HomeMy WebLinkAboutBid Bond Dorner 17-05BID BOND
Contract Number 17-05
Date Bond Executed (Date of Contract or Later) March 1. 2017
PRINCIPAL./CONTRACTOR (Legal Name and Business Address)
Dorner. Iite.
E506 Luxemburg Road
Luxemburg. WI 54217
SURM Y(IES) (legal Name(s) and Business Address(es))
Fidelity and Deposit Company of Maryland
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
RECEIVED 1 J
osj
MAR 21 2017
.DEPT OF PU13L=1C,W�ORKIS
c
OSH '0`' CITY OF OSHKOSH
Type of Organizaliai
_, fudividtrrtl _„_, Pnrinersltip
X Corporation
Stalcof bncorporalion
Wisconsin
Penal Sum of Bond
5% of Amount Bid
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 shall 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 claim upon this Bond.
The Surety hereby waives any notice of an agreement between the Owner and Contractor to extend the time in
which (lie 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, (1) 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 shalt be provided to the
Owner, Surety and/or Contractor at their address as apedfied on this Bond or to a facsin-dle, 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 this Bond. Winnebago
County shall be the venue for all disputes arising tinder 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.
Bv: of
Neme of Principal/Contractor
n
Title
Fideiitvpud Deposit Co �lp�„n�land
Bv: / u! _
Name of Surety Connie Smith
Attorney -in -Fact
Title
ZURICH ANIERICAN 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, seal and deliver, for, and on its behalf
as surety, 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 duty 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:
Secrelar-v
Eric D. Barnes
ZURICH AMERICAN INSURANCE COMPANY
COLONIAL AMERICAN CASUALTY AND SURETY COMPANY
FIDELITY AND DEPOSIT COMPANY OF MARYLAND
t D_
Vice Pr'esideni
Michael Bond
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, deposcth and saith, that
he/she is the said officer of the Company aforesaid, and that the seals affixed to the preceding instillment 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, I have hereunto set my hand and affixed my Official Seal the day and year first above written.
fir r:
lffff (11111,\\
Constance A. Dunn, Notary Public
My Commission Expires: July 9, 2019
POA -F 184-0011A
EXTRACT FROM BY-LAWS OF THE COMPANIES
"Article V, Section 8, Attorneys -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 attorneys -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
ti me."
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 I 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 at a 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 facsimile 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 51h day of
May, 1994, and the following resolution of the Hoard of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a
meeting duly called and held on the I Oth 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 attorney issued by the Company, shall he valid and binding upon the Company with the same force and effect
as though manually affixed.
IN TESTIMONY WH REOF, I have hereunto subscribed my name and affixed the corporate seals of the said Companies,
this ]_,�J day of 204.
,'p uros�� wwa =t
"uw AAL
o �
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,
Alm: Surety Claims
1299 Zurich Way
Schaumburg, IL 60196-1056
CIN
Oshkosh
TO: ALL CONTRACTORS
FROM: ENGINEERING DIVISION OF
CITY OF OSHKOSH DEPARTMENT OF PUBLIC WORKS
SUBJECT: DISCLOSURE OF OWNERSHIP FORM
RECEIVED
MAR 21 2017
i31., PUBLIC WORKS
:,,uS11, \VISCONSIN
Please review the attached Department of Workforce Development Disclosure of Ownership form. If Item 3 on this
Disclosure of Ozvnership 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 Ozonership 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 Ozvnership form does NOT apply to my
firm, or a shareholder, officer, or partner of my firm.
Dan►'A Dorn,f-r
Printed Name
PresA ex+
Title
Company Name
3 -Ski -ti
Date
1:\Enghre ring\Tracy Taylor\Public Works Contracts\Miscellaneous\Disclosure of Ownership Pom 2-1-
Page 1 Of 1
17.doa
City Hall, 215 Church Avenue P.O. Box 1130 Oshkosh, W 1 54903-1130 http,//www.ci.oshkosh.wl,us
Ciof
Oshkosh
TO: ALL CONTRACTORS
FROM: ENGINEERING DIVISION OF
CITY OF OSHKOSH DEPARTMENT OF PUBLIC WORKS
SUBJECT: SOIL AND GROUND WATER MANAGEMENT PLAN
CERTIFICATION
RECEIVED
MAR 21 2017
UI.I' f 01" PUBLIC WORKS
OSHKOSH, WISCONSIN
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.
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Printed Name
�.IZS1�
Title
btcncr -Inc .
Company Name
3-a►-- ►
Date
(AEngineering\Tracy Ta)lor\Public Works ContractoNk iscellaneous\Sall&Ground Water Page 1 of 1
Mam"ent Plan Cerdrumtion 2-1-I7.dua
City Hall, 215 Church Avenue P.O. Box 1130 Oshkosh, W154903-1130 hitp://www.cf.oshkosh.wi.us
CONTRACT 17-05
ATTACHMENT A
LIST OF SUBCONTRACTORS
RECEIVED
MAR 2 1 2011
DEPT OF PUBLIC WORKS
OSHKOSH, WISCONSIN
Pursuant to Section 66.29C7), 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
PERCENT OF
CLASS OR ITEMS OF WORK CONTRACT AMOUNT
Cot'1Ca"� J CltlLyy�„e� �
5 ��d ew�l CC � sao
Ga�dsck�c
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).
4•4--1Aiii4l_
Signature of Bidder
Page 25 of 28 (REVISED)
CONTRACT 17-05
ATTACHMENT A
LIST OF SUBCONTRACTORS
RECEIV ED
MAR 21 2017
oEPTOFPUBL,IC WORI,�
OSHKOSH, WISCONSiI',
Pursuant to Section 66.29(7), Wisconsin Statutes, the Bidder, as part of this Proposal, subnuts 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 perforin the work themselves.
NAME OF SUBCONTRACTOR
�211u 1icr &,-e-4e
14 kle5 7-11
CLASS OR ITEMS OF WORK
PERCENT OF
CONTRACT AMOUNT
I hereby certify that the use of the names) of the above Subcontractor(s) was with the knowledge and
consent of the said Subcontractor(s).
Signature of Bidder
Page X of 28 (REVI5ED)
RECEIVED
MAR 21 2017
CONTRACT 17-05 DI PT OF PUBLIC WORKS
PROPOSAL ()SHKOSH, 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
'Dbrncr Ine • ___
(Name of Corporation, Partnership, or Person Submitting Bid)
a corporation organized and existing under the laws of the State of Vv 1
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 MI authority to make such
statements and submit this Proposal in (its) (their) behalf; and that said statements are true and correct.
Signature
Pr-cs6eA�-
(Title, if any)
Subscribed and sworn to before me this Q_ day of MOM:jh 20_11...
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 Bid Bond in the amount of % of the total amount of the bid, as
called for in the Of Notice to Contractors.
Page 28 of 28 (REVISED)
RECEIVED
MAR 21 2017
DEPT OF PUBLIC WORKS
OSHKOSH, WISCONSIN
CONTRACT 17.05
PROPOSAL
It l::f::l,INi F *D
MAR , 1 2011
J) I I"1' OF I'tJ 13IJ C NVOI FK:•,
s ),0JKOSI1, 11�1`:i'O�JSIIv
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
4)6rn -y- L_ nQ .
(Naive of Corporation, Partnership, or Person Submitting Bid)
a corporation organized and existing under the laws of the State of W
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 Pleats and Specifications and have
checked the same in detail before submitting this Proposal; that I have full authority to snake such
statements and submit this Proposal in (its) (their) behalf; and that said statements are true and correct,
p
Signature
_LCt�.4- _
(Title, if any)
Subscribed and sworn to before me this clay of M&rdyN 20 "7 __,
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 Bid Bond in the amount of L-- % of the total amount of the bid, as
called for in the Official Notice to Cowitractors,
Page 28 of 28 (RMS@D)