Loading...
HomeMy WebLinkAboutRobert J Immel Excavating 2019 FEE: $20.00 RECEIVED ANNUAL RIGHT-OF-WAY EXCAVATION LICENSE F-po 21 2 019 nI_r „f 1,1, I13r. "'/se°o N•3 Application is made for a license to work within the Right-of-Way: NSI NAME: RC 10 A- 3 .U41r1'IP( EXC.t Zt1t . Type of organization: _individual _partnership E-MAIL: lre 4r\e (6, 1Y1'1wi- l e XC . Ceirl corporation ADDRESS: �� OTC \ State of Incorporation N1X retvw/%)le, `,Ji SuaU 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: I I EXPIRATION: BOND TERM: f c1 1'1 V GL I 1 /112o1a -- t'L j31 201°1 INSURANCE TERM: 0— I (0 -1 1-(9 DATE: D- ` _ 1 ReUlil Rif O Applicant's Signature Telephone Number 1:\Engineering\ROW Permits\Annual ROW Excavation Bond&Licertse_1-R-19.doc • • ANNUAL RICHT-OF-WAY EXCAVATION SAND WI5111561 1'RINCJPAI,(S)(Legal name(s)and business addrea.s(es)) Type of ce zaten; Robert J Immel Excavating Inc partnership PO Box 135,Greenville,WI 54942 corporation Surety(ies)(Name(s)and business address(es)) State of Incorporation WI ' ECEI VED Merchants Bonding Company(Mutual) P.O.Box 14498 DEpr FFE 21 201g Des Moines IA OF Penal Sum of Bond: $25,000.00 50306-3498 OSHRo t eq../C 1'�URKS OS OBf,IGATl0N: SCf�NS/N 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 three projects be covered ey 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 Specileciiens 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 hole 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 Princ.pal 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(les)that this bond supplements,but does not take the place uf,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, 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 the Principal Robert J IImmel Excavating Inc For the Surety:Merchants Bon g Company(Mutual) Signature Signature Rif/ e 0-)a-f ,14 I/V1 Qr k L e vf vl kr) Name Name Sec s' e f-s y Attorney-in-Fact Title l Title 4233 Southtowne Dr,Eau Claire,WI 54701 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&,girxeri,g1SOW Penn Arn uel ROW Exc.ration Bond E.liear,e_I43•I9 dec LP 1309 WI (1/19) ti MERCHANTS BONDING COMPANY.. POWER OF ATTORNEY Know All Persons By These Presents.that MERCHANTS BONDING COMPANY(MUTUAL)and MERCHANTS NATIONAL BONDING, INC., both being corporations of the State of Iowa(herein collectively called the"Companies")do hereby make,constitute and appoint,individually, Cayden Janse;Darrel Zaleski; Dena M Kawski;Heather Albright;Justin Trepes;Karena Froom;Kim Syverson; Kristin Boevers;Kristina Blaney; Linda D Covey; Lynn Hendrickson; MaryA Kaiser; Mary Hutson Clark:Mary McLennan; Michael L Tiedt; Richard K Carlson their true and lawful Attorney(s)-in-Fact, to sign its name as surety(ies) and to execute, seal and acknowledge any and all bonds, undertakings, contracts and other written instruments in the nature thereof, on behalf of the Companies in their business of guaranteeing the fidelity of persons. guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. This Power-of-Attorney is granted and is signed and sealed by facsimile under and by authority of the following By-Laws adopted by the Board of Directors of Merchants Bonding Company(Mutual)on April 23, 2011 and amended August 14, 2015 and adopted by the Board of Directors of Merch ants National Bonding. Inc.,on October 16,2015. "The President, Secretary, Treasurer, or any Assistant Treasurer or any Assistant Secretary or any Vice President shall have power and authority to appoint Attorneys-in-Fact, and to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto, bonds and undertakings,recognizances,contracts of indemnity and other writings obligatory in the nature thereof." "The signature of any authorized officer and the seal of the Company may be affixed by facsimile or electronic transmission to any Power of Attorney or Certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the Company,and such signature and seal when so used shall have the same force and effect as though manually fixed." In connection with obligations in favor of the Florida Department of Transportation only,it is agreed that the power and aut hority hereby given to the Attorney-in-Fact includes any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts required by the State of Florida Department of Transportation. It is fully understood that consenting to the State of Florida Department of Transportation making payment of the final estimate to the Contractor and/or its assignee, shall not relieve this surety company of any of its obligations under its bond. In connection with obligations in favor of the Kentucky Department of Highways only,it is agreed that the power and authority hereby given to the Attorney-in-Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner- Department of Highways of the Commonwealth of Kentucky at least thirty(30)days prior to the modification or revocation. In Witness Whereof,the Companies have caused this instrument to be signed and sealed this 19th day of November , 2018 . �.••A( 9.1Y. •. G C•. pit a O ' P ' •• MERCHANTS BONDING COMPANY(MUTUAL) •IL`j:' O Rq�•o :0;�OR egg••�y.4; MERCHANTS NATIONAL BONDING,INC. • p'•. 2003 it) :y 1933 c By 7.74, • • :' ........ •, •. _ •• President •STATE OF IOWA ••''"'•......• •••••••••• COUNTY OF DALLAS ss. On this this 19th day of November 2018 , before me appeared Larry Taylor, to me personally known, who being by me duly sworn did say that he is President of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC.; and that the seals affixed to the foregoing instrument are the Corporate Seals of the Companies;and that the said instrument was signed and sealed in behalf of the Companies by authority of their respective Boards of Directors. aPa'AC ALICIA K.GRAM o v Commission Number 767430 ? sum ': My Commission Expires �, /owP April 1,2020 Notary Public (Expiration of notary's commission does not invalidate this instrument) I,William Warner.Jr.,Secretary of MERCHANTS BONDING COMPANY(MUTUAL)and MERCHANTS NATIONAL BONDING,INC.,do hereby certify that the above and foregoing is a true and correct copy of the POWER-OF-ATTORNEY executed by said Companies,which is still in full force and effect and has not been amended or revoked. In Witness Whereof, I have hereunto set my hand and affixed the seal of the Companies on this 7th day of February ,2019 . •.••P10Ng4'••., .••\NO•Co.-•. Z -o- v:o' •• 0- o; • x' 2003 ;� • �: y 1933 'c• Secretary • •c . •mod. a • •..•v ......... ' • •••• ••w•. ••;*,�•. POA 0018 (3/17) ............