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Proposed License Agreement between the City of Dubuque and ImOn Communications LLCCity of Dubuque City Council Meeting Consent Items # 021. Copyrighted September 6, 2022 ITEM TITLE: Proposed License Agreement between the City of Dubuque and ImOn Communications LLC SUMMARY: City Manager recommending City Council approval of a License Agreement between the City of Dubuque and I mOn Communications LLC. SUGGESTED Suggested Disposition: Receive and File; Approve DISPOSITION: ATTACHMENTS: Description Type Proposed License Agreement between the City of City Manager Memo Dubuque and ImOn Communications LLC-MVM Memo I mOn Hub at 3155 Central Memo to the City Manager Staff Memo I mOn Hub License Agreement 3155 Central Ave Supporting Documentation Dubuque THE CITY OF Dubuque DUB TEE1. All -America City Masterpiece on the Mississippi � pp zoo�•*o 13 zoi720zoi9 TO: The Honorable Mayor and City Council Members FROM: Michael C. Van Milligen, City Manager SUBJECT: Proposed License Agreement between the City of Dubuque and ImOn Communications LLC DATE: August 30, 2022 Civil Engineer II Dave Ness, Information Services Manager Chris Kohlmann, and Sustainable Innovation Consultant David Lyons are recommending City Council approval of a License Agreement between the City of Dubuque and ImOn Communications LLC. The License would allow ImOn access to available property at a City Fire Station to place a small communications hub to support FTTH (Fiber -To -The - Home) development on the City's northside. I concur with the recommendation and respectfully request Mayor and City Council approval. Mic ael C. Van Milligen IL[yTILiWIIIIIIIIIIIIIII IIIIIIIII Attachment cc: Crenna Brumwell City Attorney Cori Burbach, Assistant City Manager Dave Ness, Civil Engineer II Chris Kohlmann, Information Services Manager David Lyons, Sustainable Innovation Consultant THE CITY OF DUB TE Masterpiece on the Mississippi TO: Michael C. Van Milligen, City Manager FROM: Dave Ness, Civil Engineer II Chris Kohlmann, Information Services Manager David Lyons, Sustainable Innovation Consultant Dubuque IIFlmeriw Cft 2007-2012.2013 2017*2019 SUBJECT: Proposed License Agreement between the City of Dubuque and ImOn Communications LLC DATE: August 30, 2022 INTRODUCTION. The purpose of this memo is to request approval of a License Agreement between the City of Dubuque and ImOn Communications LLC. The License would allow ImOn access to available property at a City Fire Station to place a small communications hub to support FTTH (Fiber -To -The -Home) development on the City's northside T_T6]20]:19111z10 In 2016 the City of Dubuque undertook its Broadband Acceleration Initiative. The Initiative focuses on public/private collaborations and includes a comprehensive strategy to reduce the cost and time required for broadband expansions in Dubuque In 2017 the City of Dubuque and ImOn entered into a Master Co -location and Shared Services Agreement to accelerate the deployment of new broadband capacity in Dubuque and there have been several subsequent amendments. The collaborations have gone well and all anticipated value to the City is being received ImOn now seeks to add additional broadband capacity and support equipment to expand their services to the City's north -end neighborhoods. DISCUSSION. ImOn would like to undertake a project that would add significant capacity to their new Dubuque fiber -to -the -home network. Part of that capacity would be a communications "hub" where a set of equipment and network components, including wires, cables, racks and associated facilities, are housed to support broadband services in that geographic area. ImOn presently has an agreement for such a communications hub in collaboration with the City at the 3rd Street Water Tower. This new installation would provide core and redundancy support for broadband availability in the City's north -end neighborhoods. The project would involve the installation of a small building on presently open City property adjacent to Fire Station 3 at 3155 Central Avenue. The City would provide ImOn with a license to place their hub at this location for a period of ten years, which license is renewable. ImOn would make a monthly license payment of eight hundred dollars ($800.00). ImOn is required to provide insurance coverage approved by the City and to relocate the hub if and when required by the City. BUDGETIMPACT There is no negative budgetary impact to the approval of the proposed License. The license would generate ninety-six thousand dollars ($96,000.00) in new City revenue over its ten-year term. RECOMMENDATION AND ACTION REQUESTED This License supports Dubuque's Broadband Acceleration Initiative and under the Connected Community goal of making broadband available to every business and residence in the City of Dubuque. We would respectfully request your approval and recommendation to City Council. c.c. Crenna Brumwell, City Attorney Barry Lindahl, Senior Counsel Steve Brown, Project Engineer Kerry Bradley, Engineering Amy Schelling, Fire Chief Wally Wernimont, Planning Services Manager HUB LICENSE AGREEMENT BY AND BETWEEN THE CITY OF DUBUQUE, IOWA AND IMON COMMUNICATIONS, LLC This Hub License Agreement ("Agreement") is made and entered into this 1 st day of July 2022, ("Effective Date"), by and between ImOn Communications, LLC, located at 101 3rd Avenue, SW, Suite 400, Cedar Rapids, Iowa 52404 (ImOn) and City of Dubuque (Owner) of property located at 3155 Central Avenue, Dubuque IA, 52001 (Property). ImOn and Owner may be collectively referred to as the "Parties." WHEREAS, ImOn owns and operates certain communications cable facilities in and around various Iowa communities; and WHEREAS, ImOn desires to place its communications hub ("Hub") on the Owner's Property listed above to provide communications services to ImOn customers. NOW, THEREFORE, in consideration of the mutual covenants contained in this Agreement, the Parties agree as follows: SECTION 1. GRANT OF LICENSE. The Owner hereby grants to ImOn a license to survey, construct, install, operate, inspect, protect, repair, alter, replace or remove its communications Hub consisting of various equipment, including without limitation, associated underground conduits, fiber optic cable, splicing boxes, and other transmission equipment (collectively the Equipment) on Owner's Property described in Exhibit A that is incorporated by reference into this Agreement (the License). The Exhibit may only be amended in writing and executed by the Owner and ImOn. Owner represents and warrants that it is the legal titleholder of the Property at this site, has the authority to enter into this Agreement, and that the Property is free and clear of encumbrances that would interfere with ImOn's contemplated use of the Property. SECTION 2. TERM OF AGREEMENT. This Agreement shall continue in force and effect from the 1 st day of July 2022 through the 1 st day of July 2032("Initial Term"). SECTION 3. RENEWAL. ImOn shall have the sole discretion and option to renew this Agreement for two (2) additional ten (10)-year renewal periods by giving notice to Owner at least sixty (60) days prior to the expiration of the Initial Term or any renewal period. The same terms and conditions shall apply during any renewal option period(s). SECTION 4. PAYMENT. As compensation for this License to use the Owner's Property, ImOn agrees to pay the Owner the sum of Eight Hundred Dollars ($800) while this Agreement remains in effect (the "License Fee"). Such License Fee shall be due on or before the first day of each month while this Agreement remains in effect. If the Effective Date is not the first of a particular month, ImOn shall pay a pro-rata amount during the first month. SECTION 5. ACCESS EASEMENT. Owner shall provide ImOn with access to the Property at all times (that is, on a 365 day per year, 24 hours per day basis). ImOn is also granted the right of ingress and egress to and from said Property over and across the adjacent properties of Owner as needed for the purposes of this Agreement, which includes access to locate, survey and layout, or perform other preliminary and preparatory operations before actual construction is commenced. The Owner grants ImOn a License for the purpose of and including the right to construct, maintain, operate, enlarge, repair, locate, and remove or replace wires, lines and/or cables for communications purposes, (hereinafter collectively referred to as the "Line") upon, over, along, and across certain real estate owned by the Owner, in order to access the Property. This grant includes the right to enter upon said Property for the purpose of construction, maintaining, operating, enlarging, repairing, locating and removing or replacing the Line. SECTION 6. USE OF PROPERTY BY OWNER. Owner shall not interfere with, impair or knowingly allow others to interfere with or impair in any way the exercise of the rights granted to ImOn under this Agreement. Owner shall endeavor to cooperate with ImOn's requirements for location or relocation, if required, of the Hub, e.g., near parking facilities, with the least potential for interference with underground utilities or other improvements made or to be made by Owner. The Hub shall be secured, and the Owner shall not enter the same without an ImOn escort. It is understood that the Property is unmanned and alarmed. Any entry must be first cleared through and approved by an authorized ImOn employee. SECTION 7. USE OF PROPERTY BY IMON. All construction and/or installation shall be done at ImOn's sole expense by ImOn or, if ImOn elects at its discretion, by its approved contractor(s). All such construction and installation shall comply with all applicable local, state and national requirements and all required licenses and permits shall be secured at ImOn's sole expense. ImOn shall abide by all reasonable rules and regulations adopted by the Owner pertaining to the operation and management of the Property. If any rules and regulations are contrary to the terms of this Agreement, the terms of this Agreement shall govern. ImOn shall keep the Property free of liens and encumbrances for labor performed on behalf of ImOn or materials furnished to ImOn. ImOn agrees not to use, or permit said Property to be used, for any unlawful purpose. SECTION 8. ELECTRICAL REQUIREMENTS. While this Agreement remains in effect, ImOn shall be responsible for obtaining electrical power and any other utilities required for its purposes, with Owner's cooperation if required by the utility company. SECTION 9. MAINTENANCE. During construction and upon completion of installation, ImOn shall remove from the Property all debris and rubbish caused by such construction to the reasonable satisfaction of the Owner. ImOn shall replace or pay replacement costs of any property damaged by its entry, use, operations or occupancy of the Property. ImOn shall restore the Property to substantially the same condition prior to the construction or any damage at the sole expense of ImOn, e.g., grading/contouring and replacing ground cover. The Owner is solely responsible at its costs to mow the grass, remove snow, trim bushes and perform any other maintenance services around the exterior of the Hub. SECTION 10. RELOCATION. If underground utilities, eminent domain or other public regulations necessitate relocation of the Hub, such relocation shall be made by ImOn at its own expense, including returning the Property and the new location to substantially the same condition existing prior to relocation. If Owner voluntarily proposes relocation of the Hub, Owner shall provide one -hundred eighty (180) days written notice to ImOn and shall provide a mutually agreeable location for reinstallation of the Hub and Equipment on the Owner's property. The Owner is liable for all relocation costs incurred by ImOn when such relocation is at the Owner's request. The period for relocation will be extended if ImOn experiences delays due to weather conditions or other events of Force Majeure or issues beyond the control of ImOn. SECTION11. EMINENT DOMAIN. In the event the Property, or any part, shall be condemned or otherwise acquired for any public purpose, Owner shall have the right to cancel and terminate this Agreement, and ImOn agrees to vacate and surrender possession of said Property within one -hundred eighty (180) days after notice in writing to vacate. ImOn shall not be required to assign to Owner any award made to ImOn for the taking of personal property, fixtures, or improvements paid for by ImOn and moving expenses of ImOn resulting from any condemnation. Owner shall advise ImOn immediately upon Owner's receipt of any information indicating such condemnation is being contemplated. SECTION 12. FIXTURES. The Hub and Equipment shall remain the sole property of ImOn. Upon termination or expiration of this Agreement or any renewal term, ImOn shall remove the Hub and Equipment from the Property within one -hundred eighty (180) days after the Effective Date of such termination notice and bring the Property reasonably back to its original condition. ImOn shall be liable to Owner for any damages to the Property caused by the removal or relocation of the Hub and/or Equipment. Should ImOn fail to reasonably bring the Property to its original condition, the Owner may elect to do such work and ImOn shall pay to Owner all commercially reasonable costs thereof. SECTION 13. INDEMNIFICATION. (a) To the fullest extent permitted by law, ImOn shall indemnify, hold harmless, and insure Owner and its directors, officers, agents, employees, affiliates, successors and assigns ("Owner") from and against any and all third party claims, demands, actions, liability, suits and judgments for damages to property, and for injury or death to persons, including payments made under any workers compensation law or under any plan for employees, disability and death benefits ("Claims"), and all expenses incurred in defending against any such Claims (including reasonable attorney fees and expenses), which may arise out of or be caused by the construction, maintenance, presence, use, relocation or removal of the Hub or Equipment on the Property or Owner's adjacent property, or by any negligent act or willful misconduct of ImOn on the Property. (b) To the fullest extent permitted by law, Owner shall indemnify, hold harmless, and insure ImOn and its directors, officers, agents, employees, affiliates, successors and assigns ("ImOn") from and against any and all third party claims, demands, actions, liability, suits and judgments for damages to property, and for injury or death to persons, including payments made under any workers compensation law or under any plan for employees, disability and death benefits ("Claims"), and all expenses incurred in defending against any such Claims (including reasonable attorney fees and expenses), which may arise out of or be caused by any negligent act or willful misconduct of Owner on or in the Property or Owner's adjacent property. SECTION 14. LIMITATION OF LIABILITY. In no event shall either Party be liable to the other for any indirect, special, incidental, or consequential damages for any reason whatsoever SECTION 15. PAYMENT OF ADDITIONAL TAXES OR CHARGES. ImOn agrees to be responsible for the payment of any tax, charge, or penalty imposed or levied against the Property growing out of the use of said Property by ImOn. While this Agreement remains in effect, ImOn shall reimburse Owner an amount equal to one hundred percent (100%) of the amount by which the annual real estate taxes or special assessments on the Property increase because of the placement of the Hub and Equipment upon the Property. ImOn shall reimburse Owner within thirty (30) days of ImOn's receipt of evidence of such increase. Notwithstanding the foregoing, ImOn shall not be responsible or liable for any increase in real estate taxes or special assessments not directly related to the placement of the Hub and Equipment on the Property, income or other taxes of Owner. SECTION 16. SIGNS. No sign, notice, advertisement, or other inscription of any kind shall be put on or attached to any part of the Hub or Property by ImOn unless approved by the Owner, such consent not being unreasonably withheld. SECTION 17. INSURANCE. ImOn shall maintain at all times during the term of this Agreement insurance as described in the attached Insurance Schedule and as such Insurance Schedule may from time to time be amended by Owner and upon notice to ImOn. SECTION 18. DEFAULT; TERMINATION. Failure of either party to cure a material default under this Agreement as soon as reasonably practical but, not less than thirty (30) days after receipt of written notice thereof, shall entitle the other party to terminate this Agreement. A default that is not susceptible of cure within such thirty (30) days shall not give rise to a right of termination, provided cure is commenced within thirty (30) days and diligently pursued to completion. Upon delivery of written notice of intent to terminate this Agreement by either party under this paragraph, ImOn shall be permitted to use the Property for a period not to exceed one hundred eighty (180) days at the end of which time ImOn shall remove the Hub and Equipment from the Property. If Owner fails to timely cure any material breach, ImOn may terminate this Agreement for any reason upon thirty (30) days prior written notice without any financial penalty owed to the Owner. SECTION 19. FORCE MAJEURE. If either Party's performance of this Agreement or any obligation under this Agreement is prevented, restricted or interfered with by causes beyond its reasonable control including but not limited to acts of God, fire, tornado, flood, derecho, explosion, vandalism (provided all reasonable precautions to protect against such vandalism), or other similar occurrence, any Law, order, regulation, direction, action or request of the United States government or state or local governments, or of any department, agency, commission, court, bureau, corporation or other instrumentality of any one or more of said governments, or of any civil or military authority, or by nationally emergencies, insurrections, riots, wars, strikes, lock -outs or work stoppages or other similar labor difficulties, supplier failures, shortages, breach or delays, then such party shall be excused from such performance on a day-to-day basis. The excused party shall use reasonable efforts under the circumstances to avoid or remove such causes of non-performance and shall proceed to perform with reasonable dispatch whenever such causes are removed or ceased. SECTION 20. NOTICES. All notices provided to be given herein shall be in writing and delivered personally (including a recognized overnight delivery service which provides a receipt of delivery), registered mail or certified U.S. mail. The address of each party, until further notification in writing is: For ImOn: ImOn Communications Attention: Facilities Director 101 3rd Avenue, SW, Suite 400 Cedar Rapids, IA 52404 With a Copy to: William H. Courter Courter Law, PLLC 3100 Oakland Road, NE, Suite A Cedar Rapids, IA 52402 For Owner: City of Dubuque, Iowa City Manager City Hall 50 West 13th Street Dubuque, IA 52001 With a Copy to: City Attorney City Hall 50 West 13th Street Dubuque, IA 52001 If notice is given by registered or certified mail, then the notice shall be deemed to have been given on the date that the envelope containing the notice, properly addressed, is deposited in the U.S. Mail, postage prepaid. Notice delivered personally shall be deemed given upon actual receipt by the notified party. SECTION 21. PAYMENT OF TAXES. Each party shall pay all taxes and assessments lawfully levied on its own property. SECTION 22. ASSIGNMENT. Neither party shall assign or transfer its rights and obligations under this Agreement without the prior written consent of the other, except each party shall have the right to assign, convey or otherwise transfer its rights, title, interest and obligations under this Agreement, in whole or in part, to any entity controlled by, controlling or under common control of said party, or any entity into which said party may be merged or consolidated or which purchases all or substantially all of the assets of said party. SECTION 23. DISPUTE RESOLUTION. In the event of any dispute or controversy arising out of or relating to this Agreement, the Parties agree to exercise their best efforts to resolve the dispute as soon as possible. The Parties shall without delay continue to perform their respective obligations under this Agreement which are not affected by the dispute. To invoke the dispute resolution process set forth in this paragraph, the invoking party shall give to the other party written notice of its decision to do so, including a description of the issues subject to the dispute and a proposed resolution thereof. Designated representatives of both parties shall attempt to resolve the dispute within thirty (30) days after such notice. If those designated representatives cannot resolve the dispute, the dispute shall be submitted to binding arbitration in accordance with Section 23 below. SECTION 24. ARBITRATION. Any controversies or disputes arising out of or relating to this Agreement, which remain unresolved after the Parties have attempted a resolution under Section 22 above, shall be exclusively resolved by binding arbitration in accordance with the current commercial arbitration rules of the American Arbitration Association. The arbitrator shall have the power to issue mandatory orders and restraining orders in connection with the arbitration. The award rendered by the arbitrator shall be final and binding on the Parties and judgment may be entered thereon in any court having jurisdiction. During any arbitration proceeding, the Parties shall continue to perform their respective obligations under this Agreement. Both Parties agree to equally share the costs of the arbitrator, but be solely liable for their own costs. Any such arbitration shall be conducted in Dubuque, Iowa. SECTION 25. WAIVERS OF TERM OR CONDITIONS. The failure of either party to enforce or insist upon compliance with any of the terms or conditions of this Agreement shall not constitute a general waiver or relinquishment of any such terms or conditions, but such conditions and terms shall be and remain at all times in full force and effect. SECTION 26. RULES OF CONSTRUCTION. No rule of construction requiring interpretation against the draftsman shall apply in the interpretation of this Agreement. Both Parties acknowledge and agree that they have negotiated this Agreement and had the opportunity to hire legal counsel at their cost to review. SECTION 27. SEVERABILITY. If any provision of this Agreement is found by any arbitrator or court of competent jurisdiction to be invalid or unenforceable, then the Parties hereby waive such provision to the extent that it is found to be invalid or unenforceable and to the extent that to do so would not deprive one of the Parties of the substantial benefit of its bargain. Such provision, to the extent allowable by law and the preceding sentence, shall not be voided or canceled, but instead will be modified by such arbitrator or court so that it becomes enforceable with all of the other terms of this Agreement in full force and effect. SECTION 28. ENTIRE AGREEMENT. This Agreement, and any Exhibits, constitute the entire and complete agreement between the Parties and supersedes all prior correspondence, discussions, agreements, and understandings between the Parties, unless mutually agreed to in writing by the Parties subsequent to the execution hereof. SECTION 29. GOVERNING LAW; VENUE. This Agreement shall be construed in accordance with and governed by the laws of the State of Iowa without giving effect to its principles of conflict of laws. Venue for any action arising out of this Agreement shall be exclusively in the Iowa District County for Dubuque County, Iowa and the parties consent to the jurisdiction of that court. SECTION 30. VOIDABLE. This Agreement shall be contingent upon any permit(s), approval(s), or zoning determinations to allow ImOn to place and operate its Hub at the Property. If ImOn is not allowed to place and operate its Hub at the Property, the Agreement shall be immediately voidable and cancelled at the discretion of ImOn. Authorized representatives of the Parties have executed this Agreement. ImOn Communications, LLC Bernard Dutchik, Vice President City of Dubuque, Iowa �/� Date: �-�`-1 y Date: Sepfernber 7, 003a Attest: Adrienne N. Breitfelder, City Clerk EXHIBIT A See attached Property Map in PDF Form cmo , Project: Dubuque Site Plan( Fire Station #3) i>6 r 36x60 ro ROIV 3-r HDPE } For tie in ducts IN 6:.c0 taut s -, iei-pad for the �3 — x`" erterator �* 1 , City of Dubuque Insurarice Requirements,for Lessees of City Property and Right Of Way Licensees or Perin, iftees INSURANCE SCHEDULE A 1. ImOn shall furnish a signed certificate of insurance to the City of Dubuque, Iowa for the coverage required in Exhibit I prior to the lease, license, or permit commencement. All lessees of City property and right of way licensees or permittees shall submit an updated certificate annually. Each certificate shall be prepared on the most current ACORD farm approved by the Iowa Insurance Division. or an equivalent. Each certificate shall include a. statement tinder Description of Operations as to %Yhy the certificate was issued. License Agreement dated 2. Ali policies of insurance required hereunder shall be with an insurer authorized to do business in Iowa and all insurers shall have a rating of A or better in the current A.M. Best's Rating Guide. 3. Each certificate shall be furnished to the Finance Department of the City of Dubuque. 4. The lessee, licensee, or permittee shafibe required to carry the minimum coverageffirnits, or greater if required by law or other legal agreement, in Exhibit I. Failure to provide the required minimum coverage shall not be deemed a waiver of such requirements by the City of Dubuque. 5. Failure to obtain or maintain the required insurance shall be considered a material breach of the lease, license, or permIL 6. All required endorsements shall be attached to certificate. 7. Whenever a specific ISO form is referenced the current edition of the form Must be used unless an equivalent form is approved by the Director of Finance and Budget. The lessee,. licensee, or penufftee must identify and list in writing all deviations and exclusions from the ISO form. S. If lessee's, licensee's, or permittee's limits of liability are higher than the required minimum limits then the lesse:e's, licensee's, or pen-niffee's linfils shall be this agreement's required limits. 9. Lessee, licensee, or permilifee shall require. all subcontractors and sub -subcontractors to obtain, and maintain during the performance of work insurance for the coverages described in this Insurance Schedule and shall obtain certificates of insurance from all such subcontractors and sub -subcontractors. Lessee, licensee, or permittee agrees that it shall be liable for the failure of a subcontractor and sub -subcontractor to obtain and maintain such coverage. The City may request a copy of such ceffificates from the lessee, licensee, or permittee. 10. Lessee, license & permittees shall be responsible for deductibles and self -insured retention and for payment of all policy premiums and other costs associated with the insurance policies required below. 11. All certificates of insurance must include agents name, phone number and email address. 12. The City of Dubuque reserves the right to require complete, certified copies of all required insurancep0licies, includinci endorsements, required by this Schedule at any time. 13. The City of Dubuque reserves the right to modify these requirements, including limits, based on changes in the risk or other special circumstances during the term of the, agreement, subject to, mutual agreement of the parties. Page 1 of 4 Sellmdute A Lemeas of City Flmpedy; Right of 'Play Lkmsees or Pennifteps Apil 2NI City of Dubuque Insurance Requirements for Lessees of City Property and Wight of Way ;Licensees or Pertnittees INSURANCE SCHEDULE A (Continued) EXHIBIT I A) COMMERCIAL GENERAL LIABILITY ,General Aggregate Limit $2,000,000 ProduGts-Completed operations Aggregate Limit s1po,00G Personal and Advertising Injury Limit $1,000,000, Each Occurrence $1,000,000 Fire Damage Linfil (any one occurrence) $50,000 Medical Payments $5,000 1 Coverage shall be wriften on an occurrence, not claims made, form. The general liability coverage shall be written in accord With ISO form CG 0,0 01 or business owners form BP 00 01 All deviations from the standard I So commercial general liability form ECG o 001„ or Business owners form BP 00 02, shall be clearly ldentified.. Include ISO endorsement form GG 25 04 "Designated Localion(s) General Aggregate LiMil.' 3) Include endorsement inclicating that coverage is primary and non-contributory. 4 Include Preservation of Governmental Innnitinities Endorsement (Sample attached). 5) Include additional insured endorsement for., The City of Dubuque, including all its elected and appointed offiClafS,r all its employees and vo[.0 ntears, all its (boards, commissions andfor authorities and their board members, employees and volunteers. Use I SO foram ECG 20 10 (Ongoing operations) or its equivalent, 6) Policy shall include Waiver of Rig fit to Recover from Others Endorsenieflit. B) WORKERS'COMPENSATION 9t EMPLOYERS LIABILITY Statutory Benefits covering all employees injured on the job by, accident or disease as prescribed by lovia Code Chapter 35. Coverage.A. Statutory —State of lovia Coverage B Employers Liability Each Accident $100,000 Each Employee -Disease $100,0001 Policy Limit -Disease $500,000, Policy ell all include Walver of Right to Recover from Others endorsement. Coverage B limits shall be greater if required by the uinbrelladexcess insurer. X101 If, 'by limps Code Section 85.1A, the lessee, licensee, or perm[ttee is not required to pumbasaWlorkers' Compensation Insurance, the lessee, licensee, or perriliffee shall'i have a copy of the State's Nunelection of Workers' Compensation or Employers" Liability Coverage form on file vAth the Icnva Workers' Compensation Insurance Commissioner, as required by lows Cade Section 67.22. Completed form niust be attached. Page 2 of 4. Seheddh A Lease-s of City Prc*m*; Rigbt of Way Ucenssnas nr Nrmilbees Apoil 2021 City of Dubuque Insurance Requirements *fDr Lessees oFC4 Property and Right of Way Licensees or Per mittees INSURANCE SCHEDULE A (Continued) C) POLLUTION LIABILITY Coverage required., —Yes —,—No Pollution liability coverage shall be required if the lessee, contracting party, or permittee has any pollution exposure for abatement of li"? rdous or contaminated maledals including, but not limited to, petroleum products, the removal of lead, asbestos, or PCBs. Pollution product and completed operations coverage sliall also be covered. Each occurrence $2,000,000 Policy Aggregate $4,00%000 1 j Policy to include job site and Iransportalion coverage. 2) Include additional insured for: The City of Dubuque, including all its elected and appointed officials, all its employees and volunteers, all its boards, commissions and/or authorities and their board members, employees and volunteers., Use ISO form CG 2010. (Ongoing operations) or its equivalent and CG2037(completed operations) or its equivalent. 3) Include Preservation of Governmental I mmunities Endorsement. 4) Provide evidence of coverage for 5 years after completion of project. D) PROPERTY INSURANCE REQUIRED BY LEASE, LICENSE, OR PERMIT * Yes No Evidence of property coverage provided: _ Yes Include the City of Dubuque as Lender Loss Payable, E) RIGHT-OF-WAY WORK ONLY: UMBRELLA/EXCESS $1,000,000 Yes No The General Liability, Autoindbile Liability and Workers Compensation insurance requirements may be satisfied %vith a combination of primary and Umbrella or Excess Liability, Insurance. If the Umbrella or Excess Insurance policy does not follow the form of the primary policies, it shall include the same endorsements as required of the primary policies including Waiver of Subrogation AND Primary and Non-contributory in favor of the City. F) FLOO D INSURANCE Yes 2— N o If Required Coverage Page 3 of 4 Satedmdp A Lesse-es of City Fropefty; Ri0it of 'Play Licensees or PeriniMea Apil 021 City, of Dubuque Insurance Requirennerits for Lessees ofy Property and Right of Way Licensees or Pertraftees Please be aware that naming the City, of Dubuque as an additional insured as is required boy this Insurance Schedule may result in the waiver of the City's governmental immunities provided in lowa Code sec. 670.4. If you viould like to preserve Musa immunities, please use this endorsement or an -equivalent form. PRESERVATION OF GOVERNMENTAL IMMUNITIES ENDORSEMENT 1. Nonwaiver of Governmental Immunity. The insurer expressly agrees and states that the purchase of this policy and the including of the City of'Dubuque, IcAlra as an Additional Insured does not waive any of the defenses of governmental immunity available to the City of Dubuque, I o%va under,Code of lowa Section 670.4 as it I s now exists and as it atay be ainanded from time to time. 2. Clainis Coveracie. The insurer further agrees that this policy of insurance shall cover only those claims not subject to the defense of governmental immunity under the Code of',lowa Section 670A as it now exists and as if may be amended from time to time. Those claims not subject to Code of Iowa Seclion 670.4 shall be covered by the terns and conditions of this insurance policy. 3. Assertion of Government Immunity. The City of Dubuque, IcAva shall be responsible for asserting any defense of governmental Immunity, and may, do so at any time anti shall do so Lillon the tin iety written request of the insurer. 4. Non -Denial of Coverage. The insurer shall not deny coverage under this policy and the insurer shall not deny any of the rights and benefits accruing to The City of Dubuque, I cAva tinder this policy for reasons of governmental inlinunity unless and until a court of competent jurisdiction has ruled in favor of the defense(s) of governmental immunity asserted by the City of DUbliclue, Iowa. No Other Change in Policy. The above preservation of governmental Immunities shall not otherwise change or alter the coverage available under the policy. (DEPARTMENT MANAGER: FILL IN ALL BLANKS AND CHECK BOXES) Page 4 of 4 Wtedule A Lesseer. of C10y Property; Right of Way Uzenrnes or Permiltepa Apfli 2021