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HomeMy WebLinkAboutNortheast Asphalt Inc 2019 FEE: $20.00 7j qi w rriu ANNUAL RIGHT-OF-WAY EXCAVATION LICENSE RECEIVED /3 SEP - 3 2019 Application is made for a license to work within the Right-of-Way: DEPT OF PUBLIC WORKS N OC NAME: `\\QA P Type of or 4- (�j OSHKOSH, WISCONSIN ganization: _individual _partnership E-MAIL: n f'L1 -� `s�J Q,S��Q l[7Y✓� X corporation State of Incorporation VJ ADDRESS: Vl)I6.3 O �LS',5A- r • �•)(• .0►do W 1 549LIA I (We) further agree to provide the City of Oshkosh with a surety bond issued by a company licensed in the State of Wisconsin in the amount of Twenty Five Thousand Dollars($25,000.00). I(we) further agree to secure a Commercial General Liability Policy with limits of: (a) $500,000 each occurrence (b) $500,000 personal liability and advertising injury (c) $500,000 general aggregate (d) $500,000 products—completed operations aggregate and shall name the City of Oshkosh, its officers, council members, agents, employees, and authorized volunteers as an additional insured thereon. Proof of said coverage in the form of an insurance certificate shall be submitted to the City of Oshkosh prior to issuance of any permit to perform work within the right-of-way. Each individual project/address at which work will be performed requires a separate permit which may be obtained from the City of Oshkosh Public Works Department-Engineering Division. DATE ISSUED: Au3 t9$t c2.O 19 EXPIRATION: 31 , o2 o I ci BOND TERM: s•Z9•ZOIq 'fo 7;3LJi L1 INSURANCE TERM: _4; 1;ZZ°I, 'T1:!. 3 •',ZOZC% DATE: 8/2 Si Jl9 C Applicant's Signature Sao -7s7- 029,0o Telephone Number I:\Engineering\ROW Permits\Annual ROW Excavation Bond&License_1-8-19.doc , ORIGINAL Bond No. 30076130 ANNUAL RIGHT-OF-WAY EXCAVATION BOND PRINCIPAL(S)(Legal name(s)and business address(es)) Type of organization: NORTHEAST ASPHALT, INC. RECEIVED _individual _partnership W6380 Design Drive corporation Greenville, WI 54942 WI Surety(ies)(Name(s)and business address(es)) J C E? — 3 2019 State of Incorporation WESTERN SURETY COMPANY WORKS 151 N. Franklin Street DEPT OF PUBLIC Chicago, IL 60606 OSNKOSH'W 15CONSIN Penal Sum of Bond: S25,000.00 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 street, sidewalk, terrace, or other public right-of-way, vacated right-of-way, or City easement areas in accordance with the current edition of the Standard Specifications for City of Oshkosh, Wisconsin; and pay to the City of Oshkosh any amounts due for services or materials furnished in connection therewith within one(1)month 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 thirty(30)days of written demand for payment;however,the penal sum of this bond shall not exceed$25,000. It is understood and agreed by the Principal(s)and Surety(ies)that this bond supplements,but does not take the place of,any liability insurance required to be carried by said Principal(s)herein by the City of Oshkosh policies or ordinances. TERM OF BOND: This bond shall cover work performed from August ze, 2019 (Date of Issuance) to December 31, 20 19 (the annual license period). This bond shall cover claims made for work performed during this annual license period and for an additional two(2)year maintenance period beyond the expiration of this annual license period. The principal agrees to correct all maintenance issues brought to the attention of the Principal(s)upon receiving notice from the City of Oshkosh within the two(2)year maintenance period. SIGNATURES/SEALS: ppCOrr, NORTHEAST ASPHALT, IDfCUrSt,fant a Spa/not WST$ SU eR pANY For the r0§ 180 0�egU red• or the L// G 20 3(C) Signature Sign re \ar\ Kelly Cody Name Name \ r 1C ,(1 Attorney-in-Fact Title \\\ \+�• Title P.O. Box 23004, Green Bay, WI 54305-3004 • 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. i\Engineering\ROW Permits\Annual ROW Excavation Bond&License_1-8-19.duo 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 Kelly Cody, Roxanne Jensen, Christopher Hoyden, Individually of Green Bay, Wisconsin Trudy A. Szalewski, Christopher H. Kondrick, Brian Krause, Individually of Milwaukee, Wisconsin Its true and lawful Attomey(s)-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 8th day of February,2019. "'suAFTy> WESTERN SURETY COMPANY ?atef v i:ig "c°3. c._oi gpi^ini <2 Lte. EAv'P " ii°A «`' aul T.Bruflat,Vice President State of South Dakota ss County of Minnehaha On this 8th day of February,2019,before me personally came Paul T.Bruflat,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 same to be the act and deed of said corporation. My commission expires ^ J.MOHR NOTARVPUBLIC 1 )--.'�1 /� / June23,2021 asaARYPU PUN / 1r/ O(_✓'v/I�jV/ J.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 printedi on the reverse hereof is still i force. In testimony w)t�reof I have hereunto subscribed my name and affixed the seal of the said corporation this D ' ' day of 0 j �,Cry 'aacrN WESTERN SURETY COMPANY oQi` 9OR 0,5_ 3 RI1GAP 1"D 1Wlit Z ... ,,. %w..,.nuoe+` L.Nelson,Assistant Secretary Form F4280-7-2012 Go to www.cnasurety.com>Owner/Obligee Services>Validate Bond Coverage, if you want to verify bond authenticity.