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FACHIANA EIIILRERSASOCIATION <br />80 YEARS OF REPUTATION, BUILT ON A FOUNDATION OF TRUST <br />COLLECTIVE BARGAINING RIGHTS STATUS <br />Return the completed page to the MBA offices (via email or mail carrier) <br />Initial in the appropriate box Lsl for your intended bargaining rights status. <br />ASSIGN WITHDRAW MBA Collective Bargaining Agreement with: <br />I x l u Laborers International Union of North America, State of Indiana District Council, Local 645 <br />International Union of Operating Engineers, Local 150, District 6 <br />Operative Plasterers & Cement Masons International Association, Local 692, Area 101 s <br />United Union of Roofers, Waterproofers, & Allied Workers, Local 23 <br />Cl <br />Indiana Ohio Kentucky Regional Council of Carpenters, Local 413, Local 615 (Zones 1 & 2) <br />International Assoc. of Bridge, Structural, Ornamental and Reinforcing Ironworkers, Local 292 <br />International Brotherhood of Teamsters, Local 364 <br />Company <br />Michude Construction, Inc. <br />Address 18505 West Creak Dr.- Suile I <br />City, Tinley Parts State IL 80477 <br />Phone 7734es-ssns Email <br />Authorized Individual (Printed name) <br />Date 7-11-2023 <br />• By choosing to assign bargaining lights (above), the u er ned (the "Contractor") hereby designates the Michiana Builders <br />Association, Inc. (MBA) as the sole and exclusive bargain g representative on the selected Collective Bargaining Agreement(s), with <br />full authority to negotiate agreement(s) on its behalf, and to obligate and commit the undersigned to those individual labor <br />Agreement(s) selected. <br />• This assignment(s) supersedes any previous delegation of bargaining authority to any other agent, and will become effective as of the <br />date it is received by the MBA, and may not be terminated prior to the conclusion of these negotiations between the MBA and the <br />designated union. <br />• By executing this assignment(s), the Contractor agrees and warrants that it will not directly negotiate, bargain or agree to any CBA <br />with any union for which bargaining rights have been assigned to the MBA, including any interim agreement(s), nor shall it become <br />party to such agreement(s), either orally or in writing, without the prior written consent of the MBA, with such consent being granted <br />only through action of its Board of Directors. <br />• This bargaining rights assignment(s) and any previous bargaining rights assignment(s) to the MBA (be it through specific assignment <br />or as a result of membership in the MBA) remain in force and effect, including all successor agreements, unfit such time as it is <br />withdrawn in writing. Such written withdrawal notice(s) must be received at the MBA's office no later than 90 days p6orto the expiration <br />of the current collective bargaining agreement(s). <br />SemBoo, IN468M <br />nACIAF <br />I min ISf4.Y8 M5 gn%L,;Lx-nNr Tii£ I 0 51RtlCfIOx INnI S7ilY <br />f 3? rA�IfrL2KM6 <br />MNII COHSTRUCTIDNSITEURG <br />WWW,C 0 NSTRU CTIO N SITL O RG <br />