HomeMy WebLinkAboutNeyers Communication 2019r (�
FEE: $20.00 raid r lti )
ANNUAL RIGHT-OF-WAY EXCAVATION LICENSE RECEIVED
FEB - 7 zo19
DEpT OI' ,
Application is made for a license to work within the Right-of-Way: OSHKOs/I.If3L/C w01
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NAME: /V e 1(��i�1rn.1'nl.)l C lan,5e VLL 1�p L... Type of organization: N
r ^ _individual _partnership
E-MAIL: Nney.P.J5 l�iieyf.4-6co'N1.n0.LLY41-Cal-tOil•[.WW1 -corporation `
ADDRESS: W tg� I Uy State of Incorporation W' 1
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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- 1-• Zo t q
EXPIRATION: j z-31- ZJ!I
BOND TERM: / 1 2a t-fb / I-a0/q
INSURANCE TERM: Fi' )1.)1 4 -tv/a,3)4.11
DATE: 2.-1-14 /
App ' nt's Signature
9n)i-m_ (n547
Telephone Number
I:\Engineering\ROW Permits\Annual ROW Excavation Bond&License_1-8-19.doc
Bond No. 64532610
ANNUAL RIGHT-OF--WAY EXCAVATION BOND
PRINCIPAL(S)(Legal name(s)and business address(es)) Type of organization:
Neyer Communication Services, Inc.
individual partnership
W9974 Kelly Drive X corporation
Hortonville, WI 54944 ItLI EJ State of Incorporation Wisconsin
Surety(ies)(Name(s)and business address(es))
WESTERN SURETY COMPANY
P.O. Box 5077 MAR - 4 219
Sioux Falls, SD 57117-5077 >11'1 ()I !'t�i31 I"
Penal Sum of Bond: $25,000.00 O ti 11 li O 1 1 \1 I
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 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, coats, 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 coats, 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(iee)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 S t, 2019 (Date of Issuance)to December 31, 2 D 1 9
(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
m nance period.
SI ES EALS:
Fo t e .1) For t /•ty: WESTERN SURETY COMPANY
Signs Signature 0 2/2 8/2 019
_p_c,„L (�Q,,,'J,3S _ Paul T. Bruflat
Name Name
PAPQ).ia-0--1 -0 boo-ur Vice President
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.
1:\Engineering\ROW Permits\Annual ROW Excavation Bond&Licenae_1-8.19.doc
Western Surety
Company
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
Paul T. Bruflat of Sioux Falls
State of Sourt ..ljkora , its regularly elected _. Vir.e President ,
as Attorney-in-Fact,with full power and authority hereby conferred upon him to sign, execute,acknowledge and deliver for and on
its behalf as Surety and as its act and deed,the following bond:
One Annual Right-of-Way Excavation City of Oshkosh
bond with bond number 69532610
for Neyer Communication Services. Inc.
as Principal in the penalty amount not to exceed: $_25,000.00 .
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. Ail 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
V-isLe_ Pr�_s-id.ent-_ with the corporate seal affixed this _ 28th day of — February ,
2019
ATTEST WESTEO URET COMPANY
CDT 9414-0-11---/ By 4.-Z 7.--
L.Nelson,Assistant Secretary Paul T ruflat,Vice President
5-1 tAt AA INP=i
STATE OF SOUTH DAKOTA 'SrSS �3*'s. A� '
COUNTY OF MINNEHAHA 11 LivrH pR,'44
,y.�
,,
On this 28th day of February _, 2019 , before me,a Notary Public,personally appeared
Paul T. Bruflat and L. Nelson
who, being by me duly sworn, acknowledged that they signed the above Power of Attorney as — Vi ce 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.
s J. MOHR r
r
r NOTARY PUBLIC ^
s SOUTH DAKOTA sEii - s NotaryPublic
r + ry Commission Expires June 23, 2021
To validate bond authenticity,go to www.cnasurety.com >Owner/Obligee Services>Validate Bond Coverage.
fs
Form F1975-1-2016