NAME OF PERMIT HOLDER TOWN OF GOSHEN
DEPARTMENT OF PUBLIC WORKS
____________________________________ ____________________________
BOND NUMBER LOCATION OF DIG
PERMIT BOND
Know all Men by these Presents,
That we, _______________________________________, of the Town of ______________________________________,County of
(Permitee)
___________________________________, and the State of Connecticut, as Principal, and _________________________________________
(Bonding Company)
of the State of ______________________________ having an office and place of business at ________________________________________
_____________________________________________________,as surety, are held and firmly bound unto the Town of Goshen, in the sum of ___________________________________________DOLLARS, lawful money of the United States, to be paid to assure completion of all work
for which payment, well and truly to be made, we bind ourselves, our heirs, executors and administrators and assigns, jointly and severally by
these presents, the said bond and surety to continue to be holden to the Town of Goshen until consent to the cancellation thereof is given in
writing by the Department of Public Works of the Town of Goshen or the authorized agent.
The condition of this obligation is such, that
WHEREAS, the above named Principal has received, or may, upon his application, receive a permit or permits from the Town of Goshen
to perform work on, about or adjacent to a road or for the use of the road right of way, on, over, or below, within said Town of Goshen as is or
may be particularly specified in said permit or permits, to which permit or permits reference is hereby made and are made a part hereof; and
WHEREAS, the said Principal has undertaken and does hereby agree to comply with all the rules, regulations and restrictions of said
Town of Goshen in regard to said permit or permits.
NOW THEREFORE, if the said Principal fails to complete the required work described in the permit, it will be the responsibility of the
bonding company to arrange for the completion of all necessary work as required, to the satisfaction of the Town of Goshen and, if the said
Principal shall well and truly perform and fulfill all the undertakings, covenants, terms, conditions and agreements specified in said permit or
permits, and shall well and truly save harmless and indemnify the said Town of Goshen and the Public Works Department of said Town, or
either of them from damages and costs that the Town of Goshen may suffer, be liable for, or be compelled to pay, or in fact does pay, for any
injuries or damages which may be caused by any action or work being carried on either by the said Principal, his servants, agents or employees,
under any permit or permits issued or which may be issued by said Town of Goshen or its authorized agent, or by reason of negligence or
violation of any law on the part of said Principal, his servants, agents or employees, and, further, indemnify said Town of Goshen for any
expenses that said Town of Goshen or the Public Works Department may suffer, be liable for, or be compelled to pay, or in fact does pay for
any required adjustments to the road and its facilities to a comparable condition, including but not limited to refilling openings or excavations,
removing cable guide railings, removing trees, tree stumps and other obstructions, replacing drainage involving driveways and restoring pavements
open or excavated, satisfactory to the Town of Goshen, as existed prior to the initiation of the work by said Principal, his servants, agents or
employees, then his obligation shall be void; otherwise to remain in full force and effect.
All of the provisions of the foregoing are to be subject to the present ordinance of the Town of Goshen and to any change, alteration or repeal
of any existing ordinances as may be enacted by the Town of Goshen.
IN WITNESS WHEREOF, we have hereunto set our hands and seals the __________________________day of _____________________________in the year two-thousand_______________________________ .
Witness to Permittee’s Signature
_________________________________________ _________________________________________________________________
Permitee’s Signature
_________________________________________________________________
Bond Company Name
_________________________________________________________________
Bond Company Address
__________________________________________________________________
Agent Representing Bond Company
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