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WPO201700055 Preconstruction Form 2018-02-14
Request for Pre -construction Meeting and Grading Permits from Albemarle County - VESCP A I�;yNt� Approved Plan Number: WPO- 101 7• 0 0 0 5 Approved Plan Name: P,� (Plans must be approved prior to a pre -construction meeting.) Bond approved date: J- b yb i (Bonds must be approved and posted prior to a pre -construction meeting or permit.) Responsible Land Disturber: Print Name: DR M• u -.+ iD State Certification Number: d S' � i 0 Address City_ ��/C:r/g State Vq Zip 0? Daytime Phone S( ��) j d J © ! ? E-mail (JcL fi ,.,.j Primary Contractor: Print Name_ C. u ram. v .► ,,:.a I XG, r.� a t :' *mac f L mac: Address '1: , a , < 9 1 7 City Vt /co . O ak State Y h_ Zip Daytime Phone (5 YQ) _ `� t� ' 6 6 E-mail _ c_ e w -j ur t A Permit Issuance and First Year Maintenance Fees: (Request must include payment) Total acres proposed to be disturbed is contained on the approved plan and application: VESCP: Acres to be disturbed Fee Due at Grading Permit Less than 1 00 Flat fee 1+ Acres .00 Per Disturbed Acre Sec 17-207 Fees for land disturbing activity solely to the VESCP. Annual Maintenance Fees [Sections 17-207 & 208 of the Albemarle County Code] —Annual maintenance fees will be assessed in March of every year this permit is active. Fees cannot be prorated after the first year of permit issuance. 9/ 11 /2017 Page 1 of 3 Person(s) to attend the Pre -construction Meeting: Names (type or Firm Contact Number or email The second part of the application fee is required to be paid with this request. This fee amount is; FOR OFFICE USE ONLY Permit Issued Date By who? 9/11 /2017 Page 2 of 3 WATER PROTECTION PERFO MANCE BOND WITH SURETY The undersigned, Commonwealth Excavating, Inc. , Principal(s), and Surety, are held and firmly bound to the County of Albemarle, Virginia (hereinafter, the "County"), in the penal sum of $12,190.00 , for which payment we jointly and severally bind ourselves and our heirs, executors, administrators, successors and assigns. Of this total penal sum, $12,190.00 is the sum required pursuant to Albemarle County Code § § 17-414 and 14-417(A) (erosion and sediment control); $0.00 is the sum required pursuant to Albemarle County Code §§ 17-414 and 14-417(B) (stormwater management and water quality). The condition of this obligation is such that the Principal(s) is obligated to satisfy the terms and conditions of Water Protection Ordinance Application No(s). WPO-2017-00055 (hereinafter, the "Plan"), which Plan and all specifications which are part thereof are incorporated herein by reference, and all applicable requirements of Chapter 17 (Water Protection) of the Albemarle County Code (hereinafter, "Chapter 17"), including any handbook and state law identified and referenced therein, related to the development of the project described as Orchard Acres Waterline Replacement, all of which is collectively referred to herein as the "work." If the Principal(s), his/her/their heirs, executors, administrators, successors, or assigns, well and truly perform the work on or before the 24 day of January, 2019, without variance, required thereby, then this obligation shall be void, otherwise it shall remain in full force and effect; provided that if, at any time during the term hereof, the Principal(s) shall commit and/or suffer or permit the commission or existence of any act, omission, or condition which shall constitute a violation of the Plan and/or Chapter 17, and fails, after proper notice of such violation is given by the Program Authority pursuant to Chapter 17, to take timely corrective action as specified in the notice, then the Principal(s) shall be in default of the terms of this Bond. Page 1 of 5 In the event of a default by the Principal(s) as described herein, the County of Albemarle, through its County Engineer, shall provide written notice of such default to the Principal(s) and the Surety. If the County Engineer determines, in his sole discretion, that the default does not create an imminent or potentially imminent threat to the public health or safety, then, in the event of such default and written notice, the Surety shall have either of the following options: 1. Within twenty-one (21) days after receipt of the default notice, the Surety shall pay over to the County the entire sum of the bond or such lesser amount as the County Engineer may determine in his sole discretion, and thereafter be relieved of further liability under this Bond. If this option is selected by the Surety, then the County shall take over and relet all or any part of the required work, and will complete the same to the extent of available funds. The cost and expenses of completing the work shall include all of the County's actual costs for the work and its administrative costs. If these funds are insufficient to complete the work, then the County may proceed against the Principal(s) for the difference. If there are any funds remaining that are not necessary for completion of the work, the County will remit this excess to the Surety after work is completed; or 2. Within twenty-one (21) days after receipt of the default notice, the Surety shall provide written notice to the County that it will assume the obligations of the Principal(s) and complete the work required to satisfy the terms and conditions of this Bond within one hundred eighty (180) days of the County Engineer's notice or such other term approved by the County Engineer, and thereafter be relieved of further liability under the terms of this Bond. If this option is selected by the Surety, but it then fails to faithfully perform all or any part of the required work; or if it unnecessarily delays completing all or any part of the required work, then: (a) upon written demand by the County Engineer, the Surety shall pay over to the County by the date specified in the written demand the entire sum of the bond or such lesser amount as the County Engineer may determine in his sole discretion; and (b) the County shall take over and relet all or any part of the required work, and complete the same at the expense of the Principal(s) and the Surety, who shall be jointly and severally liable to the County for the costs and expenses of completing the work, which shall include all of the County's actual costs for the work and its administrative costs; or bring suit, action or proceeding to enforce Page 2 of 5 the provisions of this bond. If the bond funds are insufficient to complete the work, then the County may proceed against the Principal(s) and the Surety for the difference. If the County Engineer determines, in his sole discretion, that the default creates an imminent or potentially imminent threat to the public health or safety, then options (1) and (2) described above shall not be available to the Surety. The County Engineer shall provide written notice of such default and the imminent or potentially imminent threat to the public health or safety. The Surety shall, immediately upon receipt of such written notice from the County Engineer, pay to the County the entire sum secured under this Bond, or such lesser sum specified in the written notice. The County shall apply the proceeds to complete the required work and cover its associated administrative costs. If these funds are insufficient, the County may proceed against the Principal(s) for the difference. If there are any funds remaining that are not necessary for completion of the work, the County will remit this excess to the Surety after work is completed. Nothing in this Bond shall be construed as affecting, impairing, or diminishing the obligation of the Principal(s) to complete and perform the work guaranteed under this Bond. Nothing in this Bond shall be construed as creating an obligation upon the County to pay for the completion and/or correction of the work guaranteed under this Bond. Nothing in this Bond shall be construed as creating liability upon the Surety that exceeds the total penal sum of this Bond. The Surety, for value received, stipulates and agrees that no change, extension of time, alteration, or addition to the Plan or Chapter 17 shall in any way affect its obligation on this Bond, and it hereby waives notice of any change, extension of time, alteration, or addition. In witness whereof, the parties have caused this instrument to be executed this 25th day Of January 9 2018 Page 3 of 5 PRINCIPAL Inc. BY: (Please sign above A4 1kint name below) Patricia A. Biggs TITLE: President ADDRESS: 215 Lebanon Church Rd Staunton, VA 24401 PHONE: 540-487-8103 PRINCIPAL Ira J. Biggs TITLE: Secretary/Treasurer ADDRESS: 215 Lebanon Church Rd Staunton, VA 24401 PHONE: 540-487-8103 Inc. above and print name below) Page 4 of 5 SURETY (Must be signed by a Virginia Resident Agent of Surety — attach Power of Attorney) M. and print name below) Lindsey Thompson ADDRESS: Richards Group, Inc. 4931 Boonsboro Rd Lynchburg, VA 24503 PHONE: 434-484-3900 BOND NO: S458034 ADDRESS OF SURETY'S HOME OFFICE: Employers Mutual Casualty Company 11020 David Taylor Drive, Suite 205 Charlotte, NC 28262 Approved as to Form: County Attorney Accepted: County Engineer / Authorized Agent Rev. 12/22/2015 Page 5 of 5 Date Date AWEMIC INSURANCE P.O. Box 712 • Des Moines, IA50306-0712 No. C 17294 CERTIFICATE OF AUTHORITY INDIVIDUAL ATTORNEY -IN -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 Iowa Corporation Dakota Fire Insurance Company, a North Dakota Corporation EMC Property & Casualty Company, an Iowa Corporation Hamilton Mutual Insurance Company, an Iowa Corporation hereinafter referred to severally as "Company" and collectively as "Companies", each does, by these presents, make, constitute and appoint: S.DIANE VAN HORN, ALEXIS V. RICHARDS, LINDSEY THOMPSON its true and lawful attorney -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: In an amount not exceeding Ten Million Dollars..........................................................................................................................................................$10,000,000.00 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 attorney pursuant to the authority hereby given are hereby ratified and confirmed. AUTHORITY FOR POWER OF ATTORNEY This Power -of -Attorney 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 attomey-in-fact at any time and revoke the power and authority given to him or her. Attomeys-in-fact shall have power and authority, subject to the terms and limitations of the power -of -attorney 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 obligatory in the nature thereof, and any such instrument executed by any such attomey-in-fact shall be fully and in all respects binding upon the Company. Certification as to the validity of any power -of -attorney authorized herein made by an officer of Employers Mutual Casualty Company shall 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-attomey 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 7th day of NOVEMBER 2017 Seals O0OR9�:9'� SEAL a < - = z 1863� o 1953 'IOWA IOWN 1o\aSURANOFc''. ;,P 'NSU PAN 'P :• UT UA(O9 Q1 Py`DPPOROq•: �`C c.OPP044t''CO �[yQy: OpPOR4t'.Py •; w = SEAL - : G SEAL Y SEAL ; ; o ' * /OWA * -• OFS , •�09?H 1 DPKO�P• EI G`- I11, DI NES. MUTUq�� UTUq� sG9 o KATHY LOWAIDGE F Commission Number umber 780T69 My COmmisslon E>r = October 10, 2019 ES, tO�P G ruce G. Kelley, airman Todd Strother of Companies 2, 3, 4, 5 & ; President Vice President of Company 1; Vice Chairman and CEO of Company 7 On this 7th day of NOVEMBER AD 2017 before me a Notary Public in and for the State of Iowa, personally appeared Bruce G. Kelley and Todd Strother, 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 Vice President, 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 Todd Strother, as such officers, acknowledged the execution of said instrument to be the voluntary act and deed of each ofthe Companies. My Commission Expires October 10, 2019. 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 NOVEMBER 7, 2017 on behalf of: S.DIANE VAN HORN, ALEXIS V. RICHARDS, LINDSEY THOMPSON O� (IjZ n i Notary P lic in and for the State of I a are true and correct and are still in full force and effect. In Testimony Whereof I have subscribed my name and affixed the facsimile seal of each Company this, b'_" day of w0 ; d% '—�=-�-��Vice President