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HomeMy WebLinkAboutRC-2 & MC-2 Asphalt Road Materials 6• AGREEMENT made this 8th day of May 1990, between PAUL CORAZZINI & SONS INC. with its principal office and place of business at 33 Madison Street, Greenport, New York 11944 , hereinafter called the Contractor, and the TOWN OF SOUTHOLD, a municipal corporation of the State of New York with offices at 53095 Main Road, Southold, Suffolk County, New York, hereinafter called the Town. WITNESSETH, that the Contractor has agreed to provide all necessary labor, materials, equipment and incidentals required to furnish and apply 150,000 gallons, more or less as may be needed, of Grades RC-2 and MC-2 Asphalt Road Materials for the Town of Southold for $ 1 .28 per gallon. This contract shall be for a period of one (1) year from the 3rd day of June 1990. IN WITNESS WHEREOF, the parties hereto have set their hands and seals the day and year first above written. TOWN OF SOUTHO By Scott Loui Harris, p rvisor CONT TOR By Pau Corazzini, PrAodent STATE OF NEW YORK) ss: COUNTY OF SUFFOLK) On the c,? :w day of G�� ,1990, before me personally came Paul Corazzini to me know, who being by me duly sworn, did depose and say that he resides at 33 Madison Street, Greenport, N.Y. 11944 , and that he is the President of Paul Corazzini & Sons Inc. , the corporation described in and which executed the foregoing instrument; that he knows the seal of said corporation; that the seal affixed to said instrument is such corporate seal; that it was so affixed by order of the Board of Directors of said corporation, and that he signed his name thereto by like order. N jF I i c "°tary No 52-0344 II--State eJN.w NMII Queltfied in Suffolk Cenunl IM Expire:Mel►st,f L STATE OF NEW YORK) ss: COUNTY OF SUFFOLK) On the 8th of May 1990, before me personally came Scott Louis Harris to me known, who, being by me duly sworn, did depose and say that he resides at 37800 Main Road, Orient, New York; that he is the Supervisor of the TOWN OF SOUTHOLD, the corporation described in and which executed the foregoing instrument; that he knows the seal of said corporation; that the seal affixed to said instrument is such corporate seal; that it was so affixed by order of the Town Board of said corporation, and that he signed his name thereto by like order. Notary Public JUDITH T.TERRY Yak No'52-003448�� Qualified in Suffolk County Commission Expires May 31,194 DATE BOND EXECUTED (Must be same or JUNE 1167 EDITION STANDARD FORM ZS p�� later than date of contract) i r*/ V GENERAL SERVICES ADMINISTRATION FED. PROC. REG. (4) CFR( 1-16.801 (Mart I' L7101M 40 reverse): F PRINCIPAL (Legal name and business address) ? TYPE Of ORGANIZATION ("X"one) 411 I INDIV ❑JOINTDUAI. ❑ PARTNERSHIP ❑ VENTURE CORPORATION 4�7STATE Of INCORPORATION SURETY(IES) (Name($) and business address(es)) _ PENAL SUM Of BOND MILLION(S) THOUSAND(S) HUNDREDS) CENT(S) �C/ e CONTRACT DATE CONTRACT NO. ,''�' a,. KNOW ALL MEN BY THESE PRE"N Ikat w*,,the.1?rincipai;and Surety(ies) hereto, are firmly bound to the United States of America (hereinafter'Call w Government) in the above penal sum for the payment of which we bind ourselves, our heirs, executors, administrators, and successors, jointly and severally: Provided, That, where the Sureties are corporations acting as c"uretleg; we, the Sureties, bind ourselves in such sum "jointly and severally" as well as "severally" only for the purpose of allowing a joint action or actions against any or all of us, and for all other purposes each Surety binds itself, jointly, and severally with the Principal, for the payment of such sum only as is set forth opposite the name of such°Surety;"but if no"llmit of liability is indicated, the limit of liability shall be the full amount of the penal sum. THE CONDITION OF THIS OBuGA''1<'IC)k,',lH'BUCH, that-whereas the Principal entered into the contract identified above; 3 ,F NOW, THEREFORE, if the Principal Phallt^ ,r (a) Perform and fulfill all the undertalt`lpgs, covenants,terms, conditions, and agreements of said contract during the original term of said contract and aey eirttnsions thereof that may be granted by the Government,with or without notice to the Surety(ies), and during the h6t aa any guaranty required under the contract, and shall also perform and fulfill all the undertakings, covenants,:_Win �;pgditjons,and agreements of any and all duly authorized modifications of said contract that may hereafter be toads flee'of which modifications to the Surety(ies) being:hereby waived; and (b) If the said contract is subjeet`to thilbWer.'Act, as amended (40 U.S.C. 270a-270e), pay to the Government the full amount of the taxes imposed by the d*erttmefit!'*hkh are collected, deducted, or withheld from wages paid by the Principal in carrying out the cons contract+lvlith"respect to which this bond is furnished; then the above obligation shall be void and of no A. �� � ._l IN WITNESS WHEREOF, the PrinClexecuted this performance bond and have affixed their seals on the date set forth above. PRINCIPAL 2 Signature(s) vrsGG//� Ssrl) (Seai) Goresorale Na me(sI 8 IPQG 2 ! �'ea( Title($) ,` (Typed) y�-C t1�`"7f►' _ t`"'INWIDUAL SURETY(IES) 2. (Seal) Name(s) %" "CORPORATE SURETY(IES) Name 8 STATE OF INC.. LIABILITY LIMIT Address p ` Q t. rk, 2. Signature(%) Corporate Oe Seal 'n Name(s)6 L a !?n w.� 2. Title(s) (Typed) 2s-los 1 1 Y CORPORATE SURETY(IES) (Contiavad)., Name b STATE'- INC. LIABILITY LIMM Address2. - , • - -na"*. d ,;tir' _ �m iu Signature(,) 1 or COJp0J'r/!e ul .Seal ul Nome(s)6 1. Z. - Title(s) (I yped) Name b STATE QP INC LIABILITY LIMIT Address U 1. 2. Signatore(s) Corporate rr Sea/ 'n Nome(s)b L 2 Titles) (typed/ , Nama b STATE LIABILITY LIMIT Address •'r` ` D � w Si gnature(s) t � - ['(IYpOrr/te > t :. Seal Nam.(*)6 1. 2 Title(.) (Typed) d� q* a r Name 8 LIABILITY LIMIT Address L w Signature($) Corporate Seal Name(,)b 1. ' Title(s) - (%'sped) Name 6 STATEttiIF�BVt:, LIABILITY LIMIT Address "y aL > l 2 Signature(s)ud " Corporate .Seal Names)8 .� Titles) Name b VAT ,"' I +s LIABILITY LIMIT Address w Signature(,) Corporate r Seal Na me(s) b 1 Tille(s) (Typed) ` .;., BOND RATE PER THOUSAND TOTAL PREMIUM ► S 4 ,. _.,...,;.....-.�..�..v .. INSTRUCTIONS 1. This form is authorized for use in Connection with '!(Sgtety Sttrety.8, etc.) headed "CORPORA"TE SURE. contractsfor construction work or the furnishing of TY(IES)'", and in the space designated "SURETY(IES)" supplies or services. There shall be no deviation from on the face of this form only the letter identification of this form without approval by the Administrator of the Suiedes shall be inserted. General Services. 2. The full legal name and business address of the (b)=W)ere individual sureties execute the bond, they Principal shall be inserted in the space designated "Prin. shall be-Two or more responsible persons. A completed cipal" on the face of this form. The bond shall be Affidavit of Individual Surety (Standard Form 28), for signed by an authorized person. Where such person is each individual surety, shall accompany the bond. Such signing in a representative capacity (e.g., an attorney-in- sureties may be required to furnish additional substantiat- fact), but is not a member of the firm,partnership,or joint ing information concerning their assets and financial venture, or an officer of the corporation involved,evidence " ' Capabtlitybas,the.Government may require. of his authority must be furnished. '4' " 4. (OioratiOtls"'executing the bond shall affix their 3. (a) Corporations executing the bond as sureties rt eorpor rat seals. Individuals shall execute the bond op- must be among those appearing on the Treasury Depart- posite t4'iirord;"Seal"; and, if executed in. Maine or New ment's list of approved sureties and must be acting within HampshTt,shall also affix an adhesive seal. the limitations set forth therein. Where more than a 771 single corporate surety is involved, their names Lind ad- 5. Tbit,natpe.,gf each person signing this performance dresses (city and State) shall be inserted in the spaces bond should be typed in the space provided. i ILL tWYUMMBMTMlaTlaa 4l7KL:.sM7Q �. A 25-201 DATE BOND EXECUTED (.\tint he .inir r,r : IA JJJERD FORM ON PAYMENT BOND letter than dale of ronlract) 1!i'� 1964 EDITION FEDP/.L SF RVI, (AlADMINISTRATION (Set IJJJ�rIIY/roJlJ oil "ITrseJ �,t��f� FCD. PAL REG. ( CFR) 1-16IO `f y fJ PPI11CIPAL (I rga/ name and business address) '^ TYPE OF ORGANIZATION ('. "' erre) Wlk toRAZZIMl t�So0S i (� Paso �� � INDIVIDUAL l� PARTNERSHIP JOINT "C tufOr •, VENTURE _CORPORATION J ' STATE OF INC RP RATION SURETY(IFS) (Nanif(s) and bn ainrst address(es)) PENAL SUM OF BOND �� $) THOUSAND(S) HUNDRED(S) CENTS �.. oo ______ C- MILLION(s) _I______ CONTRACT DATE CONTRACT NO IVY KNOW ALL Is1EN BY "FHESE PRESENTS, That we, the Principal and Surety(ies) hereto, are firmly hound to the I'nited States of America (hereinafter called the Government) in the above penal sum for the payment of which «e hind ourselves, our heirs, executors, administrators, and successors, jointly and severally: Prorided, "That, where the Sureties are corporations acting as co•sureties;'we, the Sureties, bind ourselves in such sum "jointly and severally as n'ell as "severally" only for the purpose of allowing a joint action or actions against any or all of us, and for all other purposes each Surety binds itself, jointly and severally with the Principal, for the payment of such sum only as is set forth opposite the name of such Surety,but if no limit of liability is indicated, the limit of liability, shall he the full amount of the penal sum. THE (-ONU17'ION OF T141S OBLIGATION IS'SUCH, that whereas the Principal entered into the contract identified abos'e; NOW, THEREFORE, if the Principal shall promptly make payment to all persons supplying labor and macerial in the prosecution of the work provided for in satd`,iontraet, and any and all duly authorized modifications of said contract that may hereafter be made, notice of vrhteb''tnodifttations to the Surety(ies) being hereby waived, then the above obligation shall be void and of no effect. IN WITNESS WHEREOF, the Principal andSurety(ies) have executed this payment bond and have affixed their seals on the date set forth above. s PRINCIPAL — 2. F t7 ''� (seal) /9Vtl �ieR I Ser" A , �, „�?'" Ltie(sl .' (I rpo/) .PIR � 1 IVIDUAL SURETY(IES) 40F 2. 10 a Syn ature(s) ell) tr, --- —— N elsl— 1 2. CORPORATE SURETY(IES) STATE OF INC.7LITY LIMIT Add,,,, y I. 2. t of w"ralt � Sono+�re(s) D __...------- tJo­"� B 1 2, Tillcdsj • CORPORATE . (IES) (Continued) _ Name a STATE Of INC. LIABILITY LIMIT Address 1 r; —— I 2. Corporate Signature(,) r' Seal N Nome(s)3 1. 2. Title(s) s� rw:ar (-t:vped? Nome a STATE OF INC. LIABILITY LIMIT Address V - 1. 2. Corporate oL Seal D Nome(,)a 1. 2, Title(,) (T)ped,) Name a STATE OF INC. LIABILITY LIMIT Address A > , 2. Corporate t5 Signoture(s) Seal Nome(s)a 1. 2. Title(,) (7:vped) Nome a tgy t;� STATE OF'IVC. LIABILITY LIMIT Address , w Corporate Signature(,) Seal_. N Nome(,)a 1. Title(,) _ (7'),ped) Name a ' STATE Of INC. LIABILITY LIMIT Address ' LL r 1 4• Corporate r j Signoture(s) r r x. �� Seal 'n Name(,)a I. '' s ;4 Title(s) (Typed) Name a th1E ;pVCa:,` LLASILITY LIMIT v L Address Corporate ut Signoture(s) ti Seal OC reel; - y 7 N-0 (sI a 1 `€. Q, Title(,) ��; %` • (Tipedl BOND RATE PER$ TOTAL:: d(rz f . ...., PREMIUM ► 'ra�rx INVTt A CTIONS 1. This form is authorized for use in connection_wntlt „;,,.,{$usety A,,Surety B, etc.) headed "CORPORATE SURE orfor construction work or the futntahiit o - TY,�IIiS)", and in the space designated "SURETY(IES)" supplies or services. There shall be no deviation on the face of this form only the letter identification of 01 this form without approval by the Administrator the Sureties shall be inserted. General Services. (b) .Where individual sureties execute the bond, they 2. The full legal name and business address otl”<th Principal shall be inserted in the space designated`"Prin, shall be two or more responsible persons. A completed cipal" on the face of this form. The bond shall bur°' Affidavit of Individual Surety (Standard Form 28), for each individual surety, shall accompany the bond. Such signed by an authorized person. Where such person n, „ sureties may be required to furnish additional substantiat- signing in a representative capacity (e.g., an attorney-i ins information concerning their assets and financial fact), but is not a member of the firm, partnership.or�otnt t capdbiU as.the,Government may require. venture, or an officer of the corporation involved,eviden - of his authority must be furnished. '4 `-Corporations executing the bond shall affix their 3. (a) Corporations executing the bond at auittrtfeB� corporate seals. `Individuals shall execute the bond op- must be among those appearing on the Treasury Depart posim the word"Seal"; and, if executed in Maine or New merit's list of approved sureties and must be actingrovithitt' z, Hampshire, shall also affix an adhesive seal. the limitations set forth therein. Where more than single corporate surety is involved, their names andsd�, ;,, 5. .The_ name of each person signing this performance dresses (city and State) shall be inserted in the spaces bond should be typed in the space provided. o U.3.GawgaMarr6YL r ee STANDARD FORM se AF�IGAV�� JUNE 1906 EDITION OF INDIVIDUAL SURETY GENRAL VI IS rE D.EPROCf RE 0e 141 CFR) RATION1 . :.( fnsbvdfons on Reverse) STATE OF COUNTY OF r �� I,the undersigned, being duly sworn, depose and may that I am one of the sureties to the attached bond;that 1 am a citizen of the United States (or a permanent resident of the place when the contract and bond are executed as provided in paragraph 3 of the Instructions on reverse),and Of full age and legally competprt;that 1 am no a partner in any business of the principal on the bored or bonds on which I appear as surety; that the information herein below furnished is true and complete to the bed of my knowledge. This affidavit is made to Induce the United States of America to accept me as surety on the attached bend. 1. NAME (First,griddle,tart) (Type or Print) Z. HOME ADDRESS (Number, Street, City,Stair, ZIP Code) 3. TYPE AND DURATION OF OCCUPATION 4. NAME OF EMPLOYER(If self-employed, so state) - — S. BUSINESS ADDRESS(Number,Street, City,SAW*,ZIP toe) 6. TELEPHONE NO, HOME— BUSINESS- 7. l t,! BUSINESS- 7. THE FOLLOWING IS A TRUE REPRESENTATION OF MY PRESENT ASSETS,LIABILITIES, AND NET WORTH AND DOES NOT INCLUDE ANY FINANCIAL INTEREST I HAVE IN THE ASSETS`"Of-THE PRINCIPAL ON THE ATTACHED BOND, a. Fair value of solely owned real testate" b. All mortgages or other encumbrances on the real estate included in linea c. Real estate equity (subtract line b from Line a) d. Fair value of all solely owned property other than real estate' e. Total of the amounts on lines c and df __ f. All other liabilities owing or Int:utiliad not included,in line b g. Net worth (subtract Line f from Line'e) $ ��- *Do not include property exempt five e>rMcsttioa and salt for any reason. Surety's interest in community property may be included if not so exempt. B. LOCATION AND DESCRIPTION OF REAL ESTATE Of WNW!AM SOLE OWNER,, AMIE OF WHICH IS INCLUDED IN LME(a),ITEM 7 ABOVE 674C S7— /Tv. k.4 C S T S 74 Amount of asseised valootim ofaiwIr reel toast fw h wtian prr)wts: 9. DESCRIPTION Of PROPERTY INCLUDED IN LINE(A},ITEM y ABOVE(lid the twist of each tategoy of property separately) 10. ALL OTHER BONDS ON WHICH I AM SURETY(Siak sharrrae►and a,.,t of each bond,if rove,so mate) —- — 11• ATURE 14, BOND AND CONTRACT TO WHICH THIS AFFIDAVIT RELAVES - (Where appropriate) t 11 L ` SUBSCRIBED AND SWORN TO BEFORE ME AS FOLLOWS: DATE OATH ADMINISTERED CRY STATE(Or other jurisdic/ior) MONTH DAY' YEAR T— /t" dal l NAME AND TITLE OF OFFICIAL ADMINISTERING OATH TUBE MY COMMISSION (Type or print) r EXPIRES 28-103 77NANCY T. FUSCO NOTARY PUBLIC, State of New York - 493247'3 Qualified In Suffoik uaunty Commission Expires Jan. 20, 19G l CERTIFICATE.OF SUFFICIENCY I Hereby Certify, That the surety ng,'. ttereltt �a"r'personally known to me; that, in my judgment, said surety is responsible, and qualified to act as such; and that, fo',the best of my knowledge, the facts stated by said surety in the foregoing affidavit are true. y,«n'.tars u,tagcg:h« ,. NAME (Typeu"ritlen) NANCY T. FUSCO OFFICIAL TITLE �,; t ASSISTANT BRANCH OFFICER, &-;TRUST CO. ADDRESS(Number,Strtet,City,Stale,ZIP Code) .i: 230 MAIN STREET, GREENPORT, 144 tM4 INSTRUCTIONS 1. This form shall be used whenever sureties,on' nent resident of the place of execution of the contract bonds to be executed in connection with Government and bond. contracts are individual sureties, as provided in gov. erning regulations (see 41 CFR 1-10.203, 1--16.801,`' 4:NThe•individual surety shall show net worth in a 101-45.3). There shall be no deviation from this fbmt` sum not less than the penalty of tine bond by supply- except as so authorized (see 41 CFR 11-11.009,", Ing the information required on the face hereof, 101-1.1 10). under oath before a United States commissioner, a clerk of a United States Court, or notary public, or 2. A corporation, partnership, or other.bus►ntss some other officer having authority to administer oaths association or firm, as such, will not be accepted !#tf Y`generally. If the officer has an official seal, it shall surety, nor will a partner be accepted as a surety dot - be affixed,`otherwise the proper certificate as to his co-partners or for a firm of which he is a'Me t. official character shall be furnished. Stockholders of a corporate principal may beciccco fed as sureties provided their qualifications assuc 1; & The certificate of sufficiency shall be signed by independent of their stockholdings therein `In a an officer of a bank or trust company, a judge or ing at the net worth figure in Item 7 on the;<faet�e}f�$ clerk of'* court of record, a United Stores district at this affidavit an individual surety will not inclyde gnX -.�=forneyVr-e►Coiiitnissioner, a postmaster, a collector or financial interest he may have in the oss,64. deputy collector of internal revenue, or any other of- principal on the bond which this affidavit support ,',64cer of the United States acceptable to the depart t moment or establishment concerned. Further certificates h p4 +0 s'showing additional assets, or a new surety, may be 3. An individual surety shall be a cititel United States, except that if the contract and required to assure protection of the Government's are executed in any foreign country, the Corn tfbn� interest. Such certificates must be based on the wealth of Puerto Rico, the Virgin Islands, tha`C# ul tk_ personal in of the certifying officer at the Zone, Guam, or any other territory or possess►on"Of time of the making thereof, and not upon prior the United States, such surety need only be a pertna- `certifications. e : '(Bac04f SF 28 June 66) - +sro i tft�or—as-L�s Ilo-61 a Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 I FAX(516)765-1823 JUDITH T.TERRY TELEPHONE(516)765-1801 TOWN CLERK REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD May 14, 1990 Paul Corazzini, President Paul Corazzini 6 Sons Inc. P. O. Box 36 Greenport, New York 11944 Dear Paul: The Southold Town Board, at their regular meeting held on May 8, 1990, accepted your bid in the amount of $1 .28 •per gallon for delivering and applying 150,000 gallons, more or less as may be needed, of Grades RC-2 and MC-2 Asphalt Road Materials. In accordance with the Specifications, upon receipt of the Labor and Material Payment Bond and Performance Bond for the faithful performance of the contract, each in the amount of $192,000.00, and the execution of the contract agreement, your $3,840.00 bid deposit check will be returned to you. Very truly yours, Judith T. Terry Southold Town Clerk cc: Supt. of Hwys. Jacobs �oc��FFOII��OGy o Town Hall, 53095 Main Road P.O. Box 1 179 Southold, New York 11971 JUDITH T.TERRY 1 FAX(516)765-1823 TOWN CLERK TELEPHONE(516) 765-1801 REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION WAS ADOPTED BY THE SOUTHOLD TOWN BOARD AT A REGULAR MEETING HELD ON MAY 8, 1990: RESOLVED that the Town Board of the Town of Southold hereby accepts the bid of Paul Corazzini 8 Sons Inc. , in the amount of $1 .28 per gallon, for furnishing and applying 150,000 gallons, more or less as may be needed, of Grades RC-2 and MC-2 Asphalt Road Materials, delivered to the Town of Southold and applied, all in accordance with the bid specifications; and be it further RESOLVED that Supervisor Scott L. Harris be and he hereby is authorized and directed to execute a contract between Paul Corazzini 8 Sons Inc. and the Town of Southold to provide all the necessary labor, materials, equipment and incidentals required to furnish and apply 150,000 gallons, more or less as may be needed, of Grades RC-2 and MC-2 Asphalt Road Materials for the Town of Southold for $1 .28 per gallon, for a period of one (1) year from the 3rd day of June, 1990. Judith T. Terry Southold Town Clerk May 10, 1990 BID FORM FOR ASPHALT ROAD MATERIALS FOR DELIVERY TO THE TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK TEM NO. 1 TO THE TOWN BOARD TOWN OF SOUTHOLD SOUTHOLD, NEW YORK 1. The undersigned hereby proposes to furnish and apply 150,000 gallons, more or less as may be needed, of Grades RC-2 and MC-2 Asphalt Road Materials to the Town of Southold, Suffolk County, New York, all in accordance with the Specifications of the Superintendent of Highways of said Town dated April 10, 1990. A. Delivered to the Town of Southold and applied per gallon. 2. The undersigned further states that the location, type and capacity of the storage facilities in the Town of Southold are as follows: A. Type of Storage Facilities dP a-f&j B. Location of Storage Facilities R®izie- C. Capacity of Storage Facilities 60 ,9,90 3. The undersigned further states that the type, capacity and number of heated 1tank trucks and transports that he will utilize are as follows: l- —n-�� 4. In submitting this bid the undersigned declares that he is or they are the only person or persons interested in the said bid and that it is made without any connection with any person making another bid for the same contract. The under- signed further declares that he has or they have carefully examined the specifications and this form of bid and has or have satisfied himself or themselves as to all the terms and conditions and understand that in signing this proposal he or they waive all right to pead any misunderstanding regarding the same. S. Accompanying this proposal is cash, a bank check or certified check in the amount of $ ? $r yO,P0' In case this proposal shall be accepted by the Town of Southold, and the undersigned shall fail to execute the contract and in all respects comply with the specifications and this form of bid, the moneys represented by such cash or check shall be regarded as liquidated damages and shall be forfeited and become the property of the Town of Southold; otherwise to be returned to the bidder as provided in' the above said provisions. 6. On acceptance of this bid the undersigned does or do hereby bind himself or themselves to enter into a written contract within ten days of the date of notice of theaward of the bid with the said Town of Southold, and to comply in all respects with the provisions of the specifications in relation to the security for the faithful performance of the terms of said contract. -1- 7. In submitting this bid the undersigned understands that the Town of Southold will only pay for such road materials as actually ordered and used in any calendar year. DATED : 1 1990. Legal name of pmon, firm or corporation B Y: The P. O. Address of the Bidder is: Street V If lL yy City, State, Zip -2- IF A CORPORATION NAME ADDRESS r�_1�c2 �rn� President Secretary42 Treasurer IF A FIRM NAME OF MEMBERS ADDRESS i -3- - F r C r r FROM: EXXON COMPANY, U.S.A. T0: SUPPLY CERTIFICATION PAVING CUTBACKS RC/MC GRADES (INCLUDING RC-250/MC-250) f Exxon Company, U.S.A. manufactures these Asphalt Products in Bayonne, NJ. f f An adequate on demand inventory is maintained in order to supply normal demand for all grades except MC/RC-800 which require 3 day advance notice. Bayonne's operations hours permit adequate access for our customers. Availability of these grades will be maintained during 1987. JT. E. Williams i k r f M k E i A k F BIDDER'S CERTIFICATE FOR ASPHALT CUTBACK This is to certify that the undersigned proposed to furnish Cutback Asphalt which will comply with the requirements for type Grade F The Cutback Asphalt is manufactured by whose plant is located at The plant has a capacity of gallonser 8 hour da ' A y and has regularly manufactured Cut Back Asphalt for the past years. The specific source of the Asphaltic Base is selected Gulf Coast and Venezuelian Crudes. If we receive an award of order or contract on any of the item(s) bid upon we will f begin delivery of Cutback Asphalt within hours of notice to deliver. We agree to furnish Cutback Asphalt at the rate ordered to maximum rate of gallons per 8 hour day. Company BY: Official Title Date: If the bidder is an authorized agent of the manufacturer, the following authorization must be executed by the manufacturer: This is to certify that Name of Bidder Street City & Zone No. State Zip Code is our authorized agent and is capable of making deliveries in compliance with the E NON-COLLUSIVE BIDDING CERTIFICATE BY SUBMISSION OF THIS BID OR PROPOSAL, THE BIDDER CERTIFIES THAT: (a) THIS BID OR PROPOSAL HAS BEEN INDEPENDENTLY ARRIVED AT WITHOUT COLLUSION: (b) THIS BID OR PROPOSAL HAS NOT BEEN KNOWINGLY DISCLOSED, _= PRIOR TO THE OPENING OF BIDS OR PROPOSALS FOR THIS PROJECT, TO ANY F OTHER BIDDER, COMPETITOR OR POTENTIAL COMPETITOR: (c) NO ATTEMPT HAS OR WILL BE MADE TO INDUCE ANY OTHER PERSON, PARTNERSHIP OR CORPORATION TO SUBMIT OR NOT TO SUBMIT A BID OR PROPOSAL: (d) THE PERSON SIGNING THE BID OR PROPOSAL CERTIFIES THAT HE HAS FULLY INFORMED HIMSELF REGARD ING THE ACCURACY OF THE STATEMENTS CONTAINED IN THIS CERTIFICATION AND F z UNDER THE PENALTIES OF PERJURY AFFIRMS THE TRUTH THEREOF, SUCH PENALTIE. BEING APPLICABLE TO THE BIDDER AS WELL AS TO THE PERSON SIGNING IN ITS BEHALF: (e) THAT ATTACHED HERETO (IF A CORPORATE BIDDER) IS A CERTIFIED COPY OF THE RESOLUTION AUTHORIZING THE EXECUTION OF THE CERTIFICATE BY THE SIGNATOR OF THIS BID OR PROPOSAL IN BEHALF OF THE CORPORATE BIDDER. t RESOLVED THAT : J �19y, N e of Officer AUTHORIZED TO SIGN AND SUBMIT THE BID OR PROPOSAL OF THIS CORPORATION FOR THE FOLLOWING PROJECT:` 11 _ 7y171�1t.1 {-,1G 1 S•D)lL'J Fv✓ G �h ,mf- s'gy liDf� Described Project AND TO INCLUDE IN SUCH BID OR PROPOSAL THE CERTIFICATE AS TO NON- COLLUSION REQUIRED BY SECTION 103-d OF THE GENERAL MUNICIPAL LAW AS THE ACT AND DEED OF SUCH CORPORATION AND FOR ANY INACCURACIES OR MISSTATEMENTS IN SUCH CERTIFICATE THIS CORPORATE BIDDER SHALL BE LIABLE UNDER THE PENALTIES OF PERJURY. THE FOREGOING IS A TRUE AND CORRECT COPY OF THE RESOLUTION ADOPTED BY CORPORATION AT A MEETING OF ITS BOARD OF DIRECTORS HELD ON THE _DAY 0F1 19 D Secret I I Ir: j!s BID - ASPHALT ROAD MATERIALS Bid Opening: 11 :00 A.M., Thursday, May 3, 1990. 1. ASCON Dist. Corp., P O Box 629, Bay Shore NY 11706 Attn: Karen 2. I[ 3. 4. 5. f^ 6. c �r f i COUNTY OF SUFFOLK ss: STATE OF NEW YORK LEGAL NOTICE NOTICE TO BIDDERS Patricia Wood, being duly sworn, says that she is the Editor, of THE LONG ISLAND TRAVELER-WATCHMAN, NOTICE IS HEREBY a public newspaper printed at Southold, in Suffolk County; GIVEN in accordance with the and that the notice of which the annexed is a printed copy, provisions of Section 103 of the General Municipal Law, that has been published in said Long Island Traveler-Watchman sealed bids are sought and re once each week for . . . . . . . . . . . . . . . . . . . . . . .l. . . weeks quired for the purchase and ap- plication of 150,000 gallons, more or less as may be needed, successively, commencing on the . . . . . . . . . . .�! . of Grades RC2 and MC-2 As- phalt Road Materials,delivered to the Town of Southold and ap- day o 1._. . . . . . . .�L��. . . ., 19 plied. Specifications for the above may be obtained at the Office of the Town Clerk,Town L/. • • • • • • • • • • • of Southold, Town Hall, Main Road, Southold, New York 11971. The sealed bids,together with -17' allon-Collusive Bid Certificate, Sworn to before me this . . . . . . . . . . . .. . . . . . . . . day of bank draft or certified check in the amount equal to 2% of the amount of the bid, Bid Form, )9 and Bidder's Certificate will be l received by the Town Clerk of the Town of Southold, at the Southold Town Hall, Main Road,Southold,New York,un- til 11:00 A.M.,Thursday,May 3, . . . . . . . . . . . . . . . .�-�" . . . . r=.':'. . . . . . . . . . . . . . . . . . . . . . 1990,at which time they will be Notary Public opened and read aloud in public. The Town Board of the 13,11R,3AnA A. SCHNEIDER Town of Southold reserves the P:JTP,^Y P;.li3Li,. tate of New `fork right to reject any and all bids �,;�. ,;066 46 and waive any and all informali- + _ ''=;.,�j iJfioist CC my ty in any bid should it be deem- ed in the best interest of the Town of Southold to do so. All bids must be signed and sealed in envelopes plainly marked: "Bid on Asphalt Road Materials,"and submitted to the Office of the Town Clerk. The bid price shall not include any tax,federal,state or local,from which the Town of Southold is exempt. DATED: April 10, 1990. JUDITH T. TERRY SOUTHOLD TOWN CLERK 1X-4/19/90(12) LEGAL NOTICE NOTICE TO BIDDERS STATE OF NEW YORK) NOTICE IS HEREBY GIVEN in )SS: accordance with the provisions of Section 103 of the General Munici- COUNTY OF SUFFOLK) Pal Law,that sealed bids are sought and required for the purchase and ''--"-- aPPlication of 150,000 gallons,more of Mattituck, In or less as may be needed,of Grades RC-2 and MC-2 Asphalt Road said Co , being duly sworn, s at he/she is Principal Materials,delivered to the Town of Southold and applied.Specifications Clerk THE SUFFOLK TIMES, a Weekly Newspaper, for the above may be obtained at the published at Mattituck, in the Town of Southold, County of Office of the Town Clerk,Town of Suffolk and State of New York, and that the Notice of which Southold, Town Hall, Main Road, 11 Southold,New York 971. the annexed is a printed copy,has been regularly published in The sealed bids, together with a said Newspaper once each week for / weeks successively, commencing cion the � _ day of Non-Collusive Bid Certificate,bank \ 191 r draft or certified check in the amount equal to 2%of the amount /7 _____�--------- of the bid,Bid Form,and Bidder's Certificate will be received by the Town Clerk of the Town of // r (.- Southold, at the Southold Town Hall, Main Road,Southold, New i Principal Clerk York,until 11:00 A.M., Thursday, May 3,1990,at which time they will be'opened and read aloud in public. The Town Board of the Town of Southold reserves the right to rejectSWOrr1 t0 or me this any and all bids and waive any and n 7� all formality in any bid should it day of "^rk 19 be deemed in the best interest of the Town of Southold toso. All bids must be signed and // sealed in envelopes plainly marked /-/f/;;�-- "Bid on Asphalt Road Materials", and submitted to the Office of the Town Clerk. The bid price shall not include any tax,federal state or lo- cal, from which the Town of Southold is exempt. DATED:April 10,1990. JUDITH T.TERRy SOUTHOLD TOWN CLERK f -�L-1TA19 a STATE OF NEW YORK) SS. COUNTY OF SUFFOLK) JUDITH T. TERRY, Town Clerk of the Town of Southold, New York, being duly sworn, says that on the 13th day of April ,1990 she affixed a notice of which the annexed printed notice is a true copy, in a proper and substantial manner, in a most public place in the Town of Southold, Suffolk County, New York, to wit: Town Clerk's Bulletin Board, Southold Town Hall, Main Road, Southold, New York 11971. Legal Notice, Notice to Bidders: Grades RC-2 and MC-2 Asphalt Road Materials. Bid opening: 11 :00 A.M. , Thursday, May 3, 1990, Southold Town Hall. Judith T. Terry Southold Town Clerk Sworn to before me this 1 th day of Al2ril 1990 . Notary Public No artryy Public,S&te of Now York No•52-8125850,Suffolk Cou ntv Term Expires October 31, 19 , I LEGAL NOTICE i i NOTICE TO BIDDERS NOTICE IS HEREBY GIVEN in accordance with the provisions of Section I 103 of the General Municipal Law, that sealed bids are sought and required for the purchase and application of 150,000 gallons, more or less as may be needed, of Grades RC-2 and MC-2 Asphalt Road Materials, delivered to the Town of Southold and applied. Specifications for the above may be obtained at the Office of the Town Clerk, Town of Southold, Town Hall, Main Road, Southold, New York 11971 . The sealed bids, together with a Non-Collusive Bid Certificate, bank draft or certified check in the amount equal to 2% of the amount of the bid, Bid Form, and Bidder's Certificate will be received by the Town Clerk of the Town of Southold, at the Southold Town Hall, Main Road, Southold, New York, until 11 :00 A.M. , Thursday, May 3, 1990, at which time they will be opened and read aloud in public. The Town Board of the Town of Southold reserves the right to reject any and all bids and waive any and all informality in any bid should it be deemed in the best interest of the Town of Southold to do so. All bids must be signed and sealed in envelopes plainly marked "Bid on Asphalt Road Materials", and submitted to the Office of the Town Clerk. The bid price shall not include any tax, federal, state or local, from which the Town of Southold is exempt. DATED: April 10, 1990. JUDITH T. TERRY SOUTHOLD TOWN CLERK PLEASE PUBLISH ONCE, APRIL 19, 1990, AND FORWARD ONE (1) AFFIDAVIT OF PUBLICATION TO JUDITH T. TERRY, TOWN CLERK, TOWN HALL, MAIN ROAD, SOUTHOLD, NEW YORK 11971 . Copies to the following: The Long Island Traveler-Watchman The Suffolk Times Town Board Members Superintendent of Highways Jacobs Dodge Reports Town Clerk's Bulletin Board LEGAL NOTICE NOTICE TO BIDDERS NOTICE IS HEREBY GIVEN in accordance with the provisions of Section 103 of the General Municipal Law, that sealed bids are sought and required for the purchase and application of 150,000 gallons, more or less as may be needed, of Grades RD-2 and MC-2 Asphalt Road Materials, delivered to the Town of Southold and applied. Specifications for the above may be obtained at the Office of the Town Clerk, Town of Southold, Town Hall, Main Road, Southold, New York 11971 . The sealed bids, together with a Non-Collusive Bid Certificate, bank draft or certified check in the amount equal to 2% of the amount of the bid, Bid Form, and Bidder's Certificate will be received by the Town Clerk of the Town of Southold, at the Southold Town Hall, Main Road, Southold, New York, until 11 :00 A.M. , Thursday, May 3, 1990, at which time they will be opened and read aloud in public. The Town Board of the Town of Southold reserves the right to reject any and all bids and waive any and all informality in any bid should it be deemed in the best interest of the Town of Southold to do so. All bids must be signed and sealed in envelopes plainly marked "Bid on Asphalt Road Materials", and submitted to the Office of the Town Clerk. The bid price shall not include any tax, federal, state or local, from which the Town of Southold is exempt. DATED: April 10, 1990. JUDITH T. TERRY SOUTHOLD TOWN CLERK PLEASE PUBLISH ONCE, APRIL 19, 1990, AND FORWARD ONE (1) AFFIDAVIT OF AINB ROAD! SOU ON TO HOLDiTNEW. YORK 11971 .WN CLERK, TOWN HALL, Copies to the following: The Long Island Traveler-Watchman The Suffolk Times Town Board Members Superintendent of Highways Jacobs Dodge Reports Town Clerk's Bulletin Board LEGAL NOTICE NOTICE TO BIDDERS NOTICE IS HEREBY GIVEN in accordance with the provisions of Section 103 of the General Municipal Law, that sealed bids are sought and required for the purchase and application of 150,000 gallons, more or less as may be needed, of Grades RD-2 and MC-2 Asphalt Road Materials, delivered to the Town of Southold and applied. Specifications for the above may be obtained at the Office of the Town Clerk, Town of Southold, Town Hall, Main Road, Southold, New York 11971 . The sealed bids, together with a Non-Collusive Bid Certificate, bank draft or certified check in the amount equal to 2% of the amount of the bid, Bid Form, and Bidder's Certificate will be received by the Town Clerk of the Town of Southold, at the Southold Town Hall, Main Road, Southold, New York, until 11 :00 A.M. , Thursday, May 3, 1990, at which time they will be opened and read aloud in public. The Town Board of the Town of Southold reserves the right to reject any and all bids and waive any and all informality in any bid should it be deemed in the best interest of the Town of Southold to do so. All bids must be signed and sealed in envelopes plainly marked "laid on Asphalt Road Materials", and submitted to the Office of the Town Clerk. The bid price shall not include any tax, federal, state or local, from which the Town of Southold is exempt. DATED: April 10, 1990. JUDITH T. TERRY SOUTHOLD TOWN CLERK PLEASE PUBLISH ONCE, APRIL 19, 1990, AND FORWARD ONE (1) AFFIDAVIT OF PUBLICATION SOUTOHOLD!TNEW. YORK 11971 .WN CLERK, TOWN HALL, MAIN ROAD, Copies to the following: The Long Islr,nd Traveler-Watchman The Suffolk Times Town Board Members Superintendent of Highways Jacobs Dodge Reports Town Clerk's Bulletin Board �oc��FFOlKcoGy o Z Town Hall, 53095 Main Road v'0 Off- P.O. Box 1179 Southold, New York 11971 JUDITH T.TERRY 1 FAX(516)765-1823 TOWN CLERK TELEPHONE(516)765-1801 REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION WAS ADOPTED BY THE SOUTHOLD TOWN BOARD AT A REGULAR MEETING HELD ON APRIL 10, 1990: RESOLVED that the Town Board of the Town of Southold hereby authorizes and directs the Town Clerk to advertise for bids for the purchase and application of 150,000 gallons, more or less as may be needed, of Grades RC-2 and MC-2 Asphalt Road Materials, delivered to the Town and applied. �Judit . erT ry Southold Town Cler April 12, 1990 RECEIVED Highway Department Town of Southold APR 9 1990 Peconic Lane Peconic, N.Y. 11958 RAYMOND L.JACOBSSOU1hold T,,•,^ i"l.rk Tel.765-3140 Superintendent 734-5211 RESOLUTION BY : SECONDED BY : RESOLVED : That the Town Board of the Town of Southold hereby authorizes the Town Clerk to advertise for bids for the Superintendent of Highways for the purchase and application of 150 , 000 gallons , more or less as may needed , of Grades RC-2 and MC-2 Asphalt Road Materials , delivered to the Town of Southold and applied . VOTE OF THE TOWN BOARD Supervisor Scott L . Harris (Yes) (No) Justice Raymond W . Edwards (Yes) (No) Councilman George L . Penny IV (Yes) (No) Councilwoman Ruth D . Oliva (Yes) (No) Councilwoman Ellen M . Larsen (Yes) (No) Councilman Thomas H . Wickham (Yes) (No) Town Clerk , Town of Southold Dated : April 10 , 1990 0 0 AGREEMENT made this day of 1990, between with its principal office and place of business at hereinafter called the Contractor, and the TOWN OF SOUTHOLD, a municipal corporation of the State of New York with offices at 53095 Main Road, Southold, Suffolk County, New York, hereinafter called the Town. WITNESSETH, that the Contractor has agreed to provide all necessary labor, materials, equipment and incidentals required to furnish and apply 150,000 gallons, more or less as may be needed, of Grades RC-2 and MC-2 Asphalt Road Materials for the Town of Southold for $ per gallon. This contract shall be for a period of one (1) year from the day of 1990. IN WITNESS WHEREOF, the parties hereto have set their hands and seals the day and year first above written. TOWN OF SOUTHOLD By Scott Louis Harris CONTRACTOR By STATE OF ) ss: COUNTY OF ) On the day of ,1990 , before me personally came to me know, who being by me duly sworn, did depose and say that he resides at , and that he is the of the corporation described in and which executed the foregoing instrument; that he knows the seal of said corporation; that the seal affixed to said instrument is such corporate seal; that it was so affixed by order of the Board of Directors of said corporation, and that he signed his name thereto by like order. Notary Public STATE OF NEW YORK) ss: COUNTY OF SUFFOLK) On the of 1990, before me personally came Scott Louis Harris to me known, who, being by me duly sworn, did depose and say that he resides at 37800 Main Road, Orient, New York; that he is the Supervisor of the TOWN OF SOUTHOLD, the corporation described in and which executed the foregoing instrument; that he knows the seal of said corporation-; that the seal affixed to said instrument is such corporate seal; that it was so affixed by order of the Town Board of said corporation, and that he signed his name thereto by like order. Notary Public SPECIFICATIONS FOR THE PURCHASE AND APPLICATION OF ASPHALT ROAD MATERIALS TOWN OF SOUTHOLD, SUFFOLK COUNTY, NEW YORK Under the specifications, bids are sought for the purchase and application of Asphalt Road Material for use by the Southold Town Highway Department in the repair and maintenance of Town Highways. Each bid must be submitted in a sealed envelope clearly endorsed with the name of the person, firm or corporation presenting it. Each bid must be marked "Bid on Asphalt Road Materials." Bid forms and Bidders Certificate may be obtained at the Office of the Town Clerk of the Town of Southold, Town Hall, Main Road, Southold, New York 11971. Bids will be received at the Office of the Town Clerk of the Town of Southold, Town Hall, Main Road, Southold, New York until 11 :00 o'clock A.M. on May 3, 1990, as set forth in the published Notice to Bidders published in The Long Island Traveler-Watchman and The Suffolk Times. Each bid must be accompanied by a bank draft or certified check made payable to the "Town of Southold" in an amount equal to 20 of the amount of the bid. All bid deposit checks except that of the lowest responsible bidder will be returned within five (5) days after signing the contract. The bid check of the lowest responsible bidder will be retained until said bidder has executed and delivered to the Town Clerk the contract, bonds and all other documents required by these specifications. Should the lowest responsible bidder fail to execute the contract and furnish the bond and other documents required, his bid deposit shall be for- feited to the Town of Southold as liquidated damages and shall be deposited by an officer or employee of the Town of Southold to the credit of the proper Town fund, and the Town Board may award the contract to the second lowest bidder or may reject all bids and readvertise for bids; whichever is deemed in the best interest of the Town. In the event all bids are rejected, all bid checks will be returned immediately upon such rejection. The Town Board reserves the right to reject any and all bids. The successful bidder shall furnish and maintain in effect at his expense, during the term of the contract, a bond for the faithful performance of the contract, the amount of which shall be 1000 of the total bid price. The form of the required performance bond, the sufficiency of sureties and the manner of execution shall be approved by the Town Board. ITEM NO. 1 Under this Item No. 1, bids are requested for the purchase of 150, 000 gallons, more or less as may be needed, for the use in repair and maintenance of the town highways, for the calendar year 1990, of Grades RC-2 and MC-2 Asphalt Road Materials, which materials shall comply with the specifications set forth below. The attention of the bidder is specifically called to the fact that the quantity of 150,000 gallons specified herein is an estimate only of the quantity of asphalt material which will be actually required by the Town for its requirements for the 1990 calendar year. The bidder will be paid for only such quantities as are ordered by the Town and delivered and applied by the bidder. Said materials must be delivered and applied in the Town of Southold. Page 2 - Specifications fo the Purchase and Application of Asphalt Road Materials The bidder must have not less than 30,000 gallons of Grade RC-2 material and not less than 30,000 gallons of Grade MC-2 material in heated storage tanks located in the Town of Southold, or delivered to and applied in locations in the Town of Southold designated by the Superintendent of Highways, heated to a temperature of not less than 150 degrees Farenheit, as and when required by the Superintendent of Highways for the calendar year 1990. The bidder must specify the facilities which he will maintain in the Town of Southold for storage of the above materials as well as the location of said storage facilities in the Town of Southold, or the heated tank trucks to be utilized in the performance of the contract. The successful bidder will be required to deliver and apply such asphalt materials in quantities of approximately 8,000 gallons within three (3) hours of notification by the Highway Department. The successful bidder's trucks must be equipped with a wheel calibrated instrument for accuracy of application. Each bid must be accompanied by a "Bidder Certificate" for Asphalt Cut Back, showing the supplier of this material and the location of the plant, and authorizing the Bidder to act as agency for the supplier in the Town of Southold. The Town will only pay for such road materials as actually ordered and used in any calendar year. DATED : April 10, 1990. TOWN OF SOUTHOLD BY: RAYMOND L. J ACOBS SUPERINTENDENT OF HIGHWAYS Page 3 0 0 SPECIFICATIONS FOR RC-2 AND MC-2 ASPHALT MATERIALS GRADE RC-2 MC-2 GR API 17. 3 15. 7 Spec. Gravity @ 770F 0.95 0. 96 Flash Teg CC°F 87. 170 f Vis SS F 140'OF 152 149 Distillation o Rec. @ 3740F 14 @ 4370F 19 @ 500017 21 8 @ 600OF 23 18 @ 680OF 24 23 Distillate % to 680°F @ 3740F 57 @ 4370 78 0 @ 500°F 86 35 @ 600OF 98 78 Residue by diff. % Vol. 76 77 Test on Residue from distial Pen at 770F 96 187 Ductility at 770F 110 f 110 1/0 Sol in CC 14 99. 9 99. 9 Spot Test OLIENSIS Reg. Reg. DATED : April 10, 1990. TOWN OF SOUTHOLD BY : RAYMOND L. JACOBS SUPERINTENDENT OF HIGHWAYS BID FORM FOR ASPHALT ROAD MATERIALS FOR DELIVERY TO THE TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK ITEM NO. 1 TO THE TOWN BOARD TOWN OF SOUTHOLD SOUTHOLD, NEW YORK 1. The undersigned hereby proposes to furnish and apply 150,000 gallons, more or less as may be needed, of Grades RC-2 and MC-2 Asphalt Road Materials to the Town of Southold, Suffolk County, New York, all in accordance with the Specifications of the Superintendent of Highways of said Town dated April 10, 1990; A. Delivered to the Town of Southold and applied per gallon. 2. The undersigned further states that the location, type and capacity of the storage facilities in the Town of Southold are as follows: A. Type of Storage Facilities B. Location of Storage Facilities C. Capacity of Storage Facilities 3. The undersigned further states that the type, capacity and number of heated tank trucks and transports that he will utilize are as follows: 4. In submitting this bid the undersigned declares that he is or they are the only person or persons interested in the said bid and that it is made without any connection with any person making another bid for the same contract. The under- signed further declares that he has or they have carefully examined the specifications and this form of bid and has or have satisfied himself or themselves as to all the terms and conditions and understand that in signing this proposal he or they waive all right to pead any misunderstanding regarding the same. 5. Accompanying this proposal is cash, a bank check or certified check in the amount of $ In case this proposal shall be accepted by the Town of Southold, and the undersigned shall fail to execute the contract and in all respects comply with the specifications and this form of bid, the moneys represented by such cash or check shall be regarded as liquidated damages and shall be forfeited and become the property of the Town of Southold; otherwise to be returned to the bidder as provided in the above said provisions. 6. On acceptance of this bid the undersigned does or do hereby bind himself or themselves to enter into a written contract within ten days of the date of notice of theaward of the bid with the said Town of Southold, and to comply in all respects with the provisions of the specifications in relation to the security for the faithful performance of the terms of said contract. -1- that the Town of understands in South undersigned un ordered and used 7. In submitting this bid the actually Southold will only pay for such road materials as any calendar year. 1990. DATED Lename of person, firm gal or corporation BY : The P. O. Address of the Bidder is Street (city, State, Zip -2- IF A CORPORATION ADDRESS NAME President Secretary Treasurer IF A FIRM NAME OF MEMBERS ADDRESS -3- BIDDER'S CERTIFICATE FOR ASPHALT CUTBACK This is to certify that the undersigned proposed to furnish Cutback Asphalt which will comply with the requirements for type Grade The Cutback Asphalt is manufactured by whose plant is located at The plant has a capacity of gallons per 8 hour day and has regularly manufactured Cut Back Asphalt for the past years. The specific source of the Asphaltic Base is selected Gulf Coast and Venezuelian Crudes. If we receive an award of order or contract on any of the item(s) bid upon we will begin delivery of Cutback Asphalt within hours of notice to deliver. We agree to furnish Cutback Asphalt at the rate ordered to maximum rate of gallons per 8 hour day. Company BY : Official Title Date: If the bidder is an authorized agent of the manufacturer, the following authorization must be executed by the manufacturer: This is to certify that Name of Bidder Street City 8 Zone No. State Zip Code is our authorized agent and is capable of making deliveries in compliance with the above certificate. Name of Manufacturer BY: Official Title Date: • M NON-COLLUSIVE BIDDING CERTIFICATE BY SUBMISSION OF THIS BID OR PROPOSAL, THE BIDDER CERTIFIES THAT: (a) THIS BID OR PROPOSAL HAS BEEN INDEPENDENTLY ARRIVED AT WITHOUT COLLUSION : (b) THIS BID OR PROPOSAL HAS NOT BEEN KNOWINGLY DISCLOSED, PRIOR TO THE OPENING OF BIDS OR PROPOSALS FOR THIS PROJECT, TO ANY OTHER BIDDER, COMPETITOR OR POTENTIAL COMPETITOR : (c) NO ATTEMPT HAS OR WILL BE MADE TO INDUCE ANY OTHER PERSON, PARTNERSHIP OR CORPORATION TO SUBMIT OR NOT TO SUBMIT A BID OR PROPOSAL: (d) THE PERSON SIGNING THE BID OR PROPOSAL CERTIFIES THAT HE HAS FULLY INFORMED HIMSELF REGARD- ING THE ACCURACY OF THE STATEMENTS CONTAINED IN THIS CERTIFICATION AND UNDER THE PENALTIES OF PERJURY AFFIRMS THE TRUTH THEREOF, SUCH PENALTIE BEING APPLICABLE TO THE BIDDER AS WELL AS TO THE PERSON SIGNING IN ITS BEHALF: (e) THAT ATTACHED HERETO (IF A CORPORATE BIDDER) IS A CERTIFIED COPY OF THE RESOLUTION AUTHORIZING THE EXECUTION OF THE CERTIFICATE BY THE SIGNATOR OF THIS BID OR PROPOSAL IN BEHALF OF THE CORPORATE BIDDER. RESOLVED THAT: Name of Officer AUTHORIZED TO SIGN AND SUBMIT THE BID OR PROPOSAL OF THIS CORPORATION FOR THE FOLLOWING PROJECT: Described Project AND TO INCLUDE IN SUCH BID OR PROPOSAL THE CERTIFICATE AS TO NON- COLLUSION REQUIRED BY SECTION 103-d OF THE GENERAL MUNICIPAL LAW AS THE ACT AND DEED OF SUCH CORPORATION AND FOR ANY INACCURACIES OR MISSTATEMENTS IN SUCH CERTIFICATE THIS CORPORATE BIDDER SHALL BE LIABLE UNDER THE PENALTIES OF PERJURY. THE FOREGOING IS A TRUE AND CORRECT COPY OF THE RESOLUTION ADOPTED BY CORPORATION AT A MEETING OF ITS BOARD OF DIRECTORS HELD ON THE DAY OF 19 Secretary