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Contract #: 004704 - From: To: - Exception - Exception
School Department Administration Building North Andover, MA Ce4ro—1 Kang Associates, Inc. January 2, 2014 FORM OF SUB -BID To All General Bidders Except those Excluded: A. The undersigned proposes to furnish all labor and materials required for completing, in accordance with the hereinafter described plans, specifications and addenda, all work specified in 095123 Acoustical Tile Ceilings of the specifications and in any plans specified in such section, prepared by Kang Associates, Inc. for the School Department Administration Building,North Andover, MA for the contract sum of: Twenty thousand three hundred dollars ($ 20, 390.00 dollars ($ n ninety and 00/100 For Alternate #1: 0 Deduct $ zero dollars ($ For Alternate #2: Add/ dollars ($ Deduct $ zero 0 For Alternate #3: Deduct $ zero For Alternate #4: Deduct $ zero For Alternate #5: zero Deduct $ dollars ($ 20, 390.00 dollars ($ 0 dollars ($ 0 0 dollars ($ 0 dollars ($ dollars ($ 0 B. This sub -bid includes addenda numbered 1 C. This sub -bid ❑X may be used by any general bidder except: G&R Construction; Inc. ❑ may only be used by the following general bidders: (To exclude general bidders, insert an "X" in one box only and fill in blank following that box. Do not answer C if no general bidders are excluded.) FORM OF SUB -BID - 1 School Department Administration Building North Andover, MA Kang Associates, Inc. January 2, 2014 D. The undersigned agrees that, if he is selected as sub -bidder, he will within five days, Saturdays, Sundays, and legal holidays excluded, after presentation of a subcontract by the general bidder selected as the general contractor, execute with such general bidder a subcontract in accordance with the terms of this sub -bid, and contingent upon the execution of the general contract, and, if requested so to do in the general bid by such general bidder, who shall pay the premiums therefor, or if pre -qualification is required pursuant to section 44D 3/4, furnish a performance and payment bond of a surety company qualified to do business under the laws of the Commonwealth and satisfactory to the awarding authority in full sum of the subcontract price. E. The names of all persons, firms and corporations furnishing to the undersigned labor or labor and materials for the class or classes or part thereof work for which the provisions of the section of the specifications for this sub -trade requires a listing in this paragraph, including the undersigned if customarily furnished by persons on his own payroll and in the absence of a contrary provisions in the specifications, the name of each such class of work or part thereto and the Bid price for such class of work or part thereof are: Name Class of Work Bid Price NONE (Do not give bid price for any class or part thereof furnished by undersigned.) The undersigned agrees that the above list of bids to the undersigned represents bona fide bids based on the hereinbefore described plans, specifications and addenda and that, if the undersigned is awarded the contract, they will be used for the work indicated at the same amounts stated, if satisfactory to the awarding authority. G. The undersigned further agrees to be bound to the general contractor by the terms of the hereinbefore described plans, specifications, including all general conditions stated therein, and addenda, and to assume toward him all the obligations and responsibilities that he, by those documents, assumes toward the owner. H. The undersigned offers the following information as evidence of his qualifications to perform the work as bid upon according to all the requirements of the plans and specifications: 1. Have been in business under present business name 5_ years. 2. Ever failed to complete any work awarded? No 3. List one or more recent buildings with names of the general contractor and architect on which you served as a subcontractor for work of similar character as required for the above named buildings. Building (a)lndian Brook Elem Architect . General Contractor Amount of Contract RDK Enterprise Equip 174,000 FORM OF SUB -BID - 2 School Department Administration Building North Andover, MA a (c) 4. Bank reference Eastern Bank Kang Associates, Inc. January 2, 2014 The undersigned hereby certifies that he is able to furnish labor that can work in harmony with all other elements of labor employed or to be employed on the work; that all employees to be employed at the worksite will have successfully completed a course in construction safety and health approved by the United States Occupational Safety and Health Administration that is at least 10 hours in duration at the time the employee begins work and who shall furnish documentation of successful completion of said course with the first certified payroll report for each employee; and that he will comply fully with all laws and regulations applicable to awards of subcontracts subject to section 44F. The undersigned further certifies under penalties of perjury that this sub -bid is in all respects bona fide, fair and made without collusion or fraud with any other person. As used in this subsection the word "person" shall mean any natural person, joint venture, partnership, corporation or other business or legal entity. The undersigned further certifies under penalty of perjury that the said undersigned is not presently debarred from doing public construction work in the commonwealth under the provisions of section twenty-nine F of chapter twenty-nine, or any other applicable debarment provisions of any other chapter of the General Laws or any rule or regulation promulgated thereunder. January 21, 2014 Date SUB -BIDDER'S CHECKLIST: Addenda Recognized Bid Deposit DCAM Certificate of Eligibility Sub -Bidder Update Statement /,Certificate of Corporate Bidder CENTRAL CEILINGS.INC. (Name of Sub -Bidder) By: Signature and Title of Person Signing Bid William B. McPherson III President 36 Norfolk Avenue Business Address South Easton Ma 02375 City and State FORM OF SUB -BID - 3 School Department Administration Building North Andover, MA CERTIFICATE OF CORPORATE BIDDER Carol McPherson Clerk Kang Associates, Inc. January 2, 2014 certify that I am the of the corporation named as Bidder in the Bid Form, and that William B. McPherson III who signed the Bid Form on behalf of the Bidder was then the president of said corporation and that I know his signature; that his signature thereto is genuine and that the Bid Form was duly signed, sealed and executed for and in behalf of said corporation by authority of its governing body. Corporate Seal Carol McPherson Secretary -Clerk January 21, 2014 Date CORPORATE BIDDER - 1 This Certificate Shall Be Used for Submitting Filed Sub -Bids Only 1. CERTIFICATION PERIOD: This Certificate is valid from 4/24/2013 to 4/24/2014 2. CONTRACTOR'S NAME: Central Ceilings, Inc. 3. CONTRACTOR'S ADDRESS: 36 Norfolk Avenue, South Easton, MA 02375 4. WORK CATEGORIES: This Contractor is certified to file bids under Massachusetts General Laws Chapter 149, Chapter 149A and Chapter 25A in the following checked Categories of Work: dj Acoustical Tile [-, HVAC ❑ Miscellaneous & Ornamental Iron ElTerrazzo El Electrical Work J Lathing & Plastering ❑ Painting ❑ Tile Elevators [_j Marble ❑ Plumbing EJ Waterproofing, Damp C] Fire Protection Sprinkler Systems [ Masonry Work [_) Resilient Floors proofing, and Caulking [7 J Glass and Glazing Metal Windows ❑Roofing &Flashing 5. EVALUATIONS: Number of Projects Evaluated: 11 Average Project Evaluation Rating: 92 Number of Projects Below Passing Score: 0 6. SUPPLIER DI�RSITY OFFICE CERTIFICATION: N/A 3 T an Grigsby, eneral Counsel, Approval Date r Carole J. Co nelison, Commissioner NOTE TO CONTRACTORS: Complete Applications for Renewal of Contractor Eligibility are due no later than three months PRIOR to the Expiration Date of the Certification Period shown above. Failure to submit Completed Applications timet result in a gap in Certification or a lapse in Certification altogether for your company. Reviewer's Initial The Commonwealth of Massachusetts Executive Office, for Administration and Finance Division of Capital Asset Management and Maintenance One Ashburton Place Boston, Massachusetts 02105 DEVAL L. PATRICK GLEN SHOR GOVERNOR Tel: (617) 727-4050 SECRETARY, ADMINISTRATION & Fcm (617) 727-5363 FINANCE TIMOTHY P. MURRAY CAROLE CORNELISON LIEUTENANT GOVERNOR COMMISSIONER Filed Sub -Bid Certificate of Contractor Eligibility CONTRACTOR IDENTIFICATION NUMBER: 1135 This Certificate Shall Be Used for Submitting Filed Sub -Bids Only 1. CERTIFICATION PERIOD: This Certificate is valid from 4/24/2013 to 4/24/2014 2. CONTRACTOR'S NAME: Central Ceilings, Inc. 3. CONTRACTOR'S ADDRESS: 36 Norfolk Avenue, South Easton, MA 02375 4. WORK CATEGORIES: This Contractor is certified to file bids under Massachusetts General Laws Chapter 149, Chapter 149A and Chapter 25A in the following checked Categories of Work: dj Acoustical Tile [-, HVAC ❑ Miscellaneous & Ornamental Iron ElTerrazzo El Electrical Work J Lathing & Plastering ❑ Painting ❑ Tile Elevators [_j Marble ❑ Plumbing EJ Waterproofing, Damp C] Fire Protection Sprinkler Systems [ Masonry Work [_) Resilient Floors proofing, and Caulking [7 J Glass and Glazing Metal Windows ❑Roofing &Flashing 5. EVALUATIONS: Number of Projects Evaluated: 11 Average Project Evaluation Rating: 92 Number of Projects Below Passing Score: 0 6. SUPPLIER DI�RSITY OFFICE CERTIFICATION: N/A 3 T an Grigsby, eneral Counsel, Approval Date r Carole J. Co nelison, Commissioner NOTE TO CONTRACTORS: Complete Applications for Renewal of Contractor Eligibility are due no later than three months PRIOR to the Expiration Date of the Certification Period shown above. Failure to submit Completed Applications timet result in a gap in Certification or a lapse in Certification altogether for your company. Reviewer's Initial BID BOND ` • Conforms with The American Institute of Architects, A.I.A. Document No. A-310 KNOW ALL BY THESE PRESENTS, That we, Central Ceilings, Inc. 36 Norfolk Avenue, South Easton, MA 02375 as Principal, hereinafter called the Principal. and the Fidelity and Deposit Company of Maryland of 100 High Street Suite 1400, Boston, MA 02110 a corporation duly organized under the laws of the State of Maryland as Surety, hereinafter called the Surety, are held and firmly bound unto Town of North Andover, MA as Obligee, hereinafter called the Obligee. in the sum of Five Percent of Bid Amount Dollars ($ 5% of Bid Amount ) , for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators. successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal has submitted a bid for Section 095123 Acoustical Tile Ceilings School Department Administration Building North Andover, MA NOW, THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enter into a Contract with the Obligee in accordance with the terms of such bid, and give such bond or bonds as may be specified in the bidding or Contract Documents with good and sufficient surety for the faithful performance of such Contract and for the prompt payment of labor and material furnished in the prosecution thereof, or in the event of the failure of the Principal to enter such Contract and give such bond or bonds, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in said bid and such larger amount for which the Obligee may in good faith contract with another party to perform the Work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. Signed and seled this 21st day of January 2014 Central Ceilings, Inc. (Seal) Principal Witness {( William B. McPherson III President Title Fidelity and De osit Company of Maryland Witness By imothy P. ons, Att rney-in-Fact S•0054IGEEF 12100 FRP ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the ZURICH AMERICAN INSURANCE COMPANY, a corporation of the State of New York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the State of Maryland, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Maryland (herein collectively called the "Companies"), by THOMAS O. MCCLELLAN, Vice President, in pursuance of authority granted by Article V, Section 8, of the By -Laws of said Companies, which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof, do hereby nominate, constitute, and appoint J. Barry DRISCOLL, Timothy P. LYONS, Claire A. CAVANAUGH, John C. DRISCOLL, George G. POWERS, Dennis W. DRISCOLL and Martin L. DONOVAN, all of Norwell, Massachusetts, EACH its true and lawful agent and Attorney -in -Fact, to make, execute, seal and deliver, for, and on its behalf as surety, and as its act and deed: any and all bonds and undertakings, and the execution of such bonds or undertakings in pursuance of these presents, shall be as binding upon said Companies, as fully and amply, to all intents and purposes, as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York, New York., the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills, Maryland., and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland., in their own proper persons. The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V, Section 8, of the By -Laws of said Companies, and is now in force. IN WITNESS WHEREOF, the said Vice -President has hereunto subscribed his/her names and affixed the Corporate Seals of the said ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 4th day of November, A.D. 2013. ATTEST: ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND i r •o R5s 0494� im tea' 3 u : ! o Zi s Awl 'y ,6 Y 1998�j=1 �� �•.,, .....•... _91 j � y/w V, /V Assistant Secretary Vice President Eric D. Barnes Thomas O. McClellan State of Maryland City of Baltimore On this 4th day of November, A.D. 2013, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, THOMAS O. MCCLELLAN, Vice President, and ERIC D. BARNES, Assistant Secretary, of the Companies, to me personally known to be the individuals and officers described in and who executed the preceding instrument, and acknowledged the execution of same, and being by me duly sworn, deposeth and saith, that he/she is the said officer of the Company aforesaid, and that the seals affixed to the preceding instrument are the Corporate Seals of said Companies, and that the said Corporate Seals and the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporations. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above written. �\ i,�4 ',1�1�11151155��, Constance A. Dunn, Notary Public My Commission Expires: July 14, 2015 POA -F 063-2190B EXTRACT FROM BY-LAWS OF THE COMPANIES "Article V, Section 8, Attorneys -in -Fact. The Chief Executive Officer, the President, or any Executive Vice President or Vice President may, by written instrument under the attested corporate seal, appoint attorneys -in -fact with authority to execute bonds, policies, recognizances, stipulations, undertakings, or other like instruments on behalf of the Company, and may authorize any officer or any such attorney-in-fact to affix the corporate seal thereto; and may with or without cause modify of revoke any such appointment or authority at any time." CERTIFICATE I, the undersigned, Vice President of the ZURICH AMERICAN INSURANCE COMPANY, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, do hereby certify that the foregoing Power of Attorney is still in full force and effect on the date of this certificate; and I do further certify that Article V, Section 8, of the By -Laws of the Companies is still in force. This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the ZURICH AMERICAN INSURANCE COMPANY at a meeting duly called and held on the 15th day of December 1998. RESOLVED: "That the signature of the President or a Vice President and the attesting signature of a Secretary or an Assistant Secretary and the Seal of the Company may be affixed by facsimile on any Power of Attorney... Any such Power or any certificate thereof bearing such facsimile signature and seal shall be valid and binding on the Company." This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held on the 5th day of May, 1994, and the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on the 10th day of May, 1990. RESOLVED: "That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature of any Vice -President, Secretary, or Assistant Secretary of the Company, whether made heretofore or hereafter, wherever appearing upon a certified copy of any power of attorney issued by the Company, shall be valid and binding upon the Company with the same force and effect as though manually affixed. IN TESTIMOI�WHEREOF, I have hereu to subscribed my name and affixed the corporate seals of the said Companies, this 9155 day of a ""iNs•"��+ p ,oz SEAL 1t1� � gVib=,� 7988 i p�f7 wr '7 O r.nl •,y YylMnl � •l�i" �(� James M. Carroll, Vice President EFFECTIVE MARCH 30, 2010 Commonwealth of Massachusetts Division of Capital Asset Management 0 UPDATE STATEMENT TO ALL SUB -BIDDERS, TRADE CONTRACTORS AND AWARDING AUTHORITIES A COMPLETED AND SIGNED SUB -BIDDER UPDATE STATEMENT MUST BE SUBMITTED WITH EVERY FILED SUB -BID PURSUANT TO M.G.L. c.149, §44F AND EVERY TRADE SUB -BID PURSUANT TO M.G.L. c. 149A. ANY FILED SUB -BID OR TRADE SUB -BID SUBMITTED WITHOUT AN APPROPRIATE SUB -BIDDER UPDATE STATEMENT IS INVALID AND MUST BE REJECTED. Caution: This form is to be used for submitting Filed Sub -Bids and Trade Sub -Bids. It is not to be used for submitting Prime/General Contract bids. AWARDING AUTHORITIES If the Awarding Authority determines that the sub -bidder is not competent to perform the work as specified on the project, it should reject the bid. SUB -BIDDER'S AFFIDAVIT swear under the pains and penalties of perjury that I am duly authorized by the bidder named below to sign and submit this Sub -bidder Update Statement on behalf of the bidder named below, that I have read this Sub -bidder Update Statement, and that all of the information provided by the bidder in this Sub -bidder Update Statement is true, accurate, and complete as of the bid date. January 21, 2014 Bid Date School Department Administration Project Number (or Building name if no number) Town of North Andover Awarding Authority SIGNATUREb Central Ceilings, Inc. Print Name of Sub -bidder or Trade Contractor 36 Norfolk Ave., South Easton, MA 02375 Business Address 508-238-6985 Telephone Number ( Y� Bi der's Authorized Representative William B. McPherson, III / President Division of Capital Asset Management Page l of 10 INSTRUCTIONS INSTRUCTIONS TO SUB -BIDDERS • This form must be completed and submitted by all Filed Sub -Bidders bidding on projects pursuant to M.G.L. c. 149, §44F and Trade Contractors bidding on projects pursuant to M.G.L. c. 149A. • You must give complete and accurate answers to all questions and provide all of the information requested. MAKING A MATERIALLY FALSE STATEMENT IN THIS SUB -BIDDER UPDATE STATEMENT IS GROUNDS FOR REJECTING YOUR BID AND FOR DEBARRING YOU FROM ALL PUBLIC CONTRACTING. • This Sub -Bidder Update Statement must include all requested information that was not previously reported on the Application used for your firm's most recently issued (not extended or amended) Sub -Bidder Certificate of Eligibility. The Sub -Bidder Update Statement must cover the entire period since the date of that Application, NOT since the date of your Certification. • You must use this official form of Sub -bidder Update Statement. Copies of this form may be obtained from the awarding authority and from the DCAM Web Site: www.mass.gov/dcam. • If additional space is needed, please copy the appropriate page of this Sub -bidder Update Statement and attach it as an additional sheet. Division of Capital Asset Management Sub -bidder Update Statement Effective March 30, 2010 INSTRUCTIONS TO AWARDING AUTHORITIES Determination of Sub -Bidder Qualifications It is the awarding authority's responsibility to determine each responsible bidder. You must consider all of the information in the bidders Sub -bidder Update Statement in making this determination. Remember: this information was not available to the Division of Capital Asset Management at the time of certification. The sub -bidders performance on the projects listed in Parts 1 and 2 must be part of your review. Contact the project references. AWARDING AUTHORITIES ARE STRONGLY ENCOURAGED TO REVIEW THE SUB -BIDDER'S ENTIRE CERTIFICATION FILE AT THE DIVISION OF CAPITAL ASSET MANAGEMENT. Telephone (617) 727-9320 for an appointment. Correction of Errors and Omissions in Sub -bidder Update Statements Matters of Form: An awarding authority shall not reject a sub -bidders bid because there are mistakes or omissions of form in the Sub -bidder Update Statement submitted with the bid pursuant to M.G.L. c.149, §44D, provided the sub -bidder promptly corrects those mistakes or omissions upon request of the awarding authority. [810 CMR 8.13(1)]. Correction of Other Defects: An awarding authority may, in its discretion, give a sub -bidder notice of minor defects and omissions as to form in the Sub -bidders Update Statement and provide an opportunity to correct its Sub -bidder Update Statement. However, the sub -bidder shall not be allowed to make corrections to a Sub -bidder Update Statement if material information about the sub -bidder was omitted from the Sub -bidder Update Statement filed with the sub -bidders bid. The Awarding Authority shall advise DCAM of any material omissions in a Sub -bidders Update Statement.. [810 CMR 8.13(2)]. Page 2 of 10 W U z, CO 0 ~W W� J W ao Z W U¢ CO w =a ���W it LL Z �F- =X OW >- LU a _? F- 0 wW of an 2cri Er O-1 oZ oU � of a LL� O Fes- � U 0a Mi I- w m Lu fnQ a J ZW a� aQa 0CUW Q a `N UC -LL Q �0X LLLLl WV Q p Ir LLI F- Lu LLJ w L'r1 r C7 CO) th M M (D 00 CL E O o O C U O U LIJ o� 0 "v — � Q 0 N z wW .� m Q N Z N r N � r N T a cr < 04- 0 1 Q r r T t 'C d w U c N m n. 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U F- U dz c _ qq U cit U � S — O '� 'a = � in v ca -M mvai « E � m i C In c = LEm Z -M Q 2 a m in c> L) u. a t7 EL o- � z a� Lu z � z m z z z c z z— z z zc5 z O w ii w Ci CO b w d� w 6S w 00 a 00 0 cry 0 0 0C) O (70 0 c90 0 0 CU CU W J — — F- c; m al t6 m L. a) o O 2 m N O L L W al u, ui c CD tr O � iL m j m 0 a N 0 L O (D T tD a1 O .r L. c O QV W o N m 0 c c E o tl c c z Z .O® (0� N a 'Zi w�� ❑� c} ro a E o` 0 CL c 3 t ow c N O o lu O � i O ?+ Ea =C �3 c mO N 0 c c ram E •N C6 W 0 o E ,;.. os m .c= a)o 3 P E N `m 12m u! => a� w CO � .O O O C t O " Qf >.� 0 3 C(a m m U> O �` m C� m Q O >1 E a, N U Q 0 '- 0 Part 1 - Completed Proiects Attachment 1 Job Name Contract Amount 1 H.0 NOCERA LABS $459,870 2 SALEM STATE NEW LIBRARY $447,700 3 BOA PROVIDENCE RI $440,217 4 TAHANTO REGIONAL MIDDLEIHS $340,811 5 FIDELITY CONF & STORAGE RENO $332,845 6 GREENBURG TRAURIG $312,814 7 HARVARD - WYSS INSTITUTE $246,179 8 MASS ART TEMP WOOD SHOP $237,707 9 JOHN D RUNKLE SCHOOL $236,452 10 1 ST VINCENTS CANCER CENTER ACT $176,255 11 INSTAR2NDFLRENO 10111849 $173,822 12 NORTHEASTERN U MARINE SCIENCE $157,305 13 441 STUART STREET $153,786 14 HU NW LABS B-1 $148,549 15 TERMINAL B TOILETS GWB $136,200 16 EXELON MYSTIC STATION $130,024 17 ILOGAN CBIS PK01 $109,709 18 CHB LOBBY RENO TEMP WALLS $97,874 19 STOP & SHOP ROSLINDALE $83,466 20 FIDELITY SOLUTION DELIVERY SF $81,503 21 CHB SERVICE ELEVATOR RENO $76,461 22 BHCC E OFFICES $69,629 23 MIT N51 & N52 $66,673 24 FALLON FITNESS CTR RENO $63,662 25 NORTH EASTON VILLAGE WWTP $62,954 26 NEWTON DISTRICT COURT $60,160 27 WHIDDEN HOSPITAL $52,750 28 FIDELITY THINK SPACE 12000358 $52,573 29 UMASS MEDICAL 4TH FL $48,460 30 HUDSON NEWS AR -07 $47,270 31 DUXBURY POLICE HQ $45,391 32 HRD HURLEY BUILDING PH 2 $44,337 33 ITERMINAL B TOILET RM RENO -ACT $43,874 34 MGH GRAY 2 IR $39,625 35 HUDSON NEWS LR02-06 $37,166 36 DOT GLASS WALL $37,139 37 GIL - F CORNICE $28,650 38 GIL- Z SOUTH HUDDLE & OFFIC $27,428 39 CAPE COD CANOPY REPAIR $27,080 40 MAH CLOUGH CONFERENCE RM $26,891 41 GIL-LOWER LVL BLDG RESTROOMS $26,050 42 FIDELITY 100 2N $24,339 43 GIL -4K HARBOR VIEW $22,544 44 CHINA TRADE CENTER $22,450 45 51 MELCHER $21,200 46 BOA MANCHESTER ATM $20,885 Attachment 1 U O D r J z W U t N a G. z O 0 O U W O CO a T LL wO oZ a T Sc. I-- W U of O� �O OW QT a F- G N W 64). T OW T U� W0 a w a= F - LL LL >O 220) (L CO cl J aw U(9 J W mIr QW ¢© F- C4 _2 -J H 0 0 0 N 0 cn 2 Eat IV 8E m m QN m nA CL co � U` o � C 0.0 y Q to u- i-- W 6 Lu Z�Y o i X �NLo wGo o fis of by U OJ za o cVol im Lo O O U n M Im to Il V Q VM^ N � �W U ti � P. o L C) za � M r U � J Q C U co cl LO) z W d N th N cr} CJ M N M cf) Q � `- a M r r 4fl t Q r r r r 0) d �, a r (/} W r r O U cv 0° m � Q m 0 0 � CD U U C7 Q co _ °o `m _ CE 1,0 U c .., in L N O ca co ~ a m a U U 0 0 0 N 0 cn 2 Eat IV 8E m m QN m nA CL co � U` o � C 0.0 y Q to W z 0 w VJ J U W mi 0 d W W J CL O z 0 4L z 0 Q 0 z W L) W W LL W 0 J OW t� z aa. F - ❑0 CL 2 rn V m c c E o c c z �z ® W® ti cnUJ , cn E o 0 0- >' C1 7Q, C E N o 00 c o N0. E O) O - O m 0 �cd , � E c L v; c .E oCc 0 D O L E c 0-0 C .� t0 (0.0 O `o M t A� v a. E w O p0 t5O >; C LM ccn°°a A �Ej 28 Q U 0 �7 T to O 0 O Cb to In 'Y a r r co c6 T 9 v M m ti co ti ri �Q X11 N 0) 1n �j 4 +- to V co cD 1, CU _Q z ►. T to CO cD C z m r� a_ n . T r. r z m co LLJ Q ECL m cc c L J r C E2a a Cl) C F-LLJ !fJ� a Z a c z p cc e mz `z cCO E C0 U) z Yz z a z W C a' N fif = C 0 O U o o 4 Qw $ a ° a F- m e v c n O iA N O Q O a O O O o y d ULu U C _ N a C V � V V U O •O a G� � O t!1 ain � Ip W e a m m o L)U N N m m CO 0 o O S N H 4! = C m q) 21 Z c x a 2 m o m i t] } a a C7 W F• v? a U m C7 U F- 0 a C9 z & ie li� 6� & & Z CD 2 CD Z t) Z 0 Z C7 Z C9 Q'S CO tib w v3 w 03: w cad w v� w 6 UO a (D0 a CD a 00 a CD0 a (90 a 0 W N m (6+`+ U H t� o = w o Ha U. m co m U S w c f � u� 0 W X a. < U J nn c 2 rn V m c c E o c c z �z ® W® ti cnUJ , cn E o 0 0- >' C1 7Q, C E N o 00 c o N0. E O) O - O m 0 �cd , � E c L v; c .E oCc 0 D O L E c 0-0 C .� t0 (0.0 O `o M t A� v a. E w O p0 t5O >; C LM ccn°°a A �Ej 28 Q U 0 Port 2 - Currently Hold Contracts Jab oma Contract Amount I BIOMC NEEDHAM 5.1.173,0-00 2 WESTFIELD ELY CC RENOVATIONS 51-122,308 3 NORTH READING HIGH SCHOOL $1.008.5m 4 SALTONSTALL ELEMENTARYSCHOOL $M.546 5 ASSABETVALLITY v5 TECH $948589 6 5 CHANNEL CENTER 5929,724 7 UMASS BOSTON ISO $920,925 6 INORTHBENNETSCHOOL $916.910 9 157 BERKELEY STREET 573 10 LEOMINSTER HIGH SCHOOL 5815 581 11 NORTON HIGH SCHOOL 5824077 12 SANOFI4TH & 5TH FL Flt OUT $517,300 13 CHB MAIN LOBBY RENO PHASE 1 $502.036 14 SOUTHWICK REGIONAL $493000 15A I NTH 1 HTS 349i 930 t6 EAST BRIDGEWATER iRiSR H 80,882 17 ILOGAN 8A MS $454,855 18 GALVIN MIDDLE SCHOOL $451000 19 PEABODY ESSEX MUSEUM $439,920 20 WOODLAND AND POWDERMILL S435-000 21 MAH = WOMENS CENTER $431,625 22 NOCK MOLIN MIDDLE SCHOOL 5419700 23 MGH ED BACKFILL PHASE 28.2E 5373181 24 MGH WHITE BLDG INFRA UPGRADE 5354,095 2& SOUTH HAD -LEY LIBRARY 5349 26 FITCHBURG ST SCIENCE CENTER 5327,491 27 MOMENTA PHARM PROCESS LAB RENO $321798 26 DISTRICT 6 HEADQUARTERS (320.436 29 CIC 5TH FLOOR 5302 054 30 BRESNAHAN ELEMENTARY SCHOOL $293,000 31 BSU RESIDENCE HALL ACT $209487 32 NORTHERN ESSEX CC $261,407 33 MT IDA CARLSON HALL $280.000 34 CONRAC 3254.000 35 WAS TMEC CLINICAL SKILLS AREA $248,233 35 HVMA KENMORE 600 -LOGY JITH FL 229.845 37 TUFTS COHEN AUD $227,037 38 HARVARD SWINGHOUSE 5210.D74 39 APPLE STORE- ROCKINGHAM $212 B0 40 NEW FAIRHAVEN ELEM SCHOOL S202,464 41 EMD SERONQ 5184,219 42 UMASS TRAINING FACILITY $177 D00 43 NIU SEAWATER UPGRADE 174,DD0 44 MAH - NS b SS 5188 150 45 WEAKLEY AND BURKE 5185 700 48 ED W. BROOKE 2 CHARTER SCHOOL $163,200 47 INVICRO SOUTH BOSTON $156,000 46 IELY CAMPUS CENTER ACT $155,400 48 BEETHOVEN SCHOOL $149,000 50 NOR LK AGGIE 5146 5110 51 TV - OFFICE RENO $146,007 62 BWH CL W IC RENO $122,590 53 MIDDINGTON HALL S106,500 54 BOSE- R d D HED OFFICES $104.525 55 BLUE HILLS TECHNICAL POOL RENO $94000 SB FIDELITY NASHUA NH 12000635 B 2 57 HYNES CONVENTION CTR 0309 58 UMASS PAIGE LAB RENO 576,800 59 LM PORTSMOUTH DATA CENTER 77,214 60 EMK INSTITUTE 09 800 61 PRET A MANGER $59,524 62 MFS IDDHANCQCK $88,324 63 IGIL - DE b F FREIGHT $67 206 64 GIL - SOUTH DOCK WIP ROOM $59,729 65 MELROSE HS SCIENCE LAB $59,251 66 WISTIA $57.1001 67 DYS CORRIDOR CEILINGS $55,175 68 MT IDA DENTAL SCHOOL 12000534 $48.500 69 VERIZON TAUNTON $48,300 70 MERCHANT WARE USE $45,000 71 LUKE$ LIQUORS WEST YARMOUT14 $41,000 2 UMASS PHYSICAL PLANT 2 $40,665 73 FOX OROU H CHARTER SCHOOL $40.431 74 SANDELLAS FIT -OUT DF YAWKEY $38,861 75 MGH RADIOLOGY XRAY REPLACEMENT M,750 76 NSCC MATH RIENCE PHI $31.900 77 STAPLES PLANOGRAM UL WALL 530.305 78 GIL - M BUILDING LOADING DOCK $29,825 9 M H - ADA TOILETS $29.600 80 SOUTH AVE FIRE STATIN 528,720 81 MARLBOROUGH EASTERLY WWTF 27,400, 82 SCHEPENS 1ST FL ADMIN RENO $28,100 83 CLSB FIFTH FLOOR 812 524,763 84 DOT 47H AND 7TH FLOORS $23 981 85 VERIZON S YARMOUTH 12000801 $23 500 86 80 STATE ST 33RD FL $23115 81 LAHEY HOSPITAL RESTROOM RENO 522.395 58 NEU Ph3 ACT $22.370 89 VERNON C RUSSELL WTP ANVERS I 521,900 90 MANSFIELD SCHOOLS VLTRAWALL 1 $20.08 Attachment 2 PART 3 - PROJECT PERFORMANCE For Parts 3 and 4, if you answer YES to any question, please provide on a separate page a complete explanation. Information you provide herein must supplement the Application for your most recently issued (not extended or amended) Sub -Bidder Certificate of Eligibility. You must report all requested information not previously reported on that Application. Include all details [project name(s) and location(s), names of all parties involved, relevant dates, etc.]. YES NO 1. Has your firm been terminated on any contract prior to completing a project or has 0 Z any officer, partner or principal of your firm been an officer, partner or principal of another firm that was terminated or failed to complete aproject? 2. Has your firm failed or refused either to perform or complete any of its work under Q any contract prior to substantial completion? 3. Has your firm failed or refused to complete any punch list work under any contract? 4. Has your firm filed for bankruptcy, or has any officer, principal or individual with a financial interest in your current firm been an officer, principal or individual with a financial interest in another firm that filed for bankruptcy? 5. Has your surety taken over or been asked to complete any of your work under any contract? 6. Has a payment or performance bond been invoked against your current firm, or has Q Z any officer, principal or individual with a financial interest in your current firm been an officer, principal or individual with a financial interest in another firm that had a payment or performance bond invoked? 7. Has your surety made payment to a materials supplier or other party under your 0 payment bond on any contract? 8. Hasany subcontractor filed a demand for direct payment with an awarding authority Q Z fora public project on any of your contracts? 9. Have any of your subcontractors or suppliers filed litigation to enforce a mechanic's 0 0 lien against property in connection with work performed or materials supplied under any of your contracts? 10. Have there been any deaths of an employee or others occurring in connection with L Z any of yourprojects? 11. Has any employee or other person suffered an injury in connection with any of your : `El 9 projects resulting in their inability to return to work for a period in excess of one ear? Division of Capital Asset Management Page 7 of 10 Sub -bidder Update Statement Effective March 30, 2010 PART 4 - Legal or Administrative Proceedings; Compliance with Laws Please answer the following questions. Information must supplement all judicial and administrative proceedings involving bidder's firm, which were instituted or concluded (adversely or otherwise) since your firm's Application for your most recently issued (not extended or amended) Sub -Bidder Certificate of Eligibility. You must report all requested information not previously reported on that DCAM Application. The term "administrative proceeding" as used in this Sub -Bidder Update Statement includes (i) any action taken or proceeding brought by a governmental agency, department or officer to enforce any law, regulation, code, legal, or contractual requirement, except for those brought in state or federal courts, or (ii) any action taken by a governmental agency, department or officer imposing penalties, fines or other sanctions for failure to comply with any such legal or contractual requirement. The term "anyone with a financial interest in your firm" as used in this Section "I", shall mean any person and/or entity with a 5% or greater ownership interest in the applicant's firm. If you answer YES to any question, on a separate page provide a complete explanation of each proceeding or action and any judgment, decision, fine or other sanction or result. Include all details (name of court or administrative agency, title of case or proceeding, case number, date action was commenced, date judgment or decision was entered, fines or penalties imposed, etc.). YES NO 1. Have any civil, judicial or administrative proceedings involving your firm or a ❑ principal or officer or anyone with a financial interest in your firm been brought, concluded, or settled relating to the procurement or performance of any construction contract, including but not limited to actions to obtain payment brought by subcontractors, suppliers or others? 2. Have any criminal proceedings involving your firm or a principal or officer or ❑ 0 anyone with a financial interest in your firm been brought, concluded, or settled relating to the procurement or performance of any construction contract including, but not limited to, any of the following offenses: fraud, graft, embezzlement, forgery, bribery, falsification or destruction of records, or receipt of stolen property? 3. Have any judicial or administrative proceedings involving your firm or a principal ❑ or officer or anyone with a financial interest in your firm been brought, concluded, or settled relating to a violation of any state's or federal procurement laws arising out of the submission of bids or proposals? 4. Have any judicial or administrative proceedings involving your firm or a principal or officer or anyone with a financial interest in your firm been brought, concluded, or settled relating to a violation of M.G.L. Chapter 268A, the State Ethics Law? Division of Capital Asset Management Page 8 of 10 Sub -bidder Update Statement Effective March 30, 2010 PART 4 - Legal or Administrative Proceedings; Compliance with Laws (continued) ra kf -U97 5. Have any judicial or administrative proceedings involving your firm ora principal El M or officer or anyone with a financial interest in your firm been brought, concluded, or settled relating to a violation of any state or federal law regulating hours of labor, unemployment compensation, minimum wages, prevailing wages, overtime pay, equal pay, child labor or worker's compensation? 6. Have any judicial or administrative proceedings involving your firm or a principal E Z or officer or anyone with a financial interest in your firm been brought, concluded, or settled relating to a violation of any state or federal law prohibiting discrimination in employment? 7. Have any judicial or administrative proceedings involving your firm or a principal ❑ Z or officer or anyone with a financial interest in your firm been brought, concluded, or settled relating to a claim of repeated or aggravated violation of any state or federal law regulating labor relations? 8. Have any proceedings by a municipal, state, or federal agency been brought, E M concluded, or settled relating to decertification, debarment, or suspension of your firm or any principal or officer or anyone with a financial interest in your firm from public contracting? 9. Have any judicial or administrative proceedings involving your firm or a principal or E] 0 officer or anyone with a financial interest in your firm been brought, concluded, or settled relating to a violation of state or federal law regulating the environment? 10. Has your firm been fined by OSHA or any other state or federal agency for 0 violations of any laws or regulations related to occupational health or safety? Note: this information may be obtained from OSHA's Web Site at www.osha.gov 11. Has your firm been sanctioned for failure to achieve DBE/MBEA BE goals, FT workforce goals, or failure to file certified payrolls on any public ro'ects? 12. Other than previously reported in the above paragraphs of this Section 1, have any 1 Z administrative proceedings or investigations involving your firm or a principal or officer or anyone with a financial interest in your firm been brought, concluded, or settled by any local, state or federal agency relating to the procurement or performance of any construction contract? 13. Are there any other issues that you are aware which may affect your firm's Q 0 responsibility and integrity as a building contractor? Division of Capital Asset Management Page 9 of 10 Sub -bidder Update Statement Effective March 30, 2010 PART 5 - SUPERVISORY PERSONNEL List all supervisory personnel who will be assigned to the project if your firm is awarded the contract. Attach the resume of each person listed below. AM ,..... NAM:r=,'.:-:. s .. TITLE Cd N. ON Cn?I William B. McPherson President Christopher McPherson Director of Operations David Donovan Vice President of Operations Jaimey Buckley Pre -Construction Manager PART 6 - CHANGES IN BUSINESS ORGANIZATION OR FINANCIAL CONDITION Have there been any changes in your firm's business organization, financial condition or bonding capacity since the date your current Certificate of Eligibility was issued? ❑ Yes ® No If YES, attach a separate page providing complete details. PART 7 — LIST OF COMPLETED CONSTRUCTION PROJECTS SUBMITTED TO THE DIVISION OF CAPITAL ASSET MANAGEMENT ALONG WITH CERTIFICATION PAGE. Attach here a copy of the list of completed construction projects which was submitted with your firm's Application for your most recently issued (not extended or amended) Sub -Bidder Certificate of Eligibility. The Attachment must include a complete copy of the entire Section F — "Completed Projects" (Section G — "Completed Projects" for firms certified based upon their Prime/General Application), and the final page — "Certification Page", (Section I in the Sub -bidder Application or Section J in Prime/General Application) containing the signature and date that the Completed Projects list (Section F or G) was submitted to the Division of Capital Asset Management. Division of Capital Asset Management Page 10 of 10 Sub -bidder Update Statement Effective March 30, 2010 E N T R A L® 31ALTY CONTRACTING YOU CAN BUILD ON William B. McPherson, III 617-238.6986 617-238-2191 Fax wmcpherson@oentralee'lings.com Experience Central Ceilings, lnc. 36 Norfolk Avenue So. Easton, MA 02375 With Central 43 Years 1985—Present President and Treasurer Duties Include: ■ President of $42 Million plus carpentry operation • Overall business development strategies • Maintains Insurance, Banking and Bonding Company relationships 1979-1985 Director of Operations ■ Over thirty years construction experience ■ Supervised major drywall and ultrawall projects ranging in size up to $2,500,000 through the mid 1980's ■ Major clients serviced included; Stratus Computer, Data General; and Prime Computer 1970-1979 Outside Supervisor ■ Coordination of field labor and materials on various projects Construction • The Associated General Contractors of Massachusetts Affillaticns ■ A.W.C.I of Massachusetts ■ Associated Subcontractors of MA (ASM) ■ 19921998 MA Carpenter Combined Benefit Fund Member of the Board • 19941996 Associated Subcontractors of MA (ASM) • 1996-1998 AGC of MA Education 1988-1990 ■ Harvard Business School—Owners, Presidents and Managers Program 1970-1975 ■ Wentworth Institute—Evening Program Building Construction Attachment B1 36 Norfolk Avenue • South Easton, MA 02375 • (508) 238-6985 • Fax: (508) 238-2191 info@centralceilings.com • www.centmlceilings.com i E N T R A Le MALTY CONTRACTING YOU CAN BUILD ON Experience Central Ceilings, Inc. 508-2388985 508-238-2191 Fax cmcpherson(gcenUalcellings.com 36 Norfolk Avenue So. Easton, MA 02375 With Central 8 Years Director of Operations 2012—Present ■ General Management of Operations ■ New Business Development ■ Project Management ■ Pre-Construction/Estimating Senior/Project Manager 2005-2012 ■ Client Relations & Business Development ■ Project Management ■ Estimating • Contracts • Vendor Buyouts ■ Submittals/Shop Drawings • Change Management ■ Safety • Field Operations ■ Supervision ofJunior Staff • Projects ranging from $5,000 to ten million dollars on projects including MIT Sloan (Cambridge, MA), Astra Zeneca Research and Development (Waltham, MA), Fenway Park (Boston, MA) Proctor and Gamble — Gillette Integration (South Boston, MA), and Fall River Trial Court (Fall River, MA), Liberty Mutual New Office Tower (Boston, MA). Construction • Associated General Contractors of MA: Young Contractors Executive Council Affiliations ■ Associated Subcontractors of Massachusetts Training and ■ OSHA 30 Certification ■ LEED Green Associate ■ FMI Young Managers Institute ■ AGC Young Contractors Professional Institute Education 2005 Hamilton College, Clinton, NY B.A. Public Policy Thesis: Impact of Wick's Law on Public Construction in the State of New York 36 Norfolk Avenue • South Easton, MA 02375 • (508) 238-6985 • Fax: (508) 238-2191 info@centralceihngs.com • www.centmiceihngs.com ATTACHMENT B2 E N T R A Le 'IAL CONTRACTING YOU CAN BUILD ON David Donovan 617-236-6985 617-236-2161 Fax ddonovan@cenlralceilings.com Experience Central Ceilings, Inc. 36 Norfolk Avenue So. Easton, MA 02375 With Central 29 Years 2005 -Present Vice President of Operations Duties Include: ■ Oversees Field Operations for all Primary Services ■ Manages the Warehouse Operations ■ Manages all Sub -Contractor and Supplier Relationships ■ Various projects successfully completed include Merk Pharmaceutical $18 Million, MA BIO Labs for $3.6 Million, Pavilion Club Renovations at Fenway Park $1.8 Million. 1999 -Present General Road Foreman Duties Include: ■ Oversees All Manpower Issues (GWB/ Rough Carpentry/ ACT) -Oversees an Average of 290 projects a year to execution -Coordinates and Average of 220 Tradesmen ■ Manages Workers Compensation Injuries ■ Supervises Field Safety ■ Auditor of Field Safety 1984-1999 Carpenter Foreman Duties Include: ■ Scheduling Manpower ■ Ordering Equipment ■ Various projects include; Fleet Bank, 75 State Street and US Federal Courthouse 1982.1984 Mansco - Carpenter ■ Carpenter Duties for Several Jobs Certifications ■ EIFS Inspector, certified in 2000 ■ Scaffold Competent, certified in 1999 ■ AWCI Cold -Formed Steel, certified 2007 ■ OSHA 30, certified in 1997 ■ CPR / First -Aid, Lull Operator and Forklift ■ CHST Construction Health & Safety Technician 2008 Associations ■ Board Member Southeastern Massachusetts Carpenter's Association ■ Member AGC and ASM Safety Committee Education' ■ Continuous Project Management development through in house training 1999 -Present with Fails Management Institute ■ 1981 Worchester State College -1 year 36 Norfolk Avenue - South EastonAVJCbM0dt-q308) 238-6985 - Fax: (508) 238-2191 info@centralceilings.com - www.centralceilings.com E N T R A Le :IALTY CONTRACTING YOU CAN BUILD ON Jaimey Buckley 617-238-6985 517-238-2191 Fax jbuckley@centralceilings.com Eiciiiewlence Centiral Cemnos, itnm 36 Norfolk Avenue So. Easton, MA 02375 With Central 14 Years 1999 -Present Pleconstrucoonmanaw ■ Oversee all preimnstruction activity including estimating and budgeting • Oversee all estimating software computer systems ■ Oversee all mid—large projects as transflonad Into operations and management ■ Train all junior and senior level estimators, project managers and associate project managers on preconsbuction activities ■ Oversee and develop new relations with new clients K& J Interiors Hanover, Me 199644 Pauctor of Marketng and Estimating ■ Chief Estimator— Oversee staff of 3 estimators and support staff ■ Review all bids and prknary negotiator of all contracts ■ Maintain and Train new and eAsting estimating team on Precision Estimator (P.E.) database and upgrade as required • Coordinate intra -departmental budgeticost information. Develop/Maintain all supporting procedural documentation as required ■ Function as Director of Marketing by Inflating and nurturing new and existing relationships wtih various construction managers, general contractors and owner's representatives. Transition construction operations from regional to Boston market 1996-1997 Senior Project Manager • Assist in development, implementation and documentation of a fully departrnentafized drywall operation ■ Develop and oversee staff of project managers and project administrators. ■ Responsible for 60+ projects & 7.0 million in sales annually ■ Develop and maintain systems for streamlining all project management processes, tracking cost and change order management 19941996 Project Managers Est6nator a Estimate Commercial Institutional & retail construction projects for framing, drywall, carpentry and acoustical ceilings scope (bids up to $2.5 million) • Project management incudes negotiate contracts; coordinate job with company foreman and general contractor, buyout all materials, supplies and equipment; generate material takeoff, labor -assignments and production schedules • OSHA 30 Ceffied CertiFications • LEEDAP Education Babson Graduate School of Business Wellesley, MA 36 credit hours earned towards MBA University of Lowell Lowell, MA Bachelor of Science 43ectrical Engineering Attachment B4 36 Norfolk Avenue • South Easton, MA 02375 • (508) 238-6985 • Fax: (508) 238-2191 info@centralceilings.com • www.centralceilings.com z a a a 3 E 3 x E i a. J c 5 aa aa QQ S o S . F$ ` § c s m' R Certification (notarization required) The undersigned, William B. McPherson. Ili hereby certifies: (type name) That I am an owner or principal of Central Ceilings, Inc. (company name) and that all answers and all statements contained in the attached application (including Sections E and F) for certificate of eligibility are true and correct. Providing false or misleading information or failure to provide all required information will be considered grounds for denial, decertification and/or debarment. I attest to the accuracy of all information contained in this application and verify that the information submitted is in fact accurate and true, under oath. Signed and Sworn under the Pains and Penalties of Perjury. Dated at 1/17/2013 This 17th day of January , 2013. By (signature): Print name: William B. McPherson, III Title or position: President _7JZJii44V ss. i'hx"44u0iK - (county) (state) Before me, , personally appeared and (notary public) known to me to be' U)'AI'-ArA B. A -PA erson ZZ ,based (name of officer) on satisfactory evidence which was his/her driver's license and acknowledged that he/she is authorized to execute the foregoing and that its execution is his/her free act and deed and the free act and deed of the firm. ffiu� am 6?.v My commission expires: o8-oyd01 (notary public signature) pr�sc:liQ A wo. fm4+ (print name) ** Upon completion of this Application and the two corresponding Excel Spreadsheets, save and email them to CertificationAnnlication.dcamaa,state.ma.us ** Page 14 of 14 Sub -Bidder Application March 2011 Computer