Contract/Bond_ Sealmasters Foam, Inc. dba S&S Builders for 2020 Asphalt Overlay Ramp Project 3B Copyrighted
September 21, 2020
City of Dubuque Consent Items # 22.
City Council Meeting
ITEM TITLE: Improvement Contracts / Performance, Payment and Maintenance
Bonds
SUM MARY: Sealmaster Foam, LLC, d/b/a S&S Builders for the 2020 Asphalt
Overlay Ramp Project 3B.
SUGGESTED Suggested Disposition: Receive and File;Approve
DISPOSITION:
ATTACHMENTS:
Description Type
Contract/Bond_Sealmaster Foam/ S&S Builders Supporting Documentation
' Dubuque Engineering Department
THE CITY OF � 5o w t3�h sr
All•A�ePie�61t) Dubuque,IA 52001
U T � l I �'' Office(563)589-4270
j:� � � Fax(563)589-4205
TTY(563)556-9948
2007�2012•2013 engineer@cityofdubuque.org
Mcrsterpiece on the Mississippi 201]1t2Q19 www•cityofdubuque.org
NOTICE TO PROCEED
TO: Sealmaster Foam dba S&S Builders ISSUE DATE: September 2, 2020
602 Peru Rd.
Dubuque, lA 52001
COMMENCEMENT DATE: September 12, 2020
PROJECT: 2020 Asphalt Overlay Ramp Project 3B
Dear S&S Builders:
You are hereby notified to commence the work on the Project, on or before the commencement date,
in accordance with the Contract Documents. The Contract Time shall begin to run on the
commencement date.
You are required to return an acknowledged copy of this Notice to Proceed to the City.
THE CITY HAS RECEIVED A COPY CITY OF DUBUQUE IOWA
OF THE CONTRACTOR'S WRITTEN gy; �
SAFETY PROGRAM .���1,�-z,
(Signature)
Gus Psiho�os
� YES (Name)
City En ineer
(Title)
ACCEPTANCE OF NOTICE
Receipt of the above Notice to Proceed is hereby acknowledged this day of , 2020.
PRINCIPAL:
(Contractor)
By:
(Signature)
(Name)
(Title)
SECTION 00600
Page 1 of 6
PUBLIC IMPROVEMENT CONTRACT
2020 Asphalt Overlay Ramp Project 3B
THIS IMPROVEMENT CONTRACT (the Contract), made in triplicate, dated for references
purposes the 28th day of Auqust 2020 between the City of Dubuque, lowa, by its City Manager,
through authority conferred upon the City Manager by its City Council (City), and Sealmaster Foam
D/B/A S&S Builders (Contractor).
For and in consideration of the mutual covenants herein contained, the parties hereto agree
as follows:
CONTRACTOR AGREES:
1. To furnish all material and equipment and to perform all labor necessary for the 2020 Asphalt
Overlay Ramp Project 3B (Project).
2. CONTRACT DOCUMENTS
A. The Contract Documents consist of the following:
1. Project Title Page (Section 00100).
2. Project Directory Page (Section 00101).
3. This Public Improvement Contract (Section 00500).
4. Performance, Payment, and Maintenance Bond (Section 00600).
5. Out-of-State Contractor Bond (Section 00610).
6. Other Bonds:
a. (Bond Name) (pages_to _ , inclusive).
b. (Bond Name) (pages_to _ , inclusive).
c. (Bond Name) (pages _to _ , inclusive).
7. The lowa Statewide Urban Design And Specifications (SUDAS) 2020 Edition.
8. CITY OF DUBUQUE Supplemental Specifications 2020 Edition.
9. Other Standard and Supplementary Specifications as listed on the Title Page of the
Contract Document Manual.
10.Special Provisions included in the project Contract Document Manual.
11.Drawings -Sheet No.1 through No.7 (7 pages) or drawings consisting of sheets
bearing the following general title:
2020 Asphalt Overlay Ramps Project 3B
12.Addenda (numbers _to _ , inclusive).
13.Insurance Provisions and Requirements (Section 00700).
14.Sales Tax Exemption Certificate (Section 00750).
15.Site Condition Information (Section 00775).
16.Construction Schedule and Agreed Cost of Delay (Section 00800).
17.Erosion Control Certificate (Section 00900).
18.Consent Decree (Section 01000).
� • �
SECTION 00600
Page 2 of 6
19.Other Project Information and Permits (Sections 01100 - 00000).
20.Exhibits to this Contract (enumerated as follows):
a. Contractor's Bid (pages 1 to 2 inclusive).
b. Bidder Status Form (Section 00460).
c. The following documentation that must be submitted by Contractor prior to Notice
of Awa rd.
i. Contractor Background Information Form (Section 00470/00471)
ii.
iii.
21.The following which may be delivered or issued on or after the Effective Date of the
Agreement:
a. Notice to Proceed (Section 00850).
b. Project Certification Page (Section 00102).
c. Change Orders (Not attached to this agreement).
There are no other Contract Documents. The Contract Documents may only be amended,
modified, or supplemented as provided in General Conditions.
3. All materials used by the Contractor in the Project must be of the quality required by the
Contract Documents and must be installed in accordance with the Contract Documents.
4. The Contractor must remove any materials rejected by the City as defective or improper, or
any of said work condemned as unsuitable or defective, and the same must be replaced or
redone to the satisfaction of the City at the sole cost and expense of the Contractor.
5. Five percent (5%) of the Contract price will be retained by the City for a period of thirty (30)
days after final completion and acceptance of the Project by the City Council to pay any claim
by any party that may be filed for labor and materials done and furnished in connection with
the performance of this Contract and for a longer period if such claims are not adjusted within
that thirty (30) day period, as provided in lowa Code Chapter 573 or lowa Code Chapter 26.
The City will also retain additional sums to protect itself against any claim that has been filed
against it for damages to persons or property arising through the prosecution of the work and
such sums will be held by the City until such claims have been settled, adjudicated or
otherwise disposed of.
6. The Contractor has read and understands the Contract Documents herein referred to and
agrees not to plead misunderstanding or deception related to estimates of quantity,
character, location or other conditions for the Project.
7. In addition to any warranty provided for in the specifications, the Contractor must also fix any
other defect in any part of the Project, even if the Project has been accepted and fully paid
for by the City. The Contractor's maintenance bond will be security for a period of two years
after the issuance of the Certificate of Substantial Completion.
8. The Contractor must fully complete the Project under this Contract on or before the date
indicated in the Construction Schedule and Agreed Cost of Delay Section of the Contract
Documents.
9. INDEMNIFICATION FROM THIRD PARTY CLAIMS. To the fullest extent permitted by law,
Contractor shall defend, indemnify and hold harmless City, its officers and employees, from
SECTION 00600
Page 3 of 6
and against all claims, damages, losses and expenses claimed by third parties, but not
including any claims, damages, losses or expenses of the parties to this Contract, including
but not limited to attorneys'fees, arising out of or resulting from perFormance of this Contract,
provided that such claim, damages, loss or expense is attributable to bodily injury, sickness,
disease or death, or injury to or destruction of property, including loss of use resulting there
from, but only to the extent caused in whole or in part by negligent acts or omissions of
Contractor, or anyone directly or indirectly employed by Contractor or anyone for whose acts
Contractor may be liable, regardless of whether or not such claim, damage, loss or expense
is caused in part by a party indemnified hereunder.
10. The Contractor hereby represents and guarantees that it has not, nor has any other person
for or in its behalf, directly or indirectly, entered into any arrangement or Contract with any
other Bidder, or with any public officer, whereby it has paid or is to pay any other Bidder or
public officer any sum of money or anything of value whatever in order to obtain this Contract;
and it has not, nor has another person for or in its behalf directly or indirectly, entered into
any Contractor arrangement with any other person, firm, corporation or association which
tends to or does lessen or destroy free competition in the award of this Contract and agrees
that in case it hereafter be established that such representations or guarantees, or any of
them are false, it will forfeit and pay not less than ten percent (10%) of the Contract price but
in no event less than $2,000.00 (Two Thousand Dollars) to the City.
11. The surety on the Bond furnished for this Contract must, in addition to all other provisions,
be obligated to the extent provided for by lowa Code 573.6 relating to this Contract, which
provisions apply to said Bond.
12. The Contractor agrees, and its Bond is surety therefore, that after the Certificate of
Substantial Completion has been issued by the City, it will keep and maintain the Project in
good repair for a period of two (2) years.
13. The Project must be constructed in strict accordance with the requirements of the laws of the
State of lowa, and the United States, and ordinances of the City of Dubuque, and in
accordance with the Contract Documents.
A. All applicable stand�rds, orders, or regulations issued pursuant to the Clean Air Act of
1970 (42 U. S. C. 1958 (H) et. seq.) and the Federal Water Pollution Act (33 U. S. C.
1368 et. seq.) as amended, Executive Order 11738, and Environmental Protection
Agency regulations (40 CFR, Part 15). Contractor must comply with Section 103 and
107 of the Contract Work Hours and Safety Standards Act (40 USC 327-330) and
Department of Labor Regulations (29 CFR, Part 5).
B.
,
�
C. ���o,� f�;�
,
,
D. The City of Dubuque in accordance with Title VI of the Civil Rights Act of 1964, 78 Stat.
252, 42 U.S.C. 2000d-2000d-4 and Title 49, Code of Federal Regulations, Department
of Transportation, Subtitle A, Office of the Secretary, Part 21, Nondiscrimination in
Federally assisted programs of the Department of Transportation issued pursuant to
SECTION 00600
Page 4 of 6
such Act, hereby notifies all bidders that it will affirmatively insure that in any contract
entered into pursuant to this advertisement, minority business enterprises will be
afforded full opportunity to submit bids in response to this invitation and will not be
discriminated against on the grounds of race, color, national origin, sex, age, or disability
in consideration for an award.
CONSENT DECREE
RELATING TO THE PROJECT
14. � THIS CONTRACTOR IS PERFORMING WORK FOR THE CITY OF DUBUQUE RELATED TO
THE WATER & RESOURCE RECOVERY CENTER OR THE SANITARY SEWER
COLLECTION SYSTEM. THEREFORE, THE CONSENT DECREE AND THIS SECTION ARE
APPLICABLE.
CITY CONTRACTOR
� THIS CONTRACTOR IS NOT PERFORMING WORK FOR THE CITY OF DUBUQUE
RELATED TO THE WATER & RESOURCE RECOVERY CENTER OR THE SANITARY
SEWER COLLECTION SYSTEM. THEREFORE THE CONSENT DECREE AND THIS
SECTION ARE NOT APPLICABLE.
The City has entered into a Consent Decree in the case of The United States of America, and the State
of lowa v. The City of Dubuque, lowa, Civil Action Number Case 2:11-cv-01011-EMJ, Civil Action
Number 2008V00041, DOJ Case Number 90-5-1-1-09339, United States District Court for the Northern
District of lowa. The provisions of the Consent Decree apply to and are binding upon the City and its
officers, directors, employees, agents, servants, successors, assigns, and all persons, firms and
corporations under contract with the City to perform the obligations of the Consent Decree.
The City is required to provide a copy of the Consent Decree to any contractor or consultant retained to
perForm work required by the Consent Decree.
A copy of the Consent Decree is included in the Contract Documents and can be viewed at
htt�:llwww.�itvafdu�uque orqlDocum�ntCenterlHomelViewl3�73. A hard copy is available upon
request at the City's Engineering Department Office.
The City must condition any contract to perForm work required under the Consent Decree upon
performance of the work in conformity with the provisions of the Consent Decree.
The Consent Decree also provides that until five (5) years after the termination of the Consent Decree,
the City must retain, and must instruct its contractors and agents to preserve, all non-identical copies of
all documents, reports, data, records, or other information (including documents, records, or other
information in electronic form) in its or its contractors' or agents' possession or control, or that come into
its or its contractors' or agents' possession or control, and that relate in any manner to the City's
performance of its obligations under this Consent Decree, including any underlying research and
analytical data. This information-retention period, upon request by the United States or the State, the
City must provide copies of any documents, reports, analytical data, or other information required to be
maintained under the Consent Decree. At the conclusion of the information-retention period, the City
must notify the United States and the State at least ninety (90) Days prior to the destruction of any
documents, records, or other information subject to such requirements and, upon request by the United
SECTION 00600
Page 5 of 6
States or the State, the City must deliver any such documents, records, or other information to the EPA
or IDNR.
CERTIFICATION BY CONTRACTOR
The undersigned, on behalf of the Contractor, with full authority to act on behalf of the Contractor,
certifies to the City of Dubuque as follows:
1. I have received a copy of the Consent Decree in the case of The United States of
America, and the State of towa v. The City of Dubuque, lowa, Civil Action Number
Case 2:11-cv-01011-EMJ, Civil Action Number 2008V00041, DOJ Case Number 90-
5-1-1-09339, United States District Court for the Northern District of lowa.
2. All work perFormed will be in conformity with the provisions of the Consent Decree.
3. All documents reports, data, records, or other information (including documents,
records, or other information in electronic form) that relate in any manner to the
performance of obligations under the Consent Decree, including any underlying
research and analytical data, will be retained as required by the Consent Decree.
4. The Contractor agrees to defend, indemnify, and hold harmless the City, its officers,
agents, or employees from and against any claims, including penalties, costs and
fees as provided in the Consent Decree, relating to or arising out of the Contractor's
failure to comply with the Consent Decree.
CONTRACTOR:
�'�� � ���\�,�5
Contractor
By. �Y .L..�..Le ' V�L 1..,-y�"/`�,
Signature
LU�� � ��-
Printed Name
� '
,`
Title
���'3 i`�l�':a.�
Date
SECTION 00600
Page 6 of 6
THE CITY AGREES:
15. Upon the completion of the Contract, and the acceptance of the Project by the City Council,
and subject to the requirements of law, the City agrees to pay the Contractor as full
compensation for the complete performance of this Contract, the amount determined for
the total work completed at the price(s) stated in the Contractor's Bid Proposal and less
any Agreed Cost of Delay provided for in the Contract Documents.
CONTRACT AMOUNT $59,892.86
CITY OF DUBUQUE, IOWA:
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Department �
By:
Signa e
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Pr�d Na
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Title
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Date
CONTRACTOR:
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Contractor
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By: � S �L�...�,� �� d'Lc�ti,.�.-,o �"�.
Signature
���'�,vV`(l ��1n Y�L'A� � `� --
Printed Name
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Title
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Date
___= END OF SECTION 00500 =___
r` .
SECTION 00600
Page 1 of 4
PERFORMANCE, PAYMENT AND MAINTENANCE BOND
SECTION 00600
KNOW ALL BY THESE PRESENTS:
That we, Sealmaster Foam D/B/A S&S Builders , as Principal (hereinafter the "Contracto�" or
"Principal") and I In , as
Surety are held and firmly bound unto the City of Dubuque, lowa, as Obligee (hereinafter referred
to as "Owner"), and to all persons who may be injured by any breach of any of the conditions of
this Bond in the penal sum of Fift -nine thousand ei ht hundred ninet -two and ei ht -six cents
($59,892.86), lawf�l money of the United States, for the payment of which sum, well and truly to
be made, we bind ourselves, our heirs, legal representatives and assigns, jointly or severally,
firmly by these presents.
The conditions of the above obligations are such that whereas said Contractor entered into a
contract with the Owner, bearing date the 28�' day of Auqust 2020, (hereinafter the "Contract")
wherein said Contractor undertakes and�agrees to construct the following project in accordance with
the Contract Documents, and to faithfully perform all the terms and requirements of said Contract
within the time therein specified, in a good and workmanlike manner, and in accordance with the
Contract Documents. The Contract Documents for 2020 Asphalt Overlav Ramp Project 3B detail
the following described improvements:
Reconstruction of 20 pedestrian access ramps on Hillcrest Road, Admiral Street and
Aurora Street in conjunction with the Public Works 2020 Asphalt Overlay Program.
It is expressly understaod and agreed by the Contractor and Surety in this Bond that the follawing
provisions are a part of this Bond and are binding upon said Contractor and Surety, to-wit: �
1. PERFORMANCE: The Contractor shall well and faithfully observe, p�rForm, fulfill, and
abide by each and every covenant, condition, and part of said Contract and Contract
Documents, by reference made a part hereof, for the project, and shall indemnify and save
harmless the Owner from all outlay and expense incurred by the Owner by reason of the
Contractor's default of failure to perForm as required. The Contractor shall also be
responsible for the default or failure to perForm as required under the Contract and Contract
Documents by all its subcontractars, suppliers, agents, or employees furnishing materials
or providing labor in the performance of the Contract.
2. PAYMENT: The Contractor and the Surety on this Bond hereby agreed to pay all just
claims submitted by persons, firms, subcontractors, and corporations furnishing materials
for or performing labor in the performance of the Contract on account of which this Bond is
given, including but not limited to claims for all amounts due for labor, materials, lubricants,
oil, gasoline, repairs on machinery, equipment, and tools, consumed or used by the
Contractor or any subcontractor, wherein the same are not satisfied out of the portion of the
contract price the Owner is required to retain until completion of the improvement, but the
Contractor and Surety shall not be liable to said persons, firms, or corporations unless the
SECTION 00600
Page 2 of 4
claims of said claimants against said portion of the contract price shall have been
established as provided by law. The Contractor and Surety hereby bind themselves to the
obligations and conditions set forth in Chapter 573 of the lowa Code, which by this
reference is made a part hereof as though fully set out herein.
3. MAINTENANCE: The Contractor and the Surety on this Bond hereby agree, at their own
expense: �
A. To remedy any and all defects that may develop in or result from work to be
performed under the Contract Documents within the period of two (2) year(s) from the
date of acceptance of the work under the Contract, by reason of defects in
workmanship, equipment installed, or materials used in construction of said work;
B. To keep all work in continuous good repair; and
C. To pay the Owner's reasonable costs of monitoring and inspection to assure that any
defects are remedied, and,to repay the Owner all outlay and expense incurred as a
result of Contractor's and Surety's failure to remedy any defect as required by this
section.
Contractor's and Surety's Contract herein made extends to defects in workmanship or
materials not discovered or known to the Owner at the time such work was accepted.
4. GENERAL: Every Surety on this Bond shall be deemed and held bound, any contract to the
contrary notwithstanding, to the following provisions:
A. To consent without notice to any extension of time authorized in approved change
orders to the Contractor in which to perForm the Contract;
�
B. To consent without notice to any change in the Contract or Contract Documents,
authorized in approved change orders which thereby increases the total contract price
and the penal sum of this Bond, provided that all such changes do not, in the
aggregate, involve an increase of more than twenty percent (20%) of the total contract
price, and that this Bond shall then be released as to such excess increase;
C. To consent without notice that this Bond shall remain in full force and effect until the
Contract is completed, whether completed within the specified contract period, within
an extension thereof, or within a period of time after the contract period has elapsed
and the liquidated damage penalty is being charged against the Contractor.
The Contractor and every Surety on the Bond shall be deemed and held bound, any contract to the
contrary notwithstanding, to the following provisions:
D. That no provision of this Bond or of any other contract shall be valid that limits to less
than five (5) years after the acceptance of the work under the Contract the right to sue
on this Bond.
SECTION 00600
Page3of4
E. That as used herein, the phrase "all outlay and expense" is not to be limited in any
way, but shall include the actual and reasonable costs and expenses incurred by the
Owner including interest, benefits, and overhead where applicable. Accordingly, "all `
outlay and expense" would include but not be limited to all contract or employee
expense, all equipment usage or rental, materials, testing, outside experts, attorney's
fees (including overhead expenses of the Owner's staff attorneys), and all costs and
expenses of litigation as they are incurred by the Owner. It is intended the Contractor
and Surety will defend and indemnify the Owner on all claims made against the
Owner on account of Contractor's failure to perform as required in the Contract and
Contract Documents, that all agreements and promises set forth in the Contract and
Contract Documents, in approved change orders, and in this Bond will be fulfilled, and
that the Owner will be fully indemnified so that it will be put into the position it would
have been in had the Contract been performed in the first instance as required.
In the event the Owner incurs any "outlay and expense" in defending itself against any claim as to
which the Contractor or Surety should have provided the defense, or in the enforcement of the
promises given by the Contractor in the Contract, Contract Documents, or approved change
orders, or in the enforcement of the promises given by the Contractor and Surety in this Bond, the
Contractor and Surety agree that they will make the Owner whole for all such outlay and expense,
provided that the Surety's obligation under this Bond shall not exceed one hundred twenty-five
percent (125%) of the penal sum of this Bond.
In the event that any actions or proceedings are initiated regarding this Bond, the parties agree that
the venue thereof shall be Dubuque County, State of lowa. If legal action is required by the Owner
to enforce the pravisions of this Bond or to collect the monetary obligation incurring to the benefit of
the Owner, the Contractor and the Surety agree, jointly, and severally, to pay the Owner all outlay
and expense incurred therefor by the Owner. All rights, powers, and remedies of the Owner
hereunder shall be cumulative and not alternative and shall be in addition to all rights, powers, and
remedies given to the Owner, by law. The Owner may proceed against surety for any amo�nt
guaranteed hereunder whether action is brought against the Contractor or whether Contractor is
joined in any such action(s) or not.
NOW THEREFORE, the condition of this obligation is such that if said Principal shall faithfully
perform all the promises of the Principal, as set forth and provided in the Contract, in the Contract
Documents, and in this Bond, then this obligation shall be null and void, otherwise it shall remain in
full force and effect.
When a work, term, or phrase is used in this Bond, it shall be interpreted or construed first as
defined in this Band, the Cantract, or the Contract Documents; second, if not defined in the Bond,
Contract, or Contract Documents, it shall be interpreted or construed as defined in applicable
provisions of the lowa Code; third, if not defined in the lowa Code, it shall be interpreted or
construed according to its generally accepted meaning in the construction industry; and fourth, if it
has no generally accepted meaning in the construction industry, it shall be interpreted or construed
according to its common or customary usage.
Failure to specify or particularize shall not exclude terms or provisions not mentioned and shall not
limit liability hereunder. The Contract and Contract Documents are hereby made a part of this
Bond.
SECTION 00600
Page 4 of 4
Project No.
Witness our hands, in triplicate, this,�1 st day of Au ust , 2020.
SURE ��, , SIC�NED BY: Title
�������'° FORM AP VEDK JB .
�� of Agent -
John E. Goodmann Representative for Owner
Printed Name of Agent
2774 Universit Ave SURETY:
Company Address INYI' Insura any
Dubu ue IA 52001 Sur�ty..�a"mpany,
City,State,Zip Code �� ���� " ,J
563-5563232 By�
gnature Attorney-in-Fact Officer
CompanyTelephone Number John E. Goodmann
PRINCIPAL: ' Printed Name of Attorney-in-Fact Officer
Sealmaster Foam d/b/a S&S Builders IN1I' Insurance Com an
Company Name
Contractor P 0 Box 1336
�-a ��
By �''`� � 4n Company Address
Signature Des Moines, IA 50306
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'--� � �.'`, , ..��y••1'1r '"� City,State,Zip Code
Printed Name
800-274-3531
Company Telephone Number
NOTE:
1, All signatures on this performance, payment, and maintenance Bond must t� original
signatures in ink; copies, facsimile, or electronic signatures will not be accepted.
2. This Bond must be sealed with the Surety's raised, embossing seal.
3. The name and signature of the Surety's Attorney-in-Fact/Officer entered on this Bond
must be exactly as listed on the Certificate or Power of Attorney accompanying this
Bond.
___= END OF SECTION 00600 =___
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5 Sean Kennedy,President 5
5 5 5
WARNING: THIS POWER IS INVALID IF NOT PRINTED WITH RED BOKDER AND R�D LOGO. 5
5 s��ArL oF iowa 5
5 COUN7'Y OF DALLAS } �1� 5
5 5 on t�us 29th d1y of_ Ma� 5
� _,—__2n2n _,beforc me appeared Richard Keith,to me personally known, 5
5 wl�o bcing hy me cluly sworii dict say that he is President of the IMT lnsw•ance Company,the corporation described in the forcgoing instrumei�t, CJ
Sand tl�at the Seal�ifFixe<I to Che said instrument is the Corporate Seal of the said Corporation and that dic said instrument was signed and sealed in 5
C� behalf of said Cotporation by authority of its Bo1rd of Directors. 5
r,57 In'I'estirriony Whereof,I havc hereunto set my hand and affixed my Official Seal xt che City of West Des Moines,Iowa,the duy and year 5
� first abovc writte�n. �
5 a' � TAMI M SODA•GOOL1 .
5 zP e e�s� Commission Number$16649 ���ry�,�, �. ����J 5
5 My C miss n Explres _ 5
5 • i p,NP + 4 Z2 l� Notar y Puhlic.Dallas Count y.Iowa C�
5 CER'CIFICATL 5
5 5
5 I.Dalene 1[olland.Secreta�y of the IM'1'Inswance C'om��any�lo hcrehy certify that thc�tbove and foregoin�is a trtie and currect cupy of �
� thc POWL;R-ON-ATTOI2NIiY,executc�l by sttid the IM1'Insurauce C'umptiny,�vliich is still in force an�l effert. CC�
5 Iu WiU�esS Whereof, 1 liavc hereunto �et my hand �iud aPfixed �he Scal of the Com�auy on _ 31St �lay of 5
5 AllgLLS.�. .�� --
5 �CQCL�� Ik� � Y�J�!-�.,�a.�v� 5
5 5
5 Dalcuc Hollan�l,Secretary }5
5
r5� sY u�,o�,�i 2n��, 5
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