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
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