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Improvement Contract_Portzen Construction, Inc. for the Dubuque Gate & Pump Station Flood Mitigation (16th St. Detenion Basin) ProjectCity of Dubuque City Council ITEM TITLE: SUMMARY: SUGGUESTED DISPOSITION: ATTACHMENTS: Copyrighted March 3, 2025 CONSENT ITEMS # 14. Improvement Contracts / Performance, Payment, and Maintenance Bonds Portzen Construction, Inc. for the Dubuque Gate & Pump Station Flood Mitigation (16th St. Detention Basin) Project. Receive and File; Approve 1. Dubuque Gate & Pump Station Flood Mitigation (16th Street Detention Basin) - Signed Contract Bond Page 258 of 629 SECTION 00500 Page 1 of 8 PUBLIC IMPROVEMENT CONTRACT SECTION 00500 DUBUQUE GATE & PUMP STATION FLOOD MITIGATION (16T" ST DETENTION BASIN) THIS IMPROVEMENT CONTRACT (the Contract), made in triplicate, dated for references purposes the 17th day of February, 2025, between the City of Dubuque, Iowa, by its City Manager, through authority conferred upon the City Manager by its City Council (City), and Portzen Construction, Inc. (Contractor). For and in consideration of the mutual covenants herein contained, the parties hereto agree as follows: CONTRACTOR AGREES: 1. To furnish all material and equipment and to perform all labor necessary for the Dubuque Gate & Pump Station Flood Mitigation (16th St Detention Basin) (Project). 2. CONTRACT DOCUMENTS A. The Contract Documents consist of the following: 1. Project Title Page (Section 00100). 2. Project Directory Page (Section 00101). 3. This Public Improvement Contract (Section 00500). 4. Performance, Payment, and Maintenance Bond (Section 00600). 5. Out -of -State Contractor Bond (Section 00610). 6. Other Bonds: N/A 7. The Iowa Statewide Urban Design And Specifications (SUDAS) 2023 Edition. 8. CITY OF DUBUQUE Supplemental Specifications 2023 Edition. 9. Other Standard and Supplementary Specifications as listed on the Title Page of the Contract Document Manual. 10. Special Provisions included in the project Contract Document Manual (Special Conditions, SRF, EDA and FEMA requirements). 11. Drawings consisting of sheets bearing the following general title: Dubuque Gate & Pump Station Flood Mitigation (16th St Detention Basin) 12.Addenda (numbers 1 to 6, inclusive). 13.Insurance Provisions and Requirements (Section 00700). 14. Sales Tax Exemption Certificate (Section 00750). 15.Site Condition Information (Section 00775). 16. Construction Schedule and Agreed Cost of Delay (Section 00800). 17. Erosion Control Certificate (Section 00900). Page 259 of 629 SECTION 00500 Page 2 of 8 18. Consent Decree (Section 01000). 19. SRF Requirements (Section 02000) 20. EDA Requirements (Section 02000) 21. FEMA Requirements (Section 02000) 22. Exhibits to this Contract (enumerated as follows): a. Contractor's Bid (pages 1 to 6 inclusive). b. Bidder Status Form (Section 00460). c. SRF Required forms d. EDA Required forms e. FEMA Required form f. The following documentation that must be submitted by Contractor prior to Notice of Award. i. Contractor Background Information Form (Section 00471) 23. The following which may be delivered or issued on or after the Effective Date of the Agreement: a. Notice to Proceed (Section 00850). b. Project Certification Page (Section 00102). c. Change Orders (Not attached to this agreement). There are no other Contract Documents. The Contract Documents may only be amended, modified, or supplemented as provided in Change Orders. 3. All materials used by the Contractor in the Project must be of the quality required by the Contract Documents and must be installed in accordance with the Contract Documents. 4. The Contractor must remove any materials rejected by the City as defective or improper, or any of said work condemned as unsuitable or defective, and the same must be replaced or redone to the satisfaction of the City at the sole cost and expense of the Contractor. 5. Five percent (5%) of the Contract price will be retained by the City for a period of thirty (30) days after final completion and acceptance of the Project by the City Council to pay any claim by any party that may be filed 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 thirty (30) day period, as provided in Iowa Code Chapter 573 or Iowa Code Chapter 26. The City will 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 will be held by the City until such claims have been settled, adjudicated or otherwise disposed of. 6. The Contractor has read and understands the Contract Documents herein referred to and agrees not to plead misunderstanding or deception related to estimates of quantity, character, location or other conditions for the Project. 7. In addition to any warranty provided for in the specifications, the Contractor must also fix any other defect in any part of the Project, even if the Project has been accepted and fully paid Page 260 of 629 SECTION 00500 Page 3 of 8 for by the City. The Contractor's maintenance bond will be security for a period of two years after the issuance of the Certificate of Substantial Completion. 8. The Contractor must fully complete the Project under this Contract on or before the date indicated in the Construction Schedule and Agreed Cost of Delay Section of the Contract Documents. 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 there from, 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. 10. The Contractor hereby represents and guarantees that it has not, nor has any other person for or in its behalf, directly or indirectly, entered into any arrangement or Contract with any other Bidder, or with any public officer, whereby it has paid or is to pay any other Bidder or public officer any sum of money or anything of value whatever in order to obtain this Contract; and it has not, nor has another person for or in its behalf directly or indirectly, entered into any Contractor arrangement with any other person, firm, corporation or association which tends to or does lessen or destroy free competition in the award of this Contract and agrees that in case it hereafter be established that such representations or guarantees, or any of them are false, it will forfeit and pay not less than ten percent (10%) of the Contract price but in no event less than $2,000.00 (Two Thousand Dollars) to the City. 11. The surety on the Bond furnished for this Contract must, in addition to all other provisions, be obligated to the extent provided for by Iowa Code 573.6 relating to this Contract, which provisions apply to said Bond. 12. The Contractor agrees, and its Bond is surety therefore, that after the Certificate of Substantial Completion has been issued by the City, it will keep and maintain the Project in good repair for a period of two (2) years. 13. The Project must be constructed in strict accordance with the requirements of the laws of the State of Iowa, and the United States, and ordinances of the City of Dubuque, and in accordance with the Contract Documents. A. All applicable standards, orders, or regulations issued pursuant to the Clean Air Act of 1970 (42 U. S. C. 1958 (H) et. seq.) and the Federal Water Pollution Act (33 U. S. C. 1368 et. seq.) as amended, Executive Order 11738, and Environmental Protection Agency regulations (40 CFR, Part 15). Contractor must comply with Section 103 and 107 of the Contract Work Hours and Safety Standards Act (40 USC 327-330) and Department of Labor Regulations (29 CFR, Part 5). B. 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 Page 261 of 629 SECTION 00500 Page 4 of 8 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. 14. The following FEMA provisions are incorporated as part of this Improvements Contract: Appendix II to Part 200—Contract Provisions for Non -Federal Entity Contracts Under Federal Awards In addition to other provisions required by the Federal agency or non -Federal entity, all contracts made by the non -Federal entity under the Federal award must contain provisions covering the following, as applicable. (A) Contracts for more than the simplified acquisition threshold currently set at $150,000, which is the inflation adjusted amount determined by the Civilian Agency Acquisition Council and the Defense Acquisition Regulations Council (Councils) as authorized by 41 U.S.C. 1908, must address administrative, contractual, or legal remedies in instances where contractors violate or breach contract terms, and provide for such sanctions and penalties as appropriate. (B) All contracts in excess of $10,000 must address termination for cause and for convenience by the non - Federal entity including the manner by which it will be effected and the basis for settlement. (C) Equal Employment Opportunity. Except as otherwise provided under 41 CFR Part 60, all contracts that meet the definition of "federally assisted construction contract' in 41 CFR Part 60-1.3 must include the equal opportunity clause provided under 41 CFR 60-1.4(b), in accordance with Executive Order 11246, "Equal Employment Opportunity" (30 FR 12319, 12935, 3 CFR Part, 1964-1965 Comp., p. 339), as amended by Executive Order 11375, "Amending Executive Order 11246 Relating to Equal Employment Opportunity," and implementing regulations at 41 CFR part 60, "Office of Federal Contract Compliance Programs, Equal Employment Opportunity, Department of Labor." (D) Davis -Bacon Act, as amended (40 U.S.C. 3141-3148). When required by Federal program legislation, all prime construction contracts in excess of $2,000 awarded by non -Federal entities must include a provision for compliance with the Davis -Bacon Act (40 U.S.C. 3141-3144, and 3146-3148) as supplemented by Department of Labor regulations (29 CFR Part 5, "Labor Standards Provisions Applicable to Contracts Covering Federally Financed and Assisted Construction"). In accordance with the statute, contractors must be required to pay wages to laborers and mechanics at a rate not less than the prevailing wages specified in a wage determination made by the Secretary of Labor. In addition, contractors must be required to pay wages not less than once a week. The non -Federal entity must place a copy of the current prevailing wage determination issued by the Department of Labor in each solicitation. The decision to award a contract or subcontract must be conditioned upon the acceptance of the wage determination. The non -Federal entity must report all suspected or reported violations to the Federal awarding agency. The contracts must also include a provision for compliance with the Copeland "Anti -Kickback" Act (40 U.S.C. 3145), as supplemented by Department of Labor regulations (29 CFR Part 3, "Contractors and Subcontractors on Public Building or Public Work Financed in Whole or in Part by Loans or Grants from the United States"). The Act provides that each contractor or subrecipient must be prohibited from inducing, by any means, any person employed in the construction, completion, or repair of public work, to give up any part of the compensation to which he or she is otherwise entitled. The non -Federal entity must report all suspected or reported violations to the Federal awarding agency. * Not applicable for FEMA funded projects. (E) Contract Work Hours and Safety Standards Act (40 U.S.C. 3701-3708). Where applicable, all contracts awarded by the non -Federal entity in excess of $100,000 that involve the employment of mechanics or laborers must include a provision for compliance with 40 U.S.C. 3702 and 3704, as supplemented by Department of Labor regulations (29 CFR Part 5). Under 40 U.S.C. 3702 of the Act, each contractor must be required to compute the wages of every mechanic and laborer on the basis of a standard work week of 40 hours. Work in excess of the standard work week is permissible provided that the worker is compensated at a rate of not less than one and a half times the basic rate of pay for all hours worked in excess of 40 hours in the work week. The requirements of 40 U.S.C. 3704 are applicable to construction work and provide that no laborer or mechanic must be required to work in surroundings or under working conditions which are unsanitary, hazardous or dangerous. These requirements do not apply to the purchases of supplies or materials or articles ordinarily available on the open market, or contracts for transportation or transmission of intelligence. Page 262 of 629 SECTION 00500 Page 5 of 8 (F) Rights to Inventions Made Under a Contract or Agreement. If the Federal award meets the definition of "funding agreement" under 37 CFR §401.2 (a) and the recipient or subrecipient wishes to enter into a contract with a small business firm or nonprofit organization regarding the substitution of parties, assignment or performance of experimental, developmental, or research work under that "funding agreement," the recipient or subrecipient must comply with the requirements of 37 CFR Part 401, "Rights to Inventions Made by Nonprofit Organizations and Small Business Firms Under Government Grants, Contracts and Cooperative Agreements," and any implementing regulations issued by the awarding agency. (G) Clean Air Act (42 U.S.C. 7401-7671q.) and the Federal Water Pollution Control Act (33 U.S.C. 1251- 1387), as amended —Contracts and subgrants of amounts in excess of $150,000 must contain a provision that requires the non -Federal award to agree to comply with all applicable standards, orders or regulations issued pursuant to the Clean Air Act (42 U.S.C. 7401-7671q) and the Federal Water Pollution Control Act as amended (33 U.S.C. 1251-1387). Violations must be reported to the Federal awarding agency and the Regional Office of the Environmental Protection Agency (EPA). (H) Debarment and Suspension (Executive Orders 12549 and 12689)—A contract award (see 2 CFR 180.220) must not be made to parties listed on the governmentwide exclusions in the System for Award Management (SAM), in accordance with the OMB guidelines at 2 CFR 180 that implement Executive Orders 12549 (3 CFR part 1986 Comp., p. 189) and 12689 (3 CFR part 1989 Comp., p. 235), "Debarment and Suspension." SAM Exclusions contains the names of parties debarred, suspended, or otherwise excluded by agencies, as well as parties declared ineligible under statutory or regulatory authority other than Executive Order 12549. (1) Byrd Anti -Lobbying Amendment (31 U.S.C. 1352)—Contractors that apply or bid for an award exceeding $100,000 must file the required certification. Each tier certifies to the tier above that it will not and has not used Federal appropriated funds to pay any person or organization for influencing or attempting to influence an officer or employee of any agency, a member of Congress, officer or employee of Congress, or an employee of a member of Congress in connection with obtaining any Federal contract, grant or any other award covered by 31 U.S.C. 1352. Each tier must also disclose any lobbying with non -Federal funds that takes place in connection with obtaining any Federal award. Such disclosures are forwarded from tier to tier up to the non -Federal award. (J) See §200.322 Procurement of recovered materials. [78 FIR 78608, Dec. 26, 2013, as amended at 79 FIR 75888, Dec. 19, 20141 15. The following EDA provision is incorporated as part of this Improvements Contract: The Contractor acknowledges to and for the benefit of the City of Dubuque ("Recipient") and the Economic Development Administration ("EDA") that it understands the goods and services under this Agreement are being funded with federal monies and have statutory requirements in section 70914 of the Infrastructure Investments and Jobs Act (Pub. L. 117-58, sections 70901-52) commonly known as "Build America, Buy America" that require all of the iron and steel, manufactured products, and construction materials used in the project to be produced in the United States ("Build America, Buy America Requirements"). The Build America, Buy America Requirements include all iron and steel, manufactured products, and construction materials provided by the Contactor pursuant to this Agreement. The Contractor hereby represents and warrants to and for the benefit of the Recipient and EDA (a) the Contractor has reviewed and understands the Build America, Buy America Requirements, (b) all of the iron and steel, manufactured products, and construction materials used in the project will be and/or have been produced in the United States in a manner that complies with the Build America, Buy America Requirements, unless a waiver of the requirements is approved, and (c) the Contractor will provide any further verified information, certification or assurance of compliance with this paragraph, or information necessary to support a waiver of the Build America, Buy America Requirements, as may be requested by the Recipient or EDA. Notwithstanding any other provision of this Agreement, any failure to comply with this paragraph by the Contractor shall permit the Recipient or EDA to recover as damages against the Contractor any loss, expense, or cost (including without limitation attorney's fees) incurred by the Recipient or EDA resulting from any such failure (including without limitation any impairment or loss of funding, whether in whole or in part, from EDA or any damages owed to the EDA by the Recipient). If the Contractor has no direct contractual privity with EDA, the Recipient and the Contractor agree that the EDA is a third party beneficiary and neither this paragraph (nor any other provision of this Agreement necessary to give this paragraph force or effect) shall be amended or waived without the prior written consent of EDA. Page 263 of 629 SECTION 00500 Page 6 of 8 CONSENT DECREE RELATING TO THE PROJECT 16. THIS CONTRACTOR IS PERFORMING WORK FOR THE CITY OF DUBUQUE RELATED TO THE WATER & RESOURCE RECOVERY CENTER OR THE SANITARY SEWER COLLECTION SYSTEM. THEREFORE, THE CONSENT DECREE AND THIS SECTION ARE APPLICABLE. CITY CONTRACTOR THIS CONTRACTOR IS NOT PERFORMING WORK FOR THE CITY OF DUBUQUE RELATED TO THE WATER & RESOURCE RECOVERY CENTER OR THE SANITARY SEWER COLLECTION SYSTEM. THEREFORE THE CONSENT DECREE AND THIS SECTION ARE NOT APPLICABLE. The City has entered into a Consent Decree in the case of The United States of America, and the State of Iowa v. The City of Dubuque, Iowa, Civil Action Number Case 2:11-cv-01011-EMJ, Civil Action Number 2008V00041, DOJ Case Number 90-5-1-1-09339, United States District Court for the Northern District of Iowa. The provisions of the Consent Decree apply to and are binding upon the City and its officers, directors, employees, agents, servants, successors, assigns, and all persons, firms and corporations under contract with the City to perform the obligations of the Consent Decree. The City is required to provide a copy of the Consent Decree to any contractor or consultant retained to perform work required by the Consent Decree. A copy of the Consent Decree is included in the Contract Documents and can be viewed at http://www.citvofdubugue.org/DocumentCenter/Home/View/3173. A hard copy is available upon request at the City's Engineering Department Office. The City must condition any contract to perform work required under the Consent Decree upon performance of the work in conformity with the provisions of the Consent Decree. The Consent Decree also provides that until five (5) years after the termination of the Consent Decree, the City must retain, and must instruct its contractors and agents to preserve, all non -identical copies of all documents, reports, data, records, or other information (including documents, records, or other information in electronic form) in its or its contractors' or agents' possession or control, or that come into its or its contractors' or agents' possession or control, and that relate in any manner to the City's performance of its obligations under this Consent Decree, including any underlying research and analytical data. This information -retention period, upon request by the United States or the State, the City must provide copies of any documents, reports, analytical data, or other information required to be maintained under the Consent Decree. At the conclusion of the information -retention period, the City must notify the United States and the State at least ninety (90) Days prior to the destruction of any documents, records, or other information subject to such requirements and, upon request by the United States or the State, the City must deliver any such documents, records, or other information to the EPA or IDNR. Page 264 of 629 SECTION 00500 Page 7 of 8 CERTIFICATION BY CONTRACTOR The undersigned, on behalf of the Contractor, with full authority to act on behalf of the Contractor, certifies to the City of Dubuque as follows: I have received a copy of the Consent Decree in the case of The United States of America, and the State of Iowa v. The City of Dubuque, Iowa, Civil Action Number Case 2:11-cv-01011-EMJ, Civil Action Number 2008V00041, DOJ Case Number 90- 5-1-1-09339, United States District Court for the Northern District of Iowa. 2. All work performed will be in conformity with the provisions of the Consent Decree. 3. All documents reports, data, records, or other information (including documents, records, or other information in electronic form) that relate in any manner to the performance of obligations under the Consent Decree, including any underlying research and analytical data, will be retained as required by the Consent Decree. 4. The Contractor agrees to defend, indemnify, and hold harmless the City, its officers, agents, or employees from and against any claims, including penalties, costs and fees as provided in the Consent Decree, relating to or arising out of the Contractor's failure to comply with the Consent Decree. CONTRACTOR: Portzen Construction. Inc. By: Michael J. Podzen President (Y- Date Page 265 of 629 SECTION 00500 Page 8 of 8 THE CITY AGREES: 17. Upon the completion of the Contract, and the acceptance of the Project by the City Council, and subject to the requirements of law, the City agrees to pay the Contractor as full compensation for the complete performance of this Contract, the amount determined for the total work completed at the price(s) stated in the Contractor's Bid Proposal and less any Agreed Cost of Delay provided for in the Contract Documents. CONTRACT AMOUNT $26,557,106.00 CITY OF DUBUQUE, IOWA: Engineering Department By: Michael C. Van Milligen Citv Manaaer Date CONTRACTOR: Portzen Construction, Inc. By: ��, a`lo A Michael J. yo ze President �0,� z Date COPY OF BID PROPOSAL ATTACHED Page 266 of 629 SECTION 00400 Page 1 of 6 UNIT PRICE BID PROPOSAL FORM SECTION 00400 PROJECT: Dubuque Gate & Pump Station Flood Mitigation (161" St Detention Basin) BID TO: Office of City Clerk City of Dubuque 50 W. 13th Street Dubuque, Iowa 52001 BID FROM: Portzen Construction, Inc. 205 Stone Valley Drive Dubuque, IA 52003 563-557-7642 (Company) (Street Address) (City, State, Zip) (Telephone) jrportzen@pci-dbq.com (Email Address) 400.1 General The undersigned Bidder agrees, if the Bid is accepted, to enter into an Contract with the City, in the form included in the Contract Documents, to perform and furnish the Work as specified or indicated in the Contract Documents for the Total Bid Amount and within the Bid time indicated in the Contract Documents and in accordance with other terms and conditions of the Contract Documents. 400.2 Recitals In submitting this Bid, Bidder represents, as more fully set forth in the Public Improvement Contract. that: a. This Bid will remain subject to acceptance for forty-five (45) calendar days after the day of Bid opening; b. The City has the right to reject this Bid and to waive any informalities in the Bidding; c. Bidder accepts the provisions to the Instructions to Bidders regarding dispositions of Bid Security; d. Bidder will sign and submit the Public Improvement Contract with the Bond and other documents required by the Contract Documents within ten (10) calendar days after the date of City's Notice of Award; The Bidder hereby certifies that the Bidder is the only person or persons interested in this proposal as principals; that an examination has been made of the plans, specifications, contract form, including the special provision contained herein, and the work site, and the Bidder understands that the quantities of work shown herein are approximate only and are subject to increase or decrease. The measured unit quantity of any item stated in the plans, Page 267 of 629 SECTION 00400 Page 2 of 6 specification, or on the bid proposal form are approximate only and the final payment must be made by the work covered in the contract (Public Improvement Contract - Section 500). The Contractor further understands that all quantities of work, whether increased or decreased, are to be performed at the Unit Prices as stipulated herein; the Bidder proposes to furnish all necessary machinery, equipment, tools, labor and other means of construction, and to furnish all materials specified in the manner and time prescribed and to do the work at the prices herein set out. 400.3 Bidder's Acknowledgment In submitting this Bid this Bidder acknowledges and represents that: 1) Bidder has examined copies of all the Contract Documents; 2) Bidder has visited the Project Area and become familiar with the general, local, and site conditions; 3) Bidder is familiar with Federal, State, and local laws, ordinances and regulations that govern the work specified by the Contract Documents; 4) Bidder has correlated the information known to the Bidder, observations obtained from the examination of the site, reports and drawings identified in the Contract Documents and additional investigations, explorations, tests, studies and data within the Contract Documents; 5) This Bid is genuine and not made in the interest of or on behalf of an undisclosed person, firm or corporation; Bidder has not directly or indirectly induced or solicited another Bidder to submit a false or sham Bid; Bidder has not solicited or induced a person, firm or corporation to refrain from Bidding; and Bidder has not sought by collusion to obtain for itself an advantage over another Bidder or over City; 6) Local and State sales and use taxes are not included in the Bid Amount. 7) Bidder has examined and understands that the following reports listed in Section 00775 are resource documents included at the end of this Contract Document/Specification book, and have been considered and included in the Bid Amount: Report Title: Geotechnical Exploration 161h Street Basin Pumping Station Kerper Boulevard Dubuque, Iowa Geotechnical Exploration - Slope Stability Phase 16th Street Basin Pumping Station Kerper Boulevard Dubuque, Iowa 16th Street Basin Levee Pressure Relief Wells Design Recommendations Report and additional reference information 400.4 Unit Prices and Bid Amount See next 2 pages for Bid Schedule Page 268 of 629 THECRYOF SECTION 00400 PAGE 3 OF 6 DUB E Masterpiece on the Mississippi CITY OF DUBUQUE, IOWA DUBUQUE GATE & PUMP STATION FLOOD MITIGATION (16TH ST DETENTION BASIN) BID SCHEDULE REVISED PER ADDENDUM NO. 6 NOTE: Bids shall EXCLUDE sales tax NO. DESCRIPTION QUANTITY PRICE PRICE DIVISION 2010 - EARTHWORK, SUBGRADE AND SUBBASE 1 Clearing and Grubbing C 1 LS $5,150.00 $5,150.00 2 Topsoil, Off -site 110 CY $75.00 $8,250.00 3 Below Grade Excavation (Core Out) 250 TON $31.20 $7,800.00 4 Subgrade Preparation 2080 SY $2.70 $5,616.00 5 Subbase, Special Backfill - Gr 30 (3/4" Dense Base Pile) 450 TON $24.00 $10,800.00 6 Subbase, 3" Breaker Run (Modified Macadam Pile) 560 TON $23.00 $12,880.00 DIVISION 3010-TRENCH EXCAVATION AND BACKFILL Replacement of Unsuitable Backfill Material Gradation 12a (Granular 7 Subbase Pile) 130 TON $29.50 $3,835.00 DIVISION 4020 - STORM SEWERS 8 Storm Sewer Gravity Main, Trenched, 12" RCP 60 LF $93.50 $5,610.00 9 Removal of Storm Sewer, 15' RCP 20 LF $77.25 $1,545.00 10 Removal of Storm Sewer, 18" RCP 25 LF $78.00 $1,950.00 DIVISION 4040 - SUBDRAINS AND FOOTING DRAIN COLLECTORS 11 Subdrain, 4" Perforated 500 LF $34.50 $17,250.00 DIVISION 6010 - STRUCTURES FOR SANITARY AND STORM SEWERS 12 Manhole Type, 48" SW-301 9 VF $728.00 $6,552.00 13 Intake Type, SW-511 4 VF $1,378.50 $5,514.00 DIVISION 7010 - PORTLAND CEMENT CONCRETE PAVEMENT 14 Pavement, PCC, 8" (Thickness) 750 SY $90.00 $67,500.00 DIVISION 7030 - SIDEWALKS, SHARED USE PATHS, AND DRIVEWAYS 15 Driveway, Paved, PCC, 6" (Thickness) 510 SY $75.50 $38,505.00 16 Driveway, Paved, PCC, 8" (Thickness) 630 SY $95.00 $59,850.00 DIVISION 7040 - PAVEMENT REHABILITATION 17 Pavement -Removal 1060 SY $12.75 $13,515.00 IDOT DIVISION 2527 - PAVEMENT MARKING 18 Painted Pavement Markings 3 STA $210.00 $630.00 IDOT DIVISION 2528 - TRAFFIC CONTROL 19 Traffic Control Phase 1 1 LS $63,000.00 $63,000.00 20 Traffic Control Phase II 1 LS $12,600.00 $12,600.00 21 Temporary Barrier Rail 615 LF $53.00 $32,595.00 22 Temporary Crash Cushions 1 EA $7,875.00 $7,875.00 DIVISION 9010 - SEEDING 23 Conventional - Seeding, Type 1, by AC 0.31 AC $7,900.00 $2,449.00 DIVISION 9030 - PLANT MATERIAL AND PLANTING 24 Plants, Lump Sum, With Warranty 1 LS $5,250.00 $5,250.00 This bid schedule accompanies the bid proposal of Portzen Construction, Inc. Page 269 of 629 SECTION 00400 PAGE 4 OF 6 CITY OF DUBUQUE, IOWA DUBUQUE GATE & PUMP STATION FLOOD MITIGATION (16TH ST DETENTION BASIN) BID SCHEDULE (continued) REVISED PER ADDENDUM NO. 6 NO. DESCRIPTION DIVISION 9040 - EROSION AND SEDIMENT CONTROL 25 Stormwater Pollution Prevention Plan (SWPPP) Management 26 Temporary Rolled Erosion Control Products (RECP) by SY 27 Riprap, Class E Revetment Stone 28 Silt Fence or Silt Fence Ditch Check, Installation 29 Silt Fence or Silt Fence Ditch Check, Removal of Sediment 30 Silt Fence or Silt Fence Ditch Check, Removal of Device 31 Stabilized Construction Entrance by SY 32 Inlet Protection Device, Installation 33 Inlet Protection Device, Maintenance DIVISION 9060-CHAIN LINK FENCE 34 Chain Link Fence, 6' 35 Gates, Chain Link DIVISION 10010 - DEMOLITION OF BUILDING STRUCTURES 36 Plug or Abandon Well DIVISION 11020 - MOBILIZATION 37 Mobilization DIVISION 11050 -CONCRETE WASHOUT 38 Concrete Washout SPECIAL PROVISIONS - NON-STANDARD PROJECT ITEMS 39 Storm Sewer Gravity Main, Trenched, 8" DIP 40 Existing Median Removal, Temporary Pavement & Reinstallation 41 Painted Pavement Markings, SolvenUWaterborne 42 Floating Silt Curtain 43 Tied Concrete Block Mat (TCBM) 44 Electrical, Complete 45 Epoxy Crack Injection 46 Partial Depth Concrete Repair incl Vertical & Overhead 47 Full Depth Concrete Repair incl Vertical & Overhead 48 Earth Retention System and Dewatering 49 Bypass Construction and Culvert Repair 50 Excavation and Working Platform 51 Concrete Filled Steel Pipe Driven Piles 52 Auger Cast Piles 53 Stormwater Pump Station 54 Control Building 55 Retaining Walls 56 Existing Pump Station Demolition Work 57 Pressure Relief Well 58 Riprap - Salvage and Install TOTAL OF BID This bid schedule accompanies the bid proposal of UNIT TOTAL QUANTITY PRICE PRICE 1 LS $2,500.00 $2,500.00 240 SY $1.65 $396.00 540 TON $65.00 $35,100.00 300 LF $2.65 $795.00 300 LF $1.05 $315.00 300 LF $0.55 $165.00 100 SY $51.50 $5,150.00 2 FA $132.00 $264.00 10 EA $53.00 $530.00 150 LF $94.50 $14,175.00 2 EA $2,100.00 $4,200.00 2 EA $16,000.00 $32,000.00 1 LS $1,408,848.00 $1,408,848.00 1 LS $5,150.00 $5,150.00 15 LF $482.00 $7,230.00 275 SY $125.00 $34,375.00 32 STA $210.00 $6,720.00 540 LF $42.00 $22,680.00 1300 SF $13.25 $17,225.00 1 Ls 48 LF $105.00 $5,040.00 274 SF $223.00 $61,102.00 134 SF $433.00 $58,022.00 1 LS $2,650,620.00 $2,650,620.00 1 LS $646,805.00 $646,805.00 1 LS $449,971.00 $449,971.00 13380 VF $147.00 $1,966,860.00 1 LS $1,090,719.00 $1,090,719.00 1 LS �o L ,, J IC' pD /�564 A'1-3 L 1 LS $346,588.00 $346,588.00 1 LS $996,129.00 $996,129.00 1 LS $89,186.00 $89,186.00 2 EA $104,450.00 $208,900.00 610 SY $33.50 $20,435.00 Portzen Construction, Inc. Page 270 of 629 SECTION 00400 Page 5 of 6 400.7 Timeliness Bidder agrees that the work shall be Substantially Complete and made ready for final payment in accordance with Contract Documents no later than the date(s) indicated in Section 00800 — Construction Schedule and Agreed Cost of Delay. 400.8 Additional Documents To Be Submitted With Bid The following additional documents are included and made a condition of this Bid. A. Bid Bond (Section 00450)—or other approved Bid Security. Accompanying this Bid in a separate sealed envelope is a Bid Bond, cashier's check, or certified check in the penal sum of ten percent (10%) of the submitted Bid. It is understood that the Bid security will be retained in the event a contract is not executed by the Contractor if award is made to the undersigned. If a Bid Bond is submitted it must be executed by the Bidder and acceptable corporate surety. If a Cashier's check or certified check is submitted it must be made payable to the City Treasurer, City of Dubuque, drawn on a bank in Iowa or a bank chartered under the laws of the United States. B. Bidder Status Form (Section 00460) C. Signed SRF Required Forms: - Attachment 1 Certification of Non -Segregated Facilities - Attachment 2 Certification Regarding Debarment, Suspension, Other Responsibility Matters - Attachment 3 Disadvantaged business Enterprise (DBE) Solicitation - Attachment 4 DBE Subcontractor Performance Form (not required if no DBE is utilized) Attachment 5 DBE Subcontractor Utilization Form (not required if no DBE is utilized) Attachment 10 Prohibition on Certain Telecommunications and Video Surveillance Services or Equipment D. EDA Required Form: - Certification Regarding Lobbying E. FEMA Required Form: - Build America, Buy America (BABA) Certification 400.9 Document Submittal Requirements by Apparent Low Bidder The apparent low bidder must submit the Contractor Background Information Form (Section 00471) to the Jurisdiction Representative within 72 hours after the bid opening. Failure to submit the Contractor Background Information Form by the required deadline may be considered justification for the City to determine the Bidder as not responsible. 400.10 Contract Execution The Bidder further agrees to execute a formal contract and Bond, within ten (10) calendar days after the date of the City's Notice of Award. The Bidder also agrees it will commence work on or before ten (10) calendar days after the date of City's Notice to Proceed, and it will complete the work within the specified contract period or pay the Agreed Cost of Delay stipulated in the Contract Documents. Page 271 of 629 SECTION 00400 Page 6of6 400.11 Questions and Interpretations Failure by the Bidder to request clarification of the Contract Documents during the bidding process does not waive the responsibility for comprehension of the documents and performance of the work in accordance with the Contract Documents. Signing of the Bid Proposal Form constitutes the Contractor's certification as implicitly denoting thorough comprehension of intent of the Contract Documents. 400.12 Addenda The Bidder acknowledges receipt of the following addenda: Addendum #1 Dated: 01-02-25 Addendum #2 Dated: 01-10-25 Addendum #3 Dated: 01-16-25 Addendum #4 Dated: 01-21-25 Addendum #5 Dated: 01-22-25 ,A#6 naacd DI-ZN-Z.i 400.13 Signatures Contractor: Portzen Construction, Inc. Dated: January 28, 2025 Contractor Name 205 Stone Valley Drive Street (Business Location) Dubuque city Iowa State C099538 Iowa Registration No. i Signature Michael J. Portzen President Title 52003 Zip MSCCZJJQAGW7 Sam.gov Unique Identifier Number 01-23-25 The Bidder's State of ToWrL- does ( ) / does not Xutilize a percentage preference for in -state Bidders. The amount of preference is percent. ___= END OF SECTION 00400 ==_ Page 272 of 629 MINUTES OF THE BOARD OF DIRECTORS MEETING OF PORTZEN CONSTRUCTION, INC. A meeting of the Board of Directors and Shareholders of Portzen Construction, Inc. was held at 10:00 A.M. on March 3, 2022 at 205 Stone Valley Drive in Dubuque, Iowa. Shareholders present were Michael E. Portzen via phone call. Others in attendance were Michael J. Portzen, Adam E. Portzen and Jayme Kluesner. The meeting was called to order and all directors and shareholders of the corporation were present, namely: Michael E. Portzen as sole director and shareholder. Discussion was regarding changing Officers of the Company, effective March 1, 2022, Michael E. Portzen will relinquish his title of President to Michael J. Portzen. Michael J. Portzen will relinquish his title of Vice -President to Adam E. Portzen. As of March 1, 2022, corporate officers will be as follows: President Michael J. Portzen Vice President Adam E. Portzen Secretary Adam E. Portzen Treasurer Jayme Kluesner There being no further business, the meeting was duly adjourned at 10:15 A.M. 4_� - Michael J. Portze President Page 273 of 629 Attachment 1 SRF Required Front -End Specifications (This form must be completed and signed by Prime Contractor and submitted with the bid.) U.S. Environmental Protection Agency Certification of Non -Segregated Facilities (Applicable to contracts, subcontracts, and agreements with applicants who are themselves performing federally assisted construction contracts, exceeding $10,000 which are not exempt from the provisions of the Equal Opportunity clause.) By the submission of this bid, the bidder, offeror, applicant, or subcontractor certifies that he does not maintain or provide for his employees any segregated facilities at any of his establishments, and that he does not permit his employees to perform their services at any location, under his control, where segregated facilities are maintained. He certifies further that he will not maintain or provide for his employees any segregated facilities at any of his establishments, and that he will not permit his employees to perform their services at any location, under his control. where segregated facilities are maintained. The bidder, offeror, applicant, or subcontractor agrees that a breach of this certification is a violation of the Equal Opportunity clause in this contract. As used in this certification, the term "segregated facilities" means any waiting rooms, work areas, restrooms and washrooms, restaurants and other eating areas, time clocks, locker rooms and other storage or dressing areas, parking lots, drinking fountains, recreation or entertainment areas, transportation, and housing facilities provided for employees which are segregated by explicit directive or are in fact segregated on the basis of race, creed, color, or national original, because of habit, local custom. or otherwise. He further agrees that (except where he has obtained identical certifications from proposed Subcontractors for specific time periods) he will obtain identical certifications from proposed subcontractors prior to the award of subcontracts exceeding $10,000 which are not exempt from the provisions of the Equal Opportunity clause; that he will retain such certifications in his files; and that he will forward the following notice to such proposed subcontractors (except where the proposed subcontractors have submitted identical certifications for specific time periods): NOTICE TO PROSPECTIVE SUBCONTRACTORS OF REQUIREMENT FOR CERTIFICATIONS OF NON -SEGREGATED FACILITIES A Certification of Non -segregated Facilities, as required by the May 9, 1967, order (33 F.R. 7808, May 28, 1968) on Elimination of Segregated Facilities, by the Secretary of Labor, must be submitted prior to the award of a subcontract exceeding $10,000 which is not exempt from the provisions of the Equal Opportunity clause. The certification may be submitted either for each subcontract or for all subcontracts during a period (i.e., quarterly, semiannually, or annuallyj. NU A 01-23-25 Signature Q Date Michael J. Portzen President Printed Name Title NOTE: The penalty for making false statements in offers is prescribed in 18 U.S.C. 1001. September 2023 EPA-7 S720-4.2 INVESTING IN IOWA'S WATER www.iowasrf.com DNR Form 542-0621 Page 274 of 629 Attachment 2 SRF Required Front -End Specifications (This form must be completed and signed by the Prime Contractor and submitted with the bid.) Debarments and Suspensions Any bidder or equipment supplier whose firm or affiliate is listed in on the U.S. General Services Administration Excluded Parties List will be prohibited from the bidding process. The excluded parties records search engine is located at the System for Award Management (SAM) website: https://sam.gov. Pursuant to 2 CFR Part 180, as supplemented by 2 CFR 1532, any entity submitting a bid while the SAM website lists that entity as having an active exclusion will be determined by the DNR to be a non -responsive bidder and will not be able to receive SRF funding. United States Environmental Protection Agency Washington, DC 20460 Certification Regarding Debarment, Suspension, and Other Responsibility Matters The prospective participant certifies to the best of its knowledge and belief that it and the principals: (a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency; (b) Have not within a three year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or local) transaction or contract under a public transaction: violation of federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; (c) Are not presently indicted or otherwise criminally or civilly charged by a government entity (Federal, State, o! local) with commission of any of the offenses enumerated in paragraph (1) (b) of this certification; and (d) Have not within a three-year period preceding this application/proposal had one or more public transactions (Federal, State, or local) terminated for cause or default. I understand that a false statement on this certification may be grounds for rejection of this proposal or termination of the award. In addition, under 18 U SC Sec. 10 01, a false statement may result in a fine of up to $10,000 or imprisonment for up to 5 years, or both. S�UVIN__ 01-23-25 Signature of Authorized Representative Date Michael J. Portzen President Printed Name Title I am unable to certify to the above statements. My explanation is attached. September 2023 INVESTING IN IOWXS WATER ,:4ww.iowasrf.com DNR Form S42-0621 Page 275 of 629 Attachment 3 SRF Required Front -End Specifications (This form must be completed and signed by Prime Contractor and submitted with the bid.) Disadvantaged Business Enterprise (DBE) Solicitation It is EPA's policy that recipients of EPA financial assistance through the State Revolving Fund programs award a "fair share" of subagreements to small, minority and women -owned businesses, collectively known as Disadvantaged Business Enterprises (DBEs). Iowa's Fair Share goals are: Minority -Owned Business Enterprise (MBE) Goal Women -Owned Business Enterprise (WBE) Goal Construction 1.7 % 2.2% Supplies 0.6% 5.6% Services 2.5% 11.3% i Goods/Equipment 2.5% 10.4% Average 1.8% 7.4 % Only work performed by certified DBEs can be counted toward the goals. In Iowa, DBEs must be certified through the Iowa Department of Transportation (IDOT). Information on certification requirements and a list of certified DBEs is on the IDOT website at https:/Isecure.iowadot.gov/DBE/Horne/Index. Prime contractors' DBE requirements for SRF projects include: Taking affirmative steps for DBE participation Documenting the efforts and the proposed utilization of certified DBEs PROJECT INFORMATION SRF Applicant: City of Dubuque Bidder: Portzen Construction, Inc. Address: 205 Stone Valley Drive City: Dubuque State: Iowa Contact Person: Michael_J_._ Portzen, President Phone Number: 563-557-7642 Email: jrportzen@pci-dbq.com Check if Prime Contractor is: ❑ Minority -Owned ❑ Women -Owned Zip: 52003 1. Do you agree to use the good faith efforts checklist to ensure the DBEs have the opportunity to compete for procurements funded by EPA financial assistance funds? XYes U No 2. At this point in time, has the prime contractor begun to solicit work opportunities to subcontractors for this project? ❑ Yes XN No ❑ N/A Subcontractors not chosen yet 3. If yes, was a DBE chosen by the prime contractor to be utilized for this project? ❑Yes [gNo Signature: 4" Y(p X_ Michael J. Portzen, President September 2023 INVESTING IN IOWA'S WATER Uiww.iowasrf.con. DNR Form 542-0621 Page 276 of 629 GOOD FAITH EFFORTS CHECKLIST Please complete the checklist to determine if you have complied with the requirement to make good faith efforts to ensure that certified DBEs have the opportunity to compete for procurements funded by EPA financial assistance funds. Bidders/offerers must make good faith efforts prior to submission of bids/proposals. 1. Did you ensure that DBEs are made aware of contracting opportunities to the fullest extent practicable through outreach and recruitment activities? Did you make information on forthcoming opportunities available to DBEs and arrange time frames for contracts and establish delivery schedules, where the requirements permit, in a way that encourages and facilitates participation by DBEs in the competitive process? This includes, whenever possible, posting solicitation for bids or proposals for a minimum of 30 calendar days before the bid or proposal closing date. jnj Yes ❑ No Did you consider in the contracting process whether firms competing for large contracts could subcontract with DBEs? This will include dividing total requirements, when economically feasible, into smaller tasks or quantities to permit maximum participation by DBEs in the competitive process. XA Yes ❑ No 4. Did you encourage contracting with a consortium of DBEs when a contract is too large for one of these firms to handle individually? Z Yes ❑ No 5. Did you use the services of the Small Business Administration and the Minority Business Development Agency of the Department of Commerce to identify potential subcontractors? Yes No List the potential DBE subcontractors that were contacted. Only list those that are certified through the Iowa Department of Transportation. Name Haw Contacted (e.g. letter, phone call, fax, e-mail) Response (e.g. did not respond, not interested, not competitive) DeLong Construction, Washington, IA Mid States Rebar & Supply, Atkins, IA Email 12-20-24 Email 12-20-24 Did not respond Did not respond Midwest Contractors, Inc., Cedar Falls, IA Email 12-20-24 Did not respond Paco Construction, Runnells, IA Email 12-20-24 Did not respond Rockette Trucking, Strawberry Point, IA Email 12-20-24 Did not respond Taylor Construction, New Vienna, IA Email 12-20-24 Did not respond Tiedt Nursery, Waverly, IA Email 12-20-24 Did not respond PROPOSED UTILIZATION OF DBE SUBCONTRACTORS Please include Attachments 4 and 5 to document the proposed utilization of certified DBE subcontractors. CONTRACT ADMINISTRATION PROVISIONS Several contract provisions are required to prevent unfair practices that adversely affect DBEs. These include: Prime Contractor must pay its Subcontractor for satisfactory performance no more than 30 days from the Prime Contractor's receipt of payment from the SRF loan recipient. September 2023 INVESTING IN IOWA'S WATER www.iowasrf.com DNR Form 542-0621 Page 277 of 629 '. Prime Contractor must notify the SRF loan recipient in writing prior to termination of a DBE subcontractor for convenience. 3. Prime Contractor must employ the six Good Faith Efforts to solicit a replacement subcontractor if a DBE subcontractor fails to complete work under a subcontract for any reason. September 2023 INVESTING IN IOWXS WATER wwwJowasrf.com DNR Form 542-0621 Page 278 of 629 Attachment 10 SRF Required Front -End Specifications (This form must be completed and signed by Prime Contractor and submitted with the bid,) PROHIBITION ON CERTAIN TELECOMMUNICATIONS AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT This term and condition implements 2 CFR 200.216 and is effective for obligations and expenditures of EPA financial assistance funding on or after 8/13/2020. EPA recipients and subrecipients, including borrowers under EPA funded revolving loan fund programs, are prohibited from obligating or expending loan or grant funds to: (a) Procure or obtain, extend or renew a contract to procure or obtain; (b) Enter into a contract (or extend or renew a contract) to procure; or (c) Obtain the equipment, services, or systems that use "covered telecommunications equipment or services" identified in the regulation as a substantial or essential component of any system, or as critical technology as part of any system. Certain equipment, systems, or services, including equipment, systems, or services produced or provided by entities subject to the prohibition are recorded in the System for Award Management exclusion list, website: https://sam.gov. (1) As described in Public Law 115-232, section 889, covered telecommunications equipment or services includes: (1) Telecommunications equipment produced by Huawei Technologies Company or ZTE Corporation (or any subsidiary or affiliate of such entities). (ii) For the purpose of public safety, security of government facilities, physical security surveillance of critical infrastructure, and other national security purposes, video surveillance and telecommunications equipment produced by Hytera Communications Corporation, Hangzhou Hikvision Digital Technology Company, or Dahua Technology Company (or any subsidiary or affiliate of such entities). (iii) Telecommunications or video surveillance services provided by such entities or using such equipment. (iv) Telecommunications or video surveillance equipment or services produced or provided by an entity that the Secretary of Defense, in consultation with the Director of the National Intelligence or the Director of the Federal Bureau of Investigation, reasonably believes to be an entity owned or controlled by, or otherwise connected to, the government of a covered foreign country. (2) Consistent with 2 CFR 200.471, costs incurred for telecommunications and video surveillance services or equipment such as phones, internet, video surveillance, and cloud servers are allowable except for the following circumstances: (i) Obligating or expending EPA funds for covered telecommunications and video surveillance services or equipment or services to procure (enter into, renew or extend contracts) or obtain the equipment, services, or systems as described in 2 CFR 200.216. I understand the above prohibitions and certify that the project will be in compliance with all the requirements. Signature Michael J. Portzen Printed Name September 2023 01-23-25 Date President Title INVESTING IN IOWXS WATER wwwJowasrN orn DNR Form 542.0621 Page 279 of 629 'FORM CD-512 ,REV 124M) U.S. DEPARTMENT OF COMMERCE CERTIFICATION REGARDING LOBBYING LOWER TIER COVERED TRANSACTIONS Applicants should review the instructions for certification included in the regulations before completing this form. Signature on 'this form provides for compliance with certification requirements under 15 CFR Part 28, 'New Restrictions on Lobbying.` LOBBYING As required by Section 1352, Title 31 of the U-S. Code, and implemented at 15 CFR Part 25, for persons entering into a grant, cooperative agreement or contract over $100,000 or a loan or loan guarantee over $150,000 as defined at 15 CFR Part 28, Sections 28.105 and 28.110, the applicant certifies that to the best of his or her knowledge and belief, that (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress in connection with the awarding of any Federal contract the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment: or modification of any Federal contract, grant, loan, or cooperative agreement. (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the &Nard documents for all subawards at all tiers (inching subcontracts, subgrants, and contracts under grants, toans, and cooperative agreements) and that all subrecipients shall certify and disclose. accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure occurring on or before October 23, 1996, and of not less than $11,000 and not more than $110,000 for each such failure occurring after October 23, 1996. Statement for Loan Guarantees and Loan Insurance The undersigned states, to the best of his or her knowledge and belief, that: In any funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this commitment providing for the United States to insure or guarantee a loan, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. Submission of this statement is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required state- ment shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure occurring on or before October 23, 1996, and of not less than $11,000 and not more than $110.000 for each such failure occurring after October 23, 1996. As the duly authorized representative of the applicant, I hereby certify that the applicant will comply with the above applicable certification, Portzen Construction, Inc. NAME OF APPLICANT AWARD NUMBER AND/OR PROJECT NAME Michael J. Portzen, President 05-79-05911 Bee Branch Stormwater Pumping Sta. PRINTED `NAME TITLE OF AUTHORIZED REPRESENTATIVE V� 01-23-25 SIGNATURE DATE Page 280 of 629 BUILD AMERICA, BUY AMERICA ACT (BABAA) (Bidders required to submit with bid) The undersigned certifies, to the best of their knowledge and belief, that: The Build America, Buy America Act (BABAA) requires that no federal financial assistance for "infrastructure" projects is provided "unless all of the iron, steel, manufactured products, and construction materials used in the project are produced in the United States" Section 70914 of Public Law No. 117-58, §§ 70901-52. The undersigned certifies that for the Dubuque Gate & Pump Station Flood Mitigation (161h St Detention Basin) project in Dubuque, Iowa, the iron, steel, manufactured products, and construction materials used in this contract are in full compliance with the BABAA requirements including: 1. All iron and steel used in the project are produced in the United States. This means all manufacturing processes, from the initial melting stage through the application of coatings, occurred in the United States. All manufactured products purchased with FEMA financial assistance must be produced in the United States. For a manufactured product to be considered produced in the United States, the cost of the components of the manufactured product that are mined, produced, or manufactured in the United States is greater than 55% of the total cost of all components of the manufactured product, unless another standard for determining the minimum amount of domestic content of the manufactured product has been established under applicable law or regulation. All construction materials are manufactured in the United States. This means that all manufacturing processes for the construction material occurred in the United States. "The, Portzen Construction, Inc. [Contractor or Subcontractor], certifies or affirms the truthfulness and accuracy of each statement of its certification and disclosure, if any. In addition, the [ Contractor or Subcontractor] understands and agrees that the provisions of 31 U.S.C. Chap. 38, Administrative Remedies for False Claims and Statements, apply to this certification and disclosure, if any." AAAx\4 %X_ Signature of [Contra tor's or Subcontractor's] Authorized Official Michael J. Portzen, President Name and Title of [ Contractor's or Subcontractor's ] Authorized Official 01-23-25 Date Page 281 of 629 SECTION 00460 Bidder Status Form SECTION 00460 To be completed by al! Bidders PartA Please answer 'Yes' or "No" for each of the following: XYes ::] No My company is authorized to transact business in Iowa. (1-ohelp you detennine if yourcompany is authorized, please review the worksheet on the next page). XYes I]No My company has an office to transact business in Iowa. Yes �.No My company's office in Iowa is suitable for more than receiving mail, telephone calls, and e-mail. XYes ONo My company has been conducting business in Iowa for at least 3 years prior to the first request for Bids on this project. XYes []No My company is not a subsidiary of another business entity or my company is a subsidiary of another business entity that would qualify as a resident Bidder in Iowa. If you answered "Yes" for each question above, your company qualifies as a resident Bidder. Please complete Parts B and D of this form. If you answered "No' to one or more questions above, your company is a non-resident Bidder. Please complete Parts C and D of this form. To be completed by all resident Bidders part B My company has maintained offices in Iowa during the past 3 years at the following addresses: Dates: 10/05/2005 to Current Address: 205 Stone Valley Drive (mmldd/yyyy) City, State, Zip: Dubuque, IA 52003 Dates: to Address: (mmldd/yyyy) City, State, Zip: Dates: to Address: (mm/d&f Wy) City, State, Zip. You may attach additional sheet(s) if needed. To be completed by all non- resident Bidders part C Name of your home state or foreign country reported to the Iowa Secretary of State Does your company's home state or foreign country offer preferences to Bidders who are residents? ❑ Yes ❑ No If you answered "Yes" to question 2, identify each preference offered by your company's home state or foreign country and the appropriate legal citation. You may attach additional sheet(s) if needed. 7o be completed by all Bidders Part D certify that the statements made on this document are true and complete to the best of my knowledge and I knoW that my failure to provide accurate and truthful information may be a reason to reject my Bid Firm Name: Portzen Construction, Inc. Signature:A.�Cf'(� , Michael J. Portzen, President Date: 01-23-25 You must submit the compleis form to the government body requesting Bids per 875 Iowa Administrative Code Chapter 1 This Form has been approved by the Labor Commissioner 309-6001 02-14 Page 282 of 629 SECTION 00460 Worksheets Authorization to Transact Business This worksheet may be used to help complete Part A of the Resident Bidder Status form. if at least one of the following describes your business, you are authorized to transact business in Iowa. XYes L-1 No My business is currently registered as a contractor with the Iowa Division of Labor. EJ Yes XNo My business is a sole proprietorship and I am an Iowa resident for Iowa income tax purposes. 0 Yes XNo My business is a general partnership or joint venture. More than 50 percent of the general partners or joint venture parties are residents of Iowa for Iowa income tax purposes. Yes ❑ No My business is an active corporation with the Iowa Secretary of State and has paid all fees required by the Secretary of State, has filed its most recent biennial report, and has not filed articles of dissolution. .J Yes XNo My business is a corporation whose articles of incorporation are filed in a state other than Iowa, the corporation has received a certificate of authority from the Iowa secretary of state, has filed its most recent biennial report with the secretary of state, and has neither received a certificate of withdrawal from the secretary of state nor had its authority revoked. 01 Yes VNo My business is a limited liability partnership which has filed a statement of qualification in this state and the statement has not been canceled CJ Yes XNo My business is a limited liability partnership which has filed a statement of qualification in a state other tnan Iowa, has filed a statement of foreign qualification in Iowa and a statement of cancellation has not been file i i Yes XNo My business is a limited partnership or limited liability limited partnership which has filed a certificate of limited partnership in this state, and has not filed a statement of termination Yes XNo My business is a limited partnership or a limited liability limited partnership whose certificate of limited partnership is filed in a state other than Iowa, the limited partnership or limited liability limited partnership has received notification from the Iowa secretary of state that the application for certificate of authority has been approved and no notice of cancellation has been filed by the limited partnership or the limited liability limited partnership. Yes XNo My business is a limited liability company whose certificate of organization is filed in Iowa and has not filed a statement of termination. C7 Yes XNo My business is a limited liability company whose certificate of organization is filed in a state other than Iowa, has received a certificate of authority to transact business in Iowa and the certificate has not been revoked or canceled. Page 283 of 629 SECTION 00600 Page 1 of 4 PERFORMANCE PAYMENT AND MAINTENANCE BOND SECTION 00600 Bond 54263020 KNOW ALL BY THESE PRESENTS: That we, Portzen Construction, Inc., as Principal (hereinafter the "Contractor" or "Principal") and United Fire & Casualty 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 -Six Million Five Hundred Fifty -Seven Thousand One Hundred Six Dollars and Zero Cents ($26,557,106.00), 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 the date of the 17th day of February, 2025, (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 Dubuque Gate & Pump Station Flood Mitigation (16th St Detention Basin) Project detail the following described improvements: The project includes the construction of a new stormwater pumping station on the protected side of the flood protection levee at the confluence of the Bee Branch Watershed with the Mississippi River. The overall structure will have approximate plan dimensions of 100' x 160'. The structure will be constructed on the west end of the existing twin 12'x12' culverts. The structure is planned to include four 90,000 gpm stormwater pumps, two 12'x14' main gates for gravity flow from the 16th Street Basin (end of Bee Branch watershed), and two 12'x9' emergency gates. Additionally, the contract will include an electrical controls building to control the pump and two standby generators to provide backup power to the proposed stormwater pumps. The project will also include the removal of the existing stormwater pumps and demolition of portions of the existing stormwater pump station. The anticipated excavation limits for the proposed project is anticipated to be approximately 140' x 200'. All excavation will be on the protected side of the levee in the 16th Street basin. There will be no excavation on the river side of the flood protection levee. The excavated area will consist of an area protected during construction by sheeting to allow the excavation and construction of the structure. The proposed bottom of the portion of the structure is planned to be approximately 15 ft. below the flowlines of the existing culverts. 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 Page 284 of 629 SECTION 00600 Page 2 of 4 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, 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; Page 285 of 629 SECTION 00600 Page 3 of 4 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: 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 attomeys), 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. Page 286 of 629 SECTION 00600 Page 4 of 4 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 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. Witness our hands, in triplicate, this 19tn SURETY COUNTERSIGNED BY: Si tore of Agent Jena Wilwert Printed Name of Agent 501 Bell Street Company Address Dubuque, Iowa 52001 City, State, Zip Code 563-556-0272 Company Telephone Number PRINCIPAL: Portzen Construction, Inc. Contractor By: Signature Michael J. Portzen President NOTE: day of February FORM7viED BY: Represefitative for owner SURETY; 2025. United Fire & Casualty Company Surety C�� B�� S) nature Attorney -in -Fact Officer Dan Wellik Printed Name of Atiorney-in-Fact Officer AssuredPartners Great Plains LLC Company Name 501 Bell Street Company Address Dubuque, Iowa 52001 City, State, Zip Code 563-556-0272 Company Telephone Number I. 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 ==== Page 287 of 629 UNITED FIRE & CASUALTY COMPANY, CEDAR RAPIDS, IA Inquiries: Surety Department UNITED FIRE & INDFMNITY COMPANY, WEBSTER.,TX 118 Second Ave SE ufg FINANCIAL PACIFIC INSURANCE COMPANY, LOS ANGELES, CA Cedar Rapids, IA 52401 NSURAINCE—un CERTIFIED COPY OF POWER OF ATTORNEY (original on file at Home Office of Company — See Certification) KNOW ALL PERSONS BY'ITIESE PRESENTS, I'liat I Inited 1, ire & Casualty Company,, , a corporation duly organized and existing under die km, of die State of Iowa; United Fire & Indemnity Conipain-, ,I corporation duly organized and existing utider the laws of the State rof Texas, and Finaricial Pacific Insurance Company, a corporation dLIIV oruani7ed and existing under die laws of the State of California (herein collectively called the Companies), and having their corporate headquarters in Cedar Rapids, State of Iowa, does make, constitute and appoint MARK J. PHALEN, DAN'�WELLIK, ERIC DESOUSA, LAUREN MOSER, JENA WILWERT, SAM MALONEY, EACH INDIVIDUALLY their true and ,.I,.awful,,:Attoracy(g)7,in-FO&.t with power and authority lierchN conferred to sign, ,cal mid C%c,ILIC in its behalf 'all lawful bonds, undertakings and othe.r.obligator*y.':';nstr.uments of similar nature provided that no single obligation shall exceed $50,000,000.00 and to bind the Complimies thereby as fully and to the game extent as il'such instruments were signed by the duk authorized officers of die Companie.s and all of the acts of said Attorney, pursuant to the authority hereby given and hereby ratified and confirmed. The Authority hereby granted is continuous and shall remain in full force and effect until revoked by.United Fire & Casualty--CoWpy United Fire. & Indemnity Company, and Financial Pacific Insurance Company. ']his Power ol'Attorney is made and executed pursuant to and by authority of the following bylaw duly adopted by the Boards of . I)jr.eddirs of -United Fire & Casualty Company, United Fire & Indemnity Company, and Financial Pacific Insurance Company. "Article VI — Surety Bonds and Undertakings" Section 2, Appointment of Attorney -in -Fact. "717he President or any Vice President, or any other officer of the Companies may, from time to time, appoint W-Nvrilt6n certi fiealeg attomqyi-i it - fact to act in behalf of the Companies in the execution of policies of insurance, bonds, undenakingh and other obligatory inst:Wments of like -nature The si&atuirc of any officer authorized hereby, and the Corporate seal, may be affixed by facsimile to any power of attorney or special power of at totiley or cenifit anon of either authorized hereby: such signature itrid seal, when so used, being adopted by the Companies as the original signature of such officer and the original seal of the Companies, to be valid and binding upon the Companies with the same force and effect as though manually affixed. Such attomey%-in-fact, subject to the limitations set of forthin their I e,pective certificates of authority shall have full power to bind the Companies by their signature and execution of any such instrument, mid to attach the scal. the Companic, dicicto. The President or any Vice President, the Board of Directors or any other officer of the Corn panics may at any time revoke pill Im )%N c I and tia hontv previously giN en to any attorney -in -fact. %011111111%, IN WITNESS WHEREOF, the COMPANIES have each caused these presents to be signed by its INSU,9"11, vice president and its corporate seal to be hereto affixed this +-.6 . .......... 44"" 17th day of October, 2024 4N 's COXFORATE 93 5Zj- %%3LY 4 L S 01966 tip .............. 0 Ill lilo%, UNITED FIRE & CASUALTY COMPANY UNITED FIRE & INDEMNITY COMPANY FINANCIAL PACIFIC INSURANCE COMPANY By: Still,: of km a. County of Linn, ss: Vice President On 17th day of October., 2024, before me personally Came Kyanna M. Saylor to me known. who being by me duly sworn; did depo,,, and say; that she resides in Cedar:Rapids, State of Iowa; that she is a VicePri sident of. United Fire & Casualty Company, a Vice President of United Fire & Indemnity Company, and a Vice President of Financial Pacific Insurance Company the corporations described in and which executed the above instrument; that she knows the seal of said corporations; that die seal affixed to -die §aid instrument is such coq)orite seal that it was so affixed pursuant to authority given by the Board of.Ditcc ion, of said corporations and that she name thereto pursuant to like authority, and acklaml ledges same to be die act and.' --deed of said corporation, Patti Waddell Iowa Notarial Seal Commission number 713274 v otary Public My Commission Expires 10126/2025 My commission expires: 10;26,22 -e & Ca,cretary of Imtckl Fire & Indemnity Company, and Asistaut I., Mary A. Bertsch, Assistant ��cictai� of United Fu sualv, Company and Assistant ScS Secretary of Financial Pacific Insurance Company, do hereby cendy that I have compared the foregoing copy of the Power of Attorney kid affidavit, and the copy of the Section of the bylaws and resolutions of said Corporations as set forth in said Power of Attorney, with the ORIGINALS ON FILE IN Tl LE HOME OFFICL 01: SAID CORPORATIONS, and that the same are correct transcripts thereof, and of die whole of the said originals, and that die said Power of Attorney has not been revoked and is now in full force and effect In testimony whereof I have hereunto subscribed niv iianic and affixed die corporate seal of the said Corporations this 19th day of February 20 25 1NSUgw 'qe % W11PORATIF, CORMRArE 91— IULY 22 �0= A 12'... Igo 1"22 M AL SEAL S -A,*. el 'r Assistant Secretary, ......... . UF&C & UF&I & FPIC BPOA0049 1217 This paper has a colored background and void pantograph. Page 288 of 629 EROSION CONTROL CERTIFICATION SECTION 00900 City: City of Dubuque Dated: j, Address: 50 W. 13th Street Dubuque, IA 52001 Project: Dubuque Gate & Pump Station Flood Mitigation (16th St Detention Basin) Project No. 5586500007 Description: The project includes the construction of a new stormwater pumping station on the protected side of the flood protection levee at the confluence of the Bee Branch Watershed with the Mississippi River. I certify under penalty of law that I understand the terms and conditions of the National Pollutant Discharge Elimination System (NPDES) Permit that authorizes the storm water discharges associated with industrial activities from the construction site and as detailed in the Contract Documents. Further, by my signature, I understand that I am becoming a co-permittee, along with the owner(s) and other contractors and subcontractors signing such certifications, to the Iowa Department of Natural Resources NPDES General Permit No. 2 for "Storm Water Discharge Associated with Industrial Activity for Construction Activities" at the project site. As a co-permittee, I understand that I, and my company, are legally required under the Clean Water Act and the Code of Iowa, to ensure compliance with the terms and conditions of the storm water pollution prevention plan developed under this NPDES permit and the terms of this NPDES permit. I agree to indemnify and hold the City harmless from any claims, demands, suits, causes of action, settlements, fines, or judgments and costs of litigation, including, but not limited to, reasonable attorney's fees and costs of investigation and arising from a condition, obligation, or requirement assumed or to be performed by the Contractor for storm water pollution and erosion control. Fines and other costs incurred against the City for the Contractor's failure to provide the required erosion control practices will be paid by the Contractor. Contractor: Portzen Construction, Inc. By: I �,U Michael J. Portze President Page 289 of 629 AC40Ro CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) z/1912025 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(ies) 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 endorsement(s). PRODUCER AssuredPartners Great Plains, LLC PO Box 759 CONTACT NAME: Jena Wllwerf PHE A/CNNo Ext : 563-556-0272 nAIC No): 563-556-4425 Dubuque IA 52004-0759 q E-MAIL ADDRESS: 'ena.WilWert assured aftnerS.COm INSURERS AFFORDING COVERAGE NAIC 0 INSURER A: Way Dint Mutual fka Midwest Builders 13126 INSURED PORTCON-02 Portzen Construction Inc INSURER B : SOm o America Insurance Company 11126 INSURER c: United Fire & Casualty 13021 205 Stone Valley Dr. INSURER D: Dubuque IA 52003 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER, 76782s990 RP\/ICIAN KII IMDCD• 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 LTR TYPE OF INSURANCEINSD ADOL SUER WVDPOLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMIDD/YYYY LIMITS C X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FxIOCCUR Y Y 60543978 12/31/2024 12/31/2025 EACH OCCURRENCE $1,000,000 D TED PREMISES Ea occurrence $ 500,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $1,000,000 AGGREGATE LIMIT APPLIES PER: POLICY a ECT LOC GENERAL AGGREGATE $3,000,000 GEN'L PRODUCTS -COMP/OP AGG $ 2,000,000 $ OTHER: C AUTOMOBILE LIABILITY ANY AUTO Y Y 60543978 12/31/2024 COMBINED MBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ uIIUIM $100,000 C X UMBRELLA LIAR X OCCUR Y Y 60543978 12/31/2024 12/31/2025 EACH OCCURRENCE $ 10,000.000 EXCESS LIAB CLAIMS -MADE AGGREGATE $10,000,000 DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? El N/A Y WC100-0001565-2024A 12/31/2024 12/31/2025 X I STATUTE ERH E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500,000 B Pollution PNV10015297101 3/1/2024 3/l/2025 Each Occurrence 4000,000 Aggregate 8:000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Dubuque Gate & Pump Station Flood Mitigation (16th St Detention Basin). 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 and Origin Design are included as an additional insured on the general liability as provided by endorsement CG7280. General Liability is on form CG0001. Coverage is on a primary and non-contributory basis as provided by endorsement IL7105. Governmental Immunities is provided by endorsement CG7163, Completed and Ongoing Operations coverage is provided by endorsements CG7280 and CG7286. Fellow Employee Exclusion has been deleted with limitations. Waiver of Subrogation is included on General Liability, Auto Liability and Workers Compensation per endorsements CG7280, CA7109 and 1WC000313. City of Dubuque is listed as Additional Insured on the Pollution Liability. City of Dubuque Attn: Engineering Dept. 50 W 13th Street Dubuque IA 52001 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED 91988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Page 290 of 629 CG 72 80 07 17 LIMITED EXTENDED ULTRA LIABILITY PLUS ENDORSEMENT COMMERCIAL GENERAL LIABILITY EXTENSION ENDORSEMENT SUMMARY OF COVERAGES This is a summary of the various additional coverages and coverage modifications provided by this endorsement. No coverage is provided by this summary. * Extended Property Damage * Expanded Fire Legal Liability to include Explosion, Lightning and Sprinkler Leakage Coverage for non -owned watercraft is extended to 51 feet in length * Property Damage - Borrowed Equipment Property Damage Liability - Elevators • Coverage D - Voluntary Property Damage Coverage $5,000 Occurrence with a $10,000 Aggregate • Coverage E - Care, Custody and Control Property Damage Coverage $25,000 Occurrence with a $100,000 Aggregate - $500 Deductible • Coverage F - Electronic Data Liability Coverage - $50,000 Coverage G - Product Recall Expense $25,000 Each Recall Limit with a $50,000 Aggregate - $1,000 Deductible Coverage H - Water Damage Legal Liability - $25,000 * Coverage I - Designated Operations Covered by a Consolidated (Wrap -Up) Insurance Program - Limited Coverage Increase in Supplementary Payments: Bail Bonds to $1,000 " Increase in Supplementary Payments: Loss of Earnings to $500 For newly formed or acquired organizations - extend the reporting requirement to 180 days * Broadened Named Insured Automatic Additional Insured - Vendors " Automatic Additional Insured - Lessor of Leased Equipment Automatic Status When Required in Lease Agreement With You Automatic Additional Insured - Managers or Lessor of Premises * Additional Insured - Engineers, Architects or Surveyors Not Engaged by the Named Insured Additional Insured - State or Governmental Agency or Subdivision or Political Subdivision - Permits or Authorizations Additional Insured - Consolidated Insurance Program (Wrap -Up) Off -Premises Operations Only - Owners, Lessees or Contractors Automatic Status When Required in Construction Agreement With You * Additional Insured - Employee Injury to Another Employee * Automatically included - Aggregate Limits of Insurance (per location) Automatically included - Aggregate Limits of Insurance (per project) Knowledge of occurrence - Knowledge of an 'occurrence", "claim or suit" by your agent, servant or employee shall not in itself constitute knowledge of the named insured unless an officer of the named insured has received such notice from the agent, servant or employee Blanket Waiver of Subrogation Liberalization Condition Unintentional failure to disclose all hazards. If you unintentionally fail to disclose any hazards existing at the inception date of your policy, we will not deny coverage under this Coverage Form because of such failure. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non -renewal. " "Insured Contract' redefined for Limited Railroad Contractual Liability * Mobile equipment to include snow removal, road maintenance and street cleaning equipment less than 1,000 Ibs GVW Bodily Injury Redefined REFER TO THE ACTUAL ENDORSEMENT FOLLOWING ON PAGES 2 THROUGH 12 FOR CHANGES AFFECTING YOUR INSURANCE PROTECTION CG 72 80 07 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 12 Page 291 of 629 CG 72 80 07 17 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LIMITED EXTENDED ULTRA LIABILITY PLUS ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SECTION I - COVERAGES A. The following changes are made at COVERAGE A - BODILY INJURY AND PROPERTY DAMAGE LIABILITY 1. Extended Property Damage At 2. Exclusions exclusion a. Expected or Intended Injury is replaced with the following: "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. 2. Expanded Fire Legal Liability At 2. Exclusions the last paragraph is deleted and replaced by the following: Exclusions c. through n. do not apply to damage by fire, explosion, lightning, smoke resulting from such fire, explosion, or lightning or sprinkler leakage to premises while rented to you or temporarily occupied by you with permission of this owner. A separate limit of insurance applies to this coverage as described in SECTION III - LIMITS OF INSURANCE. 3. Non -Owned Watercraft At 2. Exclusions exclusion g. Aircraft, Auto Or Watercraft (2)(a) is deleted and replaced by the following: (a) Less than 51 feet long; 4. Property Damage — Borrowed Equipment At 2. Exclusions the following is added to paragraph (4) of exclusion j. Damage To Property This exclusion does not apply to "property damage" to borrowed equipment while at a jobsite and while not being used to perform operations. The most we will pay for "property damage" to any one piece of borrowed equipment under this coverage is $25,000 per occurrence. The insurance afforded under this provision is excess over any valid and collectible property insurance (including deductible) available to the insured, whether primary, excess, contingent or on any other basis. 5. Property Damage Liability — Elevators At 2. Exclusions the following is added to paragraphs (3), (4) and (6) of exclusion j. Damage To Property: This exclusion does not apply to "property damage" resulting from the use of elevators. However, any insurance provided for such "property damage" is excess over any valid and collectible property insurance (including deductible) available to the insured, whether primary, excess, contingent or on any other basis. B. The following coverages are added: 1. COVERAGE D -VOLUNTARY PROPERTY DAMAGE COVERAGE "Property damage" to property of others caused by the insured: a. While in your possession; or b. Arising out of "your work". Coverage applies at the request of the insured, whether or not the insured is legally obligated to pay. For the purposes of this Voluntary Property Damage Coverage only: Exclusion j. Damage to Property is deleted and replaced by the following: CG 72 80 07 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 12 Page 292 of 629 CG 72 80 07 17 j. Damage to Property "Property damage" to: (1) Property held by the insured for servicing, repair, storage or sale at premises you own, rent, lease, operate or use; (2) Property transported by or damage caused by any "automobile", "watercraft" or "aircraft" you own, hire or lease; (3) Property you own, rent, lease, borrow or use. The amount we will pay is limited as described below in SECTION III - LIMITS OF INSURANCE For the purposes of this Voluntary Property Damage Coverage, our right and duty to defend ends when we have paid the Limit of Liability or the Aggregate Limit for each coverage, and we are granted discretion in making payments under this coverage. 2. COVERAGE E - CARE, CUSTODY AND CONTROL PROPERTY DAMAGE COVERAGE For the purpose of this Care, Custody and Control Property Damage Coverage only: a. Item (4) of Exclusion j. does not apply. The amount we will pay is limited as described below in SECTION III - LIMITS OF INSURANCE For the purposes of this Care, Custody and Control Property Damage Coverage, our right and duty to defend ends when we have paid the Limit of Liability or the Aggregate Limit for each coverage, and we are granted discretion in making payments under this coverage. 3. COVERAGE F - ELECTRONIC DATA LIABILITY COVERAGE For the purposes of this Electronic Data Liability Coverage only: a. Exclusion p. of Coverage A — Bodily Injury And Property Damage Liability in Section I — Coverages is replaced by the following: 2. Exclusions This insurance does not apply to: p. Electronic Data Damages arising out of the loss of, loss of use of, damage to, corruption of, inability to access, or inability to manipulate "electronic data" that does not result from physical injury to tangible property. However, this exclusion does not apply to liability for damages because of "bodily injury". b. "Property Damage" means: (1) 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; or (2) 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 (3) 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. For the purposes of this Electronic Data Liability Coverage , "electronic data" is not tangible property. The amount we will pay is limited as described below in SECTION III - LIMITS OF INSURANCE 4. COVERAGE G- PRODUCT RECALL EXPENSE a. Insuring Agreement (1) We will pay 90% of "product recall expense" you incur as a result of a "product recall" you initiate during the coverage period. (2) We will only pay for "product recall expense" arising out of "your products" which have been physically relinquished to others. The amount we will pay is limited as described below in SECTION III - LIMITS OF INSURANCE CG 72 80 07 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 12 Page 293 of 629 CG 72 80 07 17 b. Exclusions This insurance does not apply to "product recall expense" arising out of: (1) Any fact, circumstance or situation which existed at the inception date of the policy and which you were aware of, or could reasonably have foreseen that would have resulted in a "product recall'. (2) Deterioration, decomposition or transformation of a chemical nature, except if caused by an error in the manufacture, design, processing, storage, or transportation of "your product'. (3) The withdrawal of similar products or batches that are not defective, when a defect in another product or batch has been found. (4) Acts, errors or omissions of any of your employees, done with prior knowledge of any of your officers or directors. (5) Inherent vice, meaning a natural condition of property that causes it to deteriorate or become damaged. (6) "Bodily Injury" or "Property Damage". (7) Failure of "your product' to accomplish its intended purpose, including any breach of warranty of fitness, quality, efficacy or efficiency, whether written or implied. (8) Loss of reputation, customer faith or approval, or any costs incurred to regain customer market, or any other consequential damages. (9) Legal fees or expenses. (10) Damages claimed for any loss, cost or expense incurred by you or others for the loss of use of "your product'. (11) "Product recall expense" arising from the "product recall' of any of "your products" for which coverage is excluded by endorsement. (12) Any "product recall' initiated due to the expiration of the designated shelf life of "your product'. 5. COVERAGE H - WATER DAMAGE LEGAL LIABILITY The Insurance provided under Coverage H (Section 1) applies to "property damage" arising out of water damage to premises that are both rented to and occupied by you. The Limit under this coverage shall not be in addition to the Damage To Premises Rented To You Limit. The amount we will pay is limited as described below in SECTION III - LIMITS OF INSURANCE 6. COVERAGE I — DESIGNATED OPERATIONS COVERED BY A CONSOLIDATED (WRAP-UP) INSURANCE PROGRAM The following exclusion is added to Paragraph 2. Exclusions of SECTION I — COVERAGES COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY: r. This insurance does not apply to "bodily injury" or "property damage" arising out of either your ongoing operations or operations included within the "products -completed operations hazard" for any "consolidated (Wrap-up) insurance program" which has been provided by the prime contractor / project manager or owner of the construction project in which you are involved. This exclusion applies whether or not a consolidated (Wrap-up) insurance program: a. Provides coverage identical to that provided by this Coverage Part; or b. Has limits adequate to cover all claims. This exclusion does not apply if a "consolidated (Wrap-up) insurance program" covering your operations has been cancelled, non -renewed or otherwise no longer applies for reasons other than exhaustion of all available limits, whether such limits are available on a primary, excess or on any other basis. You must advise us of such cancellation, nonrenewal or termination as soon as practicable. For purposes of this exclusion a "consolidated (wrap-up) insurance program" is a program providing insurance coverage to all parties for exposures involved with a particular (typically major) construction project. CG 72 80 07 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 12 Page 294 of 629 CG 72 80 07 17 C. SUPPLEMENTARY PAYMENTS - COVERAGES A AND B is amended: 1. To read SUPPLEMENTARY PAYMENTS 2. Bail Bonds Item 1.b. is amended as follows: b. Up to $1,000 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. 3. Loss of Earnings Item 1.d. is amended as follows: d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $500 a day because of time off from work. 4. The following language is added to Item 1. However, we shall have none of the duties set forth above when this insurance applies only for Voluntary Property Damage Coverage and/or Care, Custody or Control Property Damage Coverage and we have paid the Limit of Liability or the Aggregate Limit for these coverages. SECTION II - WHO IS AN INSURED A. The following change is made: Extended Reporting Requirements Item 3.a. 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. B. The following provisions are added: 4. BROAD FORM NAMED INSURED Item 1.f. is added as follows: f. Any legally incorporated entity of which you own more than 50 percent of the voting stock during the policy period only if there is no other similar insurance available to that entity. However: (1) Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired more than 50 percent of the voting stock; and (2) Coverage B does not apply to "personal and advertising injury" arising out of an offense committed before you acquired more than 50 percent of the voting stock. 5. Additional Insured -Vendors a. Any person(s) or organization(s) (referred to throughout this additional coverage as vendor), but only with respect to "bodily injury" or "property damage", which may be imputed to that person(s) or organization(s) arising out of "your products" shown with the Schedule which are distributed or sold in the regular course of the vendor's business is an insured. However: (1) The insurance afforded to such vendor only applies to the extent permitted by law; and (2) If coverage provided to the vendor is required by a contract or agreement, the insurance afforded to such vendor will not be broader than that which you are required by the contract or agreement to provide for such vendor. b. With respect to the insurance afforded to these vendors, the following additional exclusions apply: (1) This insurance afforded the vendor does not apply to: (a) "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; (b) Any express warranty unauthorized by you; CG 72 80 07 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 12 Page 295 of 629 CG 72 80 07 17 (c) Any physical or chemical change in the product made intentionally by the vendor; (d) Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container. (e) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of products. (f) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product. (g) 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. (h) "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: i. The exceptions contained in Sub -paragraphs d. or f.; or ii. Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. (2) This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. 6. Additional Insured — Lessor of Leased Equipment — Automatic Status When Required in Lease Agreement With You a. Any person(s) or organization(s) from whom you lease equipment when you and such person(s) or organization(s) have agreed in writing in a contract or agreement that such person(s) or organization(s) be added as an additional insured on your policy. Such person(s) or organization(s) is an insured only with respect to your liability for "bodily injury", "property damage" or "personal and advertising injury" directly arising out of the maintenance, operation or use of equipment leased to you, which may be imputed to such person or organization as the lessor of equipment. However, the insurance afforded to such additional insured: (1) Only applies to the extent permitted by law; and (2) Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. A person's or organization's status as an additional insured under this endorsement ends when their contract or agreement with you for such leased equipment ends. b. With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after the equipment lease expires. 7. Additional Insured — Managers or Lessors of Premises a. Any person(s) or organization(s), but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you and subject to the following additional exclusions: This insurance does not apply to: (1) Any "occurrence" which takes place after you cease to be a tenant in that premises. (2) Structural alterations, new construction or demolition operations performed by or on behalf of the person(s) or organization(s) shown in the Schedule. However: (1) The insurance afforded to such additional insured only applies to the extent permitted by law; and (2) If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 72 80 07 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 6 of 12 Page 296 of 629 CG 72 80 07 17 8. Additional Insured - Engineers, Architects or Surveyors Not Engaged by the Named Insured a. Any architects, engineers or surveyors who are not engaged by you are insureds, but only with respect to liability for "bodily injury" or "property damage" or "personal and advertising injury" which may be imputed to that architect, engineer or surveyor arising out of: (1) Your acts or omissions; or (2) Your acts or omissions of those acting on your behalf; in the performance of your ongoing operations performed by you or on your behalf. But only if such architects, engineers or surveyors, while not engaged by you, are contractually required to be added as an additional insured to your policy. However, the insurance afforded to such additional insured: (1) Only applies to the extent permitted by law; and (2) Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. b. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of or failure to render any professional services, including: (1) The preparing, approving, or failing to prepare or approve, maps, drawings, opinions, reports, surveys, change orders, designs or specifications; or (2) 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", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional services. 9. Additional Insured - State or Governmental Agency or Subdivision or Political Subdivision - Permits or Authorizations Any state or governmental agency or subdivision or political subdivision is an insured, subject to the following provisions: a. This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. However: (1) The insurance afforded to such additional insured only applies to the extent permitted by law; and (2) If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. b. This insurance does not apply to: (1) "Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the federal government, state or municipality; or (2) "Bodily injury" or "property damage" included within the "products -completed operations hazard". 10. Additional Insured Consolidated Insurance Program (Wrap -Up) Off -Premises Operations Only - Owners, Lessees or Contractors a. Any persons or organizations for whom you are performing operations, for which you have elected to seek coverage under a Consolidated Insurance Program, 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 is an insured. Such person or organization is an additional insured only with respect to your liability which may be imputed to that person or organization directly arising out of your ongoing operations performed for that person or organization at a premises other than any project or location that is designated as covered under a Consolidated Insurance Program. A person's or organization's status as an insured under this endorsement ends when your operations for that insured are completed. CG 72 80 07 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 12 Page 297 of 629 CG 72 80 07 17 b. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies. This insurance does not apply to: "Bodily injury", "property damage", or "personal and advertising injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or surveying services, including: (1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, Feld orders, change orders or drawings and specifications; and (2) Supervisory, inspection 11. Additional Insured - Employee Injury to Another Employee With respect to your "employees" who occupy positions which are supervisory in nature: Paragraph 2.a.(1) of SECTION II — WHO IS AN INSURED is amended to read: a. 'Bodily injury" or "personal and advertising injury" (1) To you, to your partners or members (if you are a partnership or joint venture), or to your members (if you are a limited liability company); (2) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in paragraph (1)(a) above; or (3) Arising out of his or her providing or failing to provide professional healthcare services. Paragraph 3.a. is deleted. For the purpose of this Item 11 only, a position is deemed to be supervisory in nature if that person performs principle work which is substantially different from that of his or her subordinates and has authority to hire, direct, discipline or discharge. SECTION III - LIMITS OF INSURANCE A. The following Items are deleted and replaced by the following: 2. The General Aggregate Limit is the most we will pay for the sum of: a. Medical expenses under Coverage C; b. Damages under Coverage A, except damages because of "bodily injury" or "property damage" included in the "products -completed operations hazard"; and c. Damages under Coverage B; and d. Damages under Coverage H. 3. The Products -Completed Operations Aggregate Limit is the most we will pay under Coverage A for damages because of "bodily injury" and "property damage" included in the "products -completed operations hazard" and Coverage G. 6. Subject to 5. above, the Damage to Premises Rented to You Limit is the most we will pay under Coverage A for damages because of "property damage" to any one premises, while rented to you, or in the case of damage by fire, explosion, lightning, smoke resulting from such fire, explosion, or lightning or sprinkler leakage while rented to you or temporarily occupied by you with permission of the owner. B. The following are added: 8. Subject to Paragraph 5. of SECTION III — LIMITS OF INSURANCE $25,000 is the most we will pay under Coverage H for Water Damage Legal Liability. 9. Coverage G - Product Recall Expense Aggregate Limit $50,000 Each Product Recall Limit $25,000 a. The Aggregate Limit shown above is the most we will pay for the sum of all "product recall expense" you incur as a result of all "product recalls" you initiate during the endorsement period. CG 72 80 07 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 8 of 12 Page 298 of 629 CG 72 80 07 17 b. The Each Product Recall Limit shown above is the most we will pay, subject to the Aggregate and $1,000 deductible, for "product recall expense" you incur for any one "product recall' you initiate during the endorsement period. We will only pay for the amount of Product Recall Expenses which are in excess of the deductible amount. The deductible applies separately to each Product Recall. The limits of insurance will not be reduced by the amount of this deductible. We may, or will if required by law, pay all or any part of any deductible amount. Upon notice of our payment of a deductible amount, you shall promptly reimburse us for the part of the deductible amount we paid. 10. Aggregate Limits of Insurance (Per Location) The General Aggregate Limit applies separately to each of your 'locations" owned by or rented to you or temporarily occupied by you with the permission of the owner. "Location" 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. 11. Aggregate Limits of Insurance (Per Project) The General Aggregate Limit applies separately to each of your projects away from premises owned by or rented to you. 12. With respects to the insurance afforded to additional insureds afforded coverage by items 5 through 11 of SECTION II — WHO IS AN INSURED above, the following is added: The most we will pay on behalf of the additional insured is the amount of insurance: a. Required by the contract or agreement; b. Available under the applicable Limits of Insurance shown in the Declarations; Whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. 13. Subject to 5. of SECTION III — LIMITS OF INSURANCE, a $5,000 'occurrence" limit and a $10,000 "aggregate" limit is the most we will pay under Coverage A for damages because of "property damage" covered under Coverage D - Voluntary Property Damage Coverage. For the purposes of this Voluntary Property Damage Coverage, our right and duty to defend ends when we have paid the Limit of Liability or the Aggregate Limit for each coverage, and we are granted discretion in making payments under this coverage. 14. Subject to 5. of SECTION III — LIMITS OF INSURANCE, a $25,000 'occurrence" limit and a $100,000 "aggregate" limit is the most we will pay under Coverage E - Care, Custody and Control Coverage regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". Deductible - Our obligation to pay damages on your behalf applies only to the amount of damages in excess of $500. This deductible applies to all damages because of "property damage" as the result of any one 'occurrence" regardless of the number of persons or organizations who sustain damages because of that 'occurrence". We may pay any part or all of the deductible amount to effect settlement of any claim or "suit" and upon notification of the action taken, you shall promptly reimburse us for such part of the deductible amount as has been paid by us. As respects this coverage "Aggregate" is the maximum amount we will pay for all covered 'occurrences" during one policy period. CG 72 80 07 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 9 of 12 Page 299 of 629 CG 72 80 07 17 For the purposes of this Care, Custody and Control Property Damage Coverage, our right and duty to defend ends when we have paid the Limit of Liability or the Aggregate Limit for each coverage, and we are granted discretion in making payments under this coverage. 15. Subject to 5. of SECTION III — LIMITS OF INSURANCE, the most we will pay for "property damage" under Coverage F - Electronic Data Liability Coverage for loss of "electronic data" is $50,000 without regard to the number of 'occurrences". SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS A. The following conditions are amended: 1. Knowledge of Occurrence a. Condition 2., Items a. and b. are deleted and replaced by the following: (1) Duties In The Event Of Occurrence, Offense, Claim Or Suit (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. Knowledge of an 'occurrence" by your agent, servant or employee shall not in itself constitute knowledge of the named insured unless an officer of the named insured has received such notice from the agent, servant or employee. To the extent possible, notice should include: i. How, when and where the 'occurrence" took place; ii. The names and addresses of any injured persons and witnesses, and iii. The nature and location of any injury or damage arising out of the 'occurrence" or offense. (b) If a claim is made or "suit' is brought against any insured, you must: i. Immediately record the specifics of the claim or "suit' and the date received; and ii. 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. Knowledge of a claim or "suit' by your agent, servant or employee shall not in itself constitute knowledge of the named insured unless an officer of the named insured has received such notice from the agent, servant or employee. 2. Where Broad Form Named Insured is added in SECTION II — WHO IS AN INSURED of this endorsement, Condition 4. Other Insurance b. Excess Insurance (1).(a) is replaced by the following: (a) Any of the other insurance, whether primary, excess, contingent or on any other basis, that is available to an insured solely by reason of ownership by you of more than 50 percent of the voting stock, and not withstanding any other language in any other policy. This provision does not apply to a policy written to apply specifically in excess of this policy. B. The following are added: 10. Condition (5) of 2.c. (5) Upon our request, replace or repair the property covered under Voluntary Property Damage Coverage at your actual cost, excluding profit or overhead. 11. Blanket Waiver Of Subrogation 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: premises owned or occupied by or rented or loaned to you, ongoing operations performed by you or on your behalf, done under a contract with that person or organization, 'your work", or 'your products". We waive this right where you have agreed to do so as part of a written contract, executed by you before the "bodily injury" or "property damage" occurs or the "personal and advertising injury" offense is committed. 12. Liberalization If a revision to this Coverage Part, which would provide more coverage with no additional premium becomes effective during the policy period in the state designated for the first Named Insured shown in the Declarations, your policy will automatically provide this additional coverage on the effective date of the revision. CG 72 80 07 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 10 of 12 Page 300 of 629 CG 72 80 07 17 13. Unintentional Failure to Disclose All Hazards Based on our reliance on your representations as to existing hazards, if you unintentionally should fail to disclose all such hazards at the inception date of your policy, we will not deny coverage under this Coverage Part because of such failure. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non -renewal. 14. The following conditions are added in regard to Coverage G - Product Recall Expense In event of a "product recall', you must a. See to it that we are notified as soon as practicable of a "product recall'. To the extent possible, notice should include how, when and where the "product recall' took place and estimated "product recall expense". b. Take all reasonable steps to minimize "product recall expense". This will not increase the limits of insurance. c. If requested, permit us to question you under oath at such times as may be reasonably required about any matter relating to this insurance or your claim, including your books and records. Your answers must be signed. d. Permit us to inspect and obtain other information proving the loss. You must send us a signed, sworn statement of loss containing the information we request to investigate the claim. You must do this within 60 days after our request. e. Cooperate with us in the investigation or settlement of any claim. f. Assist us upon our request, in the enforcement of any rights against any person or organization which may be liable to you because of loss to which this insurance applies. 15. Limited Railroad Contractual Liability The following conditions are applicable only to coverage afforded by reason of the redefining of an "insured contract' in the DEFINITIONS section of this endorsement: a. Railroad Protective Liability coverage provided by ISO form CG 0035 with minimum limits of $2,000,000 per occurrence and a $6,000,000 general aggregate limit must be in place for the entire duration of any project. b. Any amendment to the Other Insurance condition of form CG 0035 alters the primacy of the coverage or which impairs our right to contribution will rescind any coverage afforded by the redefined "insured contract' language. c. For the purposes of the Other Insurance condition of form CG 0035 you, the named insured, will be deemed to be the designated contractor. SECTION V - DEFINITIONS A. At item 12. Mobile Equipment the wording at f.(1) is deleted and replaced by the following: f.(1) Equipment designed primarily for: (a) Snow removal; (b) Road maintenance, but not construction or resurfacing; or (c) Street cleaning; except for such vehicles that have a gross vehicle weight less than 1,000 Ibs which are not designed for highway use. B. Item 3. "bodily injury" is deleted and replaced with the following: 3. "bodily injury" means physical injury, sickness or disease sustained by a person. This includes mental anguish, mental injury, shock, fright or death that results from such physical injury, sickness or disease. C. Item 9. "Insured Contract' c. is deleted and replaced with the following: c. Any easement or license agreement; CG 72 80 07 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 11 of 12 Page 301 of 629 CG 72 80 07 17 D. Item 9. "Insured Contract' f.(1) is deleted E. The following definitions are added for this endorsement only: 23. "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, tape drives, cells, data processing devices or any other media which are used with electronically controlled equipment. 24. "Product recall" means a withdrawal or removal from the market of "your product" based on the determination by you or any regulatory or governmental agency that: a. The use or consumption of "your product' has caused or will cause actual or alleged "bodily injury" or "property damage'; and b. Such determination requires you to recover possession or control of "your product' from any distributor, purchaser or user, to repair or replace "your product', but only if "your product' is unfit for use or consumption, or is hazardous as a result of: (1) An error or omission by an insured in the design, manufacturing, processing, labeling, storage, or transportation of "your product; or (2) Actual or alleged intentional, malicious or wrongful alteration or contamination of "your product' by someone other than you. 25. "Product recall expense" means reasonable and necessary expenses for: a. Telephone, radio and television communication and printed advertisements, including stationery, envelopes and postage. b. Transporting recalled products from any purchaser, distributor or user, to locations designated by you. c. Remuneration paid to your employees for overtime, as well as remuneration paid to additional employees or independent contractors you hire. d. Transportation and accommodation expense incurred by your employees. e. Rental expense incurred for temporary locations used to store recalled products. f. Expense incurred to properly dispose of recalled products, including packaging that cannot be reused. g. Transportation expenses incurred to replace recalled products. h. Repairing, redistributing or replacing covered recalled products with like products or substitutes, not to exceed your original cost of manufacturing, processing, acquisition and/or distribution. These expenses must be incurred as a result of a "product recall'. CG 72 80 07 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 12 of 12 Page 302 of 629 IL 71 05 10 14 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART COMMERCIAL UMBRELLA COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured; (3) The additional insured gives us prompt written notice of any 'occurrence" which may result in a claim and prompt written notice of "suit'; (4) The additional insured immediately forwards all legal papers to us, cooperates in the investigation or settlement of the claim or defense against the "suit', and otherwise complies with policy conditions. (5) The additional insured must tender the defense and indemnity of any claim or "suit' to any other insurer which also insures against a loss we cover under this policy. This includes, but is not limited to, any insurer which has issued a policy of insurance in which the additional insured qualifies as an insured. For the purpose of this requirement, the term "insures against' refers to any self-insurance and to any insurer which issued a policy of insurance that may provide coverage for the loss, regardless of whether the additional insured has actually requested that the insurer provide the additional insured with a defense and/or indemnity under that policy of insurance. (6) The additional insured agrees to make available any other insurance that the additional insured has for a loss we cover under this policy. IL 71 05 10 14 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 Page 303 of 629 50543978 CG 71 63 04 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CITY OF DUBUQUE, IOWA ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PREMIUM 250 The City of Dubuque, Iowa, 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, are included as Additional Insureds with respect to liability arising out of the Insured's work and/or services performed for the City of Dubuque, Iowa. 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 be primary, contributing or excess. CITY OF DUBUQUE, IOWA GOVERNMENTAL IMMUNITIES ENDORSEMENT (For use when including the City as an Additional Insured) 1. Nonwaiver of Government Immunity. The insurance carrier expressly agrees and states that the purchase of this policy and the including of the City of Dubuque, Iowa as an Additional Insured does not waive any of the defenses of governmental immunity available to the City of Dubuque, Iowa 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 as it may be amended from time to time. 3. Assertion of Government Immunity. The City of Dubuque, Iowa 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 City of Dubuque, Iowa. 4, Roo -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 City of Dubuque, Iowa 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 City of Dubuque, Iowa, CG 71 63 04 09 Page 1 of 2 CO 7163 04 09 5. No QXbgr Change in Policy. The insurance carrier and the City of Dubuque, Iowa agree that the above preservation of governmental immunities shall not otherwise change or alter the coverage available under the policy. CITY OF DUBUQUE, IOWA CANCELLATION AND MATERIAL CHANGES ENDORSEMENT Thirty (30) days Advance Written Notice of Cancellation, Non -Renewal, Reduction in insurance coverage and/or limits and ten (10) days written notice of non-payment of premium shall be sent to: City of Dubuque, 50 W. 13th St., Dubuque, Iowa 52001. This endorsement supersedes the standard cancellation statement on the Certificate of Insurance to which this endorsement is attached. Note: Endorsements above per 'Urban Standard Specifications For Public Improvements', Addendum No_ 2 effective July 24, 2001. CG 71 63 04 09 Page 2 of 2 - - _ - — --- -305 of 629 CG 72 86 07 17 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - WITH PRODUCTS -COMPLETED OPERATIONS COVERAGE -AUTOMATIC STATUS FOR OTHER PARTIES AND COMPLIANCE WITH WRITTEN CONTRACTUAL REQUIREMENTS (THROUGH ISO 10/01 COVERAGE OPTIONS) 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 additional insured: I. Any person or organization for whom you are performing operations 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; and 2. Any other person or organization you are required to add as an additional insured under the contract or agreement described in Paragraph 1. above. B. The insurance provided to the additional insured is limited as follows: 1. The person or organization is an additional insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" which may be imputed to that person or organization directly arising out of: a. Your acts or omissions, or the acts or omissions of those acting on your behalf, in the performance of your ongoing operations specified in the "written contract"; or b. "your work" that is specified in the "written contract" but only for "bodily injury" or "property damage" included in the "products -completed operations hazard", and only if: (1) The "written contract" requires you to provide the additional insured such coverage; and (2) This coverage part provides such coverage; and (3) Such coverage will not apply subsequent to the first to occur of the following: i. The expiration of the period of time required by the "written contract"; or H. The expiration of any applicable statute of limitations or statute of repose with respect to claims arising out of "your work". 2. If the "written contract" specifically requires you to provide additional insurance coverage via the 04113 edition of CG2010 (aka CG 20 10 04 13), or via the 04/13 edition of CG2037 (aka CG 20 37 04 13), then in paragraph B.1. above, the words "which may be imputed to that person(s) or organization(s) directly arising out of are replaced by the words "caused in whole or in part by". 3. If the "written contract" specifically requires you to provide additional insurance coverage via the 07/04 edition of CG2010 (aka CG 20 10 07 04), or via the 07/04 edition of CG2037 (aka CG 20 37 07 04), then in paragraph B.1. above, the words "which may be imputed to that person(s) or organization(s) directly arising out of are replaced by the words "caused in whole or in part by". 4. If the "written contract" specifically requires you to provide additional insurance coverage via the 10/01 edition of CG2010 (aka CG 20 10 10 01), or via the 10/01 edition of CG2037 (aka CG 20 37 10 01) then in paragraph B.1. above, the words "which may be imputed to that person(s) or organization(s) directly arising out of are replaced by the words "arising out of'. 5. With regards to B.1. and B.2. above only, the following conditions are added; a. The insurance afforded to such additional insured only applies to the extent permitted by law; and b. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 72 86 07 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 2 Page 306 of 629 CG 72 86 07 17 6. The insurance provided to the additional insured does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of: a. The rendering of, or failure to render, any professional architectural, engineering or surveying services, including: (1) The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and (2) Supervisory, inspection, architectural or engineering activities. b. Any premises or work for which the additional insured is specifically listed as an additionalinsured on another endorsement attached to thiscoverage part. C. Only for the purpose of the insurance provided this endorsement, SECTION V— DEFINITIONS is amended to add the following definition: "Written Contract" means a written contract or written agreement that requires you to make aperson or organization an additional insured on this Coverage Part, provided the contract or agreement: 1. Is currently in effect or becoming effective during the term of this policy; and 2. Was executed prior to: a. The "bodily injury" or "property damage"; or b. The offense that caused the "personal and advertising injury", for which the additional insured seeks coverage under this coverage part. CG 72 86 07 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 2 Page 307 of 629 COMMERCIAL AUTO CA 71 09 01 17 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO ULTRA ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM COMMON POLICY CONDITIONS COVERAGE INDEX DESCRIPTION PAGE Temporary Substitute Auto Physical Damage 2 Broad Form Insured 2 Employee as Insureds 2 Additional Insured Status by Contract, Agreement or Permit 2 Bail Bond Coverage 3 Loss of Earnings Coverage 3 Amended Fellow Employee Coverage 3 Towing and Labor 3 Physical Damage Additional Transportation Expense Coverage 3 Extra Expense - Theft 3 Rental Reimbursement and Additional Transportation Expense 4 Personal Effects Coverage 4 Personal Property of Others 4 Locksmith Coverage 4 Vehicle Wrap Coverage 5 Airbag Accidental Discharge 5 Audio, Visual and Data Electronic Equipment Coverage 5 Auto Loan/Lease Total Loss Protection 5 Glass Repair — Deductible Amendment 5 Amended Duties in the Event of Accident, Claim, Suit or Loss 6 Waiver of Subrogation Required by Contract 6 Unintentional Failure to Disclose 6 Hired, Leased, Rented or Borrowed Auto Physical Damage 6 Mental Anguish 7 Extended Cancellation Condition 7 The COVERAGE INDEX set forth above is informational only and grants no coverage. Terms set forth in (Bold Italics) are likewise for information only and by themselves shall be deemed to grant no coverage. CA 71 09 01 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 7 Page 308 of 629 (Temporary Substitute Auto Physical Damage) A. TEMPORARY SUBSTITUTE AUTO PHYSICAL DAMAGE SECTION I — COVERED AUTOS, paragraph C. Certain Trailers, Mobile Equipment and Temporary Substitute Autos is amended by adding the following at the end of the existing language: If Physical Damage Coverage is provided under this Coverage form for an "auto' you own, the Physical Damage coverages provided for that owned "auto' are extended to any "auto' you do not own while used with the permission of its owner as a temporary substitute for the covered "auto' you own that is out of service because of its breakdown, repair, servicing, 'loss", or destruction B. BROADENED LIABILITY COVERAGES SECTION II — LIABILITY COVERAGE in Paragraph A. Coverage at 1. Who Is An Insured is amended to include the following: (Broad Form Insured) d. Any legally incorporated subsidiary in which you own more than 50% of the voting stock on the effective date of the Coverage Form. However, the Named Insured does not include any subsidiary that is an "insured" under any other automobile policy or would be an "insured" under such a policy but for its termination or the exhaustion of its Limit of Insurance. e. Any organization that is acquired or formed by you, during the term of this policy and over which you maintain majority ownership. However, the Named Insured does not include any newly formed or acquired organization: (1) That is a joint venture or partnership, (2) That is an "insured" under any other policy, (3) That has exhausted its Limits of Insurance under any other policy, or (4) 180 days or more after its acquisition or formation by you, unless you have given us notice of the acquisition or formation Coverage does not apply to "bodily injury" or "property damage" that results from an accident that occurred before you formed or acquired the organization. (Employee as Insureds) f. Any employee of yours while acting in the course of your business or your personal affairs while using a covered "auto' you do not own, hire or borrow. (Additional Insured Status by Contract, Agreement or Permit) g. Any person or organization whom you are required to add as an additional insured on this policy under a written contract or agreement; but the written contract or agreement must be: (1) Currently in effect or becoming effective during the term of this policy; and (2) Executed prior to the "bodily injury" or "property damage." The additional insured status will apply only with respect to your liability for "bodily injury" or "property damage" which may be imputed to that person(s) or organization(s) directly arising out of the ownership, maintenance or use of the covered "autos" at the location(s) designated, if any. Coverage provided by this endorsement will not exceed the limits of liability required by the written contract or written agreement even if the limits of liability stated in the policy exceed those limits. This endorsement shall not increase the limits stated in Section II. C. Limits of Insurance. For any covered "auto' you own this Coverage Form provides primary coverage. Page 2 of 7 Includes copyrighted material of Insurance Services Office, Inc., with its permission. CA 71 09 01 17 Page 309 of 629 C. BROADENED SUPPLEMENTARY PAYMENTS SECTION II. LIABILITY A. Coverage 2. Coverage Extensions a. Supplementary Payments (2) and (4) are replaced by the following: (Bail Bond Coverage) (2) Up to $5,000 for cost of bail bonds (including bonds for related traffic violations) required because of an "accident" we cover. We do not have to furnish these bonds. (Loss of Earnings Coverage) (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earning up to $500 a day because of time off from work. (Amended Fellow Employee Exclusion) D. AMENDED FELLOW EMPLOYEE EXCLUSION Only with respect to your "employees" who occupy positions which are supervisory in nature, SECTION II. LIABILITY B. Exclusion 5. Fellow Employee is replaced by: 5. Fellow Employee "Bodily Injury": a. To you, or your partners or members (if you are a partnership or joint venture), or to your members (if you are a limited liability company); b. To your "executive officers" and directors (if you are an organization other than a partnership, joint venture, or limited liability company) but only with respect to performance of their duties as your officers or directors; c. For which there is an obligation to share damages with or repay someone else who must pay damages because of the injury described in paragraph a and b above; or d. Arising out of his or her providing or failing to provide professional health care services. For purposes of this endorsement, a position is deemed to be supervisory in nature if that person performs principle work which is substantially different from that of his or her subordinates and has authority to hire, transfer, direct, discipline or discharge. E. BROADENED PHYSICAL DAMAGE COVERAGES SECTION III — PHYSICAL DAMAGE COVERAGE A. Coverage is amended as follows: (Towing and Labor) 2. Towing is deleted and replaced with the following: 2. Towing and Labor We will pay towing and labor costs incurred, up to the limits shown below, each time a covered "auto" is disabled: a. For private passenger type vehicles we will pay up to $100 per disablement. b. For all other covered "auto's" we will pay up to $500 per disablement However, the labor must be performed at the place of disablement. (Physical Damage Additional Transportation Expense Coverage) 4. Coverage Extensions a. Transportation Expenses is amended to provide the following limits: We will pay up to $60 per day to a maximum of $1,800. All other terms and provisions of this section remain applicable. The following language is added to 4. Coverage Extensions: (Extra Expense — Theft) c. Theft Recovery Expense If you have purchased Comprehensive Coverage on an "auto" that is stolen, we will pay the expense of returning that stolen auto to you. The limit for this coverage extension is $5,000. CA 71 09 01 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 7 Page 310 of 629 (Rental Reimbursement and Additional Transportation Expense) d. Rental Reimbursement We will provide Rental Reimbursement and Additional Expense coverage only for those Physical Damage coverages for which a premium is shown in the Declarations or schedule pages. Coverage applies only to a covered "auto". (1) We will pay for auto rental expense and the expense incurred by you because of "loss" to remove and transfer your materials and equipment from a covered "auto" to a covered "auto." Payment applies in addition to the otherwise applicable coverage you have on a covered "auto." No deductible applies to this coverage. (2) We will pay only for expenses incurred during the policy period and beginning 24 hours after the "loss" and ending, regardless of the policy's expiration, with the lesser of the following number of days: (a) The number of days reasonably required to repair or replace the covered "auto." If "loss" is caused by theft, this number of days is added to the number of days it takes to locate the covered "auto" and return it to you, or (b) 30 days. (3) Our payment is limited to the lesser of the following amounts: (a) Necessary and actual expenses incurred; or (b) $75 per day. (c) This coverage does not apply while there are spare or reserve "autos" available to you for your operations. (d) If "loss" results from the total theft of a covered "auto" of the private passenger or light truck type, we will pay under this coverage only that amount of your rental reimbursement expense which is not already provided for under the SECTION III — PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions, a. Transportation Expenses. (Personal Effects Coverage) e. Personal Effects If you have purchased Comprehensive Coverage on this policy for an "auto" you own and that "auto" is stolen, we will pay, without application of a deductible, up to $500 for Personal Effects stolen with the "auto". The insurance provided under this provision is excess over any other collectible insurance. For this coverage extension, Personal Effects means tangible property that is worn or carried by an "insured". (Personal Property of Others) f. Personal Property of Others We will pay up to $500 for loss to personal property of others in or on your covered "auto." This coverage applies only in the event of "loss" to your covered "auto" caused by fire, lightning, explosion, theft, mischief or vandalism, the covered "auto's" collision with another object, or the covered "auto's" overturn. No deductibles apply to this coverage. (Locksmith Coverage) g. Locksmith Coverage We will pay up to $250 per occurrence for necessary locksmith services for keys locked inside a covered private passenger "auto". The deductible is waived for these services. Page 4 of 7 Includes copyrighted material of Insurance Services Office, Inc., with its permission. CA 71 09 01 17 Page 311 of 629 (Vehicle Wrap Coverage) h. Vehicle Wrap Coverage If you have Comprehensive or Collision coverage on an "auto" that is a total loss, in addition to the actual cash value of the auto", we will pay up to $1,000 for vinyl vehicle wraps which are displayed on the covered "auto" at the time of total loss. Regardless of the number of autos deemed a total loss, the most we will pay under this Vehicle Wrap Coverage for any one 'loss" is $5,000. For purposes of this coverage provision, signs or other graphics painted or magnetically affixed to the vehicle are not considered vehicle wraps. (Airbag Accidental Discharge) F. SECTION III — PHYSICAL DAMAGE COVERAGE, B. Exclusions is amended at 3. to include the following language: If you have purchased Comprehensive or Collision Coverage under this policy, this exclusion does not apply to mechanical breakdown relating to the accidental discharge of an air bag. This coverage applies only to a covered auto you own and is excess of any other collectible insurance or warranty. No deductible applies to this coverage. G. BROADENED LIMITS OF INSURANCE (Audio, Visual and Data Electronic Equipment Coverage) SECTION III — PHYSICAL DAMAGE COVERAGE — C. Limit of Insurance at 1.b. is amended to provide the following limits: b. Limits of $1,000 per 'loss" is increased to $5,000 per 'loss". All other terms and provisions of this section remain applicable. (Auto Loan/Lease Total Loss Protection) SECTION III — PHYSICAL DAMAGE COVERAGE — C. Limit of Insurance is amended by adding the following language: 4. In the event of a total 'loss" to a covered "auto" shown in the Schedule pages, subject at the time of the 'loss" to a loan or lease, we will pay any unpaid amount due including up to a maximum of $500 for early termination fees or penalties on the lease or loan for a covered"auto" less: a. The amount paid under the Physical Damage Coverage Section of the policy; and b. Any: (1) Overdue lease / loan payments at the time of the 'loss"; (2) Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage; (3) Security deposits not returned by the lessor; (4) Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease; and (5) Carry-over balances from previous loans or leases. (Glass Repair— Deductible Amendment) H. GLASS REPAIR — DEDUCTIBLE SECTION III — PHYSICAL DAMAGE COVERAGE — D. Deductible is amended by adding the following: Any deductible shown in the Declarations as applicable to the covered "auto" will not apply to glass breakage if the damaged glass is repaired, rather than replaced. CA 71 09 01 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 7 Page 312 of 629 (Amended Duties in the Event of Accident, Claim, Suit or Loss) I. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS Under SECTION IV — BUSINESS AUTO CONDITIONS, A. Loss Conditions , the following is added to paragraph 2. Duties In The Event of Accident, Suit or Loss: d. Knowledge of any "accident", "claim", "suit" or "loss" will be deemed knowledge by you when notice of such "accident", "claim", "suit" or "loss" has been received by: (1) You, if you are an individual; (2) Any partner or insurance manager if you are a partnership; (3) An executive officer or insurance manager, if you are a corporation; (4) Your members, managers or insurance manager, if you are a limited liability company; or (5) Your officials, trustees, board members or insurance manager, if you are a not -for -profit organization. (Waiver of Subrogation by Contract) J. WAIVER OF SUBROGATION REQUIRED BY CONTRACT Under SECTION IV, BUSINESS AUTO CONDITIONS, A. Loss Conditions 5. Transfer of Rights of Recovery Against Others to Us the following language is added: However, we waive any rights of recovery we may have against the person or organization with whom you have agreed in writing in a contract, agreement or permit, to provide insurance such as is afforded under the policy to which this endorsement is attached. This provision does not apply unless the written contract or written agreement has been executed, or permit has been issued, prior to the "bodily injury" or "property damage." (Unintentional Failure to Disclose) K. UNINTENTIONAL FAILURE TO DISCLOSE Under SECTION IV — BUSINESS AUTO CONDITIONS, B. General Conditions , the following is added to 2. Concealment, Misrepresentation Or Fraud: Your unintentional error in disclosing, or failing to disclose, any material fact existing at the effective date of this Coverage Form, or during the policy period in connection with any additional hazards, will not prejudice your rights under this Coverage Form. (Hired, Leased, Rented or Borrowed Auto Physical Damage) L. HIRED, LEASED, RENTED OR BORROWED AUTO PHYSICAL DAMAGE Under SECTION IV — BUSINESS AUTO CONDITIONS B. General Conditions 5. Other Insurance Paragraph 5.b. is replaced by the following: b. (1) For "Comprehensive" and "Collision" Auto Physical Damage coverage provided by this endorsement, the following are deemed to be covered "autos" you own: (a) Any Covered "auto" you lease, hire, rent or borrow; and (b) Any Covered "auto" hired or rented by your "employee" under a contract in that individual "employee's" name, with your permission, while performing duties related to the conduct of your business. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto" (2) Limit of Insurance For This Section The most we will pay for any one "loss" is the lesser of the following: (a) $75,000 per accident, or (b) actual cash value at the time of loss, or (c) cost of repair. Page 6 of 7 Includes copyrighted material of Insurance Services Office, Inc., with its permission. CA 71 09 01 17 Page 313 of 629 Minus a $500 deductible. An adjustment for depreciation and physical condition will be made in determining actual cash value in the event of a total loss. No deductible applies to "loss" caused by fire or lightning. (3) This Hired Auto Physical Damage coverage is excess over any other collectible insurance. (4) Definitions For This Section (a) Comprehensive Coverage: from any cause except the covered "auto's" collision with another object or the covered "auto's" overturn. We will pay glass breakage, "loss" caused by hitting a bird or animal and, "loss" caused by falling objects or missiles. (b) Collision Coverage: caused by the covered "auto's" collision with another object or by the covered "auto's" overturn. (Mental Anguish) M. MENTAL ANGUISH Under SECTION V — DEFINITIONS, C. is replaced by the following: C. "Bodily injury" means bodily injury, sickness or disease sustained by a person including mental anguish or death resulting from bodily injury, sickness, or disease. (Extended Cancellation Condition) N. EXTENDED CANCELLATION CONDITION Under CANCELLATION, of the COMMON POLICY CONDITIONS form, item 2.b. is replaced by the following: b. 60 days before the effective date of cancellation if we cancel for any other reason. CA 71 09 01 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 7 Page 314 of 629 COMMERCIAL AUTO CA 04 49 11 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. The following is added to the Other Insurance B Condition in the Business Auto Coverage Form and the Other Insurance — Primary And Excess Insurance Provisions in the Motor Carrier Coverage Form and supersedes any provision to the contrary: This Coverage Form's Covered Autos Liability Coverage is primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that: 1. Such "insured" is a Named Insured under such other insurance; and 2. You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to such "insured". CA 04 49 11 16 The following is added to the Other Insurance Condition in the Auto Dealers Coverage Form and supersedes any provision to the contrary: This Coverage Form's Covered Autos Liability Coverage and General Liability Coverages are primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that: 1. Such "insured" is a Named Insured under such other insurance; and 2. You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to such "insured". © Insurance Services Office, Inc., 2016 Page 1 of 1 Page 315 of 629 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 04-84) BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This endorsement does not apply where prohibited by law. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Any person or organization that you perform work for that is liable for an injury, covered by this policy, that prior to the injury has a written contract requiring a waiver of our right to recover from them. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy. Endorsement Effective 12/31/2024 Policy No. WC100-0001565-2024A Endorsement WC 00 03 13 Insured Portzen Construction, Inc dba Dubuque Plumbing & Heating DBA Premium $244,805 Insurance Company Waypoint Mutual 1100 Walnut Street Suite 3000 Kansas City, MO 64106 (816)474-7799 Carrier Code 32131 }� Countersigned by WC 00 03 13 (Ed. 04-84) Page 316 of 629