HomeMy WebLinkAboutBoldt Company 2018 FEE: $20.00
ACCOUNT#100-0050-4972-00000 I
ANNUAL SIDEWALK LAYERS /
CURB CUT CONTRACTORS LICENSE
Application is made for a license to perform sidewalk laying and curb cutting work within the City of Oshkosh:
NAME: The Boldt Company Type of organization:
individual partnership
__corporation
ADDRESS: 2525 N. Roemer Rd, P.O. Box 419
State of Incorporation WI
Appleton, WI 54912
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.
Each individual project/address at which work will
1/�1/2017m d req 1 g s a separate permit which may be
obtained from the office of the City Clerk.
l
DATE ISSUED: -- -- k e
EXPIRATION: Y L-' 5) ,
f'
BOND TERM: 1/1/2018 - 12/31/2018
INSURANCE TERM: 1/1/2017 - 1/1/2018
DATE: 11/15/2017
7,‘.// Assistant Secretary
Applicant s Signature
920-739-6321
Telephone Number
Sidewalk Layers/Curb Cut Contractors II
Annual License 4/19/05
IPCEIVED
NOV 21 2017
CITY CLERK'S OFFICE
Bond No.929599809
•
t ANNUAL SIDEWALK LAYERS/CURB CUT CONTRACTORS BOND
PRINCIPAL(S)(Legal name(s)and business address(es)) Type of organization:
The Boldt Companyindividual partnership
2525 North Roemer Road, P.O. Box 419 —
Appleton,WI 54912 X corporation
Surety(ies)(Name(s)and business address(es)) State of Incorporation Wisconsin
Western Surety Company
P.O.Box 5077
Sioux Falls,SD 57117
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 sidewalk laying / curb cutting work 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 or sidewalk 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 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:
For the •ncipal:The Boldt Company For the Surety:Western Surety ompany
Name
a e
4rS.61.4„,4- .S e r e }�r>, Heather R. Goedtel,Attorney-in-Fact
Title Title
1600 Utica Ave. S.,Suite 600,Minneapolis,MN 55416
Address
Any person sighing 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.
Sidewalk layers bond
4/15/05
1
III r�'
Surety Acknowledgment
State of Minnesota }
) ss.
County of Hennepin }
On this 1' day of January 2018, before me personally came Heather R. Goedtel, to me
known,who being by me duly sworn,did depose and say that she is the Attorney-in-Fact of
Western Surety Company described in and which executed the above instrument; that she/he knows the
seal of said corporation; that the seal affixed to said instruments is such corporate seal, that it was so
affixed by order of the Board of Directors of said corporation, and that she/he signed her/she/his name to
it by like order.
3. c .
Notary Public
e" 'Tyti MICHELLE DIANE HALTER
r = Notary Public
_�` Minnesota I
1 \ :+:z My Commission Expires
...:0 3. Jan 31,2023
Western Surety Company
POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY-IN-FACT
Know All Men By These Presents,That WESTERN SURETY COMPANY,a South Dakota corporation,is a duly organized and existing corporation
having its principal office in the City of Sioux Falls,and State of South Dakota,and that it does by virtue of the signature and seal herein affixed hereby
make,constitute and appoint
Laurie Pflug, Jill N. Swanson, Brian D. Carpenter, Nicole Langer, Craig Olmstead, Jessica
Hoff, Heather R. Goedtel, Michelle Halter, Individually
of Minneapolis,MN,its true and lawful Attorneys)-in-Fact with full power and authority hereby conferred to sign,seal and execute for and on its behalf
bonds,undertakings and other obligatory instruments of similar nature
-In Unlimited Amounts -
and to bind it thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of the corporation and all the acts of said
Attorney,pursuant to the authority hereby given,are hereby ratified and confirmed.
This Power of Attorney is made and executed pursuant to and by authority of the By-Law printed on the reverse hereof,duly adopted,as indicated,by
the shareholders of the corporation.
In Witness Whereof, WESTERN SURETY COMPANY has caused these presents to be signed by its Vice President and its corporate seal to be
hereto affixed on this 17th day of February,2017.
SpET WESTERN SURETY COMPANY
4, Q,90q4AI
Pit ,z1
aril T.Brufiat.Vice President
State of South Dakota
JT ss
County of Minneltaba
On this 17th day of February,2017,before me personally came Paul T.Brullat.to me known,who,being by me duly sworn,did depose and say: that
he resides in the City of Sioux Falls,State of South Dakota;that he is the Vice President of WESTERN SURETY COMPANY described in and which
executed the above instrument:that he knows the seal of said corporation:that the seal affixed to the said instrument is such corporate seal;that it was so
affixed pursuant to authority given by the Board of Directors of said corporation and that he signed his name thereto pursuant to like authority, and
acknowledges sante to he the act and deed of said corporation.
My commission expires
J.MOHR
June 23.2021 :sul sou,a1Z=au /71'/ /J
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1.Mohr,Notary Public
CERTIFICATE
I, L.Nelson,Assistant Secretary of WESTERN SURETY COMPANY do hereby certify that the Power of Attorney hereinabove set forth is still in
force,and further certify that the By-Law of the corporation printed on the reverse hereof is still in force. In testimony whereof I have hereunto subscribed
my name and affixed the seal of the said corporation this 1st day of January , 2018
P+.--- �, WESTERN SURETY COMPANY
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1'�TH pAH�1t 3
L.Nelson,Assistant Secretary
Form F4280.7-2012