Safe USA, Inc. Material and Labor Bond 100579913PAYMENT BOND
(Bond for Labor and Material)
KNOWALL MEN BY THESE PRESENTS: THAT
Bond #'100579913
Premium: lncluded
WHEREAS, the City of Menifee,in the County of Riverside, State of California,by minute action passed See Contract , has awarded to Safe USA lnc. hereinafterdesignated as the "Principal," a contracl for construction of theAudie Murphy Ranch (AMR) Crack Seal Project project together with appurtenancesthereto, and
wHEREAS, said Principal is required to furnish a bond in connection with saidcontract providing that if said principal, or any of his or its subcontractors shall fail to payfor any materials, provisions, provender, or other supplies or equipment used in, upon,or about the performance of the work contracted to be done, or for any work or labordone thereon of any kind, the surety of this bond will pay the same to the extenthereinafter set forth;
NOW, THEREFoRE, we -
SAfC USA, INC,
and - u s. speciartv rnsu ;
tjl:tii"il
and firmly bound unto the city of Menifee. hereinafter _callgd the c_ity, in the penal sumof o^ne^hundred percent (100%) of the amount Il"".iY"L*"""'l8li,i"o^'#i,h oorrars($ 92,31a 88 ;, lawful money of the United sta@ wnich
sum well and truly to be made, we bind ourselves, our heirs, executors, administrators,
successors, jointly and severally, firmly by these presents.
THE CONDITION OF THIS OBLtcATtON tS SUCH THAT if said principat, his orits heirs, executors, administrators, successors, or assigns, shall fail to pay for any
materials, provisions, provender, rented or hired teams, implements, or machinery, or
other supplies or equipment of any kind used, in, upon, for or about the performance ofthe work contracted to be done, including, but not limited to, that part of water, gas,
power, light, heat, oil, gasoline, or telephone service direcfly applicable to the contract,
or for any work or labor thereon of any kind, or for any amounts due under the california
Unemployment lnsurance Code with respect to such work or labor, or for any amountsrequired to be deducted, withheld, and paid over to the Employment Development
Department from the wages of employees of said principal and subcontractors pursuant
to section 13020 of the california Unemployment lnsurance code with respect to suchwork and labor, and provided that any person, so furnishing said supplies or equipment
contributing to said work to be done, or any person who performs work or labor uponthe same, or any person who supplies both work and supplies or equipment thereiore
shall have complied with the provisions of chapter 7 of rifle l5 of part 4 of Division 3 ofthe california civil code, as amended, or any successor thereto, then said surety shallpay the same in or to an amount not exceeding the amount hereinabove set forth and
also shall pay in case suit is brought upon this bond, such reasonable attorney's fees asshall be fixed by the court.
The bond shall inure to the benefit of any and all persons, companies, andcorporations named in California Civil Code Section 3181, as amended, or any
Notices, papers and other documents required by Chapter 2 of Ti e 14 ot patl2
of Code of Civil Procedure, or by
Contract may be served upon Princip
any other law, regulation, or re
al at this address: Safe USA
quirement of the
,lnc.'1030 No. Mountain Ave. #180
and upon Surety at this address:unrano, ua. yt /oz
Tl\ilHCC SrIretv Grouo
igueroa St. St. 700
les, Ca. 90017
So. F
Ange
801
OS
any
The name and corporate seal of each corporate party being hereto affixed and tiresepresents duly signed by its undersigned representative pursuant to authorit,v ol itsgoverning body.
Safe USA, lnc
Principal
By-Jacob Co
re
lenas
n
Su re
By
ey-in-Fact
6
lN WITNESS WHEREOF, three (3) identical counterparts of this instrument, each
of which shall for all purposes be deemed an original thereof, have been duly executed
by the Principal and Surety herein named 6n {hs17th. day of June , 2014
GALIFORNIA ALL- PURPOSE
CERTIFICATE OF ACKNOWLEDGMENT
A notary public or other officer completing this certificate verifies only the identity
of the individual who signed the document to which this certificate is attached,
and not the truthfulness, accuracy, or validity of that document.
State of California
County of
On before me A
personally appeared
f
who proved to me on the basis of sa sfactory evidence to be the perso!(.s)whose
name subscribed to the withi n instrument and acknowled ged to me that
executed the same in &t1/,ttr2A,
strument the
authorized capacity@s
r the entity
), and that by
rll on the in perso n),Yf, o upon behalf o
ht e d, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that
the foregoing paragraph is true and correct.
WITNESS my hand a cial seal.,l 1-*r.*-\ K
8ffi1r>\
,t--4.
a Public (Notary Public Seal)
ADDITIONAL OPTIONAL INFORMATION INSTRUCTIONS FOR COMPLETING TIIIS FORM
This ford cafiplies yrilh c1ltekl Califomia slatutes regarding notary utording an4
ifneeded, shotld be ampleted and anached to the document. Acknowledgmektt
Irofi other stales nay be completedlor dacufients b.ing sent to lhat state so long
as lhe \earding does nol require lhe California nolary to ltiolate Califofiia notary
. State ard Coulty infolluation must be the State and Couaty \4here the document
signerG) personally EpFeared before the notary public for Ecklowledgment.. Date ofnotslization must be the date that the signer(s) personally appeared which
must also be lhe same date the achowledgloent is completed.. The notary public must pdnt his or her name ss it appe.rs withia his or her
commission follo*ed by a comEa and th€D you. title (trotary !ublic).. Prirt the fffle(g) of documcrt sigder(s) who personally aples! at the time of
notarization,. lndicate the corect singular or plural forms by crossiDg off hcorre.t fofins (i.e.
hdsherlSq6 is /a*e ) or circling th€ mrlEct forDs. Failure to conectly iDdicate this
infomatioD msy lesd to rejection ofdocumeDt rEcording.. The notary seal implession must be clear tu1d phologralhically rcproducible.
Inpr€ssion must not cover text o! li[$. If seal impression smudges, re-sea] ifa
sufficieat area permils, otheruise complete a dilfercnt acktrowledgment form.. Signature ofthe rctsry public must lcatch the signatrne on file wiL\ the of6ce of
the cohty clerk.l Additional information is not requLcd but coutd help to ensure llds
aclmowledgment is not hisused or attached to a diffennt doculnent.
+ Indicate tide or tpo of attached document Dumber ofpages and date.* Iodicate fiE capacity cleimed by thc signer. If th€ claimrd capBcity is a
corporate officer, indicate tIrc title (i.e. CEo, CFO, SecrEtary).. Securely attach this document to the signed document with a slaple.
DESCRIPTION OF THE ATTACHED DOCUMENT
(Title or description of allaohed doclment)
fii{e ord6scrlpllon ol atlached dooument conlinued)
Number of Pages _ Document Date-
GAPACITY CLAIMED BY THE SIGNER
tl lndividual (s)
[1 Corporate Officer
(ritle)
Partne(s)
Attorney-in-Fact
Trustee(s)
Other
tr
tr
n
tr
2Ol 5 Version www.NotaryClasses.com 800-873-9865
)
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California Acknowledgment Form
bl orrc other officernotarypu rhi certr calefi venfies on the denticompleting of thev iud vtdualty siho thegneddocumenlochirhihscertincatelsattachandnoted,the truthfuln oraccutac ali thatr-rf documen
State of California
)County of San Bernardino
On before me,Tor i S taley, Notary Public
personally appeared
who proved to me on t
to the within instrume
a fi tti
he basis of subscribednl and r/lheir au-
the entitythorized,orupon be
I certi! under PENALTY OF PERJURY under lhe laws of the State of Califomia that the foregoingparagEph is true and correct.
Seal
coMM. f231260
Notary Public - Calitomia
SAN BERI'IARDINO COUNTY
Notary
Comm.Nov 2t23
Optional lnformation
To help prevcnt fraud, il is recommendcd lhat you provide rnformarion about
"+This is lAt required under Catifornia noInry publ
Document Title:
Notes
@2014 Golden St.lc Notary, Inc (888)263 t 9?7
ss.
satisfactory the
to me executed the same
that the instrument the
executed
WTNESS my hand and
$TOKIOMARINE
HCC
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS
That, U.S. SPECIALTY INSURANCE COMPANY (the "Company"), a corporation duly organized and existing under the laws of the State of
Texas, and having its principal office in Houston, Harris County, Texas, does by these presents make, constitute and appoint,
GABRIEL HILL
its true and laMul Attorney-in-fact, with full power and authority
delver bond number '100579913
hereby conferred in its name, place and stead, to execute, acknowledge and
issued in the course of its business and to bind the Company thereby, in an
amount not to exceed Three million and 00/100 3 000 000.00
Sa id appointment is made under and by authority of the following resolutions of the Board of Directors of U. S. Specialty lnsurance Company
"Be it Resolved, that the President, any Vice-President, any Assistant Vice-President, any Secretary or any Assistant Secretary shall be and
is hereby vested with full power and authority to appoint any one or more suitable persons as Atiorney(s)-in-Fact to represent and act for andon behalf of the Company subject to the lollowing provisions:
Attorney-in-Fact fiay be given full power and authority for and in the name of and on behatf of the Company, to execute, acknowledge and
deliver, any and all bonds, recognizances, contracts, agreements or indemnity and other conditional or obligatory undertakings, including any
and all consents for the release ol retained percentages and/or final estimates on engineering and construction contracts, and any and all
notices and documents canceling or terminating the Company's liability thereunder and any such instruments so executed by any such
Attorney-in-Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary.
Be it Resolvod, that the signature of any authorized offlcer and seal of the Company heretofore or hereafter afflxed to any pow€r of attorney or
any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid
and binding upon the Company with respect to any bond or undertaking to which it is atlached." Adopted by unanimous written consent in lieu
of meeting on September 1,r, 201'1.
The Attorney-in-Facl named above may be an agenl or a brokeI of the Company. The granting of this Power of Attorney is specific to this bond
and does not ir)dicate whether the Attorney-in-Fact is or is not an appointed agent of the Company.
IN U,'ITNESS \^"/HERECF, U.S, SPE
oil this 'l8th day of liecenrber 2017.
be afflxed herelo and executed by its Senior Vice President
State of California
County of L,)s Angeles
cialty lnsurance Company has caused its sealto
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U.S, SPECIAL SU CE COMPANY
Adam S Pes in, Senior Vice President
. 2021
Secretary
AI]otary FuLriic or clher officer completing this certiticate verifies only the identity of the individual who signed the document to which this
certilicate rs attacl'icd, and not the truthfulness, accu or valdi of that document
On this 1'r day of June, 2018, betore me, Sonia O. Carrelo. a notary public, personally appeared Adam S. P€ssin, Senior Vice President of
U.S. Specialty lnsurance Company, who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the
within instrument and acknowledged to me that he executed the same in his authorized capacity, and that by his signature on the instrument
the person, or the entity upon behalf of which the person acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of CALIFORNIA that the foregoing paragraph is true and correct.
WITNESS
Srgnature
mv hand and offic al seal
rdnOfldo,r\ari5. &otri^e 1r er)-!-(seal)
l, Kio Lo, Assistant Secretary of U.S. Specialty lnsurance Company, do hereby certify that the Power of Attorney and the resolution adoptedby the Board of Directors of said Company as set forth above, are true and correct transcripts thereof and that neither the said pow8r ofAttorney nor the resolution have been revoked and they are now in f!il lorae and effect.
lN WITNESS WHEREOF, I have hereunto set my hand this 17th day o{ -_June
Bond No. 1 79913 .r"". \l:1ra, -",,,.
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Agency No. 18488
visit tmhcc.conVsu.etv far rr-,ore information
Kio Lo, Ass
HCCS?Z pOAUSS C06,?018