HomeMy WebLinkAboutRadtke Contractors 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 wi hin the Right-of-Way:
NAME: /Z aP 6*,*4 DfS Type of organization:
individual partnership
/� / corporation
ADDRESS: A h,c (v 4vv
State of Incorporation W T
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: B/ i 1 )Q
EXPIRATION: `213 ) O
BOND TERM: \ZI3 \6
INSURANCE TERM: I `
DATE: 8/ I lb
Applicant's Signature
72-'J 5Y 2 - y//
Telephone Number
Annual Work in the Right-of-Way License
4/19/05
ANNUAL EXCAVATION/WORK IN RIGHT-OF-WAY BOND
Bond No. HGMW101990455
PRINCIPAL(S)(Legal name(s) and business address(es)) Type of organization:
individual partnership
Radtke Contractors, Inc. X corporation
6408 Cross Road
Winneconne, WI 54986 State of Incorporation- Wisconsin
Surety(ies) (Name(s) and business address(es))
Hudson Insurance Company
100 William Street 5th Floor
New York, NY 10038
Penal Sum of Bond: $5,000.00
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 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 7/31/2018 (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:
For the Principal : R tractors, Inc. For the Surety: Hudson Insurance Company
��Name 0 Name
Roxanne L. Jensen,Attorney-in-Fact
Title Title
100 William St 5'h FI, New York, NY 10038
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 ExcavationNVork in the Right-of-Way
iirj‘'''.
HGMW-10199-0455
POWER OF ATTORNEY
KNOW ALI, MEN BY THESE PRESENTS: That IJUDSON INSURANCE COMPANY, a corporation of the State of Delaware, with
offices at 100 William Street, New York, Ncw York, 10038, has made, constituted and appointed, and by these presents, does make, constitute and
appoint
Kelly L.Cody,Roxanne L.Jensen,Christopher Knowlton [lovden
of the state of Wisconsin
its true and lawful Attontey(s)-in-Fact,at Ncw York,New York, each of them alone t0 have full power to act without the other or others,to make,
execute and deliver on its behalf, as Surety, bonds and undertakings given for any and all purposes, also to execute and deliver on its behalf as
aforesaid renewals,extensions,agreements,waivers,consents or stipulations relating to such bonds or undertakings provided,however,that no single
bond or undertaking shall obligate said Company for any portion of the penal sum thereof in excess of the sum of Ten Million Dollars
(S 10,000,000.00).
Such bonds and undertakings when duly executed by said Attomey(s)-in-Fact,shall be binding upon said Company as fully and to the same
cx f signed by the President of said Company under its corporate seal attested by its Secretary.
tn '��
;e..op�o�' Witness Whereof, I(UDSON INSURANCE COMPANY has caused these presents to be of its Senior Vice Prcsidcnt thercunto duly
$utg7 �c this�(J day of March ,20 18 at Ncw York,New York.
x' eC L .o
19f8 ti f' ) IIUDSON INSURANCE COMPANY
( • ?la.
,' / ) 1 1 •) C".-
— I
Attest ,-i Po,ti. ' .rG•1.... .., By.' ✓ .. r
Dina Duskalakis Michael P.Cifunc
Corporate Secretary Senior Vice President
STATE OF NEW YORK
COUNTY OF NEW YORK. SS.
On the 6th1 _ day of March 20 18 before me personally came Michael P.Cifone to me known,who being by me duly sworn did
depose and say that he is a Senior Vice President of HUDSON INSURANCE COMPANY,the corporation:described herein and which executed the above instrument,
that he knows the seal of said Corporation,that the seal affixed to said instrument is such corporate seal,th .it was so affixed by order of the Board of Directors of said
Corporation,and that he signed his name thereto t>rytlikumiles, 1lI�I
,sd``r jilt. fi4`1G�O�., ' '• irl �'111'
(Notarial Seal) �y', ANN M.MURPII\
, L n Notary Public, ate a ' w York
\` No.01 MU6067553
Qualified in Nassau County
Commission Expires December 10,2021
i,
�.T• • gyp• `CERTIFICATION
STATE OF NEW YORK • Ctc N , :r./
COUNTY OF NEW YORK SS.
The undersigned Dina Daskalakis hereby certifies:
That the original resolution,of which the following is a true and correct copy,was duly adopted by unanimous written consent of the Board of Directors of
I Judson Insurance Company dated July 27'h,2007,and has not since been revoked,amended or modified:
"RESOLVED, that the President,the Executive Vice Presidents,the Senior Vice Presidents and the Vice Presidents shall have the authority and
discretion, to appoint such agent or agents, or attorney or attorneys-in-fact, for the purpose of carrying on this Company's surety business, and to
empower such agent or agents,or attorney or attorneys-in-fact,to execute and deliver,under this Company's seal or otherwise,bonds obligations,and
recognizanccs, whether made by this Company as surety thereon or otherwise, indemnity contracts, contracts and certificates, and any and all other
contracts and undertakings made in the course of this Company's surety business,and renewals,extensions,agreements,waivers,consents or stipulations
regarding undertakings so made;and
FURTI IER RESOVLED,that the signature of any such Officer of the Company and the Company's seal may be affixed by facsimile to any power
of attorney or certification given for the execution of any bond,undertaking,recognizance,contract of indemnity or other written obligation in the nature
thereof or related thereto,such signature and seal when so used whether heretofore or hereafter,being hereby adopted by the Company as the original
signature of such officer and the original seal of the Company, to be valid and binding upon the Company with the same force and effect as though
manually affixed."
THAT the above and foregoing is a full,true and correct copy of Power of Attorney issued by said Company,and of the whole of the original and that the
said Power of Attorney is still in full force and effect and has not been revoked,and furthermore that the Resolution of the Board of Directors,set forth in the said
Power of Attorney is now in force. � I
Witness the hand of the undersigned and the seal of said Corporation this . I�'t ,day of, (2/1�(__—` _�7_---- --. 20 �(—`SJ .
I By
1,,,,,i,.,9,
!
`k Dina Daskalakis, Corporate Secretary