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WebLinkAboutS_Permit_Bond_285056566_C17002806_180123.pdfPrintFormResetFormSaveFormCITYOFJtT—“Renton0PERMITBONDBondNumber:285056566ProjectName:ValleyMedicalCenterMedicalOfficeBuildingKNOWALLMENBYTHESEPRESENT;thatweHRValleyNorth,LLCofNashvilleasPrincipal,andLibertyMutualInsuranceCompanyaCorporation,asSurety,areheldandfirmlybounduntotheCityofRenton,amunicipalcorporationoftheStateofWashington,inthesumf$1,185,246.70lawfulmoneyoftheUnitedStatesofAmerica,forthepaymentofwhich,willandtrulytobemade,wefirmlybindourselves,andeachofourheirs,executors,administratorsandassigns,jointlyandseverallybythesepresent.THECONDITIONOFTHEFOREGOINGOBLIGATIONSISSUCH,thatWHEREAS,theabovenamedPrincipalhasappliedforapermit,pursuanttotheprovisionsofOrdinanceNo.3205,todocertainworkonaCityofRentonroadway,street,alley,avenue,orotherpublicplace,duringaperiodendingJanuary23,2019NOWTHEREFORE,iftheabovenamedPrincipalshallindemnifyandsaveharmlesstheCityofRenton,fromallclaims,actionsordamagesofeverykindanddescription,whichmayaccrueasaresultofopeningand/orworkinguponaroadway,street,alley,avenue,publiceasement,orotherpublicplace,byhimorthoseinhisemploy,ininstallingormakingconnectionswithanypublicorprivatesewerorwatersystem,oranyotherpurposeorobjectwhatever,andthathewillreplaceandrestoresuchroadway,street,avenue,alleyorotherpublicplacetoasgoodastateorconditionasatthetimeofthecommencementofsaidwork,andmaintainthesameingoodordertothedecidedsatisfactionoftheCityofRenton,andthathewillcomplywithallprovisionsofhisortheirfranchiseofourpermitandallresolutionsorinstrumentsrelatingthereto,thisobligationtobevoid;otherwisetoremaininfullforceandeffect.TheliabilityunderthisbondisforaperiodofoneyearfromJanuary23,2018toJanuary23,2019andmaybeextendedbythesuretyissuingaContinuationCertificate.____ __ _January,2018LibertMutualIuranceCornany____ _ ___ _ ___BY:/SignatureofBocidingAgentAttachPowerofAttorneyFormtoBond_______________________________________1.0Includecontactinformation.DerekJ.Elston,Attorney-in-FactSealedwithoursealsandatedthis19thdayofBY:J.ApthantsSignature&jlOV3&stTh’oAlt,.‘urreApplicant’sAddress,TN,1to!,City,State,ZipH:\CEO\Data\Forms-Templates\Seif-HeIpHandout5\PublicWorks\PERMITBOND.docxRev:04/2015 THIS.POWEROFATTORNEYISNOTVALIDUNLESSITISPRINTEDONREDBACKGROUND.ThisPowerofAttorneylimitstheactsofthosenamedherein,andtheyhavenoauthoritytobindtheCompanyexceptinthemannerandtotheextenthereinstated.CertificateNo,!Z!2LibertyMutualInsuranceCompanyTheOhioCasualtyInsuranceCompanyWestAmericanInsuranceCompanyPOWEROFATTORNEYKNOWNALLPERSONSBYTHESEPRESENTSThatTheOhioCasualtyInsuranceCompany5acorporatondulyorganizedunderthelawsoftoeStaleofNewHampshire.:r.atLibertyMutualInsuranceCompanyisacorpora:or.dulyorganizedunderthelawsof(heStateo’Massachusetts.andWestAmericanInsuranceCompanyisaco’porationdu.yorganizedunderthelawsoftheStaleoflndate(hereincofecl.vetycaiedtheCompar.ins].pursuanttoandbyautnor;Iyhere,nsetformdoesherebyname,constituteandappoint.AeheWalton;AnnMullins;ChristopherP.Troha;DerekJ.Elston;MarciaK.Cesafsky;MaryF.Doyle:MichelleKrebsa,tofthecityotChicago.stateofILeachindividu&’yiftherebemorethanonenamed.itstrueandtawtutattorney-in-tacttomaire,execute,seat,acr.owledgeandde!iver,torandontsbeha.fassuretyandasitsactanddeed,anyandallundertakings,bonds,recognizarcesandothersuretyobcgaticns.ino.JrsuanceoftiesepresentsandshaHbeasbindinoupontheCompaniesasitineyhavebeendulysignedbyrnepresidentandattestedbythesecretaryoftheComoaniesintheirown010erpersonsINWITNESSWHEREOF,thisPowerofAttorneyhasbeensubscribedbyanauthonzedofficerorofficialoftheCompaniesandthecorporatesealsoftheCompanieshavebeenaffixedtheretothis13thdayofApril,2017.TheOhioCasualtyInsuranceCompany(3/’‘\bif’‘‘‘r\LibertyMutualInsuranceCompanyi119)3)1912))WestAmericanInsuranceCompanyBy:___STATEOFPENNSYLVANIADavidM.Carey,AssistantSecretaryCOUNTYOFMONTGOMERY—COnthisdayofApril,2017,,,beforemepersonallyappearedDavidkiCarey,whoacknowledgedhimselftobetheAssistantSecretaryofLibertyMutualInsuranceI—companyTheOhioCasualtyCompany,andWestAmericanInsuranceCompany,andthathe,assuch,beingauthorizedsotodo,executetheforegoinginstrumentforthepurposesthereincontainedbysigningonbehaltofthecorporationsbyhimseltasadutyauthorizedofficer2INWIThESSW-IEREOF.Ihavehereuntosubscribedmynan-sandaft’xednwnctarialseatatKingofPrussia.Per.sytvan:a,onthedayandyearfirstabovewritten.CCTeresaP.!nNwnryPjhcBy:422.-[4%tUl.upper&lc;orTwp.Mcnigomerjcnur.lyTeresaPostella,NotaryPublicMyComplexionEarrresMarco28.2021Iiorlx,rP,.”r.,çiv.’,’,a4ss’cvlr,’,ciJnxw’us02ItThisPowe,ofAttorneyismadeandexecutedpursuanttoandbyauthorityoftnefot’ow;ngBy-lawsandAuthorizationsofTheOhiocasualtyrsurancecompany.LibertyMutu&oInsurarceCompany,andWestAmericanInsurancecomnanywhichresolutionsarenowinfull‘cr00anderectreadingasfothws—asARTICLEIV—OFFICERS—Section12.PowerofAttorney.Anyo’flcerorotherofficiatofthecomorahonauthordecfo’thatDurposeinwriti.1QbythechairmanortePresident,ands’jjecI0ctosuchrni:aiionasfhechairmanorthePresidentmayprescribe.sna.tappointsucoatforneys-in.fact.asmaybenecessarytoactinbehaUoftheCorporat.’ontomake,execute,seal,z’acknowledgeanddeliverassuretyanyandaltundertakings,bonds,recognizancesandothersuretyobligations.Suchattomeysin•fact,subjecttothelimitationssetforthintheirrespective5powersofattorney,shalthavefullpowertobindthecorporationbytheirsignatureandexecutionofanysuchinstrumentsandtoattachtheretotheseatoftheCorporation.W’tensoexecuted,suchinstrumentsshaltbeasbindingasitsignedbythePresidentondattestedtobytheSecretary.Anypowerorauthoritygrantedtoanyrepresentativeorattorney-in-factunder>theprovisionsotthisarticlemayberevokedatanytimebytheBoard,theChairman,thePresidentorbytheofficerorofficersgrantingsuchpowerorauthority.—ARTICLEXIII—ExecutionofContracts—SECTION5.SuretyBondsandUndertakings.AnyofficeroftheCompanyauthorizedforthatpurposeinwritingbythechairmanorthepresident.2andsubjecttosuchlimitationsasthechairmanorthepresidentmayprescribe,shaltappointsuchattomeys-in-fact,asmaybenecessarytoactinbehalfoftheCompanytomake,execute,seat,acknowledgeanddeliverassuretyanyanda[lundertakings,bonds,recognizancesandothersuretyobligations.Suchattorneys-in-factsubjecttothelimitationssetforthintheir(9respectivepowersofattorney,shalthavefullpowertobindtheCompanybytheirsignatureandexecutionofanysuchinstrumentsandtoattachtheretotheseatoftheCompany.1enso3executedsuchinstrumentsshaltbeasbindingasifsignedbythepresidentandattestedbythesecretary.o(9CertificateofDesignation—ThePresidentoftheCompany,actingpursuanttotheBylawsoftheCompany,authorizesDavidM.Carey.AssistantSecretarytoappointsuchattorneys-in-factasmaybenecessarytoactonbehalfoftheCompanytomake,execute,seal,acknowledgeanddeliverassuretyanyandaltundertakings,bonds,recognizancesandothersuretyobligations.Authorization—ByunanimousconsentohtheCompany’sBoardofDirectors,theCompanyconsentsthatfacsimileormechanicallyreproducedsignatureofanyassistantsecretaryoftheCompanywhereverappearinguponacertifiedcepyofanypowerofattomeyissuedbytheCompanyinconnectidnw:t’tsuretybonds,shabevalidandb.nthngupontheCcmpanywiththesameforceandeffectasthoushmanuallyaffixedI,Rer.eeC.Ltewettyn,trioundersigned.AssistantSecretary.TheOhioCasuacyInsuranceCompanyLibertyMutualInsurancecompany,andWestAmenca,InsurancecompanydoherebycertiLythattheodgtaipowerofattorneyotwhichtheto.egorigisaiu;t.trueandcorrectpyofthePaverofAromeyexecutedbysaidcowpa&es.‘isinhulltorceandeffectandhasnotbeenrevoxed.‘/—INTESTIMONYWHEREOF.IhavehereuntosetmybandandaffixedtneseasofsaidCompaniesIris/dayof4&t6frIf20By : ___ __ ____ _ __ __ _ __ReneeC.L’ewt.pss:sIaitSe-creta7310ot600LMS_,12673.022017 ACKNOWLEDGEMENTBYSURETYSTATEOFILLINOISCOUNTYOFCOOKOnthis19thdayofJanuary,2018,beforeme,BaitlomiejSiepierski,aNotaryPublic,withinandforsaidCountyandState,personallyappearedDerekJ.E]stontomepersonallyknowntobetheAttorney-in-FactofandforLibertyMutualInsuranceCompanyandacknowledgedthats/heexecutedthesaidinstrumentasthefreeactanddeedofsaidCompany.INWITNESSWI-IEREOF,Ihavehereuntosetmyhandandaffixedmyofficialseal,atmyofficeintheaforesaidCounty,thedayandyearinthiscertificatefirstabovewritten.omcitMLBARTWMIEJSIEThERSINOTARYPUBUC,STATEOFIWNOISMYCOMMISSIONBWIRES0911612019theStateofIllinois•ountyofCook