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PROFESSIONAL SERVICES AGREEMENT.
Creation and Fabrication of "People of the Waters" Exhibition by Split Rock Studios
for City of Oshkosh / Oshkosh Public Museum
THIS AGREEMENT, made on the 1-1— day of, 2016, by and between the CITY OF
OSHKOSH, hereinafter referred to as CITY, and Sommervi[�-Wllson Inc. dba SPLIT ROCK STUDIOS
located at 2071 Gateway Boulevard St. Paul MN 55112, hereinafter referred to as SRS,
WITNESSETH:
That the CITY and SRS, for the consideration hereinafter named, agree as follows: (Note: If
anything in the Proposal conflicts with the Request for Proposals or this document, the provisions in the
Request for Proposals and this document shall govern.)
ARTICLE 1. PROJECT MANAGER
A. Assignment of Project Manager. SRS shall assign the following individual to manage the
project described in this Agreement:
Carrie Paulsen, Project Manager
651.631.2211 x732
cpaulsen@spiltrockstudios.com
B. Changes in Project Manager. The CITY shall have the right to approve or disapprove of any
proposed change from the individual named above as Project Manager. The CITY shall be provided with
a resume or other information for any proposed substitute and shall be given the opportunity to interview
that person prior to any proposed change.
ARTICLE 11. CITY REPRESENTATIVE
The CITY shall assign the following individual to manage the project described in this contract:
Brad Larson, Museum Director
920.236.5769
blarson@ci.oshkosh.wi.us
ARTICLE 111. SCOPE OF WORK
A. Pre -Production, Production and Installation. Upon approval by the CITY, SRS shall
commence pre -production, then production of the Exhibit. The Exhibit shall include all components
identified within approved line -item estimate at end of Design Development. Pre -production, production,
Installation will be supervised by SRS project managers and the lead builder, who may engage
subcontractors as deemed necessary and appropriate. All Exhibit production work will be performed by
SRS employees except as appropriate. Installation of the Exhibit as described in Attachment A shall be
undertaken by SRS under the supervision of its own personnel.
1331 Algoma Boulevard, Oshkosh WI 54901 • 920.236.5799 oshkoshmuseum.org
Upon completion of the production and installation, SRS shall provide the CITY with a complete
set of construction drawings, maintenance and cleaning instructions, and product information. Production
and installation shall be completed in accordance with the "Project Schedule", Attachment "B", as
modified during the project.
B. Title. Title to all work and any materials incorporated therein shall pass to the CITY upon
delivery to the CITY or upon payment, whichever occurs first. Title to partially completed work shall pass
at the time of any payment by the CITY for the percentage of work completed as of the date of such
payment. SRS shall, at the request of the CITY, execute such instruments as may be reasonably
necessary to effectuate these terms.
C. Warranties. SRS hereby provides warranties as follows:
1. SRS warrants a one (1) year guaranty of workmanship from the date of
substantial completion of installation for all exhibits and mechanical devices
supplied as a part of this Agreement,
2. SRS warrants that the materials and equipment furnished pursuant to this
Agreement will be of high quality, free from defects, and new unless otherwise
required or permitted, that the work will conform to the requirements of all
Agreement documents, and will be of such quality so as to pass without objection
by the museum community as fit for use as museum exhibits.
3. SRS warrants that its services will be in compliance with the requirements of all
regulatory authorities with jurisdiction to prescribe and enforce standards or
regulations with respect to the project and with all applicable local, state, and
federal laws, statutes, ordinances, codes, orders, rules, and regulations.
4. SRS warrants that it will deliver any and all Exhibit work designed and fabricated
pursuant to this Agreement in safe condition, and free of liens or encumbrances.
SRS warranties do not cover normal maintenance, cleaning, lubrication or normal wear and tear
of the Exhibit, nor damage resulting from abuse, improper maintenance, or operation of the Exhibit by the
CITY nor by casualty, vandalism, or conduct of unrelated third parties.
ARTICLE IV. CITY RESPONSIBILITIES
The CITY shall furnish, at the SRS's request, such information as is needed by SRS to aid in the
progress of the project, providing it is reasonably obtainable from CITY records.
To prevent any unreasonable delay in SRS's work the CITY will examine all reports and other
documents and will make any authorizations necessary to proceed with work within a reasonable time
period.
A. Project Delay. The CITY shall discharge all responsibilities including progress review,
access to site, delivery of approvals, timeliness of payment and related obligations, according to the
particular schedule without unreasonable delay so as not to occasion delay to SRS. Any such delays
shall extend the deadline for completion by a like period of time and potentially increase the Agreement
sum commensurate with costs, expenses, and compensatory, consequential, and economic damages,
including, but not limited to, storage and transportation costs and fees, occasioned by such delay.
B. Approvals. Written approval, by the CITY, of all submittals and all other elements related
to the services and deliverables being provided by SRS within the terms of this Agreement are required
within seven (7) business days following each formal submittal (i.e. Samples, mockups, construction
drawings), unless otherwise negotiated between CITY and SRS. Failure to notify SRS in writing of any
issues or complaints within the time periods provided herein shall be deemed an approval by the Client
and SRS. Each graphic and construction drawing submittal will have an allowance of two reviews;
subsequent reviews/submittals may be subject to additional costs.
2
ARTICLE V. TIME OF COMPLETION
All work to be performed under this Agreement shall be completed on or before June 30. 2017,
unless the parties agree in writing to extend this date.
ARTICLE VI.. PAYMENT
A. The Agreement Sum. The CITY shall pay to SRS for the performance of the Agreement the
not -to -exceed sum of $612,000 (Six Hundred Twelve Thousand Dollars) adjusted by any changes as
provided in the proposal, or any changes hereafter mutually agreed upon in writing by the parties hereto.
B. Method of Payment. SRS shall submit itemized monthly statements for services. The CITY
shall pay SRS within 30 calendar days after receipt of such statement. If any statement amount is
disputed, the CITY may withhold payment of such amount and shall provide to CONSULTANT a
statement as to the reason(s) for withholding payment.
C. Additional Costs. Costs for additional services shall be negotiated and set forth in a written
amendment to this agreement executed by both parties prior to proceeding with the work covered under
the subject amendment.
D. Price and Payment. Terms of Payment shall be as described in the "Payment Schedule" as
set forth in Attachment "D." Further detail regarding pricing for this Agreement can be found in the "Cost
Breakdown", Attachment "C". SRS certification for payment shall constitute a representation that the work
has progressed to the point indicated, that to the best of knowledge, information, and belief, the quality of
work is in accordance with Agreement documents, and that all lien waivers and certificates required have
been furnished in proper form.
E. Change Orders. The CITY may request changes in the work after the production phase has
begun, including deletions, additions, or revisions, which fall within the general scope of the Agreement.
Upon consultation and mutual agreement by the parties, the Agreement price and completion schedule
shall be adjusted accordingly and equitably. Change orders shall be memorialized by written form signed
by authorized representatives of both parties. SRS shall have no authority to unilaterally initiate changes
in the work after the production phase of the project has begun without prior approval of the CITY.
ARTICLE VII. CONSULTANT TO HOLD CITY HARMLESS
SRS 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 SRS, its agents or assigns, employees or subcontractors related however
remotely to the performance of this Agreement 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, attor-
ney 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 Vlll, INSURANCE
SRS shall provide insurance for this project that includes the CITY as an additional insured. The specific
coverage required for this project are identified on a separate document attached hereto and incorporated
herein.
ARTICLE IX. TERMINATION
A, For Cause. If SRS shall fail to fulfill in timely and proper manner any of the obligations under
this Agreement, the CITY shall have the right to terminate this Agreement by written notice to SRS. In
this event, SRS shall be entitled to compensation for any satisfactory, usable work completed.
3
B. For Convenience. The CITY may terminate this Agreement at any time by giving written
notice to SRS no later than 10 calendar days before the termination date. If the CITY terminates under
this paragraph, then SRS shall be entitled to compensation for any satisfactory work performed to the
date of termination.
This document and any specified attachments contain all terms and conditions of the Agreement
and any alteration thereto shall be invalid unless made in writing, signed by both parties and incorporated
as an amendment to this Agreement.
Project Coordination.
SRS shall incorporate and coordinate its work with that of any Architect and/or Builder, as
appropriate, as designated by the CITY, and agrees to use its best efforts to cooperate and reasonably
coordinate their activities with those of the Architect and/or Builder as necessary to effectuate completion
of the project work.
Subcontractors.
SRS, at its option, may use one or more subcontractors to complete any of its production
obligations under the Agreement. SRS shall submit the identity of any subcontractor to the CITY as
requested by the CITY. SRS shall prepare all subcontracts or documents for subcontractor's use as
necessary.
Relationship of Parties.
SRS shall be considered an independent contractor in connection with this Agreement and shall
not be deemed an employee. SRS shall have the authority to act on behalf of the CITY only to the extent
provided in this Agreement unless otherwise modified by written consent.
Access to Site.
SRS shall be provided access to the site at intervals appropriate to the stage of installation and
the status of the project work. The total number of visits to the site shall not be limited in number; it is the
intention of the parties that SRS shall make as many such visits as are required to fulfill the
responsibilities of SRS hereunder. The CITY shall take all reasonable precautions to provide work
premises of a safe and sound condition with a minimization of hazards to life and property, and the CITY
shall provide appropriate premises insurance and other indemnity for the protection of SRS, its personnel,
and its contract work. During installations SRS anticipates working 12 hours a day and 7 days a week.
Exhibit furniture installation including casework, graphics, AV, and artifacts will commence when the client
has Certificate of Occupancy.
Exclusivity of Obligations.
SRS shall not obligate the CITY for the payment of any money or for the performance of any
obligation without the CITY's prior written consent. The CITY shall have no contractual or employment
relationship with any consultants, subcontractors, employees, or others who may be hired or used by
SRS in performance of the work pursuant to this Agreement.
Representations of SRS.
SRS represents to the CITY that it is not in default under any law or ordinance, or under any
Order of any Court or federal, state, municipal, or other governmental department, commission, board,
bureau, agency or instrumentality wherever located; its operations are in compliance with all applicable
laws, permits, and ordinances, and there are no claims, actions, suits, or proceedings pending, or
threatened, against or affecting SRS or any shareholder thereof, at law or in equity, or before any
governmental agency, which might result in any material adverse change in the financial condition or
business of SRS or which would question the validity of propriety of this Agreement or any of the actions
to be taken in accordance with this Agreement.
4
Miscellaneous.
The CITY and SRS, respectively, bind themselves, their partners, successors, assigns, and legal
representatives to the other party to this Agreement and to the partners, successors, assigns, and legal
representatives of such other party to this Agreement with respect to all covenants of this Agreement.
Neither party to this Agreement shall assign, sublet, or transfer (by operation of law or otherwise) any
interest in this Agreement without the prior written consent of the other, nor shall SRS assign any monies
due or to become due under this Agreement without the prior written consent of the CITY. Any
assignments without such prior written consent shall be void.
Formal Approvals.
Contracts and/or written approvals shall be returned and signed in a timely manner by the CITY's
representative.
Accounts Payable 1 Invoicing information.
Company Name: Oshkosh Public Museum
Address: 1331 Algoma Blvd; Oshkosh WI 54901
Phone number: 920-236-5769
AP contact: Theresa Books, Administrative Assistant
Email AP Contact: tbooks@ci.oshkosh.wi.us
Can we email invoices: X YES NO
Complete Agreement.
This Agreement represents the entire and integrated agreement between the CITY and SRS and
supersedes all prior negotiations, representations, or agreements, either written or oral. This Agreement
may be amended only by a written instrument signed by both the CITY and SRS.
WHEREFORE, the parties have executed this Agreement on the date above written.
In the Presence of: SRS I CO ULTANT
By:
Crai om ernlle President
SOMMERVILLE-WILSON, INC.
DIBIA SPLIT ROCK STUDIOS
(Seal of Contractor
if a Corporation.)
By:
F ; r Bee Thao Vang
NOTARY PUBLIC
MINNESOTA (Specify Title)
. s..`" �+l �bn des January 31, 2ki9
CITY OF OSHKOSH
8y: --
Mark A. Rollloff, City Manager
(Witness)
2if-� k --,P And: �� `��--� I
fitness) Pamela R. Ubrig, City Clerk
APPROVED: I hereby certify that the necessary provisions
have been made to pay the liability which will
accrue under this Agreement.
4ittrney
G
,, I vn
City Comptroller
Attachment A
Scope of Work
Split Rock Studios will provide Pre -Production and Production/ Installation services for
People of the Waters at 1331 Algoma Blvd; Oshkosh, Wisconsin. We will warranty the
finished exhibits for one year from the date of completion.
Pre --Production
I . Complete all design and content revisions required for production.
2. Detailed production and installation schedule
3. Inspect exhibit space and document any problems affecting exhibit installation
4. Graphic production files and generate printed proofs; inspect #or content errors
and technical quality
5. Production color and material samples
6. Shop drawings with production details for all exhibit structures including
technical specifications
7. Audiovisual technical drawings
8. Create any required prototypes or mockups
9. Updated schedule for Production and Installation
10. Development of specialty items
Production
I . Output and mount final production graphics
2. Fabricate all elements based on approved design and/or construction drawings,
including artifact cases, panels, walls, platforms, information desks, benches,
audiovisual kiosks, etc.
3. Fabricate custom elements such as natural history models, topographic maps,
cast human figures, taxidermy, and mechanical interactive exhibits with exhibit
structures.
4. Fabricate custom artifact mounting hardware, if necessary
5. Provide exhibits for shipment to site
6. As needed, make ongoing submittals during production to keep client apprised
of progress and to gain approval for elements that are developed during this
phase.
7. AV and interactive programs move into production (filming) and post-
production in this phase
8. Acquire audiovisual hardware; install AV software; test system operation
9. Progress photos of exhibits during production
7
I O.Perform ongoing supervision of subcontractors
1 1.Host site visits at SRS for on-site review meetings by client
12.Perform ongoing coordination for building modifications with client, architect
and GC through drawings, meetings, discussions, templates, etc.
Installation
1. Finish any remaining, minor building prep work
2. Deliver exhibits. Set up staging area for unloaded exhibit elements
3. Project Manager and Designer provide on-site art direction as required
4. install all large structures, such as platforms, walls, cases, large graphic panels,
and murals
S. Install smaller graphics, AV equipment, models, interactive exhibits
6. Clean work site of debris and dust, clean artifact cases, install artifacts, perform
all other conservation requirements, and seal cases
7. Aim and adjust lighting fixtures
8. Walk-through inspection of completed exhibits
9. Develop punch -list
1 O.Supply maintenance manual and train staff in exhibit operation and
maintenance
1 1 .Correct punch --list items
Close-out Warranty
1. Contractor submits closeout package including:
L Warranty information from SRS
li. Graphic production digital files
iii. "As -built" production drawings
iv. Final written materials]
V. Final copy of maintenance manuals
Attachment B
Oshkosh
Project Schedule
*Subject to change*
updated 7.29.16
PRODUCTION AND INSTALLATION PHASE
August 15, 2016 --
Pune 30, 2017
Pre -Production
• Produce construction drawings
+ Prepare production color and material samples
• Create SOV for Pre -Production through Installation
• Complete all design and content revisions required for
production
• Provide creative directions on custom elements (artistic
and electronic), specialty lighting, and mechanical and
electromechanical devices
August 15 -
• Acquire artifacts for use in exhibit & finalize matrix
December 30, 2016
• Prepare all graphic production files and generate printed
proofs; inspect for content errors and technical quality
• Acquire high-resolution images and associated usage
rights
• Submit final graphic layouts for client review, after
approval output all graphics and photographic elements
• Contract AV production team and purchase audiovisual
hardware
+ Update Schedule with production and installation phases
Client approves all graphic files and content revisions for
December 16, 2016
production no later then
Production
■ Output and mount final production graphics
■ Prepare artifacts and fabricate custom artifact mounting
hardware
• Fabricate all elements based on construction drawings
• Fabricate custom elements such as models, maps,
sculptures, and mechanical interactive exhibits
• Purchase, fabricate or assemble and test all interactives
and electronic components. Produce AV programs
• Fabricate all murals, models and dioramas, make
submittals for approval as needed
• Fabricate all specialty items
• Provide ongoing progress photos or videos as appropriate
• Host site visits at SRS for on-site review meetings by the
client. Ideally, at least one meeting, no less than four
weeks prior to shipping, should be held for Client Team
approval prior to shipping and installation
Perform ongoing supervision of subcontractors
■ Prepare and ship exhibits to site
Installation
• Deliver, install, test and make all exhibits fully
operational
• Install murals, casework, graphics, artistic fabrication,
artifacts, audiovisual and specialty items
• Aim and adjust lighting fixtures
• Walk-through inspection of completed exhibits
• Correct any punch list items
• Provide training for cleaning and maintenance
• Provide maintenance manuals and closeout materials
10
December 5, 2016 --
June 9, 2017
June 12 -- 30, 2017
Attachment C
Cost Breakdown
People of the Waters
1. Pre -Production $ 53,000
2. Production $476,500
3. Shipping and Installation $ 82,500
4. Project Total $612,000
Clarifications and Exclusions
I Final schedule of values will be provided at the end of the Design Development phase
11
Attachment D
Payment Schedule
• [$91,800.00115% down payment upon start of production
PRI; ---PRODUCTION, PRODUCTION, & INSTALLATION PHASE
Schedule of Values will be provided upon completion of Design Development.
Pre -Production and production will be billed monthly upon percent complete.
12
SPLIT -1 OP ID: PK
CERTIFICATE OF LIABILITY INSURANCE
DATE(MYYYY1ry
06103 f2012016
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE: ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terns and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER
Maguire Agency
1970 Oakcrest Avenue,#300
Roseville, MN 55113
NAME,cT Erik D. Thompson, CIC
PHS hfo Ex1:659-6313-9100 FAC No: 851-638-9762
ADDRESS: ethom son ma ulrea enC .Com
Erik D. Thompson, CIC
INSURER(S)AFFORDING COVERAGE NAIC#
INSURERA: Travelers Insurance Companies 24775
INSURED Sommerville -Wilson, Inc, dba
Split Rock Studios
2071 Gateway Boulevard
Saint Paul, MN 55112
INSURERS:
INSURER C:
INSURERD.
CLAIMS -MADE a OCCUR
INSURERE:
iNSURERF:
6308£437648
COV092AGEC C.ERTIFIC'ATF NHMRFR! REVISION NUMBER;
THIS 1S TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO -ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAV£ BEEN REDUCED BY PAID CLAIMS.
LTR
TYPE OF INSURANCE
POLICYNUMBER
h1WDG EFF
.1rAfDPC � X
L1AfITS
A
X COMMERCIAL GENERAL LIABILITY
EACH OCCUR#tEh'CE $ 1,000,00
CLAIMS -MADE a OCCUR
X
6308£437648
07!18!2015
97118!2016
PR�IAISEs Eaocrurrence $ 300,00
MED Exf (Any one person( $ 10,000
FFItSoeLCI F, AIYd INJURY $ 1,000,00
GEN'I.AGGRE(PAJELIMITAFPLIESPER:
GENERALAGGREGAIE $ 2,000,00
PROOVCTS-CDYPlC6�AGG $ 2,QQ QrQQ
POLICY � C- LOC
$
OTHER:
AUTOMOBILE LAILITY
a,leSl LE LIMIT $ 1,000,00
EaceTc
BODILY INJURY (Pu person) $
A
AW AUTO
X
BA8 E437648
0711812015
07/1812016
BODILY INJURY (PEr eccddent) $
A'NED SLUES LED
�
O
X 1`100. -OWNED
PROP tYtNAGE $
Persccideni
X HIREDAUTOS AUTOS
$
X
UMBRELLALM
X
OCCUR ;
Fn CH OCCURRENCE 3 5,000,00
AGGREC-ATE < 5,000,00
A
EXCESS LLB
CLAIM&reADE
X
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CUPSIE437648
0711EVZOIS
07/i812016
DED I X I RETFNTICN $ None
$
WORKERS COMPENSATION _
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X STATUTE E
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AND EMPLOYERS' LIABILnY
AWPROFRETOWARTNIER�cECLMVE' Y�
uuE,137648
07!1812015
07/1812016
E.L. EACH ACCIDENT $ 1,000,00
E.L.DISEASE -FAE2PLOYEE $ 1,000,00
OFFICERAoEMKR FXCLUDED7
IMandatoryInNHli.l
MIA
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E.L. DISEA , t� -POLICY LIMIT $ 1,000,00
if es, desc1be Under
DESCRIPTIC412 OF OPERATIONS belov
RONS! LOCATIONS I VEHICLES (ACORD 101, Additional Rema v Schedule, maybe aftached 2f more space is required)
DESCRIPTION CF OPEATI
City of Oshkosh is additional insured as required by written contract per
attached Additional Insured Form CGD458 07/13
30 days written notice
Job -- Oshkosh Build, job #2834
CERTIFICA7 E HULUER I.HnC.CLLNI IUN
XOSHKOS
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE City of Oshkosh ACCORDANRATION CE WITH TDATE THEREOF, CE WILL BE DELIVERED ]N
HEPOLICY PROVISIONS.
P.O. Box 1130
215 Church Avenue AUTHORIZED REPRESENTATIVE
Oshkosh, Wl 54903-1130
cJ 1988-2014 ACUKU CUKYUKA I IL)N. AN rign[s reserves.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
SUBCONTRACTOR* IDENTIFICATION NOTICE
§779.02(2)(b), Wis. Stats.
Date: O� t � t�
Two (2) copies of this Notice are being given to the Owner within
sixty (60) days after first commencement of Subcontractor's work
by (check one):
X Registered Mail, certified mail, or by other method
of delivery where recipient makes written confirmation
of receipt
OR
Hand Delivery
Owner's Name: City of Oshkosh
Owner's Address: PO Box 1130
Oshkosh, WI 54903-1130
AS A PART OF YOUR CONSTRUCTION CONTRACT, YOUR PRIME CONTRACTOR MAY
HAVE ALREADY ADVISED YOU THAT THOSE WHO PERFORM, FURNISH OR PROCURE LABOR,
SERVICES, MATERIALS, PLANS OR SPECIFICATIONS FOR THE CONSTRUCTION ON YOUR
PROPERTY WILL BE IDENTIFYING THEMSELVES TO YOU.
THE UNDERSIGNED FIRST PERFORMED, FUR {IiSH$ID, OR PROCURED LABOR, SERVICES,
MATERIALS, PLANS OR SPECIFICATIONS ON: U s 11 FOR THE
IMPROVEMENT NOW UNDER CONSTRUCTION ON YOUR PROPERTY LOCATED AT:
1331 Algoma Blvd. Oshkosh, WI 54901
(STREET ADDRESS OR LEGAL DESCRIPTION OF PROPERTY)
PLEASE GIVE YOUR MORTGAGE LENDER A COPY OF THIS NOTICE WITHIN TEN (10)
DAYS AFTER YOU RECEIVE THIS, SO YOUR LENDER, TOO, WILL KNOW THAT THE
UNDERSIGNED IS INCLUDED IN THE WORK.
THIS NOTICE IS GIVEN FOR PURPOSES OF IDENTIFICATION, AND IS NOT A CLAIM TO
YOU OR TO YOUR LENDER FOR PAYMENT.
SUBCONTRACTOR'S NAME:
Omni Glass & Paint, Ipnc
(signature)
Authorized Agent's Name: Carrie Johnson
(print name of person signing above)
Title: CFO
Address: PO Box 2186
Oshkosh, WI 54903-2186
Telephone Number: (920) 233-3333
*A Subcontractor is anyone who performs, furnishes, or procures labor, services, materials, plans and/or specifications to improve Owner's
property under a contract with any party except the Owner of the Property being improved. See §779.02(2)(b), Wis Stats.
Yellow — Owner, Pink— Subcontractor, Blue — Contractor
SUBCONTRACTOR* IDENTIFICATION NOTICE
§779.02(2)(b), Wis. Stats.
1
Date: ` l)
Two (2) copies of this Notice are being given to the Owner within
sixty (60) days after first commencement of Subcontractor's work
by (check one):
X Registered Mail, certified mail, or by other method
of delivery where recipient makes written confirmation
of receipt
OR
Hand Delivery
Owner's Name: City of Oshkosh
Owner's Address: PO Box 1130
Oshkosh, WI 54903-1130
AS A PART OF YOUR CONSTRUCTION CONTRACT, YOUR PRIME CONTRACTOR MAY
HAVE ALREADY ADVISED YOU THAT THOSE WHO PERFORM, FURNISH OR PROCURE LABOR,
SERVICES, MATERIALS, PLANS OR SPECIFICATIONS FOR THE CONSTRUCTION ON YOUR
PROPERTY WILL BE IDENTIFYING THEMSELVES TO YOU.
THE UNDERSIGNED FIRST PERFORMED, FURN HED, OR PROCURED LABOR, SERVICES,
MATERIALS, PLANS OR SPECIFICATIONS ON: LIz IIJ I t1 FOR THE
IMPROVEMENT NOW UNDER CONSTRUCTION ON YOUR PROPERTY LOCATED AT:
1331 Aleoma Blvd. Oshkosh, WI 54901
(STREET ADDRESS OR LEGAL DESCRIPTION OF PROPERTY)
PLEASE GIVE YOUR MORTGAGE LENDER A COPY OF THIS NOTICE WITHIN TEN (10)
DAYS AFTER YOU RECEIVE THIS, SO YOUR LENDER, TOO, WILL KNOW THAT THE
UNDERSIGNED IS INCLUDED IN THE WORK.
THIS NOTICE IS GIVEN FOR PURPOSES OF IDENTIFICATION, AND IS NOT A CLAIM TO
YOU OR TO YOUR LENDER FOR PAYMENT.
SUBCONTRACTOR'S NAME:
nnOmni Glass & Paint Inc
By: 1.
(signature)
Authorized Agent's Name: Carrie Johnson
(print name of person signing above)
Title: CFO
Address: PO Box 2186
Oshkosh, WI 54903-2186
Telephone Number: (920) 233-3333
*A Subcontractor is anyone who performs, furnishes, or procures labor, services, materials, plans and/or specifications to improve Owner's
property under a contract with any party except the Owner of the Property being improved. See §779.02(2xb), Wis Stats.
Yellow — Owner, Pink — Subcontractor, Blue — Contractor