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HomeMy WebLinkAboutSynagro Central, LLC/Digester #3 Cleaning r}• CONTRACTOR AGREEMENT- DIGESTER #3 CLEANING WASTEWATER TREATMENT PLANT THIS AGREEMENT, made on the 28TH DAY OF MAY, 2014, by and between the CITY OF OSHKOSH, party of the first part, hereinafter referred to as CITY, and SYNAGRO CENTRAL, LLC, 435 WILLIAMS COURT, SUITE 100, BALTIMORE MD 21220 hereinafter referred to as the CONTRACTOR, WITNESSETH: That the City and the Contractor, for the consideration hereinafter named, enter into the following Agreement. The CITY'S Bid Specifications and Insurance requirements are attached hereto and incorporated into this Agreement. The Contractor's proposal is also attached hereto and reflects the agreement of the parties except where it conflicts with the CITY'S terms within this agreement, in which case the CITY'S Bid Specifications, Insurance requirements, and other terms of this agreement shall prevail. ARTICLE I. PROJECT MANAGER A. Assignment of Project Manager. The Contractor shall assign the following individual to manage the project described in this contract: (MICHAEL SCHWARTZ, VICE PRESIDENT) B. Changes in Project Manager. The City shall have the right to approve or disapprove of any proposed change from the individual named above as Project Manager. The City shall be provided with a resume or other information for any proposed substitute and shall be given the opportunity to interview that person prior to any proposed change. ARTICLE II. CITY REPRESENTATIVE The City shall assign the following individual to manage the project described in this contract: (KEVIN SORGE, SUPERINTENDENT OF WASTEWATER TREATMENT PLANT) ARTICLE III. SCOPE OF WORK The Contractor shall provide services described in the CITY'S Specifications dated APRIL 17, 2014, referred to as the "Invitation for Bid" for DIGESTER CLEANING, WASTEWATER TREATMENT PLANT (THIS ATTACHED AS EXHIBIT A) 1 and the Contractor's bid proposal form dated MAY 6, 2014. The Contractor's bid form is attached hereto as Exhibit B. If anything in the Contractor's proposal conflicts with the CITY'S Bid Specifications or with this agreement, the CITY'S Bid Specifications and the provisions in this agreement shall govern. The Contractor may provide additional products and/or services if such products/services are requested in writing by the Authorized Representative of the City. ARTICLE IV. CITY RESPONSIBLITIES The City shall furnish, at the Contractor's request, such information as is needed by the Contractor to aid in the progress of the project, providing it is reasonably obtainable from City records. To prevent any unreasonable delay in the Contractor's work the City will examine all reports and other documents and will make any authorizations necessary to proceed with work within a reasonable time period. ARTICLE V. TIME OF COMPLETION The work to be performed under this contract shall be commenced by 2 - 4 WEEKS AFTER RECEIPT OF ORDER ARTICLE VI. PAYMENT A. The Contract Sum. The City shall pay to the Contractor for the performance of the contract the sum of $60,490.00 (Sixty thousand, Four hundred, Ninety dollars and 00/00) adjusted by any changes hereafter mutually agreed upon in writing by the parties hereto. Fee schedules shall be firm for the duration of this Agreement. B. Method of Payment. The Contractor shall submit itemized monthly statements for services. The City shall pay the Contractor within 30 calendar days after receipt of such statement. If any statement amount is disputed, the City may withhold payment of such amount and shall provide to Contractor a statement as to the reason(s) for withholding payment. C. Additional Costs. Costs for additional services to be negotiated and set forth in a written amendment to this agreement executed by both parties prior to proceeding with the work covered under the subject amendment. 2 ARTICLE VII. CONTRACTOR TO HOLD CITY HARMLESS The Contractor covenants and agrees to protect and hold the City of Oshkosh harmless against all actions, claims and demands of any kind or character whatsoever which may in any way be caused by or result from the intentional or negligent acts of the Contractor, his agents or assigns, his employees or his subcontractors related however remotely to the performance of this Contract or be caused or result from any violation of any law or administrative regulation, and shall indemnify or refund to the City all sums including court costs, attorney fees and punitive damages which the City may be obliged or adjudged to pay on any such claims or demands within thirty (30) days of the date of the City's written demand for indemnification or refund. ARTICLE VIII. INSURANCE The Contractor shall provide insurance for this project that includes the City of Oshkosh as an additional insured. The specific coverage required for this project is identified in the CITY'S Specifications dated APRIL 17, 2014, referred to as the "Invitation for Bid" for DIGESTER CLEANING WASTEWATER TREATMENT PLANT dated APRIL 17, 2014, which is fully incorporated into this Agreement. If applicable, the Contractor is responsible for meeting all insurance requirements. The CITY does not waive this requirement due to its inaction or delayed action in the event that the Contractor's actual insurance coverage varies from the Insurance required. ARTICLE IX. TERMINATION A. For Cause. If the Contractor shall fail to fulfill in timely and proper manner any of the obligations under this Agreement, the City shall have the right to terminate this Agreement by written notice to the Contractor. In this event, the Contractor shall be entitled to compensation for any satisfactory, usable work completed. B. For Convenience. The City may terminate this contract at any time by giving written notice to the Contractor no later than 10 calendar days before the termination date. If the City terminates under this paragraph, then the Contractor shall be entitled to compensation for any satisfactory work performed to the date of termination. This document and any specified attachments contain all terms and conditions of the Agreement and any alteration thereto shall be invalid unless made in writing, signed by both parties and incorporated as an amendment to this Agreement. 3 In the Presenc= : • CONTRACTOR /CONSULTANT 4aMk /1-14., e...z.z, By: VICE" PRE`s(Dj-r (Seal of Contractor (Specify Title) if a Corporation.) BY: nati. C4114------ D;r. o-C (a4421cfs i mAi•"/ (Specify Title) `.5575 Sec."eJgry CITY OF OSHKOSH/(t-) By: ��� i �� M rk A. Rohloff, City Manager (Wit ess) 4Li, - Lf ( ( And: 41 & , 1,4614, i fitness) Pamela R. Ubrig, City lerk APPROVED: I hereby certify that the necessary provisions have been made to r 4 + pay the liability which will accrue tit , _ wAr iA IA_dill - under this contract. City At TIP-y _i nc' A,D City Comptro er 4 EXHIBIT A 5 City of Oshkosh, Wisconsin Invitation for Bid For Digester Cleaning Wastewater Treatment Plant APRIL 17, 2014 City of Oshkosh P.O. Box 1130 Oshkosh, Wisconsin 54903-1130 www.ci.oshkosh.wi.us 1 CITY OF OSHKOSH PURCHASING DIVISION NOTICE TO VENDORS 1. NOTICE IS HEREBY GIVEN that bids will be received in the City Clerk's office, Room 104, City Hall, Oshkosh, Wisconsin, for: DIGESTER CLEANING — WASTEWATER TREATMENT PLANT, DUE NO LATER THAN 10:00 A.M. THURSDAY MAY 8, 2014 at which time all bids will be publicly opened and read in room 404. 2. It is the bidder's sole responsibility to insure that the bid is timely and received by the Purchasing Division prior to the deadline set forth in this notice. Receipt of bid by the mail system or other City departments does not constitute receipt of a bid by the Purchasing Division. 3. All bids must be submitted in an envelope sealed by the bidder or designated representative. All bids should be addressed to the City Manager, c/o City Clerk's Office, City Hall, 215 Church Avenue, P.O. Box 1130, Oshkosh WI 54903-1130. On the outside of the envelope, the bidder should distinctly indicate the name and address of the bidder and in the lower left corner should clearly indicate the envelope contains a sealed bid for: "DIGESTER CLEANING — WASTEWATER TREATMENT PLANT." Bids not complying with these instructions will not be considered submitted to the City, and shall be returned to the bidder unopened and unread. 4. Submission of bid documents by facsimile equipment or electronic mail (email) will not be accepted. 5. This notice establishes a time by which bids must be received by the Purchasing Division. No bids will be accepted after that deadline. 6. The City is not responsible for bids submitted in any other way except those submitted in strict conformance with these instructions. 7. A written request for the withdrawal of a bid or any part thereof may be granted if the request is received by the City prior to the specified bid deadline. 8. All bids shall be binding for thirty-five (35) calendar days following the bid deadline date, unless the bidder(s), upon request of the General Services Manager, agrees to an extension. 9. If applicable, bidder must comply with all necessary insurance requirements, bid bond and/or performance bond as required of the project and as noted in the City of Oshkosh Insurance Requirements. 10. The City reserves the right to reject any and all bids and to waive any informality in the bids. 3 CITY OF OSHKOSH STANDARD TERMS AND CONDITIONS (Request For Bids/Proposals) 1) SPECIFICATIONS: The specifications in this request are the minimum acceptable. When specific manufacturer and model numbers are used, they are to establish a design, type of construction, quality, functional capability and/or performance level desired. When alternates are bid/proposed, they must be identified by manufacturer, stock number, and such other information necessary to establish equivalency. The City of Oshkosh shall be the sole judge of equivalency. Bidders/proposers are cautioned to avoid bidding alternates to the specifications which may result in rejection of their bid/proposal. 2) DEVIATIONS AND EXCEPTIONS: The bid/proposal shall be accepted as in strict compliance with all terms, conditions, and specifications and the bidders/proposers shall be held liable. Specific product types or manufacturers identified in specifications shall be interpreted to require bidding of those exact types and manufacturers. Specifications which allow for bids/quotes with "equal" materials must be fully supported with technical data, test results, or other pertinent information as evidence that the substitute offered is a sufficient alternate to the specification requirement. Failure to provide product information will result in disqualification of such requests. 3) QUANTITIES: The quantities shown on this request are based on estimated needs. The city reserves the right to increase or decrease quantities to meet actual needs. 4) DELIVERY: Deliveries shall be F.O.B. destination freight prepaid and included unless otherwise specified. 5) ACCEPTANCE-REJECTION: The City of Oshkosh reserves the right to accept or reject any or all bids/proposals, to waive any technicality in any bid/proposal submitted, and to accept any part of a bid/proposal as deemed to be in the best interests of the city. Only proposals which are made out on the bid/proposal form attached hereto will be considered. All bid/proposals forms must be completed in full compliance as specified. Failure to complete bid/proposals forms may result in disqualification and considered non-responsive. 6) ORDERING: Purchase orders or releases via purchasing cards shall be placed directly to the contractor by an authorized agency. No other purchase orders are authorized. 7) GUARANTEED DELIVERY: The contractor shall strictly adhere to delivery schedules as specified by the City and to promptly replace rejected or defective materials. The City retains the right to procure materials on its own when the Contractor's materials are not delivered, or replaced if necessary, according to the City's schedule. Contractor's failure to deliver, or replace 5 not the City, will be purchasing the material directly and the bid/quote must include all material costs, including without limitation, taxes. 14) WARRANTY: Unless otherwise specifically stated by the bidder/proposer, equipment purchased as a result of this request shall be warranted against defects by the bidder/proposer for one (1) year from date of receipt, or the manufacturer's warranty, whichever is longer. The equipment manufacturer's standard warranty shall apply as a minimum and must be honored by the contractor. 3/13 7 Contractor shall regularly remove trash, materials, cartons, etc. generated by their work from the premises. Contractor can work with City to block off work areas. CONTRACTOR QUALIFICATION FORM Attached is the Contractor Qualification Form that needs to be on file in the Purchasing Office 5 days prior to solicitation due date THURSDAY MAY 1, 2014 INSURANCE REQUIREMENTS Attached are insurance requirements for the City of Oshkosh for this project. SAMPLE CONTRACTOR AGREEMENT Attached is a sample contractor agreement that the successful bidder will be expected to sign upon award of this project. Bidders do NOT need to submit this agreement when submitting their quote form. BID QUANTITIES The bid will be based on the total of: a. Lump sum for mobilization and demobilization and; b. Unit price per dry ton for removal of approximately 100 dry tons of solids delivered to the Outagamie County Landfill. Actual dry tons will be determined by the collection of a minimum of 4 composite samples per day from the belt filter press during normal operation with the percent solids determination being done using the method for determining % solids as described in Standard Methods for the Examination of Water and Wastewater by the WWTP laboratory. Trucks will be weighed on scale at plant to determine net weight of material. PAYMENT QUANTITIES Payment quantity will be based on unit price per dry ton and actual quantity removed as determined by actual net weight of material removed and total average of percent solids from testing results. PREVAILING WAGE State of Wisconsin Prevailing Wage Requirements does not apply to this project. 9 ****MUST BE ON FILE 5 DAYS PRIOR TO SOLICITATION DUE DATE**** Vendor is responsible to update annually CITY OF OSHKOSH CONTRACTOR QUALIFICATION FORM Company Information Company Name: Complete Address: Phone: Fax: State Contractor's License#: State Public Works Contractor's License #: Other Applicable Licenses: Union Affiliation: Work Trades Performed: Type of Company: [] Corporation [ ] Partnership [] Sole Proprietorship Federal Tax ID#: Company Contact: Email Address: Date Formed: Number of Employees: Salaried: Hourly: Bank Reference Lenders Name and Address Lending Officers Name and Phone Number Completed Projects List four(4)representative projects completed in the last five(5)years Project Name Contracting Company Contact Name/Phone# Contract Amount Current Projects List four(4)representative projects currently under construction 11 CITY OF OSHKOSH INSURANCE REQUIREMENTS INSERT HERE 13 7/16/12 E. Aircraft Liability, "if" the project work includes the use of, or operation of any aircraft or helicopter, then Aircraft Liability insurance must be in force with a limit of $3,000,000 per occurrence for Bodily Injury and Property Damage including Passenger liability and including liability for any slung cargo. F. Builder's Risk / Installation Floater / Contractor's Equipment or Property - The contractor is responsible for loss and coverage for these exposures. City of Oshkosh will not assume responsibility for loss, including loss of use, for damage to property, materials, tools, equipment, and items of a similar nature which are being either used in the work being performed by the contractor or its subcontractors or are to be built, installed, or erected by the contractor or its subcontractors. G. Also, see requirements under Section 3. H. Bond Requirements 1. Bid Bond. Bids that are $25,000 or greater will require the contractor to provide to the owner a Bid Bond, which will accompany the bid for the project. The Bid Bond shall be equal to 5 percent of the contract bid. The City may, at its discretion, require bonds for certain contracts with amounts less than $25,000. 2. Payment and Performance Bond. If awarded the contract, bids that are $25,000 or greater will require the contractor to provide to the owner a Payment and Performance Bond in the amount of the contract price, covering faithful performance of the contract and payment of obligations arising thereunder, as stipulated in bidding requirements, or specifically required in the contract documents on the date of the contract's execution. The City may, at its discretion, require bonds for certain contracts with amounts less than $25,000. 3. Acceptability of Bonding Company. The Bid, Payment and Performance Bonds shall be placed with a bonding company with an A.M. Best rating of no less than A-and a Financial Size Category of no less than Class VI. 2. INSURANCE REQUIREMENTS FOR SUBCONTRACTOR All subcontractors shall be required to obtain Commercial General Liability (if applicable Watercraft liability), Automobile Liability, Workers' Compensation and Employers Liability, (if applicable Aircraft liability) insurance. This insurance shall be as broad and with the same limits as those required per Contractor requirements, excluding Umbrella Liability, contained in Section 1 above. II - 2 AC D' CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Insurance Agency contact NAME: information,including street Insurance Agent's address and PO Box if PHONE contact information. FAX (NC.No.Ext): ,(A/C.No): applicable. -E-MAIL — -------- --- -- _ ADDRESS: INSURER(S)AFFORDING COVERAGE j NAIC# INSURER A: ABC Insurance Com an NAIC# INSURED Insured's contact information, including name,address and INSURER B: XYZ Insurance Company NAIC# -- phone number. INSURER C: LMN Insurance Company NAIC# INSURER D: Insurer(s)must have a minimum A.M.Best rating of A- and a Financial Performance Rating of Vi or better. INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE AMY 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 I 'ADDL I SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYY) (MM/DD/YYY) 1 LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 ,77,1 GENERAL LIABILITY ® ❑ Policy effective and expiration date. DAMAGE TO RENTED PREMISES(Ea occurrence) $50,000 ----' General --.-.-..-___-----_.._.-....----.._---- ----------------------..-._..---._....... A _ '.CLAIMS-MADE®)OCCUR MED EXP(Any one person) _ $5,000 ®' ISO FORM CG 2037 OR EQUIVALENT PERSONAL&ADV INJURY $1,000,000 ❑ GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMITAPPLIES PER: PRODUCTS—COMP/OP AGG $2,000,000 In POLICY ®I,JERo-❑LOC 1 , $ I AUTOMOBILE LIABILITY i COMBINED SINGLE LIMIT (Eaaccidentt) $1,000,000 MANY AUTO ® ❑ Auto Liability Policy Number i[Policy effective and expiration date.I BODILY INJURY(Per person) $_ — AUTOS OWNED ❑ AUTOS BODILY B I BODILYINJURY(Peraccident) $ ❑I HIRED AUTOS El AUTOSWNED (Perraccident)AMAGE $ ❑i ❑ $ ®)UMBRELLA LIAR I®®;OCCUR I ® ❑ I EACH OCCURRENCE $2,000,000 ❑ 1-4111, CLAIMS-MADE i[ A EXCESS LIAB i i Umbrella Liability Policy Number j Policy effective and expiration date. AGGREGATE $2,000,000 ❑lDED 1 ERETENTION$10,000 I $ C AND EMPLOYERS'LIABILITY I ❑ ❑ ®TORY LIMITS;❑I OER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICE/MEMBER EXCLUDED? YIN Workers Compensation Policy IIPolicy effective and expiration date.' E_L EACH ACCIDENT $100,000______ (Mandatory in NH) N , Number If yes,describe under E.L.DISEASE—EA EMPLOYEE $100,000_-- DESCRIPTION OF OPERATIONS below i E.L.DISEASE—POLICY LIMIT $500,000 ❑ ❑ i , DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Additional Insureds on all Liability Policies arising out of project work shall be City of Oshkosh,and its officers,council members,agents, employees and authorized volunteers. Certificates of Insurance acceptable to the City of Oshkosh shall be submitted prior to commencement of the work to the applicable City department. These certificates shall contain a provision that coverage afforded under the policies will not be canceled or non renewed until at least 30 days'prior written notice has been given to the City Clerk—City of Oshkosh. CERTIFICATE HOLDER CANCELLATION City of Oshkosh,Attn:City Clerk Insurance Standard II SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 215 Church Avenue SAMPLE CERTIFICATE THE EXPIRATION DATE,THEREOF,NOTICE WILL BE DELIVERED IN PO Box 1130 ACCORDANCE WITH THE POLICY PROVISIONS. Oshkosh,WI 54903-1130 Please indicate somewhere on this certificate,the contract or project# AUTHORIZED REPRESENTATIVE this certificate is for. ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD CONTRACTOR AGREEMENT- SAMPLE THIS AGREEMENT, made on the th day of , 20 , by and between the CITY OF OSHKOSH, party of the first part, hereinafter referred to as CITY, and Contractor Name., address hereinafter referred to as the CONTRACTOR, WITNESSETH: That the City and the Contractor, for the consideration hereinafter named, enter into the following Agreement. The CITY'S Bid Specifications and Insurance requirements are attached hereto and incorporated into this Agreement. The Contractor's proposal is also attached hereto and reflects the agreement of the parties except where it conflicts with the CITY'S terms within this agreement, in which case the CITY'S Bid Specifications, Insurance requirements, and other terms of this agreement shall prevail. ARTICLE I. PROJECT MANAGER A. Assignment of Project Manager. The Contractor shall assign the following individual to manage the project described in this contract: (Contractor Project Manager Name & Title) B. Changes in Project Manager. The City shall have the right to approve or disapprove of any proposed change from the individual named above as Project Manager. The City shall be provided with a resume or other information for any proposed substitute and shall be given the opportunity to interview that person prior to any proposed change. ARTICLE II. CITY REPRESENTATIVE The City shall assign the following individual to manage the project described in this contract: (City Project Manager Name & Title) ARTICLE III. SCOPE OF WORK The Contractor shall provide services described in the CITY'S Bid Specifications dated , attached hereto as Exhibit A, and the Contractor's "Project Bid Proposal Form" dated , attached hereto as Exhibit B. Both Exhibit A and B are incorporated into this Agreement. If anything in the Contractor's proposal conflicts with the CITY'S Bid Specifications or with this agreement, the CITY'S Bid Specifications and the provisions in this agreement shall govern. 15 caused or result from any violation of any law or administrative regulation, and shall indemnify or refund to the City all sums including court costs, attorney fees and punitive damages which the City may be obliged or adjudged to pay on any such claims or demands within thirty (30) days of the date of the City's written demand for indemnification or refund. ARTICLE VIII. INSURANCE The Contractor shall provide insurance for this project that includes the City of Oshkosh as an additional insured. The specific coverage required for this project is identified in the CITY'S Bid Specifications dated , attached hereto as Exhibit A and fully incorporated into this Agreement. The Contractor is responsible for meeting all insurance requirements. The CITY does not waive this requirement due to its inaction or delayed action in the event that the Contractor's actual insurance coverage varies from the Insurance required. ARTICLE IX. TERMINATION A. For Cause. If the Contractor shall fail to fulfill in timely and proper manner any of the obligations under this Agreement, the City shall have the right to terminate this Agreement by written notice to the Contractor. In this event, the Contractor shall be entitled to compensation for any satisfactory, usable work completed. B. For Convenience. The City may terminate this contract at any time by giving written notice to the Contractor no later than 10 calendar days before the termination date. If the City terminates under this paragraph, then the Contractor shall be entitled to compensation for any satisfactory work performed to the date of termination. This document and any specified attachments contain all terms and conditions of the Agreement and any alteration thereto shall be invalid unless made in writing, signed by both parties and incorporated as an amendment to this Agreement. In the Presence of: CONTRACTOR /CONSULTANT By: (Seal of Contractor (Specify Title) if a Corporation.) 17 BID FORM DIGESTER CLEANING- WASTEWATER TREATMENT PLANT CITY OF OSHKOSH Page 1 of 2 BID DEADLINE IS 10:00 A.M., THURSDAY MAY 8, 2014 From: (bidder's company name) We, the undersigned, propose to furnish all labor and materials to perform this work per bid specifications. Any area of the proposal page left blank may be considered as a non-responsive bid. Base Bid: Mobilization and Demobilization $ Unit price per dry ton for removal of approximately 100 dry tons of solids delivered to the Outagamie County Landfill. 100 dry tons (more/less) x 100 dry tons $ Unit price (Total Lump Sum Base Bid Price — In Words) Total Lump Sum Bid Work to commence in after receipt of order Addendum Acknowledgement We hereby acknowledge receipt of and have thoroughly examined the written Addenda(s) issued prior to the bid date in association with this project. These Addenda are numbered through , inclusive. We further understand that failure to fully list the numbers of all published Addenda may cause the City to reject this bid. Note: If no addenda were published for this project write "N/A" in blanks above. Payment terms Date Submitted: 19 EXHIBIT B 6 BID FORM DIGESTER CLEANING- WASTEWATER TREATMENT PLANT CITY OF OSHKOSH Page 1 of 2 BID DEADLINE IS 10:00 A.M., THURSDAY MAY 8, 2014 From: Synagro Central, LLC (bidder's company name) We, the undersigned, propose to furnish all labor and materials to perform this work per bid specifications. Any area of the proposal page left blank may be considered as a non-responsive bid. Base Bid: Mobilization and Demobilization $ 9,490.00 Unit price per dry ton for removal of approximately 100 dry tons of solids delivered to the Outagamie County Landfill. 100 dry tons (more/less) $510.00 x 100 dry tons $ 51,000.00 Unit price Sixty thousand four hundred ninety dollars and zero cents $ 60,490.00 (Total Lump Sum Base Bid Price-- In Words) Total Lump Sum Bid Work to commence in 2-4 weeks after receipt of order Addendum Acknowledgement We hereby acknowledge receipt of and have thoroughly examined the written Addenda(s) issued prior to the bid date in association with this project. These Addenda are numbered N/A through N/A , inclusive. We further understand that failure to fully list the numbers of all published Addenda may cause the City to reject this bid. Note: If no addenda were published for this project write "N/A" in blanks above. Payment terms Net 30 Date Submitted: May 6, 2014 19 BID FORM DIGESTER CLEANING-WASTEWATER TREATMENT PLANT CITY OF OSHKOSH Page 2 of 2 Name of Company: Synagro Central, LLC Submitted by: (name and title) Michael Schwartz, Vice President Email address: ekneis @synagro.com Address of Company: 435 Williams Ct, Ste 100, Baltimore, MD 21220 Phone: 443-489-9000 20 (3) Matt deWitt, MBA Director of Contract Management 443-489-9104 direct 443-489-9043 fax 411D_die mdewitt@synagro.com email People + Planet-> Synchronization ir www.synagro.com 435 Williams Court, Suite 100, Baltimore, MD 21220 z June 13, 2014 Ms. Holly Magrady City of Oshkosh 215 Church Avenue Oshkosh, WI 54903 RE: Signed Contract for City of Oshkosh, WI Updated information for Synagro Project Manager Dear Ms. Magrady: The contract lists Michael Schwartz, who is a Vice President for Synagro, and will not be managing the project. The project manager for the scope of work will be: Name: Luke Ellman E-mail: lellman @synagro.com Phone: 715-421-1866 Should you have questions or need additional information, please feel free to contact me at (443) 489-9104 or mdewitt( synagro.com . We thank you for this opportunity and look forward to working with the City of Oshkosh, WI on this project. Sincerely, Synagro Central, LLC toaraVico:- Matt deWitt, MBA Director of Contract Management Enclosures (13 Matt deWitt, MBA Director of Contract Management 443-489-9104 direct 443-489-9043 fax Qmdewitt@synagro.com email People + Planet-> Synchronization www.synagro.com 435 Williams Court, Suite 100, Baltimore, MD 21220 z May 22, 2014 Ms. Holly Magrady City of Oshkosh 215 Church Avenue Oshkosh, WI 54903 RE: Performance Bond and Insurance for City of Oshkosh, WI Dear Ms. Magrady: Enclosed are the Performance Bond and Certificate of Insurance for the City of Oshkosh, WI. Should you have questions or need additional information regarding the documents, please feel free to contact me at (443) 489-9104 or mdewittCa�synagro.com . We thank you for this opportunity and look forward to working with the City of Oshkosh, WI on this project. Sincerely, Synagro Central, LLC Matt deWitt, MBA Director of Contract Management Enclosures ACOROao DATE(MM/DD/YYYY)/DD1�) ., CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to m the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the w certificate holder in lieu of such endorsement(s). c CONTACT d PRODUCER — Aon Risk Services Northeast, Inc. PHONE (866) New York NY Office (A/C.No.Ext): 283-7122 I (A/C.No.): (800) 363-0105 I..'0 199 water Street E-MAIL p New York NY 10038-3551 USA ADDRESS: I INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: Ironshore Specialty Insurance Company 25445 Synagro Technologies, Inc. INSURER B: Zurich American Ins Co 16535 SEE AFFILIATED ENTITY BELOW: 435 Williams Court #100 INSURER C: American Zurich Ins Co 40142 Baltimore MD 10038 USA INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570053793613 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD)YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY 001b39300 5/01/2013 08/01/2014 EACH OCCURRENCE $1,000,000 CLAIMS-MADE ©OCCUR DAMAGE TO RENTED $500,000 PREMISES(Ea occurrence) MED EXP(Any one person) $25,000 PERSONAL&ADV INJURY $1,000,000 2 m GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: _ —1 POLICY n PE Q © LOC PRODUCTS-COMP/OP AGG $2,000,000 m OTHER: o 0 ni- B AUTOMOBILE LIABILITY BAP924396001 05/01/2013 08/01/2014 COMBINED SINGLE LIMIT $2,000,000 u-) (Ea accident) X ANY AUTO BODILY INJURY(Per person) 0 Z X ALL OWNED —SCHEDULED BODILY INJURY(Per accident) ar AUTOS AUTOS rq X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS _(Per accident) F a ar A UMBRELLA LIAB X OCCUR 001659400 05/01/2013 08/01/2014 EACH OCCURRENCE $5,000,000 0 X EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 DED !RETENTION C WORKERS COMPENSATION AND WC924396101 05/01/2013 08/01/2014 x PER STATUTE( OTH- EMPLOYERS'LIABILITY Y/N AOS ER B ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBEREXCLUDED? © N/A 924396201 05/01/2013 08/01/2014 (Mandatory In NH) WI & MA E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,descdbe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000— A Pollutn/Env Imp 001659300 05/01/2013 08/01/2014 Each Occurrence $1,000,000— Pollution Deductible $250,000 aW DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached It more space is required) #� The City of Oshkosh, and its officers, council members, agents, employees and authorized volunteers are included as Additional sue.. Insured in accordance with the policy provisions of the General Liability policy. General Liability evidenced herein is Primary and Non-Contributory to other insurance available to an Additional Insured, but only in accordance with the policy's provisions. t- 7s.J CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. �rr�rr������..JJsssaaa City of Oshkosh AUTHORIZED REPRESENTATIVE Attn: City Clerk 215 Church Avenue PO BOX 1130 n/J `� �- O�Q �{�'cy�.p .® �i M Oshkosh WI 54903 1130 USA coon :erccKc cJ c/� � IGeJ El ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD THE GUARANTEE COMPANY OF The Guarantee Company of North America USA NORTH AFRICA 1000 Town Center, Suite 1800, Southfield, MI 48075 PERFORMANCE BOND Premium $ 1,210.00 BOND AMOUNT: $ 60,490.00 BOND NO. 76089484 KNOW ALL MEN BY THESE PRESENTS, That we SYNAGRO CENTRAL, LLC As Principal, and The Guarantee Company of North America USA, a Michigan Corporation, as Surety, are held and firmly bound unto CITY OF OSHKOSH As Obligee, in the sum of Sixty Thousand Four Hundred Ninety and 00/100 ($ 60,490.00 Dollars for which sum, we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, by these presents. WHEREAS, on the 27th day of May , 2014 , the Principal entered into a contract with the Obligee for Digester Cleaning Wastewater Treatment Plant of Cityof Oshkosh,WI. Which contract is by reference made a part hereof and is hereafter referred to as the Contract. NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, That, if the Principal shall faithfully perform said Contract in accordance with the plans, specifications and terms thereof, then this obligation shall be void; otherwise, it shall remain in full force and effect. Sealed with our Seals and Dated this 28th day of May ,2014 • SYNAGRO CENTRAL, LLC P,, cipal -- —� By: f The Guara tee Company of ort erica USA Sa' •iaz, Attorney-In-Fact • 410 THE The Guarantee Company of North America USA GUARANTEE" Southfield,Michigan POWER OF ATTORNEY KNOW ALL BY THESE PRESENTS:That THE GUARANTEE COMPANY OF NORTH AMERICA USA,a corporation organized and existing under the laws of the State of Michigan,having its principal office in Southfield,Michigan,does hereby constitute and appoint Annette Leuschner,Jessica lannotta,Cynthia Farrell,Vivian Carti,Susan A.Welsh,Sandra Diaz,Evangelina Dominick,Debra A.Deming,Edward Reilly Aon Risk Services Northeast, Inc-New York its true and lawful attorney(s)-in-fact to execute, seal and deliver for and on its behalf as surety, any and all bonds and undertakings, contracts of indemnity and other writings obligatory in the nature thereof,which are or may be allowed, required or permitted by law,statute,rule,regulation,contract or otherwise. The execution of such instrument(s) in pursuance of these presents, shall be as binding upon THE GUARANTEE COMPANY OF NORTH AMERICA USA as fully and amply,to all intents and purposes, as if the same had been duly executed and acknowledged by its regularly elected officers at the principal office. The Power of Attorney is executed and may be certified so,and may be revoked,pursuant to and by authority of Article IX,Section 9.03 of the By-Laws adopted by the Board of Directors of THE GUARANTEE COMPANY OF NORTH AMERICA USA at a meeting held on the 31n day of December,2003. The President,or any Vice President,acting with any Secretary or Assistant Secretary,shall have power and authority: 1. To appoint Attorney(s)-in-fact, and to authorize them to execute on behalf of the Company, and attach the Seal of the Company thereto, bonds and undertakings,contracts of indemnity and other writings obligatory in the nature thereof;and 2. To revoke,at any time,any such Attorney-in-fact and revoke the authority given,except as provided below 3. In connection with obligations in favor of the Florida Department of Transportation only, it is agreed that the power and authority hereby given to the Attorney-in-Fact includes any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts required by the State of Florida Department of Transportation. It is fully understood that consenting to the State of Florida Department of Transportation making payment of the final estimate to the Contractor and/or its assignee, shall not relieve this surety company of any of its obligations under its bond. 4. In connection with obligations in favor of the Kentucky Department of Highways only, it is agreed that the power and authority hereby given to the Attorney-in-Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner— Department of Highways of the Commonwealth of Kentucky at least thirty(30)days prior to the modification or revocation. Further,this Power of Attorney is signed and sealed by facsimile pursuant to resolution of the Board of Directors of the Company adopted at a meeting duly called and held on the 6th day of December 2011,of which the following is a true excerpt: RESOLVED that the signature of any authorized officer and the seal of the Company may be affixed by facsimile to any Power of Attorney or certification thereof authorizing the execution and delivery of any bond, undertaking, contracts of indemnity and other writings obligatory in the nature thereof, and such signature and seal when so used shall have the same force and effect as though manually affixed. / T ,o IN WITNESS WHEREOF, THE GUARANTEE COMPANY OF NORTH AMERICA USA has caused this instrument to be signed and / its corporate seal to be affixed by its authorized officer,this 23rd day of February,2012. 9 g THE GUARANTEE COMPANY OF NORTH AMERICA USA AIIE, ^ � /J�JSn(/^C i , /. STATE OF MICHIGAN Stephen C.Ruschak,President&COO Randall Musselman,Secretary County of Oakland On this 23rd day of February, 2012 before me came the individuals who executed the preceding instrument,to me personally known, and being by me duly sworn,said that each is the herein described and authorized officer of The Guarantee Company of North America USA;that the seal affixed to said instrument is the Corporate Seal of said Company; that the Corporate Seal and each signature were duly affixed by order of the Board of Directors of Cynthia A. Takai IN WITNESS WHEREOF,I have hereunto set my hand at The Guarantee 0.. Notary Public, State of Michigan Company of North America USA offices the day and year above written. County of Oakland . ..Z.i.to , , My Commission Expires February 27, 2018 r J a. �� � . ;,'s' Acting in Oakland County I, Randall Musselman,Secretary of THE GUARANTEE COMPANY OF NORTH AMERICA USA,do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney executed by THE GUARANTEE COMPANY OF NORTH AMERICA USA,which is still in full force and effect. saww,.. IN WITNESS WHEREOF, I have thereunto set my hand and attached the seal of said Company thisa ellay of I l a(J/ i y 4/AMt.4:)Y Randall Musselman,Secretary THE GUARANTEE COMPANY OF NORTH AMERICA USA Home Office,Southfield,Michigan STATUTORY BALANCE SHEET December 31, 2013 ASSETS Cash and Short-Term Investments $ 88,558,327 Marketable Securities 139,936,562 Premium and Agents Balances (under 90 days) 3,752,481 Reinsurance Receivable on paid losses 1,333,945 Accrued Interest and Dividends 1,235,146 Other Assets 736,888 Total Admitted Assets $235,553,349 LIABILITIES Reserve for Losses and Loss Adjustment Expenses $ 7,911,150 Unearned Premium Reserve 11,027,324 Note Payable to Parent 48,000,000 Accrued Expenses 1,467,901 Ceded Reinsurance Premiums Payable 871,910 Taxes, Licenses and Fees Payable 170,928 Net Deferred Tax Liability 1,513,678 Federal Income Tax Payable 1,447,748 Other Liabilities 7,389,391 Total Liabilities $ 79,800,030 CAPITAL AND SUPLUS Common Stock and Paid-In Capital $144,020,970 Surplus 11,732,349 Total Policyholders' Surplus $155,753,319 Total Liabilities, Capital and Surplus $235,553,349 State of Michigan County of Oakland Robert A.Dempsey being duly sworn,says: That he is the President of The Guarantee Company of North America USA;that said company is a corporation duly organized,existing,and engaged in business as a surety by virtue of the laws of the State of Michigan,and has duly complied with all the requirements of the laws of said state applicable to said company and is duly qualified to act as surety under such laws;that said company has also complied with and is duly qualified to act as surety under the Act of Congress of July 30, 1947,as amended(6 U.S.C.6-13);that the foregoing is a full,true and correct statement of the financial condition of said company on the 3151 day of December 2013. Sworn to before me this 8th day of March 2014. Notary �� /�' Robert A- .Dempsey,President ,� Cynthia A.Take! }� Notary Public,State of Michigan County of Oakland My Commission Expires February 27,2018 Acting in Oakland County THE GUARANTEE COMPANY OF NORTH AMERICA The Guarantee Company of North America USA (9\\,,,_} 1000 Town Center, Suite 1800, Southfield, MI 48075 PAYMENT BOND BOND AMOUNT: $ 60,490.00 BOND NO.: 76089484 KNOW ALL MEN BY THESE PRESENTS, That we, SYNAGRO CENTRAL, LLC As Principal, and The Guarantee Company of North America USA, a Michigan Corporation, as Surety, are held and firmly bound CITY OF OSHKOSH As Obligee, in the sum of Sixty Thousand Four Hundred Ninety and 00/100 ($ 60,490.00 ) Dollars for which sum, we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, by these presents. WHEREAS, on the 27th day of May , 2014 , the Principal entered into a contract with the Obligee for Digester Cleaning Wastewater Treatment Plant of Cityof Oshkosh,WI. Which contract is by reference made a part hereof and is hereafter referred to as the Contract. NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, That, if the Principal shall pay all lawful claims of sub-contractors, materialmen, or laborers for labor performed or materials furnished directly to the Principal, in the performance of said Contract, we agreeing that his bond shall be for the benefit of any sub- contractor, materialman, or laborer having a just claim, then this obligation shall be void; otherwise, it shall remain in full force and effect, subject, however, to the following condition: No suit or action shall be commenced hereunder by any claimant. a) After the expiration of one (1) year following the date on which Principal ceased work on said Contract it being understood, however, that if any limitation embodied in this bond is prohibited by any law controlling the construction hereof such limitation shall be deemed to be amended so as to be equal to the minimum period of limitation permitted by such law. b) Other than in a state of court of competent jurisdiction in and for the county or other political subdivision of the state in which the Project, or any part thereof, is situated, or in the United States District Court for the District in which the Project, or any part thereof, is situated, and not elsewhere. Sealed with our Seals and Dated this 28th day of May , 2014 . SYNAGRO CENTRAL, LLC Princi•-I By: L_ .AI d � The Guarantee Company o.��': h America USA / - 1 BY _ .�.IIU .L< .. I _ v.. Sandra , Attorney-In-Fact THE .� The Guarantee Company of North America USA GUARANTEE Southfield,Michigan POWER OF ATTORNEY KNOW ALL BY THESE PRESENTS:That THE GUARANTEE COMPANY OF NORTH AMERICA USA,a corporation organized and existing under the laws of the State of Michigan,having its principal office in Southfield,Michigan,does hereby constitute and appoint Annette Leuschner,Jessica lannotta,Cynthia Farrell,Vivian Carti,Susan A.Welsh,Sandra Diaz,Evangelina Dominick, Debra A.Deming,Edward Reilly Aon Risk Services Northeast,Inc-New York its true and lawful attorney(s)-in-fact to execute, seal and deliver for and on its behalf as surety, any and all bonds and undertakings, contracts of indemnity and other writings obligatory in the nature thereof,which are or may be allowed, required or permitted by law,statute, rule, regulation,contract or otherwise. The execution of such instrument(s) in pursuance of these presents, shall be as binding upon THE GUARANTEE COMPANY OF NORTH AMERICA USA as fully and amply, to all intents and purposes, as if the same had been duly executed and acknowledged by its regularly elected officers at the principal office. The Power of Attorney is executed and may be certified so,and may be revoked, pursuant to and by authority of Article IX,Section 9.03 of the By-Laws adopted by the Board of Directors of THE GUARANTEE COMPANY OF NORTH AMERICA USA at a meeting held on the 315`day of December,2003. The President,or any Vice President,acting with any Secretary or Assistant Secretary,shall have power and authority: 1. To appoint Attorney(s)-in-fact, and to authorize them to execute on behalf of the Company, and attach the Seal of the Company thereto, bonds and undertakings,contracts of indemnity and other writings obligatory in the nature thereof;and 2. To revoke,at any time,any such Attorney-in-fact and revoke the authority given,except as provided below 3. In connection with obligations in favor of the Florida Department of Transportation only, it is agreed that the power and authority hereby given to the Attorney-in-Fact includes any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts required by the State of Florida Department of Transportation. It is fully understood that consenting to the State of Florida Department of Transportation making payment of the final estimate to the Contractor and/or its assignee, shall not relieve this surety company of any of its obligations under its bond. 4. In connection with obligations in favor of the Kentucky Department of Highways only, it is agreed that the power and authority hereby given to the Attorney-in-Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner— Department of Highways of the Commonwealth of Kentucky at least thirty(30)days prior to the modification or revocation. Further,this Power of Attorney is signed and sealed by facsimile pursuant to resolution of the Board of Directors of the Company adopted at a meeting duly called and held on the 6th day of December 2011,of which the following is a true excerpt: RESOLVED that the signature of any authorized officer and the seal of the Company may be affixed by facsimile to any Power of Attorney or certification thereof authorizing the execution and delivery of any bond, undertaking, contracts of indemnity and other writings obligatory in the nature thereof, and such signature and seal when so used shall have the same force and effect as though manually affixed. -.P ltEEC IN WITNESS WHEREOF, THE GUARANTEE COMPANY OF NORTH AMERICA USA has caused this instrument to be signed and �J' its corporate seal to be affixed by its authorized officer,this 23rd day of February,2012. g THE GUARANTEE COMPANY OF NORTH AMERICA USA AMA STATE OF MICHIGAN Stephen C.Ruschak,President&COO Randall Musselman,Secretary County of Oakland On this 23rd day of February, 2012 before me came the individuals who executed the preceding instrument,to me personally known, and being by me duly sworn,said that each is the herein described and authorized officer of The Guarantee Company of North America USA;that the seal affixed to said instrument is the Corporate Seal of said Company; that the Corporate Seal and each signature were duly affixed by order of the Board of Directors of Cynthia A. Takai IN WITNESS WHEREOF, I have hereunto set my hand at The Guarantee Notary Public, State of Michigan Company of North America USA offices the day and year above written. County of Oakland ay;ygo ,' My Commission Expires February 27, 2018 e rL .ct.J a. TLS • ..... Acting in Oakland County I, Randall Musselman,Secretary of THE GUARANTEE COMPANY OF NORTH AMERICA USA,do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney executed by THE GUARANTEE COMPANY OF NORTH AMERICA USA,which is still in full force and effect. V IN WITNESS WHEREOF,I have thereunto set my hand and attached the seal of said Company this day of Gj 1 air Randall Musselman,Secretary THE GUARANTEE COMPANY OF NORTH AMERICA USA Home Office, Southfield,Michigan STATUTORY BALANCE SHEET December 31, 2013 ASSETS Cash and Short-Term Investments $ 88,558,327 Marketable Securities 139,936,562 Premium and Agents Balances(under 90 days) 3,752,481 Reinsurance Receivable on paid losses 1,333,945 Accrued Interest and Dividends 1,235,146 Other Assets 736,888 Total Admitted Assets $235,553,349 LIABILITIES Reserve for Losses and Loss Adjustment Expenses $ 7,911,150 Unearned Premium Reserve 11,027,324 Note Payable to Parent 48,000,000 Accrued Expenses 1 467 901 Ceded Reinsurance Premiums Payable 871,910 Taxes, Licenses and Fees Payable 170,928 Net Deferred Tax Liability 1,513,678 Federal Income Tax Payable 1,447,748 Other Liabilities 7,389,391 Total Liabilities $ 79,800,030 CAPITAL AND SUPLUS Common Stock and Paid-In Capital $144,020,970 Surplus 11,732,349 Total Policyholders' Surplus $155,753,319 Total Liabilities,Capital and Surplus $235,553,349 State of Michigan County of Oakland Robert A.Dempsey being duly sworn,says: That he is the President of The Guarantee Company of North America USA;that said company is a corporation duly organized,existing,and engaged in business as a surety by virtue of the laws of the State of Michigan,and has duly complied with all the requirements of the laws of said state applicable to said company and is duly qualified to act as surety under such laws;that said company has also complied with and is duly qualified to act as surety under the Act of Congress of July 30, 1947,as amended(6 U.S.C.6-13);that the foregoing is a full,true and correct statement of the financial condition of said company on the 31"day of December 2013. Sworn to before me this 8th day of March 2014. . '7 } 1" ,,,, I 'j/may I - r .. .✓ f,cL, tr =S Robert A.Dempsey.President ~ Notary Cynthia A.Take! Notary Public,State of Michigan County of Oakland My Commission Expires February 27,2018 Acting in Oakland County