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R-1172 - 04/10/2012 - PAVING PROJECT - ResolutionsRESOLUTION 2012 -PP- CNTRCT -R -1172 A RESOLUTION APPROVING AND AUTHORIZING THE AWARD AND EXECUTION OF A PAVING CONTRACT BY AND BETWEEN THE VILLAGE OF OAK BROOK AND J. A. JOHNSON PAVING COMPANY WHEREAS, the asphalt in parts of the Saddle Brook Subdivision, the Brook Forest Subdivision, Kensington Court, and the parking lots of several Village buildings is in need of replacement or repair ( "2012 Paving Project'); and WHEREAS, on March 6, 2012, the Village solicited bids for the 2012 Paving Project; and WHEREAS, the Village received five bids for the 2012 Paving Project; and WHEREAS, J. A. Johnson Paving Company ( "Johnson "), was the lowest responsible bidder for the 2012 Paving Project; and WHEREAS, the Village and Johnson desire to enter into and execute a paving contract for Johnson to implement the 2012 Paving Project ( "Contract'); and WHEREAS, the President and Board of Trustees have determined that it is in the best interests of the Village to enter into the Contract in a final form as approved by the Village Attorney; NOW THEREFORE, BE IT RESOLVED BY THE PRESIDENT AND BOARD OF TRUSTEES OF THE VILLAGE OF OAK BROOK, DU PAGE AND COOK COUNTIES, ILLINOIS as follows: Section 1: Recitals. The foregoing recitals are hereby incorporated into, and made a part of, this Resolution as the findings of the President and Board of Trustees of the Village of Oak Brook. Section 2: Approval of the Contract. The President and Board of Trustees hereby award and approve the Contract by and between the Village and Johnson in a form acceptable to the Village Manager and the Village Attorney. Section 3: Authorization and Execution of the Contract. The Village President and Village Clerk shall be, and hereby are, authorized to execute the final Contract on behalf of the Village after review and approval of the final form by the Village Manager and the Village Attorney. Section 4: Effective Date. This Resolution shall be in full force and effect upon passage and approval in the manner provided by law. [SIGNATURE PAGE FOLLOWS] APPROVED THIS 10`" day of April, 2012 PASSED THIS 10" day of April, 2012 RESOLUTION 2012 -PP- CNTRCT -R -1172 Approving Paving Contract with Johnson Page 2 of 2 Gopal G. Lalmalani Village President Ayes: Trustees Aktipis, Manzo, Moy, Wolin, Xusuf and Zannis ATTEST: Charlotte K. Pruss Village Clerk Village of Oak Brook 2012 Paving Project BidOpening Date: ............................................................. March 23, 2012 BidOpening Time:.. .................................................................. 11:30 a.m. Bid opening Location:.................... ............................Oak Brook Village Hall Bid Deposit: ........................................................ 5% of the Amount of Bid Performance Bond:.................. ...........................100% of the Amount of Bid Obtain information from: Orion Galey, P.E. Christopher B. Burke Engineering, Ltd. 9575 West Higgins Road, Suite 600 Rosemont, Illinois 60018 (847) 823-0500 Submit Bids to: Rania Serences, Purchasing Clerk Village of Oak Brook 1200 Oak Brook Road Oak Brook, IL 60523 Note: This cover sheet is an integral part of the contract documents and is, as are all of the following documents, part of any contract executed between the Village of Oak Brook and any successful BIDDER. Do not detach any portion of this document. Invalidation could result. 14 1 5. TIME OF COMPLETION: .� The undersigned affirms and declares that if awarded the contract for this work he will substantially complete said contract in strict accordance with its terms and conditions within 60 working days, unless additional time shall be granted by the Village in accordance with the provisions of the specifications. Punchlist items must be completed within 10 calendar days of receipt of the final punchlist letter. Parkway restoration of sod may be delayed until September should the Contractor ,J not have the ability to install prior to July 1. Should the contractor fail to complete the work by said time or within such extended time as may have been allowed, the contractor shall be liable to the Village in the amount set forth in the specifications. 6. BID GUARANTEE: Accompanying this bid is a bid bond, or bank cashier's check or certified check for not less than five percent (5 %) of the amount of the Base Bid made payable to the Village of Oak Brook. The amount of the bid bond or check is o F tai ($ ). If this bid is accepted and the undersigned shall fail to execute a contract and the contract bond, provide acceptable Certificates of Insurance, and provide an acceptable Progress Schedule as required herein, it is hereby agreed that the amount of the bid bond or check shall become the property of the Village and shall be considered as payment of damages due to delay and other causes suffered by the Village because of the failure to execute said contract, contract bond, acceptable Certificate of Insurance and Progress Schedule; otherwise said bid bond or check shall be returned to the undersigned. _I Page 3 Document A310 TM - 2010 Conforms with The American Institute of Architects AIA Document 310 Bid Bond Village of Oak Brook Contractor, surety, Owner or other party shall be considered CONTRACTOR: SURETY: oak Brook, IL 60523 (,Vmrre, legal slatav and addmsx; (l ,,ouu, legal smarms mrd principal place rf brerhm-w) Fidelity and Deposit Company of Maryland J.A.Johnson Paving Company 1400 American Lane, Tower I, 18th Floor ThIsdonsequence important 1025 E. Addison Court Schaumburg, IL 60196 -1056' legal consequences. Consultation Arlington Heights, IL 60005 Mailing Address for Notices with an attorney is encouraged with respeet to its completion er modification. OWNER: (,,vmrer, legalsrarirsandaddr=) Any singular reference to Village of Oak Brook Contractor, surety, Owner or other party shall be considered 1200 oak Brook road plural where applicable. oak Brook, IL 60523 BOND AMOUNT: $ 5% Five Percent of Amount Bid PROJECT: (,Iv unc. location or addml= mrdProJecrnaarber, if MY) 2012 Paving Project The Contractor and Surety are bound to the Owner in the amount set forth above, for the payment of which the Contractor and Surety bind themselves• their lieu%, executors• administrators. successors and assigns. jointly and severally, as provided herein. The conditions of this Bond are such that if the Owner accepts the bid of the Contractor within the time specified in the bid documents, or within such time period as may be agreed to by the Owner and Contractor, and the Contractor either (1) enters into a contract with the Owner in accordance with the terms of such bid, and gives such bond or bonds as may be specified in the bidding or Contract documents, with a surety admitted in the jurisdiction of tiro I�mject and otherwise acceptable to ilia Owner, for the faithful performance of such Contract and for the prompt payment of labor and material furnished in the prosecution thereof; or (2) pays to the Owner the difference, not to exceed the amount of this Bond between the amount specified in said bid and such larger amount for which the Owner may in good faith contract with another party In perlbrin the work covered by said bid, then this obligation shall be null and void, otherwise bw remain in full farce and effect. The Surely hereby waives any notice at' an agreement between the Owner and Contractor to extend the time in which the Owner may accept the bid. Waiver ol'nolice by the Surety shall not apply m any extension exceeding sixty (60) days in the aggregate beyond the time for acceptance ol'bids specified in the bid documents, and the owner and Cmmlraclor shall obtain the Surety's consent far an extension beyond sixty (60) days. - If this Bond is issued in connection with a subcontractor's bid too Contractor, the term Contractor in this Bond shall be deemed to be Subcontractor and the term Owner slall be deemed to be Contractor. When this Band bas been famished to comply with a statutory or other legal requirement in the location or the Pn4cct, any provision in this Bond contlicling with said statutory or legal requirement shall be deemed deleted herel'mm and provisions confirming to such statutory or other legal requirement shall be deemed incorporated herein. When so furnished, the intent is (fiat this nond %hull be construed as u statutory bond and not as a common law brad. _ Signed and sealed this 23rd day of March, 2 /11'ibress) �rlrjor,.%v) Hi s- OOSMAS 8110 012 J.A.Johnson Paving Company (Prfnclpal) (Seal) B. (77de) rest etl Fidelity and Deposit Company of Maryland (4umly) (Sea:) By. Nru J I epri Haller an Attorney -in -Fact Power of Attorney FIDELITY AND DEPOSIT COMPANY OF MARYLAND KNOW ALL MEN BY THESE PRESENTS: That the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, a corporation of the State of Maryland, by FRANK E. MARTIN JR., Vice President, and ERIC D. BARNES, Assistant Secretary, in pursuance of authority granted by Article VI, Section 2, of the By -Laws of said pmWy, which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the da ereby nominate, constitute and appoint Donna M. TYLER, Hina AZAM, Karen E. BO S T illiam REIDINGER and Joseph HALLERAN, all of Schaumburg, Illinois, EA } -in -Fact, to make, execute, seal and deliver, for, and on its behalf as su an \i an onds and undertakings, and the execution of such bonds or und�r ak v pfd es binding upon said Company, as fully Ifi and amply, to all intents and u b V ' had t s 'c and acknowledged by the regularly elected officers of the Company at i B re oper persons. This power of attorney revokes that issued on behalf of Donna M. BOGARD, Donna WRIGHT, William REIDINGER, dated February 4, 1 U� 2011. 1 ,� The said Assistant r 0 1 does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article VI, Section 2, of the By -Laws of said Company, and is now in force. IN WITNESS WHEREOF, the said Vice - President and Assistant Secretary have hereunto subscribed their names and affixed the Corporate Seal of the said FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 27th day of September, A.D. 2011. ATTEST: State of Maryland 1 ss: City of Baltimore J FIDELITY AND DEPOSIT COMPANY OF MARYLAND Eric D. Barnes Assistant Secretary By: Frank E. Martin Jr. Vice President On this 27th day of September, A.D. 2011, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, came FRANK E. MARTIN JR., Vice President, and ERIC D. BARNES, Assistant Secretary of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, to me personally known to be the individuals and officers described in and who executed the preceding instrument, and they each acknowledged the execution of the same, and being by me duly sworn, severally and each for himself deposeth and saith, that they are the said officers of the Company aforesaid, and that the seal affixed to the preceding instrument is the Corporate Seal of said Company, and that the said Corporate Seal and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporation. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above written. ,,....h,'1::' 1111111 \ \\ ` POA-F 036 -2112 Constance A. Dunn Notary Public My Commission Expires: July 14, 2015 EXTRACT FROM BY -LAWS OF FIDELITY AND DEPOSIT COMPANY OF MARYLAND "Article VI, Section 2. The Chairman of the Board, or the President, or any Executive Vice - President, or any of the Senior Vice - Presidents or Vice - Presidents specially authorized so to do by the Board of Directors or by the Executive Committee, shall have power, by and with the concurrence of the Secretary or any one of the Assistant Secretaries, to appoint Resident Vice - Presidents, Assistant Vice - Presidents and Attomeys -in -Fact as the business of the Company may require, or to authorize any person or persons to execute on behalf of the Company any bonds, undertaking, recognizances, stipulations, policies, contracts, agreements, deeds, and releases and assignments of judgements, decrees, mortgages and instruments in the nature of mortgages .... and to affix the seal of the Company thereto." CERTIFICATE I, the undersigned, Assistant Secretary of 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 the Vice - President who executed the said Power of Attorney was one of the additional Vice - Presidents specially authorized by the Board of Directors to appoint any Attorney -in -Fact as provided in Article VI, Section 2, of the By -Laws of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND. 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 FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on the 10th 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 WHEREOF, I have hereunto subscribed my name and affixed the corporate seal of the said Company this a3`d dayof Assistant Secretary L ri .J r Attach bid bond, bank cashier's check or certified check here. In the event that one bid bond or one check is intended to cover two or more bids, the amount must equal the sum of the proposal guarantees of the individual sections covered. The bid guarantees of all except the 2 lowest responsible bidders shall be returned after the President and the Board of Trustees of the Village of Oak Brook award the contract. The bid guarantees of the 2 lowest responsible bidders shall be returned after a contract, contract bond, acceptable certificate of insurance, and an acceptable progress schedule have been received from the successful bidder and approved by the Village of Oak Brook. The bid guarantee of all bidders shall be returned in the event that the President and Board of Trustees of the Village of Oak Brook reject all bids. Page 4 i Firm Name: J.A. JOHNSON PAVING CO _.� Address: 1025 E. ADDISON COURT City, State, ZIP: ARLINGTON HEIGHTSJL 60005 Signature: - JOHNSO Name Printed: DALE A. Title: PRESIDENT - Telephone: 647 - 438.2025 Date: 3 -23 -12 _.- if a Corporation; ATTEST: _ MICHAEL R. TARPEY Sacre ry -I ,I V 11 r r I ~ Pa rtc 5 Section F Statement of Bidder's Qualifications All questions must be answered and the data given must be clear and comprehensive. This statement must be notarized. If necessary, questions may be answered on separate attached sheets. The Bidder may submit any additional information he or she desires. 1. Name of Bidder: J.A. JOHNSON PAVING COMPANY 1025 E. ADDISON COURT, ARLINGTON HEIGHTS, IL 60005 2. Permanent main office address: 1954 3. When organized: 4. If a corporation, where incorporated: ILLINOIS ................_.... ... ............................... _ 5. How many years have you been engaged in the contracting business under your present firm or trade name: 56 YEARS 6. Contracts on hand: (Schedule these, showing amount of each contract and the appropriate anticipated dates of completion) SEE ATTACHED 7. General character of work performed by your company: ASPHALT PAVING 8. Have you ever defaulted on a contract: 9. List, on an attached sheet, the more important projects recently completed by your company, stating the approximate cost for each, and the month Et ACHED year completed. Include a contact person and phone # for each. 10. List your major equipment available for this contract: SEE ATTACHED 11. Experience in work similar in importance to this project: SEE ATTACHED 12. Background and experience of the principal members of your organization, including the officers. SEE ATTACHED 13. Credit available: N A Page 2 Bank reference: VILLAGE BANK & TRUST, ARLINGTON HEIGHTS, IL Will you, upon request, fill out a detailed financial statement and fumish any other information that may be required by the Village of Oak Brook: YES The undersigned hereby authorizes and requests any person, firm, or corporation to furnish any information requested by the Village of Oak Brook in verification of the recitals comprising this Statement of Bidder's Qualifications. DATED at COOK COUNTY Illinois this 23RD day of MARCH STATE OF ILLINOIS ) SS. COUNTY OF 2012. By: DALE A. JOHNS N, PRESIDENT - _.. Title ...... DALE A. JOHNSON being duly sworn deposes and says that he is the PRESIDENT of J.A. JOHNSON PAVING and that the answers to the foregoing questions and all statements therein contained are true and correct. SUBSCRIBED and sworn to before me this 23RD day of MARCH 2012. Notary Public LARp ROSSI C-STATE IOp1 CFILLINOIS EXPIRES:O6/i6112 Page 3 Section G References Bidder shall supply the following information listing at least five customers for which the bidder has supplied a similar type of commodities, service, or construction. 1. Company Name: sEEATTACHEo Address: Phone #: }- Contact: j,. 2. Company Name: a. Address: Phone #: Contact: 3. Company Name: Address: i Phone #: Contact: 4. Company Name: Address: Phone #: Contact: 5. Company Name: Address: Phone #: I Page 1 J.A. JOHNSON PAVING COMPANY 1025 E. ADDISON COURT ARLINGTON HEIGHTS, ILLINOIS 60005 ONE: 847-439-2025 FAR: 847 - 439'so84 2012 References: Public Works of Arlington Heights igton Heights Road )n Heights, IL 60005 Ms.Briget Schwab illage of Glendale Heights Christopher Burke Engineering 9575 W Higgins Rd, Ste 600 Rosemont, IL 60018 847 - 823- 0550/Vince Wrobeleski Village of Norridge 4000 N. Olcott Ave Norride, IL 60634 Mr. Brian Gaesor E708- 453 -0800 Illinois Department of Trans. 201 W. Center Court Schaumburg, IL 60196 847 - 705 -4000 Mr. Michael Weaver Village of Skokie 5217 Oakton Street Skokie, IL 60076 847 - 673 -0500 Mr. Mike Aleksic Village of Hanover Park 2121 West Lake Street Hanover Park, IL 60133 630 - 372 -4200 Mr. William Beckman Job: 2011 MFT Street Reconstruction Contract: $1,787,040.00 For: Street Resurfacing Job: 2011 Pavement Program — Various Streets Contract: $2,446.286.00 For: Street Resurfacing Job: 2011 MFT Resurfacing Various Streets Contract: $1,396,034.00 For: Resurfacing Job: 2Northern Cook County Various Locations Contract: $1,883,612.00 For: Patching Job: 2011 High Priority Various Streets Patch Contract: $212,947.00 For: Patching Job: 2011 Resurfacing Various Streets Contract: $550,713.00 For: Street Resurface J.A. JOHNSON PAVING COMPANY ion E. ADDISON COURT ARLINGTON HEIGHTS, ILLINOIS 60005 ONE: 847.439'2025 FAX. 847 - 439.2084 2012 References: Private Owner Projects T -Cat Enterprises, Inc. p.0. Box 657 Franklin Park, IL 60131 630.330.6800 Attn: Jim Trumbull Norridge Plaza Parking Lot c/o Chicago Title & Trust Harlem & Forest Preserve Drive Norridge, IL Ken Williams /312- 944 -8575 W.B. Olson 3235 Arnold Drive Northbrook, IL 60062 847.498 -3800 Ken Kukowicz VJS Lincoln, Inc. W233N2847 Roundy Circle West Pewaukee, WI 53072 262 -542 -1371 Attn: Joe Stueland Advocate Lutheran General 1775 Dempster Park Ridge, IL 60068 847- 723 -6550 Attn: Jonathan Kusmierski Parkway Development 1030 North DuPage Avenue Lombard, IL 60148 630 - 916 -1800 Job: Canadian RR Gate 4 Schiller Park, IL Contract: $124.885.00 For: Parking Lot Paving Job: Norridge Plaza Parking Lot Contract: $214,064.00 For: Parking Lot Job: Ravina Underpass Pavement Repair Contract: $150,542.00 For: Paving & Repair Job: Chicago Executive Airport, Wheeling Contract: $42,573.00 For: Parking Lot Paving Job: Lutheran General Parking Area Contract: $34,220.00 For: Roadway and Parking Area Paving Job: High Grove Parking Lot Glendale Heights, IL Contract: $65.879.00 For: Parking Lot Paving J.A. JOHNSON PAVING COMPANY io25 E. ADDISON COURT ARLINGTON HEIGHTS, ILLINOIS 60005 pBONE: 847 - 439-2025 FAR 547 - 439-2084 CONSTRUCTION EXPERIENCE Dale A. Johnson Michael R. Tarpey Pat Tansey Randy Slavicek Larry Alderin Edward Ruff Dick Rossi President 32 Years Secretary/Treasurer 21 Years Superintendent 35 Years Field Superintendent 31 Years Field Superintendent 27 Years Estimator 30 Years Estimator 35 Years Illinois Department of Transportation Bureau of Construction 2300 South Dirksen Parkway /Room 322 Springfield, Illinois 62764 Affidavit of AV Ilabi ty For the Letting of Z-- (Letting date) Instructions: Complete this form by either typing or using black ink. "Authorization to Bid" will not be issued unless both sides of this forth are completed in detail. Use additional forms as needed to list all work. Under Contract all work you have under contract as either a prime contractor or a subcontractor. It is required to include all pending low bids not yet awarded or joint venture, list only that portion of the work which is the responsibility of your company. The uncompleted dollar value is to be based upon the most are or owners estimate, and must include work subcontracted to others. If no work is contracted, show NONE. 1 I Award Pending I Award Pending I Award Pending Awards Number CON# 63631 `— U1 ` m "" I NA CON# 60M52 With Alliance South Barrington Deer Park Dunnett Bay I Completion Date 9112 7112 6112 9112 ,tract Price 221,000.00 541,000.00 577,000.00 103,000.0 ned Dollar Value if Firm is the 896,000.00 ving 221 Total Value of All Work Pending and Uncompleted Work to be done with your own forces. law the uncompleted dollar value of work for each contract and awards pending to be completed with your awn forces. All work a0 to others will be listed on the reverse of this form. In a joint venture, list only that portion of the work to be done by your . 1 n work is contracted, show NONE. Accumulated Totals rk 4,000.00 10,000.00 14,000.00 Cement Concrete Paving 0.00 nt Mix 215,000.00 302,000.00 284,000.00 95,000.00 896,000.00 ving 0.00 Seal Cracks /Joints 0.00 ate Bases & Surfaces 9,000.00 9,000.00 AR. and Waterway Structures 0.00 0.00 I 0.00 and Seal Coats 2,000.00 2,000.00 Construction 0.00 ..ping 0.00 0.00 1 0.00 0.00 0.00 ling, Planning & Rotomilling 6,000.00 35,000.00 80,000.00 6,000.00 127,000.00 n 0.00 ,t Markings (Paint) 0.00 - nstruction (List) - patching 39,000.00 110,000.00 149,000.00 0.00 0.00 221,000.001 389 arm nn 484,000.00 103,000.00 0.00 1,197,000.00 -• „ „o ,u.nnauon is KL%VLnKEU to accompnsn me statutory purpose as outlined in the "Illmois Procurement Code ". Failure to comply will rlon- issuance of an "Authorization To Bid." This form has been approved by the State Forms Management Center. ?dntm z14nn+1 Part III. Work Subcontracted to Others 'b d n Part I list all the work you have subcontracted to others. For each contract descn i I, being duly swum, do hereby declare this affidavit is a true and correct statemem mu w misting ALL ui umN=,o.. CO ^• -_._ -. the undersigned far Federal, State, County, City and private work, including ALL subcontract work, ALL pending low bids not yet awarded or rejected and ALL estimated completion dates Subscribed and sworn to before me Itilp sil d y of 1/� • 2g Type or Print Name MICHAEL R. Officer or Notary Pu c Signed My commission expires:: (Notaf;mo EAL OSSI E OF ILLIN OIS IRES:O6/i6/12 Company J.A. JOHNSON PAVING CO Address 1025 E. ADDISON COURT ARLINGTON HEGHTS, IL 60005 e y Awards Pending 1 2 3 Subcontractor Norridge Fortis Type of Work Sewer Concrete Subcontract Price 37,000.00 18,000.00 Amount Uncompleted 37,000.00 18,000.00 Subcontractor Geomat Staples Type of Work Raft Crk Cont Landscape Subcontract Price 32,000.00 32,000.00 Amount Uncompleted 32,000.00 32,000.00 Subcontractor Traff Cont & Prot Precision Type of Work Traff Cont Pvmt Mark Subcontract Price 3,000.00 2,000.00 Amount Uncompleted 3,000.00 2,000.00 Subcontractor AC Traff Cont & Prot Type of Work Pvmt Mark Traff Cont Subcontract Price 2,000.00 3,000.00 Amount Uncompleted 2,000.00 3,000.00 Subcontractor Fortis Norridge Type of Work Concrete Sewer Subcontract Price 13,000.00 36,000.00 Amount Uncompleted 13,000.00 36,000.00 Subcontractor Insituform Tree Rem Type of Work Sewer Lining Kramer Subcontract Price 56,000.00 2,000.00 Amount Uncompleted 56,000.00 ' 2,000.00 Subcontractor TNT Type of Work Landscape Subcontract Price 9,000.00 Amount Uncompleted 9,000m Total Uncompleted 0.00 152,000.00 93,000.00 0.00 0.00 ,.r I, being duly swum, do hereby declare this affidavit is a true and correct statemem mu w misting ALL ui umN=,o.. CO ^• -_._ -. the undersigned far Federal, State, County, City and private work, including ALL subcontract work, ALL pending low bids not yet awarded or rejected and ALL estimated completion dates Subscribed and sworn to before me Itilp sil d y of 1/� • 2g Type or Print Name MICHAEL R. Officer or Notary Pu c Signed My commission expires:: (Notaf;mo EAL OSSI E OF ILLIN OIS IRES:O6/i6/12 Company J.A. JOHNSON PAVING CO Address 1025 E. ADDISON COURT ARLINGTON HEGHTS, IL 60005 J.A. Johnson Paving Co., Inc. Equipment Item N umber` Year : Description :. Serial Number 1 1998 #434C -1 CAT 434C Roller 4DN257 2 1999 #434 -2 CAT 434C Roller 4DN341 3 1996 #534C -1 CAT 534C Roller 05NN00142 4 2009 VOGI Vociele Rubber Tire Paver 09830011 5 1993 #1404 CAT 140G Motor Grader 72V16026 6 1997 1 #4331 CAT 434C Roller 3TM414 7 1999 1 #5631 CAT 563C Roller 4KN1258 #9141 CAT 914G Rubber Tire Loader 9WM00821 1997 #9142 CAT 914G Rubber Tire Loader 9WM00871 M11 1988 #9632 CAT 963 Loader 21Z02186 1999 #9633 CAT 9638 Track Loader 9BL3219 2003 #AP1000 -1 CAT Rubber Tire Paver 7HN00347 131997 2006 #AP100o -2 CAT Rubber Tire Paver AGP00212 14 1997 #BG245 BG Mobile Track Paver 6TN00129 15 2009 #BOB -4 Bobcat Loader 521511355 16 2005 #8OMAG -1 Bomaq Roller 101920041014 17 2005 #BOMAG -2 Boma Roller 101920041016 18 2000 #GRADALL Gradall XL 4100 416521 19 1995 #MB 1 Melroe Breaker 617902720 20 1996 #MB 2 Melroe Breaker 15800232 21 1997 #MB 3 Melroe Breaker 15800651 22 2001 #MSB 1 Mustang Breaker 6M07622 23 2000 #PP2 Gilcrest Pro aver 2 -2976 24 2007 #WIRT 1 Wirt en 2000 Grinder 6200925 25 2008 Boma 4' Milling Machine 821836110166 26 2008 #WIRT 2100 Grinder & all STD E ui ment 09210297 27 2008 Skid Steer Loader include Bucket; Pallet T00328K163466 28 2008 #5343 As halt Drum Compactor EAA00662 29 2008 #5342 Asphalt Drum Compactor EAA00690 30 1986 #H ster 2 H ster Roller CA89C5493G 31 2009 Hamm HD -12 -VV H1711652 32 2009 Hamm HV -12 -VV H7111682 33 2009 Hamm HV -12 VV H1711562 34 2009 1 Road Widener SPR -6 MD1 160 35 2008 Bobcat Skid Steer Loader & Parts #6732305 & #6718007 BOB2 531117474 36 2009 Bobcat BOBGR 24 "Grinder 24" Planner & 24" Cut Drum 231713109 37 2009 Planner Bobcate Grinder 24" 231712881 38 2009 5344 Cat CBS54XW Roller O3LM0138 39 2009 5345 Cat CB534D Roller EAA00711 40 2009 Bobcat BOBS Skid Steer Loader & Heav Bucket ASGP35553 41 2010 Bobcat 24" Grinder, 24" Planer & 24" Fast Cut SOBGR3 & 24" Fast Cut Drum 231713231 42 2009 Roller Hypac 4 Hypac C350D Static Roller 901D08911015 43 2009 Midland Road Widener 164 44 2009 Static Double Drum Asphalt Roller 901D08911017 45 2010 A 655 Cat Rubber Tire Track Paver GNZ00344 46 1991 RAM1 Rammer Hammer Breaker 23BTA0037 47 2010 Bobcat Skidsteer Bob6 ASGP37001 48 - HD-14 Roller H2010516 49 HAMM HO -14 Roller H20103Z2 50 Skid Steer 165766 51 Skid Steer 165767 52 Skid Steer 165768 53 Skid Steer 165769 54 2006 #JD 2 John Deere Skid Steer 7003326135550 55 2006 #JD 1 John Deere Skid Steer T00332B135564 56 2005 #JD S John Deere Skid Steer 703328112387 57 2008 #JD 3 New 332 Skid Steer Loader T0O332B158058 58 2008 John Deere Skidsteer Loader JD4 T00332B134057 Section H Bid Certification The undersigned, being first duly sworn an oath, deposes and states that he has the authority to make this certification on behalf of the bidder for the construction, product, commodity, or service briefly described as follows: 112012 Paving Project" The undersigned certifies that, pursuant to Chapter 720, Section 5/33E of the Illinois Compiled Statutes, 1993, the bidder is not barred from bidding on this contract as a result of a conviction for the violation of State of Illinois laws prohibiting bid - rigging or bid - rotating. .The.. undersigned states under. oath.that,. pursuant. to Chapter. 65, Secticn.5 /11 -__ 42.1 -1 of the Illinois Compiled Statutes, 1993, the bidder is not delinquent in the payment of any tax administered by the Illinois Department of Revenue. The undersigned certifies that, pursuant to Chapter 775, Section 512 -105. of the Illinois Compiled Statutes, 1993, the bidder has a written sexual harassment policy in place including the following information: 1. An acknowledgment of the illegality of sexual harassment. 2. The definition of sexual harassment under State law. 3. A description of sexual harassment, utilizing examples. 4. The contractor's internal complaint process including penalties. 5. The legal recourse, investigative and complaint process available through the Illinois Department of Human Rights and the Human Rights Commission. 6. Directions on how to contact the Department or the Commission. This business firm is: (check one) x Corporation Partnership Individual Firm Name: Address: City, State, Signature:_ Name Print J.A. JOHNSON PAVING CO 7025 E. ADDISON COURT ARLINGTON HEIGHTS, IL 60005 A. PRESIDENT Page 1 Telephone: 847 -439 -2025 D SUBSCRIBED AND SWORN TO before me this 23RD day of MARCH 2012. E 3 -23 -12 ATTEST: MICHAEL R. TARPEY, SECRETARY _SEA -'/i SEXUAL HARASSMENT CERTIFICATE J.A. JOHNSON PAVING CO hereinafter referred to as "Contractor" having submitted a bid /proposal for 2012 PAVING PROJECT to the Village of Oak Brook, DuPage /Cook Counties, Illinois, hereby certifies that said Contractor has a written sexual harassment policy in place in full compliance with 775 ILCS 5/2- 105(A)(4) including the following information: 1. 2. 3 4. 5. An acknowledgment of the illegality of sexual harassment. The definition of sexual harassment under State law. A description of sexual harassment, utilizing_ examples. The contractor's internal complaint process Including penalties. The legal recourse, investigative and complaint process available through the Illinois Department of Human Rights and the Human Rights Commission. _. Directions on how to contact the Department or the Commission. 7. An acknowledgment of protection of a complaint against retaliation as provided in Section 6 -101 of the Human Rights Act Each contractor must provide a copy of such written policy to the Illinois Department of Human Rights upon request. By: Authorized ent of Contractor DALE A. JOHNS , PRESIDENT Subscribed and swom to before me this 23RD day Of MARCH 2012 [ / Notary Public RICHA IA1 SEAL w D SSIDN �R S�7 AOS Page 3 PREVAILING WAGE AFFIDAVIT DALE A. JOHNSON (name of signatory), on oath hereby state and certify that j A JOHNSON PAVING CO (name of Contractor), pursuant to a Contract dated MARCH 23,_ , 2012, with the Village of Oak Brook for the 2012 PAVING PROJECT Project, has complied and will comply with all laws, including those relating to the employment of labor, the payment of the current general prevailing rate of hourly wages for each craft or type of worker or mechanic needed to execute the Contract or perform such Work, and also the current general prevailing rate for legal holiday and overtime work, as ascertained by the Illinois Department of Labor for DuPage County, Illinois, and those prevailing rates are paid and shall be paid for each craft or type of worker or mechanic needed to execute the aforesaid Contract or to perform such work. J.A. JOHNSON PAVING CO (name of Contractor) has also complied and will comply with all record keeping requirements established in the Prevailing Wage Act (820 ILCS 13010.0 1, at seq. CONTRAC'T'OR: J.A. JOHNSON PAVING CO By: 2—Da Qr Title: DALE A. JOHNSO RESIDENT SUBSCRIBED AND SWORN TO BEFORE ME THIS M H 2012 NOTARY PFMLIC L SSI GM0 OF ILLINOISES:06 /16/12 Page 4 CERTIFICATION OF PAYROLL RECORDS 1, DALE A. JOHNSON (name of person executing this certificate), do hereby certify that I am the duly qualified and acting PRESIDENT (title) for J.A. JOHNSON PAVING CO , (name of contractor) and, as such, am authorized to certify payroll records as true and accurate for such company in accordance with the requirements of Section 5 of the Prevailing Wage Act (820 ILCS 13015) (the "ACV "), I do hereby further certify that the following document is a true and accurate copy of the records of all laborers, mechanics, and other workers employed by J.A. JOHNSON PAVING Cgname of contractor) on the 2012 PAVING Project (the "Project ") for the Village of Oak Brook (the "Village "), including each such worker's name, address, telephone number, social security number, classification or classifications; and the hourly wages paid in each pay period, hours worked each day, and the starting and ending times of work each day for each such worker on such Project. ................ . I do hereby further certify that the hourly rate paid to each worker is not less than the general prevailing rate of hourly wages required by the Act, and that J.A. JOHNSON PAVING co (name of contractor), and I on behalf of such contractor, are fully aware that filing a certified payroll that we know to be false is a Class B misdemeanor. I further certify that upon two (2) business days' notice, if requested, we and any subcontractor hired by us shall make available for inspection the records required in the Act to the District, its officers and agents, and to the Director of Labor, his deputies and agents, at reasonable hours at a location within the State of Illinois. Date, MARCH 23, , 2012 J.A. JOHNSON PAVING CO (Name of Contractor) (Signature) �.nR�rrl�-rrl (Printed Name) PRESIDENT (Title) Subscribed and sworn to before me CFFICIALSEAL this z3 of MARCH 20 RICHARD JROSSI ' NOTARY PUBLIC • STATE OF ILLINOIS l MY COMMISSION EXPIRES:06/16112 Notary Public Page 5 CONTRACTOR'S CERTIFICATIONS (CONTRACT EXECUTION) J.A. JOHNSON PAVING CO , having executed a contract for 2012 PAVING PROJECT with the VILLAGE, hereby certifies that said contractor is not barred from executing said contract as a result of a violation of either Section 5133E -3 or 5133E -4 of Chapter 720 of the Illinois Compiled Statutes. (DRUG -FREE WORKPLACE) Contractor . deposes, states and certifies it will provide a drug free workplace by complying ............ with Section 3 of the Illinois Drug Free Workplace Act, being 30 ILCS 580/3: Title: MICHAEL R. TARPEY, SECRETARY Subscribed and Sworn to before me this 23RD day of MARCH , 20 12 . r Notary Public Contractor By: Name of Contracto Executing Office Title: DALE A. JOHNSON, PRESIDENT Title of Contractor's Executing Officer My Commission Expires: OFFICIAL SEAL RICHARD J ROSS[ NOTARY PUBLIC • STATE OF ILLINOIS MY COWAISSION EVIRES:06116I12 Page 6 ion I Contract (To Be Signed and Submitted as a part of Bid Package) 2012 Paving Project THIS AGREEMENT, made and concluded this 10th day of April , 2012, between the Village of Oak Brook, a municipal rati corpoon, acting by and through its President and Board of Trustees, known as VILLAGE, and his executors, administrators, successors or assigns, known as CONTRACTOR. WITNESSETH: That for and in consideration of the payments and agreements mentioned in the Bid hereto attached, to be made and performed by the VILLAGE, and according to the terms expressed in the Bond (if applicable) referring to these presents, the CONTRACTOR agrees, at their own proper cost and expense, to do all work, furnish all materials and all labor necessary to complete the work in accordance with the plans and specifications hereinafter described, and in full compliance with all of the terms of this Contract. And it is also understood and agreed that the entire Bid Package hereto attached, approved by the VILLAGE this loth day of April 2012, are all essential documents of this contract and are a part hereof. IN WITNESS WHEREOF, the said ave executed these presents on the above mentioned date. &i "4 f4 v" OF OAK BROOK LM Clerk _ iJ.A. JOHNSON PAVING CO Corporate Name ' '�` BY CHAEL COntraCtOr .JOHNSON. PRESIDENT doing Business under (If a Co- Partnership) n J Contract Bond Bond # 2012 Paving Project 09046297 Subject to Adjustment Based on Final Contract Price J.A. Johnson Paving Company as PRINCIPAL, SURETY, are a s d and firmly bound unto the Village of Oak Brook (hereafter referred to as "VILLAGE ") the penal SUM Of One Million NneH edFiflyFSe F dredmd39 /1oo Dollars ($ 1,955,700.39 ) vful money of the United States, well and truly to be paid unto said VILLAGE, for the yment of which we bind ourselves, our heirs, executors, administrators, successors, itly to pay to VILLAGE this sum under the conditions of this instrument. EREAS THE CONDITION OF THE FOREGOING OBLIGATION IS SUCH that, the I Principal has entered into a written contract with the Village acting through its rrding authority for the above stated project, which contract is hereby referred to and ie a part hereof, as if written herein at length, and whereby the said Principal has 'raised and agreed to ep rform said work in accordance with the terms of said contract, uding, but not limited to the term requiring the paymen t at the prevailing rate of hourly Les, and has promised to pay all sums of money due for any labor, materials, laratus, fixtures or machinery furnished to such Principal for the purpose of performing h work and has further agreed to pay all direct and indirect damages to any person, i, company, or corporation suffered or sustained on account of the performance of h work during the time thereof and until such work is completed and accepted, except modified by the Guarantee section of the Bid; and has further agreed that this bond ill inure to the benefit of any person, firm, company or corporation, to whom any ney may be due from the Principal, subcontractor or otherwise, for any such labor, terials, apparatus, fixtures or machinery so furnished and that suit may be maintained such bond by any such person, firm, company, or corporation, for the recovery of any ;h money. Page 1 N, THEREFORE, if the said Principal shall well and truly perform said work in ordance with the terms of said contract, and shall pay all sums of money due or to ome due for any labor, materials, apparatus, fixtures or machinery furnished to him for purpose of performing such work, and shall commence and complete the work within time prescribed in said contract, and shall pay and discharge all damages, direct and •ect, that may be suffered or sustained on account of such work during the time of the ormance thereof and until the said work shall have been accepted, and shall hold AGE harmless on account of any such damages and shall in all respects fully and fully comply with all the provisions, conditions, and requirements of said contract, i this obligation to be void; otherwise to remain in full force and effect. TESTIMONY WHEREOF, the said PRINCIPAL and the said SURETY have caused > instrument to be signed by their respective officers this 13th day of April in PRINCIPAL J.A. Johnson Paving Company (Company Name) (Company Name) By: (Signature) (Signature) Dale A. Johnson, President (Title) (Title) PRINCIPAL is a joint venture of two or more contractors, the company names and horized signatures of each contractor must be affixed.) SURETY 119ity and Deposit Company of Maryland (Name of Surety) (Signature of Att mey in Fact) Hina Azam Page 2 State of Illinois ) ) SS. County of Cook ) 1, Joseph Halleran , a Notary Public in and for said county, do hereby certify that Dale A. Johnson & Hina Azam (names of individuals signing on behalf of Principal and Surety) who are each personally known to me to be the same persons whose names are subscribed to the foregoing instrument on behalf of PRINCIPAL and SURETY, appeared before me this day in person and acknowledged respectively, that they signed and delivered said instrument as their free and voluntary act for the uses and purposes therein set forth. Given under my hand and notarial seal this 13th day of April 2012. aeo, Notary P b�ii ,� Joseph Halleran My commission expires: 08 -30 -2015 OFFICIAL SEAL JOSEPH HALLERAN NOTARY PUBLIC. STATE OF ILLINOIS My Commission Expires 08/30/2015 Page 3 Power of Attorney FIDELITY AND DEPOSIT COMPANY OF MARYLAND NOW ALL MEN BY THESE PRESENTS: That the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, a orporation of the State of Maryland, by FRANK E. MARTIN JR., Vice President, and ERIC D. BARNES, Assistant ecretary, in pursuance of authority granted by Article VI, Section 2, of the By -Laws of said y, which are set forth on to reverse side hereof and are hereby certified to be m full force and effect on the d =reby nominate, onstitute and appoint Donna M. TYLER, Hina AZAM, Karen E- Bo � illiam REIDINGER Xk nd Joseph HALLERAN, all of Schaumburg, Illinois, EA r a in -Fact, to make, xecute, seal and deliver, for, and on its behalf as s 9 P�.�ano`, I onds and undertakings, and ae execution of such bonds or undert ak e as binding upon said Company, as fully nd amply, to all intents and U ' had ;�c and acknowledged by the regularly elected officers :f the Company at i B re oper persons. This power of attorney revokes that issued on ehalf of Donna M.R U ^J BOGARD, Donna WRIGHT, William REIDINGER, dated February 4, '.011. 0 The said Assistant does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article VI, ection 2, ofthe By -Laws of said Company, and is now in force. IN WITNESS WHEREOF, the said Vice - President and Assistant Secretary have hereunto subscribed their names and iffixed the Corporate Seal of the said FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 27th day of ;eptember, A.D. 2011. 1TTEST: Itll '_ e � o r 4 �, State of Maryland 1 ss: City of Baltimore J FIDELITY AND DEPOSIT COMPANY OF MARYLAND Eric D. Barnes Assistant Secretary 1' J By: Frank E. Martin Jr. Vice President On this 27th day of September, A.D. 2011, before the subscriber, a Notary Public of the State of Maryland, duly ,ommissioned and qualified, came FRANK E. MARTIN JR., Vice President, and ERIC D. BARNES, Assistant Secretary of be FIDELITY AND DEPOSIT COMPANY OF MARYLAND, to me personally known to be the individuals and officers iescribed in and who executed the preceding instrument, and they each acknowledged the execution of the same, and being sy me duly sworn, severally and each for himself deposeth and saith, that they are the said officers of the Company aforesaid, ind that the seal affixed to the preceding instrument is the Corporate Seal of said Company, and that the said Corporate Seal and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporation. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above written. CJ� Constance A. Dunn Notary Public My Commission Expires: July 14, 2015 PDXF 036 -2112 EXTRACT FROM BY -LAWS OF FIDELITY AND DEPOSIT COMPANY OF MARYLAND "Article VI, Section 2. The Chairman of the Board, or the President, or any Executive Vice - President, or any of the Senior Vice - Presidents or Vice - Presidents specially authorized so to do by the Board of Directors or by the Executive Committee, shall have power, by and with the concurrence of the Secretary or any one of the Assistant Secretaries, to appoint Resident Vice - Presidents, Assistant Vice - Presidents and Attorneys -in -Fact as the business of the Company may require, or to authorize any person or persons to execute on behalf of the Company any bonds, undertaking, recognizances, stipulations, policies, contracts, agreements, deeds, and releases and assignments of judgements, decrees, mortgages and instruments in the nature of mortgages,...and to affix the seal of the Company thereto." CERTIFICATE I, the undersigned, Assistant Secretary of 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 the Vice - President who executed the said Power of Attorney was one of the additional Vice - Presidents specially authorized by the Board of Directors to appoint any Attorney-in-Fact as provided in Article VI, Section 2, of the By -Laws of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND. 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 FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on the 10th 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 WHEREOF, I have hereunto subscribed my name and affixed the corporate seal of the said Company, this \271' day of % tr3x , Zal Assistant Secretary ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE (MWDDAVYI an7i2o1z 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 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 Assurance Agency, Ltd. One Century Centre 1750 E. Golf Road NAME: PHONE FAX ac Np : - E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE "Co Schaumburg IL 60173- INSURER A:XL Insurance Annedca. Inc. 24554 1/2013 INSURED JAJOHNS -01 INSURER B : INSURER C: J.A. Johnson Paving Co., Inc. 1025 East Addison Court Arlington Heights IL 60005 INSURER D: INSURER E $300,000 NISlN1ER F COVERAGES CERTIFICATE NUMBER: 1470246655 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. INSR LTR TYPE OF INSURANCE L IN SR WVD POLICY NUMBER POLICY EFF MMIDD POLICY UP MMIDD LIMITS A GENERAL LIABILITY OGS7409055 1/2012 1/2013 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY OdUMRGE TO PR MSS RENTED nCe $300,000 CLAIMS -MADE FX7 OCCUR MED UP (Any one person) $10000 PERSONAL &ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000.000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP /OP AGO $2,000,000 $ POLICY X PRO- LOC A AUTOMOBILE LIABILITY CAH740003301 /112012 1/2013 UUMBIN1,15 510=1T Ea accident)i 000 000 X BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS 80DILY INJURY (Per accident) $ PROPERTY AMAGE Par a. PROPER $ NON -OWNED HIRED Alr05 AUTOS $ B X UMBRELLA LIAR X OCCUR ZUP12S8070212NF 112012 1/2013 EACH OCCURRENCE $7,000,000 AGGREGATE $7,000,000 EXCESS LU1a CLAIMS -MADE DEO X RETENTICN$None $ C WORKERS COMPENSATION CWG740003101 1/2012 1/2013 X WC STATU- oTH- TB AND EMPLOYERS' UASILm' YIN ANY PROPRIETORIPARTNERIEXECUTNE OFFICERIMEMBER EXCLUDED? N /A E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 (Mandatory in NH) N yea, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ANach ACORD 101, AddMOnW Remarks Schedul., N mon .pace Is M9ulr I, RE: 2012 Paving Project. It is agreed that the following are added as Additional Insured, when required by written contract, on the General Liability with respect to Operations performed by the Named Insured in connection with this project: Village of Oak Brook, (Owner), its officials, officers, employees volunteers and agents and Christopher B. Burke Engineering, Ltd (Engineer), their officers, officials, employees and agents. CERTIFICATE HOLDER CANCELLATION Ij} ACORD 25 (2010105) i r L ©1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Village of OakI3 Brook ACCORDANCE WITH THE POLICY PROVISIONS. 1200 Oak Brook Road Oak Brook IL 60523 A `U}T�HORIZEDyREPRESENTATIVE ( Ij} ACORD 25 (2010105) i r L ©1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD