Board Of Aldermen

DIVISION 2

0779-021022
2022 SEWER REPLACEMENT PROJECT

>» PAYMENT BOND
>» PERFORMANCE BOND

> CERTIFICATE OF LIABILTY INSURANCE

(1)

(2)

(3)

THIS FORM MUST BE SUBMITTED WITH ALL RESPONSES TO THIS IFB

Schedule D- Professional References

CompanyName Penni chuck TASt Lh, 4

ContactNameandTitle: PE H Td der 72 x
Con tact fmarl four Hdd ty Q Pennichuck, CyVv

Contact Phane Number: (y 3) 5 ly = 3090

Company Name: Pen V\ | Chuck WAAC D0

ContactNameand Title Mar Ke Fibipa

ContactEmail: Mark.flien (0 PennicMuce. CONN

Contact Phone Number: { LoD> ) 3 v5 -{0 33 Y

Company Nyne: D uresne Cyiwp

SCHEDULE C-Equipment List

3/3/2021

Name

Erika L. Payne
Keith Patnode
Chris Stromgren
Andy Crowder

Name
Keith Patnode

Chris Stromgren

Andy Crowder

EMPLOYMENT RECORD

Present Position

‘Project Manager / Estimator (all projects)

Superintendent
Superintendent
Superintendent

Specific Projects

Railroad St. infrastructure

2013 Keene Infrastructure

Concord Route 3 Phase 6

Route 3A Water Main Imp.

THIS FORM MUST BE SUBMITTED WITH ALL RESPONSES TO THIS IFB

Schedule C- List of Project Awards from the City of Nashua In the past 5 years

Project Project Oate of Contract City City City Cry
Name Detail Completion | Price Department | Reference Reference Reference
Name Email Phone
Address Number
Ter econ Nn anove | u, [REs Boasoon| 2
Aveo. 119.993 | woes | Kenalm Ee Aathuanh:
Reo ement YA wae gpv

1FBO0779-021022 2022 SEWER REPLACEMENT PROJECT

CQ60f7

S.U.R. Construction West, Inc

SCHEDULE 0, - WORK ON HAND - Current Projects

S.U.R. Construction West, Inc

THIS FORM MUST. BE SUBMITTED WITH ALL RESPONSES TO THIS IFB

16 Furnish the following information with respect to an accredited banking institution familiar with your
organization

Name of Bank Savings Bank of Walpole
84 Marlboro Street, Keene, NH 03431

Address

Jessica Weston; Amy Lehr
603-352-1822

Account Manager

Telephone

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

S.U.R. Construction West, Inc.

LW Mody

10

it

12.

13

14.

15.

THIS FORM MUST BE SUBMITTED WITH ALL RESPONSES TO THIS IF8

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

(_lves [X]No
[_]Yes [_]No

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?

[les x JNo

if yes, describe circumstances and provide details on attachment.

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 proyects under construction by this organization, (If joint venture, list
each participant’s projects separately}