The URL can be used to link to this page

Home My WebLink AboutTDS Metrocom LLC 2018 2018 Annual Permit MEX-160825545 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: TDS Metrocom, LLC Type of organization: individual —partnership corporation ADDRESS: 525 Junction Road DE State of Incorporation Madison, WI 53717 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: a' J' it EXPIRATION BOND TERM: INSURANCE TERM: 1 ' DATE: 1/5/2018 Sean Murray:Network Specialist I-ROW Applicant's Signature 608-664-4606 sean.murray@tdstelecom.com Telephone Number Annual Work in the Right-of-Way License 4/19/05 19°( RL'tcpivjn FEB O b 2018 CITY CLERK'S OFFICE . ANNUAL EXCAVATION/WORK IN RIGHT-OF-WAY BOND BOND NUMBER: 104116421 PRINCIPAL(S)(Legal name(s)and business address(es)) TDS Metrocom, LLC Type of organisation: individual ._.._,partnership 20875 Crossroads Circle. Suite 800 X corporation Waukesha, WI 53186 Surety(ies)(Name(s)and business address(es)) State of Incorporation Delaware Travelers Casualty and Surety Company of America 215 Shuman Blvd. Naperville, IL 60563-8458 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 01, 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. SI Y T.'RES/ EA it ci DS Metrocom, LLC For the Surety: Travelers Casualty and Surety Company of America aL6LliAiret_74x‘f_A___ ' Name Renee Boucher, ROW Permit Specialist Vicki Nobinger,Attorney-in-Fact Title Title Marsh USA Inc. 1111 Northshore Drive,Suite N550,Knoxville,TN 37919 Address Dated: November 09,2017 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 State of Tennessee County of Knox SS• On November 09,2017 ,before me,a Notary Public in and for said County and State,residing therein,duly commissioned and sworn,personally appeared Vicki Nobinger known to me to be Attorney-in-Fact of Travelers Casualty and Surety Company of America the corporation described in and that executed the within and foregoing instrument,and known to me to be the person who executed the said instrument in behalf of the said corporation,and he duly acknowledged to me that such corporation executed the same. IN WITNESS WHEREOF,I have hereunto set my hand and affixed my official seal,the day and year stated in this certificate above. My Commission Expires April 04,202017 a . ` Rachel A.Chaveriat Notary Public Cit%%% : o'. • STATE Of TENNESSEE 1. NOTARY PUBLIC • • • #11, 44VX C01 0% ,IIII,,I 1\� I a i i. 4011164 TRAVELERS J 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: TDS Metrocom 104116421 Obligee:g 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 Vicki Nobinger of the City of Knoxville State of Tennessee , 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 iteoutiNst 14.sff..01Y443 00 c,-..77i.:4,,,,, esc . 40... ::„...t.2!....;,..11 c7.....--- , :0. State of Connecticut City of Hartford ss. By: Robert L. Raney,Senior Vic�sident 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.ttr My Commission expires the 30th day of June, 2021. Arch -� C- * t0S (;,, Marie C.Tetreault, Notary Public • 2 1.•. 'i