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CRANE AND HOIST =
CRANE BUILDERS, INSTALLERS AND TECHNICIANS

Thank you again, and please call with any questions...

Sincerely,
Mass Crane & Hoist Service Inc.

Steve Neily
Sales

PROPOSAL ACCEPTED BY:

DATE:

500-1 Potash Hill Road, Tyngsboro, MA 01879 e TELEPHONE 800-909-2299 e www.masscrane.com

THIS FORM MUST BE SUBMITTED WITH ALL RESPONSES TO THIS IFB

CONSTRUCTION CONTRACTOR’S
QUALIFICATION STATEMENT

On Schedule A, attached, list major engineered construction projects completed by this organization
in the past five (5) years. (If joint venture, list each participant’s projects separately).

On Schedule B, attached, list current projects under construction by this organization, (If joint
venture, list each participant’s projects separately).

On Schedule C, attached, provide a list of project awards Vendor has received from the City of
Nashua in the past 5 years. Please include project detail, City department and City project lead.

On Schedule D, attached, furnish References. Include at least three (3) professional references
(business name, contact, email address & phone number). References may be contacted as part of
our preliminary bid review to assist project committee in assessing Vendor qualifications. Current
City of Nashua personnel and elected officials shall not be used as references.

Name of Surety Company and name, address, and phone number of agent.

Is your organization a member of a controlled group of corporations as defined in I.R.C. Sec. 1563?
L_l¥es IMNo

If yes, show names and addresses of affiliated companies.

Has your organization ever failed to complete any construction contract awarded to it?

Clyes [No
If yes, describe circumstances and provide details on attachment.
Has any Corporate officer, partner, joint venture participant or proprietor ever failed to complete a

construction contract awarded to him or her in their own name or when acting as a principal of
another organization?

(_]¥es [Who

If yes, describe circumstances and provide details on attachment.

CQ-10f7

10.

11.

12.

13.

14.

15.

THIS FORM MUST BE SUBMITTED WITH ALL RESPONSES TO THIS IFB

In the last five years, has your organization ever failed to substantially complete a project in a timely
manner?

[Yes [VINo
[]Yes [[JNo

If yes, describe circumstances and provide details on attachment.

Does your organization now have any legal suits or arbitration claims pending or outstanding against
it or any officers?

[_lYes [vino

If yes, describe circumstances and provide details on attachment.

Has your organization had a contract partially or completely terminated for default (cause) within the
past five years?

LlyYes [MINo

If yes, describe circumstances and provide details on attachment.

List the licensed categories of work that your company normally performs with its own workforce.

If required, can your organization provide a bid bond for this project?

yes L_INo

What is your approximate total bonding capacity?
[-4s500,000 to $2,000,000

(1$2,000,000 to $5,000,000

[1$5,000,000 to $10,000,000

[(J$10,000,000 or more

Describe the permanent safety program you maintain within your organization, Use attachment if

necessary.

SSAPETY MABIUAL, TRALWLNG CERTS + THA AVAILABLE

CQ-2o0f7

THIS FORM MUST BE SUBMITTED WITH ALL RESPONSES TO THIS IFB

16, Fumish the following information with respect to an accredited banking institution familiar with
your organization.

Name of Bank M LOPLESE XY SAVING BANK

Address lG@& RITILETON ST
WESTFORD, MA

Account Manager

Telephone (41 8 ) 64a -1990

I hereby certify that the information submitted herewith, including any attachment is true to the best of my
knowledge and belief.

,
By: Scot ERoOStT
Tite: PRESLOENT

Dated: __\ 2| 22 20

CQ -3o0f7

DIVISION 3

PAYMENT BOND
PERFORMANCE BOND
CERTIFICATE OF INSURANCE

CONSTRUCTION PAYMENT BOND

KNOW ALL MEN BY THESE PRESENTS: that

(Name of Contractor)

(Address of Contractor)

a , hereinafter called Principal,
(Corporation, Partnership or Individual)

and

(Name of Surety)

(Address of Surety)

hereinafter called Surety, are held and firmly bound unto

(Name of Owner)

(Address of Owner)

hereinafter called OWNER and unto all persons, firms, and corporations who or which may furnish
labor, or who furnish materials to perform as described under the contract and to their successors

and assigns, in the total aggregate penal sum of Dollars,

($ =~ ~———~=*Y~SC;sé«éain. Lawful money of the United States, for the payment of which sum well and
truly to be made, we bind ourselves, our heirs, executors, administrators, 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 day of

20 , a copy of which is hereto attached and made a part hereof for the construction of:

NOW, THEREFORE, if the Principal shall promptly make payment to all persons, firms, and
corporations furnishing materials for or performing labor in the prosecution of the WORK provided
for in such contract, and any authorized extension or modification thereof, 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 construction of such WORK, and for all labor cost
incurred in such WORK including that be a subcontractor, and to any mechanic or material man
lienholder whether it acquires its lien by operation of State or Federal Law; then this obligation
shall be void; otherwise to remain in full force and effect.

PY - 1 of 3

PROVIDED, that beneficiaries or claimants hereunder shall be limited to the subcontractors, and
persons, firms, and corporations having a direct contract with the PRINCIPAL or its
SUBCONTRACTORS.

PROVIDED FURTHER, that the said Surety for value received hereby stipulates and agrees
that no change, extension of time, alteration or addition to the terms of the contract or to the
WORK to be performed thereunder or the SPECIFICATIONS accompanying the same shall in
any way affect its obligation on this BOND, and it does hereby waive notice of any such change,
extension of time, alteration or addition to the terms of the contract or to the WORK or to the
SPECIFICATIONS.

PROVIDED, FURTHER that no suit or action shall be commenced hereunder by any claimant:
(a) Unless claimant, other than one having a direct contract with the PRINCIPAL shall have
given written notice to any two of the following: The PRINCIPAL, the OWNER, or the
SURETY above named within ninety (90) days after such claimant did or performed the last of
the work or labor, or furnished the last of the materials for which said claim is made, stating with
substantial accuracy the amount claimed and the name of the party to whom the materials were
furnished, or for whom the work or labor was done or performed. Such notice shall be served by
mailing the same by registered mail or certified mail, postage prepaid, in an envelope addressed
to the PRINCIPAL, OWNER, or SURETY, at any place where an office is regularly maintained
for the transaction business, or served in any manner in which legal process may be served in the
state in which the aforesaid project is located, save that such service need not be made by a
public officer. (b) After the expiration of one (1) year following the date on which PRINCIPAL
ceased work on said CONTRACT, it being understood, however, that if any limitation embodied
in the BOND is prohibited by any law controlling the construction hereof, such limitation shall
be deemed to be amended so as to be equal to the minimum period of limitation permitted by
such law.

PROVIDED, FURTHER, that it is expressly agreed that this BOND shall be deemed amended
automatically and immediately, without formal and separate amendments hereto, upon
amendment to the Contract not increasing the contract price more than 20 percent, so as to bind
the PRINCIPAL and the SURETY to the full and faithful performance of the Contract as so
amended. The term "Amendment", wherever used in this BOND and whether referring to this
BOND, the contract or the loan Documents shall include any alteration, addition, extension or
modification of any character whatsoever.

PROVIDED FURTHER, that no final settlement between the OWNER and the

CONTRACTOR shall abridge the right of any beneficiary hereunder, whose claim may be
unsatisfied.

PY - 2 of 3

IN WITNESS WHEREOF, this instrument is executed

in

which shall be deemed an original,
this

ATTEST:

By:

(Principal) Secretary

(SEAL)

By:

Witness as to Principal

(Address)

ATTEST:

By

Witness as to Surety

(Address)

counterparts, each one of
(number)

day of , 20

Principal
BY
(Address)
(Surety)
BY

Attorney - in - Fact

(Address)

NOTE: Date of BOND must not be prior to date of Contract.
If CONTRACTOR is partnership, all partners should execute BOND.

IMPORTANT: Surety companies 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 of

New Hampshire.

PY - 3 of 3

CONSTRUCTION PERFORMANCE BOND

KNOW ALL MEN BY THESE PRESENTS: that

(Name of Contractor)

(Address of Contractor)

a , hereinafter called Principal,
(Corporation, Partnership or Individual)

and

(Name of Surety)

(Address of Surety)

hereinafter called Surety, are held and firmly bound unto

(Name of Owner)

(Address of Owner)

hereinafter called OWNER, in the total aggregate penal sum
of

Dollars, $ ( )

in lawful money of the United States, for the payment of which sum well and truly to be made,
we bind ourselves, our heirs, executors, administrators 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 day of 20 a

2

copy of which is hereto attached and made a part hereof for the construction of:

NOW, THEREFORE, if the Principal shall well, truly and faithfully perform its duties, all the
undertakings, covenants, terms, conditions, and agreements of said contract during the original
term thereof, and any extension thereof which may be granted by the OWNER, with or without
notice to the Surety and during the one year guaranty period, and if the PRINCIPAL shall
satisfy all claims and demands incurred under such contract, and shall fully indemnify and save
harmless the OWNER from all costs and damages which it may suffer by reason of failure to do
so, and shall reimburse and repay the OWNER all outlay and expense which the OWNER may
incur in making good any default, then this obligation shall be void: otherwise to remain in full
force and effect.

PF - 1 of 2

PROVIDED, FURTHER, that the said surety, for value received hereby stipulates and agrees
that no change, extension of time, alteration or addition to the terms of the contract or to WORK
to be performed thereunder or the specifications accompanying same shall in any way affect its
obligation on this BOND, and it does hereby waive notice of any such change, extension of time
alteration or addition to the terms of the contract or to the WORK or to the specifications.

PROVIDED, FURTHER, that it is expressly agreed that this BOND shall be deemed amended
automatically and immediately, without formal and separate amendments hereto, upon
amendment to the Contract not increasing the contract price more than 20 percent, so as to bind
the PRINCIPAL and the SURETY to the full and faithful performance of the Contract as so
amended. The term "Amendment", wherever used in this BOND and whether referring to this
BOND, the contract or the loan Documents shall include any alteration, addition, extension or
modification of any character whatsoever.

PROVIDED, FURTHER, that no final settlement between the OWNER and the
CONTRACTOR shall abridge the right of any beneficiary hereunder, whose claim may be

unsatisfied.
IN WITNESS WHEREOF, this instrument is executed counterparts, each one of
~~ (aumber)
which shall be deemed an original,
this day of , 20
ATTEST:
Principal

By:

(Principal) Secretary
(SEAL) BY

(Address)
By:
Witness as to Principal
(Address)
(Surety)
ATTEST: BY
Attomey - in - Fact
By
Witness as to Surety (Address)
(Address)

NOTE: Date of BOND must not be prior to date of Contract.
If CONTRACTOR is Partnership, all partners should execute BOND

IMPORTANT: Surety companies 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 of
New Hampshire

PF - 2 of 2