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FEE: $20.00
ACCOUNT# 100-0050-4972-00000
ANNUAL STREET/SIDEWALK OBSTRUCTION LICENSE
Application is made for a license to maintain street/sidewalk obstruction:
NAME: 4-0 ( OV4S I
ADDRESS: P 0 a 174_ 0
LQ7C(.) 0 f�
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 for street or sidewalk obstruction.
Each individual project/address at which an obstruction will be placed requires a separate permit which may be
obtained from the office of the City Clerk.
DATE ISSUED: J-1 3 1 1 1
EXPIRATION: ,rj _3 f 6
BOND TERM: (\e- °`
INSURANCE TERM: Cane. mac'
DATE: •
Applicant's Signature
93(2
Telephone Number
Street/Sidewalk Annual Obstruction License
11-27-02
ANNUAL STREET/SIDEWALK OBSTRUCTION BOND
• BOND NO. GRWI19590B
PRINCIPAL(S)(Legal name(s)and business address(es))
W& D Navis, Inc. Type of organization:
N2747 State Hwy. 26 individual partnership
Waupun, WI 53963-0048 X corporation
State of Incorporation_Wisconsin
Surety(ies)(Name(s) and business address(es))
Granite Re, Inc.
14001 Quailbrook Drive
Oklahoma City, OK 73134
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 placing an obstruction within street or sidewalk 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 street, sidewalk, terrace or other public area to as good a condition as it was in before excavation or
obstruction; 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, 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.
SIGNATURES/SEALS:
For the r. cipal: W& D Navis, Inc. For th;Surety: Granite R , Inc.
Ceie
ame Name: Connie Smith
Attorney-in-Fact
Title Title
14001 Quailbrook Drive, Oklahoma City, OK 73134
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 Street/Sidewalk Obstruction bond
4/15/05
GRANITE RE, INC.
GENERAL POWER OF ATTORNEY
Know all Men by these Presents:
That GRANITE RE, INC., a corporation organized and existing under the laws of the State of OKLAHOMA and having its principal office
at the City of OKLAHOMA CITY in the State of OKLAHOMA does hereby constitute and appoint:
MICHAEL J. DOUGLAS; CHRIS STEINAGEL; CHRISTOPHER M. KEMP; KARLA HEFFRON; ROBERT DOWNEY; CONNIE SMITH its true and
lawful Attorney-in-Fact(s)for the following purposes,to wit:
To sign its name as surety to, and to execute, seal and acknowledge any and all bonds, and to respectively do and perform any and all
acts and things set forth in the resolution of the Board of Directors of the said GRANITE RE, INC. a certified copy of which is hereto annexed
and made a part of this Power of Attorney; and the said GRANITE RE, INC. through us, its Board of Directors, hereby ratifies and confirms all
and whatsoever the said:
MICHAEL J. DOUGLAS; CHRIS STEINAGEL; CHRISTOPHER M. KEMP; KARLA HEFFRON; ROBERT DOWNEY; CONNIE SMITH may lawfully
do in the premises by virtue of these presents.
In Witness Whereof, the said GRANITE RE, INC. has caused this instrument to be sealed with its corporate seal, duly attested by the
signatures of its President and Secretary/Treasurer,this 3'd day of July, 2013.
oPo,T E Re.�O
— Kenneth D. Whitting on, President
STATE OF OKLAHOMA ) SEAL
SS: /1/7fr7/z./
COUNTY OF OKLAHOMA ) Kyle . McDonald,Treasurer
On this 3rd day of July, 2013, before me personally came Kenneth D. Whittington, President of the GRANITE RE, INC. Company and
Kyle P. McDonald, Secretary/Treasurer of said Company, with both of whom I am personally acquainted, who being by me severally duly
sworn, said, that they, the said Kenneth D. Whittington and Kyle P. McDonald were respectively the President and the Secretary/Treasurer of
GRANITE RE, INC., the corporation described in and which executed the foregoing Power of Attorney; that they each knew the seal of said
corporation; that the seal affixed to said Power of Attorney was such corporate seal, that it was so fixed by order of the Board of Directors of
said corporation,and that they signed their name thereto by like order as President and Secretary/Treasurer, respectively,of the Company.
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Y 1 Ia , n
My Commission Expires: `-�G it✓IwA`h`l
August 8, 2017 a ,,., Nota Public
Commission #: 01013257 N-00- 0
GRANITE RE, INC.
Certificate
THE UNDERSIGNED, being the duly elected and acting Secretary/Treasurer of Granite Re, Inc., an Oklahoma Corporation, HEREBY CERTIFIES
that the following resolution is a true and correct excerpt from the July 15, 1987, minutes of the meeting of the Board of Directors of Granite
Re, Inc. and that said Power of Attorney has not been revoked and is now in full force and effect.
"RESOLVED, that the President,any Vice President, the Secretary, and any Assistant Vice President shall each have authority to appoint
individuals as attorneys-in-fact or under other appropriate titles with authority to execute on behalf of the company fidelity and surety
bonds and other documents of similar character issued by the Company in the course of its business. On any instrument making or
evidencing such appointment,the signatures may be affixed by facsimile. On any instrument conferring such authority or on any bond
or undertaking of the Company, the seal, or a facsimile thereof, may be impressed or affixed or in any other manner reproduced;
provided, however, that the seal shall not be necessary to the validity of any such instrument or undertaking."
IN W TNESS WH OF,the undersigned hhas subscribed this Certificate and affixed the corporate seal of the Corporation this
day of 20 I pso„E�.N
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SEAL
Kyle P. McDonald, Secretary/Treasurer
G R0800-1