BID BOND
PENAL SUM FORM
BIDDER (Naine and Address):
Kenyon Pipeline Inspection, LLC
68 Park Road
Queensbury, NY_ 12804
.ETY (Name-and Address of Principal Place of Business):
United States Fire Insurance Company
305 Madison Avenue
Morristown, NJ_ 07960
OWNER (Name and Address):
City of Nashua
__229 Main Street
Nashua, NH_ 03061
BID
BID DUE DATE: February 12, 2019
PROJECT (Brief Description Including Location);
2019 CIPP Lining Project
1FB1087-021219
BOND
BOND NUMBER: NA
DATE: (Not later than Bid Due Date): February 12, 2019
PENAL SUM: Five Percent of Amount of Bid _ $---5%---
(Words) (Figures)
IN WITNESS WHEREOF, Surety and Bidder, Intending to be legally bound hiereby,. subject to the terms
Printed oh the reverse side hereof, do each cavise the Bid Bond to be duly-executed. on its behalf by its
authorized officer, agent, or representative.
BIDDER SURETY
Kenyon Pipeline Inspection, LLC (Seal) United States Fire Insu
idder's Name and Corporate Seal rs Hig-anid Corporate S
;
Bys Yo By: Oum_t. {
G ~~ — SFpatureand Title Dawn J. Riley Signatiiré- aiid Title\Attorney-in-Fact
(Attach Power of Atteraty)
Attest: _ See Power of Attorney
. Li 7
Sinan sand Lille Signature and Title
ki ' ” “ft Jr eer MManagour
Note: (1) Aboveaddresses -areta be used for giving required notice. -— a
(2) Any sidgillar reference to Bidder, Surety, OWNER or other party shall be considered plural where applicable:
Attest:
BB -1 of 2
