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HomeMy WebLinkAboutEgbert Excavating 2019 FEE: $20.00 ANNUAL RIGHT-OF-WAY EXCAVATION LICENSE Application is made for a license to work within the Right-of-Way: NAME: EGBERT EXCAVATING,INC. Type of organization: individual _partnership E-MAIL: egbertexc@centurytel.net X corporation ADDRESS: W1302 N.LAWSON DRIVE,PO BOX 462 State of Incorporation WI GREEN LAKE,WI 54941 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 Twenty Five Thousand Dollars($25,000.00). 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 to perform work within the right-of-way. Each individual project/address at which work will be performed requires a separate permit which may be obtained from the City of Oshkosh Public Works Department-Engineering Division. DATE ISSUED: 1-1-19 EXPIRATION: 12-31-19 BOND TERM: ANNUAL - ,i9 4 i - -3r ter INSURANCE TERM: CONTINUANCE BOND(#25578334) DATE: 2-25-19 e. ,Aldrj Applicant's Signature 20-294-6668 Telephone Number I:\Engineering\ROW Permits\Annual ROW Excavation Bond dr License_1-8-19.doc This bond is in replacement of and not in addition to any previous bonds issued under the same number. ANNUAL RIGHT-OF-WAY EXCAVATION BOND Bond#25578334 INQPAL(S)(Legal name(s)and business address(es)) Type of organization: • Egbert Excavating,Inc. individual _partnership P.O.Box 462,Green Lake,WI 54941 X corporation Surety(ies)(Name(s)and business address(es)) State of Incorporation Wisconsin WESTERN SURETY COMPANY RECEIVED P.O.Box 5077 Sioux Falls,SD 57117-5077 FEB 2 2 2019 Penal Sum of Bond: $25,000.00 D 1;I'T 1 113L1C W'pRKS OBLIGATION: I r' ` }I lk'I S CO NS1N 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 performing work within the right-of-way area(s)within the City of Oshkosh from time to time during the calendar year shown below The Principal desires that ill of those projects be covered by a.single bond rather than a separate bond 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$25,000. 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 Deoentber 31, 20 19 (the annual license period). This bond shall cover claims made for work performed during this annual license period and for art 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 Prim For the rety: �rv/J� , • Signature Signature 01/30/2019 n e` (4- C.LQngdon,Ass't. Sec. Name Name 4Y-ai&er k Title Title P.O.Box 5077 Sioux Falls,SD 57117-5077 Ad dress 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 Excavation Bond&License 1-B-19.doc • •r, • ' WeernSuretyCompanyst POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That WESTERN SURETY COMPANY, a corporation organized and existing under the laws of the State of South Dakota, and authorized and licensed to do business in the States of Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming, and the United States of America, does hereby make,constitute and appoint C. Langdon of Sioux Falls State of_________ SQuth_Dakota ,with limited authority,its true and lawful Attorney-in-Fact,with full power and authority hereby conferred to sign, execute, acknowledge and deliver for and on its behalf as Surety and as its act and deed, the following bond: One RIGHT OF WAY CITY OF OSHKOSH bond with bond number 25578334 for EGBERT EXCAVATING, INC. - as Principal in the penalty amount not to exceed: $5,000.00 - Western Surety Company further certifies that the following is a true and exact copy of Section 7 of the by-laws of Western Surety Company duly adopted and now in force,to-wit: Section 7. All bonds, policies, undertakings, Powers of Attorney, or other obligations of the corporation shall be executed in the corporate name of the Company by the President, Secretary, any Assistant Secretary, Treasurer, or any Vice President, or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys-in-Fact or agents who shall have authority to issue bonds, policies,or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds,policies, undertakings,Powers of Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile. In Witness Whereof, the said WESTERN SURETY COMPANY has caused these presents to be executed by its Vice President with the corporate seal affixed this 30th - day of January 2019 ATTEST Q UÜX4& WEST ' R SURET COMPANY• By G. A.Vietor,Assistant Secretary Paul T.B at,Vice President 140;ttut/till thi STATE OF SOUTH DAKOTA 3*\.. 4. Qti. *�-`' ss ' kr /*kV COUNTY OF MINNEHAHA I PK aa` On this 30th day of January 2019 , before me, a Notary Public, personally appeared Paul T. Bruflat_ - and etor who, being by me duly sworn, acknowledged that they signed the above Power of Attorney as Vice Pre,Pci dent and Assistant Secretary, respectively, of the said WESTERN SURETY COMPANY, and acknowledged said instrument to be the voluntary act and deed of said Corporation. ty5�,555555555yyyy�,SySyysy+ J. MOHR NOTARY PUBLIC ^ i g s SOUTH DAKOTA t 8 My Commission Expires June 23, 2021 Notary Public +tyhyh5y�y�,5h�,5�,5y5yh5hy5 To validate bond authenticity,go to www.cnasurety.com >Owner/Obligee Services>Validate Bond Coverage. Form 672-1-2016 This bond is in replacement of and not in addition to any previous bonds issued under the same number. ANNUAL RIGHT-OF-WAY EXCAVATION BOND Bond#25578334 PRINCIPAL(S)(Legal name(s)and business add ress(es)) Type of organization: Egbert Excavating,Inc. individual partnership P.O.Box 462,Green Lake,WI 54941 X corporation Surety(ies)(Name(s)and business address(es)) RECEIVED State of Incorporation Wisconsin WESTERN SURETY COMPANY P.O.Box 5077 13 2019 Sioux Falls,SD 57117-5077 FEB Penal Sum of Bond: $25,000.00 Dl,I,1111• hU l3 Ll t W OS N OBLIGATION: o SII OSI{, '�ISCON 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 performing work within the 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$25,000. 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 Principals)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, 20 19 (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 theePrincipali For the rety: Signature Signature 01/30/2019 •Wn �` �+ C.Langdon,Asset. Sec. Name Name Title Title P.O.Box 5077 Sioux Falls,SD 57117-5077 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. L\Engineering\ROW Permits 1 Annual ROW Excavation Bond&Liaoue_I-&19.doc Western SuretyCompany POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That WESTERN SURETY COMPANY,a corporation organized and existing under the laws of the State of South Dakota, and authorized and licensed to do business in the States of Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming, and the United States of America, does hereby make,constitute and appoint C. Langdon of Sioux Falls State of_ South Dakota _ ,with limited authority,its true and lawful Attorney-in-Fact,with full power and authority hereby conferred to sign, execute, acknowledge and deliver for and on its behalf as Surety and as its act and deed, the following bond: One RTGHT OF WAY CITY _OF OSHKOSH bond with bond number 25578334 for EGBERT EXCAVATING, INC. as Principal in the penalty amount not to exceed: $5, 000.00 Western Surety Company further certifies that the following is a true and exact copy of Section 7 of the by-laws of Western Surety Company duly adopted and now in force,to-wit: Section 7. All bonds, policies, undertakings, Powers of Attorney, or other obligations of the corporation shall be executed in the corporate name of the Company by the President, Secretary, any Assistant Secretary, Treasurer, or any Vice President, or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys-in-Fact or agents who shall have authority to issue bonds, policies,or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds, policies,undertakings, Powers of Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile. In Witness Whereof, the said WESTERN SURETY COMPANY has caused these presents to be executed by its Vice President with the corporate seal affixed this __ 3-0th _day of January 2019 ATTEST WEST . R SURET COMPANY ut„,...„• By — - G- - A.Vietor,Assistant Secretary Paul T.Br at,Vice President 00011146,44 z•yt, tA; 37+ STATE OF SOUTH DAKOTA %;`. � �4' ss *S. �a,: COUNTY OF MINNEHAHA J ,ie H p µO�,,�` ` :rrrttrrstoi `� On this _ 30th - day of January - , 2019 , before me,a Notary Public, personally appeared Paul T. Bruflat and __ A. VietQr who, being by me duly sworn, acknowledged that they signed the above Power of Attorney as Vice President and Assistant Secretary, respectively, of the said WESTERN SURETY COMPANY, and acknowledged said instrument to be the voluntary act and deed of said Corporation. }hs�s���y5555ys55y�,yhy55a} J. MOHR r NOTARY PUBLIC SE^At s g s SOUTH DAKOTA�s Notary Public ♦ate yh555hy55h5�hahh�,5hhy} My Commission Expires June 23, 2021 To validate bond authenticity, go to www.cnasurety.com >Owner/Obligee Services>Validate Bond Coverage. Form 672-1-2016 Egbert Excavating From: Nett, Matthew <MNett@ci.oshkosh.wi.us> Sent: Monday, February 25, 2019 9:11 AM To: 'egbertexc@centurytetnet Subject: City of Oshkosh Right-of-Way License Attachments: Annual ROW Excavation License_1-8-19.pdf To whom it may concern, Please fill out and sign the attached Annual Right-of-Way Excavation License form to complete your submitted Annual Right-of-Way License application.The City already has obtained and accepted the submitted license fee,bond and proof of insurance, the only form which could not be accepted was the application itself which was submitted using a previous version of the application which is no longer being accepted. Please send the original application once completed to the City of Oshkosh. Thank you Matthew Nett, F.E. Civil Engineer, Engineering Division City of Oshkosh 920.236.5037 Follow us:Web I Facebook I Twitter 6Oshkosh 1