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HomeMy WebLinkAboutRESPONSE - BID - 5737 UNION PACIFIC TRAIL DRAKE ROAD TO HORSETOOTH (4)SECTION 00300 •;u PROJECT: UNION .PACIFIC TRAIL DRAKE ROAD TO HORSETOOTH ROAD; Bid No. 5737 Place Date 1. In compliance with your Invitation to Bid dated �f2fP M LiOi 7 Z JoD� and subject to all conditions thereof,' the undersigned EscM+�PP[�ie S _�ent�i iL�'o�� a **(CorporationLimited Liability Company, Partne ship, Joint Venture, or e Proprietor'" authorized to do business in the State of Colorado hereby proposes to furnish and do everything required by the Contract Documents to which this refers for the construction of all items listed on the following Bid Schedule or Bid Schedules. 2. The undersigned Bidder does hereby declare and stipulate that this proposal is made in good faith, without collusion or connection with any other person or persons Bidding for the same Work, and that it is made in pursuance of and subject to all the terms and conditions of the Invitation to Bid and Instructions to Bidders, the Agreement, the detailed Specifications, and the Drawings pertaining to the Work to be done, all of which have been examined by the undersigned. 3. Accompanying this Bid is a certified or caGh;er's check or standard Bid bond in the sum of Eli At Y-rtov4 rr � �� iT+ fv (�' , // -s (S in accordance with the Invitlation To Bid and Instructions to Bidders. 4. The undersigned Bidder agrees to execute the Agreement and a Performance Bond and a Payment Bond for the amount of the total of this Bid within fifteen (15) calendar days from the date when the written notice of the award of the contract is delivered to him at the address given on this Bid. The name and address of the corporate surety with which the Bidder proposes to furnish the specified performance and payment bonds is as follows: 7 5. All the various phases of Work enumerated in the Contract Documents with their individual jobs and overhead, whethei specifically mentioned, included by implication or appurtenant thereto, are to be performed by the CONTRACTOR under one of the items listed in the Bid Schedule, irrespective of whether it is named in said list. 6. Payment for Work performed will be in accordance with the Bid Schedule or Bid Schedules subject to changes as provided in the Contract Documents. 7. The undersigned Bidder hereby acknowledges receipt of Addenda No. through / — d- 7/96 Section 00300 Page 1 SECTION 00430 SCHEDULE OF SUBCONTRACTORS List all subcontractors for the work items listed below and all subcontractors performing over 150 of the contract. ITEM 7/96 SUBCONTRACTOR ��s�r ref Section 00430 Page 1 �II��Isti awsrt�ueT�oa Tom. CONTRACTOR BY: ADDRESS: Walsh 5828 N. St. Louis Ave. Love an , 8. BID SCHEDULE (Base Bid) Please use the attached Bid Schedule when submitting your bid. 9. PRICES The foregoing prices shall include all labor, materials, transportation, shoring, removal, dewatering, overhead, profit, insurance, etc., to cover the complete Work in place of the several kinds called for. Bidder acknowledges that the OWNER has the right to delete items in the Bid or change quantities at his sole discretion without affecting the Agreement or prices of any item so long as the deletion or change does not exceed twenty-five percent (250) of the total Agreement Price. RESPECTFULLY SUBMITTED: )O,Iu�O-L Signature MATrh WA S`m Date �e Si A e N't Title C\—\` 1 License Number (If Applicable) (Seal - rf id is y corp o ation) Attest: v Address Walsh Construction, Inc. 5R28 N St I niiis Ave Loveland, CO 80538 Telephone 17d. bdd-Saar ryx970'07'78-939G 7/96 Section 00300 Page 2 Project: Union Pacific Trail BID SCHEDULE (BASE BID) Bid items are described in Section 01800 BID ESTIMATED UNIT ITEM ITEM # DESCRIPTION QUANTITY UNIT PRICE TOTAL 1 Mobilization 1 LS $ $ Boon coo General Conditions 1 LS $ �_ $ 4 Oco, o a 2 Traffic Control 1 LS $ $ 4 000. C. a 3 Demolition 1 LS $ $ 2i .Z 49. oo 4 Topsoil Removal/Replacement 1420 CY $ I b $ 2 'Z 5 Erosion Control 1 LS $ $ J-Op_ao 6 Earthwork: Cut 102 CY $ ) 12 $ 1 o Zo 0 7 Earthwork: Import Fill 490 CY $"ZO $ 1$00,00 8 Various Pipe Extensions 1 LS $ $ po0 , 00 9 Concrete Trail 10' wide, 5" thick 49820 SF $ j, j'U $ 174 3 :7-0,O0 10 Handicap Ramp 2 LS $ 75o $ (SSOO,vo 11 Fine Grading 1.72 AC $ )-'3 oo, oo $ ij 7- Oo 12 Metal Gate 2 LS $ /Doo $ 2-000. J0 13 Seeding 1.72 AC $$ 0 $ 3 O `) 6 , 0 0 OF BASE BID }TOTAL IWo I],/.PR.,.kNb4V.i2TL1 -/' 441 �H v�S R,Jb c ✓EyT%N 4wwa �() �",yitti Tx$ A A 1 2-44; 7 j.00 (written) Figure Section 00300 Page 3 SECTION 00430 SCHEDULE OF SUBCONTRACTORS List all subcontractors for the work items listed below and all subcontractors performing over 150 of the contract. ITEM �17N C�ZE� 7/96 SUBCONTRACTOR 1/ IAnm ovib CAN T77-UUP 6YJ Section 00430 Page 1 OCT-SS-2012 16149 15162235016 1516223SOi6 P.62AD � �Cii�lt insurance Ga* 30SSLOWSMA� 371a14�ft�M Bad No. B3WWW DID BOND AiADo=nwWW,l A310 (FchmwY, I 0 BOW) KNOW ALL UM BY T1MR8 PRBiE►f1'S. &M we VMO C mWanYna. Inc. MM N. mL Ltdt Avv4 rwwi..d. CO Ms» p pA*4 OW OW iamaaa Craopay. a OOrpMGM *Ay opsirad mda en laws of da Biro of Cntlwdam M SMW. e» Wd cad sty beuad vAw Clq tf Bort CoRbw 21! N. Amara 3et Pbtr. PA. rina lW L C*Hhm Co M n r tlbli3a►, iA da wan a< Wo bwd OA Mt anwd 3tlM�n 1hmu & miss (fi%M �`t WOO ad 1ha pwMU9 0( aar dr paymrrc orwilab wet waR and u+dY ee tin d•da. da Mid P h*d and do rid Samly. W" ewtnFint, car i10ba. aooMa., sueeeMon sad nfibsa.iabdy tadttvtotily. fsmly by ere 1� WMMS, doptin", 0 tits tabmkW a bid Aw WN PadOs T"R Mow, 71taXI i & fret OM fM don agoPr dw Ud Oren aW 69 pdaolpd &o tnon into a ota ld wW ak ObUsm is wmdwet With mn Wen *fn&b% d $Ivt wab bd srbwb u aay bt epteietd bi d» bidd'M sc Cwaatt D0°'a1°sa "Uh coed.W wmolam tumW for to rtidM psitimaaw ohi CONUM rod far ee PO=P la ym'd s[ lase tad'"W paddotd h bdl VW w fbe GbHSw do dif►ama NK is arced W pwai�,f'm U�aoufbel+wm ea taros fa UK Wd duimr pdngW >as rtmowtfww�doOMb a OW is psi ebbowwww*modwpWWmr do dMWmira da bt twU d VOK -lk-- *r a nmrbe is ihU taco wdtQMt. (MALL) 4 (TIO) IL Book ASUM- 0ULSP4B9 (7AM d/S'anva ovse 999 919 XOVYIKOJ dO VIE LO:VI can.L) ZO. 9; .loo OCT-15-2802 16%49 15162235816 15162235816 P.W.-03 GULP INSURANCE COMPANY HARTFORD, CONNECTICUT POWER OF ATTORNEY saoi + 1�lessns OAMULS OP THIS PoMER OF ATIORRET ARE PMNM ON DWI SAFETr PAPER VWITN TEAL t11R. KNOW ALL MEN BY THESE PRESENTS: Thai dw Gulf Insurenue Oompany, s CoryaEtlon duly orWlzm undor the issue of the state of Connaebad, havhrg js prlwjpf 00 in tie thy of lfvlm. Texas, pursuant to the foilordn0 rmoldton, adopted by the plena a d Exu*ja Oomid4es of the Board of Cirrxtc of the said Oompmy on the IOIh day of August, I M. M vdL 'RESOLVFA.1Nt M1e Pto*K &Aculve Vice President or 07� eCII Presided of frroy a �d holl a� m tlrne and spy sash y Power of Attorney and th MIA � AttM" him drain thepresident, or airy taeotltive Wes President, w arty Senior vice Prey *K or by tM Soard M may be removed and the arAhorf4u Olardsd him revoked by Dirrdara or M the Rnsna and ENNON CemmNles of the Scafd pf OhMm- RESOLVED, that nothing In INS Poor of Aeomey shelf be Cornsirwd as a grant of sulborlry to IM sttorneyls)'imfect eo Np", execute, eCknowledge, deever or otherwim issue a policy Of poboiae of lesursnce On bat"Of of Gulf Insurance Gempany. RESOLVED. that the signature of the Preeftlwd, Exewtive tAm President or any Senior Vleo Ptesldent. srtd the $eal m the Compagr may be afBrartl u any m SUM Power of Attorney w any mrnaaaN rahiMo dtsndo by Temlmlle. and any such powers so a WAW and certified by iaesknlls signetura and lecalrnil8 Seat shell be Valid and binding upon the Carrpiany in the future with respect 10 Rry bond anddooufnatde n1uMp to such (ands to which they an ' attadled lluR Insurance Company does hereby mft cm tRtft aryl appoha William H. Hutto Spsnoar 14. Zettler its true and hwlill atorwAs} btfid. vo full paw► end srdearhy ban"Wftw E lfs mm, pacis and dtwd, to alp. OWAN. sahnowlatlge NO lid M Its hltolf, as sorel% any did dh bonds and lsrdsr*nps is aura4u4, and to bird Gulf tnwaur: ComPatty thereby dd t* and to the sums Word de If any bonds. raldelteklrMle and dooumanbl rMaEig m audit bends ar4* undettdWnOd win signed by des droll mehedbild o� m of IN Gulf insurMrm Company and all the ads a(um atlomey(s)-lin- t, pursuant to the newly Nrahl Olean, NS hereby now and mntlrntae. TN abllpsobrt fi the Oohrpooy shelf not exceed Ile MOM 16,000,0011101 dONUL m Wfful i Wed11EDF, tee GBH warwosee frNaMeT has mead Dude prWats is be aimed fly ON 9010W of the Co'mpstr and Ib conmals goal to 0e hereto eNfad. ./'^� OULP tt VRApHX WMPAHT I, SEAL f p . ri1'4.� STATEOFNEWYORK SS Lo.ranP.MWW COUNTY OF NEWYORK Iteeawi.■ Vko Promwom Oa thR 1st day N Od*W. AO W. balers M mtee Lasnetrse F Mb*ff, waera m reo prisomrb eke Nbrp by too dab swore, did dal000 old "MasidesIntheam* ol(sa�"e=.Wen:sfNssrhnW:viedNIe*$Em ftvlmPrmi"idOreswirmfenmCe ME*IbwgaratiadeePloa; in am i was m Mtlaa � ceder M be m* df Sid he bwm of the m i Of"M an ant stoned b ooAs tNrolo W MNe le asoh onrushes mal: AN nS MAtlAtrlit-#Il<4A7E0 Soup of Nemor STATE O8 NEWYORK } SS Hwa�f.ot Amttrata Work COUNTY OF NEWYORK e]ru0tiadinlne� C Siroddra Pe cc 2SD 1, IN rnaing ind. Seabr Inn Froetdad of the NO kaaeerre CwaPerry, a Gewwduces Caaeadm. On NWIT CE MFT 1Nt M ioteeetes Said se"I ed POWER Of ATMMtL'T MOM M sub tares. eiFNFerrcet Aeeed the 15th des' et October . su 02. synod and Sealed at rune Cry of HaewVNL `reeetw�" i f / s�w�o�ttaW�owr TOTAL P.03 Z/Z'YDtld "9& 109E 9I5 XDVWW00 AD VIE 8i,:4I (ani.) ZO. 9; ".LDO SECTION 00420 STATEMENT OF BIDDER'S QUALIFICATIONS All questions must be answered and the data given must be clear and comprehensive. This statement must be notarized. If necessary, questions may be answered on separate attached sheets. The Bidder may submit any additional information he desires. Walsh Construction, Inc. 1. Name of Bidder: F8:28 NI qt I ouic Ave 2. Permanent main office address: Loveland, CO 80538 3. When organized: ja 1 I ` \c�c�g 4. If a corporation, where incorporated: (106F-Rc(o 5. How many years have you been engaged in the contracting business under your present firm or trade name? y to—G—Nt� 6. Contracts on hand: (Schedule these, showing the amount of each contract and the appropriat�ry5 anticipated dates of completi n.) t A �frtE FESTRoorMS � �'VoL '711. 03�a3 �2 o E NS10 '70 la- oa e Pa t x Isa of o� P%Am SRO-. CaecK 1Ay�8$o. 1� oa. 7. General character of Work performed by your company: u-�ILiTiE� c&c't'Q �ttetl 8. Have you ever failed to complete any Work awarded to you? t40 If so, where and why? 9. Have your ever defaulted on a contract? NO If so, where and why? 10. Are you debarred by any government agency? (J O If yes list agency name. 7/96 Section 00420 Page 1 11 12 13 List the more important projects recently completed by your company, stating the approximate cost of each, and the month and year completed, location and tune of construction. I _ List your major equipment available for this contract. Experience in construction Work similar in importance to this 14. Background and experience of the principal members of your organization, includinq officers: 15. Credit available: $ 00,O0O� \ J 16. Bank reference:�Pq 17. Will you, upon request, fill out a detailed financial statement and furnish any _other information that may be required by the OWNER? 18. Are you licensed as a General CONTRACTOR? L�JES If yes, in what city, count and state? \o,� EiME2 �y.,�t, c What class, license and numbers? C - q7 %totisS - C1 - 1\ 19. Do you anticipate subcontracting Work under is Contract? �E5 If yes, what percent of total contract? and to whom? See R1 mchE1b 20. Are any lawsuits pending against you or your firm at this time? If yes, DETAIL 7/96 Section 00420 Page 2 RESUME CHARLES P. WALSH 31 MAPLEWOOD DRIVE NORTHPORT, NEW YORK 11768 BACKGROUND & QUALIFICATIONS EDUCATION: TWO YEAR MECHANICAL ENGINERS COURSE AT FARMINGDALE (1968-1969) NORTHPORT HIGH SCHOOL GRAD CLASS OF 1968 SKILLS HEAVY EQUIPMENT OPERATOR IN BUILDING, MECHANICAL AND ELECTRICAL CONSTRUCTION PIPELINE BRIDGE AND AIRPORT CONSTRUCTION BULKHEAD WORK LICENSES CALIFORNIA STATE ENGINEERING CONTRACTORS LICENSE NYS CLASS "A" DRIVERS LICENSE NYS ADULT EDUCATION TEACHING CERTIFICATE WORK EXPERIENCE PRESENT-1997 WALSH CONSTRUCTION INC-GENERAL MANAGER PREPARE BIDS ON MUNICIPAL WORK, SUPERVISE ALL NY PROJECTS, COORDINATE MATERIALS, LABOR, LIASON BETWEEN ENGINEERS & MGT. 1984-1997-SUPERVISOR FOR AMMA CONSTRUCTION, HUNTINGTON STA, NY ALL PHASES OF CONSTRUCTION, MUNICIPAL WORK, HEAVY HIGHWAY, AND BULKHEAD WORK Matthew Walsh 5828 N. St. Louis Ave., Loveland, CO 80538 (970)635-1828 EDUCATION B.S. - Construction Management, Colorado State University, Fort Collins, CO 80521 Major GPA: 3.0/4.0 May 1997 Course Content: Construction Project Administration, Scheduling & Planning, Construction Contracts, Construction Estimating, Safety Management, Labor Relations, Elementary Structural Design WORK EXPERIENCE Walsh Construction, Inc. Loveland, CO. July 1998 - Present General Contractor • President/Owner R.D. Stewart, Inc. Loveland, CO. August 1997 - July 1998 General Contractor, Contact: Dave Hall (970) 669-1500 • Project Manager • Oversaw project operations for commercial and multi -family construction • Project estimating, budgeting, scheduling, cost control, general administration • Negotiated, wrote and organized all subcontracts • Performed on -site supervision • Reported to Divisional Operations Manager Amma Construction Corp. Huntington Station, N.Y. Summers/Winters 1988-1997 Civil Construction, Contact: Prescott Ammarell (516) 351-6124 • Supervised operations related to concrete, sitework and steel fabrication • Assisted in project estimating • Modified company's job cost control system • Diagnosed possible managerial problems in company • Assisted office engineer in everyday duties • Assisted in organizing and maintaining companies shops and yard • Operated wide range of heavy equipment • Drove tractor/trailer combinations to move equipment and materials to various jobs • Performed general labor duties Self - Employed, Walsh Contracting, Northport, N.Y. Summers 1993 - 1995 Residential Landscape Construction • Initiated company's existence • Contracted work related to residential landscaping • Planned, organized and supervised everyday operations Land Use Environmental Corp. Baiting Hollow, N.Y. Summer 1993 9 Performed general tasks in accordance with marsh and wetland renovation ADDRESS: 8. BID SCHEDULE (Base Bid) Please use the attached Bid Schedule when submitting your bid. 9. PRICES The foregoing prices shall include all labor, materials,. transportation, shoring, removal, dewatering, overhead, profit, insurance, etc., to cover the complete Work in place of the several kinds called for. Bidder acknowledges that the OWNER has the right to delete items in the Bid or change quantities at his sole discretion without affecting the Agreement or prices of any item so long as the deletion or change does not exceed twenty-five percent (25%) of the Wtal Agreement Price. Signature RESPECTF;dLI/a SUBM�TVEV: Ti License Number (If Applicable) (Seal - if Bid is by corporation) Attest: Address Telephone 7/96 Section 00300 Page 2 21. What are the limits of your public liability? DETAIL t 22. What are your company's bonding limitations? 1,0c>0,0o0 — I 1DS O00. 23. The undersigned hereby authorizes and requests any person, firm or corporation to furnish any information requested by the OWNER in verification of the recital comprising this Statement of Bidder's Qualifications. Dated at LuE1nJ9J this �(o4h day of &-,room 20Jd. Name of Bi-4k By: Title: State of Ge`or.-A"ko County of Ltk% ME.(L being duly sworn deposes and says that he is of V.sS r UCT1o1J TiJC and that (name of organization) the answers to the foregoing questions and all statements therein contained are true and correct. ubscribed and sworn to before me this ¢R- , 20C PP . QnlCL, / o-� ah 4 0 -14 Notary Pukfl is s' �• �8a g N • Lou, s Aye . = Z. My commission expires I' day of 7/96 Section 00420 Page 3 Project: Union Pacific Trail BID SCHEDULE (BASE BID) Bid items are described in Section 01800 BID ESTIMATED UNIT ITEM ITEM # . DESCRIPTION QUANTITY UNIT PRICE TOTAL 1 Mobilization i LS $ 0 $ 1490 cd General Conditions 1 LS $ 5 $ S % Q/006 2 Traffic Control 1 LS $ $ 1,01)6 3 Demolition 1 LS $ t K/ O� 4 Topsoil Removal/Replacement 1420 CY $ ,) S— 5 Erosion Control 1 LS $1� 6 Earthwork: Cut 102 CY $ J6. 9 $ 7 Earthwork: Import Fill 490 CY $ /L/ 3,2 8 Various Pipe Extensions 1 LS $�$ % SR 9 Concrete Trail 10' wide, 5" thick 49820 SF $ $ �7 o0 10 Handicap Ramp 2 LS $ 0004�0 $ 2 000 11 Fine Grading 1.72 AC $ 27) y3 12 Metal Gate 2 LS . � 13 Seeding 1.72 AC $ ?n(/r TOTAL OF BASE BID �l✓t 'P I/L JNdr�� S'K {-/ S-,Jx Tzo Sc...2.,—J LEj c�Acre� (,.yam, Figure �I ree ceti(s. 'ee (written) L crkf'V r�� Uo((ass C- ,-4 rOV/�� Section 00300 Page 3 SECTION 00400 SUPPLEMENTS TO BID FORMS 00410 Bid Bond 00420Statement of Bidder's Qualifications 00430 Schedule of Subcontractors 7/96 Section 00410 Page 1 SECTION 00410 leli�'cTi75fi7 KNOW ALL MEN BY THESE PRESENTS: that we, the undersigned as Principal, and as Surety, are hereby held and firmly bound unto the City of Fort Collins Colorado as OWNER, in .the sum of $ for the payment of which, well and truly to be made, we hereby jointly and severally bind ourselves, successors, and assigns. THE CONDITION of this obligation is such that whereas the Principal has submitted to the City of Fort Collins Colorado the accompanying Bid and hereby made a part hereof to enter into a Construction Agreement for the construction of Fort Collins Project, UNION PACIFIC TRAIL DRAKE ROAD TO HORSETOOTH ROAD; Bid No. 5737. NOW THEREFORE, (a) If said Bid shall be rejected, or (b) If said Bid shall be accepted and the Principal shall execute and deliver a Contract in the form of Contract attached hereto (properly completed in accordance with said Bid) and shall furnish a BOND for his faithful performance of said Contract, and for payment of all persons performing labor or furnishing materials in connection therewith, and shall in all other respects perform the Agreement created by the acceptance of said Bid, then this obligation shall be void; otherwise the same shall remain in force and effect, it being expressly understood and agreed that the liability of the Surety for any and all claims hereunder shall, in no event, exceed the penal amount of this obligation as herein stated. The Surety, for value received, hereby stipulates and agrees that the obligations of said Surety and its BOND shall be in no way impaired or affected by any extension of the time within which the OWNER may accept such Bid; and said Surety does hereby waive notice of any such extension. Surety Companies executing bonds must be authorized to transact business in the State of Colorado and be accepted by the OWNER. 7/96 Section 00410 Page 2 IN WITNESS WHEREOF, the Principal and the Surety have hereunto set their hands and seals this day of , 20_, and such of them as are corporations have caused their corporate seals to be hereto affixed and these presents to be signed by their proper officers, the day and year first set forth above. Name• Address: By: Title: ATTEST: By: PRINCIPAL �i Title: SURETY (SEAL) (SEAL) 7/96 Section 00410 Page 3 SECTION 00420 STATEMENT OF BIDDER'S QUALIFICATIONS All questions must be answered and the data given must be clear and comprehensive. This statement must be notarized. If necessary, questions may be answered on separate attached sheets. The Bidder may submit any additional information he desires. 1. Name of Bidder: �-' f-v.'- A4 , / i/o1'- /i e / _ _ _ Z_ _ L .- 2. Permanent main office addres�: 3. When organized: 4. If a corporation, where incorporated: 5. How many years have you been engaged in the contracting business under your present firm or trade name? 6. Contracts on hand: (Schedule these, showing the amount of each contract and the appropriate anticipated dates of completion.) / _, ,. /,. . _/ 19 — _ f . -/ /-,I 7 //1 _ _ 7. General character of Work performed by your company: � �d2Crt`L�s 8. Have you ever failed to complete any Work awarded to you? / If so, where and why? 9. Have your ever defaulted on a contract? .040 If so, where and why? 10. Are you debarred by any government agency? '�qef If yes list agency name. 7/96 Section 00420 Page 1 11. List the more important projects recently completed by your company, stating the approximate cost of each, and the month and year completed, kFA List your major equipment available for this contract. 13. Experience in construction Work similar in importance to this project: 12 _ _! n 1 14. Background and experience of the principal members of your organization, including officers: 15. Credit available: $ 16. Bank reference: 17. Will you, upon request, fill out a detailed financial statement and furnish any other _ information that may be required by the OWNER? 18. Are you licensed as a General CONTRACTOR? o If yes, in what city, county and state? What class, license and numbers? 19. Do you anticipate subcontracting Work under this Contract? If yes, what percent of total contract? 3 n l and to whom? 20. Are any lawsuits pending against you or your firm at this time? /jam If DETAIL T Yes, 7/96 Section 00420 Page 2 21. What are the limits�of your public liability? DETAIL 22. What are your company's bonding limitations? 23. The undersigned corporation to verification of Qualifications. hereby authorizes and requests any person, firm or furnish any information requested by the OWNER in the recital comprising this Statement of Bidder's Dated at Z4.'/S— this day of /�lLY l 204. Name By: Title: State of �r q County of� I �� �1I be i a ly s orn deposes and says that he is (name�rol'oL anization)of- G �Y-MW k5 � � that the answers to the foregoing questions and all statements therein contained are true and correct. S b cribed and sworn to before me this /L�/ 7 day of , 20_ My commission expires Frt com� e N t/28r1000 7/96 Section 00420 Page 3