HomeMy WebLinkAbout24-04 August Winters & Sonst
BID BOND CITY OF OSHKOSH
Contract Number 24-04 J" OF F't MU
Date Bond Executed (Date of Contract or Later) March 4, 2024
PRINCIPAL/CONTRACTOR (Legal Name and Business Address)
August Winter & Sons, Inc.
2323 N. Roemer Road, PO Box 1896
Appleton, WI 54911
SURETY(IES) (Legal Name(s) and Business Address(es))
Ohio Farmers Insurance Company
P.O. Box 5001
Westfield Center, OH 44251
OWNER (Legal Name and Business Address)
CITY OF OSHKOSH
215 Church Avenue
PO Box 1130
Oshkosh, Wisconsin'54903-1130
OBLIGA
Type of Organization
_ Individual _ Partnership
Corporation
State of incorporation
WI
Penal Sum of Bond
Five Percent of
Amount Bid (5%)
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 this
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 Bid and such larger amount for which the Owner may in good faith
contract with another party to perform the work covered in such Bid, then the Surety and the Contractor shall have
no obligation under this Bond.
Page I of 2
00430
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 (ii) two (2) business days following deposit in the United States mail,
postage prepaid; (iii) upon delivery by a commercial 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.
August Winter & Sons Inc.
Name of Principal/Contractor
Title lii dt 5
Ohio Farmers Insurance Company
Name of Surety
Title "Pflugrttor in -Fact
Page 2of2
00430
Surety Acknowledgment
State of Minnesota 7.
} ss.
County of Hennepin }.
On this 4th day of March 2024 before me personally came Haley Pflug, to me known,
who being by me duly sworn, did depose and say that she is the Attorney -in -Fact of
Ohio Farmers Insurance Company described in and which executed the above instrument; that she knows
the seal of said corporation; that the seal affixed to said instruments is such corporate seal, that it was so
affixed by order of the Board of Directors of said corporation, and that she signed her name to it by like
order,
.�._Ok<�i
o� '��, MICHELLE DIANE HALTER
`�
Notary Public
State of Minnesota
'` *�
�*
My Commission Expires
�ti �
January 31, 2028
THIS POWER OF ATTORNEY SUPERCEDES ANY PREVIOUS POWER BEARING THIS SAME
POWER # AND ISSUED PRIOR TO 01/18123, FOR ANY PERSON OR PERSONS NAMED BELOW.
General
Power
of Attorney
CERTIFIED COPY
POWER NO. 2263612 02
Westfield Insurance Co.
Westfield National Insurance Co.
Ohio Farmers Insurance Co.
Westfield Center, Ohio
Know All Men by These Presents, That WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO
FARMERS INSURANCE COMPANY, corporations, hereinafter referred to individually as a "Com any and collectively as "Companies," duly
organized and existing under the laws of the State of Ohio, and having its principal office in Westf aid Center, Medina County, Ohio, do by these
ppresents make, constitute and appoint
BRIAN D. CARPENTER, NICOLE LANGER, CRAIG OLMSTEAD, JESSICA HOFF, MICHELLE HALTER, HEATHER R. GOEDTEL,
KELLY NICOLE ENGHAUSER, BLAKE S. BOHLIG, LAURIE PFLUG, HALEY PFLUG, JOINTLY OR SEVERALLY
of BLOOMINGTON and State of MNits true and lawful Attorneys) -in -Fact, with full power and authority hereby conferred in its name,
place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings, or other instruments or contracts of
suretyship in any penal limit.... ....... • .... • .. . .. • _ . ' .. ... _ ..
LIMITATION: THIS POWER OF ATTORNEY CANNOT BE USED TO EXECUTE NOTE GUARANTEE, MORTGAGE DEFICIENCY, MORTGAGE
GUARANTEE, OR BANK DEPOSITORY BONDS.
and to bind any of the Companies thereby as fully and to the same extent as if such bonds were signed by the President, sealed with the corporate
seal of the applicable Company and duly attested by its Secretary, hereby ratifying and confirming ail that the said Attorney(s)•in-Fact may do in
the premises. Said appointment is made under and by authority of the following resolution adopted by the Board of Directors of each of the
WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY:
"Be It Resolved, that the President, any Senior Executive, any Secretary or any Fidelity & Surety Operations Executive or other Executive shall
be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attorney(s)-in-Fact to represent and act for
and on behalf of the Company subject to the following provisions:
The Attorney-fn-Fact. may be given full power and authority for and in the name of and on behalf of the Company, to execute, acknowledge and
deliver, any and all bonds, recognizances, contracts, agreements of Indemnity and other conditional or obligatory undertakings and any and all
notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such
Attorney -in -Fact shall be as binding upon the Company as If signed by the President and sealed and attested by the Corporate Secretary."
"Be it Further Resolved, that the signature of any such designated person and the seal of the Company heretofore or hereafter affixed to any
power of attorney or any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signatures or facsimile
seat shall be valid and binding upon the Company with respect to any bond or undertaking to which It is attached." (Each adopted at a meeting
held on February 8, 2000).
In Witness Whereof, WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE
COMPANY have caused these presents to be signed by their National Surety Leader and Senior Executive and their corporate seals to be hereto
affixed this 18th day of JANUARY A.D., 2023 .
Corporate
4� �Ae, ��`'11*. %ONA
.. t, ",'',,, s F• a WESTFIELD INSURANCE COMPANY
•,,,..' •• WESTFIELD NATIONAL INSURANCE COMPANY
Affixed �d'��wb. �h ? da' •'G�' = ! OHIO FARMERS INSURANCE COMPANY
SEAL M:
1848
•' �b
,'+,,lll••.1)111�„f51\I•``\``•• �Ii++NiM11NN\",v'•
State of Ohio ByGary Wfuumpe?rNationa(lurety Leader and
County of Medina ss.:Senior Executive
On this 18th day of JANUARY A.D., 2023 , before me personally came Gary W. Stumper to me known, who, being by me duly sworn,
did depose and say, that he resides in Medina, OH, that he is National Surety Leader and Senior Executive of WESTFIELD INSURANCE
COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY, the companies described in and which
executed the above instrument; that he knows the seals of said Companies; that the seals affixed to said instrument are such corporate seals; that
they were so affixed by order of the Boards of Directors of said Companies; and that he signed his name thereto by like order.
Notarial
Seal
Affixed
State of Ohio N o David A. Kotnik, Attorney at Law, Notary Public
County of Medina ss.: q My Commission Does Not Expire (Sec. 147.03 Ohio Revised Code)
1, Frank A. Carrino, Secretary of WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHiO FARMERS
INSURANCE COMPANY, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said
Companies, which is still in full force and effect; and furthermore, the resolutions of the Boards of Directors, set out in the Power of Attorney are
in full force and effect.
In Witness Whereof, I have hereunto, set my hand and affixed the seals of said Companies at Westfield Center, Ohio, this 4th day of
March A.D., 2024
IS v
50
4
'�7Et�U ime ' 11 Sgcrwtwy
184
`ti...,".'�:,..�' "`.,� ' •. °��: + '• ° ..•�' + s Frank A. Carrino, Secretary
BPOAC2 (combined) (03-22)
AFFIDAVIT OF NON -COLLUSION
0Sf'K0 SH, WF,`;CiJS i!
STATE OF
Wisconsin
COUNTY OF Outagamie
I Hereby swear (or affirm) under the penalty of perjury:
1) That I am the bidder (if the bidder is an individual), a partner in the bidder (if the bidder is a
partnership) or an officer or employee of the bidder corporation having authority to sign on its behalf
(if the bidder is a corporation);
2) That the attached bid or bids have been arrived at by the bidder individually and have been
submitted without collusion with, and without any agreement, understanding or planned common
course of action with any other vendor of materials, supplies, equipment or services described in the
Official Notice to Bidders designed to limit individual bidding or competition;
3) That the contents of the bid or bids have not been communicated by the bidder or its employees or
agents to any person not an employee or agent of the bidder or its surety on any bond furnished with
the bid or bids, and will not be communicated to any such person, prior to any official opening of the
bid or bids; and
4) That I have fully informed myself regarding the accuracy of the statements made in this affidavit.
Subscribed and sworn to before me this
1st day of March 20 2024
tttttlllrrr�
Sea
�X \AoraRr �=
'��rulitttt�
.r .
Bidder's Signature
Travis Glennon, Assistant Secretary
Title
August Winter & Sons, Inc.
Company
00450.1
City of Oshkosh
Contractor Safety Acknowledgement for Risk Management Program Facilities\ l,`
Check the appropriate facility: Water Filtration Plant X_Wastewater Treatment PIahtA
While working at this facility, all contract personnel are expected to conduct their business within the guidelines set
forth by all local, state, and federal requirements. The City of Oshkosh has the right to inspect the work site for
environmental, health, and safety violations, as well as for job performance.
This facility has certain regulatory requirements to adhere to a Risk Management Program. This facility is regulated
because it stores, transfers, or processes a sufficient quantity of the following substances:
• Chlorine
The purpose of this Checklist is to ensure the CONTRACTOR is advised of the Risk Management Program
requirements for this facility and while working on, around, or involved in, a regulated process maintains the
standard of safety and accident -prevention as set forth in the facility's Risk Managentent Plan (RMP). This facility's
goal is to prevent any accidental releases of regulated substance(s). To do this, the person responsible for RMP
compliance at this facility will, as a minimum requirement:
• Make available a copy of the most current RMP to the CONTRACTOR.
• Inform the CONTRACTOR of known hazards associated with completing their work at this facility.
• Inform the CONTRACTOR of known hazards deemed unique to this facility or process.
• Show the CONTRACTOR the location of the SDS file or provide the CONTRACTOR with copies.
• Provide the CONTRACTOR with a copy of the Emergency Response Plan.
• Provide the CONTRACTOR with sufficient time and access to expertise to answer any questions.
• Sign as a facility representative, and require the signature of a CONTRACTOR representative, attesting the
requirements of this checklist, at a minimum, have been executed.
The person responsible for RMP compliance at this facility may also, at their option, require:
• A certificate of insurance from the CONTRACTOR.
• The CONTRACTOR to name the facility as an additional insured on their insurance certificate.
• Require the CONTRACTOR to produce copies of any paperwork, including, but not limited to, permits,
training certificates, written procedures, maintenance records, etc, upon request.
• Checking for CONTRACTOR's use of required Personal Protective Equipment, such as safety glasses,
goggles, respirators, etc.
• The CONTRACTOR to provide the facility with the SDS for any substance brought on site.
• The CONTRACTOR to report all accidents or injuries that occur onsite within a set timeframe.
• Copies of any written procedures, reports, or other documentation produced as a result of an accidental
release at this facility.
We hereby certify we have reviewed this information and will (or have) completed the requirements set forth above,
and all work will be performed in compliance with the requirements outlined herein.
I �— March 1, 2024
(Contractor's Signature)
August Winter & Sons,
(Company Name — Contractor) Please Print
Travis Glennon, Assistant
(Date) (Facility Representative's Signature) (Date)
Inc.
Secretary
(Company Name — Facility) Please Print
00470
I:\Wastewater\18-16 Digester Mixing Upgrade\Project_Lifonnation\Contract Info\Contract Book\18-16 Page I of 1
Contractor Safety Acknowledgement Fonn_5-21-19.docx
City
of
Oshkosh
TO: ALL CONTRACTORS
FROM: ENGINEERING DIVISION OF
CITY OF OSHKOSH DEPARTMENT OF PUBLIC WORKS
SUBJECT: DISCLOSURE OF OWNERSHIP FORM
I ,.
@,Il ('11 i li}>„ iE
0811KRSH,
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 Oznership form does NOT apply to my
firm, or a shareholder, officer, or partner of my firm.
�,�``� ,eQ-4�
Name
Travis Glennon
Printed Name
Assistant Secretary
Title
August Winter & Sons, Inc.
Company Name
March 1, 2024
Date
l.•\Engineering\Tracy Taylor\Public Works Contracts\Miscellaneous\Disclosure of Ownership Form_2-1-
17.docx
00440
Page 1 of 1
City Hall, 215 Church Avenue P.O. Box 1130 Oshkosh, WI 54903-1130 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 according to my knowledge and belief.
Print the Name of Authorized Officer
Travis Glennon, Assistant Secretary
Aut_hofted OfficerSignature
Date Signed
March 1, 2024
Corporation, Partnership or Sole Proprietorship Name
August Winter & Sons, Inc.
Street Address or P O Box
City
State
Zip Code
2323 N. Roemer Road
Appleton
I WI
154911
If you have any questions call (608) 266-6861
ERD-7777 (R. 01/2011)
00440
NON-DISCRIMINATION AFFIDAVIT a,
;trMAC
f
iNs'I Pq
I, the undersigned, state that the organization which I represent will be in
compliance with the applicable Federal and State Statutes concerning
Affirmative Action, non-discrimination and Equal Employment
Opportunity.
Authorized Signature
Position Assistant Secretary
Name of Firm August Winter & Sons, Inc.
Date March 1, 2024
00460-1
ARTICLE 9 — BID SUBMITTAL
SUBMITTED ON March 4 20 24
State Contractor License No. HVAC: 120264 . (If applicable)
Master Plumber: 871958 <,s
If Bidder is: � ��;r�.:;:: ��a:��r 4:ra :,�
An Individual
Name (typed or printed):
By:
Doing business as:
Business address:
Phone No.:
A Partnership
Partnership Name: _
By:
(Sig
Name (typed or printed):
Business address:
N/A
(Individpal's signature)
N/A
of general partner — attach evidence of authority to
(SEAL)
(SEAL)
Phone No.: FAX No.:
A Corporation
Corporation Name: August Winter & Sons, Inc. (SEgj)
State of Incorporation: Wisconsin Y
Type (General usiness, Professional, Service, Limited Liability): General Business '
By:
nature — attach evidence of authority to
Name (typed or printed): Mark Eimmerman
Title: President
(CORPORATE SEAL)
Attest: ( )V
(Signature of Corporate Secretary)
Business Address: 2323 N . Roemer Road, Appleton, WI 5,4911
Phone No: 920-739-8881 FAX No.: 920-739-2230
Date of Authorization to do business is Since 1929 ( Incorporated 4 /27 /1953 )
BID FORM Donohue & Associates, Inc.
A1-00411-6 Project No. 14316
A Joint Venture
N/A
Name of Joint Venture:
First Joint Venturer Name:
By:
(Signature of joint venture
Name (typed or printed):
Title:
Business address:
Phone No.:
Second Joint Venturer Name:
By:
(Signature of joint venture
Name (typed or printed):
Title:
Business address:
Phone No.:
r — attach evidence of authority to
FAX No.:
— attach evidence of authority to sign)
FAX No.:
Phone and FAX Number, and Address for receipt of official communications:
(SEAL~)
(Each joint venturer must sign. The manner of signing for each individual, partnership, and
corporation that is a party to the joint venture should be in the manner indicated above.)
Donohue & Associates, Inc. BID FORM
Project No. 14316 A1-00411-7
CERTIFIED COPY OF RESOLUTION OF BOARD OF DIRECTORS
OF AUGUST WINTER & SONS, INC.
I, Gerald J. Hietpas, hereby certifying that I am duly elected and qualified
Secretary of August Winter & Sons, Inc, and keeper of its records and the Corporate
Seal and that the following is true and correct copy of a Resolution duly adopted at a
special meeting of the Board of Directors of said August Winter & Sons, Inc. duly
convened in accordance with the By -Laws of said Corporation at its office at Appleton,
Wisconsin, on the 141" day of June, 2019.
RESOLVED, that Mark M. Eimmerman, President, and Gerald J. Hietpas,
Vice -President, Secretary and Treasurer, and Travis B. Glennon, Assistant
Secretary and Assistant Treasurer, and each of them is hereby authorized to
execute all contracts and all other papers necessary in the transaction of the
Corporation's business and to bind the Corporation by such execution without
any other signature of any other Officer.
IN WITNESS WHEREOF, I have hereunto affixed my name as Secretary and
have caused this Corporate Seal of said Corporation to be hereto affixed this 101 day of
.Tune, 2019.
Gerald J. Hietpas, Secret ry
(CORPORATE SEAL)
I, Gerald J. Hietpas, a Director of said Corporation do hereby certify that the
foregoing is a correct copy of a Resolution passed as therein set forth.
Gerald J. Hietpas, Direct
PROPOSED SUBCONTRACTOR LISTING`�``�
rir Ii �5' i'r) .P,k€ '+xi ti irs
Pursuant to Section 66.29(7), Wisconsin Statutes, the Bidder, as part of this Bid Form,
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.
Approximate % of the
Name Address Phone Contract Amount
JT Rams, LLC
350 S. Tower St.
Suite #2
Saukville WI 53080
262-242-8174
50 o
BID FORM Donohue & Associates, Inc.
A1-00411-8 Project No. 14316