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'r�-ngaZ�iGP1 STATE OF CALIFORNIA-DEPARTMENT OF TRANSPORTATION PAYMENT BOND OF STATE HIGHWAY ENCROACHMENT PERMITTEE TR-0018 (REV. 1012007) PLEASE FILL OUT FORM COMPLETELY [To Accompany the Permit) Streets and Highways Code Section 677 BOND NUMBER ENCROACHMENT PERMIT NUMBER PRINCIPAL 57BS8FE2019 . Project #1103.04.12 Closure Solutions Inc. DISTRICT COUNTY ROUTE P08TMILE PREMIUMAMOUNT EFFECTIVEDATE LOCATION 11 100 September 3, 2008 INSTRUCTIONSTOSURETYCOMPANY On the Surety Bond,under the"Description of Attached Document,'on the line labeled"Title or Type of Document," the Surety Company shall listthe description of either PERFORMANCE BONPorPAYMENT BONDand shall also include the ENCROACHMENT PERMIT NUMSER. On the line,under the"signer is representing',the Surety Company shall also include the telephone number of the Principal. Performance bonds and payment bonds shall be held in force for a period of one-year, from the date of project completion, unless so stipulated differently by the State. KNOW ALL PERSONS BY THESE PRESENTS: That (insure SolutionsInc asPRINCIPAL, having an address forservice of 1243 oak Knoll Drive and Hartford Fire Insurance Company a Surety Company qualified and duly licensed to do business in the State of California,as SURETY,are held and firmly bound to the STATE OF CALIFORNIA,as OBLIGEE,in the sum of Four Thousand Dollars ($ . 000 )Jawful money of the United States of America,to be paid to the OBLIGEE,forwhich payment,we bind ourselves,our heirs,executors, administrators,successors,and assigns,jointly and severally,to those persons referred to In paragragh 4 below. THAT THE CONDITION OF THIS OBLIGATION IS SUCH: 1. Thatwhereas PRINCIPAL has made,oris abouttomake,application totheState of Californialbra permit underArticle 2 of Chapter 3 of Division 1 ofthe Streets and Highways Code to place,change or renew an encroachment in,under or over any portion of a state highway,and Streets and Highways Code Section 677 requires a bond payable to the State of California as a condition therefore,this payment bond is executed and tendered in accordance therewith. 2. That this bond shall be subject to all of the terms and provisions of the afore-mentioned provisions of the Streets and Highways Code. 3. That if the PRINCIPAL shall%il to faithfully perform the work for which the encroachment permit was issued,or fail to pay all encroachment permit fees then the SURETY herein shall pay for the same,otherwise this obligation is null and void. 4. No right of action shall accrue underthisbond toorforthe use of any person orentity other than the Stateof California. T 90 140 V