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HomeMy WebLinkAboutQ3 Contracting 2019 FEE: $20.00 — RECEIVED ANNUAL RIGHT-OF-WAY EXCAVATION LICENSE MAY 14 2019 DE T or puf3r_r� wr, Application is made for a license to work within the Right-of-Way: O HKOSH, 4y OR vS NAME: Q3 Contracting, Inc. Type of organization: _individual _partnership q3licensing@prim.com V corporation E-MAIL: ADDRESS: 3066 Spruce Street State of Incorporation MN Little Canada, MN 55117 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: S ll-1261 QI EXPIRATION: 12/31 I2611 BOND TERM: 4411 TO/OlIt f 2et9 INSURANCE TERM: Z/2J126 Ta L t21 jjfLo DATE: 61 1'$4'Z." Applicant' ignature 651.224.2424 Telephone Number I:\Engineering\ROW Permits\Annual ROW Excavation Bond&License_I-8-19.doc • ANNUAL RIGHT=OF-WAY EXCAVATION BOND Bond No.30064689 PRINCIPAL(S)(Legal name(s)and business address(es)) Type of organization: Q3 Contracting,Inc. 3066 Spruce Street individual partnership Little Canada,MN 55117 X corporation Surety(ies)(Name(s)and business address(es)) State of Incorporation Minnesota iLULI'✓ED Western Surety Company 333 S.Wabash Avenue Chicago,IL 60604 MAY 1 4 2019 Penal Sum of Bond: $25,000.00 DEPTOF PUiiil( OBLIGATION: OSHKOSH, b� 1SC(�NS�Ns 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. CONDMONS: 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 Principal(s)herein by the City of Oshkosh policies or ordinances. TERM OF BOND: This bond shall cover work performed from May 2,2019 (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 . ' cipal: Q ontracting,Inc. F e ty; Waste n S r Co any Signaturen Signa I J o ,C.?�,� Karen Rhodes Nam J Name }}} re S,O__r"TT/ — Attorney-in-Fact Title Title 333 S.Wabash Ave.,Chicago,IL 60604 Address Any person signing in a representativt,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. k\Engineering\ROW Permits\Armual ROW Excavation Bond&Llaense-1-8-t9.ec: ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Marin On May 2, 2019 before me, Trisha Chang, Notary Public (insert name and title of the officer) personally appeared Karen Rhodes who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. TRISHA CNANG 1QC- � COMM, #2258024 z �i:,sn`,. Notary Public •California az % Marin County Signature (Seal) 1 _ • M/Comm.EEires Sep. 14,2022i Westerii SuretyCompany POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY-IN-FACT Know All Men By These Presents,That WESTERN SURETY COMPANY,a South Dakota corporation,is a duly organized and existing corporation having its principal office in the City of Sioux Falls,and State of South Dakota, and that it does by virtue of the signature and seal herein affixed hereby make,constitute and appoint Michael Brophy Mc Gowan, Susan J Mc Gowan, Jon Richard Sullivan, Karen Rhodes, Trisha Chang, Individually of Novato,CA,its true and lawful Attomey(s)-in-Fact with full power and authority hereby conferred to sign,seal and execute for and on its behalf bonds, undertakings and other obligatory instruments of similar nature - In Unlimited Amounts - and to bind it thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of the corporation and all the acts of said Attorney,pursuant to the authority hereby given,are hereby ratified and confirmed. This Power of Attorney is made and executed pursuant to and by authority of the By-Law printed on the reverse hereof,duly adopted,as indicated,by the shareholders of the corporation. In Witness Whereof, WESTERN SURETY COMPANY has caused these presents to be signed by its Vice President and its corporate seal to be hereto affixed on this 8th day of October,2018. WESTERN SURETY COMPANY r�?SURET '''s _N:VO es:Ds 2f t tv.SE Ab" -41 `+w ✓ aul T.Bruflat,Vice President State of South Dakota ss County of Minnehaha On this 8th day of October,2018,before me personally came Paul T.Bruflat,to me known,who,being by me duly sworn,did depose and say: that he resides in the City of Sioux Falls,State of South Dakota;that he is the Vice President of WESTERN SURETY COMPANY described in and which executed the above instrument;that he knows the seal of said corporation;that the seal affixed to the said instrument is such corporate seal;that it was so affixed pursuant to authority given by the Board of Directors of said corporation and that he signed his name thereto pursuant to like authority,and acknowledges same to be the act and deed of said corporation. My commission expires J.MOHR ///'/�/J Wmrunwa��c( 14 ••/III�%I / June 23,2021 HO"`oTF� 41111A- J.Mohr,Notary Public CERTIFICATE 1, L. Nelson, Assistant Secretary of WESTERN SURETY COMPANY do hereby certify that the Power of Attorney hereinabove set forth is still in force,and further certify that the By-Law of the corporation printed on the reverse hereof is still in force. In testimony whereof I have hereunto subscribed my name and affixed the seal of the said corporation this 2nd day of May,2019. `r• '°s. WESTERN SURETY COMPANY 0 f�l k rh DrM`�. L.Nelson,Assistant Secretary Form F4280-7-2012 Go to www.cnasurety.com>Owner/Obligee Services>Validate Bond Coverage,if you want to verify bond authenticity. Authorizing By-Law ADOPTED BY THE SHAREHOLDERS OF WESTERN SURETY COMPANY This Power of Attorney is made and executed pursuant to and by authority of the following By-Law duly adopted by the shareholders of the Company. 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, and 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.