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Home My WebLink AboutScott DeNoble Sons Construction Inc 20181 FEE: $20.00 ACCOUNT# 100-0050-4972-00000 ANNUAL EXCAVATION/WORK IN THE RIGHT-OF-WAY LICENSE Application is made for a li nse to work w in the Rig -of-Way: V.k() A : O `- S. 14 (l G Type of organization: individual partnership corporation y ADDRESS: I / /0 ULf�lE/] ey9t) J //,,�� State of Incorporation WI �� - it SVA// I (We) further agree to provi 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: /2 3/2a EXPIRATION: /2 —3/-26/, BOND TERM: n(.� 1 _ INSURANCE TERM: // (4X ` �'lvlft2'C - DATE: k2 -ZG/7 Appllican s Signature Telephone Number Annual Work in the Right-of-Way License 4/19/05 RE' EIVED FEB 0 6 2018 CflrVCUM—CS OITICE ANNUAL EXCAVATION/WORK IN RIGHT-OF-WAY BOND Bond No. 66215199 PRINCIPAL(S)(Legal name(s) and business address(es)) Type of organization: Scott DeNoble & Sons Construction, Inc. individual partnership 1910 Verlin Road Green Bay, WI 54311 _X corporation Surety(ies) (Name(s) and business address(es)) State of Incorporation WI Auto-Owners Insurance Company P. O. Box 30660 Lansing, MI 48909-8160 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 12-31-2017 (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: • For the Principal : For the Surety: Scott eNoble& o onstruction Inc. Auto Owners Insurance Co. Narp , Name Ann M. Nader �L �'flh1 Title Attorney-in-fact Address 417 S. Monroe Ave. Green Bay WI 54305 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 DATE AND ATTACH TO ORIGINAL BOND AUTO-OWNERS INSURANCE COMPANY LANSING,MICHIGAN NO 66215199 POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS:That the AUTO-OWNERS INSURANCE COMPANY AT LANSING,MICHIGAN,a Michigan Corporation,having its principal office at Lansing,County of Eaton.State of Michigan,adopted the following Resolution by the directors of the Company on January 27, 1971,to wit: "RESOLVED. That the President or any Vice President or Secretary or Assistant Secretary of the Company shall have the power and authority to appoint Attorneys-in-fact,and to authorize them to execute on behalf of the Company,and attach the seal of the Company thereto,bonds and undertakings,recognizances, contracts of indemnity, and other writings obligatory in the nature thereof. Signatures of officers and seal of Company imprinted on such powers of attorney by facsimile shall have same force and effect as if manually affixed.Said officers may at any time remove and revoke the authority of any such appointee." Does hereby constitute and appoint ANN M NADER its true and lawful attorney(s)-in-fact,to execute,seal and deliver for and on its behalf as surety,any and all bonds and undertakings,recognizances,contracts of indemnity and other writings obligatory in the nature thereof,and the execution of such instrument(s)shall be as binding upon the AUTO-OWNERS INSURANCE COMPANY AT LANSING, MICHIGAN as fully and amply, to all intents and purposes,as if the same had been duly executed and acknowledged by its regularly elected officers at its principal office. IN WITNESS WHEREOF,the AUTO-OWNERS INSURANCE COMPANY AT LANSING, MICHIGAN, has caused this to be signed by its authorized officer this 1st day of August,2016. Denise Williams Senior Vice President STATE OF MICHIGAN 1 ss. COUNTY OF EATON On this 1st day of August,2016,before me personally came Denise Williams, to me known,who being duly sworn,did depose and s'? C OUT OF CFM say that they are Denise Williams, Senior Vice President of AUTO-OWNERS INSURANCE COMPANY,the corporation described in and ""anacH io.o z which executed the above instrument,that they know the seal of said corporation,that the seal affixed to said instrument is such Corporate 'sa. .�. Ca,nryd • Seal,and that they received said instrument on behalf of the corporation by authority of their office pursuant to a Resolution of the Board of yvj•. •P= Directors of said corporation. ,(,Q N.\J a of 7 C4- My commission expires March 10,2022 Susan E.Theisen Notary Public STATE OF MICHIGAN ss. COUNTY OF EATON I, the undersigned First Vice President, Secretary and General Counsel of AUTO-OWNERS INSURANCE COMPANY,do hereby certify that the authority to issue a power of attorney as outlined in the above board of directors resolution remains in full force and effect as written and has not been revoked and the resolution as set forth is now in force. 25th January2018 �^ NERs/y Signed and sealed at Lansing.Michigan.Dated this day of sit:............s�.p"`� i CORPORATE l n SEAL T William F.Woodbury,First Vice Preeient,Secretary and General Counsel 2940(10-17) Print Date:01/25/2018 Print Time:09:49:03 AM