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15-1201_TAYLOR TENNIS COURTS, INC_Agenda Report_F1bCity of San Juan Capistrano Agenda Report TO: Honorable Mayor and Members of the City Council 12/1/2015 F1b FROM : Thom Coughran, P.E., Interim Public Works and Utilities Director~ fY .f t/V Prepared by: Paul Meshkin, P.E., Senior Civil Engineer DATE: December 1, 2015 SUBJECT: Consideration of Rejecting the Bid and Authorization to Re-Advertise and Receive Construction Bids for the Camino Capistrano Athletic Arena Court Resurfacing Project (CIP 15304) RECOMMENDATION: By motion: 1. Reject the one bid received for the Camino Capistrano Athletic Arena Court Resurfacing Project (CIP 15304); and, 2. Authorize staff to re-advertise and receive construction bids for the Camino Capistrano Athletic Arena Court Resurfacing Project (CIP 15304). EXECUTIVE SUMMARY: Staff is recommending that the City Council reject the one bid received for construction of the Camino Capistrano Athletic Arena Court Resurfacing Project (CIP 15304) and readvertise the bid package with a revised project scope to include two (2) bid alternatives. One bid alternative will be for replacement of the existing carpet and padding with the same material and the second bid alternative will be for removal of the existing carpet and padding and repairing and repainting the concrete surface without reinstalling new paddings and carpet. DISCUSSION/ANALYSIS : The condition of the tennis, basketball and soccer courts surfaces have been deteriorated over the past several years and the site is in need of urgent repairs and resurfacing. The Project was advertised for construction on October 22, 2015, and the bid opening date was on November 12, 2015. Only one (1) responsible bid was received for the Project. The Notice Inviting Bids for construction was advertised on October 22, 2015, and the bids were due to the City Clerk's office no later than 2:00P.M. on November 12, 2015. One (1) bid was received by the City Clerk's office before 2:00 P.M. on November 12, 2015. The bid was opened by the City Clerk's staff. A time limit of Thirty (30) working days or six (6) calendar weeks from the date of Notice to Proceed had been set for completion of the construction City Council Agenda Report December 1, 2015 Pag e 2 of 3 with an expected completion date of January 31, 2016. Staff recommends that the City Council reject the one bid and readvertise the bid package with a revised project scope to include two (2) bid alternatives. One bid alternative will be for replacement of the existing carpet and padding with the same material and the second bid alternative will be for removal of the existing carpet and padding and repairing and repainting the concrete surface. FISCAL IMPACT: Rejection of the bids will incur minor cost to re-advertise the project. The bid amount that was received was for $87,879 and the total construction cost estimates are as follows: Construction (Contract) 1 0% Contingency Total Direct Construction Costs Construction Engineering (staff time) Total (Based on bid received) Fiscal Year 15/16 Budget Amount Over Budget $87,879 $8,788 $96,667 $15,333 $112,000 $88,050 $23,950 There will be a budget shortfall of $23,950 to complete the construction of this project ($112,000 less $88,050 of available budget) if the project was awarded. The Engineer's Estimate for the project was $81,000. ENVIRONMENTAL IMPACT: This project has been reviewed in accordance with the California Environmental Quality Act. The City's Environmental Administrator has determined that the project is exempt from environmental review pursuant to CEQA Guidelines Section 15061 (b)(3), General Rule, because the resurfacing of the tennis, basketball and soccer court surfaces is considered a maintenance and repair activity. The activity is covered by the general rule which exempts activities that can be seen with certainty to have no possibility for causing a significant effect on the environment. PRIOR CITY COUNCIL REVIEW : Not applicable. COMMISSION/COMMITIEE/BOARD REVIEW AND RECOMMENDATIONS : • On November 16, 2015, the Project was presented to the Parks, Recreation, Senior and Youth Services Commission as a verbal presentation and no formal action was taken. City Council Agenda Report December 1, 2015 Page 3 of 3 NOTIFICATION : Taylor Tennis Courts Inc. A ITACHMENT(S): Attachment 1-Bid Package SECTION C. BIDDER'S PROPOSAL BiDDER SHALL SUBMIT ALL FORMS UNDER SECTION C. BIDDER'S PROPOSAL AS PART OF THE BID. FAILURE TO DO SO WILL RESULT IN A NON-RESPONSIVE BID. BID PROPOSAL For the: Camino Capistrano Athletic Arena Court Resurfacing CIP 15304 From: --~~~~~~--~--~~~~~~~-+~----~~~~=3 Conn·acto ·,License No. & Classification To the Members of the City Council City of San Juan Capistrano Ladies/Gentlemen: The undersigned, as bidder, declares that he has carefully examined the location of the proposed work as described, examined the Plans, Specifications, Special Conditions, and the Standard Specifications for Public Works Construction 2012 Edition, 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 total of: $ %2 727, o'O Figures Said amount to include and cover all taxes, the furnishing of all materials, the petforming 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 and to commence work within fifteen (15) calendar days from the date of issuance of the Notice to Proceed and to diligently prosecute the work to completion before the expiration of thirty_fl.Q} Working Days. 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 11 61147.02100\20980503.2 ATTACHMENT 1 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 may be deemed expedient by the Engineer. It is also understood by Bidder that the City 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 as liquidated damages for the failure of the undersigned to comply with the terms of this proposal. Accompanying this proposal is Ji3 '.) l!:Jo """' A (Insert "$ cash, " cashier's check, certified check or bidder~v bond forms included in these Contract Documents. as the case may be), in an amount equal to at least ten percent (10%) of the total bid. NOTICE -Ifbidder or other interested person is a corporation, state legal name of corporation, also names of the president, secretary, treasurer, and manager thereof; if a co-partnership, state true name of firm, also names of all individual copartners composing firm; if bidder or other interested person is an individual, state first and last names in full. Licensed in accordance with an act providing for the registration of contractors: License No. J 7 3 fjJ.. 3 Classification(s) C-6/ 0-L[ 7 ADDENDA -This Proposal is submitted with respect to the changes to the contract included in addenda number/s: =1F/1:f,).... tfC) .......... .. (Fill in addenda numbers if addenda have been received and insert, in this Proposal, any Engineer's Estimate sheets that were received as part of the addenda.) By my signature on this proposal I certify, under penalty of peljury under the laws of the State of California, that the foregoing questionnaire and statements of Public Contract Code Sections 10162, 10232 and 10285.1 are true and correct and that the bidder has complied with the requirements of Section 8103 of the Fair Employment and Housing Commission Regulations (Chapter 5, Title 2 of the California Administrative Code). By my signature on this proposal I further certify, under penalty of perjury under the laws of the State of California and the United States of America, that the Noncollusion Affidavit required by Title 23 United States Code, Section 112 and Public Contract Code Section 7106; and the Title 49 Code of Federal 12 61147.02100\20980503.2 Regulations, Part 29 Debarment and Suspension Certification are true and correct. 61147.02100\20980503.2 Signature and Title of Bidder Signatures shall be notarized Business Address ..._S /4 4 I :St~....,.fc:rt ~w5.. a-r , ) ~ ,ftu, £5 rJ{ U,.'/Jt) Place ofBusiness ____________ v ______ _ Place ofResidence ------------------- 13 CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT 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 0 r-t{ ""~~ } Ontvove~~.-1 ['2-of) before me, f>r""~· "-" ~a~,Jnn:·~'!:-u~J,rv>01~1 ~ hL personally appeared JG\Me j lo...)' lor who prov~ to me on the basis of satisfactory evidence to be the person~ whose nam e(i} lis/are subscribed to the within instrument and acknow ledged to me t hat qg/she /t hey execu te d t he same i ~/he r/their a uthorized capacity{(es), and t hat by tll&/her/the ir s i gnat ure~) on the inst rument the person(~. or the entity upon be half of wh ich th e person~) ac ted , executed the instrumen t. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. %-:--A Notary Public Signature (Notary Public Seal) INSTRUCTIONS FOR COMPLETING THIS FORM ADDITIONAL OPTIONAL INFORMATION 11ti form compliu 11'/th ''ttrrclll Cnlifol'llilt statutes r~gnrdlng 1111/0IJ' Wtil'lling tmd, DESCRIPTION OF THE ATTACHED DOCUMENT ifn~edtd. s houltl /l e atltfJlmtf muluuached to tlte do cumum. Acknoll'ledgmrms from ot/tet· smtes may be clmtpleted for dot:I/1111!11/S bei11g Still 10 thm .!late so ltmg /') fl J.' 11 r . y, J as the II'OI'llil!g do es tl(ll rt>qufrq the Cultfol~tittiiO IIII)' 10 wolatt Cultfomio 110/<11)' "-. 0 l r:J'e>r .> IE_• PCJ .S ~ /(Ill'. (Tille or description of attached document) ~ • State and County information must be the State and County where the document (T itle or description of attached document continued) Number of Pages __ Document Date ___ _ CAPACITY CLAIMED BY THE SIGNER 0 Individual (s) 0 Corporate Officer (TiOe) 0 Partner(s) 0 Attorney-in-Fact o Trustee(s) 0 Other ---------- 2015 Version www .NolaryCiasses.com 800-873-9865 signcr(s) personally appeared before the notary public for acknowledgment. • Date of notari'lA~tion JliU$1 be the date that the signer(s) personally appeared which must also be the same. dote the acknowledgment is completed. • The notary public must print his or her name as it appears within his or her commission followed by a comma and then your title (notary public). • Pr in1 the name(s) of document signer(s) who personally appear at the time of notarization. • Indicate rhc correct singular or pluml forms b)• cro~s i ng off incorrect font\~ {i.e. 'l<lll;hc/lhey; is /ere) or circling the correct fom1s. Failure to corrc<:tly indicate this informlltion may lead to rejection of document recording • TI1e notary seal impression must be clear and photogmphically reproducible . Impression must not CO\'tr text or lines , If eal impression smud~es, re-seal if a snrtidchl area pemlits, othurwise C<lrnplcle U·diffcri:nt acknowledgment form . o Signature of the notary public must match the signature on file with the office of the county clerk. •!• Additional infomlation is not requ ired but could hell> to ensure this acknowledgment is not misused or aunched to a differ¢nt documcm •:• lndk.OIIc tit I~ or type oraunch~d document, •1umbcr of pages and tllltC •!• Ind icate the cnpacity cJ, hncd by the signer. 1r the claimed l11pa cll)' is a corporate ofToccr . mdic:ato the Jitlc (i.e. CEO , CFO, Scc rctsry). • Securely attach this document to the signed document with a staple . Item 1 2 3 4 5 6 7 8 9 10 11 12 SCHEDULE OF WORK ITEMS Camino Capistrano Sport Court Resurfacing CIP 15304 Un Description Qty it Unit Price Mobilize LUMP 1 Soo SUM -Power-wash & Clean Tennis and LUMP 1 d-.Do0 Basketball Courts SUM Tennis and Basketball courts: LUMP 1 Fill Bird-baths/Cracks with Nova SUM ),000 Bond Prime all courts with Novasurface LUMP 1 l~ooo SUM Tennis Courts: LUMP 1 2 Coats Novacrylic SUM Jl,ooV Combination Surface Stadium Blue Courts I Grass Green Surround Basketball Courts: LUMP 1 2 Coats Novacrylic SUM }~so-o Novaplay -Color to match existing I Tennis and Basketball courts: LUMP 1 fDCJ Titanium White Lines SUM Remove Soccer Court padding and LUMP turf, prepare surface for new SUM --; 000 installation 1 ....J, Remove and apply 2 coats of paint LUMP and reinstall wood planks around the SUM ) SvCJ soccer court 1 I Remove and reinstall Soccer Goals -LUMP ISO Anchor to concrete surface SUM 1 Install new Soccer Court padding and LUMP turf-Same material as existing. SUM 4 I, Lt d.-<f Install new Soccer court markings and layout lines 1 Add Windscreen around the Tennis LUMP 7, OCf() Courts SUM 1 . Total Bid Pnce (Enter here and on Page 10) Total ~ou ;)~ ooo I. oou 1 of)c.J I i I, OOD /d.-, soD ?)Do ~ oou Jt t6ou I J-eD Lf 7,Lf :J_ ~ 1 1 ooo $ '[7. r71. 00 • Figures 14 61147.02100\20980503.2 NON-COLLUSION DECLARATIO N The undersigned declares: I am the Prrt ? foregoing Bid. of ~ 4 ·-I J j.:· 7'£ ( }.e VI V\ • S (, tJ, the party making the The Bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation. The Bid is genuine and not collusive or sham. The Bidder has not directly or indirectly induced or solicited any other Bidder to put in a false or sham bid. The Bidder has not directly or indirectly colluded, conspired, connived, or agreed with any Bidder or anyone else to put in a sham bid, or to refrain from bidding. The Bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the Bid Price of the Bidder or any other Bidder, or to fix any overhead, profit, or cost element of the Bid Price, or of that of any other Bidder. All statements contained in the Bid are true. The Bidder has not, directly or indirectly, submitted his or her Bid Price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, to any corporation, partnership, company, association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid, and has not paid, and will not pay, any person or entity for such purpose. Any person executing this declaration on behalf of a Bidder that is a corporation, partnership, joint venture, limited liability company, limited liability partnership, or any other entity, hereby represents that he or she has full power to execute, and does execute, this declaration on behalf of the Bidder. I declare under penalty of perjury under the laws of the State of California that the foregoing is true £.nd correct and that th is ~cla ration is executed on 1 J-/1-;~-[date], at ,~ Y'Y\ [city],..A... [state]. 15 61147.02100\20960503.2 IRAN CONTRACTING ACT CERTIFICATION (PUBLIC CONTRACT CODE SECTION 2200 ET SEQ.) As required by California Public Contract Code Section 2204, the Contractor certifies subject to penalty for perjury that the option checked below relating to the Contractor's status in regard to the Iran Contracting Act of 2010 (Public Contract Code Section 2200 et seq.) is true and correct: ~ The Contractor is not: (1) identified on the current list of person and entities engaged in investment activities in I ran prepared by the California Department of General Services in accordance with subdivision (b) of Public Contract Code Section 2203; or (2) a financial instruction that extends, for 45 days or more, credit in the amount of $20,000,000 or more to any other person or entity identified on the current list of persons and entities engaging in investment activities in Iran prepared by the California Department of General Services in accordance with subdivision (b) of Public Contract Code Section 2203, if that person or entity uses or will use the credit to provide goods or services in the energy sector in Iran. 0 The City has exempted the Contractor from the requirements of the Iran Contracting Act of 2010 after making a public finding that, absent the exemption, the City will be unable to obtain the goods and/or services to be provided pursuant to the Contract. 0 The amount of the Contract payable to the Contractor for the Project does not exceed $1,000,000. Signature : Sr . .fff'l .-.--./-::2_ ./¥~ / /.; j P:'-J Printed Name: , ~ v--A t?'S }~v<.:, fv ,r- / Titl e : __ _,P.;....__r---=e-~_~ _,., ________ _ Firm Na me: ;;; VJ ;;; r le, ~ ·...) &..;.-(. r'l-.5 . ./ Da te:_---'-Jf-J-........ !~1:....--...:...I_..;..._) -------- Note: In accordance with Public Contract Code Section 2205, false certification of this form shall be reported to the California Attorney General and may result in civil penalties equal to the greater of $250,000 or twice the Contract amount, termination of the Contract and/or ineligibility to bid on contracts for three years. 16 61147.02100\20980503.2 DESIGNATION OF SUB-CONTRACTORS In compliance with the Subletting and Subcontracting Fair Practices Act Chapter 4 (commencing at Section 41 00), Part 1 , Division 2 of the Public Contract Code of the State of California and any amendments thereof, Bidder shall set forth below: {a) the name and the location of the place of business, (b) the California contractor license number, (c) the DIR public works contractor registration number, and (d) the portion of the work which will be done by each subcontractor who will perform work or labor or render service to the Bidder in or about the construction of the work or improvement to be performed under this Contract in an amount in excess of one-half of one percent (0.5%) of the Bidder's Total Bid Price. Notwithstanding the foregoing, if the work involves the construction of streets and highways, then the Bidder shall list each subcontractor who will perform work or labor or render service to the Bidder in or about the work in an amount in excess of one-half of one percent {0.5%) of the Bidder's Total Bid Price or $10,000, whichever is greater. No additional time shall be granted to provide the below requested information. If a Bidder fails to specify a subcontractor or if a contractor specifies more than one subcontractor for the same portion of work, then the Bidder shall be deemed to have agreed that it is fully qualified to perform that portion of work and that it shall perform that portion itself. Work to be CSLB DIR Name of Location of Contractor Registration %of done by Subcontractor Business License No. Number Work Subcontractor u~ ~ cl v - 61147.02100\20980503.2 17 CSLB DIR Work to be Name of Location of Contractor Registration %of done by Subcontractor Business License No. Number Work Subcontractor /\ J \ J ,C'\ . -~ /'\. /2 I \j IV'\(__ 61147.02100\20980503.2 18 STATEMENT OF EXPERIENCE THIS PAGE TO BE COMPLETED BY BIDDER AND SUBMITTED TO CITY AS PART OF THE BID. 1. &i:,,/ k hV\ '5 ~u~h tdd r's Name Company Name 2 . :J ;Lf :sa Yv-h · Ksm4t c.9~?/ Business Address 3. 9~9-JsJ-j3192 Business Telephone Number 4. Attach additional sheets if necessary Year Client/Owner Name & Location of Type of Work & Site Contract Amount :lo /Lf (o/-u t:-J. e [q_ 2 .,"'-i.o fu j e ~?&'\. (!;; .:>u..-f-~ .... c ~ Ye ' & v 1 f. o;-o2?i c 1 t• .t f-6 S-DvO ' V'o.. s {/ KSrA Jrlc:;,~~ fa ,e ·-re.. d-O /:J c;;.f! v/. J(?_$ W\. o4. DtJD I ill iA ·5 d-· () );;)_ ~~ AVI.v... ~//e0 J-/s Re. s u ~ !-~-..... e-/e.~' l{".'{,·~els O . 9~oov r;)o I I c.·-17 ~1-L.A. v~(";ou.s Po..rks ;<.e5t.J. r/r;t..se ~ ..c:_~-_ OD i) ~() ;u c:JJ c/ f owt~ .:~ Jtx v ,' OcA) Pa ( b R,-s u.,. f,;._.L.-e_. 1 72 DOt) "ignature " 61147.02100\20980503.2 19 Bond Number: CDGB104156 BID BOND The makers of this bond are, Taylor Tennis Courts, Inc. , as Principal , and State Natlon11l In s urance Company, lnc. administered by: Contractor Managing,• as Surety and are held and firm ly bound unto the City of San Juan Capis.trano, hereinafter called the City, in the penal sum of TEN PERCENT (10%) OF THE TOTAL BID PRICE of the Principal submitted to CITY for the work described below, for the payment of which sum In lawful money of the United States, well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors and assigns , jointly and severallv, flrmlv bY. these _presents. *General insurance Agency, Inc. 20335 Venfura Blvd. Suite 426 Woodlana Htlls, CA 91364 THE CONDITION OF THIS OBLIGATION IS SUCH that whereas the Principal has submitted the accompanying bid dated November 12 , 20 _rs_, for the Camino Capistrano Athletic Arena Court Resurfacing Project -Cl P 15304 . If the Principal does not withdraw its Bid within the time specified in the Contract Documents; and if the Principal is awarded the Contract and provides all documents to the City as required by the Contract Documents; then this obligation shall be null and void. Otherwise, this bond will remain in full force and effect. Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration or addition to the terms of the Contract Documents shall in affect its obligation under this bond, and Surety does hereby waive notice of any such changes. In the event a lawsuit is brought upon this bond by the City and judgment is recovered, the Surety shall pay all litigation expenses incurred by the City in such suit, including reasonable attorneys' fees, court costs, expert witness fees and expenses. IN WITNESS WHEREOF, the above-bound parties have executed this instrument under their several seals this 1Oth day of November , 20_12_, the name and corporate seal of each corporation. (Corporate Seal) Taylor Tennis Courts, Inc. (Corporate Seal) ct (Attach Attorney-in-Fact Certificate) hnnie Hope Shear, Altorney-J n-Fact 6114?.02100\20980503.2 20 Notary Acknowledgment A notary pu blic or other officer completing this certifica te verifies only the iden ti ty of the individua l who sig ned the docu ment to which this certificate Is attached , and no t the truthful ness, acc uracy, or validity of that document STATE OF CALIFORNIA COUNTY OF----- On _______ ___. 20_, before me,--------------' Notary Public, personally appeared , who proved to me on the basis of satisfactory Nam e(s) or Slgnal{s) evid ence to be t he person(s) whose name(s) is/are subscribed to th.e within instrum ent and acknowledged to me that he/-s he/they executed the same in his/her/their authorized capacity(ies ), and that by his/her/their sign atu re (s) on the instr um ent t he pe r son(s), or the entity upon behalf o f wh ich the person (s ) acted, executed the Instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature of Notary Public OPTIONAL Though the Information below Is not required by law, it may prov o valuabl e to persons r el y ing on the document and could prevent fraudulent removal and reattachment of th is form to a no t/l er do cument. CAPACITY CLAIMED BY SIGNER 0 Individual 0 Corporate Officer oPartner(s) 0 Attorney-In-Fact OTrustee(s) 0 Guardian/Conservator OOther: Signer is representing: Tide(s} 0 Limited 0 General Name Of Person(s) Or Entity(ies) 61147.02100\20980503.2 DESCRIPTION OF ATTACHED DOCUMENT Title or Type of Document Number of Pages Date of Document Slgner(s) OlherThan Named Above 21 Bond No: CDGB104156 State Nationallosurance Company, Inc. Administered by: Premium: _N_I_'A __ _ CONTRACTOR MANAGING GENERAL INSURANCE AGENCY, INC. POWER OF ATI'ORNEY KNOW BY ALL THESE PRESENTS That STATE NATIONAL INSURANCE COMPANY, INC. a corporation organized and existing under the laws of the State of Texas, having its principal office in Bedford , Te xas does hereby constitute and awoint Ste phnnie Hope She;:n- (individually, jointly, or se~rnlly) its true and lawful agent and attorney(s}-in-fact to execute, seal and deliver for and on its behalf as surety, any and all bonds in an amount not to exceed: Three MUii&n and 00/100 Dollars C$3,000,000) and undertAkings, contrncls of indemnity and olhcr writings obligatory in the nature thereof, which are or may be allowed, required or pennitted by law, sln tut c, n1lc , regulotion, contract or oth erwise. The acknowle dge ment and execution of bond by snld Attorney-in-Fac t, shall be as bindin g upon STATE NATIONAL INSURANCE COMPANY, INC. as fully and amply, to all intents and purposes, as if the s11.me had been duly executed and aeknowledgc:d by its regularly elected officers at the principal office. RESOLVED that the signature and date of any uuthorizcd officer nnd the seal of the Company may be affiX ed by facsimile or olhcr electronic imog~: to nny Power or Attorney or ecrtilication thereof authoriz ing the execution and delivery of any bond, unde.rtnking , contracts of indemnity and other writings obligatory in the natu re thereof, and such s ignatur e, date, and seal when so used shall have the same force and effect liS though mnnuall.y affixed. This Power of Attorney shall remain in full force and effect until revoked by STATE NATIONAL INSURANCE COMPANY, INC. in a signed writing delivered to the foregoing Attorney-in-Fact. STATE OF TEXAS County of Tarrant IN WITNESS WHEREOf, STATE NATIONAL INSURANCE COMPANY, INC. has caused I his instrumen t to be signed DJ\d its corporate se al to be affixed by its authorized officer, this 7th day of August, 2015 . STATE NATIONAL INSURANCE COMPANY, INC. --·--.,_ z~ . .--7'~ /" • i·race "tte~ Secretary 0Jtlhis 71h day of August, 2015 before me came the individuals who executed the preceding instrument, to me pcrsonl\lly known, and being by me duly swom, said !hot C3Ch of the herein described and authorized officer ofST ATE NA TlONAL INSURANCE COMPANY, INC.; tbotthc seal affixed 10 said instrument is tbc Corporate St:al of said Compnny; that the Corporate Seal and each signature were duly affixed by order of the Board of Directors of said Company . IN WITNESS WHEREOF, l have hereunto set my hand at Bedford, Texas the day and year above written . ~-[ bci(Ll__ ,,,, .. ,, ,,,~';t:.,~!4~·-, DEANA HOWELL g~~:"1 Notary Public, State ot Texas ~;{.·-.f.-~.-·,.,._f My Comf'niSSJon Exp 1res ---~~~i.~~~,~ January 07, 2018 Signature of Notary [Notary Stamp] I, th e undersigned, Secretary of STATE NATIONAL INSURANCE COMPANY, INC., do hereby ccrti:fY that the o.bove wtd foregoing is a true and correct copy of a Power of Attorney exe cuted by STATE NATIONAL INSURANCE COMPANY, INC., which is still in full force and eiT~t IN WITNESS WHEREOF, I have thereunto systematically set my hand and attested the seal of said Compwty this 1Oth day cfil~~£11.§ CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 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 LOS ANGELES } On __ N_0_V_1_0_20_1_5 __ before me, SHIRLEY GIGGLES , NOTARY PUBLIC Date Here Insert Name and Title of the Officer personally appeared --------=S'--'T--'-'E:..:...P_H_A_N_IE_H--=0'-'-P--=E:....S~H_EA:.-=...;R ___________ _ Name(s) of Signer(s) 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. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. Place Notary Seal Above -----------------------------OPTIONAL---------------------------- Though this section is 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: Signer(s) Other Than Named Above: ------------ Capacity(ies) Claimed by Signer(s) Signer's Name: ___________ _ 0 Corporate Officer -Title(s): ______ _ 0 Partner -0 Limited 0 General 0 Individual 0 Attorney in Fact 0 Trustee 0 Guardian or Conservator 0 Other:-------------- Signer Is Representing:--------- Signer's Name:------------ 0 Corporate Officer -Title(s): ______ _ 0 Partner -0 Limited 0 General 0 Individual 0 Attorney in Fact 0 Trustee 0 Guardian or Conservator 0 Other:------------- Signer Is Representing: ________ _ ~~~~~~~{~~~~~"C<>.~~~..<,~~~-g~~~ ©2014 National Notary Association· www.NationaiNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907