HomeMy WebLinkAboutTown & Country Underground Utility Construction 2019 FEE: $20.00
ANNUAL RIGHT-OF-WAY EXCAVATION LICENSE
Application is made for a license to work within the Right-of-Way:
NAME )n v- �, in i-- Lin n Type of organization:
individual partnership
X corporation
E-MAIL: je D.fr^ , LI • Cco'1
State of Incorporation W I
ADDRESS: c1Ci O )nn ter.
it/L4 !IJ:14, (c)1 5` ',
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) $500,000 products—completed operations aggregate
and shall name the City of Oshkosh, its officers, council members, agents, employees, and authorized volunteers as an
additional insured thereon. Proof of said coverage in the form of an insurance certificate shall be submitted to the City of
Oshkosh prior to issuance of any permit to perform work within the right-of-way.
Each individual project/address at which work will be performed requires a separate permit which may be obtained from
the City of Oshkosh Public Works Department-Engineering Division.
DATE ISSUED: q 21 76�q
EXPIRATION: t2 31.7tt L
BOND TERM: <'•15•2- 19 TO 2.31 Till
INSURANCE TERM: 12. 3 I-Z(;1$ lb fa.31 70(7
DATE: 21. 7O(c7
Va/l/WA-L 7g44‘2--
Applicant's Signature
(C(D-)) -
Telephone Number
I:\Engineering\ROW Permits\Annual ROW Excavation Bond&License_1-8-19.doc
•
ANNUAL RIGHT-OF-WAY EXCAVATION BOND W15171982
PRINC1PAL(S)(Legal name(e)and business address(es))
Type of organization:
individual partnership
Town&Country Underground Utility Construction Inc. X corporation
W2899 Dunn Road Mayville,WI 53050
Surety(i.es)(Name(s)and business address(es)) State of Incorporation Wisconsin
Merchants Bonding Company(Mutual)
P.O. Box 14498
Des Moines IA 50306-3498
Penal Sum of Bond: S25,000.00
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.
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, 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 refold 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 August 15,2019 (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:
Town&Country
F r + I.Principal:Undergroun 1 Uti ty Construction Inc. For the S nts Bonding Company(Mutual)
Signature Signa lure
l c c rP cT Pit ;Le_ Jenny L Hirth
Name Name
I-A do,,t Attorney-in-Fact
Title W23900 Stone Ridge Drive
Waukesha,WI 53188
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.
f:1F. r.ee;:r.pROa'1'ecadu NAnr a: E.cavadon S,,..i&'..lemse-13.19.doe
LP 1309 WI (1/19)
MERCHANT`S
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,
Jenny L Hirth
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 Merchants 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 15th day of August , 2019 -
•�At •
`P'0 4� ": �O� RPD OM'o�•• MERCHANTS BONDING COMPANY(MUTUAL)
:co
'c o R ) G?- •y, o 94
y�; MERCHANTS NATIONAL BONDING, INC.
tt‘0- •r 2003 0 :y. 1933 c; By 6;477 7:74_
•
,•• ''
9 ••ly ••• •••• .• President
STATE OF IOWA �•"" "'���''
COUNTY OF DALLAS ss.
On this this 15th day of August 2019 , 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.
A s ALICIA K.GRAM
o Commission Number 767430
. . My Commission Expires
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 15th day of August , 2019 .
..•P110 . t. ••.4. „�\NG Co
. • ,, .•
;ham oaPORq 0 : :�o••oP0 .y ;
:2 -o- O •ti._2 _o- ''z• i ,ctiprcli�.
v
2003 !c; •y. 1933 . C' Secretary
ate; ;�6• .. :AC •
POA 0018 (3/17)