SS9901-CN041018 S.J. LOUIS CONSTRUCTION OF TEXAS LTD. 7
J20 South 6th Ave., P.O. Box 834 817/477-0320 Office" 817/477-0552 Fax
Mansfield, Texas 76063 Equal Opportunily Employer / Contractor
AFFIDAVIT OF BILLS PAID AND
WAIVER OF ALL CLAIMS
BEFORE ME, the.~,ndersigned authority, on this day personally appeared Les V.
Whitman, party to,that certain Contract entered into in the month of March, 2004,
between the City of Coppell, Texas and S.J. Louis Construction of Texas Ltd. for the
erection, construction, and completion of certain improvements and/or additions upon the
following described premises, to wit:
Deforest Road Lift Station Improvements Force Main Lines A & B
Said party being by me duly sworn states upon oath that the said improvements have
been erected and functionally completed in full compliance with the above referenced
Contract, Project Manuals and Plans.
Deponent further states that he or she has paid all bills for materials furnished and labor
performed or materials furnished upon said job.
Secretary/Treasurer
Subscribed and sworn to before me, the undersigned authority on this the 18th day of
October, 2004. ~0~ (~x~-
Notary Public in and for
Tarrant County, Texas
CONSENT OF SURETY
TO,FINAL PAYMENT
AIA Document G707
(Instructions on reverse si(lc)
Bond No.
190-011-817
OWNER
ARCHITI!CI
CONTRACI'OR
StJREI~
OTtlER
Ii
L~J
El
TO O~NER:
PROJECT:
City of Coppell
255 Parkway Blvd.
P.O. Box 9478
Coppell, TX 75019
Construction of the: DeForest Road
Lift Station Improvements
Force Main Lines A & B
Project No. SS 99-01
Bid No. Q- 1203 -02
ARCIIITECT'S PROJECT NO:
CONTRACT FOR:
Lift Station lmrpvements
CONTRACT I)ATED:
Liberty Mutual Fire Insurance Company
Interchange Corporate Center
450 Plymouth Road, Suite 400
Plymouth Meeting, PA 19462-1644
on bond of
S.J. Louis Construction of Texas, Ltd.
520 South Sixth Avenue
Mansfield, TX 76063
. SI Jl/Ffl¥.
City of Coppell
255 Parkway Blvd.
P.O. Box 9478
Coppell, TX 75019
, OWNFIL
IN WrFNESS WHEREOF, thc Surcl,/has hereunto set its hand on this date October 18, 2004
(Seal):
LIBERTY MUTUAL FIRE INSURANCE COMPANY
Laurent R, Laventure, Attorney-in-Fact
CAUTION: You should sign an original AIA document that has this caution printed in red. An
original assures that changes will not be obscured as may occur when documents are reproduced.
See Instruction Sheet for Limited License for Reproduction of this document.
G707--1994
INSTRUCTION SHEET
A. GENERAL INFORMATION
1, Purpose
2, Related Documents
3. Use of Current Documents
4. Limited License for Reproduction
B. CHANGES FROM THE PREVIOUS EDITION
C. COMPLETING THE G707 FORM
D. EXECUTION OF THE DOCUMENT
12716
THIS POWER OF ATTORNEY iS NOT VALID UNLESS IT IS PRINTED ON RED 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 exten<t herein stated.
LIBERTY MUTUAL FIRE INSURANCE COMPANY
BOSTON, MASSACHUSETTS
POWER OF ATTORNEY
KNOW ALL PERSONS BY THESE PRESENTS: That Liberty Mutual Fire Insurance Company (the "Company"), a Massachusetts stock insurance
company, pursuant to and by authority of the By-law and Authorization hereinafter set forth, does hereby name. conshtute and appoint
CRAIG REMICK, TONY D. BECKER, NATHAN P. HUGHES, STEVEN C. ARONSON JANET D. BUERG,
TERESA HAMMERS, LAURENT R. LAVENTURE, KATHLEEN SORENSON, JOHN D. MOORE, JAMES R. PERKINS,
STANLEY L. PEARSON ALL OF THE CITY OF BLOOMINGTON~ STATE OF MINNESOTA .............................................
, each individually if there be more than one named, its true and awfu attorney-in-fact to make. execute, seal acknow edge and de ver, for and on ts
behalf as surety and as ~ts act and deed, any and all undertakings, DOndS. recognizances and other surety obligations in the penal sum not exceeding
FIFTY MILLION AND 00/100'***** ...... '~******* DOLLARS ($ 5010001000.00***** / each, and the
execution of such undertakings, bonds recognizances and other surety obligations. ~n cursuance of these presents shal be as binding upon the
Company as if they had been duly signed by me president and attested by the secretary of the Company n their own proper persons.
That this power is made and executed oursuant to and by authority of the following By-law and Authorization:
ARTICLE XIII - Execution of Contracts: Section 5. Surety ~onds and Undertakings
Any officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such limitations as the
chairman or the president may prescribe, shall appoint such attorneys-in-fact as may be necessary to act in behalf of the Company to make,
execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such
attorneys-in-fact, subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Company by their
signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be
as binding as if signed by the president and attested by the secretary.
By the following instrument the chairman or the president has authorized the officer or other official named therein to appoint attorneys-in-fact:
Pursuant to Article XIII, Section 5 of the By-Laws, Garnet W. Elliott, Assistant Secretary of Liberty Mutual Fire Insurance Company, is hereby
authorized to appoint such attorneys-in-fact as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and
deliver as surety any and all undertakings, bonds, recognizances and other surety obligations.
That the By-law and the Authorization set forth above are true copies thereof and are now in full fome and effect.
~ WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Company and the corporate seal of
,bert,/Mutual Fire Insurance Company has been affixed thereto in Plymouth Meeting, Pennsylvania this lOfhday of Ma), ,
LIBERTY MUTUAL FIRE INSURANCE COMPANY
Garnet w. Elliott, Assistant Secretary
COMMONWEALTH OF PENNSYLVANIA ss
COUNTY OF MONTGOMERY
On this 10th day of May , 2004 , before me, a Notary Public, personally came Garnet W. EHiott, to me known, and
acknowledged that he is an Assistant Secretary of Liberty Mutual Fire Insurance Company; that he knows the seal of said corporation; and that he
executed the above Power of Attorney and affixed the corporate seal of Liberty Mutual Fire Insurance Company thereto with the authority and at the
direction of said corporation.
IN TESTIMONY wH~F~unto~'~--~ subscribed my name and affixed my notarial seal at Plymouth Meeting, Pennsylvania, on the day and year
first above written l
CERTIFICATE ~
October , 2004
David M. Oarey, ~ssi~t Secre~a~