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FEE: $20.00
ACCOUNT# 100-0050-4972-00000
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:
SONAME: SO rJ`,W1Q.(S co, ,,,A ,0 'J Type of organization:
individual partnership
78 4 Silt." r l S-+C x corporation
ADDRESS: VvState of Incorporation WI
Shioc OQ ) wa - 5 { 70
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) p„
I (we) further agree to secure a Commercial General Liability Policy with limits of: "l
(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 be performed requires a separate permit which may be
obtained from the office of the City Clerk.
DATE ISSUED: 3.4k (6
EXPIRATION: 1 Z3\ 1 g
BOND TERM: 12' \'--1 o
INSURANCE TERM: I'l— 1
DATE: 3— —1
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Applicant's Signature
9 - 330 7
Telephone Number
Sidewalk Layers/ Curb Cut Contractors
Annual License 4/19/05
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\ v1AR 2 2 2018
CITY CL1sRK'S O1'FICE.
a
ANNUAL SIDEWALK LAYERS/CURB CUT CONTRACTORS BOND
Bond No. WI 2740
PRINCIPAL(S)(Legal name(s) and business address(es))
Type of organization:
individual partnership
SOMMERS CONSTRUCTION CO.INC. X corporation
W7841 SMITH STREET
SHIOCTON,WI 54170
Surety(ies) (Name(s)and business address(es)) State of Incorporation Wisconsin
Merchants Bonding Company(Mutual)
P.O. Box 14498
Des Moines IA 50306-3498
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, 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 Principal : For the S'arety:
Mereht t1,s Bonding Company(Mutual)
SCAT RS CON CT O.INC.
Name — Julie E Grimes
3' •- Attorney-In-Fact
Title Title
P.O.Box i 4498,Des Moines,IA 50306-3498
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.
Sidewalk layers bond
4/15/05
LP 1737 WI (6/07)
y
MERCHANTS
BONDING COMPANY
POWER OF ATTORNEY
Know All Persons By These Presents,that MERCHANTS BONDING COMPANY(MUTUAL)and MERCHANTS NATIONAL BONDING, INC.,
both being corporations of the State of Iowa(herein collectively called the"Companies")do hereby make,constitute and appoint, individually,
Julie E Grimes
their true and lawful Attorney(s)-in-Fact, to sign its name as surety(ies) and to execute, seal and acknowledge any and all bonds, undertakings,
contracts and other written instruments 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.
This Power-of-Attorney is granted and is signed and sealed by facsimile under and by authority of the following By-Laws adopted by the Board
of Directors of Merchants Bonding Company (Mutual) on April 23, 2011 and amended August 14, 2015 and adopted by the Board of Directors
of Merchants National Bonding, Inc.,on October 16,2015.
"The President, Secretary, Treasurer, or any Assistant Treasurer or any Assistant Secretary or any Vice President shall have 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 obiigdtory in the nature thereof."
"The signature of any authorized officer and the seal of the Company may be affixed by facsimile or electronic transmission to any Power of Attorney
or Certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the
Company,and such signature and seal when so used shall have the same force and effect as though manually fixed."
In connection with obligations in favor of the Florida Department of Transportation only, it is agreed that the power and aut hority hereby given to the
Attorney-in-Fact includes any and all consents for the release of retained percentages and/or final estimates on engineering and construction
contracts required by the State of Florida Department of Transportation. It is fully understood that consenting to the State of Florida Department
of Transportation making payment of the final estimate to the Contractor and/or its assignee, shall not relieve this surety company of any of
its obligations under its bond.
In connection with obligations in favor of the Kentucky Department of Highways only,it is agreed that the power and authority hereby given
to the Attorney-in-Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner-
Department of Highways of the Commonwealth of Kentucky at least thirty(30)days prior to the modification or revocation.
In Witness Whereof,the Companies have caused this instrument to be signed and sealed this 1st day of October , 2017 .
.•`i10Ne:••, •• oNG fin;•.
,•'•�Y P.OR �O •�0• lit �A9••• MERCHANTS BONDING COMPANY(MUTUAL)
:(* 0 9J:. 2; . V .1• •A •• MERCHANT NATIONAL BONDING, INC.
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2003 ,4" •a•' 1933 C: By•
a�.•' ••63 .... �1a•• President
STATE OF IOWA """'�•
COUNTY OF DALLAS ss.
On this this 1st day of October 2017 , before me appeared Larry Taylor, to me personally known, who being by me duly sworn
did say that he is President of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC.; and that the
seals affixed to the foregoing instrument are the Corporate Seals of the Companies; and that the said instrument was signed and sealed ir,behalf
of the Companies by authority of their respective Boards of Directors.
cktA4 s ALICIA K.GRAM
O A. p Commission Number 767430
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My Commission Expires h
April 1,2020
Notary Public
(Expiration of notary's commission
does not invalidate this instrument)
I,William Warner,Jr.,Secretary of MERCHANTS BONDING COMPANY(MUTUAL)and MERCHANTS NATIONAL BONDING, INC.,do hereby
certify that the above and foregoing is a true and correct copy of the POWER-OF-ATTORNEY executed by said Companies,which is still in full
force and effect and has not been amended or revoked.
In Witness Whereof, I have hereunto set my hand and affixed the seal of the Companies on this 1st day of October , 2017 .
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_•• 2003 '�; ••�Est .' 1933 'C• Secretary
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POA 0018 (3/17)