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(INSTRUCTIONS ON SEPARATE SHEET) EJ IYE')PINK)LLOWI -OTHER AGENCY -APPLICANT APPROVED r J APPLICATION NO.: NOT APPROVED CITY OP I'IGARU, OREGON FEE AMT.: I<_ Z 411 PENDING FEE. PMT. I] CIM HALT. RECEIPT NO.: _, PENDING SECURITY ❑ PUBLIC WORKS DEPARTMENT BY PC - DATE:jL1� 1 c PENDING AGENCY ''OK" ❑ Application and Progress Record PENDING INFORMATION ❑ MAINTENANCE BOND FOR STREET IMPROVEMENT/EXCAVATION AS REQUIRED ANNUAL Ll PENDING VARIANCE ❑ _ - _ EXPIRATI N D TE: PERMIT NO.: _Z�>;F3 DATE ISSUED: --��-_Lz1_ '4 BY: ( 1 ) APPLICATION IS HEREBYMADE TO EXCAVATE FOR AND INSTALL "ek I ( l Inc AS DESCRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REQUIREMENTS. APPLICANT QVAK� _. _ t �1 (�C��I_L �`•�-4�a��(o NAME ADDRESS - CITY PHONE CONTRAC i 7R__ N�ME PLANS BY - A.1—C4 -•-------^D`oR�Ss —ciT"v----__.__ PHONE — ESTIMATED IMPROVEMENT TOTAL VALUATION ( COST): E -_ DOLLARS EXCAVATION DATA: FOR OFFICE USE: STREET DESCRIPTION PROGRESS & INSPECTION STATUS NAME - SURFACE CUT CUT CUT MATERIAL INSTALLED ITEM DA re REMARKS/TYPE BY TYPE LENGTH WIDTH DEPTH ITEM & QUANTITY STREET - OEENED INSP C- _ R TION IE —- Q E STIMATED STREET OPENING DATE: / / E ESTIMATED STREET CLOSING DATE: T - E -- --- --- - _ D 3) SECURITY NO. 1 n� max. STREET SEC RITY AMT _ w� CLOSE SURETY CO.: — 1�nc, • Tv ,�n_••�\_, _ FINAL CERTIFIED CHECK _ _—_ cA a soND INSPEC. (4) PLOT PLAN: INDICATE SITE PERTINENT PHYSICAL SPECIAL PROVISIONS;CONDITIONS: FEATURES; EXCAVATION LOCATION AND EXTENT. rim) ; Wc�Ick . A� F h ri 1►til c ori r aclt>► 1 I I 1 ----- 1 i�]eav\f �S � �_G ► I W O v- 'r-r- SLL �O e. cr` 7 i� co _�y C r a ►n --- —_=- v I`+) NOTE THE CITY OF TIGARD DOES NOT. HEREBr, GRANT PERMISSION TO APPLICANTS TO CONDUCT WOR WHERE RIGHT-OF-WAY JURISDICTION IS THAT OF WASHINGTON COUNTY OR THE STATE OF OREGON. THE APPLICANT AGREES To DEPOSIT THE REQUIRED SECURITIES, TO COMPLY WITH ALL PERTINENT LAWS AND CONSTRUCTION SPECIFICATIONS PERTINENT TO CONDUCT OF THE WORK, AND TO SAVE HARMLESS THE CITY AND CMPLOYEES AGAINST ANY INJURY OR DAMAGE WHICri MAY RESULT FROM APPLICANTS ACTIONS. APPLICANTS SIGNATURE Q�� �^�� DATE—L) i „ h A �[a Y Q� 1 m Q a4.j c Z C ! O I m _ L a U co m H r y v) ma _ O C W Q1 H �•� m CM ` U_ CD V)g�4m ~ •y L1 ` O N L I M m r a U 3x0 � a p � u E � 06 O C > > > cn rn y (n E o oma y ua E � a U. ' $ p � � fm 00) 0 y o o ` �� ,� C e �v Inn. (naOv) � cnaacna) < caLLc3 _ cncn (zcl 8 6 m I I CM 91 ri. Y'7 �7 • OMNI ELECTRIC CONTRACTORF 'NC. P.O. BOX 1147 M� Mo TUALATIN, OR 97062 636-4306 i GATE SUBJECT �` A«✓SAN Ce-� . l�.tr Fw alp btu '�,uL CJ mown (01111 NO.iMt t/N CfIndustrial Indemnity . C-.n F.M.a0/n1,.11on Bond No. YT859-6566 OREGON PUBLIC WORKS CONTRACT BOND That we,..OMNI ELECTRIC CONTRACTORS INC....................................... as Princi ......................... ...... 7.. .. Principel, and ._...Indtlatrial Indemnity Company of„the Northwest„,,,,,,,,,,,,,,,,,,,,,,,,,,,,, incorporated under the laws of the State of.......Washington.................. and authorized to transact surety business in the State of Oregon,as Surety,are held and firmly bound unto _. ............................................... CI.TY....OF...T.IGA....R.D.,...OREGO......N. ....... . .. ... .. .. .. ..... ..................................................................................................... hereinafter called the Obligee,In the sum of............ '""'""'"'"”' ...DOLLARS, lawful money of the United States of America (........650.00.._ to be paid to said Obligee,we do bind ourselves,our hpirs, executors,administrators,successors and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THE ABOVE OBLIGATION IS SUCH, that whereas on the 18th.. ._ day of............Qctp�er................... 19 64.., the princ+pal entered into a contract with the Obligae described as follows; Trenching and laying pipe for the Carman Center Project in Tigard, Cregon NOW, THE.-IEFOPE, if the Principal herein ;hall faithfully and truly observe and comply with the terms of the contract and shall well and truly perform all matters and things undertaken to be performed under said contract upon the terms proposed therein and shall pro,nptly make payments to all persons supplying labor or material for Pny prosecution of the work provided for in such contract and shall not permit any lien or claim to be filed or prosecuted against the Obligee on account of ary labor or material furnished, and shall promptly pay all contributions or amounts due the State Acc'Aent Industrial Fund and all contributions or amounts due the State Unemployment Compensation Trust f=und Incurred in the perform- ance of said contract and shall promptly, as due,make payment to the person,copartnership,association or corporation entitled thereto of the monies and sums mentioned in Section 279.320 of the Oregon Revised Statutes,then this obligation to be void,otherwise to remain in full force and effect. The total amount of the Surety's liability under this bond both to the Obligee and to the persons furnishing labor or materials, provisions, and goods and to any other person or persons, shall in no event exceed the penalty hereof. Provided, however, that the conditions of this obligation shall not apply to any money loaned or advanced to the Principal or to any subcontractor or other person in the performance of ary such work, whether ' specifically p•ovided tot in the contract or not. The bond is executed for the purpose of complying witF Chapter 279 of Title 26,ORS,the provisions of which are hereby incorporated herein and made a part hereof. IN WITNESS WHEREOF, the above bounden parties have exect.ted this instrument this........18th- day of.....October.................. .._ .., 19......b4... OMNI ELECTRIC CONTRACTORS.,„INC,,,,,,,,,,, ,,,,,,,,, .........../..... . . .... .. 6HnClpl By...... ................................... .................Industrial Inde.pity_„Clgmp4fly..Q.>...thO..N+71CtbMf suretyt ....................... L .. ..................... Carol A. Robb Anomwa"'R'°r 421 S W 6th, Suite 920, PortlarJ, OR 97204 1'.179 R719/831 OREGON dIndusirial IndemnRy .Cnnn.no Fo 01&mWnUston 11iniver of �ttornq NO. 8 NW — �Rnafv all mr.•n bU these presents: That INDUSTRIAL INDEMNITY COMPANY OF THE NORTHWEST, a corporation organized and existing under the laws of the State of Washington and having its principal office in the City of Seattle,Stare of Washington,does hereby make, constitute and appoint -------------------------------------CAROL A. ROBB------------------------------------ its true and lawful attorney-in-fact for it and in its name, place and stead to execute on its behalf as surety, bonds, undertakings, stipulations, .onsents and all contracts of suretyship and to attach its corporate seal to such obligations in favor of all e`rligees, provided that the liability of the Company as surety under this authority in no one instance shall exceed the sum of UNLIMITED-- ------------------------------------------------------•------------------------------------ aud reserving to itself full power of substitution and revocation. This Power of Attorney is made and executed in accordance with the resolution adopted by unanimous consent of the Board of Directors of INDUSTRIAL INDEMNITY COMPANY OF THE NORTHWEST on July 19, 1989,reading as follows: "RESOLVED,that the Chairman of the Board or President or Executive Vice President or Senior Vice President or Vice President of the Company, in conjunction with the Secretary or an Assistant Secretary of this Company,or the Secretary's designee,be, and he hereby is, authorized to execute, acknowledge or verify Powers of Attorney qualifying attorneys-in-fact to act under such Powers of Attorney to execute on behalf of INDUSTRIAL INDEMNITY COMPANY OF THE NORTHWEST bonds,undertakings,stipulations, consents and all contracts of suretyship and to attach the corporate seal thereto; "FIIRIHER RESOLVED, that the signatures of said officers so authorized by this Company may be printed facsimile, hthoa graphed or otherwise reproduced, and that the facsimile signature of any person who shall have been such officer of this Company at the time of such execution, acknowledgment or verification may continue to be used for the purpose hereinabove stated and will be binding on this Company,notwithstanding the fact that he may have ceased to be such officer at the time when such instruments shall be issued." In witness whereof, INDUSTRIAL INDEMNITY COMPANY OF THE NORTHWEST has caused these presents to be signed and its corporate seal to be affixed by its proper officers this 28th day of November , 1983 CAttest. INDUSTRIAL INDEMNITY COMPANY OF THE NORTHWEST r ;U mcOAPOanr) r i AUG.114 1112wl�r v SEATTLE.•A 41 +tr Lawfence E. Mulryan,Secretary R.J. Derr,President 1, Lawrence E. kulryan, Secretary of INDUSTRIAL INDEMNITY COMPANY OF THE NORTHWEST, do hereby certify that 1 have compared the lower of Attorney granted herein and the resolution recited herein with the originals now on File in the principal offi(a of said Company,and that the same arc correct transcripts therefrcm and of the whole of the said originals, and that said Power of Attorney has not been revoked but is still in full force and effect. In witness whereof, 1 have hereunto subscribed my name as such officer and affixed the seal of INDUSTRIAL INDEMNITY COMPANY OF THE NORTHWEST this �.i --` day of (%- . l+. 19 ". y �A,A COMPAhr, INCOPPOAATt0 =I Lawrence E. Mulryan,Secretary i AUG IS. 1912 0 SCATTIf r1A / �vst. lais�� o OMNI ELECTRIC CONTRACTuMS, INC. LE1 . cR OF TRANSMITTAL M P. O. Box 1147 TUALATIN, OR 97062 ell, -N„ OA„_ 10/1/84 4� --- ' .' '7 wQ'•1� ATTENTION 503-635-4306 John Hagman City of Tigard T Engineering services o WE ARE SENDING YOU --” the followinq ❑ Attached ❑ Under separate cover via -- ❑ Shop Drawings r] Specifications ❑ Copy of letter ❑ Change order ❑ Prints Plans ❑ Samples ❑ — COPIES DATE NUMBER DESCRIPTION 5 10/1/84 Proposed feeder location to serve the Carman Center property from an existing PGE street crossing. THESE TRANSMISSIONS ARE: ® For your apwovai ❑ Approved as submitted ❑ Resubmit with copies for approval ❑ For your u.b ❑ Approved as noted ❑ Submit copies for distribution ❑ As per your request ❑ Corrections noted ❑ Return _ corrected prints ❑ For your review and comment(s) ❑ ❑ FOR BIDS DUE— — 1y -- ❑ PRINTS RETURNED AFTER LOAN TO US I1FMARKS: the i:zatallation_of__-this feeder wi1Lb.-$650.00. _ If you have any questions please call 635-4306. P1 age raYiew thin plan and Approve_it, fa - construction as soon-Aa.Tponnihie. N hope to start this portinn_._.of__the-Atork_as_soon as possible. I II'v I I) SIGNATURE �` ..•_ " ''I Iii"•i"il' ' 'il •.{rSl CfniF[1 gt1N'= .•I11 .1:•: IF ENCLOSURES ARE NOl AS DESCRIBED.PLEASE NOTIFY US IMMEr)IATEI Y UrON1 ELECTRIC CONTRACTORS, INC. P.O. Box 1'147 TUALATIN, CR 97062 15c&,315 (503) 635-4306 > �l Ave 73 r)l llp +0 -4 All"r L) M 141 P 0. (lox TUAt.ATIN, CR (J'062 J uJ 503) 635 4306 A d � , ~ Z Y I i I `y �G AI L :'ACES P.�l1ST cF t"NDOPSE pt ?N;r 1aIrV♦ _.�-- � to w �r.�.,rr, �,F.� �A7 •aV�1� � �`. _.._ -,,•�� + U FrecFIYro y fy�.� ,1 •I t.` .� 1 ' , a,,,. •.... ''� I ( �, OCT 1 1984 OMNI ELECTRIC 146 15 0m 3 �--� _ -- - - , ELECTRIC - - m _ -- _ 4, '4A 169 SeaaLE' rn ivr na CUnVC 'HOBO iD c� O L O a •� O p 0) — a rt, 2. W y - N ' Ui m )i 50102G'i6"E ; r 33 n00e02'40"w ?In 15 202 IV !0 ea II oT O O t➢ 0 V4 I <. lO ti S OU0 '�0 E X95 ^O s05 40UfN 90 20 °°� L O e • O I GA W a ` e 0 .f• ti l� 2 � 00 00 N � I 137? 1 ?0 PWIIC ?8-U4N'era vrx°n25e0°N o ., ............ ........,.._ �•.......� ,_A ,..,..... A,1�1l1.1 S.W. X40 vv o A, Z ,yam O -