HomeMy WebLinkAboutSupplemental Attachments -5/21/2018City of Waterloo
Finance Committee Open Invoice Report
For May 21, 2018 Approval
Finance Committee Accounts Payable Open Invoice Report Total
As of Friday, May 18th, 2018
EFT Transactions:
Wellmark Weekly Claims
639,754.01
194,630.27
Subtotal - as of Monday, May 21, 2018
834,384.28
Workers Compensation Issued by TPA
Housing Authority Housing Assistance EFT's
Housing Authority Housing Assistance EFT's
Payroll
8,349.08
1,874.49
Bill Payment Total - Monday May 21, 2018
844,607.85
Payment to Council members or related entities:
TRAVEL REQUEST
CITY OF WATERLOO
FINANCE DEPT. STAFF ONLY
LINE ITEM USED 0/0 03 876-D M3/48&
FY :20 IS BUDGETED (5:_)d
EXPENDED YTD ---
THIS REQUEST itOO
LEFT AFTER THIS
REQUEST /00
DATE 7/4w
Original - Clerk/Finance Co. - be•artment
NAME(S) AND POSITION(S):
Ed Stoffer, Production Coordinator
April/May 2018
NAME OF CLASS / MEETING:
Drone On -Line Pilot Training (Drone Pilot School) and
Certification Testing (Hawkeye CC)
DEPARTURE DATE:
DESTINATION: Waterloo, IA
DEPARTURE POINT
IF NOT WATERLOO:
RETURN DATE:
DATE(S) OF MEETING:
April/May 2018
PURPOSE OF TRAVEL/TRAINING:
In order to get insurance and fly the City Drone, user has to be certified as a remote drone pilot.
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL:
X COST $
YES NO
METHOD OF TRAVEL:
N/A CITY VEHICLE
AIRFARE DEPARTING FROM:
PRIVATE VEHICLE
ESTIMATE OF COST:
LODGING - TAXI
MEALS PARKING
$400.00 REGISTRATION AIRFARE
MILEAGE/FUEL
MISC/TOLLS
TOTAL FOR ALL: $ 400.00
BUDGET LINE ITEM: 010-03-8150-1346
X GRANT REIMBURSABLE
YES NO
X REQUIRED CERTIFICATION
YES NO
TOTAL: $ 400.00 PER PERSON
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE
AND IS NECESSARY AND BENEFICIAL TO THE
CITY OF WATERLOO
DEPARTM ' T HEAD
s--/6 gig
I APPROVE THIS TRAVEL REQUEST
MAYOR
5/z--1/ t a
DATE DATE
K:\Shared Goodies\Forms\Travel Request Form January 2010
TRAVE , REQUEST
CITY Y OF WATERLOO
L.
NAME(S) AND POSITION(S):
Forrest Graves John Hyman
Allan Fecht Steve Hoambrecker
Joe Schaefer Brian Rath
Joe Jones JR. _
NAME OF CLASS / MEETING:
Iowa Water Environment Association Annual Conference
DATE:
DEPARTURE DATE:
06-05-18
PURPOSE OF TRAVEL/TRAINING:
Education
FINANCE DEPT.
LINE ITEM USED
FY ,MgeBUDGETED
EXPENDED YTD
THIS REQUEST
LEFT AFTER THIS
REQUEST
DATE
STAFF ONLY
Ego , na0 13Wo
l?OUa a-
a9ya
/2eici3L
Original - Clerk/Finance Copy - Department
05-16-18
DESTINA/TION:
DEPARTURE POINT
IF NOT WATERLOO:
RETURN DATE:
06-07-18
Waterloo, IA
DATE(S) OF MEETING:
06/05-06/07/2018
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL:
x COST $
YES NO
METHOD OF TRAVEL:
x
CITY VEHICLE
AIRFARE
DEPARTING FROfill:
PRIVATE VEHICLE
ESTIMATE OF COST:
LODGING
MEALS
1375.00 REGISTRATION
MILEAGE/FUEL
TOTAL FOR ALL: $ 1815.00
TAXI
PARKING
AIRFARE
MISC/TOLLS
BUDGET LINE ITEM: 520-14-5200-1346
YES
x
NO
YES NO
GRANT REIMBURSABLE
REQUIRED CERTIFICATION
275.00non-mbr
TOTAL: $ 220 memb
PER PERSON
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE
AND IS NECESSARY AND BENEFICIAL TO THE
CITY OF WA'C R 0 - 1
-'DEPAR T MENTLHEAD
47;4 /FS
I APPROVE THIS TRAVEL REQUEST
MAYOR
FU Eaared Goodies\Forms\Travel Request Form January 2010 DATE
C/24o 119
11'RAV1IK1 REQUEST
CITY OF WATERLOO
FINANCE DEPT. STAFF ONLY
LINE ITEM USED 6//D A (3SJ6- / 6467
FY (2‘)i L6 BUDGETED
EXPENDED YTD
THIS REQUEST
LEFT AFTER THIS
REQUEST
DATE
Original - Clerk/Finance
3a15`'` -
I leir
/3 2 o ```-
9
Copy - Department
NAME(S) AND POSITION(S):
Ed Abben, Joel Shepard, Todd Henrich; Chris Petersen —
Building Maintenance
DATE:
5/16/2018
NAME OF CLASS / MEETING:
Navigating Asbestos - Webinar
DEPARTURE DATE:
June 12th thru June 14, 2018
(2 hrs each day)
DESTINATION City Hall
DEPARTURE POINT
IF NOT WATERLOO
RETURN DATE:
June 12th thru June 14th, 2018
DATE(S) OF MEETING:
June 12th thru June 14th, 2018
PURPOSE OF TRAVEL/TRAINING
For personnel who perform maintenance, inspection, custodial or other work of lead and asbestos.
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL:
x COST $
YES NO
METHOD OF TRAVEL:
CITY VEHICLE
AIRFARE
DEPARTING FROM:
PRIVATE VEHICLE
ESTIMATE OF COST:
LODGING
MEALS
1,320.00 REGISTRATION
MILEAGE/FUEL
TOTAL FOR ALL: $ 1,320.00
TAXI
PARKING
AIRFARE
MISC/TOLLS
BUDGET LINE ITEM: 010-22-8800-1346
X GRANT REIMBURSABLE
YES NO
x
YES NO
REQUIRED CERTIFICATION
TOTAL: $ 330.00
PER PERSON
I BELIEVE THIS TRIP SERVES fA_PUBLIC PURPOSE
AND IS NECESSARY AND BENEFI _.0 THE
CITY OF WATELOO
DEPARTMENT HEAD
DATE
K:\Shared Goodies\Forms\Travel Request Form January 2010
I APPROVE THIS TRAVEL REQUEST
\)c AeX1/t
MAYOR
7( E
DATE
TRAVEL REQUEST
CITY OF WATERLOO
FINANCE bEPT. STAFF ONLY
«2 (06-/.3 4t6
ry 40
417 C 41f
201(6 k3
LINE ITEM USED
FY 2 df kBUDGETED
EXPENDED YTD
THIS REQUEST
LEFT AFTER THIS
REQUEST
DATE
Original - Clerk/Finance
Copy - Department
NAME(S) AND POSITION(S):
Fred Burton, Artist / Guest Speaker
DATE:
May 15, 2018
NAME OF CLASS / MEETING:
Gallery Talk
DEPARTURE DATE:
May 22, 2018
DESTINATION: Waterloo, IA
DEPARTURE POINT
IF NOT WATERLOO: Memphis, TN
RETURN DATE:
May 24, 2018
•
DATE(S) OF MEETING:
May 23, 2018
PURPOSE OF TRAVEL/TRAINING:
Fred Burton will be giving a public gallery talk and lecture as a part of related programing to his exhibition "Graphic
Epistles and Messages in Motion 1 Works by Fred Burtion" currently on display at the WCA. Expenses will be supported
by the Cultural Leadership Partnership grant program through the Iowa Arts Council.
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL:
X COST $
YES NO
METHOD OF TRAVEL:
x
CITY VEHICLE
AIRFARE
PRIVATE VEHICLE
DEPARTING FROM: Memphis TN (MEM)
ESTIMATE OF COST:
$150 LODGING
$105 MEALS
REGISTRATION $563.10
MILEAGE/FUEL
TOTAL FOR ALL: $ $818.10
TAXI
PARKING
AIRFARE
MISC/TOLLS
BUDGET LINE ITEM: 26STG.OSG 010 26 42651346
GRANT REIMBURSABLE
YES NO
REQUIRED CERTIFICATION
YES NO
TOTAL: $ PER PERSON
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE
AND IS NECESSARY AND BENEFICIAL TO THE
CITY OF WATERLOO
DEPARTMENT HEAD
I APPROVE THIS TRAVEL REQUEST
MAYOR
--
DATE DATE
K:\Shared Goodies\Forms\Travel Request Form January 2010
TRAVEL REQUEST
CITY OF WATERLOO
FINANCE bEPT. STAFF ONLY
Ulcer l�
et -261C/26/6
LINE ITEM USED
FYMe BUDGETED
EXPENDED YTD
THIS REQUEST
LEFT AFTER THIS
REQUEST
DATE
-7Octo d4)
Wo
SGL a
w
61-16
Original - Clerk/Finance Copy - Department
NAME(S) AND POSITION(S):
Steve Gerberich, Artist / Guest Speaker
DATE:
May 15, 2018
NAME OF CLASS / MEETING:
Gallery Talk
DEPARTURE DATE:
May 22, 2018
DESTINATION: Waterloo, IA
DEPARTURE POINT
IF NOT WATERLOO: New York City, NY
DATE(S) OF MEETING:
May 23, 2018
RETURN DATE:
May 24, 2018
PURPOSE OF TRAVEL/TRAINING:
Steve Gerberich will be giving a public gallery talk and lecture as a part of related programing to the exhibition "Graphic
Epistles and Messages in Motion 1 Works by Fred Burtion" currently on display at the WCA. Works by Gerberich are also
included in the exhibit. Expenses will be supported by the Cultural Leadership Partnership grant program through the Iowa
Arts Council.
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL:
X COST $
YES NO
METHOD OF TRAVEL:
CITY VEHICLE
AIRFARE
PRIVATE VEHICLE
DEPARTING FROM: New York (LGA)
ESTIMATE OF COST:
$150 LODGING
$105 MEALS
REGISTRATION $225
MILEAGE/FUEL
TOTAL FOR ALL: $ $480
TAXI
PARKING
AIRFARE
MISC/TOLLS
BUDGET LINE ITEM: 26STG.OSG 010 26 42651346
GRANT REIMBURSABLE
YES NO
REQUIRED CERTIFICATION
YES NO
TOTAL: $ PER PERSON
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE
AND IS NECESSARY AND BENEFICIAL TO THE
CITY OF WATERLOO �
v_
DEPARTMENT HEAD
4.
1
I APPROVE THIS TRAVEL REQUEST
MAYOR
DATE DATE
K:\Shared Goodies\Forms\Travel Request Form January 2010
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Wooden boards, painted black and installed with
simple screws, run the entire length of the canopied
pedestrian bridge.
The 207,„
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ribbon cutting
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CITY OF WATERLOO, IOWA
CITY ATTORNEY'S OFFICE
715 Mulberry Street • Waterloo, IA 50703 • (319) 291-4327 Fax (319) 291-4286
May 21, 2018
Mayor Quentin Hart and
City Council Members
City Hall
Waterloo, IA 50703
Dear Mayor Hart and Council Members:
I have examined the bonds filed with the City Clerk/Auditor's Office up to the
close of business on May 21, 2018.
Of the 6 bonds submitted, (.`) were approved and C were rejected, as
shown on the attached list.
Very ,truly yours,
Dav4d R. Zellhoefer
Waterloo City Attorney
DRZ:sda
CITY WEBSITE: www.cityofwaterlooiowa.com
WE'RE WORKING FOR YOU!
An Equal Opportunity/Affirmative Action Employer
BONDS FOR COUNCIL APPROVAL
May 21, 2018
RIGHT OF WAY CONSTRUCTION BOND
7900428147
--7900414955
_
_95 CC 8008 4
—7900452183
—95 BM J361 5
—95 BM J031 6
BROCK EVEN CONSTRUCTION LLC
ENVISION CONCRETE & LANDSCAPE CONSTRUCTION LLC
JOE JONES dba JONES BROTHERS ASPHALT PAVING COMPANY
K. CUNNINGHAM CONSTRUCTION CO., INC.
NIHAD MASIC
WES GARDNER dba GARDNER PLUMBING
AMOUNT $15,000.00
JESUP, IA
WATERLOO, IA
WATERLOO, IA
CEDAR FALLS, IA
WATERLOO, IA
LA PORTE CITY, IA
CITY OF WATERLOO, IOWA
CITY ATTORNEY'S OFFICE
715 Mulberry Street • Waterloo, IA 50703 • (319) 291-4327 Fax (319) 291-4286
May 21, 2018
Mayor Quentin Hart and
City Council Members
City Hall
Waterloo, IA 50703
Dear Mayor Hart and Council Members:
I have examined the bonds filed with the City Clerk/Auditor's Office up to the
close of business on May 21, 2018.
Of the 6 bonds submitted,
shown on the attached list.
Very truly yours,
. - - '. d
David R. Zellhoefer
Waterloo City Attorney
DRZ:sda
were approved and '. were rejected, as
CITY WEBSITE: www.cityofwaterlooiowa.com
WE'RE WORKING FOR YOU!
An Equal Opportunity/Affirmative Action Employer
BONDS FOR COUNCIL APPROVAL
May 21, 2018
RIGHT OF WAY CONSTRUCTION BOND
7900428147
7900414955
95 CC 8008 4
7900452183
95 BM J361 5
95 BM J031 6
BROCK EVEN CONSTRUCTION LLC
ENVISION CONCRETE & LANDSCAPE CONSTRUCTION LLC
JOE JONES dba JONES BROTHERS ASPHALT PAVING COMPANY
K. CUNNINGHAM CONSTRUCTION CO., INC.
NIHAD MASIC
WES GARDNER dba GARDNER PLUMBING
AMOUNT $15,000.00
JESUP, IA
WATERLOO, IA
WATERLOO, IA
CEDAR FALLS, IA
WATERLOO, IA
LA PORTE CITY, IA
RIGHT OF WAY CONSTRUCTION BOND
No. 7900428147
ea3/
Applicant's Telephone Number:
KNOW ALL MEN BY THESE PRESENTS:
That (1), (We), Brock Even Construction LLC
of 13012 Fox Rd , Jesup
IA
Street City State
as Principal, and Nationwide Mutual Insurance Company
Des Moines IA
of
as Surety, are held and firmly bound unto the City of Waterloo, Black Hawk County, Iowa, in the penal
sum of FIFTEEN THOUSAND DOLLARS ($15,000.00) lawful money of the United States of America,
to the payment of which sum, well and truly to be made, the Principal herein firmly binds (himself)
(herself) (themselves) their heirs, executors and administrators, and the said Surety binds
themselves, their successors, assigns, executors and administrators, jointly and severally, firmly by
these presents.
THE CONDITIONS OF THE ABOVE OBLIGATION ARE SUCH that, by the provisions of the
Ordinances of the City of Waterloo, Iowa, a Surety Bond in the sum of Fifteen Thousand Dollars
($15,000.00) must be filed with the City Clerk/Auditor of the City of Waterloo, Iowa, before one may
engage in construction, reconstruction or excavation in the public right of way in said City.
NOW, THEREFORE, if the above bounden Brock Even Construction LLC of
Jesup IA will faithfully perform any and all duties
and abide by any and all regulations required by said Ordinances regulating the construction,
reconstruction and excavation projects within said City; and if (he), (she), (they) will promptly pay to
said City any and all sums and amounts due or that may become due or owing by reason of or under
said Ordinances; and if (he), (she), (they) will pay all fines imposed upon (him), (her), (them), or a
violation of said Ordinances occurring during the life of this bond; and if (he), (she), (they) will
indemnify and keep the City harmless from all liability for any accident and/or damages arising from
(his), (her), (their) doing, protecting or completing the work, then this obligation to be null and void,
otherwise to remain in full force and effect.
The effective date of this Bond is May 1, 20 18 . through April 30, 20 19 .
Witness our hands this 3rd day of January , 20 18 .
Brock Even Construction LLC
PRINCIPAL
PLEASE MAIL TO:
By:
City of Waterloo, Iowa
Engineering Department Printed Name: �'ve
7.15 Mulberry Street
Waterloo, IA 50703
Updated 1-24-00
PLEASE COMPLETE CHECKLIST ON REVERSE SIDE BEFORE SUBMITTING BOND.
Nationwide Mutual Insurance Company
SURET
By:
Attorney-in-fact Cassie Mckittrick
Nationwide'
Power of Attorney
KNOW ALL MEN BY THESE PRESENTS THAT:
Nationwide Mutual Insurance Company, an Ohio corporation AMCO Insurance Company, an Iowa corporation
Allied Property and Casualty Insurance Company, an Iowa corporation
National Casualty Company, an Ohio corporation
hereinafter referred to severally as the "Company" and collectively as "the Companies' does hereby make, constitute and appoint:
Cassie McKittrick
each in their individual capacity, its true and lawful attorney-in-fact, with full power and authority to sign, seal, and execute on its behalf any and all bonds and
undertakings, and other obligatory instruments of similar nature, in penalties not exceeding the sum of
Fifteen Thousand Dollars ($15,000.00)
and to bind the Company thereby, as fully and to the same extent as if such instruments were signed by the duly authorized officers of the Company; and all acts
of said Attorney pursuant to the authority given are hereby ratified and confirmed.
This power of attorney is made and executed pursuant to and by authority of the following resolution duly adopted by the board of directors of the Company:
"RESOLVED, that the president, or any vice president be, and each hereby is, authorized and empowered to appoint attorneys -in -fact of the Company,
and to authorize them to execute and deliver on behalf of the Company any and all bonds, forms, applications, memorandums, undertakings,
recognizances, transfers, contracts of indemnity, policies, contracts guaranteeing the fidelity of persons holding positions of public or private trust, and other
writings obligatory in nature that the business of the Company may require; and to modify or revoke, with or without cause, any such appointment or
authority; provided, however, that the authority granted hereby shall in no way limit the authority of other duly authorized agents to sign and countersign any
of said documents on behalf of the Company."
"RESOLVED FURTHER, that such attorneys -in -fact shall have full power and authority to execute and deliver any and all such documents and to bind the
Company subject to the terms and limitations of the power of attorney issued to them, and to affix the seal of the Company thereto; provided, however, that
said seal shall not be necessary for the validity of any such documents."
This power of attorney is signed and sealed under and by the following bylaws duly adopted by the board of directors of the Company.
Execution of Instruments. Any vice president, any assistant secretary or any assistant treasurer shall have the power and authority to sign or attest all
approved documents, instruments, contracts, or other papers in connection with the operation of the business of the company in addition to the chairman of
the board, the chief executive officer, president, treasurer or secretary; provided, however, the signature of any of them may be printed, engraved, or
stamped on any approved document, contract, instrument, or other papers of the Company.
IN WITNESS WHEREOF, the Company has caused this instrument o be ealed anmy attested by the signature of its officer the 1st day of
May 2017
4soalltib
/,:SEAL 0
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4, `'`I
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/` SEAL10
Antonio Albanese, Vice President of Nationwide Mutual Insurance Company, National
Casualty ompany, AMCO Insurance Company, Allied Property and Casualty Insurance Company
ACKNOWLEDGMENT
STATE OF NEW YORK, COUNTY OF NEW YORK: ss
On this 1st day of May , 2017 , before me came the above-named officer for the
Company aforesaid, to me personally known to be the officer described in and who executed the
preceding instrument, and he acknowledged the execution of the same, and being by me duly
sworn, deposes and says, that he is the officer of the Company aforesaid, that the seal affixed
hereto is the corporate seal of said Company, and the said corporate seal and his signature were
duly affixed and subscribed to said instrument by the authority and direction of said Company.
BARRY T. BASSIS
Notary Public, State of New York
No. 025A4656400
Qualified in New York County
Commission Expires April 30, 2019
Notary Public
My Commission Expires
CERTIFICATE April 30, 2019
I, Laura B. Guy, Assistant Secretary of the Company, do hereby certify that the foregoing is a full, true and correct copy of the original power of attorney issued
by the Company; that the resolution included therein is a true and correct transcript from the minutes of the meetings of the boards of directors and the same has
not been revoked or amended in any manner; that said Antonio C. Albanese was on the date of the execution of the foregoing power of attorney the duly elected
officer of the Company, and the corporate seal and his signature as officer were duly affixed and subscribed to the said instrument by the authority of said board
of directors; and the foregoing power of attorney is still in full force and effect.
IN WITNESS WHEREOF, I have hereunto subscribed my name as Assistant Secretary, and affixed the corporate sgal of said Company this 3rd
January 2018
Assistant Secretary �v1
This power of attorney expires: April 30, 2019
BDJ 1(05-17)00
day of
RIGHT OF WAY CONSTRUCTION BOND
No. 7900414955
Applicant's Telephone Number: 319-269-5219
KNOW ALL MEN BY THESE PRESENTS:
That (I), (We), Envision Concrete & Landscape Construction LLC
of 3354 E Shaulis Rd , Waterloo IA
Street City State
as Principal, and Nationwide Mutual Insurance Company
Des Moines IA
of
as Surety, are held and firmly bound unto the City of Waterloo, Black Hawk County, Iowa, in the penal
sum of FIFTEEN THOUSAND DOLLARS ($15,000.00) lawful money of the United States of America,
to the payment of which sum, well and truly to be made, the Principal herein firmly binds (himself)
(herself) (themselves) their heirs, executors and administrators, and the said Surety binds
themselves, their successors, assigns, executors and administrators, jointly and severally, firmly by
these presents.
THE CONDITIONS OF THE ABOVE OBLIGATION ARE SUCH that, by the provisions of the
Ordinances of the City of Waterloo, Iowa, a Surety Bond in the sum of Fifteen Thousand Dollars
($15,000.00) must be filed with the City Clerk/Auditor of the City of Waterloo, Iowa, before one may
engage in construction, reconstruction or excavation in the public right of way in said City.
NOW, THEREFORE, if the above bounden Envision Concrete & Landscape Construction LLC of
Waterloo IA will faithfully perform any and all duties
and abide by any and all regulations required by said Ordinances regulating the construction,
reconstruction and excavation projects within said City; and if (he), (she), (they) will promptly pay to
said City any and all sums and amounts due or that may become due or owing by reason of or under
said Ordinances; and if (he), (she), (they) will pay all fines imposed upon (him), (her), (them), or a
violation of said Ordinances occurring during the life of this bond; and if (he), (she), (they) will
indemnify and keep the City harmless from all liability for any accident and/or damages arising from
(his), (her), (their) doing, protecting or completing the work, then this obligation to be null and void,
otherwise to remain in full force and effect.
The effective date of this Bond is May 1, 20 18 , through April 30, 20 19 .
Witness our hands this 3rd day of
PLEASE MAIL TO:
January , 20 18 .
Envision Concrete & Landscape Construction LLC
PRINCIPAL ,7
By:
City of Waterloo, Iowa
Engineering Department Printed Name: 44S9GiCZ 7/ '?69- 52/7
715 Mulberry Street
Waterloo, IA 50703 Nationwide Mutual Insurance Company
SURETY
By:
Attorney-in-fact Cassie McMarick
Updated 1-24-00
PLEASE COMPLETE CHECKLIST ON REVERSE SIDE BEFORE SUBMITTING BOND.
Nationwide
Power of Attorney
KNOW ALL MEN BY THESE PRESENTS THAT:
Nationwide Mutual Insurance Company, an Ohio corporation AMCO Insurance Company, an Iowa corporation
Allied Property and Casualty Insurance Company, an Iowa corporation
National Casualty Company, an Ohio corporation
hereinafter referred to severally as the "Company" and collectively as "the Companies" does hereby make, constitute and appoint:
Cassie McKittrick
each in their individual capacity, its true and lawful attorney-in-fact. with full power and authority to sign, seal, and execute on its behalf any and all bonds and
undertakings, and other obligatory instruments of similar nature, in penalties not exceeding the sum of
Fifteen Thousand Dollars ($15,000.00)
and to bind the Company thereby, as fully and to the same extent as if such instruments were signed by the duly authorized officers of the Company; and at acts
of said Attorney pursuant to the authority given are hereby ratified and confirmed.
This power of attorney is made and executed pursuant to and by authority of the following resolution duly adopted by the board of directors of the Company:
"RESOLVED, that the president, or any vice president be, and each hereby is, authorized and empowered to appoint attorneys -in -fact of the Company,
and to authorize them to execute and deliver on behalf of the Company any and alt bonds, forms, applications, memorandums, undertakings,
recognizances, transfers, contracts of indemnity, policies, contracts guaranteeing the fidelity of persons holding positions of public or private trust, and other
writings obligatory in nature that the business of the Company may require; and to modify or revoke, with or without cause, any such appointment or
authority; provided, however, that the authority granted hereby shall in no way limit the authority of other duly authorized agents to sign and countersign any
of said documents on behalf of the Company."
"RESOLVED FURTHER, that such attorneys -in -fact shall have full power and authority to execute and deliver any and all such documents and to bind the
Company subject to the terms and limitations of the power of attorney issued to them, and to affix the seal of the Company thereto; provided, however, that
said seal shall not be necessary for the validity of any such documents."
This power of attorney is signed and sealed under and by the following bylaws duly adopted by the board of directors of the Company.
Execution of Instruments. Any vice president, any assistant secretary or any assistant treasurer shall have the power and authority to sign or attest all
approved documents, instruments, contracts, or other papers in connection with the operation of the business of the company in addition to the chairman of
the board, the chief executive officer, president, treasurer or secretary; provided, however, the signature of any of them may be printed, engraved, or
stamped on any approved document, contract, instrument, or other papers of the Company.
IN WITNESS WHEREOF, the Company has caused this instrument o be eaied anly attested by the signature of its officer the 1st day of
May 2017 .
Antonio Albanese, Vice President of Nationwide Mutual Insurance Company, National
Casualty ompany, AMCO Insurance Company, Allied Property and Casualty Insurance Company
ACKNOWLEDGMENT
STATE OF NEW YORK, COUNTY OF NEW YORK: ss
On this 1st day of May , 2017 , before me came the above-named officer for the
Company aforesaid, to me personally known to be the officer described in and who executed the
preceding instrument, and he acknowledged the execution of the same, and being by me duly
sworn, deposes and says, that he is the officer of the Company aforesaid, that the seal affixed
hereto is the corporate seal of said Company, and the said corporate seal and his signature were
duly affixed and subscribed to said instrument by the authority and direction of said Company.
BARRY T. BASSIS
Notary Public, State of New York
No. 02BA4656400
Qualified in New York County
Commission Expires April 30, 2019
Notary Public
My Commission Expires
CERTIFICATE April 30, 2019
1, Laura B. Guy, Assistant Secretary of the Company, do hereby certify that the foregoing is a full, true and correct copy of the original power of attorney issued
by the Company; that the resolution included therein is a true and correct transcript from the minutes of the meetings of the boards of directors and the same has
not been revoked or amended in any manner; that said Antonio C. Albanese was on the date of the execution of the foregoing power of attorney the duly elected
officer of the Company, and the corporate seal and his signature as officer were duly affixed and subscribed to the said instrument by the authority of said board
of directors; and the foregoing power of attorney is still in full force and effect.
IN WITNESS WHEREOF, I have hereunto subscribed my name as Assistant Secretary, and affixed the corporate seal of said Company this 3rd day of
January 2018
This power of attorney expires:
BDJ 1(05-17)00
April 30, 2019
Assistant Secretary
RIGHT OF WAY CONSTRUCTION BOND
NO. 95 CC 8008 4
Applicant's Telephone Number: � 4207
KNOW ALL MEN BY THESE PRESENTS:
That (I) (We), JOE JONES DBA JONES BROTHER ASPHALT PAVING COMPANY,
of 909 SHORT ST WATERLOO IA 50707,
Street City State
as Principal, and STATE FARM FIRE AND CASUALTY COMPANY of
ONE STATE FARM PLAZA, BLOOMINGTON, IL 61710
as Surety, are held and firmly bound unto the City of Waterloo, Black Hawk County, Iowa, in the penal
sum of FIFTEEN THOUSAND DOLLARS ($15,000.00) lawful money of the United States of America,
to the payment of which sum, well and truly to be made, the Principal herein firmly binds (himself)
(herself) (themselves) their heirs, executors and administrators, and the said Surety binds
themselves, their successors, assigns, executors and administrators, jointly and severally, firmly by
these presents.
THE CONDITIONS OF THE ABOVE OBLIGATION ARE SUCH that, by the provisions of the
Ordinances of the City of Waterloo, Iowa, a Surety Bond in the sum of Fifteen Thousand Dollars
($15,000.00) must be filed with the City Clerk/Auditor of the City of Waterloo, Iowa, before one may
engage in construction, reconstruction or excavation in the public right of way in said City.
NOW, THEREFORE, if the above bounden JOE JONES DBA JONES BROTHER ASPHALT PAVING
COMPANY of
909 SHORT ST WATERLOO IA 50707 will faithfully perform any and all duties
and abide by any and all regulations required by said Ordinances regulating the construction,
reconstruction and excavation projects within said City; and if (he), (she), (they) will promptly pay to
said City any and all sums and amounts due or that may become due or owing by reason of or under
said Ordinances; and if (he), (she), (they) will pay all fines imposed upon (him), (her), (them), for a
violation of said Ordinances occurring during the life of this bond; and if (he), (she), (they) will
indemnify and keep the City harmless from all liability for any accident and/or damages arising from
(his), (her), (their) doing, protecting or completing the work, then this obligation to be null and void,
otherwise to remain in full force and effect.
The effective date of this Bond is MAY 1, 2018 through APRIL 30, 2019.
Witness our hands this 5TH day of MARCH, 2018.
PLEASE MAIL TO:
City of Waterloo, Iowa
Engineering Department
715 Mulberry Street
Waterloo, IA 50703
Updated 1-24-00
k'"EAN�c `" Printed ame: SUZANNE M ROBERTSON
O
pPPRgT
. _.• 4._ SURE Y
State Farm Fire and Casualty Company
By.
orney-in-Fact
PLEASE COMPLETE CHECKLIST ON REVERSE SIDE BEFORE SUBMITTING BOND.
SFB-4000151A.1
THE FOLLOWING IS A HELPFUL CHECKLIST TO ASSIST THE PRINCIPAL
AND / OR SURETY. THERE MAY BE OTHER ITEMS REQUIRED BY THE SURETY,
WHICH ARE NOT LISTED HERE. BEFORE SUBMITTING THIS RIGHT-OF-WAY
CONSTRUCTION BOND FORM, PLEASE BE SURE THE FOLLOWING ITEMS ARE
COMPLETED:
d the correct local telephone number of the principal is included;
✓ the typewritten name of the principal is the same as the name on the signature
line;
✓ the bond is signed by the principal;
d the correct address for the principal is included;
b surety's address is correct;
✓ beginning and expiration dates are correct, beginning date on bond may be
changed, all right-of-way construction bonds expire on April 30 of the following
year (i.e. bond written during 2005 shall expire April 30,2006);
✓ the attached power -of attorney must be effective prior to, or on, the date the
bond is issued.
d attorney-in-fact signing the right-of-way construction bond is listed on the
power-of-attorney; and
✓ name of attorney-in-fact is typed under the signature line.
✓ once the above -referenced items are completed this form must be submitted to
the City of Waterloo Engineering Department so that it can be forwarded to the
City Council for approval before any permits can be issued. Any items received
in the Engineering Department by 4:00 P.M. on Tuesdays will be placed on the
following Monday's agenda or the next available Council meeting due to a fifth
Monday in a month and/or holidays.
SFB-4000151A.1
Power of Attorney
STATE FARM FIRE AND CASUALTY COMPANY
KNOW ALL PERSONS BY THESE PRESENTS: That STATE FARM FIRE AND CASUALTY COMPANY, an Illinois corporation, with its principal office in
Bloomington, Illinois, does hereby constitute and appoint: Eugina Brant, Amanda J. Clifton, Pamela Chancellor, Julie Fehrman, Kim Filter, Mark Fink, Julie
Freed, Matthew J. Gibbons, Jay W. Hendren, John R. Horton, Jeanette Hughes, Jerry Jacek, Susan K. Johnson, Connie S. Knox, Leann Lemmel, Christine
Macdonnell, Lori McDowell, Thomas P. Miller, Melissa L. Morris, Vicki Redman, Suzanne M. Robertson, Alice Schuler, Heidi Simmons, Heidi Stevens,
Steven M. Straub, Perry Tracy, Kathy J. Walker, Karen Weber, Karli Yoder of Bloomington, Illinois its true and lawful Attorney(s)-in-Fact, to make, execute,
seal and deliver for, and on its behalf as surety, any and all bonds, undertakings or other writings obligatory in the nature of a bond as follows:
Any such obligation in any amount
This appointment is made under and by the authority of a resolution which was passed by the Executive Committee of the Board of
Directors of State Farm Fire and Casualty Company on the 5th day of September, 2017, as is duty authorized by the Board of Directors in
Article Il, Section 6 of the By -Laws of the Company, which resolution is:
Resolved, that the Officer of the Company who works regularly with surety bonds is hereby authorized to appoint and empower any
representative of the Company or other person or persons as Attorney -in -Fact to execute on behalf of the Company any bonds,
undertakings, policies, contracts of indemnity or other writings obligatory in the nature of a bond, which the Company might execute through
its officers, and affix the seal of the Company thereto. Any said execution of such documents by an Attorney -in -Fact shall be as binding
upon the Company as if they had been duly executed and acknowledged by the regularly elected or appointed officers of the Company. Any
Attorney -in -Fact, so appointed, may be removed for good cause and the authority so granted may be revoked as specified in the Power of
Attorney. _
Resolved, that the signature of any Officer of the Company noted above and the seal of the Company may be affixed by facsimile on
any power of attorney granted, and the signature of the any Officer of the Company noted above, and the seal of the Company may be
affixed by facsimile to any certificate of any such power and any such power or certificate bearing such facsimile signature and seal shall be
valid and binding on the Company. Any such power so executed and sealed and certificate so executed and sealed shall, with respect to
any bond or undertaking to which it is attached, continue to be valid and binding on the Company.
IN WITNESS THEREOF, STATE FARM FIRE AND CASUALTY COMPANY has caused this instrument to be signed by its Assistant
Secretary Treasurer, and its Corporate Seal to be affixed this 5th day of September, 2017.
This APPOINTMENT SHALL CEASE AND TERMINATE AUTOMATICALLY AS OF DECEMBER 31, 2021, UNLESS SOONER
REVOKED AS PROVIDED.
ARO Cgs,
. ,0APOgq? O ,
W ; i
;•.., SEARE,
STATE OF ILLINOIS
COUNTY OF McLEAN
On this 5th day of September, 2017, before me personally came John R. Horton to me known, who being duly sworn, did depose and say that he is
Assistant Secretary Treasurer of STATE FARM FIRE AND CASUALTY COMPANY, the corporation described in and which executed the above instrument;
that he knows the seal of said corporation; that the seal affixed to said instrument is such Corporate Seal; and that he executed said instrument on behalf of
the corporation by authority of his office under the By -Laws of said corporation.
STATE FARM FIRE AND CASUALTY COMPANY
1
By: 1,.
John R.-torton - Assistant Secretary Tfeasur r /
CERTIFICATE
My commission expires August 30, 2021
I, the undersigned Assistant Secretary Treasurer of STATE FARM FIRE AND CASUALTY COMPANY, do hereby certify that the original Power of
Attorney of which the foregoing is a true and correct copy, is in full force and effect and has not been revoked and the resolutions as set forth are now in
force.
Signed and sealed at Bloomington, Illinois. Dated this 5TH day of MARCH, 2018.
�l4 .' GOPPONgl ':.o �i
F ;
SEfi JI
ay • far_
If you have a question concerning the validity of this Power of Attorney, call (309) 766-2090.
FB6-9043.54A
(09-05-2017)
A- istant Treasurer
Printed in U.S.A.
RIGHT OF WAY CONSTRUCTION BOND
No. 7900452183
Applicant's Telephone Number: S/0 ./7360/
KNOW ALL MEN BY THESE PRESENTS:
That (I), (We), K. Cunningham Construction Co., Inc.
of 1025 Center Street Cedar Falls IA
Street
City State
as Principal, and Nationwide Mutual Insurance Company of
Des Moines IA
as Surety, are held and firmly bound unto the City of Waterloo, Black Hawk County, Iowa, in the penal
sum of FIFTEEN THOUSAND DOLLARS ($15,000.00) lawful money of the United States of America,
to the payment of which sum, well and truly to be made, the Principal herein firmly binds (himself)
(herself) (themselves) their heirs, executors and administrators, and the said Surety binds
themselves, their successors, assigns, executors and administrators, jointly and severally, firmly by
these presents.
THE CONDITIONS OF THE ABOVE OBLIGATION ARE SUCH that, by the provisions of the
Ordinances of the City of Waterloo, Iowa, a Surety Bond in the sum of Fifteen Thousand Dollars
($15,000.00) must be filed with the City Clerk/Auditor of the City of Waterloo, Iowa, before one may
engage in construction, reconstruction or excavation in the public right of way in said City.
NOW, THEREFORE, if the above bounden K. Cunningham Construction Co., Inc. of
Cedar Fans IA will faithfully perform any and all duties
and abide by any and all regulations required by said Ordinances regulating the construction,
reconstruction and excavation projects within said City; and if (he), (she), (they) will promptly pay to
said City any and all sums and amounts due or that may become due or owing by reason of or under
said Ordinances; and if (he), (she), (they) will pay all fines imposed upon (him), (her), (them), or a
violation of said Ordinances occurring during the life of this bond; and if (he), (she), (they) will
indemnify and keep the City harmless from all liability for any accident and/or damages arising from
(his), (her), (their) doing, protecting or completing the work, then this obligation to be null and void,
otherwise to remain in full force and effect.
The effective date of this Bond is May 1, 20 18 , through April 30, 20 19 .
Witness our hands this 3rd day of January
PLEASE MAIL TO:
City of Waterloo, Iowa
Engineering Department
715 Mulberry Street
Waterloo, IA 50703
, 20 18
K. Cunningham Construction Co., Inc.
PRINCIPAL
By:
yr
Printed Name: —]`C ((c, CU r-rq
Nationwide Mutual Insurance Company
SURE Y
By:
Attorney-in-fact Cassie McKittrick
Updated 1-24-00
PLEASE COMPLETE CHECKLIST ON REVERSE SIDE BEFORE SUBMITTING BOND,
Nationwide
Power of Attorney
KNOW ALL MEN BY THESE PRESENTS THAT:
Nationwide Mutual Insurance Company, an Ohio corporation AMCO Insurance Company, an Iowa corporation
Allied Property and Casualty Insurance Company, an Iowa corporation
National Casualty Company, an Ohio corporation
hereinafter referred to severally as the "Company" and collectively as "the Companies" does hereby make, constitute and appoint:
Cassie McKittrick
each in their individual capacity, its true and lawful attorney-in-fact, with full power and authority to sign, seal, and execute on its behalf any and all bonds and
undertakings, and other obligatory instruments of similar nature, in penalties not exceeding the sum of
Fifteen Thousand Dollars ($15,000.00)
and to bind the Company thereby, as fully and to the same extent as if such instruments were signed by the duly authorized officers of the Company; and all acts
of said Attorney pursuant to the authority given are hereby ratified and confirmed.
This power of attorney is made and executed pursuant to and by authority of the following resolution duly adopted by the board of directors of the Company:
"RESOLVED, that the president, or any vice president be, and each hereby is, authorized and empowered to appoint attorneys -in -fact of the Company,
and to authorize them to execute and deliver on behalf of the Company any and all bonds, forms, applications, memorandums, undertakings,
recognizances, transfers, contracts of indemnity, policies, contracts guaranteeing the fidelity of persons holding positions of public or private trust, and other
writings obligatory in nature that the business of the Company may require; and to modify or revoke, with or without cause, any such appointment or
authority; provided, however, that the authority granted hereby shall in no way limit the authority of other duly authorized agents to sign and countersign any
of said documents on behalf of the Company."
"RESOLVED FURTHER, that such attorneys -in -fact shall have full power and authority to execute and deliver any and all such documents and to bind the
Company subject to the terms and limitations of the power of attorney issued to them, and to affix the seal of the Company thereto; provided, however, that
said seal shall not be necessary for the validity of any such documents."
This power of attorney is signed and sealed under and by the following bylaws duly adopted by the board of directors of the Company.
Execution of Instruments. Any vice president, any assistant secretary or any assistant treasurer shall have the power and authority to sign or attest all
approved documents, instruments, contracts, or other papers in connection with the operation of the business of the company in addition to the chairman of
the board, the chief executive officer, president, treasurer or secretary; provided, however, the signature of any of them may be printed, engraved, or
stamped on any approved document, contract, instrument, or other papers of the Company.
IN WITNESS WHEREOF, the Company has caused this instrument o be ealed an.. my attested by the signature of its officer the 1st day of
May s 2017
Irl�
%''t!>arr ,�
r
/ t SEALL
,`;4.--
0:.SEAL0
Antonio Albanese, Vice President of Nationwide Mutual Insurance Company, National
Casualty ompany, AMCO Insurance Company, Allied Property and Casualty Insurance Company
ACKNOWLEDGMENT
STATE OF NEW YORK, COUNTY OF NEW YORK: ss
On this 1st day of May , 2017 , before me came the above-named officer for the
Company aforesaid, to me personally known to be the officer described in and who executed the
preceding instrument, and he acknowledged the execution of the same, and being by me duly
sworn, deposes and says, that he is the officer of the Company aforesaid, that the seal affixed
hereto is the corporate seal of said Company, and the said corporate seal and his signature were
duly affixed and subscribed to said instrument by the authority and direction of said Company.
BARRY T. BASSIS
Notary Public, State of New York
No. 02BA4656400
Qualified in New York County
Commission Expires April 30, 2019
Notary Public
My Commission Expires
CERTIFICATE April 30, 2019
I, Laura B. Guy, Assistant Secretary of the Company, do hereby certify that the foregoing is a full, true and correct copy of the original power of attorney issued
by the Company; that the resolution included therein is a true and correct transcript from the minutes of the meetings of the boards of directors and the same has
not been revoked or amended in any manner; that said Antonio C. Albanese was on the date of the execution of the foregoing power of attorney the duly elected
officer of the Company, and the corporate seal and his signature as officer were duly affixed and subscribed to the said instrument by the authority of said board
of directors; and the foregoing power of attorney is still in full force and effect.
IN WITNESS WHEREOF, I have hereunto subscribed my name as Assistant Secretary, and affixed the corporate seai of said Company this
January 2018
•
This power of attorney expires: April 30, 2019
BDJ 1(05-17)00
3rd day of
Assistant Secretary
RIGHT OF WAY CONSTRUCTION BOND
NO. 95 BM J361 5
Applicant's Telephone Number: 319-529-8172
KNOW ALL MEN BY THESE PRESENTS:
That (I) (We), NIHAD MASIC
of 1302 HAMMOND AVE, WATERLOO, IOWA 50702
Street City State
as Principal, and STATE FARM FIRE AND CASUALTY COMPANY
of
ONE STATE FARM PLAZA, BLOOMINGTON, IL 61710
as Surety, are held and firmly bound unto the City of Waterloo, Black Hawk County, Iowa, in the penal
sum of FIFTEEN THOUSAND DOLLARS ($15,000.00) lawful money of the United States of America,
to the payment of which sum, well and truly to be made, the Principal herein firmly binds (himself)
(herself) (themselves) their heirs, executors and administrators, and the said Surety binds
themselves, their successors, assigns, executors and administrators, jointly and severally, firmly by
these presents.
THE CONDITIONS OF THE ABOVE OBLIGATION ARE SUCH that, by the provisions of the
Ordinances of the City of Waterloo, Iowa, a Surety Bond in the sum of Fifteen Thousand Dollars
($15,000.00) must be filed with the City Clerk/Auditor of the City of Waterloo, Iowa, before one may
engage in construction, reconstruction or excavation in the public right of way in said City.
NOW, THEREFORE, if the above bounden NIHAD MASIC of
1302 HAMMOND AVE WATERLOO, IOWA 50702 will faithfully perform any and all duties
and abide by any and all regulations required by said Ordinances regulating the construction,
reconstruction and excavation projects within said City; and if (he), (she), (they) will promptly pay to
said City any and all sums and amounts due or that may become due or owing by reason of or under
said Ordinances; and if (he), (she), (they) will pay all fines imposed upon (him), (her), (them), for a
violation of said Ordinances occurring during the life of this bond; and if (he), (she), (they) will
indemnify and keep the City harmless from all liability for any accident and/or damages arising from
(his), (her), (their) doing, protecting or completing the work, then this obligation to be null and void,
otherwise to remain in full force and effect.
The effective date of this Bond is MAY 7, 2018 through APRIL 30 2019.
Witness our hands this 7TH day of MAY 2018.
PLEASE MAIL TO:
City of Waterloo, Iowa
Engineering Department
715 Mulberry Street
Waterloo, IA 50703
Updated 1-24-00
-Ix ANO C44•
'h,ii
� opvo"4
sW: f ;
sysz State Farm Fire and Casualty Company
SURET"
+O
N. had /llast ei
PRINCIPAL
By: A 7 /:/J 47 -s_
Printed Name: EUGINA BRANT
By:
,B -(0_46t,
Attorr
-in-Fact
PLEASE COMPLETE CHECKLIST ON REVERSE SIDE BEFORE SUBMITTING BOND.
SFB-4000151A.1
THE FOLLOWING IS A HELPFUL CHECKLIST TO ASSIST THE PRINCIPAL
AND / OR SURETY. THERE MAY BE OTHER ITEMS REQUIRED BY THE SURETY,
WHICH ARE NOT LISTED HERE. BEFORE SUBMITTING THIS RIGHT-OF-WAY
CONSTRUCTION BOND FORM, PLEASE BE SURE THE FOLLOWING ITEMS ARE
COMPLETED:
✓ the correct local telephone number of the principal is included;
✓ the typewritten name of the principal is the same as the name on the signature
line;
✓ the bond is signed by the principal;
✓ the correct address for the principal is included;
✓ surety's address is correct;
✓ beginning and expiration dates are correct, beginning date on bond may be
changed, all right-of-way construction bonds expire on April 30 of the following
year (i.e. bond written during 2005 shall expire April 30,2006);
✓ the attached power -of attorney must be effective prior to, or on, the date the
bond is issued.
✓ attorney-in-fact signing the right-of-way construction bond is listed on the
power-of-attorney; and
✓ name of attorney-in-fact is typed under the signature line.
✓ once the above -referenced items are completed this form must be submitted to
the City of Waterloo Engineering Department so that it can be forwarded to the
City Council for approval before any permits can be issued. Any items received
in the Engineering Department by 4:00 P.M. on Tuesdays will be placed on the
following Monday's agenda or the next available Council meeting due to a fifth
Monday in a month and/or holidays.
SFB-4000151A.1
Power of Attorney
STATE FARM FIRE AND CASUALTY COMPANY
KNOW ALL PERSONS BY THESE PRESENTS: That STATE FARM FIRE AND CASUALTY COMPANY, an Illinois corporation, with its principal office in `
Bloomington, Illinois, does hereby constitute and appoint: Eugina Brant, Amanda J. Clifton, Pamela Chancellor, Julie Fehrman, Kim Filter, Mark Fink, Julie
Freed, Matthew J. Gibbons, Jay W. Hendren, John R. Horton, Jeanette Hughes, Jerry Jacek, Susan K. Johnson, Connie S. Knox, Leann Lemmel, Christine
Macdonnell, Lori McDowell, Thomas P. Miller, Melissa L. Morris, Vicki Redman, Suzanne M. Robertson, Alice Schuler, Heidi Simmons, Heidi Stevens,
Steven M. Straub, Perry Tracy, Kathy J. Walker, Karen Weber, Karli Yoder of Bloomington, Illinois its true and lawful Attorney(s)-in-Fact, to make, execute,
seal and deliver for, and on its behalf as surety, any and all bonds, undertakings or other writings obligatory in the nature of a bond as follows:
Any such obligation in any amount
This appointment is made under and by the authority of a resolution which was passed.bythe Executive Committee of the Board of
Directors of State Farm Fire and Casualty Company on the 5th day of September, 2017, as is duly authorized by the Board of Directors in
Article II, Section 6 of the By -Laws of the Company, which resolution is:
\ is
Resolved, that the Officer of the Company who works regularly with surety bonds is hereby. authorized to appoint and empower any
representative of the Company or other person or persons as Attorney -in -Fact to execute on behalf of the Company any bonds,
undertakings, policies, contracts of indemnity or other writings obligatory in the nature of a\bond, which the Company might execute through
its officers, and affix the seal of the Company thereto. Any said execution of such,documents by an Attorney -in -Fact shall be as binding
upon the Company as if they had been duly executed and acknowledged by the regularly elected or appointed officers of the Company. Any
Attorney -in -Fact, so appointed, may be removed for good cause. and the authority so granted may be revoked as specified in the Power of
Attorney.
Resolved, that the signature of any Officer of the Company noted above and the seal of the Company may be affixed by facsimile on
any power of attorney granted, and the signature\ of the any Officer of the Company noted above, and the seal of the Company may be
affixed by facsimile to any certificate of any such power and any such power or certificate bearing such facsimile signature and seal shall be
valid and binding on the Company. Anyssuch power so executed and sealed and certificate so executed and sealed shall, with respect to
any bond or undertaking to which it is attached, continue to be valid and binding on the Company.
IN WITNESS THEREOF, STATE FARM°,FIRE AND CASUALTY COMPANY has caused this instrument to be signed by its Assistant
Secretary Treasurer and its',Corporate Seal to be affixed this 59' day of September, 2017.
This APPOINTMENT SHALL CEASE AND TERMINATE AUTOMATICALLY AS OF DECEMBER 31, 2021, UNLESS SOONER
REVOKED AS PROVIDED.
STATE OF ILLINOIS
COUNTY OF McLEAN
On this 5th day of September, 2017, before me personally came John R. Horton to me known, who being duly sworn, did depose and say that he is
Assistant Secretary Treasurer of STATE FARM FIRE AND CASUALTY COMPANY, the corporation described in and which executed the above instrument;
that he knows the seal of said corporation; that the seal affixed to said instrument is such Corporate Seal; and that he executed said instrument on behalf of
the corporation by authority of his office under the By -Laws of said corporation.
STATE FARM FIRE AND CASUALTY COMPANY
f
By:..
John R., -• rton - Assistant Secretary Tfeasur r
CERTIFICATE
My commission expires August 30, 2021
I, the undersigned Assistant Secretary Treasurer of STATE FARM FIRE AND CASUALTY COMPANY, do hereby certify that the original Power of
Attorney of which the foregoing is a true and correct copy, is in full force and effect and has not been revoked and the resolutions as set forth are now in
force.
Signed and sealed at Bloomington, Illinois. Dated this 7TH day of MAY 2018.
__ `Q,E AND CgsU h,i
�. ,oaroRgT..?
Z
SEAL
0
If you have a question concerning the validity of this Power of Attorney, call (309) 766-2090.
FB6-9043.54A
(09-05-2017)
istant Treasurer
Printed in U.S.A.
RIGHT OF WAY CONSTRUCTION BOND
Applicant's Telephone Number:
KNOW ALL MEN BY THESE PRESENTS:
That (I) (We), WES GARDNER DBA GARDNER PLUMBING ,
of PO BOX 64, LA PORTE CITY IA,
Street City State
as Principal, and STATE FARM FIRE AND CASUALTY COMPANY
of
ONE STATE FARM PLAZA, BLOOMINGTON, IL 61710
as Surety, are held and firmly bound unto the City of Waterloo, Black Hawk County, Iowa, in the penal
sum of FIFTEEN THOUSAND DOLLARS ($15,000.00) lawful money of the United States of America,
:to_the _payment of which sum, well and truly to be made, the Principal herein firmly binds (himself)
(herself) (themselve)_ their-h-eirST-executors-and-adrn-inistrators,_and -the said Surety binds
themselves, their successors, assigns, executors and administrators, jointly and severally, firmly these presents.
presents.
THE CONDITIONS OF THE ABOVE OBLIGATION ARE SUCH that, by the provisions of the
Ordinances of the City of Waterloo, Iowa, a Surety Bond in the sum of Fifteen Thousand Dollars
($15,000.00) must be filed with the City Clerk/Auditor of the City of Waterloo, Iowa, before one may
engage in construction, reconstruction or excavation in the public right of way in said City.
NOW, THEREFORE, if the above bounden WES GARDNER DBA GARDNER PLUMBING of
PO BOX 64, LA PORTE CITY IA will faithfully perform any and all duties
and abide by any and all regulations required by said Ordinances regulating the construction,
reconstruction and excavation projects within said City; and if (he), (she), (they) will promptly pay to
said City any and all sums and amounts due or that may become due or owing by reason of or under
said Ordinances; and if (he), (she), (they) will pay all fines imposed upon (him), (her), (them), for a
violation of said Ordinances occurring during the life of this bond; and if (he), (she), (they) will
indemnify and keep the City harmless from all liability for any accident and/or damages arising from
(his), (her), (their) doing, protecting or completing the work, then this obligation to be null and void,
otherwise to remain in full force and effect.
The effective date of this Bond is MAY 1 201 through APRIL 30 2019.
Witness our hands this 4TH day of JANUARY, 2018.
3(1' 2C? `f.2 6
NO. 95 BM J031 6
3(q? ? (sq2—
PLEASE MAIL TO:
City of Waterloo, Iowa
Engineering Department
715 Mulberry Street
Waterloo, IA 50703
Updated 1-24-00
���
FRINCIPALr•` rJl'r
By. ____G
=' &NG C46'‘1y
`k Printed Name: EUGJNA BRANT
i w GpPrOR9f h
,.31;1d(L State Farm Fire and Casualty Company
vii,-a;`M•........•`e-^- SUR -
in. 1I CT...;,,,00 -
By:
rney-in-Fact
cutL
PLEASE COMPLETE CHECKLIST ON REVERSE SIDE BEFORE SUBMITTING BOND.
SFB-4000 1 51A. 1
I•'d ££9L17•£Z61•£
"ed elelS Ple14pea8
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Power of Attorney
STATE FARM FIRE AND CASUALTY COMPANY
KNOW ALL PERSONS BY THESE PRESENTS: That STATE FARM FIRE AND CASUALTY COMPANY, an Illinois corporation, with its principal office in�
Bloomington, Illinois, does hereby constitute and appoint: Eugina Brant, Amanda J. Clifton, Pamela Chancellor, Julie Fehrman, Kim Filter, Mark Fink, Julie
Freed, Matthew J. Gibbons, Jay W. Hendren, John R. Horton, Jeanette Hughes, Jerry Jacek, Susan K. Johnson, Connie S. Knox, Leann Lemmel, Christine
Macdonnell, Lori McDowell, Thomas P. Miller, Melissa L. Morris, Vicki Redman, Suzanne M. Robertson, Alice Schuler, Heidi Simmons, Heidi Stevens,
Steven M. Straub, Perry Tracy, Kathy J. Walker, Karen Weber, Karli Yoder of Bloomington, Illinois its true and lawful Attorney(s)-in-Fact, to make, execute,
seat and deliver for, and on its behalf as surety, any and all bonds, undertakings or other writings obligatory in the nature:of a bond as follows:
Any such obligation in any amount
JI
This appointment is made under and by the authority of a resolution which was passed •by the Executive Committee of the Board of
Directors of State Farm Fire and Casualty Company on the 5'h day of September, 2017, -as is duly authorized by the Board of Directors in
Article 11, Section 6 of the By -Laws of the Company, which resolution is:
Resolved, that the Officer of the Company who works regularly with surety bonds;is hereby authorized to appoint
representative of the Company or other person or persons as Attorney -in -Fact. to execute on'behalf of the Company any bonds, wer any
undertakings, policies, contracts of indemnity or other writings obligatoryin the nature of a: :bond, which the Company might execute through
its officers, and affix the seal of the Company thereto. Any said execution cif such documents by an Attorney -in -Fact shall be as binding
upon the Company as if they had been duly executed and acknowledged.by-the regularly elected or appointed officers of the Company. Any
Attorney -in -Fact, so appointed, may be removed for good cause and the authority so granted may be revoked as specified in the Power of
Attonnoy.
Resolved, that the signature of any Officer of the Company noted above and the seal of the Company may be affixed by facsimile on
any power of attorney granted, and the signature of the any -Officer of the Company noted above, and the seal of the Company may be
affixed by facsimile to any certificate of any such power and,any such power or certificate bearing such facsimile signature and seal shall be
valid and binding on the Company. Any such power; so executed and sealed and certificate so executed and sealed shall, with respect to
any bond or undertaking to which`it is attached, continue to be valid and binding on the Company.
IN WETNESS THEREOF, STATE FARM FIRE AND CASUALTY COMPANY has caused this instrument to be signed by its Assistant
Secretary Treasurer, and its'Corporate Seal to be affixed this 51h day of September, 2017.
This APPOINTMENTSHALL CEASE AND TERMINATE AUTOMATICALLY AS OF DECEMBER 31, 2021, UNLESS SOONER
REVOKED AS PROVIDED.
•
STATE OF ILLINOIS
COUNTY OF McLEAN
STATE FARM FIRE AND CASILALTY COMPANY
By:
John R:1 -t. rton - Assistant Secretary Treasurer
On this 5th day of September, 2017, before me personally came John R. Horton to me known, who being duly sworn, did depose and say that he is
Assistant Secretary Treasurer of STATE FARM FIRE AND CASUALTY COMPANY, the corporation described in and which executed the above instrument;
that he knows the seal of said corporation; that the seal affixed to said instrument is such Corporate Seal; and that he executed said instrument on behalf of
the corporation by authority of his office under the By -Laws of said corporation.
)`-,(4/r\_-( —air?
Notary Public
CERTIFICATE My commission expires August 30, 2021
I, the undersigned Assistant Secretary Treasurer of STATE FARM FIRE AND CASUALTY COMPANY, do hereby certify that the original Power of
Attorney of which the foregoing is a true and correct copy, is in full force and effect and has not been revoked and the resolutions as set forth are now in
farce.
Signed and sealed at Bioominglon, Illinois. Dated this 4TH day of JANUARY. 2018.
If you have a question concerning the validity of this Power of Attorney, call (309) 766-2090.
FB6-9043.54A
(09-05-2017)
Z'd ££9Lt£Z61,£
Susan K. Johnson A s istant Treasurer
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Printed in U.S.A.
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