THE STATE OF NEW HAMPSHIRE
DEPARTMENT OF TRANSPORTATION
Department af Transportation
Willian Cuss, PLE.
VMictaria F. Sheehan
Assistant Comoanissioner
Commissioner
March 11, 2020
Sealcoating, Inc., dba indus
825 Granite Street
Braintree, MA 02184
I hereby certify that the information submitted herewith, including any attachment is true to the best of
my knowledge and belief,
~
By: Richard L. Goodick
Title: Vice President
Dated “May 15, 2020
CQ -3 of 7
10.
Hi
12.
13.
14,
15.
Has your organization had a contract partially or completely terminated for default (cause) within
the past five years?
LTyves [XINo
If yes, describe circumstances and provide details on attachment.
List the licensed categories of work that your company normally performs with its own
workforce. Crack Sealing, Micro Surfacing, Pavement Restoration
If required, can your organization provide a bid bond for this project?
[X]¥es []No
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).
Name of Surety Company and name, address, and phone number of agent.
Fidelity and Deposit Company of Maryland
100 High Street, Suite 1400
ZURICH AMERICAN INSURANCE COMPANY
COLONIAL AMERICAN CASUALTY AND SURETY COMPANY
FIDELITY AND DEPOSIT COMPANY OF MARYLAND
POWER OF ATTORNEY
BID BOND
Conforms with The American Institute of
Architects, ALLA. Document No. A-310
KNOW ALL BY THESE PRESENTS, That we, Sealcoating inc. DBA indus
825 Granite Street, Braintree, Massachusetts 02184
as Principal, hereinafter called the Principal,
andthe Fidelity and Deposit Company of Viaryland ;
of 100 High Street - Suite 1400, Boston, MA 02440 ; & corporation duly organized under
the laws of the State of Winois , a8 Surety, hereinafter called the Surety, are held and firmly bound unto
roads. bridges, airports.
STATE TAX ATTESTATION FORM
Pursuant to M.G.L. Ch. 62C, Sec. 494A, | certify under the penalties of perjury that |, to my best
knowledge and belief, have filed all state tax returns and paid all state taxes required under law.
Sealcoating, Inc. d/b/a indus 04-3520246
Corporate Name {Mandatory} Federal Identification Number
Richard L. Goodick
TITLE: Vice President
DATE: May 15, 2020
roads. bridges. airports.
CERTIFICATE OF NON-COLLUSION
The undersigned certifies under penaities of perjury that this bid or propasal has been made and
submitted in good faith and without coilusion or fraud with any other person. As used in this
certification, the word “person” shall mean any natural person, business, partnership, corporation,
union, committee, club, or other organization, entity, or group of individuals.
Rickard L. Goodick
THTLE: Vice President
DATE: May 15, 2020
LE JO RL
WOO*OUTSNPUTATL TELA UeTe ‘ssaippy jlewy
OOvE-8Z4-182 “su0Ud
Ozoz ‘ST eK ra1eq
JUapTSerg BOTA ‘YOTEPCoD “qT paeuoTy
LEENA raunqyeusis pazouyny
eee
Y8I¢cO WH faeaqupTeIg ‘Jeeaa¢ eqtTuReag ¢zg ssalppy
SupPUT e/q/p "oUuT *SurqeooTeeg 407923] U07}
FOV TARLVNSIS
SAN IVA 40 ATAAAHDS
OCLOPO-S9ZOEAI
WVdDOUd NOILVAYASMUd LNAAGA Vd 0207
$ua9
0197
SOYOM NI did 1WLOL
