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HomeMy WebLinkAbout23-13 Norcon CorpBID BOND CITY OF OSHKOSH Contract Number 23-13 Date Bond Executed (Date of Contract or Later) 2/07/2024 PRINCIPAL/CONTRACTOR (Legal Name and Business Address) NORCON CORPORATION 5600 Municipal St Schofield, WI 54476 SURETY(IES) (Legal Name(s) and Business Address(es)) Old Republic Surety Company P.O. Box 1635 Milwaukee, WI 53201-1635 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 Corporation State of Incorporation WI Penal Sum of Bond Five Percent Of Amount Bid 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. 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, email 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, email 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 er legal requirement shall be deemed incorporated herein. NORCON PORATION 'Name 'ring I 'ontractor itle Just y4iri ,-�sident Old Republic Surety Company_ Nance of Surety OAwd `f�� , rl• / 7 j Title Samuel Duchow, Attorney -in -fact% * OLD REPUBLIC .SURETY COMPANY POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That OLD REPUBLIC SURETY COMPANY, a Wisconsin stock insurance corporation, does make, constitute and appoint: MICHAEL J. DOUGLAS, CHRIS M. STEINAGEL, CHRISTOPHER MATHER KEMP, ROBERT S. DOWNEY, CONNiE SMITH, KORY C. MORTEL, ELIOT MOTU, SAMUEL DUCHOW of HUDSON, WI Its true and lawful Attomey(s)-in-Fact, with full power and authority for and on behalf of the company as surety, to execute and deliver and affix the seal of the company thereto (if a seal is required), bonds, undertakings, recognizances or other written obligations In the nature thereof, (other than bail bonds, bank depository bonds, mortgage deficiency bonds, mortgage guaranty bonds, guarantees of Installment paper and note guaranty bonds, self-insurance workers compensation bonds guaranteeing payment of benefits, or black lung bonds), as follows: ALL WRITTEN INSTRUMENTS and to bind OLD REPUBLIC SURETY COMPANY thereby, and all of the acts of said Attorneys -in -Fact, pursuant to these presents, are ratified and confirmed. This appointment is made under and by authority of the board of directors at a special meeting held on February 18, 1982. This Power of Attorney is signed and sealed by facsimile under and by the authority of the following resolutions adopted by the board of directors of the OLD REPUBLIC SURETY COMPANY on February 18,1982. RESOLVED that, the president, any vice-president or assistant vice president, in conjunction with the secretary or any assistant secretary, may appoint attorneys -in -fact or agents with authority as defined or limited in the Instrument evidencing the appointment in each case, for and on behalf of the company to execute and deliver and affix the seal of the company to bonds, undertakings, recognizances, and suretyship obligations of all kinds; and said officers may remove any such attorney -in -fact or agent and revoke any Power of Attorney previously granted to such person. RESOLVED FURTHER, that any bond, undertaking, recognizance, or suretyship obligation shall be valid and binding upon the Company (1) when signed by the president, any vice president or assistant vice president, and attested and sealed (if a seal be required) by any secretary or assistant secretary; or (ii) when signed by the president, any vice president or assistant vice president, secretary or assistant secretary, and countersigned and sealed (if a seal be required) by a duly authorized attorney -in -fact or agent; or (ill) when duly executed and sealed (if a seal be required) by one or more attorneys -in -fact or agents pursuant to and within the limits of the authority evidenced by the Power of Attorney issued by the company to such person or persons, RESOLVED FURTHER that the signature of any authorized officer and the seal of the company may be affixed by facsimile 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 affixed. IN WITNESS WHEREOF, OLD REPUBLIC SURETY COMPANY has caused these presents to be signed by its proper officer, and Its corporate seal to be affixed this 22nd day of September __ 2022 OLD REPUBLIC SURETY COMPANY W /Gf PPOAAtr OCO Assbtant Secret.,President STATE OF WISCONSIN, COUNTY OF WAUKESHA - SS On this 22nd day of September 2022 personally came before me, Alan Paylic and Karen J Haffner to me known to be the individuals and officers of the OLD REPUBLIC SURETY COMPANY who executed the above instrument, and they each acknowledged the execution of the same, and being by me duly sworn, did severally depose and say: that they are the said officers of the corporation aforesaid, and that the seal affixed to the above instrument is the seal of the corporation, and that said corporate seal and their signatures as such officers were duly affixed and subscribed to the said Instrument by the authority of the board of directors of said corporation. �vJ �. °TAR (�.. h. �. ll W Notary PublIG y� `on My Commission Expires: September 28, 2026 CERTIFICATE (Expiration of notary's commission does not invalidate this instrument) 1, the undersigned, assistant secretary of the OLD REPUBLIC SURETY COMPANY, a Wisconsin corporation, CERTIFY that the foregoing and attached Power of Attorney remaids In fgll,,force_and has not been revoked; and furthermore, that the Resolutions of the board of directors set forth in the Power of Attorney, are now irkforce,......... ;���atiomw,p h' ; o J° sLaer 4; • :� JO. %'fig ' _ PPA�.�E\° _ 7th February 2024 24-5172 7 stl\\ SEASL i n _ Signed and sealed at the City of Brookfield, WI this day of ORSC 22282 't Secret. , 3.06 ( ) -r J. RYAN BONDING, "INC. AFFIDAVIT OF NON -COLLUSION STATE OF Wisconsin COUNTY OF Marathon I Hereby swear (or affirm) under the penalty of perjury: Wworm- OS`5B{OM I, 1I r of y I) That I am the bidder (if the biddies 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 invitation to bid 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 day of it, 200?y C Notaryp:/ji��D off' P E -.rd a iAi► N�A p(Jf3L\Gor • 2 W t President Title Norcon Corporation Company 00450-1 ARTICLE 9 — BID SUBMITTAL SUBMITTED ON State Contractor License No. If Bidder is: An Individual Name (typed or printed): By: Doing business as: Business address: Phone No.: A Partnership Partnership Name: March 4 . 2024 P0, , 1 A (if applicable)sH: o,cf j �: (SEAL) (individual's signature) FAX No.: (SEAL) By: (Signature of general partner — attach evidence of authority to sign) Name (typed or printed): Business address: Phone No.: A Corporation Corporation Name: Norcon Corpor State of Incorporation: Wisconsin Type (General Business, Pro sloe By: ` Dame (typed or printed): Justin Title: President Attest: FAX No.: Service, Limited Liability): General Business -4Q43-1w — attach evidence of authority to sign) prose (CPRPQRATE SEAL) 4k '_ StAL f r t 'S reta ) �1 DF w Business Address: 5600 Mun:icital Strut, Schaff d, W154476'; Phone No: 715-359-5808 FAX No.: 715-359-9339 Date of Authorization to do business is April 26, 1993 Donohue & Associates, Inc. BID FORM Project No. 14314 00411-7 A Joint Venture Name of Joint Venture: First Joint Venturer Name: M (Signature of joint venture partner — attach evidence of authority to sign) Name (typed or printed): Title: Business address: Phone No.: Second Joint Venturer Name: By: FAX No.: (Signature of joint venture partner — attach evidence of authority to sign) Name (typed or printed): Title: Business address: 91 0 - ► • FAX No.: Phone and FAX Number, and Address for receipt of official communications: EAL) (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.) BID FORM Donohue & Associates, Inc. 00411-8 Project No. 14314 no;;con CO RP0;R /&TIOn 0IVERSIPI60 CONSTRUCTION SERVICES 5600 Municipal Street, Schofield WI 54476 Ph:715.359.5808 Fox:715.359.9339 e-mail: norcon@norconcorp.com website: www.norconcorp.com CORPORATE RESOLUTION I, John Penrose, Secretary and Justin Penrose, President of Norcon Corporation, a corporation organized and existing under the laws of the State of Wisconsin (the "Company"), do hereby certify that the following is a true and correct copy of a resolution duly adopted at a meeting of the Board of Directors of the Company duly held and convened on January 3, 2024, at which meeting a duly constituted quorum of the Board of Directors was present and acting throughout, and that such resolution has not been modified, rescinded or revoked, and is at present in full force and effect: RESOLVED: That Justin Penrose, President of Norcon Corporation, and John Penrose, Secretary of Norcon Corporation, are both empowered and authorized to execute contracts on behalf of the Company. IN WITNESS WHEREOF, the undersigned has affixed his signature and the corporate seal of the Company this 3rd day of January, 2024. ustin P Preside t SCAL OF r Witness Witness City of Oshkosh Contractor Safety Acknowledgement for Risk Management Program Facilities Check the appropriate facility: Water Filtration Plant X Wastewater Treatment Plant 111KO'-,' ' c° 7 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 Management 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. tracto{s Si tt-- (Date) Norton Corporation - Justin Penrose (Company Name — Contractor) Please Print (Facility Representative's Signature) (Date) (Company Name — Facility) Please Print I:\Wastewater\18-16DigestexMlxing Upgrade\Protect Infonnetion\Contractlnfo\Contract Book\19-16 00470 Page 1 of 1 Contractor Safety Aclawwledgement Form 8.21-19.docx 3 [<p j �cf{' 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. me Justin Penrose Printed Name President Title Norcon Corporation Company Name March 4, 2024 Date M EngineeringWracy Taylor\ Public Works Contracts\Miscellaneous\DMosure of ownership Porat2-1- 17.docx 00440 Page 1 of 1 City Hall, 215 Church Avenue P.O. Box 1130 Oshkosh, WI 54903-1130 http://www.ci.oshkosh.wl.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) 00440 �'q NON-DISCRIMINATION AFFIDAVIT 1, the undersigned, state that the organization which I represent will be in 1� compliance with the applicable Federal and State Statutes concerning Affirmative Action, non-discrimination and Equal Employment Opportunity. Position President Name of Firm Norcon Corporation Date March 4, 2024 00460-1 PROPOSED SUBCONTRACTOR LISTING A! ' Pursuant to Section 66.29(7), Wisconsin Statutes, the Bidder, as part of this Bid Form, subrrt,�<thiifull 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 None Donohue & Associates, Inc. BID FORM Project No. 14314 00411-9