HomeMy WebLinkAbout18030159 Right of way PermitLICENSE AND PERMIT BOND
Bond No.
(Individual, Partner or Corporate Officer)
Principal
KNOW ALL MEN BY THESE PRESENTS:
That we, ,
as Principal, and the , a corporation duly licensed to do business in the state
of , as Surety, are held and firmly bound unto the
, State of , Obligee,
in the penal sum of ,
( ) DOLLARS, lawful money of the United States, to be paid to the said Obligee, for which payment well and
truly to be made, we bind ourselves and our legal representatives, jointly and severally by these presents.
THE CONDITION OF THE ABOVE OBLIGATION IS SUCH, That whereas, the said Principal has been licensed as a(n)
by the Obligee.
NOW, THEREFORE, if the said Principal shall faithfully perform the duties and in all things comply with the laws and ordinances,
including all Amendments thereto, pertaining to the license or permit applied for, then this obligation to be void, otherwise to remain in
full force and effect for a period commencing on the day of , , and ending on the
day of , .
This bond may be terminated at any time by the Surety upon sending written notice to the clerk of the Political Subdivision with whom
this bond is filed and to the Principal, addressed to them at their first known address, and at the expiration of thirty (30) days from the
mailing of said notice, or as soon thereafter as permitted by applicable law, whichever is later, this bond shall terminate and the Surety
shall thereupon be relieved from any liability for any acts or omissions of the Principal subsequent to said date.
Dated this day of , .
By
RLI Insurance Company
P.O. Box 3967 Peoria IL 61612-3967
Phone: (309)692-1000 Fax: (309)683-1610
LSM1108465
Mattox Property Group LLC DBA Mattox Roofing
1283 Mayfair Ct
Greenwood, IN 46143
RLI Insurance Company
Indiana
City of Carmel Indiana
Five Thousand and 00/100
$ 5,000.00
Contractor
2nd April 2018 2nd
April 2019
2nd April 2018
RLI Insurance Company
Barton W. Davis Vice President
R0002307-20,30
04/24/18
Nick Mishler
"All bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation shall be executed in the
corporate name of the Company by the President, Secretary, any Assistant Secretary, Treasurer, or any Vice President, or
by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant
Secretary, or the Treasurer may appoint Attorneys in Fact or Agents who shall have authority to issue bonds, policies or
undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds, policies,
undertakings, Powers of Attorney or other obligations of the corporation. The signature of any such officer and the
corporate seal may be printed by facsimile."
A0083817
Know All Men by These Presents:
That the , a corporation organized and existing under the laws of the State of
, and authorized and licensed to do business in all states and the District of Columbia does hereby make,
constitute and appoint: in the City of , State of
, as it's true and lawful Agent and , with full power and authority hereby
conferred upon him/her to sign, execute, acknowledge and deliver for and on its behalf as Surety, in general, any and all bonds, and
undertakings in an amount not to exceed Dollars
( ) for any single obligation, and specifically for the following described bond.
The further certifies that the following is a true and exact copy of a
Resolution adopted by the Board of Directors of , and now in force to-wit:
IN WITNESS WHEREOF, the has caused these presents to be executed by
its with its corporate seal affixed this day of , .
(Valid only when a County, City, Town or Village is named as Obligee)
Principal:
Obligee:
Type Bond:
Bond Amount:
Effective Date:
Jean M. Stephenson
SS
Notary Public
By:
} CERTIFICATE
By:
By:
Corporate Secretary
I, the undersigned officer of
do hereby certify that the attached Power of Attorney is in full force
and effect and is irrevocable; and furthermore, that the Resolution of
the Company as set forth in the Power of Attorney, is now in force. In
testimony whereof, I have hereunto set my hand and the seal of the
this day of , .
State of Illinois
County of Peoria
On this day of , , before me, a Notary Public,
personally appeared , who being by me
duly sworn, acknowledged that he signed the above Power of Attorney as the
aforesaid officer of the ,
and acknowledged said instrument to be the voluntary act and deed of said
corporation.
Bond No.
POWER OF ATTORNEY
RLI Insurance Company
9025 N. Lindbergh Dr. Peoria, IL 61615
Phone: 800-645-2402
LSM1108465
RLI Insurance Company
Illinois
Barton W. Davis Peoria
Illinois Vice President
One Million and 00/100
$ 1,000,000.00
Mattox Property Group LLC DBA Mattox Roofing
City of Carmel
Contractor
$ 5,000.00
April 2, 2018
RLI Insurance Company
RLI Insurance Company
RLI Insurance Company
Vice President 2nd April 2018
RLI Insurance Company
Barton W. Davis Vice President
April 2018
Barton W. Davis RLI Insurance Company
RLI Insurance Company
RLI Insurance Company
April 2018
Gretchen L. Johnigk RLI Insurance Company
2nd
2nd
04/24/18
Nick Mishler