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1UCIIC <br />BQ30iH i+4�+e7 �gyEiu g, ; <br />tAr-Wtt.u"1 'IV.,AkL t%" <br />BID BOND <br />PENAL SUM FORM <br />Any singular reference to Bidder, Surety, Owner or other party shall be considered plural where applicable. <br />BIDDER (Name and Address): <br />Peerless -Midwest, Inc. <br />55860 Russell Industrial Parkway, Mishawaka, IN 46545 <br />SURETY (Name, and Address of Principal Place of Business): <br />Travelers Casualty and Surety Company of America <br />One Tower Square, Hartford, CT 06183 <br />OWNER (Name and Address): <br />City of South Bend, Indiana <br />Department of Public Works, County -City Building Room 1316 <br />227 West Jefferson Street, South Bend, IN 46601 <br />BID <br />Bid Due Date: February 12, 2019 <br />Description (Project Name— Include Location): <br />Well No. 1 Replacement - North Station (830 North Michigan Street, South Bend, Indiana 46601) <br />BOND <br />Bond Number: Bid Bond <br />Date: February 12, 2019 <br />Penal SUM Five Percent of Amount Bid $ 5% <br />(Words) (Figures) <br />Surety and Bidder, intending to be legally bound hereby, subject to the terms set forth below, do each cause <br />this Bid Bond to be duly executed by an authorized officer, agent, or representative. <br />BIDDER SURETY <br />Peerless -Midwest, Inc. (Seal) Travelers Caslually and Surety CornRapyof'An <br />Bidder's Name and Corporate Seal Surety's Name and Corporate Seal <br />1____) I/' / <br />By: cap, �.6Z By: <br />Sign ure <br />Print Name <br />G of ,0_iG A t— o w .✓.o 2 !' 1_r__ <br />Title <br />1-11 <br />Attest: 6��Attest: <br />Sig ature 61 <br />Title Wnels <br />Signature (Attach Power of <br />J. Karl Sherrill, Jr. <br />Print Name <br />Attorney -in -Fact <br />Title <br />-_ - �L Aa� <br />Signature Anne Baker <br />Title Witness to Surety <br />Note: Addresses are to be used for giving any required notice. <br />Provide execution by any additional parties, such as joint venturers, if necessary. <br />EJCDC' C-430, Bid Bond (Penal Sum Form). Published 2013. <br />Prepared by the Engineers Joint Contract Documents Committee. <br />Page 1 of 2 <br />HARTFO ) i <br />COIN. .� <br />