HomeMy WebLinkAboutBid Bond Carl Bowers & Sons 17-04RECEIVED
SEB 21 2011
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THE AMERICAN INSTITUTE OF ARCHITECTS OSHKOSH,
A 1 Document A3 T 0
Bid Bond
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Bond No.: 297206
KNOW ALL MEN BY THESE PRESENTS, that we Carl Bowers & Sons Construction Co., Inc.
N1844 Maloney Road, Kaukauna, WI 54130
as Principal, hereinafter call the Principal, and Merchants Bonding Company (Mutual)
P.O. Box 14498, Des Moines, Iowa 50306-3498
a corporation duly organized under the laws of the State of Iowa
as Surety, hereinafter called the Surety, are held and firmly bound unto City of Oshkosh
215 Church Ave Oshkosh WI 54903
as Obligee, hereinafter called the Obligee, in the sum of Five Percent of Bid Amount
Dollars ($ 5 %
for the
payment of which sum well and trulyto 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
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 materials 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 7th day of February 2017 XXX
Carl Bowe-&-SnTMCQnstruction Co., Inc.
Jf=Z('P:rinciTpa1) (Seat)
(Witness)
vVJY,c_.
(Title)
AIA UvcUMENT A310•BID BOND•AIA®•FEBRUARY 1970 ED. *THE AMERICAN
INSTITUTE OF ARCHITECTS, 1735 N.Y. AVE., N.W., WASHINGTON D.C. 20006
MERCHANT Bond #: 297206
BONDING COMPANY,
POWER OF 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,
Mary McLennan
their true and lawful Attorney(s)-in-Fact, to make, execute, seal and deliver on behalf of the Companies, as Surety, bonds, undertakings
and 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
This Power -of -Attorney 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 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 connection with obligations in favor of the Florida Department of Transportation only, it is agreed that the power and authority hereby given
to the Attorney -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 Attorney -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 25th day of August 2015
SIOf1 MERCHANTS BONDING COMPANY (MUTUAL)
�``,�p•�PO. < O ' ' Op.POR04A!*** MERCHANTS NATIONAL BONDING, INC.
4i, O 4�.0 ' 9 .2
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x;• .` 1933 c'c:
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••. . . vd;. .ao:• By
� .. • ,�• •..... JCC
STATE OF IOWA ,,a•`�`, s ••••
COUNTY OF Dallas ss. President
On this 25th day of August 2015 before me appeared Larry Taylor, to me personally known, who being by me 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 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.
�va'a<s WENDY WOODY
> Commission Number 784654
My Commission Expires
June 20, 2017
Notary Publ� , 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 this 7th day of February 2017
POA 0014 (6/15)
�O.•�RPO 9 ••
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1933 o-1933 ; c;
Secretary
TO: ALL CONTRACTORS
FROM: ENGINEERING DIVISION OF
CITY OF OSHKOSH DEPARTMENT OF PUBLIC WORKS
SUBJECT: DISCLOSURE OF OWNERSHIP FORM
RECEIVED
FEB 21 2017
DEPT" PUBLIC WORKS
OSHK(-)Sll, WISCONSIN
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
Printed Name
'1LQ
Title
rm'(
ompany Name
LD1 �
Date
l:\Engineering\Tracy Taylor\Public Works Contracts\Miswllaneous\Disclosure of Ownership Form_2-1- Page 1 Of 1,
17.doo
City Hall, 215 Church Avenue P.O. Box 1130 Oshkosh, WI 54903-1130 http://www.cl.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 l(
Street Address or P O Box
City
State
Zip Code
Business Name
Street Address or P O Box
City
State
Zip Code
Business Name
Street Address or P O Box
City
State
Zip Code
Business Name
Street Address or P O Box
City
State
Zip Code
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 Name of Authorized Officer � r%
P��
Authorized O
Date Signed
Corporatior�Pa ner hip or Sole Proprietorship Name
Z
vrf
��5f 6
Street Address or F50 Box
City �i
State
Zip Code
L //<
v –
CJS
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If you have any questions call (608) 266-6861
ERD-7777 (R. 01/2011)
0,A%
city fv�
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 2 1 2017
Dt�PT OF PUBLIC WORKS
OSHKOSH, WISCONSIN
I certify by my signature below that our firm has read the Soil and Ground Water Management Plait
included in the Specifications and will comply with the requirements of the Plan.
Name
9-t ( 'Lye Y
Printed Name
J,O,c 'j, K—
Title
C4.1 , E�,s �.Jy � �,c
Company Name
)WIDD
Date
L•\Engineering\Tracy Taylor\Public Works Contracts\ Miscellaneous\ Soil k Ground Water Page 1 of 1
Management Plan Certification «
_2-1-17.do
City Hall, 215 Church Avenue P.O. Box 1130 Oshkosh, WI 54903-1130 http://www.Ci.oShkosh.wi.us
CONTRACT 17-04
PROPOSAL
RECEIVED
FEB 2 12017
DEPT OF PUBLIC WORKS
OSHKOSH, WISCONSIN
The undersigned will begin work as specified after award of the Contract and complete as specified.
certify that all statements are made in behalf of
AL
(Name of Corporation, Partnership, or Person Submitting Bid)
a corporation organized and existing under the laws of the State of �,tJl jGcln,f
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.
Signature
(Title, if any)
Subscribed and sworn to before me this 1 day of 20
�Uwqg5x�'�
Notary P 'c, 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 Bid Bond in the amount of L % of the total amount of the bid, as
called for in the Official Notice to Contractors.
Page 21 of 21
CONTRACT 17-04
ATTACHMENT A
LIST OF SUBCONTRACTORS
RECEIVED
FEB 2 2 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 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, shallbe 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.
1.r."Evil.���i�:l z• we�
14l 61Y cwcrej_
-U 1A W
c C_
CLASS OR ITEMS OF WORK
S iAf'j4/`C
A 510heid:
PERCENT OF
CONTRACTT AMOUNT
I hereby certify that the use of the name(s) of the above Siubcontractor(s) was :with the knowledge,and .
consent of. the;sa(d.Subcontractor(s). ;..
Signaturl of Vidifer
Page 18 of 21 (Revised)