HomeMy WebLinkAbout05/17/2022 Motion to accept lowest-cost, responsive bid for the 2022 Mount Prospect Train Station Parking Lot Improvement Project in an amount not to exceed $39,479.tem Cover Page
Su bject Motion to accept lowest -cost, responsive ford for the
2022 Mount Prospect Train Station Parking L®t
Improvement Project in ars amount not to exceed
$39,479.
Meeting May 17, 2022 - REGULAR MEETING OF THE MOUNT
PROSPECT VILLAGE BOARD --
Fiscal Impact true
Dollar Amount $39,479.00
Budget source capital Improvements Fund
Type consent
Maintaining the paved lots that service the Village's buildings and facilities is important to
the efficient operations of the Village. The public parking lot adjacent to Wille street, south
of Prospect Avenue, was selected to be resurfaced in 2022 during original planning
discussions. However, a construction trailer and laborers personal Vehicles associated with
the construction of the Prospect Place development currently occupy the lot and will be
there until the end of the year. To avoid any disruption, Village staff has chosen an
alternate parking lot that is need of repair; the train station center lot.
Proposed work includes resurfacing the paved areas, utility structure adjustments, and
pavement markings. work will be limited to the center lot, immediately adjacent to the
train station building. No work will be performed in the east or west commuter parking
lots. The Wille street parking lot will be resurfaced in 2023.
A notice to bidders was posted on the online bid service Demandstar and several
contractors qualified to do the work were notified. A copy of the bid document is attached.
On April 18, 2022 at 1:00 PM, sealed bids for the Mount Prospect Train station Parking Lot
Improvements were publicly opened and read aloud. seven (7) contractors submitted bids
for this project. The bids ranged from a low of $35,890.00 by Lakewood Paving Company,
1
to a high of $74,.515.00 by A Lamp Concrete Contractors, Inc.
Below is a summary of the bids:
Bidders Total Bid
Lakewood Paving Company $35,890.00
M & J Asphalt Paving Company $39,851.00
TAT Enterprises Inc. $44,574.00
Advantage Paving Solutions Inc. $45,161.86
Arrow Road Construction Company $45f 222.39
Co.
Maneval Construction Co Inc. $59,707.00
A Lamp Concrete Contractors, Inc. $74,515.00
Engineer's 6
$36, 35. DD
Estimate
All bid submittals were checked for accuracy. All bidders submitted bid bonds in the
amount of 10% of their total bids, as required. All bidders correctly signed their bids and
bid bonds.
The lour! bidder, Lakewood Paving Company, meets the requirements of the contract
documents and is qualified to complete the work involved with this project. They have
successfully completed similar parking lot projects in numerous communities. While they
have not performed work in Mount Prospect, references have indicated their work is
acceptable.
Village staff recommends including a 10% contingency in the project award to allow for
quantity variances and unanticipated construction conflicts. This would result in a total
recommended award of $39,,479-00 ($35,890.00 + 3,589.00 = $39,,479-00).
Alternatives
1. Accept lowest cost, responsive bid for the Mount Prospect Train Station Parking Lot
Improvements by Lakewood Paving Company of Chicago Ridge, Illinois, in the amount
not to exceed $39,,479.
2. Action at discretion of Village Board.
K:
Staff recommends that the lowest cost responsive bidder, Lakewood Paving Company of
Chicago Ridge, Illinois, be awarded the contract for the Fount Prospect Train Station
Parking Lot Improvements in the amount not to exceed $39,479.
Train Station Parking Lot Plans.pdf
Bid Tab.pdf
Lakewood Paving Company Bid . pdf
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2022 Mount Prospect Train Station Parking Lot improvements
Bid Form Page 7
BID FORM
2022 Mount Pros ect Train Station Parkin Lot Improvements
Village of Mount Prospect
Department of Public Works
FROM:
Joseph Kopczynski, Chief Operations Officer
Lakewood Paving Company, LLC
thereinafter called "Bidder`
To; office of the Village Manager, 3rd Floor
50 South Emerson Street
Mount Prospect, Illinois 50055
(hereinafter called "Village" or "Village of Mount Prospect")
Bid For: "2022 Mount Prospect Train station Parking Lot Improvements"
The bidders have familiarized themselves with the work and probable work conditions
required under this Bid affecting the cost of the work and with the Bid Documents which
include:
• Notice to Bidders
• Table of Contents
• Instructions for Bidders
• General Conditions and Special Provisions
• Specifications
• Bid Form
• Affidavit — Bid Certification Form
• Bid Security
• Bid Sheet — 2022 Mount Prospect Train Station Parking Lot Improvements
Contract Document
• Labor and Materials Payment bond form
Performance Bond Form
Supporting Documents
Therefore, the Bidder hereby proposes to furnish all supervision, technical personnel,
labor, materials, tools appurtenances, equipment, and services (including all utility and
transportation services) required to construct and complete the Work, all in accordance
with the above listed documents.
Bidder agrees to perform all of the Work and provide the equipment and materials
described in the Bid Documents, as follows.-
Bidder
ollows;
Bidder has bid on all items and has provided a price for all items.
w
9
2022 Mount Prospect Train Station Parking Lot Improvements
Bid Form Page 2
The Bidder acknowledges that it is responsible for verification of all pipe sizes and
depths prior to the ordering of materials.
The Bidder will complete and provide all labor, equipment, materials and mobilization (if
applicable) to perform the Work as incidental to the fixed item price for each item
proposed.
In submitting this bid, the Bidder understands that the Village of Mount Prospect
reserves the right to add to or subtract from the estimated quantities.
The Village of Mount Prospect intends to award one 1) contract (if at all) for the items
bid. If written notice of award of this bid is mailed, emailed or otherwise delivered to the
Bidder at any time before this bid is withdrawn, the Bidder agrees to execute and deliver
the contract in the prescribed form and furnish payment and performance bonds, or
letter of credit, and the insurance certificates required by the Bid Documents to the
Village within ten (10) days after receipt.
The Bidder, and as successful bidder/Contractor upon award of the contract
understands and agrees to the following:
1) The Contractor agrees to provide all Work and items and material to the Village as
noted in the Bid Documents and comply with the requirements of the Bid
Documents.
2} The Contractor agrees to comply with all applicable state and federal laws, rules
and regulations, and county and municipal ordinances, as described in the General
Conditions.
All Addenda pertaining to this project shall be acknowledged by the Bidder in the
spaces provided below:
Addendum Addendum Acknowledgement by Bidder orDate
Da Authorized Representative..___w.._._.w____............................. ....cknowled..9.ed._..µ
_.N.°..�...............................w._�.w........�._.....te .....................�_w_.v�. A_ ._.....,.......w...._.....
Failure to acknowledge receipt, as provided above, may be considered sufficient
grounds for disqualification of the bidder and rejection of his/her bid submittal. A record
of all Addenda and copies of same will be available to all qualified bidders from the
Village of Mount Prospect Public Works Department, 1 700 West Central Road, Mount
Prospect, Illinois two (2) days prior to the letting. It shall be the bidder's responsibility to
become fully advised of all Addenda prior to submitting its bid.
39
10
2022 Mount Prospect Train Station Parking Lot Improvements
Bid Form Page 3
Upon award the contract the Village will send Notice of Award to the successful bidder,
the bidder must then execute the contract and provide the required bonds or letter of
credit and certificate of insurance to the Village within ten (10) days. The Village will
then issue a written Notice to Proceed, which starts the performance period. The
Contractor shall reach substantial completion within nnet consecutive calendar
days after the Notice to Proceed with final completion fourteen '14 days thereafter,
Failure to complete the work in the designated time frame may result in the Director of
Public Works withholding compensation due the contractor for failure to complete the
said work in the designated time frame, calling the bonds, or taking such other action as
may be available.
Security in the sum of ten (10%) percent of the amount bid in form of (check one):
X Bid Bond Certified Check Bank Cashier's Check
is attached hereto in accordance with the "Instructions for Bidders".
This Bid Submittal contains the following:
1) Bid Form
2) Affidavit —Bid Certification Form
3) Bid Security
4) Bid Sheet(s) — 2022 Mount Prospect Train Station Parking Lot Improvements
Respectfully submitted:
Name of Firm/Bidd : Lakewood Pav n . Cpm a LLC
........... .. . . . ........
.............. .
B y:
1 r
dig � re
Titl ;; Chlef Op6rtl ns icer
pIF�''M""�nniae
......
Apf". 18th 2022
Date.
Contact Information:
Official Address: 10748 Central Ave
Chicago Ridge, IL 60415
Telephone: (708) 638-3711
Email: joe.kopczynski@lakewoodpavingco.com
ONE (1) SIGNED COPY OF THIS BID FORM AND BID SHEET(S) ALONG WITH THE AFFIDAVIT --
BID CERTIFCATION FORM, AND BID SECURITY SHALL BE SUBMITTED IN A SEALED MARKED
ENVELOPE.
ON
11
2022 Mount Prospect Train Station Parking Lot Improvements
VILLAGE OF MOUNT PROSPECT
AFFIDAVIT — BID CERTIFICATION FORM
qaw
Company/Firm Name. Lakewood Paving Company, LLC
Address: 10748 Central Ave, Chicago Ridge, IL 60415
As a condition of entering into a contract with the Village of Mount Prospect, and under
oath and penalty of perjury and possible termination of contract rights and debarment,
the undersigned, Jose h Ko cz nski _, being first duly sworn on oath,
deposes and states that he or she is Chief 4 eratin Officer
(sole owner, partner, joint ventured, President, Secretary, etc.) of
Lakewood Pavin Company, LLC and has the authority to make all
(Name of Company)
certifications required by this affidavit.
Section I
0 a _ •
The undersigned certifies that this bid is genuine and not collusive or a sham, that said
bidder has not colluded, conspired, connived or agreed, directly or indirectly, with any
bidder or person, to put in a sham bid or to refrain from bidding, and has not in any
manner, directly or indirectly, sought by agreement or collusion, or communication or
conference with any person, to fix the bid price element of this bid, or of that of any
other bidder, or to secure any advantage against any other bidder or any person
interested in the proposed contract.
Section II Bid--Rig,.qJ,nq. and Rotating
The undersigned further states that Lakewood Pavin Company, LLC
(Name of Company)
is not barred from bidding or contracting as a result of a conviction for violations of state
laws prohibiting bid rigging or bid rotating or any similar offense of any state of the
United States, as provided in Sections 33E-3 and 33E-4 of the Illinois Criminal Code,
720 ILCS 5/33E-3, 33E-4.
Section III Drua Free Workplace
The undersigned further states that Lakewood Paving Company, LLC
(Name of Company)
provides a drug free workplace pursuant to the Drug Free Workplace Act, 30 ILCS
580/1, et seq., and has, to the extent not covered by a collective bargaining that deals
with the subject of the Substance Abuse Prevention in Public Works Projects Act, 820
ILCS 265/1 et seq., a substance abuse prevention program that meets or exceeds
these requirements of that Act.
41
G YA
2022 Mount Prospect Train Station Parking Lot Improvements
AFFIDAVIT — BID CERTIFICATION FORM — Page 2
Section IV Tax Peen
The undersigned further states that Lakewood Paving Company, LLC is
(Mame of Company)
not delinquent in payment of any taxes to the Illinois Department of Revenue, in
accordance with Illinois Compiled Statues, 65 ILCS 5/11-42.1. The undersigned
understands that making a false statement regarding delinquency in taxes is a Class A
Misdemeanor and, in addition voids the contract and allows the municipality to recover
all amounts paid to the individual or entity under the contract in civil action.
Section V
Sexual Harassment Folic
Pursuant to Section 2-105(A) of the Illinois Human Rights Act, 775 ILCS 512-105 (A), every party to a
public contract must:
"Have written sexual harassment policies that shall include, at a mini -mum, the following information: (I)
the illegality of sexual harassment; (II) the definition of sexual harassment under State law; (III) a
description of sexual harassment, utilizing examples; (IV) the vendor's internal complaint process
including penalties; (V) the legal recourse, investigative and complaint process available through the
Department (of Human Rights) and the Commission (Human Rights Commission); (VI) directions on how
to contact the Department and Commission; and (VII) protection against retaliation as provided by
Section 6-101 of the Act, (Illinois Human Rights Act),"
A "public contract" includes: ,.every contract to which the State, any of its political subdivisions or any
municipal corporation is a party." 775 ILCS 511-103 M (2002),
The undersigned further states that Lakewood Paving Company, LLC has
(Name of Company)
a written sexual harassment policy in place in full compliance with 775 ILCS 5/2-105 (A)
(4).
It is expressly understood the foregoing statements and representations and promises
are made as a condition to the right of the bidder to receive payment under any award
made under the terms and provisions of this bid.
The undersigned certifie at all information contained in this Affidavit is true and
correct. 1.
Signed by:
jr
�: "Signa ure
Name Printed JOqf_�Dh KODC7vnk*l
Signed and sworn to before me this 18th day of
My commission expires
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.qo ,. N�,"www.cvw,ml�n�xrancewar"�"�
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Notary Public�w
42
Title: Chief Operating Officer
April , 2022.
if'>3r 1G f ��� v h' 4r f Ik. S' • r, f��� !� 7
r Ali. �� ;�',r• ••II/r... yarn'. •:.:� ,; k�dr ,. �. r ..;�. ,,#.% �'Fs:1 � .rrl rrd � ` ��' "�Srll IIL �rf' ���l�i
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F�ii;,!"?rsr'siNsl.,R•,,�%:``rrti 'krui� rr,,if `•n.rrr7 �1rr' i� kkJ' ''rli .r 'ks. �I� ry�"'fi�
13
2022 Mount Prospect Train Station Parking Lot Improvements
■ - W
Included with this bid is a bank cashier's check, certified check or bid bond in the amount of
$,34589.00 , being ten percent 10%) of the total amount bid by
Lakewood Pavin Qoni an LL . the Bidder, in favor of the village of Mount Prospect. It is hereby
agreed that, should Bidder be awarded the Work contemplated under this bid and fail or refuse
to execute a contract for said Work, or to provide the required payment and performance bonds,
or letter of credit, and certificate of insurance, then this security, in the amount stipulated above,
shall be forfeited and may be retained by the village of Mount Prospect as liquidated damages
and not as a penalty. All bids to remain firm for a period of ninety (g0) days after bid opening
date.
SUBMITTED THIS 18th DAY OF ..,.,April , 2022.
SEAL (if corporation)
Ryan P Conway Agency LLC
Title
Bidder's Agent and Agent's Title
Note: If bidder is a partnership, the bid must be signed by at least two of the partners.
Note: If bidder is a corporation, the bid must be signed by an authorized officer of the
corporation, attested and sealed by the secretary or other authorized officer.
If a corporation, note here the state of incorporation:
Incorporated under the laws of the State of Delaware
43
06
14
2022 Mount Prospect Train Station Parking Lot Improvements
BID SHEET
SCHEDULE of FENCES
2022 Mount Prospect Train Station Parking Lot Improvements
(TO BE FILLED OUT BY THE CONTRACTOR/BIDDER)
The Bidder will complete pricing for all items (No. 1 through 1 Q) to provide all labor, equipment, materials
and mobilization (if applicable) to perform this work. The fixed item price given is to be all incklSi e.
SND
DESCRIPTION
UNIT
QUANTITY
UNIT PRICE
TOTAL
1
SPECIAL EXCAVATION
CU YD
10
$10.00
$100.00
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AGGREGATE BASE COURSE, TYPE B, 8
m�.____.................................�_...._.._�..._�.,_..
SQ Yd
100"
I $1.00
....... $100.00. .....2
3
_.
HMA SURFACE REMOVAL 3"
w�...��wwwwwww._.�.
SQ YD
_.m.............._...._mw.._ww.
1005
$20.04$20,140.20.......
4
HMA LEVEL BINDER (MM), N50, 1.5"
TON
90
$]],00
$6,930.00
5
HMA SURFACE COURSE, MIX "D", N50.1.5"
TON
90
$]].00
$6,930.00
6
BIT MATERIAL (TACK COAT)
POUND
460
$1.20
$552.00
7
THERMOPLASTIC PAVEMENT MKGS - 4"
FOOT
690
`0.583
$402.27
8
THERMOPLASTIC PAVEMENT MKGS - 24"
FOOT
18
$4.125
$74.25
9
THERMOPLASTIC PAVEMENT MKGS LET & SYMB
SQ FT
88
$4.125
$363.00
10
TRAFFIC CONTROL &PROTECTION
L SUM
1
$298.28
$29$,2$
-- ------ .
........
TOTAL
FOR ITEMS (1
through 10) 1
$35,890.00
I . .......... -'-1 . ...... . ...
44
15
P.O. BOX 3967 PEORIA, IL 61612-3967 BID BOND
RLI P. (800)645-2402 E: contract,surety@ricor pxorn
SURETY RLISURE]'Y.COM BondNo.
KNOW ALL MEN BY THESE PRESENTSm��....� � ..���.�u.M�,
That We . .... . . ...... ..... - — - --------
ne L, L d -P yijag_CQMP.a-JV�"
. . ........
as Principal, and
LIMs
ItrIlptv, Cha of
as Surety, an ry corporation duly licensed to
- - — - — -------
do business in the State of are held and firm ly bound unto ..............................
. . ..... . ...... as Obligee, in the penal sum of
0% olTotal Ani cru nt Bid M.. . ....... . ........
for the payment of which the Principal and the Surety bind thernselves, their heirs, executors, administrators, successors and
assigns, jointly and severally, firmly by these presents,
THE CONDITION OF THIS OBLIGATION IS SUCH, That whereas the Principal has submitted, or is about to submit, a
proposal or a bid to the Obligee on a contract for .........
. ...... . . ....Ap.... . . . .... ........
. . . ....... .
NOW, THEREFORE, if the aforesaid principal shall be awarded the contract, the said principal will within the period specified
therefore, or if no period be specified, within ten (10) days after the notice of such award enter into a contract and give bond for
the faithful performance of the contract, then this obligation shall be null and void, otherwise the principal and the surety will
pay unto the obligee the difference in money between the amount of the bid of said principal and the amount for which the
obligee may legally contract with another party to perform the work if the latter arnount be in excess of the former, in no event
shall the liability hereunder exceed the penal sum hereof.
PROVIDED AND SUIBJECT TO THE CONDITION PR-ECEDENT, that any suits at law or proceedings in equity brought or to
be brought against the Surety to recover any claim hereunder must be instituted and service had upon the Surety within ninety
(90) days after the acceptance of said bid of the Principal by the Obligee.
SIGNED, SEALED AND DATED this __J W,. day of April 2022
By: -- . ...........
Ryan Conway Attorney In F,Cwt
C0038015-50,0
16
POWER OF ATTORNEY
RLI Insurance Company
9025 N. Lindbergh Dr. Peoria, IL 61615
Phone: 800-645-2402 Bond No.
Know All Men by These Presents.
That. this Power ofAttorney is not valid or in effect unless attached to the bond which it authorizes executed, but may be d iziched by
the approving officer if desired.
That the �f,1±�ft�x�� W:a,� 7 a corporation organized and existing under the laws of the of
lil:inuis , and authorized and licensed to clo business in all states and the District of Columbia docs hereby make,
a to of
constitute and appoint: in the C>Ity of I� she � � ,,rv�� State
. xa s i is true and ! awfi� l Agent and x.,�.........��„x.x.. � � :t � � � ��t�.xxx����. ,,,,,
with full power and ttttho ity hei°eby
�.�
conferred upon him/her to sign, execute, acknowledge and deliver for and on its behalf as Surety, specifically for the following
described bond.
Principal: I.. lc.ewqq(,l lj)g Company_, LLC
Obligee: Village of Mount Prospect
Bond Amount: _40% 0.7170(al Afoo 14 Bid
The acknowledgement and execution of such bond by the said Attorney in Fact shall be as binding upon the Comj,)i�wny as i i,,, R.r�.ii.� .11� bond
had been executed and acknowledged by the regularly elected officers of the Company.
The R1..J Insc.>Iaranc a Com n � further certifies that the following is a true and a-ct copy of a
Resolution adopted by the Board of Directors of ,�. ',.1.,�1; fnsl�tt�����r�ce '����� �1k��I�mm �x.x,x,....�
e, and now in force to -wit:
.--- ...............
................................ ....... -
"All bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation shall l' ca�ec; te�� i�� the
corporate name of the Company by the President, Secretary, any Assistant Secretary, Treasurer, yr any 'tee leilent,� or
by such other officers as the Board of Directors may authorize., any Vice President Sl�lj*)�, ally AssistantAssistantThe President , ���ecre
Secretary, or the Treasurer may appoint Attorneys in Fact or Agents who shall have authority to issue bunds, policies or
undertakings in the name of the Company. The corporate seal is not necessary for the validity of arty boncls, policies,
undertakings, Powers of Attorney or other obligations of the corporation. The signature of any stick office and the
corporateff�
seal ity be printed [)y facsimile."
........... ...... ... ... .
......... . . . . ........... .......................................
. .... .... . ..............
..........................................
...... .................,
1I Insurance Comaeb�N executed by WIT -NESS WHEREOF, the r
its Vice Pre idetxtt with its corporate seal affixed this �------18th _ day of Ari! , ��Q M
,�„µ,xxx....m�x...�.x.�„�re. �.x.....�:�,..........,....,
State of Illinois
County of Peoria
I ss
RLI Insurance Company
qy. y 6Y • M M' yy 0
CORPORA roN�
SEAL
Barton W. Davis Mice President
On this .. 12.q day of Ai2rii`,,-„, before rn.e, a Notary Public:,
°s
11!y appeared
W'x who being by me
PP �� Po
duly swcn,-n , ackno led ed that he signed the, a1,wve flower of Attorney as the
aforesaid (,,)ffice of the pMA ,, ffi-t
and acknowledged said to be the voluntary act �41nd devil ot” said
corporation.
By: tU—
Catherine D. Glover Notary Public
lit ............. - - - - - - - - - - - - . . . . . . . . . . ..... . . . . . . .
CRTHEF I1" � kk L ....... 1�1 ,
TA.OFFICIAL SEAL
wun ub �. ws of
My Comm*k>n r
maxh
CERTIFICA"11'
11 the undersigned officer of���
(Jo 1tereby c r ify that the at,Ua:cJuNd 11ow er (,) Attorney is in NH k'nc e
and effect and is irrevoc)ble; and futthe niore, that:the [(Cso9,utiu>n
the Company as set forth in the Power of Awn,-ncy, i s now in florce. lei
testimony whereof, I have hereunto set my hfflacl and the seal ofthe
RI t Insurance C0j.,)�! y � ��........�
..... x.x......�x�m.� � :� �� .. = .. �„ �� � �::::::� � �x ��j� � ...
this 1 tl�_ Jay of ► ,, � 1
RLI Insurance Company
By: All �w.um,xuw,.,uuuuxwnmmrnmrnin.mex�. n wr+w.+wHx��uuununw..nnrw n xxiN*uru,urcnnmrm»mvnw,MMMMMm,F,,,,,,www,ww+�xaxwuuuuuuuxwiwwwmmnwxnr.rciawh.w+.m
Jeflrcy r) � ��° cls, p (7of'-portue, Secretary
A-1)(9)622 1 -,SUBS. -BID
17
IMMOL.- � 7
P.J. BOX 3967 PEORIA, IL 61612now
'p: (800)64E5 -2Y402 E: c ontraci.s�irety r@rlicorp.coni
i 61�FIS�JJI�B.i Sry9. .COM
STATE OF
ssN
COUNTY OF� �r
Acknowledgment of Surety
On this 18th day of ____A ...x2022 _, before me, a Notary Public in and for said County, personally
appeared M • ,,,,,.x... ...... Ivan— x.x.x.x.x.x.. personally known to rne, who being by me duly sworn did say that
he/she is the aforesaid r n r�M "w: � n ��.
o f the R�,,�11ic��nnxx.
ofnnnnn� �., mmmmmmmmm�., wx M�� a eararatic�n duly ar�Lrlfzed and existing under the laws of
the Stats; of � �� M �, that the seal affixed to the foregoing instrument is the corporate seal of said
corporation, that the said instrument was signed, sealed and executed in behalf of said corporation by authority of its Board of
Directors, and further acknowledge that the said instrument and the execution thereof to be a voluntary act and deed of said
corporation.
IN WITNESS WHEREOF", I have hereunto subscribed my name and affixed by official seal the dory and year last
above written.
My Commission. Expires a
Notary 'ub1ic;
X10007204
18
ekicP.O. Box 3967
Peoria, IL 61612-3967 Illinois Disclosure Notice
Wf",a0,"�1 Phone: (309)692-1906 Fax: (309)683-1610
Bond No. LSM 13555
KEEP w . ....THIS .NmOTICE WITH_1''19...M$,VtE F'F
If you are having problems with your insurance company or agent, do not hesitate to contact the insurance company or
agent to resolve your problem.
RLI Insurance Company
9025 N. Lindbergh Drive
Peoria, IL 61615
TOLL-FREE (800)645-2402
(309)692-1000
In the unlikely event you are unable to resolve any complaints with the company, you may contact the
Illinois Department of Insurance
Consumer Division
320 W. Washington Street
Springfield, IL 62767
(866)445-5364 Toll -Free
This Notice is for information only and does not become a part of or a condition of your policy.
UW 1012 (12112)
RLI Insurance Company
M1203D12
19