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City of Albany Water and Sewer Permit Performance Bond Requirements SURETY BOND (PERFORMANCE) Bond# Amount $10,000.00 KNOW ALL MEN BY THESE PRESENTS, that we, as Principal; and the duly authorized to transact business in the State of New York, having an office and usual place of business at as Surety, are held and firmly bound unto City of Albany, City Hall, Eagle Street, Albany, New York in the sum of Ten thousand and no\100 Dollars ($10,000) for the payment of which, well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. Signed and sealed with our seals this day of , 20 . WHEREAS, the above bounden Principal has received and will apply from time to time for permits for the purpose of water, sewer and site restoration work. NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH that if the above bounden Principal shall indemnify and save harmless the said City of Albany from all liability, damages, and expenses of every kind and nature, resulting directly, or indirectly to persons or property and arising from and in consequence of any license or permit, and shall well, truly and faithfully perform the duties and privileges pertaining to any license or permit, and shall perform all required water, sewer, and site restoration work, then this obligation to void, otherwise to remain in full force and effect. And shall further indemnify, save harmless and pay the City of Albany any damages, loss, charges, or expenses which, in any way, be sustained or incurred by it in relation to or in connection with any and all such claims, suits, or proceedings at law or in equity. This bond takes effect , 20 and expires on , 20 ---PAGE BREAK--- ---PAGE BREAK--- ---PAGE BREAK--- Rev 2019-06-26 Water and Sewer Permit Certificate of Insurance Requirements Before a permit is granted, the applicant shall provide a certificate of insurance of a duly authorized insurance company, in the sum of one million dollars ($1,000,000) designating the City as additional insured and evincing coverage to indemnify and save harmless the City of Albany from all loss, damage, cost, and liability whatever which the City may sustain or incur by reason of any accident, act or omission of the person to whom such permit is granted or any person employed by him while engaged in such employment and performing any of the work done under or pursuant to such permits. The applicant shall also provide proof of coverage for compensation and disability insurance. City of Albany Department of Water and Water Supply 10 North Enterprise Drive Albany, New York 12204 (518) 434-5300 KATHY M. SHEEHAN CITY OF ALBANY DEPARTMENT OF WATER & WATER SUPPLY 10 NORTH ENTERPRISE DRIVE ALBANY, NEW YORK 12204 TELEPHONE (518) 434-5300 FAX (518) 434-5332 JOSEPH E. COFFEY, JR, P.E. MAYOR COMMISSIONER