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Home My WebLink About24-12 Carl Bowers & Sons ConstructionBID BOND CITY bfr OSHKOSH Contract Number 24-12 East 7th Avenue and Grand Street Reconstruction ; Date Bond Executed (Date of Contractor Later) A er< < i Zb o PRINCIPAL/CONTRACTOR (Legal Nance and Business Address) Carl Bowers & Sons Construction Co Inc N1844 Maloney Road Kaukauna WI 54130 SURETY(IES) (Legal Name(s) and Business Address(es)) Merchants Banding Company (Mutual) PO Box 14498 Des Moines IA 50306-3498 OWNER (Legal Name and Business Address) CITY OF OSHKOSH 215 Church Avenue PO Box 1130 Oshkosh, Wisconsin 54903-1130 OBLIGATION Type of Organization Individual —Partnership X Corporation State of Incorporation WI Penal Sum of Bond 5% of bid amount The Contractor and Surety, jointly and severally, bind themselves, their heirs, executors, administrators, successors, and assigns to the Owner for the amount of the penal sum identified above if the Owner accepts the bid of tivs Contractor within the time specified in the Bid documents or within such time period as may be agreed upon between the Owner and the Contractor, and the Contractor shall fail to execute the Contract within five (5) business days of written notice to the Contractor and Surety of Owner's intent to make a claim upon this Bond. 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. If the Contractor either enters into a contract with Owner in accordance with the terms of the Bid and gives such bond(s) that may be specified in the Bidding documents for the faithful performance of the Contract and for the prompt payment of labor, materials, and supplies furnished for the purpose thereof; or pays to the Owner the difference between the amount specified in the Sid and such larger amount for which the Owner may in good faith contract with another party to perform the work covered in such laid, then the Surety and the Contractor shall have no obligation under this Bond. Page 1 of 2 Notice to the Contractor or Surety shall be deemed to have been given. (i) upon delivery to an officer or person entitled to such notice, if hand delivered; or (R) two (2) business days following deposit in the United States mail, postage prepaid; (iii) upon delivery by a couunercial carrier that will certify the date and time of delivery; or (iv) upon transmission if by facsimile, e-mail, or other form of electronic transmission. Notices shall be provided to the Owner, Surety, and/or Contractor at their address as specified on this Bond or to a facsimile, e-mail or other electronic address that has been provided in writing to the other party to be used for this purpose. The laws of the State of Wisconsin shall govern the interpretation and construction of this Bond. Winnebago County shall be the venue for all disputes arising under this Bond. Any provision in this Bond that may conflict with statutory or other legal requirement shall be deemed deleted herefrom and provisions conforming to the statutory or other legal requirement shall be deemed incorporated herein. ame of Prue pal/Contractor tU /V' �t rxy- Title 11�x�4 N f Sure erchants Bonding Company (Mutual), Cayden Janse Attorney -in -Fact Title Page 2 of 2 MERCHAN BONDING CO,(vt.PANY.s 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, d/b/a Merchants National Indemnity Company (in California only) (herein collectively called the "Companies") do hereby make, constitute and appoint, individually, Brad Van Camp; Brian Christ; Cayden Janse; Darrel Zaleski; David R Snook; Justin Tropes; Karena Froom; Kim Syverson; Kristin Boevers; Kristina Blaney; Linda D Covey; Lynn Hendrickson; Mary Hutsop Clark; Michael L Tiedt; Mike Ladwig; Nicole Andersen; Patrick Arendt; Regina Keller 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, 2016 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 obligatory 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 seat when so used shall have the same force and effect as though manualtyfixed," 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 Altomey-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 3rd day of February 2024 rpA rFrlir °"`•(it1N�+'', ,4`0� 0'a• MERCHANTS BONDING COMPANY (MUTUAL) °'t3�;.•• •.'� �,'+f{ «°d �� MERCHANTS NATIONAL BONDING, INC. pi R;Q ® ��?; 4Z$ ,9 d/b/a MERCHANTS NATIONAL INDEMNITY COMPANY 20031933 s, d -� •`1�`• PreSirlenf STATE OF IOWA , �++++li!l�irtr°'°a e° «®«• 4 0,t, 4 + a COUNTY OF DALLAS as. On this 3rd day of February 2024 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 seats affixed to the foregoing instrument are the Corporate Seals of the Companies; and that the said instrument was signed and sealed in behalf of the Companles by authority of their respective Boards of Directors. �ri�,tA<s�, Penni Miller z r- Commission Number787952 Y My Commission Expires 10M January 20, 2027 ` Not b11pl1, (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-ATi'ORNEY 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 day of '20Z1 U�~ 2003`, 1933 Secretary PQA0018(1/24) *+iirir°,ir� .044« THE AMERICAN INSTITUTE OF ARCHITECTS AIA Doc: urneni A31 D Bid v nd A NQg Bond No,; 462311 KNOW ALL MEN BY THESE PRESENTS, that we Carl Bowers & Sons Construction Co., hie, N1844 Maloney Road, Kaukauna, WI 54130 as Principal, hereinafter call the Principal, and Merchants Bonding Company (Mutual) P.O. Box 14498, Des Moines, Iowa 50306-3498 a corporation duly organized under the laws of the State of Iowa as Surety, hereinafter called the Surety, are held and firmly bound unto City of Oshkosh 215 Church Ave, PO Box i 130 Oshkosh, WI 54903-1130 as Obligee, hereinafter called the Obligee, in the sum of Five. Percent of Bid Arnount Dollars ($ 5 % } for the payment of which sum well and truly to be rnade, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these prescents. WHEREAS, the Principal has submitted a bid for Contract 24-12 East ?th Avenuc and Grand Street Reconstruction NOW "THEREFOR(:, if the Obligee shall accept the bid of the Principal and the Principal shall enter into a Contract with the Obligee in accordance with the terms of such bid, and give such bond or bonds as may be specified in the bidding or Contract Documents with good and sufficient surety for the faithful performance of such Contract and for the prompt' t payment of labor and materials furnished in the prosecution thereof, or in the event of the failure of the Principal to eriter ; such Contract and give such bond or bonds, if the Principal shall pay to the Obligee the difference not to exceedthe penalty hereof between the amount specified in said bid and such larger amount for which the Obligee nray iwood faith " contract with another party to perform the Work covered by said bid, then this obligation shall be null and void othetw{se to remain in full force and effect. Signed and sealed this 1501 day of March 2024 Carl & Sons Construction Co., Inc. )Bowers (Prindpal) a ry ------- _ (Title), , Merchants T3ondin ? Com an(Mutual) (Witness) U7e Michael L, Tiedt Attorney-m-l;act c" AIADOC:UMENTA3t0,081Df3OND#AIA@+FF13RUARY1970ED.sTHI.AMERICAN lNST1TUTE OF ARCHil"EC:1:5, 1735 N.Y. AVE„ N.W., WASHINGION D,C. 2.0006 'r J, ; Bond #; 462311 MERCHAN BONDING COMPANY,,. POWER OF ATTORNEY Know All Persons By Those Presents, that MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL. BONDING, INC., both being corporations of the State of Iowa, d/b/a Merchants National Indemnity Company (in California only) (herein collectively called the "Companies") do hereby make, constitute and appoint, individually, Michael l., Tledt their true and lawful Attorney(s)-i n- Fact, to sign Its name as surety(les) 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 obligatory In the nature thereof." "The signature of any authorized officer and the seal of ilia 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 alit 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 Stale 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 seated this 15th day of March 2024 �rysy{{rrr{yry aa.. •"a +oc .t JO sj,� .," '" , � Cp "a MERCHANTS BONDING COMPANY (MUTUAL) .•°�aQ........... fyCt + ",° 4.•' '•,. fp`+® MERCHANTS NATIONAL BONDING, INC. �y1', CJ •.'pCr+)'prQ '•,9 " dlbla MERCHANTS NATIONAL INDEMNITY COMPANY A. p v' 2003 e i933; Y. A5C By STATE OFIUWA {{{yy{r.{'{y''y "a»•+a+" President COUNTY OF DALLAS ss. On this 15th day of March 2024 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 scaled in behalf of the Companies by authority of their respective Boards of Directors. �pptA(s Penni Miller i a • y Commission Number 787952 ® * My Commission Expires town January 20, 2027 gtary T c (Expiration of notary's commission-� does not invalidate this instrument) 1, 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. i In Witness Whereof, I have hereunto set my hand and affixed the seal of the Companies on this 15th day of March 2024 y',ytyy{t{{{{• yak " °�. ;"°Q�Pi)ft�•,�+� 2003 �?� ``�'� 1933 Secretary POA0018 (1/24) �Y',,,iiW,yi,,s•JJ y+asy+ 3 �Ia1 DATE (MM/DDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 3/15/2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terns and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER CONTACT KBStm BOOVerS S )ectrurn Insurance Group PH`G --- 3 3 Packeriand Dr., Ste C '`I'°,'", zfa_Extl 9.?0 28 2431._ _.. _ I (Aic No):92o 385 0855 _ Green BayWI 54303 E MnIL gRFss_kllsiln_ ocvcrs spaotruminsgroup,rom ____—_ Ark INSURED C Carl Bowers & Sons Construction Co Inc)1.f-T (, N1844 Maloney Rd „_ r , t, v.l Kaukauna WI54130 INSURERS} AFFORDING COVERAGE NAIC # ._.. 3_n Selective Insurance CGmpany_ 12572 i B Selective Insurance Company of South Carolina _ t9259 3_C......... ........ .. ._.__. _ _. --- __.__.__.. tD: COVFRAnFS r r-PTIKI(':ATF NI IMRGR, ArrRRr1rr 144:11101nm NIiAAr1ro. THIS 15 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE. FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT 1'0 WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ...... .. ... _ ---- _- _-. . ............... . . ____..__, INSR __.-... ADDL SUOR' ._____..._.... ... .. ... . .... POLICY EFF POLICY EXP L TYPE OF INSURANCE POLICY NUMBER M D MM/DDlYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY S 2553019 411/202:3 411/2024 EACH OCCURRENCE $1,000,000 A - ----_. ....... i.,. ... -..�) CLAIMS-h1ADE t J OCCUR PREtd SES Ea ecnmetico b 500,OOfl ED MExP (rnyw, ,�rwry $1s coo PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 0ENERALAGGRE6A rE' $ 2 000 OLIO PRO POLICY l X X_; LOG PRODUCTS-COMP/OPALG -- — -- .._ $2,000,000 OTHER: _ I S AUTOMOBILELIABILITY S 2551019 4/1%2023 4/112024 L_C(.DaMaccNdEeDntS)IGLCLIITA _—,_X _. $1,000,000 ANYAUTO BODILY INJURY (Per Poison) $ OWNED ; SCHFOULED- AUTOS ONLY AUTOS BODILY IN Il1RY (Par ar urfent) S F X _ HIRED X NNON-OWNEDPROahRiYLlAh1ME — _ - $ AU 108 ONLY _... AUTOS ONLY . {Pete nu�danl) I UMBRELLAUAB OCCUR 255019 4/112023 41JI02-EACHOCCURRNCE __$..5,0__0....0_.,000A _..-_...- _.....-.--.__ EXCESS LIAB CLAIMS -MADE .[X AGGREGATF $ 5,00U,OQQ L} D X RETENTION R WORKERS COMPENSATION WC9135809 4/1/2023 4/112024 _ X STATIJ'n=_ ` AND EMPLOYERS' LIABILITY YIN i ,.�L{H. ANYPROPRIETOR/PARTNLR/EXECUTIVE N F..L, EACH A4CIDEN 1 $ 50Q,000 Off-ICEItlMEMDGRI:XCLIJ 7-D9 N 1 A Atandnto in NH ( ry ) E.L. ) SEASE - EA EMPE OYEr $ 50Q,000 if yes, describe under _ _._-_------_—r.... ..... DESCRIPTION OF OPERAI7ONS below I E.I.. DISEASE - POLICY UMI1 $ 500,000 A Ranted/Lr:ased Fquivnenl 5 2553019 4/1%20`L3 i 4l1(2U24 Equipment Limit $3(JU,000 A Installation Floatar S 2553019 4(112023 1 4/112024 instatbaflnn Limit $2,000,000 DESCRIPTION OF OPERATIONS i,LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) 4l1 /2024 Bid for Contract 24-12 East 7th Avenue & Grand Street Reconstruction City of Oshkosh 231 Church Ave PO Box 1130 Oshkosh WI 54003-1130 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE.. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRPSFNTATIVE n r CU 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD TO: FROM: SUBJECT: M. t city f Oshkosh ALL CONTRACTORS ENGINEERING DIVISION OF CITY OF OSHKOSII DEPARTMENT OF PUBLIC WORKS DISCLOSURE OF OWNERSHIP FORM lE if t. �� ffJt� Please review the attached Department of Workforce Development Disclosure of Owmership 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 Ozonership 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. CF,RTIFICATION 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. J, i �---- Name � �er Printed Name �PiUi�- �4�1 �i' a6we-o Title Company Name 411 lzo -z-g Date 1:ltingtnee.ringl'rra(:y9ayl0rlPub9c Ownership Fonu_2'1Page 1 of ] 17.docr City Nall, 215 Church Avenue P.O. Box 1130 Oshkosh, WI 54903-1 130 http://www.ci.osl)kosh,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. 16,04(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 ,{ /one - 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 Cade 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 according to my knowledge and belief. Print the Name of Authorized Officer �r11 �0t.✓G4 Authorized Officer Signature .- -- - Date Signed Corporation, Partnership or Sole Proprietorship Name 6Ct,r1 9VWe_",3 , 60k1,4 Street Address or P O Box Nl d qq Wtnr(.9, ?e'y k'V(61 Jkaulr City ally State �,� Zip Code S �I � If you have any questions call (608) 266.6861 ERD-7777 (R. 01/2011) r,A Citywof Oshkosh A� �i , TO: ALL CONTRACTORS FROM: ENGINEERING DIVISION OF CITY OF OSHKOSH DEPARTMENT OF PU3LTC WORKS SUBJECT: SOR, AND GROUND WATER MANAGEMENT PLAN CERTIFICATION I certify by my signature below that our firm has read the Soil and Ground ]'hater Management Plat) included in the Specifications and wit] comply with the requirements of the Plan. —I- Name ILr2 1)0�� Printed Name �,-ewl,hW4 A166OU41,if— Title 44 weri � Ojs &e Company Name q1j /?�,q Zjx Date Works Con1rads\Nfisce11aneovs\$ofl & Groundivater Page 1 of 1 Management Plan CertMcotioik-2-1-17.du« City Hall, 215 Church Avenue M.sox 1130 Oshkosh, WI 54903-1130 h0p://www.cl,oshkosh.wWs CONTRACT 24-12 ATTACHMENT A LIST OF PROPOSED SUBCONTRACTORS 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, The CONTRACTOR will be permitted to sublet a portion of the Contract, but shall perform with their organization work amounting to at least thirty percent (30%) of the original Contract amount. Work performed by the CONTRACTOR for any Bid Item that had been subcontracted will not be included towards the thirty percent (30%) calculation. 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 SU13CONTRACTOR lzld Lp/ CLASS OR ITEMS OF WORK PAS %,II q _ PERCENT OF CONTRACT AMOUNT -Z0 ; -. 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 Bidder Page 19 of 22 (Revised) CONTRACT 24-12 PROPOSAL 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 Gail 25o rVell -4 .5orl,5 � (Name of Corporation, Partnership, or Person Submitting Bid) a corporation organized and existing under the laws of the State of I'i`.�G0PI31.,9 a Partnership consisting of or an individual trading as of the City of State of _v That I. have exannined 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 are true and correct. Subscribed and sworn to before me this % s� day of Notary Public, or other authorized to adininister Signature (Title, if. any) ADAM CARL BOWERS Notary Public State of Wtsconsin 20-9—q. (Bidder should not add any conditions or qualifying statements to this Proposal as otherwise the Proposal may be declared irregular as not being responsive to the Advertisement.) Accompanying this Proposal is a Biel Bond in the amount of b- °/0 of the total amount of the Bid, as called for in the Official Notice to Contractors. Page 22 of 22 (Revised)