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HomeMy WebLinkAboutHealth Permit # 8/19/2015 Permit Number TOV��r ca'r Noz��e>:�ANno�iLa j NORTH ANDOVER,MASSACHUSET"T'S 011845 a Date Issued Expiration Date ' Rn+nrw R E CCI n E D .. Jackie's Law — P'ennit Application 1�°`�j�� � �� ° ��� ' N VCS€�4 f����n �� �V �•.fl�N Pursuant to G.L. c, 82A §1 and 520 CMR 7.00 et seq.(as amended) THIS PERMIT MUST BE FULLY commyTED PRIOR TO CONSIDERATION Name of Applicant Phone cell C.J. Mabardy, Inc. StreeetAddress 50 Mooney Street 617-354-7580 . 617-590-4131 CitylTown MA I ZIP . Cambridge 02138 Name of Exeavator(if different from applicant) Phone cell Street Address City/Town MA I ZIP Name of Owner(s)of Property Phone Cell Lawrence Municipal Airport ' Street Address 978-794-5$8'0 492 Sutton Street City/Town MA Z7p North Andover 01845 Other Contact Permit Fee Received No Yes Description,location and purpose of proposed trench. Please describe the exact location of the proposed trench and its purpose(include a description of what is(or is intended)to be laid in proposed trench(eg;pipeslcable lines etc..)Please use reverse side It additional space is needed. The purpose of the project is to construct end safety areas at each end of runway 14-32, as well as to install edge lighting along taxiway E. Trenching will be conducted for stormwater drainage utilities at both ends of runway 14-32, erosion controls, lighting cable&conduit, &ductbanks. Please see attached drawing for reference. Insurance Certiffcate M GL:ESG3000746 l WC:AWC400702861$2014A-MA t Y c�ev�#e.intl�isseeta�i- 1R11 " 13II RA Am _ r = _ — = _ CONDITIONS AND REQUIREMENTS PURSUANT TO G.L.C.82A AND 520 CMR 7.00 et seq. (as amended) By signing the application,the applicant understands and agrees to comply with the following: i. No trench maybe excavated unless the requirements of sections 40 through 40D of chapter 82,and any accompanying regulations,have been met and this permit is invalid unless and until said requirements have been complied with by the excavator applying for the permit including,but not limited to,the establishment of a valid excavation number with the underground plant damage prevention system as said system is defined in section 76D of chapter 164(DIG SAFE); - FI, Trenches may pose a significant health and safety hazard. Pursuant to Section 1 of Chapter 82 of the General Laws,an excavator shall not leave any open trench unattended without first making every reasonable effort to eliminate any recognized safety hazard that may exist as a result of leaving said open trench unattended. Excavators should consult regulations promulgated by the Department of Public Safety in order to familiarize themselves with the recognized safety hazards associated with excavations and open trenches and the procedures required or recommended by said department in order to make every reasonable effort to eliminate said safety hazards which may include covering, barricading or otherwise protecting open trenches from accidental entry. Persons engaging in any in any trenching operation shall familiarize themselves with the federal safety standards promulgated by the Occupational Safety and Health Administration on excavations:29 CFR 1926.650 et.seq.,entitled Subpart P"Excavations". iv. Excavators engaging in any trenching operation who utilize hoisting or other mechanical equipment subject to chapter 146 shall only employ individuals licensed to operate said equipment by the Department of Public Safety pursuant to said chapter and this permit must be presented to said licensed operator before any excavation is commenced; V. By applying for,accepting and signing this permit,the applicant hereby attests to the following:(1)that they have read and understands the regulations promulgated by the Department of Public Safety with regard to construction related excavations and trench safety; (2)that he has read and understands the federal safety standards promulgated by the Occupational Safety and Health Administration on excavations:29 CMR 1926.650 et.seq.,entitled Subpart P"Excavations"as well as any other excavation requirements established by this municipality;and(3)that he is aware of and has,with regard to the proposed trench excavation on private property or proposed excavation of a city or town public way that forms the basis of the permit application,complied with the requirements of sections 40- 40D of chapter 82A. vi. This permit shall be posted in plain view on the site of the trench. For additional information please visit the DeARkR bfi website at www,mass.eov/dns SOAR H LTH C'N\ NAME � J 3 1 P a g e Name and Contact Information of Insurer: GL:USI Insurance Services LLC(855-8740123)1 WC:DeSancfis Insurance Agency.Inc.(781-935.8480) Polic y Expiration Date:9101/15 Dig safe#:20153403325 Name of Competent Person(as defined by 520 CMR 7.02): John J. Sherwin Massachusetts Hoisting License 9 HE-050931 License Grade: Hoisting Engineer iration Date.7/11/2016 BY SIGNING THIS FORM, THE APPLICANT, OWNER, AND EXCAVATOR ALL ACKNOWLEDGE AND CERTIFY THAT THEY ARE FAMILIAR WITH, OR, BEFORE COMMENCEMENT OF THE WOW WILL BECOME FAMILIAR WITH, ALL LAWS AND REGULATIONS-APPLICABLE TO WORK PROPOSED,INCLUDING OSHA REGULATIONS, G.L.c.82A,520 CMR 7.00 et seq.,AND ANY APPLICABLE MUNICIPAL ORDINANCES,BY-LAWS AND REGULATIONS AND THEY COVENANT AND AGREE THAT ALL WORD DONE TINDER THE PERMIT ISSUED FOR SUCH WORK WILL COMPLY THEREWITH IN ALL RESPECTS AND WITH THE CONDITIONS SET FORTH BELOW, THE UNDERSIGNED OWNER AUTHORIZES THE APPLICANT TO APPLY FOR THE PERMIT AND THE EXCAVATOR TO UNDERTAKE SUCH WORD ON THE PROPERTY OF THE OWNER, AND ALSO,FOR THE DURATION OF CONSTRUCTION,AUTHORIZES PERSONS DULY APPOINTED BY THE MUNICIPALITY TO ENTER UPON THE PROPERTY TO MONITOR AND INSPECT THE WORK FOR CONFORMITY WITH THE CONDITIONS ATTACHED HERETO AND THE LAWS AND REGULATIONS GOVE RING SUCH WORIZ THE UNDERSIGNED APPLICANT,OWNER AND EXCAVATOR AGREE JOINTLY AND SEVERALLY TO REIMBURSE THE MUNICIPALITY FOR ANY AND ALL COSTS AND EXPENSES INCURRED BY THE MUNICIPALITY IN CONNECTION WITH THIS PERMIT AND THE WORK.CONDUCTED THEREUNDER,INCLUDING BUT NOT LIMITED TO ENFORCING THE REQUIREMENTS OF STATE LAW AND CONDITIONS OF THIS PERMIT,INSPECTIONS MADE TO ASSURE COMPLIANCE THEREWITH,AND MEASURES TAKEN BY THE MUNICIPALITY TO PROTECT THE PUBLIC WHERE THE APPLICANT OWNER OR EXCAVATOR HAS FAILED TO COMPLY THEREWITH INCLUDING POLICE DETAILS AND OTHER REMEDIAL MEASURES DEEMED NECESSARY BY THE MUNICIPALITY, THE UNDERSIGNED APPLICANT,OWNER AND EXCAVATOR AGREE JOINTLY AND SEVERALLY TO DEFEND,INDEMNIFY,AND HOLD HARMLESS THE MUNICIPALITY AND ALL OF ITS AGENTS AND EMPLOYEES FROM ANY AND ALL LIABILITY,CAUSES OR ACTION,COSTS,AND EXPENSES RESULTING FROM OR ARISING OUT OF ANY INJURY, DEATH, LASS, OR DAMAGE TO ANY PERSON OR PROPERTY DURING THE WORD CONDUCTED UNDER THIS PERMIT. APPI.,IC T SIGNAT � / DATE C 1 EXCAVATOR SIGNATURE(IF DIFFERENT) DATE OWNER'S SIGNA (IF DIFFERENT) DATE: /�� 3 a` ? zzz z3 $ 8 06 §€i4 u I I = x ® a € Sd OU)k z $ 4U' ti®' r Iz i - \.. or gia 9LL pi 8 - �'�.rv3t�-r NO MW � . ., �'' .-_�r• '.(''.��. a�%'•,�C = `sS :�'Gr.. #�.-. Ochs? _ .� '_�: CONDITIONS AND REQUMEMENTS PURSUANT TO G.L.C.82A ANA 520 CMR 7.00 et seq. (as amended) By signing the application,the applicant understands and agrees to comply with the following: No trench maybe excavated unless the requirements of sections 40 through 40D of chapter 82,and any accompanying regulations,have been met and this permit is invalid unless and until said requirements . have been complied with by the excavator applying for the permit including,but not limited to,the establishment of a valid excavation number with the underground plant damage prevention system as said system is defined in section 76D of chapter 164(DIG SAFE); ii. • Trenches may pose a significant health and safety hazard. Pursuant to Section 1 of Chapter 82 of the General Laws,an excavator shall not leave any open trench unattended without first making every reasonable effort to eliminate any recognized safety hazard that may exist as a result of leaving said open trench unattended. Excavators should consult regulations promulgated by the Department of Public Safety in order to familiarize themselves with the recognized safety hazards associated with excavations and open trenches and the procedures required or recommended by said department in order to make every reasonable effort to eliminate said safety hazards which may include covering, barricading or otherwise protecting open trenches from,accidental entry. iii. ' Persons engaging in any in any trenching operation shalt familiarize themselves with the federal safety standards promulgated by the Occupational Safety and Health Administration on excavations:29 CPR 1926.650 et.seq.,entitled Subpart P`Excavations". iv. Excavators engaging in any trenching operation who utilize hoisting or other mechanical equipment subject to chapter 146 shall only employ individuals licensed to operate said equipment by the Department of Public Safety pursuant to said chapter and this permit must be presented to said licensed operator before any excavation is commenced; V. By applying for,accepting and signing this permnit,the applicant hereby attests to the following:(1)that they have read and understands the regulations promulgated by the Department of Public Safety with regard to construction related excavations and trench safety; (2)that he has read and understands the federal safety standards promulgated by the Occupational Safety and Health Administration on excavations:29 CMR 1926.650 et.seq.,entitled Subpart P"Exoavatlons"as well as any other excavation requirements established by this municipality;and(3)that he is aware of and has,with regard to the proposed trench excavation on private property or proposed excavation of a city or town public way that forams the basis of the permit application,complied with the requirements of sections 40- 40D of chapter 82A. Vi. This permit shall be posted in plain view on the site of the trench. For additional information please visit the Department of Public Safety's website at www.m ss.ao /d s Sumunary of Excavation and Trench Safety,Regulation(520 tvlR 14.00 et sea 1 This summary was prepared by the Massachusetts Department of Public Safety pursuant to G1,02A and does not include all requirements of the 520.CMR 14.00. To view the full regulation and G.L.c.92A,go to www/mass.gov/dps Pursuant to M:G.L. c. 82, § 1, the Department of Public Safety,jointly with the Division of Occupational Safety, drafted regulations relative to trench safety. The regulation is codified in section 14.00 of title 520 of the Code of Massachusetts Regulations, The regulation requires all excavators to obtain a-permit prior to the excavation of a trench made for a construotion-related purpose on public or private land or rights-of-way. All municipalities must . establish a local permitting authority for the purpose of issuing permits for trenches within their municipality. Trenches on land owned or controlled by a public(state)agency requires a permit to be.issued by that public agency unless otherwise designated. In addition to the permitting requirements mandated by statute, the trench safety regulations require that all excavators,whether public or private,take specific precautions to protect the general public and prevent unauthorized access to unattended trenches, Accordingly,unattended trenches must be covered,barricaded or backfilled. Covers trust be road plates at least%1'thick or equivalent;barricades must be fences at least 6'high with no openings greater than 4' between vertical supports; backfilhing must be sufficient to eliminate the trench. Alternatively, excavators may choose to attend trenches at all times,for instance by hiring a police,detail,security guard or other attendant who will be present during times when the trench will be unattended by the excavator. The regulations f wthet provide that local permitting authorities,the Department of Public Safety,or the Division of Occupational Safety may order an immediate shutdown of a trench in the event of a death or serious injury;the failure to obtain a permit; or the failure to implement or effectively use adequate protections for the general public. The trench shall remain shutdown until re-inspected and authorized to re-open provided,however,the excavators shall have the right to appeal an immediate shutdown. Permitting authorities are further authorized to suspend or revoke a permit following a hearing. Excavators may also be subject to administrative fines issued by the Department of Public Safety for identified violations. Summary of 1926 CFR Subpart P-OSHA Excavation Standard This is a worker protection standard,and is designed to protect employees who are working inside a trench. This summary was prepared'by the Massachusetts Division of Occupational Safety and not OSHA for informational purposes only and does not constitute an official interpretation by OSHA of their regulations,and may not include all aspects of the standard. For further information or a full copy of the standard go to www.osha. ov. Trench Definition per the OSHA standard: • An excavation made below the surface of the ground,narrow in relation to its length. • In general,the depth is greater than'the width,but the width of the trench is not greater than fifteen feet. • Protective Systems to prevent soil wall collapse are always required in trenches deeper than 5',and are also required in trenches less than 5'deep when the competent person determines that a hazard exists. Protection options include: o Shoring. Shoring must be used in accordance with the OSHA Excavation standard appendices,the equipment manufacturer's tabulated data,or designed by a registered professional'engineer. o Shielding(Trench Bdxes). Trench boxes must be used in accordance with the equipment manufacturer's tabulated data,or a registered professional engineer. o Sloping or Benching. In Type C soils(what is most typically encountered)the excavation must extend horizontally 1 t/z feet for every foot of trench depth on both sides,I foot for Type 13 soils, and%foot for Type A soils. o A registered professional engineer must design protective systems for all excavations greater than 20'in depth. continued Client#:1059124 CJMABARDY �.�61=2`�3M/M21�1�5`YY) ACOR N, CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFIC ATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.if SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT PRODUCER NAME: Ellen Reagan FAT( '1-376-5035 USI Insurance Services LLC arc PHONE No Ext:781-939_2052 _ �(A/c,No)_78 12 Gill Street Suite 5500 EMAIL ADDRESS: ----------- --.-._.- Woburn,IVIA 01801 INSURERS)AFFORDING COVERAGE NAIC iF 855 874-0123 _ INSURE-RA:XL Specialty Insurance Company 37885 INSURED INSURER B:Starr Indemnity&Liability Corn 38318 CJ Mabardy,Inc.; Nlich-Lin LLC INSURER C:Commerce Insurance Company 34754 CJ Mabardy Recycling and Disposal INSURER D: 50 Mooney Street INSURER E: - ----------- Cambridge,MA 02138 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE INDICATED. NOTWITHSTANDING ANY CREQUIREMENT, TERM I OR OCONDIIT ON OF ANY CONTRACTOR HOTHER DOCUMENT WITH RESPECT ETO POLICY WHICH PERIOD'Cy CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED B POPACID XP IMS. ___ L R ADDLSUB LIMITS TYPE OF INSURANCE INSR WVD POLICY NUMBER MMIDDIYYYY MMIDDIYYYY A GENERAL LIABILITY X X ESG3000746 0312212015 031221201 EACHOCCURRENCE $1,000,000 DAMAGET RENTED X COMMERCIAL GENERAL LIABILITY PREMISES Eaoccarrence 5250,000 MED EXP(Any one person) $5,000 CLAIMS-MADE a OCCUR PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE s2,000,000 PRODUCTS-COMP/OP AGG x2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: $ POLICY a PRO- LOC COMBINED SINGLE LIMIT C, AUTOMOBILE LIABILITY X X 16MMBGGDGV 03/22/2015 03/22/201 Ea accident 81,000,000 BODILY INJURY(Per person) x ANY AUTO BODILY INJURY(Per accident) $ ALL OWNED X SCHEDULED AUTOS AUTOS PROPERTY DAMAGE 8 X HIRED AUTOS X AUTOS NON-OWNED Peraccidenl _ Hired Phys Dmg 500/Coll 500 1Comp $ B UMBRELLA LIAB )( OCCUR 1000020819 0312212015 03/22/201 EACH OCCURRENCE $10,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $10'00%000 000 5 DED I X RETENTION SO WC STAT TS RTH WORKERS COMPENSATION TORY AND EMPLOYERS'LIABILITY E.L,EACH ACCIDENT S ANY FICER/MEMBER EXCLUDED?ECUTIVE� NIA E.L.DISEASE-EA EMPLOYEE x (Mandatory in NH) "yes,describe under E1.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,it more space is required) The General Liability policy includes an automatic Additional Insured endorsement that provides Additional Insured status to The Town(North Andover)and the Owner(Lawrence Municipal Airport Commission),only when there is a written contract that requires such status,and only with regard to work performed on behalf of the named insured. (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Lawrence Municipal Airport THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 492 Sutton Street ACCORDANCE WITH THE POLICY PROVISIONS. North Andover,MA 01845 AUTHORIZED�Rj/EPRE�S)ENygTATIVE ie ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) 1 of 2 The ACORD name and logo are registered marks of ACORD SYNZP #S15615942lM14618532 COP ID:TD 1 061231` 5 CERTIFICATE OF THIS CERTIFICATE IS ISSUED Af FIARMAT AFFIRMATIVELY NEGATIVELY AMEND, EXTEND CONFERS OR ALT R Tti� NCO COVERAGE AFFORDED�s)THE AUTHORIZFEQ CERTIFICATE DOES N BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT IS REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. v IMPORTANT: If fh�itionsf c the t. of policy,is certa•IAnDf ohcOiesAn'ayirequire E an endorsement. A s atenrent on this certtiiROGe does not WAIVED,nferightsJto the the terms and co 1 u�_ x certificate holder in lieu of such endorsement(s)_ courncT Phone:781-935-8480'NAA±E -- FAX' PRODUCER VNONE (VC,NO): DOSanctis Insurance Acdcy,Inc• Fax-,781-93:3-5645 tae, E exc) 1100 Unicorn Park Drive E-MAIL ADDRESS WOi)tlril,MA 01801 PRODUCER MAE3AR-3 CUSTOMER ID II: - ..._.. .. NAIL It INSURERIS)AFFORUING COVERAGE a,suR•_D C.J. Mahardy Inc.etai INSURER Mutual Insurance Co s,a 31325 50 Mooney Street INSURER R Acadia Insurance Comp, Cambridge,MA 02138 Ir15URER C INSRER D: INSUREF.E: INSURER F; �T — _ REVISION NUMBER: _.__ COVERAGES CERTIFICATE NUMESER; _ I{)7-71 5 j5 TO C;CRTIFY iHJ 11HE POlhl S OF INSURANCE LISTED DEIOVV IIAVE BEEtd ISSUED TO THr INSURED NAIiEG.ABOVE FOR TILE POI IVY FHfHIS INDICA NOTVIIII n.Y/BE ISSUED OR N1 IY PERTAIN LME THET E M OR CONDiTION OF A�0'CONTRACT OR AFFORDED BY Tf E PC),IC FS 0 6C)it+t}EOOHEREf l ils 1SUEsJ CT TOTALL l'FItCIIriiIHS. CE RT1F C E"xct USIONS AND CONDITIONS OF SUCH POLICIES L1141TS SHOWN triAY HAVE f3EEr1 R.EPOL POLICY E BY PAID POLICY IXPS LIVITS ADDL SUBIi pOLICY'NU")BER L'd 61100lY YYYf"_ff t.,ODiYYYYI I l513 TYPE OF INSURANCE ��g+)_CQ V"0 ._----. MR _ _ CALH OCC:UrtM r 5 GCCIERAL LIABILITY DA,IAGE TO RENTED S PRFAIISFS IV,' COCA'>1rRGh14.OENFRAL I IARIL 11Y 1,1GD EX1'Vlrq one parson) _5 CI AIMS-MADE X OCCUR PERSONAL&ADV INJURY S (L NFRAL AGGREGATE S PRODUCrB�CDbIPiUP AGG i GLN I,A6GRCG.ATL 1.11011 APPLIES P[iR I I'(X ICY 1�GT- LOP -- --- � COP R1,0 )51NC LE i Orli e I-"--_ (Ea I AUTOMOBILE LIABILITY llOUIIY ItI, ANY ALTO HOOILY IrIJ JRY(PaI ot•=:dent) & n)I OVVNF.D ALILOS i1i10PP}y)Y 1)ArMt9F S SCI 11 RULED AUTOS {^a•accd?ntj { < i I 1111tH)ALTOS I c i NUN-OWNED AUTOS -- VAMI OCCURRENCE Um BRELLA LIAR OCCUR ,";iuYE<:ATI' ExCESS LIAB CLAIMSWADL { DEDLICI IBI r: .. __ 5 _ ._X FVCSTATU- OT)+ L Igrevllrai s F.R. 500,00.0 F10RKE RS COIAPENSATION AUD ENPLOYERJ LIABILITY YIN AIVGA0DJD2gG102VIAA fAA 09101114 09101116 1-( Lid:.H ACCIDFNt 500,00. A ti r z I)'I?� It1!I+ ',rtrN R EXFGU)IVI N� N I A CARRIER TO SEND CERT L D.stA.at )n Fr.ahl uYl�t S .r 6?%1 .,t)LN t xaI UDF., 500,000, I IC1indalory In IQU .t U.SFJASI- P0i icy IA.MII 5 000 II yc- Ai srr,i,r•under '--` I,LS r,PUC .'�HAT!L�NSu�IV�— ' CIMS01128713 --- — 09101114 09101/15 DecluCi g Equipment leased 300,000 �DF.SCRIP rION OF OPERATIONS I L OCATION5I VEHICLLS tARach ACORD 101,Atltlittonai Roniarks SchDdula,if more space is rnquirotl) 1EV'1.Cence OP covera<j'e 4 II CANCELLATION CERTIFICATE HOLDER LAWRE20 SHOMON.ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE ATE THEREOF, NOTICE WILL BE DELIVERED IN i Lawrence Municipal Airport ACCHE POLICY PRO%f IONS. Commission , 492 SUt1Olt Stl Pith{ _ AUTHOTIVE + �North Andover,MA 01845 I'Vu 09 ACORD CORPORATION. All rights reserved. f ACORD 25(2009109) The ACORD name and 1090 are registered marks of ACORD I BOND NO, 259553P PERPOP.I\�!�\NC'I f3ONl_7 I�N04V Al.i, MEl>) Bl`TI[t�S(�' PRC�;C(NI'�;; Ih,lt ( ante nl ttllllfiliSti r) Moo l -`r' NIA u 7 3 t3 - - -t A --�_�rl Ire=iL tl l,t-1►I - — --- llcwlhl;lfwl called Principal, (C_'u1171�Isllil n. !'�r`lul:r�;llih, or fndivlr_lnal) and Cove PoinLe Ill it:►C lrr_.'+.-' 1.U117tJdIl)� (Name oI Sul'ety) - 401 S 01101 6Vc o(bl6trd Avenue, Sup to 300, Birmi -_MI 118009 (Address of Surety) hereinafter called Surety, are held and firmly bound unto the City of Lawrence, Massachusetts herrTinafter called OWNER,4in the penal sum equal to lilt%of c�onlract amount "1 or_ dowers and _ _cents (t,1, g 1 g 7. 5$) in lawfill money of the United States, for the pay►nent of which sum well and truly to be made, we hind ourselweS, successors, and assigns,jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION is such that whereas, the Principal entered into a certain contract with the OWNER, dated the 23�— day of June_ 1015, a copy of which is hereto attached and made a hart hereof for the coil st►ltction of: Construct Runway 14-32 End Sarety Areas and Light Taxiway E, Lawrence Municipal Airport, North Andover, (Massachusetts, AIP No, 3-25-0026-35-20[5. NOW,THERFFORE, if tlle. Principal shall well, truly and taithfidly purfo►7n its duties, all the undertaking's, covcnants, terms, conditions, and agreements of said contract during the original tern) thereof; and any extensions thereof which may be granted by the OWNER, with or wilhout notice to flit: Surety and during the one year guaranty period, and if he shall satisfy all claims and demands incurred under such contract, and shall hilly indemnify and save harmless the OWNER Groin all costs and damage~ which it may suffer 1.►y reason of fi►ilure to do so, and shall reimhursc and repay the OWNER all outlay and expense which file OWNER may incur in making good any default, then this obligation in hill force and affect, shall be void; otherwise to rctttain PROVIDED, FURTI IfiR, that the said surety, for value roceived hereby stipulates and agrees that no change,extension oftilrie, alteration or addition to the terms of the contract or to Work to be perforinvd thereunder or the 'Specifications accompanying the same shall in any wise affect its obligation oft this Bond, and it does hereby waive notice of any such change, extension of tune, alteration or addition to the terms of the contract or to the Work or to the Specifications, PROVIDED, FURTHER, that no final scUlenlent be keen the OWNER and the CONTRACTOR shall ahriil-e the right of any heneficiary hereunder, whose claim may be 18 unsatisfied, IN WITNESS WI(EREOF this irtsnument is executed ill six (6)counterparts, cash one t�f"Idol MKdl be deemed an original, dais the --29th __ .duty of Ju11e 2015. KI TFST: -L ( y r J� (Principal (SEAL) {y L .. f9r,���uN P y �t ti, t � �'.�ud-�ri�Iy •, dh u�>1 38 (Qness as lo Prntcipat) - ---(Addr"s) (Address) CcorePoint InSUrance LomDa t`,- __.�-,.�.___ __----- surety ATTEST: (Surety) Secretary (SERI,) t — By — ,•Witness as to Surety Attomcy-in-Fact 401 S old woodwacd Avenue, sluite 300 jQ J:hLPYO1aLe Drive piimtn-ham, MT 4901)'? n_i gGeld RA 01019_ y - - pJ��sr E. � , -_ _ _. (Address) (Address) NOTE: Date of Fond mast not be prior to date. of('01,11,'act If CC)1�1'1 RACTOR is partnership, all parmers should execute 11011d. 1(V(PUR"fRNT; Surety conipanws executing Bonds must appear on the Treasury Department's most current list (Circular 570 as amended) and be authorized to transact business in the state where the Project is Ideated. 19 pAVMEN­I' f3c7i�ID BoDID MO . -1159553P KNOW AI_.1,MEN 13Y '1'111 SE PRESLNTS: that C'.1 k'rlak� ►rciY — Tnc . --- ---------------- _ � lNiul►!�4ft=unilact�►r� !iU c,L L!?C (. , C�.Illl=llicltMA 021 38 - —----- ('Address ofC mlh-,1000 a c ! rPor�Lrou Irc°reim1rt(!r called I'riniilrll, (t't,rpolalion I'artn�l5hip of hldividwil) and C'c�Iehoilit __in i u(ance_Cort)clny_--- -- ---------- -- -- _ (Nlnrcor5urOy) 4 0 1 —- — ---- . �; Ole] 4Vorticlwrxtl Avt=nue, �uitr 3QQ,_ I3itrninc�h nl, XI. 43QQ: (Address of Surcty) hereinafter called Surety, are held and firmly Mound unto the City of Lawrence, Massachusetts, hereinafter called ObVNER, in thep anal sum equal to 100%or the contract „n MlS1 tai tl Ufn Lur,dc 1 Fart' T Ph�arri on.. i:un��a eia:r•v <.•,.,n �, g,942 1f37.5t1 rn Ia4Vful amount or_ _ c�o�lars and cents(S ) money of the United States, for the payment of Which sum well and truly to be made, 4ve hind ourselves,successors, and assigns,,jointly and severally, firmly by these presents. TILE CONDITION Oh THIS OBLIGATION is such that whereas, the Principal entered intO a certain contract with tile OWNER,dated the 23rd —_d Jane 2015 a ay of �— — copy of which is hereto aunclled and made a part hereof for the construction or: Construct Runway 14-32 End Safety Areas and Light Taxiway E, Lawrence Municipal Airport,North Andover, Massachusetts, AIP No. 3-25-0026-35-2015. NOW,'THERF',RORE, irthe Principal shall promptly make payment to all persons, firms, Subcontractors, and corporations furnishing materials for or performing labor in the prosecution of the Work provided for in such contract,tend any authorized extension or nlodificatiorl thereat•, including all amounts due for materials, lubricants,oil, gasoline, coal and,coke, repairs on machinery, equipment and tools, consumed or used in connection with the co►lstJrction of such Work, and all insurtmce premiums oil said Work, and for all labor, performed in such Work whether by Subcontractor or otherwise, then this obligation shall be void: otherwise to remain in full force and effect. PROVIDED, FURTHER, that the said Surety far Value rr:ceived hereby stipulates and agrees that no change, extension ortirrle,alteration or addition to the tctalls of the contact or to the Work to be perlornled thereunder or the Specifications accompanying the same shall ill any wise affect its obligation on this 13011d, and it does hereby waive notice of ally such change, 16 extellSton or time, cllteration or addition th the tenim or the contract or to the Work or tr! the specifications. PROVIDED, IJIRTI IER. that no final settlement bcI%VcQn tilt: (AVNFR and the- CON rR AC OR shall abri lge the right ofatly ben Hodary hcmundc'r, c Nse chilli Imq be Im..alisoK IN WITNESS "!I ll-.l?i of, this instnnumH N e,xem dad "I sk (6)c"Welll,lri each „I �c'Iri�:h strait he d, ,,d an original, jhk the 291-h day of mine _fit)I`?. E t'J Nlat-) rILdy, Inc. -- (�V4ness us 10 Principal) J (Address) (N \Inc and 111.0) Dnl`�luthorized Z So money screet, Cambridge, MA O 138 -_--) (Address) CorePointe In, urance Comp, (Witness as to Surety) (Surety) f-f) 123 Interstate Drive 1 (Add ress)� Attorney-in-Fact Gail (flcid Duly Authorized dol S old Woodward Ave, Suite 300 Birrninglzam, Nil 48009 (Address) NOTE: Date or Bond trust not be prior to dale orcontraat. IF CONTRACTOR is Partnership, all partners should execute Bond. IMPORTANT: Surely contptlnies executing Fonds must appear on the Treasury Department's most c:ument list (C hmular 570 as amended) and be authorized to transact bnshess in the-Skate where. the Project is located. 17 ginl[Jyl'ENAIJ(IL LONG BOND NO. 2S9553P- KNOW ALL MEN BY TI IFSF PRESENTS Ihttl '7 Nl,ai,ardy, Inc. . ----- r�rc°rine� to-urnn = �mp.ur>> its Principal, herc.illafte) called C on(ractor, and -- _ a, Surety, 11cwin.lficr ct111cd Surety, are held and fir-1-111y hound l,lutr) tht ( i(y of I_rlevrcnc-c, 1Vlastiacllu:;clt its (lbll�rc, h�rculallcl l.aUid fhvlt�l in the llen,tl worn +Anal to °il(d-de contract tlntoltnl (1r :1 Y SC`I I(Ill "TAHO ,IL. IlVtll .�, ��:�'? 111 1s 6pn - --- d(1f hn S ilil(1 ecllts t�l �?, t u�, �� ) I«1 the paylnollt �G h�t��(1l - , til ,(e 51rh, tl� tontroctor and Surety hilt(,[ (1H,nrelveg, (hltl, heirs': excCutols, 'Idllllnl4(1,1t(1 assigns, totally and scweridly, 1-11-1111Y by tllese ln-cscnts. �7 LIP-0 2 2 ,ell s' WI-IGRL.A;�, Contractor ha;, by wntten agrl�cment dalc(I -_ 32 2, cnle.rer_I into a c(ultrnct with owner for, C'ons'truct RuttvwaV I4-32 End Safety AR-eas and Li-M Taxiway E All? No. 3-25-0026-35-2015 Lawrence Municipal Airport North Andover, Massachusetts in accordance Willi the general conditions, (lie drawings and specifications, which contract is by reference incorporated lierein,and made a part hercol, and is referenced to as the Contractor, NOW THEREFORE, the condition of this obligation is such that, if Contractor shall remedy any defects clue to faulty materials or worklnansllip, and pay for ally damage to other Work resulting therefrom, which shall appear within a period one year from the date of final acceptance of the .work provided for in the Contract, then this obligation to he void; otherwise to remain in Cull force and effect. (PROVIDED, HOWEVER, that Owner shall given Contractor rind Surety notice of observed defects With t-casonable promptness. 7 - SIGNED and scaled this ---29th, v..---- day of one 2015 SIGNED In the presence of �� _ Ca Mabardy, Surety: i��1:ePoiI,r Insllz ant cnm��a.ny d QY Gail -l;errifi (SEAL) AUorney-in�l�aut 20 POWER OF ATTORNEY C'OREPOINTTE INSURANCE CONIPANY KNOW ALL MEN 13Y THESE PRESENTS,that COREPOINTE INSURANCE COMPANY (the"Company"I a corporation duly organized and existing under the laws of the State or Michigan, having its principal orrice.at 401 S. Old Woodward Ave, Suite 300, Birmingham,Michigan,leas made,constituted and appointed,and does by these presents make,constitute and appoint: Steven Vilorino Bernadette Peace Eugene Millard Chi! Perrin \Virtual Hertel Shelly Andrade Join Mailhot Jiro Mostors Jenniller Mack K.athWen Bilodcau Danielle Wiest Jennifer Chaudottnct Kevin G Racine Maurya Bucklc)' Jacqueline Normandin each its true and lawful Attorney-in-luck to sWn its name as sruuy as dolineMed below and to execule,seal, acknowledg, and delint; any and all bonds and unclertakiugs, with the, exception or i9nanum Guartulty Insurance, providing that no single obligation shall vxceed k1Nh,i1Vll`I'KQ to tho same extent as if such bonds had been duly ounied and admimvicdge+a by the regularly aloctecl officers of the Company al its rithwifial office in their own pruner persons, This Power of Attorney shall be construed and wil'orced in ttccordame wills,rind y,1wriled hy, the haws ofthe State of Ntichig,m, without giving efre_ct to the principles of conflicts of haws thereof, `Phis Po�yer of Attorney is grallC�?d pursuant Io the l'ullo�•ving resolutions, vyhich were duly and validly nclopted al a inecting of the Board of Directors of the Company held on lkuember 6, 2012: RESOLVED, that all bonds, undertakings, powers of attorney, turd usher instrtnnents for and on behalf of the Company which it is authorized to execute, may be executed in the name and on behalf ordw Company by the Chairman of the Board or tlle. President, jointly with the Secretary or an Assistant Secretary, under their respective designations,except that any one Or more officers or atlorneys-in-fact designated in any resolution of the Board of Dhvdors, or in any power of attorney cxecatcd as provided for in these resolutions, may execute any such bond, undertaking,or other instrument as provided in such resolution or power of attorney. IN WITNESS WHEREOF, the Company has caused these presents to be signed and attested by its appropriate Officers and its corporate seal hereunto affixed this 09th clay of June,2015, Col'CPOillte Insu►'allee Company �0SUt7��'4 s SEA �e v BY �') r�ti._ � _ By a. phmes S. 11atm,President Thomas J.O'Brien, Assistant Secretary STATE OF MICHIGAN ) SS: COUNTY OF OAKLAND ) Sworn la bcl'orc.mc,a Notary Public in the Stale ol'Nlichigan,Ibis_09thPo iluy of_.lune '2015, by James S.I% who swore w bete President ores tu,11tc Insurance Company, STACY CA[YjRBGLI Y° jA I f y (Julary Public, State of Michigan County of Oakland le) Camphc t \\ (seal) My Commission Expires 00.22,-2019 1110tary Public,State urlw igan Acting In the County of, My Commission Expires June 22,2019 1,the undersigned,Assistant Secrelary orC:OREPOIN`i'E INSURANCE COMPANY,do hereby certify that the foregoing is a true,correct and complete copy or the original Power of Attorney; that said Tower or Attorney has not been revolted or resci WW and dw the authority of the Anorney=in-I'acl set tinth therein,who executed the hand or mWea•lakialg to which this Power orAttunmy is aunched,is In full force and eribel as of this data Given under my hand and seal of the Company,Ihis(9- Zi1.iy of_—L),il.l-L- r rhtnnttsJ.O'Brien.Assistant Secretary Request Number:20153403325 Date 08/17/2015 Time 16:49 Latitude: Longitude: State: MASSACHUSETTS Municipality: NORTH ANDOVER Address!Intersection:492 SUTTON ST Nearest Cross Street 1: OSGOOD ST Nearest Cross Street 2: Additional Information:WRKNG INSIDE THE AIRPORT/WRKNG AT RUNWAY 14-32 AND TAXIWAY E INSIDE LAWRENCE MUNICIPAL AIRPORT// CHECK IN WITH SECURITY AT GATES TO GAIN ACCESS Nature Of Work: EXC FOR UTILITIES,PAVEMENT RECLAIM,GRAVEL Area Of Work: PLACEMENT,PAVING,ELEC LIGHTING, EROSION CONTROLS,GRADING,AND SIGNAGE/FENCE INSTLL,/WRKNG ON AIRPORT PROPERTY Area Is Prenarked:YES Start Date: 08/20/2015 Start Time: 16:45 Caller:JIMMY Title: PROJ MANG Return Call: B5 Phone#:617-354-7580 Fax#:617-864-9057 Alt.Phone#: Email Address: Contractor: MABARDY C J CO Address; 50 MOONEY ST City: CAMBRIDGE State: MA Zip:02138 Excavator Doing Work: SAME/ Member Utility List Code Abbreviation Name *EG CMAGAS _ COLUMBIA GAS OF MASSACHUSETTS =H NGRDGS NATIONAL GRID GAS-ESSEX X ME NGRDEL NATIONAL GRID ELECTRIC-MASS ELEC *ON ONTARG ON TARGET LOCATING *RJ VERIZN VERIZON *SD ALGGAS ALGONQUfN GAS\SPECTRA ENERGY X SE VERIZN VERIZON X TV COMCAS COMCAST • There may be non-member utilities in the area that you need to notify. • Electric and other companies may not mark lines they don't own or maintain. You may want to contact them for more information. • The excavator is responsible to maintain markings placed by member utilities... Previous Screen , New Query Print Ticket ; Display Dig Location Map I