HomeMy WebLinkAboutGabe's Construction Co. Inc 2018 •
FEE: $20.00 ({0
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: /er i7"f (1,41"-rt3 f1 a oYJ 9, _in() . Type of organization:
individual partnership
✓ corporation
ADDRESS: yIec' (/ 4.2 1-70 Sf;
State of Incorporation �CJ>
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:
EXPIRATION: l 'CFIVEP
BOND TERM: \2 '31- ICE DEC 15 2017
INSURANCE TERM: 1-17 CITY CLERK'S0;:FICE
DATE: -I }- 1 -1
Applicant's Signature
g62D - S0- oc)
Telephone Number
Annual Work in the Right-of-Way License
4/19/05
ANNUAL EXCAVATION/WORK IN RIGHT-OF-WAY BOND
PRINCIPAL(S)(Legal name(s) and business address(es)) Type of organization:
individual partnership
Gabe's Construction Co.,Inc.
4804 North 40th Street-P.O.Box 385 ✓ corporation
Sheboygan,Wisconsin 53082-0385 Wisconsin
State of Incorporation
Surety(ies) (Name(s) and business address(es))
Travelers Casualty and Surety Company of:America
13935 Bishops Drive-Suite 200,Brookfield,Wisconsin 53005
Penal Sum of Bond: $5000.00 Bond No. 105080175
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, 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:
7ePal : G!:s(onstruction(OflC.
e Name Elixab M.Fedyne
' :' ARTFORD.'-�
J' S t C v Attorney-In-Fact NN
Title Title •. �
nii,
20975 Swenson Drive-Suite 175,Waukesha,WI 53186% '/
v
Address ,"Innlinnm,�n����
*
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
WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER
POWER OF ATTORNEY
TRAVELERSJ� 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. f 232082 Certificate No. 0 0 2 6 98 53
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
Anthony S.Von Rueden,Todd Looker,Robert E Flath,Dennis M Barton,Joseph L Vigna,and Elizabeth M Fedyn
of the City of Milwaukee/Waukesha ,State of Wisconsin ,their true and lawful Attomey(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 19th
day of June 2017
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
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State of Connecticut By:
City of Hartford ss. Robert L.Raney,Senior Vice President
On this the 19th day of June 2017,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•Y,7
In Witness Whereof,I hereunto set my hand and official seal. TAR t, w� � C.
My Commission expires the 30th day of June,2021. * A0f eot, �r `Marie C.Tetreault,Notary Public
4ECTP
58440-5-16 Printed in U.S.A.
WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER