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HomeMy WebLinkAboutFI Elizabeth Field Airport - Wind Cone replacement s DENIS NONCARROW Town Hall,53095 Main Road P.O. TOWN CLERK ©f Satjp Box 1179 p•�� D�� Southold,New York 11971 Fax REGISTRAR OF VITAL (631) 765-6145 Telephone (631) STATISTICS MARRIAGE OFFICER 765-1800 RECORDS MANAGEMENT www.southoldtownny.gov OFFICER FREEDOM OF �a INFORMATION OFFICER � �allNr't. OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2026-732 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON AUGUST 25, 2026: RESOLVED that the Town Board of the Town of Southold hereby authorizes and directs Supervisor Albert J. Krupski, Jr. to execute the Agreement between the Town of Southold and Baseline King Corp. for the Fishers Island Elizabeth Field Airport Primary Wind Cone Replacement in the amount of$67,700.00 in connection with FAA AIP No. 3-36-0029-036-2026 (C), subject to the approval of the Town Attorney, Budget Line SM5610-529750. Denis Noncarrow Southold Town Clerk RESULT: Adopted NIOVER: Councilwoman Suess SECONDER: Councilman Mealy AYES: Councilman Mealy, Justice Stevens, Councilwoman Doherty, Councilwoman Smith, Councilwoman Suess, Supervisor Krupski, Jr. NAYES: None Page 47 of 77 Elizabeth Field Airport Primary Wind Cone Replacement CONTRACT FORM THIS AGREEMENT is dated as of the Z day of 10 IV in the year 2026 by and between the Town of Southold, New York, a municipal corporation ha ' g an address at P.O. Box 1179, Southold, New York, 11971 (hereinafter called Owner)and Baseline King Cop?.,a Corporation organized and existing under the laws of the State of New York with its principal offices at 111 Liberty Lane,Barneveld,New York 13304(hereinafter called Contractor). The Fishers Island Ferry District,having an address at P.O. Box H,Town of Southold,New York, shall act on behalf of The Town of Southold as the Owner's representative for this agreement. Owner/Owner's representative and Contractor,in consideration of the mutual covenants hereinafter set forth, agree as follows: ARTICLE 1-WORK Contractor shall perform, construct and complete all Work as specified and indicated in the Primary Wind Cone Replacement Contract. ARTICLE 2-CONTRACT TIMES 2.1 Contract Time. The Work shall be substantially complete within the Contract Time as stated in General Provisions Section 80-08 "Failure to Complete on Time", and accepted in accordance with General Provisions Section 50-15"Final Acceptance".In addition,intermediate stages or sequences of the Work shall be substantially completed and accepted as in accordance with General Provisions Section 80-08. 2.2 Damages for Delay in Completion. If the Work is uncompleted after the Contract Time,including all extensions and adjustments in accordance with General Provisions Section 80-07"Determination and Extension of Contract Time",the sum stipulated in General Provisions Section 80-08"Failure to Complete on Time"will be deducted from any money due or to become due the Contractor or their surety. Such deducted sums shall not be deducted as a penalty but shall be considered as liquidation of a reasonable portion of damages including but not limited to additional engineering services that will be incurred by the Owner should the Contractor fail to complete the work in the Contract Time provided in this Contract. ARTICLE 3-CONTRACT PRICE 3.1 The Owner will pay Contractor for completion of the Work in accordance with the Contract for the Total Base Bid in the amount of$67,700.00,hereby identified as the Contract Price, as shown in the Contractor's Proposal, with discrepancies corrected in accordance with General Provisions Section 30-01 "Consideration of Proposals"if applicable. 3.2 When unit bid price items are included in the Contract Price,the quantities of various units contained. in the Proposal are estimated and payment to the Contractor will be made only for the actual quantities of units that are incorporated in the Work or materials furnished in accordance with the plans and specifications, as determined by the Engineer in accordance with General Provisions Section 90,"Measurement and Payment". 2018 Contract Form-1 Elizabeth Field Airport Primary Wind Cone Replacement ARTICLE 4-PAYMENT PROCEDURES 4.1 Partial Payments. Partial payments will be made at least once per month based on the Engineer's estimate in accordance with General Provisions Section 90,"Measurement and Payment". Progress payments will be made in accordance with General Provision Section 90-06,"Partial Payments". 4.2 Retainage. From the total of the amount determined to be payable on a partial payment,the amount specified in General Provisions Section 90-06,"Partial Payments",will be deducted and retained by the Owner until the final payment is made. 4.3 Final Payment: Final payment will be made in accordance with General Provisions Section 90-09, "Acceptance and Final Payment". ARTICLE 5-CONTRACTOR'S REPRESENTATIONS In executing this Agreement,Contractor makes the following representations: 5.1 Contractor has examined and carefully studied the Contract including Addenda. 5.2 Contractor has visited the site and become familiar with and is satisfied as to the general, local and site conditions that may affect cost,progress,performance or furnishing of the Work. 5.3 Contractor is familiar with and is satisfied as to all federal,state and local Laws and Regulations that may affect cost,progress,performance and furnishing of the Work. 5.4 Contractor has carefully studied all reports of explorations and tests of subsurface conditions at or contiguous to the site and all drawings of physical conditions in or relating to existing surface or subsurface structures at or contiguous to the site (except Underground Facilities) which have been identified in the Contract. Contractor acknowledges that such reports and drawings are not part of the Contract and may not be complete for Contractor's purposes.Contractor acknowledges that Owner and Engineer do not assume responsibility for the accuracy or completeness of information and data shown or indicated in the Contract with respect to Underground Facilities at or contiguous to the site. Contractor does not consider that any additional examinations, investigations, explorations, tests, studies or data are necessary for the performance and furnishing of the Work at the Contract Price, within the Contract Times and in accordance with the other terms and conditions of the Contract. 5.5 Contractor is aware of the general nature of work to be performed by Owner and others at the site that relates to the Work as indicated in the Contract. 5.6 Contractor has correlated the information known to Contractor, information and observations obtained from visits to the site, reports and drawings identified in the Contract and all additional examinations,investigations,explorations,tests, studies and data with the Contract. 5.7 Contractor has given Design Engineer written notice of all conflicts, errors, ambiguities or discrepancies that Contractor has discovered in the Contract and the written resolution thereof by the Design Engineer is acceptable to Contractor, and the Contract is generally sufficient to indicate and convey understanding of all terms and conditions for performance and furnishing of the Work. 5.8 If this Project utilizes multiple prime contracts,the Contractor has examined the Contract for all prime contracts and has acquired sufficient knowledge of the required work of the other prime contractors to the extent that Contractor clearly understands his own obligations and responsibilities relative to the other prime contracts. 2018 Contract Form-2 Elizabeth Field Airport Primary Wind Cone Replacement ARTICLE 6-CONTRACT The Contract which comprises the entire Agreement between Owner and Contractor concerning the Work consists of the following: 6.1 The Proposal with discrepancies corrected. 6.2 This Contract Form. 6.3 The Contractor's Performance Bond and Payment Bond. 6.4 The Contractor's Certificates of Insurance. 6.5 The Notice of Award and Notice to Proceed. 6.6 The General Provisions and the Technical Specifications,which are a part of the Contract. 6.7 The Contract Drawings as listed in the Table of Contents. 6.8 Addenda listed below: Addendum No. Date N/A N/A 6.9 There are no documents other than those listed above in this Article 6. The Contract may only be modified by Supplement Agreement. ARTICLE 7-MISCELLANEOUS 7.1 Terms used in this Agreement shall have the meanings in the General Provision Section 10, "Definition of Terms". 7.2 No assignment by a party hereto of any rights under or interests in the Contract will be binding on another party hereto without the written consent of the party sought to be bound;and specifically but without limitation, moneys that may become due and moneys that are due may not be assigned without such consent(except to the extent that the effect of this restriction may be limited by law), and unless specifically stated to the contrary in any written consent to an assignment no assignment will release or discharge the assignor from any duty or responsibility under the Contract. 7.3 Owner and Contractor each binds itself,its partners, successors, assigns and legal representatives to the other party hereto, his partners, successors, assigns and legal representatives in respect to all covenants,agreements and obligations contained in the Contract. 7.4 Any provision or part of the Contract held to be void or unenforceable under any Law or Regulation shall be deemed stricken, and all remaining provisions shall continue to be valid and binding upon Owner or Contractor,who agree that the Contract shall be reformed to replace such stricken provision or part thereof with a valid and enforceable provision that comes as close as possible to expressing the intention of the stricken provision. 2018 Contract Form-3 Elizabeth Field Airport Primary Wind Cone Replacement IN WITNESS WHEREOF, Owner and Contractor have signed copies of this Agreement. This.Agreement will be effective on the day and year first above written. OWNER (SEAL) (Signature) Albert J. Krupski Jr. (Printed Name) Town Supervisor (Printed Title) OWNER' 7 PRESENTATIVE (Signature) George B. Cook (Printed Name) District Manager (Printed Title) CONTRACTOR: ' e 1.0 r- (SEAL.) (Co pan e) ( igna e) (Printed Nare) Pr-e tS (Printed Title) 2018 Contract Form-4 Elizabeth Field Airport Primary Wind Cone Replacement (ACKNOWLEDGMENT OF OFFICER OF OWNER) STATE OF NEW YORK SS: COUNTY OF SUFFOLK On the _day of in the year 20 Z j .,before me,the undersigned,a Notary Public in and for said State,personally ppeared Albert J.Krupski Jr.,personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), and that by his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, executed the instrument. MICHELLE L TOMASZEWSKI NOTARY PUBLIC-STATE OF NEW YORK No. 01T06156671 Qualified in Suffolk.County No&q Public My Commission Expires 11-27-2026 n f (ACKNOWLEDGMENT OF CONTRACTOR,IF A CORPORATION) STATE OF I U U SS: COUNTY OF L V1. 16(� On the day of j in the year 20L4 before me,the undersigned, a Notary Public in and for said State,personally appeared l l V Oo Imo,v\ to me known, who, being by me duly sworn, did depose and say that he/she/they reside(s) at N that he/she/they is(are) the G c:S of �)as' V� c lG-r the corporation described in and which executed the above instrument; and that he/she/they know(s) the seal . of said corporation; that the seal affixed to said instrument is such corporate seal;that it was so affixed by authority of the board of directors of said corporation, and that he/she/they signed his/her/their name(s) thereto by like authority. 0 Notary Publi PATRICEJOSLIN KING ,r, Notary Public,State of New York I `' No.01K16327i?4 r, Qualified in Oneida County ' CommissionExpiresJune29;20?1 2018 Contract Form-5 Elizabeth Field Airport Primary Wind Cone Replacement (ACKNOWLEDGMENT OF CONTRACTOR,IF OTHER THAN A CORPORATION) STATE OF SS: COUNTY OF On the day of in the year 20_,before me,the undersigned, a Notary Public in and for said State,personally appeared ,personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is(are) subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), and that by his/her/their signature(s) on the instrument,the individual(s), or the person upon behalf of which the individual(s) acted, executed the instrument. Notary Public (CERTIFICATE OF OWNER'S ATTORNEY) I, the undersigned, the duly authorized and acting legal representative of the Owner, do hereby certify as follows: I have examined the foregoing Contract and surety bond and the manner of execution thereof, and I am of the opinion that each of the aforesaid Agreements has been duly executed by the proper parties thereto acting through their duly authorized representatives; that said representatives have full power and authority to execute said Agreements on behalf of the respective parties named therein; and that the foregoing Agreements constitute valid and legally binding obligations upon the parties executing the same in accordance with the terms, conditions, and provisions thereof. Owner's Attorney Date END OF CONTRACT FORM 2018 Contract Form-6 . 7 ® DATE(MWDD/YYYY) ACoR® CERTIFICATE OF LIABILITY INSURANCE 7/22/2026 THIS CERTIFICATE 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 have ADDITIONAL INSURED provisions or 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). PRODUCER CONTACT Client Service Team Arthur J.Gallagher Risk Management Services, LLC F— PHONE 200 Delaware Avenue A/c No Ext:716-853-7960 FAX No)-855 5s5 4sos Suite 1100 EMAIL ADDRESS: CertRe nests a' .com Buffalo NY 14202 INSURERS AFFORDING COVERAGE NAIC& INSURERA:Southern Insurance Company 19216 INSURED BASEKI"2 INSURERB:The Cincinnati Insurance Company 10677 Baseline King Corp. INSURERC:National Union Fire Insurance Company of Pittsburg19445 111 Liberty Lane Bameveld NY 13304 INSURER D INSURER E INSURER F COVERAGES CERTIFICATE NUMBER:1469691105 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED_ NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS 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 BY PAID CLAIMS_ 1NSR ADDL SUER POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE Iµ POLICY NUMBER MM/DD MMIDD C X COMMERCIAL GENERAL LIABILITY Y Y AP-020591740-01 7/1/2026 7/1/2027 EACH OCCURRENCE $10,000,000 DAMAG O REN CLAIMS-MADE a OCCUR PREMISES Ea occurrence $1 00,D00 MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $10,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRODUCTS-COMP/OP AGG $10,000,000 X POLICY❑JE a LOC $ OTHER: AUTOMOBILE LIABILITY d SINGLE LIMIT $ acci dent) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS PROPERTY DAMAGE HIRED NON-OWNED Per accident) $ 'AUTOS ONLY P AUTOS ONLY - UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ $ DED I I RETENTION$ _ STATUTE A WORKERS COMPENSATION Y OWC1013127 1/1/2026 1/1/2027 X ERH AND EMPLOYERS'LIABILITY Y/N ANYPROPRIETORIPARTNER/EXECUTIVE EL EACH ACCIDENT $1,000,000 OFFICER/MEMBEREXCLUE N/A El.DISEASE-EA EMPLOYEE $1,OOD,000 (Mandatory m NH) - If yes,describe under E.L DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS below B Leased/Rented Equipment ENP 0751184 7/1/2026 7/1/2029 Limit $300,000 Umd Installation Floater DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is requaed) The Following Applies,Subject to Policy Terms and Conditions: General Liability-Additional Insured Designated Person or Organization Endorsement General Liability-Primary and Non-Contributory General Liability-Waiver of Subrogation Workers Compensation-Waiver of Our Right to Recover from Others Endorsement,Form#WC 00 03 13(Ed.04-84) Thirty(30)Day Notice of Cancellation Applies See Attached... CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of Southold PO Box 1179 AUTHORIZED REPRESENTATIVE Southold NY 11971 ,q LUYJ. (7aVag;lef'12%, M Selrv%ceks LLG c01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: BASEKIN-02 LOC#: AC"RV ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED Arthur J.Gallagher Risk Management Services,LLC Baseline King Corp. 111 Liberty Lane POLICY NUMBER Bameveld NY 13304 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE RE: Elizabeth Field Airport-Primary Wind Cone Replacement. Additional Insureds: Town of Southold,Fishers Island Ferry District(Owners'Representative),C&S Companies,and all other required parties. ACORD 101 (2008101) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY ' WC 00 0313 (Ed.04-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy.We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Any person or organization as required by written contract This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to.preparation of the policy.) Endorsement Effective 1/1/2026 Policy No. OWC1013127 Endorsement No. 0 Insured Baseline Fling Corp Premium$ Insurance Company Southern Insurance Company Countersigned by WC 00 03 13 (Ed. 04-84) FOR c4orkers' CERTIFICATE OF �E Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE Board 1 a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured Baseline King Corp. 315-89MI06 111 Liberty Lane Bameveld,NY 13304 1c.NYS Unemployment Insurance Employer Registration Number of Insured Work Location of Insured(Only required if coverage is specifically limited to 1 d.Federal Employer Identification Number of Insured or Social Security certain locations in New York State,i.e.,a Wrap-Up Policy) Number 134035681 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Southern Insurance Company Town of Southold PO Box 1179 3b,Policy Number of Entity Listed in Box"la" Southold,NY 11971 owc1013127 3c.Policy effective period 0 1101/20 26 to 01/01/2027 3d.The Proprietor,Partners or Executive Officers are y❑ included.(Only check box if all partners/officers included) ND all excluded or certain partnerslofficers excluded. This certifies that the insurance carrier indicated above in box"3"insures the business referenced above in box"1 a"for workers' compensation under the New York State Workers'Compensation Law.(To use this form, New York(NY)must be listed under Item 3A on the INFORMATION PAGE of the workers'compensation insurance policy). The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box"2". The insurance carrier must notify the above certificate holder and the Workers'Compensation Board within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate.(These notices may be sent by regular mail.)Otherwise,this Certificate is valid for one year after this form is approved by the insurance carrier or its licensed agent,or until the policy expiration date listed in box"3c",whichever is earlier. This certificate is issued as a matter of information only and confers no rights upon the certificate holder.This certificate does not amend, extend or alter the coverage afforded by the policy listed, nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This certificate may be used as evidence of a Workers'Compensation contract of insurance only while the underlying policy is in effect. Please Note:Upon cancellation of the workers'compensation policy indicated on this form,if the business continues to be named on a permit,license or contract issued by a certificate holder,the business must provide that certificate holder with a new Certificate of Workers'Compensation Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers'Compensation Law. Under penalty of perjury,I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has the coverage as depicted on this form. Approved by: Arthur J. Gallagher Risk Management Services,LLC (Print name of authorized representative or licensed agent of insurance carrier) Approved by: ;f 7/22/2026 (Signature) (Date) Northeast Zone President Title: 71"63-7960 Telephone Number of authorized representative or licensed agent of insurance carrier. Please Note: Only insurance carriers and their licensed agents are authorized to issue Form C-105.2.Insurance brokers are NOT authorized to issue it. C-105.2 (9-17) www.wcb.ny.gov Workers' Compensation Law Section 57. Restriction on issue of permits and the entering into contracts unless compensation is secured. 1. The head of a state or municipal department, board, commission or office authorized or required by law to issue any permit for or in connection with any work involving the employment of employees in a hazardous employment defined by this chapter, and notwithstanding any general or special statute requiring or authorizing the issue of such permits, shall not issue such permit unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair, that compensation for all employees has been secured as provided by this chapter. Nothing herein, however, shall be construed as creating any liability on the part of such state or municipal department, board, commission or office to pay any compensation to any such employee if so employed. 2. The head of a state or municipal department, board, commission or office authorized or required by law to enter into any contract for or in connection with any work involving the employment of employees in a hazardous employment defined by this chapter, notwithstanding any general or special statute requiring or authorizing any such contract, shall not enter into any such contract unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair,that compensation for all employees has been secured as provided by this chapter. C-105.2(9-17) REVERSE `R° Workers' CERTIFICATE OF INSURANCE COVERAGE S7ATE Compensation i Board NYS DISABILITY AND PAID FAMILY LEAVE BENEFITS 'LAW PART 1.To be completed by NYS disability and Paid Family Leave benefits carrier or licensed insurance agent of that carrier 1 a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured BASELINE KING CORP 315-896-6106 111 LIBEP,I Y LANE BARNEVELD,NY 13304 1 c.Federal Employer Identification Number of Insured or Social Security Number Work Location of Insured(Only required ifcoverage is specifically limited to certain locations in New York State,i.e.,wrap-up Policy) 134035681 2.Name and Address of Entity Requesting Proof of Coverage 3a.Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) ShelterPoint Life Insurance Company Town of Southold PO Box 1179 3b.Policy Number of Entity Listed in Box"I a" Southold, NY 11971 DBL170431 3c.Policy effective period 10/01/2025 to 09/30/2027 4. Policy provides the following benefits: u A.Both disability and paid family leave benefits. ® B.Disability benefits only. C.Paid family leave benefits only. 5. Policy covers: A_All of the employer's employees eligible under the NYS Disability and Paid Family Leave Benefits Law. ® B.Only the following class or classes of employers employees: Under penalty of perjury,I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has NYS Disability and/or Paid Family Leave Benefits insurance coverage as described above. Date Signed 7/22/2026 By (Signature of insurance carrier's authorized representative or NYS Licensed Insurance Agent of that insurance carrier) Telephone Number 516-829-8100 Name and Title Wade Harrison, President IMPORTANT: If Boxes 4A and 5A are checked,and this form is signed by the insurance carrier's authorized representative or NYS Licensed Insurance Agent of that carrier,this certificate is COMPLETE.Mail it directly to the certificate holder. If Box 4B,4C or 5B is checked,this certificate is NOT COMPLETE for purposes of Section 220,Subd.8 of the NYS Disability and Paid Family Leave Benefits Law. It must be emailed to PAU@wcb.ny.gov or it can be mailed for completion to the Workers'Compensation Board,Plans Acceptance Unit,PO Box 5200, Binghamton, NY 13902-5200. PART 2.To be completed by the NYS Workers'Compensation Board(Only if Box 413,4C or 5B have been checked) State of New York Workers' Compensation Board According to information maintained by the NYS Workers'Compensation Board,the above-named employer has complied with the NYS Disability and Paid Family Leave Benefits Law(Article 9 of the Workers'Compensation Law)with respect to all of their employees. Date Signed By (Signature of Authorized NYS Workers'Compensation Board Employee) Telephone Number Name and Title Please Note:Only insurance carriers licensed to write NYS disability and paid family leave benefits insurance policies and NYS licensed insurance agents of those insurance carriers are authorized to issue Form OB-120.1.Insurance brokers are NOT authorized to issue this(form.1a p( DB-120.1 (12-21) 1I Jill I'I'l��l�ll�ll�o (itl�2l�l'UI��I��II�� Additional Instructions for Form D13-120.1 By signing this form,the insurance carrier identified in Box 3 on this form is certifying that it is insuring the business referenced in Box 1 a for disability and/or Paid Family Leave benefits under the NYS Disability and Paid Family Leave Benefits Law.The insurance carrier or its licensed agent will send this Certificate of Insurance Coverage (Certificate)to the entity listed as the certificate holder in Box 2. The insurance carrier must notify the above certificate holder and the Workers'Compensation Board within 10 days IF a . policy is cancelled due to nonpayment of premiums or within 30 days IF there are reasons.other than nonpayment of premiums that cancel the policy or eliminate the insured from coverage indicated on this Certificate. (These notices may be sent by regular mail.)Otherwise,this Certificate is valid for one year after this form is approved by the insurance carrier or its licensed agent, or until the policy expiration date listed in Box 3c,whichever is earlier. This Certificate is issued as a matter of information only and confers no rights upon the certificate holder.This Certificate does not amend, extend or alter the coverage afforded by the policy listed, nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This Certificate may be used as evidence of a NYS disability and/or Paid Family Leave benefits contract of insurance only while the underlying policy is in effect. Please Note: Upon the cancellation of the disability and/or Paid Family Leave benefits policy indicated on this form, if the business continues to be named on a permit, license or contract issued by a certificate holder,the business must provide that certificate holder with a new Certificate of Insurance Coverage for NYS disability and/ or Paid.Family Leave Benefits or other authorized proof that the business is complying with the mandatory coverage requirements of the NYS Disability and Paid Family Leave Benefits Law. NYS DISABILITY AND PAID FAMILY LEAVE BENEFITS LAW §220. Subd. 8 (a) The head of a state or municipal department, board, commission or office authorized or required by law to issue any permit for or in connection with any work involving the employment of employees in employment as defined in this article, and not withstanding any general or special statute requiring or authorizing the issue of such permits, shall not issue such permit unless proof duly subscribed,by an insurance carrier is produced in a form satisfactory to the chair, that the payment of disability benefits and after January first,two thousand and twenty-one,the payment of family leave benefits for all employees has been secured as provided by this article. Nothing herein, however, shall be construed as creating any liability on the part of such state or municipal department, board, commission or office to pay any disability benefits to any such employee if so employed. (b)The head of a state or municipal department, board, commission or office authorized or required by law to enter into any contract for or in connection with any work involving the employment of employees in employment as defined in this article and notwithstanding any general or special statute requiring or authorizing any such contract, shall not enter into any such contract unless proof duly subscribed by an insurance carrier is produced in a form satisfactory to the chair,that the payment of disability benefits and after January first,two thousand eighteen,the payment of family leave benefits for all employees has been secured as provided by this article. DB-120.1 (12-21)Reverse Bond#RCB0064039 Arl � TM _ AIADocument A312 2010 Performance Bond CONTRACTOR: SURETY: (Name, legal status and address) (Name, legal status and principal place Baseline King Corp. of business) 111 Liberty Street RLI Insurance Company This document has important legal Barneveld, NY 13304 9025 N. Lindbergh Drive Peoria, IL 61615 consequences.Consultation with OWNER: an attorney is encouraged with respect to its completion or (Name, legal status and address) modification. Town of Southold 53095 Rt.25 Any singular reference to Southold,NY 11971 Contractor,Surety,Owner or other party shall be considered CONSTRUCTION CONTRACT plural where applicable. Date: July 28,2026 AIA Document A312-2010 combines two separate bonds,a Amount: Sixty-Seven Thousand Seven Hundred and 00/100 Dollars($67,700.00) Performance Bond and a Payment Bond,into one form. This is not a single combined Description: Performance and Payment Bond. (Name and location) Primary Wind Cone Replacement-Elizabeth Field Airport BOND Date:July 28,2026 (Not earlier than Construction Contract Date) Amount: Sixty-Seven Thousand Seven Hundred and 00/100 Dollars($67,700.00) Modifications to this Bond: ®None ❑ See Section 16 CONTRAC R AS PRINCIPAL SURETY Company: (Corporate Seal) Company. (Corporate Seal) Baseline King orp. RLI Insurance Company `,,��rri„rrrrr Signature: AAI Signature: r= c�•��` °®¢°°°����•,� Name James Ki Name Jesse ampagne and Title:Presid nt and Title:Attorney-in-Fact ` a ! t3 (Any additional 'gnatures appe on the last page of this Performance Bond.) _ � m (FOR INFORMATION ONLY— me, address and telephone) ''�� °°° ° : AGENT or BROKER: OWNER'S REPRESENTATIVE: Arthur J.Gallagher Risk Management Services LLC(Architect,Engineer or other party.) 6712 Brooklawn Parkway,Suite 100 C&S Engineers Inc. Syracuse, NY 13211 499 Col Eileen Collins Boulevard 800-716-8314 Syracuse, NY 13212 Init. AIA Document A312T —2010.The American Institute of Architects. 061110 1 i T §1 The Contractor and Surety,jointly and severally,bind themselves,their heirs, executors,administrators,successors and assigns to the Owner for the performance of the Construction Contract,which is incorporated herein by reference. §2 If the Contractor performs the Construction Contract,the Surety and the Contractor shall have no obligation under this Bond, except when applicable to participate in a conference as provided in Section 3. §3 If there is no Owner Default under the Construction Contract,the Surety's obligation under this Bond shall arise after .1 the Owner first provides notice to the Contractor and the Surety that the Owner is considering declaring a Contractor Default. Such notice shall indicate whether the Owner is requesting a conference among the Owner,Contractor and Surety to discuss the Contractor's performance.If the Owner does not request a conference,the Surety may,within five(5)business days after receipt of the Owner's notice, request such a conference.If the Surety timely requests a conference,.the Owner shall attend.Unless the Owner agrees otherwise,any conference requested under this Section 3.1 shall be held within ten (10)business days of the Surety's receipt of the Owner's notice.If the Owner,the Contractor and the Surety agree,the Contractor shall be allowed a reasonable time to perform the Construction Contract, but such an agreement shall not waive the Owner's right,if any, subsequently to declare a Contractor Default; .2 the Owner declares a Contractor Default,terminates the Construction Contract and notifies the Surety; and .3 the Owner has agreed to pay the Balance of the Contract Price in accordance with the terms of the Construction Contract to the Surety or to a contractor selected to perform the Construction Contract. §4 Failure on the part of the Owner to comply with the notice requirement in Section 3.1 shall not constitute a failure to comply with a condition precedent to the Surety's obligations,or release the Surety from its obligations,except to the extent the Surety demonstrates actual prejudice. §5 When the Owner has satisfied the conditions of Section 3,the Surety shall promptly and at the Surety's expense take one of the following actions: §5.1 Arrange for the Contractor,with the consent of the Owner,to perform and complete the Construction Contract; §5.2 Undertake to perform and complete the Construction Contract itself,through its agents or independent contractors; §5.3 Obtain bids or negotiated proposals from qualified contractors acceptable to the Owner for a contract for performance and completion of the Construction Contract,arrange for a contract to be prepared for execution by the Owner and a contractor selected with the Owner's concurrence,to be secured with performance and payment bonds executed by a qualified surety equivalent to the bonds issued on the Construction Contract, and pay to the Owner the amount of damages as described in Section 7 in excess of the Balance of the Contract Price incurred by the Owner as a result of the Contractor Default;or §5.4 Waive its right to perform and complete, arrange for completion,or obtain a new contractor and with reasonable promptness under the circumstances: .1 After investigation,determine the amount for which it may be liable to the Owner and, as soon as practicable after the amount is determined,make payment to the Owner;or .2 Deny liability in whole or in part and notify the Owner,citing the reasons for denial. §6 If the Surety does not proceed as provided in Section 5 with reasonable promptness,the Surety shall be deemed to be in default on this Bond seven days after receipt of an additional written notice from the Owner to the Surety demanding that the Surety perform its obligations under this Bond,and the Owner shall be entitled to enforce any remedy available to the Owner.If the Surety proceeds as provided in Section 5.4, and the Owner refuses the payment or the Surety has denied liability,in whole or in part,without further notice the Owner shall be entitled to enforce any remedy available to the Owner. Init. AIA Document A312Tm—2010.The American Institute of Architects. 2 . c §7 If the Surety elects to act under Section 5.1,5.2 or 5.3,then the responsibilities of the Surety to the Owner shall not be greater than those of the Contractor under the Construction Contract,and the responsibilities of the Owner to the Surety shall not be greater than those of the Owner under the Construction Contract. Subject to the commitment by the Owner to pay the Balance of the Contract Price,the Surety is obligated,without duplication,for .1 the responsibilities of the Contractor for correction of defective work and completion of the Construction Contract; .2 additional legal,design professional and delay costs resulting from the Contractor's Default,and resulting from the actions or failure to act of the Surety under Section 5;and .3 liquidated damages,or if no liquidated damages are specified in the Construction Contract,actual damages caused by delayed performance or non-performance of the Contractor. §8 If the Surety elects to act under Section 5.1,5.3 or 5.4,the Surety's liability is limited to the amount of this Bond. §9 The Surety shall not be liable to the Owner or others for obligations of the Contractor that are unrelated to the Construction Contract,and the Balance of the Contract Price shall not be reduced or set off on account of any such unrelated obligations.No right of action shall accrue on this Bond to any person or entity other than the Owner or its heirs, executors,administrators,successors and assigns. §10 The Surety hereby waives notice of any change,including changes of time,to the Construction Contract or to related subcontracts,purchase orders and other obligations. §11 Any proceeding,legal or equitable,under this Bond may be instituted in any court of competent jurisdiction in the location in which the work or part of the work is located and shall be instituted.within two years after a declaration of Contractor Default or within two years after the Contractor ceased working or within two years after the Surety refuses or fails to perform its obligations under this Bond,whichever occurs first.If the provisions of this Paragraph are void or prohibited by law,the minimum period of limitation available td sureties as a defense in the jurisdiction of the suit shall be applicable. §12 Notice to the Surety,the Owner or the Contractor shall be mailed or delivered to the address shown on the page on which their signature appears. §13 When this Bond has been furnished to comply with a statutory or other legal requirement in the location where the construction was to be performed, any provision in this Bond conflicting with said statutory or legal requirement shall be deemed deleted herefrom and provisions conforming to such statutory or other legal requirement shall be deemed incorporated herein.When so furnished,the intent is that this Bond shall be construed as a statutory bond and not as a common law bond. §14 Definitions §14.1 Balance of the Contract Price.The total amount payable by the Owner to the Contractor under the Construction Contract after all proper adjustments have been made,including allowance to the Contractor of any amounts received or to be received by the Owner in settlement of insurance or other claims for damages to which the Contractor is entitled,reduced by all valid and proper payments made to or on behalf of the Contractor under the Construction Contract. §14.2 Construction Contract.The agreement between the Owner and Contractor identified on the cover page, including all Contract Documents and changes made to the agreement and the Contract Documents. §14.3 Contractor Default.Failure of the Contractor,which has not been remedied or waived,to perform or otherwise to comply with a material term of the Construction Contract. §14.4 Owner Default.Failure of the Owner,which has not been remedied or waived,to pay the Contractor as required under the Construction Contract or to perform and complete or comply with the other material terms of the Construction Contract. §14.5 Contract Documents.All the documents that comprise the agreement between the Owner and Contractor. §15 If this Bond is issued for an agreement between a Contractor and subcontractor,the term Contractor in this Bond shall be deemed to be Subcontractor and the term Owner shall be deemed to be Contractor. [nit. AIA Document A312T1'—2010.The American Institute of Architects. 3 §16 Modifications to this bond are as follows: (Space is provided below for additional signatures of added parties, other than those appearing on the cover page) CONTRACTOR AS PRINCIPAL SURETY Company: (Corporate Seal) Company: (Corporate Seal) Signature: Signature: Name and Title: Name and Title: Address Address CAUTION:You should sign an original AIA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. Init. AIA Document A312T"—2010.The American Institute of Architects. 4 Bond#RCB0064039 ® � AIA Document A312 TM - 2010 Payment Bond CONTRACTOR: SURETY: (Name, legal status and address) (Name, legal status and principal place Baseline King Corp. of business) 111 Liberty Street RLI Insurance Company Barneveld, NY 13304 9025 N. Lindbergh Drive This document has important legal Peoria, IL 61615 consequences.Consultation with an attomey is encouraged with OWNER: respect to its completion or (Name, legal status and address) modification. Town of Southold 53095 Rt.25 Any singular reference to Southold, NY 11971 Contractor,Surety, Owner or other party shall be considered CONSTRUCTION CONTRACT plural where applicable. Date: July 28,2026 AIA Document A312-2010 combines two separate bonds,a Amount:Sixty-Seven Thousand Seven Hundred and 00l100 Dollars($67,700.00) Performance Bond and a Payment Bond,into one form. This is not a single combined Description: Performance and Payment Bond. (Name and location) Primary Wind Cone Replacement-Elizabeth Field Airport BOND Date:July 28,2026 (Not earlier than Construction Contract Date) Amount: Sixty-Seven Thousand Seven Hundred and 001100 Dollars($67,700.00) Modifications to this Bond: El None ❑ See Section 18 CONTRACT AS PRINC AL SURETY Company: (Corporate Seal) Company: (Corporate Seal) Baseline King rp. RLI Insurance Company Signature: Signature: Name James Ki Name Jes Formy-in-Fact hampagne `` m �t and Title: Presid nt and Title: , co ®®ems (Any additional 'gnatures appear o the last page of this Payment Bond.) to \ 0 o (FOR INFORMATION ONLY—Name, address and telephone) \ o AGENT or BROKER: OWNER'S REPRESENTATIVE. (Architect,Engineer or other party:) �- Arthur J.Gallagher Risk Management Services LLC 6712 Brooklawn Parkway,Suite 100 C&S Engineers Inc. Syracuse, NY 13211 499 Col Eileen Collins Boulevard 800-716-8314 Syracuse,NY 13212 Init. AIA Document A312TM'—2010.The American Institute of Architects. 061110 5 §1 The Contractor and Surety,jointly and severally,bind themselves,their heirs,executors,administrators,successors and assigns to the Owner to pay for labor,materials and equipment furnished for use in the performance of the Construction Contract,which is incorporated herein by reference,subject to the following terms. §2 If the Contractor promptly makes payment of all sums due to Claimants,and defends,indemnifies and holds harmless the Owner from claims, demands,liens or suits by any person or entity seeking payment for labor,materials or equipment furnished for use in the performance of the Construction Contract,then the Surety and the Contractor shall have no obligation under this Bond. §3 If there is no Owner Default under the Construction Contract,the Surety's obligation to the Owner under this Bond shall arise after the Owner has promptly notified the Contractor and the Surety(at the address described in Section 13) of claims,demands,liens or suits against the Owner or the Owner's property by any person or entity_seeking payment for labor,materials or equipment furnished for use in the performance of the Construction Contract and tendered defense of such claims,demands,liens or suits to the Contractor and the Surety. §4 When the Owner has satisfied the conditions in Section 3,the Surety shall promptly and at the Surety's expense defend,indemnify and hold harmless the Owner against a duly tendered claim,demand,lien or suit. §5 The Surety's obligations to a Claimant under this Bond shall arise after the following: §5.1 Claimants,who do not have a direct contract with the Contractor, .1 have furnished a written notice of non-payment to the Contractor,stating with substantial accuracy the amount claimed and the name of the party to whom the materials were, or equipment was,furnished or supplied or for whom the labor was done or performed,within ninety(90)days after having last performed labor or last furnished materials or equipment included in the Claim;and .2 have sent a Claim to the Surety(at the address described in Section 13). §5.2 Claimants,who are employed by or have a direct contract with the Contractor,have sent a Claim to the Surety(at the address described in Section 13). §6 If a notice of non-payment required by Section 5.1.1 is given by the Owner to the Contractor,that is sufficient to satisfy a Claimant's obligation to furnish a written notice of non-payment under Section 5.1.1. §7 When a Claimant has satisfied the conditions of Sections 5.1 or 5.2,whichever is applicable,the Surety shall promptly and at the Surety's expense take the following actions: §7.1 Send an answer to the Claimant,with a copy to the Owner,within sixty(60)days after receipt of the Claim, stating the amounts that are undisputed and the basis for challenging any amounts that are disputed;and §7.2 Pay or arrange for payment of any undisputed amounts. §7.3 The Surety's failure to discharge its obligations under Section 7.1 or Section 7.2 shall not be deemed to constitute a waiver of defenses the Surety or Contractor may have or acquire as to a Claim,except as to undisputed amounts for which the Surety and Claimant have reached agreement. If,however,the Surety fails to discharge its obligations under Section 7.1 or Section 7.2,the Surety shall indemnify the Claimant for the reasonable attorney's fees the Claimant incurs thereafter to recover any sums found to be due and owing to the Claimant. §8 The Surety's total obligation shall not exceed the amount of this Bond,plus the amount of reasonable attorney's fees provided under Section 7.3,and the amount of this Bond shall be credited for any payments made in good faith by the Surety. §9 Amounts owed by the Owner to the Contractor under the Construction Contract shall be used for the performance of the Construction Contract and to satisfy claims,if any,under any construction performance bond.By the Contractor furnishing and the Owner accepting this Bond,they agree that all funds earned by the Contractor in the performance of the Construction Contract are dedicated to satisfy obligations of the Contractor and Surety under this Bond,subject to the Owner's priority to use the funds for the completion of the work. Init. AIA Document A312Tm—2010.The American In of Architects. 6 §10 The Surety shall not be liable to the Owner,Claimants or others for obligations of the Contractor that are unrelated to the Construction Contract. The Owner shall not be liable for the payment of any costs or expenses of any Claimant under this Bond, and shall have under this Bond no obligation to make payments to,or give notice on behalf of, Claimants or otherwise have any obligations to Claimants under this Bond. §11 The Surety hereby waives notice of any change,including changes of time,to the Construction Contract or to related subcontracts,purchase orders and other obligations. §12 No suit or action shall be commenced by a Claimant under this Bond other than in a court of competent jurisdiction in the state in which the project that is the subject of the Construction Contract is located or after the expiration of one year from the date(1)on which the Claimant sent a Claim to the Surety pursuant to Section 5.1.2 or 5.2,or(2)on which the last labor or service was performed by.anyone or the last materials or equipment were furnished by anyone under the Construction Contract,whichever of(1)or(2)first occurs.If the provisions of this Paragraph are void or prohibited by law,the minimum period of limitation available to sureties as a defense in the jurisdiction of the suit shall be applicable. §13 Notice and Claims to the Surety,the Owner or the Contractor shall be mailed or delivered to the address shown on the page on which their signature appears.Actual receipt of notice or Claims,however accomplished,shall be sufficient compliance as of the date received. §14 When this Bond has been famished to comply with a statutory or other legal requirement in the location where the construction was to be performed,any provision in this Bond conflicting with said statutory or legal requirement shall be deemed deleted herefrom and provisions conforming to such statutory or other legal requirement shall be deemed incorporated herein.When so furnished,the intent is that this Bond shall be construed as a statutory bond and not as a common law bond. §15 Upon request by any person or entity appearing to be a potential beneficiary of this Bond,the Contractor and Owner shall promptly furnish a copy of this Bond or shall permit a copy to be made. §16 Definitions . § 16.1 Claim.A written statement by the Claimant including at a minimum: .1 the name of the Claimant; .2 the name of the person for whom the labor was done, or materials or equipment famished; .3 a copy of the agreement or purchase order pursuant to which labor,materials or equipment was famished for use in the performance of the Construction Contract; .4 a brief description of the labor,materials or equipment famished; .5 the date on which the Claimant last performed labor or last furnished materials or equipment for use in the performance of the Construction Contract; .6 the total amount earned by the Claimant for labor,materials or equipment furnished as of the date of the Claim; .7 the total amount of previous payments received by the Claimant;and .8 the total amount due and unpaid to the Claimant for labor,materials or equipment furnished as of the date of the Claim. §16.2 Claimant.An individual or entity having a direct contract with the Contractor or with a subcontractor of the Contractor to furnish labor,materials or equipment for use in the performance of the Construction Contract. The term Claimant also includes any individual or entity that has rightfully asserted a claim under an applicable mechanic's lien or similar statute against the real property upon which the Project is located. The intent of this Bond shall be to include without limitation in the terms"labor,materials or equipment"that part of water,gas,power,light,heat, oil, gasoline,telephone service or rental equipment used in the Construction Contract,architectural and engineering services required for performance of the work of the Contractor and the Contractor's subcontractors,and all other items for which a mechanic's lien may be asserted in the jurisdiction where the labor,materials or equipment were furnished. §16.3 Construction Contract.The agreement between the Owner and Contractor identified on the cover page, including all Contract Documents and all changes made to the agreement and the Contract Documents. Init. AIA Document A312m—2010.The American Institute of Architects. 7 §16.4 Owner Default.Failure of the Owner,which has not been remedied or waived,to pay the Contractor as required under the Construction Contract or to perform and complete or comply with the other material terms of the Construction Contract. §16.5 Contract Documents.All the documents that comprise the agreement between the Owner and Contractor. §17 If this Bond is issued for an agreement between a Contractor and subcontractor,the term Contractor in this Bond shall be deemed to be Subcontractor and the term Owner shall be deemed to be Contractor. §18 Modifications to this bond are as follows: (Space isprovided below for additional signatures of addedparties, other than those appearing on the cover page) CONTRACTOR AS PRINCIPAL SURETY Company: (Corporate Seal) Company: (Corporate Seal) Signature: Signature: Name and Title: Name and Title: Address Address CAUTION:You should sign an original AIA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. Init. AIA Document A312T —2010.The American Institute of Architects. CORPORATE ACKNOWLEDGMENT State of New York County of Oneida On the 281'day of July.2026,before me personally came James King to me known who being by me duly sworn, did depose and say;that he is President of the Baseline King Corp.the Corporation described in and which executed the above instrument; that he knows the seal of such said corporation;that the seal affixed to the instrument is such corporate seal that it was so affixed by order of the Board of Directors of the said corporation,and he signed his name thereto by like order. Not Public KIMBERLY A.OROURKE NOTARY PUBLIC,STATE OF NEW YORK ONONDAGA LIC#01 OR6383315 COMM.EXP. 11/13/2026 SURETY ACKNOWLEDGMENT State of New York County of Onondaga On the 28'day of July,2026,before me a Notary Public in and for the said County and State,residing therein,duly commissioned and sworn,personally appeared Jesse M. Champagne known to me to be the Attomey-in-Fact of the RLI Insurance Company the corporation described in and that executed the within and foregoing instrument and known to me to be the person who executed the said instrument in behalf of the said corporation,and he duly acknowledged to me that such corporation executed the same. IN WITNESS THEREOF,I have hereunto set my hand and affixed my official seal,the day and year stated in this certificate above. Notary Public KIMBERLY A.OROURKE NOTARY PUBLIC,STATE OF NEW YORK ONONDAGA LIC#01 OR6383315 COMM. EXP. 11/13/2026 EWER OF ATTORNEY RLI Insurance Company Contractors Bonding and Insurance Company 9025 N.Lindbergh Dr. Peoria,IL 61615 Phone: 800-645-2402 Know All Men by These Presents: That this Power of Attorney is not valid or in effect unless attached to the bond which it authorizes executed, but may be detached by the approving officer if desired. That RLI Insurance Company and/or Contractors Bonding and Insurance Company, each an Illinois corporation, (separately and together,the"Company")do hereby make,constitute and appoint: Jesse M.Champagne David L.Mehlbaum Kimberly A O'Rourke jointly or severally in the City of Syracuse , State of New York its true and lawful Agent(s) and Attomey(s) in Fact, with full power and authority hereby conferred, to sign, execute, acknowledge and deliver for and on its behalf as Surety, in general, any and all bonds and undertakings in an amount not to exceed Thirty Million Dollars ( $30,000,000.00 for any single obligation. The acknowledgment and execution of such bond by the said Attorney in Fact shall be as binding upon the Company as if such bond had been executed and acknowledged by the regularly elected officers of the Company. RLI Insurance Company and/or Contractors Bonding and Insurance Company, as applicable, have each further certified that the following is a true and exact copy of a Resolution adopted by the Board of Directors of each such corporation,and is now in force,to-wit: "All bonds,policies,undertakings,Powers of Attorney or other obligations of the corporation shall be executed in the corporate name of the Company by the President, Secretary,any Assistant Secretary,Treasurer,or any Vice President, or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys in Fact or Agents who shall have authority to issue bonds,policies or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds,policies,undertakings,Powers of Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile." IN WITNESS WHEREOF, the RLI Insurance Company and/or Contractors Bonding and Insurance Company, as applicable, have caused these presents to be executed by its respective Sr.Vice President Iwith its corporate seal affixed this 5th day of January 2026 ,, RLI Insurance Company 0o�o.NGANDjHSG➢9. \���QtR�cE CoA,, Contractors Bonding and Insyranc�eCompany 197 GOPPORgT�•.n1 ?4 �ppPORgy.F•°: ram i /..._ .�/' � .EAR, By. YAL a'_ = Eric Raudins Sr.Vice President State of Ohio l } SS County of Cuyahoga JJ CERTIFICATE On this 5th day of Januaa 2026 before me, a Notary Public, I, the undersigned officer of RLI Insurance Company and/or personally appeared Eric Raudins who being by me duly swom, Contractors Bonding and Insurance Company, do hereby certify acknowledged that he signed the above Power of Attorney as the aforesaid �twvIth�dflft,pttached Power of Attorney is in full force and effect and is officer of the RLI Insurance Company and/or Contractors Bonding atld`"' %, WEY'&' abkr,,,and furthermore, that the Resolution of the Company as Insurance Company and acknowledged said instrument to be the volu ry °°°mtoTcil,* '41�e Power of Attorney, is now in force. In testimony act and deed of said.corporation. V eof;°U ale hereunto set my hand and the seal of the RLI °°°° Ins r cd°C�iu�any and/or Contractors Bonding and Insurance a6ompanny ° 8th day of July 2026 B i° • •� ° �Ri Inrc�e company y' CC�ahtrac -Soding and Insurance Company f Jill A.Scott Notary plc° w ,�. t��_•'�� 11LLA.SCOT �flt"t�Lit`',t```\` •j'� -��• •.N°u'1'Public.Swe of OA�o By. 1�.�-�,�f i��� A � r _ FAY Comm�son Expires: a 'o! Seplembei 22.2030 Christina Dean Corporate Secretary 3149696020212 A0058D 19 ®RLIIP.O.BOX3967PEORIA,IL 61612-3967 RL Insurance Company P:(800)645-2402 E:asksurety@rlicorp.com Company SURETY RLISURETY.COM December 31, 2025 Admitted Assets Liabilities and Surplus Investments: Liabilities: Fixed maturities .............................. $ 1,881,898,375 Reserve for unpaid losses and loss Equity securities.............................. 1,790,250,301 adjustment expenses .,..................... $ 1,223,062,557 Short-term investments ........................ 0 Unearned premiums ,,........................ 492,611,252 Real estate.....................:............... 21,892,838 Accrued expenses ........................... 139,970,672 Properties held to produce income .................. 0 Funds held................................... 574,049 Cash and cash equivalents ........................ 90,026,167 Advance premiums •.,,....,,................. 36,092,100 Other invested assets ............................ 44,208,503 Amounts withheld ,......,.................... 88,922,340 Receivables for securities ......................... 122,669 Remittances and items not allocated,,.,,.......,. 2,687,969 Agents'balances ................................ 90,349,311 Dividends declared and unpaid ,•,.......,....... 21,522 Investment income due and accrued ................ 15,665,146 Ceded reinsurance premium payable •.,.,,....... 22,103,335 Funds held ..................................... 0 Payable for securities.......................... 3,000,438 Reinsurance recoverable on paid losses ............. 6,622,819 Statutory penalties,,.....,.................... 516,869 Federal income taxes receivable .................... 0 Current federal and foreign income taxes ...,...... 26,959,811 Net deferred tax asset ............................ 260,545 Net deferred tax liability,,...................... 0 Guarantee funds receivable or on deposit 198,938 Borrowed money and accrued interest ..._........ 50,181,264 Electronic data processing equipment. ............... Drafts outstanding .,......._. .................. 0 net of depreciation ,,,....•....:...........I... 1,775,675 Payable to affiliate ,,,............................ 9,344,792 Receivable from affiliates.......................... 7,505,399 Other liabilities,.................................. 14,003,896 Other admitted assets ............................ 5.891.645 Total Liabilities $ 2,110,052,866 Total Admitted Assets $ 3,956,668,331 Surplus: Common stock•......••...................... $ 10,000,375 Additional paid-in capital........................ 242,451,084 Unassigned surplus........................... 1,594,164,006 State of Ohio Total Surplus $ 1,846,615,465 County of Cuyahoga Total Liabilities and Surplus $ 3,956,668,331 The undersigned, being duly sworn, says: That he is the President of RLI Insurance Company, that said Company is a corporation duly organized, in the State of Illinois, and licensed and engaged in business in the State of and has duly complied with all the requirements of the laws of said State applicable of said Company and is duly qualified to act as Surety under such laws;that said Company has also complied with and is duly qualified to act as Surety under the Act of Congress approved July 1947, 6U.S.0 sec. 6-13; and that to the best of his knowledge and belief the above statement is a full, true, and correct statement of the financial condition of the said Company on the 31 st day of December 2025. Attest: CE c: OURQopprk�' - Corporate Craig Kliethermes President Seal SEAL _ { Affixed ALE liva 1 0 +''I��'�a��l l�N•4����• `a Olg " Hapfiel Assistant Secretary Sworn to before me this 3rd day of March, 2026. ` d ; 11LL A.SCOTT ��, F`yc•�e° a c°°c n a�. ``�` i /, ! ;Notap'PW;c.Stale of Ob,o �.+' ♦� /1 ( _ My com.i sro Exp.—: Notarial ``11 September 22.2030 Seal `rrr'.... Affixed Jill A.Scott Notary Public, State of Ohio J M0058326_Portal