Rolling Oaks MC-CS111116 Liberty Mutual Surety 03953
Office Dallas Contract Bond �
12750 MERIT DRIVE SUITE 710
DALLAS, TX 75251 -9698 Status Query VI', Liberty
G Mutual®
Phone: 972-233 -9588
Fax: 866 -546 -9684
Liberty Mutual Surety
CITY OF COPPELL
255 PARKWAY BOULEVARD Date of Request: 10/3/2011
COPPELL, TX 75019
In order to allow us to monitor the progress of our contractor, please complete and return this form. Your response will not prejudice
your rights or affect our liability under our bond(s) referred to below. We enclose a prepaid return envelope for your use.
Rond N'omber: 6nc01 1799 Contract Price: $2 829 058.00 I nce ti n Date: 9/100009
,� p_A..I)a_
Cross Reference Bond Number: 65410930001
Contract Description: ROLLING OAKS MEMORIAL CENTER CEMETERY DEVELOPMENT2 YR MAINT.
Our Bond On Behalf Of: THE FAIN GROUP INCORPORATED
Bond Executed In The
Following Company: SAFECO INSURANCE COMPANY OF AMERICA
Signed
Tim Mikolajewski
President - Liberty Mutual Surety
1. HAS CONTRACT BEEN COMPLETED? �Q g
2. IF COMPLETED PLEASE STATE:
a. Date of acceptance '1 f k(p t
b. Total amount of completed contract 2 X2, 1 JJ
I l
3. IF NOT COMPLETED PLEASE STATE:
a. Probable completion date
b. Amount paid contractor to date
c. Aiitouiii withheld as retained pe,ccntagc
4. HAS WORK PROGRESSED SATISFACTORILY? d
5. ARE THERE ANY UNSATISFIED CLAIMS OR LIENS ON FILE? KID
REMARKS:
Dated: 1 l 1 1 1.1 \ 11 Signed %;
Name to n-iA -rA C- 1A -R.zA
Title 60 ADs111,z f. it JL
Phone: P-12 )n' . 1 t 9 Fax: 912 ),41 33-10