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HomeMy WebLinkAboutSteiro Appraisal ServiceCITY OF OSHKOSH DEPARTMENT OF PUBLIC WORKS 215 CHURCH AVENUE, P.O. BOX 1130, OSHKOSH, WI 54903-1130 PHONE: (920) 236-5065 FAX (920) 236-5068 LETTER OF TRANSMITTAL To: David Steiro Subject: Steiro Appraisal Service, Inc. 2244 Fox Heights Lane, Suite 101 Green Bay, WI 54304 Date: September 1, 2017 Subject: Executed Agreement for Kienast and Paulus Quarries Appraisal Services 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 Executed Agreement These are being transmitted as indicated below: ❑ For Approval Remarks: ® For Your Use ❑ As Requested ❑ For Review & Comment Enclosed is a copy of the executed agreement for the Kienast and Paulus Quarries appraisal services. A City of Oshkosh Purchase Order will follow shortly. If you have any questions, please contact us. City Clerk's Office — Original cc: _File — Original Signed: Trac .Taylor L\ Engineering\ 2018 CONTRACTS\18-01 Kienast-Paulus LF\Project_lnformation\Contract Info\Consultant Agreements\Steiro Appr Sery\18-01 Steiro LOT -Executed Agreement_9-1- 17.docx AGREEMENT This AGREEMENT, made on the 2!��day of 2017, by and between the CITY OF OSHKOSH, party of the first part, herein ter referred to as CITY, and STEIRO APPRAISAL SERVICE, INC., 2244 Fox Heights Lane, Suite 101, Green Bay, WI 54304, party of the second part, hereinafter referred to as the CONSULTANT, WITNESSETH: The CITY and the CONSULTANT, for the consideration hereinafter named, enter into the following AGREEMENT for KIENAST AND PAULUS QUARRIES APPRAISAL SERVICES. ARTICLE I. PROJECT MANAGER A. Assignment of Project Manager. The CONSULTANT shall assign the following individual to manage the PROJECT described in this AGREEMENT: David E. Steiro, GAA— Consultant/Appraiser 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 II. CITY REPRESENTATIVE The CITY shall assign the following individual to manage the PROJECT described in this AGREEMENT: James Rabe, P.E. — Director of Public Works ARTICLE III. SCOPE OF WORK The CONSULTANT shall provide the services described in the CONSULTANT's Proposal. The CITY may make or approve changes within the general Scope of Services in this AGREEMENT. If such changes affect CONSULTANT's cost of or time required for performance of the services, an equitable adjustment will be made through an amendment to this AGREEMENT. I:\Engineering\2018 CONTRACTS\18-01 Kienast-Paulus LF\ Project_lnformation\Contract Page 1 of 6 Info \ Consultant Agreements\ Steiro Appr Sem \ 18-01 Agreement-APpr Sen_8-9-17.docx All reports, drawings, specifications, computer files, field data, notes, and other documents and instruments prepared by the CONSULTANT as instruments of service shall remain the property of the CITY. ARTICLE IV. STANDARD OF CARE The standard of care applicable to CONSULTANT's services will be the degree of skill and diligence normally employed by professional consultants or consultants performing the same or similar services at the time said services are performed. CONSULTANT will re -perform any services not meeting this standard without additional compensation. ARTICLE V OPINIONS OF COST FINANCIAL CONSIDERATIONS AND SCHEDULES In providing opinions of cost, financial analyses, economic feasibility projections, and schedules for the PROJECT, CONSULTANT has no control over cost or price of labor and materials; unknown or latent conditions of existing equipment or structures that may affect operation or maintenance costs; competitive bidding procedures and market conditions; time or quality of performance by operating personnel or third parties; and other economic and operational factors that may materially affect the ultimate project cost or schedule. Therefore, it is understood between the parties the CONSULTANT makes no warranty the CITY's actual project costs, financial aspects, economic feasibility, or schedules will not vary from CONSULTANT's opinions, analyses, projections, or estimates. ARTICLE VI. CITY RESPONSIBILITIES The CITY shall furnish, at the CONSULTANT's request, such information as is needed by the CONSULTANT to aid in the progress of the PROJECT, providing it is reasonably obtainable from City records. To prevent any unreasonable delay in the CONSULTANT'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. ARTICLE VII. TIME OF COMPLETION The work to be performed under this AGREEMENT shall be commenced and the work completed within the time limits as agreed upon in the CONSULTANT's Proposal. The CONSULTANT shall perform the services under this AGREEMENT with reasonable diligence and expediency consistent with sound professional practices. The 1:\Engineering\2018 CONTRACTS\18-01Kienast-Paulus LF\Project_Infonnation\Contract Page 2 of 6 Info\Consultant Agreements\Steiro Appr Serv\18-01 Agreement-Appr Serv_8-9-17.docx CITY agrees the CONSULTANT is not responsible for damages arising directly or indirectly from any delays for causes beyond the CONSULTANT's control. For the purposes of this AGREEMENT, such causes include, but are not limited to, strikes or other labor disputes, severe weather disruptions or other natural disasters, failure of performance by the CITY, or discovery of any hazardous substances or differing site conditions. If the delays resulting from any such causes increase the time required by the CONSULTANT to perform its services in an orderly and efficient manner, the CONSULTANT shall be entitled to an equitable adjustment in schedule. ARTICLE VIII. COMPONENT PARTS OF THE AGREEMENT This AGREEMENT consists of the following component parts, all of which are as fully a part of this AGREEMENT as if herein set out verbatim, or if not attached, as if hereto attached: 1. This Instrument 2. CONSULTANT's Proposal dated July 18, 2017 and attached hereto In the event any provision in any of the above component parts of this AGREEMENT 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. ARTICLE IX. PAYMENT A. The Agreement Sum. The CITY shall pay to the CONSULTANT for the performance of the AGREEMENT the total sum as set forth below, adjusted by any changes hereafter mutually agreed upon in writing by the parties hereto: • Time and Materials Not to Exceed $8,850 (Eight Thousand Eight Hundred Fifty Dollars). B. Method of Payment. The CONSULTANT shall submit itemized monthly statements for services. The CITY shall pay the CONSULTANT within thirty (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. I:\Engineering\2018 CONTRACFS\18-01 Kienast-Paulus LF\ Project_Information\Contract Page 3 of 6 Info\Consultant Agreements\Steiro Appr Sery\18-01 Agreement-Appr Serv_8-9-17.docx 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. Indirect Costs. Indirect costs such as computer time, printing, copying, cell phone charges, telephone charges, and equipment rental shall be considered overhead and shall not be invoiced separately to the PROJECT. E. Expenses. Expenses may be billed with up to a maximum of 10% mark-up. All invoices with expenses shall include supporting documentation of the expense. Failure to include the supporting documentation will result in the reduction of payments by the amount of those expense(s) not including documentation. ARTICLE X. HOLD HARMLESS The CONSULTANT covenants and agrees to protect and hold the City of Oshkosh harmless against all actions, claims, and demands which may be to the proportionate extent caused by or result from the intentional or negligent acts of the CONSULTANT, his/her agents or assigns, his/her employees, or his/her 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, 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 for those actions, claim, and demands caused by or resulting from intentional or negligent acts as specified in this paragraph. Subject to any limitations contained in Sec. 893.80 and any similar statute of the Wisconsin Statutes, the CITY further agrees to hold CONSULTANT harmless from any and all liability, including claims, demands, losses, costs, damages, and expenses of every kind and description (including death), or damages to person or property arising out of re -use of the documents without consent where such liability is founded upon or grows out of the acts or omission of any of the officers, employees or agents of the City of Oshkosh while acting within the scope of their employment. ARTICLE XI. INSURANCE The CONSULTANT agrees to obtain General Liability Coverage of $500,000 per occurrence. The following must be named as additional insureds — City of Oshkosh, and its officers, council members, agents, employees, and authorized volunteers. I:\Engineering\2018CONTRACTS\18-01 Kienast-Paulus LF\Project—Information\Contract Page 4 of 6 Info\Consultant Agreements\Steiro Appr Serv\18-01 Agreement-Appr Sery8-9-17.docx Certificates of Insurance acceptable to the CITY shall be submitted to the Engineering Division of the Department of Public Works prior to the commencement of the work. These certificates shall contain a provision that coverage afforded under the policies will not be cancelled or non -renewed until at least 30 days prior written notice has been given to the City Clerk of the City of Oshkosh. ARTICLE XII. TERMINATION A. For Cause. If the CONSULTANT 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 the CONSULTANT. In this event, the CONSULTANT shall be entitled to compensation for any satisfactory, usable work completed. B. For Convenience. The CITY may terminate this AGREEMENT at any time by giving written notice to the CONSULTANT no later than ten (10) calendar days before the termination date. If the CITY terminates under this paragraph, then the CONSULTANT 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. ARTICLE XIII. RE -USE OF PROTECT DOCUMENTS All reports, drawings, specifications, documents, and other deliverables of CONSULTANT, whether in hard copy or in electronic form, are instruments of service for this PROJECT, whether the PROJECT is completed or not. The CITY agrees to indemnify CONSULTANT and CONSULTANT's officers, employees, subcontractors, and affiliated corporations from all claims, damages, losses, and costs, including, but not limited to, litigation expenses and attorney's fees arising out of or related to the unauthorized re -use, change, or alteration of these project documents. ARTICLE XIV. SUSPENSION DELAY OR INTERRUPTION OF WORK The CITY may suspend, delay, or interrupt the services of CONSULTANT for the convenience of the CITY. In such event, CONSULTANT's contract price and schedule shall be equitably adjusted. I:\Engineering\2018CONTZACPS\18-01 Kienast-Paulus LF\ Project_Information\Contract Page Jr of 6 Info\Consultant Agreements\Steiro Appr Serv\18-01 Agreement -Aper Serv_8-9-17.docx ARTICLE XV. NO THIRD -PARTY BENEFICIARIES This AGREEMENT gives no rights or benefits to anyone other than the CITY and CONSULTANT and has no third -party beneficiaries. In the Presence of: (Seal of Consultant if a Corporation) (Witness) (Witness) APPROVED: C7 TANT BL I y: LIS Cres; Li, as*%ro kepruiui sm-aww. . (Specify Title) (Specify Title) CITY OF OSHKOSH By:I z4e�el Mar c A. Rohloff, City Manager And: �. Pamela R. Ubrig, City Clerk I hereby certify that the necessary provisions have been made to pay the liability which will accrue under this AGREEMENT. JO-Cft �k4) City Comptroller L\Engineering\2018 CONTRACTS\18-01 Kienast-Paulus LF\Pmject_Information\Contract Page 6 of 6 Info \ Consultant Agreements\ Steim Appr Sery \ 18-01 Agreement-APpr Serv_8-9-17.docx Proposal of Services Kienast and Paulus Quarries City of Oshkosh —�^ - RECEIVED Negotiation Acquisition of parcels: 2 Full Acquisitions $2,025 1 Partial Acquisition $600 Total $2,625 Relocation Small Projects Relocation Plan $1,500 Relocation of Relocatees $2,000 Appraiser 4 Appraisals $8,850 Grand Total $14,975 JUL 18 2017 DEPT OF PUBLIC WORKS OSHKOSH, WISCONSIN LIA Administrators & Insurance ServiCes APPRAISAL AND VALUATION A S P E N PROFESSIONAL LIABILITY INSURANCE POLICY RECEIVED DECLARATIONS ASPEN AMERICAN INSURANCE COMPANY AUG 162017 (A stock insurance company herein called the "Company" E PT OF PUBLIC WORKS 175 Capitol Blvd. Suite 100 OSHKOSH, WISCONSIN Rocky Hill, CT 06067 Date Issued Policy Number Previous Policy Number 11/23/2016 AAI007452-02 ASIO03389-01 THIS IS A CLAIMS MADE AND REPORTED POLICY. COVERAGE IS LIMITED TO LIABILITY FOR ONLY THOSE CLAIMS THAT ARE FIRST MADE AGAINST THE INSURED DURING THE POLICY PERIOD AND THEN REPORT- ED TO THE COMPANY IN WRITING NO LATER THAN SIXTY (60) DAYS AFTER EXPIRATION OR TERMINATION OF THIS POLICY, OR DURING THE EXTENDED REPORTING PERIOD, IF APPLICABLE, FOR A WRONGFUL ACT COMMITTED ON OR AFTER THE RETROACTIVE DATE AND BEFORE THE END OF THE POLICY PERIOD. PLEASE READ THE POLICY CAREFULLY. Item 1. Customer ID: 164218 Named Insured: STEIRO APPRAISAL SERVICE, INC. 2244 Fox Heights Lane, Suite 101 Green Bay, WI 54304 2. Policy Period: From: 01/01/2017 To: 01/01/2018 12:01 A.M. Standard Time at the address stated in 1 above. 3. Deductible: $2,500 Each Claim 4. Retroactive Date: 01/01/1999 5. Inception Date: 01/01/2016 6. Limits of Liability: A. $1,000,000 Each Claim B. $1,000,000 Aggregate 7. Mail all notices, including notice of Claim, to: LIA Administrators & Insurance Services 1600 Anacapa Street Santa Barbara, California 93101 (800)334-0652; Fax: (805)962-0652 8. Annual Premium: $4,586.00 9. Forms attached at issue: LIA002 (12/14) LIA WI (11/15) LIA012 (12/14) LIA013 (10/14) LIA018 (10/14) LIA020 (10/14) LIA139 (10/14) This Declarations Page, together with the completed and signed Policy Application including all attachments and exhibits thereto, and the Policy shall constitute the contract between the Named Insured and th any. 11/23/2016 Date Authorized Sighature LIA-001 (12/14) Aspen American Insurance Company Appraisal and Valuation Professional Liability Insurance Policy ASPEN Named Insured: STEIRO APPRAISAL SERVICE, INC. Policy Number: AAI007452-02 Effective Date: 01/01/2017 Customer ID: 164218 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL COVERED APPRAISERS ENDORSEMENT In consideration of the premium charged, it is agreed that Section IV. DEFINITIONS (I) "Insured" is amended to include: "Insured" means: The persons identified below, but only while acting on behalf of the Named Insured: All other terms, conditions, and exclusions of this Policy remain unchanged. Aspen American Insurance Company Page 1 of 1 LIAO 12 (12/14) Coverage Principal/Owner, Name Effective Date Appraiser or Trainee David Steiro 01/01/2017 Principal/Owner Jeri L. Hidde 01/01/2017 Appraiser John Barnack 01/01/2017 Appraiser Chris Sherbert 01/01/2017 Appraiser Andrew (AJ) Phillips 01/01/2017 Appraiser All other terms, conditions, and exclusions of this Policy remain unchanged. Aspen American Insurance Company Page 1 of 1 LIAO 12 (12/14) Appraisal and Valuation Professional Liability Insurance Policy Named Insured: STEIRO APPRAISAL SERVICE, INC. �Pv ASPEN Policy Number: AAI007452-02 Effective Date: 01/01/2017 Customer ID: 164218 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL APPRAISAL ENDORSEMENT In consideration of the premium charged, it is agreed that the Insureds identified below have been approved by the Company to perform Professional Services involving Commercial Property. Insured David Steiro John Bamack Chris Sherbert Andrew (AJ) Phillips Effective Date of Approval 01/01/2017 01/01/2017 01/01/2017 01/01/2017 Exclusion (I) remains unchanged and effective, however, unless the Insured identified is approved for Professional Services involving undeveloped or vacant land whose proposed use is for multiple unit single-family housing developments, condominium developments, co-operative housing developments or apartment developments consisting of 10 units or more. All other terms, conditions, and exclusions of this Policy remain unchanged. Aspen American Insurance Company Page 1 of 1 LIAO 13 (10/14) CERTIFICATE OF LIABILITY INSURANCE American Family Insurance Company ❑ American Family Mutual Insurance Company, S.I. if selection box is not checke MERICAN FAMILY 6000 American Pky Madison, Wisconsin 53783-0001 - rts Insured's Name and Address Agent's Name, Address and Phone Number (Agt./Dist.) Steiro Appraisal Service, Inc. Donald Michael Bohnert RECEIVED 2244 Fox Heights Lane Suite 101 806 S Military Ave Green Bay, WI 54304 Green Bay, WI 54304 (920) 499-6611 (039/023) AUG 2 017 This certificate is issued as a matter of information only and confers no rights upon the Certificate Holder. eJ This certificate does not amend, extend or alter the coverage afforded by the policies listed below. DEPT Or, pr I r, r r„ ,. COVERAGES OS _ I This is to certify that 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 oiler 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. TYPE OF INSURANCE POLICY NUMBER POLICY DATE LIMITS OF LIABILITY EFFECTIVE EXPIRATION (Mo, Day, Yr) (Mc, Day, Yr) Homeowners/ Bodily Injury and Property Damage Mobilehomeowners Liability Each Occurrence $ ,000 Boatowners Liability Bodily Injury and Property Damage Each Occurrence $ ,000 Personal Umbrella Liability Bodily Injury and Property Damage Each Occurrence $ ,000 Farm Liability & Personal Liability Farm/Ranch Liability Each Occurrence $ ,000 Farm Employer's Liability Each Occurrence $ 000 Statutory Workers Compensation and Employers Liability t 48-XG3807-90 04/22/2017 04/22/2018 Each Accident $ 100,000 Disease - Each Employee $ 100,000 Disease - Policy Limit $ 500,000 General Liability General Aggregate $ 2,000,000 Products • Completed Operations Aggregate $ 2,000,000 0 Commercial General Personal and Advertising Injury $ 1,000,000 Liability (occurrence) ❑ 48-XG3807-03 04/22/2017 04/22/2018 Each Occurrence $ 1,000,000 ❑ Damage to Premises Rented to You $ 1 00 ,000 Medical Expense (Any One Person) $ 5.000 Businessownet5 Liability Each Occurrencett $ ,000 Aggregatett $ ,000 Liquor Liability Common Cause Limit $ 000 Aggregate Limit $ 000 Automobile Liability Bodilylnjury - Each Person $ 250,000 ❑ Any Auto ❑ All Owned Autos Bodily Injury -Each Accident $ 500,000 Property Damage $ 250,000 D Scheduled Autos 48-XP9677-01 03/26/2017 03/26/2018 ❑ Hired Auto Bodily Injury and Property Damage Combined $ 000 ❑ Nonowned Autos El Excess Liability ❑ Commercial Blanket Excess Each occurrence/Aggregate $ 000 Other (Miscellaneous Coverages) DESCRIPTION OF OPERATIONS ! LOCATIONS / VEHICLES / RESTRICTIONS / SPECIAL ITEMS tThe individual or partners ❑ Have shown as insured elected to be covered under this policy. ❑ Have not ttProducts-Completed Operations aggregate is equal to each occurrence limit and is included in policy aggregate. CERTIFICATE HOLDER'S NAME AND ADDRESS CANCELLATION CITY OF OSHKOSH, AND ITS OFFICERS, x❑ Should any of the above described policies be cancelled before the expiration date thereof, the company will endeavor to mail ( 30 days) written notice to the Certificate COUNCIL MEMBERS AGENTS EMPLOYEES , Holder named, but failure to mail such notice shall impose no obligation or liability of any kind upon the company, its agents or representatives. '10 days unless different number of days AND AUTHORIZED VOLUNTEERS PO BOX 1130 shown. Lx] This certifies coverage on the date of issue only. The above described policies are subject to cancellation inconformity with their terms and by the laws of the state of Issue. OSHKOSH, WI 54903-1130 DATEISSUED 08/30/2017 AUTHORIZED REPRESENTATIVE Kristi Vaught AUe2f6yE d.lag& Mutual Insurance Company, S.I. & Its Operating Companies, American Family Life Insurance Company, 6000 AmericarSf*kXf g 0.fhfd283 92 48XG380703 05 001 ULF081 AMERICAN FAMILY m THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY CHANGES POLICY NUMBER EFFECTIVE DATE ADD'L PREMIUM RETURN PREMIUM POLICY CHANGE NO. 48XG380703 08-24-2017 001 ISSUED TO STEIRO APPRAISAL SERVICES INC AGENT 039-023 D MICHAEL BOHNERT The following item(s): ❑ Additional Interested Parties ❑ Covered Property/Location Description ❑ Insured's Name ❑ Insured's Mailing Address ❑ Insured's Legal Status/Business of Insured ❑ Underlying Insurance ❑ Policy Number is (are) changed as follows: CUSTOMER BILLING ACCOUNT 013-204-967 05 ❑ Classification/Class Codes Coverage Forms and Endorsements ❑ Deductibles ❑ Limits/Exposures ❑ Premium Determination Rates BUSINESSOWNERS POLICY THE FOLLOWING CHANGES APPLY TO ALL PREMISES: THE FOLLOWING IS ADDED: LIABILITY FORMS AND ENDORSEMENTS APPLYING TO ALL PREMISES: BP 04 52 01 06 ADDITIONAL INSURED — STATE OR POLITICAL SUBDIVISIONS — PERMITS All other terms remain unchanged. AMERICAN FAMILY MUTUAL INSURANCE COMPANY MADISON, WISCONSIN IL 75 37 09 09 A'ITHOR17Fi1 � ^�-p--� �__ rp11NTFRSIGNED REPRESENTATIVE read nt C LICENSED RE51NENf AGENI Secretary INSURED Page 01 of 01 Stock No. 18020 American Family Mutual Insurance Company, S.I. & Its Operating Companies, American Family Life Insurance Company, 6000 American Parkway, Madison, WI 53783 . 92 48XG380703 O 001 JLF081 AMERICAN FAMILY POLICY NUMBER: 48XG380703 ELAUJLM BP 04 52 0106 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED — STATE OR POLITICAL SUBDIVISIONS — PERMITS This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM SCHEDULE State Or Political Subdivision: CITY OF OSHKOSH Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph C. Who Is An Insured in Section II — Liability: 3. Any state or political subdivision shown in the Schedule is also an insured, subject to the following provisions: a. This insurance applies only with respect to operations performed by you or on your behalf for which the state or political subdivision has issued a permit. b. This insurance does not apply to. (1) "Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the state or municipality; or (2) "Bodily injury" or "property damage" included within the "products -completed operations hazard". BP 04 52 0106 © ISO Properties: Inc., 2004 Stock No. 13803 American Family Mutual Insurance Company, S.I. & Its Operating Companies, American Family Life Insurance Company, 6000 American Parkway, Madison, WI 53783