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Home My WebLink AboutB&L Contracting LLC 2018 FEE: $20.00 ACCOUNT# 100-0050-4972-00000 ANNUAL EXCAVATION/WORK IN THE RIGHT-OF-WAY LICENSE Application is made for a license to work within the Right-of-Way: NAME: ` L L Type of organisation: J individual partnership corporation ADDRESS: Ck 522 State of Incorporation 0 01 rJ iti� 9 43 I (We) further agree to provide the City with a surety bond issued by a company licensed in the State of Wisconsin in the amount of Five Thousand Dollars ($5,000.00) I (we) further agree to secure a Commercial General Liability Policy with limits of: (a) $500,000 each occurrence for Bodily Injury and Property Damage Liability (b) $500,000 personal injury (c) $500,000 general aggregate (d) $500,000 products/completed operation aggregate and shall name the City of Oshkosh, its employees and officers, as an additional insured thereon. Proof of said coverage in the form of an insurance certificate shall be submitted to the City 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 Public Works Department. DATE ISSUED: \ 0-9— EXPIRATION: \- ' 1) RECEIVED OCT 042018 BOND TERM: ,��' — ounce /� CITY CLER INSURANCE TERM: `O \. l DATE: (,6 Applicant's Signature e- - f(-5' Telephone Number Annual Work in the Right-of-Way License 4/19/05 • Bond Number 45254 ANNUAL EXCAVATION/WORK IN RIGHT-OF-WAY BOND PRINCIPAL(S)(Legal name(s)and business address(es)) Type of organization: LLC B& L CONTRACTING LLC 4822 Rivermoor Rd, Omro, WI 54963-9425 State of Incorporation Wisconsin Surety(ies)(Name(s) and business address(es)) Western National Mutual Insurance Company 4700 W 77th St, Edina, MN 55435-4818 Penal Sum of Bond: $5000.00 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 area within the right-of-way to as good a condition as it was in prior to Principal's activities; and pay to the City of Oshkosh any amounts due for services or materials furnished in connection therewith within one week of invoice. The Principal shall for a period begi nning on the date of issuance of this bond th rough a two(2)year perio d 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, co sts, an d expenses of any kind o r character arising o ut of or resulting, howe ver 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 fa ilure to gu and against injury to pe rsons passing u pon the str eet or sidewa Ik, o r 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 obli gated to pay, including damages, punitive damages, attorney fees and court costs, within 30 days of written demand for payment, however the penal sum of this bond shall not exceed $5000. 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 October 3, 2018 (Date of Issuance)to December 31, 2018 SIGNATURES/SEALS: For the Principal B & L CONTRACTING LLC For the S ilaGl- - - • . .- Co. Name Brian Wilke Name � OOwner A • —7i'eise _ J -z_ G •can= Title Title SEAL . VNESo.• 0 ; 4700 W 77th St, Edina, MN 55435-4818 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. Annual Excavation/Work in the Right-of-Way 4/15/05 r • WESTERN NATIONAL Ihr rrho+i.hip cwrepany POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That Western National Mutual Insurance Company, a Minnesota mutual insurance company, does make, constitute and appoint: Brandon Heise ADEMINO&ASSOCIATES INC Its true and lawful Attorney(s)-in-Fact, with full power and authority for and on behalf of the Company as surety, to execute and deliver and affix the seal of the Company thereto (if a seal is required) bond, undertakings recognizances or other written obligations in the nature thereof, (other than trail bonds, bank depository bonds, mortgage deficiency bonds, mortgage guaranty bonds, guarantees of installment paper and note guaranty bonds, self-insurance workers compensation bonds guaranteeing payment of benefits. hazardous waste remediation bonds or black lung bonds) as follows: All written instruments in an amount not to exceed an aggregate of Five Thousand Dollars($5,000.00) for any single obligation, regardless of the number of instruments issued for the obligation. and to bind Western National Mutual Insurance Company thereby, and all of the acts of said Attorneys-in-Fact, pursuant to these presents, are ratified and confirmed. This appointment is made under and by authority of the board of directors at a meeting held on September 28, 2010. This Power of Attorney is signed and sealed by facsimile under and by the authority of the following resolutions adopted by the board of directors of Western National Mutual Insurance Company on September 28, 2010: RESOLVED that the president, any vice president, or assistant vice president in conjunction with the secretary or any assistant secretary, may appoint attorneys-in-fact or agents with authority as defined or limited in the instrument evidencing the appointment in each case, for and on behalf of the company to execute and deliver and affix the seal of the Company to bonds, undertakings, recognizances, and suretyship obligations of all kinds, and said officers may remove any such attorney-in-fact or agent and revoke any Power of Attorney previously granted to such person. RESOLVED FURTHER that any bond, undertaking, recognizance, or suretyship obligation shall be valid and binding upon the Company (i) when signed by the president, any vice president or assistant vice president, and attested and sealed (if a seal be required) by any secretary or assistant secretary; or (ii) when signed by the president, any vice president or assistant vice president, secretary or assistant secretary, and countersigned and sealed(if a seal be required) by a duly authorized attorney-in-fact or agent; or (iii) when duly executed and sealed (if a seal be required) by one or more attorneys-in-fact or agents pursuant to and within the limits of the authority evidenced by the Power of Attorney issued by the Company to such person or persons. RESOLVED FURTHER that the signature of any authorized officer and the seal of the company may be affixed by facsimile 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 affixed. IN WITNESS WHEREOF, Western National Mutual Insurance Company has caused these presents to be signed by its proper officer and its corporate seal to be affixed this 16th day of December , 2015. �� W SEAL'€ %.,V.S.tyt'.•••;;t1 (_?"4-7-7,/yk---- Jon R. Hebeisen, Secretary Larry A. Byers, Sr.Vice President STATE OF MINNESOTA,COUNTY OF DAKOTA On this 16th day of December, 2015, personally came before me, Jon R. Hebeisen and Larry A. Byers and to me known to be the individuals and officers of the Western National Mutual Insurance Company who executed the above instrument, and they each acknowledged the execution of the same, and being by me duly sworn, did severally dispose and say; that they are the said officers of the corporation aforesaid, and that the seal affixed to the above instrument is the seal of the corporation, and that said corporate seal and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority of the board of directors of said corporation. :t:' � `-• � JENNIFER A YOUNG 9,--)-x-A-2A) Q 6� NOTARY PUBLIC•MININESOTA f';of MY COMMISSION EXPIRESC',31e202' Jennifer A. Young, Notary Public My commission expires January 31,2021 CERTIFICATE I, the undersigned, assistant secretary of the Western National Mutual Insurance Company, a Minnesota corporation, CERTIFY that the foregoing and attached Power of Attorney remains in full force and has not been revoked; and furthermore, that the Resolutions of the board of directors set forth in the Power of Attorney, are now in force. •i= i, SEAL)i= 9 . . .... Signed and sealed at the City of Edina, MN on 10/3/2018 Jennifer A. Young, Assistant Secretary