HomeMy WebLinkAboutAndrius Doniela- Right Of Way BondeBonding Cover Page
Use the following checklist to ensure the documents are properly signed and distributed.
Thank you for choosing Liberty Mutual Surety for your bonding business. The enclosed package is a complete set
of bond documents. Please file the documents in this bond package that are required by the Obligee. Some
documents may not need to be filed.
SURETY BOND PACKAGE
Liberty Mutual Surety: Cincinnati
8044 Montgomery Rd, Suite 150E
Cincinnati, OH 45236
(513) 984-2222 Fax: (866) 548-6645
Please verify the accuracy of all documents thoroughly. For immediate changes or corrections, please contact
your Liberty Mutual Surety office listed above.
The principal must sign the bond as the name is printed on the bond form. If the principal is a company, any
officer of the company may sign the bond.
This bond has been digitally signed on behalf of the Surety. An Attorney-in-fact signature is not required.
A Power of Attorney form is included in the bond package. This form should be attached to the bond and
filed with the obligee.
Right of Way
Five Thousand Dollars And Zero Cents
One Civic Square, Carmel, IN 46032
Andrius Doniela
13120 Six Points Road,
Carmel, IN 46032
City of Carmel Engineering Department
The Ohio Casualty Insurance Company
999019542
THE CONDITION OF THIS OBLIGATION IS SUCH, THAT WHEREAS, the Principal has been or is about to be
granted a license or permit to do business as
Sealed with our seals, and dated this ,day of .
for which sum, well and truly to be paid, we bind ourselves, our heirs, executors, administrators, successors and assigns,
jointly and severally, firmly by these presents.
LICENSE OR PERMIT BOND
by the Obligee.
NOW, THEREFORE, if the Principal well and truly comply with applicable local ordinances, and conduct business in
conformity therewith, then this obligation to be void; otherwise to remain in full force and effect.
PROVIDED, HOWEVER:
Certificate executed by the Surety
Until , or until the date of expiration of any Continuation
OR
Until canceled as herein provided.
Principal
By
This bond shall continue in force:
day of
, and the
as Principal, of
and firmly bound unto
KNOW ALL BY THESE PRESENTS, That we,
, of
(
Attorney-in-Fact
By
Bond No.:
,
LMS-11235e 03/01
New Hampshire
$5,000.00
9th October 2019
9th October 2020
Andrius Doniela
The Ohio Casualty Insurance Company
Timothy A. Mikolajewski
This bond may be canceled by the Surety by the sending of notice in writing to the Obligee, stating when, not less
than thirty days thereafter, liability hereunder shall terminate as to subsequent acts or omissions of the Principal.
1.
2.
, a
Liberty Mutual Surety Claims • P.O. Box 34526, Seattle, WA 98124 • Phone: 206-473-6210 • Fax: 866-548-6837
Email: HOSCL@libertymutual.com • www.LibertyMutualSuretyClaims.com
corporation, as Surety, are held
, as Obligee, in the sum of
)
POAOutputOCe
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 extent herein stated. Not valid for mortgage, note, loan, letter of credit, currency rate, interest rate or residual value guarantees.To confirm the validity of this Power of Attorney call 1-610-832-8240 between 9:00 am and 4:30 pm EST on any business day.POWER OF ATTORNEY
The Ohio Casualty Insurance Company
Agency Name:
Principal:
Obligee:
Bond Number:
Andrius Doniela
Feighner Insurance Inc.
City of Carmel Engineering Department
999019542
Bond Amount: ()$5,000.00 Five Thousand Dollars And Zero Cents
KNOW ALL PERSONS BY THESE PRESENTS: that The Ohio Casualty Insurance Company, a corporation duly organized under the laws of the State of New Hampshire (herein
collectively called the "Company"), pursuant to and by authority herein set forth, does hereby name, constitute and appoint Timothy A. Mikolajewski in the city and state of Seattle, WA,
each individually if there be more than one named, its true and lawful attorney-in-fact to make, execute, seal, acknowledge and deliver, for and on its behalf as surety and as its act and
deed, any and all undertakings, bonds, recognizances and other surety obligations, in pursuance of these presents and shall be as binding upon the Companies as if they have been duly
signed by the president and attested by the secretary of the Company in their own proper persons.
On this 26th day of September, 2016, before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of The Ohio Casualty Insurance
Company and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as duly
authorized officer.
David M. Carey, Assistant Secretary
IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Company and the corporate seal of the Company has been affixed thereto
this 26th day of September, 2016.
The Ohio Casualty Insurance Company
By:
STATE OF PENNSYLVANIA
COUNTY OF MONTGOMERY ss
Renee C. Llewellyn, Assistant Secretary
This Power of Attorney is made and executed pursuant to and by authority of the following By-law and Authorizations of The Ohio Casualty Insurance Company, which is now in full force
and effect reading as follows:
By:
ARTICLE IV – OFFICERS: Section 12. Power of Attorney.
Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the
President may prescribe, shall appoint such attorneys-in-fact, as may be necessary to act in behalf of the Corporation 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 Corporation by their signature and executed, such instruments shall be as binding as if signed by the President and attested to by the Secretary. Any
power or authority granted to any representative or attorney-in-fact under the provisions of this article may be revoked at any time by the Board, the Chairman, the President or by
the officer or officers granting such power or authority.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Company this
By:
Teresa Pastella, Notary Public
IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at King of Prussia, Pennsylvania, on the day and year first above written.
Certificate of Designation – The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assistant Secretary to appoint such attorneys-in-
fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety
obligations.
Authorization – By unanimous consent of the Company’s Board of Directors, the Company consents that facsimile or mechanically reproduced signature or electronic signatures of any
assistant secretary of the Company or facsimile or mechanically reproduced or electronic seal of the Company, wherever appearing upon a certified copy of any power of attorney or
bond issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with the same force and effect as though manually affixed.
I, Renee C. Llewellyn, the undersigned, Assistant Secretary, of The Ohio Casualty Insurance Company do hereby certify that this power of attorney executed by said Company is in full
force and effect and has not been revoked.
day of ,.9th October 2019
eBonding TranReport 10/17
TRANSACTION REPORT
Liberty Mutual Surety: Cincinnati
8044 Montgomery Rd, Suite 150E
Cincinnati, OH 45236
(513) 984-2222 Fax: (866) 548-6645
Preparer Name:Theresa Compton Feighner Insurance Inc.Agency Name:
Preparer Email:tcompton@insmgt.com Agency Code:285084
Principal:Obligee:
Andrius Doniela City of Carmel Engineering Department
13120 Six Points Road
Carmel, IN 46032
One Civic Square
Carmel, IN 46032
Effective Date:Bond Number:
Bond Information:
Bond Amount:Expiration Date:
Renewal Type: Cancel Days:
Class Code:
$5,000.00
999019542
Renewable (by certificate)
October 9, 2019
October 9, 2020
30 Days
S910Direct BillRenewal Billing Method:
Underwriting Paper:The Ohio Casualty Insurance CompanyRenewal Term (Months):12
YesRenew Automatically:Bond Rating State:Indiana
Right of WayDescription of Bond:
Invoiced To:
Andrius Doniela
13120 Six Points Road
Carmel, IN 46032
Renewal Billing Information:
Andrius Doniela
13120 Six Points Road
Carmel, IN 46032
Remarks:
Premium Information:
Bond Premium:$100.00
Total Premium Due:$100.00
This bond is a direct billed bond. It is the applicant's responsibility to ensure payment is received in full for this new business. Payment
must be received within 20 days from the date this bond was issued. If payment is not received in full, this bond may be subject to
cancellation. Bond(s) changes are available for your agency through https://agents.libertymutualsurety.com
Mail Payment To:
Liberty Mutual Insurance Company
25761 Network Place
Chicago, IL 60673-1257