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HomeMy WebLinkAboutBONDS 24-10U b7°o a y m 7 N O C 0 C H � o :*' •yC n � n O M a O � b Oa m C7LtwyCi- Odmo � 'ON WpaW„� �IWmPfD '07 oi-1 SS�j• P :NR3 1AoaO . 0 i o0 : aov ao ° 09 O w a rb n PC+ O w fKD 4 w , R. o G w n a m �o Py' p a fo Rw• m Q, o m y n �p O pF, m n y 4 Ky a c y C Z a m H a y P. 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A,W n n t' c�ii fD N o p b O O O O O O O �p O O W ul O N VI O O O O O O O O O O O O O O ro C �• � H y Oo Vt O �D V Ut �O 0 o O o 0 0 o w O n µ tlo ? ro p N � N O O O O [iJ W VI O O Hi --+ O, O O iA N O O O O W W O O N m V tJi O fA O IJ O ' O O O V3 O O O O W V�1 O O O 46S (OJI O O O O 7 G' n VI o O NQom. V o P O O V1 O O O N O V W V IP [n m w W y O 0 0 O o p Cl 0 0 0 0 p Ct1 x � n �^p m W L0 161) O O o 0 00 cn 0 0 rn 0 o o 0 N in 0 o o 0 o 0 0 w 0 0 b 0 0 cn 0 0 cn 0 W C O C o :7 m h N O O H OV p p �, H CxC ro n� N � o o p n a 7 o 0 0 .• o n o n10 n p 0 v cn m � C D D MW.7� C' On± N n yryOf y O n mop (yGp y n n x .. � y Ia. 5 �° 'O w sL .. p, A n o y moo ¢' m Wes• d 'm r H m C3. �... m p• rt y w i]. w 9L a � ty I G.m ZIT b m M io w y 'o �• 'U o g d r too E °O' y r A o O r m o °O' r t�rf tnrf L" �jH /cn b F O O O O O O O O o O O O O O o O O O O O O O O O �• ro C �• EA hit C {A 6A o O N W y o o h1 N p� in o p, ;p rn N ut w W o o (n O p Vt o o O 0 0 0 0 0 0 0 0 0 0 o o C N W W P� Gi iy FQ y n 0 7 7 N O� En � Vi V fA O G.W � IJ V O 6s O O O O O o O O O o O O Qq O O O� O o ro n cn N � En to m cn Ol O O O O O O O Vt W 00 O O O O O O pw� co O A X � ` m N NW V1 O W N O W O O VVI o VI ll�OV W V N p� 0\ O N O (~JI N O O 0 O O O Ui O O O O O O i RECEIVED 'JUL Z 2024 Contract Number 24-10 DEPT OF PUBLIC WORKS OSHKOSH, W►SCONSIN Date Bond Executed (Date of Contract or Later) July 1, 2024 PRINCIPAL/CONTRACTOR (Legal Name and Business Address) Vinton Construction Company 1322 33rd Street Two Rivers, WI 54241 SURETY(IES) (Legal Name(s) and Business Address(es)) Travelers Casually and Surety Company of America One Tower Square Hartford, CT 06183 OWNER (Legal Name and Business Address) CITY OF OSHKOSH 215 Church Avenue PO Box 1130 Oshkosh, Wisconsin 54903-1130 OBLIGATION CITY OF OSHKOSH Type of Organization Individual _ Parhtersltip -L Corporation State of hicorporatiott Wisconsin Penal Sum of Bond Five Percent of the 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 un 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 un 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 (ii) two (2) business days following deposit in the United States mail, postage prepaid; (iii) upon delivery by,a commercialcarrier 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 thus pui pose. 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. Vinton Construction Company Name of Principal/Contractqa��`"`"""'t""''n,, Gr �Rp p RqT F, Lin c o , , > Title Richard P. Lamers /M10- sjde r Travelers Casualty and Surety Company of America Name of Surety Title Kathryn A. Weidner, Attorney -In -Fact Page 2 of 2 Travelers Casualty and Surety Company of America TRAVELERSAdlikk � Travelers Casualty and Surety Company St. Paul Fire and Marine Insurance Company POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and St. Paul Fire and Marine Insurance Company are corporations duly organized under the laws of the State of Connecticut (herein collectively called the "Companies"), and that the Companies do hereby make, constitute and appoint Kathryn A. Weidner of MADISON . Wisconsin , their true and lawful Attorney -in -Fact to sign, execute, seal and acknowledge any and all bonds, recognizances, conditional undertakings and other writings obligatory In the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. IN WITNESS WHEREOF, the Companies have caused this instrument to be signed, and their corporate seals to be hereto affixed, this 17th day of January, 2019. u Wfct�` ewa�,n� y C .� State of Connecticut By: City of Hartford ss. Robert L. Rane , enior Vice President On this the 17th day of January, 2019, before me personally appeared Robert L. Raney, who acknowledged himself to be the Senior Vice President of Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and St. Paul Fire and Marine Insurance Company, and that he, as such, being authorized so to do, executed the foregoing Instrument for the purposes therein contained by signing on behalf of said Companies by himself as a duly authorized officer. ,. N ,P,f iN WITNESS WHEREOF, I hereunto set my hand and official seal. • / I� U11011AIMMy Commission expires the 30th day of June, 2021 * Anna P. NoWk, Notary Public This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and St. Paul Fire and Marine Insurance Company, which resolutions are now In full force and effect, reading as follows: RESOLVED, that the Chairman, the President, any Mee Chairman, any Executive Vice President, any Senior Vice President, any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint Attorneys -in -Fact and Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the Company's seal bonds, recognizances, contracts of indemnity, and other writings obligatory in the nature of a bond, recognizance, or conditional undertaking, and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her; and it is FURTHER RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided that each such delegation Is in writing and a copy thereof is filed in the office of the Secretary; and it is FURTHER RESOLVED, that any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance, or conditional undertaking shall be valid and binding upon the Company when (a) signed by the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary; or (b) duly executed (under seal, If required) by one or more Attorneys -in -Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority; and it is FURTHER RESOLVED, that the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President, any Vice President, any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to any Power of Attorney or to any certificate relating theretoappointing Resident Vice Presidents, Resident Assistant Secretaries or Attorneys -in -Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof, and any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or understanding to which it is attached. I, Kevin E. Hughes, the undersigned, Assistant Secretary of Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and St. Paul Fire and Marine Insurance Company, do hereby certify that the above and foregoing is a true and correct copy of the Power of Attorney executed by said Companies, which remains in full force and effect. Dated this 1st day of July 2024 01(s Kevin E. Hughes, Assi tant Secretary To verify the authenticity of this Power ofAttorney, please calf us at 1-800-421-3880. Please refer to the above -named Attorney-ln-Fact and the details of the bond to which this Power of Attorney is attached TO: FROM: SUBJECT: CIfof RECEIVED Oshkosh JUL -1 Z024 ALL CONTRACTORS ENGINEERING DIVISION OF CITY OF OSHKOSH DEPARTMENT OF PUBLIC WORKS DISCLOSURE OF OWNERSHIP FORM DEPT OF PUBLIC WORKS OSHKOSH, WISCONSIN Please review the attached Department of Workforce Development Disclostre of Ozonerslrip 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 Ozonersltip 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,Atem 3 of the attached Disclosure of Ownership form does NOT apply to my firm, or a shareholder, office��,RR ftr6 *,Y firm, 41 I. 4' r \ _ —�C�i.L i Z Name Richard P. Lamers Printed Name Vice President Title Vinton Construction Company Company Name 7/01/2024 Date L\Engineering\Tracy Taylor\Public Worls Contracts\Miscellaneous\Disclosure of Ownership Fomi_2-1- Page 1 of 1 17.doa City Hall, 215 Church Avenue P.O, Box 1130 Oshkosh, WI 54903-1 130 hitp://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>I 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 26% 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 N/A 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,par4liju,that the information, contained in this document, is true and accurate qrrnrr1inq to mv kA&W6dtf"Nd belief. Print the Name of Authorized ' ••O�f ,r-'""``•.�'t� Richard P. Lamers = V'' 01P 0 Rq ', =. Authorize Off�Signatur$ a- s-� Date Signed 7/01/2024 t R 1 Corporation, Partnership or %o`t'e P.rVrietor ij3fie �••�:S�Q`�S Vinton Construction Company,, ' Street Address or P O Box ,,��11� City State Zip Code 1j1,`, 11111161 1322 33rd Street P.O. Box 137 Two Rivers I WI 154241 If you have any questions call (608) 266-6861 ERD-7777 (R. 01/2011) CONTRACT 24-10 F RECEIVED ATTACHMENT A JUL —1 2024 LIST OF PROPOSED SUBCONTRACTORS DEPT OF PUBLIC WORKS OSHKOSH, WISCONSIN Pursuant to Section 66.29(7), Wisconsin Statutes, the Bidder, as part of this Proposal, submits this full and complete list of all the proposed 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 perforin 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 from the Subcontractors 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 PROPOSED SUBCONTRACTOR ..LIM I I M10 CLASS OR ITEMS OF WORK PERCENT OF 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 Subcor�tt���'up p�,•'"""`', pip , G�✓�-- `�' r G�RPORAT��'Or� , Signature of Bidder , , U ;a 7'A erg .'u'ice President Page 13 of 16 RECEIVER CONTRACT 24-10 PROPOSAL 'JUL — 1 2024 The undersigned will begin work as specified after award of the Contract and �9p�Sf#�tt 1�3s• OSHKOSH, WISCONSIN I hereby certify that all statements are made in behalf of Vinton Construction Company (Name of Corporation, Partnership, or Person Submitting Bid) a corporation organized and existing under the laws of the State of Wisconsin a Partnership consisting of ; or an individual trading as ; of the City of Two Rivers ; State of Wisconsin That I have examined and carefully prepared this Proposal from the Plans and Specifications a�ve Y checked the same in detail before submitting this Proposal; that I have full authoritycs```�k statements and submit this Proposal in (its) (their) behalf; and that said statements are trl�co e•; Ci GOR�'0 �qT � U Si atfi ,,`p111g11N1fp///j�,,, rr4r,�r ``�� ` �" 0 J• BUR/f ���� Richard P. Lamers / Vi&gresi nt � o'ei�R y � 10. (Title, if any) \G PUBS 2: to before me this 1st day of Jul Notary PuVic, or other authorized to administerCP� �� ��i O• �7i� 20 24 (Bidder should not add any conditions or qualifying statements to this Proposal as otherwise the Proposal may be declared irregular as not being responsive to the Advertisement.) Accompanying this Proposal is a Biel Bond in the amount of 5 % of the total amount of the Bid, as called for in the Official Notice to Contractors. Page 16 of 16 cito� Oshkosh TO: ALL CONTRACTORS FROM: ENGINEERING DIVISION OF CITY OF OSHKOSH DEPARTMENT OF PUBLIC WORKS SUBJECT: SOIL AND GROUND WATER MANAGEMENT PLAN CERTIFICATION RECEIVED 'JUL - Y 2024 DEPT OF PUBLIC WORKS OSHKOSH, WISCONSIN I certify by my signature below that our firm has read the Soil altd Ground Water Maltagenlertt Plan included in the Specifications and will comply with the requirements of the Plan. `,`t"pfn'it 'Ploo r� GO RTF`'r 2 Name � Per - ` SE AL Richard P. Lamers Printed Name r=`rrnttunu;rT Vice President Title Vinton Construction Company Company Name 7/01/2024 Date l:\Engineering\Tracy Taylor\ Publfi:Works Contracts\Miscellaneous\Soil&Groundwater Page 1 of 1 Management Plan Certif1catlon_2-1-17.doo: City Hall, 215 Church Avenue P.O. Box 1130 Oshkosh, WI 54903-1 130 http://www.ci.oshkosh.wi.us r RECEIVED I.1 up] ROOM 91 Contract Number City Contract 24-10 Date Bond Executed (Date of Contract or Later) June 26, 2024 PRINCIPAL/CONTRACTOR (Legal Name and Business Address) Michels Road & Stone, Inc. 817 Main Street Brownsville, WI 53006 SURETY(IES) (Legal Name(s) and Business Address(es)) Liberty Mutual Insurance Company 175 Berkeley Street Boston, MA 02116 OWNER (Legal Name and Business Address) CITY OF OSHKOSH 215 Church Avenue PO Box 1130 Oshkosh, Wisconsin 54903-1130 OBLIGATION JUL m 1 20211 CITY OF OSHKOSH DEPT OF PUBLIC WORKS OSHKOSH, WISCONSIN Type of Organization _ Individual _ Partnership X Corporation State of Incorporation DE 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 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 (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. Michels Road & Stone, Inc. Liberty Mutual Insurance Company Name of Principal/Contractor Name, of Surety Un M- � Title 05"' i u Y C S ICE G(_i Title Heather R. Goedtel, Attorney -in -Fact QppD & STO'}V tv ` I , '�Ig1111/I11N11/, Page 2 of 2 Acknowlediament of Corporate Surety STATE OF Minnesota COUNTY OF Hennepin On this 26th day of June ) ss ) 2024 Heather R. Goedtel who being by me duly sworn did say that she is the aforesaid Attorney -in -Fact of the before me appeared , to be known, Liberty, Mutual Insurance Company a corporation; that the seal affixed to the foregoing instrument is the corporate seal of said corporation, and that said instrument was signed and sealed on behalf of said corporation by the aforesaid officer, by authority of its Board of Directors; and the aforesaid officer acknowledged said instrument to be the free act and deed of said corporation. Notary Public Signature (Notary Seal) MICHELLE DIANE HALTER a'' a Notary Public State of Minnesota My Commission Expires January 31, 2028 N > a_Z c.N o� >v do O N C RYf m M 1= d 0. E� 0�Liberty mutua. SURETY This Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in the manner and to the extent herein stated. Liberty Mutual Insurance Company The Ohio Casualty Insurance Company West American Insurance Company POWER OF ATTORNEY Certificate No: 8212026-190003 KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire, that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana (herein collectively called the "Companies*), pursuant to and by authority herein set forth, does hereby name, constitute and appoint; Blake S Bohlig; Brian D Carpenter; Charles Draper, Craig_ Olmstead; Erik T. Gunk -el- I laley PfluE; f leather R. Goedtek Jessica Flecker, Kelly Nicole [nghauser: Laurie Michelle Ilalter: Michelle Ward, Nicole Laneer; Sara Whitlieid all of the city of Bloomington state of MN each individually if there be more than one named, its true and lawful atoomey-in-fact to make, execute, seal, acknowledge and deliver, for and on its behalf as surety and as its act and deed, any and all undertakings, bonds, recognizances and other surety obligations; in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons, IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 25th day of June 1 2024 . Liberty Mutual Insurance Company P".1Nst/ P01 INS& a 1NSUga The Ohio Casualty Insurance Company �J ace"oQ"r y0 gJ 4oaPaa,r'Pyy \�P4oavo�r Ln West American Insurance Company 6 dNO >n Y;1912�0 0 1919� rn 1991 0 a w o a rd�� °Acltue�da y0 NAM?�T7� v, 'NDIANF y: aa� B n-w 6A r.-v A-itrnnt Sarrohry State of PENNSYLVANIA County of MONTGOMERY this 25th day of June 1 2024 before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance npany, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes -ein contained by signing on behalf of the corporations by himself as a duly authorized officer. IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at Plymouth Meeting, Pennsylvania, on the day and year first above written y- tor` 0F Commonwealth or PennsMna - Notary Seal Teresa Pastella, Notary Public Montgomery County Mycomm"onexOesMa1ch28,2025 B y Ir Commission number 1126044 rye RY t� Teresa Pastella, Notary Public Mcrt+ber. PennsyNarra Assaciativn or Noiarias ry This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Insurance Company, and West American Insurance Company which resolutions are now in hill force and effect reading as follows: Liberty ARTICLE IV— OFFICERS: Section 12, Power of Attorney. Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the; President, and subject to such limitation as the Chairman or the President may prescribe, shall appoint such attorneys -in -fact, as may be necessary to actin behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys -in -fact, subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation, When so executed, such instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attorney -in -fact under the provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority. ARTICLE XIII — Execution of Contracts: Section 5. Surely Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Company to make, execute, sea[, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys -in -fact subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company; When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation — The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assistant Secretary to appoint such attorneys -in - fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Authorization — By unanimous consent of the Companys Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with the same force and effect as though manually affixed. 1, Renee C. Llewellyn, the undersigned, Assistant Secretary, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy of the Power of Attorney executed by said Companies, is in full force and effect and has not been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this 26th day of June , 2024 . Pv 1NSU� �jV INS& � VNSU4 9 °oavoagrcoy�i+� �J ooaPo�>��c+ `VProavoRyroyc'ca 1912 o Z 1919 co o 6 1991' e rd�g�/ Z4-14-d� -4, ugeaaas y°, 'rAUQs� aa� '<p 'Ho,ANi" A By. -Renee C. Llewellyn, Assistant Secretary LMS-12873 LMIC OCIC WAIL Multi Co 02/21 O It N N 00 0 9 9 City of Oshkosh TO: ALL CONTRACTORS FROM: ENGINEERING DIVISION OF CITY OF OSHKOSH DEPARTMENT OF PUBLIC WORKS SUBJECT: DISCLOSURE OF OWNERSHIP FORM RECEIVED JUL - 12024 OE!IiIC; OF PUBLIC WORKS OSOSK WISCONSIN 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. Otto J Ramthun, Jr Printed Name Sr. Vice President Title Michels Road & Stone, Inc Company Name Date L\engineering\Tracy Taylor\ Public Works Contracts\6liscellanews\Disclosure ofOwnershipForn_2-1- Page I of I 17.doa City Hall, 215 Church Avenue P.O. Box 1130 Oshkosh, WI 54903-1 130 http://www.cl.oshkosh.wl.us CONTRACT 24-10 ATTACHMENT A f RECEIVED JUL — Y 2024 LIST OF PROPOSED SUBCONTRACTORS DEPTOFPUBLIC WORKS OSHKOSH, WISCONSIN Pursuant to Section 66.29(7), Wisconsin Statutes, the Bidder, as part of this Proposal, submits this full and complete list of all the proposed 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 from the Subcontractors 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 PROPOSED SUBCONTRACTOR NC(j%-,(`aS"- 6 1 CLASS OR ITEMS OF WORK AspVIA (� Loy,& N't conskv�.h� Cor�Akw^ Po�«\A- Mallon PERCENT OF CONTRACT AMOUNT (D • 91 °lo IS.03°/u oz. 716,010 c0q)- CDC CyYy'a".mA . ZNC • Jaw M!� . y 0I o fwn loVr�Oer► cS .�l`� �TVA�1-►�- Cor% Jo 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). 446%.q.ZooF�A04 — Signatur f Bidder Rarnthun, Jr Sr. vice President Page 13 of 16 RECEIVED CONTRACT 24-10 JUL - 12024 PROPOSAL DEPT OF PUB L[C W 012 h; 7SHKOSr-1 The undersigned will begin work as specified after award of the Contract and complete as spe�Ci�e�i: I hereby certify that all statements are made in behalf of Michels Road & Stone, Inc (Name of Corporation, Partnership, or Person Submitting Bid) a corporation organized and existing under the laws of the State of Delaware a Partnership consisting of an individual trading as the City of State of or of That I have examined and carefully prepared this Proposal from the Plans and Specifications and have checked the same in detail before submitting this Proposal; that I have full authority to make such statements and submit this Proposal in (its) (their) behalf; and that said statement are true correct. O Q R ro'L,��= tun, Jr Sign Otto J R U o� q�ti ,Lu Subscribed and sworn to before me this day of Notary Public, or other authorized to administer Sr. Vice President (Title, if any) .•�i°��P� SAF„'''�. 20. (Bidder should not add any conditions or qualifying statements to this Proposal as otherwise the Proposal may be declared irregular as not being responsive to the Advertisement.) Accompanying this Proposal is a Bid Bond in the amount of 5 % of the total amount of the Bid, as called for in the Official Notice to Contractors. Page 16 of 16 RECEIVED City of JUL -1 2024 Oshkosh DEPT OF PUBL IC WORKS OSHKOSH, WISCONSIN TO: ALL CONTRACTORS FROM: ENGINEERING DIVISION OF CITY OF OSHKOSH DEPARTMENT OF PUBLIC WORKS SUBJECT: SOIL AND GROUND WATER MANAGEMENT PLAN CERTIFICATION I certify by my signature below that our firm has read the Soil and Ground Water Management Plan included in the Specifications and will comply with the requirements of the Plan. Otto J Ramthun, Jr Printed Name Sr. Vice President, Highway Title Michels Road & Stone, Inc Company Name --7-1 Date h Engineering\ Tracy Taylor \ Public Works Contracts\ Miscellaneous \Soil &Groundwater Page 1 of 1 Management Plan Certification_2-1-17,docx City Hall, 215 Church Avenue P.O. Box 1130 Oshkosh, WI 54903-1130 http://www.cl.oshkosh.wi.us