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Improvement Contract_Royalwood Subdivision Water Main Loop Noth Cascade Road Crossing Project
City of Dubuque City Council Meeting Consent Items # 017. Copyrighted November 7, 2022 ITEM TITLE: Improvement Contracts / Performance, Payment and Maintenance Bonds SUMMARY: Black Hawk Roof Company for the Carnegie -Stout Library - Roofs 1 & 2 Restoration Project; Midwest Concrete, Inc. for the Royalwood Subdivision Water Main Loop North Cascade Road Crossing Project; Midwest Concrete, Inc. for the Highway 20 - N. Cascade Road Truck Stop Water Service Connection Project. SUGGESTED Suggested Disposition: Receive and File; Approve DISPOSITION: ATTACHMENTS: Description Carnegie -Stout Library - Roofs 1 & 2 Restoration Project Royalwood Subdivision Water Main Loop North Cascade Road Crossing Project Highway 20 - N. Cascade Road Truck Stop Water Service Connection Project Type Supporting Documentation Supporting Documentation Supporting Documentation THE CITY OF D,UTBQE Masterpiece on the Mississippi SECTION 00500 Page 1 of 5 Dubuque Engineering Department 50 W 131i St All-AmericaCitr Dubuque, IA 52001 Off -ice (563) 589-4270 I Fax (563) 589-4205 TTY (563) 556-9948 200Y•2012-2013 engineer'(r;cit),ofdubuyue.org 2017 * 2019 wvvw.cityofdubuque.org CITY OF DUBUQUE, IOWA SHORT FORM PUBLIC IMPROVEMENT CONTRACT THIS PUBLIC IMPROVEMENT CONTRACT (the Contract), made in triplicate, dated for references purposes the 14th day of October 2022 between the City of Dubuque, Iowa (City), by its City Manager, through authority conferred upon the City Manager by its City Council and Midwest Concrete, Inc. (Contractor) of the City of (Contractor Name) 9835 Midwest Ln Peosta, IA 52068 (Contractors Address - City and State) PROJECT TITLE: ROYALWOOD SUBDIVISION WATER MAIN LOOP NORTH CASCADE ROAD CROSSING PROJECT For and in consideration of the mutual covenants herein contained, the parties hereto agree as follows: CONTRACTOR AGREES: To furnish all material and equipment and to perform all labor necessary for the: Royalwood Subdivision Water Main Loop - N. Cascade Road Crossing Proiect (the Proiect Project Scope of Work: The project will provide for the construction of a new 8-inch water main that crosses North Cascade Road to serve as a water main loop for the Royalwood Subdivision. The new 8- inch water main will connect to an existing 8-inch valve on the north side of the road and connect to an existing 6-inch main on the south side of the road. The project will include asphalt pavement sawcut, removal and replacement, excavation, and approximately 55 L.F. of 8-inch PVC water main. I ne worK aescriDea aaove snail be completed at the tollowing location(s): Royalwood Subdivision Water Main Loop - N. Cascade Road Crossing Project Approx. 15740 North Cascade Road, Dubuque, Iowa, 52001 The Project shall be constructed to the meet the requirements as described in this Project Contract and the attached special conditions; in strict accordance with the requirements of the laws of the State of Iowa and ordinances of the City of Dubuque relating to public works, and in accordance with the Contract Documents which provisions and documents are each and all hereby referred to and made a part of this Contract just as much as if the detailed statements thereof were repeated herein. SECTION 00500 Page 2 of 5 2. Contract Documents shall mean and include the following: This Improvement Contract; all ordinances and resolutions heretofore adopted by the City Council having to do with the Project; the Contractor's Proposal; and the conditions described in the Contract, including any Special Conditions, Plans and Specifications and General Requirements as adopted by the City Council for the Project. 3. All materials used by the Contractor in the Project shall be the best of their several kinds and shall be put in place to the satisfaction of the City Manager. 4. The Contractor shall remove any materials rejected by the City Manager as defective or improper, or any of said work condemned as unsuitable or defective, and the same shall be replaced or done anew to the satisfaction of the City Manager at the cost and expense of the Contractor. 5. Five percent (5%) of the Contract price may be retained by the City for a period of thirty (30) days after final completion and acceptance of the Project by the City Manager to pay any claim that may be filed within said time for labor and materials done and furnished in connection with the performance of this Contract and for a longer period if such claims are not adjusted within that time, as provided in Iowa Code Chapter 573. The City shall also retain additional sums to protect itself against any claim that has been filed against it for damages to persons or property arising through the prosecution of the work and such sums shall be held by the City until such claims have been settled, adjudicated or otherwise disposed of. 6. The Contractor has read and understands the SUDAS Standard Specifications (Current Edition) including but not limited to Division 1: General Provisions and Covenants and the City of Dubuque Supplemental Specifications — Division 1 (Current Edition), and has examined and understands the project description described in Section 1 and any attached Special Conditions herein referred to and agrees not to plead misunderstanding or deception because of estimates of quantity, character, location or other conditions surrounding the same. 7. The Contractor shall guarantee for a period two years and make good any other defect in any part of the Project due to improper construction or material performance notwithstanding the fact that said Project may have been accepted and fully paid for by the City. The guarantee shall commence on the date that the City pays full compensation for the complete performance of this contract. 8. The Contractor shall fully complete the Project under this Contract on or before November 23, 2022 (DATE) 9. INDEMNIFICATION FROM THIRD PARTY CLAIMS. To the fullest extent permitted by law, Contractor shall defend, indemnify and hold harmless City, its officers and employees, from and against all claims, damages, losses and expenses claimed by third parties, but not including any claims, damages, losses or expenses of the parties to this Contract, including but not limited to attorneys' fees, arising out of or resulting from performance of this Contract, provided that such claim, damages, loss or expense is attributable to bodily injury, sickness, disease or death, or injury to or destruction of property, including loss of use resulting therefrom, but only to the extent caused in whole or in part by negligent acts or omissions of Contractor, or anyone directly or indirectly employed by Contractor or anyone for whose acts Contractor may be liable, regardless of whether or not such claim, damage, loss or expense is caused in part by a party indemnified hereunder. SECTION 00500 Page 3 of 5 10. Unless otherwise specified in the Contract Documents, prior to the commencement of any work on the Project and at all times during the performance of this Contract, the Contractor shall provide evidence of insurance which meets the requirements of the City's Insurance Schedule for Artisan Contractors or General Contractors. 11. The City of Dubuque in accordance with Title VI of the Civil Rights Act of 1964, 78 Stat. 252, 42 U.S.C. 2000d-2000d-4 and Title 49, Code of Federal Regulations, Department of Transportation, Subtitle A, Office of the Secretary, Part 21, Nondiscrimination in Federally assisted programs of the Department of Transportation issued pursuant to such Act, hereby notifies all bidders that it will affirmatively insure that in any contract entered into pursuant to this advertisement, minority business enterprises will be afforded full opportunity to submit bids in response to this invitation and will not be discriminated against on the grounds of race, color, national origin, sex, age, or disability in consideration for an award. 12. The City of Dubuque, State of Iowa and Department of Justice have entered into a Consent Decree requiring the City to complete certain capital improvements pursuant to an established schedule and to comply with certain capital improvements pursuant to an established schedule and to comply with certain reporting and recordkeeping requirements. One of the terms of the Consent Order is for the City to advise contractors whose duties might reasonably include compliance with any provision of the Consent Decree with a copy of the Consent Decree. The City expects its contractors to comply with the Consent Decree and to assist the City in complying with the Consent Decree. As a requirement of this Contract, the Contractor shall execute and return to the City Exhibit A that is attached to this Contract. THE CITY AGREES: Upon the completion of the Contract, and the acceptance of the Project by the City Manager, the City agrees to pay the Contractor as full compensation for the complete performance of this Contract, the amount determined for the total number of units completed at the unit prices stated in the Contractor's Proposal and less any liquidated damages provided for in the Contract Documents. The number of units stated in the contract, special conditions and contractors' proposal is approximate only and the final payment shall be made by the work covered by the Contract. CONTRACT ESTIMATED AMOUNT: $ 23,496.95 THE MAXIMUM CONTRACT AMOUNT SHALL BE LIMITED TO AN INCREASE OF 10 % OF THE ABOVE LISTED ESTIMATED AMOUNT, UNLESS AUTHORIZED BY CHANGE ORDER OR CONTRACT AMMENDMENT. CITY OF-.D BUQUE, IOWA MicWael C. Van Milligen ate City Manager SECTION 00500 Page 4 of 5 CONTRACTOR: Midwest Concrete, Inc. Company Name By: / G 10-14-22 Signs re Date Zyan Coates Printed Name President Title CONTRACTOR ACKNOWLEDGEMENT OF ATTACHED SPECIAL CONDITIONS: 1 By: 10-14-22 Signs re Date Ryan Coates Printed Name President Title SECTION 00500 Page 5 of 5 END OF SECTION 00500 =___ Bond No. 2530220 Page 1 of 4 PERFORMANCE PAYMENT AND MAINTENANCE BOND SECTION 00600 KNOW ALL BY THESE PRESENTS: That we, Midwest Concrete, Inc__, as Principal (hereinafter the "Contractor" or "Principal") and West Bend Mutual Insurance Company , as Surety are held and firmly bound unto the City of Dubuque, Iowa, as Obligee (hereinafter referred to as "Owner"), and to all persons who may be injured by any breach of any of the conditions of this Bond in the penal sum of Twenty-three thousand, four hundred ninety-six dollars and ninety-five cents ($23,496.95), lawful money of the United States, for the payment of which sum, well and truly to be made, we bind ourselves, our heirs, legal representatives and assigns, jointly or severally, firmly by these presents. The conditions of the above obligations are such that whereas said Contractor entered into a contract with the Owner, bearing date the 14th day of October, 2022, (hereinafter the "Contract") wherein said Contractor undertakes and agrees to construct the following project in accordance with the Contract Documents, and to faithfully perform all the terms and requirements of said Contract within the time therein specified, in a good and workmanlike manner, and in accordance with the Contract Documents. The Contract Documents for Royalwood Subdivision Water Main Loop - North Cascade Road Crossin Project detail the following described improvements: The project will provide for the construction of a new 8-inch water main that crosses North Cascade Road to serve as a water main loop for the Royalwood Subdivision. The new 8-inch water main will connect to an existing 8-inch valve on the north side of the road and connect to an existing 6-inch main on the south side of the road. The project will include asphalt pavement sawcut, removal and replacement, excavation, and approximately 55 L.F. of 8-inch PVC water main. It is expressly understood and agreed by the Contractor and Surety in this Bond that the following provisions are a part of this Bond and are binding upon said Contractor and Surety, to -wit: 1. PERFORMANCE: The Contractor shall well and faithfully observe, perform, fulfill, and abide by each and every covenant, condition, and part of said Contract and Contract Documents, by reference made a part hereof, for the project, and shall indemnify and save harmless the Owner from all outlay and expense incurred by the Owner by reason of the Contractor's default of failure to perform as required. The Contractor shall also be responsible for the default or failure to perform as required under the Contract and Contract Documents by all its subcontractors, suppliers, agents, or employees furnishing materials or providing labor in the performance of the Contract. 2. PAYMENT: The Contractor and the Surety on this Bond hereby agreed to pay all just claims submitted by persons, firms, subcontractors, and corporations furnishing materials for or performing labor in the performance of the Contract on account of which this Bond is given, SECTION 00600 Page 2 of 4 including but not limited to claims for all amounts due for labor, materials, lubricants, oil, gasoline, repairs on machinery, equipment, and tools, consumed or used by the Contractor or any subcontractor, wherein the same are not satisfied out of the portion of the contract price the Owner is required to retain until completion of the improvement, but the Contractor and Surety shall not be liable to said persons, firms, or corporations unless the claims of said claimants against said portion of the contract price shall have been established as provided by law. The Contractor and Surety hereby bind themselves to the obligations and conditions set forth in Chapter 573 of the Iowa Code, which by this reference is made a part hereof as though fully set out herein. 3. MAINTENANCE: The Contractor and the Surety on this Bond hereby agree, at their own expense: A. To remedy any and all defects that may develop in or result from work to be performed under the Contract Documents within the period of Two (2) year(s) from the date of acceptance of the work under the Contract, by reason of defects in workmanship, equipment installed, or materials used in construction of said work; B. To keep all work in continuous good repair; and C. To pay the Owner's reasonable costs of monitoring and inspection to assure that any defects are remedied, and to repay the Owner all outlay and expense incurred as a result of Contractor's and Surety's failure to remedy any defect as required by this section. Contractor's and Surety's Contract herein made extends to defects in workmanship or materials not discovered or known to the Owner at the time such work was accepted. 4. GENERAL: Every Surety on this Bond shall be deemed and held bound, any contract to the contrary notwithstanding, to the following provisions: A. To consent without notice to any extension of time authorized in approved change orders to the Contractor in which to perform the Contract. B. To consent without notice to any change in the Contract or Contract Documents, authorized in approved change orders which thereby increases the total contract price and the penal sum of this Bond, provided that all such changes do not, in the aggregate, involve an increase of more than twenty percent (20%) of the total contract price, and that this Bond shall then be released as to such excess increase. C. To consent without notice that this Bond shall remain in full force and effect until the Contract is completed, whether completed within the specified contract period, within an extension thereof, or within a period of time after the contract period has elapsed and the liquidated damage penalty is being charged against the Contractor. The Contractor and every Surety on the Bond shall be deemed and held bound, any contract to the contrary notwithstanding, to the following provisions: SECTION 00600 Page 3 of 4 D. That no provision of this Bond or of any other contract shall be valid that limits to less than five (5) years after the acceptance of the work under the Contract the right to sue on this Bond. E. That as used herein, the phrase "all outlay and expense" is not to be limited in any way but shall include the actual and reasonable costs and expenses incurred by the Owner including interest, benefits, and overhead where applicable. Accordingly, "all outlay and expense" would include but not be limited to all contract or employee expense, all equipment usage or rental, materials, testing, outside experts, attorney's fees (including overhead expenses of the Owner's staff attorneys), and all costs and expenses of litigation as they are incurred by the Owner. It is intended the Contractor and Surety will defend and indemnify the Owner on all claims made against the Owner on account of Contractor's failure to perform as required in the Contract and Contract Documents, that all agreements and promises set forth in the Contract and Contract Documents, in approved change orders, and in this Bond will be fulfilled, and that the Owner will be fully indemnified so that it will be put into the position it would have been in had the Contract been performed in the first instance as required. In the event the Owner incurs any "outlay and expense" in defending itself against any claim as to which the Contractor or Surety should have provided the defense, or in the enforcement of the promises given by the Contractor in the Contract, Contract Documents, or approved change orders, or in the enforcement of the promises given by the Contractor and Surety in this Bond, the Contractor and Surety agree that they will make the Owner whole for all such outlay and expense, provided that the Surety's obligation under this Bond shall not exceed one hundred twenty-five percent (125%) of the penal sum of this Bond. In the event that any actions or proceedings are initiated regarding this Bond, the parties agree that the venue thereof shall be Dubuque County, State of Iowa. If legal action is required by the Owner to enforce the provisions of this Bond or to collect the monetary obligation incurring to the benefit of the Owner, the Contractor and the Surety agree, jointly, and severally, to pay the Owner all outlay and expense incurred therefor by the Owner. All rights, powers, and remedies of the Owner hereunder shall be cumulative and not alternative and shall be in addition to all rights, powers, and remedies given to the Owner, by law. The Owner may proceed against surety for any amount guaranteed hereunder whether action is brought against the Contractor or whether Contractor is joined in any such action(s) or not. NOW THEREFORE, the condition of this obligation is such that if said Principal shall faithfully perform all the promises of the Principal, as set forth and provided in the Contract, in the Contract Documents, and in this Bond, then this obligation shall be null and void, otherwise it shall remain in full force and effect. When a work, term, or phrase is used in this Bond, it shall be interpreted or construed first as defined in this Bond, the Contract, or the Contract Documents; second, if not defined in the Bond, Contract, or Contract Documents, it shall be interpreted or construed as defined in applicable provisions of the Iowa Code; third, if not defined in the Iowa Code, it shall be interpreted or construed according to its generally accepted meaning in the construction industry; and fourth, if it has no generally accepted SECTION 00600 Page 4 of 4 meaning in the construction industry, it shall be interpreted or construed according to its common or customary usage. Failure to specify or particularize shall not exclude terms or provisions not mentioned and shall not limit liability hereunder. The Contract and Contract Documents are hereby made a part of this Bond. CIP # 7402746, Project Code: 4281000033 Witness our hands, in triplicate, this 14th SURETY COUNTERSIGNED BY: Signature of Agent Printed Name of Agent Company Address City, State, Zip Code Company Telephone Number PRINCIPAL: Midwest Concrete, Inc. Contractor Signature Ryan Coates Printed Name Owner Title day of October , 2022. FORM APPR�/ED BY: Repres ative for Owner �_11l��lrs West Bend Mutual Insurance Company Surety Company Signature Attorney -in -Fact Officer Kim Hess Printed Name of Attorney -in -Fact Officer Tricor Company Name 600 Star Brewery Dr Ste 1 10 Company Address Dubuque, IA 52001 City, State, Zip Code !� 563-556-5441 Company Telephone Number NOTE: 1. All signatures on this performance, payment, and maintenance Bond must be original signatures in ink; copies, facsimile, or electronic signatures will not be accepted. 2. This Bond must be sealed with the Surety's raised, embossing seal. 3. The name and signature of the Surety's Attorney-in-Fact/Officer entered on this Bond must be exactly as listed on the Certificate or Power of Attorney accompanying this Bond. ==== END OF SECTION 00600 ==== WEST BEND A MUTUAL INSURANCE COMPANY" POWER OF ATTORNEY THE SILVER LINING® Bond No. 2530220 Know all men by these Presents, That West Bend Mutual Insurance Company, a corporation having its principal office in the City of West Bend, Wisconsin does make, constitute and appoint: KIM HESS lawful Attorney(s)-i n -fact, to make, execute, seal and deliver for and on its behalf as surety and as its act and deed any and all bonds, undertakings and contracts of suretyship, provided that no bond or undertaking or contract of suretyship executed under this authority shall exceed in amount the sum of: Ten Million Dollars ($10,000,000) This Power of Attorney is granted and is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of West Bend Mutual Insurance Company at a meeting duly called and held on the 21st day of December, 1999. Appointment of Attorney -In -Fact. The president or any vice president, or any other officer of West Bend Mutual Insurance Company may appoint by written certificate Attorneys -In -Fact to act on behalf of the company in the execution of and attesting of bonds and undertakings and other written obligatory instruments of like nature, The signature of any officer authorized hereby and the corporate seal maybe affixed byfacsimile to any such power of attorney or to any certificate relating therefore and any such power of attorney or certificate bearing such facsimile signatures or facsimile seal shall be valid and binding upon the company, and any such power so executed and certified by facsimile signatures and facsimile seal shall be valid and binding upon the company in the future with respect to any bond or undertaking or other writing obligatory in nature to which it is attached. Any such appointment may be revoked, for cause, or without cause, by any said officer at any time. In witness whereof, the West Bend Mutual Insurance Company has caused these presents to be signed by its president undersigned and its corporate seal to be hereto duly attested by its secretary this 17th day of August, 2021. �hl�ibllygl�h'' tli G(1i �a.uuu ,. Attest I .e`�•' FtPORA7 "'° Christopher C. Z gait Go F`! Kevin A. Steiner Secretary '' SSAL?i Chief Executive Officer/President State of Wisconsin County of Washington On the 17th day of August, 2021, before me personally came Kevin A. Steiner, to me known being by duly sworn, did depose and say that he resides in the County of Washington, State of Wisconsin; that he is the President of West Bend Mutual Insurance Company, the corporation described in and which executed the above instrument; that he knows the seal of the said corporation; that the seal affixed to said instrument is such corporate seal; that is was so affixed by order of the board of directors of said corporation and that he signed his name thereto by like order. Matthew E. Carlton Senior Corporate Attorney Notary Public, Washington Co., WI My Commission is Permanent The undersigned, duly elected to the office stated below, now the incumbent in West Bend Mutual Insurance Company, a Wisconsin corporation authorized to make this certificate, Do Hereby Certify that the foregoing attached Power of Attorney remains in full force effect and has not been revoked and that the Resolution of the Board of Directors, set forth in the Power of Attorney is now in force. Signed and sealed at West Bend, Wisconsin this 14th day of October 2022 F pORPORAZe" Heather Dunn Vice President — Chief Financial Officer Notice: Any questions concerning this Power of Attorney may be directed to the Bond Manager at West Bend Mutual Insurance Company, 1900 South 18th Avenue I West Bend, WI 53096 1 Phone: (608) 410-3410 1 Fax: (877) 674-2663 1 www.thesilverlining.com -�� MIDWCON-03 KHES ACORO" CERTIFICATE OF LIABILITY INSURANCE D 1018120118/20Y2 �--�-"'"- 22 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy((es) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . ME PRODUCER CONTACT TRICOR, LLC - Dubuque PHONE 600 Star Brewery Drive (A/C, No, Ext : (563) 556-5441 ac, No :(608) 723-6440 Suite 110 E-MA' • service@tricorinsurance.com Dubuque, IA 52001 INSURERS AFFORDING COVERAGE I NAIC # INSURERA:Sheboynan Falls/LeMars/Donenal Ins Co. 115148 INSURED Midwest Concrete Inc AHL Equipment Leasing, Inc. 9835 Cottingham Rd Peosta, IA 52068 INSURER D : INSURER E : INSURER F : L Rl1X/1=DAf_PA r`1=RTIPIrATF NI IMRFR• DC\/ICIf1hI KIIIaaDCD- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TR TYPE OF INSURANCE ADDL I SUBR POLICY NUMBER POLICY EFF POLICY EXP YY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F_X] OCCUR CPA9030194 4/16/2022 4/15/2023 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMI o urran e $ 1 OO,000 MED EXP (Any oneperson) $ 5,000 PERSONAL & ADV INJURY 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY �X JE C El LOC GENERAL AGGREGATE 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: A AUTOMOBILE LIABILITY COMBINEDISINGLE LIMIT $ 1,000,000 X BODILY INJURY Perperson) $ ANY AUTO CAA9030194 4/15/2022 4/15/2023 OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,005 AGGREGATE $ 4,000,000 EXCESS LIAB CLAIMS -MADE CWA9030194 4/15/2022 4/15/2023 DED RETENTION $ A AND EMPLOYCOMPENSATION RS' N A TIOI N Y/ N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑N (Mandatory in NH) If es, describe under DESCRIPTI N OF OPERATIONS below N / A 1000024036 4/15/2022 4/15/2023 y( ISTATUPER TE ER OTH- E.L. EACH ACCIDENT 500,Opp $ E.L. DISEASE - EA EMPLOYEE $ 500,005 E.L. DISEASE - POLICY LIMIT 500,000 $ B Pollution Liability CPLMOL111008 4/15/2022 4/15/2024 Each Incident/Aggreg 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Project: Royalwood Subdivision Water Main Loop North Cascade Road Crossing City of Dubuque including all its elected and appointed officials, all its employees and volunteers, all its boards, commmissions and/or authorities and their board members, employees and volunteers are additional insured on a primary, non-contributory basis including ongoing and completed operations. Governmental Immunities applies in favor of City of Dubuque. Waiver of subrogation on the Work Comp and general liability policies in favor of the City of Dubuque. Notice of cancel is ammended to 30 days. f CDTICIt"ATC Wni r19:10 /`A W 'CI 1 A r1n K1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CI Of Dubuque City q 50 W 13th St THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Dubuque, IA 52001 — AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: CPA9030194 September 28, 2022 (WF) POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CGD90360119 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS - AUTOMATIC STATUS WHEN REQUIRED IN WRITTEN CONSTRUCTION CONTRACT OR AGREEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. SECTION II - WHO IS AN INSURED is amended to include as an insured any person or organization whom you are required under a written contract or agreement to provide insurance such as is afforded under this policy, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" performed at the site or location designated in the written contract or agreement. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. The insurance afforded to such additional insured will not be broader than: a. The coverage you have agreed to provide in the written contract or agreement; or b. The coverage provided by this endorsement. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: 1. This does not apply to "bodily injury" or "property damage" occurring prior to the date the written contract or agreement was executed and in effect. 2. "Bodily injury" or "property damage" arising out of an architect's, engineer's, or surveyor's rendering of or failure to render any professional services for you, for such person or organization, or for others, including: a. The preparing, approving, or failure to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, designs, drawings or specifications; and b. Supervisory, inspection, or engineering services. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage" involved the rendering of or the failure to render any professional services. 3. Any "bodily injury" or "property damage" for which valid and collectible insurance is available under an Owners and Contractors Protective Liability policy that you have purchased. C. With respect to the Insurance provided by this endorsement, the following is added to SECTION III - LIMITS OF INSURANCE: 8. The most we will pay under the insurance provided by this endorsement is: a. The applicable limit of insurance to which you have agreed in the written contract or agreement to provide; or b. The applicable Limit of Insurance shown in the Declarations, whichever is less. D. With respect to the Insurance provided by this endorsement, Paragraph 4. Other Insurance as found under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS is replaced by the following: 4. Other Insurance This insurance is excess over any other valid and collectible insurance, whether primary, excess, contingent or on any other basis, unless you have agreed in a written contract or agreement for this insurance to apply either on a: (1) Primary and non-contributory; or (2) Contributory basis. When this insurance is excess, we will have no duty under Coverage A to defend the insured against any "suit" if any other insurer has a duty to defend the insured against that "suit". If no other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. CGD 90 36 01 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 2 Donegal Insurance Group POLICY NUMBER: CPA9030194 September 28, 2022 (WF) When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (1) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (2) The total of all deductible and self -insured amounts under all that other insurance. We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. CGD 90 36 01 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 2 Donegal Insurance Group POLICY NUMBER: CPA9030194 September 28, 2022 (WF) POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CGD 20 33 05 15 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. SECTION II - WHO IS AN INSURED is amended to include as an insured any person or organization whom you are required under a written contract or agreement to provide insurance such as is afforded under this policy, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations at the site or location designated in the written contract or agreement. However, 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. The insurance afforded to such additional insured will not be broader than: a. The coverage you have agreed to provide in the written contract or agreement; or b. The coverage provided by this endorsement. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: 1. This does not apply to "Bodily injury" or "property damage" occurring: a. Prior to the date the written contract or agreement was executed and in effect; b. After all work on the project (other than service, maintenance or repairs) to be performed at the site or location of the covered operations has been completed; or c. After that portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. 2. "Property damage" to: a. Property owned, occupied or used by; b. Property rented to, in the care, custody, or control of, or over which physical control is being exercised for any purpose by; or c. "Your work" for, such person or organization 3. "Bodily injury" or "property damage" arising out of an architect's, engineer's, or surveyor's rendering of or failure to render any professional services for you, for such person or organization, or for others, including: a. The preparing, approving, or failure to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, designs, drawings or specifications; and b. Supervisory, inspection, or engineering services. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage" involved the rendering of or the failure to render any professional services. 4. Any "bodily injury" or "property damage" for which valid and collectible insurance is available under an Owners and Contractors Protective Liability policy that you have purchased. C. With respect to the Insurance provided by this endorsement, the following is added to SECTION III - LIMITS OF INSURANCE: 8. The most we will pay under the insurance provided by this endorsement is: a. The applicable limit of insurance to which you have agreed in the written contract or agreement to provide; or b. The applicable Limit of Insurance shown in the Declarations, whichever is less. CGD 20 33 05 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 2 Donegal Insurance Group POLICY NUMBER: CPA9030194 September 28, 2022 (WF) D. With respect to the Insurance provided by this endorsement, Paragraph 4. Other Insurance as found under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS is replaced by the following: 4. Other Insurance This insurance is excess over any other valid and collectible insurance, whether primary, excess, contingent or on any other basis, unless you have agreed in a written contract or agreement for this insurance to apply on either a: (1) Primary and non-contributory basis; or (2) Contributory basis. When this insurance is excess, we will have no duty under Coverage A to defend the insured against any "suit" if any other insurer has a duty to defend the insured against that "suit". If no other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (1) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (2) The total of all deductible and self -insured amounts under all that other insurance. We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. CGD 20 33 05 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 2 Donegal Insurance Group POLICY NUMBER: CPA9030194 September 28, 2022 (WF) POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CGD 09 08 0519 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS SILVER SERIES GENERAL LIABILITY COVERAGE ENHANCEMENT ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM SCHEDULE* Coverage Limit(s) of Insurance Page * Information required to complete this Schedule, if not shown on this endorsement, will be shown in the Declarations. CGD 09 08 05 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 8 Donegal Insurance Group POLICY NUMBER: CPA9030194 September 28, 2022 (WF) The following Coverages apply only if they are shown in A. Subparagraph j. Damage To the Schedule above. Each of the Coverages is subject to Property under paragraph 2. the limit of insurance associated with such Coverage in Exclusions as found in COVERAGE the Schedule. A. BODILY INJURY AND I. NON -OWNED WATERCRAFT COVERAGE PROPERTY DAMAGE LIABILITY A. Subparagraph g.(2) under paragraph 2. (SECTION I - COVERAGES) isdeleted and replaced by the Exclusions as found in COVERAGE A. following: BODILY INJURY AND PROPERTY DAMAGE LIABILITY (SECTION I - COVERAGES) is j. Damage To Property deleted and replaced by the following: "Property damage" to: (2) A watercraft you do not own that is: (a) Less than 51 feet long; and (1) Property you own, rent, or occupy, including any costs or expenses (b) Not being used to carry persons or incurred by you, or any other person, property for a charge; organization or entity, for repair, B. With respect to COVERAGE A. BODILY replacement, enhancement, restoration INJURY AND PROPERTY DAMAGE or maintenance of such property for any LIABILITY only, the following provision is added reason, including prevention of injury to to SECTION II - WHO IS AN INSURED: a person or damage to another's 4. Any person is an insured with respect to a property; watercraft you do not own that is less than (2) Premises you sell, give away or 51 feet long and is not being used to carry abandon, if the "property damage" persons or property for a charge, while using arises out of any part of those premises; such watercraft with your permission. Any other person or organization responsible for (3) Property loaned to you; the conduct of such person is also an (4) Personal property in the care, custody or insured, but only with respect to liability control of the insured; arising out of the operation of the watercraft. However, no person or organization is an (5) That particular part of real property on insured: which you or any contractors or subcontractors working directly or a. With respect to "bodily injury" to a co- indirectly on your behalf are performing "employee" of the person operating the operations, if the "property damage" watercraft; arises out of those operations; or b. With respect to "property damage" to (6) That particular part of any property that property owned by, rented to, loaned to, must be restored, repaired or replaced occupied by, or otherwise in the care, because "your work" was incorrectly custody or control of, you or the performed on it. employer of any person who is insured under this provision; or Paragraph (2) of this exclusion does not c. If other insurance of any kind is available apply if the premises are "your work" and to that person or organization for this were never occupied, rented or held for liability, unless such insurance was rental by you. written to apply specifically in excess of Paragraphs (3), (4), (5) and (6) of this this policy. exclusion do not apply to liability assumed IL BROADENED DAMAGE TO PREMISES RENTED under a sidetrack agreement. TO YOU COVERAGE Paragraph (6) of this exclusion does not The following provisions apply only if a Limit of apply to "property damage" included in the Insurance is shown in the Declarations for Damage "products -completed operations hazard". To Premises Rented To You. If no Limit of Insurance is shown in the Declarations for Damage To Premises Rented To You, or if Damage To Premises Rented To You is shown as excluded, the following provisions do not apply. CGD 09 08 05 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 Of 8 Donegal Insurance Group POLICY NUMBER: CPA9030194 September 28, 2022 (WF) B. The last subparagraph under paragraph 2. Exclusions as found in COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY (SECTION I - COVERAGES) is deleted and replaced by the following: Exclusions c. through e. and g. through n. do not apply to "property damage" to premises while rented to you or temporarily occupied by you with permission of the owner. Exclusion f. does not apply to damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in Section III - Limits Of Insurance and as provided under the Broadened Damage To Premises Rented To You Coverage. C. Subject to the Each Occurrence Limit Shown in the Declarations, the Limit of Insurance shown in the Schedule above for Broadened Damage To Premises Rented To You Coverage is the most we will pay under Coverage A for damages because of "property damage" to any one premises, while rented to you or temporarily occupied by you with permission of the owner. The Limit of Insurance for Broadened Damage To Premises Rented To You Coverage shown in the Schedule above is in addition to any Limit of Insurance shown in the Declarations for Damage To Premises Rented To You. III. ELECTRONIC DATA LIABILITY A. Subparagraph p. Electronic Data under paragraph 2. Exclusions as found in COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY (SECTION I - COVERAGES) is deleted and replaced by the following: p. Access Or Disclosure Of Confidential Or Personal Information And Data -related Liability Damages arising out of: (1) Any access to, or disclosure or theft of, any person's or organization's confidential or personal information, including patents, trade secrets, processing methods, customer lists, financial information, an individual's name, social security number, driver's license number, state identification number, credit card information, debit card information, account number, account histories, passwords, health information, medical information, or any other type of nonpublic information; or (2) The loss of, loss of use of, damage to, corruption of, inability to access, inability to transmit or receive, or inability to manipulate "electronic data" that does not result from physical injury to tangible property. This exclusion applies even if damages are claimed for notification costs, monitoring expenses, forensic or investigation expenses, public relations expenses or any other loss, cost or expense incurred by you or others arising out of that which is described in Paragraph (1) or (2) above. B. The following paragraph is added to SECTION III - LIMITS OF INSURANCE: Subject to 5. above, the Electronic Data Liability Limit shown in the Schedule above is the most we will pay under COVERAGE A for "property damage" because of all loss of "electronic data" arising out of any one "occurrence". C. With respect to the insurance provided by this endorsement, the definition of "Property Damage" in the Definitions Section is replaced by the following: 17. "Property damage" means: a. Physical injury to tangible property, including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it; b. Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the time of the "occurrence" that caused it; or c. Loss of, loss of use of, damage to, corruption of, inability to access, or inability to properly manipulate "electronic data", resulting from physical injury to tangible property. All such loss of "electronic data" shall be deemed to occur at the time of the "occurrence" that caused it. "Property damage" does not include any loss, cost or expense to correct any defective, faulty or incorrect work performed by you or by any contractors or subcontractors working directly or indirectly on your behalf. For the purposes of this insurance, "electronic data" is not tangible property. CGD 09 08 05 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 8 Donegal Insurance Group POLICY NUMBER: CPA9030194 September 28, 2022 (WF) D. With respect to the insurance provided by this endorsement, the following Definition is added to SECTION V - DEFINITIONS: "Electronic data" means information, facts or programs stored as or on, created or used on, or transmitted to or from computer software (including systems and applications software), hard or floppy disks, CD-ROMS, tapes, drives, cells, data processing devices or any other media which are used with electronically controlled equipment. IV. SUPPLEMENTARY PAYMENTS - COVERAGES A AND B INCREASED LIMITS A. Subparagraph b. under paragraph 1, as found in SUPPLEMENTARY PAYMENTS - COVERAGES A AND B (SECTION I - COVERAGES) is deleted and replaced by the following: b. Up to the Limit of Insurance shown in the Schedule above for Supplementary Payments -Coverages A and B - Bail Bonds Increased Limit for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. B. Subparagraph d. under paragraph 1. as found in SUPPLEMENTARY PAYMENTS - COVERAGES A AND B (SECTION I - COVERAGES) is deleted and replaced by the following: d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit". Expenses paid under this provision includes actual loss of earnings, up to the Limit of Insurance shown in the Schedule above for Supplementary Payments - Coverages A and B - Loss of Earnings Increased Limit, because of time off from work. V. BROAD FORM NAMED INSURED COVERAGE With respect to COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY and COVERAGE B. PERSONAL AND ADVERTISING INJURY LIABILITY, the following provision is added to paragraph 1. as found in SECTION II - WHO IS AN INSURED: f. An organization other than a partnership, joint venture or limited liability company, your legally incorporated subsidiaries are insureds if you own a financial interest of more than 50 percent of the voting stock on the effective date of this endorsement. However, coverage under this provision does not apply to "bodily injury", "property damage", or "personal and advertising injury" with respect to which an insured under this policy, including any endorsement attached to and made a part of this policy, is also an insured under another policy, or would be an insured under such policy but for its termination or the exhaustion of the applicable limits of insurance, unless such policy was written to apply specifically in excess of this policy. VI. INCIDENTAL MALPRACTICE LIABILITY - NURSE, EMT OR PARAMEDIC COVERAGE Paragraph 2.a.(1)(d) as found in SECTION II - WHO IS AN INSURED is deleted and replaced by the following: (d) Arising out of his or her providing or failing to provide professional health care services. This paragraph 2.a.(1)(d) does not apply to a nurse, emergency medical technician (EMT) or paramedic employed by you. VII. BROADENED NEWLY FORMED OR ACQUIRED ORGANIZATIONS COVERAGE Paragraph 3.a. as found in SECTION II - WHO IS AN INSURED is deleted and replaced by the following: a. Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier; VIII.BROADENED WHO IS AN INSURED The following is added to SECTION II - WHO IS AN INSURED: The following is an additional insured: A. 1. Any person or organization from whom you lease equipment when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an insured only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person or organization. A person's or organization's status as an insured under this endorsement ends when their contract or agreement with you for such leased equipment ends. CGD 09 08 05 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 8 Donegal Insurance Group POLICY NUMBER: CPA9030194 September 28, 2022 (WF) However, such person or organization is not (8) "Bodily injury" or an insured with respect to any "occurrence" "property damage" which takes place after the equipment lease arising out of the sole expires. negligence of the vendor 2. Any person or organization (referred to for its own acts or below as vendor) with whom you agree in a omissions or those of its written contract or agreement to provide employees or anyone insurance such as is afforded under this else acting on policy, but only with respect to "bodily injury" its behalf. However, this exclusion or "property damage" caused, in whole or in does not apply to: part, by "your products" which are distributed (i) The exceptions contained in or sold in the regular course of the vendor's Subparagraphs (4) or (6) above; business, subject to the following additional or exclusions: (ii) Such inspections, adjustments, (a) The insurance afforded the vendor does tests or servicing as the vendor not apply to: has agreed to make or normally (1) "Bodily injury" or "property damage" undertakes to make in the usual for which the vendor is obligated to course of business, in pay damages by reason of the connection with the distribution assumption of liability in a contract or sale of the products. or agreement. This exclusion does (b) This insurance does not apply to any not apply to liability for damages that insured person or organization, from the vendor would have in the whom you have acquired such products, absence of the contract or or any ingredient, part or container, agreement; entering into, accompanying or (2) Any express warranty unauthorized containing such products. by you; 3. Any person or organization but only with (3) Any physical or chemical change in respect to their liability for "bodily injury" or the product made intentionally by "property damage" caused, in whole or in the vendor; part, by your ongoing operations due to: (4) Repackaging, unless unpacked (a) Their financial control of you; or solely for the purpose of inspection, (b) Premises they own, maintain or control demonstration, testing, or the substitution of parts under while you lease or occupy these instructions from the manufacturer, premises. and then repackaged in the original However, the insurance afforded to such container; person or organization does not apply to (5) Any failure to make such structural alterations, new construction and inspections, adjustments, tests or demolition operations performed by or for that person or organization. servicing as the vendor has agreed to make or normally undertakes to 4. Any person or organization but only with make in the usual course of respect to liability for "bodily injury" or business, in connection with the "property damage" as co-owner of a distribution or sale of the products; Described Premises shown in the (6) Demonstration, installation, declarations. servicing or repair operations, 5. Any person or organization but only with except such operations performed respect to liability for "bodily injury" or at the vendor's premises in "property damage" as grantor of a franchise connection with the sale of the or license to you. product; (7) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor. CGD 09 08 05 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 8 Donegal Insurance Group POLICY NUMBER: CPA9030194 September 28, 2022 (WF) 6. Any person or organization but only with (b) The construction, erection, or respect to liability for "bodily injury" or removal of elevators; or "property damage" caused, in whole or in (c) The ownership, maintenance, part, by your ongoing operations on that part or use of any elevators of the land leased to you and shown in the covered by this insurance. Schedule. However, the insurance afforded to such person or organization does not B. The insurance afforded to such apply to: person or organization described in paragraph A. above only applies to the extent (a) Any "occurrence" which takes place permitted by law. after you cease to lease that land; C. The insurance afforded to such person or (b) Structural alterations, new construction organization described in paragraph A. above or demolition operations performed by will not be broader than: or for that person or organization. 1. The coverage you have agreed to provide in 7. Any person or organization but only with the written contract or agreement; or respect to liability for "bodily injury" or 2. The coverage provided by this "property damage" as a mortgagee, endorsement. assignee, or receiver and arising out of the D. A person's or organization's status as an ownership, maintenance, or use of a additional insured under this endorsement ends Described Premises shown in the when their contract or agreement with you ends. declarations. However, the insurance afforded to such person or organization does E. The insurance provided to such person or not apply to structural alterations, new organization described in paragraph A. above construction and demolition operations does not apply to bodily injury or property performed by or for that person or damage occurring: organization. 1. Prior to the date the written contract or 8. Any person or organization but only with agreement was executed and in effect;2. After your contract or agreement with such respect to liability for bodily injury or additional insured ends; or "property damage" caused, in whole or in 3. After the requirement in the written contract part, by your ongoing operations performed or agreement to add such person or in that part of the premises leased to you and organization as an additional insured on shown as a Described Premises in the your policy ends. declarations. However, the insurance afforded to such person or organization does F. The insurance afforded to any additional insured not apply to is excess over any other valid and collectible insurance, whether primary, excess, contingent (a) Any "occurrence" which takes place or on any other basis, unless you have agreed in after you cease to be a tenant in that a written contract or agreement for this premises. insurance to apply on either a: (b) Structural alterations, new construction 1. Primary and non-contributory basis; or or demolition operations performed by 2. Contributory basis. or for that person or organization. IX. MEDICAL EXPENSE INCREASED LIMIT 9. Any state or political subdivision, but only The following provision applies only if a Limit of with respect to liability for "bodily injury" or Insurance is shown in the Declarations for Medical "property damage". This insurance applies Expense. If no Limit of Insurance is shown in the only with respect to the following hazards for Declarations for Medical Expense, or if Medical which the state or political subdivision has Expense is shown as excluded, the following issued a permit in connection with premises provision does not apply. you own, rent, or control and to which this Subject to the Each Occurrence Limit Shown in the insurance applies: Declarations, the Limit of Insurance shown in the (a) The existence, maintenance, repair, Schedule above for Medical Expense Increased construction, erection, or removal of Limit is the most we will pay under Coverage C for advertising signs, awnings, canopies, all medical expenses because of "bodily injury" cellar entrances, coal holes, driveways, sustained by any one person. The Limit of Insurance manholes, marquees, hoistaway for Medical Expense Increased Limit shown in the openings, sidewalk vaults, street Schedule above is in addition to any Limit of banners, or decorations and similar Insurance shown in the Declarations for Medical exposures; or Expense. CGD 09 08 05 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 6 of 8 Donegal Insurance Group POLICY NUMBER: CPA9030194 September 28, 2022 (WF) X. AMENDMENT OF GENERAL AGGREGATE LIMIT OF INSURANCE - PER PROJECT AND PER LOCATION A. With respect to COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY and COVERAGE C. MEDICAL PAYMENTS only, the following provision is added to SECTION III - LIMITS OF INSURANCE: The General Aggregate as described in paragraph 2. under SECTION III - LIMITS OF INSURANCE applies separately to each of your projects away from premises owned by or rented to you and separately to each of your "locations" owned by or rented to you. However: 1. This Amendment of General Aggregate Limit of Insurance - Per Project and Per Location provision does not apply if a single "occurrence" under Coverage A, or a single accident under Coverage C, can be attributed to multiple projects or "locations". The General Aggregate Limit of Insurance shown in the Declarations will apply to the sum of all damages under Coverage A arising out of such 'occurrence" and all medical expenses under Coverage C arising out of such accident; 2. This Amendment of General Aggregate Limit of Insurance - Per Project and Per Location does not apply to damages under Coverage B. The General Aggregate Limit of Insurance shown in the Declarations continues to apply to the sum of all damages under Coverage B, regardless of the number of projects or "locations"; B. With respect to the insurance provided by this endorsement, the following Definition is added to SECTION V - DEFINITIONS: "Locations" means premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right-of-way of a railroad. XI. KNOWLEDGE OF AN OCCURRENCE, OFFENSE, CLAIM OR SUIT Subparagraphs a. and b. under paragraph 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit as found in SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS are deleted and replaced by the following: a. You must see to it that we are notified as soon as practicable of an 'occurrence" or an offense which may result in a claim. To the extent possible, notice should include: (1) How, when and where the 'occurrence" or offense took place; (2) The names and addresses of any injured persons and witnesses; and (3) The nature and location of any injury or damage arising out of the 'occurrence" or offense. This Condition only applies when the "occurrence", offense, claim or "suit' is known to you (if you are an individual), to a partner (if you are a partnership), a manager (if you are a limited liability company), or an officer or insurance manager of a corporation (if you are a corporation). Knowledge of an 'occurrence", offense, claim or "suit' by an agent, servant or "employee" of an insured (other than a partner, manager, officer, or insurance manager) does not imply knowledge by the insured unless the insured has received notice from the agent, servant or "employee". b. If a claim is made or "suit' is brought against any insured, you must: (1) Immediately record the specifics of the claim or "suit' and the date received; and (2) Notify us as soon as practicable. You must see to it that we receive written notice of the claim or "suit' as soon as practicable. Failure by an agent, servant or "employee" of an insured (other than a partner, manager, officer, or insurance manager) to notify us of an "occurrence", offense, claim or "suit' will not jeopardize your coverage. XII. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY The following is added to the paragraph 8. Transfer Of Rights Of Recovery Against Others To Us as found in SECTION IV - COMMERCIAL LIABILITY CONDITIONS: We waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of "your work" included in the "products -completed operations hazard" or your ongoing operations, subject to the following: a. You are required under a written contract to waive your rights to recover from that person or organization; and b. The written contract was executed and in effect before any injury or damage that would give rise to a claim under this Commercial General Liability Coverage Part. This waiver does not apply to any person who is an engineer or architect, or to any organization with respect to an engineer or architect employed by such organization, unless agreed to in writing by us. CGD 09 08 05 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 8 Donegal Insurance Group POLICY NUMBER: CPA9030194 September 28, 2022 (WF) XIILUNINTENTIONAL FAILURE TO DISCLOSE HAZARDS The following Condition is added to SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS: 10. Unintentional Failure To Disclose Hazards Any unintentional error or omission in the description of, or failure to completely describe, any premises or operations intended to be covered by this Coverage Part will not invalidate or affect coverage for those premises or operations. Such unintentional error or omission must be reported to us as soon as practicable after its discovery. This Condition does not affect our right to collect any additional premium associated with such unintentional error or omission or our right to cancel or non -renew this policy. XIV. CONTRACTUAL LIABILITY - RAILROADS Subparagraph f.(1) under the definition of "insured contract" as found in SECTION V - DEFINITIONS or as found in endorsement CG 24 26 AMENDMENT OF INSURED CONTRACT DEFINITION is deleted. XV. MOBILE EQUIPMENT REDEFINED Subparagraph f.(1) under the definition of "mobile equipment' as found in SECTION V - DEFINITIONS is deleted and replaced by the following: (1) Equipment with a gross vehicle weight of 1000 pounds or more and designed primarily for: (a) Snow removal; (b) Road maintenance, but not construction or resurfacing; or (c) Street cleaning. CGD 09 08 05 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 8 of 8 Donegal Insurance Group F OLICY NUMBER: CPA9030194 September 28, 2022 (WF) POLICY NUMBER: INTERLINE ILD 90 30 05 14 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GOVERNMENT ENTITY AS ADDITIONAL INSURED - IOWA This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART BUSINESSOWNERS LIABILITY COVERAGE PART SCHEDULE Mailing Address Municipality: Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Cancellation and Material Changes Provision The following is added to the Cancellation Provisions included in the policy: In the event of cancellation for non-payment of premium, the insurer agrees to advise the municipality at the address shown in the schedule by written notice ten days prior to the effective date of cancellation. If the policy is, for any other reason, cancelled, not renewed, or there is a reduction in Insurance coverage and/or limits the insurer agrees to advise the municipality at the address shown in the schedule by written notice thirty days prior to the effective date of cancellation, non -renewal or change in coverage. B. Additional Insured Provision The municipality shown in the Schedule, including all its elected and appointed officials, all its employees and volunteer workers, all its boards, commissions and/or authorities and their boards, members, employees, and volunteer workers, are included as additional insureds but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf: in the performance of your ongoing operations for the municipality shown in the schedule. This coverage shall be primary to the additional insureds, and not contributing with any other insurance or similar protection available to the additional insureds, whether other available coverage is primary, contributing or excess. C. Governmental Immunities Provision 1. Nonwaiver of Governmental Immunity. The insurance carrier expressly agrees and states that the purchase of this policy and the including of the municipality shown in the Schedule as an Additional Insured does not waive any of the defenses of governmental immunity available to them under Code of Iowa Section 670.4 as it now exists and as it may be amended from time to time. 2. Claims Coverage. The insurance carrier further agrees that this policy of insurance shall cover only those claims not subject to the defense of governmental immunity under the Code of Iowa Section 670.4 as it now exists and may be amended from time to time. 3. Assertion of Governmental Immunity. The municipality shown in the Schedule shall be responsible for asserting any defense of governmental immunity, and may do so at any time and shall do so upon the timely written request of the insurance carrier. Nothing contained in this endorsement shall prevent the carrier from asserting the defense of governmental immunity on behalf of the municipality shown in the Schedule. Includes copyrighted material of ISO, Inc., with its permission. ILD 90 30 05 14 Donegal Insurance Group Page 1 of 2 POLICY NUMBER: CPA9030194 September 28, 2022 (WF) 4. Non -Denial of Coverage. The insurance carrier shall not deny coverage under this policy and the insurance carrier shall not deny any of the rights and benefits accruing to the municipality shown in the Schedule under this policy for reasons of governmental immunity unless and until a court of competent jurisdiction has ruled in favor of the defense(s) of governmental immunity asserted by the municipality. 5. No Other Change In Policy. The insurance carrier and the municipality shown in the schedule agree that the above preservation of governmental immunities shall not otherwise change or alter the coverage available under the policy. Includes copyrighted material of ISO, Inc., with its permission. ILD 90 30 0514 Donegal Insurance Group Page 2 of 2 POLICY NUMBER: CPA9030194 General Liability Schedule of Additional Interests (Continued) N Endorsement - - ------ ------- Additional Insured CGD 20 37 01/19 Owners, Lessees or Contractors - 71 Completed Operations In a Written Contract Premium: $35 or Agreement Location of Completed Operations: PAVING Additional Insured ILD 90 30 Government Entity as Additional Insured - S Iowa ( Additional Insured City of Dubuque ILD 90Yf Government Entity as Additional Insured - 50 W 13th St Iowa Dubuque IA 52001 05/14 05/14 CLDEC 10-17 04/0112022 08:58:12 Page 15 of 29 LA