HomeMy WebLinkAboutCharter Communication 2018 FEE: $20.00
ACCOUNT# 100-0050-4972-00000
ANNUAL EXCAVATION/WORK IN THE RIGHT-OF-WAY
Application is made for a license to work within the Right-of-Way:
NAME: 01 4 COM,'MVaiG -110i4s Type of organization:
individual partnership
corporation
ADDRESS: :SAO E Dts{inalm,, D._
APple-'DK L ( 5' ri
1 State of Incorporation (4.1Z
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: ' ' Y 18
EXPIRATION: 2' J l '
BOND TERM: ' 3 1 s
INSURANCE TERM: 1 ' _ 1 JAN $ a 2018
DATE: 1 ' a(�' GITY+OLRK'SOIrtte1
A cant's Signature
9a0-7 'i 9,,215
Telephone Number
Annual Excavation/Work in the Right-of-Way License
, ANNUAL EXCAVATION/WORK IN RIGHT-OF-WAY BOND
PRINCIPAL(S)(Legal name(s) and business address(es))
Type of organization:
Charter Communications, Inc.
individual partnership
400 Atlantic Street
Stamford, CT 06901 X corporation
Surety(ies) (Name(s) and business address(es)) State of Incorporation DE
Travelers Casualty and Surety Company of America
One Tower Square, 5PB
Hartford, CT 06183
Bond No. 106638089
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 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 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 January 1, 2018 (Date of Issuance)to December 31, 20 18 (The annual license
period). This bond shall cover claims made for work performed during this annual license period and for an additional two-year
maintenance period beyond the expiration of this annual license period.
SIGNATURES/SEALS:
F9vtfieTrincipal : For the Surety:
harter ommG ns nc.• ve ers Cas Ity d urety Com ny of America
Name: Jessica M. Fisc er, Na : Debra C. Schneider
GVP, puty Treasurer Attorney-In-Fact
Title Title
One Tower Square, 5PB, Hartford. CT 0n183
Address
Any person signing in a representative capacity (e.g., an attorney-in-fact) must furnish evidence cf 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
ACKNOWLEDGMENT BY SURETY
STATE
OF Missouri
}
City of St. Louis ss.
On this 1 6th day of November 201 7 ,before me personally
appeared Debra C.. Schneider ,known to me to be the Attorney-in-Fact of
Travelers Casualty and Surety Company of America
,the corporation
that executed the within instrument,and acknowledged to me that such corporation executed the same.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed my official seal, at my office in the aforesaid
County,the day and year in this certificate first above written.
My Commission Expires: December 03,2019 Kel ey Jones
Notary Public in the State of Missouri
(Seal) _ City of Si Louis
p• •_,.,, r,;;;',;;;';:.;;' Commission Number: 15973646
A
S-0230/GEEF 2/98
TRAVELERS
POWER OF ATTORNEY
Farmington Casualty Company St. Paul Mercury Insurance Company
Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company
Fidelity and Guaranty Insurance Underwriters,Inc. Travelers Casualty and Surety Company of America
St. Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company
St. Paul Guardian Insurance Company
Attorney-In-Fact No. 230490
Surety Bond No. or Project Description: Principal: Charter Communications, Inc.
106638089 Obligee:9 City of Oshkosh
KNOW ALL MEN BY THESE PRESENTS: That Farmington Casualty Company, St. Paul Fire and Marine Insurance Company, St. Paul Guardian
Insurance Company, St. Paul Mercury Insurance Company, Travelers Casualty and Surety Company, Travelers Casualty and Surety Company of
America,and United States Fidelity and Guaranty Company are corporations duly organized under the laws of the State of Connecticut, that Fidelity and
Guaranty Insurance Company is a corporation duly organized under the laws of the State of Iowa, and that Fidelity and Guaranty Insurance
Underwriters, Inc. is a corporation duly organized under the laws of the State of Wisconsin (herein collectively called the "Companies"), and that the
Companies do hereby make,constitute and appoint Debra C.Schneider of the City of St. Louis
State of Missouri , their true and lawful Attorney(s)-in-Fact, each in their separate capacity if more than one is named
above, to sign, execute, seal and acknowledge any and all bonds, recognizances, conditional undertakings and other writings obligatory 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.
IN WITNESS WHEREOF, the Companies have caused this instrument to be signed and their corporate seals to be hereto affixed, this 20th day of
September, 2016.
Farmington Casualty Company St. Paul Mercury Insurance Company
Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company
Fidelity and Guaranty Insurance Underwriters,Inc. Travelers Casualty and Surety Company of America
St. Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company
St. Paul Guardian Insurance Company
eau 1SO" off+ .r6 ...y4 w • .c a.o ' r wry `�' �fair
0. V. ' � ' 1951 3\BAL
State of Connecticut
By
City of Hartford ss. Robert L. Raney,Senior Vice President
On this the 20th day of September, 2016, before me personally appeared Robert L. Raney, who acknowledged himself to be the Senior Vice
President of Farmington Casualty Company, Fidelity and Guaranty Insurance Company,Fidelity and Guaranty Insurance Underwriters,Inc.,St. Paul Fire
and Marine Insurance Company, St. Paul Guardian Insurance Company, St. Paul Mercury Insurance Company,Travelers Casualty and Surety Company,
Travelers Casualty and Surety Company of America, and United States Fidelity and Guaranty Company,and that he,as such, being authorized so to do,
executed the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer.
In Witness Whereof, I hereunto set my hand and official seal. p.7[T
My Commission expires the 30th day of June, 2021. 4- C-
* * Marie C.Tetreault, Notary Public
This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of Farmington
Casualty Company, Fidelity and Guaranty Insurance Company, Fidelity and Guaranty Insurance Underwriters,Inc., St. Paul Fire and Marine
Insurance Company,St. Paul Guardian Insurance Company, St. Paul Mercury Insurance Company,Travelers Casualty and Surety Company,
Travelers Casualty and Surety Company of America, and United States Fidelity and Guaranty Company, which resolutions are now in full force
and effect, reading as follows:
RESOLVED,that the Chairman, the President,any Vice Chairman,any Executive Vice President, any Senior Vice President, any Vice President,
any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint
Attorneys-in-Fact and Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of
authority may prescribe to sign with the Company's name and seal with the Company's seal bonds, recognizances, contracts of indemnity,and
other writings obligatory in the nature of a bond, recognizance,or conditional undertaking, and any of said officers or the Board of Directors at
any time may remove any such appointee and revoke the power given him or her; and it is
FURTHER RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any
Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided that
each such delegation is in writing and a copy thereof is filed in the office of the Secretary; and it is
FURTHER RESOLVED, that any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance, or
conditional undertaking shall be valid and binding upon the Company when (a) signed by the President,any Vice Chairman, any Executive Vice
President, any Senior Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate
Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary; or(b) duly
executed (under seal, if required) by one or more Attorneys-in-Fact and Agents pursuant to the power prescribed in his or her certificate or
their certificates of authority or by one or more Company officers pursuant to a written delegation of authority; and it is
FURTHER RESOLVED, that the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President,
any Vice President, any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by
facsimile to any Power of Attorney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or
Attorneys-in-Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof, and
any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and
any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding on the Company in the
future with respect to any bond or understanding to which it is attached.
I, Kevin E. Hughes, the undersigned, Assistant Secretary, of Farmington Casualty Company, Fidelity and Guaranty Insurance Company, Fidelity
and Guaranty Insurance Underwriters, Inc., St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance Company, St. Paul Mercury
Insurance Company, Travelers Casualty and Surety Company, Travelers Casualty and Surety Company of America, and United States Fidelity and
Guaranty Company 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 in full force and effect and has not been revoked.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this 16h day of
November 2017
Kevin E. Hughes,Assistant Secretary
( ) 'Ô)
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a ;SEAL , sli�L.'F } ,p
To verify the authenticity of this Power of Attorney, call 1-800-421-3880 or contact us at www.travelersbond.com.Please refer to the
Attorney-In-Fact number,the above-named individuals and the details of the bond to which the power is attached.
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