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Home My WebLink AboutCR Meyer 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: /'Q Q Type of organization: individual partnership corporation ADDRESS: 4 k f\� ,.6�'�' State of Incorporation ��/-�- ALY-)Z) w—r 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: .SIMP EXPIRATION: 1 0IA/h JP BOND TERM: vec+-C- ( ra,/t' � - 1 a/,�/7;.41 INSURANCE TERM: C/// I ? 4-o C DATE: ��7� i lic9 Applicant's Signature Telephone Number Annual Work in the Right-of-Way License 4/19/05 MAY 18 an( co- ANNUAL EXCAVATION/WORK IN RIGHT-OF-WAY BOND Bond #105543465 PRINCIPAL(S)(Legal name(s) and business address(es)) Type of organization: C.R. Meyer and Sons Company _individual partnership 895 W. 20th Avenue X corporation Oshkosh, WI 54902 State of Incorporation Wisconsin Surety(ies) (Name(s) and business address(es)) Travelers Casualty and Surety Company of America One Tower Square Hartford, CT 06183 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 December 31, 2017_(Date of Issuance) to December 31, 2018 (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: Forth rincip For the Surety: Th .. ., Michael R. Zahn 1 • • NSA L`A .•--ca --, t�Y Name f ^�s ,�� Attorney-In-Fact Title .L , Title • R' ' 828 John Nolen Drive, Madison,WI 53713 'c � Address c- • a • mod Any person sigkir in a fv ntatii eapacity(e.g., an attorney-in-fact) must furnish evidence of authority if that representative is not • a member of theAf7r :Yrpat 5Ait3e2van officer of the corporation involved. •, ANdd' .•s Annual Excavation/Work Trithe Aight of-Way 4/15/05 WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER • Ink POWER OF ATTORNEY J*TRAVELERS 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. 230979 Certificate No.0 0 6 8 3 7 0 31 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 Timothy T.Cleary,Kim E.Schwenn,Heidi M.Hodel,Julie Zimmerman,Jacquelyn Plaszcz,Trisha Stark,Kristi Kulas,Becky Zimmer, Peggy Tromblay,Annette Dillon,Tiffanie Courtney,Travis Schreiber,and Michael Zahn of the City of Madison ,State of Wisconsin _ ,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 23rd day of June 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 r ‘� C Pic1. V r,c, r'IS MO 1r....-Os 6+'0, r•��a 41/AIH State of Connecticut By: 2 City of Hartford ss. Robert L.Raney,Senior Vice President On this the 23rd day of June 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. G'T� In Witness Whereof,I hereunto set my hand and official seal. � � C • My Commission expires the 30th day of June,2021. * PUetAG i Marie C.Tetreault.Notary Public r 58440-5-16 Printed in U.S.A. WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER