HomeMy WebLinkAboutOpening of Bids - Spec AG - Two More or Less 2018 or Newer 1-2 Ton Crew Cab Four Wheel Drive Pickup Trucks - Jordan FordCITY OF SOUTH BEND, INDIANA
SELLER'S BID FOR SALE OR LEASE OF MATERIALS
AND NON -COLLUSION AND NON DEBARMENT AFFIDAVIT AND
NON-DISCRIMINATION COMMITMENT FOR SELLERS
Spec AG - Two (2) More or Less 2018 or Newer % Tory Crew Cab Four Wheel Drive Pickup
BID NAME Trucks
FOR BIDS DUE December 12 2017 at 9:30 a.m.
Bidder
Date: DECEMBER 12, 2017 (Firm): JORDAN FORD
Address: 609 E. JEFFERSON BLVD.
City/State/Zip: MISHAWAKA, IN 46545 Telephone Number: (..5.74 )259-1981
Agent of Bidder (if Applicable): N/A
When the prospective Contractor is unable to certify to any of the statements below, it shall attach an explanation to this Affidavit.
CONTRACTOR'S NON -COLLUSION AND NON -DEBARMENT AFFIDAVIT,
CERTIFICATION REGARDING INVESTMENT WITH IRAN, EMPLOYMENT
ELIGIBILITY VERIFICATION, NON-DISCRIMINATION COMMITMENT AND
CERTIFICATION OF USE OF UNITED STATES STEEL PRODUCTS OR FOUNDRY
PRODUCTS
(Must be completed for all quotes and bids. Please type or print)
STATE OF TNT)lANA
) SS:
sTL .TnsFpx COUNTY )
The undersigned Contractor, being duly sworn upon his/her/its oath, affirms under the penalties of perjury
that:
1. Contractor has not, nor has any other member, representative, or agent of the firm,
company, corporation or partnership represented by him, entered into any combination,
collusion or agreement with any person relative to the price to be bid by anyone at such
letting nor to prevent any person from bidding nor to induce anyone to refrain from
bidding, and that this bid is made without reference to any other bid and without any
agreement, understanding or combination with any other person in reference to such
bidding. Contractor further says that no person or persons, firms, or corporation has, have
or will receive directly or indirectly, any rebate, fee, gift, commission or thing of value
on account of such sale; and
2. Contractor certifies by submission of this proposal that neither contractor nor any
of its principals are presently debarred, suspended, proposed for debarment, declared
ineligible, or voluntarily excluded from participation in this transaction by any Federal
department or agency; and
4
3. Contractor has not, nor has any successor to, nor an affiliate of, Contractor, engaged in
investment activities in Iran.
a. For purposes of this Certification, "Iran" means the government of Iran and any
agency or instrumentality of Iran, or as otherwise defined at Ind. Code § 5-22-16.5-5,
as amended from time -to -time.
b. As provided by Ind. Code § 5-22-16.5-8, as amended from time -to -time, a Contractor
is engaged in investment activities in Iran if either:
L Contractor, its successor or its affiliate, provides goods or services of twenty
million dollars ($20,000,000) or more in value in the energy sector of Iran;
or
ii. Contractor, its successor or its affiliate, is a financial institution that extends
twenty million dollars ($20,000,000) or more in credit to another person for
forty-five (45) days or more, if that person will (i) use the credit to provides
goods and services in the energy sector in Iran; and (ii) at the time the
financial institution extends credit, is a person identified on list published by
the Indiana Department of Administration.
4. Contractor does not knowingly employ or contract with an unauthorized alien, nor
retain any employee or contract with a person that the Contractor subsequently learns is
an unauthorized alien. Contractor agrees that he/she/it shall enroll in and verify the work
eligibility status of all of Contractor's newly hired employees through the E-Verify
Program as defined by I.C. 22-5-1.7-3. Contractor's documentation of enrollment and
participation in the E-Verify Program is included and attached as part of this bid/quote;
and
5. Contractor shall require his/her/its subcontractors performing work under this
public contract to certify that the subcontractors do not knowingly employ or contract
with an unauthorized alien, nor retain any employee or contract with a person that the
subcontractor subsequently learns is an unauthorized alien, and that the subcontractor has
enrolled in and is participating in the E-Verify Program. The Contractor agrees to
maintain this certification throughout the term of the contract with the City of South
Bend, and understands that the City may terminate the contract for default if the
Contractor fails to cure a breach of this provision no later than thirty (30) days after being
notified by the City.
6. Persons, partnerships, corporations, associations, or joint venturers awarded a
contract by the City of South Bend through its agencies, boards, or commissions shall not
discriminate against any employee or applicant for employment in the performance of a
City contract with respect to hire, tenure, terms, conditions, or privileges of employment,
or any matter directly or indirectly related to employment because of race, sex, religion,
color, national origin, ancestry, age, gender expression, gender identity, sexual
orientation or disability that does not affect that person's ability to perform the work.
In awarding contracts for the purchase of work, labor, services, supplies, equipment,
materials, or any combination of the foregoing including, but not limited to, public works
5
contracts awarded under public bidding laws or other contracts in which public bids are
not required by law, the City, its agencies, boards, or commissions may consider the
Contractor's good faith efforts to obtain participation by those Contractors certified by
the State of Indiana as a Minority Business ("MBE") or as a Women's Business
Enterprise ("WBE") as a factor in determining the lowest, responsible, responsive
bidder.
In no event shall persons or entities seeking the award of a City contract be required to
award a subcontract to an MBE/WBE; however, it may not unlawfully discriminate
against said WBE/MBE. A finding of a discriminatory practice by the City's MBE/WBE
Utilization Board shall prohibit that person or entity from being awarded a City contract
for a period of one (1) year from the date of such determination, and such determination
may also be grounds for terminating the contact for which the discriminatory practice or
noncompliance pertains.
7. The undersigned contractor agrees that the following nondiscrimination
commitment shall be made a part of any contract which it may henceforth enter into with
the City of South Bend, Indiana or any of its agencies, boards or commissions.
Contractor agrees not to discriminate against or intimidate any employee or applicant for
employment in the performance of this contract with privileges of employment, or any
matter directly or indirectly related to employment, because of race, religion, color, sex,
gender expression, gender identity, sexual orientation, handicap, national origin or
ancestry. Breach of this provision may be regarded as material breach of contract.
I, the undersigned bidder or agent as contractor on a public works project, understand my
statutory obligations to the use of steel products or foundry products made in the United
States (I.C. 5-16-8-1). I hereby certify that I and all subcontractors employed by me for
this project will use steel products or foundry products made in the United States on this
project if awarded. I understand I have an affirmative duty to notify the City in my bid
that my proposal does not include the use of steel products or foundry products made in
the United States. I understand it is my sole obligation and responsibility to provide a
justification to the City, subject to review and approval, why the cost of United States
made steel or foundry products is unreasonable. Prior to award and upon submission of
bid which does not use steel products or foundry products made in the United States, the
City, through its director of public works, shall make a determination if the price of
United States made steel or foundry is unreasonable. I understand that violations
hereunder may result in forfeiture of contractual payments.
I hereby affirm under the penalties of perjury that the facts and information contained in the foregoing bid
for public works are true and correct.
Dated this 12mu day of DEGEMrtW- 17
J ORDAN FORD
C1
Contractor/Bidder (Firm)
Signature of Contractor/Bidder or Its Agent
DEBRA STARKWEATHER
COMMERCIAL FIXET SA - I 'ES MANAGER
Printed Name and Title
Subscribed and sworn to before me this 12TH day of DECEMBER , 20 17
My Commission Expires (pl I2oZt
Notary Public
County of Residence
WHITNEY R, PYLE, notary Public
County of St. Joseph, State of Indiana
My Commission Expires 01/09/2021
VA
(To be completed only by Contractors/Bidders claiming to he a "local Indiana business "pursuant to I.0 36-1-12-22)
INDIANA LOCAL BUSINESS PREFERENCE CLAIM
A "local Indiana business " refers to any of the following:
(1) A business whose principal place of business is located in an affected county.
(2) A business that pays a ?najority of its payroll (in dollar volume) to residents of affected counties.
(3) A business that employs residents of affected counties as a majority of its employees.
(4) A business that makes significant capital investments in the affected counties as defined in rules adopted by the political
subdivision.
(5) A business that has a substantial positive economic impact on the affected counties as defined by criteria in rules adopted by
the political subdivision.
An "affected county" refers to St. Joseph County, Indiana, or the following counties located adjacent to St. Joseph County:
Elkhart County, Mat -shall County, Starke County and LaPorte CounoJ
There are the following price preferences for supplies purchased from a local Indiana business:
• 5% for a purchase expected by the purchasing agency to be less than $50, 000
• 3%for a purchase expected by the purchasing agency lobe at least $50,000 but less than $100, 000.
• I % for a purchase expected by the purchasing agency to beat least $100, 000.
Date: DECEMBER 12, 2017
Pursuant to I.C. 36-1-12-22, JORDAN FORD claims a local Indiana business
preference for Project spp:r Ac� 1 19 TpN CREW PTCKTiP (Project 4 �, located within the City of
South Bend, St. Joseph County, Indiana.
❑X The location of the principal place of business is 609 E JEFFERSON MTSHAWAKA TN 46545
(Addremv)
® St. Joseph County, Indiana
❑ The following county located adjacent to St. Joseph County, Indiana:
The majority of the business's payroll for the 12 months prior to the date of this Bid is to residents of St.
Joseph County, Indiana or the adjacent county noted above.
® The majority of the business's employees for the 12 months prior to the date of this Bid are residents of
St, Joseph County, Indiana, or the adjacent county noted above.
If the business is deemed to be the apparent lowest, responsible, responsive bidder, then it shall provide
supporting documentation for the 12 month period prior to the date of the Bid of (i) the total payroll
amount paid to all employees of the business, and (ii) the total payroll amount paid to employees who are
residents of St. Joseph County and the adjacent county noted above.
WHEN SUPPLYING SUPPORTING PAYROLL RECORDS, BIDDER SHALL REDACTALL
SOCIAL SECURITY NUMBERS.
Dated this 12TH day of DECEMBER , 20_17_
C ntractor/Bidder (Firm}
Signature of Contractor/Bidder or Its Agent
DEBRA STARKWEATHER
COMMERCIAL FT.ERT SALES MANAGER
Printed Name and Title
BID/PROPOSAL
PKA T
CITY OF SOUTH BEND
Spec AG — Two (2) More or Less 2018 or Newer % Ton Crew Cab Four
BID NAME Wheel Drive Pickup Trucks
FOR BIDS DUE December 12, 2017 at 9:30 a.m.
Description
Year/Make/Model
Unit Price
4X4 CREW CAB
2018 FORD F150 XL
$30,945.00 EAC
Alternate#
Description
Unit Price
1
Bi-Fuel Conversion, Gasoline/CNG conversion with state
of the art com onents and minimum 20 G.G.E. tanks.
$ 11,150.00 EAC
2
Utility type truck cap with 3 doors, no windows painted to
match truck. ALUMINUM
$ 1, 884.00 EACH
3
Roll type tonneau cover. SOFT COVER
$ 448.00 EACH
Estimated number of days for delivery from award 84 To 98 DAYS
date.
Bidder (Firm):
Address:
JORDAN FORD
609 E. JEFFERSON BLVD.
City/State/Zip: MISHAWAKA, IN 46545
Telephone Number: 574/259_19RI Fax Number: 574/254-9777
By� �� &
(Signature)
coo.] 7.11KI1 KWI DY 1i.Pit
(Printed Name)
COMMERCIAL FLEET SALES MANAGER
(Title)
14
BOARD OF PUBLIC WORKS
Gary A. Gilot, President
Suzanna M. Fritzberg, Member
James A. Mueller, Member
15
Elizabeth A, Maradik, Member
Therese J. Dorau, Member
Attest: Linda M. Martin, Clerk
fir atve
Tuet"Systems
Fresno, CA * Elkhart, IN
BI-FUIEL CNG/Gasoline
Will Gutilla 559-289-8522
will@alallffuels,com Im. III
DATE QUOTE
11/30/2017 17113OWG
NAME ADDRESS
Deb Starkweather
Jordan Automotive Group
Mishawaka, IN
P.O. NO.
FORD DROP SHIP
TERMS
'REP
END USER
FOB
88MNZ4
Due on Complefion
WG
South Bend
Elkhart, IN
ITEM
DESCRIPTION
QTY
PRICE EA.
Underbodw
EPA Certified Bi-Fuel CNG System
F150-AE10-UB-BF
10 GGE 2018 Ford F-1 50 5.01E
1
$9,400,00
CNG Tanks Mounted Behind Rear Axle; OEM Gasoline Tank
_,:;t�/
Per Unit
Remains (Must Be Midshilp)
In -Bed
EPA Certified Bi-Fuel CNG System
F1 50-AE23-IIB-BF
23 GGE 2018 Ford F-150 5.01_
1
$10,900.00
CNG Tank Mounted! In -Bed; OEM Gasoline Tank Remains; Cannot
Per Unit
be 5.5'Bed
All items in "Alternate V section of South Bend bid sent by D
Starkweather on 11 -21-17 are included, EXCEPT:
For underbody option, tanks to be installed are Type 1, not Type 4.
- For underbodly option, tanks will amount to 10 GGE, not the
required 20 GGE.
• No methane detector is provided, It is not recommended on this
vehicle type.
Note: Quote is contingent on 2018 EPA certification.
Note: Quote is good 60 days and is FOB Elkhart, IN.
Note: CNG tanks will have approximately 1000psi upon completion.
Note: After receipt of purchase order, vehicle will be put into production schedule.
Note: After parts and vehicle arrive please allow 25 working days for delivery of first vehicle, and approximately 5
days for each additional vehicle.
Note: Vehicle must be ordered with Fordl's Gaseous Fuel Prep Engine option.
BUYER AUTHORIZATION : Buyer's signature below is acceptance to purchase the product identified above.
Signature............................................................ Date: ----------------------------------
1Aca,
L C CAP SALES, INC
1819 CASSOPOLIS ST.
ELKIMRT, IN 46514
574-262-2301
FAX4574-264-3782
11"if.111MCMA 5151:91
JORDON FORD
FAX41-574-254-2776
1-574-259-1981
DEB STARKWEATHER
FAX41-574-254-2777
DATE Order #
11/29/2017 226
ITEM
DESCRIPTION
CITY
COST
TOTAL
ALUM CAP
ALUM CAP DCC LEER 2018 FORD
1
1,495.00
1,495.00
F- 150 CREW CAB 6.5 BED
SIDE DOORS
SIDE DOORS SOLID NO WINDOWS
2
0.00
0.00
PASS + DRIVER
REAR DOOR
REAR DOOR SOLID NO WINDOW
1
0.00
0.00
PAINTED T ...
PAINTED TO MACTH COLOR# PCB
1
389.00
389.00
RACE RED
MOUNT CL ...
MOUNT CLAMPS, SEAL, BRAKE
0.00
0.00
LIGHT
SER#
TOTAL $1,884.00
L C CAP SALES, INC
1819 CASSOPOLIS ST.
ELKHART, IN 46514
5174-262-2301
FAX4574-264-3782
NAME /ADDRESS
JORDON FORD
FAX#1-574-254-2776
1-574-259-1981
DEB STARKWEATHER
FAX#1-574-254-2777
Sales
Order
ITEM
DESCRIPTION
QTY COST
TOTAL
100 R
100 R-CC FIBERGLASS BY LEER
1 1,525.00
1,525.00
CAP 2018 F-150 CREW AB 6.5
NO WINDO...
NO WINDOW IN FRONT
0.00
0.00
SIDE DOORS
SIDE DOORS SOLID DRIVER + PASS
2 279.00
558.00
REAR DOOR
REAR DOOR SOLID
1 239.00
239.00
PAINTED T...
PAINTED TO MACTH NIC,
1 0.00
0.00,
MOUNTCL...
MOUNT CLAMPS, SEAL, BRAKE
0.00
0.00
LIGHT
COLOR# PQ RACE RED
SER#
TOTAL $2,322.00
CNGP530 VEHICLE ORDER CONFIRMATION 11/21/17 11:07:22
> Dealer: F48207
2018 F-150 Page: 1 of 2
order NO: 1111 Priority: A2 Ord FIN: QA587 order Type: 5B Price Level: 815
Ord PEP: 101A Cust/Flt Name: SOUTH BEND PO Number:
RETAIL DLR INV RETAIL DLR INV
WlE F150 4X4 CREW $39685 $37701.00 18B BLK PLAT BDS $250 $231.00
157" WHEELBASE PRO TRAILER AST
PQ RACE RED SYNC
C CLOTH 40/20/40 53A TRAILER TOW PKG 995 916.00
G MED EARTH GRAY AM/FM CD
101A EQUIP GRP 2255 2075.00 67T TRL BRAKE CONTR 275 253.00
.XL SERIES 85H BACK UP ALARM 125 115.00
.POWER EQUIP GRP
.CRUISE CONTROL TOTAL BASE AND OPTIONS 45690 42139.92
.17"SILVER STEEL XL MID DISCOUNT (750) (691.00)
995 5.OL V8 FFV ENG NC NC TOTAL 44940 41448.92
44G ELEC 10-SPDAUTO *THIS IS NOT AN INVOICE
.265/70R-17
X27 3.31 REG AXLE NC NC MORE ORDER INFO NEXT PAGE
7050# GVWR F8-Next
CNGP530
VEHICLE ORDER CONFIRMATION
11/21/17 11:07:25
Dealer: F48207
2018 F-150
Page: 2 of 2
order NO: 1111 Priority:
A2 Ord FIN: QA587 Order Type:
5B Price Level: 815
Ord PEP: 101A CUSt/Flt Name:
SOUTH BEND PO Number:
RETAIL
DLR INV
RETAIL DLR INV
96W SPRAY- IN LINER
$495
$456.00
FLEX FUEL
98G CNG/PROPANE PAC
315
289.00
SP FLT ACCT CR
(1200.00)
FUEL CHARGE
8.92
DEST AND DELIV
1295
1295.00
TOTAL BASE AND OPTIONS
45690
42139.92
XL MID DISCOUNT
(750)
(691.00)
TOTAL
44940
41448.92
*THIS IS NOT AN INVOICE'
CITY OF SOUTH BEND
BID FOR SPEC AG - TWO MORE OR LESS 2018 OR NEWER
TON CREW CAB FOUR WHEEL DRIVE PICKUP TRUCKS
BID DUE DATE: DECEMBER 12, 2017
NOTES & EXCEPTION PAGE
IN LIEU OF SERVICE MANUALS, FREE ACCESS TO FORD'S TECHNICAL
RESOURCE CENTER
ALTERNATE #4 - IF YOU PREFER A HARD TONNEAU COVER, PRICE IS
$849 INSTEAD
BID INCLUDES FORDS TRAILER TOW PACKAGE: TOWING CAPABILITY
UP TO 11,100 LBS, AND INCLUDES 4-PIN/7-PIN WIRING HARNESS,
AUXILIARY TRANSMISSION OIL COOLER, CLASS IV TRAILER HITCH
RECEIVER, UPGRADED FRONT STABILIZER BAR
REAR SLIDING WINDOW IS NOT AVAILABLE.
PAYMENT IS DUE WITHIN 30 DAYS OF DELIVERY.
Conforms with The American Institute of Architects AIA Document 310
Bid Bond
CONTRACTOR: SURETY:
(A'ame, legal .Yfalay andird4h-e-m) legal siams andpMicipal plave oftl4vilress)
Jordan Automotive Group dba Jordan Ford The Hanover Insurance Company This document has Important
609 E. Jefferson Boulevard 440 Lincoln Street legal consequences. Consultation
Mishawaka, IN 46545 Worcester, MA 01653 with an attorney Is encouraged
with respect to its colmpleflon or
modification.
OWNER.,
(Name, legalstalusandad(iress) Any singular reference to
Contractor, Surety, Owner or
City of South Bend other party shall be considered
13th Floor, County -City Building, Room 1316, 227 West Jefferson Boulevard plural where applicable.
South Bend, IN 46601
BOND AMOUNT: $ 10% Ten Percent of Amount Bid
PROJECT:
(Name, location or address. andIlrqlocinamber, ifaltl}
Spec AG - Two (2) More or Less 2018 or Newer 1/2 Ton Crew Cab Four Wheel Drive Pickup Trucks
The Contractor and Surety are bound to ilia Owner ill the amount sot forth above, for ilia payniont of which the Contractor and Surety bind
tilemselves, their hairs, executors, administrators, successors and assigns, jointly and severally, as provided herein. Tile renditions of this
Bond are such that if the Owner accepts the bid of the Contractor wilhin tho tirtic specified ill the bid documents, or within such flino period
03 1110V be agreed to by the Owner and Contractor, and tho Contractor cither (1) enters into, a contract with the Owner in accordance with
the terns of such bid, and gives such bond or bonds as stay be specified in tile bidding or Contract Documents, willi -a surety admitted in
Ilia jurisdiction of the llrqiect and otl)cr%viso acceptable to the Owner, for the faithful porformanco of such Contract and for tile prompt
payment of labor and material furnished ill the prosecution Ilicreof; or (2) pays to the Owner the difference, not to exceed the amount of
this Dorid, between Ilic amount specified in said bid and such larger amount for which the Owner may ill good faith contract %vith anollier
party to perl'brni the Nvork covered by said bid, theta this obligation shall be nall and void, otherwise to remain in 1'411 force and ellbct. The
Surely lierel)y %vaives any notice ()['an agreement b(',I%Vecll tile OWIlUr and Contractor to extend the time in which the Owner may accept 1110
bid. \«Iaivcrofnotice: by the Surety shall not apply Io any extension exceeding sixty (60) days in the aggregate beyond the time liar
ac"ptunce ol'bids specified in the bid documents. and the Owner and Contractor shall obtain the Surety's consent tier ail extension beyond
sixty (60) days.
If this Bond is issued its connection with a subcontractor's bid to Contractor, the tents Contractor in this Bond shill be dcomed to be
Skibcontractor and the torn Owner shall be deemed to be Contractor.
When this Dolld has been l'iffnished to comply wills a stalfflory or other legal requirement in the location ol'the Project, any provi.sion in
this Bond conflicting with said statutory or legal rectairenient shall be deemed deleted heret'rom and provisions confbnifliig to such
sstaimoD, or other legal requirement shall be deemed incorporated herein.. When so kimislied, the intent is that this Bond shall be construed
as asiatutory bond and not as a common la%v bond.
Signcd and scaled this 12th day of December, 2017
C�
. L.
(07oloss)
iZ
(ft-ijjTE,v,$)'Uharissaf U. Lecuyer
Jordan Automotive Group dba Jorden Ford
(Plincipal)
(,Scat)
--4-r By: -
f Ti 110 r4 V, `-I eet f k
The Hanover Insurance Company
(Seal)
By: )/V
(Titiv)Christy,. Braile Attorney -in -Fact
Surety Phone No. 508-853-7200
S-0054/AS 8110
THE HANOVER INSURANCE COMPANY
MASSACHUSETTS BAY INSURANCE COMPANY
CITIZENS INSURANCE COMPANY OF AMERICA
POWER OF ATTORNEY
THIS Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in
the manner and to the extent herein stated.
KNOW ALL PERSONS BY THESE PRESENTS:
That THE HANOVER INSURANCE COMPANY and MASSACHUSETTS BAY INSURANCE COMPANY, both being corporations
organized and existing under the laws of the State of New Hampshire, and CITIZENS INSURANCE COMPANY OF AMERICA, a
corporation organized and existing under the laws of the State of Michigan, (hereinafter individually and collectivelythe "Company') does
hereby constitute and appoint,
Jeffrey C. Carey, Mary T. Flanigan, Christy M. Braile, Patrick T. Pribyl, Debra J. Scarborough, Laura M. Buhrmester, Charles R. Teter, III,
Charissa D. Lecuyer, Evan D. Sizemore, Larissa Smith, Rebecca S. Leal, C. Stephens Griggs, Tahitia M, Fry and/or Megan L. Burns -Hasty
Of Lockton Companies of Kansas City, MO each individually, if there be more than one named, as its true and lawful attorney(s)-in-
fact to sign, execute, seal, acknowledge and deliver for, and on its behalf, and as its act and deed any place within the United States,
any and all surety bonds, recognizances, undertakings, or other surety obligations. The execution of such surety bonds, recognizances,
undertakings or surety obligations, in pursuance of these presents, shall be as binding upon the Company as if they had been duly
signed by the president and attested by the secretary of the Company, in their own proper persons. Provided however, that this power of
attorney limits the acts of those named herein; and they have no authority to bind the Company except in the manner stated and to the
extent of any limitation stated below:
Any such obligations in the United States, not to exceed Fifty Million and No1100 ($50,000,000) in any single instance
That this power is made and executed pursuant to the authority of the following Resolutions passed by the Board of Directors of said
Company, and said Resolutions remain in full force and effect:
RESOLVED: That the President or any Vice President, in conjunction with any Vice President, be and they hereby are authorized and
empowered to appoint Attorneys -in -fact of the Company, in its name and as it acts, to execute and acknowledge for and on its behalf as surety,
any and all bonds, recognizances, contracts of indemnity, waivers of citation and all other writings obligatory in the nature thereof, with power to
attach thereto the seal of the Company. Any such writings so executed by such Attorneys -in -fact shall be binding upon the Company as if they
had been duly executed and acknowledged by the regularly elected officers of the Company in their own proper persons.
RESOLVED: That any and all Powers of Attorney and Certified Copies of such Powers of Attorney and certification in respect thereto, granted
and executed by the President or Vice President in conjunction with any Vice President of the Company, shall be binding on the Companyto the
same extent as if all signatures therein were manually affixed, even though one or more of any such signatures thereon may be facsimile.
(Adopted October 7, 1981 — The Hanover Insurance Company; Adopted April 14, 1982 — Massachusetts Bay Insurance Company; Adopted
September 7, 2001 — Citizens Insurance Company of America)
IN WITNESS WHEREOF, THE HANOVER INSURANCE COMPANY, MASSACHUSETTS BAY INSURANCE COMPANY and CITIZENS
INSURANCE COMPANY OF AMERICA have caused these presents to be sealed with their respective corporate seals, duly attested by
two Vice Presidents, this 151h day of November, 2016.
THE HANOVER INSURANCE COMPANY
MASSACHUSETTS SAY INSURANCE COMPANY
CmZ512tiANCE pMPANY pF AMERICA
Ruben Thomas. Vice Prrsidant
THE RANOVER INSURANCE COMPANY
MA SAli Utyr T_ SAY I. � RA CE COMPANY
CIT EN E 15U roe 1. OF AMERICA
THE COMMONWEALTH OF MASSACHUSETTS )
COUNTY OF WORCESTER ) ss. �. I el.. . 6
On this 15th day of November 2016 before me came the above named Vice Presidents The Hanover Insurance Company,
Massachusetts Bay Insurance Company and Citizens Insurance Company of America, to me pe sonally known to be the individuals and
officers described herein, and acknowledged that the seals affixed to the preceding instrument are the corporate seals of The Hanover
Insurance Company, Massachusetts Bay Insurance Company and Citizens Insurance Company of America, respectively, and that the
said corporate seals and their signatures as officers were duly affixed and subscribed to said instrument bythe authority and direction of
said Corporations.
OIANio ub"o
Hulvy Pu6Ne
osrugpu
Diane 1. a o, Notary RIWIC
My Expires March 4, 2022
],the undersigned Vice President of The Hanover Insurance Company, Massachusetts Bay Insurance Company and Citizens Insurance
Company of America, hereby certify that the above and foregoing is a full, true and correct copy of the Original Power of Attorney issued
by said Companies, and do hereby further certify that the said Powers of Attorney are still in force and effect.
'fit 1�
GIVEN under my hand and the seals of said Companies, at Worcester, Massachusetts, this day of
CERTMED COPY
- - ' -'- 7'IEcodore G. Martinez, Vicc Presid"t