04/22/1992 Contract CONTRACT
THIS AGREEMENT, made and entered into this as ,1 day of /r�j� Y 1 , 1992,
by and between Monroe County, Florida, party of -' first part
(hereinafter sometimes called the "Owner "), and Environmental Petroleum
& Remediation Services, Inc., party of the second part (hereinafter
sometimes called the "Contractor ").
WITNESSED: That the parties hereto, for the consideration
hereinafter set forth, mutually agree as follows:
1.01 SCOPE OF THE WORK
The Contractor shall furnish all labor, materials, equipment,
machinery, tools, apparatus, transportation and dump fees; and
perform all the work as stated in the Contractor's Proposal dated
March 19, 1992 and shall do everything required by this Contract.
1.02 THE CONTRACT SUM
A. The Owner shall pay to the Contractor for the faithful performance
of the Contract, in lawful money of the United States, as follows:
B. Based upon the price shown in the Proposal dated March 19, 1992
heretofore submitted to the Owner by the Contractor, a copy of said
Proposal being a part of these Contract Documents, the aggregate
amount of this Contract is the lump sum of
Nine Thousand Three Hundred Fifty Dollars ($9350.00)
I. Drilling
a. Installation and development of five shallow monitoring wells
to a depth of 15' minimum. Wells will consist of 2 -inch PVC
riser and 0.01 slot screens, sand - filter packs (silica - quartz),
cement -grout with flush mounted covers and watertight locking
caps.
PRICE: Two Thousand Dollars - $2000.00
($2,000.00)
b. Installation of one deep monitoring well. Well construction
details are similar to shallow wells.
PRICE: Five Hundred and Fifty Dollars - $ 550.00
($550.00)
c. Install six (6) soil borings to the groundwater table
($60.00 /boring).
PRICE: Three Hundred and Sixty Dollars - $ 360.00
($360.00)
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II. Laboratory /Analysis
a. Purge and sample six monitoring wells. Run the following
laboratory analysis for each well:
6 - EPA Method 602 - 140.00 /sample
6 - EPA Method 610 - 150.00 /sample
2 - EPA Method 601 - 150.00 /sample
2 - EPA Method 239.2 (lead - filtered /unfiltered)
- $100.00 /sample
2 - EDB - $ 100 /sample
2 - Quality Assurance Samples analyzed for EPA Methods
602/610 - $290.00 /sample
Field Organic Meter - $ 100.00
Subtotal - $3,120.00
III. Hydrogeologic Investigation
a. Conduct three (3) slug tests to evaluate aquifier
characteristics (transmissibility, storativity, hydraulic
conductivity) ($200.00 /test) - $ 600.00
IV. Site Supervision /Report Preparation
a. Site personnel monitoring well installation, drilling
clearance, well surveying, isopotential measurements.
Estimated 32 hours at $40.00 /hour - $1,280.00
b. Documentation including Contamination Assessment Report,
twenty -four (24) hours at $60.00 /hour - $1,440.00
Site supervision /Report Prep., Subtotal - $2,720.00
TOTAL COST - $9,350.00
1.03 COMMENCEMENT AND COMPLETION OF WORK
A. The Contractor shall commence work within Ten (10) calendar days
after issuance of a Notice to Proceed.
B. The Contractor shall prosecute the work with faithfulness and
diligence and shall complete the work not later than ninety (90)
calendar days after commencement.
1.04 CONTRACTOR'S ACCEPTANCE OF CONDITIONS
A. The Contractor hereby agrees that he has carefully examined the
site and has made investigations to fully satisfy himself that such
site is correct and suitable for this work and he assumes full
responsibility therefore.
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B. It is understood and agreed that the passing, approval, and /or
acceptance of any part of the work or material by the Owner shall
not operate as a waiver by the Owner of strict compliance with the
terms of this Contract, and the Proposal covering said work; and
the Owner may require the Contractor and /or his surety repair,
replace, restore, and /or make to comply strictly and in all things
with the Contract and the Proposal any and all of said work and /or
materials which within a period of one year from and after the date
of the passing, approval, and /or acceptance of any such work or
material, are found to be defective or to fail in any way to comply
with this Contract or with the Proposal. This provision shall not
apply to materials or equipment normally expected to deteriorate or
wear out and become subject to normal repair and replacement before
their condition is discovered. Failure on the part of the
Contractor and /or his Surety to replace defective materials and
workmanship shall entitle the Owner, if it sees fit, to replace or
repair the same and recover the reasonable cost of such replacement
and /or repair from the Contractor and /or his surety, who shall in
any event be jointly and severely liable to the Owner for all
damage, loss, and expense caused to the Owner by reason of the
Contractor's breach of this Contract and /or his failure to comply
strictly and in all things with this Contract and with the
Proposal.
1.05 LIQUIDATED DAMAGES
A. It is mutually agreed that time is of the essence and should the
Contractor fail to complete the work within the specified time, or
any authorized extension thereof, there shall be deducted from the
compensation otherwise to be paid to the Contractor, and the Owner
will retain the amount of Fifty Dollars ($ 50.00) per calendar day
as fixed, agreed, and liquidated damages for each calendar day
elapsing beyond the specified time for completion or any authorized
extension thereof, which sum shall represent the actual damages
which the Owner will have sustained by failure of the Contractor to
complete the work within the specified time; it being further
agreed that said sum is not a penalty, but is the stipulated amount
of damages sustained by the Owner in the event of such default by
the Contractor.
B. For the purposes of this Article, the day of final acceptance of
the work shall be considered a day scheduled for completion.
1.06 INSURANCE
The Contractor shall furnish all insurances as required by Monroe
County Code, Monroe County Public Works Manual, and all State and
Federal Statutes.
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Prior to the execution of this Contract, the Contractor shall
furnish the Owner with Certificates of Insurance indicating current
coverage in the minimum amounts herein stated and name Monroe
County as an additional insured, and shall provide for 45 days
notice in the event of termination, non - renewal, or reduction in
coverage.
Insurer's providing coverage(s) must be financially stable and
authorized to do business in the State of Florida. Certificates of
insurance shall be furnished to Monroe County prior to commencing
work under this contract.
Minimum limitations of required insurances are:
Public Liability $ 500,000.00
Property Damage $ 500,000.00
Worker's Compensation statutory
Commercial General Liability with minimum limits of $1,000,000
per occurrence, with explosion, collapse, and excavation (xcu)
coverage included.
Auto Liability Insurance with minimum limits of $500,000 per
occurrence.
1.07 PERMITS AND LICENSES
A. Before starting work, the Contractor shall obtain and pay for
all required licenses and permits.
1.08 INDEMNIFICATION AND HOLD HARMLESS
The Contractor shall defend, indemnify and hold harmless the
County, its officials, employees and agents, from any and all
claims, liabilities, losses and causes of action which may arise
out of the performance of the Contract except such causes of action
may which may arise because of the County's negligent actions or
omissions. Compliance with the insurance requirements shall not
relieve the Contractor from the obligations imposed by this
article.
1.09 PAYMENT
In accordance with the provisions fully set forth herein, and
subject to additions and deductions as provided, the Owner shall
pay the Contractor as follows:
Lump sum for full contract price upon one hundred percent (100X)
completion and acceptance by the Owner. All written warranties,
manufacturer's data, and operational manuals shall be furnished by
the Contractor to the owner prior to final acceptance and payment.
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1.10 PUBLIC ENTITY CRIMES
A. The Contractor shall complete the attached sworn statement and
shall return it with the executed contract.
1.11 ETHICS CLAUSE
A. The Contractor shall complete the attached sworn statement under
Ordinance No. 010 -1990 and shall return it with the executed
contract.
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IN WITNESS WHEREOF the parties hereto have executed this Agreement
on the day and date first above written in four (4) counterparts,
each of which shall, without proof or accounting for the other
counterparts, be deemed an original Contract*
MONROE COUNTY
Party of the First Part
AP AS TO FORM
, '• By:
By AlwmeesOMm
Date -ZD Z� At test uaAb NY L YOL HAGE, Clerk
Seal)
Signed, Sealed and Witnessed in
the presence of: **
Environmental Petroleum &
Remediation Services, Inc.
Party of the Second Part
BY: ; \,)3,:.Q.:-.>
it l
Att }-� Kelly F Splain
W 'Y STATE OF FLORIDA
Pu�btic MY Comm Exp3/4/95
BONDED
(Seal)
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( *) In the event that the Contractor is a -• .ora on, there shall be
attached to each counterpart a certified copy of a resolution of
the Board of Directors of the Corporation, authorizing the officer
who signs the Contract to do so in its behalf.
( * *) Two witnesses are required when Contractor is sole ownership or
partnership.
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IsABILQEMSINTLIZNAMEAMEBI
• MAYOR Wiheknina Harvey, District 1
0 U NTY o M O N R O E
Mayor Pro Douglas em. Jack London District z
Jones, District 3
KEY WEST R ORtt�l► 33040 `� •��;,� ' A Ch
Earl eal District 4
(ce) 294 -4641 rl Li John Stormont. District 5
Aiti
REOUEST FOR PROPOSAL THIS IS AN INQUIRY -- NOT AN ORDER
• TO: Environmental Petroleum Please quote the best price you offer on
& Ramediation Services, Inc.
6555 N.W. 9th Avenue, Suite #2t✓( the items listed below. Note Delivery Re-
Ft. Lauderdale, Florida 33309
quirements, and state firm Delivery Date.
DATE REPLY DUE BY 1 DELIVERY REQUIRED BY 1 M.C. SALES TAX EXEMPT It
2 -13 -92 3 -19 -92 4:OOPM 190 Days from Notice 1 03- 00021 -03 -54
QTY UNIT DESCRIPTION 1 UNIT PRICE AMOUNT
< AUr-ati.%NK oN Q rA igT (c,%
1 EACH T LONG KEY LANDFILL( ‘ . -. SO .0 C)
1
"SEE ATTACHED SPECIFICATIONS"
1
1
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SPECIAL NOTES: FOR FURTHER INFORMATION PLEASE CONTACT JACK JULIAN AT (305) 664 -9315.
VENDOR: PLEASE COMPLETE THIS INFORMATION
1. Delivery Promised: N/A We offer to furnish you the above commodities
2. F.O.B. Point: KEY WEST, FLORIDA or services at the prices indicated:
3. Terms: NET •
Vendor Name: 4, �,..u‘l«s v.c.-
4 . Date of Proposal:
5. Date quoted prices will expire: itle)
8 110 , 19`13 ,p
ADDRESS REPLY TO:
Monroe County Purchasing ALL BIDS MUST BE SUBMITTED IN A
5100 College Road SEALED ENVELOPE MARKED ON THE OUTSIDE
Cross Wing, Room 0002 "SEALED PROPOSAL TANK CLOSURE, LONG
Key West, Florida 33040 KEY, FLORIDA DUE MARCH 19, 1992 AT
PH: (305)292 -4466, 4464 4:OOPM"
FAX: (305) 292 -4401
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• EN rIkONMENTAL
PETROLEUM&
REMEDIATION = �+
SERVICES Inc. w
ENVIRONMENTAL - ENGINEERING/CONSULTING/CONSTRUCTION
March 10, 1992
Mr. R. M. Cofer
Monroe County Director of Purchasing
5100 College Rd.
Cross Wing, Rm #002
Key West, F1. 33040
RE: Client /Project #922608
Contamination Assessment
Aboveground Tank - Long Key Landfill
Long Key, F1
Dear Mr. Cofer:
As follow -up to the Tank Closure Assessment performed at the site,
Environmental Petroleum & Remediation Services, Inc. (EPRS) part
of the U.S. Environmental Group (USEG) is pleased to provide the
following proposal for the above referenced site. Presented below
is a summary of the work and associated costs that will be required
as part of the Contamination Assessment for the site. Per FDER
requirements, all work will be done per EPRS's State of Florida
Department of Environmental Regulation (FDER) approved Quality
Assurance plan and per FDER 17.770 guidelines. Additionally, EPRS
guarantees all costs will be within the State Inland Trust Fund
Reimbursement guidelines.
Per FDER guidelines a Contamination Assessment (CAR) must be
initiated within 1 month after discovery of a contamination problem
and the assessment must be completed within 6 months. The proposed
assessment, described below, is designed to meet the Florida
Department of Environmental Regulations (FDER) 17 -770 guidelines.
Information has been provided describing the steps that are
required in conducting a cleanup of a petroleum contaminated site
under the FDER rules. These rules (guidelines) must be followed
• in -order for the State to reimburse the costs associated with this
assessment.
For further explanation or additional information, please contact
me at (305) 772 -6091 or 1(800) 741 -7430.
Sincerely,
Kelly S. Winslow, P.E.
Environmental Engineer
B: \25 \2608CAR.PRO
Broward Palm Beach Dada Other Areas
(305) 486 -7418 (407) 820 -8977 (305) 530 - 0085 1- 800 - 834 -7810
Summary of Work
Per FDER requirements, a contamination assessment must be performed
at the site. This assessment must be conducted by a State Licensed
consultant and designed to meet FDER 17 -770 guidelines. Prior to
initiation of the Contamination Assessment, a site specific Quality
Assurance Plan (Tearsheet) will be submitted to FDER. Without
prior approval of this plan, reimbursement of the costs associated
with this investigation will not be made by the State.
Per Chapter 17 -770 guidelines, a Contamination Assessment has
been approved by the FDER if the following requirements are
met:
The horizontal and vertical extent of contamination have
been delineated.
The source of contamination has been identified and
removed.
Summary of Work
The Contamination Assessment will consist of the installation
of up to six (6) monitoring wells. The monitoring wells will
be drilled using a truck mounted drill rig (B -57) driving a
6 1/4 -inch i.d. hollow stem auger. The shallow wells will be
completed at a depth of 15 feet (more or less, depending on
the groundwater level) with 2 inch i.d. casing and 10' of
screen.
The shallow monitoring wells will be utilized to evaluate the
areal extent of groundwater contamination. The new wells will
be located north, south, east and west of the tank farm areas
(see ATTACHMENT 1). Shallow monitoring well No.5 will be
located at the center of the tank excavation to evaluate the
peak levels of groundwater contamination.
Monitoring well No.6 will be utilized to delineate the depth
of groundwater contamination and will be drilled to a depth
of 30 ft. below groundlevel. This well will be completed at
• a depth of 30 feet (more or less, depending on the groundwater
level) with 2 inch i.d. casing and 5' of screen.
A total of six (6) soil borings will be installed to evaluate
soil contamination levels around the tank farm area. The soil
borings will be drilled to the groundwater table and soil
samples will be taken using the split -spoon sampling method.
The soil samples will be screened in the field for organic
vapor content.
Laboratory analysis will be done per FDER 17.770 guidelines
as shown below.
•
Laboratory Analysis
MW No.1 - EPA 602/610
MW No.2 - EPA 602/610
MW No.3 - EPA 602/610
MW No.4 - EPA 602/610
MW No.5 - EPA 601/602/610/418.1, EDB, Lead
MW No.6 (deep well) - EPA 601/602/610, EDB, Lead
2 Quality Assurance Blanks - Equipment and Rinse
will be analyzed for EPA Method 602/610.
The hydrogeologic investigation will include three (3) slug
tests to evaluate aquifier characteristics (transmissibility,
storativity, hydraulic conductivity). The well casing tops
and fluid levels will be surveyed for all monitoring wells on
site to determine groundwater flow direction.
The final report will summarize the contamination assessment
results, hydrogeologic findings, contamination plume maps,
isopotential maps and remedial recommendations.
Summary of Costs
Drilling
A. Install five (5) shallow 2" diameter
monitoring wells to a depth of 15'
($400.00 /well) $2000.00
B. Install one (1) deep 2" diameter
monitoring well to a depth of 30'
($550.00 /well) $ 550.00
C. Install six (6) soil borings to the
groundwater table ($ 60.00 /boring) $ 360.00
Drilling Subtotal $2910.00
Laboratory /Analysis
A. Purge and sample six monitoring wells.
Run the following laboratory analysis for
each well:
6 - EPA Method 602 - $140.00 /sample
6 - EPA Method 610 - $150.00 /sample
2 - EPA Method 601 - $150.00 /sample
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2 - EPA Method 239.2 (lead - filtered /unfiltered)
- $100.00 /sample
2 - EDB - $100 /sample
2 - Quality Assurance Samples analyzed for
EPA Methods 602/610 - $290.00 /sample
Field Organic Meter - $100.00
Laboratory /Analysis, Subtotal $3120.00
Hydrogeologic Investigation
A. Conduct three (3) slug tests to evaluate aquifier
characteristics (transmissibility, storativity,
hydraulic conductivity) ($200.00 /test) $ 600.00
Site Supervision /Report Preparation
A. Site personnel monitoring well
installation, drilling clearance, well
surveying, isopotential measurements.
Estimated 32 hours at $40.00 /hour $1280.00
B. Documentation including Contamination
Assessment Report, twenty -four (24) hours at
$60.00 /hour $1440.00
Site Supervision /Report Prep., Subtotal $2720.00
TOTAL COST $9350.00
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March 10, 1992
Mr. R. M. Cofer
Monroe County Director of Purchasing
Public Service Building
5100 College Rd.
Cross Wing, Rm 1002
Key West, F1. 33040
RE: Client /Project 1922608
Contamination Assessment
Aboveground Tank - Long Key Landfill
Long Key, F1
Based on the property description and knowledge of this area we
have prepared the following cost estimate.
TOTAL COST $ 9,350.00
Balance due upon completion of report.
This proposal will be activated by return of signed acceptance of
this document. Should you have further questions, please contact
me at (305) 772 - 6091.
ACCEPTANCE
The scope of the services defined in the above proposal are
accepted and Environmental Petroleum & Remediation Services, Inc.
is authorized to proceed with the work.
Submitted for acceptance: Acceptance:
ENVIRONMENTAL PETROLEUM & REMEDIATION SERVICES, INC.
By: �Q4 -
Date: 3`\0 \4Z
Remit to: EPRS
6555 N.W. 9th Ave., Suite 201
Ft. Lauderdale, F1 33309
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ti .
N0.3 STORAGE TANK DIESEL
0 :► .c •
O
N0.2 NO.40 O
NO.5* e O
* NO.6
N0.1
O DEEP WELL
CONTAINMENT AREA
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ENVIRONMENTAL PETROLEUM & REMEDIATION SERVICES. INC. 1 2/92
LEGEND �. SITE PLAN
O PROPOSED /: ►� _ TRANSFER STATION
MONITORING WELL - \�
PROPOSED LONG KEY, FL A TTACHMENT 1
SOIL BORING ,
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i •
SWORN STATEMENT PURSUANT TO SECTION 287.133(3)(a),
FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES
THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR
OTHER OFFICIAL AUTHORIZED TO ADMINISTER OATHS.
�/ •
1. This sworn statement is submitted to l o n /0 c (O (An
[print name of the public entity]
by re Il �. Wcnsto / I Q (esiCIe
[int individual' name and title
for EnVi rdaQ t' fro (eurnw- Kerne& fin ei'ii dx-5 � ine_,
[print name of entity submitting sworn statement]
whose business address is &SY - I✓ v'.1441 141/. Z0 l r Pk La uderdai e �
F l. 333
and (if applicable) its Federal Employer Identification Number (FEIN) is ‘ 7 )
(If the entity has no FEIN, include the Social Security Number of the individual signing this sworn
statement:
2. I understand that a "public entity crime' as defined in Paragraph 287.133(1)(g), Florida Statutes,
means a violation of any state or federal law by a person with respect to and directly related to
the transaction of business with any public entity or with an agency or political subdivision of any
other state or of the United States, including, but not limited to, any bid or contract for goods or
services to be provided to any public entity or an agency or political subdivision of any other state
or of the United States and involving antitrust, fraud, theft, bribery, collusion, racketeering, -
conspiracy, or material misrepresentation.
3. I understand that "convicted" or "conviction" as defined in Paragraph 287.133(1)(b), Florida Statutes,
means a finding of guilt or a conviction of a public entity crime, with or without an adjudication of
guilt, in any federal or state trial court of record relating to charges brought by indictment or
information after July 1, 1989, as a result of a jury verdict, nonjury trial, or entry of a plea of guilty
or nolo contendere.
4. I understand that an "affiliate" as defined in Paragraph 287.133(1)(a), Florida Statutes, means:
1. A predecessor or successor of a person convicted of a public entity crime; or
2. An entity under the control of any natural person who is active in the management of the entity
and who has been convicted of a public entity crime. The term "affiliate" includes those officers,
directors, executives, partners, shareholders, employees, members, and agents who are active in the
management of an affiliate. The ownership by one person of shares constituting a controlling
interest in another person, or a pooling of equipment or income among persons when not for fair
market value under an arm's length agreement, shall be a prima facie case that one person controls
another person. A person who knowingly enters into a joint venture with a person who has been
convicted of a public entity crime in Florida during the preceding 36 months shall be c&nsidered
an affiliate.
5. I understand that a "person" as defined in Paragraph 287.133(1)(e), Florida Statutes, means any
} natural person or entity organized under the laws of any state or of the United States with the legal '
power to enter into a binding contract and which bids or applies to bid on contracts for the provision
of goods or services let by a public entity, or which otherwise transacts or applies to transact business
with a public entity. The term "person" includes those officers, directors, executives partners,
shareholders, employees, members, and agents who are active in management of an entity.
•
6. Based on information and belief, the statement which I have marked below is true in relation to
the entity submitting this sworn statement. [indicate which statement applies.]
Neither the entity submitting this sworn statement, nor any of its officers, directors, executives,
partners, shareholders, employees, members, or agents who are active in the management of the
entity, nor any affiliate of the entity has been charged with and convicted of a public entity crime
subsequent to July 1, 1989.
The entity submitting this sworn statement, or one or more of its officers, directors, executives,
partners, shareholders, employees, members, or agents who are active in the management of the
entity, or an affiliate of the entity has been charged with and convicted of a public entity crime
subsequent to July 1, 1989.
The entity submitting this sworn statement, or one or more of its officers, directors, executives,
partners, shareholders, employees, members, or agents who are active in the management of the
entity, or an affiliate of the entity has been charged with and convicted of a public entity crime
subsequent to July 1, 1989. However, there has been a subsequent proceeding before a Hearing
Officer of the State of Florida, Division of Administrative Hearings and the Final Order entered by
the Hearing Officer determined that it was not it the public interest to place the entity submitting
this sworn statement on the convicted vendor list. [attach a copy of the final order]
I UNDERSTAND THAT THE SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER FOR
THE PUBLIC ENTITY IDENTIFIED IN PARAGRAPH 1 (ONE) ABOVE IS FOR THAT PUBLIC ENTITY
ONLY AND, THAT THIS FORM IS VALID THROUGH DECEMBER 31 OF THE CALENDAR YEAR IN
WHICH IT IS FILED. I ALSO UNDERSTAND THAT I AM REQUIRED TO INFORM THE PUBLIC
ENTITY PRIOR TO ENTERING INTO A CONTRACT IN EXCESS OF THE THRESHOLD AMOUNT
PROVIDED IN SECTION 287.017, FLORIDA STATUTES FOR CATEGORY TWO OF ANY CHANGE IN
THE INFORMATION CONTAINED IN THIS FORM.
% 11111
[signature
1(.9/
[date]
STATE OF f//
•
COUNTY OF nietlard
PERSONALLY APPEARED BEFORE ME, the undersigned authority,
K e I( S. Ali (l h/ who, after first being sworn by me, affixed his/her signature
[nom of individual signing]
in the spa Ce r vi d b ve on this ___ day of ,/ i 1 , 19 q off.
r.eiy r p
Notary STATE OF FLCRID1
Public My Comrn Exp3 /tf' / 4: .
BONDED • / �
TARP PUBL
My commission expires: 3/4/9` --
•
Form PUR 7068 (Rev. 04 /10/91)
• . .. .
•
SWORN STATEMENT UNDER ORDINANCE NO. 010 -1990
MONROE COUNTY, FLORIDA
ETHICS CLAUSE
& ef f olyie „ j��, ,;;�, ./o,, t t i ;L,og .e,- � warrants that it has not employed,
retaine or otherwise had act on its behalf any former County office or
employee subject to the prohibition of Section 2 of Ordinance No.
010 -1990 or any County officer or employee in violation of Section 3 of
Ordinance No. 010 -1990. For breach or violation of this provision the
County may, in its discretion, terminate this contract without liability
and may also, in its discretion, deduct from the contract of purchase
price, or otherwise recover, the full amount of any fee, commission,
percentage, gift, or consideration paid to the former County office or
employee.
(signature)
Date: 4///
STATE OF
COUNTY OF 6011/aid
PERSONALLY APPEARED BEFORE ME, the undersigned authority, , 4 / ./� , �j / u,'
who, after first being sworn by me, affixed his /her signature (name of
individual signing) in the space provided above on this fJ day of
t r)/i ` , 19 .
e Kelly F Splain
STATEoFFLo�J RA "�
My Comm Exp3 /4/95 ' `
BONDED
My commission expires: JA//9
7