HomeMy WebLinkAbout97-00581
9, On or about March 28, 1996, Plaintiff received correspondence from the
Commonwealth of Pennsylvania, Pennsylvania Game Commission, requesting
reimbursement in the amount of $6,299 for outstanding hunting license fees that the
Defendants collected during 1995, A true and correct copy of this correspondence and the
Proof of Loss Statement is attached hereto as Exhibit "B."
10. By letter dated April 16, 1996, Plaintiff notified the Defendants that the
Commonwealth of Pennsylvania had requested reimbursement in the amount of $6,299
for delinquent hunting license fees, and requested that Defendants promptly remit full
payment for the delinquent fees to the Commonwealth, A true and correct copy of this
correspondence is attached hereto as Exhibit "C."
11. On or about May 20, 1996, Plaintiff made a payment in the amount of
$6,299 to the Pennsylvania Game Commission, Hunting License Division on behalf of the
Defendants for delinquent hunting license fees. A true and correct copy of the Release
and Assignment of Claim and the check receipt, evidencing payment by the Plaintiff in
the amount of $6,299 to the Commonwealth of Pennsylvania, is attached hereto ss Exhibit
"D."
12, By letter dated July 17, 1996, Plaintiff demanded, pursuant to the terms
and conditions of the Bond Application, that Defendants reimburse Plaintiff for the $6,299
payment made by Plaintiff on Defendants' behalf to the Commonwealth of Pennsylvania.
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APPLICATION FOlf
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LICENSE, PERMIT, OR MI~CELLANEOUS BOND
~Cl/vd.. IW, .2-67<< --3 G~-cf
HAMILTOH. OHIO
Alenl P..'?,'9,\'7-,'?9(.\,: ,.QO,M.e.r.,." .::\:.0.<......"..,......,.",.., laCJlian .P.~"f. .l~~'l' ,rr.,~,~,~.q~!~~k~ [j. ,1:~, ~ ,:,o,~.;;
I. N.m. 0' ApplTClnI ..,(1~O)~~~~~ ....Q\.I.hlaar.....~.(.~..')....~~o.r.~ e-....H"..~I::\l,~r.~..!Itt.................
Address ... .iDD, , .5".. Fr.Ct:\:t., '~j" ,Wc.tml.~s.b.u.Cj" ,) ,PeL".. ..1.J.~I~,},......, ,...."..,....."..,."",
~, Amounl of Band S..\,~.OCQ................. .......... W"!;,, 011. .... .....,............ ..... ,... ......... ,.................,..
3. To Whom P'Ylbl. ,(',c."X\mC(\w,€Q !f.n..O,~, R~:.......... ............... ,......... ......... ..... ...... ........................
4, OmrJptlon 0' Bond ,\AVt\h nfij ,l,\~p':\~,3()~r.t,......., "... ,......." '... ............"....,.." ........ '.. ..,..,'..""."
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THE oj'lIe) CA~UJ.;l..',ry,,-,
INSURANCE COMPANY
......................................................................................................................................
5. IIlhl,.Ueenll Bond, OII.llc.,1O Expi", ......,....,................................................,............,....................,
II . Sp,cill Sond Form 'S R.~uJ"d, AlI"~ Bond Form
6, Itlppllclnlls I cOPlrln'"hlp,li.. n.mu .nd .dd"llls of Porl"'f1:.... ............................,..................................,....,
IF BOND IS OVER $5,000 OR IS A FINANCIAL GUARANTEE
THE FOLLOWING SECTION MUST BE COMPLETED
(Financial Guarantees Are Livestock Dealers Bonds, Tax Bonds, Etc.)
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1-/:.g7
.... .\-.!\C:I, ........, ,......,.....".....,..".......,.."".."" "..,... ....." '.....,. ......",.., ........." ........ ....",...,.."
7, If a carporlllon, In whll 1111. Incorporoledl .....),J~r,~:..............,,,.......... 011.0' Incorparalio. ....................,................
R ~h"'rt" nf hUll,... 5(lt'do.3 '3L\cd.Q, .....}",.I1/,."..."", ....,',.......,...,....,..,..,........,..."......... .............",
9. Hove you appli.d 10 any other IU"ly comp,ny for lhis bond? .1.\0............... If so. live full parlicullts .......;:l'AifR'lsB'(iRG........
......................................................................................................................................
'.' . ;.. " ": ,:. : AUG 0 ! 1087
10, If you hm furnished Illmillt bond heretofore, W"y Is n.w bond dul"d? ,)J.l~..........::.'::,~.':'..~..:::'..:,-:-.............:...~......,......
.. .. .. ..' ' BRANCH OFFlc.e
......................................................................................:,-..............................................
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11. ..... 'ou over been blnk,upt or Inso venl?" \ .. ,.................... ..... ......... ...._...,'. ..'.;.':.. ,;:.: ;:.:.:........... ,~;...:,..; ..... ,
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12. HlYI you "" compromised with your credUors! ..t-JiJ'............... ............................................,........................
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13, Re/mnm, latnkers Ind Merchlnu prorerredl:
OCCUPATION \ POST OffiCE !O,ORESS', S m10
~ v:~.\...,.... 't.,f ~'C t/<\.s!;l~r /lei,: '. -, . ~
~c:r..:,r~~\~~~...!~:I.........., ..~~~:,c.'t;~.ci/1'c;...l.~,'~~ 17"
~f.~f,\b"'J .~Ii~A.<,...w.~de.......lu ,X4./'.~~\l,....!:J.... .,~,~.~~~.., '"
~.,.,';>\"..;.~...,' c\o\>.'\~ 11.:-:f'~~]~~'" ~~.<?l,~ ~~.f.W~WI~.".,I~r.b~, ~..
. "'''C.~''1(. l"c\j :.
Th. .pplica,t Ind ind,m^ilor(ll, if .ny, .grll to p,y $...................... Ihe Complny's usu,1 premium for this bond, In .d.tnce Ind th. ume Imounl
tnnullly Ihlte.ller, In .d"nc., sa rone as Ih. bond, or 'ny new bond, or anI "newlllh",o" or SUbsUMe there'or, sh.1I conlinu. in forco, IOd untilth"e
shall hIve been 'urnish,d 10 I~. Surely compelent, wrill.n. 1'1/1 ",id.ne. o. III disch"ge .nd ItIUst fr.m .ny tnd llIli.bilily upon Slid bond.
NAME
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rotlft S.lll~I'lIIP"~
COMPLETE ON REVERSE SIDE
COP7r"lIt 196:. Chlo CUUJltJ' IllS. Ca.
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A. . bJli: IJI ""idmlicn ;; Ihi. :'..liellion pl.... ""'pl'lI In d.IJilth. roliowb, (in'ncl.1 .tll.,m'1ir.1~b'yinl.'; 'of ~hlt d.l. 'the .t'l~m.nt I. m.d..
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ASSETS
CI:h In 'allawin, bJnks, ",.,~
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.... ,,'.,... '" '" ...............,.. to.. .to. $.. ..,.. '" ..... 10.'.
. ........... ,.,.........0..... ....... ....... $...... ... to. ........
Cavlln""nt band. ..,............... ......... $............. .......
Other m"itlu ImJlk.t ,.Iutl
O.scrlptiorh
.....,......................................
S....... .............
,....., '...... ....,.....,."..,... ........... $....., ......... ....,
kcount. RmiYlbl. .......................... $....lao.O'.Q,O
Notu Rmiv.bl. ,.' ,..,. '.., ,. ..,'. ,."", .;J/"'" ,., ,..", ..,., '.
"'.rchlndl" on h.nd ..,....................:1t$..\CC,'WCO...,
R"I .Illl. In my nl"":
~.Dm'iolian Ind loc.tion <lP
,,;,1.~Q.N. ~t .W(:?~\~:, ,\~~$"':' 7.6,,0 .00..
'." 2 ,~I;C..$...fn;1'I r..Wp,r.M\t:.,':).~,:y,,, t 3D.pM.D.
J ',..........................,............. $.............. ......
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LlAIILlTIlS
"",,unts p.y.~I"
Dl,ll In
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Out tI\
30 41,$
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$,Scco,~ $S~f.. $............. .
TOl11 $..~.o,pCQ,C'
NOlu P.y.bl. lnot to b.nkl' ..,................ $....................
t..nl 'rom 8.nkl,
Wh.n dUll . How lICur'dl ^*
"....... tq.~.~... ......^~\ 0..",... dO.. 100.0", ..
,........." ......,......,...,....., ........ $.....".,....""...
MOlt,'"1 on R"I E,t.I.,
Omripli.n .nd Locali.n I-a....p clI>
t ,8.1{p.N..~M...w..,\,'I'r'..~.... L~,~p.cO"
2 .......................................... $....................
3 ...................,.. .................... $....... ............,
Olher Li.bilities Cdemib.h
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Olh" 1l1l!.ld!lcrlbeJ, C.pitll Sloc~ IP.id Inl ......................... $...............)::10.. ::
a...B~:-,u~.A~(,~.~"\M.'=:::;...... $......!.~...O.Q.O Surplus or N., Worth .......................... $,..............~, :
~TA~'AslfTs~ ~~,:~~~.~...",..........., S......J? !.o.~.? TOTAl LlA81L1T1ES ............ ................ $.......... ......~. j
-t\ ~?4 \).00. _
The u'~"'ie"d IlpliC3nl I.r.d I'~.m'itors, il Inyl h",~y ,'.Qu.st Th. Ohl. Camlly Insurance Comp.ny Ihlllinllter leI""d I. lllhe Comp.ny) 10 b~e
lur,ly for. Ind furnish luch bond Or bondl II m.y nON or her..!llr be IIculred by 01 .n b.h.1I Q( the ur.dlllienld IppllcJnt IIh. Indemniton, II .ny. wllrlll!i4,
Ih.I,lh.y hi" · ,ublllnti.l, mJI.'I.1 .nd b,n,fici.1 inlere.1 In Ihe Jff.I'1 .1 th. 'Pollc.nt .nd In the lranSletionl In e.nnlction 'wiln which such bondlll lIe
t.quuedl.
Ih. undlllien.d .pplicant (.r.d Indlmnll.n. if .nyl h!l.by certify Ih.1 th. lI,t.m.nll m.d. In the fOrtioinl .ppliCllion, Including Ihe tinln,isl 11.I.m.nl.
lie Ilu' .nd lit m.de for th. P",p," of induc:r., the Com..ny :. Ute.l. such bonel.l, lnd ll1e unde"l,n.d .pplicant land Ind.mollm, if .nyl, In con.lderation
of Ihe COmP'lny !ltculine luCh bond:,I, .nd for vSlue rec,ivld, do h'reby j.intly .r.d .evmlly coven.nt .nd 'ire.,
1'1 I. ind.mnlty ane "" Ih, CO"'PI'y h"ml.5s trIm IOd 'i.inst .lIlil~iIill, ,1.lm., I.ms. c.. Is. d'm.e'l, lull.. chltlU .nd exp.nses 0' wh"SO.,,,
lind "d nJlm, Includin, "",n.bll II10rn'1I f..., wh"h the C.mp,ny.hlll " ,"y time sust;,n or incul, fIr or by '....n 01 In e.nllOU"" .f the Comp.ny
hl'/inl bttome SUftt7 on any $vch bcnCl:3J or any modilicJ:ion. rene'twi! Dr conlir.u,uiOfl Ihtle,', or n,'N bond!SI S:.zbl:iltJled Iherdel.
l~; :" ptOC:.rft, ,! Iht f.cues: ." the Com"any. tl':r 1"Use and ~i:c~.uU of the Ca:nPJny Itom in~ further liability ulIder Slid bondes). 2nd should 11'1. u"t:er.
s!ined fail or nluu to do so. the COlTi;Unl shall h~'..e the tliht to pteceed in ar., mJnr.tr it miY In fit to secure or .1I.mpt to uc::r. its discha1it. and Ih.
unC:.rsie::ed ,:,pllcan! (,nd ltl~trr:r.ilotS. it Jflll "'al'~t ~i'l and 311 claims Ji:ainst tl':a C.:mpany for damJges i'rcwing aut of such proUlCfini! and 'frn to reimburse
th, Compar.y ':It all 'lPfnns. inch:dmi :Us~nable IltCtnl!l1S fus. whiCh the Ccmplny may incur.
."", :~.....'l'lSo~.... "" .::f<>-.......... .. .:::'(,:.. ... .....~.. ".~.7
W;lnllllor AIIt:Ii, U Appl' t -~"S'e..s
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I'~ \. t;, ,..;.',:.;.iJ'oit:a~................ flo"'~~.~;i;.,~.s.~,~,........................
NQr~1 It -'OD!iCi"1 Of ll\dtlft"itor 'I. CO,.,o',tlOl'l. COl1loutt ".~t Mu,.
tit Ilt"'d .,. filII. w.tft tll. olllun ",mt UI4 rill, on 1ft, lint below I d I'
~"d tn, "'I vI 1111 CO'~".aliO" 'IIn'd. prllp"'1 .UuttO. . n emni vt...... ............ ......... ". ........... I.....................
" · (I),p,'f:'l",II,tl. fi,,., n't.lt 1'l'I\,l\l bt I'C"'d J"4 tlell mtmbtr 0'
li,:':1 ,"!.Ill I'I~ 111(1'''''111111.
Ind"".ilcl".."",.,."....""".".."........".. ........, ......",.,
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IIln"""L ".",11105,1561
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BO,ND
KNOW ALL MEN BY THESE PRESENTS, THAT WE GQ.O(,Q~'" Ol.<...\knr S\OC"E' as. Principal
\ tN."",., "~ & "'II'IOt) \
of County or Cv..l"n be..r \o...n d . Stale of '+'o'nu'5 V ~ l'\ ~ 01.,
l"'JOt "I ,.~
WITH HIS (THEIR) (ITS) PRINCIPAL PLACE OF BUSINESS IN PENNSYLVANIA AT \(')0 S fro,",
~ t~~~N~M"2
\ \ f"\ I \ I '!he Chio Casualty Insurance
or"", \p l~~~l!.::.:t~ COUNTY OF\. .u...... n.. r (tho'. . AND '"'~'''''''''' C~mpany
A CORPORATION OROANlhD UNDER THE' LAWS OF 0110 . AND DULY AUTHORIZED TO
ENGAOE IN BUSINESS IN THE COMMONWEALTH OF PENNSYLVANIA, WITH ITS PRINCIPAL OFFICE
THEREIN LOCATED At '3555 N. Progress Ave. IN THE CITY o~sblU'P;
AS SURETY ARE HELD AND FIRMLY BOUND UN,T.O:rHE COMMONWEALTH OF PENNSYLVANIA INTHE SU M
OF r;w..1".. '1l'ln;,il:inrl DOLLARS ($ ," nnn M) LAWFUL MONEY OF TIlE UNITED STATES OF
AMERICA. to be paid to the said Commonwealth o( PennsylV:\nla, to which payment well and trul)' to be made. we bind
ourselv", .nd each of UI. our and each our helrs,executors, admonillralors. successors and asslens.jointly and severally, firmly by
these presents.
Slened, sealed. and delivered this 5th day of August A,O, 19 ~.
WHEREAS the above bounden PRINCIPAL has been designated itsagenl by the Pennsylvania Game Commission 10 issue
Hunting Licenses in accordance with the ~ 2928 or the Game and Wildlife Code (34 Pa. C,S. ~ 2928): and
WHEREAS lhis bond isliled with the Pennsylvania Game Commission, Commonwealth or Pennsylvania. in accordance with
said Acts or Assembly to enable said PRINCIPAL to obtain Crom the Pennsylvania Game Commission. the annual supply of
Llcen>ts; .
NOW,thereCore, the condition oflhisoblieation is such thai if the above bounden PRINC1PALshall well and Iruly,correclly
and faithfully In all things, execute. perform and discharee the truslS and dutics or his office as req,uired b)'la w. and shall well and
truly, correctly and Caithfully aceount Cor and pay according 10 law, all moneys which shall be receIved by, or for him in his official
capacity, due and owing to Ihe Commonwealth and shall faithfully comply with the provisions or the AclS referred 10 abov'e or the
Commonwealth or Pennsylvania, until the revocation orthe permit in connecllon with this bond which is being filed. unless berore
that dale the SURETY shall be released and discharged in the manner and to the extent prescribed by the S3ld ACI, then this
obligation shall be void; otherwise it shall be and remain in full force and virlue,
AND.I~the eve~tthal.lhe above bounden PRINCIPAL shall, rrom and after the erfective date of the permil aroresald. fail in
any respect to faithCullycomply with the provisions of the Acts referred 10 above, we do hereby empower the AlIorne)' General of
the Commonwealth oC Pennsylvania, or any allomey or .ny Court of Record wilhin the Commonweallh of Penns)'lvania or
elsewhere, to appear for and enter judgment against us or either of us. OUr or eilher of our heirs. executors, adminlmalors.
successors or aSSIgns. for the above sum with costs oC suits. release or ali errors and withoul Slay of execulion, And we waive the
right orinquisition on any realeslate which may bje levied upon 10 collect the above sum, and we do hereby voluritaril)' relinqui~h
the same and authorize the prothonotary to enter upon a writ or e.eculion our said relinquishment. And we further agree lhat said
Real Ellate may be sold on a writ of execullon and hereby waive and release all ...lier rrnm MY and allorrrailrmenl. sial' or
exemption laws of any Slate now in force or hereafter to be passed. And for the enlering of such judgementthi~ shall be the
su(fiCtCnt warrant for any such allorney,and a copy of this Bond and Warrant being filed in said action, it shall nol be necessar)'to
file the original as a warrant of allorney, any law or rule of court 10 lhe contrary nOlwilhslanding. '
In witness whereor lhis Instrument has been duly execuled by the above.named principal and surety the da)' and year above
wrillen ..
,', ," .tlI'\CO'pot"l'II~''''laio,,~lo.'
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tN.~ 01 COI'elOflloOftl
~Allary
By
"',,'c1,nt
, "
, WITNESSES
'. ,:.#^,:',~'~~"::'::' :
(P.,tlMI,tI\iO Ao.nlllf" ~Io-)
tiARRISBURG
AlJG 0 I.i 1%/
(SEAL)
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tH.""O""If"l'''''I')
llRMICIl OfFICE
(SEAL)
(PIIII'\I'1
IhoJ,....:..~1 ",,,,.\lI'Q.\ t.4t,:..1
Ili,m, OlCcllfo"loon,
i
AIICIl:
"'Utl..,
By
"..~.'"
(,
WITNESSES
1"""""J'lill Av."',," t/t6o_1
tJAR fH 5 Bll R a
AIJG 0 li lUlJl
tN..". 0' "MfIIN'1
UMMel! OFFice
(SEAL)
l"'&nfl)
(SEAL)
~qJ~~
Gtl- ~\\~rs
(hloJf.":"~"Y""'lf"~.1
Ge...,e1.;
. (),....\J."".. S\er~
\hl"'" 01 CaPII",,".,.II"'r,
(SEAL)
(1~""''''''J
(SEAL)
'll1e Ohio Casualty Insurance COR;>aI\Y
rf: I M,(1~~ IN.....'...."I
_/1. _'T_~ Alles!:
( Paula WachtnBf1"'''' '" 'UII
(CORP)
(SEAL)
"
By
Received
'5th
day of
AU!1;\.Ist
.19-U,
IMPORTAN., Pic... prf.,..... aad.m,,'h neb _rfltr" "I..'...,
..'..... ..,
.
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25
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March 26, 1996
George H, Sellers
Va George's Outdoor Store
100 South Front Street
Wonnleysburg, PA 17043
Account #210659
Adult Resident 21381C-21500C :: 120
21S13C-21700C :: ~
T.otal 308 x $12.00 '" 53,696,00
Junior Resident 29941 R-29S60R :: 40 x $5.00 = $200,00
Senior Resident 26261Y-26300Y = 40 x $10,00 :: $400,00 . .
Adult Non-Resident 16921-16930 :: 10 x $80.00 $800,00
7 -Day Non-Resicent 4411-4420 :: 10 x $15,00 = $150,00
Archery 84441 SAC60 . :: 117 x $5.00 $585.00
MuzzJeJoader 39361-39420 = 60 x $5,00 :: 5300,00
Adult Furtaker 7621-7630 :: 10 x $12.00 :: $120,00
Junior Furtaker 4221-4230 :: 10 x $5,00 :: $50,00
Senior Furtak!" 4181-4190 = 10 x $10,00 = $100,00
Sub Total $6,401.00
OVERAGE IN ACCOUNT (5102.00\
TOTAL AMOUNT DUE $6,299.00
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To W ... .. aUlld.Utp c:1.a.tm. La"""'.
" U_-.Jtt 1IjI' kldU,..bl. empJo,...
..".-'. ..--
RELEASE alld ASSIGNMENT OF CLAIM
~ODl }"be phi,. Cao:1' l.r:ur~ce Compa'Y'.')of Hamilton. Ohio, the IUID of................
.' . ..l!.~,.I!I.. ,.tV,M..I.............($&t?{,n-?.........) Dollara, In pa)'IDcut In full
and/o ill comprom!sc IClttlement 0 claim preoented by the underajgned, under tald CompaD7'a bood
:;:~;;.2(.3!~.~:~;~;.:;5./fii:rPj.::zy~::
~.a .._, ,!'y'< . "&or
NOW, THEREFORE. or and in conaideration of ,he aforCBaid payment to the undenlgned. by aaid
Compan)'. the undenigned hereby reI...... and diaeharc.. acid Company of and from any and all
claima, demand.. actionl or ca...... of action, accrued, or to accrue, by reaoon of, or In aDT lDllI1Iler
arowlnc out of laid alleied defaull. under the term.. condition.. or pro'rioioRl of aald Bond. and.
furthermore, .. a further conoid.ration fer thil payment. th. undeTlIgned hereby aMicn- and ICt.I
over unto aald Company, all ib ri8hta. c1aiml, actiona, er caUSCll of action, accrued. or to
acerue. wh~h the undenigned noW hu, or hereafter can have, resultlnll hom, or arowlns out of the
act, or aell, r..wtinll In laid default under acid Bond, and th. undeni~od hereby appninll Mid Com.
p&ny. or ill authorized repr..entatlve, ill AllOrney.In.F act for the purpo.e of BiiJ1!ng the name of the
undenimed to any and all pape.. nec......ry to enjoy the rlllhla herein provided and _med to aaid
Company,
. 'IN W~ WHffiEOF. the Imdellligned h.. hereun'tolet ill hand';"'d leal ~j,ia...J~~....,; d~:f'.
.........(:(}.9:~...............................19..jl~...
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A TrEST:
................................................................................
.~b:\~:f.....~~~1 :~!:\~..,~,\oI'!:,t;)~!>......O'Ly.l~i l:l '"'
State of
County of
{ SS.
Before me. . notary public in and for the County of................................................
........................................ and State of.................................................................................., peraoDa1l,
appeared .. ........ ..... ... ....... .................. ........... .............. ..................... ............... ........ ....... .........................
pcnonally known to me to be the penon who ""ecuted the foreaoing reI....... and uoignment of ela1m.
&lid acknowledll'ed that he ""ecuted ...me .................................... free act and deed. for the URI and
purp_ therein Ht forth.
.........................NOTARy..PlJBUC.........................
My commiNion ""pire..
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