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HomeMy WebLinkAbout25-05 Bondsli re Contract Number 25-05 Bond Number Date Bond Executed (Date of Contract or La(er) February 4, 2025 PRINCIPAL/CONTRACTOR (Legal game and Business Address) Advance Construction, Inc. 2141 Woodale Ave Green Bay, WI 54313 SURETY(TES) (Legal Name(s) and Business Address(es)) Great American Insurance Company 301 E. Fourth St., Cincinnati, OH 45202 OWNER (Legal Name and Business Address) CITY OF OSHKOSH 215 Church Avenue PO Box 1130 Oshkosh, Wisconsin 54903-1130 OBLIGATION , LECEI ) CITY OF OSHKOSH --. ..... _.... OUT c�T, P LJC W c?,s k)S1? i?Sli, SCONSI9*t Type o/Organization —,_ hutiuidual _ Parhiership X— Corporatioal State of hicorporation Wisconsin Penal Sum of Bond 5% 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 uponbetween 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. A ce Construction, Inc, Great American Insurance Company Name of Principal/Contractor Title Name of Surety Title - Deborah Knapp - Attorney -In -Fact Page 2 of 2 GREAT AMERICAN INSURANCE COMPANY® Administrative Office: 301 E 4TH STREET • CINCINNATI, OHIO 45202 • 513-369-5000 0 FAX 513-723-2740 The number of persons authorized by this power of attorney is not more than THIRTEEN No.0 22545 POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the GREAT AMERICAN INSURANCE COMPANY, a corporation organized and existing under and by virtue of the laws of the State of Ohio, does hereby nominate, constitute and appoint the person or persons named below, each individually if more than one is named, its true and lawful attorney -in -fact, for it and in its name, place and stead to execute on behalf of the said Company, as surety, any and all bonds, undertakings and contracts of suretyship, or other written obligations in the nature thereof; provided that the liability of the said Company on any such bond, undertaking or contract of suretyship executed under this authority shall not exceed the limit stated below. Name KIMBERLY ASCHENBACH BRIAN REIMER DEBORAH KNAPP DILLON HOLEWINSKI RHONDA KLUESSENDORF ZACHARY KAISER ANNEMARIE WILLBANKS LYNN CLAUSEN SHELLEY RADATZ NICHOLAS JULIAN ANDREW WEISHEIPL CHRISTEEN CARNEY Address Limit of Power LAYNE SELIN ALL $100,000,000 ALL OF MENASHA, WISCONSIN This Power of Attorney revokes all previous powers issued on behalf of the attorneys) -in -fact named above. IN WITNESS WHEREOF the GREATAMERICAN INSURANCE COMPANY has caused these presents to be signed and attested by its appropriate officers and its corporate seal hereunto affixed this 24TH day of SEPTEMBER 2024 Attest GREAT AMERICAN INSUYLANCE COMP Assistant Secretary divisional Senior rice President STATE OF OHIO, COUNTY OF HAMILTON - ss: MARK VICARIO (977-377-2405) On this 24TH day of SEPTEMBER 2024 , before me personally appeared MARK VICARIO, tome known, being duly swom, deposes and says that he resides in Cincinnati, Ohio, that he is a Divisional Senior Vice President of the Bond Division of Great American Insurance Company, the Company described in and which executed the above instrument; that he knows the seal of the said Company; that the seal affixed to the said instrument is such corporate seal; that it was so affixed by authority of his office under the By -Laws of said Company, and that he signed his name thereto by like authority. SUSAN A KOHORST Notary Public State of Ohio =o °+ My Comm. Expires May 18, 2025 This Power of Attorney is granted by authority of the following resolutions adopted by the Board of Directors of Great American Insurance Company by unanimous written consent dated June 9, 2008. RESOLVED: That the Divisional President, the several Divisional Senior Vice Presidents, Divisional Vice Presidents and Divisonal Assistant Vice Presidents, or any one of them, be and hereby is authorized, from time to time, to appoint one or more Attorneys -in -Fact to execute on behalf of the Company, as surety, any and all bonds, undertakings and contracts ofsuretyship, or other written obligations in the nature thereof; to prescribe their respective duties and the respective limits of their authority; and to revoke any such appointment at any time. RESOLVED FURTHER: That the Company seal and the signature of any of the aforesaid officers and any Secretary or Assistant Secretary of the Company may be affixed by facsimile to any power of attorney or certificate of either given for the execution of any bond, undertaking, contract of suretyship, or other written obligation in the nature thereof, such signature and seal when so used being hereby adopted by the Company as the original signature of such officer and the original seal of the Company, to be valid and binding upon the Company with the same force and effect as though manually affixed. CERTIFICATION I, STEPHEN C. BERAHA, Assistant Secretary of Great American Insurance Company, do hereby certify that the foregoing Power of Attorney and the Resolutions of the Board of Directors of June 9, 2008 have not been revoked and are now in full force and effect. Signed and sealed this 4th day of February 2025 41,— e � 3 Assistant Secretary S1029AH (03/20) City o� Oshkosh TO: ALL CONTRACTORS OSHKOSH, WISCONSIN 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. Name Brian Joski Printed Name Secretary Title Advance Construction, Inc. Company Name 2/17/25 Date 1:\Engineering\Tracy Taylor\Public Works Contracts \Miscellaneous\Sol[ & Groundwater Page 1 of 1 Management Plan Certificatior_2-1-17.docx City Hall, 215 Church Avenue P.O. Box 1130 Oshkosh, WI 54903-1130 http://www.ci.oShkosh.wi.us CONTRACT 25-05 PROPOSAL il €pA The undersigned will begin work as specified after award of the Contract and 5[,[p[tpej;isy( [' p d. I hereby certify that all statements are made in behalf of Advance Construction Inc. (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 • State 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 statements are true and correct. 6 Signature Secretary (Title, if any) Subscribed and sworn to before me this 17 day of Febr 2025 = rapt ARYNo ary ublic, or other authorized to administer 3/17/26 Z PUSO'j Jc r zAygt,, ,o • „SGO�s F� (Bidder should not add any conditions or qualifying statements to'I t7 'rroposal 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 19 of 19 IRECVINhi CONTRACT 25-05 ATTACHMENT A) �)E,I?T ()V PUBLIC WORKS LIST OF PROPOSED SUBCONTRACTORS 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 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 CLASS OR ITEMS OF WORK PERCENT OF CONTRACT AMOUNT � Z eo Oo I hereby certify that the use of the name(s) of the above Proposed Subcontractor(s) was with the knowledge and consent of the said Subcontractor(s). 7 01, ") ? J, Signature idder Page 16 of 19 TO: ALL CONTRACTORS FROM: ENGINEERING DIVISION OF CITY OF OSHKOSH DEPARTMENT OF PUBLIC WORKS SUBJECT: DISCLOSURE OF OWNERSHIP FORM 'Z,4CFRN) I ' m t� DEff OF VUBLIC WORKS <}SHKOSII, 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. Name Brian Joski Printed Name Secretary Title Advance Construction, Inc. Company Name 2/17/25 Date I:\Engineering\Tracy Taylor\ Public Works Contracts\Miscellaneous\ Disclosure ofownership Porm 2-1- Page 1 of 1 17.docx City Hall, 215 Church Avenue P.O. Box 1130 Oshkosh, WI 54903-1130 http://www.cl.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 None 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 accordina to my knowledae and belief. Print the Name of Authorized Officer Brian Joski Authorized Officer Sign re Date Signed ` 12/17/25 Corporation, Partn`erdlIp or Sole Proprietorship Name Advance Construction, Inc. Street Address or P O Box City State Zip Code 2141 Woodale Ave Green Bay. WI I 54313 If you have any questions call (608) 266-6861 F:pn-7777 rR nion111 r ; � FER 17 2025 MY CAP O-gMCOSH 71�" OF PUBLIC WORKS Contract Number 25.05 OSH OSH, WISCONSIN Date Boni Executed: (I)ate of Contract ax *Later) 2/1012025 PRINCIPAL/CONTRACTOR (Legal Name and Business Address) JOSSART BROTHERS, INC. 1682 Swan Road Cie Pere, WI 64115 SURETY(IM) (Legal Name(s) and Business Address(es)) Merchants National Bonding Company 570.0 Westown Pkwy Weat Des Moines, IA 60266 OWNER (Legal Name and Business Address) CITY OF OSHKOSH 215 Church Avenue SRO Box 1130 Oshkosh, Wisconsin 349031130 OBLIGATION Typs of Organization Individual []Partnership Corporation State of1'ncorpara�on. Portal Suns 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 identifted above it the Ow n.er 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) buusixtess days of writtertnotice 'to the Coat factor and Surety of Owner's intent to matte a claim upon#his. 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 coAtract with Owner in accordance with the terms of the bid and golves" such bond(s) that may be ;specified in the bidding documents for the faithful perforthance 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 corxtract with another party to perform the work covered in such bid, then the Surety and the Contractor shall, have no obligation twder this Borid. Notice to the Contractor or Surety " be deemed to have been &Av= (i) upon delivery to an officer or persoA entitled to such notice, if hand delivered; or (H) two (2) business days following deposit. in the United States mail, postage prepaid; (M) 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 transwAlWon. Notices shall be provided to the Ovaaer, Surety and/or Contractor at their address as specified on this Bond or to 41kcsimile; email or other electronic address that has been provided in writing to the, other .party to be used for this puVose. The laws of the State, of Wisconsin shall govern the interpretation and construction of .this Bond. Winnebago County shall be the venue for an disputes arising under this Bond. Any provision In this Bond that may conflict with statutory* or other legal requirement shall be deemed deleted herefrow and provisions conforming to the statutory or other legal requirement shall be deemed incorporated horOhn. JOSSART BROTHERS, INGX Merchants National Bonding Compqqy._-..,. Name ofPrincipal/ContraName of Surety A BONDING POWER OF ATTORNEY KnowAii persons t3y These Presents, that MEF�CHANTS 11ONDING COMPANY MUTUAL) and MERCHANTS NATIONAL BONDING, INC., both being corporations ofthe'_5tate of lower di�la Merohanio National indemnify ompany {in California only) (herein collectively called the tompanles') do hereby make, constitute and appoint, individually, Chris Stelnagel; Christopher M Kemp; C'onnle Smith; Eliot Motu; Julia DoV91001 Kory Mortal; Michael J Douglas; Robert Downey; Samuel Duchow their true and laWNI A4ttomey(skln+act to sign Its name as surety(fea) and tc execute, seal and acknowledge any and all bonds, undurtaldngs, contracts aitd anise wriffen :instruments In the nature thereof, on behalf 01 the Cgrripanies in their bustness of guaranteeing the fidelity of persons, guaranteeing the, performance of contracts and executing or guarant Wln6 bonds and ❑ndonakingrx isgpired or permitted In any act bns or proceedings allowed by law: This. Powe"f-Attorney is granted and Is signed and sealed by facsimile under and by authority of the following Sy Laws aws adopted by the Board of Directors of Merchants Bonding Company (Mutual) on April 23, 2611 and a nanded August 14, 2015 and adopted by the Board of Directors of MerchantsNational Bonding, Inc:, on October 16, 2013. *The President, Secretary, Treasurer, or any Assistant Treasurer or any P isistant secretary or arty Vide President shall have power and authority to appDfn# Att4mays-ln•Fact, and to authorize: them to execute on b sif of the Company, and attach the seat of the Company thereto,. bonds and undertakings, recogritzences, contracts aftndemnify and otherwNting pbligatory in the tiat4ratherecf,' "The signature of any authorized offrcer and the seal. ofthe,Company may be, at xed byteosimile or olectronie Ifensmission to any Flower of Attorney or Certification thereof authorizing the execution and defivery of any bond, undertaking, recognizonob, or other suretyshlp obligations of the Company, and such signature and seal when ad used shall have the same force nd effect.as though manually itxed. In connection with obiigations In favor of the Florida Department of Ttensportetic n only, it is agreed thatthe power and aut hority hereby given to the Attamey-in-Feet tnalmdes any and ail consents for the Mlease of retained mentages and/or final estimates on engineering' and ccnstructlon rogtracYs required i y the Sfa.N pf Flonda Department. of Transportatloh, It is bily understood that consenting. to the State oft=iodda Department of trensporlatlon making payment of the ifiial estimate to the Contractor an Vor its 6s8lgnae, shall not'retieve this surety company of any of its obligations under its bond. In connection with obligations in favor of the Kentucky Department of HI to the Attomey-lri•Fact cannot be modified or revoked unless prior w Department of Highways of the Commonwealth of Kentucky at least thi in Witness Whereof, the Companies have caused this fnstrunientto be STATE OF IOWA COW 7Y OF [iALI.AS ss. On this 3rd. day of did say that he Is President seals affixed to the foregoir of the companiess by au hori February 2024 , before me MERCHANTS BONDING COMPANY ishrnent are the Corporate Seale of It 0 their reaneative Boards Of Directors. Miller Z- 11 commiselon Number'787952 j A Y My commisston rzolres rOWP January 20, 202 I, William Warner, Jr, Secretary of MERCHANTS BONDING C certtfythotthe above and.forpUding is a true.and correct copy force and effect.and has not been amended or revoked: Witness Whereof, I have PQA0018 (1/24) hand and Oxed the seal of *00-106 aG4�Pooq «��•. 1tI23 . dr ix It to agreed that th'e power and authority hereby given ri notice of such intent has been given to the Cornmtsstoner- rriorto the modification or revocation. ;,sled this 3rd day of February , 2024 MERCHANTS BONDING COMPANY (MUTUAL) MERCHANTS NATiONA,L BONDING, INC dlbfa MERCHANTS! NATIONAL INiJ)GNINrty compmy By Fresfdent rry Taylor, to me personally- known, who- being by me duly.sworn and MERCHANTS NATIONAL BONDING, INC4 and that the as; and that the sold instrument Was signed and.sealed in behalf C?24 —18w�.4v MERCHANTS NATIONAL, BONDING, INC.., do hereby RNDY executed by said Companies, which to $611 in full Companies on this 10th day of February , 2025 . are'' secretary M mvw) cirof- Oshkosh" TO: ALL CONTRACTORS FROM: ENGINEERING DIVISION OF CITY OF OSHKOSH DEPARTMENT OF PUBLIC WORKS SUBJECT: SOIL AND GROUND WATER MANAGEMENT PLAN CERTIFICATION FED 17 2f-2 DE TOr,, P1If3I,If.: VV0RKS 0S14X0SII, WISCONSIii I certify by my signature below that our -firm has read the Soil and Ground Water Management Plan included in the Specifications and Do comply with the requirements of the Plan. Name CS Jesse Jossart Printed Name VP/Secretary Title Jossart Brothers, Inc. Company Name February 11, 2025 Date I:\Engineering\Tracy Taylor\Public Works Contracts\Miscellaneous\Soil do Groundwater Page 1 of 1 Management Plan Certification_2-1-17,dooc City Hall, 215 Church Avenue P.O. Box 1130 Oshkosh, WI 54903-1130 http://www,ci.oshkosh.wi.us CONTRACT 25-05 202 PROPOSAL DFP'D' OF PUBLIC WORYc, The undersigned will begin work as specified after award of the Contract and coriif¢ I hereby certify that all statements are made in behalf of Jossart Brothers, Inc. (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 State 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�4re ie and correct. Signature Jesge Jossart, VP/Secretary (Title, if any) a e't . a 41 Subscribed and sworn to before me this E E February 2025 OOTAR e N ary Public, or other authorized to adn irtii sfer �)BLIG . �A Expiration Date: April 12, 2027 '®'�je ' ..,,,,..•'` 0 (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 19 of 19 CONTRACT 25-05 ATTACHMENT A 01, Pt r 3�_,I( G�It�I2� s c� srry LIST OF PROPOSED SUBCONTRACTORS c SHKO&I, 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 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 PERCENT OF SUBCONTRACTOR CLASS OR ITEMS OF WORK CONTRACT AMOUNT Storm Companies, Inc. Vinton Construction Al Dix Concrete Bodart Electric MCC, Inc. Fox River Landscaping Traffic Control 1 % Excay. & Conc. Paving 22% Concrete 7% Electrical 2% Asphalt Paving 2% Landscaping 2% I hereby certify that the ttW of the name(s) of the above Proposed Subcontractor(s) was with the knowledge and c2nsenjA the said Subcontractor(s). Bidder Jesse Jossart, VP/Secretary Page 16 of 19 t gY.F..:. f.`'' DEPT OP PUBLIC WORK c OSMKOSH, WISCONSIN 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. N2W Jesse Jossart Printed Name VP/Secretary Title Jossart Brothers, Inc. Company Name February 11, 2025 Date 1.•\Engineering\Tracy Taylor\Public Works Contracts\Miscellaneous\Dlsclosure of Ownership Form-k1- Page 1 of 1 17.docx City Hail, 215 Church Avenue P.O. Box 1130 Oshkosh, WI 54903-1130 http://www.cl.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 N/A Street Address or P 0 Box City State Zip Code Business Name Street Address or P 0 Box City State Zip Code Business Name Street Address or P O Box City State Zip Code Business Name Street Address or P 0 Box City State Zip Code I hereby state under penalty of perjury that the information, contained in this document, is true and sscr"rnfa artrtnMing to my knnwlAddp and heli2f_ Print the Name of Authorized Officer Jesse Jossart Authorized Officer Sig Date Signed February 11, 2025 Corporation, P ip or Sole Proprietorship Name Jossart Brothe , Inc. Street Address or P 0 Box City State Zip Code 1682 Swan Road De Pere WI 54115 If you have any questions call (608) 266-6861 ERD-7777 (R. 0112011) BID BOND CITY OF OSHKOSH Contract Number 25-05 EPT OF PUBLIC WORKS 0sHx OM, WIscOrrSrN Date Bond Executed (Date of Contract or Later) 1/29/2025 PRINCIPAL/CONTRACTOR (Legal Name and Business Address) DORNER, INC. E506 Luxemburg Road Luxemburg, WI 54217 SURETY(IES) (Legal Name(s) and Business Address(es)) Fidelity And Deposit Company Of Maryland 1299 Zurich Way, 5th Floor Schaumburg, IL 60196-1056 OWNER (Legal Name and Business Address) CITY OF OSHKOSH 215 Church Avenue PO Box 1130 Oshkosh, Wisconsin 54903-1130 OBLIGATION Type of Organization FIndividual ❑Partnership Corporation State of Incorporation \All 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 statutory or other legal requirement shall be deemed incorporated herein. DORNER INC. Fidelity And Deposit Company Of Maryland Name of Principal/Contractor Name of Surety Q R A/ eel V Title (n 7 "11� � rn0Z1tle Connie Smith, Attorney -in -fact ' ` ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the ZURICH AMERICAN INSURANCE COMPANY, a corporation of the State of New York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the Stale of Illinois, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Illinois (herein collectively called the "Companies"), by Robert D. Murray, Vice President, in pursuance of authority granted by Article V, Section 8, of the By -Laws of said Companies, which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the dale hereof, do hereby nominate, constitute, and appoint Michael J. DOUGLAS, Connie SMITH, Chris STEINAGEL, Christopher M. KEMP, Robert DOWNEY, Kory MORTEL and Eliot MOTU, all of Hudson, Wisconsin, its true and lawful agent and Attorney -in -Fact, to make, execute, seat and deliver, for, and on its behalf as surely, and as its act and deed: any and all bonds and undertakdngs, and the execution of such bonds or undertakings in pursuance of these presents, shall be as binding upon said Companies, as fully and amply, to all intents and purposes, as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at Its office In Now York, New York., the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at Its office in Owings Mills, Maryland,, and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland., in their own proper persons. The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V, Section 8, of the By -Laws of said Companies, and is now in force. IN WITNESS WHEREOF, the said Vice -President has hereunto subscribed his/her names and affixed the Corporate Seals of the said ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 27th day ofNovember, A.D. 2019. 0,yh-ItAs all 3 $ SEAL5 ATTEST: ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND By. Robert D, Murray lice President t %>6%A-v7L By. Dawn B. Brown Secretary State of Maryland County of Baltimore On this 27th day of November, A.D. 2019, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, Robert D. Murray, Vice President and Dawn E. Brown, Secretary of the Companies, to me personally known to be the individuals and officers described in and who executed the preceding Instrument, and acknowledged the execution of same, and being by me duly sworn, deposeth and satth, that he/she Is the sold officer of the Company aforesaid, and that the seals affixed to the preceding instrument are the Corporate Seals of said Companies, and that the said Corporate Seals and the signature as such officer were duly affixed and subscribed to the sold Instrument by the authority and direction of the said Corporations. IN TESTIMONY WHEREOF, I have hereunto sot my hand and affixed my Official Seal the day and year first above written. �R, Constance A. Dunn, Notary Public 4, kryrg;;;ir•3.�` tttpm,0`` My Commission Expires: July 9, 2023 EXTRACT FROM BY-LAWS OF THE COMPANIES "Article V, Section 8, AttomW-in-Fact, The Chief Executive Officer, the President, or any Executive Vice President or Vice President may, by written instrument under the attcsted corporate seal, appoint attorneys -in -fact with authority to execute bonds, policies, recognizances, stipulations, undertakings, or other like Instruments on behalf of the Company, and may authorize any officer or any such attorney -in -fact to affix the corporate seal thereto; and may with or without cause modify of revoke any such appointment or authority al any lime." CERTIFICATE 1, the undersigned, Secretary of the ZURICH AMERICAN INSURANCE COMPANY, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, do hereby certify that the foregoing Power of Attorney is still In full force and effect on the date of this certificate; and I do further certify that Article V, Section 8, of the By - Laws of the Companies is still in force. This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the ZURICH AMERICAN INSURANCE COMPANY at a meeting duly called and held on the 15th day of December 1998. RESOLVED: "That the signature of the President or a Vice President and the attesting signature of a Secretary or an Assistant Secretary and the Seal of the Company may be affixed by facsimile on any Power of Attorney ...Any such Power or any certificate thereof bearing such facsimile signature and seal shall be valid and binding on the Company," This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held on the 5th day of May, 1994, and the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on the 10th day of May, 1990, RESOLVED: "That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature of any Vice -President, Secretary, or Assistant Secretary of the Company, whether made heretofore or hereafter, wherever appearing upon a certified copy of any power of attorney issued by the Company, shall be valid and binding upon the Company with the same force and effect as though manually affixed. IN TESTIMONY WHEREOF, I have hereunto subscribed my name and affixed the corporate seals of the said Companies, this 29th— day -of -January , 2025, . � O Myhi"1wM� By: Brian M. Hodges Vice President TO REPORT A CLAIM WITH REGARD TO A SURETY BOND, PLEASE SUBMIT A COMPLETE DESCRIPTION OF THE CLAIM INCLUDING THE PRINCIPAL ON THE BOND, THE BOND NUMBER, AND YOUR CONTACT INFORMATION TO: Zurich Surety Claims 1299 Zurich Way Schaumburg, IL 60196-1056 www,reportsfclaimsOzurichna,com 800.6264577 r,A City fV Oshkosh TO: ALL CONTRACTORS FROM: ENGINEERING DIVISION OF CITY OF OSHKOSH DEPARTMENT OF PUBLIC WORKS SUBJECT: SOIL AND GROUND WATER MANAGEMENT PLAN CERTIFICATION � -;° -0 -NJBLIC WORKS osi-IKOSH, WISCONS'-N 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. Name Todd Dorner Printed Name Vice President Title Dorner Inc. Company Name 2/17/25 Date I:\Engineering\Tracy Taylor\Public Works Contracts\ Miscellaneous \Soil &Groundwater Page 1 of 1 Management Plan Certlf cation_24-17.docx City Hall, 215 Church Avenue P,O. Box 1 130 Oshkosh, WI 54903-1 130 http://www,cl,oshkosh.wl.us CONTRACT 25-05 PROPOSAL )a The undersigned will begin work as specified after award of the Contract and compldtd`�i�p&jlfi@d S St , ISCONSVN I hereby certify that all statements are made in behalf of Dorner Inc. (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 ; State 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 sta ents e true and correct. Signature Vice President (Title, if any) Subscribed and sworn to before me this �Z_ day of,.,►�';' ► 'i r u 20 atenu� _, �: NorgR�, •: �^ Notary Public, or other authorized to administer p�/gL IG s y• WI sco (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 19 of 19 CONTRACT 25-05 ATTACHMENT A _ LIST OF PROPOSED SUBCONTRACTORS 4 ° ` ` �UBLIC jSC0NS N 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 waiversof 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 PROPOSED SUBCONTRACTOR 11�vl-rw,ov X - MCC />cid XI-` —r*'- SuRVEY CLASS OR ITEMS OF WORK �.Nc. ��Two,elz / SP6l.9,L7' _LEG �,2zr,q L. � u✓zvc-- I hereby certify that the use of the name(s) of the knowled d consent of the said Subcontractor(s). ature o Bidder PERCENT OF CONTRACT AMOUNT <j7_ above Proposed Subcontractor(s) was with the Page 16 of 19 17 22 ; e �t_)BLICWO KS WISCONSIN 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, Name Todd Dorner Printed Name Vice President Title Dorner inc, Company Name 2/17/25 Date l:\RngIneering\Tracy Taylor\Public Works ContractAMlscellaneous\Disclosure of O%vnershlp Form 2-1- Page 1 of 1 17,docx City Hall, 215 Church Avenue P.O. Box l l30 Oshkosh, WI 54903-1130 http://www,ci,oshkosh.wl.us BID BOND Contract Number 25-05 Bond Number 488846 Date Bond Executed (Date of Contract or Later) 2/12/2025 PRINCIPAL/CONTRACTOR (Legal Name and Business Address) CARL BOWERS & SONS CONSTRUCTION CO INC N1844 Maloney Rd Kaukauna, WI 54130 SURETY(IES) (Legal Name(s) and Business Address(es)) MERCHANTS BONDING COMPANY (MUTUAL) PO Box 14498 Des Moines, IA 50306-3498 OWNER (Legal Name and Business Address) CITY OF OSHKOSH 215 Church Avenue PO Box 1130 Oshkosh, Wisconsin 54903-1130 OBLIGATION CITY MOS HKOSH DrR71' 011 " )DL tC WORKS Type of Organization Individual Partnership X Corporation State of Incorporation Wisconsin Penal Sum of Bond 5% of bid amount 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 performm the work covered in such Bid, then the Surety and the Contractor shall have no obligation under this Bond. Page 1 of 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. CARL BOWERS & SONS CONSTRUCTION CO INC ?tm zle N e of Principe ontractor Title MERCHANTS BONDING COMPANY (MUTUAL) Name of Surety (Kristin Boevers) Attorney -In -Fact Title Page 2 of 2 Bond 't41 s 1 b BONDING COMPANY. POWER OF ATTORNEY Know All Persons By These Presents, that MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., both being corporations of the State of Iowa, d/b/a Merchants National Indemnity Company (in California only) (herein collectively called the "Companies") do hereby make, constitute and appoint, individually, Kristin Boevers their true and lawful Attorney(srin-Fact, to sign Its name as surety(les) and to execute, seal and acknowledge any and all bonds, undertakings, contracts and other written instruments 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. This Power-of-Attomey is granted and is signed and sealed by facsimile under and by authority of the following By -Laws adopted by the Board of Directors of Merchants Bonding Company (Mutual) on April 23, 2011 and amended August 14, 2015 and April 27, 2024 and adopted by the Board of Directors of Merchants National Bonding, Inc., on October 16, 2015 and amended on April 27, 2024, 'The President, Secretary, Treasurer, or any Assistant Treasurer or any Assistant Secretary or any Vice President shall have power and authority to appoint Attomeys4n-Fact, and to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto, bonds and undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof." "The signature of any authorized officer and the seal of the Company may be affixed by facsimile or electronic transmission 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 fixed." In connection with obligations In favor of the Florida Department of Transportation only, It is agreed that the power and aut horny hereby given to the Attorney -in -Fact includes any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts required by the State of Florida Department of Transportation. It is fully understood that consenting to the State of Florida Department of Transportation making payment of the final estimate to the Contractor and/or its assignee, shall not relieve this surety company of any of Its obligations under its bond. In connection with obligations in favor of the Kentucky Department of Highways only, It is agreed that the power and authority hereby given to the Attorney -in -Fact cannot be modified or revoked unless prior written personal notice of such Intent has been given to the Commissioner - Department of Highways of the Commonwealth of Kentucky at least thirty (30) days prior to the modification or revocation. In Witness Whereof, the Companies have caused this instrument to be signed and sealed this 12th day of February , 2025 MERCHANTS BONDING COMPANY (MUTUAL) ;�%�N:41® r+Po•C?46 ®® MERCHANTS NATIONAL BONDING, INC. ®R•�;®$' ®®®QR��/9;�•i dib/a MERCHANTS NATIONAL INDEMNITY COMPANY 2003 '� " ®yy 1933 * : • By STATE OFIOWA ot0j0°°{■{{®0®0000•° President At 0 49 COUNTY OF DALLAS ss. On this 12th day of February 2025 , before me appeared Larry Taylor, to me personally known, who being by me duly swom did say that he is President of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC.; and that the seals affixed to the foregoing instrument are the Corporate Seals of the Companies; and that the said instrument was signed and sealed in behalf of the Companies by authority of their respective Boards of Directors. i 1,Q,FUA( s Penni Miller - O Commission Number 787952 4z t e ® My Commission Expires IOVVN January 20, 2027 Notary Public (Expiration of notarys commission does not invalidate this instrument) I, Elisabeth Sandersfeld, Secretary of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC„ do hereby certify that the above and foregoing Is a true and correct copy of the POWER -OF -ATTORNEY executed by said Companies, which is still In full force and effect and has not been amended or revoked. In Witness Whereof, I have hereunto set my hand and affixed the seal of the Companies on this 12th day of February 2025 . • ®�NQ CO�f°• o,�O�o�POq. AA. • & ; 1933 C • secretary .� POA 0018 (6/24) City o� Oshkosh TO: ALL CONTRACTORS FROM: ENGINEERING DIVISION OF CITY OF OSHKOSH DEPARTMENT OF PUBLIC WORKS SUBJECT: SOIL AND GROUND WATER MANAGEMENT PLAN CERTIFICATION DEPT OF III PILWWORIcs OSFI OSH, w S ONStN 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. <me Printed Name Title Company Name Date l:\6nglneertnS\Tracy Taylor\Public Works Contracts \Miscellaneous\Soil & Groundwater Page 1 of 1 Management Pion Certificat1on_2-1-17.docx City Hall, 215 Church Avenue P.O. Box 1130 Oshkosh, WI 54903-1130 http://www.ci.oshkosh.wi.us CONTRACT 25-05 PROPOSAL F Ii. The undersigned will begin work as specified after award of the Contract a MP111 9,aM 9�ified. OSHKO&-J, WISCONSIN I hereby certify that all statements are made in behalf of (Name of Corporation, Partnership, or Person Submitting Bid) a corporation organized and existing under the laws of the State of a Partnership consisting of or an individual trading as ; of the City of • State 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 statements are true and correct. (Title, if any) Subscribed and sworn to before me this 17 0'-h day of Fe-l"W Cl q , 20 . 08 BOWERSt Notary Public, or other authorized o administer Notary Public State of Wisconsin (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 % of the total amount of the Bid, as called for in the Official Notice to Contractors. Page 19 of 19 CONTRACT 25-05 ATTACHMENT A LIST OF PROPOSED SUBCONTRACTORS ° ' ``' � 'ONSIWORKS c�srrxc�sr�, �r�v�r�srN 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 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 dl/ G V,/q I o �0'/ CLASS OR ITEMS OF WORK 6aac re,fie. _ a le r"e- PERCENT OF CONTRACT AMOUNT ,- o, / f' I hereby certify that the use of the name(s) of the above Proposed Subcontractor(s) was with the knowledge and consent of the said Subcontractor(s). 1` Signature o idder Page 16 of 19 TO: ALL CONTRACTORS FROM: ENGINEERING DIVISION OF CITY OF OSHKOSH DEPARTMENT OF PUBLIC WORKS SUBJECT: DISCLOSURE OF OWNERSHIP FORM r DEPT OF i' .f sf.it WORKS OSH1Ko S! y„ \ S—(S ONSIN 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. ky'p , - ame Printed Name Title —�— G� fl err 3 1 /®�° Company Name Date 1:\Eng1neering\Tracy Taylor\Public Works Conrad.\Miscellaneous\Dlsdosure of Ownership Form-2-1- Page 1 of 1 17.docx City Hall, 215 Church Avenue P.O. Box 1130 Oshkosh, WI 54903-1130 http://www.cl.oshkosh.wl.us State of Wisconsin Department of Workforce Development Equal Rights Division 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 d/_/14 Street Address or P O Box City State Zip Code Business Name Street Address or P 0 Box City State Zip Code Business Name Street Address or P 0 Box City State Zip Code Business Name Street Address or P 0 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 '?--//,7�;?-,0Z Corporation, Partnership or Sole Proprietorship Name Z-1.4 ae�yV_WeY9 Street Address or P 0 Box City State Zip Code If you have any questions call (606) 266-6861 ERD-7777 (R. 01/2011) BID BOND CITY OF OSHKOSH Contract Number 25-05 Bond Number NA Date Bond Executed (Date of Contract or Later) February 17, 2025 EP2 ���. L, (l€ r,W `rVOiiKS OSHKQSIvs wiN PRINCIPAL,/CONTRACTOR (Legal Name and Business Address) PTS CONTRACTORS, INC. 4075 Eaton Road Green Bay, WI 54311 SURETY(IRS) (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 Type of Organization —Individual _Partnership X Corporation State of Incorporation Wisconsin Penal Sum of Bond 5% 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. Page X 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. PTS CONTRACTORS INC.LIBERTY MUTUAL INSURANCE COMPANY Name of Principal/Contractor Name of Surety Title teve C. Horn, President Title Roxanne Jensen, Attorney -in -Fact WASL JhJP oaPor�y°� r$1912y o p�sACNuB a Seal No, 6088 Page 2 of 2 This Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in the manner and to the extent herein staled. Liberty Liberty Mutual Insurance Company MutuAlo The Ohio Casualty Insurance Company Certificate No:8209723-354019 SURETY West American Insurance Company POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the Stale of New Hampshire, that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the Stale of Massachusetts, and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana (herein collectively called the "Companies'), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, Brian Krause Kelly Cody, Marc Saci•r Roxanne Jensen, Trudy A Szalewski all of the city of Milwaukee state of WI each individually if there be more than one named, Its true and lawful attorney -in -fact to make, execute, seal, acknowledge and deliver, for and on its behalf as surety and as its act and deed, any and all undertakings, bonds, recognizences and other surety obligations, in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seats of the Companies have been affixed thereto this 3rd day of April 2023 Liberty Mutual Insurance Company P4 1NSJJ P�ZV INsp a 1NSQ4 The Ohio Casualty Insurance Company J�J3°p4P0R1f°b ��°oaPOktr��aoaPO�ro�West American insurance Company y 1912 o 0 y 1919 0 � 1991 �V1'S`4�CIIU6�.Oa yp �HAAIPBN�,d$ (s�vHC1AN��,aa By: g�> * r� �Hd * * M * � David M. Carey, Assistant Seaelary State of PENNSYLVANIA County of MONTGOMERY ss ' On this 3rd day of Aril , 2023 before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance r i>3 Company, The Ohio Casua iy Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing Instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. i� - o 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. Commonwealth of Pennsylvania - O r� Uo pOPI� 9 TS�y, Teresa a Notary Public Seal Montgomery County j OF My commission expires March 28, 2026 B Y� ,w Commission number 1126N4 Teresa Paslella, NotaryPublic .� Q `�3YLV1` G Member,PennsvivamaAssociatiionofNolarias j ARy V a? 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 full 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 act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety' any and all undertakings, bonds, recognizances and other surety obligations. Such altomeys-in-fact, subject to the limitations set forth in their respective powers of attomey, 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 attomey-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. Surety 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 altomeys-in-fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, reoognizances and other surety obligations. Such altomeys-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 altomeys-in- fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surely any and all undertakings, bonds, recognizanoes and other surety obligations. Authorization — By unanimous consent of the Company's 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, I, 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, [rue and correct copy of the Power of Attorney executed by said Companies, is in full force and effect and has not been revoked. f(, , lam. r. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this 1 I t v1 day of rc ► 2025 . v tNSU �qI INs& tNSUR J~,3°°PPO�Fo.0 U�°�POq�r�gm �Pr0 OR, C*1� °1912a0 0 1919vo a 1991 d�a�7 °*eb ��a y°�,yNnMP9�ada� rs� o* c+s�ada� By Renee C. Llewellyn, Assistant Secretary 0 Oa. N M a m L LMS•12073 LMIC OCIC WAIC Multi Co 02r21 cito� Oshkosh TO: ALL CONTRACTORS FROM: ENGINEERING DIVISION OF CITY OF OSHKOSH DEPARTMENT OF PUBLIC WORKS SUBJECT: SOIL AND GROUND WATER MANAGEMENT PLAN CERTIFICATION .f V5 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. 1� Name Steve C. Horn Printed Name President Title PTS Contractors Inc. Company Name Feb.17 2025 Date l:\EngineedngWracyTaylor\Public Works Contracts\Miscellaneous\Soil&Groundwater Page 1 of 1 Management Plan Certificatiort2447.docx City Hall, 215 Church Avenue P.O. Box 1130 Oshkosh, WI 54903-1130 http://WWW.Ci.oShkosh.wl.us CONTRACT 25-05r3: PROPOSAL The undersigned will begin work as specified after award of the Contract and complete as specified. I hereby certify that all statements are made in behalf of PTS Contractors, Inc (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 ; State 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 sta ents are true and correct. Signature President (Title, if any) Subscribed and sworn to before me this 17 day of February , 20 25 a°®®®eoeeeoe 4:21 O�yCj Os00oo'•�A-®® • s •s O 0 Not ry Public, or other authorized to administer m o ? C m e 00 O ••••••000°°° • NSjN o0 (Bidder should not add any conditions or qualifying statemeittsetoothiS®proposal as otherwise the Proposal may be declared irregular as not being responsive to the Advertisement.) Accompanying this Proposal is a Bid Bond uz the amount of 5 % of the total amount of the Bid, as called for in the Official Notice to Contractors. Page 19 of 19 d11"(;ds8$/t' t. CONTRACT 25-05 FEB 7€ ATTACHMENT A OF Puf3j.IC v ORK LIST OF PROPOSED SUBCONTRACTORS i '10814, 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 hi 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 PROPOSED PERCENT OF SUBCONTRACTOR CLASS OR ITEMS OF WORK CONTRACT AMOUNT '130J6 r � J"1(O�A ,V bl'y 6 W 7 c) —Z� I hereby certify that the use of the name(s) of the above Proposed Subcontractor(s) was with the knowledge and onsent of the said Subcontractor(s). Siggffl e of Bidder Page 16 of 19 I-EB 208 3° fl)? PUBLIC WORKS 11 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. Name Steve C. Horn Printed Name President Title PTS Contractors, Inc. Company Name Feb. 17, 2025 Date I:\Engineering\Tracy TaylorVublie Works Contracts\10iscellaneous\Disclosure of ownership Form 2-1- Page 1 of I 17.docx City Hall, 215 Church Avenue P.O. Box 1130 Oshkosh, WI 54903-1130 http://www.cf.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 accordina 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)