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HomeMy WebLinkAboutPW CNT 14-04/PTS Contractors 4/2/2014 CITY OF OSHKOSH LEGAL DEPARTMENT 215 CHURCH AVENUE, P.O. BOX 1130, OSHKOSH, WI 54903-1130 PHONE: (920)236-5115 FAX(920) 236-5106 LETTER OF TRANSMITTAL To: PTS Contractors, Inc. Date: April 2, 2014 4075 Eaton Road Project: Concrete paving and utilities project Green Bay, WI 54311-9340 From: Carol Marchant, Adm. Assistant Re: Contract 14-04 Attn: Please find: ® Attached ❑ Under Separate Cover ❑ Copy of Letter ® Contracts ❑ Amendment ❑ Report ❑ Agenda ❑ Meeting Notes ❑ Photos ❑ Mylars ❑ Change Order ❑ Plans ❑ Specifications ❑ Estimates ❑ Diskette ❑ Zip Disk ❑ Other Quantity Description 1 Copy of the fully executed Contract 14-04 (original) These are being transmitted as indicated below: ❑ For Approval ® For Your Use ❑ As Requested ❑ For Review& Comment Remarks: cc: City Clerk (original) Public Works, Engineering (original) City Attorney (copy) CONSTRUCTION CONTRACT THIS AGREEMENT, made on the 26th day of February, 2014, by and between the CITY OF OSHKOSH, party of the first part, hereinafter referred to as CITY, and PTS CONTRACTORS, INC., 4075 Eaton Road, Green Bay, WI 54311-9340, party of the second part, hereinafter referred to as the CONTRACTOR, WITNESSETH: That the CITY and the CONTRACTOR, for the consideration hereinafter named, agree as follows: ARTICLE I. SCOPE OF WORK The CONTRACTOR hereby agrees to furnish all of the materials and all of the equipment and labor necessary, and to perform all of the work shown on the plans and described in the specifications for the project entitled or described as follows: Public Works Contract No. 14-04 for various concrete paving & utility projects — Bowen Street, for the Public Works Department, pursuant to Resolution 14-73 adopted by the Common Council of the City of Oshkosh on the 25th day of February, 2014, all in accordance and in strict compliance with the CONTRACTOR's Proposal and the other Contract Documents referred to in ARTICLE V of this Contract. ARTICLE II. TIME OF COMPLETION The work to be performed under this contract shall be commenced and the work completed within the time limits specified in the Special Conditions and/or CONTRACTOR's proposal. ARTICLE III. PAYMENT (a) The Contract Sum. The CITY shall pay to the CONTRACTOR for the performance of the Contract the sum of$3,339,890.77, adjusted by any changes as provided in the Specifications, or any changes hereafter mutually agreed upon in writing by the parties hereto, provided, however, in the event the Proposal and Contract Documents are on a "Unit Price" basis, the above mentioned figure is an estimated figure, and the CITY shall, in such cases, pay to the CONTRACTOR for the performance of the Contract the amounts determined for the total number of each of the units of work as set forth in the CONTRACTOR's proposal; the number of units therein contained is approximate only, and the final payment shall be made for the actual number of units that are incorporated in or made necessary by the work covered by the Contract. 1 (b) Progress Payments. In the event the time necessary to complete this Contract is such that progress payments are required, they shall be made according to the provisions set forth in the Specifications. ARTICLE IV. CONTRACTOR TO HOLD CITY HARMLESS The CONTRACTOR covenants and agrees to protect and hold the CITY harmless against all actions, claims and demands of any kind or character whatsoever which may in any way be caused by or result from the intentional or negligent acts of the CONTRACTOR, his agents or assigns, his employees or his subcontractors related however remotely to the performance of this Contract or be caused or result from any violation of any law or administrative regulation, and shall indemnify or refund to the CITY all sums including court costs, attorney fees, and punitive damages which the CITY may be obliged or adjudged to pay on any such claims or demands within thirty (30) days of the date of the CITY's written demand for indemnification or refund. ARTICLE V. INSURANCE The Insurance required by the City of Oshkosh as specified in the CITY's specifications, including addenda, or plans, or instructions, or advertisements, shall be primary coverage and that any insurance or self insurance maintained by the City of Oshkosh, its officers, council members, agents, employees or authorized volunteers will not contribute to a loss. All insurance shall be based upon the occurrence of an event, and not based on claims made. All insurance shall be in full force prior to commencing work and remain in force until the entire job is completed and the length of time that is specified, if any, in this Contract, the Specifications, whichever is longer. ARTICLE VI. COMPONENT PARTS OF THE CONTRACT This Contract consists of the following component parts, all of which are as fully a part of this contract as if herein set out verbatim, or if not attached, as if hereto attached: 1. This Instrument 2. The City's Approved Plans 3. Specifications, including any addenda 4. City of Oshkosh Standard Specifications 5. Instructions to Bidders 6. Advertisement for Bids 7. Contractor's Proposal The Contract Documents are complementary;what is required by one is as binding as if required by all. Before undertaking each part of the work, the CONTRACTOR shall carefully study and compare the Contract Documents and check and verify all pertinent figures and measurements required therein. CONTRACTOR shall promptly report in writing to the Engineer any conflict, error, ambiguity or discrepancy which CONTRACTOR may discover and shall obtain written clarification from the Engineer before proceeding with any work affected thereby. 2 In the event that any provision in any of the above component parts of this Contract conflicts with any provision in any other of the component parts, the provision in the component part first enumerated above shall govern over any other component part which follows it numerically except as may be otherwise specifically stated. IT IS HEREBY DECLARED, UNDERSTOOD AND AGREED that the word "CONTRACTOR" wherever used in this Contract means the party of the second part and its/his/their legal representatives, successors, and assigns. IN WITNESS WHEREOF, the City of Oshkosh, Wisconsin, has caused this contract to be sealed with its corporate seal and to be subscribed to by its City Manager and City Clerk and countersigned by the Comptroller of said City, and the party of the second part hereunto set its, his or their hand and seal the day and year first above written. In the Presence of: CONTRACTOR PTS CONTRACTORS, INC. Corporate Secretary M ark C.Schleis Vice-President (Seal of Contractor (Specify Title) if a Corporation.) By: (Specify Title) CITY OF OSHKOSH By: �jr�--- 2ti ! Mark A. Rohloff, City Manager (Wi mess) Cd- And: `.I_a • iib . ..J (Witness) Pamela R. Ubrig, City Cl-rk , APPROVED: I hereby certify that the necessary provisions have been made to pay the liability which will accrue under `# ,, this contract WA,AA)Illa orney- Othril City Corn ptro r,A55nStadt ' 3 MERCHANT7N,H • BONDING COMPANY.. MERCHANTS BONDING COMPANY(MUTUAL) • MERCHANTS NATIONAL BONDING, INC. 2100 FLEUR DRIVE • DES MOINES, IOWA 50321-1158 (800) 678-8171 • (515)243-3854 FAX MAINTENANCE BOND KNOW ALL PERSONS BY THESE PRESENTS: Bond No. WIC 55246 That PTS Contractors,Inc. of 4075 Eaton Rd.,Green Bay,WI 54311 as Principal, and the Merchants Bonding Company(Mutual) of Des Moines, Iowa as Surety are held and firmly bound unto the City of Oshkosh in the penal sum of Three Million Three Hundred Thirty Nine Thousand Eight Hundred Ninety&77/100 ($3,339,890.77 ) DOLLARS, lawful money of the United States of America, for the payment of which, well and truly to be made, the Principal and Surety bind themselves, their and each of their heirs, executors, administrators, successors and assigns,jointly and severally, firmly by these presents. Signed and delivered this 7th day of March 2014 WHEREAS,the Principal entered into a certain contract, dated the 26th day of February 2014 with the City of Oshkosh to furnish all the material and labor necessary for the construction of Public Works Contract 14-04 for Various Concrete Paving&Utility Projects-Bowen Street Oshkosh,WI in conformity with certain specifications; and WHEREAS, a further condition of said contract is that the Principal should furnish a bond of indemnity, guaranteeing to remedy any defects in workmanship or materials that may develop in said work within a period of 2 years from the date of acceptance of the work under said contract; and WHEREAS,the above work has been completed and accepted and if not accepted will be automatically accepted upon the filing of this maintenance bond; and WHEREAS, the Merchants Bonding Company(Mutual) of Des Moines, Iowa for valuable consideration, has agreed to join with said Principal in such bond or guarantee, indemnifying said PTS Contractors,Inc. as aforesaid; NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, that if the said Principal does and shall, at the Principal's own cost and expense, remedy any and all defects that may develop in said work,within the period of 2 years from the date of acceptance of the work under said contract, by reason of bad workmanship or poor material used in the construction of said work, and shall keep all work in continuous good repair during said period, and shall in all other respects, comply with all the terms and conditions of said contract with respect to maintenance and repair of said work, then this obligation to be null and void; otherwise to be and remain in full force and virtue in law. It is agreed that while the Principal shall be and remain liable for failure to adhere to the specifications which form the basis for the work, the Surety, inasmuch as the original work was not bonded, shall be obligated only to assure the maintenance of the work in the condition in which it existed at the time the work was accepted.Any obligation beyond this shall be that of only the Principal. PTS Contractors,Inc. Principal Approved ByM rk U. Schlels, l esident By Merchants Bonding Company(Mutual) By 1° 1cc1-tree CON 0304 (2/12) Roxanne Jensen, Attorney-in-Fact MERCH N rs BONDING COMPANY.,, POWER OF ATTORNEY Know All Persons By These Presents,that MERCHANTS BONDING COMPANY(MUTUAL)and MERCHANTS NATIONAL BONDING. INC.,both being corporations duly organized under the laws of the State of Iowa(herein collectively called the"Companies"), and that the Companies do hereby make,constitute and appoint,individually, Brian Krause; Jeffrey R Meisinger; Kelly Cody; Kenton D Arps; Roxanne Jensen; Trudy A Szalewski of Green Bay and State of \7i,/I their true and lawful Attorney-in-Fact,with full power and authority hereby conferred in their name,place and stead,to sign,execute,acknowledge and deliver in their behalf as surety any and all bonds, undertakings,recognizances or other written obligations in the nature thereof,subject to the limitation that any such instrument shall not exceed the amount of: FIFTEEN MILLION($15,000,000.00)DOLLARS and to bind the Companies thereby as fully and to the same extent as if such bond or undertaking was signed by the duly authorized officers of the Companies,and all the acts of said Attorney-in-Fact, pursuant to the authority herein given,are hereby ratified and confirmed. This Power-of-Attorney is made and executed pursuant to and by authority of the following By-Laws adopted by the Board of Directors of the Merchants Bonding Company(Mutual)on April 23,2011 and adopted by the Board of Directors of Merchants National Bonding,Inc.,on October 24,2011. "The President,Secretary,Treasurer,or any Assistant Treasurer or any Assistant Secretary or any Vice President shall have power and authority to appoint Attorneys-in-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 Witness Whereof,the Companies have caused this instrument to be signed and sealed this 2nd day of March , 2012. ,��4'�,tt?1,tI( `'4,,: •••��\Nr�•CD�A• MERCHANTS BONDING COMPANY(MUTUAL) `�r .•Q004n;�. �? ;��'ORG9q'9y: MERCHANTS NATIONAL BONDING,INC. % .4 {..- •co V �:,c.• �v`t 20.13 ::�:s • •y'' 1933 ;C; C+, •" �J6:. ,���;• By 7� STATE OF IOWA •s'.,�+r+'. +++., ,r� ••�ffi' \�•. COUNTY OF POLK ss. »+Nr�+++x' President On this 2nd day of March 2012.before me appeared Larry Taylor,to me personally known,who being by me duly sworn did say that he is President of the MERCHANTS BONDING COMPANY(MUTUAL)and MERCHANTS NATIONAL BONDING,INC.;and that the seals affixed to the foregoing instrument is the Corporate Seals of the Companies;and that the said instrument was signed and seated in behalf of the Companies by authority of their respective Boards of Directors. In Testimony.Whereof,I have hereunto set my hand and affixed my Official Seal at the City of Des Moines,Iowa,the day and year first above written. t. MARANDA GREENWALT • Commission Number 770312 t4,w 1147 My Commission Expires "� October 28,2014 Notary Public,Polk County,Iowa STATE OF IOWA COUNTY OF POLK ss. I, William blamer,Jr.,Secretary of the 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 day of , r ' W, t0NTA .44 • ;AG�fCo j . 004-%41-%a . p O 9 • • t, ZOO 3 i" Via' 1933 c Secretary • .c?. tiJ, POA 0014(11/11) s;���.•..... ��`�,t? •. �6y• -•�\-3�'• 44 i7lM..+INK�H !HUMP *111111114 WISCONSIN SOCIETY OF ARCHITECTS 4::••:ti •• THE AMERICAN INSTITUTE OF ARCHITECTS `�■i!;:...�`�� av• WIS. AIA DOCUMENT w JULY 1980 ED. WIS. A312 P 0' P v PUBLIC IMPROVEMENT PERFORMANCE/LABOR AND MATERIAL vi PAYMENT BOND u THIS BOND IS TO BE USED ON PUBLIC IMPROVEMENT CONTRACTS PURSUANT TO SECTION 779.14 WISCONSIN STATUTES. Bond No.WIC 55246 KNOW ALL MEN BY THESE PRESENTS: that (Here insert name and address or legal title of the Contractor, referred to in Sec.779.14 Wisconsin Statutes as the prime contractor) PTS CONTRACTORS,INC. 4075 Eaton Road Green Bay WI 54311 as Principal, hereinafter called Principal, and, (Here insert the legal title and address of Surety) MERCHANTS BONDING COMPANY(MUTUAL) 2100 Fleur Drive Des Moines IA 50321-1158 duly authorized and licensed to do business in the State of Wisconsin, as Surety, hereinafter called Surety, are held and firmly bound unto (Name and address or legal title of Owner) CITY OF OSHKOSH 215 Church Avenue Oshkosh WI 54903-1130 as Obligee, hereinafter called Owner, for the use and benefit of claimants as hereinafter provided in the amount of Three Million Three Hundred Thirty Nine Thousand Eight Hundred Ninety and 77/100Dollars ($ 3,339,890.77 ), (Here insert • sum at least equal to the contract price) for the payment whereof Principal and Surety bind themselves, their heirs, executors, administrators, suc- cessors and assigns, jointly and severally, firmly by these;•presents. WHEREAS, PTS CONTRACTORS,INC. Principal has by written agreement dated 2/26/2014 , entered into a contract with Owner for Public Works Contract 14-04 for Various Concrete Paving&Utility Projects-Bowen Street,Oshkosh,WI in accordance with drawings and specifications prepared by (Here insert full name, title and address) J which contract is by reference made a part hereof and is required by Section 779.14,Wisconsin Statutes, p The said written agreement, drawings, specifications and amendments are hereinafter referred to as the Contract. C PUBLIC IMPROVEMENT PERFORMANCE/LABOR-MATERIAL BOND TWO PAGES WIS.AIA DOC.WIS.A3I2AUGUST. 1989ED. PAGE 1 t7 Copr. 1969 Wisconsin Society of Architects/AIA 321 S.Hamilton St. Madison,Wis.53703 NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION, as required by Section 779.14, Wisconsin Statutes, is such that, if the'Principal shall faithfully perform the said contract and pay every person entitled thereto for all the claims for labor performed and materials furnished under the Contract, to be used or consumed in making the public improvement or performing the public work as provided in the Contract, then this obligation shall be null and void; otherwise it shall remain in full force and effect, subject, however, to the following conditions: 1) No assignment, modification or change of the Principal and the Surety upon this bond for the Contract, or change in the work covered thereby, or recovery of any damages he may have sustained by any extension of time for the completion of the Con- reason of the failure of the Principal to comply with tract shall release the sureties on the bond. the Contract or with the Contract between the Prin- cipal and his subcontractors. If the amount realized 2) Not later than one year after the completion of on this bond is insufficient to satisfy all claims of work under the Contract, any party in interest may the parties in full, it shall be distributed among the maintain an action in his own name against the parties pro rata. Signed and sealed this 7th day of March 2014 IN THE PRESENCE OF: PTS CONTRACTORS, INC. + __/,, Principal ;,,e2,144e.e.; 377114[� o■—• (Seal) Witness 'Tk: M ark C.Schleis,Vice-President MERCHANTS BONDING COMPANY(MUTUAL) Name or Surety By: (sad) W 77tia; Roxanne Jensen Attorney-in-Fact APPROVED BY IN THE PRESENCE OF: Owner By: (Seal) Witness Title: *This bond shall be approved in the case of the state by the state official authorized to enter into such con- tract, of a county by its district attorney, of a city by its mayor, of a village by its president, of a town by its chairman, of a school district by the director or president and of any other public board or body by the presiding officer thereof. PUBLIC IMPROVEMENT PERFORMANCE/LABOR-MATERIAL BOND TWO PAGES WIS.AIA DOC.WIS.A312 AUGUST 1989 ED. PAGE 2 MERCFANTI BONDING COMPANY.,. POWER OF ATTORNEY Know All Persons By These Presents,that MERCHANTS BONDING COMPANY(MUTUAL)and MERCHANTS NATIONAL BONDING, INC.,both being corporations duly organized under the laws of the State of Iowa(herein collectively called the`Companies"), and that the Companies do hereby make,constitute and appoint,individually, Brian Krause; Jeffrey R Meisinger; Kelly Cody; Kenton D Arps; Roxanne Jensen; Trudy A Szalewski of Green Bay and State of WI their true and lawful Attorney-in-Fact,with full power and authority hereby conferred in their name,place and stead,to sign,execute,acknowledge and deliver in their behalf as surety any and all bonds, undertakings,recognizances or other written obligations in the nature thereof,subject to the limitation that any such instrument shall not exceed the amount of: FIFTEEN MILLION($15,000,000.00)DOLLARS and to bind the Companies thereby as fully and to the same extent as if such bond or undertaking was signed by the duly authorized officers of the Companies,and all the acts of said Attorney-in-Fact, pursuant to the authority herein given,are hereby ratified and confirmed. This Power-of-Attorney is made and executed pursuant to and by authority of the following By-Laws adopted by the Board of Directors of the Merchants Bonding Company(Mutual)on April 23,2011 and adopted by the Board of Directors of Merchants National Bonding,Inc.,on October 24,2011. The President,Secretary,Treasurer,or any Assistant Treasurer or any Assistant Secretary or any Vice President shall have power and authority to appoint Attorneys-in-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 tartness Whereof,the Companies have caused this instrument to be signed and sealed this 2nd day of March , 2012. �t.4t it]1�t1( `''y .• \NG C0 •. s ` ';--- • t1�l\ X1.0•. MERCHANTS BONDING COMPANY(MUTUAL) gzlot,O'::�. 01 ; ,. POyq•y�. MERCHANTS NATIONAL BONDING,INC. ▪ x'- '"�" 4.1.":3-.":. •t►'_ -o- ih; • i-4: t =a 1933 :3; • t). �:� By (2/0" 77,4, • i .STATE OF IOWA 'r w* •* . fit COUNTY OF POLK ss. HN+++•++`ape President On this 2nd day of March 2012,before me appeared Larry Taylor,to me personally known,who being by me duly swum did say that he is President of the MERCHANTS BONDING COMPANY(MUTUAL)and MERCHANTS NATIONAL BONDING,INC.;and that the seals affixed to the foregoing instrument is 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. In Testimony.Whereof,I have hereunto set my hand and affixed my Official Seal at the City of Des Moines,Iowa,the day and year first above written. • MARANDA GREENWALT ..` ,4 Commission Number 770312 1 4,44-4-113.4112/ c My Commission Expires October 28,2014 Notary Public,Polk County,Iowa STATE OF IOWA COUNTY OF POLK ss. I, William Warner,Jr.,Secretary of the 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 hereuntg set my hand and affixed the seal of the Companies on this`7��_ day ofe� , �j! •,rq• �nsfrtie•,'�+G3 • �O�ORQ9q'O'yy: s C) : .y . 1933 i Secretary •POA 0014(11/11) s,` " ,•<....••;;-y�■ a`� ••d-�'�4,-• �1'Q.• ..4.%4151 •• tt • BRBA ACC; DATE(MM/DD/YYYY) EVIDENCE OF PROPERTY INSURANCE 3/24/2014 THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE ADDITIONAL INTEREST. AGENCY PHONE (920)739-7711 COMPANY (A/C.No.Ext): ) Willis of Wisconsin,Inc.-Appleton Hanover Ins 122 E.College Avenue P.O. Box 81042 City Center East,2nd Floor Woburn, MA 01813-1042 Appleton,WI 54911 FAX - E-MAIL (A/C,No): I ADDRESS: CODE: 1309299 SUB CODE: AGENCY PTSCONT-01 CUSTOMER ID#: INSURED PTS Contractors, Inc. LOAN NUMBER POLICY NUMBER 4075 Eaton Road IH1 A249022 Green Bay,WI 54311- EFFECTIVE DATE EXPIRATION DATE CONTINUED UNTIL 4/1/2014 11/1/2014 TERMINATED IF CHECKED THIS REPLACES PRIOR EVIDENCE DATED: PROPERTY INFORMATION LOCATION/DESCRIPTION North Side of Bowen Street,City of Oshkosh,WI THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS EVIDENCE OF PROPERTY INSURANCE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. COVERAGE INFORMATION COVERAGE/PERILS/FORMS AMOUNT OF INSURANCE DEDUCTIBLE Builders Risk,Special Coverage Form 3,339,891 2,500 Transit Limit 100,000 2,500 Offsite Storage Limit 100,000 2,500 Testing Limit 100,000 2,500 REMARKS(Including Special Conditions) See attached page. CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ADDITIONAL INTEREST NAME AND ADDRESS MORTGAGEE X ADDITIONAL INSURED LOSS PAYEE City of Oshkosh LOAN# 215 Church Avenue PO Box 1130 Oshkosh,WI 54903-1130 AUTHORIZED l!REPRESENTATIVE ,y ACORD 27(2009/12) ©1993-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD PTSCONT-01 BRBA PAGE 1 OF 1 SPECIAL CONDITIONS - PTS Contractors, Inc. City of Oshkosh 4075 Eaton Road 215 Church Avenue Green Bay,WI 54311- P O Box 1130 Oshkosh,WI 54903-1130 Revised-Replaces Evidence issued 3/20/2014 The City of Oshkosh, it's officers, council members,agents,employees,and authorized volunteers are additional named insureds