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EIC",F)CEi-t: <br />o;low91 h q <br />A TOMIC IL I <br />Any singular reference to Bidder, Surety, Owner or other pairty shall be considered plural where applicable. <br />BIDDER (Name and Address): <br />Kokosing Industrial, Inc. <br />6235 Westerville Road <br />Westerville, OH 43081 <br />SURETY (Name, andAddress of Principal Place of Business): <br />Liberty Mutual insurance Company <br />175 Berkeley Street <br />Boston, MA 02116 <br />OWNER (Name and Address): <br />City of South Bend, Indiana <br />Department of Public Works <br />County -City Building Room 1316 <br />227 West Jefferson Street <br />South Bend, fN 46601 <br />BID <br />Bid Due Date: September 22, 2020 <br />Description (Project Name— Include Location): <br />WWTP Final Clarifier Nos. 4-5, Aeration Tank, Nos. 1-4 and Disinfection Improvements (3113 Riverside Drive, South <br />Bend, Indiana 46628) <br />BOND <br />Bond N u m b,e r: 45472-Liberty -20-308 <br />Date: September 16, 2020 <br />Penal sum Two Hundred Sixty Thousand Dollars $ 260,000.00 <br />(Words) (Figuires) <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 />Kokosing Industrial, Inc. (Seal) Liberty Mutual insurance Company (Seal) <br />Bidder's Name and Corporate Seal Surety's Name and Corporate Seal <br />—Iyd <br />Signature Signature (4ttach Power of Attorney), <br />C,Ab <br />Print Name <br />— VIM PECSA.)G'17"' <br />Title <br />Attest: 4�" 10 "ZI <br />Title <br />Carolyn E. Wheeler <br />Print Name <br />Attest: <br />Signature <br />Linda M. Howard, Witness to <br />Title <br />EJ CDCO C-430, Bid Bond (Penal Sum Form). Published 2013, <br />Prepared by the Engi neers J'�oi nt Contrart Dow ments Comm ittee. <br />Page 00 43 13-1 of 2 <br />