HomeMy WebLinkAboutSupplemental Attachments - 6/4/2018City of Waterloo
Finance Committee Open Invoice Report
For June 04. 2018 Approval
Finance Committee Accounts Payable Open Invoice Report Total
As of Friday, June ist, 2018
EFT Transactions:
'Subtotal - as of Monday, June 04, 2018
713,888.36
Workers Compensation Issued by TPA
Housing Authority Housing Assistance EFT's
Housing Authority Housing Assistance EFT's
Payroll
713,888.36
3,895.20
5,516.48
'Bill Payment Total - Monday June 04, 2018
Payment to Council members or related entities:
723,300.04
TRAVEL REQUEST
CITY OF WATERLOO
FINANCE DEPT.
LINE ITEM USED
FY 2t4I BUDGETED
EXPENDED YTD
THIS REQUEST
LEFT AFTER THIS
REQUEST
STAFF ONLY
a,2 32 6755-3 /3 e/‘
7 ! Co
r v
&7 27 u
DATE M``) /
Original - Clerk/Finance Copy - be•artment
NAME(S) AND POSITION(S):
Anita Merfeld
NAME OF CLASS / MEETING:
Lead Safe Renovator Class
DATE:
DEPARTURE DATE:
05/31/18
DESTINATION: Waterloo, Iowa-Hazmat
DEPARTURE POINT
IF NOT WATERLOO:
RETURN DATE:
DATE(S) OF MEETING:
June 4, 2018
PURPOSE OF TRAVEL/TRAINING:
This training is funded thru the three year Lead Hazard grant we received and is counted towards our training benchmarks
we need to meet with our Lead Hazard Control Grant.
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL:
x COST$
YES NO
METHOD OF TRAVEL:
CITY VEHICLE
AIRFARE
DEPARTING FROM:
ESTIMATE OF COST:
LODGING
MEALS
125.00 REGISTRATION
MILEAGE/FUEL
TOTAL FOR ALL: $ 125.00
TAXI
PARKING
AIRFARE
MISC/TOLLS
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE
AND IS NECESSARY AND BENEFICIAL TO THE
CITY OF WATERLOO
iA
DEPARTMENT HE f
573/
DATE
K:\Shared Goodies\Forms\Travel Request Form January 2010
PRIVATE VEHICLE
1
1
BUDGET LINE ITEM: 224-32-58531315
x
YES NO
x
YES NO
GRANT REIMBURSABLE
BGLED18.CNSLT
REQUIRED CERTIFICATION
TOTAL: $ 125.00
PER PERSON
I APPROVE THIS TRAVEL REQUEST
Lt te
MAYOR
8
DATE
TRAVEL REQUEST
CITY OF WATERLOO
NAME(S) AND POSITION(S):
Rudy Jones/Maggie Howard-Heretakis/Angie Fordyce
DATE:
FINANCE DEPT. STAFF ONLY
LINE ITEM USED '4161
,,��.1 - 2%--3
FYoc BUDGETED
EXPENDED YTD
THI5 REQUEST
LEFT AFTER THIS
REQUEST
DATE
Original - Clerk/Finance
k q
Sv
AAJ
Co . — Desartment
05/31/18
NAME OF CLASS / MEETING:
Lead Abatement Worker to Contractor Training
16 hour
DEPARTURE DATE:
DESTINATION: Waterloo, Iowa-Hazmat
DEPARTURE POINT
IF NOT WATERLOO:
RETURN DATE:
DATE(S) OF MEETING:
May 10-11
PURPOSE OF TRAVEL/TRAINING:
This training was funded through the Lead Hazard Control Grant and the training will be counted towards our benchmarks
that we need to meet with the lead grant.
WILL TRAVEL REQUIRE ADDITIONAL PERSONNEL:
x
YES NO
COST $
METHOD OF TRAVEL:
CITY VEHICLE
AIRFARE
DEPARTING FROM:
PRIVATE VEHICLE
ESTIMATE OF COST:
LODGING
MEALS
450.00 REGISTRATION
MILEAGE/FUEL
TOTAL FOR ALL: $ 450.00
TAXI
PARKING
AIRFARE
MISC/TOLLS
I BELIEVE THIS TRIP SERVES A PUBLIC PURPOSE
AND IS NECESSARY AND BENEFICIAL TO THE
CITY OF WATERLOO
igre / -7 4V ---
DEPARTMENT HEAD /
3/3 r
DATE
K:\Shared Goodies\Forms\Travel Request Form January 2010
BUDGET LINE ITEM: 224-32-5853-1315
x
YES NO
GRANT REIMBURSABLE
BGLED18.CNSLT
x REQUIRED CERTIFICATION
YES NO
TOTAL: $ 150.00
PER PERSON
I APPROVE THIS TRAVEL REQUEST
l�I.LCM�
MAYOR
tC/L) 71 a
DATE
CITY OF WATERLOO, IOWA
CITY ATTORNEY'S OFFICE
715 Mulberry Street • Waterloo, IA 50703 • (319) 291-4327 Fax (319) 291-4286
June 4, 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 June 4, 2018.
Of the 6 bonds submitted,
shown on the attached list.
Very truly yours,
David R. Ze lhoefer
Waterloo City Attorney
DRZ:sda
were approved and 0 were rejected, as
CITY WEBSITE: www.cityofwaterlooiowa.com
WE'RE WORKING FOR YOU!
An Equal Opportunity/Affirmative Action Employer
BONDS FOR COUNCIL APPROVAL
June 4, 2018
RIGHT OF WAY CONSTRUCTION BOND
X240498
- 95 BAG 306 0
— IA5129192
--W150316379
—016069339
,_1A5129500
ANDY MILLS dba MILLS CONCRETE
IOWA FLATWORKS
KEVIN CASEY
PROFESSIONAL CONCRETE
TECOM CONSTRUCTION, INC.
VINCENT H EDWARDS dba VE CONSTRUCTION
AMOUNT $15,000.00
WATERLOO, IA
CEDAR FALLS, IA
WATERLOO, IA
WATERLOO, IA
CLEARWATER, MN
WATERLOO, IA
/EMC
INSURANCE
EMPLOYERS MUTUAL CASUALTY COMPANY
CONTINUATION CERTIFICATE
BOND NO. T240498
PRINCIPAL ANDY MILLS DBA MILLS CONCRETE
ADDRESS 3103 CRANE CREEK RD
WATERLOO, IA 50703-9505
OBLIGEE
CITY OF WATERLOO, IOWA
ENGINEERING DEPT.
TYPE OF BOND
RIGHT OF WAY CONSTRUCTION BOND
BOND PENALTY:
$ 15,000
BOND TERM: From 04/30/18 to 04/30/19
The Company indicated hereby continues in force, for the period described, the Bond
Designated above, subject to all the agreements, limitations, and conditions thereof and
Provides that the liability under said Bond and all continuations thereof shall not be cumulative
And shall not in any event exceed the amount of said Bond herein before set forth.
Signed, Sealed and Dated:
B
•
01/19/18
ELIZABETH D. BECK
Attorney-in-fact
if Renewal is Not Desired, Please Return Original Certificate Within 30 Days of Renewal Date for Flat Cancellation
Form 7887e Rev. 11-13
912 KL
DATE OF ENTRY: 01/19/18
FNS T240498 19001
RIGHT OF WAY CONSTRUCTION BOND
No. T240498
Applicant's Telephone Number:-an 161 Oqi-q
KNOW ALL MEN BY THESE PRESENTS:
That (I), (We), Andy Mills DBA Mills Concrete
of 3103 Crane Creek Rd. Waterloo
IA 50703 ,
Street City
as Principal, and Fmpinyers Mutual Casualty Company
State
of
PO Box 712, Des Moines, IA 50306 ,
as Surety, are held and firmly bound unto the City of Waterloo, Black Hawk County, Iowa, in the penal
sum of FIVE THOUSAND DOLLARS ($5,000.00) 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 Five Thousand Dollars
($5,000.00) 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 Andy Mills DBA Mills Concrete 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 16 , through April 30, 20 17
Witness our hands this 3rd day of May , 20 16
Andy Mills DBA Mills Concrete
PLEASE MAIL TO:
City of Waterloo, Iowa
Engineering Department
715 Mulberry Street
Waterloo, IA 50703
PRINCIPAL
By:
Printed Name: Andy Mills
Employers Mutual Casualty Company
SURETY
By:
Att ney-in-fact Elizabeth D. Bea
Updated 1-24-00
PLEASE COMPLETE CHECKLIST ON REVERSE SIDE BEFORE SUBMITTING BOND.
/EMC
INSURANCE
THE FACE AND REVERSE OF THiS DOCUMENT HAVEA COLORED FLAG ON WHITE PAPER
P.O. Bax 712 • Des Moines, IA 50306-0712
No. B30223
CERTIFICATE OF AUTHORITY INDIVIDUAL ATTORNEY -1N -FACT
KNOW ALL MEN BY THESE PRESENTS, that:
1. Employers Mutual Casualty Company, an Iowa Corporation
2. EMCASCO Insurance Company, an Iowa Corporation
3. Union Insurance Company of Providence, an Iowa Corporation
4. Illinois EMCASCO Insurance Company, an towa Corporation
hereinafter referred to severally as "Company" and collectively as "Companies", each does, by these presents, make, constitute and appoint
ELIZABETH D. BECK
5. Dakota Fire Insurance Company, a North Dakota Corporation
6. EMC Property & Casualty Company, an Iowa Corporation
7. Hamilton Mutual Insurance Company, an Iowa Corporation
its true and lawful attomey-in-fact, with full power and authority conferred to sign, seal, and execute its lawful bonds, undertakings, and other obligatory instruments of a
similar nature as follows:
ANY AND ALL BONDS
and to bind each Company thereby as fully and to the same extent as if such instruments were signed by the duly authorized officers of each such Company, and all of
the acts of said attomey pursuant to the authority hereby given are hereby ratified and confirmed.
The authority hereby granted shall expire
APRIL 1, 2017 unless sooner revoked.
AUTHORITY FOR POWER OF ATTORNEY
This Power-of-Attomey is made and executed pursuant to and by the authority of the following resolution of the Boards of Directors of each of the Companies at a
regularly scheduled meeting of each company duly called and held in 1999:
RESOLVED: The President and Chief Executive Officer, any Vice President, the Treasurer and the Secretary of Employers Mutual Casualty Company shall have power
and authority to (1) appoint attorneys -in -fact and authorize them to execute on behalf of each Company and attach the seal of the Company thereto, bonds and
undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof, and (2) to remove any such attorney-in-fact at any time and revoke
the power and authority given to him or her. Attorneys -in -fact shall have power and authority, subject to the terms and limitations of the power-of-attomey issued to them,
to execute and deliver on behalf of the Company, and to attach the seal of the Company thereto, bonds and undertakings, recognizances, contracts of indemnity and
other writings obfgatory in the nature thereof, and any such instrument executed by any such attorney-in-fact shall be fully and in ail respects binding upon the Company.
Certification as to the validity of any power-of-attomey authorized herein made by an officer of Employers Mutual Casualty Company shaft be fully and in all respects
binding upon this Company. The facsimile or mechanically reproduced signature of such officer, whether made heretofore or hereafter, wherever appearing upon a
certified copy of any power-of-attorney of the Company, shall be valid and binding upon the Company with the same force and effect as though manually affixed.
IN WITNESS THEREOF, the Companies have caused these presents to be signed for each by their officers as shown, and the Corporate seals to be hereto affixed this
8th day of DECEMBER , 2014
Seals
/NES,CERTIFICATE
I, James D, Clough, Vice President of the Companies, do hereby certify that the foregoing resolution of the Boards of Directors by each of the Companies,
and this Power of Attorney issued pursuant thereto on DECEMBER 8, 2014 on behalf of;
ELIZABETH D. BECK
z
P;=40nP0q,�Q�
=H= 1863 :o;: ; 1953 <'
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„
T a``OpPogRe �cOw.� �rp42„, POn�lr.s
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SEAL SEAL
i'1'�Rm10A�OP , •��,'I'tOINLs.�O
1o, Le KATHY LYNN LOVERIDGE
I; GommGamfsstonmNumberlaslon 780769
ow My Expires
October 10, 2016
Bruce G. Kelley, Chairman
of Companies 2, 3, 4, 5 & 6; President
of Company 1; Vice Chairman and
CEO of Company 7
Michael Freel
Assistant Vice President
On this ath day of DECEMBER AD 2014 before me a
Notary Public in and for the State of Iowa, personalty appeared Bruce G. Kelley and Michael Freel,
who, being by me duly sworn, did say that they are, and are known to me to be the Chairman,
President, Vice Chairman and CEO, and/or Assistant Vice President/Assistant Secretary,
respectively, of each of The Companies above; that the seals affixed to this instrument are the
seals of said corporations; that said instrument was signed and sealed on behalf of each of the
Companies by authority of their respective Boards of Directors; and that the said Bruce G. Kelley
and Michael Freel, as such officers, acknowledged the execution of saki instrument to be the
voluntary act and deed of each of the Companies.
My Commission Expires October 10, 2016.
ckao
Nota . Public i and for tihhee State owe
are true and correct and are still in full force and effect.
In Testimony Whereoff t, ave subscr'!ef my name and affixed the facsimile seal of
each Company this , 31 U day of LA i, .
9832(1-74) "For verification of the authcnticity of the Power of Attorney you may call (515).345-2689.”
Vice President
ArEMC
INSURANCE
EMPLOYERS MUTUAL CASUALTY COMPANY PRIOR POLICY: T24-04-98
REPORT OF EXECUTION
BOND PERIOD: 04/30/17 TO 04/30/18
* *
* BOND NUMBER: T240498 *
* EXPIRATION YEAR: 2018
* *
AGENT ARCHITECT
GNB INSURANCE
603 7TH ST
PO BOX 248
GRUNDY CENTER, IA 50638-0248
AGENT NO. A -A-1127
P RINCIPAL OBLIGEE
ANDY MILLS DBA MILLS CONCRETE
3103 CRANE CREEK RD
WATERLOO, IA 50703-9505
CITY OF WATERLOO, IOWA
ENGINEERING DEPT.
715 MULBERRY ST
WATERLOO, IA 50703-5714
B OND TYPE AMOUNT OF BOND
LICENSE AND PERMIT
NATURE & DESCRIPTION OF RISK:
RIGHT OF WAY CONSTRUCTION BOND
STATE, CITY OR TOWN IN WHICH RISK IS LOCATED:
WATERLOO, IA
$ 15,000
UNDERWRITER NAME: ELIZABETH D. BECK
DATE OF ISSUE: 04/26/17 (FNS)
TOTAL BONDS PREMIUM $ 150.00
FORM 7001 (ED. 04/80) 04/30/17
912
KL
T240498 18002
/EMC
HOME OFFICE OR BRANCH SERVICE OFFICE - DES MOINES, IOWA
EMPLOYERS MUTUAL CASUALTY COMPANY
CHANGE ENDORSEMENT OR RIDER
ATTACHED TO AND FORMING
PART OF BOND OR POLICY NO.
T240498
Obligee:
CITY OF WATERLOO, IOWA
ENGINEERING DEPT.
715 MULBERRY ST
WATERLOO, IA 50703-5714
DATE ENDORSEMENT OR RIDER
EXECUTED
04/26/2017
INSURANCE
EFFECTIVE DATE OF
ENDORSEMENT OR RIDER
04/30/2017
Agent:
GNB INSURANCE
603 7TH ST
PO BOX 248
GRUNDY CENTER, IA 50638-0248
Principal:
ANDY MILLS DBA MILLS CONCRETE
3103 CRANE CREEK RD
WATERLOO, IA 50703-9505
It is hereby agreed that the words:
Bond Amount: Five Thousand and 00/100 Dollars ($5,000)
are hereby deleted,
And the words;
•Bond -_Amount.: Fifteen T?7.10usand- and 00/100 Dollars
(15,000)
are hereby substituted therefor;
Provided that, no amount carried under the Bond during any period shall be cumulative with the amount or amounts
carried under the Bond during any other period or periods.
0'01 UALCd`
9 .
oV• 8.'7,', -7
O_
-E SEAL
'�O�SMOINES,ssf,
ACCEPTED BY PRINCIPAL: ANDY MILLS DBA
MILLS CONCRETE
By:
By.
ACCEPTED BY OBLIGEE: CITY OF WATERLOO, IOWA
By:
Form 7001.1e Rev. 10-13
EMPLOYERS MUTUAL CASUALTY COMPANY
ELIZABETH D. BECK
Attorney-in-fact
DATE OF ENTRY: 04/26/17
912 KL FNS T240498 18002
RIGHT OF WAY CONSTRUCTION BOND
Applicant's Telephone Number:
KNOW ALL MEN BY THESE PRESENTS:
That (I) (We), IOWA FLATWORKS,
of PO BOX 333 CEDAR FALLS IA 50613,
Street City State
NO. 95 BA G306 0
3i'? 722
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 IOWA FLATWORKS of
PO BOX 333 CEDAR FALLS IA 50613 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
'•��l��li,
k:• Oo ,VONgl "i
W F ;
'. SEAL:,
bt)a / <Jt JCSiZ
PRINCIPAL
By: )( .. f _ /s fl 1)
Printed Name: SUZANNE M ROBERTSON
State Farm Fire and Casualty Company
SURETY
Bv•
ct7orney-in-Fact
PLEASE COMPLETE CHECKLIST ON REVERSE SIDE BEFORE SUBMITTING BOND.
S FB-400015IA.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 natureof 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 duly authorized by the Board of Directors in
Article II, 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 powerand 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.
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
By:
John R/Horton - Assistant Secretary T easi rer
CERTIFICATE
Notary Public
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.
If you have a question concerning the validity of this Power of Attorney, call (309) 766-2090.
FB6-9043.54A
(09-05-2017)
L
Susan K. Johnson 'Asistant Treasurer
{
Printed in U.S.A.
RIGHT OF WAY CONSTRUCTION BOND
No.
Applicant's Telephone Number:
KNOW ALL MEN BY THESE PRESENTS:
That (I), (We), Kevin Casey
G �
IA5129192 '
of 2107 W 4th Street Waterloo
Iowa
Street
as Principal, and
City State
Merchants Bonding Company (Mutual) of
P.O. Box 14498, Des Moines, IA 50306-3498
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 boundenKevin Casey 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 lo be null and void,
otherwise to remain in full force and effect.
The effective date of this Bond is May 24, 2018 , through April 30, 2019
Witness our hands this 24th day of
PLEASE MAIL TO:
City of Waterloo, Iowa
Engineering Department
715 Mulberry Street
Waterloo, IA 50703
Updated Mardi 2017
PLEASE COMPLETE CHECKLIST ON REVERSE SIDE BEFORE SUBMITTING BOND.
May 2018
Kevin Casey
PRINCIPAL
By:
Printed Name: Kevin Casey
Merchants Bonding Company (Mutual)
SURETY
By:
Attorney-in-fact William Warner Jr., Attorney -in -Fact
LP 0467 IA (2/17)
MERCHANTS
BONDING COMPANY,.
POWER OF ATTORNEY
Know All Persons By These Presents, that MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC.,
both being corporations of the State of Iowa (herein collectively called the "Companies") do hereby make, constitute and appoint, individually,
William Warner Jr.
their true and lawful Attomey(s)-in-Fact, to sign its name as surety(ies) and to execute, seal and acknowledge any and all bonds, undertakings,
contracts and other written instruments in the nature thereof, on behalf of the Companies in their business of guaranteeing the fidelity
of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any
actions or proceedings allowed by law.
This Power -of -Attorney is granted and is signed and sealed by facsimile under and by authority of the following By -Laws adopted by the Board
of Directors of Merchants Bonding Company (Mutual) on April 23, 2011 and amended August 14, 2015 and adopted by the Board of Directors
of MerchantsNational Bonding, Inc., on October 16, 2015.
"The President, Secretary, Treasurer, or any Assistant Treasurer or any Assistant Secretary or any Vice President shall have power and authority
to appoint Attorneys -in -Fact, and to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto, bonds and
undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof."
"The signature of any authorized officer and the seal of the Company may be affixed by facsimile or electronic transmission to any Power of Attorney
or Certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the
Company, and such signature and seal when so used shall have the same force and effect as though manually fixed."
In connection with obligations in favor of the Florida Department of Transportation only, it is agreed that the power and aut hority hereby given to the
Attomey-in-Fact includes any and all consents for the release of retained percentages and/or final estimates on engineering and construction
contracts required by the State of Florida Department of Transportation. It is fully understood that consenting to the State of Florida Department
of Transportation making payment of the final estimate to the Contractor and/or its assignee, shall not relieve this surety company of any of
its obligations under its bond.
In connection with obligations in favor of the Kentucky Department of Highways only, it is agreed that the power and authority hereby given
to the Attorney -in -Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner -
Department of Highways of the Commonwealth of Kentucky at least thirty (30) days prior to the modification or revocation.
In Witness Whereof, the Companies have caused this instrument to be signed and sealed this 24th day of May , 2018 •
:s 2003 �C)
STATE OF IOWA
COUNTY OF DALLAS ss.
On this this 24th day of May 2018 , before me appeared Larry Taylor, to me personally known, who being by me duly sworn
did say that he is President of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC.; and that the
seals affixed to the foregoing instrument are the Corporate Seals of the Companies; and that the said instrument was signed and sealed in behalf
of the Companies by authority of their respective Boards of Directors.
,+..,.+}
:0.42: -o- tn.
•
:•1`1933 '�: By
• j'Y
mo•b•
.
!! l hV •!
MERCHANTS BONDING COMPANY (MUTUAL)
MERCHANTS NATIONAL BONDING, INC.
President
ALICIA K. GRAM
Commission Number 767430
My Commission Expires
April 1, 2020
Notary Public
(Expiration of notary's commission
does not invalidate this instrument)
I, William Warner, Jr., Secretary of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., do hereby
certify that the above and foregoing is a true and correct copy of the POWER-OF-ATTORNEY executed by said Companies, which is still in full
force and effect and has not been amended or revoked.
In Witness Whereof, I have hereunto set my hand and affixed the seal of the Companies on this
-
`•� w, .•��4tN P O,g41r0+
:Q:
2003
POA 0018 (3/17)
•` 1933 ��
,
24th day of May , 2018 .
Secretary
RIGHT OF WAY CONSTRUCTION BOND
No.
Applicant's Telephone Number:3/4
KNOW ALL MEN BY THESE PRESENTS:
W150316379
3 D33;
That (1), (We), Professional Concrete
of 4641 Gilbertville Rd
Waterloo , IA
Street
City State
as Principal, and Old Republic Surety Company of
445 S Moorland Rd, Suite 200 Brookfield, WI 53005
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 Professional Concrete of
4641 Gilbertville Rd Waterloo, IA 50701 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 23rd day of May , 20 18 .
Professional Concrete
PLEASE MAIL TO:
City of Waterloo, Iowa
Engineering Department
715 Mulberry Street
Waterloo, IA 50703
PRINCIPAL
By:
Printed Name: Professional Concrete
Old Republic Surety Company
SURETY
By: /20 Zeve—
Attorney-in-fact
Updated 1-24-00
PLEASE COMPLETE CHECKLIST ON REVERSE SIDE BEFORE SUBMITTING BOND.
****
*
* OLD REPUBLIC SURETY COMPANY
***
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS: That OLD REPUBLIC SURETY COMPANY, a Wisconsin stock insurance corporation, does make, constitute and
appoint: Roberta S. Witherow of Brookfield, WI
its true and Lawful Attorney(s)-in-Fact, with full power and authority, not exceeding $10,000,000, for and on behalf of the company as surety, to execute and
deliver and affix the seal of the company thereto (if a seal is required), bonds, undertakings, recognizances or other written obligations in the nature thereof,
(other than bail bonds, bank depository bonds, mortgage deficiency bonds, mortgage guaranty bonds, guarantees of installment paper and note
guaranty bonds, self-insurance workers compensation bonds guaranteeing payment of benefits, asbestos abatement contract bonds, waste
management bonds, hazardous waste remediation bonds or black lung bonds), as follows: Effective Date: 5/23/2018 12:00:00 AM
Bond Number: W150316379 Bond Amount: Fifteen Thousand Dollars $15,000.00
Principal Name: Professional Concrete
Obligee Name: City of Waterloo Engineering Dept of Waterloo, IA
and to bind OLD REPUBLIC SURETY COMPANY thereby, and all of the acts of said Attorneys -in -Fact, pursuant to these presents, are ratified and confirmed.
This appointment is made under and by authority of the board of directors ata special meeting held on February 18, 1982.
This Power of Attorney is signed and sealed by facsimile under and by the authority of the following resolutions adopted by the board of directors of the OLD
REPUBLIC SURETY COMPANY on February 18,1982.
RESOLVED that the president, any vice president or assistant vice president, in conjunction with the secretary or any assistant secretary, may appoint
attorneys -in -fact or agents with authority as defined or limited in the instrument evidencing the appointment in each case, for and on behalf of the company to
execute and deliver and affix the seal of the company to bonds, undertakings, recognizances, and suretyship obligations of all kinds; and said officers may
remove any such attorney-in-fact or agent and revoke any Power of Attorney previously granted to such person.
RESOLVED FURTHER that any bond, undertaking, recognizance, or suretyship obligation shall be valid and binding upon the Company
(i) when signed by the president, any vice president or assistant vice president, and attested and sealed (if a seal be required) by any secretary or assistant
secretary; or
(ii) when signed by the president, any vice president or assistant vice president, secretary or assistant secretary, and countersigned and sealed (if a seal be
required) by a duly authorized attomey-in-fact or agent; or
(iii) when duly executed and sealed (if a seal be required) by one or more attorneys -in -fact or agents pursuant to and within the limits of the authority
evidenced by the Power of Attorney issued by the company to such person or persons.
RESOLVED FURTHER that the signature of any authorized officer and the seal of the company may be affixed by facsimile to any Power of Attorney or
certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the company; and such
signature and seal when so used shall have the same force and effect as though manually affixed.
IN WITNESS WHEREOF, OLD REPUBLIC SURETY COMPANY has caused these presents to be signed by its proper officer, and its corporate seal to be
affixed this 23rd day of May 2018
Cc
cO PUR�TE O
SEAL _>_
OLD REPUBLIC SURETY COMPANY
Assistant Secretary " President
STATE OF WISCONSIN, COUNTY OF WAUKESHA - SS
On this 23rd day of May 2018 personally came before me, Alan Pavlic
and Jane E. Cherney , to me known to be the individuals and officers of the OLD REPUBLIC SURETY COMPANY
who executed the above instrument, and they each acknowledged the execution of the same, and being by me duly sworn, did severally depose and say: that
they are the said officers of the corporation aforesaid, and that the seal affixed to the above instrument is the seal of the corporation, and that said corporate seal
and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority of the board of directors of said corporation.
Al\ _ U K
Notary Public
My Commission Expires: 09/28/2018
CERTIFICATE (Expiration of notary's commission does not invalidate this instrument)
I, the undersigned, assistant secretary of the OLD REPUBLIC SURETY COMPANY, a Wisconsin corporation, CERTIFY that the foregoing and attached
Power of Attorney remains in full force and has not been revoked; and furthermore, that the Resolutions of the board of directors set forth in the Power of
Attorney, are now in force.
0405139
W coNwP40.E O
p ! SEAL 'E Signed and sealed at the City of Brookfield, WI this 23rd day of
3 . ,ael
ORSC 22262 (3-06)
SCOTT INSURANCE SERVICES
May 2018
Assistant Secretary
RIGHT OF WAY CONSTRUCTION BOND
No. 016069339
Applicant's Telephone Number: (320) 558-9485
KNOW ALL MEN BY THESE PRESENTS:
That (I), (We) Telcom Construction, Inc.
Of 2218 200th Street East, P.O. Box 189
Clearwater, MN 55320
Street City State
Liberty Mutual Insurance Company
as Principal, and of
175 Berkeley Street, Boston, MA 02116
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 Telcom Construction, Inc. of
2218 200th Street East, Clearwater, MN 55320 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, 2018 , through April 30, 20 19
10th March 18
Witness our hands this day of , 20
PLEASE MAIL TO:
City of Waterloo, Iowa
Engineering Department
715 Mulberry Street
Waterloo, IA 50703
Updated 1-24-00
PLEASE COMPLETE CHECKLIST ON REVERSE SIDE BEFORE SUBMITTING BOND.
Telcom Construction, Inc.
PRINCIPAL
By: 1
Printed Name: Ir -)i Ili=
Liberty Mutual Insurance Company
SURET
By:
Attorney-in-fact Loret : M. Jones
THIS'i'OWEFf OF ATTORNEY IS NOT VALID UNLESS IT IS PRINTED ON RED BACKGROUND.
• 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.
Certificate No. 7951156
Liberty Mutual Insurance Company
The Ohio Casualty Insurance Company West American Insurance Company
POWER OF ATTORNEY
KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire, that
Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly
organized under the laws ofthe State of Indiana (herein collectively called the "Companies"), pursuant to and by authority herein set forth, does hereby name, constitute and appoint,
Julie Karnes; Rachel A. Chaveriat; Rebecca J. Hobbs; Loretta M. Jones; Sandra King; Sandy McElhaney; Vicki Nobinger; Bonnie Rice; Mary Y. Volmar;
Carolyn E. Wheeler; Joy M. Williams
at of the city of Knoxville , state of TN 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 Companies in their own proper persons.
IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed
, loan, letter of credit,
or residual value guarantees.
thereto this 29th day of November 2017
wer of Attorney call
and 4:30 pm EST on any business day.
9
19'WestAmerican
z
STATE OF PENNSYLVANIA
COUNTY OF MONTGOMERY
On this 29th day
912
*
ss
of November
The Ohio Casualty Insurance Company
t 901 Liberty Mutual Insurance Company
Insurance Company
x By __7.r __-_-
David M. Carey, -Assistant Secretary
2017 before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance
Company. The Ohio Casualty Company. and West American 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 a duly authorized officer.
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.
PSp COMMONWEALTH OF PENNSYLVANIA
-
i
y
OF
ar
Notarial Sea
Notary
Teresa Paste la. Nota Pubitc
upper Merlon Twp.. Montgomery County
My Commission Exp res March 28, 2021
By. —...._..._
Teresa Pastella, Notary Public
Not valid for mortgage, note
currency rate, interest rate
Member, Pennsylvoo,a Association of Notaries
_ 7N Fi
This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual
Insurance Company, and West American insurance Company which resolutions are now in full force and effect reading as follows:
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 execution of any such instruments and to attach thereto the seal of the Corporation. When so
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.
ARTICLE XIII - Execution of Contracts - SECTION 5. Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president,
and subject to such limitations as the chairman or the president may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Company 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 Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so
executed such instruments shall be as binding as if signed by the president and attested by the secretary.
To confirm the validity of this Po
1-610-832-8240 between 9:00 am
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 of any assistant secretary of the
Company, wherever appearing upon a certified copy of any power of attorney 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, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do
hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy of the Power of Attorney executed by said .meanies, is in full force and effect and
has not been revoked / Cl
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this 1 " day of �- 20
` lit _
Y �
19 19 �r i9l114yt
Z
y: ..
By-
-
Renee C. Llew- . ', a ssistant Secretary
276 of 500
LMS_12873 022017
2018-05-30 09:24 rjernagel Insurance 3192340377 >> 319 291 4571
RIGHT OF WAY CQN TR ICTIQN BOND
No, 1/0t29500
Applicant's Telephone Number: (319)491-201
KNOW ALL MEN BY THESE PRESENTS:
That (I), (Vfe), Vincent 1I I;clwurt,ty dhn VI: Construction
of 410 Adams Street Waterloo
Street City
as Principal, and
P 1/3
Iowa
State
Merchants 13ondint; ('ompany (Mutual) of
__�.�.,..m.,.._........,, l' Sn? ,.,l > ..!. 91) , I?4 .M�ail3 ze IA �:tflt�W34�tt ,
as Surety; arc 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 ;he payment of which sum, well and truly to be mado, the Principal herein firmly binds (himself)
(herself) (thernselves) their heirs, executors and administrators, and the said Surety binds
themselves, their successors, assigns, executors and administrators, jointly and severally, firmly by
these present,.
THE CONDITIONS OF THE ABOVE OBLIGATION ARE SUCH that, by the provisions of the
Ordinances o1 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 trio public right ol way in said City.
NOW, THEREFORE, if the above boundenVincent 1 I Ldwrtrds dba VE Construction 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 aid excavation projects within sald 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
indemnity and keep the City harmless from all liability tor any accident and/or damages arising from
(his), (her), (their) doing, protecting or completing the work, thea this obligation to be null and void,
otherwise to remain in full force and effect,
The effective date of this Bond is
May 30, „tl I r4
Witness our hands this 301h day of
PLEASE MAIL TO:
City of Waterloo, Iowa
Engineering Department
715 Muiborr'y Street
Waterloo, IA 50703
Updated Mach M17
PLEASE COMPLETE CHECKLIST ON REVERSE SIDE BEFORE SUBMITTING BOND,
, through April 30, 2019
May 2018
Vincent 11 Edwards dba VI'. Construction
PRINCIPAL
By,
Printed Name'. I)on ikt f je.rnf;el
Merchants; (.Bonding ( omprniy (rvlutu ti)
SURETY
Oy:
Attorney -intact William Warner Jr., Attorney -in -tact
LP 0467 IA (2/17)
2018-05-30 09:24
Tjernagel Insurance 3192340377 >> 319 291 4571 P 3/3
MER.CHA.N1
771116\
BONDING COMPANY
POWER OF ATTORNEY
Know All Persons By These Presents, that MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BC)NDING, INC
both being corporations of the State of Iowa (herein collectively called the "Companies') do hereby make, constitute and appoint, indivlduait
William Warner Jr.
their true and lawful Attorney(s)-in-Fact, to sign its name as surety(tea) and to execute, seal and acknowledge any and all bonds, undertakings,
contracts and other written instruments in the nature thereof, on behalf or the Companies in their business of guaranteeing the fidelity
of parsons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted In any
actions or proceedings allowed by law.
This Power -of -Attorney is granted and Is signed and sealed by facsimile under and by authority of the foltowing fay -Laws adopted by the Board
of Directors of Merchants Bonding Company (Mutual) on April 23, 2011 and emended August 14. 2015 and adopted by the Board of Directors
of Merchants National Bonding, Inc., on October 16, 2015.
'The President, Secretary. Treasurer. or any Assistant Treasurer or any Assistant Secretary or any Vice president shall have power and authority
to appoint Attorneys -le -Fact. and to authorize there to execute on behalf of the Company, and attach the seal of the Company thereto, bonds and
undertakings. recogrtlzances, contracts of indemnity and other writings obligatory In the nature thereof.'
"The signature of any authorized officer and the seal of the Company may be affixed by facsimile or electronic transmission to any Power of Attorney
or Certification thereof authorizing the execution and delivery of arty bond, undertaking, recognizance, or other suretyship obligations of the
Company, and such signature and seal when so used shall have the same force and effect as though manually fixed,"
in connection with obligations In favor of the Florida Department of Trer'tsportalion only. It is agreed that the power and aut hority hereby given to the
Attorneyin-Fact includes any and alt consents for the release of retained percentages and/or final estimates on engineering and construction
contracts required by tha State of Florida Department of Transportation. It is fully understood that consenting to the State of Florida Department
of rranaporlation making payment of the final estimate to the Contractor and/or its assignee, shall not relieve this surety company of any of
its obllgetlons under Its bond,
In connection with obligations In favor of the Kentucky Department of Highways only., It Is agreed that the power and authority hereby given
to the Attorney -in -Feel cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commereloner-
Departrnent of Highways of the Commonwealth of Kentucky at least thirty (30) days prior to the modification or revocation.
In Witness Whereof. the Companies have caused this instrument to be signed and sealed this 30th day of
". P'(1ANqI .• fid, •CCH •
/ poRq.e •�o'oiNP°R •�9y
•
'• 2003 •:-,c y , 1933 •,,,-v. By
By .ff
V if •r V `0 s•
-E. ••,.. ,•'1.4*"" ••.�{y ,,_.' `'1•. President
May . 2018
MERCHANTS BONDING COMPANY (MUTUAL)
MERCHANTS NATIONAL BONDING, INC.
STATE OF IOWA
COUN'T'Y OF DALLAS ss.
On this this 30th day of May . 2018 before me appeared Larry Taylor, to me personally known, who being by me duly sworn
dict say that he is President of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., and that the
seals aft)xed 10 the foregoing instrument are the Corporate Seals of the Companies, and that the said instrument was signed and sealed in behalf
of the Companies by authority of their res.ective Boards of Directors.
ALICIA K. GRAM
commission Number 767430
My Commission Expires
April 1, 2020
Notary Public
(Expiration of notary's commission
does not Invalidate this instrument)
I, Wiltiem Warner, Jr„ Secretary of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL, BONDING, INC , do hereby
oertify that the above and foregoing is a true and correct copy of the POWER-OF-ATTORNEY executed by said Companies, which is stilt In full
force and effect and has not been amended or revoked,
In Witness Whereof. I have hereunto set my hand and affixed the seal of the Companies on this :loth day of May . 2018
i
(:':. �r bry .tom-:'' -p 2003 .•`s'' 1933 ., Sscrete,y
POA 0018 (3/17)