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BID BOND (PENAL SUM FORM) <br />Bidder <br />Name: Selge Construction Co., Inc. <br />Address (principal place of business): <br />2833 South 11 th Street <br />Niles, MI 49120 <br />Owner <br />Name: City of South Bend Board of Public Works <br />Address (principal place of business): <br />227 West Jefferson Boulevard <br />South Bend, IN 46601 <br />Surety <br />Name: The Cincinnati Insurance Company <br />Address (principal place of business): <br />P.O. Box 145496 <br />Cincinnati, OH 45250-5496 <br />Bid <br />Project (name and location): <br />Project No. 124-045 Westmoor and Bendix <br />Intersection — Sewer Repair <br />Bid Due Date: July 9, 2024 <br />Bond <br />Penal Sum: $5,000.00 Five Thousand Dollars and 00/100 <br />Date of Bond: July 9, 2024 <br />Surety and Bidder, intending to be legally bound hereby, subject to the terms set forth in this Bid Bond, <br />do each cause this Bid Bond to be duly executed by an authorized officer, agent, or representative. <br />Bidder Surety <br />Seel a Construction Co., Inc. The Cincinnati Insurance Com an <br />(Full f r al n e nf�idder) (Fu!!fargrrof name of Surety) (corporate sea (;€ com <br />/ I Af ��I . I 1 S E <br />By: <br />CZ (Signature) <br />Name: Justin Butler <br />(Printed or typed) <br />Title: iceCPresid <br />Attest: ? f �. <br />- (Signature) <br />Name: Allison Swinehart <br />(Printed or typed) <br />By: <br />(Signature) (Attach Power of. <br />Name: Tracie House <br />(Printed or typed) <br />Title: Att me -in-F ct <br />Attest: <br />(Signature) <br />Name: Tracey Heiss <br />(Printed or typed) <br />Title: Corp. Secretary Title: Witness <br />Notes: (1) Note: Addresses are to be used for giving any required notice. (2) Provide execution by any additional parties, such as <br />joint venturers, if necessary. <br />EJCDC® C-430, Bid Bond (Penal Sum Form). (EA-02/21) <br />Copyright° 2018 National Society of Professional Engineers, American Council of Engineering Companies, <br />and American Society of Civil Engineers. All rights reserved. <br />Page i of 2 <br />