Finance Committee

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Spring 2017 Landfill Gas System Expansion
IFB0593-113016

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

[]Yes [X]No

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?

[_]Yes [X]No

If yes, describe circumstances and provide details on attachment.

Spring 2017 Landfill Gas System Expansion
IFB0593-113016

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.

AIC 0000194202

In Testimony Whereof, the Company has caused this instrument to be signed and its corporate seal to be affixed by their authorized

officers, this 16" day of August, 2016.

Attested and Certified Arch Insurance Company

1 bool Abel Dad Fi lelt—

Patrick K. Nails, Secretary David M. Finkelstein, Executive Vice President

STATE OF PENNSYLVANIA SS
COUNTY OF PHILADELPHIA SS

AIC 0000194202

THIS POWER OF ATTORNEY IS NOT VALID UNLESS IT IS PRINTED ON BLUE BACKGROUND.

This Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in the
manner and to the extent herein stated. Not valid for Mortgage, Note, Loan, Letter of Credit, Bank Deposit, Currency Rate,
interest Rate or Residential Value Guarantees.

POWER OF ATTORNEY

KnowzAll Persons By These Presents:

Bidder and Surety, jointly and severally, bind
themselves, their heirs, executors, administrators,
successors, and assigns to pay to OWNER upon
default of Bidder the penal sum set forth on the face
of this Bond.

BID BOND
PENAL SUM FORM

BIDDER (Name and Address):
Charter Contracting Company LLC
500 Harrison Avenue, Suite 4R
Boston, MA 02118-2439

SURETY (Name and Address of Principal Place of Business):
Arch Insurance Company

3 Parkway, Ste. 1500
Philadelphia, PA 19102

OWNER (Name and Address):
City of Nashua
840 West Hollis Street
Nashua, NH 03062

BID

BID DUE DATE:_ 11/30/2016

PROJECT (Brief Description Including Location):
Spring 2017 Landfill Gas Collection and Control System Expansion

LIST OF SUBCONTRACTORS
(to be submitted after bid opening)

LIST OF SUBCONTRACTORS
(to be submitted with bid)

The name and address of each subcontractor who will be paid at least five percent (5%) of the prime
contractor's total bid shall be listed below. To be deemed a responsive bid, this form must be submitted
even if no subcontractors are required to be listed. In that case, the bidder should state “None” (or similar
language stating that no subcontractors need to be listed) in the space below. (Refer to General Condition
6.09.H)

Name Address of Subcontractor Portion of Work

None.

By:
(Signature of joint ventured partner -- attach evidence of authority to sign)

Name (typed or printed):

Title:

Business Address:

Phone No.: Fax No.:

Address for receipt of official communications:

(Each joint ventured must sign. The manner of signing for each individual, partnership and
corporation that is a party to the joint venture should be in the manner indicated above).

6 of 8
Bid Form

A Corporation

Corporation Name: (SEAL)

Date and State of Incorporation:

List of Executive Officers

Name Title

Type (General Business, Professional, Service, Limited Liability):
By:

(Signature -- attach evidence of authority to sign)

Name (typed or printed):

Title: (Corporate Seal)
Attest:

(Signature of Corporate Secretary)

Business Address:

Phone No.: Fax No.:

Date of Qualification to do business is

A Joint Venture

Bid Form

Joint Venture Name: (SEAL)