IN WITNESS WHEREOF, this instrument is executed
in
which shall be deemed an original,
this
ATTEST:
By:
counterparts, each one of
(number)
day of , 20
(Principal) Secretary
(SEAL)
By:
Witness as to Principal
(Address)
ATTEST:
By
Witness as to Surety
(Address)
Principal
BY
(Address)
(Surety)
BY
Attorney - in - Fact
(Address)
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.
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)
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
