STATE OF MAINE
STATE OF MAINE
DEPARTMENT OF TRANSPORTATION
Highway Opening Permit Escrow Agreement
|WHEREAS, | |(hereinafter “Permittee”) |
| | |Name of Utility/Permittee | |
| |has made application for a special Highway Opening Permit; and |
| | | | | |
|WHEREAS, |the Maine Department of Transportation intends to issue Highway Opening |
| | | | | |
| |permit # | |to said Permittee, and |
| | |Permit Number | | |
| | | | | |
|WHEREAS |an escrow account (# | |) |in the amount of $ | |
| | |Account Number | |Escrow Amount |
| |has been made with | |
| | | |Name of Financial Institution | |
| |(hereinafter “Financial Institution”) by | |
| | | |Permittee Representative |
| |in the name of the Permittee |
| | |
|NOW THEREFORE, it is understood and agreed: | |
| | | | | |
| |I. |That the Financial Institution shall hold in trust said deposit in the amount specified above until notified of |
| | |completion of work by the Department of Transportation. |
| | | |
| |II. |Upon satisfactory completion of the work, and in accordance with the terms and conditions stipulated for the above |
| | |referenced Highway Opening Permit, the Department of Transportation shall notify the Financial Institution, in |
| | |writing, to specify the final amounts to be released to the State of Maine and to the Permittee. Any excess monies in|
| | |the form of principal and/or interest remaining in said account, over and above the amounts specified, shall be |
| | |released to the Permittee. |
| | | | | |
| |This AGREEMENT made and executed on this | |day of | |
| |In the year | |by the undersigned. | |
_________________________ _________________________ _________________________
Permittee Financial Institution Representative Maine Department of Transportation
|Permittee Contact Information: | |Financial Institution Contact Information: |
| | | |
| | | |
| |Permittee Name (Company or Utility Name) | | |Financial Institution Name |
| | | |
| |Permittee Representative | | |Financial Institution Representative |
| | | |
| |Mailing Address | | |Mailing Address |
| | | |
| |City, State, Zip | | |City, State, Zip |
| | | |
| |Telephone Number | | |Telephone Number |
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