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Home My WebLink AboutJeff Foust Excavating 2019 (2) ' 1 i • • FEE: $20.00 RI- ANNUAL RIGHT-OF-WAY OBSTRUCTION LICENSEvID 414' 4p147, r82019 Application is made for a license to maintain street/sidewalk obstruction: 1:44kOsH ICW O�kS NAME: de ff Foust, LVat1ncd))(coo I�( Type of organization: NS[ fo e / / I 1' �� tindividual partnership 41 lJ(`J�`i/I �' corporation E-MAIL: good8L/ Ca;rvj // State of IncorporationADDRESS: l Cs11KI2I1) YJI Oq904 I (We) further agree to provide the City of Oshkosh with a surety bond issued by a company licensed in the State of Wisconsin in the amount of Five Thousand Dollars($5,000.00). I(we)further agree to secure a Commercial General Liability Policy with limits of: (a) $500,000 each occurrence (b) $500,000 personal liability and advertising injury (c) $500,000 general aggregate (d) $500,000 products-completed operations aggregate and shall name the City of Oshkosh, its officers, council members, agents, employees, and authorized volunteers as an additional insured thereon. Proof of said coverage in the form of an insurance certificate shall be submitted to the City of Oshkosh prior to issuance of any permit for street or sidewalk obstruction. Each individual project/address at which an obstruction will be placed requires a separate permit which may be obtained from the City of Oshkosh Department of Public Works-Engineering Division. DATE ISSUED: l E - ICI EXPIRATION: / A- I -/q BOND TERM: I -I 1 q Mr() / 2 6l Il 9 INSURANCE TERM: 2/-1 .16 thfl) 6 3 -I / DATE: I -i 8-i q Applicant's Signature 6808 Telephone Number I:\Engineering\ROW Permits\Annual ROW Obstruction Bond&License_1-8-19.doc ANNUAL RIGHT-OF-WAY OBSTRUCTION BOND Bond No.3-782-343 PRINCIPAL(S)(Legal name(s)and business address(es)) JEFF FOUST EXCAVATING, INC. of organization: 2824 Clairville Rd ndividual OPartnership Oshkosh, WI 54904 Corporation REt Surety(ies)(Name(s)and business address(es)) - I'V)rD State of Incorporation Wisconsin The Ohio Casualty Insurance Company 175 Berkeley St BAN 1 8 2019 Boston, MA 02116 DEFT or apl e Penal Sum of Bond: $5,000.00 OSHIti f. l 1�ISC0ORICS' NSIN_ OBLIGATION: We, the Principal(s)and Surety(ies),are firmly bound to the City of Oshkosh in the above penal sum. For payment of the penal sum, we bind ourselves,our heirs,executors,administrators,and successors,jointly and severally. CONDITIONS: The Principal contemplates placing an obstruction within right-of-way area(s)within the City of Oshkosh from time to time during the calendar year shown below. The Principal desires that all of those projects be covered by a single bond rather than a separate bond for each contract. The Principal shall faithfully perform all work done in the City of Oshkosh with proper care and skill;obey all laws of the State of Wisconsin and ordinances of the City of Oshkosh in connection with such work performed and with the employment of labor;properly replace and restore any street, sidewalk, terrace, or other public right-of-way, vacated right-of-way, or City easement areas in accordance with the current edition of the Standard Specifications for City of Oshkosh, Wisconsin; and pay to the City of Oshkosh any amounts due for services or materials furnished in connection therewith within one(1)month of invoice. The Principal shall for a period beginning on the date of issuance of this bond through a two(2)year period from the expiration date of the annual license save, defend, and hold harmless the City of Oshkosh from and against any and all claims, damages, costs, and expenses of any kind or character arising out of or resulting,however remotely,from the work performed by the Principal under the attached license,including but not limited to,all accidents and damages caused by any failure to erect and maintain sufficient barriers or lights at the place where licensee has placed obstruction or performed work,or by failure to guard against injury to persons passing upon the street or sidewalk,or by failure to promptly remove all tools, implements, refuse, and unused materials from said right-of- way. The Principal shall indemnify and refund to the City of Oshkosh all sums which it may become obligated to pay, including damages,punitive damages,attorney fees,and court costs,within thirty(30)days of written demand for payment;however,the penal sum of this bond shall not exceed$5,000. It is understood and agreed by the Principal(s)and Surety(ies)that this bond supplements,but does not take the place of,any liability insurance required to be carried by said Principal(s)herein by the City of Oshkosh policies or ordinances. TERM OF BOND: This bond shall cover work performed from January 1, 2019 (Date of Issuance) to December 31, 2019 (the annual license period). This bond shall cover claims made for work performed during this annual license period and for an additional two(2)year maintenance period beyond the expiration of this annual license period. The principal agrees to correct all maintenance issues brought to the attention of the Principal(s)upon receiving notice from the City of Oshkosh within the two(2)year maintenance period. SIGNATURES/SEALS: For the Principal: For the Surety: JEFF FOUST EXCAVATING, INC. The Ohio Casualty Insurance Company Signatur Sittre aT Name Nuef F ! iost1 i sid t Connie Smith, Attorney-in-fact Title Title 175 Berkeley St Boston, MA 02116 Address Any person signing in a representative capacity(e.g.,an attorney-in-fact)must furnish evidence of authority if that representative is not a member of the firm or partnership or an officer of the corporation involved. 1:\Engineering\ROW Permits\Annual ROW Obstruction Bond is License_1-8-19.doc This Power of Attorney limits the acts of those named herein,and they have no authority to or .... bind the Company except in the manner and to the extent herein stated. °V. i Liberty Liberty Mutual Insurance Company ro ` Mutual. The Ohio Casualty Insurance Company Certificate No: 8196952 West American Insurance Company SURETY POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS:That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire,that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts,and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana(herein collectively called the"Companies"),pursuant to and by authority herein set forth,does hereby name,constitute and appoint, Michael J.Douglas,Robert Downey,Christopher M.Kemp,Kory Mortel,Connie Smith,Chris Steinagel all of the city of Hudson state of WI each individually if there be more than one named,its true and lawful attorney-in-fact to make, execute,seal,acknowledge and deliver,for and on its behalf as surety and as its act and deed,any and all undertakings,bonds,recognizances and other surety obligations,in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF,this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 4th day of October , 2018 . Liberty Mutual Insurance Company P, 1NSU� P\ZV INSG d 1NSUg4 The Ohio Casualty Insurance Company e LoePOn, 4c� vjs G00°k4,./y `PcoaP Oki. 4c, West American Insurance Company > f ? PD m V ? F0 t :it: FQ COm co 1912 0 0 1919 0 2 1991 0 // co ip dj19s94CHU`+�rda� O F�NAMPs�,db� `en 'N01,40/aa3 r u�� C N %7 * 0 ''yl * to ''M * 0 By: N David M.Carey,Assistant Secretary co -,- State of PENNSYLVANIA >, c County of MONTGOMERY ss co c rn c o tv On this 4th day of October , 2018 before me personally appeared David M.Carey,who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance 0 o 2 Company,The Ohio Casualty Company,and West American Insurance Company,and that he,as such,being authorized so to do,execute the foregoing instrument for the purposes= 'a-) > therein contained by signing on behalf of the corporations by himself as a duly authorized officer. 23 w 1:11 IN WITNESS WHEREOF,I have hereunto subscribed my name and affixed my notarial seal at King of Prussia,Pennsylvania,on the day and year first above written. c eL �O c'N p, PAS O r.r� Q 4) Q,r,��O�NWf .ce COMMONWEALTH OF PENNSYLVANIA idd140 Q4 O �0 ��=y. Notarial Notary /f\ 0'�O OF { Teresa Pastella,onto Publicval pW J Upper Meson Two.,Montgomery County By: co C 12 gv My Commission Expires March 28.2021 aP eresa Pastella,Notary Public o 1a AI ._gyp, Member,Pennsylvania Association of Notaries a O nl• � W� NO rj)a) This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual �' o.. Insurance Company,and West American Insurance Company which resolutions are now in full force and effect reading as follows o a, ID ARTICLE IV-OFFICERS:Section 12.Power of Attorney. . o Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the _0 o e President may prescribe,shall appoint such attorneys-in-fact,as may be necessary to act in behalf of the Corporation to make,execute,seal,acknowledge and deliver as surety >o To c any and all undertakings,bonds,recognizances and other surety obligations.Such attorneys-in-fact,subject to the limitations set forth in their respective powers of attorney,shall,,N > 22have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation.When so executed, such 0O Z instruments shall be as binding as if signed by the President and attested to by the Secretary.Any power or authority granted to any representative or attorney-in-fact under the,-M co provisions of this article may be revoked at any time by the Board,the Chairman,the President or by the officer or officers granting such power or authority. co d ARTICLE XIII-Execution of Contracts:Section 5.Surety Bonds and Undertakings. o o cfl Any officer of the Company authorized for that purpose in writing by the chairman or the president,and subject to such limitations as the chairman or the president may prescribe, H shall appoint such attorneys-in-fact,as may be necessary to act in behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings, bonds,recognizances and other surety obligations.Such attorneys-in-fact subject to the limitations set forth in their respective powers of attorney,shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company.When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation-The President of the Company,acting pursuant to the Bylaws of the Company,authorizes David M.Carey,Assistant Secretary to appoint such attorneys-in- fact as may be necessary to act on behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety obligations. Authorization-By unanimous consent of the Company's Board of Directors,the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company,wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds,shall be valid and binding upon the Company with the same force and effect as though manually affixed. I,Renee C.Llewellyn,the undersigned,Assistant Secretary,The Ohio Casualty Insurance Company,Liberty Mutual Insurance Company,and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full,true and correct copy of the Power of Attorney executed by said Companies,is in full force and effect and has not been revoked. IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this 1st day of January , 2019 . P,„INSU\ \SY INSG tNSUR j 4oaPortyrtc ct� =oonvory,ro'eqt ci.VP4spooq,,'e4,0r • 1912 0' 0 1919 Ini 1991 (4c.G+`�� i •W O ! O �..?„CH%*ado; yO s NA MPS-Abe V:s,%wits�Ab� By:Renee C.Llewellyn,Assistant Secretary 977 * f * 1 M * 0 LMS-12873 LMIC OCIC WAIC Multi Co_062018 t City of Oshkosh COLLECTIONS PO BOX 1128 215 Church Ave. Oshkosh, WI 54903-1128 (920) 236-5024 001797-0011 Jill V. 01/18/2019 02:58PM MISCELLANEOUS 2019 Item: ROWLIC 1 W 40.00 RIGHT-OF-WAY LICENSE FEES (ROWLIC) 40.00 40.00 Subtotal A0.00 Total 40.00 CHECK 40.00 Check Number002418 Change due 0.00 Paid by: foust excavating CUSTOMER COPY