HomeMy WebLinkAboutBid Bond 23-24 Advance ConstructionGR/_ AM GREAT AMERICAN INSURANCE COMPANY
INSURANCE GROUP OHIO
BID BOND
RECEIM
OCT - 2 2023
Any singular reference to Contractor, Surety, Owner or other party shall be considered plural where applicab OF PUBLIC WORKS
CONTRACTOR: SURETY: OSHKOSH, wISCONSIN
(Name, legal status and address) (Name, legal status and principal place of business):
Advance Construction, Inc.
2141 Woodale Ave
Green Bay, WI 54313
OWNER:
(Name, legal status and address)
City of Oshkosh
215 Church Ave
Oshkosh, WI 54901
BOND AMOUNT: $ 5% of amount bid
PROJECT: City Contract 23-24
(Name, location or address, and Project number, if any)
Rusch Park Trail
Great American Insurance Company
301 E. Fourth Street
Cincinnati, OH 45202
The Contractor and Surety are bound to the Owner in the amount set forth above, for the payment of which the Contractor
and Surety bind themselves, their heirs, executors, administrators, successors and assigns, jointly and severally, as
provided herein. The conditions of this Bond are such that if the Owner accepts the bid of the Contractor within the time
specified in the bid documents, or within such time period as may be agreed to by the Owner and Contractor, and the
Contractor either (1) enters into a contract with the Owner in accordance with the terms of such bid, and gives such bond or
bonds as may be specified in the bidding or Contract Documents, with a Surety admitted in the jurisdiction of the Project
and otherwise acceptable to the Owner, for the faithful performance of such Contract and for the prompt payment of labor
and material furnished in the prosecution thereof; or (2) pays to the Owner the difference, not to exceed the amount of this
Bond, between the amount specified in said bid and such larger amount for which the Owner may in good faith contract with
another party to perform the work covered by said bid, then this obligation shall be null and void, otherwise to remain in full
force and effect. The Surety hereby waives any notice of an agreement between the Owner and Contractor to extend the
time in which the Owner may accept the bid. Waiver of notice by the Surety shall not apply to any extension exceeding sixty
(60) days in the aggregate beyond the time for acceptance of bids specified in the bid documents, and the Owner and
Contractor shall obtain the Surety's consent for an extension beyond sixty (60) days.
If this Bond is issued in connection with a subcontractor's bid to a Contractor, the term Contractor in this Bond shall be
deemed to be Subcontractor and the term Owner shall be deemed to be Contractor.
When this Bond has been furnished to comply with a statutory or other legal requirement in the location of the Project, any
provision in this Bond conflicting with said statutory or legal requirement shall be deemed deleted herefrom and provisions
conforming to such statutory or other legal requirements shall be deemed incorporated herein. When so furnished, the
intent is that this Bond shall be construed as a statutory bond and not as a common law bond.
Signed and sealed this 19th day of September , 2023
� GREAT AME CAN INSURANCE COMPANY
G�'/V��r/ ��
(Surety) � (Seat)
(Witness)
Ottomey-in-Fact) Deborah Knapp
The Company executing this bond vouches that this document conforms to American Institute of Architects Document A310 - 2010 Edition
GREAT AMERICAN INSURANCE COMPANY®
Administrative Office: 301 E 4TH STREET 0 CINCINNATI, OHIO 45202 • 513-369-5000 • FAX 513-723-2740
The number of persons authorized by
this power of attorney is not more than TEN
No. 0 21609
POW ER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS: That the GREATAMERICAN INSURANCE COMPANY, a corporation organized and existing under
and by virtue of the laws of the State of Ohio, does hereby nominate, constitute and appoint the person or persons named below, each individually if more than
one is named, its true and lawful attorney -in -fact, for it and in its name, place and stead to execute on behalf of the said Company, as surety, any and all bonds,
undertakings and contracts of suretyship, or other written obligations in the nature thereof; provided that the liability of the said Company on any such bond,
undertaking or contract of suretyship executed under this authority shall not exceed the limit stated below.
Name
KIMBERLY ASCHENBACH
BRIAN REIMER
DEBORAH KNAPP
DILLON HOLEWINSKI
RHONDA KLUESSENDORF
ZACHARY KAISER
ANNEMARIE WILLBANKS
LYNN CLAUSEN
SHELLEY RADATZ
NICOLE HEIL
Address Limit of Power
ALL OF ALL
MENASHA, WISCONSIN $100,000,000
This Power of Attorney revokes all previous powers issued on behalf of the attomey(s)-in-fact named above.
IN WITNESS WHEREOF the GREATAMERICAN INSURANCE COMPANY has caused these presents to be signed and attested by its appropriate
officers and its corporate seal hereunto affixed this 6TH day of DECEMBER 2022
Attest GREAT AMERICAN INSU ANCE COMPAN
A.ssivani Secretary Divisional Senior Yce President
STATE OF OHIO, COUNTY OF HAMILTON - ss: MARK viCARiO (877-377-2405)
On this 6TH day of DECEMBER 2022 , before me personally appeared MARK VICARIO, tome known,
being duly swam, deposes and says that he resides in Cincinnati, Ohio, that he is a Divisional Senior Vice President of the Bond Division of Great American
Insurance Company, the Company described in and which executed the above instrument; that he knows the seal of the said Company; that the seal affixed to the
said instrument is such corporate seal; that it was so affixed by authority of his office under the By -Laws of said Company, and that he signed his name thereto
by like authority.
SUSAN A KOHORST
n 'a Notary Public
State of Ohio
My Comm. Expires
May 18, 2025
This Power ofAttomey is granted by authority of the following resolutions adopted by the Board of Directors of GreatAmerican Insurance Company
by unanimous written consent dated June 9, 2008.
RESOLVED: That the Divisional President, the several Divisional Senior Vice Presidents, Divisional Vice Presidents and Divisonal Assistant Vice
Presidents, or any one of them, be and hereby is authorized, from time to time, to appoint one or more Attorneys -in -Fact to execute on behalf of the Company,
as surety, any and all bonds, undertakings and contracts of suretyship, or other written obligations in the nature thereof to prescribe their respective duties and
the respective limits of their authority, and to revoke any such appointment at any time.
RESOLVED FURTHER: That the Company seal and the signature of any of the aforesaid officers and any Secretary or Assistant Secretary of the
Company may be affixed by facsimile to any power of attorney or certificate of either given for the execution of any bond, undertaking, contract of suretyship,
or other written obligation in the nature thereof, such signature and seal when so used being hereby adopted by the Company as the original signature of such
officer and the original seal of the Company, to be valid and binding upon the Company with the same force and elect as though manually affixed.
CERTIFICATION
I, STEPHEN C. BERAHA, Assistant Secretary of Great American Insurance Company, do hereby certify that the foregoing Power of Attorney and
the Resolutions of the Board of Directors of June 9, 2008 have not been revoked and are now in full force and effect.
Signed and sealed this 19th day of September , 2023
Assistant Secretary
S1029AH (03/20)
RECEIV$D
OCT — 2 2023
DEPT OF PUBLIC WORKS
OSHKOSH, WISCONSIN
TO: ALL CONTRACTORS
FROM: ENGINEERING DIVISION OF
CITY OF OSHKOSH DEPARTMENT OF PUBLIC WORKS
SUBJECT: DISCLOSURE OF OWNERSHIP FORM
Please review the attached Department of Workforce Development Disclosure of Ownership form. If Item 3 on this
Disclosure of Ownership form applies to your company, you must complete the Disclosure of Ownership form and
upload in the appropriate location on Quest V-Bid.
If Item 3 on the Disclosure of Ownership form does NOT apply to your company, you must complete the
information below and upload this page in the appropriate location on Quest V-Bid.
CERTIFICATION
I certify by my signature below that Item 3 of the attached Disclosure of Ownership form does NOT apply to my
firm, or a shareholder, officer, or partner of my firm.
Name
Glenn Joski
Printed Name
President
Title
Advance Construction, Inc.
Company Name
10/2/23
Date
[:\ Engineering \Tracy Taylor\Public Works Contracts\ Miscellaneous \Disclosure of ownership Form_2-1-
17.docx
Page 1 of 1
City Hall, 215 Church Avenue P.O. Box 1130 Oshkosh, WI 54903-1 130 http://www.ci.oshkosh.wi.us
State of Wisconsin
Department of Workforce Development
Equal Rights Division
Disclosure of Ownership
The statutory authority for the use of this form is prescribed in Sections 66.0903(12)(d), 66.0904(10)(d) and 103.49(7)(d), Wisconsin
Statutes.
The use of this form is mandatory. The penalty for failing to complete this form is prescribed in Section 103.005(12), Wisconsin
Statutes.
Personal information you provide may be used for secondary purposes [Privacy Law, s. 15.04(1) (m), Wisconsin Statutes).
(1) On the date a contractor submits a bid to or completes negotiations with a state agency, local governmental unit, or
developer, investor or owner on a project subject to Section 66.0903, 66.0904 or 103.49, Wisconsin Statutes, the
contractor shall disclose to such state agency, local governmental unit, or developer, investor or owner, the name of
any "other construction business," which the contractor, or a shareholder, officer or partner of the contractor, owns or
has owned within the preceding three (3) years.
(2) The term 'other construction business" means any business engaged in the erection, construction, remodeling,
repairing, demolition, altering or painting and decorating of buildings, structures or facilities. It also means any
business engaged in supplying mineral aggregate, or hauling excavated material or spoil as provided by Sections
66.0903(3), 66.0904(2), 103.49(2) and 103.50(2), Wisconsin Statutes.
(3) This form must ONLY be filed, with the state agency project owner, local governmental unit project owner, or
developer, investor or owner of a publicly funded private construction project that will be awarding the contract, if both
(A) and (B) are met.
(A) The contractor, or a shareholder, officer or partner of the contractor:
(1) Owns at least a 25% interest in the "other construction business," indicated below, on the date the contractor
submits a bid or completes negotiations; or
(2) Has owned at least a 25% interest in the "other construction business" at any time within the preceding three
(3) years.
(B) The Wisconsin Department of Workforce Development (DWD) has determined that the "other construction
business" has failed to pay the prevailing wage rate or time and one-half the required hourly basic rate of pay, for
hours worked in excess of the prevailing hours of labor, to any employee at any time within the preceding three (3)
years.
Other Construction Business
Business Name
none
Street Address or P O Box
City
State
Zip Code
Business Name
Street Address or P O Box
City
State
Zip Code
Business Name
Street Address or P O Box
City
State
Zip Code
Business Name
Street Address or P O Box
City
State
Zip Code
I hereby state under penalty of perjury that the information, contained in this document, is true and
accurate accordina to my knowledge and belief_
- ----- -- ------
Print the Name of Authorized Officer
Glenn Joski
Authorize O i r S' na re
Date Signed
110/2/23
Corporation, Partn hip or Sole Proprietorship Name
Advance Con uction, Inc.
Street Address or P O Box
City
State
Zip Code
2141 Woodale Ave
Green Bay
WI
54313
If you have any questions call (608) 266-6861
ERD-7777 (R. 01/2011)
CONTRACT 23-24
ATTACHMENT A
LIST OF SUBCONTRACTORS
RECORD
OCT - 2 2023
DEPT OF PUBLIC WORKS
OSHKOSH, WISCONSIN
Pursuant to Section 66.29(7), Wisconsin Statutes, the Bidder, as part of this Proposal, submits this full and
complete list of all the Subcontractors and the class of work to be performed by each.
If the CONTRACTOR shall sublet any part of this Contract, the CONTRACTOR shall be as fully
responsible to the CITY for the acts and omissions of their Subcontractor and of the persons either directly
or indirectly employed by their Subcontractor as they are by acts or omissions of persons directly
employed by themselves. All Subcontractors, if any, shall be listed in the spaces provided on the
Proposal Form and said list shall not be added to or altered without the written consent of the CITY.
Signed, final waivers of lien will need to be provided to the CITY prior to the release of the final retainage
to the CONTRACTOR.
When a Subcontractor and the class of work to be performed are not listed, it shall be considered that the
Bidder will perform the work themselves.
NAME OF SUBCONTRACTOR
Ll.4n >>V4
CLASS OR ITEMS OF WORK
I hereby certify that the use of the name(s) of the above Subcontractor(s) was with the knowledge and
consent of the said Subcontractor(s).
Signature of B' er
Page 3 of 6
RECEIVED
CONTRACT 23-24 OCT - 2 2023
PROPOSAL DEPT OF PUBLIC WORKS
OSHKOSH, WISCONSIN
The undersigned will begin work as specified after award of the Contract and complete as specified.
I hereby certify that all statements are made in behalf of
Advance Construction, Inc.
(Name of Corporation, Partnership, or Person Submitting Bid)
a corporation organized and existing under the laws of the State of Wisconsin
a Partnership consisting of
an individual trading as
the City of
State of
or
of
That I have examined and carefully prepared this Proposal from the Plans and Specifications and have
checked the same in detail before submitting this Proposal; that I have full authority to make such
statements and submit this Proposal in (its) (their) behalf; and that said statements a rue and correct.
Al . i �-7
/ Signature
President
(Title, if any)
Subscribed and sworn to before me this 2 day of October 2023
�E A',
`,,, J� O
NOTARY`
Ita,'yLPublic, or other authorized to administer 3/17/26 =_
N jOUBLIG
O��``,`
or ... IGG
(Bidder should not add any conditions or qualifying statemens"t'c��tt1Ys�Proposal as otherwise the Proposal
may be declared irregular as not being responsive to the Advertisement.)
Accompanying this Proposal is a Bid Bond in the amount of 5 % of the total amount of the Bid, as
called for in the Official Notice to Contractors.
Page 6 of 6
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