HomeMy WebLinkAboutUnited Concrete & Construction Inc 2018 FEE: $20.00
ACCOUNT#100-0050-4972-00000
ANNUAL SIDEWALK LAYERS / ?..)0
CURB CUT CONTRACTORS LICENSE
Application is made for
(1 or/a license to perform sidewalkw laying and curb cutting work within the City of Oshkosh:
NAME: U.il1'�'4�1�I it e re'te Y1ST CD . Type of organization:
individual partnership
•� ✓corporation
ADDRESS: 5qo'. ry . Rt1n 'L4 � L
State of Incorporation
�Op1d-an Wt' .64913
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 be performed requires a separate permit which may be
obtained from the office of the City Clerk.
DATE ISSUED: l a • 31 • .24)11
EXPIRATION: lot $ I• .1.0 I
BOND TERM: I yY
INSURANCE TERM:
DATE: D l. lb . 1,611
p*cant's ig a re
c140 gg...1 • 14141
Telephone Number
Sidewalk Layers/Curb Cut Contractors
Annual License 4/19/05
EC] IVED
FEB 19 20-181
CITY CLERK'S OFFICE
ANNUAL SIDEWALK LAYERS/CURB CUT CONTRACTORS BOND
BO N D#6060129
PRINCIPAL(S)(Legal name(s)and business address(es))
Type of organization:
UNITED CONCRETE&CONSTRUCTION INC
individual partnership
5902 N RICHMOND ST x corporation
APPLETON,WI 54913-9642
Surety(ies)(Name(s)and business address(es)) State of Incorporation MINNESOTA
FEDERATED MUTUAL INSURANCE COMPANY
PO BOX 328
OWATONNA MN 55060
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 DECEMBER 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.
SIGNMA
ES
ALS:
UNITED CONCRETE&
may; ki '. CONSTRUCTION INC For the Surety: FEDERATE AL INSURANCE COMPANY
, 441
�� Name..1'
F � • SHELLY ROHWER-ATT RNEY-IN-FACT
Title Title
PO BOX 328 OWATONNA MN 55060
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
- T
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS:
That FEDERATED MUTUAL INSURANCE COMPANY, a corporation duly organized and existing
under the laws of the State of Minnesota, and having its principal office in the City of Owatonna, State of
Minnesota,does hereby constitute and appoint:
SHELLY ROHWER of the City of OWATONNA State
of MINNESOTA its true and lawful attorney for the following purposes:
To sign its name as surety to, and to execute, affix the seal, acknowledge and deliver any and all surety
bonds and penalties not exceeding:
ONE HUNDRED THOUSAND DOLLARS ($100,000) EACH
UNITED CONCRETE Si CONSTRUCTION INC APPLETON, WI
The execution of such bonds or undertakings in pursuance of these presents shall be binding upon the
Company as if they had been executed and acknowledged by the regularly elected officers of the Company.
This Power of Attorney granted by Federated Mutual Insurance Company shall terminate when the
designee ceases to be:
1) Employed by Federated Mutual Insurance Company or
2) Employed by Federated Mutual insurance Company in a job for which such Power of
Attorney is required.
IN WITNESS WHEREOF,the said FEDERATED MUTUAL INSURANCE COMPANY has caused
this instrument to be signed and its corporate seal to be affixed by its Executive Vice President and Assistant
Secretary this the 8TH day of APRIL , 2016
FEDERATED MUTUAL INSURANCE COMPANY
BY 4t2i '1L4 4. /��G >
(SEAL) E ek cuti e Vice resident
and BY •
sistant Secretary
STATE OF MINNESOTA
COUNTY OF STEELE
On this STH day of APRIL, 2016 personally appeared before me, the undersigned notary
public, James A. Thon and Jonathan R. Hanson to me personally known, who, each being duly sworn by me, did
say that they are respectively the Executive Vice President and Assistant Secretary of the FEDERATED MUTUAL
INSURANCE COMPANY and that the seal affixed to this instrument is the corporate seal of said Corporation and
that this instrument was signed and sealed of behalf of said Corporation by authority of its Board of Directors and
said James A. Thon and Jonathan R. Hanson acknowledge said instrument to be the free act and deed of said
corporation.
tee. KELLY J.HAGEN
► NOTARY PUBLIC-MINNESOTA
��(SEAL) l My Commission EvIms Jan.31,202071(.. 9:74-eirti