AMR SLURRY SEAL
PMP 22-01
CONTRACTOR'S CERTIFICATION OF COMPLETION
DATE: February 6, 2024
TO: City of Menifee
29844 Haun Rd
Menifee, California 92586
FROM: VSS International, Inc.
(Firm or Corporation)
PROJECT: AMR Slurry Seal - PMP 22-01
This is to certify that I, acting as an authorized official of the above stated firm or corporation, have been properly authorized by said firm or corporation to sign the following statements pertaining to the subject contract:
1. I know, of my own personal knowledge, and do hereby certify, that the work of the contract described above has been performed, and materials used and installed in every particular, in accordance with, and in conformity to, the contract drawings and specifications.
2. The contract work is now complete in all parts and requirements, and ready for your final inspection.
3. I understand and agree that neither the determination by the Owner that the work is complete, nor the acceptance thereof by the Owner, shall operate as a bar to claim against the Contractor under the terms of the guarantee provisions of the contract documents.
Signature of Prime Contractor Signature of Prime Contractor Jeff Roberts | Senior Vice President Jordan X. Reed - Secretary | Treasurer Print name and title Print name and title
(If the Prime Contractor is a corporation two signatures of corporate officers are required.) 4-2
AMR SLURRY SEAL Bond No. 30155124
Premium: Included in
PMP 22-01
Performance Bond
CONSENT OF SURETY FOR FINAL PAYMENT
In accordance with the provisions of the contract between the Owner and the Contractor, and the following named Surety: Western Surety Company
on the Payment Bond in the amount of Three Hundred Ninety-Six Thousand One Hundred Twenty and 00/100° Dollars, *S396,120.00
of the following named Contractor:_ VSS International, Inc. hereby approves of final payment to the Contractor, and further agrees that said final payment to the Contractor shall not relieve the Surety named herein of any of its obligations to the Owner, as set forth in said Surety company's bond.
6th day
IN WITNESS WHEREOF, the Surety Company has hereunto set its hand and seal this of February , 2024
Western Surety Company
shaunise h. Johnston
Signature of Authorized Surety
Shawndrae N. Johnston, Attorney-in-Fact
Title
(CORPORATE SEAL
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CALIFORNIA ACKNOWLEDGMENT CIVIL CODE § 1189
888888888888888888888888888888888888888888888888888888888888888888889888888988888 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
State of California
County of Contra Costa
FEB 0 6 2024
On before me, K. Hummel, Notary Public
Date Here Insert Name and Title of the Officer
personally appeared Shawndrae N. Johnston
Name(s) of Signers)
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
K. HUMMEL I certify under PENALTY OF PERJURY under the
COMM. #2358812 laws of the State of California that the foregoing TUP1 NOTARY PUBLIC • CALIFORNIA
CONTRA COSTA COUNTY paragraph is true and correct.
MY COMM. EXP. MAY 24, 2025
WITNESS my hand and official seal.
Signature
Place Notary Seal and/or Stamp Above Signature of Notary Public
OPTIONAL
Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document.
Description of Attached Document
Title or Type of Document:
Document Date: Number of Pages: _
Signers) Other Than Named Above: _
Capacity(ies) Claimed by Signer(s)
Signer's Name: Signer's Name:
• Corporate Officer - Title(s): • Corporate Officer - Title(s):
• Partner - • Limited • General • Partner - • Limited • General • Individual X Attorney in Fact • Individual • Attorney in Fact • Trustee • Guardian or Conservator • Trustee • Guardian or Conservator • Other: • Other:
Signer is Representing: Signer is Representing: _
888888888888888888888888888888888889988888883888888888888888888888383888888988388 ©2019 National Notary Association
Western Surety Company
POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY-IN-FACT Know All Men By These Presents, That WESTERN SURETY COMPANY, a South Dakota corporation, is a duly organized and existing corporation having its principal office in the City of Sioux Falls, and State of South Dakota, and that it does by virtue of the signature and scal herein affixed hereby make, constitute and appoint Steven N Passerine, Kathleen E Earle, Doreen Green, Shawndrae N Johnston, Individually of San Ramon, CA, its true and lawful Attorney(s)-in-Fact with full power and authority hereby conferred to sign, seal and execute for and on its behalf bonds, undertakings and other obligatory instruments of similar nature - In Unlimited Amounts -
and to bind it thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of the corporation and all the acts of said Attorney, pursuant to the authority hereby given, are hereby ratified and confirmed.
This Power of Attorney is made and executed pursuant to and by authority of the Authorizing By-Laws and Resolutions printed at the bottom of this page, duly adopted, as indicated, by the shareholders of the corporation.
In Witness Whereof, WESTERN SURETY COMPANY has caused these presents to be signed by its Vice President and its corporate seal to be hereto affixed on this 9th day of November, 2023.
SURETY WESTERN SURETY COMPANY
CORPORAT
SEA
SOUTH DANCES Any tatto
Larry Kasten, Vice President
State of South Dakota
} SS
County of Minnehaha
On this 9th day of November, 2023, before me personally came Larry Kasten, to me known, who, being by me duly swor, did depose and say: that he resides in the City of Sioux Falls, State of South Dakota; that he is a Vice President of WESTERN SURETY COMPANY described in and which executed the above instrument; that he knows the seal of said corporation; that the seal affixed to the said instrument is such corporate scal; that it was so affixed pursuant to authority given by the Board of Directors of said corporation and that he signed his name thereto pursuant to like authority, and acknowledges same to be the act and deed of said corporation.
My commission expires M. BENT
March 2, 2026 SOUTH DAKOTA SEAL M. Bent
M. Bent, Notary Public
CERTIFICATE
1, L. Nelson, Assistant Secretary of WESTERN SURETY COMPANY do hereby certify that the Power of Attorney hereinabove set forth is still in force, and further certify that the By-Law and Resolutions of the corporation printed below this certificate are still in force. In testimony whereof I have hereunto subscribed my name and affixed the scal of the said corporation this 6th day of February, 2024.
WESTERN I SURETY COMPANY
ПРОРАТ
7. Nelson
SEAV
SOUTH DANGE L. Nelson, Assistant Secretary
Authorizing By-Laws and Resolutions
ADOPTED BY THE SHAREHOLDERS OF WESTERN SURETY COMPANY
This Power of Attorney is made and executed pursuant to and by authority of the following By-Law duly adopted by the sharcholders of the Company.
Section 7. All bonds, policies, undertakings, Powers of Attomey, or other obligations of the corporation shall be executed in the corporate name of the Company by the President, Secretary, and Assistant Secretary, Treasurer, or any Vice President, or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys in Fact or agents who shall have authority to issue bonds, policies, or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile.
This Power of Attorney is signed by Larry Kasten, Vice President, who has been authorized pursuant to the above Bylaw to exccute power of attorneys on behalf of Western Surety Company.
This Power of Attorney may be signed by digital signature and sealed by a digital or otherwise electronic-formatted corporate scal under and by the authority of the following Resolution adopted by the Board of Directors of the Company by unanimous written consent dated the 27 day of April, 2022:
"RESOLVED: That it is in the best interest of the Company to periodically ratify and confirm any corporate documents signed by digital signatures and to ratify and confirm the use of a digital or otherwise electronic-formatted corporate scal, cach to be considered the act and deed of the Company." Go to www.cnasurety.com > Owner / Obligee Services > Validate Bond Coverage, if you want to verify bond authenticity.
Form F4280-6-2023
AMR SLURRY SEAL
PMP 22-01
CONTRACTOR'S AFFIDAVIT OF PAYMENT
To All Whom It May Concern:
WHEREAS, the undersigned has been contracted by the City of Menifee to furnish labor and materials for AMR Slurry Seal - PMP 22-01, under a contract dated the 3rd day of May , 2022, in the City of Menifee, County of Riverside, State of California, of which City of Menifee is the Owner.
NOW, THEREFORE, this 6th day of February _, 2024 the
undersigned, as the Contractor for the above-named Contract pursuant to the Conditions of the Contract hereby certifies that, except as listed below, he has paid in full or has otherwise satisfied all obligations for all materials and equipment furnished, for all work, labor, and services performed, and for all known indebtedness and claims against the Contractor for damages arising in any manner in connection with the performance of the Contract referenced above for which the Owner or his property might in anyway be held responsible.
EXCEPTIONS: (If none, write "None". If required by the Owner, the Contractor shall furnish bond satisfactory to the Owner for each exception.)
2/6/2024 2/6/2024
Date Signature of Prime Contractor Date
Signature of Prime Contractor
Jeff Roberts | Senior Vice President Jordan X. Reed - Secretary | Treasurer Print name and title Print name and title
(If the Prime Contractor is a corporation two signatures of corporate officers are required.) 4-6
AMR SLURRY SEAL
PMP 22-01
GUARANTEE AGREEMENT
We hereby guarantee that AMR Slurry Seal - PMP 22-01, has been installed in accordance with the drawings and specifications and that the work as installed will fulfill the requirements included in the specifications. The undersigned agrees to promptly repair or replace, in a manner satisfactory to the Engineer, any or all of such work, together with any other adjacent work which may be displaced in connection with such repair or replacement, that may prove to be defective in workmanship or material within a period of one (1) year from the date of acceptance of the above referenced project by City of Menifee, ordinary wear and tear and unusual abuse or neglect excepted.
The Contractor also agrees to indemnify and hold City of Menifee harmless from claims of any kind arising from damage due to said defects in the work constructed under the Contract.
In the event that the undersigned fails to comply with the abovementioned conditions within a reasonable period of time, as determined by City of Menifee, the undersigned hereby authorizes the City of Menifee to proceed with the repair of said defects and the Contractor and his/her surety shall be liable to the City of Menifee for the cost thereof.
VSS International, Inc. 3785 Channel Drive, West Sacramento, CA 95691 Firm name Address
Signature of Prime Contractor or Sub-Contractor Signature of Prime Contractor or Sub-Contractor Jeff Roberts Senior Vice President Jordan X. Reed - Secretary | Treasurer Print name and title Print name and title
Countersigned (required by Prime Contractor if this Guarantee Agreement is for a Sub-Contractor):
Firm name Address
Signature of Prime Contractor Signature of Prime Contractor Print name and title Print name and title
Contact for Service:
Name
Address
Telephone number and email address
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