APPENDIX A: EXCESS WEIGHT PERMIT

DAVIESS COUNTY, KENTUCKY

DAVIESS FISCAL COURT

DAVIESS COUNTY ENGINEER

IN RE: ) APPLICATION

EXCESS WEIGHT )

PERMIT

1. ________________________________________________________________________________ hereinafter called APPLICANT, requests the Daviess County Engineer to issue him or her an Excess Weight Permit for the hereinafter specifically described road(s) and bridge(s).

NAME OF ROAD(S) AND BRIDGE(S) FROM TO DISTANCE (miles)

_________________________________________________________________________________________________________________

2. This applicant agrees to assume the responsibility and conditions in the Daviess County Ordinance regulating the issuance of Excess Weight Permits including, but not limited to, assuming responsibility for making road repairs.

3. The applicant tenders herewith a certified check made payable to the Daviess County Treasurer in the amount of $_________, which is the required amount of damage deposit for the designated county road(s) set out above.

4. The applicant attaches herewith an executed Surety Bond DCF-02.

5. Applicant states that _____________, having an address of ___________________________, and phone number of __________, is this applicant’s authorized agent in this area who will be on

call on a 24-hour basis in case an emergency arises on the designated county road(s).

EXCESS WEIGHT PERMIT

The Daviess County Engineer states that he or she has examined the application, has received a certified check as set out in Paragraph No. 3 of the application, has received a properly executed surety bond as set out in Paragraph No. 4 of the application, has examined the proposed Daviess County road(s), and has found that as of the date of issuance of this permit there are no damages to said road(s) except as hereinafter set out.

NAME OF ROAD(S) AND BRIDGE(S) FROM TO DISTANCE (miles)

_________________________________________________________________________________________________________________

Having examined the foregoing, he or she is satisfied that the application has met all the requirements for issuance of a permit and the applicant be and is hereby authorized to operate vehicles having a total gross weight not to exceed _________ pounds over the herein designated county road(s) for a period of one year from date.

This the _____ day of ____ , 201____.

_______________________

County Engineer

Applicant acknowledges road(s) in proper repair except for portions noted herein.

______________________________

Applicant

DAVIESS COUNTY, KENTUCKY

SURETY BOND

Permits to haul loads over county-maintained roads in Daviess County, Kentucky, in motor trucks, semi-trailers, trailers, truck tractors, contract carriers, and motor carriers shall be marked and identified.

KNOW ALL MEN BY THESE PRESENTS:

WHEREAS, the hereinafter named principal has applied to the Daviess County Engineer of Daviess County, Kentucky, for the issuance of a permit in accordance with and subject to the provisions of the Daviess County Ordinance, and the applicant is required to file a bond conditioned for the proper compliance with the requirements of said Ordinance.

NOW, THEREFORE, __________________________________________, hereinafter called the PRINCIPAL, and ______________________________, a corporation organized under the laws of the State of Kentucky, and authorized to transact business in the State of Kentucky, hereinafter called the SURETY, are held and firmly bound unto Daviess County, hereinafter called the OBLIGEE, the sum of $120,000 per mile, less $25,000 deductibility damage deposit, for blacktop roads and $43,500 per mile, less $8,500 deductibility deposit, for rock roads, the payment of which sum, well and truly to be made, we hereby bind ourselves, our corporate officers, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents.

THE CONDITIONS OF THIS OBLIGATION ARE SUCH THAT IF THE PRINCIPAL SHALL:

Repair or pay for the cost of repairing damage to the designated county road(s) or bridge(s) listed below as determined by the Daviess County Engineer, in the event the damage deposit is not sufficient to cover the costs of repair.

NAME OF ROAD(S) AND BRIDGE(S) FROM TO DISTANCE (miles)

_________________________________________________________________________________________________________________

THEN THIS OBLIGATION SHALL BE VOID: OTHERWISE TO BE IN FULL FORCE AND EFFECT.

The obligation of this bond shall be due and payable on a pro rata basis with bonds by other parties, with the payments to the County to be charged equally to each party making a bond covering the portion of road required to be repaired. If any party whose bond is forfeited, is of the opinion that damage to the road was caused by some other party, his or her sole remedy for recovery of his or her payment in accordance with this bond shall be against the other party or parties, and he or she shall be deemed subrogated to the rights of the County for purposes of asserting said remedy. Any party who is of the opinion that the damage to the road was caused by Acts of God, may recover his or her bond from the County upon presenting proof sufficient to overcome the presumption of this bond.

This bond expires one year from the date hereof.

IN TESTIMONY WHEREOF, witness our hand and seal this ________ day of ________, 201_.

___________________________

Principal

___________________________

Title

___________________________

Surety

NOTICE: Professional Surety must be

licensed to execute bonds in the

State of Kentucky and will have

a firmly established resident agency in

Owensboro Daviess County Kentucky