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Home My WebLink AboutWisconsin Independent Network 2019 bocuSign Envelope ID:39FA681F-2B60-4620-A88F-OEDC7D9D3C3B FEE: $20.00 ANNUAL RIGHT-OF-WAY EXCAVATION LICENSE Application is made for a license to work within the Right-of-Way: NAME: Wisconsin Independent Network, LLC Type of organization: _individual `partnership E-MAIL: Ken.Wh i ti ngOri ntechnol ogy.com x corporation ADDRESS: 4955 eul l i s Farm Road, Eau Claire, wi 54701 State of Incorporation WI 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: •. •/pet EXPIRATION: ra•3l•2al -_ BOND TERM: 4/28/2019 - 12/31/2019 INSURANCE TERM: 06/01/2019 - 06/01/2020 DATE: July 23, 2019 oo.u8I n.d by: 4ott A. Hoffmann A ialffigSigfature 715-832-3750, Ken Whiting 715-858-3172 Telephone Number I.\Engineering\ROW Permita\Annual ROW Excavation Bond&Llcenre_1-8-19.doc ANNUAL RIGHT-OF-WAY EXCCAVATION BOND 91BSBIE2154 This bond replaces and supersedes bond 91BSBHQ2690 PRINCIPAL(S)(Legal name(s)and business address(es)) Type of organization: Wisconsin Independent Network individual _partnership 800 Wisconsin Street,Mailbox 107 Bldg 02,Suite 219 Eau Claire WI 54703 X. corporation Surety(ies)(Name(s)and business address(es)) State of Incorporation WI Hartford Fire Insurance Company One Hartford Plaza Hartford CT 06155 Penal Sum of Bond: $25,000.00 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. 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 July 25,2019 (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 ncipal:W. co In endent Network For the Surety:Hartford Fire Insurance Company A. Signature Signature C o- - 1-6W. Ajk' Robert L Reynoldson ��►NIIIIIII/ii If P��y Name Name `��u�� f'' •.,.(ee , Attorney-in-Fact Title File :_ Title t ��'~ . - 1128 Lincoln Mall,Suite 200 Lincoln NE 68508 .... ; PUMA ...4 Address Any person signing in a representative attorney-in-fact)must furnish evidence of authority if that representative is not a member of the firm or partnership or a1 t10fhe corporation involved. 1:\Engineering\ROW Permits\Annual ROW Excavation Bond&License_L&19.doc Direct Inquiries/Claims to: THE HARTFORD POWER OF ATTORNEY Hartford C Connecticut Bond.Claims(ct7thehartford.com calf:888-266-3488 or fax:860-757-5835 Agency Name: UNICO GROUP INC KNOW ALL PERSONS BY THESE PRESENTS THAT: Agency Code: 91-913540 X Hartford Fire Insurance Company, a corporation duly organized under the laws of the State of Connecticut Hartford Casualty Insurance Company,a corporation duly organized under the laws of the State of Indiana Hartford Accident and Indemnity Company,a corporation duly organized under the laws of the State of Connecticut Hartford Underwriters Insurance Company,a corporation duly organized under the laws of the State of Connecticut Twin City Fire Insurance Company, a corporation duly organized under the laws of the State of Indiana Hartford Insurance Company of Illinois, a corporation duly organized under the laws of the State of Illinois Hartford Insurance Company of the Midwest, a corporation duly organized under the laws of the State of Indiana Hartford Insurance Company of the Southeast,a corporation duly organized under the laws of the State of Florida having their home office in Hartford,Connecticut(hereinafter collectively referred to as the"Companies")do hereby make, constitute and appoint Robert L. Reynoldson its true and lawful Attorney-in-Fact, to sign its name as surety(ies) only as delineated above by , and to execute, seal and acknowledge the following bond, undertaking, contract or written instrument: Bond No. 91BSBIE2154 Naming Wisconsin Independent Network as Principal, and City of Oshkosh as Obligee, in the amount of See Bond Form(s)on behalf of Company in its 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. In Witness Whereof, and as authorized by a Resolution of the Board of Directors of the Companies on May 6,2015 the Companies have caused these presents to be signed by its Senior Vice President and its corporate seals to be hereto affixed, duly attested by its Assistant Secretary. Further, pursuant to Resolution of the Board of Directors of the Companies, the Companies hereby unambiguously affirm that they are and will be bound by any mechanically applied signatures applied to this Power of Attorney. /�� ? 4% f?% i :',rN•n•.ai.i ►01'Al j y f r r r^ear►oM e �lll �Y �„3•tti•t� �,, rn e,�• ' %MO 17- 1a7V�= a�la7s i • 9/9 A5/0") John Gray,Assistant Secretary M. Ross Fisher,Senior Vice President STATE OF CONNECTICUT ss. Hartford COUNTY OF HARTFORD On this 5th day of January, 2018, before me personally came M.Ross Fisher,to me known,who being by me duly sworn, did depose and say: that he resides in the County of Hartford, State of Connecticut; that he is the Senior Vice President of the Companies, the corporations described in and which executed the above instrument; that he knows the seals of the said corporations; that the seals affixed to the said instrument are such corporate seals; that they were so affixed by authority of the Boards of Directors of said corporations and that he signed his name thereto by like authority. Jtnr Y4, air • a Kathleen T.Maynard Notary Public CERTIFICATE My Commission Expires July 31,2021 I, the undersigned,Assistant Vice President of the Companies, 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 effective as of July 25, 2019. Signed and sealed at the City of Hartford. iMY y ‘1/4 A'r �. f >. mr.f*' P.14# t,:• 1979/ ; ta74:-F +G 1919 Kevin H kman,Assis an Vice AIM ENGINEERED TO SERVE June 6, 2019 City of Oshkosh Department of Public Works—Engineering Department 215 Church Ave, PO Box 1130 Oshkosh, WI 54903-1130 RE: Annual Excavation License Application To Whom It May Concern: Please find enclosed a signed Annual Excavation License, Original Bond, Certificate of Insurance (COI), and $20 license payment (check#44626) as requested. Please note that our attorney has requested that not sign the Annual Right-of-Way Excavation Bond page, as we have provided the original bond in its place. If you have any questions, please feel free to contact myself or Ken Whiting at 715-858-3172 or Ken.Whiting@wintechnology.com. Thank you in advance, Sarah Peck Wisconsin Independent Network, LLC Administrative Assistant—Contracts 4955 Bullis Farm Road Eau Claire, WI 54701 (715) 858-3175 Sarah.Peck@wintechnology.com enclosures Address Phone Web 4955 Bullis Farm Road 715-832-3750 info@wintechnology.com Eau Claire, WI 54701 866-206-2027 www.wintechnology.com