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Opening of Bids - Main & Colfax Structure Repairs Proj No. 115-143BR - Pullman SST, Inc.
Qr CITY OF SOUTH BEND, INDIANA,rr " CONTRACTOR'S BID FOR PUBLIC WORK x �' rs6"s CHECKLIST FOR BIDDERS Project Name Main & Colfax Parking Structure Repairs 2020 Project No. 115-143BR For Bids Due May 26, 2020 at 9:30 a.m., Local Time From time to time the South Bend Board of Public Works finds it necessary to reject a bid because it does not comply with statutory requirements. In preparing your bid, please use the following checklist in order to make sure that your bid is done in the proper manner. Proper bid security included. The bidder has the option of providing either a Certified Check X or Bid Bond. Bid prepared on the City of South Bend Contractor's Bid for Public Work Form, completely X executed. Contractor's Non -Collusion and Non -Debarment Affidavit, Certification Regarding Investments with Iran, Employment Eligibility Verification, Non -Discrimination Commitment, and X Certification of use of United States Steel Products or Foundry Products. Proof of MBE/WBE Participation Goal Form [MWBE-1.0]. If minimum participation goal is not met, also provide Evidence of Good Faith Efforts Form [MWBE-2.0] and MBE/WBE Contacted X Form [MWBE-2.1]. X Acknowledge Receipt of Addendum(s) included with the bid. X All required additional information is included with the bid. Proposal statements and other affidavits all signed by the proper party with name either X printed or typed underneath signature. X This checklist submitted with the Bid. This checklist is provided for bidder's use in assuring compliance with required documentation; however, it does not include all specifications requirements and does not relieve the bidder of the need to read and comply with the specifications. Bidder: Pullman SST, Inc. By Authorized Rep Signature: Print Name & Title: Date: 5/26/2020 Version 4/2/2019 Contractor's Bid for Public Works - 1 CITY OF SOUTH BEND, INDIANA�` CONTRACTOR'S BID FOR PUBLIC WORK ]865 Project Name Main & Colfax Parking Structure Repairs 2020 Project No. 115-143BR For Bids Due May 26, 2020 at 9:30 a.m., Local Time PART I (Must be completed for all bids. Please type or print) Date: 5/26/2020 Address: 280 W. Jefferson Ave. City/State/Zip: Trenton, MI 48183 Bidder (Firm): Pullman SST, Inc. Telephone Number: (734 ) 282-760 Agent of Bidder (if Applicable): Pursuant to notices given, the undersigned offers to furnish labor and/or material public works project of: Main & Colfax Parking Structure Repairs 2020 necessary to complete the the City of South Bend, Indiana, in accordance with plans and specifications prepared by: WGI and dated 4-29-2020 for the sum of (enter the Total Bid as shown on the Proposal) Three Hundred One Thousand Six Hundred Sixty Eight Dollars ($ 301,668.00 ) (Enter sum of Total Base Bid plus Alternates shown on Proposal) (Numerical) The undersigned further agrees to furnish a bond or certified check with this bid for an amount specified in the notice of the letting. If alternative bids apply, the undersigned submits a proposal for each in accordance with the notice. Any addendums attached will be specifically referenced at the applicable page. If additional units of material included in the contract are needed, the cost of units must be the same as that shown in the original contract if accepted by the City of South Bend. If the bid is to be awarded on a unit basis, the itemization of the units shall be shseparate att c ment Byown ignature) obert Johnson stimati ci Mana er (Printed Name of Person Signing) The above bid is accepted this Subject to the following conditions: BOARD OF PUBLIC WORKS Gary A. Gilot, President Elizabeth A. Maradik, Member ACCEPTANCE day of Jordan V. Gathers, Member Therese J. Dorau, Member Joseph R. Molnar, Member Attest: Linda M. Martin, Clerk 20 Version 4/2/2019 Contractor's Bid for Public Works - 2 PART II (For projects of $100,000 or more — IC 36-1-12-4) These statements to be submitted under oath by each bidder with and as part of his/her/its bid. Attach additional pages for each section as needed. SECTION I EXPERIENCE QUESTIONNAIRE 1. Attach information regarding projects your organization has completed for the period of one (1) year prior to the date of the current bid. 2. Attach a listing of public works projects currently in process of construction by your organization. 3. Attach information regarding any failure to complete any work awarded to you and the location thereof. 4. Attach references from private firms for which you have performed work. SECTION II PLAN AND EQUIPMENT QUESTIONNAIRE 1. Attach an explanation of your plan or layout for performing proposed work. (Examples could include a narrative of when you could begin work, complete the project, number of workers, etc. and any other information which you believe would enable the City of South Bend to consider your bid.) 2. Attach a listing of the names and addresses of all subcontractors (i.e. persons or firms outside your own firm who have performed part of the work) that you have used on public works projects during the past five (5) years along with a brief description of the work done by each subcontractor. 3. If you intend to sublet any portion of the work, attach the name and address of each subcontractor, equipment to be used by the subcontractor, and whether you will require a bond. However, if you are unable to currently provide a listing, please understand a listing must be provided prior to contract approval. Until the completion of the proposed project, you are under a continuing obligation to immediately notify the City of South Bend in the event that you subsequently determine that you will use a subcontractor on the proposed project. 4. Attach a listing of equipment you have available to use for the proposed project. 5. Have you entered into contracts or received offers for all materials which substantiate the prices used in preparing your proposal? If not, attach an explanation for the rationale used which would corroborate the prices listed. SECTION III CONTRACTOR'S FINANCIAL STATEMENT Attachment of bidder's financial statement is mandatory. Any bid submitted without said financial statement as required by statute shall thereby be rendered invalid. The financial statement provided hereunder to the City of South Bend awarding the contract must be specific enough in detail so that said City of South Bend can make a proper determination of the bidder's capability for completing the project if awarded. Version 4/2/2019 Contractor's Bid for Public Works - 3 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 Michigan ) ) SS: Wayne 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 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: i. 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. Version 01/29/2020 Contractor's Bid for Public Works - 4 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, firms, 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 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 will consider the Contractor's good faith efforts to obtain participation by those subcontractors 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. Contractors seeking the award of a City contract cannot be required to award a subcontract to an-MWBE; however, they may not unlawfully discriminate against said MBE/WBE. A finding of noncompliance or a discriminatory practice shall prohibit that Contractor 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 to 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. Version 01/29/2020 Contractor's Bid for Public Works - 5 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 10th day of April . 202C Pullman BST, Inc. Contractor/Bidder (Firm) Signature of ContractorBidder or Its Agent Y M BRITTANANOR Notary Public - State of Mldilpn County of Wayne Robert Johnson -Estimating Manager My Commission Expires , 2' printed Name and Title Acting in the County of Subscribed and sworn to before me this `' day of '- ----� 20% My Commission Expires 1-'(� " Notary blic County of Residence WUV Version 01/29/2020 Contractor's Bid for Public Works - 6 BID/PROPOSAL CITY OF SOUTH BEND Project Name: Main & Colfax Parking Structure Repairs 2020 Project Number: For Bids Due: 115-143BR May 26, 2020 at 9:30 a.m., Local Time Contractor Name: Pullman SST. Inc. BASE BID Item No. Description Quantity Unit Unit Price Total Amount 1 Contractor Mobilization 1 LS $18,885.00 $18,885.00 2 General Conditions 1 LS $20,205.00 $20,205.00 3 Slab Partial Depth Repair 300 SF $47.00 $14,100.00 4 Slab Full Depth Repair 3,000 SF $65.25 $195,750.00 5 #5 Epoxy Coated Rebar 2,700 LF $7.50 $20,250.00 6 Temperature Post -Tensioning Repair 3 EA $3,650.00 $10,950.00 7 Repair Cove Joint Sealant 60 LF $8.80 $528.00 8 Rout & Seal Cracks 80 LF $7.50 $600.00 9 Deck Coating — Full System — Heavy Duty Slab Repairs) 4,000 SF $4.70 $18,800.00 10 Line Striping 1 LS $1,600.00 $1,600.00 BASE BID TOTAL $301,668.00 Bidder (Firm): Pullman SST, Inc. Address: 280 W. Jefferson Ave. City/State/Zip: Trenton, MI 48183 Telephone Number: (734 ) 282-7760 By /gnature) Robert Johnson - Estimating Manager (Printed Name of Person Signing) Version 4/2/2019 Contractor's Bid for Public Works - 7 F- U) w w w U) 22 a� ow�z I-- 0: MwO Q' w�. h- Ozz U) 0ma.. O Imo— W W V2w OO 0 z Q E-' O z_ 9 c o O d41 IV E Q- ''O t L CL O W m 0 C uj m 4- 0 C N 2t O +0 + > m C U N U a) � O N L � 1N N L � 'O a) U v Q d a 'N d C m m O 0 3 O L U) O 0 U Cc G y C N m= ++ C M m a t 3 3 � d a) > CL 0 CL >, N =_ d .Q � N O 0 CL O N N L E 2 4-N d L N a.a)r d 'a — E .0 0 0 C d � N O F- = 0 M T T 0 M O (D w N m � w m 2i O O 06 O Ch c D cO C Q a m cu O U C U) U) C M C }co@O 0 ~ U d � � ao m c N o 0 0 c o- E E EU Q W (6 m o �m m m Q. m O O EE5 m `C IL (D C O 0 o N o � L d u)CL 0 ca Q N � a o r U Q @ N C N OF U � N@ E a` w >m w m O 2 o Q C6 N E @ Z O N O N CV LO a) E Z c fl 00 IR CITY OF SOUTH BEND ��`O"THa<tio MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY DEVELOPMENT PROGRAM wt ri♦cv _ � i FORM MWBE-2.0' EVIDENCE OF GOOD FAITH EFFORTS `aes This completed form should be included as part of the Bids documents related to City of South Bend Public Works Projects requiring Good Faith Efforts to obtain MBE/WBE participation. It is the bidder's sole responsibility to verify whether any listed minority or woman business meets the qualifications of a Minority or Women's owned business as defined by the Indiana Department of Administration ("IDOA"). Project Number: 115-143BR Project Name: Main & Colfax Parking Structure Repairs 2020 Bidder: Pullman SST, Inc. Contact Person: Robert Johnson - Estimating Manager Address: 280 W. Jefferson Ave. City: Email: Trenton State: MI rjohnson@pullman-services.com Date: 5/26/2020 Telephone: 734-282-7760 Zip: 48144 To determine whether a bidder has demonstrated good faith efforts to reach the MBE/WBE utilization goals set forth in the City of South Bend Public Works Project Specifications, the City and its agencies, boards, or commissions, REQUIRE ALL of the following Good Faith Efforts as listed in the table below*: EVIDENCE OF GOOD FAITH EFFORTS MBE/WBE LIST(S): The bidder reviewed the City of South Bend's Minority and Women Business RJ Enterprise Diversity Development Program, which uses the IDOA approved list of Minority and Women Owned Business as found on their website (http://www.in.gov/idoa). RJ ACTION (ADVERTISE/CONTACT): In order for your bid to be deemed responsive, the City of South Bend requires that all perspective bidders complete no less than 2 of the following: 1. Attend all pre -bid meetings scheduled by the City to inform MBE/WBEs of contracting and subcontracting opportunities. 2. Advertise in general circulation and/or trade association publications concerning subcontracting opportunities, and allow MBE/WBEs reasonable time to respond. 3. Perform any and all necessary steps to provide written notice in a manner reasonably calculated to inform MBE/WBEs of subcontracting opportunities and allowed sufficient time for them to participate effectively. 4. Utilize pre-existing services of available community organizations, small and/or disadvantaged business assistance offices and other organizations that provided assistance in the recruitment and placement of MBE/WBE firms. **Bidder must circle or otherwise notate which of the two (2) required actions were performed. RJ GOOD FAITH NEGOTIATIONS: The bidder negotiated in good faith with interested MBE/WBEs, including providing such MBE/WBE's with adequate information about the plans, specifications and other requirements of the subcontract and did not reject MBE/WBEs as unqualified without sound business reasons based on a thorough investigation of their capabilities. SMALL CONTRACT(S): The bidder selected specific portions of the work to be performed by RJ MBE/WBEs in order to increase the likelihood of meeting the MBE/WBE goals (including breaking down contracts into smaller units to facilitate MBE/WBE participation) RJ CONTRACT RECORDS: The bidder has maintained the following records for each MBE/WBE that has bid on the subcontracting opportunity: 1. Name, address, and telephone number; 2. A description of information provided by the bidder or subcontractor; and 3. A statement of whether an agreement was reached, and if not, why not, including any reasons for concluding that the MBE/WBE was unqualified to perform the job. *Proper demonstration of Good Faith Effort requires your initials next to all of the above boxes. Any omissions shall be considered grounds for rejection of the bid by the Board of Public Works. The City of South Bend reserves the right to request additional information. Version 4/2/2019 Contractor's Bid for Public Works - 9 CITY OF SOUTH BEND o4ovThol�f„ MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY DEVELOPMENT PROGRAM FORM MWBE-2.1 MBE/WBE CONTACTED _ iays This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects requiring contacted MBE/WBE to obtain Good Faith Efforts. It is the bidder's sole responsibility to verify whether any listed minority or woman business meets the qualifications of a Minority or Women's owned business. PAGE OF Project Number: 115-143BR MBE/WBE Participation Goal Project Name: Main & Colfax Parking Structure Repairs 2020 Bidder: Pullman SST, Inc. By: Estimating Manager 5/26/2020 (Signature) (Title) (Date) MBE/WBE Firm Sneed Construction Owner or Contact at MBE/WBE Firm Chevis Sneed Telephone: 219-712-8715 Fax: Email: sneedconstruction@gmail.com TYPE OF WORK SOLICITED FOR THIS PROJECT: Line Stripirly RESULTS OF CONTACT WITH THE MBE/WBE FIRM: Bidder Declined - Scope too small 1 South Bend too far away MBE/WBE Firm An Honest Hand Owner or Contact at MBE/WBE Firm Miguel Covarubias Telephone: 219-201-7210 Fax: Email: anhonesthand@outlook.com TYPE OF WORK SOLICITED FOR THIS PROJECT: Line Striping RESULTS OF CONTACT WITH THE MBE/WBE FIRM: Declined - too far away Version 4/2/2019 Contractor's Bid for Public Works - 10 DocumentAIA d Bond KNOW ALL MEN BY THESE PRESENTS, THAT WE Pullman SST" Inc. 10150 Old Columbia Road Columbia MD 21046 as Principal, hereinafter called the Principal, and Fidelity and Deposit Company of Maryland 1299 Zurich Way, 5th Floor, Schaumburg, IL 60196-1056 a corporation duly organized under the laws of the State of IL as Surety, hereinafter called the Surety, are held and firmly bound unto City of South Bend 227 West Jefferson Street, South Bend, IN as Obligee, hereinafter called the Obligee, in the sum of Five Percent of Amount Bid Dollars ($ 5% }, for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal has submitted a bid for Main & Colfax Parking Structure Repair - 2020;Project No. 115-143BR NOW, THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enter into a Contract with the Obligee in accordance with the terms of such bid, and give such bond or bonds as may be specified in the bidding or Contract Documents with good and sufficient surety for the faithful performance of such Contract and for the prompt payment of labor and materials famished in the prosecution thereof, or in the event of the failure of the Principal to enter such Contract and give such bond or bonds, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in said bid and such larger amount for which the Obligee may in good faith contract with another party to perform the Work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. Signed and sealed this 26th day of May 2020 Pullman SST, Inc. {Principal) (Seat) (Witness) F�9 Qf Fo�jd (Tiffe) Fidelity and Deposit Company of Maryland i _,(Surety -' i Diane S. Loughry V rinesMl op _ M Attomey4n-Fact Robert A. Chlada t Abe) L AIA DOCUMENT A310 • BID BOND • AIA • FEBRUARY 1970 ED. 0 THE AMERICAN INSTITUTE OF ARCHITEM,1735 N.X. AYE., IY.W., WASHINGTON, D.C. 20006 ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY" KNOW ALL MEN BY THESE PRESENTS: That the ZURICII AMERICAN INSURANCE COMPANY, a corporation of the State of New York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the State of Illinois, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Illinois (herein collectively called the "Companies"), by Robert D. Murray, Vice President, in pursuance of authority granted by Article V. Section 8, of the By -Laws of said Companies, which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof, do hereby nominate, constitute, and appoint Joseph A. PIERSON, Robert A. CHLADA, Cynthia M. CHARVAT, Dennis C. OURAND, Steven A. DZURIK, JR., John T. MARKOTiC and Diane S. LOUGHRY, all of Hunt Valley, Maryland, EACH its true and lawful agent and Attorney -in -Fact, to make, execute, seal and deliver, for, and on its behalf as surety, and as its act and deed: any and all bonds and undertakings, and the execution of such bonds or undertakings in pursuance of these presents. shall be as binding upon said Companies, as fully and amply, to all intents and purposes, as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York, New York_, the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills, Maryland, and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland, in their own proper persons. The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V. Section 8, of the By -Laws of said Companies and is now in force. IN WITNESS WHEREOF, the said Vice -President has hereunto subscribed his/her names and affixed the Corporate Seals of the said ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 5" day of May, A.D. 2020. ATTEST: ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND By_ Robert D. Murray ["ice President BY. Dmvn E. Brown Secretary State of Maryland County of Baltimore On this 5th dap of May, A.D. 2020, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, RobertD. Murray, Vice President and Dawn L Brown, Secretary of the Companies, to me personally known to be the individuals and officers described in and who executed the preceding instrument, and acknowledged the execution of same, and being by me duly sworn, deposeth and saith, that he/she is the said officer of the Company aforesaid, and that the seals affixed to the preceding instrument are the Corporate Seals of said Companies, and that the said Corporate Seals and the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporations. IN TESTIMONY WftEREOF, I have hereunto set my hand and axed my Official Seal the day and year first above written. • Constance A. Dunn, Notary Public My Commission Expires: July 9,2023 EXTRACT FROM BY-LAWS OF THE COMPANIES "Article V, Section 8, Attorneys -in -Fact. The Chief Executive Officer, the President, or any Executive Vice President or Vice President may, by written instrument under the attested corporate seal, appoint attorneys -in -fact with authority to execute bonds, policies_ recognizances, stipulations, undertakings; or other like instruments on behall' of the Company, and may authorize any officer or any such attomey-in-fact to affix the corporate seal thereto; and may with or without cause modify ofrevoke any such appointment or authority at any time." CERTIFICATE 1, the undersigned, Vice President of the ZURICH AMERICAN INSURANCE COMPANY, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and the FIDELITY AND DEPOSIT COMPANY OF MARYL.AND, do hereby certify that the foregoing Power of Attorney is still in full force and effect on the date of this certificate, and 1 do further certify that Article V, Section 8, of the By- Laws of the Companies is still in force. This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the ZURICH AMERICAN INSURANCE COMPANY at a meeting duly called and held on the l5th day of December 1998. RESOLVED: "That the signature of the President or a Vice President and the attesting signature of a Secretary or an Assistant Secretary and the Seal of the Company may be affixed by facsimile on any Power of Attorney... Any such Power or any certificate thereof bearing such facsimile signature and seal shall be valid and binding on the Company." This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held on the 5th day of May, 1994, and the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on the I Oth day of May, 1990, RESOLVED: "That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature of any Vice -President, Secretary, or Assistant Secretary of the Company, whether made heretofore or hereafter, wherever appearing upon a certified copy of any power of attorney issued by the Company, shall be valid and binding upon the Company with the same force and effect as though manually affixed. this�IN TE TI1vIONY WFIE F, I have hereunto subscribed my name and affixed the corporate seals of the said Companies, day "iWiicsu'Ra�.,,� '; sn: to- l " 8EAL By: Brian M. 14odges Vice President TO REPORT A CLAIM WITH REGARD TO A SURETY BOND, PLEASE SUBMIT A COMPLETEDESCRIPTION OF THE CLAM INCLUDING THE PRINCIPAL ON THE BOND, THE BOND NUMBER, AND YOUR CONTACT INFORMATION TO: Zurich Surety Claims 1299 Zurich Way Schaumburg, IL 60196-1056 \v< % ;.reia:arL3fciUin1Srnrzurichna.com 800-626-4577 z5aa,z558''S8?S'zz8z'��SdS�aaS 3zo�-.n n Zz z:¢o c c $$ 8 8 oQ 8 8 8 8 $I88 8 $ 8 8 $:$$o$ 8 8 8 8 a$ 8 8 8 o 8 8 $ 8 8 8 8 8 8 $\ 8 8 8 8 88 8 8 8 8 8 $ 8 8 d 88 8 8 8 8 o �s ,r YxL q'. 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F o n E Eo E ; v 'v o 2 L m g n c = o E E T. Z u Y r n o o. o ow Y o 3z 3° n m m ry o Z w > > E v m > i s v mLL.�om u�, C 111IIN 1A/e1 April 2, 2020 City of South Bend, IN 227 West Jefferson Street South Bend, IN RE: Section 1.3 No Failure to Compete Any Work To Whom it May Concern: This letter states that Pullman SST, Inc. has never had any failure completing any work awarded to it. Sincerely, V - - . victor Junca" Assistant Secretary Pullman SST, Inc. 10150 Old Columbia Road • Columbia, MD 21046 • Phone: 410-850-7000 • Fax: 410-850-4111 www.puliman-services.com J, o oo N:. o -o- m v... N.a o N'.m m N om o oNo'N o m e n m v+ v v ry uni n m v v m w O1 m mo N n,i m umi vmi n m ry m v n o m �: m 1. N n m vmi `i ° ry m 'm m n m a m mm ry m ry m w n'' cw m w o m V m N o. 0 � o a. m m O N n a{ N O N vmi T. O N.. 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E n. c� m m w 3 ¢ t E E '° w g a « t7l m° F t7 m«n0 vi m a m °u v 0 o�L,... _ z. a ° N eo - m o '� u mN n �vp E=w o E, ° m c x ° m. 2'u _v.'t« C O N m u ° V u c, v�3 3. m m ¢_ 0 m N n `w ° m o< r u N O 0 Z LL 3 3 et E m 3 x 3 3 o m E v « A 0 tl °§ o. w m c �. 3 m x L ° c IN v O m ._ °O�V�>" v (7 2 0 2 p m a u m�vi 6l Ua U' zx m. x v u. u n v�i .�-, Up' m�Opa(7 mmam3 V' vi n m .-, m �I mN o N N O.om N+ aa o 0mo am.m N �vVv mm N0 uin VV� N m Pullman SST, Inc Asset List GAAP For the Period December 1, 2018 to December 31, 2018 Co Asset No Description Location Serial Number Acquisition Date Ending Asset Ending Accum Balance Depr Asset Type: Automobile VE02120 2017 CHEVY IMPALA CA 2G1105S35H9135347 12/16/2016 32,379.40 12,951.77 Subtotal., Automobile (1) $32,379.40 $12,951.77 Asset Type: Computer CP10352 COMPUTER SERVER NJ 7/6/2010 3,888.08 3,888.08 CP10362 PHONE SYSTEM (VOIP) NJ 4/1/2011 10,846.65 10,846.65 CP10390 THINKING PHONES NJ 4/3/2012 1,512.98 1,512.98 CP10395 THINKING PHONES NJ 6/11/2012 3,226.97 3,226.97 CP10418 SERVER MI MXQ24206Q5 5/31/2013 5,050.12 5,050.12 CP10419 SERVER NJ MXQ24206RB 5/31/2013 5,050.13 5,050.13 CP10334 RICOH 3045 COPIER NJ A3045 K9465400824 5/11/2009 3,498.48 3,498.48 CP10335 RICOH 3045 COPIER CA A345P K9465301273 5/1/2009 3,498.49 3,498.49 CP10438 MICROSOFT OFFICE PRO CA 8/28/2013 1,442.21 1,442.21 CP10439 MICROSOFT OFFICE PRO NJ 8/28/2013 25,479.08 25,479.08 CP10440 MICROSOFT OFFICE PRO MI 8/28/2013 12,979.91 12,979.91 CP10455 THINKPAD COMPUTERS (WINDOWS 7) CA 7/24/2013 439.90 439.90 CP10476 THINKPAD COMPUTERS (WINDOWS 7) MI 7/24/2013 5,777.00 5,777.00 CP10477 THINKPAD COMPUTERS (WINDOWS 7) NJ 7/24/2013 8,083.85 8,083.85 CP10494 WAN ACCELERATOR DEVICES NJ 10/30/2013 4,837.57 4,837.57 CP10495 WAN ACCELERATOR DEVICES MI 10/30/2013 3,570.91 3,570.91 CP10496 WAN ACCELERATOR DEVICES CA 10/30/2013 1,670.91 1,670.91 CP10509 T410 LAPTOP (WINDOWS 7) MI 3/1/2014 4,065.10 4,065.10 CP10517 T410 LAPTOP (WINDOWS 7) NJ 3/1/2014 12,008.82 12,008.82 CP10518 T410 LAPTOP (WINDOWS 7) CA 3/1/2014 1,947.42 1,947.42 CP10529 X240 LAPTOP (WINDOWS 7) MI 3/1/2014 1,172.14 1,172.14 CP10536 X240 LAPTOP (WINDOWS 7) NJ 3/1/2014 2,371.12 2,371,12 CP10537 X240 LAPTOP (WINDOWS 7) CA 3/1/2014 2,490.80 2,490,80 CP10310 BIZHUB 250 COPIER MI 31117217 4/24/2007 7,025.00 7,025.00 CP10379 THINKING PHONES MI 3/15/2012 7,053.73 7,053.73 CP10564 TALARI REMOTE APPLIANCE T730 MI 12/15/2014 7,347.12 7,347.12 CP10577 TALARI REMOTE APPLIANCE T730 CA 12/15/2014 7,347.11 7,347.11 CP10578 TALARI REMOTE APPLIANCE T730 NJ 10/1/2014 6,918.54 6,918.54 CP10585 BRANCH HYPER-U SERVER CA 2/9/2015 6,332.34 6,332.34 CP10587 COLOR COPIER NJ 3/13/2015 10,703.80 10,703.80 CP10592 COLOR COPIER MI 8/4/2015 8,894.28 8,894.28 CP10600 COLOR COPIER CA 9/11/2015 9,369.22 9,369.22 CP10601 COLOR COPIER NY 8/31/2015 8,437.40 8,437.40 Page: 1 Net Book Value 19,427.63 $19,427.63 Co Asset No Description Location Serial Number Acquisition Date Ending Asset Ending Accum Net Book Value Balance Depr CP10602 SERVER NY 2M41535PCV 10/13/2015 6,469.87 6,469.87 0.00 CP10606 SLAIT CONSULTING STEELHEAD NY 10/13/2015 4,210.27 4,210.27 0.00 CP10633 SURFACE PRO (WINDOWS 8) MI 9/1/2016 15,579.03 12,117.02 3,462.01 CP10652 SURFACE PRO (WINDOWS 8) NJ 9/1/2016 28,042.26 21,810.64 6,231.62 CP10653 SURFACE PRO (WINDOWS 8) CA 9/1/2016 7,789.52 6,058.52 1,731.00 CP10658 SURFACE PRO (WINDOWS 8) NY 9/1/2016 3,115.81 2,423.40 692.41 CP10695 TALARI REMOTE APPLIANCE CA 10/1/2017 2,902.19 1,209.26 1,692.93 CP10696 TALARI REMOTE APPLIANCE NJ 10/1/2017 2,902.19 1,209.26 1,692.93 CP10697 TALARI REMOTE APPLIANCE MI 10/1/2017 4,381.75 1,825.73 2,556.02 CP10698 TALARI REMOTE APPLIANCE NY 10/1/2017 2,902.18 1,209.25 1,692.93 Subtotal., Computer(43) $282,632.25 $262,880.40 $19,751.85 Asset Type: Equipment EQ07111 COMPRESSORS NJ 4/28/2009 15,500.00 15,500.00 0.00 EQ07125 CHIPPING HAMMERS NJ 3/16/2009 7,000.00 7,000.00 0.00 EQ07115 WELDING MACHINE NJ 3/17/2009 11,900.00 11,900.00 0.00 EQ07124 GUNITE HOSE NJ 10/1/2009 8,000.00 8,000.00 0.00 EQ07143 SAFETY MONITORS NJ 3/13/2009 4,800.00 4,800.00 0.00 EQ07142 STUD WELDING NJ 10/2812009 5,000.00 5,000.00 0.00 EQ07128 MIXED STANDS NJ 10/8/2009 6,000.00 6,000.00 0.00 EQ07174 SAFETY EQUIPMENT NJ 1/16/2009 3,000.00 3,000.00 0.00 EQ07197 ENGINES NJ 9/30/2009 2,000.00 2,000.00 0.00 EQ07159 MULE NJ 9/30/2009 3,500.00 3,500.00 0.00 EQ07155 SANDBLAST POT NJ 11/3/2009 3,800.00 3,800.00 0.00 EQ07175 PRESSURE WASHERS NJ 9/30/2009 3,000.00 3,000.00 0.00 EQ07215 HOBART NJ 8/30/2009 1,500.00 1,500.00 0.00 EQ07196 CHIPPING HAMMERS NJ 7/20/2009 2,000.00 2,000.00 0.00 EQ07251 HOBART NJ 8/25/2009 1,000.00 1,000.00 0.00 EQ07252 HOBART NJ 8/2812009 1,000.00 1,000.00 0.00 EQ07126 RIVET BUSTER & CHISELS - NJ NJ 9/15/2005 6,800.00 6,800.00 0.00 EQ07140 Gunite Rig and Brick Saws NJ 4/29/2003 5,000.00 5,000.00 0.00 EQ07152 48X60X16 BUILDING NJ 7/l/2001 4,000.00 4,000.00 0.00 EQ07153 TROVEL PUMP NJ 9/29/2006 4,000.00 4,000.00 0.00 EQ07172 VARIOUS EQUIPMENT (COMPRESSOR, NJ 8/28/2006 3,000.00 3,000.00 0.00 TRAILER) EQ07189 BUILDING NJ 8/9/2001 2,000.00 2,000.00 0.00 EQ07190 CHIPPING GUNS NJ 12/31/2002 2,000.00 2,000.00 0.00 EQ07191 EPLOSION PROOF NJ 7/14/2003 2,000.00 2,000.00 0.00 EQ07194 ROTOR STATOR PUMP NJ 9/22/2004 2,000.00 2,000.00 0.00 EQ07195 BUSTER HAMMER IND GRADE NJ 9/20/2006 2,000.00 2,000.00 0.00 EQ07213 WELDING EQUIPMENT NJ 1/24/2008 1,500.00 1,500.00 0.00 EQ07246 WELDING EQUIPMENT NJ 1/8/2008 1,000.00 1,000.00 0.00 Page: 2 Co Asset No Description Location Serial Number Acquisition Date Ending Asset Ending Accum Net Book Value Balance Depr EQ07103 EQUIPMENT NJ 3/20/2006 35,920.00 35,920.00 0.00 EQ07104 EQUIPMENT NJ 920-604 6/22/2006 35,000.00 35,000.00 0.00 EQ07105 BROKK HAMMER NJ 920-755 5/31/2007 35,000.00 35,000.00 0.00 EQ07106 DEMOLITION MACHINE -WV NJ 920-531 8/31/2005 30,000.00 30,000.00 0.00 EQ07108 REFRACTORY PUMP NJ 206320 12/6/2005 20,000.00 20,000.00 0.00 EQ07109 AIR COMPRESSOR 400 CFM NJ 1008 4/26/2006 18,000.00 18,000.00 0.00 EQ07112 EQUIPMENT NJ 12/31/2008 13,000.00 13,000.00 0.00 EQ07113 R9000 GUNITE NJ 4/11/2006 12,000.00 12,000.00 0.00 EQ07114 MIXER AND STAND NJ RFI-010 9/25/2003 12,000.00 12,000.00 0.00 EQ07116 BRICKING SOL NJ 2/8/2005 10,000.00 10,000.00 0.00 EQ07118 FIREPRO PUMP/RIG NJ 7/25/2006 10,000.00 10,000.00 0.00 EQ07120 GUNITE RIG/COMPRESSOR NJ 6/29/2000 8,500.00 8,500.00 0.00 EQ07121 GUNITE RIG NJ 7/21/2006 8,000.00 8,000.00 0.00 EQ07122 COMPRESSOR NJ 1/15/1996 8,000.00 8,000.00 0.00 EQ07123 R900 RIG NJ 7/11/2001 8,000.00 8,000.00 0.00 EQ07129 LISA MOS NJ 7/5/2007 5,000.00 5,000.00 0.00 EQ07130 WISTAR NJ 6610089 4/13/2005 5,000.00 5,000.00 0.00 EQ07132 GUNITE RIGS NJ 316/1996 5,000.00 5,000.00 0.00 EQ07133 GUNITE RIGS NJ 4/30/1996 5,000.00 5,000.00 0.00 EQ07134 GUNITE RIGS NJ 6/30/1996 5,000.00 5,000.00 0.00 EQ07135 GUNITE RIGS NJ 8/28/1996 5,000.00 5,000.00 0.00 EQ07136 THOMAS KNOW NJ 119/1998 5,000.00 5,000.00 0.00 EQ07137 1 TON MIXER NJ 9/3/1998 5,000.00 5,000.00 0.00 EQ07138 CANGRO IN REED GUN NJ 11/10/1998 5,000.00 5,000.00 0.00 EQ07139 H-3500 PROPORTIONING HUT NJ 12/10/1999 5,000.00 5,000.00 0.00 EQ07141 BOBCAT NJ 4/30/2008 5,000.00 5,000.00 0.00 EQ07144 SILO MIXER NJ 36K591-0107 6/6/2007 4,500.00 4,500.00 0.00 EQ07145 SAND BLAST NJ 3/26/2007 4,500.00 4,500.00 0.00 EQ07146 STVO WELDOS NJ 710880 7/31/2007 4,300.00 4,300.00 0.00 EQ07147 EQUIPMENT NJ 5/25/2006 4,000.00 4,000.00 0.00 EQ07148 SCHWING 350 LINE PUMP NJ 1040372 10/3/2005 4,000.00 4,000.00 0.00 EQ07150 WAREHOUSE HEATER NJ 1/7/2000 4,000.00 4,000.00 0.00 EQ07151 25KW GENERATOR NJ 2/2/2000 4,000.00 4,000.00 0.00 EQ07154 STEP DOWN TRANSFORMER WITH POWER NJ 4/4/2008 4,000.00 4,000.00 0.00 EQ07156 MILLER POWCON ARC NJ 1/2/2007 3,700.00 3,700.00 0.00 EQ07157 Gunite rig chipping guns NJ 1/1/2003 3,500.00 3,500.00 0.00 EQ07158 MORTAR HENCHMAN 4 HSM NJ 10/28/2008 3,500.00 3,500.00 0.00 EQ07160 TOMMY GUN NJ 8/29/2006 3,000.00 3,000.00 0.00 EQ07162 COMPRESSOR, POWER WASHERS NJ MO666710 7/22/2004 3,000.00 3,000.00 0.00 EQ07165 COMPRESSOR NJ 11/22/1995 3,000.00 3,000.00 0.00 EQ07166 WHARTON EQUIPMENT NJ 4/2/1998 3,000.00 3,000.00 0.00 EQ07167 BOB CAT NJ 12/21/1998 3,000.00 3,000.00 0.00 Page: 3 Co Asset No Description Location Serial Number Acquisition Date Ending Asset Ending Accum Net Book Value Balance Depr EQ07168 INNOVATIVE PUMPS NJ 4/21/1999 3,000.00 3,000.00 0.00 EQ07169 EPDXY SPRAY PUMP NJ 4/1/2001 3,000.00 3,000.00 0.00 EQ07170 COMPRESSOR NJ 12/31/2003 3,000.00 3,000.00 0.00 EQ07171 GENERATOR EBAY NJ 1/23/2004 3,000.00 3,000.00 0.00 EQ07173 REBAR TIER NJ 6/30/2008 3,000.00 3,000.00 0.00 EQ07177 FORKLIFT NJ A31T53837 11/14/2006 2,500.00 2,500.00 0.00 EQ07178 CONCRETE MIXER NJ 222005416 7/9/2007 2,500.00 2,500.00 0.00 EQ07179 CONCRETE PUMP- NJ NJ 554-P2-KL5-NB 9/30/2005 2,500.00 2,500.00 0.00 EQ07180 H2S MONITOR - NJ NJ 8125/2005 2,500.00 2,500.00 0.00 EQ07181 THOMAS KNOW NJ 3/10/1998 2,500.00 2,500.00 0.00 EQ07182 CD-15 DISPENSER PUMP NJ 10/2/2000 2,500.00 2,500.00 0.00 EQ07183 PRESSURE WASHER NJ 6/17/2004 2,500.00 2,500.00 0.00 EQ07184 WHARTON EQUIPMENT NJ 7/13/1999 2,200.00 2,200.00 0.00 EQ07185 GUNITE RIG -USED NJ 12/31/2003 2,000.00 2,000.00 0.00 EQ07186 EQUIPMENT NJ 11/18/2008 2,000.00 2,000.00 0.00 EQ07188 KINZY STANLEY RIG NJ 6/10/1998 2,000.00 2,000.00 0.00 EQ07192 STUDWELDING NJ 2/25/2004 2,000.00 2,000.00 0.00 EQ07193 H25 MONITOR NJ 4127/2004 2,000.00 2,000.00 0.00 EQ07198 Mortar Mix 8 cubic feet 8 hp Honda NJ 452007276 12/18/2007 1,800.00 1,800.00 0.00 EQ07200 EQUIPMENT NJ 12/4/2008 1,750.00 1,750.00 0.00 EQ07201 ELECTRIC SALAMANDER NJ 1/28/2008 1,600.00 1,600.00 0.00 EQ07202 FITTEST MACHINE NJ 11A-A-78 12/26/2006 1,500.00 1,500.00 0.00 EQ07203 R9000 GUNITE NJ 1/30/2006 1,500.00 1,500.00 0.00 EQ07205 5K FORKLIFT NJ 1/511998 1,500.00 1,500.00 0.00 EQ07214 EQUIPMENT NJ 11/24/2008 1,500.00 1,500.00 0.00 EQ07216 DIESEL ENGINE NJ 8/31/2006 1,200.00 1,200.00 0.00 EQ07217 MORTAR MIXER NJ 634063 5/17/2007 1,200.00 1,200.00 0.00 EQ07218 OFFICE TRAILER NJ 5/8/2006 1,200.00 1,200.00 0.00 EQ07221 Dayton 480V 3 phase 15 KW Salamander Heater NJ W25090 12/11/2007 1,000.00 1,000.00 0.00 EQ07247 AIR SYSTEM BREATHER BOX NJ 4/18/2008 1,000.00 1,000.00 0.00 EQ07248 VIBRATORY PLATE FOR ASPHALT NJ 6/3/2008 1,000.00 1,000.00 0.00 EQ07249 EQUIPMENT NJ 11/13/2008 1,000.00 1,000.00 0.00 EQ07250 EQUIPMENT NJ 12/4/2008 1,000.00 1,000.00 0.00 EQ07253 BRICKSAW NJ 12/6/2005 900.00 900.00 0.00 EQ07259 BOXTRAILER NJ 8/31/2006 800.00 800.00 0.00 EQ07263 ALPHA CARD SYSTEM NJ 3/31/2008 800.00 800.00 0.00 EQ07264 GENERATOR 650OW CONT GRADE NJ 11/4/2008 800.00 800.00 0.00 EQ07265 SANDBLASTER NJ 33883 3/31/2006 700.00 700.00 0.00 EQ07269 PNEUMATIC CHIPPING GUN NJ 2/12/2008 700.00 700.00 0.00 EQ07273 FORKLIFT NJ 1/1/1994 550.00 550.00 0.00 EQ07407 MR D NJ 1GKFK63867J305021 2/15/2007 0.00 0.00 0.00 Page: 4 Co Asset No Description Location Serial Number Acquisition Date Ending Asset Ending Accum Net Book Value Balance Depr EQ07408 FORKLIFT -WV NJ GPX230-0341-9250 8/19/2005 0.00 0.00 O.0 EQ07409 MORTAR MIXER NJ 3/17/2010 6,547.58 6,547.58 O.0 EQ07410 MORTAR MIXER NJ 3/17/2010 6,547.59 6,547.59 0.( EQ07468 GUNITE MACHINE NJ 4/21/2010 21,000.00 21,000.00 0.( C002203 100 CFM COMPRESSOR CA 6/25/2010 2,195.00 2,195.00 0.( EQ07470 400 AMP WELDING MACHINE CA 6/25/2010 2,195.00 2,195.00 O.0 EQ07498 40 QUART MIXER CA 10/1/2010 4,161.00 4,161.00 O.0 EQ07764 TOOLS -MANIFEST NJ 1/23/2011 12,014.76 12,014.76 OX EQ07784 SKYCLIMBER & HOIST NJ 4/29/2011 17,779.49 17,779.49 0.( EQ07785 SKYCLIMBER & HOIST NJ 4/29/2011 17,779.50 17,779.50 0.( EQ07786 SKYCLIMBER & HOIST NJ 4/29/2011 17,779.50 17,779.50 0.( EQ07787 SKYCLIMBER & HOIST NJ 4/29/2011 17,779.50 17,779.50 0.( EQ07800 PUMP HZ-30E NJ 3/15/2011 10,816.05 10,816.05 0.( EQ07813 COLOR COPIER (RICOH) NJ 3/11/2011 8,000.00 8,000.00 0.( EQ07816 VICTORY CAR CARRIER NJ 719/2011 5,875.31 5,875.31 0.( EQ07817 GUN FLOW PUMP NJ 7/22/2011 12,232.97 12,232.97 0.( EQ07828 USED HOIST MOTORS (8) NJ 5/31/2011 14,777.47 14,777.47 0.( EQ07838 650OW GAS GENERATOR NJ 10/3/2011 2,491.56 2,491.56 0.( EQ07846 ENGINE D2011L02 W/ PANEL NJ 11/21/2011 6,411.19 6,411.19 0.( 4252 BPA 500 SCHWING PUMP NJ 171500171 9/1/2001 21,567.00 21,567.00 0.( 4751 ALLENTOWN POWER CRETE NJ 10/22/2004 58,015.84 58,015.84 0.( EQ07959 PUMP NJ 8/22/2012 26,592.36 26,592.36 0.( EQ07965 ROTOR STATOR PUMP (RSP 100) NJ 7/3/2012 3,210.00 3,210.00 0.( EQ08017 CONCRETE MIXER CA 10/1/2012 3,091.59 3,091.59 0.1 EQ08019 PNEUMATIC ROTOHAMMER CA 10/1/2012 2,866.12 2,866.12 0.1 EQ08020 PNEUMATIC ROTOHAMMER CA 10/1/2012 2,866.11 2,866.11 0.1 EQ08021 ROTOR -STATOR PUMP NJ 10/412012 14,019.35 14,019.35 0.1 EQ08022 ROTOR -STATOR PUMP NJ 10/4/2012 14,019.35 14,019.35 01 EQ08023 ROTOR -STATOR PUMP NJ 10/4/2012 14,019.35 14,019.35 0.1 EQ08024 ROTOR -STATOR PUMP NJ 10/4/2012 14,019.35 14,019.35 0.1 EQ08061 ROTOR -STATOR PUMP NJ 460V-3PH-VFD-2L6 2/8/2013 14,634.05 14,634.05 0.1 EQ07942 AIR COMPRESSOR (375) CA 3223 7/25/2012 28,665.92 28,665.92 0.1 EQ06853 GENERAC SHOTBLAST GENERATOR CA 7854270 211/2009 2,500.00 2,500.00 0., EQ06850 2000 BOBCAT CA 519028016 2/112009 8,000.00 8,000.00 0.' EQ06849 2000 NEW HOLLAND SKID STEER NJ LT665/64211 2/1/2009 2,000.00 2,000.00 0.' C002190 SULLAIR 185 COMPRESSOR MI 2/1/2009 3,000.00 3,000.00 0.' C002177 ATLAS COPCO 375 AIR COMPRESSOR MI 450OB12144HOO9948 2/1/2009 6,000.00 6,000.00 0. EQ07839 MULTIQUIP WM70SHB CEMENT MIXER MI 10/1/2011 2,656.70 2,656.70 0 EQ07924 GENERATOR HONDA 6501 MI EBLC1005649 6/14/2012 2,174.03 2,174.03 0. EQ07434 AED HEARTSTART ONSITE DEFIBRILLATOR MI 8127/2010 1,456.00 1,456.00 0. EQ06938 1998 763 BOBCAT SKIDSTEER MI 6/10/2009 2,000.00 2,000.00 0- Page: 5 Co Asset No Description Location Serial Number Acquisition Date Ending Asset Ending Accum Net Book Value Balance Depr EQ06844 VERSA CLAMP GUARDRAIL SAFETY SYSTEM- MI 5/11/2009 7,185.05 7,185.05 0.00 EQ08101 50 SHORING SCAFFOLDING NJ 11/14/2012 18,565.77 18,565.77 0.00 EQ08102 SHORING SCAFFOLDING NJ 11/14/2012 18,565.77 18,565.77 0.00 CO02188 INGERSOLL RAND COMPRESSOR MI V153259 2/26/2009 682.53 682.53 0.00 CO02192 ATLAS COPCO 250 AIR COMPRESSOR MI 2/1/2009 1,000.00 1,000.00 0.00 CO02193 ATLAS COPCO 250 AIR COMPRESSOR MI 2/1/2009 1,000.00 1,000.00 0.00 CO02196 ATLAS COPCO 375 AIR COMPRESSOR MI 2/1/2009 6,000.00 6,000.00 0.00 EQ06834 REPAIRS TO MANLIFT MI 2/1/2009 6,135.38 6,135.38 0.00 EQ06851 2003 CATERPILLAR MI 242B 2/1/2009 10,000.00 10,000.00 0.00 EQ06890 LUSTER AUTOMATIC HOT AIR WELDING MI 2/1/2009 1,000.00 1,000.00 0.00 EQ06888 MACHINE KOHLER 5000 PSI POWERWASHER MI 2/1/2009 1,000.00 1,000.00 0.00 EQ06891 LEISTER VARIANT AUTOMATIC HOT AIR MI 211/2009 1,000.00 1,000.00 0.00 WELDING TOOL MI 2/1/2009 1,000.00 1,000.00 0.00 EQ06892 SARNAMATIC WELDER 2/1/2009 1,000.00 1,000.00 0.00 EQ06894 GEOWALD PLUS POWER WEDGE WELDER MI EQ06895 220V GEOWALD POWER WEDGE WELDER 220V MI 211/2009 1,000.00 1,000.00 0.00 EQ06896 COLUMBINE EXTRUDER/HEAT WELDER+ MI 2/1/2009 1,000.00 1,000.00 0.00 EQ06897 CASE GEOWALD PLUS POWER WEDGE WELDER MI 2/1/2009 1,000.00 1,000.00 0.00 EQ06898 220V GEOWALD POWER WEDGE WELDER 220V MI 2/1/2009 1,000.00 1,000.00 0.00 EQ06899 GEOWALD PLUS POWER WEDGE WELDER MI 2/1/2009 1,000.00 1,000.00 0.00 EQ06900 220V COLUMBINE EXTRUDER/HEAT WELDER D- MI 2/1/2009 1,000.00 1,000.00 0.00 EQ07766 HANDLE SCAFFOLDING MI 3/29/2011 5,858.15 5,858.15 0.00 EQ07958 FORKLIFT MI 7/18/2012 3,540.08 3,540.08 0.00 EQ07923 GENERATOR HONDA 6500 MI EBLC1005648 6/14/2012 2,174.02 2,174.02 0.00 EQ08154 SKID STEER (NEW HOLLAND) MI 11/13/2013 36,327.26 36,327.26 0.00 EQ08155 SKID STEER (NEW HOLLAND) MI 11/13/2013 36,327.26 36,327.26 0.00 EQ08156 SWING STAGE EQUIPMENT NJ 10/1/2013 76,668.71 76,668.71 0.00 EQ08163 SWING STAGE EQUIPMENT NJ 10/1/2013 14,855.28 14,855.28 0.00 EQ08262 SWINGSTAGE COMPONENTS NJ 5/27/2014 116,290.52 106,599.64 9,690.88 EQ07072 300' GUNITE HOSE & ACCESSORIES NJ 4/12/2010 5,935.06 5,935.06 0.00 EQ07531 HOBART MIXER 60 QT. NJ 11-289-218 11/11/2010 7,597.37 7,597.37 0.00 EQ07540 PREDAMPER NJ 11/15/2010 20,806.50 20,806.50 0.00 EQ07541 BATCH MIXER NJ 12/1/2010 45,341.02 45,341.02 0.00 EQ07634 ALLENTOWN R-900 GUNITE RIG NJ 12/6/2010 83,009.11 83,009.11 0.00 EQ07635 ALLENTOWN R-900 GUNITE RIG NJ 12/6/2010 82,966.26 82,966.26 0.00 EQ07655 RAMMING GUNS NJ 1/20/2011 336.76 336.76 0.00 Page: 6 Co Asset No Description EQ07656 RAMMING GUNS NJ EQ07657 RAMMING GUNS NJ EQ07658 RAMMING GUNS NJ EQ07659 RAMMING GUNS NJ EQ07660 RAMMING GUNS NJ EQ07661 RAMMING GUNS NJ EQ07662 RAMMING GUNS NJ EQ07663 RAMMING GUNS NJ EQ07664 RAMMING GUNS NJ EQ07665 RAMMING GUNS NJ EQ07666 RAMMING GUNS NJ EQ07667 RAMMING GUNS NJ EQ07668 RAMMING GUNS NJ EQ07669 RAMMING GUNS NJ EQ07670 RAMMING GUNS NJ EQ07676 SCALING GUNS NJ EQ07677 SCALING GUNS NJ EQ07678 SCALING GUNS NJ EQ07679 SCALING GUNS NJ EQ07680 SCALING GUNS NJ EQ07681 SCALING GUNS NJ EQ07682 SCALING GUNS NJ EQ07683 SCALING GUNS NJ EQ07684 SCALING GUNS NJ EQ07685 SCALING GUNS NJ EQ07709 VERTICAL AIR RECEIVERS-400 GALLONS NJ EQ07710 VERTICAL AIR RECEIVERS400 GALLONS NJ EQ07854 80 QUART HOBART MIXER NJ EQ07855 40 QUART HOBART MIXER NJ EQ07594-01 40 QUART HOBART MIXER BEATER NJ EQ07595-01 60 QUART HOBART MIXER BEATER NJ EQ07898 MOTORS FOR GUNITE RIG NJ EQ07899 BELTS FOR GUNITE RIG NJ 2083 I/R 250 CFM COMPRESSOR MI 3822 EPDXY INJECTION PUMP MI Location Serial Number Acquisition Date 11-348-149 31-1362-239 277461UEH359 1/20/2011 1/20/2011 1/20/2011 1/20/2011 1/20/2011 1/20/2011 1/20/2011 1/20/2011 1120/2011 1/20/2011 1/20/2011 1/20/2011 1/20/2011 1/20/2011 1/20/2011 1/20/2011 1/20/2011 1/20/2011 1/20/2011 1/20/2011 1/20/2011 1/2012011 1/20/2011 1/20/2011 1/20/2011 3/10/2011 3/10/2011 1/5/2012 1/5/2012 10/1/2011 10/1/2011 1 /27/2012 2/22/2012 6/5/1997 6/26/1997 Ending Asset Balance 336.76 336.76 336.76 336.76 336.76 336.77 336.77 336.77 336.77 336.77 336.77 336.77 336.77 336.77 336.77 165.16 165.16 165.17 165.17 165.17 165.17 165.17 165.17 165.17 165.17 1,952.31 1,952.31 9,840.13 3,549.41 1,048.63 1,048.63 30,836.58 3,496.90 14,070.00 3,500.00 Ending Accum Depr 336.76 336.76 336.76 336.76 336.76 336.77 336.77 336.77 336.77 336.77 336.77 336.77 336.77 336.77 336.77 165.16 165.16 165.17 165.17 165.17 165.17 165.17 165.17 165.17 165.17 1,952.31 1,952.31 9,840.13 3,549.41 1,048.63 1,048.63 30,836.58 3,496.90 14,070.00 3,500.00 Net Book Value 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 3870 NH L865 SKIDSTER MI 895585 11/15/1997 16,734.37 16,734.37 0.00 3873 NEW HOLLAND LX865 SKID LOADER MI 99267 12/2/1997 25,537.00 25,537.00 0.00 4052 GROUTPUMP MI 99HM1559P4K8 4/30/1999 6,126.43 6,126.43 0.00 2103 I/R P250WJD COMPRESSOR MI 311145 5/10/2000 14,840.00 14,840.00 0.00 2104 I/R P250WJD COMPRESSOR MI 311146 5/10/2000 14,840.00 14,840.00 0.00 4195 NEW HOLLAND SKID STEER MI 167053 1/10/2001 19,265.50 19,265.50 0.00 4196 NEW HOLLAND SKID STEER MI 167055 1/10/2001 19,265.50 19,265.50 0.00 Page: 7 Co Asset No Description Location Serial Number Acquisition Date Ending Asset Ending Accum Net Book Value Balance Depr 4198 HYDRO BREAKER SKID STEER ATTACHMENT MI 87963 1/17/2001 8,374.00 8,374.00 0.00 2109 I/R 250 CFM COMPRESSOR MI 4/20/2001 14,732.94 14,732.94 0.00 4214 NEW HOLLAND SKID STEER MI 4/11/2001 24,516.02 24,516.02 0.00 2110 I/R 250CFM COMPRESSOR MI 321833 5/16/2001 15,287.75 15,287.75 0.00 4219 KOMATSU FORKLIFT MI 321055A 5/29/2001 7,950.00 7,950.00 0.00 2120 I/R P260WIR COMPRESSOR MI 4FVCABAA12U32759 3/7/2002 14,910.00 14,910.00 0.00 7 2119 I/R P20WIR COMPRESSOR MI 327257UAM389 2/20/2002 15,052.00 15,052.00 0.00 2127 I/R P260WIR COMPRESSOR MI 329191 4/24/2002 14,910.00 14,910.00 0.00 4300 FORKLIFT MI 04219236KOF 4/30/2002 4,226.20 4,226.20 0.00 2128 I/R 375 COMPRESSOR MI 330230UEM061 6/19/2002 22,495.20 22,495.20 0.00 4420 COMPACT CONCRETE SAW MI G05746 9/27/2002 2,212.80 2,212.80 0.00 4415 MORTAR MIXER MI 2EP11511321012830 9/27/2002 2,592.00 2,592.00 0,00 4416 POWER BUGGY 16 CU MI CB464 9/27/2002 6,372.00 6,372.00 0.00 4432 HOIST POCKET CLIMBER MI G02B9873 11/11/2002 4,326.66 4,326.66 0,00 4433 HOIST POCKET CLIMBER MI G0289875 11/11/2002 4,326.67 4,326.67 0.00 4434 HOIST POCKET CLIMBER MI G0289880 11/11/2002 4,326.67 4,326.67 0.00 4491 SWING STAGING MI 11/18/2002 11,839.66 11,839.66 0.00 4512 AIR TUGGER MI 3/10/2003 7,359.15 7,359.15 0.00 4514 MOBILE OFFICE TRAILER MI 6684 2/26/2003 5,922.72 5,922.72 0.00 4538 CONCRETE FORMS MI 6/23/2003 9,921.60 9,921.60 0.00 4651 SCISSOR LIFT MI 9200177 11/11/2003 10,140.00 10,140.00 0.00 5031 SKID STEER LOADER MI LMU4082225 2/17/2005 28,032.20 28,032.20 0.00 4519 SWING STAGE MOTOR MI GOOBB188 6/27/2003 2,520.00 2,520.00 0.00 4520 SWING STAGE MOTOR MI HOOBB379 6/27/2003 2,520,00 2,520.00 0.00 4527 SWING STAGE MOTOR MI J0088452-P 6/27/2003 2,520.00 2,520.00 0.00 4528 SWING STAGE MOTOR MI FOOB8138-P 6/27/2003 2,520.00 2,520.00 0.00 4521 SWING STAGE MOTOR MI JOOB8045 6/27/2003 2,520.00 2,520.00 0.00 4522 SWING STAGE MOTOR MI KOOB8532 6/27/2003 2,520.00 2,520.00 0.00 4523 SWING STAGE MOTOR MI KOOB8546 6/27/2003 2,620.00 2,520.00 0.00 4524 SWING STAGE MOTOR MI KOOB8548 6/27/2003 2,520.00 2,520.00 0.00 4525 SWING STAGE MOTOR MI K00BS550 6/27/2003 2,520.00 2,520.00 0.00 4526 SWING STAGE MOTOR MI KOOB8552 6/27/2003 2,520.00 2,520.00 0.00 4769 CONCRETE BUGGY WBH16 Ml 9909-59384 1/31/2005 2,968.36 2,968.36 0.00 EQ05050 PUMP JACK MI 6/8/2005 3,460.04 3,460.04 0.00 EQ05051 PUMP JACK MI 6/8/2005 3,460.05 3,460.05 0.00 EQ05052 PUMP JACK MI 6/8/2005 3,460.04 3,460.04 0.00 EQ05053 PUMP JACK MI 6/8/2005 3,460.04 3,460.04 0.00 5048 GUNITE MACHINE MI 05-4056-SR7 5/25/2005 9,943.89 9,943.89 0.00 EQ05145 HOTSY HOT WATER PRESSURE WASHER MI 977/2005 7,526.00 7,526.00 0.00 EQ05687 8000 WATT GENERATOR MI 3/14/2006 1,681.25 1,681.25 0.00 EQ05688 8000 WATT GENERATOR MI 3/14/2006 1,681.25 1,681.25 0.00 Page: 8 Co Asset No Description Location Serial Number Acquisition Date Ending Asset Ending Accum Net Book Value Balance Depr EQ05689 8000 WATT GENERATOR MI 3/14/2006 1,681.24 1,681.24 0.00 EQ05810 POWER SCREED ENGINE MI 8/17/2006 7,950.00 7,950.00 0.00 EQ06277 16 CF MILLER POWER BUGGY MI G-16500 7/12/2007 7,397.74 7,397.74 0.00 EQ06510 HILTI CORE DRILL MI 10/17/2007 2,780.06 2,780.06 0.00 EQ06528 SWING HOIST 1-TON 1224 MI 11/16/2007 15,061.62 15,061.62 0.00 EQ06526 HYDRAULIC POWER UNIT MI 1/8/2008 2,150.00 2,150.00 0.00 EQ06527 GROUT AND CONCRETE PUMP MI 1/3/2008 2,595.00 2,595.00 0.00 EQ07048 POWER CLIMBER PC-1000E MI 3/15/2010 5,835.86 5,835.86 0.00 EQ07049 POWER CLIMBER PC-1000E MI 3/15/2010 5,835.86 5,835.86 0.00 EQ07052 POWER CLIMBER PC-1000E MI 3/15/2010 5,835.86 5,835.86 0.00 EQ07063 POWER CLIMBER PC-1000E-USED MI 3/15/2010 4,872.30 4,872.30 0.00 EQ07066 POWER CLIMBER PC-1000E-USED MI 3/15/2010 4,872.30 4,872.30 0.00 EQ07067 POWER CLIMBER PC-1000E-USED Ml 3/15/2010 4,872.30 4,872.30 0.00 EQ07424 TWO ROLL SATURATOR KIT MI 7/8/2010 13,305.16 13,305.16 0.00 EQ07432 AED HEARTSTART ONSITE DEFIBRILATOR MI 8/27/2010 1,433.19 1,433.19 0.00 EQ07435 CONCRETE MIXER MI 8/6/2010 6,255.75 6,255.75 0.00 EQ07462 375 INGERSOL RAND COMPRESSOR MI 8/24/2010 28,309.55 28,309.55 0.00 7031A 30' SWINGSTAGES MI 12/31/2011 37,315.70 37,315.70 0.00 EQ06171 BLASTRAC SHOT BLASTER 8" MI 9911004 4/1/2007 2,500.00 2,500.00 0.00 EQ06178 BLASTRAC VAC MI 4/1/2007 1,250.00 1,250.00 0.00 EQ06172 BLASTRAC SHOT BLASTER 8" MI 20060024 4/112007 2,500.00 2,500.00 0.00 7031AC SWINGSTAGE MI 12/31/2011 7,713.54 7,713.54 0.00 7031AD MISC STAGE COMPONENTS MI 12/31/2011 76,885,12 76,885.12 0.00 EQ07044 POWER CLIMBER PC-1000E MI 3/15/2010 5,835.86 5,835.86 0.00 EQ07045 POEWR CLIMBER PC-1000E MI 3/15/2010 5,835.86 5,155.04 680.82 EQ07047 POWER CLIMBER PC-1000E MI 3/15/2010 5,835.86 5,835.86 0.00 EQ07050 POWER CLIMBER PC-1000E MI 3/15/2010 5,835.86 5,835.86 0.00 EQ07051 POWER CLIMBER PC-1000E MI 3/15/2010 5,835.86 5,835.86 0.00 EQ07053 POWER CLIMBER PC-1000E MI 3/16/2010 5,835.86 6,835.86 0.00 EQ07054 POWER CLIMBER PC-1000E MI 3/15/2010 5,835.86 5,835.86 0.00 EQ07055 POWER CLIMBER PC-1000E MI 3/15/2010 5,835.86 5,835.86 0.00 EQ06885 TITAN SHORING (LEGS, BRACES) MI 2/1/2009 5,000.00 5,000.00 0.00 EQ08338 DEK MACHINE MI 10/30/2014 7,208.00 6,006.66 1,201.34 EQ08339 SATURATOR CA 1/26/2015 8,071.88 6,322.98 1,748.90 EQ08358 DEK MACHINE MI 10/30/2014 6,996.00 5,830.00 1,166.00 EQ08359 SUSPENDED SCAFFOLDING EQUIPMENT MI 3/31/2015 41,071.47 30,803.58 10,267.89 EQ08392 SCAFFOLDING MI 5/20/2015 17,877.70 12,812.35 5,065.35 EQ08393 SKID STEER (NEW HOLLAND) MI NEM48631 5/20/2015 37,630.00 26,968.18 10,661.82 EQ08394 AIR COMPRESSOR (SULLIVAN 250cfm) MI 5/20/2015 26,826.00 20,309.02 6,516.98 EQ08412 SWING STAGE MOTORS NJ 6/15/2015 19,795.00 14,186.43 5.608.57 EQ08413 SKYCLIMBER EQUIPMENT NJ 5/31/2015 57,095.20 43,129.71 13,965.49 EQ08439 KAWASAKI MULE 4X4 CLUB CAR 2011 MI KZ1219280821 7/10/2015 5,406.00 3,784.20 1,621.80 Page: 9 Co Asset No Description Location Serial Number Acquisition Date Ending Asset Ending Accum Net Book Value Balance Depr EQ08440 KAWASAKI MULE 4X4 CLUB CAR 2010 MI KZ1048153686 7/16/2015 4,770.00 3,259.50 1,510.50 EQ08441 CONCRETE BUGGY MI 150724 8/19/2015 8,374,00 5,582.68 2,791.32 EQ08442 CONCRETE BUGGY MI 150720 8/19/2015 8,374.00 5,582.68 2,791.32 EQ08443 CONCRETE BUGGY MI 150730 8/19/2015 8,374.00 5,582.68 2,791.32 EQ08444 CONCRETE BUGGY MI 150737 8/19/2015 8,374.00 5,582.68 2,791.32 EQ08503 SWING STAGE ACCESS EQUIPMENT NY 12/10/2015 290,684.40 192,059.32 98,625.08 EQ08784 SKID STEER (NEW HOLLAND) MI 3/28/2016 43,250.00 23,787.49 19,462.51 EQ08785 SKID STEER (NEW HOLLAND) MI 3/28/2016 43,250.00 23,787.49 19,462.51 EQ08789 SWING STAGE MOTORS NJ 3/31/2016 36,433.50 20,038.42 16,395.08 EQ08790 AIR COMPRESSOR (ATLAS COPCO) MI HOP076226 5/16/2016 41,289.12 21,332.70 19,956.42 EQ08844 AIR COMPRESSOR (ATLAS COPCO 400445 CA HOP076334 7/21/2016 42,311.61 20,450.60 21,861.01 EQ08845 CFM) CLUB CAR 4x4 DIESEL CA RF/1648/800193 7/21/2016 15,108.28 7,302.34 7,805.94 EQ08897 SATURATOR NJ 10/11/2016 13,161.00 5,922.45 7,238.55 EQ08909 Swing Stage Equipment NY 10113/2016 172,769.98 77,746.50 95,023.48 EQ08946 Bob Cat Skid Steer MI B31,11-11872 2/21/2017 39,135.20 14,349.56 24,785.64 EQ08947 Epoxy injection Machine CA 2/14/2017 8,423.14 3,228.88 5,194.26 EQ08966 Bobcat Skidsteer NJ 3/15/2017 36,476.30 13,374.65 23,101.65 EQ08967 4400 All Terrain Forklift MI 3/1612017 19,525.20 6,833.82 12,691.38 EQ08999 Compressor MI HOP076778 6/8/2017 52,443.50 16,607.11 35,836.39 EQ09012 Truck Lift NJ 7/19/2017 8,436.18 2,390.25 6,045.93 EQ09013 Truck Lift NJ 7/19/2017 8,436.18 2,390.25 6,045.93 EQ09027 Rotec System NY 7/26/2017 146,654.18 41,552.03 105,102.15 EQ09028 Air Compressor MI 6/16/2017 52,443.50 15,733.06 36,710.44 EQ07105-01 Brokk 90 NJ 9/14/2017 9,804.58 2,614.56 7,190.02 EQ09046 Saturator CA 7/24/2017 14,030.23 3,975.24 10,054.99 EQ07105-02 Brokk 90 (Repair) NJ 11/8/2017 5,911.83 1,379.43 4,532.40 EQ09104 Compressor MI 483357ULABF44 11/28/2017 26,256.04 5,688.81 20,567.23 EQ09105 Compressor MI 483358ULABF44 11/28/2017 26,256.04 5,688.81 20,567.23 EQ08062 DIRECT DRIVE POWER SQUARING SHEAR NJ 2/11/2013 10,731.02 10,731.02 0.00 EQ08063 10' BREAK NJ 2/12/2013 2,889.00 2,889.00 0.00 EQ08064 PNEUMATIC HOG RING TOOL NJ HC1511 2112/2013 2,400.56 2,400.56 0.00 EQ09126 Forklift MI FGA15-1290-00167 2/28/2018 23,659.20 3,943.20 19,716.00 EQ09127 Skid Steer MI B3NL13321 3/6/2018 39,831.38 6,638.57 33,192.81 EQ09128 Skid Steer MI B31,11-13320 3/7/2018 39,831.38 6,638.57 33,192.81 EQ09129 Versa Pump NJ LLL1159649 12/5/2017 27,362.73 5,928.60 21,434.13 EQ09172 Saturator CA 5/9/2018 12,360.81 1,648.10 10,712.71 EQ09173 Saturator CA 5/9/2018 12,360.81 1,648.10 10,712.71 NY 6/15/2018 12,031.13 1,403.64 10,627.49 EQ09174 Saturator MI 5/16/2018 37,598.25 4,386.47 33,211.78 EQ09204 Swing Stage CA 2106A1354 5!1/2018 61,334.83 8,177.99 53,156.84 EQ09221 Concrete Pump NJ 9/30/2018 28,670.00 1,433.49 27,236.51 EQ09232 Avant Compact Loader Page: 10 Co Asset No Description Location Serial Number Acquisition Date Ending Asset Ending Accum Net Book Value Balance Depr EQ09295 Swing Stage NY 10/17/2018 403,850.17 13,461.68 390,388.49 EQ09321 375 Air Compressor MI 10/1/2018 52,344.92 2,617.25 49,727.67 $4,597,502.95 $3,199,065.16 $1,398,437.79 Subtotal: Equipment (355) Asset Type: Furniture & Fixtures FF07290 CUBICLE WORKSTATIONS NJ FF07291 EQUIPMENT NJ FF07292 OFFICE EQUIPMENT NJ FF07293 Cannon ScannerDR3080CII NJ FF07297 SERVER CABINET NJ FF07300 OFFICE FURNITURE-2010 NJ FF07302 OFFICE FURNITURE-2011 NJ FF07311 OFFICE FURNITURE - 2013 MI FF07317 OFFICE FURNITURE - WORKSTATIONS 2015 NJ FF07318 OFFICE FURNITURE - MODULAR OFFICES NJ Subtotal: Furniture & Fixtures (10) Asset Type: Leasehold Improvements LH06155 BACKLOT PAVING MI LH06157 OFFICE ADDITION 2013 MI LH06165 BENICIA OFFICE BUILDOUT CA 6047 FACILITY UPGRADE-DT MI LH06073-01 FACILITY UPGRADE 20051O6 - DT MI LH06109 DETROIT WAREHOUSE RENOVATIONS-2009 MI LH06148 ASPHALT PAVING PARKING LOT MI LH06169 HHP OFFICE IMPROVEMENTS NJ LH06186 HVAC NJ LH06187 Roof NJ LH06188 Office Fit Out NJ LH06191 SST NYC Buildout NY Subtotal: Leasehold Improvements (12) Asset Type: Trailer TR01053 DUMP TRAILER (7x14) NJ TR1037 2007 MID-SOTA HV-12 CA TR1024 2001 TOWMASTER BOBCAT TRLR CA 4081 U-DUMP TRAILER MI 4147 WELLS CARGO TRAILER MI 4310 CARGO PRO ENCLOSED TRAILER MI 4536 ANDERSON SKID STEER TRAILER MI Page: 11 Co Asset No Description 4688 TR1008 TR1033 TR1038 TR01082 TR01083 TR01084 TR01088 TR01101 TR01102 TR01106 TR01107 TR01108 TR01109 TR01110 TR01111 TR01112 TR01113 Subtotal., Trailer (25) Asset Type: Vehicle EQ07176 VE01760 VE01762 VE01767 VE01774 VE01776 VE01778 VE01779 VE01780 VE01782 VE01784 11/12/2008 50,000.00 50,000.00 0.00 10/23/2006 0.00 0.00 0.00 4/3/2006 0.00 0.00 0.00 9673A002AB 12/19/2007 0.00 0.00 0.00 6/30/2010 228.63 228.63 0.00 11/30/2010 3,000.00 3,000.00 0.00 6/20/2011 7,490.51 7,490.51 0.00 10/26/2012 2,806.58 2,472.46 334.12 4/1/2015 58,000.00 31,071.43 26,928.57 4/l/2015 25,000.00 13,392.86 11,607.14 $146,525.72 $107,655.89 $38,869.83 3/4/2013 16,395.00 16,395.00 0.00 3/1/2013 13,694.90 13,694.90 0.00 1/1/2014 64,813.85 64,813.85 0.00 9/l/2000 14,048.18 14,048.18 0.00 10/6/2005 9,239.19 9,239.19 0.00 1/13/2009 20,215.63 20,215.63 0.00 10/12/2012 5,220.66 5,220.66 0.00 4/1/2015 90,280.22 33,855.08 56,425.14 8/23/2018 40,896.32 2,097.24 38,799.08 9/30/2018 212,930.12 8,295.98 204,634.14 9/30/2018 19,900.00 775.32 19,124.68 10/1/2018 479,522.10 33,455.04 446,067.06 $987,156.17 $222,106.07 $765,050.10 6/20/2012 6,733.09 6,733.09 0.00 1M9AD12257A633057 9/2/2009 2,152.50 2,152.50 0.00 4KNUT202911-162593 9/2/2009 807.19 807.19 0.00 432DJ2264Z0005334 11/8/1999 5,000.00 5,000.00 0.00 1WC200F22Y109148 4/25/2000 4,800.00 4,800.00 0.00 5 1C9B116232B776614 6/6/2002 3,897.54 3,897.54 0.00 4YNBN16263C014215 8/25/2003 2,966.94 2,966.94 0.00 Location Serial Number Acquisition Date 2004 PACE AMERICAN TRAILER MI 40LUB14204P100636 3/8/2004 STORAGE UTILITY TRAILER MI 40LFB10136P128276 10/30/2006 2005 MID-SOTA HV-12 MI iM9AD12225A633210 9/2/2009 2004 MID-SOTA HV-12 MI iM9AD12235A633183 9/2/2009 2016 DUMP TRAILER (GRIFFIN) MI 56WBU1423GE00732 3/16/2016 1 2016 DUMP TRAILER (GRIFFIN) MI 56WBU1427GE00733 3/16/2016 7 2016 DUMP TRAILER (GRIFFIN) MI 56WBU1425GE00782 3/16/2016 3 2016 HOMESTEADER 8.5x18 ENCLOSED NJ 5HABE1827GN04993 6/29/2016 TOOL TRAILER 2 7X17 Legend Cyclone Trailer MI 11-9BE17241-11317240 9/19/2017 7X1 7 Legend Cyclone Trailer MI 1L9BE1729H1317248 9/19/2017 18' ENCLOSED TRAILER MI 3/17/2018 18' ENCLOSED TRAILER MI 3/17/2018 18' ENCLOSED TRAILER MI 3/17/2018 12' ENCLOSED TRAILER MI 3/17/2018 12' ENCLOSED TRAILER MI 3/17/2018 12' ENCLOSED TRAILER MI 3/17/2018 12' ENCLOSED TRAILER MI 3/17/2018 12' ENCLOSED TRAILER MI 3/17/2018 Ending Asset Balance 3,425.00 2,463.44 1,614.38 2,690.63 7,350.00 7,350.00 7,350.00 6,279.65 6,016.46 6,016.46 6,857.57 6,878.87 6,019.74 5,849.90 5,849.90 5,892.54 5,873.10 5,967.80 $126,102.70 Ending Accum Depr 3,425.00 2,463.44 1,614.38 2,690.63 4,042.50 4,042.50 4,042.50 3,139.82 1,504.11 1,504.11 1,028.63 1,031.84 902.96 877.49 877.49 883.88 880.96 895.16 $62,204.66 Net Book Value 0.00 0.00 0.00 0.00 3,307.50 3,307.50 3,307.50 3,139.83 4,512.35 4,512.35 5,828.94 5,847.03 6,116.78 4,972.41 4,972.41 5,008.66 4,992.14 5,072.64 $63,898.04 F-800 STACK TRUCK NJ 1FDNF80C9WVA2766 2/3/2006 2,500.00 2,500.00 0.00 8 FORD TRUCK S-DUTY F-350 (#47) NJ 1FTWW30PX6EB443 4f7/2006 16,000.00 16,000.00 0.00 66 FORD E450#32 NJ 1FDXF46P14EC6347 7/6/2007 14,000.00 14,000.00 0.00 1998 FORD FSERIES #110 NJ IFDNF80CIWVA3217 12/l/2006 13,000.00 13,000.00 0.00 0 2002 FORD F350#59 NJ 1FDWF37F52EC3629 12/1/2006 12,000.00 12,000.00 0.00 3 2007 FORD F-1 50 #62 NJ IFTRF12217NA12164 3/5/2007 11,500.00 11,500.00 0.00 2007 FORD F-150 #67 NJ 1FTRF12217NA88175 9/10/2007 11,500.00 11,500.00 0.00 2008 FORD F-15O XLT#71 NJ 1FTRF122X8KB86091 11/5/2007 11,000.00 11,000.00 0.00 2008 FORD F-1 50 #70 NY 1FTRF12228KB80785 11/5/2007 11,000.00 11,000.00 0.00 FORD F4502001 (#56) NJ 1FDXF46FBIEB40538 9/5/2006 11,000.00 11,000.00 0.00 2001 FORD F 350-TRUCK 25 NJ 1FTSW301`71EA4934 12/18/2003 10,500.00 10,500.00 0.00 3 VE01792 FORD F-550 4X4 2002 (#112) NJ 1 FDAF56F52EC80785 10/20/2006 8,000.00 8,000.00 0.00 Page: 12 Co Asset No Description Location Serial Number Acquisition Date Ending Asset Ending Accum Net Book Value Balance Depr VE01802 2006 FORD FREESTYLE (#17) NJ 1FMZK01106GA4531 8/14/2006 5,500.00 5,500.00 0.00 5 VE01807 2004 FORD RANGER -TRUCK 30 NJ 1FTYR10UX4PB4177 9/1/2004 5,000.00 5,000.00 0.00 VE01813 1999 F800 STAKE BODY -STAKE 108 NJ 3FENF8000XMAO76 8/11/2003 4,000.00 4,000.00 0.00 07 VE01814 2001 FORD E 350 CLUB WAGON -TRUCK 27 NJ 1FBSS31F71HB74436 3/1/2004 3,300.00 3,300.00 0.00 1FBSS31F71HB74436 VE01816 TRUCK NJ 8/12/1997 2,000.00 2,000.00 0.00 VE01817 TRUCK#8 FROM SECURED NJ I FTSW31 F3XEC6120 12/1/2006 0.00 0.00 0.00 0 VE01722 2006 FORD F550 CA 1FDAW56P06EA1834 9/2/2009 13,453.13 13,453.13 0.00 7 1261 1999 CHEVY PICKUP #114 NJ 1GBKC34F4XF04657 6/4/1999 22,803.53 22,803.53 0.00 VE01876 2013 CHEVY SILVERADO NJ IGCRCPE00DZ11114 9/27/2012 28,425.51 28,425.51 0.00 7 VE01877 2013 CHEVY SILVERADO NJ IGCRCPE07CZ14622 9/27/2012 27,488.82 27,488.82 0.00 0 VE01882 2013 CHEVY SILVERADO NJ IGC1CVCG2DF10782 10/24/2012 32,368.61 32,368.61 0.00 9 VE01883 2013 CHEVY SILVERADO NJ IGC2CVCG5DZ13849 10/24/2012 29,659.89 29,659.89 0.00 4 VE01849 2011 FORD F-250 CA 1FT7X2A62BEC37359 3/17/2011 26,839.27 26,839.27 0.00 VE01847 2011 FORD F-250 NJ i FT7X2A69BEC37357 3/17/2011 26,839.27 26,839.27 0.00 VE01869 2012 Chevy Silverado MI IGC2CVCG9CZ29452 2/21/2012 28,573.57 28,573.57 0.00 2 VE01461 2006 CHEVY SILVERADO MI 1GCHC29U76E10036 8/29/2005 22,223.08 22,223.08 0.00 2 VE01927 2014CHEVY SILVERADO2600 NJ IGClCVCGlEF11602 11/2112013 32,025.76 32,025.76 0.00 3 VE01928 2014CHEVY SILVERADO1500 NJ 1GCRCPECIEZ11744 11121/2013 28,654.97 28,654.97 0.00 0 VE01932 2014 CHEVY TRAVERSE NY 1GNKVFED6EJ22012 1/6/2014 31,817.29 31,817.29 0.00 9 VE01936 2015CHEVY SILVERADO2500 MI IGCOCUEGOFZ10520 2/20/2014 29,193.71 28,220.58 973.13 9 VE01937 2015CHEVY SILVERADO, 2500 MI 1GCOCUEG7FZ10556 2/20/2014 29,193.71 28,220.58 973.13 3 VE01938 2015CHEVY SILVERADO, 2500 MI 1GCOCUEG7FZ10503 2/20/2014 29,193.71 28,220.58 973.13 1 VE01848 2011 FORDF-250 NJ 1FT7X2A60BEC37358 3/17/2011 26,839.27 26,839.27 0.00 VE01946 2015CHEVY SILVERADO, 2500 NJ 1GCICUEGOFF13567 5/8/2014 32,414.55 30,253.57 2,160.98 2 VE01947 2014 CHEVY SILVERADO 1500 NJ 1GCRCPEHlEZ24155 5/12/2014 28,486.15 26,587.08 1,899.07 7 VE01964 2014 CHEVY SILVERADO 1500 NJ 1GCRCPEHOEZ35141 9/11/2014 28,786.03 24,947.91 3,838.12 8 VE01968 2015 CHEVY TRAVERSE NJ IGNKRGKDXFJ23968 12/23/2014 32,728.00 26,182.41 6,545.59 5 Page: 13 Co Asset No Description Location Serial Number Acquisition Date Ending Asset Ending Accum Net Book Value Balance Depr 1384 2002 CHEVY LIGHT DUTY MI 3GBKC34F52M11270 1/2/2003 33,757.62 33,757.62 0.00 3 VE01491 2006 CHEVY SILVERADO MI 3GCEC14V76G19157 4/13/2006 17,195.14 17,195.14 0.00 4 VE01529 2006 GMC TC5500 MI 1GBJ5C1285F525596 9/26/2006 53,642.00 53,642.00 0.00 VE01592 2007 CHEVY SILVERADO MI 1GCHC24K47E57765 6/1/2007 21,363.58 21,363.58 0.00 9 VE01593 2007 CHEW SILVERADO MI 1GCHC24K47E57681 6/1/2007 21,363.58 21,363.58 0.00 8 VE01618 2008 CHEVY SILVERADO 2500HD MI 1GCHC24K48E15827 11/29/2007 22,847.93 22,847.93 0.00 5 VE01629 2008 CHEVY IMPALA MI 2GlWB58K68121312 2/6/2008 19,009.29 19,009.29 0.00 9 VE01638 2008CHEVY SILVERADO2500 MI 1GCHC24K28E17156 5/7/2008 22,123.07 22,123.07 0.00 0 VE01663 2009 CHEVY SILVERADO MI 1GCEC19J89E128811 1/15/2009 24,081.51 24,081.51 0.00 VE01738 2010 FORD F150 PICKUP MI IFTMFlCWOAKB571 12/28/2009 19,834.41 19,834.41 0.00 04 VE01862 2011 FORD F150 MI 1FTFWICF16FC1586 7/20/2011 27,311.68 27,311.68 0.00 8 VE01711 1999 CHEVY 1 TON MI 1GBKC34J5XF070402 9/2/2009 2,152.50 2,152.50 0.00 VE01846 2011 CHEVY MALIBU MI 1GIZA5EU7BF30411 3/2/2011 21,001.59 21,001.59 0.00 1 VE01972 2015 CHEVY SILVERADO 2500 MI 1GCOCUEG6FZ52687 3/23/2015 29,501.58 24,197.11 5,304.47 0 VE01973 2015 CHEVY SILVERADO 2500 MI 1GCOCUEG3FZ52737 3/23/2015 29,501.58 24,197.11 5,304.47 6 VE01974 2015 CHEVY SILVERADO 1500 NJ 1GCRCPEH7FZ17006 4/15/2015 28,236.99 21,177.76 7,059.23 0 VE01975 2015 CHEVY SILVERADO 2500 NJ 1GC1CUEG4FF55120 4/15/2015 34,280.43 25,710.33 8,570.10 7 VE01976 2015 CHEVY TRAVERSE NJ 1GNKRFED5FJ21248 4/21/2015 30,044.00 22,032.26 8,011.74 VE01988 2015 CHEVY SILVERADO 1500 NY 1 1GCRCPEH7FZ25065 7/23/2015 29,945.35 20,462.66 9,482.69 3 VE01728 2009 CHEVY MALIBU CA 1G1ZG57B89F260253 10/16/2009 20,036.13 20,036.13 0.00 VE02001 2016 CHEVY SILVERADO 1500 CA 3GCPCNECIGG1249 11/3/2015 35,746.25 22,639.29 13,106.96 19 VE02002 2016 CHEVY SILVERADO 1500 CA IGCNCNEHXGZ1347 11/9/2015 27,180.57 17,214.35 9,966.22 41 VE02008 2015 CHEVY SILVERADO 2500 NJ 1GC2CUEGXFZ55358 12/2/2015 33,925.37 21,275.25 12,650.12 0 VE02009 2015 CHEVY SILVERADO 2500 NJ IGClCUEGXFF67199 12/3/2015 35,244.42 22,102.43 13,141.99 6 VE02010 2016 CHEVY IMPALA NJ IG1105SA4GU10380 12/2/2015 29,846.54 18,717.31 11,129.23 0 VE02011 2016 CHEVY SILVERADO 2500 CA I GCOCUEG9GZ1 557 12/7/2015 31,886.28 19,663.22 12,223.06 54 VE02089 2016 CHEVY SILVERADO 2500 MI IGCOCUEGOG72909 5/2/2016 32,391.90 17,275.68 15,116.22 00 Page: 14 Co Asset No Description Location Serial Number Acquisition Date Ending Asset Ending Accum Net Book Value - Balance Depr VE02090 2016 CHEVY SILVERADO 2500 MI 1GCOCUEG7GZ2945 5/2/2016 32,400.90 17,280.49 15,120.41 24 VE02091 2016 CHEVY SILVERADO 2500 MI 1GCOCUEG5GZ2919 5/2/2016 32,400.90 17,280.49 15,120.41 28 VE02097 2016 FORD F-550 NJ 1FDUF5GTOGEC7444 5/23/2016 59,528.50 30,756.39 28,772.11 8 VE02098 2016 FORD F-650 NJ. 1FDNF6DE5GDA0661 6/13/2016 73,399.50 39,919.03 33,480.47 5 VE02099 2016 FORD F-650 NY 1 FDWF6DE3GDA066 6/13/2016 107,248.69 58,328.24 48,920.45 20 VE02100 2016 CHEVY SILVERADO 2500 NY 1GCIKUEG8GF23157 6/16/2016 39,280.23 20,392.17 18,888.06 1 VE02106 2017 CHEVY IMPALA MI 2GI105SA31-19108971 8/19/2016 30,011.50 14,005.36 16,006.14 VE02127 2017 CHEVY SILVERADO 2500 NJ 1GB2CUEGXHZ23220 3/15/2017 38,389.18 14,076.04 24,313.14 9 VE01609 2007 CHEW C6500 MI 1GBJ6C1327F402837 10/10/2007 60,671.15 60,671.15 0.00 VE02139 2017 CHEVY TAHOE NY 1GNSKBKC7HR3153 6/19/2017 58,105.07 17,431.52 40,673.55 82 VE02140 2017 CHEVY SILVERADO 2500 NJ 1GB2CUEG6HZ31882 6/19/2017 41,078.50 12,323.55 28,754.95 7 VE02152 2018 NPR HD Box NY JALC4W16OH700039 11/2/2017 58,135.05 13,564.85 44,570.20 4 VE02153 2018 CHEVY SILVERADO 2500 CA 1GCRCREC7JZ15189 11/6/2017 35,509.06 8,285.45 27,223.61 0 VE02155 2018 CHEVY SILVERADO 2500 CA 1GC2CUEG6JZ19005 12/15/2017 34,329.79 7,438.11 26,891.68 6 VE02156 2003 Ford Cargo Van NY IFTNE24LX3H859167 10/26/2017 7,516.12 1,753.77 5,762.35 VE02159 2018 CHEVY SILVERADO 2500 NJ 1GB2CUEG2JZ20927 1/16/2018 39,484.99 7,238.91 32,246.08 1 VE01868 2012 CHEVY MALIBU NJ 1G1ZB5E03CF204759 4/24/2012 20,676.75 20,676.75 0.00 VE01993 2015 CHEVY SILVERADO 1500 MI 1GCVKPEC2FZ35732 9/9/2015 33,926.64 22,617.75 11,308.89 5 VE02105 2016 CHEVY SILVERADO 1500 MI 1GCVKNEC6GZ3862 8/11/2016 34,733.69 16,787.96 17,945.73 35 VE02178 2009 Ford E350 NJ 1FBNE31LX9DA2704 3/28/2018 14,500.08 2,175.02 12,325.06 VE02179 2018 Chevy Stake Truck MI 1GB3CYCG4JF22414 4/21/2018 43,611.13 5,814.81 37,796.32 4 VE02180 2018 CHEVY SILVERADO 2500 MI 1GCOCUEG4JZ29979 4/21/2018 32,499.17 4,333.21 28,165.96 8 VE02181 2018 CHEVY SILVERADC, 2500 MI 1GCOCUEGBJZ30301 4/21/2018 32,499.17 4,333.21 28,165.96 3 VE02182 2018 CHEVY SILVERADO 2500 MI IGCOCUEG5J729852 4/21/2018 32,499.17 4,333.21 28,165.96 9 VE02183 2018 CHEVY SILVERADO 2500 MI IGCOCUEGIJZ30133 4/21/2018 32,499.17 4,333.21 28,165.96 1 Page: 15 Co Asset No Description Location Serial Number Acquisition Date Ending Asset Ending Accum Net Book Value Balance Depr VE02188 2018 CHEVY SILVERADO 2500 NY 1GCVKNEC3JZ25907 5/4/2018 36,402.81 4,853.70 31,549.11 6 VE02189 2018 CHEVY SILVERADO 2500 NY 1GC2KUEG3JZ29541 5/4/2018 38,447.55 5,126.33 33,32122 5 VE02199 2018 CHEVY SILVERADO 2500 NJ 1GCOCUEG8JZ21018 4/18/2018 33,800.36 4,506.72 29,293.64 4 VE01602 2007 CHEVY SILVERADO CA 1GCHC29U07E18539 8/30/2007 22,855.33 22,855.33 0.00 8 VE02206 2018 CHEVY SILVERADO 2500 NJ 3GCUKREC2JG37921 7/11/2018 46,190.35 4,619.04 41,571.31 3 VE02218 2019 CHEVY SILVERADO 2500 CA 2GC2CREG4K111978 10/1/2018 35,323.61 1,766.19 33,557.42 4 VE02225 2019 CHEVY SILVERADO 2500 NJ 2GC2CREG3K113084 11/19/2018 33,946.64 565.78 33,380.86 2 Subtotal. Vehicle (98) $2,745,159.87 $1,795,273.21 $949,886.66 Grand Total $8,917,459.06 $5,662,137.16 $3,255,321.90 Page: 16 Project Name Main & Colfax Parking Structure Repairs 2020 Project No. 115-143BR For Bids Due May 26, 2020 Contractor Name: Pullman SST, Inc. The City seeks to enhance its ability to identify responsive and responsible bidders on all City public works projects by institution of comprehensive submission requirements in compliance with State law. Quality workmanship, efficient operation, safety, and timely completion of projects requires that all bidders meet certain minimum requirements to be responsive and responsible bidders. THIS FORM MUST BE SUBMITTED WITH YOUR BID. INSTRUCTIONS: If you are a pre -qualified bidder, complete Section I only. If you are not a pre -qualified bidder, complete Section If only. Section 11 acts as an application for pre -qualification. Submission of Section II will allow the bidder to be considered for pre -qualification for bids with the City of South Bend Department of Public Works. Pre - qualified bidders will then be exempt from a portion of the submission requirements outlined in Section 6- 63 of The Responsible Bidding Ordinance No. 10594-18 (hereinafter, "Responsible Bidding Ordinance") for a period of twelve (12) months. Thereafter, contractors who are pre -qualified must submit a complete application for continuation of "pre - qualified" standing, on a form provided by the City ("Responsible Bidder Checklist (1) Pre -Qualified Bidders") by December 31st for the upcoming calendar year, or within twelve (12) months of obtaining pre - qualified standing. If the status of any item changes within the twelve (12) months, it is the responsibility of the contractor to notify the City. Failure by any pre -qualified contractor to submit its complete application for continuation of "pre -qualified" standing within the time prescribed above shall result in automatic removal of the designation, effective January 1 of the following year, or immediately following the twelve (12) months of pre -qualified standing. However, the "removed" contractor or subcontractor shall still be permitted to bid on City public works projects, though the contractor must submit all required documents under 6-63 until "pre -qualified" status is re-established. Please Note: The City reserves the right to request supplemental information from the bidder, additional verification of any information provided by the bidder, and may also conduct random inquiries of the bidder's current and previous customers regardless of pre -qualified standing. It is the sole responsibility of the potential bidder to comply with all submission requirements applicable to the bidder in Section 6-63 of the Responsible Bidding Ordinance no later than the date of the public bid opening. Version 5/16/2019 General Conditions - 6 POST BID SUBMISSIONS: Post -bid submissions must be submitted in accordance with Section 6-64 of the Responsible Bidding Ordinance. The post -bid submission requirements are as follows: 1. All bidders shall collect, maintain, and provide upon request, a current written list that discloses the name, address, licensing status, and type of work for any subcontractor from whom the bidder has accepted a bid and/or intends to hire on any part of the public work project, including individuals performing work as independent contractors. 2. Each subcontractor, whose portion of the project is estimated to be at least one -hundred fifty thousand dollars ($150,000.00), shall be required to adhere to the requirements of Section I of the Responsible Bidder Ordinance as though it were bidding directly to the City, except that the subcontractor shall submit the required information (including the name, address, and type of work) to the successful bidder prior to the commencement of work. 3. Failure of a subcontractor to submit the required information shall not disqualify the successful bidder from performing work on the project and shall not constitute a contractual default and/or breach by the successful bidder. However, the City may withhold all payment otherwise due for work performed by a subcontractor, until the subcontractor submits the required information and the City approves such information. 4. The disclosure of a subcontractor list ("Disclosed Subcontractor(s)") to the City by a bidder shall not create any rights in the Disclosed Subcontractor(s). Thus, a bidder may substitute another subcontractor for a Disclosed Subcontractor by giving the City, upon request, written notice of the name, address, licensing status, and type of work of the substitute subcontractor. 5. The successful bidder and all subcontractors on a public works project are required to submit certified payroll utilizing the federal form known as WH-347 or a similar form on a bi-weekly basis, submitted within 10 days after the end of each bi-weekly payroll period. Certified payrolls shall identify the job title and craft for each employee. Certified payrolls shall be submitted electronically. Please Note: Submissions deemed inadequate, incomplete, or untimely by the City may result in the automatic disqualification of the bid. The City, after review of complete and timely submissions, shall, in its sole discretion, after taking into account all information in the submission requirements, determine whether a bidder is responsive and responsible, and provide a Pre -Qualification Verification Letter. The City specifically reserves the right to utilize all information provided in the contractor's submission and any information obtained by the City through its own independent verification of the information provided by the contractor. Version 5/16/2019 General Conditions - 7 PRE -QUALIFIED BIDDER CHECKLIST (a) Acknowledgements: (i) _ By checking this box, I hereby acknowledge that I am a pre -qualified bidder with the City of South Bend and that I have met the pre -qualification requirements within the last twelve (12) months. A copy of my Pre -Qualification verification letter is attached. (ii) _ By checking this box, I hereby acknowledge that the City reserves the right to request supplemental information, additional verification of any information provided by me, and may also conduct random inquiries of my current and prior customers. (b) Attachments: (i) _ Indiana Secretary of State's on-line records (ie. Business verification) dated within sixty (60) days of the submission of said document showing that business is in existence, current with the Indiana Secretary of State's Business Entity Report, and eligible for a certificate of good standing. (Not applicable to individuals, sole proprietors or partnerships). Statement on staffing capabilities, including labor sources. This statement indicates and ensures I have sufficient employees on staff to complete the work. It outlines how I intend to meet the staffing needs of the work. List of projects of similar size and scope of work performed in all areas, including the State of Indiana, within the last three (3) years. (iv) _ For every project, submit evidence of participation in apprenticeship and training programs, applicable to the work to be performed on the project, which are approved by and registered with the United States Department of Labor's Office of Apprenticeship, or its successor organization. Version 5/16/2019 General Conditions - 8 PRE -QUALIFICATION CHECKLIST (FOR BIDDERS THAT ARE NOT PRE -QUALIFIED) (a) Acknowledgements: (i) X By checking this box, I hereby acknowledge that I am not a pre -qualified bidder with the City of South Bend. (ii) X By checking this box, I hereby acknowledge that the City reserves the right to request supplemental information, additional verification of any information provided, and may also conduct random inquiries of my current and prior customers. The City reserved the right to utilize all information provided in this submission and all information obtained in inquiries or requests to determine if a bidder is responsive and responsible. Additionally, I acknowledge that all information provided to the City shall be regarded as public records. (iii) X By checking this box, I hereby acknowledge that copies of all Applicable apprenticeship certificates or standards for training programs applicable to the work performed on the project may be requested at any time and shall be furnished upon request. (iv) X By checking this box, I hereby acknowledge and ensure that I and all sub- contractors, from whom I have accepted a bid and/or intend to hire to perform work on the public work project, are properly licensed. Furthermore, I acknowledge my understanding that it is my responsibility to ensure that all sub -contractors have the necessary licenses to undertake the work called for in this bid. If a sub- contractor loses their license at any point, it is the responsibility of that sub- contractor to notify the City. (b) Attachments: (i) X Indiana Secretary of State's on-line records (ie. Business verification) dated within sixty (60) days of the submission of said document showing that business is in existence, current with the Indiana Secretary of State's Business Entity Report, and eligible for a certificate of good standing. (Not applicable to individuals, sole proprietors or partnerships). (ii) X List identifying all former business names. (iii) X Any determinations by a court or governmental agency any violations of federal state, or local laws including, but not limited to, violations of contracting or antitrust laws, tax or licensing laws, environmental laws, Occupational Safety and Health Act (OSHA), or federal Davis -Bacon and related Acts, within the preceding five (5) (iv) X years. Statement about staffing capabilities, including labor sources. This statement indicates and ensures I have sufficient employees on staff to complete the work I am bidding on OR outlines how I intend to meet the staffing needs of the work. (v) X Statement that individuals who will perform work on the public work project on my behalf will be properly classified as an employee or as an independent contractor under all applicable state and federal laws and local ordinances. (vi) X For every project, submit evidence of participation in apprenticeship and training programs, applicable to the work to be performed on the project, which are approved by and registered with the United States Department of Labor's Office of Apprenticeship, or its successor organization. (vii) X Copy of a written plan for employee drug testing that covers all of my employees who will perform work on the public work project and meets or exceeds the requirements set forth in IC 4-13-18-5 or IC 4-13-18-6. (viii) X Evidence that I am utilizing a surety company which is on the Bureau of Fiscal Service "Department of Treasury's Listing of Approved Sureties" as required in the bid specifications or contract. Version 5/16/2019 General Conditions - 9 (ix) X Written statement of any federal, state or local tax liens or tax delinquencies owed to any federal, state or local taxing body in the preceding three years. (i) X List of projects of similar size and scope of work performed in all areas, including the State of Indiana, within three (3) years prior to the date on which the bid is due. (Print Name Here) Pullman SST, Inc. (Name of Company) 280 W. Jefferson Ave. (Address of Company) Trenton (City) MI (State) 734-282-7760 (Telephone Number) Version 5/16/2019 General Conditions - 10 Pre -qualification Checklist (for Bidders that are not pre -qualified) Attachments Section; Signed Statements (i) Indiana Secretary of State's on-line records (ie. Business verification) dated within sixty (60) days of the submission of said document showing that business is in existence, current with the Indiana Secretary of State's Business Entity Report, and eligible for a certificate of good standing. (Not applicable to individuals, sole proprietors or partnerships). Pullman SST, Inc. has an Indiana Secretary of State's on-line records (ie. Business verification) dated within sixty (60) days of the submission of said document showing that business is in existence, current with the Indiana Secretary of State's Business Entity Report, and eligible for a certificate of good standing. (Not applicable to individuals, sole proprietors or partnerships). Please see attached. (ii) List identifying all former business names. Pullman SST, Inc. was formerly known as Shared Systems Technology, Inc. Please see attached. (iii) Any determinations by a court or governmental agency any violations of federal state, or local laws including, but not limited to, violations of contracting or antitrust laws, tax or licensing laws, environmental laws, Occupational Safety and Health Act (OSHA), or federal Davis -Bacon and related Acts, within the preceding five (5) years. Pullman SST, Inc. has not had Any determinations by a court or governmental agency any violations of federal state, or local laws including, but not limited to, violations of contracting or antitrust laws, tax or licensing laws, environmental laws, Occupational Safety and Health Act (OSHA), or federal Davis -Bacon and related Acts, within the preceding five (5) years. (iv) Statement about staffing capabilities, including labor sources. This statement indicates and ensures I have sufficient employees on staff to complete the work I am bidding on OR outlines how I intend to meet the staffing needs of the work. PULLMAN SST, Inc. will provide a team of labor resources from existing company employees and leveraging our relationship with the local union halls to supplement our crew. We currently employ over 130 field crew members. This project is of relatively short duration and we will easily be able to meet the staffing requirements of this project. (v) Statement that individuals who will perform work on the public work project on my behalf will be properly classified as an employee or as an independent contractor under all applicable state and federal laws and local ordinances. Pullman SST, Inc. 10150 Old Columbia Road • Columbia, MD 21046 • Phone: 410-850-7000 - Fax: 410-850-4111 www.puliman-services.com Page 2 of 3 PULLMAN SST, INC will utilize direct hire employees on this project. All employees will meet applicable state and federal laws and ordinances. (vi) For every project, submit evidence of participation in apprenticeship and training programs, applicable to the work to be performed on the project, which are approved by and registered with the United States Department of Labor's Office of Apprenticeship, or its successor organization. PULLMAN SST, Inc. is a Union signatory contractor. We utilize and rely on the applicable UNION apprenticeship and training programs provided. Upon request PULLMAN can submit a listing of Union affiliations. (vii) Copy of a written plan for employee drug testing that covers all of my employees who will perform work on the public work project and meets or exceeds the requirements set forth in IC 4-13-18-5 or IC 4-13-18-6. Pullman SST, Inc. has a substance abuse policy and drug testing policy in place that covers all of my employees who will perform work on the public work project and meets or exceeds the requirements set forth in IC 4-13-18-5 or IC 4-13-18-6. Please see attached. (viii) Evidence that I am utilizing a surety company which is on the Bureau of Fiscal Service "Department of Treasury's Listing of Approved Sureties" as required in the bid specifications or contract. Pullman SST, Inc. utilizes Fidelity and Deposit Company of America (Zurich) brokered by Arthur J. Gallagher, Inc. They are on the Bureau of Fiscal Service "Department of Treasury's Listing of Approved Sureties" as required in the bid specifications or contract. Please see attached. (ix) Written statement of any federal, state or local tax liens or tax delinquencies owed to any federal, state or local taxing body in the preceding three years. Pullman SST, Inc. does not have any federal, state or local tax liens or tax delinquencies owed to any federal, state or local taxing body in the preceding three years. Confidential: Any unauthorized use or distribution is prohibited. I:\Probid\FY 2020\565000 - 570000\569563 Main and Colfax PS Repairs 2020\RE-BID Docs\Re-bid Prequal\RBC_Signed Statements.pdf.docx 05/26/20 Page 3 of 3 (x) List of projects of similar size and scope of work performed in all areas, including the State of Indiana, within three (3) years prior to the date on which the bid is due. Pullman SST, Inc. has completed projects of similar size and scope of work performed in all areas, including the State of Indiana, within three (3) years prior to the date on which the bid is due. Please see attached. Date 5/26/2020 Confidential: Any unauthorized use or distribution is prohibited. I:\Probid\FY 2020\565000 - 570000\569563 Main and Colfax PS Repairs 2020\RE-BID Docs\Re-bid Prequal\RBC_Signed Statements.pdf.docx 05/26/20 CERTIFICATE OF EXISTENCE To Whom These Presents Come, Greeting: I, CONNIE LAWSON, Secretary of State of Indiana, do hereby certify that I am, by virtue of the laws of the State of Indiana, the custodian of the corporate records and the proper official to execute this certificate. I further certify that records of this office disclose that PULLMAN SST, INC. duly filed the requisite documents to commence business activities under the laws of the State of Indiana on May 15, 2012, and was in existence or authorized to transact business in the State of Indiana on April 16, 2020. 1 further certify this Foreign For -Profit Corporation has filed its most recent report required by Indiana law with the Secretary of State, or is not yet required to file such report, and that no notice of withdrawal, dissolution, or expiration has been filed or taken place. All fees, taxes, interest, and penalties owed to Indiana by the domestic or foreign entity and collected by the Secretary of State have been paid. In Witness Whereof, I have caused to be affixed my signature and the seal of the State of Indiana, at the City of Indianapolis, April 16, 2020 CONNIE LAWSON SECRETARY OF STATE 2012051600198 / 20201392860 All certificates should be validated here: https://bsd.sos.in.gov/ValidateCertificate Expires on May 16, 2020. State of Indiana Office of the Secretary of State APPLICATION FOR AMENDED CERTIFICATE OF AUTHORITY of SHARED SYSTEMS TECHNOLOGY, INC. I, CONNIE LAWSON, Secretary of State of Indiana, hereby certify that Application for Amended Certificate of Authority of the above Delaware For -Profit Foreign Corporation has been presented to me at my office, accompanied by the fees prescribed by law and that the documentation presented conforms to law as prescribed by the provisions of the Indiana Business Corporation Law, The name following said transaction will be: PULLMAN SST, INC. NOW, THEREFORE, with this document I certify that said transaction will become effective Monday, December 02, 2013. In Witness Whereof, I have caused to be affixed my signature and the seal of the �•��......•.••r State of Indiana, at the City of Indianapolis, �..• '• December 2, 2013. r ... 01 W • ~1: S M F w • : CONNIE LAWSON, �: •., .;& SECRETARY OF STATE 2012051600198/2013120371484 PAGE 1 I, JEFFREY W. BULLOCK, SECRETARY OF STATE OF THE STATE OF DELAWARE, DO HEREBY CERTIFY THAT THE SAID 11SHAREDISYSTEMS TECHNOLOGY, INC.", FILED A CERTIFICATE OF AMENDMENT, CHANGING ITS NAME TO ,pUILMAN SST, INC. ", THE NTY-FIRST DAY OF OCTOBER, A.D. 2013, AT 2:51 O'CLOCK P.M. CORPORATION IS DULY INCORPORATED UNDER THE LAWS OF THE STATE OF DELAWARE AND IS IN GOOD STANDING AND HAS A LEGAL CORPORATE EXISTENCE NOT HAVING BEEN CANCELLED OR DISSOLVED SO FAR AS THE RECORDS OF THIS OFFICE SHOW AND IS DULY AUTHORIZED TO TRANSACT BUSINESS. AND I Do HEREBY FURTHER CERTIFY THAT AND I DO HEREBY FURTHER CERTIFY THAT THE FRANCHISE TAXES HAVE BEEN PAID TO DATE. 2364175 8320 131349191 You may verify this certificate online at corp,delaware•gov/authear.shtml v y W. Bullock, Secretary of State AUTHON: 0925655 DATE: 11-25-13 From December 16, 1993 until October 21, 2013, Pullman SST, Inc. was known as Shared Systems Technology, Inc. From October 21, 2013 until the present day, this business has been known as Pullman SST, Inc. Proof of our name change in our state of domicile, Delaware, is attached. Pullman SST, Inc. 10150 Old Columbia Road • Columbia, MD 21046 • Phone: 410-850-7000 • Fax: 410-850-4111 www.puliman-services.com SUBSTANCE ABUSE POLICY DOCUMENT No.: EHS-000146 REV M 1 Date of Issue: 8/23/2016 Next Rev.: EH&S Procedures Issued By: Corporate Safety Director 6/15/2021 Date of Approval: 6/15/2017 Standard Owner: EH&S Department Approved By: Safety Substance Abuse Policy Document No. EHS-000146 Page 1 of 22 SUBSTANCE ABUSE POLICY DOCUMENT NO.: EHS-000146 REV #: 1 Date of Issue: 8/23/2016 Next Rev.: EH&S Procedures Issued By: Corporate Safety Director 6/15/2021 Date of Approval: 6/15/2017 Standard Owner: EH&S Department Approved By: Safety TABLE OF CONTENTS 1. PURPOSE...........................................................................................................................3 2. SCOPE................................................................................................................................3 3. DEFINITIONS AND ABBREVIATIONS...............................................................................3 4. RESPONSIBILITIES...........................................................................................................5 5. REQUIREMENTS................................................................................................................6 6. PROCEDURE......................................................................................................................6 7. TRAINING.........................................................................................................................11 8. REFERENCES..................................................................................................................12 9. EXHIBITS..........................................................................................................................12 10. APPENDICES...................................................................................................................12 11. RECORDS.........................................................................................................................12 12. REVISION HISTORY.........................................................................................................12 Page 2 of 22 SUBSTANCE ABUSE POLICY DOCUMENT NO.: EHS-000146 REV #: 1 Date of Issue: 8/23/2016 Next Rev.: EH&S Procedures Issued By: Corporate Safety Director 6/15/2021 Date of Approval: 6/15/2017 Standard Owner: EH&S Department Approved By: Safety 1. Purpose The Company is committed to providing safe, dependable and economic service to their customers, maintaining a safe workplace and promoting high standards of employee health. To achieve this, the Company must have a workforce and workplace, which is free of the adverse effects of alcoholic beverages and illegal drugs, or legal drugs obtained illegally or taken for purposes of abuse. Employees shall observe the company rules and regulations; the Company shall observe the owners or job site rules and regulations. The owner's rules and regulations shall supersede any Company rules when the rules are considered more stringent then the Company's rules and regulations. Requirements shall be considered with established practices of the owner. 2. Scope This program applies to all Company operations. This program contains Company and regulatory requirements for all programs involved. Employees shall comply with the requirements of this program. 3. Definitions and Abbreviations 3.1. Aberrant Behavior - Significant documented behavior, including deteriorating performance, over a period of time, which deviates from the norm which has been established by the prior behavior of the employee or the norms of behavior which have been established by society; or isolated conduct or action which is a severe departure from the prior behavior of the employee. 3.2. Alcoholic Beverages - Any beverage containing levels of alcohol, which are controlled under law as to manufacture, use, possession, or sale. 3.3. Alcohol Concentration (or content) - The alcohol in a volume of breath expressed in terms of grams of alcohol per 210 liters of breath. 3.4. Alcohol Use - The consumption of any beverage, mixture, or preparation including medication, containing alcohol. 3.5. Aliquot - A portion of a specimen used for testing. 3.6. Chain of Custody - Procedures to account for the integrity of each urine specimen by tracking its handling and storage from the point of specimen collection to final disposition of the specimen. These procedures shall require that an approved chain of custody form be used from the point of time of collection to receipt by the laboratory and that upon receipt by the laboratory an appropriate laboratory chain of custody form(s) account for the sample or sample aliquot within the laboratory. Chain of custody forms shall, at a minimum, include an entry documenting date and purpose each time a specimen or aliquot is handled or transferred and identifying every individual in the chain of custody. 3.7. Confirmatory Test - A second analytical procedure to identify the presence of a specific drug or metabolite which is independent of the initial test and which uses a different technique and chemical principle from that of the initial test in order to ensure reliability Page 3 of 22 SUBSTANCE ABUSE POLICY DOCUMENT No.: EHS-000146 REV #: 1 Date of Issue: 8/23/2016 Next Rev.: EH&S Procedures Issued By: Corporate Safety Director 6/15/2021 Date of Approval: 6/15/2017 Standard Owner: EH&S Department Approved By: Safety and accuracy. (At this time, gas chromatography/mass spectrometry (GC/MS) is the only authorized confirmation method for cocaine, marijuana, opiates, amphetamines, and phencyclidine. 3.8. Confirmed Positive Test - The result of a confirmatory test utilizing the Gas Chromatography/Mass Spectrometry (GC/MS) technique that has established the presence of drugs or drug metabolites in a specimen at or above the cut-off level, and that has been deemed positive by the Medical Review Officer. For determining blood alcohol levels, a confirmatory test means a second test using another breath alcohol analysis device. Further alcohol confirmations upon demand will be by gas chromatography analysis of blood. Confirmatory Test Cut -Off Levels: n /ml Marijuana metabolites' 15 Cocaine Metabolites' 150 Opiates 2000 Codeine 2000 Morphine 2000 Amphetamines: Amphetamine 500 Metham hetamine3 500 Phencyclidine 25 Benzodiaze Ines 300 Barbiturates 300 Methadone 300 'Delta-9-tetrahydrocannabinol-9-carboxylic acid 2Benzoylecgonine 3Specimen must also contain amphetamine at a concentration > 200 ng/ml. 3.9. Drugs - Includes the following: (1) any chemical substance whose manufacture, use, possession, or sale is prohibited by law, and (ii) legal drugs (whether a narcotic, controlled substance, or prescribed drug or over-the-counter medication) obtained illegally or taken for purposes of abuse. 3A 0. Impermissible Level of Drugs - A positive test result. An alcohol breath test will be deemed positive when the blood alcohol concentration is at or above the 0.04 percent cut-off level as measured by an evidential -grade breath alcohol analysis device of a brand and model that conforms to NHTSA standards and to any applicable state statutes. The 0.04% cut-off level may be revised in the future to such level that may be established by the U.S. Department of Transportation as the allowable limit of blood alcohol content. 3.11. Initial Test (Screening Test) - An immunoassay screen for drugs or drug metabolites to eliminate negative urine specimens from further consideration or the first set of breathalyzer tests for alcohol. 3.12. Medical Review Officer (MRO) - A licensed physician responsible for receiving laboratory results generated by a drug testing program who has knowledge of Page 4 of 22 SUBSTANCE ABUSE POLICY DOCUMENT No.: EHS-000146 REV #: 1 Date of Issue: 8/23/2016 Next Rev.: EH&S Procedures Issued By: Corporate Safety Director 6/15/2021 Date of Approval: 6/15/2017 Standard Owner: EH&S Department Approved By: Safety substance abuse disorders and has appropriate medical training to interpret and evaluate an individual's positive test result together with his or her medical history and any other relevant biomedical information. 3.13.On-Duty - Includes break and meal periods in addition to actual working time, regardless of whether the individual is on a company premises during said times. 3.14. Positive Alcohol Test - A test with a result indicating the presence of alcohol at or in excess of 0.04% BAC or BrAC or such level in the future that may be established by the U.S. Department of Transportation as the allowable limit of blood alcohol content. 3.15. Prescribed on Over- the- Counter Medication - Medication normally taken for medicinal or other legitimate reasons, consistent with directions of a physician or, in the case of over-the-counter medication, consistent with the directions on the package 4. Responsibilities 4.1. Management — Oversees and provides executive guidance for yearly safety procedure review and the means for all employees to obtain proper training and equipment necessary to abide by this program. 4.2. Safety Director/Safety Personnel — Administers and provides guidance for the written Drug and Alcohol Program, directs personnel on proper implementation of its requirements, and provides periodic review of the company's program and related training process. 4.3. Superintendent/Foreman — Responsible for implementing the program in their area, ensuring that the program is understood and followed by the employees under their charge, and directing the work in such a manner that risk to employees is minimized and adequately controlled. Superintendents and foremen are also responsible for ensuring the written compliance program is available on the job -site and ensures appropriate control methods are implemented 4.4. Employees — Responsible for ensuring that they fully understand and comply with all requirements of this program. Employees are to ensure they are properly trained and equipped prior to working. 5. Requirements 5.1. The requirements outlined in this procedure shall be considered the minimum acceptable. Employees shall comply with any additional requirements of the Company, Branch, Clients, Local, State, and Federal Laws. 6. Procedure 6.1. Prescribed or Over- the- Counter Medication 6.1.1. It is the employee's responsibility to inform his or her supervisors of any prescribed or over-the-counter medication, which may affect or impact the employee's ability to properly or safely, perform job responsibilities. Advance Page 5 of 22 SUBSTANCE ABUSE POLICY DOCUMENT No.: EHS-000146 REV #: 1 Date of Issue: 8/23/2016 Next Rev.: EH&S Procedures Issued By: Corporate Safety Director 6/15/2021 Date of Approval: 6/15/2017 Standard Owner: EH&S Department Approved By: Safety notification to the supervisor of prescribed or over -the- counter medication may not only aid in avoiding a safety hazard, but also help to explain potential fitness for duty concerns that could arise if, for example, the medication causes drowsiness or lack of coordination. 6.2. Prohibited Conduct 6.2.1. The sale or distribution of drugs and/or alcohol. 6.2.2. The use, possession, concealment or purchases of drugs or alcoholic beverages while on Company property, while on duty, in a company vehicle, or on a job site. All alcoholic beverage containers whether opened or unopened are prohibited. On-dut includes paid and unpaid break and meal periods. Company premises include parking lots, vehicles, and all areas where the Company performs work, whether or not owned or leased by the company (e.g., public streets and customer homes). Off -duty use is prohibited on Company premises including buildings, parking lots, and Company vehicles. 6.2.3. The on -duty impairment of any Company employee due to the use of drugs or alcoholic beverages, or an impermissible level of drugs or alcohol in the system of any Company employee while on duty. 6.2.4. Off -duty and Off -premises involvement with drugs or alcohol which has or may have an adverse impact on the Company. Such conduct may have an adverse impact where, for example, it has or may have an effect on an employee's ability to perform his or her duties or may endanger the safety of employees or the public. 6.2.5. The use of prescription or over-the-counter medications while on -duty or on - premises is prohibited where this medication may interfere with job performance. 6.3. Chemical Testing: 6.3.1. To provide a means to deter and detect substance abuse and to ensure that Company employees are fit -for -duty while on any Company job site, all Company employees shall be required to submit to drug and alcohol testing under the following circumstances: 6.3.1.1. Testing prior to the commencement of work: A Company employee who has not been issued a certification card or has not been tested within one year may begin work provided that the Company certifies that the employees sample will be collected within the first eight (8) working hours. Once the employee provides a sample the employee may be allowed to work pending results of the drug and alcohol test. 6.3.1.2. Testing for cause: i.e., as soon as possible following any observed behavior indicating possible substance abuse; after accidents involving a failure in individual performance resulting in personal injury Page 6 of 22 SUBSTANCE ABUSE POLICY DOCUMENT No.: EHS-000146 REV #: 1 Date of Issue: 8/23/2016 Next Rev.: EH&S Procedures Issued By: Corporate Safety Director 6/15/2021 Date of Approval: 6/15/2017 Standard Owner: EH&S Department Approved By: Safety requiring treatment away from the scene of the accident; the occurrence on any negligent or careless act which has or could have caused a personal injury requiring treatment away from the scene of the accident or which caused any Company property damage or other property; or after any auto accident. 6.3.1.3. Selection by a lottery pool: of Company employees to be administered by an independent agent. 6.3.1.4. Any Company employee who returns to work following rehabilitation or other form of appropriate counseling shall be subject to a reasonable program of follow-up testing without prior notice for thirty- six (36) months after his or her return to duty. 6.3.2. Substance testing shall, at a minimum, be conducted for alcohol, marijuana, cocaine, opiates amphetamines and phencyclidine. 6.3.3. When conducting reasonable suspicion, post -accident for unsafe practice testing, testing may be conducted for any drug listed in Schedule I or II of the Controlled Substances Act. 6.3.4. In addition, reasonable suspicion testing can be conducted at the job site utilizing instant test. These tests are non -binding for results unless confirmed by tests that meet the requirement of this policy. In the event, a positive test results during the administration of an instant test, that person is required to report for a confirmatory test as soon as possible. 6.4. Administration: 6.4.1. Because of the importance of ensuring that Company employees are fit -for - duty while on a job site or on company property, the substance testing is delegated to an Company agent 6.4.2. The Company specifies only those laboratories that are certified by the Department of Health and Human Services (DHHS) shall be used to perform substance testing. 6.4.3. The Company shall use as a guideline the DHHS "Mandatory Guidelines for Federal Workplace Drug Testing Programs", and subsequent amendments hereto. These guidelines shall be administered by a third -party administrator engaged on behalf of the Company and shall cover split specimen collection procedures, chain -of -custody procedures, and laboratory qualifications, testing methodologies, quality control procedures, and reporting requirements. 6.4.4. The initial test of breath for alcohol performed at the collection site shall be conducted using an evidential -grade breath alcohol analysis device of a brand and model that conforms to National Highway Traffic Safety Administration (NHTSA) standards and to any applicable State statutes. An alcohol breath test will be deemed positive when the blood alcohol concentration is at or Page 7 of 22 SUBSTANCE ABUSE POLICY DOCUMENT No.: EHS-000146 REV #: 1 -Rev. Date of Issue: 8/23/2016 EH&S Procedures Issued By: Corporate Safety Director 6/15/2021 Date of Approval: 6/15/2017 Standard Owner: EH&S Department Approved By: Safety above the 0.04 percent cut-off level or such level in the future that may be established by the U.S. Department of Transportation as the allowable limit of blood alcohol content. An individual who has a positive alcohol test may request a confirmatory blood test in accordance with the Appeals section. 6.4.5. In order to ensure the full reliability and accuracy of drug assays, the accurate reporting of test results, and the integrity and efficacy of drug testing programs, the Company may make changes to this specification to reflect improvements in the available science and technology. 6.5. Appeals: 6.5.1. An employee may appeal the results of a drug test by submitting a written request for independent GC/MS confirmation to the Company within seventy- two (72) hours of receipt of the final test result from the MRO. The employee may specify testing by the original laboratory or by a second laboratory that is certified by DHHS. The employee shall be required to pay in advance the cost of shipment and reanalysis of the split sample. The employee will be reinstated with back pay, and reimbursed for such re -testing expense if the re -test is negative. 6.5.2. Since some analyses may deteriorate during storage, the reanalysis is NOT subject to specific cut-off requirements, but must only provide data sufficient to confirm the presence of the drug(s) or metabolite(s). 6.5.3. An individual who has a positive alcohol test may request further confirmation by voluntarily providing a blood specimen for confirmatory analysis by gas chromatography. 6.5.4. The request for this additional confirmation must be made in writing at the time the breath alcohol analysis is completed. Failure of the individual to request a confirmatory blood test will be considered to indicate that the individual accepts the breath test results. 6.5.5. Company employees who have been precluded from performing work may appeal this sanction by submitting a written request to the designated representatives of the coalition companies within twenty (20) working days of notification of the sanction. 6.6. Supervisory Training: 6.6.1. It is recommended that supervisors and union stewards working for the Company and those who are responsible for evaluating the performance of the workers performing that work be provided appropriate training to ensure they understand: 6.6.1.1. The effects and consequences of controlled substance use on personnel health, safety, and the work environment. Page 8 of 22 SUBSTANCE ABUSE POLICY DOCUMENT NO.: EHS-000146 REV #: 1 Date of Issue: 8/23/2016 Next Rev.: EH&S Procedures Issued By: Corporate Safety Director 6/15/2021 Date of Approval: 6/15/2017 Standard Owner: EH&S Department Approved By: Safety 6.6.1.2. The manifestations and behavioral changes that may indicate substance use or abuse; and, 6.6.1.3. Their role and responsibilities in implementing the program. 6.7. Employee Assistance Programs (SAPS): 6.7.1. It is recommended that each employee subject to this specification maintain a relationship to an EAP to strengthen the Fitness for Duty program by offering assessment, short-term counseling, referral services, and treatment monitoring to employees with problems that could adversely affect their performance. EAPs should be designed to achieve early intervention and provide for confidential assistance and counseling follow up. 6.8. Management Actions and Sanctions: 6.8.1. The Company shall remove from any job site and preclude from performing any work by any Company employee who: 6.8.2. violates any of the prohibitions set forth in the Drug & Alcohol section of this specification; 6.8.3. provides a false or tampered sample in connection with a drug test; or 6.8.4. refuses or fails to appear or provide a sample on the day or at the time requested 6.8.5. A Company employee, who reports to work while taking prescribed or over-the- counter medication which interferes with his or her performance and who has not notified supervision as required in the Drug & Alcohol section, risks the safety of his or her fellow workers and the public, and is subject to removal from any Company job site and preclusion from subsequent work. 6.8.6. A Company employee, who has violated this policy (15' Offense) will be precluded from performing work, may not return to work at the same company or any other Company job site until the following is completed: 6.8.6.1. Minimum of (1) one month suspension for all work within the Company from the date of D&A Test 6.8.6.2. The employee shall complete an appropriate rehabilitation program satisfactory to the Company at the employee's expense. 6.8.6.3. The rehabilitation program must be completed before the employee is permitted to return to work, even if suspension time has been completed. 6.8.6.4. The Medical Review Officer (MRO) has determined that the the Company employee is fit to return to duty. Page 9 of 22 SUBSTANCE ABUSE POLICY DOCUMENT NO.: EHS-000146 REV #: 1 Date of Issue: 8/23/2016 Next Rev.: EH&S Procedures Issued By: Corporate Safety Director 6/15/2021 Date of Approval: 6/15/2011 Standard Owner: EH&S Department Annrnved Bv: Safety 6.8.6.5. The employee shall pass a drug test administered under tnls specification at the employee's expense 6.8.7. A second violation (2°d Offense) of the prohibitions set forth in this policy will result in the following protocols: 6.8.7.1. Minimum of (6) six month suspension for all work within the Company from the date of D&A Test 6.8.7.2. The employee shall complete an appropriate rehabilitation program satisfactory to the Company at the employee's expense. 6.8.7.3. The rehabilitation program must be completed before the employee is permitted to return to work, even if suspension time has been completed. 6.8.7.4. The Medical Review Officer (MRO) has determined that the Company employee is fit to return to duty. 6.8.7.5. The employee shall pass a drug test administered under this specification at the employee's expense 6.8.8. Any additional violations beyond a second offense will be ground for immediate termination which will prohibit the employee from returning to work within the Company. 6.8.9. NOTE: The DISA drug and alcohol program is a third party administrator which the Company utilizes for specific customers across the United States. If an employee is identified as having an issue within this program, the employee will be held to the Company's Drug and Alcohol program in addition to the proposed corrective actions stipulated by the DISA program. 6.9. Alcohol Impairment: 6.9.1. Employees participating in Random, Post -Accident, Reasonable Suspicion, Return -to -Duty, or Follow-up Testing and are found to have a breath alcohol test greater than 0.00 but less than 0.04 are considered to have alcohol impairment and will removed from (all) work activities for the remainder of the workday. The identified employee shall report for complete follow-up testing at the next scheduled work shift or 24 hours after the test, whichever is greater, before they are permitted back to work. 6.9.2. With the exception of a removal from work activities or company vehicle operation, the Company will not enforce the requirements as outlined in the (Management Actions & Sanctions Section) against an employee with regard to an alcohol test result that is greater than 0.00 but less than 0.04. However, this does not prohibit the Company from taking action that is consistent with existing law, and/or the Corporate Safety Manual. 6.10. Search Policy: Page 10 of 22 SUBSTANCE ABUSE POLICY DOCUMENT No.: EHS-000146 REV #: 1 Date of Issue: 8/23/2016 Next Rev.: EH&S Procedures Issued By: Corporate Safety Director 6/15/2021 Date of Approval: 6/15/2017 Standard Owner: EH&S Department Annroved Bv: Safety 6.10.1. The Company hereby places all of its employees on notice that: 6.10.1.1. They and their possessions are subject to search whenever they are on a Company job site. Premises include parking lots; vehicles and all other areas where employees perform work, whether or not said areas are owned or leased by the Company. 6.11. Violations: 6.11.1. If an individual possesses or conceals drug(s) or alcohol on a Company job site, the individual will be removed from the premises and precluded from performing any subsequent work. Law enforcement officials will be contacted in the event illegal drugs is discovered. 6.12. Record -Keeping Requirements: 6.12.1. The Company shall comply with the following specifications in regards to record keeping: 6.12.1.1. Retain records that show an employee had a positive drug test, as confirmed by the Company Medical Review Officer (MRO), and any records that demonstrate rehabilitation, for at least five (5) years. The record shall include: 6.12.1.1.1. the reason the test was conducted (e.g., pre -employment, for cause, etc) 6.12.1.1.2. the functions performed by the employee who failed the drug test; 6.12.1.1.3. the prohibited drug(s) used by the employee; and 6.12.1.1.4. the related administrative actions (e.g., termination, suspension, rehabilitation, etc) 6.12.1.2. Records of drug tests that show a contractor employee passed a drug test will also be retained by the third -party agent for the Company for at least two (2) years. 7. Training 7.1. Branch Management shall review this program with all employees prior to initial assignment of work privileges. Additional reviews of this program shall be reviewed when: 7.1.1. There are changes made to this program. 7.1.2. Branch Management believes there are inadequacies in the employee's understanding of this program. Page 11 of 22 SUBSTANCE ABUSE POLICY DOCUMENT NO.: EHS-000146 REV #: 1 Date of Issue: 8/23/2016 Next EH&S Procedures Issued By: Corporate Safety Director 6/15/2021 Date of Approval: 6/15/2017 Standard Owner: EH&S Department Approved By: Safety 7.2. Employees may be required to attend periodic training events, as scheduled by Branch Management, or when required by this program. 8. References 8.1. Unavailable 9. Exhibits 9.1. Unavailable 10. Appendices 10.1. Appendix — A: Uniform Drug and Alcohol Policy Drug and Alcohol Screening Consent Form 10.2. Appendix — B: Explanation of reasonable Suspicion and Post Accident/ Incident testing 10.3. Appendix — C: Reasonable Suspicion Report 10.4. Appendix — D: Recognition and Referral 10.5. Appendix — E: Refusal to Test 10.6. Appendix — F: Notification of Medication: Employee notification of medications 11. Records 11.1. Unavailable 12. Revision History Rev. 1 6/15/2017 Document Control and Format Revisions Rev.0 8/23/2016 Initial Issue Page 12 of 22 SUBSTANCE ABUSE POLICY DOCUMENT NO.: EHS-000146 REV #: 1 Date of Issue: 8/23/2016 Next Rev.: EH&S Procedures Issued By: Corporate Safety Director 6/15/2021 Date of Approval: 6/15/2017 Standard Owner: EH&S Department Approved By: Safety NAME: ADDRESS: TELEPHONE: Appendix — A: Uniform Drug and Alcohol Policy Drug and Alcohol Screening Consent Form PLEASE PRINT Last Name First Middle SS# I agree to undergo drug screening by urinalysis and alcohol screening by breath analysis as a condition of working at the Company. I understand and agree that the result of such test will be released to the Company's, Medical Review Officer, the Company's Safety Committee, the Company's Third Party Administrator, or as required by law. Results will be used consistent with the Company's Drug and Alcohol Policy. I understand that if I refuse to consent to testing or the tests show impermissible levels of drugs and/or alcohol. a) I will not be hired, if I am applicant for the Company b) I will be denied access to Company premises. Signature Date Page 13 of 22 SUBSTANCE ABUSE POLICY DOCUMENT No.: EHS-000146 REV #: 1 Date of Issue: 812312016 Next Rev.: EH&S Procedures Issued By: Corporate Safety Director 6/15/2021 Date of Approval: 6/15/2017 Standard Owner: EH&S Department Annroved Bv: SafetV Appendix — B: Explanation of Reasonable Suspicion and Post Accident / Incident Testing Reasonable Suspicion Testing: If an employee exhibits inappropriate behavior, demonstrates performance problems or there is other evidence to suspect an employee is under the influence of controlled substances, (See Attachment A — Reasonable Suspicion Report, to assist and document) the employee may be subject to a substance abuse screen/test. If the employee is requested to be tested either on the job site or refuses to submit to such a substance abuse test, they will be disciplined the same as if they had tested positive. Disciplinary action based on a positive result or refusal to submit to a test will be in compliance with the Federal/State Regulations and the Company policy. Employees shall submit to drug/alcohol screening where there is cause to believe this policy has been violated. Examples of sufficient cause include, but are not limited to: a. Known possession of controlled substances. b. Involvement in a drug related incident. c. Employees exhibiting drug or alcohol symptoms. • Lack of balance, unsteady or staggered walk or muscle twitching. • Red, watery or glassy eyes, dilated or constricted pupils or having difficulty focusing eyes • Disorientation, uncoordinated movement of body and hands. • Face/cheeks flushed, face sallow. • Slurred speech, memory loss or drowsiness. d. Has violated the substance abuse policy or work rules. e. Has sustained a personal injury or has caused another person to sustain a personal injury. f. Has caused a work -related accident or was operating or helping to operate machinery, equipment, or vehicles involved in a work -related accident or incident. To assist supervision further in the determination of a reasonable suspicion related case; (Attachment B) contains guidelines. Post Accident and Incident Testing: Testing will be required following an on-the-job injury requiring medical treatment or following a potentially serious incident, including near misses, in which safety precautions were violated, unsafe instructions, or orders were given, potentially serious accident occurred where vehicles/equipment/property was damaged, unusually careless acts were performed, or where the cause was due to failure to wear prescribed personal protective equipment. Page 14 of 22 SUBSTANCE ABUSE POLICY DOCUMENT No.: EHS-000146 REV #: 1 Date of Issue: 8/23/2016 Next Rev.: EH&S Procedures Issued By: Corporate Safety Director 6/15/2021 Date of Approval: 6/15/2017 Standard Owner: EH&S Department Approved By: Safety Individuals involved or that may have contributed in the incident/accident may also be subject to testing. If it is impossible or impractical, because of the physical condition to the individual(s) involved in the accident/incident to give a urine sample, and if in subsequent medical treatment that person(s) blood or other bodily fluid will be drawn, then the blood or other bodily fluids will be analyzed for prohibited substances. If a required alcohol test is not administered within (2) hours following the accident/incident, the Contractor/subcontractor shall prepare and maintain on file a record stating the reasons the test was not promptly administered. If a required test is not administered within eight hours following the accident/incident, the Contractor/subcontractor shall cease attempts to administer an alcohol test and shall maintain the same record. Records shall be submitted to CUDAP upon request of the Contracting Officer. The Contractor/subcontractor shall ensure that individuals required to be tested for drugs are tested as soon as possible and within 32 hours of the accident/incident. An individual who is subject to post -accident testing who fails to remain readily available for such testing, including notifying the Contractor/subcontractor of his or her location if he or she leaves the scene of the accident/incident prior to submission to such test, may be deemed to have refused to submit to testing. Page 15 of 22 SUBSTANCE ABUSE POLICY DOCUMENT NO.: EHS-000146 REV #: 1 Date of Issue: 8/23/2016 Next Rev.: EH&S Procedures Issued By: Corporate Safety Director 6/15/2021 Date of Approval: 6/15/2017 Standard Owner: EH&S Department q roved B : Safet Date: Time: Name: Appendix — C: Reasonable Suspicion Report Interview Location: Address: Payroll/Badge #: SS#: Interview: Are you ill? . Have you been to a doctor/dentist recently? Are you presently taking medication? If so, what?_ Last dose: AM/PM Do you have diabetes? Are you taking insulin?_ Are you hurt? Where? Examination: (Check words describing observed conditions. Add other words which may be appropriate.) Breath: Odor of alcohol or liquor: ❑ None ❑ Faint ❑ Moderate ❑ Strong Attitude: ❑ Polite ❑Excited ❑ Hilarious ❑ Talkative ❑ Sleepy ❑ Other ❑ Cooperative ❑ Indifferent Carefree ❑ Antagonistic ❑ Combative ❑ Insulting Eyes: ❑ Normal Pupils: ❑ Normal ❑ Watery ❑ Dilated ❑ Bloodshot ❑ Constricted ❑Poor Reaction to Light Balance: ❑ Fair ❑ Falling ❑ Sure ❑Swaying ❑ Other ❑Wobbling ❑ Swaying Knees Walking: ❑Fair ❑ Sure ❑Swaying ❑Uncertain ❑Stumbling ❑ Other ❑ Staggering ❑ Falling Speech: ❑ Fair ❑ Slurred ❑ Stuttering ❑confused incoherent ❑ Choice of words, clearness and correctness of enunciation abnormal for individual. What first led supervisor to suspect influence of intoxicant? Disposition or action: Interviewed by: Date: Time: Decision concurred with by: Name: Title: Page 16 of 22 SUBSTANCE ABUSE POLICY DOCUMENT NO.: EHS-000146 REV #: 1 Date of Issue: 8/23/2016 Next Rev.: EH&S Procedures Issued By: Corporate Safety Director 6/15/2021 Date of Approval: 6/15/2017 Standard Owner: EH&S Department Annroved Bv: Safety Appendix — D: Recognition and Referral Recognition: An employee's immediate supervisor is usually the first member of management to notice or deal with conduct indicating an emotional or behavioral problem, including alcoholism or drug abuse. Supervisors are expected to be familiar with an employee's appearance, behavior and work habits, and to be alert for negative changes. It isn't possible or desirable for a supervisor to determine whether the changes observed are t the result of emotional illness, physical illness, and alcoholism or drug abuse. Changes could result from illness, properly prescribed drugs used as directed, or fatigue. In other words, the supervisor shouldn't make a diagnosis - leave that to qualified professionals - but he should be able to spot significant changes in behavior patterns. Extremes in behavior of an employee may suggest the individual has a problem that should receive medical attention, or be brought to the attention of the personnel department. Marked changes in behavior and job performance are key signals. Symptoms may arise suddenly or gradually, may be short-lived or continuous. Some signs and symptoms suggesting possible alcoholism or other drug abuse are: • Deterioration of job performance - decreased productivity, damaged work, lack of interest in carrying out assigned tasks, difficulty in understanding instructions or taking direction, poor memory, bad judgment. • Long, frequent visits to the washroom or unexplained absences from the work area. • Non -work -related visits by strangers or employees from other areas. • Increased absenteeism (often with a Friday and Monday pattern or following a holiday weekend). Constantly showing up late for work. • Frequent change in mood, ranging from agitation, excitement, nervousness and irritability to undue fatigue, drowsiness, inattentiveness. • Clinging dependency on supervisor or fellow employee. • Rebelliousness, contempt for authority. • Complaints from co-workers about employee's behavior. • Deterioration in dress and appearance (may include marked weight loss). • Long periods of staring into space. Page 17 of 22 SUBSTANCE ABUSE POLICY DOCUMENT No.: EHS-000146 REV #: 1 Date of Issue: 8/23/2016 Next Rev.: EH&S Procedures Issued By: Corporate Safety Director 6/15/2021 Date of Approval: 6/15/2017 Standard Owner: EH&S Department Aooroved By: Safety • Unsteady gait, trembling of hands and mouth. • Excessive sweating, heavy cigarette smoking. • Inappropriate wearing of sunglasses. • Disorientation, impaired coordination, slurred speech. • Coming to work drunk or with a hangover, morning drinking before work, evidence of drinking during working hours, drinking at lunch time, mood changes after lunch, sensitivity about references to his or her drinking, use of breath purifiers. • An inclination to put things off. Neglect of details, tendency to blame fellow workers, asking the company or associates for loans. • Avoiding the boss or associates, becoming intolerant and suspicious of fellow workers, a tendency to talk loudly. • Increased number of lost -time accidents off the job, accidents on the job, or near miss accidents on the job. Referral: The presence of any or all of those signs or symptoms may not be the result of an alcohol or drug problem — they may be symptoms of medical or other problems that require immediate attention. However, when such signs are evident or alcohol or other drug misuse is suspected, the employee should be interviewed confidentially. The supervisor should make clear that the discussion arises from unsatisfactory work performance, unsafe practices, excessive absence or lateness, attitude or behavior. The subject can be approached discreetly by asking the employee if he or she has a health problem or is taking any prescribed medication or drug. One useful technique is to have the supervisor: Discuss the employee's deteriorating work performance, asking if he or she knows any reason for the change. If no valid reason is given or apparent, suggest employee be seen by the plant physician Escort the employee to the medical department. If he or she refuses to cooperate and refuses a second request to do so, ask the employee to reconsider because he or she is risking insubordination. If the employee still refuses, notify personnel and medical departments. Document the discussion and any observations. Page 18 of 22 SUBSTANCE ABUSE POLICY DOCUMENT NO.: EHS-000146 REV #: 1 Date of Issue: 8/23/2016 Next Rev.: EH&S Procedures Issued By: Corporate Safety Director 6/15/2021 Date of Approval: 6/15/2017 Standard Owner: EH&S Department Approved By: Safety It's necessary to be sure there is no other explanation for the symptoms before concluding the employee is an alcohol or drug abuser. Drugs may have been prescribed by an employee's personal physician, with no abuse or illegal activity involved. Excessive fatigue can cause a number of symptoms similar to those caused by depressants, including alcohol. • In any event, the plant physician or medical personnel should be called in when the employee appears in need of medical care or assistance. Page 19 of 22 SUBSTANCE ABUSE POLICY EH&S Procedures Standard Owner: EH&S Department DOCUMENT No.: EHS-000146 Date of Issue: 8/23/2016 Issued By: Corporate Safety Director Date of Approval: 6/15/2017 Approved By: Safety Appendix — E: Refusal to Test REV M 1 Next Rev.: 6/15/2021 , hereby refuse to provide a specimen to appropriate medical personnel or to the person administering the instant so that a drug - screening test can be performed. I recognize that this refusal constitutes a presumption of a positive result, which will result in disqualification and discipline up to and including termination. Date: Time: Supervisor: Comments: Employee Refusal to Sign ( (Supervisor) Employee: Date: Page 20 of 22 SUBSTANCE ABUSE POLICY EH&S Procedures Standard Owner: EH&S Department DOCUMENT No.: EHS-000146 Date of Issue: 8/23/2016 Issued By: Corporate Safety Director Date of Approval: 6/15/2017 Appendix — F: Notification of Medication: Employee notification of medications EMPLOYEE'S PORTION Employee Name: Date: Describe Medication: Time: a.m. / p.m. REV #: 1 Next Rev.: 6/15/2021 Describe warnings contained on the medication, which may affect your ability to safely perform your position. Time medication taken: a.m. / p.m. Stated time medication side effects remain: Employee's signature: SUPERVISOR'S PORTION Date: Based on the review of medication information provided above and a discussion with the employee's physician, if necessary, the employee is: Allowed to continue to perform current duties: Date: Time a.m. / p.m. Temporarily reassigned to non -safety sensitive duty: Date: Time a.m. / p.m. Temporary reassignment in place until: - - - - - - - - - - - - - - - - - - - - - - - - - - - - Sent home as no non -safety sensitive duties are available; Pay will be handled as appropriate under the sick pay policy. Page 21 of 22 SUBSTANCE ABUSE POLICY DOCUMENT No.: EHS-000146 REV #: 1 Date of Issue: 812312016 Next Rev.: EH&S Procedures Issued By: Corporate Safety Director 6/15/2021 Date of Approval: 6/15/2011 Standard Owner: EH&S Department Annroved By: Safety Date: Time a.m. / p.m. To report back to work: Date: Time a.m./P.m. Supervisor's Signature:_ Date: Page 22 of 22 Gallagher Insurance I Risk Management I Consulting May 5, 2020 Re: Pullman SST, Inc. Surety Qualification To Whom It May Concern: We represent Pullman SST, Inc. relative to their bonding program and serve as Attorney -in -Fact for their Surety, Fidelity and Deposit Company of Maryland (Zurich North American Insurance Company). Pullman SST, Inc. has a single bonding capacity of $30,000,000 and an aggregate program capacity of $300,000,000. Pullman SST, Inc. enjoys an excellent reputation with their surety who they have been with for nearly 10 years. We highly recommend them. Our consideration and issuance of bonds is a matter solely between Pullman SST, Inc. and ourselves, and we assume no liability to third parties or to you by the issuance of this letter. We also possess certificates of authority as an acceptable surety authorized to do business throughout the United States as published annually in the Federal Register, Department of Treasurer, Fiscal Service, Department Circular 570 and both sureties have an A.M. Best Rating of "A+", "XV". Please feel free to contact us should you require further clarification or need additional information. Sincerely, Fidelity and Deposit Company of Maryland Gallagher CRS Robert A. Chlada, Vice -President, Surety and Attorney -in -Fact 11311 McCormick Road, Suite 450 Hunt Valley, MD 21031-8622 443-798-7499, 877-740-1963, Fax 443-798-7290 ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the ZURICH AMERICAN INSURANCE COMPANY, a corporation of the State of New York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the State of Illinois, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Illinois (herein collectively called the "Companies"), by ROBERT D. MURRAY, Vice President, in pursuance of authority granted by Article V, Section 8, of the By -Laws of said Companies, which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof, do hereby nominate, constitute, and appoint Joseph A. PIERSON, Robert A. CHLADA, Cynthia M. CHARVAT, Dennis C. OURAND, Steven A. DZURIK, JR., John J. MARICOTIC and Diane S. LOUGHRY, all of Hunt Valley, Maryland, EACH its true and lawful agent and Attorney -in - Fact, to make, execute, seal and deliver, for, and on its behalf as surety, and as its act and deed: any and all bonds and undertakings, and the execution of such bonds or undertakings in pursuance of these presents, shall be as binding upon said Companies, as fully and amply, to all intents and purposes, as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York, New York., the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills, Maryland., and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland., in their own proper persons. The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V, Section 8, of the By -Laws of said Companies, and is now in force. IN WITNESS WHEREOF, the said Vice -President has hereunto subscribed his/her names and affixed the Corporate Seals of the said ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 31st day of July, A.D. 2019. ATTEST: W. Assistant Secretar y Dawn E Brown ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND o � S4.t'�i S 1y 1tM Y 4 K n, ,4 ra.....• �H� Nice F'r•esident Robert D. Murray State of Maryland County of Baltimore On this 31st day of July, A.D. 2019, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, ROBERT D. MURRAY, Vice President, and DAWN E. BROWN, Assistant Secretary, of the Companies, to me personally known to be the individuals and officers described in and who executed the preceding instrument, and acknowledged the execution of same, and being by me duly swom, deposeth and saith, that fixed to the preceding instrument are the Corporate Seals of said Companies, and that he/she is the said officer of the Company aforesaid, and that the seals af were duly affixed and subscribed to the said instrument by the authority and direction of the said the said Corporate Seals and the signature as such officer Corporations. IN TESTIMONY WHEREOF, i have hereunto set my hand and affixed my Official Seat the day and year first above written. �1,11ti ftl l`"` Constance A. Dunn, Notary Public My Commission Expires: July 9, 2023 POA-P 025-0056C EXTRACT FROM BY-LAWS OF THE COMPANIES "Article V, Section 8, Attorneys -in -Fact. The Chief Executive Officer, the President, or any Executive Vice President or Vice President may, by written instrument under the attested corporate seal, appoint attorneys -in -fact with authority to execute bonds, policies, recognizances, stipulations, undertakings, or other like instruments on behalf of the Company, and may authorize any officer or any such attorney -in -fact to affix the corporate seal thereto; and may with or without cause modify of revoke any such appointment or authority at any lime." CERTIFICATE I, the undersigned, Vice President of the ZURICH AMERICAN INSURANCE COMPANY, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, do hereby certify that the foregoing Power of Attorney is still in full force and effect on the date of this certificate; and I do further certify that Article V, Section 8, of the By -Laws of the Companies is still in force. This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the ZURICH AMERICAN INSURANCE COMPANY at a meeting duly called and held on the 15th day of December 1998. RESOLVED: "That the signature of the President or a Vice President and the attesting signature of a Secretary or an Assistant Secretary and the Seal of the Company may be affixed by facsimile on any Power of Attorney...Any such Power or any certificate thereof bearing such facsimile signature and seal shall be valid and binding on the Company." This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held on the 5th day of May, 1994, and the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on the l Oth day of May, 1990. RESOLVED: "That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature of any Vice -President, Secretary, or Assistant Secretary of the Company, whether made heretofore or hereafter, wherever appearing upon a certified copy of any power of attorney issued by the Company, shall be valid and binding upon the Company with the same force and effect as though manually affixed. IN TESTIMONY WI IEREOF, I have hereunto subscribed my name and affixed the corporate seals of the said Companies, this day of 120 nO Otto, j 00 a- ltN o 4•! o%` 1g9U t, r� ern i, Brian M. Hodges, Vice President TO REPORT A CLAIM WITH REGARD TO A SURETY BOND, PLEASE SUBMIT ALL REQUIRED INFORMATION TO: Zurich American Insurance Co. Attn: Surety Claims 1299 Zurich Way Schaumburg, IL 60196-1056 o o P N $ $ o. P r 4 A m � ol" $ ry m ,q o m r v 11111 H 9 a - 'zza ,nz:.zzzzz 3niz$�� _.s_.... La z_Y�«= zzz86 z5is3d6!d 3mini Hunts m' Mad 2 E o 3 > Z 0 3 2 23 > i$` ``' o Z t� mnu �-a1 H �' m f m°0..� W.a n ° u v� t� F n t� u m .. r¢ C m ogig, _ t o 3 !silly, 31 E - 3 f E'. 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E 3 m o o m r �ffioa 1Omdua.. m_.-+ 3 — ® sec®�r® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 411 /2020 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 have ADDITIONAL INSURED provisions or 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 Arthur J. Gallagher Risk Management Services, Inc. 11311 McCormick Road, Ste 450 Hunt Valley MD 21031-8622 CONTACT NAME: Certificates Administrator PHONE 443-798-7499 FAX No): 443-798-7290 c ° A BW2.BSD.Certs a' .com -ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A: National Union Fire Ins Co Pittsbur h PA 19445 INSURED Pullman SST, Inc. 10150 Old Columbia Road INSURER B : New Hampshire Insurance Co 23841 INSURERC: XL Specialty Insurance Company 37885 Columbia, MD 21046 INSURER D : INSURER E : INSURER F : rrn11cDA1__ca r r-PTIF!C-ATE NIIMRFR- 1RArA97RFR 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. INS R LS TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD1YYYY EXP MM/DDY/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY 6938932 7/1/2019 7/1/2020 EACH OCCURRENCE $2,000,000 CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 1,000,000 X MED EXP (Any one person) $ 10,000 Contractual Liab X XCU PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 PRODUCTS-COMP/OPAGG POLICY � PEA LOC _$4,000,000 OTHER: A AUTOMOBILE LIABILITY 2867423 7/112019 7/1/2020 COMBINED SINGLE LIMIT Ea accident $ 2 000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ OWNED SCHEDULED AUTOS ONLY AUTOS X HIRED IX NON -OWNED AUTOS ONLY AUTOS ONLY ROr PERTY DAMAGE $ $ C X UMBRELLA LIAB X OCCUR US00062096LI19A 7/1/2019 7/1/2020 EACH OCCURRENCE $10,000,000 AGGREGATE $ 10,000,000 EXCESS LIAB CLAIMS -MADE DED I X I RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE FN] OFFICER/MEMBEREXCLUDED? (Mandatory in NH) N / A 063724479 7/1/2019 7/1/2020 H X STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) COW IC-0503160 - Job #569563 - Main & Colfax Parking Structure Repair - 2020 City of South Bend is included as additional insured with respect to the general liability, automobile liability and umbrella liability policies as required by written contract. r'AAIr`FI I ATWIM SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of South Bend, IN 227 West Jefferson Street South Bend IN AU HORIZEDREPRESENTATIVE ona U �aiS tS-L U"Ib fiI.VKU I.VKYVKAi IVIV. HII rlgtil5 IeJtli VCU. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD ENDORSEMENT This endorsement, effective 12:01 A.M. 7/1/2019 forms a part of Policy No. 2867423 by THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - WHERE REQUIRED UNDER CONTRACT OR AGREEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM SCHEDULE ADDITIONAL INSURED: Any person or organization for whom you are contractually bound to provide additional insured status but only to the extent of such person or organizations liability arising out of the use of a covered automobile, €. SECTION It - COVERED AUTOS LIABILITY COVERAGE, A. Coverage, 1. - Who Is Insured, is amended to add: d. Any person or organization, shown in the schedule above, to whom you become obligated to include as an additional insured under this policy, as a result of any contract or agreement you enter Into which requires you to furnish insurance to that person or organization of the type provided by this policy, but only with respect to liability arising out of use of a covered "auto". However, the insurance provided will not exceed the lesser of: (1) The coverage and/or limits of this policy, or (2) The coverage and/or limits required by said contract or agreement_ AUTHORIZED REPRESENTATIVE 87950 (9/14) Page 1 of 1 POLICY NUMBER: GL 693-89-32 COMMERCIAL GENERAL LIABILITY CG20100413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONALOWNERS,OR • •RS - SCHEDULED PERSON • • ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organizations Locations Of Covered Operations Any person or organization to whom you become Per the written contract or written agreement. obligated to include as an additional insured as a result of any written contract or written agreement that you have entered into. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of 'your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 04 13 POLICY NUMBER:• 6938932 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. K6161 ilk 9 . t 8 1 0: Has This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Qr ion Location And Description Of Completed Operations Any person or organization whom you become obligated to include as an additional insured as a result of any contract or agreement you have entered into. Per the written contract or written agreement Information required to complete this Schedule, if not shown above, will be shown in the Declarations_ A. Section 11 - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agree- ment, the insurance afforded to such addi- tional insured will not be broader then that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section Ill - Limits Of insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1, Required by the contract or agreement; or 2. Available under the applicable Limits of Insu- rance shown in the Declarations; whichever is less. This endorsement shall not increase the appli- cable Limits of Insurance shown in the Decla- rations. CO 20 37 04 13 0 insurance Services Office, Inc., 2012 Page 1 of 1 11 Policy No. US00062096LI19A Umbrella Liability Additional Insured (3) If we and the insured disagree on whether a disaster event has occurred, the insured's right of reimbursement under Insuring Agreement C shall be arbitrated pursuant to the rules of the American Arbitration Association for the state shown in Declarations Item 1. (4) Payment by us of disaster response expenses will not determine or be evidence of our rights or obligations under Insuring Agreement A or B. (5) Payment by us of disaster response expenses will not oblige us to assume any duty to control the investigation, settlement or defense of any claim or suit that might arise from a covered disaster event. II. WHO IS AN INSURED (A) The following are insureds under Insuring Agreement A: (1) The named insured. (2) Any person or organization qualifying as an insured under the scheduled underlying insurance, but for no broader coverage than would be afforded to such person or organization by the scheduled underlying insurance. (B) The following are insureds under Insuring Agreements B and C: (1) The named insured. (2) Any person or organization, other than an employee or volunteer worker, while such person or organization is acting as your real estate manager. (3) Your legal representative if you die, but only with respect to his or her duties as such. (4) Your employees, but only for acts within the scope of their employment by you, or while performing duties related to the conduct of your business. (5) Your volunteer workers, but only while performing duties related to the conduct of your business. (6) If you are designated in the Declarations as an individual, then your spouse, but only with respect to the conduct of a business of which you are the sole owner. (7) If you are designated in the Declarations as a partnership or joint venture, your partners and their spouses, but only with respect to the conduct of your business. (8) If you are designated in the Declarations as a limited liability company, your members, but only with respect to the conduct of your business, and your managers, but only with respect to their duties as such. (9) If you are designated in the Declarations as an organization other than a partnership, joint venture or limited liability company, your executive officers and directors, but only with respect to their duties as such. Your stockholders are also insureds, but only with respect to their liability as stockholders. (10) If you are designated in the Declarations as a trust, your trustees, but only with respect to their duties as such. (11) Any organization in which you maintain an interest of more than fifty percent (50%) as of the effective date of this policy. XCU 050 0811 © 2011 X.L. America, Inc. All Rights Reserved. Page 4 of 26 May not be copied without permission. Includes copyrighted material of Insurance Services Offices, Inc., with its permission. (12) A partnership, joint venture or limited liability company that you acquire or form during the policy period, but only if we have named such partnership, joint venture or limited liability company as an insured on a written endorsement that is made part of this policy. III. DEFENSE AND SETTLEMENT (A) We will have the right and duty to defend any suit covered by Insuring Agreement A, but only when the scheduled underlying insurance or other insurance has been exhausted by payment of loss to which this policy applies. (B) We will have the right and the duty to defend any suit covered by Insuring Agreement B, but only when such suit seeks damages because of bodily injury, property damage, or personal and advertising injury that are not covered by the scheduled underlying insurance or by other insurance. (C) When we assume the defense of any suit under Paragraph (A) or (B) above, we will have the right to investigate, defend and settle such suit as we deem appropriate. We will defend any such suit even if it is groundless, false or fraudulent. We also will pay the following supplementary payments in connection with any suit we defend, but only if such supplementary payments are not covered by the scheduled underlying insurance or any other insurance: (1) Premiums on appeal bonds or bonds to release attachments, subject to the applicable Limits of Insurance set forth in the Declarations, provided that we will not be obligated to apply for or furnish any such bond. (2) All costs taxed against an insured in connection with the suit. (3) Pre -judgment interest awarded against the insured on that part of any judgment paid under this policy, but only such interest as shall accrue before we make a settlement offer within the policy's applicable Limits of Insurance. (4) Post -judgment interest that accrues after entry of judgment and before we have paid, offered to pay, or deposited in court, that part of the judgment that is within this policy's applicable Limits of Insurance. (5) Reasonable expenses incurred by an insured at our request or with our consent. (D) We will have no duty to defend, investigate, pay or settle, or continue to defend, investigate, pay or settle, a suit after the applicable Limits of Insurance set forth in the Declarations have been exhausted by the payment of loss; in which case we will have the right to withdraw and discontinue our investigation or defense of such suit. (E) We will have no duty to defend the insured against any suit seeking damages to which this insurance does not apply. (F) If we are prevented by law or statute from assuming our defense obligations under Paragraph (A) or (B), we will pay any expenses incurred by you with our consent in connection with the defense of a suit otherwise covered by that section. (G) Except as otherwise provided in this Section III. Defense and Settlement, we shall have no duty to defend any suit against an insured. We, however, will have the right, but not the duty, to associate with you in the investigation, settlement or defense of any claim or suit to which this policy applies, in which case the insured will cooperate with us and make available all information and records we reasonably require. We will exercise our right to associate at our expense. XCU 050 0811 © 2011 X.L. America, Inc. All Rights Reserved. Page 5 of 26 May not be copied without permission. Includes copyrighted material of Insurance Services Offices, Inc., with its permission.