HomeMy WebLinkAboutBid Bond 17-04 DornerRECEIVED
FEB 21 2017
DEPT
OSHKOSH WlsCONSKS
BID BOND CITY OF OSHKOSH
Contract Number 17-04
Date Bond Executed (Date of Contract or Later) February 3. 2017
PRINCIPAL/CONTRACTOR (Legal Name and Business Address) Type of Orgnaizatioll
Dorner, Inc. hidividanf Parhurship
E506 Luxemburg Road X Corporation
Luxemburg. WI 5.1217
Stale of h1co)VOralion
Wisconsin
SURETY(IES) (Legal Name(s) and Business Address(ea)) Penal Sum of Bond
Fidelity and Deposit Company of Maryland 5% of Amount Bid
1299 Zurich Way
Schaumburg. IL 60196-1056
OWNER (Legal Name and Business Address)
CITY OF OSHKOSH
215 Church Avenue
PO Box 1130
Oshkosh, Wisconsin 54903-1130
OBLIGATION
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 shalt 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 clahn 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 tl-ds 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.
O mer.
B:
N e of Prin pal/Contractor
Vice Qt^ GS til=&.
Title
Fidelian Deposit Compan f Marvl n
Bv:
Name of Surety Colulie tnitll
Attorney -in -Fact
Title
EXTRACT FROM BY-LAWS OF THE COMPANIES
"Article V. Section 8, Atiornevs-in-Fact. The Chief Executive Officer, the President, or any Executive Vice President or Vice President
may, by written instrument under the attested corporate seal, appoint atlomeys-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 at any
lime."
CERTIFICATE
1, the undersigned, Vice President 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 1 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 ata 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 fucsi mile 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 attomey issued by the Company, shall he valid and binding upon the Company with the some force and effect
as though manually affixed.
this3�N STIMO Y WHEREOF;l have her unto subscribed my name and affixed the corporate seals of the said Companies,
day of , 20,I.
F�,u otipf�
v
SEAL
((Ov _
50�*190
,�.a _ At,
Gerald F. Haley, Vice President
TO REPORT A CLAIM WITH REGARD TO A SURETY BOND, PLEASE SUBMIT ALL REQUIRED
INFORMATION TO:
Zurich American Insurance Co.
Alin: Surety Claims
1299 Zurich Way
Schaumburg, IL 60196-1056
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 State of Maryland, and the FIDELITY
AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Maryland (herein collectively called the "Companies"). by
MICHAEL BOND, 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 date hereof, do hereby nominate,
constitute, and appoint Michael J. DOUGLAS, Chris STEINAGEL, Christopher M. KEMP, Robert DOWNEY and Connie SMITH,
all of Hudson, Wisconsin, EACH 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 undertakings, 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 New 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 28th day of September, A.D. 2016.
ATTEST:
Secretary
Eric D. Banes
ZURICH AMERICAN INSURANCE COMPANY
COLONIAL AMERICAN CASUALTY AND SURETY COMPANY
I7DELITY AND DEPOSIT COMPANY OF MARYLAND
Vice President
Michael Bond
074
State of Maryland
County of Baltimore
On this 28th day of September, A.D. 2016, before the subscriber. a Notary Public of the State of Maryland, duly commissioned and qualified,
MICHAEL BOND, Vice President, and ERIC D. BARNES, 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 saith, that
he/she Is the said officer of the Company aforesaid, and that the scats 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 said instrument by the authority and direction of the said
Corporations.
IN TESTIMONY WHEREOF, t have hereunto set my hand and affixed my Official Seal the day and year first above written.
tAa%'.s .
Constance A. Dunn, Notary Public
My Commission Expires: July 9, 2019
POA•F 184.00IIA
TO: ALL CONTRACTORS
FROM: ENGINEERING DIVISION OF
CITY OF OSHKOSH DEPARTMENT OF PUBLIC WORKS
RECEIVED
FEB 21 2017
DEPT OF PUBLIC WORKS
OSHKOSH, WISCONSIN
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 Otonership 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.
Diz e_1 Dorn tr'
Printed Name
eresidznl '
Title
uernet --Ent
Company Name
a-a�-��
Date
I;\EngiiimringkTracy Taylo6 Public Works Conlraclnl �•lisn'llnru•m�s1(Jixlosurc of lhrncrofiip Furm_'I Page 1 Of I
17.d—
City Hall, 215 Church Avenue P.O. Box 1 130 Oshkosh, WI 54903-1130 http://www.ci.oihkosh.wi.us
TO: ALL CONTRACTORS
FROM: ENGINEERING DIVISION OF
CITY OF OSHKOSH DEPARTMENT OF PUBLIC WORKS
SUBJECT: SOIL AND GROUND WATER MANAGEMENT PLAN
CERTIFICATION
-- RECEIVED
FEB 21 2017
DEPT OF PUBLIC WORKS
OSHKOSH, WISCONSIN
I certify by my signature below that our firm has read the Sail and Gromid Water Mnnitgenlenl Plait
included in the Specifications and will comply with the requirements of the Plan.
DcmifA DDmer
Printed Name
Presidcn+
Title
Company Name
a-wn1`j
Date
I:\Englnirring\TracyTaylor\Public Weeks Contracts\Miscell.—ua\SoiiscGround Miter Page 1 of '1
Mmagenent Plan Cerlitical Mn_2-1-17.do .
City Holl, 215 Church Avenue P.O. Box 1 130 Oshkosh, WI 54903-1 130 http://www.ci.oshkosli.wi,us
CONTRACT 17-04
ATTACHMENT A
LIST OF SUBCONTRACTORS
RECEIVED
FEB 21 2017
DEPT OF PUBLIC WORKS
OSHKOSH, WISCONSIN
Pursuant to Section 66.29(7), Wisconsin Statutes, the Bidder, as part of this Proposal, submits this full
and complete list of all the Subcontractors and the class of work to be performed by each. The
CONTRACTOR will be permitted to sublet a portion of die Contract, but shall perform with their
organization work amounting to at least 30 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 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.
PERCENT OF
NAME OF SUBCONTRACTOR CLASS OR ITEMS OF WORK CONTRACT AMOUNT
r
I hereby certify that the use of the name(s) of the above Subcontractor(s) was with the knowledge and
consent of the said Subcontractor(s).
Signature of Bidder
Page 18 of 21 (Revised)
RECEIVED -
CONTRACT 17-04 FEB 2 1 2017
PROPOSAL DEPT OF PUBLIC WORKS
OSHKOSH, WISCONSIN
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
1)6rner enc.
(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.
n I . .
Signature
Prtsi6 t'
(Tide, if any)
Subscribed and sworn to before me this at day of 20.
�ALno- (1 0 YAX AQ
Notary Public, or other authorized to administer
(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 Birt Bond in the amount of % of the total amount of the bid, as
called for in the Official Notice to Contractors.
Page 21 of 21 (Revised)