1998-0629_MD CONSTRUCTION GROUP_Bid Proposal -
P.
BID PROPOSAL
For the: CITY BRIDGE REPAIRS
From: 6
"A "
eall-Satu crrce,1 &ea)P 1-164„-Esc
Contractor, License No. & Classification
To the Members of the City Council
City of San Juan Capistrano
Gentlemen:
The undersigned, as bidder, declares that he has carefully examined the location of the proposed work
as described, examined the Plans, Specifications, Special Provisions, and the Standard Specifications
- - for Public Works Construction, 1997 Edition, including all supplements therefore,read the Instructions
to Bidders, and is familiar with all proposal requirements, and hereby proposed and agrees, if the
proposal is accepted, to complete the said construction in accordance with the Contract Documents,
as defined in Section 1-2 of the Standard Specifications, in the time stated herein, for the unit price or
lump sum given on the following pages of this proposal, amounting to a Base Bid Price (Bid Items 2A,
3A, 8A, 4B, 5B, 8B, 3C, 4C, 6C, 8C, 7D, 8D)of:
61z r,-( p-ta ./4.6,46 014 IA-04 ti(2 ,0 CA14-t F---( S-1,0d15 $ 66? I iv
• Words Figures
Said amount to include and cover all taxes, the furnishing of all materials, the performing of all the
labor requisite or proper and the providing of all necessary machinery, tools, apparatus, and other
_
means of construction; also, the performance and completion of all the work in the manner set forth,
described and shown in the Specifications or the drawings for the work.
The undersigned, as bidder, also agrees that at the City's option, before the contract is awarded, the
following work items may be added to the base bid at the costs stated.
Additive Alternate Bid Price (Bid Items 1A, 9A, 1B, 9B, 1C, 9C) of:
rio
-p(CVS POI-L.A(2.5 $ 4 s;vot)—
Words Figures
Said amount to include and cover all taxes, the furnishing of all materials, the performing of
all the labor requisite or proper and the providing of all necessary machinery, tools, apparatus, and
other means of construction; also, the performance and completion of all the work in the manner set
forth, described and shown in the Specifications or the drawings for the work.
If the contract is awarded, the undersigned agrees to enter into a contract with the City of San
Juan Capistrano and to commence work within fifteen (15) calendar days from the date of execution
thereof, and to diligently prosecute the work to completion before the expiration of twenty-five (25),
calendar days for the Base Bid, from the date of the Notice to Proceed, or forty-five(45) calendar days
for the Total Bid (13asc Bid plus Additive Alternate Bid), from the date of the Notice to Proceed.
All bids are to be computed on the basis of the given Estimated Quantities of Work, as
indicated in this proposal, times the unit prices as submitted by the bidders. In case of discrepancy
between words and figures, the words shall prevail. In case of discrepancy between unit prices and
the extension thereof, the unit price shall prevail and bids will be computed as indicated above and
compared on the basis of corrected totals, given solely as a basis for comparison of bids. It is •
understood that the City does not expressly, nor by implication, agree that the actual amount of work
will correspond therewith, but reserves the right to increase or decrease the amount of any item or
- portion of the work or to omit portions of the work as maybe deemed expedient by the Engineer.
It is also understood by Bidder that the City of San Juan Capistrano has the right to reject this
proposal or to award a contract to the undersigned at the prices stipulated. If the proposal is rejected,
then any check or cashier's check shall be returned to the undersigned within thirty (30) days. No bid
bonds will be returned. If the proposal is accepted and the undersigned fails to enter into a contract
within fifteen (15) days after the agreement is delivered to him for signature, or within such further
time as may be granted by the Members of the City Council, then said check shall be cashed or said
bond declared forfeit and an amount equal to the difference between the lowest bid and the next lowest
bid who will execute a contract shall be paid into the treasury of the City of San Juan Capistrano as
liquidated damages for the failure of the undersigned to comply with the terms of this proposal.
Accompanying this proposal is plops 3oN (Insert
"$ cash," cashier's check, certified check or bidder's bond on the forms from pages BB-1
and BB-2 of these Contract Documents, as the case may be), in an amount equal to at least ten percent
(10%) of the Total Bid (Base Bid plus Additive Alternative Bid).
The following is the name and place of business of the surety company which will furnish the
required bonds as surety if the work is awarded to the undersigned:
124-4)1-0•-,06S ,,,Mt6U C-E ecNA'�9.w1 . cit. •�1t Usme4 c lcomn,4,4, 3z70 1n��ca.�9 Lwtp i26- ,141-1 Do`
Licensed in accordance with an act providing for the registration of contractors -- License No. BN o,6'
zv'4 83 and Classification 'P4 q 1764
Signature of Bidder:
e , 6e0oP
, , .
4.ReA,42.. / IOlVaQ' -t -0fMPlfrj?
(If an individual, so state. If a firm or co-partnership,.state the firm name and give the names of all
individual co-partners composing the firm: President, Secretary, Treasurer, and Manager thereof.)
Dated: Tc.M1tE i 1(7)963 f O Bo-,gBo-,g evlz A b€I- U4 2 cA �I 445
Business Address
4
• - .
•
• Dated: -1.1•1.e 29, me 049) 7 5-9-0 Z 64
Telephone Number
• Further, the undersigned bidder certifies that he has thoroughly checked the figures set forth in this
proposal, that they are correct to the best of his knowledge and that they constitute his proposal for the
work called out herein.
Dated: --SA'ke" jay
-
Signature of Bidder
•
Dated:
Telephone Number
•
. _
.
1 '
SCHEDULE OF WORK ITEMS
CITY BRIDGE REPAIRS
BASE BID
Estimated Work Items With Contract Unit Price Contract Unit Price Total Amount
Item
Quantity (Written in Words) (In Figures)
I. A. Del Obispo Street Bridge .
1 2A 152 LF Repair Longitudinal Deck Joint for the
price of:
TRie-r'i SCA/44 1 . 1)1100 cry ,
I •
dollars
per lineal foot. $ 3-7'52 $ 5700
3A L.S. Repair Spalled Concrete (Deck) for the
i . lump sum price of:
-THez-E- -n-tousthq_O riP-rq dollars. $ (10
3050 ---
1 8A L.S. Traffic Control, Striping, and Signage for
the lump sum price of: ittpiq.poi E:
411c Tiovsogo fizgr KW%) ci o liars. $ 6e is- !
B. La Novia Avenue Bridge
1 4B 180 LF Repair Approach Joint Seals for the price
I of:
12-c1
II-1112r'-( Iwo .f_ ioci zs-
I , dollars per linealifoot. $
5B 18.5 LF Repair Tube Railing for the price of:
I bkJE vi-utiAgee4 Aii 4.€1,-( vo
$ 190-
dollars per lineal foot.
1 8B L.S. Traffic Control, Striping, and Signage for
the lump sum price of: ay
$ -1 32-5--
,,,i,x 144101 ° luiVii,k
I -5N eg 17-1005449 ' — t- dollars.
C. Rancho Viejo Road Bridge
I3C L.S. Repair Spalled Concrete (Deck) for the
price of:
I Nur" ThoiA611,A0 itte--0--
$ 3300
dollars. ro
I6
I
, - i I
1 - C.;
I . .
4C 140 LF Repair Approach Joint Seals for price of:
I 6‘46,H- I1L $e- ,._rz,7 - vo
$ 10,500
dollars per lineal foot.
. ,
i6C L.S. Repair Spalled Concrete Railing for the
lump sum price of:
vo
I 1i-4013E prOosNto GrPo4 dollars. $ 305-0
I8C L.S. Traffic Control, Striping, and Signage for
the lump sum price of:
„a, al.
I6ix Tztoutsiwo saur /4-' - dollars, $ 6W14-7
ID. Camino Capistrano Bridge
7D L.S. Repair Median Joint Seal for the lump
I sum price of:
1..KALIOp?,0
liftligg. Vousit740 i"'- dollars. $ vv
I8D L.S. Traffic Control, Striping, and Signage for
I . the lump sum price of:
i'f- 1740060.0 C-Abl-ir /4dollars. $ 1,600(2
I
Base Bid (Bid Items 2A, 3A, 8A, 4B, 5B, 8B, 3C, 4C, 6C, 8C, 7D, 8D, Enter here and on page 3) of:
I '61"4 (61-1 r" -p-toosikt4Demir,: svp.oareo .5“(e..,s,—,( $ 66, (70 e
Words Figures
1
I
I
I
I
I
• • r
ISCHEDtTLE OF WORK ITEMS
CITY BRIDGE REPAIRS
ADDITIVE ALTERNATE BID
iItemestimated Work Items With Contract Unit Price Contract Unit Price Total Amount
Quantity (Written in Words) (In Figures)
A. Del Obispo Street Bridge
1A 9,820 LF Seal Deck for the price of:
oos- e --)10o
3z . 40
dollars per square foot. $ I — $ 12,96Z —
I9A L.S. Traffic Control, Striping, and Signage for
the lump sum price of:
r
I 60 1
-Roo 114ouuk
dollars. ska -1-Eitep4 SEvf4a f boo
eo
$ 1037 —
IB. La Novia Avenue Bridge
1B 6,330 LF Seal Decktfor the price of:
OWE. c 4(lico i 40
dollars per square foot. $ I — Gro
$ 8g6z —
9B L.S. Traffic Control, Striping, and Signage for
the lump sum price of: savo fa owl OM(
•
1)-% EE 17401.)4646 OalE WM° dollars.
$ 31 at3e
C. Rancho Viejo Road Bridge
-1'
1C 13,650 LF Seal Depk for the price of:
ega 6- f MI 00 dollars per square 2,0vo
foot. e $ 1 — $ It, 380—
9C L.S. Traffic Control, Striping, and Signage for
the lump sum price of:
„, ,0-1
Ogd 'T40061'040'51i )4440"13 - dollars. . wo
$ 16zo-
,
Additive Alternate Bid Price (Bid Items 1A, 9A, 1B, 9B, 1C, 9C, Enter here and on page 3) ,
. etzs4- r")E T.005 f1.4 6 bo Li,Ar2-S $ 4.5-;000 -=
Words Figures
8
•
NON-COLLUSION AFFIDAVIT TO. BE EXECUTED BY
BIDDER AND SUBMITTED WITH BLID
STATE OF CALIFORNIA
) SS. •
County of 0e41-.46,a )
-
..--8L-A-00c. , being first duly sworn deposes and says
that he is 0,4-N,L.P-ii of Ai
tamsraverEw (Aerkr P , the party making the foregoing bid; that such bid is not made in
the interest of or on behalf of any undisclosed person, partnership, company, association,
organization or corporation; that such bid is genuine and not collusive or sham; that said bidder
has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid,
and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or
anyone else to put in a sham bid, or that anyone shall refrain from bidding; that said bidder has not
in any manner, directly or indirectly, sought by agreement, communication or conference with
anyone to fix the bid price of said bidder or of any other bidder, or to fix the bid price of or cost
element of such bid price, or of that of any other bidder, or to secure any advantage against the
public body awarding the contract of anyone interested in the proposed contract; that all
statements contained in such bid are true; and further, that said bidder has not directly or
indirectly, submitted his bid price or any breakdown thereof; or the contents thereof; or divulged
information or data relative thereto, or paid and will not pay' any fee in connection therewith, to
any corporation, partnership, company, association, organization, bid depository, or to any
member or agent thereof, or to any other individual except to any person or persons as have a
partnership or other financial interest with sa'f. eidder in this general business.
DATED: -I 14-1,‘ Ole
SIGNATURE
4L &<
On this the day of , 19 , before me, the undersigned, a Notary
Public in and for said State, personally appeared
, personally known to me/proved to me on
the basis of satisfactory evidence, to be the person(s) whose name(s) subscribed to
the within instrument, and acknowledge that executed it.
_
WITNESS my hand and official seal.
Notary Public in and for said State
9
CALIFORNIA.ALL-PURPOSE ACKNOWLEDGMENT
State of California
4 ✓/ ss. )
County of (�I�f'KA-7161& •
,
r�On J1f I✓ 2-9, 19 9$', before me, - N 1 fa M• )4ii G R-1" , AsTAc26A-61-tG
` Date Name and Title of Officer(e.g.,"Jane Doe,Notary Public")
Ce )
Ce personally appeared DAv 1b. A A . 6621 :0(4 )
Name(s)of Signer(s)
1 Elpersonally known to me )
)
proved to me on the basis of satisfactory
ie
evidence
?
(�. to be the person whose name) Fa'r'e ?
( subscribed to the within instrument and )
( • acknowledged to me thatc/shethey executed
q the same _ in eg/hof-Alteir authorized )
qcapacity(] )' and that by 63/1vritT )
JENNIFER M.KNIGHT
( signature,Kon the instrument the person.(sr or ?
< , u Commission m 1176904 Z 1
�� z Y �S , Notary Pubic California ;
•
DESIGNATION OF SUB-CONTRACTORS
Submit with Proposal.
In compliance with the Provisions of Section 4100-4107 of the Government Code of the State of
California as amended, the undersigned certifies that he has used the sub-bids of the following
listed sub-contractors in making up his bid, and that the sub-contractors listed will be used for the
work for which they bid, subject to the approval of the Engineer, and in accordance with the
applicable provisions of the Specifications. It is understood and agreed that all those portions of
the work called for in the contract documents for which a sub-contractor is not listed will be
performed by the undersigned through his forces. If no sub-contractors are listed, all bonds and
insurance will be written in the name of the general contractor only.
Item of Work Sub-contractor License No. Address Phone
& Classification
vA,i+
1.
V4PE ra P4.4kL . 5463673 telu(1.1 te , 64— -714-17Z-‘16---0
(44--r, 2. 64.4,4 eAtirttam,4 ,1;2r4t.te,_IP. , 66- 6I --OS-V-17/1
3.
•
4.
5.
6.
7.
8.
0445n2uorre4 4P-oc.iP
BIDDER'S NAME
1. 1 /
AUTHORIZED SIGNATURE
10
•
BID BOND
• KNOW ALL MEN BY THESE PRESENTS, that we, ND CONSTRUCTION GROUP
az PRINCIPAL, and REDLAND INSURANCE CCNPANY
, as SURETY, hereinafter called Surety, are held and
firmly bound unto the CITY OF SAN JUAN CAPISTRANO, Obligee, hereinafter called
City, in the sum of $ 10% OF BID*** , for payment whereof Principal and Surety bind
themselves, their heirs, executors, administrators, successors, and assigns, jointly. and
severally, fairly by these presents.
THE CONDITION OF THIS OBLIGATION is such that whereas the Principal has
submitted the accompanying bid dated JUNE 29 , 19,98 , for the construction
of CITY BRIDGEREPAIRS for the
City of San Juan Capistrano, Orange County, California.
NOW, THEREFORE, if the Principal shall not withdraw said bid within thirty (30)
days after the opening of same, and shall, within fifteen (15) days after the agreement
has been presented to him for execution, enter into a written contract with the City in
accordance with the bid as accepted, and if the Principal shall give the required bond
With good and sufficient sureties, or sureties for the faithful performance and proper
fulfillment of such contract and for the protection of Laborers and materialmen, or in
the event of the withdrawal of said bid within the periods specified, or the failure to
enter into said contract and give said bond within the time specified, if the Principal
shall within sixty (60) days after request by the City,'pay the City the difference
between the amount specified in said bid and the amount for which the City may procure
the required work and/or supplies if the latter amount be in excess of the former, then
the above obligation shall be void and of nal effect, otherwise to remain in full force and
virtue.
Further, as a part of the obligation secured hereby, andin addition to the face
amount specified therefor, there shall be included costs and reasonable expenses and
fees, including reasonable attorney's fees, incurred by City in successfully enforcing such
obligation, all to be taxed as costs and included in any judgment rendered.
•
83-1
' ,, i '`
t
IN WITNESS WHEREOF, the above-bounden parties have executed this
instrument under their several seals this 25TH day of'JUNE 19 9 , the name and
corporate seal of each corporate party being affixed hereto and these presents duty
Isigned by its undersigned representative pursuant to authority of its governing body.
•
Two Witnes3•1 ( Individual) M) CONSTRUCTION GROUP
fI PRINCIPAL
-V- i ' ( $',,...,, 9r,,,„„,,,APF BY:
# l
lifg-L'
Title: akimere
f ATTEST (If Corporation)
Corporate Seal REMAND INSURANCE COMPANY . ,, ;1 . ; i{r�
I 5 R ETY ,
I a
fi
ATTEST BY: ,� \~ rr
l 7,'
Title: KELLY A. ATTORNEY-IN=FACT- =
:
----'''''':/i:,77,- *,1-1 11:1
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APPROV a AS TO FORM:
i 1 i I
John - Shaw, City - ttorney
BB-2
ALL \-`L-RPOSE ACKNOWL1' !GEMENT
STATE OF CALIFORNIA )
s . s .
COUNTY OF 1 SAN BERNARDINO )
On LO (a5pg before me,
FRANCES LER, NOTARY PSI TC , personally appeared
KELLY A. SAITMAN, ATTORNEY—IN—FACT ,
X personally known to me;
or proved to me on the basis of satisfactory evidence to be the
persons) whose name(-s) is/ar.a. subscribed to the within instrument and
acknowledged to me that (he/she/they) executed the same in
11 /her/ authorized capacity('cc) , and that the entity upon
behalf of which the persons}-_acted, executed the instrument.
WITNESS my hand and official seal . •
(SEAL) e�:k?f=°:+6}CaC3t54C�G,9tac3r�carsur�c,r��ae�csr,�;a;oe*
z
(.,+•, ,; •.FRANCES LEFLER zs COMM. #1058976 s
r e NOTARY PUBLIC-CALIFORNIA,;
SAN BERNARDINO COUNTY
o ' �' My Comm.Exp. May 14, 1999
3C+aJPJ44Czt�caci0t�4Y�7r�r���r� ChOC@PdSa6i�4R�sWq
` A/14/1/moo , / /�
Signature of Nota ,/ Public .
****k************ k******************************************
CAPACITY CT•ATxRD BY SIGNER:
Though statute does not require the notary to fill in the data below,
;,doing so may prove invaluable to persons relying on the document.
Individual(s)
• Corporate Officer(s) and
Titles and
Partner( s) Limited _ General
X Attorney-in-Fact
Trustee ( s )
Guardian/Conservator
Other:
Signer is representing:
****k******************************************************
ATTENTION NOTARY: . Although the information requested below is
optional, it could prevent fraudulent attachment of this certificate
to unauthorized document.
Title of type of document: BOND
Number of pages : .
• Date of document:
Signer( s ) other than named above:
THIS CERTIFICATE MUST BE ATTACHED TO THE DOCUMENT DESCRIBED ABOVE.
KAS/189637
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, • $; } ''".4, :,',' ,s,
"REDLAND INSURANCE COMPANY - :,,''.'"'v, ''''
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, , RED • 1
0 512 5 9-
- - - - - " POWER OFATTORNEY '-':K1,-. : ', 'I' nEu , .i.,j._ _v: .'
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KNOW ALL MEN THESE PRESENTS,THAT REDLAND INSURANCE COMPANY does'rhereby make • ' ,:,,: ':'.1*P.,
'''"'•-s' ''''''' ..,;7.••••-' -,'''''• ,•, ''::-• 1 7',', ' ' e, •• , ••.--',c.c?.
JAY•Th..FRPEMAK*FRANCES LEFLER7 kip..LyAAAITIvIAN OF ONTARIO, CALIFORNIA ,.7.',„: ' ';,:,,•,,,,,,,7,,,, ''.::.,-,:',` ' '''''.•:,,,.,7:'",' ` •-:',,"' ' .,...,,-..,
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its true and lawful Attorney-in-FaCtilo make,"executeind deliver on its'behalf Surety bonds,undertakings and other instruments:of.
• .7_,7,r'r.,,,, 'smular nature;as folloyvs: _
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\ ..,WITHOUT PMITNATIOS,AS to.•TypE.ANDAm". t:t0'.-tirt. . ' ' i
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;,:,,,,,,,„:* ' ,,,•, .•This PoWer'bf,'Attorney is granted and,sealed under and by the authority of the following Resolution adopted by;:the,Board of
•''Directors of the Company on the 18th( day of 1993.• • • 7::••;'•'• . '' '''"". ";-"`" 7.' • , ;::, • .•-',:, -...., -, ,:•/,, •:,/,,,f
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":9„2.21.1 ( ••.',,, :,:,.,•:"RES,O.,14VED,that the Chairman of the-Board;the President,an Executive Vice President or'af•Vice President be,and,that.eadi •' t.....;-,I.,,,V,;;
of them is,authorized to-execute Powers of Attorney.qUalifying`the Attoiney-in:Fact named in the given Power of Attorney tb.-.;,, :,.,:,,,.,,. ":,,•-••.;;;P-
•-•1;7,4 .f,
execute hi:behalf of the Company,bonds,undertakings and other instruments of similar nature,and said officers/110yT. rename any
-.--,'-'y •,,such Attorney-M-Fiani'agent-and reyoke..any,Power of Attorney previously granted to such person
•,:'''' ''' • .• ,r, ;,,,t,.7-•. •,,,..,,-;•:f• ' -',;V,' . ,••,, w-K,
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:,•,..; ;.i,',.0, ,i:,.',', •'Fpwrikit RESOLVED,that an Assistant Secretary be,and that each any of them hereby is,authorized to the
execution of any such Power of AttOrneysand,to attachtheretri,the seal of the,Company. 7.•'-- "'.••,,.'•,,,, -,-',7';•:,•• ••• ••b'
I' '''' ',:, ' . ...• ..,./ •:-
that the FURTHER RESOLVED,: 'signatures of such officers and the seal of the Company may be affixed to any•such•PoWer of •,•• ' f-10-,:',
--,..,,,g:•:,' ., •:'•-- -- , , - .. , , , ,
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Attorney or to any certificate relating thereto by facsiMile,and any such Power of Attorney or certificate bearing such•facsirmle ,,
'',.tt•ii! ,;,:',,signatures iir„fa.6irriilp seal shall be binding upon the Companywhenso affixed and in the future with respect to any bond,
undertaking or_iiirUm
stents of similar nature to which it attached.c'
''.%e('',' ',I:;'''' •••••••• • ., '' - ;, . ,„ , %,, ,i :,, •-,, 1 -'0''.'''-'s.:_
'',"- IN-WITNESS WHEREOF,REDLAND INSURANCE COMPANY has caused its official sealtobe hereuntRaffixedand these
'presents'tO,be Signedbyis President,this1.8th day of October 1993 :' -`7, :,',,, "•- , ,, , .., ' ''''•- -
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REDLAND INSURANCE COMPANY i 8 i' ;,.....--' .•7:.• ,:a-7.,:p,
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•,'. ', -'-' , ''' ' •''' '-'':-PETERA' KNOLLA'' . ''''' "''..*, ,',,,.
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,isF,i-etary,,„. „::,,- ,: ,,,. ,:..,_-,-,/, JOHN P. NELSON . .., __„ .„s
--,,,,, ,,, ,.. • .,,.,•,, , ,.,• President; ,•„:,
STATE OF IOWA . 7, ' ,- • } ' -,' , ,,' ,••4ilf,_;,.
-1A.,,, ) ss Council CounCll•Bluffs
•-• I COUNTY•OF,PoTTAWATTAMIE ' JP-; . ,,,'" 4,:„ ';•,‘-: •-,'••. ' •-,,, , ,. , , „
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-7,,,i,v , -,••• ,.-,, this,18t11 day of October,1993 beforemepersonally came John P.Nelson,to me known,who benigbrinq.clulk r,orri, :
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depose and say thathe is President of REDLAND INSURANCE COMPANY the corporation described in and which executed the .,,,,, ,-,w,
above instrument that he knoWs the seal of the said'COrporatiOn,that•the Seal affixed to the said instrument such corporate seal .. ,V,,!‘:'i
that iewag:sd affixed by order nf the Board of Directors of said corporation and•that he signed hisnamethereto by like order
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•4,,- 7, '•-.. .!. JEANETTE, ALDREDGE ,,,. i,-. r-, 101,4 kb. ,, ., • " ' •--)
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, „,. ,,,,,,, '. . *-• .* MY COMMISSIONEX .:::. • , ,,,,,. „, , . ,
,.i.,, ' -,.. JEANETT.E,ALDREPGE ' : .,;•,,•;,:, .7.,•,:;,:-,,, .',?),-,•,3,:,„:::
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My.Commission Expires March 15 1r9
NQTARYPUBLIC
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•-•.f1C,.cv , :-., ..; I,theiundersigned,Vice President of-REDLAND INSURANCE COMPANY an Iowa-corporation,DO," HEREBY,CERTIFY that
the
e foregoing and attached Of Attorney remains full force and not been and furtheirnorethattheResoiution ,,,,',
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of the Board of Directors set forth in the said Power of Attorney,is now force.,,,
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Signed and sealed at t.li' 'City of Council Bluffs,in the State of Iowa,dated the,:'25-n-i.'• ' day of',••• •,, ,
JUNE 4.19'. 98',-:.• . ':. ;..:-V,
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, HDOCUMENT IS NOT VALID uN4Ess,PRINTED ON GREY SHADED BACKGROUND-WITH ;i ED SERIAL NUgBER.IN-THE
UPPER RIGHT HAND CORNER.:-.THE,BACK ORTHIS.DOCUMENT,CONTAINS AN,AkTIFJCIAt.WATEkMARK,TwLp AT. AN,
ANGLE TO VIEW IF YOU HAVE ANY QQESTIO- r$,CONCERNING THE AUTHENTICITY OF THIS DOCUMENT;you ARE URGED
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