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AGREEMENT
WHEREAS, the City of Oshkosh has received an application for a privilege in street by
the undersigned to place an obstruction within the street right-of-way as follows:
Installation of a ground water monitoring well within the public right-of-way of Marion
Road, approximately 110 feet east of 474 Marion Road (north side of the right-of-way,
terrace) .
WHEREAS, State law provides that the undersigned shall become primarily responsible
for damages to person or property by reason of placing the obstruction within the street right-
of-way;
NOW, THEREFORE, in consideration of the City of Oshkosh, a Municipal Corporation
granting permission to the undersigned to place an obstruction within the street right-of-way,
the undersigned agrees that he/she/it is solely 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 the placement of the obstruction in the right-of-way or in activities placing the obstruction
with the street right-of-way 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 allowing the placement of the obstruction in the right-of-way by
the City under this agreement.
This agreement cannot be assigned without the written consent of the City of Oshkosh.
Placement of the obstruction in the right-of-way will be subject to all terms and conditions
contained in any authorizing resolution adopted by the City of Oshkosh Common Council
authorizing the privilege in street for the placement of an obstruction in the Marion Road right-
of-way by the undersigned or representative. By executing this agreement and placement of
the obstruction in the right-of-way, 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.
Dated this j S day of )\.\4'«. h ,2004.
MERCURY MARINE.
¿;;;;:> /l ~ .-,.,.
By: 6a---~
And:
STATE OF WISCONSIN)
) SS.
WINNEBAGO COUNTY)
it" M.
Personally came before me this ~ day of Q.Vê ~ ,2004, the above-named
OM ;3QUM q"'-¡"'€.\r tome known to be the person(s) who
executed the fore oing document on behalf of said Mercury Maril" and acknowledged the same.
MOk.,({~
'..
Notary Public, Fóv¡d, d u&1~ Co., Wisconsin
My Commission: 3- S - 0("
City Attorney's Office
Phone: (920) 236-5115
Fax: (920) 236-5090
http;/lwww.ci.oshkosh.wi.us
May 13, 2004
Ms. Mary Clifford
Sigma Environmental Services, Inc.
1300 E. Canal St.
Milwaukee, WI 53233
RE:
Privilege in Street Permit/City of Oshkosh
Sec. 66.045, Wis. Stats.
Dear SirlMadam:
On March 23, 2004, by resolution #04-67, the City of Oshkosh Common Council approved your request
for a privilege in street permit subject to certain conditions that are made a part of the approval resolution.
In order for the permit to be valid, each one of these conditions must be satisfied.
To that end, please find enclosed for your signature an Agreement releasing, and holding the City
harmless, from all liability arising from your use of the permit. This, along with the insurance filing
requirements ($200,000/$500,000 limits) are part of state law that enables the City to allow you this use.
Kindly return to this office the signed Agreement along with your proof of insurance, either a separate
policy or naming the City as an additional insured on your policy.
I apologize for the delay in getting this document to you. Please execute and return to us as soon as
possible. These conditions of approval must be met before you exercise the privilege in the street. If not,
the city is empowered to shut down any activities undertaken before the paperwork is finished. Direct
any questions about insurance and liability releases to this office. Any other questions concerning the
remaining conditions should be directed to the Public Works Department at 236-5065. Thank you very
much for your timely cooperation in these matters.
Sincerely,
CITY OF OSHKOSH
Lynn A. Lorenson
Asst. City Attorney
cc:
Pâ'f!'lelaR:.Ubrlg~;Cit)i Clerkë$..
Dave Patek, Dir. of Public Works
Mike Fisher, Public Works
Darryn Burich, Community Dev.
ACORD", CERTIFICATE OF LIABILITY INSURANCE Page 1 of 2 I DATE
07/29/2003
PRODUCER 877-559-6769 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
willis North >merica, Inc. - Regional Cert Center HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
11201 N. Tatum Boulevard ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Suite 300
Phoenix, AZ B5D2B INSURERS AFFORDING COVERAGE
INSURED Sigma Environmental Services, Inc. INSURER A, American International Specialty Lines In 26BB3-DDI
220 East Ryan Road INSURER B, Illinois National Insurance Company 23B17-DDI
Oak Creek, WI 5315<
INSURERC, Virginia Surety Company, Inc. 'DB27-1DD
INSURER 0,
INSURERE,
COVERAGES
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 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.
INf,\' TYPE DF INSURANCE POLlCV NUMBER P'¡>k~V ,¡rtgg;œ,E Pg¡,ife" ~~b~.w¡N LIMITS
A ~NERALLIABILITY PR01950864 8/1/2003 8/1/2004 EACH OCCURRENCE $
eX-~MMERCIALGENE~ABILITY FIRE DAMAGE (A""". "",) $
f--!---J CLAIMS MADE i.XJ OCCUR MEDEXP(A"""epe"",,) $
eX- Prof Liab c1aims made PERSONAL& ADV INJURY $
eX- Poll Liab c1aims made GENERAL AGGREGATE $
ñ'~~~I~~Eñ ~~P; APñS :~: PRODUCTS. COMPIOP AGG $
B ~TOMOBILE LIABILITY
eX- ANV AUTO
f-- ALL OWNED AUTOS
r- SCHEDULED AUTOS
r- HIRED AUTOS
f-- NON.OWNEDAUTOS
r-
CA5054315
8/1/2003
COMBINED SINGLE LIMIT
(Ea,ocide",)
8/1/2004
BODILY INJURY
(Pecpe,".,)
BODIL V INJURV
(Pe,"oc'de",)
PROPERTY DAMAGE
(Pe,"oc'de",)
ñAGE LIABILITY
II ANV AUTO
AUTO ONLY. EAACCIDENT $
EAACC $
AGG $
$
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$
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X I T'¿;~~T[¡N;; I IO¡~.
E.L EACH ACCIDENT $
E.L DISEASE. EA EMPLOYEE $
E.LDISEASE-POLlCVLlMIT $
OTIŒRTHAN
AUTOONLV,
A EXCESS LIABILITY
~. OCCUR 0 CLAIMS MADE
h DEDUCTIBLE
IX1 RETENTION $ 10 00
C ~,¡'~L~~"R~?~'::~~~~'ON AND
PROU1950865
EACH OCCURRENCE
AGGREGATE
8/1/2003
8/1/2004
OTHER
-~ ¡ç ít ~1"iC~
~~OïS2638 ... :\~.i 2003
\~ \1 ~UG - 7 1.003 i-'
'I CLERK'S O¡::¡::IC,--
C\\~
8/1/2004
1000000
100 000
25 000
1 000 000
1 000 000
1 000 000
$
1,000,000
$
$
$
5 000 000
5 000 000
1 000 000
1 000 000
1 000 000
DESCRIPTION OF OPERA TIONSILDCA TIONSNEHICLES7E)(CLUSIDNS ADDED BV ENDORSEMENTISPECIAL PROVISIONS
Policy #PR01950864, Retro Active Date: 08/01/87 refers to Professiona1 and Po11ution Liability
Umbrella does set above Professional Liability Coverage.
Certificate Holder is named as an Additional Insured with respect to work performed by the Named
Insured under the contract in effect between them.
CERTIFICATE HOLDER
I I ADDITIONAL INSURED; INSURER LETTER,
CANCELLATION
SHOULD ANV OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE TIiEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL -.!.Q.... DAVS WRITTEN
NOTICE TO THE CERTIACATE HOLDER NAMED TO TIiE LEFT, BUT FAJLURE TO DO so SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANV KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
A.£~A~~
City of Oshkosh
Attn, Lynn A. Lorenson
PO Box 1130
Oshkosh, WI 54903-1130
ACORD 25-S (7/97)
ColJ.:780902 Tp1:192981 Cert:3296142
@ACORDCORPORATION1988
ACORo'M CERTIFICATE OF LIABILITY INSURANCE Page 1 of 2 I DATE
03/11/2004
PRODUCER 877-945-7378 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
willis North America, Inc. - Regional Cert Center HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
26 Century Blvd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P. O. Box 305191
Nashville, TN 372305191 INSURERS AFFORDING COVERAGE
INSUREO Sigma Environmental services, Inc. INSURER A, American International Specialty Lines In 26BB3-DDI
1300 .West Canal..Street INSURERB, Illinois National Insurance C"""any 23B17"DDI
Milwaukee, WI 53233
INSURERC, Virginia Surety con.,any, Inc. <DB27-lDD
INSURER 0'
INSURERE,
COVERAGES
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 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 PAlO CLAIMS.
I'~~~ TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
A ~NERAL LIABILITY PROP1950864 8/1/2003 8/1/2004 EACH OCCURRENCE $ 1 000 000
x.. =r~ERCIAL GENERAL LIABILITY FIRE DAMAGE IMy 0"' Ikel $ 100 000
- CLAIMS MADE [i] OCCUR MEDEXPIMyooepe~oo) $ 25 000
X Prof Liab claims made PERSONAL & ADV INJURY $ 1000 000
X Po1l Liab c1aims made GENERAL AGGREGATE $ 1000 000
~'~:,:~Eñ ~;; APñ ~~: PRODUCTS. COMP/OP AGG $ 1000 000
B ~OMOBILE LIABILITY CA5054315 8/1/2003 8/112004 COMBINED SINGLE LIMIT
(Ea~,idooll $ 1,000,000
x.. ANY AUTO
- AllOWNEDAUTOS BODIlY INJURY
SCHEDULED AUTOS IPe,pe~ool $
-
- HIRED AUTOS BODILY INJURY
NON.OWNEO AUTOS (pe,~,;deml $ ...
-
PROPERTY DAMAGE $
,... ,'. (Pe,a,,;dem)
=fAGE LIABILITY AUTOONlY.EAACCIDENT $
ANY AUTO OTHER THAN EAACC $
AUTO ONLY' AGG $
A EXCESS LIABILITY PROU1950865 8/1/2003 8/1/2004 EACH OCCURRENCE $ 5000 000
~-OCCUR 0 ClAJMSMADE AGGREGATE $ 5 000 000
$
~ DEDUCTIBLE $
X RETENTION $ 10 00 -- $
C WORKERS COMPENSATION AND B0200252638 8/1/2003 8/1120 DI X ~~CSTATU- nrJi'
EMPLOYERS' LIABILITY E.&ACi4?\1:;C~ "' $
1000000
/ ~) ~,?!§~..&~l~ ~](oOO~L
E.l. DISEASE. POLICY LIMIT $ rr'¡¡ljo 000
OTHER / ...' MAR 1 j! Ii
5 2004 IØ;
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS ebffiV ¿;:; /
Po1icy #PR01950864, Retro Active Date: 08/01/87 refers to Profes . ~~~.ution LiabijLity
v aFPIC I
umbre11a does set above Professional LiabiJ.ity Coverage. 'E ¡
-~ I
City of Oshkosh is named as an Additional Insured as respects Genera1 Liabi1ity and A';;;;oobiJ.e
Liability policies with respect to work performed by the Named Insured under the contract in effect
between them.
CERTIFICATE HOLDER I x I ADDmONAL INSURED, INSURER LETTER, CANCELLATION
SHOULD ANY OFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL ...!Q.... DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLOER NAMED TO THE LEFT. BUT FAILURE TO 00 SO SHAll
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR
City of Oshkosh REPRESENTATIVES.
P. O. Box 1130 ?~A4ð~
oshk,osh, WI 54903
ACORD 25.S (7/97)
Coll:942756 Tpl:192981 Cert:4181043
@ACORD CORPORATION 1988
MARCH 23, 2004
04-67
RESOLUTION
(CARRIED ~LOST
WITHDRAWN
LAID OVER
PURPOSE:
GRANT PRIVILEGE IN STREET / MARION ROAD, ADJACENT
TO MERCURY MARINE
INITIATED BY:
SIGMA ENVIRONMENTAL SERVICES & MERCURY MARINE,
PETITIONERS
WHEREAS, Sigma Environmental Services and Mercury Marine have requested
the Common Council grant them the privilege of installing a groundwater monitoring well
within the right-of-way of Marion Road, adjacent to Mercury Marine's Plant 64, per the
attached; 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 Sigma
Environmental Services and Mercury Marine the privilege of installing a groundwater
monitoring well within the right-of-way of Marion Road, per the attached, contingent
upon the following:
1 )
2)
3)
4)
5)
6)
7)
8)
9)
10)
The well(s) 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.
If no longer needed, the well(s) be properly abandoned and removed in
accordance with City standards and under the direction of the Department of
Public Works.
Any problem which may arise as a result of the placement of the well(s) be the
responsibility of the petitioners to correct in coordination with the Department of
Public Works.
All appropriate permits be obtained prior to the start of placement of the well(s).
The well(s) be modified or removed immediately upon the request of the City.
The petitioners secure and submit 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.
It is the responsibility of the petitioners 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.
The petitioners execute a hold harmless agreement with the City.
Analytical test data derived from the monitoring welles) be made available to the
City's environmental consultant.
Access to the monitoring well(s) to measure groundwater levels be made
available to the City's environmental consultant.