organized under the laws of the State of Maryland,that Fidelity and Guaranty Insurance Company is a corporation duly organized under the laws of the State of Iowa,and that Fidelity and Guaranty Insurance Underwriters,Inc,is a corporation duly organized under the laws of the State of Wisconsin (herein collectively called the"Companies"),and that the Companies do hereby make,constitute and appoint Thomas Bean,Rita Sagistano, Gerard S Macholz,Susan Lupski,Robert T Pearson, Camille Maitland, George O Brewster,and Colette R Chisholm of the City of Garden City .State of New York ,their true and lawful Attomey(s)-in-Fact, each in their separate capacity if more than one is named above,to sign,execute,seal and acknowledge any and all bonds,recognizances,conditional undertakings and other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons,guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law 7th IN WITNESS WHEREOF,the Companies have caused this instrument to be signed and their corporate seals to be hereto affixed,this day of October 2010 Farmington Casualty Company St.Paul Mercury Insurance Company Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company Fidelity and Guaranty Insurance Underwriters,Inc. Travelers Casualty and Surety Company of America St Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company St.Paul Guardian Insurance Company �°O�P.♦ ,i.O�' J�P1![a4 p\rM iRs`} `/a'�i�MSUgq 80's�7D,,l S SP ER R�9 L �1tt89'6th 0 < ��SJ AtN State of Connecticut By City of Hartford sS Georg V Thompson, mor ice President On this the 7th day of October 2010 before me personally appeared George W Thompson,who acknowledged himself to be the Senior Vice President of Farmington Casualty Company, Fidelity and Guaranty Insurance Company,Fidelity and Guaranty Insurance Underwriters, Inc, St Paul Fire and Marine Insurance Company, St Paul Guardian Insurance Company, St Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers Casualty and Surety Company of America,and United States Fidelity and Guaranty Company,and that he,as such,being authorized so to do, executed the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer p,TEt In Witness Whereof,I hereunto set my hand and official seal My Commission expires the 30th day of June,2011 i0Or lIBU0 * Mane C Tetreault,Notary Public 58440-4-09 Printed in U S A WARNING THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA HARTFORD,CT, 06183 'a ATTORNEY-IN-FACT JUSTIFICATION t_ 1 PRINCIPAL'S ACKNOWLEDGMENT—IF A CORPORATION State of New-Ymt County of �t/LS }u, Onthls dayof /t' aM 20I i before me personally appeared ��.Q, ��` ` "��:.•� - to me known,who,be by in ly sw�gqjn,deposes and says; That hdshe resides In the Cityof s = that he(she is the TW a4 * of cS5'�SS�_/�[2 :�",::. the corporation described in and which gecuied the withm mstntment;that hdshe knows the seal of said corporation; at the seal affixed to said instrument is such corporate seal,that it was so affixed by order of the Board of Di cctora of said corporation,and that he/she signed hWlter name theme ke orde' PRINCIPAL'S ACKNOWLEDGMENT—IF INDM DUAL OR FIRM State of New York County of )31. C"this day of 20 before me personally appeared to me known to be(the individual)(one of the firm of ) described in and who executed the within uuuiument,and hdshe thereupon duly acknowledged to me that bdsbe executed the same(as the act and deed of said firm) SURETY COMPANY'S ACKNOWLEDGMENT State of New York County of Nassau }as Onthis 23rd day of May .20 11 befommapersonallywoored Rita Sagistano to me kn own.who.beIngbyme duly sworn,did depose and say That hdshe resides m*xRk9Pk Nassau COUmy NY that he/she is Attorney-in-Fact of TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA,the corporation described in and which executed the within Instrument;that hdshe knows the corporate seal of said Company;that the seal affixed to said instrument is each corporate seal;and that he/she signed said instrument as Attomey-in-Feat by authority of the Board of Directors ofsdd Company;and atfiant did Arrther depose and say that the Superintendent of Insurance of the Stale or New York has,pursuant to Chapter 882 of the Laws of the State or New York for theyear 1939,constituting chapter 28 of the Consolidating Laws of the State of New York as the Insumnee Law es amended,issued to TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA hisltier ticiru Bate that said Company is qualified to become and be accepted as surety or guarantor on all bonds,undertakings,recogniamces,guaranties, and other obligations required or permitted by law; and that such certificate has not been revoked Notary Pub r 19.LY RENT IWICH TRAVELERS CASUALTY AND SURETY COMPANY OP AMERICA slowY Public,state or NM To* Hartford,Connecticut D6183 fYo.01RE6218L% FINANCIAL STATEMENT AS OF DECEMBER 31,2010 •C6W9ff dM bc0YY laCfi AS FILED WITH THE INSURANCE DEPT.OF THE ESTATE OF NEW YORK CAPITAL STOCK$6,480,000 ASSET$ LIABILITIES CASH AND INVESTED CASH 6 40,780,178 UNEARNED PREMIUMS S 813,064,297 BONDS 3.517.467,280 LOSSES 920,2.20,402 INVESTMENT INCOME DUE AND ACCRUED 53,309,211 REINSURANCE PAYABLE 4N PAID LOSSES I LOSS AOJ EXPENSES 2 526,742 PREMIUM BALANCES 179,026,702 LOSS ADJUSTMENT EXPENSES 477,405,945 NET DEFERRED TAX ASSET 67.7E3.379 COMMISSIONS 31,067,828 REINSURANCE RECOVERABLE 26,000,686 TAXES.LICENSES AND FEES 4079,6" RECEIVABLES FROM PARENT,SUBSIDIARIES AND AFFILIATES 34,04.660 OTHER EXPENSES 34,623,82E SECURITIES LENDING REINVESTED COLLATERAL ASSETS 11,344,000 FUNDS HELD UNDER REINSURANCE TREATIES 96,187,063 UNDISTRIBUTED PAYMENTS 4,507.W6 CURRENT FEDERAL AN D FOREIGN INCOME TAXES 3,320,637 OTHER ASSETS 513,768 REMITTANCES AND ITEM NOT ALLOCATED %428,732 AMOUNTS WITHHELD i RETAINED BY COMPANY FOR OTHERS 25.591,M RETROACTIVE REINSURANCE RESERVE ASSUMED 3,269,M POLICYHOLDER DIVIDENDS 7,479,805 PROVISION FOR REINSURANCE 5,258,e54 PAYABLE FOR SECURITIES LENDING 11.844,000 CEDED REINSURANCE NET PREMIUMS PAYABLE (80.386,527) OTHER ACCRUED EXPENSES AND LIABILITIES 1,053.075 TOTAL LIABILITIES S 2.43¢.Ig3338 CAPITAL STOCK S 6,480,0D0 PAID IN SURPLUS 433,M.700 OTHER SURPLUS 1,3621141,625 TOTAL SURPLUS TO POUCYHOLDERS 5 1.t102325.283 TOTAL ASSETS 4238.298 523 TOTAL LIABILITIES a SURPLUS S 4 238158,523 Secundes carried at$7,754.486 in the above statement are deposited with public authorities,as required by few CITY OF KENT COMBINED AFFIDAVIT & CERTIFICATION FORM: NON-COLLUSION, MINIMUM WAGE (NON-FEDERAL AID) NON-COLLUSION AFFIDAVIT Being first duly sworn, deposes and says, that he/she is the identical person who submitted the foregoing proposal or bid, and that such bid is genuine and not sham or collusive or made in the interest or on behalf of any person not therein named, and further, that the deponent has not directly induced or solicited any other bidder on the foregoing work equipment to put in a sham bid, or any other person or corporation to refrain from bidding, and that deponent has not in any manner sought by collusion to secure to himseMerself or to any other person any advantage over other bidder or bidders. AND MINIMUM WAGE AFFIDAVIT FORM I, the undersigned, having duly sworn, deposed, say and certify that in connection with the performance of the work of this project, I will pay each classification of laborer, workman, or mechanic employed in the performance of such work not less than the prevailing rate of wage or not less than the minimum rate of wage as specified in the principal contract; that I have read the above and foregoing statement and certificate, know the contents thereof and the substance as set forth therein is true to my knowledge and belief. FOR;NON-COLLUSION AFFIDAVIT AND NIINIMUM WAGE AFFIDAVIT Kent Corrections Facility—Boiler Replacement and Heating System Upgrades NAME OF PROJECT Design Air, Ltd. NAME OF BIDDER'S FIRM iI sJA eL 124 -11 SIGNATURE OF AUTHFf. ED REPRESENTATIVE OF BIDDER T�T t Subscribed and sworn to before me this 2 day of fto 2011. � w „e Notary Public in an I for the State 9Washington, ys residing at ,�, BIDDER'S CHECKLIST The following checklist is a guideline to help the Contractor make sure all forms are complete. The bidder's attention is especially called to the following forms Failure to execute these forms as required may result in rejection of any bid. Bidder's Package should include the following: Bid Document Cover Sheet filled out with Bidder's Name..............................................p Tableof Contents Sheet.......................................................................................................P Callfor Bids..........................................................................................................................P ContractorCompliance Statement.....................................................................................P Date.......................................................................................................................... .P Have/have not acknowledgment.............................................................................P Signatureand address.............................................................................................P Declaration—City of Kent Equal Employment Opportunity Policy..............................p Datedand signed.................................................................................................... .P Cityof Kent Administrative Policy.................................................................................. .P Proposal................................................................................................................................P Firstline of proposal—filled in...............................................................................P Unitprices are correct and written in words........................................................P Bid the same unit price for asterisk(*) bid items.................................................P City of Kent Subcontractor List (over$100K)..................................................................P Subcontractorslisted properly...............................................................................p Signature..................................................................................................................P SubcontractorList(over$1 million)..................................................................................p Subcontractorslisted properly...............................................................................p Signature................................................................................................................. .P Contractor's Qualification Statement................................................................................P Filledout and notarized...........................................................................................P ProposalSignature Page.................................................................................................... .P AllAddenda acknowledged.....................................................................................P I Date,signed and addressed.....................................................................................p BidBond Form.....................................................................................................................P Signed,sealed and dated........................................................................................ .P 1 Powerof Attorney....................................................................................................p (Amount of bid shall equal 5% of the total amount bid) Non-Collusion Affidavit......................................................................................................P Signed, dated and notarized....................................................................................P Bidder's Check List.............................................................................................................p The following forms are to be executed AFTER the Contract is awarded: A) CONTRACT This agreement to be executed by the successful bidder. B) PERFORMANCE BOND To be executed by the successful bidder and his surety company. i Page 1 of 3 State of Washington Department of Labor & Industries Prevailing Wage Section - Telephone 360-902-5335 PO Box 44540, Olympia, WA 98504-4540 ------Statement oflntent to Pay- Prevailing Wage -- Document Received Date: Intent ID: Affidavit ID: Status: Approved On 6/22/2011 462030 7/7/2011 Company Details Company Name: DESIGN AIR LTD Address: 8657 SOUTH 190TH ST KENT, WA, 98031 Contractor Registration No. DESIGL*212DG WA UBI Number 600314241 Phone Number 253-854-2770 Industrial Insurance Account ID 402,710-00 Email Address c.moryt@design-air.com Filed By Moryl,Cathy Prime Contractor Company Name DESIGN AIR LTD Contractor Registration No. DESIGL*212DG WA UBI Number 600314241 Phone Number 253-854-2770 Project Information Awarding Agency KENT, CITY OF 220 - 4TH AVE S KENT, WA - 98032-5895 Awarding Agency Contact Charles Lindsey Awarding Agency Contact Phone Number 253-856-5080 Contract Number Project Name Kent Corrections Boiler Replacement and Heating System Upgrades Contract Amount $141,747.75 Page 2 of 3 ------------------- - ---- - ---- -------------- Bid due date 5/25/2011 Award Date 6/9/2011 Project Site Address or Directions Payment Details Check Number: Transaction Id: 103173813 Intent Details Expected project start date: (MM-DD-YYYY) 7/15/2011 In what county (or counties) will the work be King performed? In what city (or nearest city) will the work be Kent performed? What is the estimated contract amount? OR is this $141,747.75 a time and materials estimate? Will this project utilize American Recovery and No Reinvestment Act (ARRA) fund s? Specifically, will this project utilize any No weatherization or energy efficiency upgrade funds (ARRA or otherwise)? Does your company intend to hire ANY Yes subcontractors? Does your company intend to hire subcontractors No to perform ALL work? Will your company have employees perform work Yes on this project? Do you intend to use any apprentices? Yes (Apprentices are considered employees.) How many owner/operators performing work on 0 the project own 30% or more of the company? journey Level Wages County Trade Occupation Wage Fringe # Workers King Plumbers 8 Pipefitters Journey Level $70.84 $0 00 4 King Sheet Metal Workers Journey Level $63.27 $0.00 4 ' 7 DATE(MMIODIrl AFRO CERTIFICATE OF LIABILITY INSURANCE 0711912011 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(es) must be endorsed If SUBROGATION IS WAIVED, subject to the terns 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 endorsements) PRODUCER CONTACT MARSH USA,INC NAME PHONE FAX ATTN CHRISTINE CAYO AIc No Ert A/C,No 601 MERRITT 7,NORWALK CT 06856.6010 E-MAIL Emcor Call est@marsh com ADDRESS —Fax 203.229.6787 --- - --- INSURER(S)AFFORDING COVERAGE - NAIC N 381312-DES-AIR 10-11 11011 INSURER A Continental Casualty Company 20443 INSURED INSURER B Transportation Insurance Co 20494 DESIGN AIR LT D 8657 SOUTH 190TH STREET INSURER C KENT,WA 9W31 INSURER D INSURER E INSURER F COVERAGES CERTIFICATE NUMBER NYC-006190211-03 REVISION NUMBER•3 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 ADDL SUER POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MMIDD IDDM'MM A GENERAL LNBILITY GL 2095785243 10/01/2010 10/01/2011 EACH OCCURRENCE $ 2,000 000 X DAMAGE TO RENI ED COMMERCIAL GENERAL LIABILITY PREMISES Ea omurrence $ 1,000,000 CLAIMS-MADE M OCCUR MED EXP(Any one person) $ 25,000 PERSONAL&ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 6,000,000 GENL AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 14,000,000 POLICY RO-X P LOC I $ A AUTOMOBILE LIABILITY BUA2095785291 10101,2010 10/012011 COMBINEDSINGLELIMIT 2,000,000 Ea acadent _ X ANY AUTO BODILY INJURY(Per person) $ ALLOW A NED SCHEDULED AUT OS UT OS BODILY INJURY(Per acndanl) E X X NON-OWNED PROPERTY DAMAGE $ HIREDAUTOS AUTOS Per acatlent AUTO PHY DAMAGE $ Included A X UMBRELLALIAS X OCCUR L2068208285 10/012010 10N12011 EACH OCCURRENCE $ 5,000,000 EXCESS LIAR CLAIMS-MADE AGGREGATE $ 5,000,000 DED 1 X I RETENTION$10,000 - $ WORKERS COMPENSATION 1 WC STATU- OTH- AND EMPLOYERS'LIABILITY Y I N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? NIA (Mandatory in NH) E L DISEASE-EA EMPLOYE $ If yes describe Linder DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $ $1,000,000-EACH PERSON 8 OCC B WA STOPGAP LIABILITY IGL 2095785260 10/012010 101012011 $1,000,000-13I DISEASE AGG DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD IN,Additional Remarks Schedule,if more space Is required) RE PROJECT NO DAL#11011,CITY OF KENT CORRECTIONS FACILITY BOILER REPLACEMENT AND HEATING SYSTEMS UPGRADES ADDITIONAL INSURED UNDER ALL POLICIES(EXCEPT STOP GAP LIABILITY)WHERE REQUIRED BY CONTRACT CITY OF KENT COVERAGE PROVIDED TO THE ADDITIONAL INSUREDS IS PRIMARY&NON-CONTRIBUTORY WAIVER OF SUBROGATION AS REQUIRED BY CONTRACT CERTIFICATE HOLDER CANCELLATION CITY OF KENT,FACILITIES MANAGEMENT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ATTN CHARLES LINDSEY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 220 4TH AVENUE SOUTH ACCORDANCE WITH THE POLICY PROVISIONS KENT,WA 98032 AUTHORIZED REPRESENTATIVE of Marsh USA Inc Heidi Bauermelster , V1 ez'' e, ©1988-2010 ACORD CORPORATION All rights reserved ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD z14 0qD—DV1J1V // 1.7/ 4V11 O . %.L ; ±L Yrl Y['1VL . / vvz aw,n vva •va ADDITIONAL INFORMATION NYC 03190211-03 DATE(MMrDD/YY) 07119)2011 PRODUCER MARSH USA,INC ATTN CHRISTINE CAYO 601 MERRITT 7,NORWALK CT 06856-6010 Emcor Cerlrequest@marsh corn Fax 203-229-6787 381312-DES-AIR-10-11 11011 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER G DESIGN AIR LTD INSURER H 8657 SOUTH 190TH STREET KENT,WA 98031 INSURERI TEXT Aulomobile Liability Policy Covers APD see limns section Y Limits $500 COMPI$5D0 COLL DED In the event of cancellation or material change that reduces or restricts the insurance afforded bythis Coverage Part(otherthan the reduction of aggregate limits through payment of claims as apphcable),Insurer agrees to mail prior written notce of cancellation or material change to Cerificale Holder Schedile 1 Number of days advance notice For any statutorily penmited reason otherlhan non-payment of premium,the number of days required for notice of cancellation as provided in paragraph 2 of either the Cancellation Common Policy CDnditors oras amended by the applicable stale cancellation endorsement is increased to the lesser of 60 days or the number of days required In a written contrad For non-payment of premium,The greater of(1)tie number o`days required by stale law or(2)the number of days required by written contract. 2 Name Notice will be mailed to Certificate holder CERTIFICATE HOLDER CITY OF KENT,FACILITIES MANAGEMENT ATTN CHARLES UNDSEY 2204TH AVENUE SOUTH KENT,WA 98032 AUTHORIZED REPRESENTATIVE of Marsh USA Inc Heidi Bauermeisler ✓>�(r,L{'�.fi ��4�i1l�rn.GP! Page'2 POLICY NUMBER- GL 2095785243 CG 20 10 10 93 Carrier: Continental Casualty Co Effective date: 10l01,'2010 — 10l01/2011 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED , OWNERS, LESSEES OR -CONTRACTORS (FORM B) This endorsement modifies insurance provided under the following- COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: All persons or organizations you are required by contract to add as an additional insured but onlyif the person or organization does not cuatily as an additional insured Nth respect to worts perforrred by or for you pursuant to that contract on another additions insured endorsement atlached to and forming part of this policy. (If no entry appears above, information required to complete this endorsement will be shown in the Declara- tions as applicable to this endorsement) WHO IS AN INSURED(Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability ansing out of your ongoing operations performed for that insured This endorsement is part of your policy and takes effect on the effective date of your policy, unless another effective date is shown above QVA Countersigned by Authorized Representative Bond No. 105631259(TR), 82288015(FE) PERFORMANCE BOND TO CITY OF KENT KNOW ALL PERSONS BY THESE PRESENTS: That we,the un ersigned�esign Air, Ltd;�65onth 196th�tre�ttf�nt;yVA98 as Principal,and Travelers Casualty and Surety Company of America & Federal Insurance Company a Corporation organized and existing under the laws of the State of*ICJ,(as a Surety Corporation,and qualified under the laws of the State of Washington to become Surety upon bonds of Contractors with Municipal Corporations, as Surety, are jointly and severally held and firmly bound to the CITY OF KENT in the penal sum of$ ** , together with any adjustments,up or down, in the total contract price because of changes in the contract work,for the payment of wluch sum on demand we bind ourselves and our successors, hens, administrators or personal representatives,as the case may be. *CT& IN ** One Hundred Forty One Thousand Seven Hundred Forty Seven and 751100 ($141,747.75) This obligation is entered into in pursuance of the statutes of the State of Washington,and the Codes and Ordinances of the CITY OF KENT. Nevertheless,the conditions of the above obligation are such that: WHEREAS,under and pursuant to a motion,duly tirade,seconded and passed by the City Council of the City of Kent,Icing County,Washington,the Mayor of the City of Kent has let or is about to let to the above bounden Principal,a certain contract,the said contract providing for construction of Kent Corrections Facility—Boiler Replacement and Heating System Upgrades (which contract is referred to herein and is made a part hereof as though attached hereto),and WHEREAS, the Principal has accepted,or is about to accept,the contract,and undertake to perform the work therein provided for in the manner and within the time set forth: NOW,THEREFORE,for non-FHWA projects only,if the Principal shall faithfully perform all the provisions of said contract in the manner and within the time herein set forth,or within such extensions of time as may be granted under the said contract,and shall pay all laborers,mechanics, subcontractors and material men, and all persons who shall supply the Principal or subcontractors with provisions and supplies for the carrying on of said work and shall indemnify and hold the CITY OF KENT harmless from any damage or expense by reason of failure of performance as specified in said contract or hom defects appearing or developing in the material or workmanship provided or performed under said contract,then and in that event this obligation shall be void;but otherwise it shall be and remain in full force and effect. IN WITNESS WHEREOF, the above bounden parties have executed this instrument under their separate seals. The name and corporate seal (if required by law) of each corporate party is hereto affixed and duly signed by its undersigned representatives ursuant to authority of its governing body, g Y -TWOVITNESSES DesigirAirtt PRINCIPA ente ncipal's narrAe above) BY: DATE: DATE: ( — 2—LJ— •ZC CORPORATE SEAL: PRINT NAME Travelers Casualty and Surety Company of America DATE: Federal Insurance Comnanv SURETY CORPORATE SEAL: BY: DATE: June 22, 2011 TITLE: Rita Sagistano,Attorney-In-Fact ADDRESS:One Tower Square, Hartford,CT 06183 JR) 15 Mountain View Road,Warren, NJ 07059(FE) CERTIFICATE AS TO CORPORATE SEAL I hereby certify that I am the(Assistant)Secretary of the Corporation named as Principal in the within Bond;that Who signed the said bond on behalf of the Principal Of the said Corporation;that I know his signature thereto is genuine,and that said Bond was duly signed,sealed,and attested for and in behalf of said Corporation by authority of its governing body, SECRETARY OR ASSISTANT SECRETARY WARNING THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER � POWER OF ATTORNEY TRAVELERSJ Farmington Casualty Company St.Paul Mercury Insurance Company Fidelity and Guaranty Insurance Company _ Travelers Casualty and Surety Company_ Fidelity and Guaranty Insurance Underwriters,Inc Travelers Casualty and Surety Company of America St Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company St Paul Guardian Insurance Company Attorney-In Fact No. 222895 Certificate No. 004147936 KNOW ALL MEN BY THESE PRESENTS That St Paul Fire and Marine Insurance Company,St Paul Guardian Insurance Company and St Paul Mercury Insurance -Company are corporations duly organized under the-laws-of the State of Minnesota,that Farmington Casualty Company,Travelers Casualty-and Surety Company,and- Travelers Casualty and Surety Company of America are corporations duly organized under the laws of the State of Connecticut,that United States Fidelity and Guaranty Company is a corporation duly organized under the laws of the State of:Maryland,that Fidelity and Guaranty Insurance Company is a corporation duly organized under the laws of the State of Iowa,and that Fidelity and Guaranty Insurance Underwriters,Inc,is a corporation duly organized under the laws of the State of Wisconsm (herein collectively called the"Companies"),and that the Companies do hereby make,constitute and appoint Thomas Bean,Rita Sagistano, Gerard S Macholz, Susan Lupski,Robert T Pearson,Camille Maitland,George O Brewster,and Colette R Chisholm of the City of Garden City State of New York their true and lawful Attomey(s)-m-Fact, each in their separate capacity if more than one is named above,to sign,execute,seal and acknowledge any and all bonds,recognizances,conditional undertakings and other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons,guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or pemutted in any actions or proceedings allowed by law 7th IN WITNESS WHEREOF,the Companies have caused this instrument to be signed and their corporate seals to be hereto affixed,this day of October 2010 Farmington Casualty Company St.Paul Mercury Insurance Company Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company Fidelity and Guaranty Insurance Underwriters,Inc. Travelers Casualty and Surety Company of America St Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company St Paul Guardian Insurance Company Lem 00.4, uO�rbSye�y1 9,.•cn8 yF2�Rl�ttr','a��°nO �•yi 97T7$�g x�19to$sa1i ta uy`F.`,OS*NRMEP^OA�RNI.Lr>G ,ROCR" ZX --- SEAL U qf+y�O:,' a�°u,AJ HrA�c�aor'FawOtiR gD J i9To $ia11aei"r"c-f,s•YA� t Y '�a aqr 4ra� 'rid • +'�" r'AtI AN't State of Connecticut By City of Hartford sS Georg 'Thompson, error 5ce President On this the 7[h day of October 2010 before me personally appeared George W Thompson,who acknowledged himself to be the Senior Vice President of Farmington Casualty Company, Fidelity and Guaranty Insurance Company,Fidelity and Guaranty Insurance Undemnters, Inc, St Paul Fire and Marine Insurance Company, St Paul Guardian Insurance Company, St Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers Casualty and Surety Company of America,and United States Fidelity and Guaranty Company,and that he,as such,being authorized so to do, executed the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer G•Te /) In Witness Whereof,I hereunto set my hand and official seal TN1 � v • �.�� My Commission expires the 30th day of June,2011 '0(IBU� t Mane C Tetreault,Notary Public mi On 58440-4-09 Printed in U S A WARNING THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER WARNING THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of Farmington Casualty Company,Fidelity and Guaranty Insurance Company,Fidelity and Guaranty Insurance Underwriters,Inc,St Paul Fire and Marine Insurance Company,St Paul Guardian Insurance Company,St Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers Casualty and Surety Company of America,and United States - Fidelity and Guaranty Company,which resolutions are now in full force and effect,reading as follows —---- - — - RESOLVED,that the Chairman,the President,any Vice Chairman any Executive Vice President,any Senior Vice President,any Vice President any Second Vice President,the Treasurer,any Assistant Treasurer,the Corporate Secretary or any Assistant Secretary may appoint Attorneys-m-Fact and Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the Company's seal bonds,recognizances,contracts of indemnity,and other writings obligatory in the nature of a bond,recogmzance,or conditional undertaking,and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her,and it is FURTHER RESOLVED,that the Chairman,the President,any Vice Chairman,any Executive Vice President,any Senior Vice President or any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company,provided that each such delegation is in writing and a copy thereof is filed in the office of the Secretary,and it is FURTHER RESOLVED,that any bond,recogmzance,contract of indemnity,or witting obligatory in the nature of a bond,recognizance,or conditional undertaking shall be valid and binding upon the Company when(a)signed by the President,any Vice Chairman,any Executive Vice President,any Senior Vice President or any Vice President,any Second Vice President,the Treasurer,any Assistant Treasurer,the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary,or(b)duly executed(under seal,if required)by one or more Attorneys-in-Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority, and rt is FURTHER RESOLVED,that the signature of each of the following officers President,any Executive Vice President,any Senior Vice President,any Vice President, any Assistant Vice President any Secretary,any Assistant Secretary,and the seal of the Company may be affixed by facsirmle to any Power of Attorney or to any certificate relating thereto appointing Resident Vice Presidents,Resident Assistant Secretaries or Attorneys-in-Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof,and any such Power of Attorney or certificate hearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certtfied by such facsimile signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or understanding to which it is attached I,Ken M Johanson,the undersigned,Assistant Secretary,of Farmington Casualty Company,Fidelity and Guaranty Insurance Company,Fidelity and Guaranty Insurance Underwriters,Inc,St Paul Fire and Marine Insurance Company,St Paul Guardian Insurance Company,St Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers Casualty and Surety Company of America,and United States Fidelity and Guaranty Company do hereby certify that the above and foregoing is a true and correct copy of the Power of Attorney executed by said Companies,which is in full force and effect and has not been revoked W TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this 22nd day of .Tune 20 11 Kon M Johans Assistant Secretary �y�e LL � i p0 9 JP yy i c yF D3 ft 6 w c A^ �1COPPOP�iE S, f2 ORPOR9T �1'^ y 9,^ y j is _-_ � s iwafc0ao, S 1696 SEA L+Sof t 6SEAL p301 AINdi'- To verify the authenticity of this Power of Attorney,call 1-800-421-3880 or contact us at www travelersbond com Please refer to the Attorney-In-Pact number,the above-named individuals and the details of the bond to which the power is attached WARNING THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA.,.-Z. - -- - — - HARTFORD,CT. 06183 ATTORNEY-IN-FACT JUSTIFICATION PRINCIPAL'S ACKNOWLEDGMENT—IF A CORPORATION State of.Nvw-Yoe*County of Y\1!It t 17) rG^ Onthn Z'A'—t" dayor 30tivL 20 belore=Pawmillyappemsd �V.e+ti�-ACC A Nc P� �tt't4t 3"2��.'• '�` to me known,who,being by mo duly i wom,deposes and" That he/she resides in the City of that hdshcuthe iic of t��s.5� !�� ' La-c1 piiNNiyt .•hF��\\\\\�`� the corponuon described in and whnoh mauled the within instrument;that he/she knows the seal orsai(i corporation;that the affixed to sale/ s such corpOrLLa scel;that it was so atffxcd by order of the Board of Dmeetors of said corporation.and that lidshe signed hiaMer name like o - PRINCIPAL'S ACKNOWLEDGMENT—IF INDIVIDUAL OR FIRM Slav DrNewyetk County or (a. On this day of .20 before me personally appeared to ate kn own to be(the rndivn3na0 tone of the firm of ) described in and who executed the within monument and he/she thacupuc duly acknowledged to me that he/she cx=dW the same(as the act and deed of said fumy. SURETY COMPANY'S ACKNOWLEDGMENT State of New York,County of Nassau )a& on this 22nd dayof June .20 11 berDMMepersmml)y appeared Rita Sagistano me(mown•who,being by me duly swom,did depose and say. That he/she resides in the M.3t7C County of Nassau, NY that hdsle a Attomcy-ail-Fact of TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA,the corporation described in and whmh ceccutcd the within instrument,that he/she knows the corporate seal of said Company;that the seal affixed to said insWment a such eotporxte seal;and that bdshe signed stud instrument as Anomey-in-Fiia by authority of the Board orDncalass of said Company;and atfiant did Outlier depose and say that the Suporintendatt of Innslxaneo orthc Stale of New YD* has,pursuant to Chaps 982 of the Laws of the State of New York fin the year 1939,constituting chapter 28 of the Consolidating laws of the State of Now York as the lnwrcance law as amaided,issued to TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA bw*bw certificate that said Company is qualified to becomo and be accepted as suray or guarantor on all bonds,rmdnatakaig%seoognimneea,guaranties,tmd other obligmkre required or permitted by law;and that such cahfimie has not been revoked Notary Public TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA CAMILLE MATTLAND Hartford.Connecti ut 06183 NOTARY PUBuc STATE OFNEWYORK KlNGSCDUNlY FINANCIAL STATEHEWT AS OF DECEMBER 31,2010 UC 001MA60DW44 AS FILED WITH THE INSURANCE DEPT.OF THE STATE OF NEW YORK COftiY F`W APRIL 20.2014 CAPITAL STOCK$6�480,000 -- -- ASSETS LIABILITIES CASH AND INVESTED CASH $ 40,78e,17e UNEARNED PREMIUMS S 813.0e4,297 BONDS 3en487.2e0 LOSSES 920.sm,402 INVESTMENT IINCOME DUE AND ACCRUED 'R30 07 DURANCE PAYABLE ON PAID LOSSES 7LOSS ADI E)MM 2.5M742 PRBLNNI BALANCES 179,028.7D2 LOSSADAISTMENT E*SN5ES 477,495" MET DEFERRED TAX ASSET 67,798,379 COMMISSIONS S 31.987,828 REINSURANCE RECOVERABLE 2k990.8a5 TAXES.LICENSES AND FEES 53.079=1 RECETVAELES FROM PARENT.SUBSOUkRIES AND AFFILIATES 3025,080 OTHER D:PENSES 34.623,82E SECURITIES LENDING REYJVEIF ED COLLATERAL ASSETS 11AM.000 FUNDS HELD UNDER REINSURANCE TREATER W187,983 UNDISTRIBUTED PAYMENTS 4,W7.4568 CURRENT FEDERAL AND FOREIGN INCOME TAXES S,32D,537 OTHER ASSETS 613.788 REMITTANCES AND REM6 NOT ALLOCATED 9,4m.m AMOUNTS Wn'loomI RETAINED BY COMPANY FOR OTHERS 25 581.395 RETROAC TVE REINSURANCE RESERVE ASSUMED 3.289.979 POLICYHOLDER DIVIDENDS 7,479,805 PROVt510N FOR REINSURANCE `a.E58.154 PAYABLEFORSECURIT1ES UENMNG 11.844AM CEDED REINSURANCE MET PREMIUMS PAYABLE (90.38a t n OTHER ACCRUED EXPENSES AND LIABILITIES S�5_ TOMLABI.TTIES 2 436 238 CAPMAL STOCK $ a.49D.Wo PAID IN SURPLUS 433,t103 7W OTHER SURPLUS 143UPM 525 TOTAL SURPLUS TO POLICYHOLDERS 1 TOTAL ASSETS TOTAL LIAIAL7TIES&SURPLUS i d Seaxdles cashed at$7.754,486 in the above statement are deposited wAh public wAxi ibes.as required by law Chubb POWER Federal Insurance Company Attn: Surety Department OF Vigilant Insurance Company 15 Mountain View Road CKusa Surety ATTORNEY Pacific Indenfutity Company Warren,NJ 07059 Know All by These Presents, That FEDERAL INSURANCE COMPANY, an Indiana corporation, VIGILANT INSURANCE COMPANY,a New York corrpporation,and PACIFIC INDEMNITY COMPANY,a Wisconsin corporation,do each hereby constitute and appoint Thomas Bean, George O. Brewster, Colette R. Chisholm, Susan Lupski, Gerard S. Macholz, Camille Maitland,Robert T.Pearson,-Rita Sagistano of Garden City,New York each as their true and lawful Attorney-In-Fad to execute under such designation In their names and to affix their corporate seals to and deliver for and on their behalf as surety thereon or otherwise,bonds and undertakings and other writings obllgatory In the nature thereof(other than ball bonds)given or executed In the course of business,and any drrslnanents emending or altering the same,and consents to the modification or alteratlon of airy Instrument referred to In said bonds or oargations. In Witness Whereof,said FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY have each executed and attested these presents and affixed their corporate seals on this 8th day of December,2010. �/ ` r Kenneth�L.PWendel,Assistant Secretary r id&Norris,Jr,Vice Pleat STATE OF NEW JERSEY County of Somerset On this 8th day of December,2010 before me,a Notary Public o1 New forsey,personally came Kenneth C.Wendel,to me mown to be Assistant Secretary of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY,the companies which executed the foregoing Power of Attorney,and the said Kenneth C.Wan del,beirlB by me duly sworn,did depose and say that he Is Assistant Secretary of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY and knows the corporate seats themol,that she seats affixed to the foregoing Power of Attorney are such corporate seals and were thereto affixed by authority of the By-Laws of said Companles,and that he signed card Power of Attorney as Assistant Secretary of said Companies by like authority,and that he is acquainted with David 9.Norris,Jr,and(mows him to be Vice President of said Companies;and that the signature of David B-Noms,Jr,subscribed to said Powei of Attorney is In the genuine handwriting of Oewd S Norris,Jr.,and was tholeb stbscrfbod by authority of said By- Laws and In daponem's presence Notarial Seal �s% TA-°r NOTE Pueuc cF��r�)i Y No.2316685 / ��w � 4;ammlael®It6lpkesdnidilll8®i6 Ll�f/ PUBLIC Notary Public y�,IERgic, CERTIFICATION Extract from the By-Laws of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,And PACIFIC INDEMNITY COMPANY: "AI powers of attorney for and on behalf of the Company may and shelf be executed In the name and an behalf of the Company,ether by On Chairman or the President or a Vice President or an Assistant Vice President,Jointly wlth the Secretary or an Assistant Secretary,under their respective designations The signature of such officers may be engraved,primed or lift ographed The signature of each of the following officers Chairman,President any Vice President,any Assistant Vice President,any Secretary,any Assistant Secretary and the seal of the Company may be affixed by facsimile to city power of attorney or b any certgcaN relabng thereto appointing Assistant Secretaries or Attorneys.in.Fact for puposes only,of executing and attesting bonds and undertakings and other writings otllgatury in the nature thereof,and any such power of attorney or corbleater bearing such facsimile signature or facstmlle seal Shed be valid and bindng upon the Company and any such power so oxaeuiad and earafied by such facsimile signature and facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which R Is eNaehed-' 1,Kenneth C Wendel,Assistant Secretary of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY (the"Con"riles-)do hereby certify that (1) the foregoing einred of the By-Laws of the Companies is We and correct (II) the Companies are duly licensed and autxirbed to transact surety business In all 50 of the thiited States of America and the DlsMct of Columbia and are outhodmd by the U S.Treasury Department bather,Federal and Vigilant are Sear a id in Puerto Rim and the U S.Virgin Wainds,and Federal is Lcensed in American Samoa,Guam,and each of the Pmwnma of Canada except Prince Edward Island,and (trig fire foregoxg Power of Atomey is time,correct and in lull force and effect Given under my hand and seals of said Companies at Warren,NJ this 22nd day of June,2011 s '1YOIAw!!� rr S` 5i4�W ypte'e ��bsti� '�� Kenneth C. nde),Assistant Secretary IN THE EVENT YOU WISH TO NOTIFY US OF A CLAIM,VERIFY THE AUTHENTICITY OF THIS BOND OR NOTIFY US OF ANY OTHER MATTER,PLEASE CONTACT US AT ADDRESS LISTED ABOVE,OR BY Telephone(908)903.3493 Fax(90e)903-3656 e-mail- suretV@chubbcom Form 15•t0-02258-11 (Ed-S•03) CONSENT ACkNOWLEDOMENT OF SURETY COMPANY STATE OF ,.New York,, .._,. COUNTY OF .... } ss On this .......June 22,2011 me personally came ....... ................ to me known, who, being by me duly swom, did depose and say; that helshe resides in Nassau County State NY that he/she Is the Attomey-in-Fact of the .............. ... ...................................... . , _ .. Federal Insurance,CompanY .....................................the corporation described ki which euroouted the above instrument; that he/she knows the seal of said corporation; that the seal affixed to said Instrument is such corporate seal;that Is was so affixed by the Board of Directors of said corporation;and that he/she signed hWher name thereto by like order, and the affiant did further depose and say that the Superintendent of Insurance of the State of New York,has, pursuant to Section 1111 of the Insurance Law of the State of New York, issued to Federal Insurance,Company_,__, (Surety) haTher certificate of qualification evidencing the qualification of said Company and Its sufficiency under any law of the State of New York as surety and guarantor,and the propriety of accepting and approving it as such;and that such certificate has not been revoked �• � � ............................. Notary Pubic MWXrawugwu 0FM asucsatEaFr�r awcoum ua,rmw�e wW =M.omuwat axr FEDERAL INSURANCE COMPANY STATEMENT OF ASSETS, LIABILITIES AND SURPLUS TO POLICYHOLDERS Statutory Basis DECEMBER 31,2010 (in thousands of dollars) LIABILITIES FF_ AND ASSETS SURPLUS TO POLICYHOLDERS Cash and Short Term Investments $ 235,579 Outstanding Losses and Loss Expenses $ 12,051,257 United States Government, State and Unearned Premiums 3,331,654 Municipal Bonds 10,931,173 Ceded Reinsurance Premiums Payable 329,476 Other Bonds 4,110,731 Provision for Reinsurance 70,491 Stocks 837,803 Other Liabilities 962,493 Other Invested Assets 1,909,914 TOTAL INVESTMENTS . ..... . . .. 18,025,200 TOTAL LIABILITIES 16,745,371 Investments in Affiliates Special Surplus Funds 174,400 Chubb Investment Holdings, Inc 3,002,346 Capital Stock 20,980 Pacific Indemnity Company 2,424,142 Paid-In Surplus 3,106,808 Chubb Insurance Investment Holdings Ltd 1,275,789 Unassigned Funds 11,015,075 Executive Risk Indemnity Inc 1,111,774 CC Canada Holdings Ltd 752,455 Great Northern Insurance Company 459,252 SURPLUS TO POLICYHOLDERS 14,317,263 Chubb Insurance Company of Australia Limited 313,107 Chubb European Investment Holdings SLP 234,636 Vigilant Insurance Company 212,646 Other Affil sates 381,791 Premiums Receivable 1,441,826 Other Assets 1,427,670 TOTAL LIABILITIES AND SURPLUS TO POLICYHOLDERS $ 31,062,634 TOTAL ADMITTED ASSETS $ 31,062,634 Investments are valued in accordance with requirements of the National Association of Insurance Commissioners Investments with a carrying value of$452,427,638 are deposited with government authorities as required by law State,County&City of New York, — ss Yvonne Baker,Assistant Secretary of the Federal Insurance Company being duly sworn, deposes and says that the foregoing Statement of Assets, Liabilities and Surplus to Policyholders of said Federal Insurance Company on December 31,2010 is true and correct and is a true abstract of the Annual Statement of said Company as filed with the Secretary of the Treasury of the United States for the 12 months ending December 31,2010 Subscribed and sworn to before me this DOROTHY M BAKER I Assistant Secretary [mac" Notary Public,State of New York Notary Public No 31-4904994 Qualified in New York County Commission Expires Sept 14,2013 Form 1510-0313A(Rev 3/11) REQUEST FOR MAYOR'S SIGNATURE KENT Please Fill in All Applicable Boxes Routing Information (ALL REQUESTS MUST FIRST BE ROUTED THROUGH THE DEPARTMENT) AkD Reviewed by Parks Director Originator: Charlie Lindsey Phone (Originator): 5081 Date Sent: 7/20/2011 Date Required: 7/25/2011 Return Signed Document to: Rosalie CONTRACT TERMINATION DATE: 10/2011 VENDOR NAME: Design Air, Ltd. DATE OF COUNCIL APPROVAL: 6/7/2011 Brief Explanation of Document: Corrections Facility Boller Replacement and Heating System Upgrades. o A t �+(c.l S �'c Jc�t.rt-.Q 4 r•.� oc,W q r eeQ 40 be, lyl•-� f' �'- . Fo� Go Y All Contracts Must Be Routed Through The Law Department (This area to be completed by the Law Department) Received: RECEIVED Approval of Law Dept.: 2 2011 JUL 2 xo� Law Dept. Comments: KENT LAW DEPT. Date Forwarded to Mayor: Shaded Areas To Be Completed By Administration Staff Received: Recommendations and Comments: Disposition: Date Returned: