HomeMy WebLinkAbout24-08 Classic Protective CoatingsBID BOND ;; : f CITY OF OSHKOSH
Contract Number 24-08
Date Bond Executed (Date of Contract or Later) 01 /24/2024
PRINCIPAL/CONTRACTOR (Legal Name and Business Address) Type of Organization
Classic Protective Coatings Inc. Individual _Partnership
N7670 State Rd. 25 —
Menomonie, WI 54751 x Corporation
State of Incorporation
Wisconsin
SURETY(IES) (Legal Name(s) and Business Address(es)) Penal Sum of Bond
Western Surety Company 5% of Amt. Bid--
151 N Franklin Street, 17th Floor
Chicago, IL 60606
OWNER (Legal Name and Business Address)
CITY OF OSI-IKOSI I
215 Church Avenue
PO Box 1130
Oshkosh, Wisconsin 54903-1130
OBLIGATION
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 stun 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 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 (if) 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.
Classic Protective Coatings Inc.
Name of Principal/Contractor
Title
Michael Burke, Chief Operations Officer
,�ttt� •��
Western Surety Company
Name of Surety
M Klein, Attorney -in -Fact
Page 2 of 2
INDIVIDUAL OR PARTNERSHIP ACKNOWLEDGMENT
STATE OF
COUNTY OF
On this day of , before me
personally appeared
to me known to be the person described in and who executed the forgoing
bond, and acknowledged that he executed the same as free
act and deed.
Notary Public
CORPORATION ACKNOWLEDGMENT
STATE OF
COUNTY OF
s
On this day of V �� , UM , before me
personally came Michael Burke to me known,
who being by me duty sworn, did depose and say; that he is the Chief. Operations Officer
of Classic Protective Coatings, Inc. ,
the corporation described in and which executed the above instrument; that he knows the seal
of said corporation; affixed by order of the Board of Directors of said corporation, and that he
signed his name thereto by like order.
c
SURETY ACKNOWLEDGMENT =
STATE OF MINNESOTA O Z /C �•�~
COUNTY OF HENNEPIN
/���,�SCONS��
On this 24th day of January , 2024 > beirie
appeared STEPHEN M. KLEIN to me personally known, who, being
duly sworn, did say that he is the Attorney -in -Fact of Western Surety Company
of Sioux Falls, SD
that the seal affixed to the foregoing instrument is the corporation seal of said corporation;
that the said instrument was signed and sealed on behalf of said corporation by authority of
its Board of Directors; and he did also acknowledge that he executed the said instrument as
the free act and deed of said Company.
otary Public
w KARLA J DVUTSCH BUNT
NDFAAV P,18ur'
` -iav JAN Ji. 2921
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 scat herein affixed hereby make, constitute and appoint
Wendy M Schmid, Sheryl L Cohen, John C Klein, .Till M Lowder, Mill M Lowder, Stephen M Klein, Christine Scott,
Lynn Dvergsten, Kristin M Bakos, Emily Tschimperle, DeeAnn Briegel, Rita Carlson, Karla Deutsch -Hunt, Thomas
Towner, Kerri Hatton-Rudnik, Michael Zalm, Emily Tschimperle, Tracy Chehoski, Individually
of Minneapolis, MN, its into and lawful Atiomey(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 Authorizing By -Laws and Resolutions punted at the bottom of this page, 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 3rd day of January, 2024,
X.�." WESTERN SURETY COMPANY
aSUAEI :~No'
Ht{rtj
'o�•,.....,,ra v�,fknramp a
Lary Kasten, Vice President
Stale or South Dakota 2
County ofMinnehaha
i ss
On this 3rd day of January, 2024, before me personally came Larry Kasten, to me known, who, being by me duly swom, did depose and say: that lie resides in the
City of Sioux Falls, State of South Dakota; that he is a 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.
�44444444Wb444444ibi 4 +
My commission expires M. BENT +{
HOTAnY PUBLIC
March 2, 0026 _ sec SOUTH DAKOTA
�4bbibbbbhibibbhbbhbb404i r ' //
M. Bent, Notary Public
CERTIFICATE
1, 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-La)v and Resolutions of the corporation printed below this certificate are still in force. In testimony whereof I have hereunto subscribed my name and
affixed the seal of the said corporation this 24th day of January . 2024
,SvaErrr"° WESTERN SURETY COMPANY
a a,.•.. o s
€1�1�oQQ0�a'F�y
cyt�TH,DPµ�a �" L. Ne1SOn, Assistant Secretary
WihYNI1NINt��
Authorizing By -Laws and Resolutions
ADOPTED BY TIIE SIiAREHOLDERS OF WESTERN SURETY COMPANY
This Power of Attorney is made and executed pursuant to and by authority of tho following By -Law duly adopted by the shareholders of the Company.
Section 7. All bonds, policies, undertakings, Powers of Attorney, or other obligations of the corporation shall be executed in the corporate name of the Company by
the President, Secretary, and Assistant Secretary, Treasurer, or any Vice President, or by such other officers as the Board of Directors may authorize. The President, any
Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys in Pact or agents who shalt have authority to issue bonds, policies, or
undertakings in the name of the Company. The corporate seat is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other
obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile.
This Power of Attorney is signed by Larry Kasten, Vice President, who has been authorized pursuant to the above Bylaw to execute power of attorneys on behalf of
Western Surety Company.
This Power of Attorney may be signed by digital signature and settled by a digital or otherwise electronic -formatted corporate seal under and by the authority of the
following Resohttion adopted by the Board of Directors of the Company by unanimous written consent dated the 27" day of Apil, 2022:
"RESOLVED: That it is in the best interest of the Company to periodically ratify and confinn any corporate documents signed by digital signatures and, to ratify and
confirm the use of a digital or othcnviw electronic -formatted corporate seal, each to be considered the act and deed of the Company."
Go to www,cr asuretv.com > Owner / Obligee Services> Validate Bond Coverage, if you want to verify bond authenticity.
Fonn F4280-0.2023
ARTICLE 5 — BID SUBMITTAL
5.01 BIDDER hereby submits this Bid through QuestCDN.com
Bidder: Classic Protective Coatings, Inc.
(typed
By; '2' �j'Got�
Name: Michael Burke
Title: Chief of Operations
Date: 1-26-24
printed narne of organization)
(individual 's signature)
3< ,
If Bidder is a corporation, a partnership, or ajoint venture, attach evidence of authority to sign.
Attest:
e
T
�,41111t
(individual's signature)
Name:
RayWitke,
A
Title:
President
Date:
1-26-24
Address for giving notices:
N7670 State Road 25 Menomonie, WI 54751
�'' ►, + �.
Bidder's Contact and Agent for Service or Process:
Name: Travis Nelson
Title: Estimator
Phone: 715-233-6267
Email: Travis@classicprotectivecoatings.com
(Email will be used for Electronic Document 'Transfer Protocol)
All Business Entities
Date of Qualification to do business in Wisconsin [&ate Where Project is Located] is
7 \6 \2016
OSHKOSH - BID FORM - 5
'IE
FLORIDA DEPARTMENT OF STATE
Division of Corporations
January 20, 2021
CLASSIC PROTECTIVE COATINGS, INC.
N 7670 STATE HWY 25
MENOMONIE, WI 54751-5928 US
Re: Document Number P00000079477
The Articles of Amendment to the Articles of Incorporation for CLASSIC PROTECTIVE
COATINGS, INC., a Florida corporation, were filed on January 8, 2021,
The certification requested is enclosed.
Should you have any question regarding this matter, please telephone (850) 245-6050,
the Amendment Filing Section.
Yasemin Y Sulker
Regulatory Specialist III
Division of Corporations Letter Number: 921 A00001 285
www.sunbiz.org
Division of Corporations - P.O. BOX 6327 -Tallahassee, Florida 32314
BI'purtmp"t of #tatp
The document numberof this corporation is P0000007
CVE-022 (01-1t)
;Gau*Gee
Secretary of State
N
Articles of Amendment
to
Articles of Incorporation
of
(Doeument Number. of Corporation (if known)
Pursuant to the provisions of section 607.1006, Florida Statutes, this TYorida Profit Corporation adopts the following amendment(s) to
its Articles of incorporation:
A. If amending name, enter the new name of the corporation:
The new
name nntst be distinguishable and contain the word "corporation, " "company, " or "incorporated" or the abbreviation "Corp., "
"Inc., " or Co.," or the designation "Corp " "Inc, " or "Co ". A professional corporation name must contain the word
"chartered, " "professional association, " or the abbreviation "I'.A. "
B. Enter new principal office address, if applicable:
(Principal office address MUSTBE A STREET ADDRESS )
C. Enter new nnailing address, if iit)i)licable:
(Mailing address MA Y BE A POST Or1710E B
D. If amending the registered went and/or registered office address in Florida, eater the name of the
new registered agent and/or the new registered office address:
Maine of 1lrenv Res),istered A
(Florida street address)
Neiv Registered OOce Address: , Florida
(City) (Zin CO Cie)
New Registered Aeent's Signature, if chaneine Registered Agent:
I hereby accept the appointment as registered agent. I am familiar with and accept the obligations of the position,
Signature of New Registered Agent, if changing
Check if applicable
El The amendment(s) is/are being filed pursuant to s. 607.0120 (11) (e), F.S,
If amending the Officers and/or Directors, enter the title and name of each officer/director being removed and title, name, and
address of each Officer and/or Director being added:
(,Attach additional sheets, if necessary)
Please note the gffrcerldirector title by the first letter of the office title:
P = President; V= Vice President; T= Treasurer; S= Secretary; D= Director; TR= Trustee; C = Chairman or Clerk; CEO = Chief
Executive Officer; CF0 Chicf Financial Officer. If an oj frcer/director holds more than one title, list the first letter of each gffice held,
President, Treasurer, Director would be PTD.
Changes should be noted in the following manner. Currently John Doe is listed as the PST and Rfike Jones is listed as the V. There is
a change, Alike Jones leaves the corporation, Sally Srnith is named the V and S. These should be noted as John Doe, PT as a Change,
Alike Jones, Vas Remove, and Sally Smith, SV as, an rldd
Example;
X Change P_I' John Doe
X Remove v Mike Jones
X Add Sv Sally Smith
Type of Action Title Name Address
(Check One) t - { -�
1) Change i1'1a\ t L hY N I' P b
Add eYl0YYlom& V'm
Remove
2) T Change
Add
Remove
3) Change
Add
Remove
4) _ Change
Add
Remove
Sj Change
Add
Remove
fi) Change
Add
__ ___ Remove
E. if ainendine or adding additional Articles, enter cha►ige(s) bore,
(Attach additional sheets, if necessary). (Be speck)
F. If an amendment provides for an exclianue, reclassification, or cancellation of issued shares,
provisions for implementing the amendment if not contained in the amendment itself:
(if not applicable, indicate N/A)
IA
The date of each amendment(s) adoption:if other than the
date this document was signed.
Effective date if applicable:
(no snore than 90 days after cnnendment file (late)
Note: if the date inserted in this block does not meet the applicable statutory filing requirements, this date will not be listed as the
document's effective date on the Department of State's records.
Adoption of A►nendtnent(s) (CHECK ONE)
The amendment(s) was/were adopted by the incorporators, or board of directors without shareholder action and shareholder
action was not required.
❑ The amendments) was/were adopted by the shareholders, The number of votes cast for the amendments)
by the shareholders was/were sufficient for approval,
E) The amendrnent(s) was/were approved by the shareholders through voting groups. The fallowing statement
must be separately provided for each voting group entitled to vote separately on the amendrnent(s);
"The number of votes cast for the amendment(s) was/were sufficient for approval
by
(voting group)
Dated ) / " o 20 ,
Signature
(By a direcior, p#e dent or other officer — if directors or officers have not been
selected, by an errporator- if in the hands of a receiver, trustee, or other court
appointed fiduciary by that fiduciary)
(Typed or printed name of person signing)
e:& de�L-t-
(Title of person signing)
ARTICLES OF INCORPORATION
OF
CLASSIC PROTECTIVE COATINGS, INC.
THE UNDERSIGNED subscriber to these Articles of Incorporation, a natural
person competent to contract, hereby forms a Corporation under the Laws of the State
of Florida, specifically Chapter 607, F.S.
ARTICLE I. NAME
The name of the corporation shall be:
Classic Protective Coatings
ARTICLE II. PRINCIPAL OFFICE p v; own -
The principal place of business of this Corporation shall be:
3336 Ridge Rd.
Wimauma, FL 33598-7218 cn cz't`,ten51
'P �J0
ARTICLE III. SHARES
The maximum number of shares of stock that this Corporation is authorized to
have outstanding at any one time is 1,000 shares of common stock having a par value of
$1.00 per share.
ARTICLE IV. INITIAL REGISTERED AGENT AND STREET ADDRESS
The name of the initial Registered Agent of the Corporation shall be Ray L.
Witke, and the street address for the Registered Agent of ,the Corporation shall be 3336
Ridge Rd., Wimauma, FL 33598-7218.
ARTICLE V. INCORPORATORS
The name and addresses of the Incorporators to these Articles of Incorporation
are:
'1 NAME ADDRESS SHARES OF COMMON CONSIDERATION
t
STOCK ISSUED
Ray L. Witke, 3336 Ridge Rd., 100 $100.00
Wimauma, FL 33598-7218
ARTICLE VI. OFFICERS
The names and addresses of the initial officers of the Corporation who shall
hold office for the first year of the Corporation, or until their successors are elected or
appointed, are:
OFFICE OFFICER ADDRESS
President Ray L. Witke, 3336 Ridge Rd., Wimauma, FL 33598-7218
Secretary Ray L. Witke, 3336 Ridge Rd., Wimauma, FL 33598-7218
Treasurer Ray L. Witke, 3336 Ridge Rd., Wimauma, FL 33598-7218
ARTICLE VII. DIRECTORS
This Corporation shall have one director initially. The names and addresses of
the initial members of the Board of Directors are:
DIRECTOR ADDRESS
Ray L. Witke, 3336 Ridge Rd., Wimauma, FL 33598-7218
ARTICLE VIII. NATURE OF BUSINESS
This Corporation may engage in, or transact, any or all lawful activities or
business permitted under the laws of the United States, the State of Florida, or any
other State, Country, Territory or Nation. The specific purpose of this Corporation
shall be sandblasting and coating water towers.
ARTICLE IX. TERM OF EXISTENCE
This Corporation is to exist perpetually.
2
ARTICLE X. PREEMPTIVE RIGHTS
Every shareholder upon the sale for cash of any new stock of this Corporation
of the same kind, class, or series as that which he/she already holds, shall have the
right to purchase his/her pro-rata share thereof at the price at which it is offered to
others.
ARTICLE XI. SECTION 1244 PROVISION
The stock of this Corporation is intended to qualify under the requirements of
Section 1244 of the Internal Revenue Code and the regulations issued thereunder. Such
actions as are necessary will be taken by the appropriate officers to accomplish this
compliance.
ARTICLE XZI. BY-LAWS
The initial directors shall submit the proposed by-laws to the shareholders at a
meeting to be held for that purpose not more than thirty (30) days following the
issuance of the Certificate of Incorporation. Following the adoption of by-laws by
unanimous vote of the shareholders, the internal affairs of the Corporation are to be
regulated and managed in accordance with such by-laws.
ARTICLE XIII. TAX STATUS OF CORPORATION
It is the intent of the undersigned subscribed that the Corporation shall be
treated as a subchapter C corporation for federal tax purposes.
ARTICLE XIV. NON -REGISTRATION AS SECURITY
The shares of common stock to be issued to subscriber(s) are not registered
under state or federal securities laws. The subscriber(s) represent that it is the intent of
the Corporation that the shares of common stock issued comply with the applicable
private placement exemptions from registration under federal and state law. All stock
certificates issued shall bear the legend:
THESE SECURITIES HAVE NOT BEEN REGISTERED UNDER
THE SECURITIES ACT OF 1933 IN RELIANCE UPON AN
3
EXEMPTION PROVIDED IN THAT ACT AND MAY NOT BE
OFFERED, SOLD OR TRANSFERRED UNTIL THEY HAVE
BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933
OR, UNLESS IN THE OPINION OF COUNSEL FOR THE
ISSUER, REGISTRATION IS NOT REQUIRED UNDER THAT
ACT.
The Corporation shall only issue shares to individuals that comply with the
private placement rules, i.e., Federal Securities Act §4(2) and §517.061, F.S., and
agree:
1. That no offer or sale of stock shall be made to a non-resident of the State of
Florida;
2. That no offer or sale of stock shall be made to more than 35 purchasers for a
period in excess of 12 months;
3. That no general solicitations or advertisements of an offer or sale of stock
shall occur in Florida or any other state;
4. That before any sale of stock, each purchaser shall be given reasonable
,�. access to full and fair disclosure of all material information concerning the
corporation;
5. That no person shall be paid a commission for the sale of stock or otherwise
receive compensation for the sale of stock; and
6. That if sales are made to five or more persons in Florida, the purchasers
shall be given a three (3) day right of rescission in accordance with
§517.06(11)(a)(5).
The undersigned incorporators acknowledge they have been provided access to
all material books and records of the Corporation for review, to all material contracts
and documents relating to this private offering and have had an opportunity to question
all appropriate officers of the Corporation concerning the private offering.
The Undersigned incorporators agree that they are purchasing their shares for
investment and not with the intent to re -sell or distribute shares to the public. In the
4
event that incorporators wish to sell their shares in the future, such sale must qualify
and satisfy all federal and state private placement exemptions.
ARTICLE IV. AMENDMENT
This Corporation reserves the right to amend or repeal any provisions contained
in these Articles of Incorporation, or any amendment hereto, and any right conferred
upon the shareholders is subject to this reservation.
ARTICLE XVI. INFORIMAL SHAREHOLDERS ACTION
The holders of not less than a majority of the issued and outstanding shares of
the voting stock of the Corporation may act by written agreement without a meting, as
provided in §607.0704, F.S. and the By-laws.
IN WITNESS WHEREOF, the undersigned have hereunto set their hands and
seals on this 2 day of 2000.
Ray L. Witite
INCORPORATOR
ACCEPTANCE OF REGISTERED AGENT
Having been named as registered agent and to accept service of process for the
above state Corporation at the place designated in this certificate, I hereby accept the
appointment as registered agent and agree to act in this capacity. I further agree to
comply with the provisions of all statutes relating to the. proper and j complete
performance of my duties, and I am familiar with and accept the obligat ar of3ny
position as registered agent. y ►`�' "`�°�
Cn
Ray L. Witke i i „0 V ,
REGISTERED AGENT ��'
MSW2000.FRM 101
D� cX) �
5
United States of America
State of Wisconsin
DEPARTMENT OF FINANCIAL INSTITUTIONS
Division of Corporate & Consumer Services
To All to Whom These Presents Shall Come, Greeting:
I, Patti Epstein, Administrator of the Division of Corporate and Consumer Services, Department of Financial
Institutions, do hereby certify that
CLASSIC PROTECTIVE COATINGS, INC.
is a foreign corporation or foreign limited liability company authorized or registered to transact business in
Wisconsin and that its date of qualification or registration is July 06, 2016.
I further certify that said organization has, within its most recently completed report year, filed an annual report
required under ss. 180.1622, 181.1622 or 183.0120, Wis. Stats.; that it has not applied for a certificate of
withdrawal under ss. 180.1520, 181.1520 or 183,1011, Wis. Stats.; and that it is not the subject of a proceeding
under ss. 180.1531, 181.1531 or 183.1021, Wis. Stats., to revoke its certificate of authority or registration.
� oq Financ�3
m:
MI&I- vL11% . , IM
DFI/Corp/33
To validate the authenticity of this certificate
Visit this web address: http://www.wdfi.org/apps/ccs/verify/
IN TESTIMONY WHEREOF, I have hereunto set
my hand and affixed the official seal of the
Department on January 07, 2021.
PATTI EPSTEIN, Administrator
Division of Corporate and Consumer Services
Department of Financial Institutions
Enter this code: 284478-FE3FA033
x
inF`'.
City
of
Oshkosh
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 Owuership form and
upload in the appropriate location on Quest V-Sid.
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.
Michael Burke
Name
Michael Burke
Printed Name
Chief of Operations
Title
Classic Protective Coatings, Inc.
Company Name
1-29-24
Date
f.•\ Engineering\Tracy Taylor\ Public Works Contracts\ Miscellaneous \ Disclosure of Ownership Fonn_2-1- Page I of I
17.docx
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
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
Authorized Officer Signature
Date Signed
Corporation, Partnership or Sole Proprietorship Name
Street Address or P O Box
City
State
Zip Code
If you have any questions call (608) 266-6861
ERD-7777 (R. 01/2011)
SECTION 00 54 00
SCHEDULE OF VALUES
_ r;s>E'
3I {.'`�1, %V 1 , CIA,` TPI
PART 1
1.01 LINE ITEMS
A. Bidder agrees to perform all work as described in the Contract Documents, including all
labor and material for the following items — Section 05 00 00:
1. MUD VALVE
$ 3 600.00
2. CATHODIC COVERS
$2,750.00
3. ROOF PAINTER'S RAILING
01,450.00
4. CLEAN -OUT LINE
$1,650.00
5. WET INTERIOR LADDER
%6.700.00
6. FALL PREVENTION DEVICES
$8 300.00
7. FALL PREVENTION DEVICES — DRY INTERIOR — MARION TANK
$6 850.00
8. FALL PREVENTION DEVICES — WET INTERIOR — MARION TANK
$3,750.00
9. FALL PREVENTION DEVICES — DRY INTERIOR — SOUTHWEST TANK
0,650.00
10. FALL PREVENTION DEVICES —WET INTERIOR — SOUTHWEST TANK
3,700.00
B. Bidder agrees to perform all work as described in the Contract Documents, including all
labor and material for the following items — Section 09 00 00:
OSHKOSH - SCHEDULE of VALUES - I
11. EXTERIOR REPAINT with CONTAINMENT
$644,875.00
12. LETTERING AND LOGOS
$11.850.00
13. WET INTERIOR REPAINT
095.610.00
14, DRY INTERIOR SPOT REPAINT
$ 28,540.00
C. Bidder agrees to perform all work as described in the Contract Documents, including all
labor and material for the following items — Section 13 00 00:
15. MIXER
$29 350.00
D. Bidder agrees to perform all work as described in the Contract Documents, including all
labor and material for the following items — Section 16 00 00:
16. AVIATION LIGHT
0.850.00
E. Bidder agrees to perform all work as described in the Contract Documents, including all
labor and material for the following items — Section 26 00 00:
17. CATHODIC PROTECTION SYSTEM
$23,475.00
PROJECT TOTAL INCLUDING #1 THROUGH #17:
$1,188, 950.00
1.02 TOTALS
A. Project Total Base Bid is to match total Base Bid price supplied in Bid Form.
1.03 MISTAKES
A. Project Total of Schedule of Values paragraph should equal sum of individual items.
If the addition of individual items does not match the total, then each individual item
will be added again, and the math corrected.
OSHKOSH - SCHEDULE of VALUES - 2
B. A mistake in addition for schedule items cannot be used to increase lump sum bid. If
Bid correction results in an increased price, then Owner may request Bidder to reduce
all individual item prices proportionally, or may reject Bid.
C. Mistakes discovered after the Award, even after completion will adjust Price
downward only. It is the Bidder's responsibility to recheck prices prior to Award.
D. A mistake in the Schedule of Values may be used as evidence of error in any request
to withdraw bids because of error. Approval of request to withdraw bids is covered in
the hiforination for Bidders. This section is not intended to conflict with any portion
of the bid package. Approval of bid withdrawal will be based solely on the Owner's
interpretation of the severity of the mistake.
1.04 CHANGES in SCHEDULE of VALUES by OWNER
A. The Owner reserves the right to delete any line item of Part 1.01 adjusted line item;
except for coating work, at their sole discretion for any reason. All contract general
costs (mobilization, demobilization, bonds, etc.) should be evenly distributed over the
coating items which are not subject to deletion.
B. The Bidder is advised not to overload any specific deductible line item. It could
result in loss of profit if the overload item is deleted.
1.05 NON-DELETABLE WORK BEFORE and AFTER NOA
A. Any deletion of line items or increase or decrease in unit cost items deemed necessary
after the Notice of Award, will be completed through the Change Order procedure.
Prices used in the Schedule of Values will be used in the Change Order adjustment.
OSHKOSH - SCHEDULE of VALUES - 3
� CONTRACT24-08 `°`
LIST OF PROPOSED SUBCONTRACTORS✓IR
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 SUBCONTRACTOR
105
PERCENT OF
CLASS OR ITEMS OF WORK CONTRACT AMOUNT
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).
79e�,,.a a- F"
Signature of Bidder
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