HomeMy WebLinkAboutBid Bond 17-04 Advance ConstructionTHE AMERICAN INSTITUTE OF ARCHITECTS, CEIV _D t --2-0
AIA Document A310 FEB 21 2017
Bid Bond DEPT OF PUBLIC WORKS
OSHKOSH, WISCONSIN
KNOW ALL MEN BY THESE PRESENTS, that we Advance Construction, Inc.
2141 Woodale Avenue Green Bay, WI 54313
as Principal, hereinafter called the Principal, and Merchants Bonding Company (Mutual)
P.O. Box 14498 Des Moines, IA 50306 - 3498
a corporation duly organized under the laws of the State of IA
as Surety, hereinafter called the Surety, are held and firmly bound unto City of Oshkosh
215 Church Avenue Oshkosh, WI 54901
as Obligee, hereinafter called the Obligee, in the sum of Five Percent of Amount Bid
Dollars IS 5% I
for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind
ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by
these presents.
WHEREAS, the Principal has submitted a bid for
City Contract 17-04, Paving, Sidewalk, Driveway & Utilities/First Local Street Concrete Paving
Program(near East Side)
NOW, THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enter into a Contract with the Obligee in
accordance with the terms of such bid, and give such bond or bonds as may be specified in the bidding or Contract Documents with
good and sufficient surety for the faithful performance of such Contract and for the prompt payment of labor and material furnished
in the prosecution thereof, or in the event of the failure of the Principal to enter such Contract and give such bond or bonds, if the
Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in said bid and such
larger amount for which the Obligee may in good faith contract with another party to perform the Work covered by said bid, then this
obligation shall be null and void, otherwise to remain in full force and effect.
Signed and sealed this 21st day of February, 2017
rtness)
Cheryl er an (Witness) $-
Advance Construction, Inc.
(Principal) (SeatIr-
s�
By: C�� j.
(Title} Li55 xt _
Merchants Bonding Company (Mutual)
(Surety) (Sea!)
B��/y�A.x1Y.
(Title)
Pamela L. Ronski , Attorney-in-fact
ALA DOCUMENT A310 • BID BOND • AIA ® • FEBRUARY 1970 ED • THE AMERICAN
INSTITUTE OF ARCHITECTS, 1735 N.Y. AVE., N.W., WASHINGTON, D.C. 20006
MERCHANTS
BONDING COMPANYI.
POWER GF ATTORNEY
Know All Persons By These Presents, that MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING,
INC., both being corporations of the State of Iowa (herein collectively called the "Companies) do hereby make, constitute and appoint,
individually,
Pamela L. Ronski
their true and lawful Attorney -in -Fact, with full power and authority hereby conferred to sign, execute and acknowledge, at any
place within the United States, the following surety bond:
Surety Bond #: Bid Bond
Principal: Advance Construction, Inc.
Obligee: City of Oshkosh
This Power-of-Attomey is granted and is signed and sealed by facsimile under and by authority of the following By -Laws adopted by the
Board of Directors of Merchants Bonding Company (Mutual) on April 23, 2011 and 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 Attomeys-in-Fact, and to authorize them to execute on behalf of the Company, and attach the seat 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 foxed."
In connection with obligations in favor of the Florida Department of Transportation only, it is agreed that the power and authority hereby given
to the Attomey-in-Fact includes any and all consents for the release of retained percentages and/or final estimates on engineering and
construction contracts required by the State of Florida Department of Transportation. it is fully understood that consenting to the State of Florida
Department of Transportation making payment of the final estimate to the Contractor and/or its assignee, shall not relieve this surety company
of any of its obligations under its bond.
In connection with obligations in favor of the Kentucky Department of Highways only, it is agreed that the power and authority hereby given
to the Attomey-in-Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner -
Department of Highways of the Commonwealth of Kentucky at least thirty (30) days prior to the modification or revocation.
In Witness Whereof, the Companies have caused this instrument to be signed and sealed this 1st day of August, 2015.
.1111,.1. ... •
\MERCHANTS BONDING COMPANY
p�lO....4( . ..q
,- �O..... • MERCHANTS NATIONALBONDING, INC.
QO:OPPO.9.9Z:
=�j: 2003 :.n - • y 1933 v C;
b �7�� . • J6; anti • By
STATE OF IOWA"••.,,�� «I.�``
COUNTY OF DALLAS ss. """ • • President
On this 1st day of August , 2015, before me appeared Larry Taylor, to me personally known, who being by me swom 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 are the Corporate seals of the Companies; and that the said instrument was signed and sealed in behalf of the
Companies by authority of their respective Boards of Directors.
4ow'.
sWENDY WO0Commission Number 784654
My Commission Expires 'C' June 20 2017 Notary Pub o County, Iowa
(Expiration of notary's commission
does not invalidate this instrument)
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 hereunto set my hand and affixed the seal of the Companies on this21 st day of February , 2017 .
POA 0007 (6/15)
Secretary
TO: ALL CONTRACTORS
FROM: ENGINEERING DIVISION OF
CITY OF OSHKOSH DEPARTMENT OF PUBLIC WORKS
SUBJECT: DISCLOSURE OF OWNERSHIP FORM
RECEIVED
FEB 21 W7
pEP'C OF PU W15 ONSINIC S
OSHKOSH,
Please review the attached Department of Workforce Development Disclosure of Ownership form. If Item 3 on this
Disclosure of Ownership form applies to your company, you must complete the Disclosure of Ownership form and
upload in the appropriate location on Quest V -Bid.
If Item 3 on the Disclosure of Ownership form does NOT apply to your company, you must complete the
information below and upload this page in the appropriate location on Quest V -Bid.
CERTIFICATION
I certify by my signature below that Item 3 of the attached Disclosure of Ownership form does NOT apply to my
firm, or a shareholder, officer, or partner of my firm.
Name
1
Printed Name
Title
Sk
Company Name
Date
h\Engineering\Tracy Taylor\ Public Works Contracts\Miscellaneous\ Disclosure of OwnershipForm_2-1- Page 1 of 1
17.do"
City Hall, 215 Church Avenue P.O. Box 1130 Oshkosh, Wl 54903-1130 http://www.ci.oshkosh.wi.us
State of Wisconsin
Department of Workforce Development
Equal Rights Division
Disclosure of Ownership
The statutory authority for the use of this form is prescribed in Sections 66.0903(12)(d), 66.0904(10)(d) and 103.49(7)(d), Wisconsin
Statutes.
The use of this form is mandatory. The penalty for failing to complete this form is prescribed in Section 103.005(12), Wisconsin
Statutes.
Personal information you provide may be used for secondary purposes [Privacy Law, s. 15.04(1) (m), Wisconsin Statutes].
(1) On the date a contractor submits a bid to or completes negotiations with a state agency, local governmental unit, or
developer, investor or owner on a project subject to Section 66.0903, 66.0904 or 103.49, Wisconsin Statutes, the
contractor shall disclose to such state agency, local governmental unit, or developer, investor or owner, the name of
any "other construction business," which the contractor, or a shareholder, officer or partner of the contractor, owns or
has owned within the preceding three (3) years.
(2) The term "other construction business" means any business engaged in the erection, construction, remodeling,
repairing, demolition, altering or painting and decorating of buildings, structures or facilities. It also means any
business engaged in supplying mineral aggregate, or hauling excavated material or spoil as provided by Sections
66.0903(3), 66.0904(2), 103.49(2) and 103.50(2), Wisconsin Statutes.
(3) This form must ONLY be filed, with the state agency project owner, local governmental unit project owner, or
developer, investor or owner of a publicly funded private construction project that will be awarding the contract, if both
(A) and (B) are met.
(A) The contractor, or a shareholder, officer or partner of the contractor:
(1) Owns at least a 25% interest in the "other construction business," indicated below, on the date the contractor
submits a bid or completes negotiations; or
(2) Has owned at least a 25% interest in the "other construction business" at any time within the preceding three
(3) years.
(B) The Wisconsin Department of Workforce Development (DWD) has determined that the "other construction
business" has failed to pay the prevailing wage rate or time and one-half the required hourly basic rate of pay, for
hours worked in excess of the prevailing hours of labor, to any employee at any time within the preceding three (3)
years.
Other Construction Business
Business Name
t r
Street Address or P O Box
City
State
Zip Code
Business Name
Street Address or P O Box
City
State
Zip Code
Business Name
—7-
Street Address or P O Box
City
State
Zip Code
Business Name
Street Address or P O Box
City
State
Zip Code
I hereby state under penalty of perjury that the information, contained in this document, is true and
accurate according to my knowledge and belief.
Print the ame of Authorii er-
Authorized Of ' 'n:�.t"
Date Signed
Corporation Partnership or `e Proprietorship lame 1
k V li C
Street Adorress bi P O B�o�x I ;
tyK�J
State
Zip Code
I 1C
If you have any questions call (608) 266-6861
ERD-7777 (R. 01/2011)
n,A
city fA:�
Oshkosh
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
I)E-:PT OF PUBLIC WORK
OSHKOSH, W SCONSIN'�
I certify by my signature below that our firm has read the Soil and Ground Water Management Plan
included in the Specifications and will comply with the requirements of the Plan.
Name
Printed Name
Title
Company Name
f ;�
Date
1:\Engineering\Tracy Taylor\Public Works Contracts\Miscellaneous \Soil& Ground Water Page 1 of 1
Management Plan Certification-2.1-17.docx
City Hall, 215 Church Avenue P.O. Box 1130 Oshkosh, WI 54903-1130 http://www.cl.oshkash.vA.us
RECEIVED
CONTRACT 17-04
ATTACHMENT A FEB 21 2017
LIST OF SUBCONTRACTORS [)E')"' 0f'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 the 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.
NAME OF SUBCONTRACTOR
CLASS OR ITEMS OF WORK
PERCENT OF
CONT 7 AMOUNT
l,)
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).
6
Signature of Bidd
Page 18 of 21 (Revised)
RECEIVED
CONTRACT 17-04 FEB 21 2017
PROPOSAL
ut P f ()F PUBLIC W0WII I-
'OSH, WISCONSIN,
The undersigned will begin work as specified after award of the Contracf anted complete as specified.
I hereby certify that all statements are made in behalf of
(Name of Corporation, Partnership, or Person Submitting Bid)
a corporation organized and existing under the laws of the State of���[
a Partnership consisting of ; or
an individual trading as • of
the City of : State of
That I have examined and carefully prepared this Proposal from the Plans and Specifications and have
checked the same in detail before submitting this Proposal; that I have full authority to make such
statements and submit this Proposal in (its) (their) behalf; and that said statements are true and correct.
Si ture
(Title, if any)
Subscribed and sworn to before me this day of 20.
Nota Public, or other authorized to administer
1
(Bidder should not add any conditions or qualifying statements to this Proposal as otherwise the
Proposal may be declared irregular as not being responsive to the Advertisement.)
Accompanying this Proposal is a Bid Bond in the amount of .c5- % of the total amount of the bid, as
called for in the Official Notice to Contractors.
Page 21 of 21 (Revised)