JRG License Bond.tif STATE FARM
State Favmv
Providing Insurance and Financial Services a 4 0D
Home Office, Bloomington, Illinois 61710 NSURANCE
December 29, 2011
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CITY OF BLAIR
218 S 16TH ST
BLAIR, NE 68008
RE: Bond Number: 97 -CB- 1247 -1
Principal: Bernasek, Josh
DBA JRG Electric
State Farm Fire and Casualty Company as Surety, executed the bond
referenced above on behalf of the named principal. The bond by its terms,
provides that the Surety may terminate its liability by giving notice of
its election to do so to the Obligee. In accordance with the terms of the
bond, we hereby elect to terminate our liability and shall, as of
February 11, 2012, consider ourselves released from all liability by
reason of any default committed thereafter by the principal.
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Fidelity & Surety Bonds
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A -B5
cc: Beau Iske, Nebraska Agent, #7115
Bernasek, Josh
DBA JRG Electric
18667 W St
Omaha NE 68135 -4169
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CNASURETY
1- 800 - 331 -6053
Fax 1 -605- 335 -0357
PO Box 5077 Sioux Falls SD 57117 -5077 J www.cnasurety.com
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December 08, 2011 Agent Code: 48 -16318
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CITY OF BLAIR
CITY CLERK
218 S. 16TH STREET
BLAIR, NE 68008
Re: Bond No. 61178120 Penalty $5,000
JOHN GOEPFERT DBA JRG ELECTRIC
19055 T STREET
OMAHA, NE 68135
ELECTRICIAN CITY OF BLAIR
Company Code: 0601 - WESTERN SURETY COMPANY
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We wish to take advantage of the cancellation provision
pertaining to this bond or policy.
You are hereby notified that this bond or policy is cancelled
and voided as of January 19, 2012, or the earliest time
permitted by applicable law, whichever is later.
This bond or policy has been cancelled or nonrenewed because of
nonpayment of premium.
cc: JOHN GOEPFERT DBA JRG ELECTRIC
AMERICAN FAMILY BRKG., INC.
ATTN: BOND TEAM
6000 AMERICAN PARKWAY
MADISON, WI 53783 -0001
Underwriting Services
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11/04/2011 FRI 11:06 FAX C® 0 I6041 /002
Bond No . 97 CB 1247 1 FB- 9006.1
LICENSE AND PERMIT BOND
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STATE FARM FIRE AND CASUALTY COMPANY
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BLOOMINGTON, ILLINOIS
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KNOW ALL PERSONS BY THESE PRESENTS, That we, JOSH BERNASEK DBA JRG ELECTRIC
of OMAHA, NE as Principal,
and STATE FARM FIRE AND CASUALTY COMPANY, a corporation organized under the laws of the State of Illinois,
having its principal office in.the city of Bloomington, Illinois, as Surety, are held and firmly bound unto
CITY OF BLAIR
in the full and aggregate sum of FIVE THOUSAND AND Dollars ($ 5,000.04 )
lawful money of the United States, Which payment we an ru y to be made, we 6ina ourselves, our heirs, e xecutors,
administrators, successors and assigns, jointly and severally, firmly-by these presents.
THE CONDITION OF THE ABOVE OBLIGATION IS SUCH that whereas the said Principal has been granted a
ELECTRICAL_ CONTRACTOR'S LICENSE
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for a term beginning OCTOBER 18, 2011 and ending OCTOBER 18, 2012
NOW, THEREFORE, if the above Principal shall indemnify and save harmless the Obligee, against loss by reason of
said Principal's breach of any ordinance, rule or regulation relating to the above described license or permit, then this
obligation shall be null and void, otherwise to remain in full force and effect.
Provided, that if the Surety shall so elect, this bond may be cancelled by giving thirty (30) days notice in writing to
the said Obligee and this bond shall be deemed cancelled at the expiration of said thirty ($0) days; but said Surety so filing
said notice shall not be discharged from any liability already incurred under this bond or which shall accrue hereunder
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before the expiration of said thirty (30) day period.
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This band may be continued from year to year by means of a continuation certificate.
Signed, sealed and dated this ^18TH day of OCTOBER , 2011
Prindpal
By:
STATE FARM FIRE AND CASUALTY COMPANY
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Mome 6Y - fatt
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F8. 0006,1 01.20.2010
11/04/2011 FRI 11006 FAX
Power of Attorney
,TATS FARM FIRE AND
CASUALTY COMPANY
KNOW ALL PERSONS BY THESE PRESENTS; That STATE FARM FIRE AND CASUALTY COMPANY, an Illinois corporation, with its principal office in
Bloomington, Illinois, does hereby constitute and appoint: Jennifer Bless, Eugina Brant, Amanda Clifton, Christine Kruley, Ce01a Campbell, Pamela
Chancellor, Julie Fehnnan, Mark Fink, Julie Freed, Matthew J_ Gibbons, John R_ Horton, Cynthia Johnson, Susan K. Johnson, Connie S. Knox, Christine
Macdonnell, Lori McDowell, Melissa L. Morris, Mary Ann Nix, Amy C. Ogan, James Platt, Vicki Redman, Leann Rees, Linda Rieck, Suzanne M. Robertson,
Alice Schuler, Tiffany Smith, Mary A. Spotts, Heidi Stevens, Perry Tracy, Justin Veach, Susan M. Wagoner, Karen Weber, Jennifer Wyant, of Bloomington,
Illinois its true and lawful Attorneys) -In -Fact, to make, execute, seal and deliver for, and on its behalf as surety, any and ail bonds, undertakings or other
writings obligatory in the nature of a bond as follows:
Any such obligation in any amount "�'�`
Thts appointment is made under and by the authori #y of a resolution which was passed by tFteXeeutiva Committee of the Board of
Directors of State Farm Fire and Casualty Company on the 8th day of June, 2x09, as is dulycrtlioriietl the Board of Direc #ors in Article
II, Section B of the By -Laws of the Company, which resolution is' .,; `� r�;.�q, �,�'
Resolved, that the Officer of the Company who works regularly with suretyrtibnds is lier'etiy�aLthorized to appoint and empower any
representative of the Company or other person or persons as Attorney- in- Fsct;t ; eic cuI' an``b;half of the Company any bonds,
undertakings, policies, contracts of indemnity or other writings obligatory =tt%eature'of 'I'Uond, which the Company might execute through
its officers, and affix the seal of the Company thereto. Any said exec0tio'n''csfauch docGr>ients by an Attorney -in -Fact shall be as binding
upon the Company as if they had been duly executed and ackp dWledge <4y the regularly elected or appointed officers of the Company. Any
Attorney -in -Fact, so appointed, may be removed for good oause;�and,thd;''aut lonly so granted may be revoked as specified in the Power of j
Attorney.'y�;.
Resolved, that the signature of any Officer pf d above and the seal of the Company may be affixed by facsimile on
any power of attorney granted, and the signature?f`''the,an+' \ Ricer of the Company noted above, and the seal of the Company may be
affixed by facsimile to any certificate of any such p'ov�er;anq "y such power or certificate bearing such facsimile signature and seal shall be
valid and binding on the Company. Anys iich power sa executed and sealed and Certificate so executed and sealed shall, with respect to
any bond or undertaking to which•it Is;sttached, coritiriue to be valid and binding on the Company.
IN WITNESS THEREO STATE FARM FIRE AND CASUALTY COMPANY has caused this instrument to be signed by its Assistant
Secretary Treasurer, and Seal to be affixed this 3 th. day of June, 2009.
This APPOR+TatNt3 CEASE AND TERMINATE AUTOMATICALLY AS OF DECEMBER 31, 2013, UNLESS SOONER
REVOKED AS PROVIDED,
STATE FARM FIRE AND CASUALTY COMPANY
r 6o a1'o Ka c,'`Qli
�' � .. fio� \ \ o�' sistant Secretary Treasurer
STATE OF ILLINOIS ���Tom..ti�.
COUNTY OF McLEAN
On this 8th day of June 2009, before me personally came Bradley M. Weaver to me known, who being duly sworn, did depose and say that he is
Assistant Secretary Treasurer of STATE FARM FIRE AND CASUALTY COMPANY, the corporation described In and which executed the above Instrument;
that he knows the seal of said corporation; that the sea[ affixed to said instrument is such Corporate Seal; and that he executed said instrument on behalf of
the corporation by authority of his office under the By -Laws of said corporation,
OFFICIAL. SEAL J p
Karen Weber
NOTARY PUBLIC - STATE OF ILLINOIS Notary Pubiic
MY Commission ExplrssJuly 24, 2014 My commission expires July 24, 2014
CERTIFICATE
I, the undersigned Officer of STATE FARM FIRE AND CASUALTY COMPANY, do hereby certify that the original Power of Attorney of which the
foregoing is a true and correct copy, is in full force and effect and has not been revoked and the resolutions as set forth are now in force.
Signed and sealed at Bloomington, Illinois_ Dated this 18TH day of OCTOBER, 2811
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tI/ ,P �Xr ALldp '
Assistant Secretary Tre ur r
If you have a question concerning the validity of this Power of Attorney, call (309) 766 -2090,
FB6- 9043.44A
(10- 14 -14) Printed in U.S.A_
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