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DOCXZIOCNC%MSZICKDOCOOCXDOW,ESTERN S U R E T 'Y C O M P 4 N V . O N E or A M E R I C n S OLDEST EC
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Effective Date. November 3rd, 2010
Western Surety Company
LICENSE AND PERMIT BOND
KNOW ALL PERSONS BY THESE PRESENTS: Bond No 24859022
That we, RPMS-CA c/o Innovative Environmental Solutions
of the City of Encinitas
, State of California , as Principal,
and WESTERN SURETY COMPANY, a corporation duly licensed to do surety business in the State of
California
City of National City
, as Surety, are held and firmly bound unto the
, State of California
, as Obligee, in the penal
sum of Two Thousand and 00/100 DOLLARS ($2, 000.00 ),
lawful money of the United States, to be paid to the Obligee, for which payment well and truly to be made,
we bind ourselves and our legal representatives, firmly by these presents.
THE CONDITION OF THE ABOVE OBLIGATION IS SUCH, That whereas, the Principal has been.
licensed Encroachment Permit
by the Obligee.
NOW THEREFORE, if the Principal shall faithfully perform the duties and in all things comply
with the laws and ordinances, including all amendments thereto, pertaining to the license or permit
applied for, then this obligation to be void, otherwise to remain in full force and effect until
November 3rd 2013 , unless renewed by Continuation Certificate.
This bond may be terminated at any time by the Surety upon sending notice in writing, by First Class
U.S. Mail, to the Obligee and to the Principal at the address last known to the Surety, and at the expiration
days from the mailing of said notice, this bond shall ipso facto terminate and the Surety
lieved from any liability for any acts or omissions of the Principal subsequent to said
. %ie number of years this bond shall continue in force, the number of claims made
is bo' •- the number of premiums which shall be payable or paid, the Surety's total limit of
shall not b4 nulative from year to year or period to period, and in no event shall the Surety's total
tyo a afr a exceed the amount set forth above. Any revision of the bond amount shall not be
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Dated tT is
day of
December 2010
Rpms-Ca C/O Innovative Environmental
Solutions
Principal
Principal
WESTE QSURET COMPANY
By
Paul T. Bruflat, Senior Vice President
Form 532-1-2010
tslf - W E S T E U N SURETY COMPANY or .\ M E S 1 C,' S O L DES T
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STATE OF SOUTH DAKOTA
ss
COUNTY OF MINNEHAHA
ACKNOWLEDGMENT OF SURETY
(Corporate Officer)
On this 13th day of December 2010 , before me, the undersigned officer,
personally appeared Paul T. Bruflat , who acknowledged himself to be the aforesaid
officer of WESTERN SURETY COMPANY, a corporation, and that he as such officer, being authorized so to do, executed
the foregoing instrument for the purposes therein contained, by signing the name of the corporation by himself as such
officer.
IN WITNESS WHEREOF, I have hereunto set my hand and official seal.
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My Commission Expires February 12, 2015
STATE OF
COUNTY OF
ss
Notary Public — South Dakota
ACKNOWLEDGMENT OF PRINCIPAL
(Individual or Partners)
On this day of
before me personally appeared
known to me to be the individual _ described in and who executed the foregoing instrument and acknowledged to me
that _he executed the same.
My commission expires
STATE OF
COUNTY OF
Notary Public
ACKNOWLEDGMENT OF PRINCIPAL
(Corporate Officer)
On this day of , before me personally appeared
who acknowledged himself/herself to be the
of , a corporation, and that he/she as
such officer being authorized so to do, executed the foregoing instrument for the purposes therein contained by signing
the name of the corporation by himself/herself as such officer.
My commission expires
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26
Western Surety Connpany
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS:
That WESTERN SURETY COMPANY, a corporation organized and existing under the laws of the State of South Dakota, and
authorized and licensed to do business in the States of Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut,
Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine,
Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey,
New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina,
South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming, and the United
States of America, does hereby make, constitute and appoint
Paul T Bruflat of Sioux Falls
State of South Dakota , its regularly elected Senior Vice President
as Attorney -in -Fact, with full power and authority hereby conferred upon him to sign, execute, acknowledge and deliver for and on
its behalf as Surety and as its act and deed, the following bond:
One Encroachment Permit City of National City
bond with bond number 24859022
for RPMS-CA c/o Innovative Environmental Solutions
as Principal in the penalty amount not to exceed: $ 2, 000. 00
Western Surety Company further certifies that the following is a true and exact copy of Section 7 of the by-laws of Western Surety Company
duly adopted and now in force, to -wit:
Section 7. All bonds, policies, undertakings, Powers of Attorney, or other obligations of the corporation shall be executed in the corporate
name of the Company by the President, Secretary, any Assistant Secretary, Treasurer, or any Vice President, or by such other officers as the
Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint
Attorneys -in -Fact or agents who shall have authority to issue bonds, policies, or undertakings in the name of the Company. The corporate seal is
not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation. The signature of any
such officer and the corporate seal may be printed by facsimile.
In Witness Whereof, the said WESTERN SURETY COMPANY has caused these presents to be executed by its
Senior Vice President with the corporate seal affixed this 13th day of December
2010
ATTEST
241,2are
STATE OF SOUTH DAKOTA
COUNTY OF MINNEHAHA
By
L. Nelson, Assistant Secretary Paul T. Brufl, Senior Vice President
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, before me, a Notary Public, personally appeared
and L. Nelson
WESTE' N URETCOMPANY
ss
On this 13th day of December 2010
Paul T. Bruflat
who, being by me duly sworn, acknowledged that they signed the above Power of
Attorney as
Senior Vice President
and Assistant Secretary, respectively, of the said WESTERN SURETY COMPANY, and acknowledged said instrument to be the
voluntary act and deed of said Corporation.
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My Commission Expires November 30, 2012
Notary Public
Form F1975-9-2006
27
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Western Surety Company
RIDER
It is hereby mutually agreed and understood by and between the Principal and Western
Surety Company, that instead of as originally written:
The description has been changed to read:
Encroachment Permit Security Deposit For The Life of The Monitoring
Wells Installed
No further changes other than above.
Nothing herein contained shall be held to vary, alter, waive or extend any of the terms, limits or
conditions of the Bond , except as hereinabove set forth.
totiatiata,o
s.s vibe' effective on the 14th day of February 2011 at
tvs �We o e'ix,t'clock a.m., standard time.
heii EO V inin art of Bond No 24859022
issu'% �Q t E R N S U R E T Y C O M P A N Y of Sioux Falls, South Dakota, to
$9dg[tddddLtitti
RPMS-CA C/O Innovative Environmental Solutions
Signed this l4th day of February 2011
WESTER SURETY COMPANY
By
Paul T. Bruflat, Seor';'. ;'resident
Form 128-4-2002
28
WILSHIRE
INSURANCE!
INTERLINE
WI 00 99 07 06
DATE: 02/18/2011
WILSHIRE INSURANCE COMPANY
P.O. Box 7006, Lancaster, California 93539-7006
NOTICE OF CANCELLATION / NONRENEWAL
To ALL Insureds, Loss Payees, and Other Interests named in the Policy shown below:
Additional Interest
CITY OF NATIONAL CITY
1243 NATIONAL CITY BLVD*
NATIONAL CITY, CA 92050-0000
Policy Number:
BA2490250 57 02
We are notifying you, in accordance with the Terms and Conditions of the policy shown above, that your policy will
cease at 12:01 a.m. Standard Time at the first Named Insured's Mailing Address on the date shown below:
CANCELLATION / TERMINATION DATE OF POLICY:
03/20/2011
PREMIUM ADJUSTMENT: If this policy is cancelled and the premium has not been paid, the earned premium due
and payable shall be computed as provided in the policy, and demand is hereby made for payment thereof. If
premium has been paid, the excess paid premium above the earned premium, if any, if, not tendered with this
Notice of Cancellation/Nonrenewal, will be refunded as soon as practicable after cancellation becomes effective.
The following, when applicable, have also been
notified (by separate notice) Certificate Holder(s),
Additional Insured(s) or Interest(s), and all
Domestic and Foreign Motor Carrier Regulatory
Entities.
Named Insured:
JOSE LUIS ALVARADO
DBA:J A T TRANSPORT, INC.
4313 GREYSTONE CIRCLE
RIVERSIDE, CA 92509-0000
AVAILABILITY OF OTHER INSURANCE
We are notifying you that we are cancelling your policy for
Commercial Automobile insurance. Other insurance is
possibly available through your agent, another insurer or
through the Automobile Insurance Plan. For additional
information, please contact your insurance agent.
Countersigned at Lancaster. California on 02/18/11
Policy Issued through Agency:
THE EMPIRE COMPANY
PO BOX 5400
RANCHO CUCAMONGA, CA 91729-0000
WI 00 99 07 06 Page 1 of 1
Authorized Representative
Countersignature
Producer Code: 150670008
ADD'L INSURED
02/18/2011
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