R-1995 - 01/25/2022 - FIREWORKS - Resolutions THE VILLAGE OF OAK BROOK
COOK AND DUPAGE COUNTIES, ILLINOIS
RESOLUTION
2022-FI REWORKS-AG-R-1995
A RESOLUTION
APPROVING AND AUTHORIZING
THE EXECUTION OF AN AGREEMENT
BY AND BETWEEN
THE VILLAGE OF OAK BROOK AND
MIAND INC. DBA MAD BOMBER FIREWORKS PRODUCTIONS
FOR THE 2022 INDEPENDENCE DAY FIREWORKS DISPLAY
GOPAL G. LALMALANI, Village President
CHARLOTTE K. PRUSS, Village Clerk
LAURENCE HERMAN
MICHAEL MANZO
JAMES NAGLE
A. SURESH REDDY
EDWARD TIESENGA
ASIF YUSUF
Village Board
Published in pamphlet form by authority of the
President and the Board of Trustees of the Village of Oak Brook
on this the 25th day of January 2022
RESOLUTION NO. 2022-FIREWORKS-AG-R-1995
A RESOLUTION
APPROVING AND AUTHORIZING
THE EXECUTION OF AN AGREEMENT
BY AND BETWEEN
THE VILLAGE OF OAK BROOK AND
MIAND INC. DBA MAD BOMBER FIREWORKS PRODUCTIONS FOR THE 2022
INDEPENDENCE DAY FIREWORKS DISPLAY
WHEREAS, the Village of Oak Brook is a municipal corporation with authority provided for
and granted pursuant to the Illinois Municipal Code to exercise certain powers and perform certain
functions pertaining to its local government and affairs;
WHEREAS, the Village of Oak Brook (hereinafter referred to as "Village") upon approval
of the corporate authorities may enter into an agreement with another party pursuant to Illinois
Statute;
WHEREAS,the Village will be conducting its official 2022 fireworks display on July 3, 2022
("Fireworks Display!'); and
WHEREAS, the Village requested proposals from qualified vendors to provide the
Fireworks Display; and
WHEREAS, the Village received a sole proposal from Miand Inc., DBA Mad Bomber
Fireworks Productions ("Mad Bomber'); and
WHEREAS, Village Staff has determined that Mad Bomber submitted a proposal that is
satisfactory and will provide a value to the Village; and
WHEREAS, Staff checked references submitted by Mad Bomber and determined that thier
fireworks display will be performed in a safe, efficient, and professional manner; and
WHEREAS, the Village and Mad Bomber desire to enter into and execute an agreement
for Mad Bomber to provide the Fireworks Display, which agreement is attached to this Resolution
as Exhibit A("Agreement'); and
WHEREAS, the President and Board of Trustees have determined that it is in the best
interests of the Village to enter into the Agreement as approved by the Village Attorney;
WHEREAS,the Village of Oak Brook Corporate Authorities feel that it is in the best interest
of the Village of Oak Brook to award the agreement to Mad Bomber as provided for herein.
NOW, THEREFORE, BE IT RESOLVED by the Village President and Board of Trustees
of the Village of Oak Brook, DuPage and Cook Counties, Illinois as follows:
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Section One — Recitals
The Corporate Authorities hereby find that all of the recitals hereinbefore stated as
contained in the preamble to this resolution are full, true and correct and do hereby, by reference,
incorporate and make them part of this resolution as legislative findings.
Section Two—Approval of Agreement and Proposal
The Village hereby accepts the proposal from the proposer set forth herein and approves
the agreement substantially in the form attached hereto as Exhibit A.
Section Three—Authorization and Direction
The Village Manager is hereby authorized to execute, and the Village Clerk is hereby
authorized to attest the agreement, in the form of such agreement attached hereto as Exhibit A,
with such changes therein as shall be approved by the Village Attorney and the officials of the
Village executing the same, their execution thereof to constitute exclusive evidence of their
approval to any and all changes or revisions therein from and after the execution and delivery of
such agreement.
Section Four- Other Actions Authorized
The officers, employees and/or agents of the Village shall take all actions necessary or
reasonably required to carry out and give effect to the intent of this resolution and otherwise to
consummate the transactions contemplated herein, and shall take all actions necessary in
conformity therewith including, without limitation, the execution and delivery of all documents
required to be delivered in connection with the transaction contemplated herein.
Section Five -Authorization of Expenditures
The Corporate Authorities hereby authorize and direct the expenditure of all costs related
to the execution of the agreement, additionally, the Village is authorized and directed to allocate
and spend all necessary funds to fulfill the requirements of the agreement and of this resolution.
Section Six- Acts of Village Officials
That all past, present and future acts and doings of the officials of the Village that are in
conformity with the purpose and intent of this resolution are hereby, in all respects, ratified,
approved, authorized and confirmed.
Section Seven — Prevailing Wage Act
The successful proposer shall be required to comply with all of the terms and conditions
of the Illinois Prevailing Wage Act, to the extent that it applies.
Section Eight— Effective Date
This resolution shall be in full force and effect upon passage and approval in the manner
provided by law.
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Section Nine - Publication
This resolution shall be published in book or pamphlet form as provided by the Illinois
Municipal Code.
Section Ten—Conflict Clause
All resolutions, parts of resolutions or board actions in conflict herewith are hereby repealed
to the extent of such conflict.
Section Eleven —Saving Clause
If any section, paragraph, clause or provision of this resolution is declared by a court of
law to be invalid or unconstitutional, the invalidity or unconstitutionality thereof shall not affect the
validity of any other provisions of this resolution, which are hereby declared to be separable.
Section Twelve— Recording
This resolution shall be entered into the minutes and upon the journals of the Board of
Trustees of the Village of Oak Brook.
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PASSED THIS 25th day of January 2022
Ayes: Trustees Herman, Manzo, Nagle, Reddy, Tiesenga, Yusuf
None
Nays:
Absent:
None
APPROVED THIS 25' day of January 2022
' 7
Gopal G. Lalmalani
Village President
ATTEST:
A"
Charlotte K. Pruss
Village Clerk t 0 F 0
44,
G ; y
' 4
5
Exhibit A
Contract
6
R' Not,
REVIEW OF CONTRACTS
Awarding Agency: pe of Contract:
Department: ram/Account Number:
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Awarded Contrail Price: ���Amount:
Q Under $20,000 Q $500,001 - $1,000,000
$20,000 - $500,000 Q Over $1,000,000
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Name: , �.u,� Date:
Name: Date: �� ZZ
Name: Date:
Name: Date: I ¢1Z2
Q Three (3) Originals signed by other party Date/Initials
[-1 Original provided to staff member for other party Date/Initials
C] Original provided to Official Files Date/Initials
Village of Oak Brook I Approved by Board of Trustees• Datehnnials:
INDEPENDENCE DAY FIREWORKS DISPLAY AGREEMENT
THIS AGREEMENT ("Agreement'l is entered into this_day of 2022,
and is by and between MIAND INC. DBA MAD BOMBER FIREWORKS PRODUCTIONS, an
Indiana corporation ("Contractor''), and the VILLAGE OF OAK BROOK, an Illinois municipal
corporation ("Village').
IN CONSIDERATION OF the recitals and the mutual covenants and agreements set
forth in this Agreement, and pursuant to the Village's statutory powers, the Contractor and the
Village hereby agree as follows:
SECTION ONE: TIME AND PLACE OF DISPLAY. The Contractor shall provide a
twenty three (23) minute continuous aerial fireworks display ("Display's at that certain location
within the Village's Sports Core designated by the Village ("Site"). The Display shall begin at
approximately 9:15 p.m. at the annual Taste of Oak Brook celebration hosted by the Village,
scheduled for Sunday, July 3, 2022 ("Display Date"), and shall continue thereafter for no less
than twenty three (23) minutes with no lags between firing of the individual fireworks devices
("Time of Performance'. The Contractor shall be responsible for completion of all work within
the Time of Performance, notwithstanding any strike or other work stoppage by employees of
either Contractor or of the Village.
SECTION TWO: CONTRACTOR OBLIGATIONS. The Contractor shall be obligated to
perform the following:
A. The Contractor shall furnish all labor, equipment, supplies, personnel and
supervision necessary to provide the Display, as set forth on the proposal attached as Exhibit A
to this Agreement ("Proposal'j; provided, however, that the Contractor may, at its discretion,
substitute fireworks devices of equal or greater value and duration than those devices set forth
on Proposal;
B. The Contractor shall, at its sole cost and expense, ensure that all personnel
involved in the set-up, operation, removal, and disposal of all fireworks devices involved in the
Display be experienced pyrotechnic operators licensed to perform such work under the laws of
the State of Illinois;
C. The Contractor shall deliver, set up, and execute the Display at the Time of
Performance;
D. The Contractor shall, upon completion of the Display, cause all equipment
associated with the Display to be removed from the Site, and shall remove and properly dispose
of all unfired or unexploded material; and
E. The Contractor shall conduct the Display in accordance with National Fire
Protection Association standards and guidelines for safety.
1
SECTION THREE: VILLAGE OBLIGATIONS. The Village shall be obligated to
perform the following:
A. The Village shall furnish an area adequate for the parking of automobiles by
spectators of the Display;
B. The Village shall, at its sole cost and expense, provide personnel for the purpose
of establishing crowd control in the general area of the Site;
C. The Village shall, at its sole cost and expense, provide a fire guard during the
Contractor's clearing of debris from the Site immediately following the conclusion of the Display;
D. The Village shall establish a sufficient area for the safe operation of the Display,
including, without limitation, establishment of a spectator safety area ("Spectator Safety
Area', which Spectator Safety Area shall include all points within 700 feet of the Site, and
which shall be marked with rope or other suitable materials to prevent spectators from entering
the Spectator Safety Area. The Village shall also provide adequate police protection to prevent
spectators from entering the Spectator Safety Area; and
E. The Village shall conduct a search of the fallout area the morning after the
Display is conducted to remove all debris resulting from the Display.
SECTION FOUR: INTOXICATED EMPLOYEES. The Contractor shall cause any of its
employees who are intoxicated or under the influence of a controlled substance to be removed
immediately from the Site, and shall prohibit any such employee from performing any work on
the Display or at the Site.
SECTION FIVE: TERMINATION RIGHTS. The Contractor shall have the right, but not
the obligation, to terminate the Display in the event that unauthorized persons enter the
Spectator Safety Area and the Village is unable or unwilling to satisfy its obligations pursuant to
Section 3 of this Agreement.
SECTION SIX: PAYMENT. The Village shall pay the Contractor the sum of $32,500.00
("Fee") for the Display within 30 days after the date of performance of the Display. The Fee
includes all applicable federal, state, and Village taxes of every kind and nature applicable to the
Display. Contractor may charge the Village a service fee equal to 1.5% of the Fee per month if
the Village fails to pay the Fee within 60 days after the Contractor conducts the Display.
SECTION SEVEN: CANCELLATION: RESCHEDULING OF DISPLAY.
A. Cancellation by Contractor. The Contractor shall have, in its sole and absolute
discretion, the right to make a determination that the Display should be cancelled due to
inclement or unsafe weather conditions. In the event the Display is cancelled by the Contractor
due to inclement or unsafe weather conditions, the Display shall be on July 4, 2022 at 9:15 p.m.
("Rain Date'). If inclement or unsafe weather conditions prevent the Contractor from
performing the Display on either the Display Date or the Rain Date, the Parties shall confer and
agree to a mutually convenient alternate date ("Alternate Display Date"), no later than six
months after the original Display Date set forth herein to conduct the Display. In the event the
Village does not choose to reschedule another date or cannot agree to a mutually convenient
date, Village shall pay to Contractor an amount equal to 40% of the Fee as full payment and
settlement for the Contractor's costs, damages and expenses.
B. Cancellation by Village. In the event the Display is cancelled by the Village prior
to the Display Date, the Village shall pay to the Contractor an amount equal to Contractor's
actual expenses incurred in preparation for the Display, including, but not limited to, material
purchases, preparation and design costs, deposits, licenses and employee charges. Contractor
will provide documentation of such expenses to the Village upon request for payment. Payment
of the Contractor's expenses pursuant to this Section 7.6 shall be the Contractor's sole remedy
for cancellation of the Display by the Village prior to the Display Date.
SECTION EIGHT: INSURANCE. The Contractor, at its sole cost and expense, shall
provide liability insurance in the amount of $10,000,000, which insurance shall include, without
limitation, protection for the benefit of spectators from the time the Contractor arrives at the Site
until the residuals from the Display are removed therefrom. The limit of liability shall be
$10,000,000 for bodily injury and $10,000,000 for property damage. The Contractor shall cause
the Village to be named as an additional insured on the insurance policy required by this
Section. At least one week prior to the Display, the Contractor shall provide the Village with
either (a) a copy of the entire insurance policy, or (b) a Certificate of Insurance along with a
letter from the broker issuing the insurance policy to the effect that the Certificate accurately
reflects the contents of the insurance policy.
SECTION NINE: INDEMNITY. The Contractor shall, and does hereby agree to, hold
harmless and indemnify the Village and all Village elected or appointed officials, officers,
employees, agents, representatives, engineers, and attorneys, from any and all claims that may
be asserted at any time against any of such parties in connection with the Display; provided,
however, the foregoing indemnity shall not apply to willful misconduct or gross negligence on
the part of the Village.
SECTION TEN: PERMITS; FEES. The Contractor shall, at its sole cost and expense,
obtain all permits, give all necessary notices, pay all license fees, and comply with all applicable
local, state, and federal rules, regulations, and ordinances.
SECTION ELEVEN: VEHICLES. All vehicles utilized by the Contractor shall be
properly identified and licensed as required by the laws of the State of Illinois.
SECTION TWELVE: TAXES. The Contractor assumes complete and sole liability for
the payment of all applicable federal, state, and local taxes.
SECTION THIRTEEN: BIDDING. The Contractor certifies hereby that it is not barred
from bidding on this contract as a result of violations of either Section 33E-3 or Section 33E-4 of
the Illinois Criminal Code.
SECTION FOURTEEN: SEXUAL HARRASMENT. The Contractor certifies hereby that
it has a written sexual harassment policy in place in full compliance with 775 ILCS 5/2-
105(A)(4).
SECTION FIFTEEN: OPTION TO RENEW. The Village shall have four options to
renew this Agreement by delivering written notice to Contractor for Contractor to provide a
Display to the Village in 2023, 2024, 2025, and 2026 on the dates set forth below:
_
Display Date Rain Date
2023
July 3, 2023 July 4, 2023
2024 _Ayjy 3, 2024 July 4, 2024
2025 July 3, 2025 July 4, 2025
2026 July 3, 2026 July 4, 2026
If the Village exercises either of its options to renew this Agreement, all of the terms of
this Agreement shall apply, including, without limitation, the Fee provision contained in Section 6
herein. The Village shall have no obligation to exercise either of its options to renew this
Agreement.
SECTION SIXTEEN: GENERAL PROVISIONS.
A. Relationship of the Parties. The Contractor shall act as an independent
contractor in providing and performing the Display. Nothing in, nor done pursuant to, this
Agreement shall be construed (i) to create the relationship of principal and agent, employer and
employee, partners, or joint venturers between the Village and Contractor; or (ii) to create any
relationship between the Village and any subcontractor of the Contractor.
B. Amendment. No amendment or modification to this Agreement shall be
effective unless and until such amendment or modification is in writing, properly approved in
accordance with applicable procedures, and executed.
C. Assignment. This Agreement may not be assigned by the Village or by the
Contractor without the prior written consent of the other party.
D. Binding Effect. The terms of this Agreement shall bind and inure to the benefit
of the Parties hereto and their agents, successors, and assigns.
E. Notice. Any notice or communication required or permitted to be given under
this Agreement shall be in writing and shall be delivered (i) personally, (ii) by a reputable
overnight courier, (iii) by mail, return receipt requested, and deposited in the U.S. Mail, postage
prepaid, or (iv) by email. Unless otherwise expressly provided in this Agreement, notices shall
be deemed received upon the earlier of (a) actual receipt; (b) one business day after deposit
with an overnight courier as evidenced by a receipt of deposit; or (c) five business days
following deposit in the U.S, mail, as evidenced by a return receipt. By notice complying with
the requirements of this Subsection, each Party shall have the right to change the address or
the addressee, or both, for all future notices and communications to such party, but no notice of
a change of addressee or address shall be effective until actually received.
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Notices and communications to the Village shall be addressed to, and delivered at, the following
address:
Village of Oak Brook
1200 Oak Brook Road
Oak Brook, Illinois 60523
Attention: Greg Summers, Village Manager
Email: gsummers(d)-oak-brook.orq
Notices and communications to the Contractor shall be addressed to, and delivered at,
the following address:
Miand Inc. DBA Mad Bomber Fireworks Productions
3999 E. Hupp Road
Building R-3-1
LaPorte, IN 46350
Attention: Andrew James, President
Email: and rewCaD-mad bomberfireworks.com
F. Provisions Severable. If any term, covenant, condition, or provision of this
Agreement is held by a court of competent jurisdiction to be invalid, void, or unenforceable, the
remainder of the provisions shall remain in full force and effect and shall in no way be affected,
impaired, or invalidated.
G. Time. Time is of the essence in the performance of this Agreement.
H. Governing Law, Venue. This Agreement and any dispute arising out of or
relating to this Agreement shall be governed by and construed in accordance with the laws of
the State of Illinois, without reference to its conflict of law rules. All judicial actions relating to
any interpretation, enforcement, dispute resolution or any other aspect of this Agreement shall
be brought in the Circuit Court of the State of Illinois, DuPage County, Illinois. Any matter
brought pursuant to the jurisdiction of the federal courts shall be brought in the United States
District Court of the Northern District of Illinois.
I. Entire Aareement. This Agreement constitutes the entire agreement between
the parties and supersedes any and all previous or contemporaneous oral or written
agreements and negotiations between the Village and the Contractor with respect to the
services contemplated in this Agreement.
J. Waiver. No waiver of any provision of this Agreement shall be deemed to or
constitute a waiver of any other provision of this Agreement (whether or not similar) nor shall
any such waiver be deemed to or constitute a continuing waiver unless otherwise expressly
provided in this Agreement.
K. Rights Cumulative. Unless expressly provided to the contrary in this
Agreement, each and every one of the rights, remedies, and benefits provided by this
Agreement shall be cumulative and shall not be exclusive of any other such rights, remedies,
and benefits allowed by law.
L. Exhibits. Exhibit A attached to this Agreement is, by this reference,
incorporated in and made a part of this Agreement. In the event of a conflict between an exhibit
and the text of this Agreement, the text of this Agreement shall control.
M. Conflicts of Interest. Contractor represents and certifies that, to the best of its
knowledge: (1) no elected or appointed Village official, employee or agent has a personal
financial interest in the business of Contractor or in this Agreement, or has personally received
payment or other consideration for this Agreement; (2) as of the date of this Agreement, neither
Contractor nor any person employed or associated with Contractor has any interest that would
conflict in any manner or degree with the performance of the obligations under this Agreement;
and (3) neither Contractor nor any person employed by or associated with Contractor shall at
any time during the term of this Agreement obtain or acquire any interest that would conflict in
any manner or degree with the performance of the obligations under this Agreement.
N. Force Majeure. No Party shall be liable or responsible to the other Party, nor be
deemed to have defaulted under or breached this Agreement, for any failure or delay in fulfilling
or performing any term of this Agreement (except for any obligations to make previously owed
payments to the other Party hereunder) when and to the extent such failure or delay is caused
by or results from acts beyond the impacted Party's ("Impacted Party") reasonable control,
including, without limitation, the following force majeure events ("Force Majeure Event(s)") that
frustrates the purpose of this Agreement: (a) acts of God; (b) flood, fire, earthquake or
explosion; (c) war, invasion, hostilities (whether war is declared or not), terrorist threats or acts,
riot or other civil unrest; (d) government order or law; (e) actions, embargoes or blockades in
effect on or after the date of this Agreement; (f) action by any governmental authority; (g)
national or regional emergency; (h) strikes, labor stoppages or slowdowns or other industrial
disturbances; (i) epidemic, pandemic or similar influenza or bacterial infection (which is defined
by the United States Center for Disease Control as virulent human influenza or infection that
may cause global outbreak, or pandemic, or serious illness); U)emergency state; (k) shortage of
adequate medical supplies and equipment; (1) shortage of power or transportation facilities; and
(m)other similar events beyond the reasonable control of the Impacted Party.
G
IN WITNESS WHEREOF, the parties hereto have affixed their signatures the date and
year first above written.
VILLAGE OF OAK BROOK, an Illinois municipal corporation
Greg Summers, Village Manager
ATTEST:
Charlotte K. Pruss, Village Clerk
MIAND INC. DBA MAD BOMBER FIREWORKS PRODUCTIONS, an Indiana corporation
By:
Its:
ATTEST:
By:
Its:
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EXHIBIT A
Proposal
VILLAGE OF OAK BROOK
Purchasing Division
1200 Oak Brook Road
Oak Brook, IL 60523
(630) 368-5164
REQUEST FOR PROPOSAL
Independence Day Fireworks Display
November 2021
j lworddoc\rfp\2021 rfp\independence day fireworks.docx
TABLE OF CONTENTS
SECTION 1. REQUEST FOR PROPOSALS...............................................................................................2
A. NOTICE POSTED ON THE VILLAGE WEBSITE NOVEMBER 2.2021 ........................................................2
B, PROJECT DESCRIPTION......................................................................................................................3
C GENERAL TERMS AND CONDITIONS..................................................................................................... 1
SECTION 2. PROPOSAL INSTRUCTIONS.................................................................................................9
A. DOCUMENTS/INFORMATION TO BE SUBMITTED.....................................................................................9
B. PROPOSAL....................................................................................................................................... 10
C. REFERENCES...................................................................................................................................11
E. CONTRACTORS CERTIFICATION.........................................................................................................13
D. SEXUAL HARASSMENT POLICY...................................... ..............15
......................................................
SECTION3. REVIEW PROCESS.............................................................................................................16
A. EVALUATION OF PROPOSALS AND SELECTION....................................................................................16
B. BASIS OF AWARD ............................................................................................................................. 16
j:\worddoc\rfpl202l rfpGndependence day fireworks.docx
Section 1. Request for Proposals
A. Notice—posted on the Village Website November Z 2021
Village of Oak Brook
Request for Proposals
Independence Day Fireworks Display
November 2021
The Village of Oak Brook is soliciting proposals for Independence Day Fireworks Display.
Proposals shall be addressed to:
Rania Serences
Senior Purchasing Assistant
Village of Oak Brook
1200 Oak Brook Road
Oak Brook, IL 60523
The closing date and time for receipt of proposals is Tuesday, November 16, 2021, at 3:00 P.M.
prevailing time. Proposals received after the submittal time will be rejected and returned unopened to
the sender.
A complete proposal package is on file for inspection and may be downloaded from the Village's website
at www.oak-brook.ora or picked up at the Butler Government Center, 1200 Oak Brook Road, Oak Brook,
Illinois 60523, between the hours of 8:00 a.m. and 4:30 p.m., Monday through Friday. There is no charge
for the package.
The Village of Oak Brook reserves the right to reject any or all proposals, waive all technicalities, errors,
omissions, erasures, alterations, and additions not called for, and to make an award which, in its
judgment, is the best and most favorable to the interests of the Village and the public.
Page 2
B. Project Description
1. Introduction
The Village of Oak Brook will be hosting the Taste of Oak Brook followed by an Independence
Day Fireworks display on July 3, 2022. The Taste of Oak Brook celebration kicks off in the
afternoon and will include food from some of Oak Brook's finest restaurants and children activities.
The Taste will conclude with fireworks beginning at approximately 9:15 p.m. The rain date for
fireworks only is July 4, 2022.
2. Scope of Services
Contractor shall furnish, erect, and fire under Village direction the Village of Oak Brook's July 3,
2022, fireworks display at the Oak Brook Sports Core Field #1 in Oak Brook, Illinois.
Contractor shall provide through the field pyro technician, at the contractor's expense, one (1)
assistant chief pyro technician, and two (2) additional qualified pyro technician aides to assist in
the erection and firing of the display. Each person shall be an employee of the contractor.
Contractor's personnel and materials shall report to the Oak Brook Sports Core in Oak Brook,
Illinois, (fireworks display site) no later than 9 a.m., July 3, 2022, to begin setting up the fireworks
display. The contractor shall have the fireworks display material ready for show by 5 p.m., July 3,
2022. Contractor will have the flexibility to set up July 2, 2022. Cancellation or postponement due
to inclement weather will be made at the discrimination of the Village of Oak Brook and the
contractor's representative.
Contractor shall perform tests before beginning the official program to make sure that the winds
aloft will not distort the exhibition nor carry hot or burning matter where it can cause damage to
persons or property.
Contractor shall provide for at all times in preparation of, during, and immediately after fireworks
display, a safe and clean operating environment at the fireworks display site in Oak Brook.
Contractor shall provide for a fireworks display lasting twenty-three (23) minutes in duration and
fireworks display shall exhibit rapid, constant fire for the entire twenty-three (23) minutes.
Rain date shall be July 4, 2022. Times and arrangements shall be the same as outlined in the
preceding paragraphs of these specifications. Decision by the Village of Oak Brook to cancel the
event will be made by 7 p.m. on the date in question.
The closest building to the site of the fireworks display will be no closer than 1,200 feet. The
closest residential area to the site of the fireworks display will be no closer than 1,200 feet. The
closest spectators to the site of the fireworks display will be no closer than 1,200 feet. The firing
location may be subground level; only aerial shells are to be incorporated into show.
Pyrotechnic materials may arrive early for the Oak Brook show if they are enclosed and secured
in a weather tight motor vehicle stored outdoors. The Village of Oak Brook will not assume the
responsibility or liability for the storage of pyrotechnical materials.
All pyrotechnic materials shall be top-grade and have been factory tested by the manufacturer to
assure their individual quality, performance, and safety.
Contractor shall provide for his employees' and public safety at all times.
Page 3
Contractor shall perform this agreement as an independent contractor and shall not be considered
an agent of the Village of Oak Brook, or shall any employees or agents of contractor be considered
an agent of the Village.
3. Show Design and Work
Contractor shall provide labor, material, and equipment for presentation of an innovative and
attractive aerial fireworks display on July 3, 2022, at the Oak Brook Sports Core, Oak Brook,
Illinois. Program objective shall be to create a spectacular, continuous fire, aerial display visible
to an audience viewing from many area vantage points not immediately adjacent to the discharge
site and accompanied to music. At the conclusion of the fireworks display, the William Tell
Overture shall be played unless prior written direction is given by the Village Manager. To achieve
this objective, the contractor shall allow for appropriate layering and balance of the overall
program with no perceptible breaks or gaps in the display. Proposal must include patriotic music
selections with corresponding pyrotechnics. The proposed synchronized audio must be provided
via audio CD to the Village by July 11. The following general parameters are provided for
accomplishment of the objective.
Length of Display: 23 minutes continuous firing
Pyrotechnics: Total display shall include approximately 2,000 individual shells. Suggested
number of shells is provided as a guideline; therefore, innovation and creativity on the part of the
contractor is essential. Proposal shall be an aerial display only, which must include a riveting
opening, unique body, and dramatic finale (no set pieces). No parachute shells of any type shall
be allowed.
Substitutions: Contractor must perform show that was proposed. Substitution(s) shall not be
made after award of contract unless approved by the Village Manager 15 days prior to July 3,
2022. Failure to provide exact brand, size, and quantity of shell as submitted in final proposal
will result in reduction in payment.
4. Conduct of the Display
The display shall be conducted in accordance with National Fire Protection Association standard
1123-1995, code for the Outdoor Public Display of Fireworks published by the National Fire
Protection Association, Inc. The following modifications apply:
A. Construction of Shells
In addition to the standard paper mache shells, shells with molded plastic casing shall be
permitted. However, mortars firing shells with plastic casings shall not be reloaded.
B. Installation of Mortars
Mortars shall be installed in mortar racks in accordance with NFPA standards and be properly
anchored to the ground,
C. Discharge Sites
The discharge site shall be limited to the area specified by the Village of Oak Brook.
D. General Requirements
No aerial display may be fired when winds exceed 20 MPH, when unusually wet weather
presents other definite dangers, or when conditions are deemed unsafe by the Village of Oak
Brook.
The contractor shall be responsible for the complete installation and cleanup of the display and
supplying all necessary materials and equipment in connection therewith except as provided for
under Village Furnished Items.
Page 4
The contractor shall furnish qualified operators for set-up, launch, and take down, and abide by
all Federal, State, and Local regulations that apply to handling pyrotechnics.
The contractor shall provide necessary safety equipment and materials, transportation, and
security for fireworks and launch site. Fire extinguishers shall be in plain view when any live loads
are on-site. Numbers of fire extinguishers shall be adequate to the size of the display.
The fireworks display is scheduled to commence at approximately 9:15 p.m. The exact firing
command shall be given by the Village representatives at the launch site. In the event that the
performance provided is delayed through any fault of the contractor, the contractor shall
reimburse the Village the amount of $500.00 per each 5 minute delay beyond the scheduled
starting time of the performance as noted above.
In the event of inclement weather, the display will be rescheduled for July 4, 2022. The decision
to postpone displays shall be made by the Village representative.
The contractor shall be responsible for cleanup of the safety zone to include: cleanup of shell
fragments, bits of fusing, and any hazardous material; gathering any other trash and debris
generated by the contractor's personnel in appropriate trash containers.
5. Transportation and Storage of Fireworks
The transportation of fireworks shall be in compliance with the regulations of the U.S. Department
of Transportation, 41 CFR, Part 170-189 and Part 390-399 and all state and local motor vehicle
laws applicable to the area through which fireworks are transported. All fireworks materials shall
be packaged and shipped in compliance with all applicable laws and ordinances (Federal, State,
and Local) for delivery and storage of fireworks and explosives. Packaging to be in sealed,
weather protected, heavy duty containers to completely prevent deterioration or diminution of fire
ability due to moisture and/or other contaminations. Vehicle operators will be responsible for the
safety of the fireworks and all related equipment, remaining with the vehicle(s) at all times.
Supplemental site security will only be provided by the Village of Oak Brook during the evening
hours of the event and shall not relieve the contractor of this responsibility.The number of vehicles
allowed on site will be kept to a minimum.
6. Notification of Fire Department
The Fire Department will be notified of the Village's intent to have the fireworks display and will
request the appropriate fire apparatus be on site during the display and to relate the name and
address of the contractor.
Upon receipt of the contract, the contractor shall contact Chief Barry Liss of the Oak Brook Fire
Department and arrange for review of the pyrotechnics set up plan and site inspection on the
event day. It is the responsibility of the contractor to provide all required and relevant information.
Should the contractor require assistance with contacting the Fire Department, the Senior
Purchasing Assistant shall provide assistance in providing a liaison with the Village of Oak Brook
Fire Department.
7. Qualification of Operators
The person in charge of firing the display(chief pyro technician)and one assistant(assistant chief
pyro technician) shall:
• Be at least 21 years of age.
• Have a minimum of 4 years pyrotechnic experience.
• Have fired a minimum of 12 displays of the size and nature of the display proposed
herein.
• Possess a valid and current explosive permit issued by the State of Illinois.
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The chief pyro technician must be licensed by the Office of the State Marshall. An out of state
contractor must have a person licensed under the Pyrotechnic Operator Licensing Act(225 ILCS
227) as the lead pyrotechnic operator supervising the display.
All other assistants shall be at least 18 years of age.
No other persons are permitted within fenced-off firing area.
8. Village Furnished Items
• Protection of the display are by roping-off or similar facility
• Adequate police protection to prevent spectators from entering display area
9. Safety
Contractor shall submit prior to event a list of assigned employees. The only persons permitted
to be within the fenced-off firing area will be the authorized pyrotechnical staff and a Village
Representative. No exceptions will be made.
Contractor shall submit with his proposal a loss run prepared by his insurance company, or
companies,for the period covering 5 years prior to the date of the proposal. This information shall
be submitted from any and all insurance companies used by the contractor during this 5-year
period.
A loss run is defined as an itemization of all paid and reserved occurrences resulting from activities
associated with a fireworks display as defined under a general liability policy for the term of the
policy, which is the subject of the loss run. The loss run shall distinguish employee injuries from
spectator injuries and shall identify pending and closed cases. Loss run shall be accompanied by
sufficient evidence to indicate that the loss run is accurate and has been prepared by the
insurance company. The Villages hall be the sole judge as to whether the information provided
meets the specifications.
Failure to submit complete and accurate loss run information may result in rejection of proposal.
10. Contract
The successful contractor agrees that upon acceptance of its proposal by the Village of Oak Brook
this Request for Proposal, along with all instructions, conditions, and specifications attached
thereto, constitute a binding contract which may be enforced by the Village.
11. Contract Extension
At the conclusion of the 2022 fireworks display, the Village of Oak Brook reserves the right to
award an annual contract extension for each following years, not to exceed 4 years (2023, 2024,
2025, and 2026), to the current contractor. Determination will be made annually solely by the
Village of Oak Brook with the concurrence of the contractor and will be determined no later than
12 weeks following the display.
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C General Terms and Conditions
1. Preparation and Submission of Proposals:
a) The proposal shall be submitted in an opaque sealed envelope on or before the time stated
and shall bear the name of the individual,firm, or corporation submitting the Proposal and
the Project Name: "Independence Day Fireworks Display".
b) Contractors may attach separate sheets to the proposal for the purpose of explanation,
exception, alternate proposal and to cover unit prices, if needed.
c) Contractors may withdraw their proposal either personally or by written request at any time
before the hour set for the proposal opening, and may resubmit it. No proposal may be
withdrawn or modified after the receipt of proposals except where the award of contract
has been delayed for a period of more than ninety(90)days.
d) In submitting this proposal, the contractor further declares that the only person or party
interested in the proposal as principals are those named herein, and that the proposal is
made without collusion with any other person, firm or corporation.
e) The contractor further understands and agrees that if their proposal is accepted, the
individual/company is to furnish and provide all necessary materials and/or equipment and
other means to do all of the work and to furnish all of the materials specified in the contract,
except such materials as are to be furnished by the Village (Village), in the manner and at
the time therein prescribed, and in accordance with the requirements therein set forth.
f) The contractor further agrees to execute all documents within this Proposal Package,
obtain a Certificate of Insurance for this work and present all of these documents to the
Village within fifteen (15)days after the receipt of the Notice of Award and the Contract by
the company.
g) The contractor further agrees to begin work not later than ten (10)days after receipt of the
Notice to Proceed, unless otherwise provided, and to execute the work in such a manner
and with sufficient materials, equipment and labor.
h) By submitting a proposal, the contractor understands and agrees that, if the proposal is
accepted, and the contractor fails to enter into a contract forthwith, the company shall
be liable to the Village for any damages the Village may thereby suffer.
2. Conditions
a) The Village is exempt from Federal excise tax and the Illinois Retailer's Occupation Tax.
This proposal cannot include any amounts of money for these taxes.
b) Any contractor agreement resulting from the acceptance of this proposal by the Village
shall be on forms either supplied by or approved by the Village's Legal Department.
The Village reserves the right to reject any agreement that does not conform to the
Request For Proposal and any Village requirements for agreements and contracts.
c) The Village reserves the right to request clarification of information submitted and
request additional information as needed.
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d) The requirements of this RFP shall be included in the contract with the selected
firm.
3. Payment
The Village authorizes the payment of invoices on the second and fourth Tuesday of the
month. For consideration on one of these dates, payment request must be received no later
than fourteen (14)days prior to the second or fourth Tuesday of the month
4. Indemnirication
The Contractor shall protect, indemnify, save, defend and hold forever harmless the Village
and/or its officers,officials, employees,volunteers and agents from and against all liabilities,
obligations, claims, damages, penalties, causes of action, costs and expenses, including
without limitation court costs, insurance deductibles and attorney's fees and expenses,
which the Village and/or its officers, officials, employees, volunteers and agents may incur,
suffer or sustain, or for which the Village and/or its officers, employees and agents may
become obligated by reason for any accident, injury to or death of persons or loss of or
damage to property, or civil and/or constitutional infringement of rights(specifically including
violations of the Federal Civil Right Statutes), arising indirectly or directly in connection with
or under, or as a result of, this or any Agreement by virtue of any act or omission of any of
the Contractor's officers, employees, subcontractors, and/or agents, provided that the
Contractor shall not be liable for claims, obligations, damages, penalties, causes of action,
costs and expenses arising solely from any act or omission of the Village's officers, officials,
employees, volunteers and/or agents.
The contractor shall hold the Village harmless for any and all claims for labor, material,
apparatus, equipment, fixtures or machinery furnished to the contractor for the purpose of
performing the work under the contract; and the payment of all direct and indirect damages
to any person, firm, company or corporation suffered or sustained on account of the
performance of such work during the time the contract is in force.
5. Insurance
Certificates of Insurance and Additional Insured Endorsement shall be presented to the
Village within fifteen (15)days after the receipt by the contractor of the Notice of Award and
the unexecuted contract, it being understood and agreed that the Village will not approve
and execute the contract nor will the bid guarantee be returned until acceptable insurance
certificates are received and approved by the Village.
Each contractor performing any work pursuant to a contract with the Village and each
permittee working under a permit as required pursuant to the provisions of Title 1, Chapter
8 of the Code of Ordinances of the Village (hereinafter referred to as "Insured") shall be
required to carry such insurance as specified herein. Such contractor and permittee shall
procure and maintain for the duration of the contract or permit insurance against claims for
injuries to persons or damages to property which may arise from or in connection with the
performance of the work under the contract or permit, either by the contractor, permittee, or
their agents, representatives, employees or subcontractors.
A contractor or permittee shall maintain insurance with limits no less than:
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a) General Liability-$10,000,000 combined single limit per occurrence for bodily injury,
personal injury and property damage, provided that when the estimated cost of the work in
question does not exceed $5,000 the required limit shall be$500,000;
b) Automobile Liability(if applicable)-$1,000,000 combined single limit per accident for
bodily injury and property damage;
c) Worker's Compensation and Employer's Liability-Worker's Compensation limits as
required by the Labor Code of the State of Illinois and Employer's Liability limits of
$1,000,000 per accident.
Any deductibles or self-insured retention must be declared to and approved by the Village.
At the option of the Village, either the insurer shall reduce or eliminate such deductible or
self-insured retention as respects the Village, its officers, officials, employees and
volunteers; or the Insured shall procure a bond guaranteeing payment of losses and related
investigations, claim administration and defense expenses to the extent of such deductible
or self-insured retention.
The policies shall contain, or be endorsed to contain, the following provisions:
d) General Liability and Automobile Liability Coverage-
I. The Village, its officers,officials, employees and volunteers are to be covered
as additional insureds as respects: liability arising out of activities performed
by or on behalf of the Insured; premises owned, occupied or used by the
Insured. The coverage shall contain no special limitations on the scope of
protection afforded to the Village, its officers, officials, employee's volunteers
or agents.
II. The Insured's insurance coverage shall be primary insurance as respects the
Village, its officers, officials, employees, volunteers and agents. Any
insurance or self-insurance maintained by the Village, its officers, officials,
employees, volunteers or agents shall be in excess of the Insured's insurance
and shall not contribute with it.
III. Any failure to comply with reporting provisions of the policies shall not affect
coverage provided to the Village, its officers, officials, employees, volunteers
or agents.
IV. The Insured's insurance shall apply separately to each covered party against
whom claim is made or suit is brought except with respect to the limits of the
insurer's liability.
e) Worker's Compensation and Employer's Liability Coverage
The policy shall waive all rights of subrogation against the Village, its officers,officials,
employees, volunteers and agents for losses arising from work performed by the
insured for the Village.
Each insurance policy shall be endorsed to state that coverage shall not be
suspended, voided, canceled by either party, reduced in coverage or in limits except
after thirty(30)days prior written notice by certified mail has been given to the Village.
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Each insurance policy shall name the Village, its officers, officials and employees,
volunteers and agents as additional Insureds. Insurance is to be placed with insurers
with a Best's rating of no less than A: VI1.
Each Insured shall furnish the Village with certificates of insurance and with original
endorsements effecting coverage required by this provision. The certificate and
endorsements for each insurance policy are to be signed by a person authorized by
that insurer to bind coverage on its behalf. The certificates and endorsements are to
be on forms approved by the Village and shall be subject to approval by the Village
Attorney before work commences. The Village reserves the right to require complete,
certified copies of all required insurance policies, at any time.
Each insured shall include all subcontractors as insureds under its policies or shall
furnish separate certificates and endorsements for each subcontractor. All
coverages for subcontractors shall be subject to all of the requirements stated herein.
6. Safety
The contractor and any subcontractors shall comply with all the provisions of the Federal
Occupational Safety and Health Act of 1970 (84 Stat. 1590), as amended.
7. Equal Opportunity
The Contractor will not discriminate against any employee or applicant for employment
because of race, color, religion, sex, ancestry, national origin, place of birth, age or handicap
unrelated to bona fide occupational qualifications.
8. Execution of Documents
The Contractor, in signing his Proposal on the whole or on any portion of the work, shall
conform to the following requirements:
Proposals signed by an individual other than the individual represented in the Proposal
documents shall have attached thereto a power of attorney evidencing authority to sign the
Proposal in the name of the person for whom it is signed.
Proposals which are signed for a partnership shall be signed by all of the partners or by an
attorney-in-fact. If signed by an attorney-in-fact, there shall be attached to the Proposal a
power of attorney evidencing authority to sign the proposal, executed by the partners.
Proposals which are signed for a corporation, shall have the correct corporate name thereof
and the signature of the President or other authorized officer of the corporation manually
written below the corporate name.
If such Proposal is manually signed by an official other than the President of the Corporation,
a certified copy of a resolution of the board of directors evidencing the authority of such official
to sign the Proposal shall be attached to it. Such Proposal shall also bear the attesting
signature of the Secretary of the corporation and the impression of the corporate seal.
The Contract shall be deemed as have been awarded when formal notice of award shall
have been duly served upon the intended awardee.
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9. Non-Discriminating
The Vendor, its employees and subcontractors, agrees not to commit unlawful discrimination
and agrees to comply with applicable provisions of the Illinois Human Rights Act, the U.S.
Civil Rights Act and Section 504 of the Federal Rehabilitation Act, and rules applicable to
each.
10. Negotiations
The Village reserves the right to negotiate specifications, terms, and conditions which may
be necessary or appropriate to the accomplishment of the purpose of the RFP. The Village
may require the entire proposal be made an integral part of the resulting contract.This implies
that all responses, supplemental information, and other submissions provided by the
contractor during discussions or negotiations will be held by the Village as contractually
binding on the successful contractor.
11. Incurred Costs
The Village will not be liable in any way for any costs incurred by respondents in replying
to this RFP. Contractor agrees to comply with all laws, ordinances, and rules of the Village
and the State of Illinois.
12. Contractor Responsibilities
The selected Contractor will be required to assume responsibility for all services offered
in this proposal. The Village will consider the selected Contractor to be the sole point of
contact with regard to contractual matters, including payment of any and all charges
resulting from the contract.
13. Prevailing Wage
All wages paid by the Contractor and each subcontractor shall be in compliance with The
Prevailing Wage Act (820 ILCS 130), as amended, except where a prevailing wage
violates a federal law, order, or ruling, the rate conforming to the federal law, order, or
ruling shall govern. If the Department of Labor revises the wage rates, the revised rate,
as made available on the Department's official website, shall apply to this contract and
the Contractor will not be allowed additional compensation on account of said revisions.
The Contractor shall be responsible to notify each subcontractor of the wage rates set
forth in this contract and any revisions thereto.
Contractor will comply with the Illinois prevailing wage law, as amended from time to time
and made available on the Department of Labor's official website. Not less than the
prevailing rate of wages as found by the Illinois Department of Labor shall be paid to all
laborers, workers and mechanics performing work under the Contract. If the Department
of Labor revises the prevailing rate of wages to be paid laborers, workers or mechanics
under the Contract, the revised prevailing rate of wages shall apply to the Contract and
Contractor shall have the sole responsibility and duty to pay, and ensure that all
Subcontractors pay,the revised prevailing rate of wages to each person to whom a revised
rate is applicable. Revision of the prevailing wages shall not result in an increase in the
Contract sum or other cost to Village of Oak Brook. Contractor shall indemnify, defend
and hold Village of Oak Brook harmless from any loss, including but not limited to Village
of Oak Brook's attorney's fees, resulting from Contractor's failure to comply with this
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prevailing wage clause. All bonds applicable to the Contract shall include a provision as
will guarantee the faithful performance of the obligation to pay the prevailing rate of wages.
The Contractor and each subcontractor shall make and keep,for a period of not less than
3 years, records of all laborers, mechanics, and other workers employed by them on the
project; the records shall include each worker's name, address, telephone number when
available, last four digits of their social security number, gender, race, ethnicity, veteran
status, classification or classifications, the hourly wages paid in each period, the number
of hours worked each day, the starting and ending times of work each day, the worker's
hourly rate, the worker's hourly overtime wage rate, the worker's hourly fringe benefit
rates, the name and address of each fringe benefit fund, the plan sponsor of each fringe
benefit, if applicable, and the plan administrator of each fringe benefit. The Contractor
and each subcontractor shall submit monthly, in person, by mail, or electronically a
certified payroll to the Department of Labor, or to the public body if the Department of
Labor has yet to activate the database created by Section 5.1 of 820 ILCS 130. The
certified payroll shall consist of a complete copy of the records. The certified payroll shall
be accompanied by a statement signed by the contractor or subcontractor which states
that: (i) such records are true and accurate; (ii) the hourly rate paid to each worker is not
less than the general prevailing rate of hourly wages required; and (iii) the contractor or
subcontractor is aware that filing a certified payroll that he or she knows to be false is a
Class B misdemeanor.
Upon 7 business days' notice, the contractor and each subcontractor shall make
available for inspection and copying at a location within this State during reasonable
hours, the records to the public body in charge of the project, its officers and agents, and
to the Director of Labor and his deputies and agents. The Contractor and each
subcontractor shall permit his/her employees to be interviewed on the job, during
working hours, by compliance investigators of the Department or the Department of
Labor.
14. Default
The contract may be canceled or annulled by the Village in whole or in part by written
notice of default to the Contractor upon nonperformance or violation of contract terms. An
award may be made to another contractor with services similar to those so terminated.
Failure of the Contractor to deliver services within the time stipulated on his offer, unless
extended in writing by the Village, shall constitute contract default.
15. Force Majeure
A force majeure occurrence is an event or effect that cannot be reasonably anticipated
or controlled and is not due to the negligence or willful misconduct of the affected
party.
Unless otherwise agreed in the contract between the parties expressly or impliedly,
where a party to a contract fails to perform one or more of its contractual duties, the
consequences set out in this clause will follow if and to the extent that the party
proves: (a) that its failure to perform was caused by an impediment beyond its
reasonable control; (b) that it could not reasonably have been expected to have
taken the occurrence of the impediment into account at the time of the signing of
the contract; and (c) that it could not reasonably have avoided or overcome the
effects of the impediment.
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A party invoking this clause shall be presumed to have established the conditions
described in the preceding paragraph in the case of the occurrence including, but
not limited to, one or more of the following impediments or other similar causes
beyond the control of the contractor or the Village in the performance of the contract
where non-performance, by exercise of reasonable diligence, cannot be prevented:
• acts of God or natural disaster such as but not limited to violent storm, cyclone,
typhoon, hurricane, tornado, blizzard, earthquake, volcanic activity, landslide, tidal
wave, tsunami, flood, damage or destruction by lightning, drought;
• acts of war (whether declared or not), armed conflict or the serious threat of the
same (including but not limited to hostile attack, blockade, military embargo),
hostilities, invasion, act of a foreign enemy, extensive military mobilization;
• civil war, riot, rebellion, revolution, military or usurped power, insurrection, civil
commotion or disorder, mob violence, act of civil disobedience;
• acts of public enemies, acts of terrorism, sabotage or piracy;
• plague, epidemic, pandemic, outbreaks of infectious disease or any other
public health crisis, including quarantine or other employee restrictions;
• act of authority whether lawful or unlawful, compliance with any law or
governmental order, rule, regulation or direction, curfew restriction, expropriation,
compulsory acquisition, seizure of works, requisition, nationalization;
• explosion, fire, destruction of machines, equipment, factories and of any kind of
installation, prolonged break-down of transport, telecommunication or electric
current;
• general labor disturbance such as but not limited to boycott, strike and lock-out,
go-slow, occupation of factories and premises;
• shortage or inability to obtain critical material or supplies to the extent not subject
to the reasonable control of the subject Party.
The affected party shall provide the other party with written notice of any force
majeure occurrence as soon as the delay is known and provide the other party with a
written contingency plan to address the force majeure occurrence. Furthermore, the
affected party shall use its commercially reasonable efforts to resume proper
performance within an appropriate period of time. Notwithstanding the foregoing, if the
force majeure condition continues beyond 30 days, the parties to the contract shall
jointly decide on an appropriate course of action that will permit fulfillment of the
parties' objectives under the contract.
Contractor shall not be entitled to an adjustment in contract price or other non-price
related items caused by or within the control of contractor. Delay, disruption, and
interference attributable to and within the control of a subcontractor or supplier shall
be deemed to be within the control of contractor.
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16. Independent Contractor
There is no employee/employer relationship between the Contractor and the Village.
Contractor is an independent contractor and not the Village's employee for all purposes,
including, but not limited to, the application of the Fair Labors Standards Act minimum
wage and overtime payments, Federal Insurance Contribution Act, the Social Security Act,
the Federal Unemployment Tax Act, the Worker's Compensation Act (820 ILCS 305/1, et
seq.). The VILLAGE will not (i) provide any form of insurance coverage, including but not
limited to health, worker's compensation, professional liability insurance, or other
employee benefits, or (ii) deduct any taxes or related items from the monies paid to
Contractor. The performance of the services described herein shall not be construed as
creating any joint employment relationship between the Contractor and the Village, and
the Village is not and will not be liable for any obligations incurred by the Contractor,
including but not limited to unpaid minimum wages and/or overtime premiums, nor does
there exist an agency relationship or partnership between the Village and the Contractor.
17. Governing Law
The laws of the State of Illinois as to interpretation, performance and enforcement shall
govern this Agreement. The forum for resolving any disputes concerning the parties'
respective performance or failure to perform under this Agreement shall be the Circuit
Court for the Eighteenth Judicial Circuit, DuPage County, Illinois.
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Section 2. Proposal Instructions
Four (4) copies of the proposal shall be submitted in a sealed envelope to:
Rania Serences
Senior Purchasing Assistant
Village of Oak Brook
1200 Oak Brook Road
Oak Brook, IL 60523
and clearly marked on the outside of the envelope "Independence Day Fireworks Display" on
or before Tuesday, November 16, 2021 at 3:00 p.m. prevailing time. Any proposal received
after this date and time will be rejected and returned unopened.
Lengthy, detailed proposals are not required. Proposals are intended to be an expression of
interest in providing services for the project, as well as background information on the firm and on
its professional qualifications.
A. Documents/Information to be Submitted
Proposal Form (Section C below), Detailed cost Spreadsheet and Narrative
References (Section D below)
Contractors Certification (Section E below)
Sexual Harassment Policy (Section F below)
Statement of Qualifications
• Provide background information on your firm including, but not limited to,
the age of the business, the number of employees, and pertinent financial
data that will permit the Village to determine the capability of the contractor
to meet all contractual requirements.
• List the abilities, qualifications, and experience of the persons who would
be assigned to the engagement and their experience on similar contracts.
Project Approach
• Terms and Conditions
List any terms and conditions which may apply to this contract and are
not included in this RFP.
Additional Information and Comments
Include any other information you believe to be pertinent but not specifically
mentioned elsewhere.
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B. Proposal
In compliance with this Request for Proposals, and subject to all conditions thereof, the
undersigned offers and agrees, if this proposal is accepted, to furnish the services as outlined
herein for the Village of Oak Brook at the amount indicated, subject to modification through
negotiations. The time and material, not to exceed, cost proposed shall include all anticipated
expenses.
Perform the 2022 Independence Day Fireworks Display
Not-to-Exceed Cost of$ $32,500.00
Please provide a detailed list (size, amount, cost) of mortars and shells, etc. that will be used for the
display.
Firm Name: Miand In . DBA Mad Bomber Fireworks Productions
Address: 3999 E Hupp Rd R-3-1
City, State, Z aPor , tN 0350
Signature:
Name Print d: ndrew a es
Title: Preside t y
Telephone: 21 393-5051 _ Date: November 5, 2021
If a Corporation:
ATTEST:
Randall McCasland
Secretary
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FIREWORKS PRODUCTIONS
3999 E. HUPP ROAD, BUILDING R-3-1 LA PORTE IN 46350
PHONE(219) 393-5051 TOLL FREE(877)623-2662 FAX(219)393-3177
Mad Bomber Fireworks Productions is in our Thirty-First year of producing professional fireworks
displays. In the beginning we quickly earned the reputation as a company who catered to'smaller'
clients that other fireworks companies tended to dictate terms to.We were often appreciated as a
firm that worked with our clients to ensure expectations were met by both parties. It was always
going above and beyond the norm that helped us compete with the big family companies that
dominated the fireworks industry. Many of whom had the benefit of generations of loyal customers.
We approached growth cautiously; while never losing sight of what had put us above the crowd for
our clients, now we enjoy a strong and loyal clientele.
Today we produce approximately 500 displays per year throughout the Midwest. Our offerings
include traditional displays, electric fired,choreographed to music, computer fired, indoor and close
proximity displays. Our clientele ranges from high school homecomings to extravagant displays for
summer festivals and of course Independence Day fare.
Andrew James, President,started Mad Bomber Fireworks in 1991. Due to his love of fireworks he
knew he wanted to build a company that provided the best displays as well as exceptional service. He
has produced thousands of displays over the years and has grown the company into the premiere
display company in the Midwest.
Randy McCasland, Director of Operations started working with his father on displays at a young age.
Having grown up in the industry, he provides an insight into display production paralleled by few. He
has been the lead operator on well over one thousand displays throughout fourteen states. Randy has
designed, produced and worked on displays for many industries, including professional baseball,
professional basketball,concert events, air shows,festivals, and cities and towns.
Mad Bomber Fireworks currently has eight full time employees. During the summer we bring on ten
to twelve college students full time to work preparing for the busy season. Many of whom return
season after season to work for the summer. Nearing the Fourth of July,we ramp up for our displays,
and we bring on 400-500 workers producing displays throughout the Midwest. We pride ourselves on
the extensive training,skill and talent of our operators and crews.
C. References
Your Company Name: Miand Inc. DBA Mad Bomber Fireworks Productions
.
(Please Print)
The Contractor shall list five (5) current references with needs similar to the Village of Oak Brook
for whom Contractor has provided comparable services. Please include company name,address,
telephone number, year(s) employed by referenced firms, contact person, and type of work you
performed for that entity.
1. Company Name/Municipality: Village of Bensenville
Address: 12 S Center St Bensenville,IL 60106
Phone: ( 630 ) 697.3439
Contact Person: Gary Thorsen
Type of Work and Date Performed: July 4th Fireworks Displays
2. Company Name/Municipality: Westmont Park District
Address: 55 E Richmond St Westmont, IL 60559
Phone: 1 630 ) 969.8080
Contact Person: Bob Fleck
Type of Work and Date Performed: July 4th Fireworks Displays
3. Company Name/Municipality: Village of Orland Hills
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Address: 16553 S Haven Ave Orland Hills, IL 60487
Phone: ( 708 ) 349.7211
Contact Person: Glenn Bylina
Type of Work and Date Performed: Independence Day Celebration
4. Company Name/Municipality: City of Waukegan
Address: 100 N Martin Luther King Jr Ave Waukegan,IL 60085
Phone: ( 847 ) 599.2525
Contact Person: David Motley
Type of Work and Date Performed: Juky 4th Fireworks Display
5. Company Name/Municipality: village of Woodridge
Address: 5 Plaza Dr Woodridge IL 60517
Phone: ( 630 ) 719.4705
Contact Person: Peggy Halik
Type of Work and Date Performed: Iuly 4th Fireworks Display
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E. Contractors 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 contractor for the construction, product, commodity,or service
briefly described as follows:
"Independence Day Fireworks Display"
1) The undersigned certifies that, pursuant to Chapter 720, Section 5/33E of the Illinois
Compiled Statutes, 1993,the contractor 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.
2) The undersigned states under oath that, pursuant to Chapter 65, Section 5/11-42.1-1 of the
Illinois Compiled Statutes, 1993, the contractor is not delinquent in the payment of any tax
administered by the Illinois Department of Revenue.
3) The undersigned certifies that, pursuant to Chapter 775, Section 5/2-105. of the Illinois
Compiled Statutes, 1993, the contractor has a written sexual harassment policy in place
including the following information:
a) An acknowledgment of the illegality of sexual harassment.
b) The definition of sexual harassment under State law.
c) A description of sexual harassment, utilizing examples.
d) The Consultant's internal complaint process including penalties.
e) The legal recourse, investigative and complaint process available through the Illinois
Department of Human Rights and the Human Rights Commission.
f) Directions on how to contact the Department or the Commission.
This business firm is: (check one)
X CorporationPartnership Individual
Firm Name: Miand IS DBA Mad Bomber Fireworks Productions
Address: 999 E Hupp Rd R-3-1
i
City, State, ZI VatJNP�6350
ejt.
Signature:
Name Printed: rew Jaynes
Title: Presiden
Telephone: 219-393-5051 Date: November 5,2021
13
K=--E`ah%E HATFIELD TURLEY
o waary Public-Seal
La
ATTEST: pone County•State 0(Indiana
Commissipr Number NP07310S2
My Commiss,pr E+owes Jar 18.2029
-SEAL-
SUB GRIBED A ORN TO
bo a his a
Of, 7
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14
D. Sexual Harassment Policy
Miand Inc. DBA Mad Bomber Fireworks Productions hereinafter referred to as "Contractor" having
submitted a bid/proposal for Independence Day Fireworks Display 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) 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 Cot
o fission.
7) An acknowledgment of protection of a complaint ainst taliation as provided in Section 6-
101 of the Human Rights Act.
Each contractor must provide a copy of such written polic the III s artment of Human Rights
upon request. jL
`1
By:
A horiz d Agent of Contractor
Subs ibed and sw to
b r e this
Subs '
KELLEY ANNE HATFIELD TURI EY
Notary Public•seal
x La Porte County•state of Indiana
IVO ilU C i MYCCommiss o Exp'es Jaer n td73�2082
029
15
Section 3. Review Process
A. Evaluation of Proposals and Selection
The proposals received will be evaluated by the Village on the basis of professional qualifications,
previous experience on similar projects, key personnel assigned to the project, satisfaction of
previous clients on work performed for them, current billing rates of the firm, and the proposal that
best meets the needs of the Village. This proposal is not intended to be detailed; it is intended to
be an expression of interest in providing services for the project, as well as to provide background
information on the firm and its professional qualifications. Firms will be contacted during the
evaluation if further information is needed. The Village may choose to interview one or more firms
before final selection is made.
This Request for Proposal does not commit the Village to award a contract, to pay any costs
incurred in the preparation of a proposal based on this request, or to procure or contract for
services. All proposals submitted in response to this Request for Proposal become the property
of the Village. The Village reserves the right to accept or reject any or all proposals received as
a result of this request, to negotiate with qualified consultants, or to cancel in part or in its entirety
the Request for Proposal, if it is in the best interest of the Village to do so. The Village may require
the consultant selected to participate in negotiations concerning contract price or the nature and
extent of services to be provided. The results of such negotiations shall be incorporated into the
final contract between the Village and its consultant.
B. Basis of Award
Village staff will perform an evaluation of the proposals received. Appropriate finalist(s) may be
interviewed by the Village, after which a selection will be made.
The Village reserves the right to reject any or all proposals and to waive any informality or
technical error and to accept any proposal deemed most favorable to the interests of the Village.
The Village will review proposals based on the following criteria:
1) Compliance with RFP. Adherence to all conditions and requirements of the RFP.
2) Understanding of the Project. The contractor's understanding of the engagement, the
Village's objectives, and the nature and scope of the work involved.
3) Services to be Provided. The exact type and nature of the contractor's proposed services
and how they accomplish the objectives of the project.
4) Qualifications of the Contractor. The contractor's capability in all respects to perform fully
all contract requirements, and the integrity and reliability which will assure good faith
performance. This criterion includes:
• The experience of the firm and its record on projects of a similar nature.
Personnel to be assigned to the project,their education, qualifications,and experience
on similar projects.
• The availability of necessary personnel and other resources to successfully complete
the project specified herein on a timely basis.
16
5) Costs. Proposed contract price.
6) Ability, capacity and skill to fulfill the contract as specified.
7) Ability to supply the commodities; provide the services or complete the construction
promptly, or within the time specified, without delay or interference.
8) Character, integrity, reputation,judgment, experience and efficiency.
9) Quality of performance on previous contracts.
10)Previous and existing compliance with laws and ordinances relating to the contract.
11)Sufficiency of financial resources.
12)Quality, availability and adaptability of the commodities, services or construction, in
relation to the Village's requirements.
13)Ability to provide future maintenance and service under the contract.
14)Number and scope of conditions attached to the proposal.
15)Record of payments for taxes, licenses or other monies due the Village.
17
AtAU UC,4UU-U
R"WORKSPRODUCTIONS
3999 E HUPP RD R-3-1 LAPORTE, IN 46350
PHONE(219)393-5051 Toll Free(877)MAD-BOMB FAX(219)393-3177
OAK BROOK
PROPOSAL
JULY 3, 2022
MAD BOMBER FIREWORKS PRODUCTIONS IS PLEASED TO PRESENT FOR YOUR
CONSIDERATION THIS EXCEPTIONAL PROPOSAL FOR A SPECTACULAR
FIREWORKS SHOW TO BE PRESENTED FOR YOUR INDEPENDENCE DAY
CELEBRATION.
FIREWORKS SHOW $32,500.00
PROFESSIONAL PRESENTATION INCLUDED
$10,000,000 LIABILITY INSURANCF. INCLUDED
POST DISPLAY CLEANUP INCLUDED
EARNEST MONEY DEPOSIT WAIVED
BALANCE DUE AFTER PRESENTATION $32,500.00
Mad Bomber Fireworks will also supply the following:
1. We will secure all permits. Buyer will cover cost of permit.
2. CDL driver with a Hazmat endorsement.
3. Registered with the USDOT to haul hazmat. (mandatory by Federal Law)
4. Carry $5,000,000.00 auto insurance to haul hazmat. (mandatory by Federal Law)
5. Haul hazmat material in a properly placarded vehicle.
RA,�Rtii�
Randy McCasland,Dimctorof0pcm6uns
I
I
MAD BOMBER
FIREWORKS PRODUCTIONS
AGREEMEN7'
This contract entered into this 5th day of November , 2021 by and between Mad Bomber Fireworks
Productions of Kingsbury,Indiana hereinafter referred to as Seller.and
Villave of Oak Brook
Herein after referred to as Buyer,of Oak Brook State:Illinois
Illinois
Witness: Seller agrees to provide and Buyer agrees to purchase a Fireworks Display in accordance with the program agreed
upon. Buyer will pay Seller a sum of $32,500.00 for Display. Upon acceptance of this agreement Buyer will pay Seller a sum of
Waived as an Earnest Money Deposit with the Balance due and payable within 30 days after the display date agreed upon. A late
charge of 1 !ra%per month will be assessed on accounts not paid within thirty days of display date. Buyer agrees to pay any and all
collection costs,including reasonable attorney's fees and court cost incurred by Seller in the collection or attempted collection of any
amount due under this agreement and invoice.
Both Seller and Buyer mutually agree to the following terms.conditions,and stipulations:
1. Seller will present said Fireworks Display on the evening of the 3rd Day of July,2022, it being understood that
should there be inclement weather the day of the display the Seller has sole discretion to cancel display. An alternate display
date will be given within six months of the original display date agreeable to both the Seller and Buyer.
2. The Fee for cancellation for any reason of the Fireworks Display is 40%of the agreement price if Buyer chooses to not
select another display date within six months of the original display date.
3.Buyer will provide a sufficient area for the Display, including a minimum spectator setback of 560' feet at all points
from the discharge area. Buyer will provide protection of the display by roping-off or other suitable means. Buyer will
provide adequate police protection to prevent spectators from entering display area. Buyer agrees to search the fallout
area at first light following a night display.
4. Seller reserves the right to terminate the Display in the event that persons enter the secured Danger Zone and Security is
unable to secure the Danger Zone.
5.Seller agrees to provide Qualified Technicians to take charge of and present said Display.
6.Seller agrees to provide Liability insurance in the amount of$10,000,000.00 for the benefit of both the Buyer and Seller.
All individual entities listed on the Certificate of insurance will be deemed an additional insured per this contract,
7.Mad Bomber Fireworks Productions retains the right to substitute product of equal or greater value in the event of
shortages or unavailability of any particular item on the proposal.
8.Seller and Buyer agree to included Attachments,if any. See Attachments: none
Both Seller and Buyer hereto do mutually and severally guarantee terms,conditions,and payments of this contract,these articles to
be binding upon the parties,themselves,their heirs,executors.administrators,successors and assigns.
Mad Bomber Fireworks Productions BUYER
By By
Randy McCasland (its duly authorized agent,who represents that he/she has full authority to
Bind the Buyer.)
Date Date
Print Name
Address
Oak Brook
Opening
36 2.5" Color Willows
24 3" Assorted Color Shells
6 4" Assorted Color Shells
2 5" Assorted Color Shells
1 6" Thousand Blooming Flowers
Mad Bomber
Fireworks Productions
Oak Brook
SPECIALTY BARRAGES Displayed by pond
300 Shot Color Xsette and Crackling
300 Shot Blooming Stars
200 Shot S & I Coconut w/Turbillion
170 Shot Chrys to Chrys (Crackling Chrysanthemums)
200 Shot Z Brocade Crown Blue Comet
400 Shot Color and Salute
100 Shot Red Dahlia w/Red Tail
100 Shot Fan Red White and Blue Crossette
100 Shot Crackling Chrysanthemum
Mad Bomber
Fireworks Productions
Oak Brook
36 3 INCH SHELLS
Three Shot Volleys
Coconut Palms Gold Kamuro
Purple Sky Mines Yellow Chrysanthemum w/Red Pistil
Silver Flying Fish Silver Peony w/Orange Pistil
Green Strobe Three Color Changing
White Strobe Cyan Peony w/Color Changing Pistil
Red White & Blue Ring w/Mine Red White & Blue Rings
Red Strobe Violet Chrysanthemums
Red White & Blue w/Brocade Mine Blue Chrysanthemums
Brocade w/Red White & Blue Mine Purple Peony
Turquoise Peony w/Palm Core Mag Green Peony
Peach Flying Stars Mag Red Peony
Lemon Peony Mag Orange Peony
30 4 INCH SHELLS
Three Shot Volleys
Red Green Blue Sparkling Rain Color Flying Stars
Green White Blue Clustering Strobe Silver Strobe
Color Peont w/Sparkling Pistil Hummer
Cyan w/Mag Pistil Pixie Dust Willow
1/2 Red 1/2 Silver Glittering Silver
Orange Glittering Waterfall White Strobe Waterfall
Brocade w/Red Leaves Brocade w/Raind\bow Dahlia
Three shells shot simultaneously and
spread across sky Mad Bomber
Fireworks Productions
Oak Brook
24 3" SPECIALTY SHELLS
3" Color Wolfs 3" Assorted Sky Mines
3" Silver Serpent w/Magenta 3" Peach Flying Stars
3" Whistling w/Color Stars 3" Banger Chartreuse
3" Red Sky Mines 3" Blue Comets
3" Blue Sky Mines 3" Diamond Screamer w/Color Stars
3" White Sky Mines 3" White Strobe Waterfall
3" Smile Face 3"Orange Strobe
3" Silver Turbulence w/Report
18 4" SPECIALTY SHELLS
4"Cyan Sky Mine 4" Whirlpool Green Xsette
4" Whistle Red Stars 4" Whirlpool Red Xsette
4"Silver Flying Fish 4"Green Sound Ring
4"Aqua w/Silver Turbulence 4"Tourbillion w/Color Stars
4" Farfalla w/Magenta Stars 4" Diamond Screamer w/Color Stars
4"Assorted Color Wolfs 4" Lemon Xsette w/Time Rain
4" Multi Color Flying Stars 4"Ti Serpent w/Red & Blue to Report
4"Silver Serpents w/Mag Colors 4"Ti Whistle Ring w/Lemon
10 5" SPECIALTY SHELLS
5"Farfalla w/Color 5" Red Wave to Xsette
5'Multi Color Wolf 5" Pixie Dust w/Stain Glass
5' Multi Color Sky Mine 5" Orange Glittering Waterfall w/Red Glitt
5' Multi Color Poinsatte 5' Glittering Xsette
5' Five Arm Cut Glass 5"Whirl w/Blue Pistil
5"White Strobe Waterfall 5" Color Changing Ghost
5'Gold Whirl to Report 5"Tourbillion to Color and Report
5"Silver Wave to Crackling Color 5' Brocade to Thousand Green
Mad Bomber
Fireworks Productions
Oak Brook
Specialty Stacks
Silver Strobes
12 3"
6 4"
2 5"
Red, White and Blue
12 3"
6 4"
2 5"
Colorful Falling Leaves
12 3"
6 4"
2 5"
Different size shells breaking at multiple
heights creating a stack. Mad Bomber
Fireworks Productions
Oak Brook
3 INCH SHELLS * main body
18 Pheonix
Red Peony w/Red Tail Golden Gamboge to Blue
Green & Purple Peony w/Tail Golden Gamboge to Green
Green & Blue Chrysanthemum w/Tail Silver Strobe
Glittering Big Willow Brocade Crown to Red
Five Pieces Willow Brocade Crown to Blue
Red Stars w/1000Green w/Tail Ripples to Red
Yellow to Crackling Ripples to Blue
Silver Crown to Red Red Peony w/Strobe Pistil
Silver Crown to Yellow Color Flower Rain w/Silver Tail
18 Vulcan
Green Peony w/Palm Core & Tail Glitt Silver to Green to Red
Red Peony w/Glitt Coco Core & Tail Red and Spangle Chrysanthemum
Purple Peony w/Green Pistil & Pur Tail Silver Strobe w/Strobe Tail
Vareigated Chrysanthemum w/Blue Tail Multi Color Chrysanthemum
Spangle Chrysanthemum w/Red Tail Yellow to Crackling w/Crack Tail
Crack Flower Chrys w/Crack Tail Vareigated Color to Crack Flower
112 Yellow 1/2 Blue w/Blue Tail Ruby Red Peony
Orange to Blue Chrysanthemum Blue to Crackling Rain
Gold Wave Green Strobe Chrys Crackling Palm Tree w/Crackling Tail
12 Yung Feng
White Twinkling Chrysanthemum Crackling Nishiki Kamuro
Variegated Cycas Bloom Golden Wave to Purple Chrysanthemum
Green Chrysanthemum w/Crackling Glittering Silver to Red Chrysanthemum
Golden Silk Chrysanthemum Reddish Gamboge to Silver Chrysanthemum
Red Cherry Blossom w/Tail Nishiki Kamuro Niagra Falls
Nishiki Kamuro Silver Willow
Mad Bomber
Fireworks Productions
Oak Brook
3 INCH SHELLS * main body
72 Wizard Brand
Silver Strobe Glittering Sil to Red w/Blue Pistil w/Sil Tail
USA Style Titanium Whistle Cannister Glittering Sil to Blue w/Red Pistil w/Sil Tail
Red to Crackling Chrysanthemum Bowtie w/Ring w/Sil Tail
Blue Cycas w/ Gold Tail Green Peony w/Purple Pistil w/Sil Tail
Crackling Spider to Yellow w/Silver Tail Red Chrys w/Blue Pistil w/Gold Tail
Silver to Green to Blue Peony w/Gold Tail Glittering Coconut w/Glittering Tail
Red to Blue Peony w/Coco Pistil w/ Sil. Tail New Rainbow Color Dahlia
Gold Silk w/Gold Tail Blue USA Style Cannister
Purple Chrys. w/Coco Pistil w/Sil Tail RWB Peony to Crack Chrys w/Gold Tail
Green to Flash w/Coco Pistil Glittering Silver to Blue
Blue to Red Flash Yellow Chrys w/Coco Pistil w/Sil Tail
Brocade Crown w/Blue Pistil Magenta Peony w/Palm Core
Red Cycas Blossom 1/2 Red 1/2 Blue Chrysanthemum
Purple Peony w/Gold Coco Pistil Red White & Blue Peony
Firefly Waterfall w/Firefly Tail Red to Crackling
Silver Palm Tree w/Silver Tail Silver Peony w/Green Pistil
Green Peony w/Coco Pistil Gold Spangle w/Purple Pistil
Gittering Silver to Vareigated Silver Fish w/BlueRing
b Titanium Salute
3 INCH SHELLS Mad Bomber
Fireworks Productions
Oak Brook
4 INCH SHELLS * main body
24 Anshan
Red Peony w/Red Tail Golden Gamboge to Blue
Red Chrysanthemum w/tail Golden Gamboge to Green
Blue Chrysanthemum w/Tail Silver Strobe
Glittering Big Willow Brocade Crown to Red
Five Pieces Willow Brocade Crown to Blue
Red to Crackling Ripples to Red
Yellow to Crackling Ripples to Blue
Silver Crown to Red Red Peony w/Strobe Pistil
Silver Crown to Yellow Red Peony wCrockling Pistil
24 Guandu
Green Peony w/Palm Core & Toil Glitt Silver to Green to Red
Red Peony w/Glitt Coco Core & Tail Red and Spangle Chrysanthemum
Purple Peony w/Green Pistil & Pur Tail Silver Strobe w/Strobe Tail
Vareigated Chrysanthemum w/Blue Tail Brocade Crown to Crackling w/Crack Tail
Spangle Chrysanthemum w/Red Tail Yellow to Crackling w/Crack Tail
Crack Flower Chrys w/Crack Tail Vareigated Color to Crack Flower
1/2 Yellow 1/2 Blue w/Blue Tail Green Ring w/Green Tail
Color Wave w/Silver Tail Crackling Willow w/Gold Tail
Gold Wave Green Strobe Chrys Crackling Palm Tree w/Crackling Tail
Mad Bomber
Fireworks Productions
Oak Brook
41NCH SHELLS * main body
36 Wizard Brand
Blue to Flash w/Coco Pistil Glittering Sil to Red w/Blue Pistil w/Sil Tail
Blue Cherry Blossom w/ Silver Tail Glittering Sil to Blue w/Red Pistil w/Sil Tail
Brocade Crown w/Silver Tail Bowtie w/Ring w/Sil Tail
Blue Cycas w/ Gold Tail Green Peony w/Purple Pistil w/Sil Tail
Crackling Spider to Yellow w/Silver Tail Red Chrys w/Blue Pistil w/Gold Tail
Silver to Green to Blue Peony w/Gold Tail Glittering Coconut w/Glittering Tail
Red to Blue Peony w/Coco Pistil w/ Sil. Tail New Rainbow Color Dahlia
Gold Silk w/Gold Tail Blue USA Style Cannister
Purple Chrys. w/Coco Pistil w/Sil Tail RWB Peony to Crack Chrys w/Gold Tail
Green to Flash w/Coco Pistil Glittering Silver to Blue
Red Cherry Blossom Yellow Chrys w/Coco Pistil w/Sil Tail
Brocade Crown w/Blue Pistil Magenta Peony w/Palm Core
Red Cycas Blossom 1/2 Red 1/2 Blue Chrysanthemum
Purple Peony w/Gold Coco Pistil 3 Concentric Ring
Crackling Nishiki Kamuro Red to Crackling
Silver Palm Tree w/Silver Tail Silver Peony w/Green Pistil
Green Peony w/Coco Pistil Gold Spangle w/Purple Pistil
Gittering Silver to Vareigated Silver Fish w/BlueRing
Mad Bomber
Fireworks Productions
Oak Brook
5 INCH SHELLS * main body
18 Ansheng
Chrys w/Rthree Section Time Rain w/Coco Pistil Blue Peony to Brocde w/Palm Core
Red Strobe w/Blue Sky w/Rising Tail Flower Wave to Purple w/Rising Tail
Silver Coconut w/ Glittering Glittering Silver to Blue to Green
Sun Ring w/ Rising Tail Green Cherry Blossom
Double Half Red to Red Red Peony w/Rising Tail
Yellow Cycas w/Rising Tail Yellow Peony w/Green Pistil
Red to Green Crossette Ring Green to Flickering
Silver Wave w/Special Green Strobe Ring w/ Multi Color Flower
Thousand Red w/Time Rain Kaleidoscope w/Waterfall
18 Dominator
Color Diadem w/Gold Tail Eight Hearts w/Rising Purple Flowers
Gold Silk Chrysanthemum Revolving Dragons w/Blooms
Golden Willow w/Flare Moons Thousand Color Titanium Salutes
Color Palm Tree w/Crown Flowers Silver Crossette in Red & Blue Peony
Nishiki Kamuro w/Color Tips Nishiki Kamuro w/Niagra Falls
Mad Bomber
Fireworks Productions
Oak Brook
5 INCH SHELLS * main body
36 wizard
Glitt Sil to Red w/Blue Pistil Ti Whistle Ring w/Red & Blue Cannister Shell
Red Crossette Palm Tree w/tail Glitt Sil to Blue Chrys w/Broc Red Pistil
Silver Crossette Palm Tree w/Tail Brocade Waterfall w/Silver Leaves
Gold Crossette Palm Tree w/Tail Gold Coconut to Green Flowers
Giant Brocade Crossette Palm Tree Giant Gold Octopus w/Red Eyes & Bro Ring
Five Concentri Ring Giant Green Peony w/Brocade Ring
Gold Strobes w/tail Gold Chrys w/Rainbow Ring
1/2 Red 1/2 Blue Chrys w/ Broc Cross Pistil Gold Crossette Palm w/Trunk
Saturn Giant Red Peony w/Brocade Ring Glittering Silver
Sil to Blue Chrys w/Red Pistil Red Peony w/Blue Pistil
Blue to Green Peony w/Coco Pistil Red to Blue Peony w/Coco Pistil
Three Ring w/Pistil Brocade to Red to Blue Chrys
Schreecher Cannister Gold Peony w/Blue Pistil
RWB Peony w/Coco Pistil Red Strobes w/Tail
Green Strobes w/Tail Giant Z Willow Palm w/Z Willow Tail
Gold Crossette w/Gold Strobe Pistil Glitt Sil to Blue Chrys w/Brocade Pistil
Gold Willow to Purple w/Peony Center Giant Golden Octopus w/Tail
Green Peony w/Crackling Pistil Brocade Crown w/Broc Crossette Pistil
12 Phoenix
Chrys w/Red to Green Ring Silver Crown w/Small Red Flowers
Silver Crackling Palm Tree Ripples to Vareigated Wave
Purple Wave Crackling to Sil Crossette
Red Flower Rain China Storm
Gold Wave to Aqua White Strobing
Smiley Face Yellow Peony
Brocade Butterfly Red to Purple to Green Peony
Sea Blue and Lemon Dahlias Red Peony w/Glitt Gold Palm Tree Core
Blue Palm Tree Gold Wave to Red to Green
Blue Peony w/Silver Core Green to Yellow w/Yellow to Green Pist
Gold Diadem Willow Yellow Peony w/Blue Palm Tree Core
Gold Wave to Purple to Green Silver Wave to Green to Crackling
Mad Bomber
Oak Brook
6 INCH SHELLS * main body
9 New Year
Cascading Corolla Yellow to Green to Yellow w/Green Pistil
Green w/Yellow Pistil and Rising Flowers Corolla w/Blue to Red Pistil
Multi Color Cycas w/Rising Stem Silver Glittering w/Red to Blue Pistil
Red Chrys to Corolla w/Rising Tail Blue Chrys to White Strobe
Blue to Red with Silver Pistil Red Chrys to White Strobe
9 Yuan Yeng
Orange Chrysanthemum Silver Chrysanthemum
Gold Brocade Crossette Yellow Chrysanthemum
Red Chrysanthemum Red to Blue to White Peony
Blue Chrysanthemum Yellow and Green Peony
Green Chrysanthemum Glittering Orange Waterall
9 Kanto
Red and Yellow Sunflower Multi Color Poinsetta
Silver Palm w/Rising Tail Silver Wave to Crackling Color
Farfalla w/Multi Color 1/2 Lemon 1/2 Lime w/Tail
Multi Color Howling Wolf 1/2 Red 1/2 Blue White Pistil
Red and Blue w/Rising Tail Violet w/Green Pistil
Mad Bomber
Fireworks Productions
Oak Brook
8 8 INCH SHELLS * main body
Brocade Purple Flickering w/Gold Strobe Pistil
Brocade new/New Color Pistil Gold Wave to Purple to Red w/Pistil
Gold Crown w/Kaleidescope Fist Crack Nishiki Kamuro w/Pistil
Color Kaleidescope w/Glitt Pistil Eight Hearts w/Rising Leaves Purple
8 INCH SHELLS
Oak Brook
Finale
144 2.5" Assorted Color Peonies
288 Silver Comets
288 3" Finale Shells
Dominator Color Finale
Dominator Specialty Finale
Kanto Mag Color Finale
Kanto Comet and Color Finale
Kanto Premium Color Finale
Wizard Color Finale
Wizard Specialty Finale
Wizard Glittering Silver Finale
Guandu Titanium Salutes
12 4" Finale Shells
Vulcan Color Finale
Wizard Color Finale
Kanto Color Finale
8 5" Assorted Peonies and Chrysanthemums
4 6" Assorted Peonies and Chrysanthemums
6 5" Gold Nishiki Kamuro
2 6" Gold Nishiki Kamuro
Mad Bomber
Fireworks Productions
File Number 7153-650-5
e
d
To all to whom these Presents Shall Come, Greeting:
I, Jesse White, Secretary of State of the State of Illinois, do hereby
certify that I am the keeper of the records of the Department of
Business Services. I certify that
MIAND, INC., INCORPORATED IN INDIANA AND LICENSED TO"TRANSACT BUSINESS IN
THIS STATE ON JANUARY 31, 2018, APPEARS TO HAVE COMPLIED WITH ALL THE
PROVISIONS OF THE BUSINESS CORPORATION ACT OF THIS STATE, AND AS OF THIS
DATE,IS A FOREIGN CORPORATION IN GOOD STANDING AND AUTHORIZED TO
TRANSACT BUSINESS IN THE STATE OF ILLINOIS.
sTArE In Testimony Whereof, t hereto Set
0
my hand and cause to be affixed the Great Seal of
r Q the State of Illinois, this 25TH
day of FEBRUARY A.D. 2021
ti,. xw 4L
UG,2azv 1 l
Authentication ft: 2105603678 verifiable until 02/75/2022
Authenticate at: http://www.cyberdrivaillinois.rom
SECRETARY OF STATE
STATE OF ILLINOIS
OFFICE OF THE STATE FIRE MARSHAL = ,
DIVISION OF FIRE PREVENTION
1035 Stevenson Drive- Springfield, 1L 62703-4259 1
Pyrotechnic Distributor License
PLANET PRODUCTIONS/MAD BOMBER FIREWORKS
3999 E HUPP RD BLDG R-3-1
LA PORTE, IN 46350
IL06-OP-00029 05/15/2024
License # ISSUE DATE
OP _
(watt Perez EXPIRATION DATE
STATE FIRE MARSHAL
This license may be revoked by
the Office of the State Fire Marshal
for failure to comply with the lawful
rules regulating this program.
1 L NO15
Illinois
Department of
Natural Resources
DEPARTMENT OF
NATURAL
RESOURCES
Office of Mines and Minerals
Oper#: 2166
PLANET PRODUC f-d -
3999 E`JjUPP.:ROAD
BUILVMG'R-3-1
LA PORTE, IN 46350
HAS PAID THE REQUNREG-FEE AND IS HERESY ISSUED A
STORA ;f 'VICATE
Not exceeding 19000 Pounds/count 6 explosives
Under the "Illinois Explosives Act"
Approved January 1, 2011
Effective Date, 311/2021
Certificate No.: 8856
xpires: Last day of February, 2022
Office f Mines
and Minerals
UNITED STATES OF AMERICA
DEPARTMENT OF TRANSPORTATION
PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION
HAZARDOUS MATERIALS
CERT111CAT'E OF REGISTRATION
FOR REGISTRATION YEAR(S)2019-2022
Registrant; MIAND INC DBA PLANET PRODUCTIONS
ATTN: Kelley Hatfield Turley
3999 HUPP ROAD,BUILDING R-3-1
LA PORTE, IN 46350
This certifies that the registrant is registered with the U.S. Department of Transportation as required by
49 CFR Part 107,Subpart G.
This certificate is issued under the authority of 49 U.S.0 5108. It is unlawful to alter or falsify this
document.
Reg.No: 062419550231BD Effective: Jule 1,2019 Expires: June 30, 2022
RM Company ED: 38154
Record Keeping Requirements for the Registration Program
The following must be maintained at the principal place of business for a period of three years from the
date of issuance of this Certificate of Registration
(l) A copy of the registration statement filed with PHMSA,and
(2) This Certificate of Registration
Each person subject to the registration requirement must furnish that person's Certificate of Registration
(or a copy)and all other records and information pertaining to the infortnation contained in the
rc&ttation statement to an authorized representative or special agent of the U S Department of
Transportation upon request
Each motor carrier(private or for-hire)and each vessel operator subject to the registration requirement
must keep a copy of the current Certificate of Registration or another document bearing the registration
number identified as the"U.S.DOT Hazmat Reg.No."in each truck and truck tractor or vessel(trailers
and semi-trailers not included)used to transport hazardous materials subject to the registration
requirement. The Certificate of Registration or document bearing the registration number must be made
available,upon request,to enforcement personne!
For information,contact the Hazardous Materials Registration Manager,PHH-52,Pipeline and
Hazardous Materials Safety Administration,U S.Department of Transportation, 12700 New Jersey
Avenue;SE,Washington,DC 20590,telephone(202)366-4109
tom. ri
Federal Explosives License/Permit
U.S.Department of Justice
Bureau of Alcohol,Tobacco.Firearms and Explosives (I8 U.S C Chapter 40)
•r��maw srw utW•sat sor
I
In accordance with the provisions of Title XI.Organwed Crime Control Act of 1970,and the regulations issued thereunder(27 CFR Pari 555),you may engage in
the activity specified in this license or permit within the limitations of Chapter.40,Title 18,United States Code and the regulations issued thereunder,until the
expiration date shown THIS LICENSE IS NOT TRANSF RA B E UNDER 27 C R.55.53. Sec"WARNINGS"and"NOTICES"on reverse.
Direct ATF ATF-Chief,FELC Ltc4 jseJPerlp
Correspondence To 244 Needy Rand Number
Martinsburg,W V 25405-9431
Chief Federal Expbsives Licensing Cent (FL 1.C) Expireti`n
. Date j
November 1 , 2023i
Name
PLANET PROD/MAD BOMB F/WKS/NIGH1 MAG DISP/SKY MAJ
Premises Address(Changes? Notdv the FEL'C at Ieast 10 clays befccu the move.)
3999 E HUPP RD MIDWEST WAREHOUSING BLDG R-3-1
LA PORTS IN 46350-
Type of License or Permit t
51-IMPORTER OF EXPLOSIVE
+ p�3
' r ,m+4ilg. ,
Purchasing Certification +'=�p.'�� Mailul� address(C'Iltutgcs' N(Ait} the FELC of any changes.)
Me licensee or permittee named above shall use a ' fcxst>k'tN; tn�t to'a}sins a
transferor of explosives to verify the identity and the 1' * 6 of the h�eM
perntitteeaspmvidedby27CFR Put 555 Thesiol r mud ereior�l MIAND INC.:.
sieiature. A faxed,scanned or e-mailed copy oftht'licci;� ith a ser slurc
intended to be an original signature is accgriablc. The stgn`ldilr,t` of the Federal PLANET PROD/MAD BOMB F/WKS/NIGHT MAG
Explosives Licensee(FEL)or a responsible person of the F$3,'3 a true DISP%SKY.t A4.
ogry of license or perms isrued to the license or permittec HUPP RD MIDWEST WAREHOUSING BLDG
bu or operations specified above under"7ype of License `
i'1' 1`- t�.•,".. L'A'0ORTE, IN 46350-
Licen ermittee Responsible Person Signature Position facie
Printed Name Date AIV Farm 340 14/540 15 Part I
Previous Edit sun isabaotate Isills@sUME OJIV VA MOPUtvweaiarneww1.rw1+wuurnr.o111116 Revised Septanba2011
Client Name T.H.E. Insurance Company
Report Name Carrier Loss Run
As of Date 11-07-2021
T.H.E.INSURANCE COMPANY W-
Carrier Loss Run Sedgwick
As of Date:11-07-2021 Fitter Name:MIAND INC Run Date:11-08-2021
File Num Date of Loss Cause Cd Desc Cimt Name Pd Ind Pd Med Pd Exp/Oth Tot Paid
(Lasl_First)
Cim Slat Desc Date Rep to Insured Nature/Result Desc WC CIm Type Fut Res Ind Fut Res Med Ful Res Exp Tot Fut Reserves
Date Clm Closed Date Rep to Sedgwick State/Province of Loss Tot Recov Inc Ind Inc Med Inc Exp Tot Inc
Policy Number-Carrier Name,Insured Name CPP010529W1l-T.H.E INSURANCE COMPANY,MIAND,INC.
Carrier Policy Period 20170204(0210412017 TO OV0412018)
176002-1181-1 01Y01/2017 MISCELLANEOUS BVPD SPASOFF,NICK 0.00 0.00 0100 O.DO
Closed 0810 212 01 7 Not ProvidedINOC/lnsufficient Data 0.00 0.D0 0.00 0.00
03/1012018 08/0212017 IN 0.00 0.00 0.00 0.00 0.00
175884-t1PD-1 07105/2017 Not Provided/NOCllnsufficientData JOHNSON,DAWN 2,930.95 0.00 0.00 2,930.95
Closed 07/2712017 Not Provided/NOVInsufficient Data 0.00 000 0.00 0.DO
08/22/2017 07/2712017 MI 0.00 2,930.95 0.00 0.00 2,930.95
178613-11PO-1 07/04/2017 MISCELLANEOUSBIIPD MAIDENBERG 0.00 0.00 0.00 000
ASSOCIATES LLC
Closed 03/09/2018 Not Provided/NOC/Insufficient Data 0.00 0.00 0 D 000
0926/2019 03/09/2018 IN 0 DO 0.00 000 O.DD 0.00
20170204(02104/2017 TO 02M4/2018)Totals COUNT: 3
2,930.95 0.00 0.00 2,930.95
0.00 0.00 0.00 0.00
0.00 2,930.95 0.00 0.00 2,930.95
CPP010529901•T.H.E INSURANCE COMPANY,MIAND.INC.Totals COUNT: 3
2,930.95 0.00 0.00 2,930.95
0.00 0.00 0.00 0.00
0.00 2,930.95 0.00 0.00 2,930.95
Confidential Information Any accessing,ac uisllion,review,retransmission,disseminatlon or other use of.or talung of any Page 3 of 8
acdm in nviiance upon the Sensitive Infortnallon by persons or entilios other than an Authorized Rectole nt is sttF-*prohbibd.
T.H.E.INSURANCE COMPANY 0)
Carrier Loss Run Sedgwick
As of Date:11-07-2021 Filter Name:MIAND INC Run Date:11-08-2021
File Num Date of Loss Cause Cd Desc Clint Name Pd Ind Pd Med Pd Exp/Oth Tot Paid
(Last_First)
Clm Stat Desc Date Rep to Insured Nalure/ResuB Desc WC Clm Type Fut Res Ind Fut Res Med Fut Res Exp Tot Ful Reserves
Date Clm Closed Date Rep to Sedgwick StatelProvince of Loss Tot Recov Inc Ind Inc Med Inc Exp Tot Inc
Policy Number-Carrier Name,Insured Name CPP010520902-T.H.E INSURANCE COMPANY,MIAND,INC.
Carrier Policy Period 20180204(02/04/2018 TO 02/0412019)
181646-51CL-1 02101!2019 Damaged Vehicle MIAND INC 994.33 0.00 0.00 994.33
Closed 02/12/2019 Dented 0.00 0.00 0.00 0.00
04!2312020 02/12/2019 IN 0.00 994.33 0.00 0.00 994.33
179859-51CL-1 07/20/2018 Damaged Vehicle MIAND INC 0.00 0.00 868.00 868.00
Closed 07123/2018 Dented 0.00 0.00 0.00 0.00
06/25/2020 07/2312018 OH 0.00 0.00 0.00 868.00 868.00
179859.11PO-2 07/20/2018 Damaged Vehicle Gaicc insurance 7120.00 000 1,525.75 8,645.75
Closed 07/23/2018 Cracked 0.00 0.00 0.00 0.00
0612512020 07/23/2018 OH 0.00 7.120.00 0.00 1.525.75 8,645.75
20180204(02/0412018 TO 02/0412019)Totals COUNT: 3
8,114.33 0.00 2,393.75 10,508.08
0.00 0.00 0.00 0.00
0.00 8,114.33 0.00 2.393.75 10,508.08
CPP010529902-T.H.E INSURANCE COMPANY,MIAND,INC.Totals COUNT: 3
8,114.33 0.00 2,393.75 10,508.08
0.00 0.00 0.00 0.00
0.00 8,114.33 0.00 2,393.75 10,508.08
Confidential Information.Any amassing,acquisition,review,retransmission,dissemination or other use or,or taking of any Page 4 of 8
action in reliance upon are Sensitive Information by persons or entities other than an Authorized Recipient is stneny prohibited.
T.H.E.INSURANCE COMPANY ( )
Cartier Loss Run Sedgwick
As of Date:11-07-2021 Fitter Name:MIAND INC Run Date:11 08.2021
File Num Date cf Loss Cause Cd Desc Cimt Name Pd Ind Pd Med Pd Exp/Oth Tot Paid
(Last—First)
Cirri Stat Desc Date Rep to Insured Nature/Result Desc WC Cirri Type Fut Res Ind Fut Res Med Fut Res Exp Tot Fut Reserves
Date Cim Closed Date Rep to Sedgwick State/Pmvinoe of Loss Tot Recov, Inc Ind Inc Med Inc Exp Tot Inc
Polley Number-Carrier Name,Insured Name ELP001210400-T.H.E INSURANCE COMPANY,MIAND,INC.
Carrier Policy Period 20160204(02104!2016 TO 0210412017)
No records found.
20160204(021041`2016 TO 02104/2017)Totals COUNT: 0
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
ELP001210400-T.H.E INSURANCE COMPANY,MIAND,INC.Totals COUNT: 0
0.00 0A0 0.00 0.00
0.00 0.00 0.00 0.00
0.00 0.00 0.00 0.00 MOO
Confslentlal InOwnwbon Any accessing,acquisltidr,revbw,retransmission,disseminoWn or other use or,or talung of any Page 5 of 9
scuon m reliance upon the Sena"inrw nwvn by person w enteks other than an Audwized Roppknt is ovictly prehiNled.
T.H.E.INSURANCE COMPANY
Carrier Loss Run Sedgwick
As of Date.11-07-2021 Filter Name:MIAND INC Run Date:11.08-2021
File Num Date of Loss Cause Cd Desc Cimt Name Pd Ind Pd Med Pd Exp/Oth Tot Paid
(Last_First)
Clm Slat Desc Date Rep to Insured Nature/Result Desc WC Clm Type Fut Res Ind Fut Res Med Fut Res Exp Tot Fut Reserves
Date Cim Closed Date Rep to Sedgwick StatelProvinoe of Loss Tot Recov Inc Ind Inc Med Inc Exp Tot Inc
Policy Number-Carrier Name,Insured Name ELP001210401-T.H.E INSURANCE COMPANY,MIAND,INC.
Caller Policy Period 20170204(0210412017 TO 0 210 412 01 8)
No records found.
20170204(02M4=17 TO 0 210 412 01 0)Totals COUNT: 0
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
ELP001210401-T.H.E INSURANCE COMPANY,MIAND,INC.Totals COUNT: 0
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
i
ill
Conrideribai Information Any accessev.acquisition,review,relronsrossion,dissemination or other use of.or taking of any Page 8 of 8
action in reliance upon the Sensitive information by parsons or entities other than on Authorized Recipient is strictly prohibited..
T.H.E.INSURANCE COMPANY 00
Carrier Loss Run Sedgwick:
As of Date:11.07-2021 Filter Name:MIAND INC Run Date:11-0&2021
File Num Date of Loss Cause Cd Desc Cimt Name Pd Ind Pd Med Pd Exp/Oth Tot Paid
(Last_First)
Clm Stat Desc Date Rep to Insured Nature/Result Desc WC Clm Type Fut Res Ind Fut Res Med Fut Res Exp Tot Ful Reserves
Date Clm Closed Date Rep to Sedgwick State/Province of Loss Tot Recov Inc Ind Inc Med Inc Exp Tot Inc
Policy Number-Carrier Name,insured Name ELP001210402•T.H.E INSURANCE COMPANY,MIAND,INC.
Carrier Polley Period 20180204(0210412018 TO 021042019)
No records found.
20180204(02!042018 TO 021042019)Totals COUNT: 0
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
ELP001210402-T.H.E INSURANCE COMPANY,MIAND,INC.Totals COUNT: 0
0.00 0.00 O.DD 0.00
0.00 0.00 0.00 0.00
0.00 0.00 0.00 0.00 0.00
Conrideribal Information.Any accessing.acquisition.inview,retransmission,dissemination or other use of.or taking of any Page 7 of 8
action in mtianco upon the Sensitive Information by persons or entities other than an Authorized Recipient is str"y prohibited
T.H.E.INSURANCE COMPANY
Carrier Loss Run sed$W ick
As of Date:11-07-2021 Filter Name:MIAND INC Run Date:11-08-2021
File Num Date of Loss Cause Cd Desc Clmt Name Pd Ind Pd Med Pd Exp/Oth Tot Paid
(Last First)
Cim Stat Desc Date Rep to Insured Nature/Result Desc WC Clm Type Fut Res Ind Fut Res Med Fut Res Exp Tot Fut Reserves
Date Clm Closed Date Rep to Sedgwick Stale/Provinoe of Loss Tot Recov Inc Ind Inc Med Inc Exp Tot Inc
Grand Totals COUNT: 8
18,688.29 0.00 2,560.25 21.248.54
0.00 0.00 0.00 0.00
0.00 18,688.29 0.00 2,560.25 21,248.54
Conridentiat information.Any accessing.acquisition.review.retransmitskrn,dissemination or other use of.or taking of any Page 8 Of 6
action in reliance upon the Sensitive Informltlon by persons or entities other than an Auegrized Recipient is strictly prohibited
Insured: MIAND INC.DBA PLANET PRODUCT
Policy Number: SISGL01460
EVEREST LOSS RUN
Policy Period: 02/0412021-0210412022 as of Oct 15 2021 fvF.RF_VI
Cancel Date:
LOBGeneral Liability
Claim Number Date of Loss Description of Loss Claimarl Name Indemnity Paid Medical Paid Expense Paid Subroi Deductibles Total Paid
Claim Status Date Reported Cause of Loss Driver/Class Cd Indemnity Reserve Medical Reserve Expense Reserve Salvage Recovery Total Reserve
Closed Date Days Between Loss State/Lor:Veh Num Loss Subline Indemnity Incurred Medical Ircurred Expense Incurred Total Incurred
A2128517 s 0710412021 CLAIMANT HAS ALLEGED THAT DAVIS,JARED 0.00 0.00 0.00 0.00
4A2107322D HE SUSTAINED AN EYE INJURY
20001 AS A RESULT OF DE
OPEN 0712112021 5,000.00 0.00 0.00 5,000.00
17 100000006 Premtses/Operations 5.000.00 0.00 0.00 0.00 0.00 5.000.00
Liability
A2128519/ 07/04/2021 CLAIMANT IS CLAIMING EYE DAVIS,JARED 0.00 0.00 0.00 0.00
4A DAMAGES SUSTAINED AS A
2107357140001 RESULT OF FIREWORK DEB
CLOSED 07/2212021 0.00 0.00 U.00 0.00
08111/2021 18 11-110000006 Premises/Operations 0.00 0.00 0.00 0.00 0,00 0.00
Liability
Sub Total for SubLine Premises/Operations Liability 2 0.00 0.00 0.00 0.00
5.000.00 0.00 0.00 5,000.00
5.000.00 0.00 0.00 0.00 0.00 5,000.00
Sub Total for Line Of Business:General Liability 2 0.00 0.00 n.00 0.00
5,000.00 0.00 0.00 5,000.00
5.000.00 0.00 0.00 0.00 0.00 5,000.00
Sub Total for Policy Numhev S18GLO1460-211 .2 0.00 0.00 0.00 0.00
5,000.00 0.00 0.00 5,000.00
5,000.00 0.00 0.00 0.00 0.00 5,000.00
Run Date:11/2/2021 Page No 1 of 3
Insured: MIAND INC.DBA PLANET PRODUCT
Policy Number: SISGL01460 EVEREST LOSS RUN
Policy Period: 02/04/2020-02/0412021 as of Oct 15 2021 e VFRFSti
Cancel Date:
LOB:
Clam Number Date of Loss Description of Loss Claimant Name Indemnity Paid Medical Paid Expense Pari Subro/ Deductible/ Total maid
Claim Status Date Reported Cause of Loss Driver/Class Cd Indemnity Reserve Medical Reserve Expense Reserve Salvage Recovery Total Reserve
Closed Date Days Between Loss State/Loc-Veh Num Loss Suhllne Indemnity Incurred Medical Incurred Expense Incurred Total Incurred
No Claims for this Policy Period 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
Sub Total for SubLine: 0 0.00 0.00 0.00 000
0.00 0.00 0.00 9.00
0.00 0.00 0.00 0.00 0.00 100
Sub Total for Line Of Business: :0 0.00 0.00 0.00 0.00
0.00 0.00 0.00 0.00
0.00 000 0.00 0.00 0.00 0.00
Sub Total for Policy Numner.SIBGLO1460-201 :0 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
Run Date-11/2/2021 Page No 2 of 3
Insured MIAND INC.DBA PLANET PRODUCT
Policy Number S18GLO1460 EVEREST LOSS RUN
Policy Period: 02/04/2019-02104/2020 as of Oct 15 2021
Cancel Date:
LOB'
Claim Number Date of Loss Description of Loss Claimant Name Indemnity Paid Medical Paid Expense Paid Subrol Deductibles Total Paid
Claim Status Date Reported Cause of Loss Driver/Class Co Indemnity Reserve Medical Reserve Expense Reserve Salvage Recovery Total Reserve
Closed Date Days Between Loss State/Loc-Veh Num Loss Subline Indemnity Incurred Medical Incurred Expense Incurred Total Incurred
No Claims for this Policy Period 0.00 0.00 0.00 0.00
0.00 0.00 0.00 0.00
0.00 Q00 0,00 0.00 0.00 0.00
Sub Total for SubLine :0 0.00 0.00 0.00 0 00
0.00 000 0.00 0.130
0.00 000 0.00 0.00 0.00 0.00
Sub Total for Line Of Business- 0 0.00 0.00 0.00 0.00
0.00 0.00 0.00 0.00
0.00 0.00 0.00 0.013 0,00 0.00
Sub Total for Policy Number.S18GLO1460-191 0 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
Grand Total of Selected Years for Policy Number S18GL01460 2 0.00 0.00 0.00 0.00
5,000.00 0.00 0.00 5.000.00
5,000,00 0.00 0.00 0.00 0.00 5.000.00
Run Date-11/2/2021 Page No 3 of 3
T.H.E.INSURANCE COMPANY C�1
Design Your Own 3-Line Detail Sedgwick
As of Date:01-04-2021 Filter Name:N11426- MIAND LOSS RUNS
Acct Name Policy Num Struct Loc Code(03) File Num Date of Loss Date Rep to Sedgwick Clm Stat Desc Date Clm Closed
Line Desc Event Desc State/Province of Tot Paid Tot Fut Reserves Tot Inc
Loss
Carrier Policy Period 20180204(02/0412018 TO 02/0412019)
Line Code And Coverage Code AL-PD
MIAND,INC. CPP010529902 N11426 179859-11 PD-2 07/20/2018 07/23/2018 Closed 06/25/2020
Auto Liability(3rd COLLISION DAMAGE OH S 8.645.75 $ 0.00 $ 8,645.75
Parry)
AL-PD Totals COUNT: 1
$ 8,645.75
$ 0.00 $ 8,645.75
Line Code And Coverage Code AU-CL
MIAND,INC CPP010529902 N11426 179859-51CL-1 07/20/2018 07/23/2018 Closed 06/2512020
Auto I1st Party) COLLISION DAMAGE OH S 868.00 $ 0.00 $ 868.00
MIAND,INC CPP010529902 N11426 181646-51CLA 02/01/2019 02/1212019 Closed 04/23/2020
Auto(1st Party) COLLISION DAMAGE IN S 994.33 $ 0.00 $ 994.33
AU-CL Totals COUNT: 2
S 1,862.33
$ 0.00 $ 1,862.33
20180204(0210412018 TO 02/04/2019)Totals COUNT: 3
f 10,508.08
S 0.00 f 10,508.08
Grand Totals COUNT: 8
$ 21,248.54
$ 0.00 $ 21,248.54
Coniklentiat Infonnat on.Any aceeamg,aoquailwn,revew,retransmission,dissemination or other use of,or taking of any Page 4 of 4
action in reliance upon the Sensitive Inh-mation by persons or entities other than an Authonzed Recipient is strictly prohibltad.
T.H.E.INSURANCE COMPANY VOW
Design Your Own 3-1-lne Detail sedgwicK
As of Date 01-04-2021 Filter Name:N11426- MIAND LOSS RUNS
Acct Name Policy Num Struct Loc Code(03) File Num Date of Loss Date Rep to Sedgwick Gm Stat Desc Date Cim Closed
Line Desc Event Desc State/Province of Tot Pao Tot Fut Reserves Tot Inc
LOSS
Carrier Policy Period 20160204(021041`2016 TO 0210412017)
Line Code And Coverage Code AL-PD
WAND,INC. CPP0105299M N11426 171564-IIPD-1 07/04/2016 07/14/2016 Closed 08/16/2016
Auto Liability(3rd IV DAMAGED CLMT IN S 3.272.81 $ 0.00 $ 3.272.81
Party) PROPERTY
AL-PD Totals COUNT: 1
$ 3.272.81
$ 0.00 $ 3,272.81
Line Code And Coverage Code AU-CL
MIAND,INC. CPP010529900 N11426 171564.41CL-2 07/0412016 07114/2016 Closed 12/06/2016
Auto(1st Party) IV DAMAGED CLMT IN $ 4,536.70 $ 000 $ 4,536.70
PROPERTY
AU-CL Totals COUNT: 1
S 4,536.70
S 0.00 S 4,536.70
20160204(0210412016 TO 0210412017)Totals COUNT: 2
S 7,809.51
f 0.00 S 7,809.51
Carrier Policy Period 20170204(0210412017 TO 02104)2018)
Line Code And Coverage Code AL-PD
MIAND,INC. CPP010529901 N11426 175884-11PD-1 07/05/2017 07/27/2017 Closed 08/22/2017
Auto Liability(3rd IV DAMAGED CLMT MI $ 2,930.95 S 0.00 $ 2.930.95
Party) PROPERTY
Confidenriel Intormalion Any accessing.atarntilion,rev~m1nmsmKsitm,dhesenwuson or oew use of,or feting of arty Page 2 Of 4
adton in reliance upon ins Sensitive Inlormalion bV pemans or entities other than an Authorized RwtWnt is atrlcay prohibited.
T.H.E.INSURANCE COMPANY %MJ
Design Your Own 3-Llne Detail Sedgwick
As of Date:01-04-2021 Fitter Name:N11426- MIAND LOSS RUNS
Acct Name Policy Num Struct Loc Code(03) File Num Date of Loss Dale Rep to Sedgwick Clm Stal Desc Date Clm Closed
Line Desc Event Desc State/Province of Tot Paid Tot Fut Reserves Tot Inc
Lass
AL-PD Totals COUNT: 1
S 2,930.95
S 0.00 S 2,930.95
Line Code And Coverage Code GL-61
MIANO,INC CPP010529901 N11426 176002-1181.1 08101/2017 08102!2017 Closed 03/1012018
General Liability INJUREDIDAMAGE BY IN $ 0.00 S 0.00 $ 0.00
FIREWORK
GL431 Totals COUNT: 1
S U.W
S 0.00 f 0.00
Line Code And Coverage Code GL-PD
MIAND,INC. CPP010529901 N11426 178613-11 PD-1 07/0412017 0310912018 Closed 09/26/2019
General Liability INJUREDIDAMAGE BY IN $ 0.00 S 000 $ 0.00
FIREWORK
GL-PD Totals COUNT: 1
S 0.00
f 0.00 f 0.00
20170204(02/0412017 TO 02/0412018)Totals COUNT: 3
S 2.930.95
$ 0A0 f 2,930.95
confidentW IMorrnaloon.Any aroessing,acquisition revmw.reuans ri""on,dissemination or ot"t use of,or taking of any Page 3 of 4
ecuon in reliance upon the Sensitive Information ov persons or entities other than an Authorized Reaptenl is slnctty prohibited.