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AGREEMENT ¿;
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WHEREAS, the City of Oshkosh has granted to the undersigned a privilege to place an obstruction
within the street right-of-way as follows:
Installation of a 1 inch diameter flush mounted monitoring well in the terrace area along the
west side of Division Street., per the attached Exhibit (Letter agreement dated 9/23/03)
WHEREAS, State law provides that by its acceptance of this privilege the undersigned shall become
primarily responsible for damages to person or property by reason of the granting of the privilege;
NOW, THEREFORE, in consideration of the City of Oshkosh, a Municipai Corporation granting
permission to the undersigned to place an obstruction within the street right-of-way, the undersigned agrees
that he/she/it is soiely responsible for his/her/its activities under this agreement. The undersigned hereby
releases the City of Oshkosh from all debt, claims, demands, damages, actions and causes of action
whatsoever which may result from the placement of an obstruction in the street right-of-way by the
undersigned. Further, the undersigned agrees to protect and hold the City of Oshkosh harmless against all
actions, claims and demands of any kind or character whatsoever which may in any way be caused by the
activities under this privilege by the undersigned or agents or employees. Further, the undersigned agrees
to indemnify and refund to the City all such sums which the City may be obligated or adjudged to pay,
including the City's attorney fees and costs, on such actions, claims or demands within 30 days after written
request for such indemnification. The undersigned agrees that this paragraph is to be liberally construed in
favor of the City of Oshkosh, in consideration of the privilege granted by the City under this agreement.
This agreement and the privilege cannot be assigned without the written consent of the City of Oshkosh. The
privilege is subject to all terms and conditions contained in any authorizing resolution adopted by the City of
Oshkosh Common Council, which is incorporated by reference as if fully recited within this document. By
executing this agreement and by using the privilege, the undersigned agrees to fully abide by such terms and
conditions, including revocation upon written notice for noncompliance with the authorizing resolution and this
agreement. Ii
Dated this ,2:; day of ¥'
ST~NN RD DRY CLE
,2003.
And:
Name & Title:
STATE OF WISCONSIN)
) SS.
WINNEBAGO COUNTY)
J),.. Personally came before me this ~day of ~
or\ \'If¡, J. 'Ie h2j , 8IEI- ~f'¡.zed 1-
(name & title) , (name & title)
person(s) and officer(s) who executed the foregoing document on behalf of said STANNARD DRY
CLEANING and acknowledged the same. ~ . .
~ð.~~
Notary Public, tJ~ Co., Wisconsin
My Commission: . /-,f-c2IXJG
, 2003, the above-named
to me known to be the
Attachment:
Letter agreement from Stannard Dry Cleaning dated 9/23/03.
.
-
~
OJHKOJH
City of Oshkosh
Dept. of Community Development
215 Church Ave., PO Box 1130
Oshkosh, WI 54902-1130
(920) 236.5055
(920) 236-5053 FAX
http://www.ci.oshkosh.wi.us
(pf~
JACKSON R. KINNEY
Director
O",HE WAT"
September 23, 2003
Donna LeRoy
Stannard Dry Cleaning
653 North Main Street
Oshkosh, WI 54901
Re; Privilege in Street - Monitoring Well
Dear Ms. LeRoy;
This confinns my telephone conversation of September 23, 2003, during which time I discussed with
you the pre-conditions of Stannard Dry Cleaning to install a 1 inch diameter flush mounted moIÙtoring
well in the terrace area along the west side of Division while a privilege in the street is pending. State
law requires that prior to any such work beginning, the muIÙcipality must approve a pennit subject to
certain conditions. I understand Stannard is seeking to place the moIÙtoring well at this time in order to
obtain two samples prior to the end this year. I have spoken with Kathy Sylvester at the WDNR and she
recommended the moIÙtoring well be placed as earlier as possible to be able to obtain samples at the
same time as others placed on the Stannard property.
The pre-conditions are as follows;
1.
Stannard Dry Cleaning shall file an application with the city admiIÙstration to obtain a privilege
in street, and shall provide all the appropriate documentation, and shall pay all appropriate fees.
Stannard will secure and submit to the City Clerk a separate insurance policy, which names the
city as an additional insured with a mirùmum coverage of $200,000 per person and $500,000 in
general aggregate (it is Stannard's responsibility to file in a timely manner a new insurance
certificate with the City Clerk upon expiration of an existing certificate. Failure to due so will
result in revoking the privilege upon ten (10) days notice.
Stannard will execute a hold harmless agreement with the city (available from the Secretary to
the City Attorney, Room 401 City Hall).
Stannard shall understand that any construction activity done prior to Council approve is done at
Stannard's own risk. If the Common Council, for some reason, deIÙes or modifies the pennit
request, Stannard will be required to remove all improvements within ten (10) working days and
restore the right-of-way to its pre-construction condition.
The moIÙtoring well is to be installed in a manner and location that is approved by the
Department of Public Works.
2.
3.
4.
5.
6.
The authorized representative of Stannard Dry Cleaning must endorse the bottom of this letter as
agreement to these conditions.
Sincerely,
Darryn Burich
Principal Planner
Stannard Dry Cleaning agrees to and will abide by the above conditions.
Dated: September 23, 2003
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F~OM-ALYHA TE~~A meN"t
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...aQUeER (920)457-7781
UIT-Marit:ime, Inc.
832 Niagara Avenue
PO Sox 251
sheboygan, I'll 53082-0251
IN"U." Alpha Terra Science Inc
1237 South Pllgr1m Road
Plymouth. I'll 53073
CERTIFICATE OF LIABILITY INSURANCE I ~~i~;;;~~3
FAX (920)451-8248 ~EyC;~6'~g~#~~~I~~U~g~~sAu~~LTf~EO¿J~f~~'1~~ION
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INSURERS AF~ORDING COVERAGE NAIC #
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INSURER D
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THE POll~'ES OF INSURANCE LISTED BELOW HAVE BEEN 'SSUED TOTHE INSURED NAMEO ABOVE FOR THE POLICY PERIOD INDICATeD. NO1W11>1STANDING
ANY REQUIReMENT, nRM OR CONDITION OF ANY CONTRACT OR 01>1eR DOCUMENT WITH ReSPECT TO WHICH THIS ceRT1FI~ATE MAY Be ISSUED OR
MAY PERTAIN. WE INSURANCE AFFORDED BV THe POLICies DESCRIBeD HEREIN IS SUBJECT TO All THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
Ji.'!;!<.~'iiJ ",.0I'..8U""eE PO""YNU..ER pa"CYEf' < a"CYE,p...TION
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'¡gIlt-of-way, for the Stannard Cleaners project.
C;1:y of Oshkosh
Ann: Darryn Burdch,
Dept of Community Dev...1opmen1:
215 Church Street
PO Box 1130
Oshl(osh, WI 54903-1130
CANCe~LATION
BHOuLe ANV °' THe ABOVE OEBCRIB'" pouelES Be CANeB.r.oO B""".-
ex_YIONOAYETHe.eOF, ",elssu..,..."",,",WL' ENOEAV.RTOMA~
...lJL ""'" WO"""" HOTICE TO "'" c.."FlCATe HOUJER H"OO TO - 'OFT,
O""""-"",,TO- SUCHNOTIC.",ALl "p""eNoOOlIGA"'ONOR""~1TY
0' AW KIND "fONTHEINSU..,," AGENTS aR ..,....eNTAmiO.
AUTl<ORIZEO ....eOENTAT1VE
Denice Klett: MI,A(S~ WISC
C~"TI"CATE HOlDER
ACORD 25 (2001/09)
@ACORDCORPORATlON1988
ACORQM CERTIFICATE OF LIABILITY INSURANCE 1 DATE (MMlDDJVYVV)
02/09/2004
PRODUCER (920)457-7781 FAX (920)451-8248 THIS CERTiFICATE is ISSUED AS A MATTER OF iNFORMATION
Maritime Insurance Group, Inc.~ ONLY AND CONFERS NO RiGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
832 Niagara Avenue ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
PO Box 251 ~~
SheboygalÌ, WI 53082'è0251 °1::/1/;:; iNSURERS AFFORDiNG COVERAGE NAIC#
- ""'.T"" '.","00 ~ 'U INSURER A' Frankenmuth Mutuäl 13986
"""'"'" 'H,,;. ,~ 11 ¿ ! INSURER E'
, Pl ymouth, WI 53073 COMM(¡~ VOl INSURERC.
17YOE:~ INSURER 0, " ,
ô,q"M,<-,,- INSURER E,
COVERAGES '-..,:: I
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INOICATED. NOTWITHSTANDINt
ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
'~i'! ,¡:>,g; TYPE OF INSURANCE POUCV NUMBER POLICY EFFECTIVE POUCYEXPIRATION LIMITS
GENERAL LIABILITY CPP3025585 01/29/2004 01/29/2005 EACH OCCURRENCE $ 1,000,000
X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 300,000
~ :::J CLAIMS MADE [K] OCCUR MED EXP (Aoy ooe pe~oo) $ 10,000
A PERSONAL & ADV INJURY $ I,OOO,OO(
GENERAL AGGREGATE $ 2,000,000
GEN'L AGG~EñE LIMIT APñS PER PRODUCTS. COMPIOP AGG $ 1,000,000
"I POLICY II'.?, LOC
~TOMOBILE LIABILITY BA3025585 01/29/2004 01/29/2005 COMBINED SINGLE LIMIT
$
ANY AUTO (E, aceldeol) 1,000,000
-
- ALL OWNED AUTOS BODILY INJURY
$
.;. SCHEDULED AUTOS (Pe'pe~aol ...
A
X HIRED AUTOS. BODILY INJURY
X $
NON-DWNED AUTOS (P" aceldeol)
I-'-'-
PROPERTY DAMAGE $
(P"aceld"')
RRAGE LIABILITY AUTO ONLY. EAACCIDENT $
ANY AUTO OTHER THAN EAACC $
AUTO ONLY, AGG $
pESSIUMBRELLA LIABILITY EACH OCCURRENCE ,
OCCUR 0 CLAIMS MADE AGGREGATE ,
,
R DEDUCTIBLE '
RETENTION $ $
WORKEOS COMPENSATION AND WC3025585 01/29/2004 01/29/2005 WC STATU X iO}!!
EMPLOYERS' LIABILITY E.L. EACH ACCIDENT 500,000
A ANY PROPRIETOR/PARTNERlEXECUTIVE $
OFFICER/MEMBER EXCLUDED? E.L. DISEASE. EA EMPLOYEE' 50O, OOC
~Þ~~I~t'~R'ò";:s18~s below E.L. DISEASE. POLICY LIMIT , 500,000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBEO POLICIES BE CANCELLED BEFORE THE
City of Oshkosh EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
Attn: Darryn Burrich, ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
Dept of Community Development
215 Church Street BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
PO Box 1130 OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.
Oshkosh, WI 54903-1130 AUTHORIZED REPRESENTATIVE
Denice Klett, AAI, ACSR, WISC
ACORD 25 (2001/08)
@ACORD CORPORATION 1988
OCTOBER 14, 2003
03-416
RESOLUTION
(CARRIED
6-0
LOST
LAID OVER
WITHDRAWN
INITIATED BY:
GRANT PRIVILEGE IN STREET / DIVISION STREET; WEST
SIDE, ACROSS FROM 653 N. MAIN STREET
ALPHA TERRA SCIENCE, PETITIONER FOR STANNARD
DRY CLEANING .
PURPOSE;
PLAN COMMISSION RECOMMENDATION: Approved w/conditions
WHEREAS, Alpha Terra Science has requested the Common Council to grant
them the privilege of installing a monitoring well within the right-of-way on Division
Street; and
WHEREAS, Section 66.0425, Wis. Stats., provides for the granting of a privilege
in a right-of-way; and
WHEREAS, the Plan Commission has approved of this request with conditions.
NOW, THEREFORE, BE IT RESOLVED by the Common Council of the City of
Oshkosh that the proper City officials are hereby authorized and directed to grant Alpha
Terra Science the privilege of installing a monitoring well within the right-of-way of
Division Street, across from 653 N. Main Street, per the attached, contingent upon the
following;
1) The monitoring well be installed in a manner that is approved by the Department
of Public Works with no modifications or changes in construction procedure without prior
approval by the Department of Public Works.
2) If no longer needed, the monitoring well be properly abandoned and removed in
accordance with City standards and under the direction of the Department of Public
Works.
3) Any problem which may arise as a result of the installation of the monitoring well
be the responsibility of the petitioner/owner to correct in coordination with the
Deparment of Public Works. .
All appropriate permits be obtained prior to the start of boring or excavation work.
The monitoring well be modified or removed immediately upon the request of the
4)
5)
City.
6) The petitioner/owner secures and submits to the City Clerk a separate insurance
policy which names the City as an additional insured with a minimum coverage of
$200,000 per person and $500,000 in general aggregate.
7) It is the responsibility of the petitioner/owner to file in a timely manner a new
insurance certificate with the City Clerk upon expiration of an existing certificate. Failure
to do so will result in the revocation of the privilege in street upon 10 days notice.
8) The petitioner/owner execute a hold harmless agreement with the City.