Loading...
HomeMy WebLinkAboutGabe's Construction Company 2019 FEE: $20.00 RECEIVED ANNUAL RIGHT-OF-WAY EXCAVATION LICENSE FEB -6 2019 DLPT OI' PUBLIC WORKS OSHKOSH. WISCONSIN Application is made for a license to work within the Right-of-Way: &c NAME: t/j f '.5 ei3i2 5f -1-ru( ,n n (j., 2 a(.. Type of organization: r J II _individual _partnership E-MAIL: r V t('V t�O(+('l g ct.Y1>°s a IMl j corporation State of Incorporation Z[r ADDRESS: yg 0 y //) 5-1 st gb �9yg�Ii , �X .530E3 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: Z 1(o 1 Zblq EXPIRATION: 12 1 31 /'2019 BOND TERM: OI !A1 //ea9— '21a112011 INSURANCE TERM: /01 /7o15-- 7-/61 /7_019 DATE: o?— y` 19 Applicant's Signature 61,70- ys4-at.000 Telephone Number I:\Engineering\ROW Permits\Annual ROW Excavation Bond&License_1-8.19.doc SB 0379387 ANNUAL RIGHT-OF-WAY EXCAVATION BOND PRINCIPAL(S)(Legal name(s)and business address(es)) Type of organization: Gabe's Construction Co., Inc. individual _partnership 4804 N 40th St XXcorporation Sheboygan WI 53082 State of Incorporation Wisconsin f cEIVED Surety(ies)(Name(s)and business address(es)) Pennsylvania National Mutual Casualty Insurance Company FEB -0 2019 PO Box 2361, Harrisburg PA 17105-2361 Drl )Penal Sum of Bond: $25,000.00 ()s11h(tti!Uyt LSC WORKS CONSIN 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 I'rincipal 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 casement 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 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 th Princi . Gabe's Construction Co., Inc. For the Sur :Pennsylvani National Mutuai Casualty Insurance Company ignature ignature Todd Looker Name Matthew GebrIelse Name Prestlent Attorney-In-Fact Gabe's Construction Co., Inc. Title Title 20975 Swenson Drive,Suite 175,Waukesha WI 53186 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. I:1 Engineering t ROW Permits\Annual ROW Excavation Bond&Licenx_i-14-79.doc PENNSYLVANIA NATIONAL MUTUAL CASUALTY INSURANCE COMPANY Harrisburg, Pennsylvania 1132 POWER OF ATTORNEY Know All Men By these Presents,That PENNSYLVANIA NATIONAL MUTUAL CASUALTY INSURANCE COMPANY,a corporation of the Commonwealth of Pennsylvania,does hereby make,constitute and appoint ROBERT E. FLATH,JOE VIGNA, DENNIS BARTON,AND TODD LOOKER,ALL OF WAUKESHA,WISCONSIN(EACH)its true and lawful Attorney(s)-in-Fact to make,execute,seal and deliver for and on its behalf,as surety,as its act and deed: ANY AND ALL BONDS AND UNDERTAKINGS PROVIDED THE AMOUNT OF NO ONE BOND OR UNDERTAKING EXCEEDS THE SUM OF FIVE MILLION DOLLARS ($5,000,000.00)ALL POWER AND AUTHORITY HEREBY CONFERRED SHALL HEREBY EXPIRE AND TERMINATE WITHOUT NOTICE AT MIDNIGHT ON JANUARY 31,2028,AS RESPECTS EXECUTION SUBSEQUENT THERETO. And the execution of such bonds in pursuance of these presents shall be as binding upon said Company as fully and amply,to all intents and purposes,as if they had been duly executed and acknowledged by the regularly elected officers of the Company at its office in Harrisburg, Pennsylvania,in their own proper persons. This appointment is made by and under the authorization of a resolution adopted by the Board of Directors of the Company on October 24, 1973 at Harrisburg,Pennsylvania which is shown below and is now in full force and effect. RESOLVED, that (1) the President,any Vice President, the Secretary, or any Department Secretary shall have power to appoint, and to revoke the appointments of, Attorneys-in-Fact or agents with power and authority as defined or limited in their respective powers of attorney,and to execute on behalf of the Company,and affix the Company's seal thereto,bonds,undertakings,recognizance's,contracts of indemnity and other written obligations in the nature thereof or related thereto;and(2)any of such Officers of the Company may appoint and revoke the appointments of joint-control custodians, agents for acceptance of process,and Attorneys-in-Fact with authority to execute waivers and consents on behalf of the Company;and(3)the signature of any such Officer or of any Assistant Secretary or Department Assistant Secretary and the Company seal may be affixed by facsimile to any power of attorney or certification given for the execution of any bond,undertaking,recognizance,contract of indemnity or other written obligation in the nature thereof or related thereto,such signature and seal when so used whether heretofore or hereafter,being hereby adopted by the Company as the original signature of such Officer and the original seal of the Company,to be valid and binding upon the Company with the same force and effect as though manually affixed. In Witness Whereof: PENNSYLVANIA NATIONAL MUTUAL CASUALTY INSURANCE COMPANY has caused these presents to be signed and its corporate seal to be hereto affixed on January 9,2018. PENNSYLVANIA NATIONAL MUTUAL CASUALTY INSURANCE COMPANY �`_�'iJ:N1ZEp'�r��'a -- lir' Well W.1443TA. 4el Mark F. alct,Vice President-Surety 1/44•,II11111 MI1\11"0 Commonwealth of Pennsylvania,County of Dauphin—ss: On January 9,2018,before me appeared Mark Fitzgerald to me personally known,who being by me duly sworn,did say that he resides in the New Jersey,that he is the Vice President—Surety of PENNSYLVANIA NATIONAL MUTUAL CASUALTY INSURANCE COMPANY,that he is the individual described in and who executed the preceding instrument,and that the seal affixed to said instrument is the corporate seal of said Company, and that said instrument was signed and sealed on behalf of said Company by authority and direction of said Company,and the said office acknowledged Sledged said.insire tr,be the f•ec act and aced of said Cw:rpany. COMMONWEALTH OF PENNSYLVANIA Notarial Seal •NOTARY pueuc• Traci A Kimmich,Notary Public .4iK City Of Harrisburg,Dauphin County Notary p My Commission Expires Oct 31,2020 Nota Public of Member,Pennsylvania Association of Notaries I,Mark Fitzgerald,Vice President—Surety of the PENNSYLVANIA NATIONAL MUTUAL CASUALTY INSURANCE COMPANY,a corporation of the Commonwealth of Pennsylvania,do hereby certify that the above and foregoing is a true arc,;.orrect co? of a Power of Attorney, executed by the said Company,which is still in full force and effect. "ti wy,'lilcAs4; In Witness Whereof,I have hereunto set my hand and affixed the corporate seal of said Company on (+�0l ^`�o ,,,. u ,4 � , � o: /7/1411.._ • , '•"�SYLV Vice Preside y ' � Hof uret , 78-190e(Rev 10/2012)