Signed ContractsCity of Dubuque
City Council
CONSENT ITEMS # 14.
Copyrighted
November 17, 2025
ITEM TITLE: Signed Contracts
SUMMARY: 563 Design, PLLC for Taks Order No. 04 — Finance
Department — 7800 Chavenelle Road; Dubuque County E911
Board for the Health Services — Animal Control 911 Radio
Access Fee; Dubuque Regional Humane Society for City of
Dubuque Veterinary Services; Environmental Management
Services of Iowa, Inc. for the Eagle Point Water Treatment
Plant Roof Rehabilitation — Asbestos Abatement Project; Hills
and Dales for the FY 2026 Special Services Grant Program
Agreement; ImOn Communications, LLC MSA Addendum for
Changes and Letter of Agency; Kramer Pest Control for Pest
Control at 6 fire stations; Midwest Injection, Inc for the
Terminal Street Lift Station Bypass Pumping Project; Outfly
Development LLC for Site Access Agreement; Racom for City
Hall Video Decoder: City Manager; RSM US , LLP for
Statement of Work — Finance Organizational Assessment
and Design; The EMS Training School, LLC Clinical Affiliation
Agreement; Top Grade Excavating for the Catfish Creek
Sanitary Utility Easement Stream Crossings Restoration;
WHKS & Co. for Task Order #25-Brunskill Road Sanitary
Sewer and Streambank Restoration
SUGGUESTED Receive and File
DISPOSITION:
ATTACHMENTS:
1. FY26 Special Services Grant Program Agreement with Hills and Dales
2. Kramer Pest Control
3. Brunskill Rd Sanitary Sewer Streambank Restoration WHKS
4. Racom
5. Site Access Agreement for Outfly Development LLC Hodge
6. RSM Finance Organizational Assessment Contract
7. 563 Design Task Order for 7800 and 7850 Chavenelle (3)
8. Contract for Cleaning Centrate Tank at WRRC
9. Catfish Creek Sanitary Utility Easement Stream Crossing
10. IA - Dubuque Fire Department_AA_2025
11. Water Plant Roof Rehab Project Award Asbestos Abatement
Page 215 of 750
12. DBQ CO E911
13. DBQ Regional Humane Society
14. ImOn Communications Addendum For Changes to Service
15. IMON Telephone Services Letter of Agency
Page 216 of 750
CITY OF DUBUQUE, IOWA
AND
HILLS AND DALES
FY 2026 SPECIAL SERVICES GRANT PROGRAM AGREEMENT
THIS AGREEMENT, executed on the 15t day of July 2025 is entered into by and between the City of
Dubuque, Iowa, a municipal corporation organized and existing under the laws of the State of Iowa (Recipient)
and Hills and Dales, with its principal place of business in Dubuque, Iowa (Subrecipient).
WHEREAS, the City Council deems it in the best interests of the City to provide special services funding
to support organizations in the city of Dubuque; and
WHEREAS, Recipient wishes to engage Subrecipient to assist Recipient in providing services to a
presumed low -and moderate- income population.
NOW THEREFORE, in consideration of the premises and respective covenants, agreements and
representations hereinafter set forth, the parties agree as follows:
SCOPE OF SERVICES:
a. Subrecipient shall:
i. Provide the services to eligible residents of the City of Dubuque in a manner satisfactory
to Recipient and consistent with any standards required as a condition of providing these
funds. Such program shall include the following activities similar to those eligible under
the Community Development Block Grant Program: Operating costs for the Hills and
Dales Lifetime program to provide educational, recreational and social programs to
elderly persons.
1. In the event of a conflict between Subrecipient's proposals and the provisions
hereto attached, that provision which in the judgment of Recipient provides the
greatest benefit to Recipient shall prevail. Failure of Subrecipient to provide any
of the services proposed shall be deemed a material breach of this Agreement.
ii. Comply with City Council goals and priorities are attached.
City Responsibilities
City designates the City Manager, or the City Manager's designee, to act as its representative
with respect to the work to be performed under this Agreement, and such person shall have
authority to transmit instructions, receive information, interpret and define City's policies and
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provide decisions in a timely manner pertinent to the work covered by this Agreement
until Agency has been advised in writing by City that such authority has been revoked.
IV. Project Budget
The total compensation to be paid to Subrecipient by Recipient for the services shall in no event
exceed the sum of $25,000 for the program as described in the City of Dubuque's FY26 fiscal year
budget.
Recipient may require a more detailed budget breakdown, and Subrecipient shall provide such
supplementary budget information in a timely fashion in the form and content prescribed by
Recipient. The Recipient and Subrecipient must approve any amendments to this Agreement in
writing.
V. Dates of Commencement and Completion
The services to be provided under this Agreement shall be commenced on July 1, 2025 and shall
be completed not later than June 30, 2026.
VI. Agreement Documents and Provisions
Subrecipient shall perform or arrange for the provision of services under this Agreement in the
manner and time provided herein.
VII. Payment
a. It is expressly agreed and understood that the total amount to be paid by Recipient to
Subrecipient under this Agreement shall not exceed the amount stated in Section III of
this Agreement. Such amount shall constitute complete compensation for all services to
be rendered, including expenses for the operation of the physical structure and the cost
in providing staff to deliver homeless services. Such amount shall be paid upon written
request on the Request for Payment form, with proof satisfactory to the recipient of
expenses. Drawdowns for payment of eligible expenses are reimbursement only.
b. Payment shall be supported by documentation provided by Subrecipient of costs incurred
for services provided pursuant to this Agreement.
c. Payments are be contingent upon certification of Subrecipient's financial management
system in accordance with the standards specified in 2 CFR 200, the provisions of which
are available in the office of Recipient.
VIII. Insurance.
At the time of execution of this Agreement by Subrecipient, Subrecipient shall provide to
Recipient copies of Subrecipient's insurance certificates showing general liability, automobile
liability, and workers compensation insurance coverage to the satisfaction of Recipient (attached
Insurance Schedule A) for the term of this Agreement.
Page 218 of 750
X
01
at
Reporting.
Organization agrees to submit the final report and remit any unspent grant funds by August 31,
2026. Final reports must include documentation of project expenditures, required match, and
activities completed. Details pertaining to match requirements are outlined in the program
guidelines. Failure to submit a final report may impact eligibility for receiving future City arts
funding.
Audit & Evaluation.
Because the funds provided to Organization by City are public funds, Organization must
maintain books, financial records, and accounting in accordance with generally accepted
accounting standards and necessary documentation to support all expenditures.
Organization will retain all financial records, reporting documents, and other records for
three (3) calendar years after the end of the term of this Agreement.
Organization's funding request application and applicant assurances are incorporated by
reference into this Agreement.
Termination of Agreement
This Agreement may be terminated by either party by giving the other party a written, ninety (90)
day notice of such termination or upon such other terms as may be mutually agreeable.
If, through any cause, Agency shall fail to fulfill in a timely and proper manner its obligations under
this Agreement or if Agency shall violate any of the covenants, agreements, or stipulations of this
Agreement, City shall have the right to terminate this Agreement by giving written notice to Agency
of such termination not less than five (5) days before the effective date of such termination.
Notices
Communication and details concerning this Agreement shall be directed to the following
agreement representatives:
Recipient
Dan Kroger
Recreation Division Manager
Leisure Services Department
2200 Bunker Hill Rd.
Dubuque, Iowa 52001
Subrecipient
Jack Mescher
Hills and Dales
1011 Davis
Dubuque, IA 52001
Assignability
Agency shall not assign this Agreement or any interest in this Agreement without prior written
approval of City.
XIII. Civil Rights
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During the performance of this Agreement, the grantee, for itself, its officers and employees,
agrees to comply with the following non-discrimination statutes and authorities, as applicable,
including but not limited to:
a) Title VI of the Civil Rights Act of 1964 (42 U.S.C. § 2000d et seq., 78 stat. 252), (prohibits
discrimination on the basis of race, color, national origin); and 49 CFR Part 21;
b) The Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, (42
U.S.C. § 4601), (prohibits unfair treatment of persons displaced or whose property has been
acquired because of Federal or Federal -aid programs and projects);
c) Federal -Aid Highway Act of 1973, (23 U.S.C. § 324 et seq.), (prohibits discrimination on the
basis of sex);
d) Section 504 of the Rehabilitation Act of 1973, (29 U.S.C. § 794 et seq.), as amended,
(prohibits discrimination on the basis of disability); and 49 CFR Part 27;
e) The Age Discrimination Act of 1975, as amended, (42 U.S.C. § 6101 et seq), (prohibits
discrimination on the basis of age);
f) Airport and Airway Improvement Act of 1982, (49 U.S.C. § 471, Section 47123), as amended,
(prohibits discrimination based on race, creed, color, national origin, or sex);
g) The Civil Rights Restoration Act of 1987, (PL 100-209); (broadened the scope, coverage and
applicability of Title VI of the Civil Rights Act of 1964 to include that entities that receive
federal funding must comply with civil rights legislation, including the Civil Rights Act of
1964, the Age Discrimination Act of 1975, and Section 504 of the Rehabilitation Act of 1973,
in all operations, not just in the program or activity receiving federal funding);
h) Titles II and III of the Americans with Disabilities Act, which prohibit discrimination on the
basis of disability in the operation of public entities, public and private transportation
systems, places of public accommodation, and certain testing entities (42 U.S.C. §§ 12131
- 12189) as implemented by Department of Transportation regulations at 49 C.F.R. Parts 37
and 38;
i) The Federal Aviation Administration's Non-discrimination statute (49 U.S.C. § 47123)
(prohibits discrimination on the basis of race, color, national origin, and sex);
j) Section 1557of the Affordable Care Act (prohibits discrimination on the basis of national
origin);
k) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. § 1681 et seq.)
(prohibits discrimination because of sex in education programs or activities);
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1) Drug Abuse Office and Treatment Act of 1972, as amended (21 U.S.C. § 1101 et seq.); and
m) Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970, as
amended (42 U.S.C. § 4541, et seq.);
n) All applicable standards, orders, or regulations issued pursuant to the Clean Air Act of 1970
(42 USC 1958(H) et. seq.);
o) The Federal Water Pollution Act (33 USC 1368 et. seq.) as amended;
p) Environmental Protection Agency regulations (40 CFR, Part 15);
q) Contract Work Hours and Safety Standards Act (40 USC 327-330); and
r) Department of Labor Regulations (29 CFR, Part 5).
IN WITNESS WHEREOF, the parties have executed this contract with the referenced attachments Exhibit A, B
and C as of the date first written above.
Witness:
awa""7'tt r,
Adrienne Breitfelder, City Clerk
City of Dubuque, Iowa
v
Mi hael C. Van Milligan
Hills and Dales
Jack e cher, CEO
Page 221 of 750
Dubuque
THE CITY OF
DUB TE 111111
2007-2012.2013
Masterpiece on the Mississippi 2017*2019
City of Dubuque
Fire Department
11 West 9th Street, Dubuque
(address)
Dubuque, IA 52001
Phone # 563-589-4160
CITY OF DUBUQUE, IOWA
SHORT FORM
VENDOR SERVICE AGREEMENT
THIS VENDOR SERVICE AGREEMENT (the Contract), between the City of
Dubuque, Iowa (City), by its City Manager, through authority conferred upon the City
Manager by its City Council and
;Vendor) at Kramer Pest Control
(Vendor Name)
14561 Forest Ridge Road, Dubuque, IA 52002-9754
(Vendor Address - City and State)
PROJECT TITLE: Pest Control at 6 fire stations
(Project)
For and in consideration of the mutual covenants herein contained, the parties hereto
agree as follows:
VENDOR AGREES:
1. To furnish all material and equipment and to perform all labor necessary for
Pest control at 6 fire stations
The work described above shall be completed at the following location(s):
Fire Headquarters (11 W. 9th St), Station 2 (2180 JFK Rd), Station 3 (3155 Central Ave.), Station 4 (1697 University Ave),
Station 5 (689 S. Grandview), Station 6 (1500 Rhomberg)
The Project shall be completed in strict accordance with the terms as described in this
Contract; in strict accordance with the requirements of the laws of the State of Iowa
Page 1 of 20 Page 222 of 750
and ordinances of the City of Dubuque, just as much as if the detailed statements
thereof were repeated herein.
2. Contract Documents shall mean and include the following WHERE APPLICABLE
Documents listed in bold should be attached to this document upon submission.
• Request for Proposal (or procurement documentation)
• This Contract;
• Ordinances and resolutions heretofore adopted by the City Council having to
do with this Project,
• The Vendor's Proposal:
• Plans and Specifications;
• General Requirements as adopted by the City Council for the Project;
• Terms and Conditions (Exhibit A); and
• INSURANCE — Please include one applicable Insurance Schedule:
Insurance Schedule F for General Artisan or Trade Contractors or
Subcontractors (Exhibit B)
Insurance Schedule G for Vendors (Exhibit C)
Insurance Schedule J for Professional Services (Exhibit D)
Check Appropriate Box
Insurance Schedule F — General Artisan or Trade Contractors or
Subcontractors
Insurance Schedule G — Vendors
I ; Insurance Schedule J — Professional Services
• Other:
3. All materials used by the Vendor on this Project shall be of the quality required by the
Contract Documents and shall be put in place in accordance with the Contract
Documents.
4. The Vendor shall remove any materials rejected by the City Manager as defective or
improper, or any of said work condemned as unsuitable or defective, and the same
shall be replaced or done anew to the satisfaction of the City Manager at the cost and
expense of the Vendor.
5. The Vendor has read and understands the Contract Documents and has examined
and understands the project description described in Section 1 of this Agreement and
any attached Special Conditions herein referred to and agrees not to plead
misunderstanding or deception because of estimates of quantity, character, location
or other conditions surrounding the same.
6. The Vendor shall fully complete the Project under this Contract on or before
(date)
Page 2 of 20 Page 223 of 750
7. Indemnification; Liability for City Damage
A. To the fullest extent permitted by law, the Contractor shall indemnify and hold
harmless the City from and against all claims, damages, losses and expenses,
including but not limited to attorneys` fees, arising out of or resulting from
performance of the 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 (other than the Project itself) including loss of use resulting therefrom,
but only to the extent caused in whole or in part by negligent acts or omissions of
the Contractor, the Contractor's subcontractor, or anyone directly or indirectly
employed by the Contractor or the Contractor's subcontractor or anyone for whose
acts the Contractor or the Contractor's subcontractor may be liable, regardless of
whether or not such claim, damage, loss or expense is caused in part by a party
indemnified hereunder.
B. The Contractor shall also be liable to the City for any damage to City property
arising out of or related to the Contractor's negligent performance of the Contract.
8. Prior to the commencement of any work on this Project and at all times during the
performance of this Contract, the Vendor shall provide evidence of insurance which
meets the requirements of the City's Insurance Schedule as' indicated above and
attached hereto.
9. The Vendor agrees that no work under this Contract shall commence until the City has
authorized said work in writing. Any work started by the Vendor prior the City
authorization shall be considered unauthorized and done at the sole risk to the
Vendor.
10. Vendor will comply with all federal, state, and local laws and regulations in the
performance of this Contract.
11. The City may terminate this Contract with or without cause upon fourteen (14) days'
written notice delivered to the Vendor.
12. This Contract shall be governed by the laws of the State of Iowa and exclusive
jurisdiction and venue for any action arising out of or related to this Contract shall be
the Iowa District Court for Dubuque County.
Page 3 of 20 Page 224 of 750
THE CITY AGREES:
The City agrees to pay the Vendor for the work actually performed under this
Contract, up to the amount stated below, less any agreed damages provided for in the
Contract Documents.
CONTRACT AMOUNT $ up to $4,000
CITY OF DUBUQUE, IOWA
By;
Michael C. Van II Illigen
City Manager
10/30/2025
Date
VENDOR:
Kramer Pest Control
Company Name
By: �V6 VAMyt&A 10/29/2025
Sig ature Date
Printed Name
Title
Page 4 of 20 Page 225 of 750
EXHIBIT A
TERMS AND CONDITIONS
The following Terms and Conditions apply to City of Dubuque Transactions:
1. The City of Dubuque is exempt from federal excise tax and Iowa sales tax.
2. The City of Dubuque will not be responsible for payment for any goods delivered
without a purchase order.
3. The vendor will send a separate invoice for each purchase order number. All
invoices, packages, shipping notices, or the like affecting the order shall contain
the applicable purchase order number. The vendor is to submit original invoice to
the address shown in the SHIP TO section on the front of this order.
4. No freight or packing charges will be allowed by the City of Dubuque unless
specifically authorized.
5. It is understood by the vendor that the cash discount period to the City of Dubuque
will date from the receipt of the invoice or from the date of the receipt of the goods,
whichever is later,
E. The risk of loss of and damage to the goods which are the subject of this order,
regardless of the F.Q.B. point, is and will remain with the vendor until the goods
are delivered to the destination set out in the order and accepted by the City of
Dubuque or the authorized City of Dubuque representative.
7. In the event of the vendor's failure to deliver as and when specified, or to perform
as and when specified, the City of Dubuque reserves the right to cancel this order,
or any part thereof, without prejudice to its other rights, and the vendor agrees that
the City of Dubuque may return part or all of any shipment so made and may
charge the vendor with any loss expense sustained as a result of such failure to
deliver or to perform.
8. In the event any article, service, or process sold, delivered and/or performed
hereunder is covered by any patent, copyright, or application for either, the vendor
will indemnify and. save harmless the City of Dubuque from any and all loss, cost,
or expenses on account of any and all claims, suits, or judgments on account of
the use or sale of such article or the use of such service or process in violation of
such patent, copyright or application for either.
9. In the event any article, service, or process sold and delivered or sold and
performed hereunder is defective in any respect whatsoever, the vendor will
indemnify and save harmless the City of Dubuque from all loss or the payment of
all sums of money by reason of all accidents, injuries or damages to person or
property that may happen or occur in connection with the use or sale of such
article, or process and are contributed to by said defective condition.
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1 D. The vendor agrees not to release any advertising copy mentioning the City of
Dubuque or quoting the opinion of any City of Dubuque employee without the prior
written authorization from the City of Dubuque.
11. The vendor represents and warrants that no federal or state statute or regulation,
or local municipal ordinance has been or will be violated in the manufacturing, sale
and, delivery hereunder, If such violation has or does occur, the vendor will
indemnify and save harmless the City of Dubuque from all loss, penalties, or
payment of all sums of money on account of such violation.
12. The City of Dubuque may at any time insist upon strict compliance with these terms
and conditions notwithstanding any previous custom, practice, or course of dealing
to the contrary.
13. The terms and conditions of sale as stated in this order govern in the event of
conflict with any terms of the vendor's proposal, and are not subject to change by
reason of any written or verbal statements by the vendor or by any terms stated in
the vendor's acknowledgement unless same be accepted in writing by the City of
Dubuque.
14. Current Safety Data Sheets (SDS), when applicable to the order, must be provided
by the vendor in accordance with all regulations.
Page 6 of 20 Page 227 of 750
EXHIBIT B
Class A:
Class B:
Class C:
INSURANCE SCHEDULE F
Asbestos Removal
Fiber Optics
Sanitary Sewers
Asphalt Paving
Fire Protection
Sheet Metal
Concrete
Fireproofing
Site Utilities
Construction Managers
General Contractors
Shoring
Cranes
HVAC
Special construction
Culverts
Mechanical
Steel
Decking
Paving & Surfacing
Storm sewers
Demolition
Piles & Caissons
Structural Steel
Deconstruction
Plumbing
Trails
Earthwork
Retaining Walls
Tunneling
Electrical
Reinforcement
Water main
Elevators
Roofing
Chemical Spraying
Landscaping
Rough Carpentry
Doors, Window &
Masonry
Stump Grinding
Glazing
Vehicular Snow Removal
Tank Coating
Drywall Systems
Painting & Wall Covering
Tree Removal
Fertilizer Application
Pest Control
Tree Trimming
Geotech Boring
Scaffolding
Tuckpointing
Insulation
Sidewalks
Waterproofing
Finish Carpentry
Plastering
Well Drilling
Carpet Cleaning
Carpet & Resilient
Flooring
Caulking & Sealants
Acoustical Ceiling
Filter Cleaning
General Cleaning
Grass Cutting
Janitorial
Non Vehicular Snow &
Ice Removal
Office Furnishings
Power Washing
Tile & Terrazzo Flooring
Window Washing
Page 7 of 20 Page 228 of 750
INSURANCE SCHEDULE F (continued)
Contractor shal€ furnish a signed certificate of insurance to the department responsible for the contract for the
coverage required in Exhibit I prior to commencing work and at the end of the project if the term of work is longer
than 60 days. Contractors presenting annual certificates shall present a certificate at the end of each project with
the final billing. Each certificate shall be prepared on the most current ACCRD form approved by the Iowa
Department of Insurance or an equivalent approved by the Director of Finance and Budget or Designee. The
certificate must clearly indicate the project number, project name, or project description for which it is being
provided Eg: Project # Project. name: Pest Control for 6 Fire Stations or Project location at
or construction of
All policies of insurance required hereunder shall be with an insurer authorized to do business in Iowa and all
insurers shall have a rating of A or better in the currant A.M. Best's Rating Guide.
Each Certificate required shall be furnished to the Fire Department of the City of Dubuque.
4. Failure to provide the coverages described in this Insurance Schedule shall not be deemed a waiver of these
requirements by the City of Dubuque. Failure to obtain or maintain the required insurance shall be considered a
material breach of this contract.
Contractor shall require all subcontractors and sub -subcontractors to obtain and maintain during the performance
of work insurance for the coverages described in this Insurance Schedule and shall obtain certificates of
insurance from all such subcontractors and sub -subcontractors. Contractor agrees that it shall be liable for the
failure of a subcontractor and sub -subcontractor to obtain and maintain such coverage. The City may request a
copy of such certificates from the Contractor.
All required endorsements shall be attached to the certificate. The certificate is due before the contract/agreement
can be approved.
7. Whenever an ISO form is referenced the current edition must be provided.
8. Contractor shall be required to carry the minimum coverage/limit, or greater if required by law or other legal
agreement, in Exhibit I - Insurance Schedule F. If the contractor's limits of liability are higher than the required
minimum limit, then the contractor's limits shall be this agreement's required limits.
9. Contractor shall be responsible for deductibles and self -insured retention for payment of all policy premiums and
other cost associated with the insurance policies required below.
10. All certificates of insurance must include agents name, phone number, and email address.
11. The City of Dubuque reserves the right to require complete, certified copies of all required insurance policies,
including endorsements, required by this Schedule at any time.
12. The City of Dubuque reserves the right to modify these requirements, including limits, based on changes in the
risk or other special circumstances during the term of the contract, subject to written mutual agreement attached
hereto.
Page 8 of 20
Page 229 of 750
INSURANCE SCHEDULE F (continued)
EXHIBIT I
A) COMMERCIAL GENERAL LIABILITY
General Aggregate Limit $2,000,000
Products -Completed Operations Aggregate Limit $2,000,000
Personal and Advertising Injury Limit $1,000,000
Each Occurrence $1,000,000
Fire Damage Limit (any one occurrence) $50,000
Medical Payments $5,000
1) Coverage shall be written on an occurrence, not claims made, form, The general liability
coverage shall be written in accord with ISO form CG 00 01 or business owners form BP 00 02.
All deviations from the standard ISO commercial general liability form CG 00 01 or business
owners form BP 00 02 shall be clearly identified.
2) Include ISO endorsement form CG 25 04 "Designated Location(s) General Aggregate Limit" or
CG 25 03 "Designated Construction Project(s) General Aggregate Limit' as appropriate.
3) Include endorsement indicating that coverage is primary and non-contributory.
4) Include Preservation of Governmental Immunities Endorsement. (Sample attached).
5) Include additional insured endorsement for:
The City of Dubuque, including all its elected and appointed officials, all its employees,
agents, and volunteers, all its boards, commissions and/or authorities and their board
members, employees, agents, and volunteers. Use ISO form CG 20 10 (Ongoing operations).
6) The additional insured endorsement shall include completed operations under ISO form CG 20
37 during the project term and for a period of two years after the completion of the project.
7) Policy shall include Waiver of Right to Recover from Others endorsement.
8) Policy shall include cancellation and material change endorsement providing thirty (30) days
advance written notice of Cancellation, non -renewal, reduction in insurance coverage and/or limits
and ten (10) days written notice of nonpayment of premium shall be sent to: City of Dubuque
Finance Department, 50 West 13th Street Dubuque, Iowa 52001.
9) Contractor and subcontractor shall not use any drone without the prior written approval of the City
of Dubuque. Any drone usage must comply with above liability limits and the additional insured
endorsement must name the City of Dubuque with respect to aircraft liability coverage.
B) WORKERS' COMPENSATION & EMPLOYERS LIABILITY
Statutory Benefits covering all employees injured on the job by accident or disease as prescribed by Iowa
Code Chapter 85,
Coverage A Statutory —State of Iowa
Coverage B Employers Liability
Each Accident $100,000
Each Employee -Disease $100,000
Policy Limit -Disease $500,000
Policy shall include Waiver of Right to Recover from Others endorsement.
Coverage B limits shall be greater if required by the umbrella/excess insurer,
OR
If, by Iowa Code Section 85.1A, the Contractor is not required to purchase Workers' Compensation
Insurance, the Contractor shall have a copy of the State's Nonelection of Workers' Compensation or
Employers' Liability Coverage form on file with the Iowa
Workers' Compensation Insurance Commissioner, as required by Iowa Code Section 87.22. Completed
form must be attached.
Page 9 of 20
Page 230 of 750
C) AUTOMOBILE LIABILITY
Combined Single Limit $1,000,000
Coverage shall include all owned, non -owned, and hired vehicles. If the Contractor's business does not
own any vehicles, coverage is required on non -owned and hired vehicles.
1} Policy shall include Waiver of Right to Recover from Others endorsement.
D) UMBRELLAIEXCESS LIABILITY
The General Liability, Automobile Liability and Employer's Liability Insurance requirements may be
satisfied with a combination of primary and Umbrella or Excess Liability Insurance. If the Umbrella or
Excess Insurance policy does not follow the form of the primary policies, it shall include the same
endorsements as required of the primary policies including but not limited to Waiver of Subrogation and
Primary and Non-contributory in favor of the City.
All Class A contractors with contract values in excess of $1010001000 must have umbrella/excess liability
coverage of $10, 000, 000.
All Class A and Class B contractors with contract values between $500,000 and $10,000,000 must have
umbrella/excess liability coverage of $3,000,000.
All Class A and B contractors with contract values less than $500,000 must have umbrella/excess liability
coverage of $1,00.0,000.
All Class C contractors are not required to have umbrellalexcess liability coverage.
All contractors performing earth work must have a minimum of $3,000,000 umbrella regardless of the
contract value.
E) POLLUTION LIABILITY
Coverage required: " Yes x No
Pollution liability coverage shall be required if project involves any pollution exposure for hazardous or
contaminated materials including, but not limited to, the removal of lead, asbestos, or PCB's. Pollution
product and complete operations coverage shall also be covered.
Each Occurrence $2,000,000
Policy Aggregate $4,000,000
1) Policy to include job site and transportation coverage.
2) Include additional insured for:
The City of Dubuque, including all its elected and appointed officials, all its employees,
agents, and volunteers, all its boards, commissions and/or authorities and their board
members, employees and volunteers. Use ISO form CG 20 10. (Ongoing operations) or its
equivalent and CG 20 37 (completed operations) or its equivalent.
3) Include Preservation of Governmental Immunities Endorsement.
4) Provide evidence of coverage for 5 years after completion of project.
5) Include endorsement indicating that coverage is primary and non-contributory.
6) Policy shall include waiver of right to recovery from others endorsement.
7) Pollution liability shall include ISP endorsement CA 99 48, Pollution Liability -Broadened Coverage
for Covered Autos, or equivalent endorsement if the contractor has vehicles that transport fuel
onto the Owner's property.
P) RAILROAD PROTECTIVE LIABILITY
Coverage required: _Yes x No
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Page 231 of 750
Any contract for construction or demolition work on or within fifty feet (50') from the edge of the tracks of a
railroad and affecting any railroad bridge, trestle, tracks, roadbeds, tunnel, underpass, or crossing, for
which an easement, license or indemnification of the railroad is required, shall require evidence of the
following additional coverages.
Railroad Protective Liability:
$ each occurrence (per limits required by Railroad)
$ policy aggregate (per limits required by Railroad)
AND
An endorsement to the Commercial General Liability policy equal to ISO CG 24 17 (Contractual Liability -
Railroads). A copy of this endorsement shall be attached to the certificate of insurance.
Page 11 of 20
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Iowa Code Chapter 670, Liability of Governmental Subdivisions, provides cities with certain immunities which may be
available to you. Naming the City of Dubuque as an additional insured on your insurance as is requested by this
Insurance Schedule may result in your waiver of those immunities. If you would like to preserve those immunities, please
use this endorsement or an equivalent form. The preservation of immunities is for your benefit.
PRESERVATION OF GOVERNMENTAL IMMUNITIES ENDORSEMENT
1. NonwaNer of Governmental lmmun&. The insurer 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 Covers e. The insurer further agrees that this policy of insurance shall cover only those claims not subject
to the defense of governmental immunity under the Code of Iowa Section 670.4 as it now exists and as it may be
amended from time to time. Those claims not subject to Code of Iowa Section 670.4 shall be covered by the terms and
conditions of this insurance policy.
3. Assertion of Government Immunit . 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 insurer.
4. Non -Denial of Coverage, The insurer shall not deny coverage under this policy and the insurer shall not deny any
of the rights and benefits accruing to the City of Dubuque, 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.
No Other Change in Policy. The above preservation of governmental immunities shall not otherwise change or alter the
coverage available under the policy.
SPECIMEN
JDEPARTMENT MANAGER: FILL IN ALL BLANKS AND CHECK BOXES)
Page 12 of 20
Page 233 of 750
whks
CITY OF DUBUQUE
TASK ORDER #25 — Brunskill Road Sanitary Sewer and Streambank Restoration
This TASK ORDER is issued under the PROFESSIONAL SERVICES AGREEMENT (dated June 7, 2021
agreement reference number 9290.00) between the City of Dubuque ("Client") and WHKS & Co.
("WHKS") for Services to be provided by Consultant for Client on the Brunskill Road Sanitary Sewer
and Streambank Restoration ("Project"), described below to this Task Order.
A. Project Information
The North Fork of Catfish Creek has migrated and fully eroded around an existing sanitary
manhole. The 24" sanitary sewer aligned south from the manhole is partially exposed above the
streambed. This project will move the creek channel back to the east, encase the sewer in concrete,
armor the streambank, and provide grade control to prevent further erosion. This task order is to
complete environmental permit applications and associated agency coordination, final design plans
and specifications, and to aid the City in the bidding process.
B. Scope of Services
1. Project Management and Meetings
• Perform general project administrative duties including supervision and coordination
of the project team, review of project costs and billings, preparation of invoices using
Consultant's standard forms, preparation of status reports, and general
administrative activities.
• Hold virtual kick-off meeting with Client to discuss the project and review the scope.
• Advise the Client of the necessity of obtaining Special Engineering Services as
described in Section C., and act as the Client's representative in connection with any
such services not actually performed by WHKS.
• Attend two (2) meetings for the project.
2. Stream Assessment, Topographic Survey and Research of Existing Conditions
• Perform site topographical surveys to support new facilities, exclusive of boundary
surveys for land and easement acquisition.
• Conduct a stream assessment and survey, including stream thalweg profile, stream
water surface profile, identification of run -riffle -pool features, three representative riffle
cross sections, three representative pool cross sections, and riffle pebble counts.
• Develop project control and base map for the project.
• Locate existing underground utilities through the Iowa One Call system.
• Collect, obtain and review relevant information from the Client.
3. Final Design
• Determine bankfull elevation and velocity based on collected field data to support
design of bank restoration and in -stream grade control.
• Prepare final plans and specifications to show the character and scope of work to be
performed by contractors on the Project. The project will be designed in accordance
with the applicable Natural Resources Conservation Service (NRCS) practice
standards.
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whks
• Prepare bid documents using the City of Dubuque standard template.
• Prepare opinion of probable construction cost for completed plans and specifications.
• Answer contractor's questions during the bidding phase.
• Assist in the receiving and tabulation of Contractors' proposals and assist in awarding
construction contract.
• Prepare a Storm Water Pollution Prevention Plan (SWPPP).
• Furnish signed copies of the plans, specifications, and other contract documents as
required to the Client.
4. Environmental Permitting
• Delineate wetlands within the study area using field and desktop data. The delineation
will be done according to the 1987 Corps of Engineers Manual and Midwest Regional
Supplement.
• Collect and review available data that could aid in the delineation of wetlands. These
data may include historical aerial photography, soil maps, existing wetland maps,
and various Geographic Information System (GIS) data sets.
• Perform a field investigation for the purpose of delineating wetlands within the project
study area. Information to be collected will include plant community composition and
cover, presence or absence of wetland hydrology and indicators, and hydric soil
characteristics.
• Perform hydraulic modeling of the stream corridor in support of state and local floodplain
permitting requirements for the project. Modeling will be completed using HEC-RAS
software.
• Prepare a cover letter summarizing hydraulic modeling results, compile electronic
copies of hydraulic model files, and prepare a no -rise certification.
• Prepare and submit permit application package to the IA DNR and USACE.
• Coordinate with agency representatives during permit review.
C. Special Engineering Services:
Special Engineering Services are those services not listed above, but which may be required or
advisable to accomplish the Project. Special Engineering Services shall be performed when
authorized by the Client for additional fees, to be determined at the time authorized.
Special Engineering Services include:
1. Land surveying and platting
2. Easement research, plats or descriptions
3. Negotiation for easements or land acquisition
4. Quality control testing and construction materials testing
5. Permits other than those identified above
6. Funding assistance, including grant and/or loan applications
7. Geotechnical design/recommendations
8. Cultural resource survey or other studies or documentation that may be required by
regulatory agencies that are not specifically listed in the scope of services
9. National Environmental Policy Act (NEPA) compliance, including historical and
archeological investigations
10. Attendance at additional meetings (other than those listed above)
11. Construction phase engineering services, including construction administration, staking,
construction observation, preparation of record drawings and project close-out services
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whks
D. Basis of Compensation:
For the services described above, the Client shall remunerate WHKS as follows:
This Task Order is for Civil Engineering work with a Not -to -Exceed Fee of $42,000 including
expenses. Permit fees will be paid separately by Client. External expenses include an
administrative charge of 10 percent.
All terms and conditions of the Professional Services Agreement shall continue in full force and effect.
This Task Order is accepted, and the Consultant is authorized to proceed.
City of Dubuque WHKS & co.
By: By:
Printed Name: Michael C. Van Milligen Printed Name: Derek J. Thomas, PE
Title: City Manager Title: Vice President
Page 236 of 750
THE CITY OF
DUB E
Masterpiece on the Mississippi
CITY OF DUBUQUE, IOWA
SHORT FORM
VENDOR SERVICE AGREEMENT
City of Dubuque
Dept: City Managers Office
50 W. 1311 Street
Dubuque, IA 52001
Phone # 563-589-4416
THIS VENDOR SERVICE AGREEMENT (the Contract), between the City of Dubuque, Iowa
(City), by its City Manager, through authority conferred upon the City Manager by its City Council
and
Racom (Vendor) at
(Vendor Name)
201 West State St Marshalltown, IA 50158
(Vendor Address - City and State)
PROJECT TITLE: City Hall Video Decoder: City Manager
(Project)
For and in consideration of the mutual covenants herein contained, the parties hereto agree as
follows -
VENDOR AGREES:
1. To furnish all material and equipment and to perform all labor necessary for:
Install a video decorder and program decoder with citv hall cameras
The work described above shall be completed at the following location(s):
City managers office 50 W 13th street. 2nd Floor.
The Project shall be completed in strict accordance with the terms as described in this Contract;
in strict accordance with the requirements of the laws of the State of Iowa and ordinances of the
City of Dubuque, just as much as if the detailed statements thereof were repeated herein.
Page 1 of 14
Page 237 of 750
2. Contract Documents shall mean and include the following where applicable:
Documents listed in bold should be attached to this document upon submission.
• Request for Proposal (or procurement documentation)
• This Contract;
• Ordinances and resolutions heretofore adopted by the City Council having to do with this
Project;
• The Vendor's Proposal;
• Plans and Specifications;
• General Requirements as adopted by the City Council for the Project;
• Terms and Conditions (Exhibit A); and
• Insurance Schedule G for Vendors (Exhibit B) or Insurance Schedule J for
Professional Services (Exhibit C).
Check Appropriate Box
❑ Insurance Schedule G — Vendors
❑ Insurance Schedule J — Professional Services
• Other:
3. All materials used by the Vendor on this Project shall be of the quality required by the Contract
Documents and shall be put in place in accordance with the Contract Documents.
4. The Vendor shall remove any materials rejected by the City Manager as defective or improper,
or any of said work condemned as unsuitable or defective, and the same shall be replaced or
done anew to the satisfaction of the City Manager at the cost and expense of the Vendor.
5. The Vendor has read and understands the Contract Documents and has examined and
understands the project description described in Section 1 of this Agreement and any attached
Special Conditions herein referred to and agrees not to plead misunderstanding or deception
because of estimates of quantity, character, location or other conditions surrounding the same.
6. The Vendor shall fully complete the Project under this Contract on or before
11-20-2025
(DATE)
7. Indemnification; Liability for City Damage
A. To the fullest extent permitted by law, the Contractor shall indemnify and hold harmless the
City from and against all claims, damages, losses and expenses, including but not limited to
attorneys' fees, arising out of or resulting from performance of the 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 (other than the Project itself) including loss of use resulting
therefrom, but only to the extent caused in whole or in part by negligent acts or omissions of
the Contractor, the Contractor's subcontractor, or anyone directly or indirectly employed by
the Contractor or the Contractor's subcontractor or anyone for whose acts the Contractor or
the Contractor's subcontractor may be liable, regardless of whether or not such claim,
damage, loss or expense is caused in part by a party indemnified hereunder.
Page 2 of 14
Page 238 of 750
B. The Contractor shall also be liable to the City for any damage to City property arising out of
or related to the Contractor's negligent performance of the Contract.
8. Prior to the commencement of any work on this Project and at all times during the performance
of this Contract, the Vendor shall provide evidence of insurance which meets the requirements
of the City's Insurance Schedule G or Insurance Schedule J attached to this Contract.
Check Appropriate Box
❑ Insurance Schedule G — Vendors
0 Insurance Schedule J — Professional Services
9. The Vendor agrees that no work under this Contract shall commence until the City has authorized
said work in writing. Any work started by the Vendor prior the City authorization shall be
considered unauthorized and done at the sole risk to the Vendor.
10. Vendor will comply with all federal, state, and local laws and regulations in the performance of
this Contract.
11. The City may terminate this Contract with or without cause upon fourteen (14) days' written notice
delivered to the Vendor.
12. This Contract shall be governed by the laws of the State of Iowa and exclusive jurisdiction and
venue for any action arising out of or related to this Contract shall be the Iowa District Court for
Dubuque County.
THE CITY AGREES:
Upon the completion of this Contract, and the acceptance of the Project by the City Manager,
the City agrees to pay the Vendor as full compensation for the complete performance of this Contract,
the amount stated below, less any agreed damages provided for in the Contract Documents.
CONTRACT AMOUNT $ $985.65
CITY OF DUBUQUE, IOWA
By: _Z�1AjII4 k�,
M chael C. Van Mi ligen
City Manager
VENDOR:
10/30/2025 Racom
Date Company Name
By: .A&f>�&a
Signature 61
Alec Metz
Printed Name
Service Manager
Title
Page 3 of 14
10/20/2025
Date
Page 239 of 750
VENDOR ACKNOWLEDGEMENT OF
ATTACHED SPECIAL CONDITIONS:
By: ,4&1" 2La
Signature
Alec Metz
Printed Name
Service Manager
Title
10/20/2025
Date
Page 4 of 14
Page 240 of 750
EXHIBIT A
TERMS AND CONDITIONS
The following Terms and Conditions apply to City of Dubuque Transactions:
1. The City of Dubuque is exempt from federal excise tax and Iowa sales tax.
2. The City of Dubuque will not be responsible for payment for any goods delivered without a
purchase order.
3. The vendor will send a separate invoice for each purchase order number. All invoices,
packages, shipping notices, or the like affecting the order shall contain the applicable
purchase order number. The vendor is to submit original invoice to the address shown in the
SHIP TO section on the front of this order.
4. No freight or packing charges will be allowed by the City of Dubuque unless specifically
authorized.
5. It is understood by the vendor that the cash discount period to the City of Dubuque will date
from the receipt of the invoice or from the date of the receipt of the goods, whichever is later.
6. The risk of loss of and damage to the goods which are the subject of this order, regardless of
the F.O.B. point, is and will remain with the vendor until the goods are delivered to the
destination set out in the order and accepted by the City of Dubuque or the authorized City of
Dubuque representative.
7. In the event of the vendor's failure to deliver as and when specified, or to perform as and
when specified, the City of Dubuque reserves the right to cancel this order, or any part thereof,
without prejudice to its other rights, and the vendor agrees that the City of Dubuque may return
part or all of any shipment so made and may charge the vendor with any loss expense
sustained as a result of such failure to deliver or to perform.
8. In the event any article, service, or process sold, delivered and/or performed hereunder is
covered by any patent, copyright, or application for either, the vendor will indemnify and save
harmless the City of Dubuque from any and all loss, cost, or expenses on account of any and
all claims, suits, or judgments on account of the use or sale of such article or the use of such
service or process in violation of such patent, copyright or application for either.
9. In the event any article, service, or process sold and delivered or sold and performed
hereunder is defective in any respect whatsoever, the vendor will indemnify and save
harmless the City of Dubuque from all loss or the payment of all sums of money by reason of
all accidents, injuries or damages to person or property that may happen or occur in
connection with the use or sale of such article, or process and are contributed to by said
defective condition.
Page 5 of 14
Page 241 of 750
10. The vendor agrees not to release any advertising copy mentioning the City of Dubuque or
quoting the opinion of any City of Dubuque employee without the prior written authorization
from the City of Dubuque.
11. The vendor represents and warrants that no federal or state statute or regulation, or local
municipal ordinance has been or will be violated in the manufacturing, sale and delivery
hereunder. If such violation has or does occur, the vendor will indemnify and save harmless
the City of Dubuque from all loss, penalties, or payment of all sums of money on account of
such violation.
12. The City of Dubuque may at any time insist upon strict compliance with these terms and
conditions notwithstanding any previous custom, practice, or course of dealing to the contrary.
13. The terms and conditions of sale as stated in this order govern in the event of conflict with any
terms of the vendor's proposal, and are not subject to change by reason of any written or
verbal statements by the vendor or by any terms stated in the vendor's acknowledgement
unless same be accepted in writing by the City of Dubuque.
14. Current Safety Data Sheets (SDS), when applicable to the order, must be provided by the
vendor in accordance with all regulations.
Page 6 of 14
Page 242 of 750
EXHIBIT B
INSURANCE SCHEDULE G
1. Vendor shall furnish a signed certificate of insurance to the City of Dubuque, Iowa for the coverage required in
Exhibit I prior to the contract commencement. Each certificate shall be prepared on the most current ACORD
form approved by the Iowa Insurance Division or an equivalent. Each certificate shall include a statement
under Description of Operations as to why the certificate was issued. Vendor Service Agreement dated
2. All policies of insurance required hereunder shall be with an insurer authorized to do business in Iowa and all
insurers shall have a rating of A or better in the current A.M. Best's Rating Guide.
3. Each certificate shall be furnished to the Finance Department of the City of Dubuque.
4. The service provider shall be required to carry the minimum coverage/limits, or greater if required by law or
other legal agreement, in Exhibit I. Failure to provide the required minimum coverage shall not be deemed a
waiver of such requirements by the City of Dubuque.
5. Failure to obtain or maintain the required insurance shall be considered a material breach of this agreement.
6. All required endorsements shall be attached to the certificate. The certificate is due before the
contract/agreement can be approved.
7. Whenever a specific ISO form is referenced the current edition of the form must be used unless an equivalent
form is approved by the Director of Finance and Budget. The service provider must identify or list in writing all
deviations and exclusions from the ISO form.
8. If vendor's limits of liability are higher than the required minimum limits then the vendor's limits shall be this
agreement's required limits.
9. Vendor shall require all subcontractors and sub -subcontractors to obtain and maintain during the performance
of work insurance for the coverages described in this Insurance Schedule and shall obtain certificates of
insurance from all such subcontractors and sub -subcontractors. Vendor agrees that it shall be liable for the
failure of a subcontractor and sub -subcontractor to obtain and maintain such coverage. The City may request a
copy of such certificates from the Vendor.
10. Vendor shall be responsible for deductibles/self-insured retention for payment of all policy premiums and other
costs associated with the insurance policies required below.
11. All certificates of insurance must include agents name, phone number, and email address.
12. The City of Dubuque reserves the right to require complete, certified copies of all required insurance policies,
including endorsements, required by this Schedule at any time.
13. The City of Dubuque reserves the right to modify these requirements, including limits, based on changes in the
risk or other special circumstances during the term of the agreement, subject to written mutual agreement
attached hereto.
Page 7 of 14
Page 243 of 750
INSURANCE SCHEDULE G (continued)
EXHIBIT I
A) COMMERCIAL GENERAL LIABILITY
General Aggregate Limit $2,000,000
Products -Completed Operations Aggregate Limit $1,000,000
Personal and Advertising Injury Limit $1,000,000
Each Occurrence $1,000,000
Fire Damage Limit (any one occurrence) $50,000
Medical Payments $5,000
1) Coverage shall be written on an occurrence, not claims made, form. The general liability
coverage shall be written in accord with ISO form CG 00 01 or business owners form BP 00
02. All deviations from the standard ISO commercial general liability form CG 00 01, or
Business owners form BP 00 02, shall be clearly identified.
2) Include ISO endorsement form CG 25 04 "Designated Location(s) General Aggregate Limit."
3) Include endorsement indicating that coverage is primary and non-contributory.
4) Include Preservation of Governmental Immunities Endorsement (Sample attached).
5) Include additional insured endorsement for:
The City of Dubuque, including all its elected and appointed officials, all its employees and
volunteers, all its boards, commissions and/or authorities and their board members,
employees and volunteers. Use ISO form CG 20 10 (Ongoing operations) or its
equivalent.
6) Policy shall include Waiver of Right to Recover from Others endorsement.
7) Policy shall include cancellation and material change endorsement providing 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 Finance Department, 50 West 13th Street Dubuque, Iowa 52001.
B) WORKERS' COMPENSATION & EMPLOYERS LIABILITY
Statutory Benefits covering all employees injured on the job by accident or disease as prescribed by
Iowa Code Chapter 85.
Coverage A Statutory —State of Iowa
Coverage B Employers Liability
Each Accident $100,000
Each Employee -Disease $100,000
Policy Limit -Disease $500,000
Policy shall include Waiver of Right to Recover from Others endorsement.
Coverage B limits shall be greater if required by the umbrella/excess insurer.
OR
If, by Iowa Code Section 85.1A, the Vendor is not required to purchase Workers' Compensation
Insurance, the Vendor shall have a copy of the State's Nonelection of Workers' Compensation or
Employers' Liability Coverage form on file with the Iowa Workers' Compensation Insurance
Commissioner, as required by Iowa Code Section 87.22. Completed form must be attached.
Page 8 of 14
Page 244 of 750
C)
D)
E)
F)
INSURANCE SCHEDULE G (continued)
POLLUTION LIABILITY
Coverage required: _Yes _ No
Pollution liability coverage shall be required if the lessee, contracting party, or permittee has any
pollution exposure for abatement of hazardous or contaminated materials including, but not limited to,
petroleum products, the removal of lead, asbestos, or PCBs. Pollution product and completed
operations coverage shall also be covered.
Each Occurrence $2,000,000
Policy Aggregate $4,000,000
1) Policy to include job site and transportation coverage.
2) Include additional insured for:
The City of Dubuque, including all its elected and appointed officials, all its employees and
volunteers, all its boards, commissions and/or authorities and their board members,
employees and volunteers. Use ISO form CG 20 10. (Ongoing operations) or its
equivalent and CG 20 37(competed operations).
3) Include Preservation of Governmental Immunities Endorsement.
4) Provide evidence of coverage for 5 years after completion of project.
5) Include endorsement indicating that coverage is primary and non-contributory.
6) Policy shall include waiver of right to recovery from others endorsement.
PROFESSIONAL LIABILITY $1,000,000
Coverage required: _Yes _ No
If the required policy provides claims -made coverage:
1) The Retroactive Date must be shown and must be before the date of the agreement.
2) Insurance must be maintained and evidence of insurance must be provided for at least five (5)
years after completion of the work or services.
3) If coverage is canceled or non -renewed and not replaced with another claims -made policy
form with a Retroactive Date prior to the date of the agreement, the contractor must provide
"extended reporting" coverage for a minimum of five (5) years after completion of the work or
services.
CYBER LIABILITY/BREACH $1,000,000
Coverage required: _Yes _ No
Coverage for First and Third Party breach liability including but not limited to lost data and restoration,
loss of income and cyber breach of information.
UMBRELLA/EXCESS
Coverage required:
Yes No
$1,000,000
The General Liability, Automobile Liability and Employer's Liability Insurance requirements may be
satisfied with a combination of primary and Umbrella or Excess Liability Insurance. If the Umbrella or
Excess Insurance policy does not follow the form of the primary policies, it shall include the same
endorsements as required of the primary policies including but not limited to Waiver of Subrogation
and Primary and Non-contributory in favor of the City.
Page 9 of 14
Page 245 of 750
Please be aware that naming the City of Dubuque as an additional insured as is required by this Insurance Schedule
may result in the waiver of the City's governmental immunities provided in Iowa Code sec. 670.4. If you would like to
preserve those immunities, please use this endorsement or an equivalent form.
PRESERVATION OF GOVERNMENTAL IMMUNITIES ENDORSEMENT
1. Nonwaiver of Governmental Immunity. The insurer expressly agrees and states that the purchase of this policy
and the including of the City of Dubuque, 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 insurer further agrees that this policy of insurance shall cover only those claims not
subject to the defense of governmental immunity under the Code of Iowa Section 670.4 as it now exists and as it may
be amended from time to time. Those claims not subject to Code of Iowa Section 670.4 shall be covered by the terms
and conditions of this insurance policy.
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 insurer.
4. Non -Denial of Coverage. The insurer shall not deny coverage under this policy and the insurer shall not deny
any of the rights and benefits accruing to the City of Dubuque, 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.
No Other Change in Policy. The above preservation of governmental immunities shall not otherwise change or alter the
coverage available under the policy.
SPECIMEN
(DEPARTMENT MANAGER: FILL IN ALL BLANKS AND CHECK BOXES)
Page 10 of 14
Page 246 of 750
EXHIBIT C
INSURANCE SCHEDULE J
shall furnish a signed certificate of insurance to the City of Dubuque, Iowa for the
coverage required in Exhibit I prior to commencing work and at the end of the project if the term of work is
longer than 60 days. Contractors presenting annual certificates shall present a certificate at the end of each
project with the final billing. Each certificate shall be prepared on the most current ACORD form approved by
the Iowa Department of Insurance or an equivalent approved by the Director of Finance and Budget. Each
certificate shall include a statement under Description of Operations as to why the certificate was issued. Eg:
Project # or Project Location at or construction of
2. All policies of insurance required hereunder shall be with an insurer authorized to do business in Iowa and all
insurers shall have a rating of A or better in the current A.M. Best's Rating Guide.
3. Each certificate shall be furnished to the Finance Department of the City of Dubuque.
4. Failure to provide coverage required by this Insurance Schedule shall not be deemed a waiver of these
requirements by the City of Dubuque. Failure to obtain or maintain the required insurance shall be considered
a material breach of this agreement.
5. Contractors shall require all subconsultants and sub-subconsultants to obtain and maintain during the
performance of work insurance for the coverages described in this Insurance Schedule and shall obtain
certificates of insurances from all such subconsultants and sub-subconsultants. Contractors agree that they
shall be liable for the failure of a subconsultant and sub-subconsultant to obtain and maintain such coverages.
The City may request a copy of such certificates from the Contractor.
6. All required endorsements shall be attached to the certificate. The certificate is due before the
contract/agreement can be approved.
7. Whenever a specific ISO form is listed, required the current edition of the form must be used, or an equivalent
form may be substituted if approved by the Director of Finance and Budget and subject to the contractor
identifying and listing in writing all deviations and exclusions from the ISO form.
8. Contractors shall be required to carry the minimum coverage/limits, or greater if required by law or other legal
agreement, in Exhibit I. If the contractor's limits of liability are higher than the required minimum limits then
the provider's limits shall be this agreement's required limits.
9. Contractor shall be responsible for deductibles and self -insured retention for payment of all policy premiums
and other cost associated with the insurance policies required below.
10. All certificates of insurance must include agents name, phone number, and email address.
11. The City of Dubuque reserves the right to require complete, certified copies of all required insurance policies,
including endorsements, required by this Schedule at any time.
12. The City of Dubuque reserves the right to modify these requirements, including limits, based on changes in the
risk or other special circumstances during the term of the agreement, subject to written mutual agreement
attached hereto.
Page 11 of 14
Page 247 of 750
INSURANCE SCHEDULE J (continued)
Exhibit I
A) COMMERCIAL GENERAL LIABILITY
General Aggregate Limit $2,000,000
Products -Completed Operations Aggregate Limit $1,000,000
Personal and Advertising Injury Limit $1,000,000
Each Occurrence $1,000,000
Fire Damage Limit (any one occurrence) $50,000
Medical Payments $5,000
1) Coverage shall be written on an occurrence, not claims made, form. The general liability
coverage shall be written in accord with ISO form CG 00 01 or business owners form BP 00
02. All deviations from the standard ISO commercial general liability form CG 00 01, or
business owners form BP 00 02, shall be clearly identified.
2) Include endorsement indicating that coverage is primary and non-contributory.
3) Include Preservation of Governmental Immunities Endorsement. (Sample attached).
4) Include additional insured endorsement for:
The City of Dubuque, including all its elected and appointed officials, all its employees and
volunteers, all its boards, commissions and/or authorities and their board members,
employees and volunteers. Use ISO form CG 20 26.
5) Policy shall include Waiver of Right to Recover from Others endorsement.
6) Policy shall include cancellation and material change endorsement providing 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 Finance Department, 50 West 13t" Street Dubuque, Iowa 52001.
B) AUTOMOBILE LIABILITY
Combined Single Limit $1,000,000
Coverage shall include all owned, non -owned, and hired vehicles. If the Contractor's business does
not own any vehicles, coverage is required on non -owned and hired vehicles.
1) Policy shall include Waiver of Right to Recover from Others endorsement.
C) WORKERS' COMPENSATION & EMPLOYERS LIABILITY
Statutory Benefits covering all employees injured on the job by accident or disease as prescribed by
Iowa Code Chapter 85.
Coverage A Statutory —State of Iowa
Coverage B Employers Liability
Each Accident $100,000
Each Employee -Disease $100,000
Policy Limit -Disease $500,000
Policy shall include Waiver of Right to Recover from Others endorsement.
Coverage B limits shall be greater if required by the umbrella/excess insurer
OR
Page 12 of 14
Page 248 of 750
If, by Iowa Code Section 85.1A, the Contractor is not required to purchase Workers' Compensation
Insurance, the Contractor shall have a copy of the State's Nonelection of Workers' Compensation or
Employers' Liability Coverage form on file with the Iowa Workers' Compensation Insurance
Commissioner, as required by Iowa Code Section 87.22. Completed form must be attached.
D) UMBRELLA/EXCESS LIABILITY $1,000,000
The General Liability, Automobile Liability and Employer's Liability Insurance requirements may be
satisfied with a combination of primary and Umbrella or Excess Liability Insurance. If the Umbrella or
Excess Insurance policy does not follow the form of the primary policies, it shall include the same
endorsements as required of the primary policies including but not limited to Waiver of Subrogation
and Primary and Non-contributory in favor of the City.
E) PROFESSIONAL LIABILITY $2,000,000
If the required policy provides claims -made coverage:
1) The Retroactive Date must be shown and must be before the date of the agreement.
2) Insurance must be maintained and evidence of insurance must be provided for at least five (5)
years after completion of the work or services.
3) If coverage is canceled or non -renewed and not replaced with another claims -made policy
form with a Retroactive Date prior to the date of the agreement, the contractor must provide
"extended reporting" coverage for a minimum of five (5) years after completion of the work or
services.
F) CYBER LIABILITY/BREACH $1,000,000
Yes _ No
Coverage for First and Third Party breach liability including but not limited to lost data and restoration,
loss of income and cyber breach of information.
Page 13 of 14
Page 249 of 750
Please be aware that naming the City of Dubuque as an additional insured as is required by this Insurance Schedule
may result in the waiver of the City's governmental immunities provided in Iowa Code sec. 670.4. If you would like to
preserve those immunities, please use this endorsement or an equivalent form.
PRESERVATION OF GOVERNMENTAL IMMUNITIES ENDORSEMENT
1. Nonwaiver of Governmental Immunity. The insurer expressly agrees and states that the purchase of this policy
and the including of the City of Dubuque, 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 insurer further agrees that this policy of insurance shall cover only those claims not
subject to the defense of governmental immunity under the Code of Iowa Section 670.4 as it now exists and as it may
be amended from time to time. Those claims not subject to Code of Iowa Section 670.4 shall be covered by the terms
and conditions of this insurance policy.
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 insurer.
4. Non -Denial of Coverage. The insurer shall not deny coverage under this policy and the insurer shall not deny
any of the rights and benefits accruing to the City of Dubuque, 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.
No Other Change in Policy. The above preservation of governmental immunities shall not otherwise change or alter the
coverage available under the policy.
SPECIMEN
(DEPARTMENT MANAGER: FILL IN ALL BLANKS AND CHECK BOXES)
Page 14 of 14
Page 250 of 750
SITE ACCESS AGREEMENT
BETEWEEN
THE CITY OF DUBUQUE, IOWA
AND
OUTFLY DEVELOPMENT LLC
This Agreement is made and entered into this 29tlday of October , 2025, by
and between the City of Dubuque, Iowa, an Iowa municipal corporation (City), and Outfly
Development, LLC, an Iowa limited liability corporation (Developer).
WHEREAS, City is the owner of the following real estate
Lot 3 of Dubuque Industrial Center South Third Addition in the City of Dubuque,
Iowa (Parcel A)
Lot 2 of Dubuque Industrial Center South Third Addition in the City of Dubuque,
Iowa (Parcel B), (the Property)
shown on Exhibit B-1 (the Plat) and Exhibit B-2 (the Proposed Site Plan), attached hereto,
which is being considered as a Development Project by City and Developer; and
WHEREAS, Developer and City have entered into a Development Agreement
dated October 6, 2025 to convey Property to Developer; and
WHEREAS, the Closing of the Development Agreement has not yet taken place;
and
WHEREAS, Developer desires access to the Site prior to Closing for purposes of
site analysis, excavation and grading; and
WHEREAS, the City desires to allow Developer access to the Site for such
purposes prior to the closing subject to the conditions set forth herein.
NOW, THEREFORE, IT IS AGREED BY AND BETWEEN THE PARTIES AS
FOLLOWS:
SECTION 1. ACCESS TO SITE. City hereby grants to Developer, its counsel,
accountants, agents and representatives full and continuing access to the Site and all
parts thereof, upon reasonable notice to City, and at Developer's sole expense, for site
analysis, excavation and installation of footings and such other work as City and
Developer shall agree in writing is appropriate.
SECTION 2. RESTORATION OF SITE. Developer acknowledges that any site
preparation or other work performed by Developer is at Developer's sole risk. Developer
agrees to timely pay and discharge all claims of any kind by its contractors, subcontractors
and suppliers with respect to any work performed on the Site, including but not limited to
10282025ba1
Page 251 of 750
claims for labor or material furnished in connection therewith, and to defend, indemnify
and hold harmless City from and against any and all such claims. In the event that the
City Council does not complete the transfer of Property for any reason at the May 1, 2026
Closing, (or as may be mutually extended by the parties), Developer shall, at the City's
option, restore the Site at Developer's sole expense but not later than August 1, 2026 (or
as may be mutually extended by the parties), and this Agreement shall then terminate.
For the purposes of this Agreement, the term "restore the Site" means removing any and
all structures that may have been constructed on the Site, replacing any removed
roadway structures, filling any holes on the Site to adjoining grade level and seeding the
Site. In the event Developer fails to restore the Site by such date, City will have the Site
restored and Developer shall reimburse City for all costs of restoration within thirty days
of receipt of a statement from City for such costs. This obligation shall survive the
termination of this Agreement.
SECTION 3. CONDITION OF THE SITE.
3.1 City makes no warranty or representation as to the condition of the Site. Developer
acknowledges that any work performed by Developer and/or its consultant(s) at the Site
is at its sole risk. Developer shall ensure that all work at the Site is done in accordance
with all applicable laws and permits and in a good worker -like manner. Developer and its
consultants shall daily leave the Site in a condition no less safe than before the work was
conducted. Developer and its consultant(s) are solely responsible for obtaining any and
all permits required for the work to be conducted at the Site. No hazardous chemicals
and wastes may be stored or disposed of on the Site and all such materials must be used
only as allowed by law. Developer shall be responsible for identifying any and all utilities
serving the Site prior to conducting invasive work on the Site.
3.2 City has provided Developer with certain information in its possession regarding
the environmental condition of the Site. Developer shall conduct work at the Site under
this Agreement, taking due precautions to prevent exacerbation or expansion of any
existing condition.
SECTION 4. SHARING OF INFORMATION. Developer shall provide City with copies of
any and all reports and documents resulting from the work conducted at the Site upon the
request of the City. In the event such information is confidential, it shall be managed by
the parties pursuant to a separate Confidentiality Agreement. Developer and/or its
consultant(s) shall notify the City immediately upon discovery of any hazardous or unsafe
condition at the Site.
SECTION 5. INDEMNIFICATION. Developer shall defend, indemnify and hold
harmless City, its officers, agents and employees from and against any claim and cost of
any kind, including without limitation, attorneys' fees and consulting fees, arising out any
work at the Site by or on behalf of Developer and its consultants. This obligation shall
survive the termination of this Agreement.
2
Page 252 of 750
SECTION 6. INSURANCE. Developer shall at all times while performing site analysis,
excavation and installation of footings and all other work pursuant to this Agreement
provide insurance as set forth in the attached Insurance Schedule.
CITY OF DUBUQUE, IOWA
/ p I �'
BY: _ — ��t,�l v w�, _ _
Mi ,hael C. Van Milligan
City Manager
OUTFLY DEVELOPMENTLLC
Michael Fulla
President
Page 253 of 750
EXHIBIT B-1
PLAT
Page 254 of 750
FINAL PLAT
DUBUQUE INDUSTRIAL CENTER SOUTH THIRD ADDITION IN THE CITY OF DUBUQUE, IOWA
EASEMENT NOTE: THE ACCESS, STORM WATER
DRAINAGE, STORM SEWER, AND SANITARY SEWER SETS ' 9'W 227.94' DAB
EASEMENTS ARE SHOWN AS PER DOC. 2014-1397 ° 9 w }11 OB IEIJ89.92 P 1 138.02' - cAS�Iy FRSTOVS \
NW CORNER LOT B t
YELLaw CAP /11](W 511,0�19
Ir145.l7 111]OG FIt308 10On?/,1�
R-1060A0'
CH-146.49 OB SB738''W 648.74' 648.42'
L T' Q p1�ON Q (Ol
i DRAINAT 1
STOM GE NTATERE pJOJOJf o 4.83A CRES°gyp 9.22A ACRES
EASEMENT �, r
/' ':+' Iqi CURVE DATA: C1 c> z
LOT 3 s 'L=36.00' R=64.00' o-3213'38' m�
6.72 ACRES < a y LOT A cr1oR0=No2'50'33"w, 35.53' a W
/ E > FOR PUBLIC ROW f
0,48 ACRES Ex 11 40• WIDE
VERENA COURT STORM
DRAINAGE
i �+" ` Big• L-53.45L=111.62' EASEMENT w�
�Y,1•t00. R-64.00' R-64.00' EX � 20, WIDE
\ B�O',j`c, ; PUBLIC
6-47'50'31" A=99'55'31" SANITARY
`pt SEWER EASEMENT CHORD-S3711'42"W CHORD=N68'55'07"W
51.91, 98.00, L=363.40' °o
9'34"W 254.12'- 1 R=1050;00'
NDiiTM GSA ( L\ P,U•E SN _ t42Y A-1949'4r
GRAPHIC SCALE ��9 �+7 .{ N131816 E C1 _ CHORD N89'08 30 E
( a 7 11255' 111 )2$ V� 36159'. �•f /ttme
I 0 120 240 �)$•(,b �l '��,� QO' P• ' ! -
1" = 120' i713••Zgf `. _ -1I 07 0� E 509.26.
DRAWING MAY HAVE BEEN REDUCED%\ 1?$ry79' _
rails SURVEY IS SUBJECT TO EASEMENTS, CeNrE-R C) 6.6�� N1316'16'E YLuow CAP p11 (1p° R�
RESERVATIONS, RESTRICTIONS AND ORO>S7 110.94' ptJW PARTM�S 4
RIGHTS -OF -WAY OF RECORD AND NOT OF RECORD. 1?$0�633 [ t J '01
LEGEND °t ''5 Tu
DESCRIPTION: LOT I AND LOT 2 PLAT BOUNDARY
DUBUQUE INDUSTRIAL CENTER - - — LOT LINE ,W,q 4w��uw
SOU
1H SECOND ADDITION IN —_ ' ' —_ • ' —PROPOSED EASEMENT LINE ! uxuv uws a do su>E
THE CITY OF DUBUQUE, IOWA — EASEMENT LINE
EX EXISTING J s CRAIG L s smsim ..
PROPRIETOR: CTY OF DUBUQUE h P.U.E. PUBLIC UTILITY EASEMENT " GEISFR `--
ROASTING SOLUTIONS, LLC FOUND 5/8" REBAR NTH RED '" =sLS 21403 Cam. ,/�p� • • 6x 1R_1�
SURVEYED FOR: CITY OF DUBUQUE PLASTIC CAP 21408. UNLESS NOTED $zi" • iy-- x�� _
DATE OF SURVEY: DECEMBER 16, 2015 p SET 5/8" REBAR WITH .,�.0"•�.... ,. umu,. xa rae xr uNxse lx+cwn oxtc n+x/n/ssu .rt rn-u xis
TOTAL AREA SURVEYED: 21.25 ACRES RED PLASTIC CAP N0. 21408 '9j+m�m 1.10 _. sxlns m� er ,xrs_ ax"r, x
vswswrmwrn�n�s =..
Lot 3 represents Parcel A
Lot 2 represents Parcel B
I
Page 255 of 750
EXHIBIT B-2
PROPOSED SITE PLAN
Page 256 of 750
Parcel A Parcel B
\ \\ //////����jyii��a�a�+� � �i� = -=_-_- �==r= t�s�„ass � � _ _ ---•� �-�,: � _
�75'
\A, rl( _
25' -- - - - - -- /
u rr r
\ �\ 11611�1� r 11111��4�If1
\\\ QII Illllr� WOO O 240
Psi\ -'\�1�1111`�II1t1 �t i Phase 1
Sti}1111411`�I�111 J -- 50,000
�nFrEk'I �
=1\�\`k& -� -� - -0 Phase 2 4W
\Q\�` \' `
)
_ _- ------------
X,\\"\ _ _CT-
IIIIIIIIIIIIIIIIIIL�1111 '
VERENA
Elb6nS 20' MDE
tc.1 ! BLK SANITARY SE VIER E.j$[
HODGE Company Customer Project: Phase 1, Phase 2 Date: 2l2005
HODGE
7465 Ch-fle Road
Dubuque, /A 52002 Location: Dubuque, IA Contact: Wiichael Fullan Revision: 0
7
Page 257 of 750
INSURANCE SCHEDULE A
Page 258 of 750
City of Dubuque Insurance Requirements for Lessees of City Property and Right of Way
Licensees or Permittees
INSURANCE SCHEDULE A
1. Walter Development, LLC shall furnish a signed certificate of insurance to the City of Dubuque,
Iowa for the coverage required in Exhibit I prior to the lease, license, or permit commencement.
All lessees of City property and right of way licensees or permittees shall submit an updated
certificate annually. Each certificate shall be prepared on the most current ACORD form approved
by the Iowa Insurance Division or an equivalent. Each certificate shall include a statement under
Description of Operations as to why the certificate was issued. Eg: Site Access Agreement dated
2. All policies of insurance required hereunder shall be with an insurer authorized to do business in
Iowa and all insurers shall have a rating of A or better in the current A. M. Best's Rating Guide.
3. Each certificate shall be furnished to the Finance Department of the City of Dubuque.
4. The lessee, licensee, or permittee shall be required to carry the minimum coverage/limits, or
greater if required by law or other legal agreement, in Exhibit I. Failure to provide the required
minimum coverage shall not be deemed a waiver of such requirements by the City of Dubuque.
5. Failure to obtain or maintain the required insurance shall be considered a material breach of the
lease, license, or permit.
6. All required endorsements shall be attached to certificate.
7. Whenever a specific ISO form is referenced the current edition of the form must be used unless
an equivalent form is approved by the Director of Finance and Budget. The lessee, licensee, or
permittee must identify and list in writing all deviations and exclusions from the ISO form.
8. If lessee's, licensee's, or permittee's limits of liability are higher than the required minimum limits
then the lessee's, licensee's, or permittee's limits shall be this agreement's required limits.
9. Lessee, licensee, or permittee shall require all subcontractors and sub -subcontractors to obtain
and maintain during the performance of work insurance for the coverages described in this
Insurance Schedule and shall obtain certificates of insurance from all such subcontractors and
sub -subcontractors. Lessee, licensee, or permittee agrees that it shall be liable for the failure of a
subcontractor and sub -subcontractor to obtain and maintain such coverage. The City may
request a copy of such certificates from the lessee, licensee, or permittee.
10. Lessee, license & permittees shall be responsible for deductibles and self -insured retention.
Page 1 of 4 Schedule A Lessees Of City Property; Right Of Way Licensees or Permittees May 2019
X
Page 259 of 750
City of Dubuque Insurance Requirements for Lessees of City Property and Right of Way
Licensees or Permittees
INSURANCE SCHEDULE A (Continued)
EXHIBIT I
A) COMMERCIAL GENERAL LIABILITY
General Aggregate Limit $2,000,000
Products -Completed Operations Aggregate Limit $1,000,000
Personal and Advertising Injury Limit $1,000,000
Each Occurrence $1,000,000
Fire Damage Limit (any one occurrence) $50,000
Medical Payments $5,000
1) Coverage shall be written on an occurrence, not claims made, form. The general
liability coverage shall be written in accord with ISO form CG 00 01 or business
owners form BP 00 02. All deviations from the standard ISO commercial general
liability form CG 0001, or Business owners form BP 00 02, shall be clearly
identified.
2) Include ISO endorsement form CG 25 04 "Designated Location(s) General
Aggregate Limit."
3) Include endorsement indicating that coverage is primary and non-contributory.
4) Include Preservation of Governmental Immunities Endorsement (Sample
attached).
5) Include additional insured endorsement for:
The City of Dubuque, including all its elected and appointed officials, all its
employees and volunteers, all its boards, commissions and/or authorities and
their board members, employees and volunteers. Use ISO form CG 20 10
(Ongoing operations) or its equivalent.
6) If lessee, licensee, or permittee utilizes Trikkes or Segways in the conduct of
business, include an endorsement reflecting that these vehicles are not excluded
from Commercial General Liability coverage.
7) Policy shall include Waiver of Right to Recover from Others Endorsement.
B) WORKERS' COMPENSATION & EMPLOYERS LIABILITY
Statutory Benefits covering all employees injured on the job by accident or disease as
prescribed by Iowa Code Chapter 85.
Coverage A Statutory —State of Iowa
Coverage B Employers Liability
Each Accident $100,000
Each Employee -Disease $100,000
Policy Limit -Disease $500,000
Policy shall include Waiver of Right to Recover from Others endorsement.
Coverage B limits shall be greater if required by the umbrella/excess insurer.
OR
Nonelection of Workers' Compensation or Employers' Liability Coverage under Iowa
Code sec. 87.22. Completed form must be attached.
Page 2 of 4 Schedule A Lessees Of City Property, Right Of Way Licensees or Permittees May 2019
10
Page 260 of 750
City of Dubuque Insurance Requirements for Lessees of City Property and Right of Way
Licensees or Permittees
INSURANCE SCHEDULE A (Continued)
C) POLLUTION LIABILITY
Coverage required: _yes X no
Pollution liability coverage shall be required if the lessee, contracting party, or permittee
has any pollution exposure for abatement of hazardous or contaminated materials
including, but not limited to, petroleum products, the removal of lead, asbestos, or PCBs.
Pollution product and completed operations coverage shall also be covered.
Each occurrence $2,000,000
Policy Aggregate $4,000,000
1) Policy to include job site and transportation coverage.
2) Include additional insured for:
The City of Dubuque, including all its elected and appointed officials, all its
employees and volunteers, all its boards, commissions and/or authorities and
their board members, employees and volunteers. Use ISO form CG 2010.
(Ongoing operations) or its equivalent and CG2037(completed operations) or
its equivalent.
3) Include Preservation of Governmental Immunities Endorsement.
4) Provide evidence of coverage for 5 years after completion of project.
D) PROPERTY INSURANCE REQUIRED BY LEASE, LICENSE, OR PERMIT
yes X no
Evidence of property coverage provided: _yes
Include the City of Dubuque as Lender Loss Payable.
E) RIGHT-OF-WAY WORK ONLY:
UMBRELLA/EXCESS $1,000,000
X yes no
Umbrella/excess liability coverage must be at least following form with the underlying
policies included herein.
F) FLOOD INSURNACE
yes X no
If Required Coverage $.
Page 3 of 4 Schedule A Lessees Of City Property, Right Of Way Licensees or Permittees May 2019
11
Page 261 of 750
City of Dubuque Insurance Requirements for Lessees of City Property and Right of Way
Licensees or Permittees
PRESERVATION OF GOVERNMENTAL IMMUNITIES ENDORSEMENT
1. Nonwaiver of Governmental Immunity. The insurer expressly agrees and states that the purchase
of this policy and the including of the City of Dubuque, 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 is now exists and as it may be amended from time to time.
2. Claims Coverage. The insurer further agrees that this policy of insurance shall cover only those
claims not subject to the defense of governmental immunity under the Code of Iowa Section 670.4 as it
now exists and as it may be amended from time to time. Those claims not subject to Code of Iowa
Section 670.4 shall be covered by the terms and conditions of this insurance policy.
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 insurer.
4. Non -Denial of Coverage. The insurer shall not deny coverage under this policy and the insurer
shall not deny any of the rights and benefits accruing to the City of Dubuque, 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.
No Other Change in Policy. The above preservation of governmental immunities shall not otherwise
change or alter the coverage available under the policy.
SPECIMEN
(DEPARTMENT MANAGER: FILL IN ALL BLANKS AND CHECK BOXES)
Page 4 of 4 Schedule A Lessees Of City Property, Right Of Way Licensees or Permittees May 2019
12
Page 262 of 750
RSM
RSM US LLP
STATEMENT OF WORK —FINANCE ORGANIZATIONAL ASSESSMENT AND DESIGN
This Statement of Work ("Statement of Work" or "SOW') dated October 22, 2025, ("SOW Effective Date")
is entered into by and between the City of Dubuque, an Iowa municipal corporation, with an office at 50
West 13th Street, Dubuque, IA 52001 ("Client," "you" or "your") and RSM US LLP, an Iowa limited liability
partnership ("RSM," "we," "us" or `bur") pursuant to the Master Services Agreement dated September 16,
2022, (the "Agreement') all of the terms of which are hereby incorporated herein by reference. RSM and
Client are each a "party" to this SOW and sometimes collectively referred to herein as the "parties." Any
capitalized terms used herein which are not otherwise defined in this SOW shall have the same meaning
as that given to them in the main body of the Agreement.
A. Services and Scope of Work
Our work will be to assist and advise you with this engagement. As stated below and for clarity, we will not,
nor does Client desire us to, perform any management functions, make management decisions, or
otherwise perform in a capacity equivalent to that of an employee or officer of Client.
Engagement Objectives
Client is seeking support from RSM to complete a review of the current -state organizational structure for
the finance department. The goal is to summarize areas of opportunities and structural recommendations
in alignment with leading practice, focused on an assessment of staffing and workload distribution.
• Rapid Assessment — Conduct a focused review to identify immediate gaps, process inefficiencies,
enterprise resource planning (ERP) implications, and short-term resourcing needs. Identify initial
process improvement wins and resourcing needs and support requirements including leveraging
current resources or third -party support.
• Design of Future -State Operating Model and Structure — Develop an optimal structure, clarify roles and
titles, and map required skills and capabilities.
• Transition and Implementation Planning — Create a phased plan to move from the current to the desired
future -state, promoting a minimal disruption and clear accountability. This approach will be informed by
benchmarking work already completed and tailored to support both immediate stabilization and long-
term effectiveness.
Scope
This engagement is focused on high-level responsibilities and roles for finance department at the Client. It
includes a review of the current -state organization and design a future -state organization including transition
plans to identify changes in staff duties, roles and responsibilities, structure and headcount implications.
Phase I of the engagement will include an initial planning period, during which the focus areas may be
refined based on emerging insights to ensure we are addressing the most critical and high -impact elements
of the Client operations. _
THE POWER OF BEING UNDERSTOOD
ASSURANCE I TAX I CONSULTING qr
RSM US LLP is the U.S. member firm of RSM International, a global network of independent assurance, tax and consulting firms.
Visit rsmus.com/aboutus for more information regarding RSM US LLP and RSM International.
LrPage 263 of 750
City of Dubuque
October 22, 2025
Page 2 of 8
The below table represents the key engagement activities and deliverables:
Phase I:
0 Identify stakeholders
0 Stakeholder list
Engagement
0 Develop stakeholder
0 Stakeholder engagement plan
Kickoff and
engagement/communication plan
0 Document request list
Planning
0 Develop engagement plan and
0 Design principles
meeting cadence
0 Engagement plan
• Develop and submit document
0 Interview guide and agenda
request
• Ongoing engagement management
(RAID, status updates, budget
tracking)
• Develop current -state interview
guide and associated
communications
• Provide the leadership, and
engagement team assistance in
planning and communication
Phase II: Rapid
0 Summarize resources, services
0 Department inventory and
Assessment
and gather internal job role
summary of resources/services
documentation
0 Current -state summary report
• Leverage completed benchmarking
draft/readout
data for headcount role
0 Assessment of strengths and
responsibilities and process
weaknesses
recommendations
0 Identification of immediate priorities
• Summarize initial gaps
and quick win recommendations for
• Workshop 1: identify immediate
process improvement
gaps, process inefficiencies and
short-term resourcing needs
• Summarize and prioritize
immediate process and resource
recommendations
• Workshop 2: Align on plan and
prioritize to close immediate gaps
• Review draft of current -state
summary report and
recommendations
Page 264 of 750
City of Dubuque
October 22, 2025
Page 3 of 8
Phase III: Analyze
• Draft job architecture
0 Service delivery structural options
and Future -State
• Assess strategic grouping
and cost implications
Conceptual
alternatives
0 Basic options for future -state
Design
0 Provide standard leading practice
organization revisions
recommendations on headcount
0 Span of control review
and skills gaps
0 Preliminary recommendations
• Draft alternative internal service
delivery models
• Provide recommendation for
internal service delivery model
• Review and align on service
delivery model
• Define high-level activities
responsibilities by role
• Provide options for proposed
organization structure and staffing
recommendations
• Review outcomes with leadership
• Select departments for detailed
design
Phase IV: Conduct
• Inventory organizational
0 Recommended future -state
Detailed Design
enhancements
organizational structure staffing
• Provide final recommendation for
recommendations
proposed org structure
0 Gap assessment of current roles,
• Finalize and prioritize
headcount and reporting
recommendations
relationships
• Clarify roles, responsibilities to the
0 Roles and responsibilities
job -level
0 Job descriptions
• Draft future -state job descriptions
0 Business process update
for net new roles
recommendations
• Provide recommendations for core
business process updates in
alignment to organizational
changes
• Review report and
recommendations
Page 265 of 750
City of Dubuque
October 22, 2025
Page 4 of 8
Phase V:
0 Develop risk mitigation/change
0 Implementation roadmap
Transition and
management plan
0 Final written report (findings,
Talent Planning
0 Identify preliminary change
conclusions and recommendations)
management risks and barriers
for organizational structure and
• Develop roadmap with sequence
business process
and method of rolling out changes
0 Communication plan
• Enhance roadmap with resource,
cost, dependency and milestone
factors
• Revise communication plan
• Prepare written final report
summarizing business process
review and organization review
inclusive of findings, conclusions,
and recommendations for each
department
• Present final report to leadership
The Services performed hereunder will not constitute an audit, review, or compilation of Client's financial
statements or any part thereof, nor the external examination of management's assertions concerning the
effectiveness of Client's internal control systems or an examination of compliance with laws, regulations, or
other matters. Accordingly, our performance of Services hereunder will not result in the expression of an
opinion or any other form of assurance on Client's financial statements or any part thereof, nor an external
opinion or any other form of assurance of Client's internal control systems or its compliance with laws,
regulations, or other matters.
During engagement planning, we will establish mutually agreeable milestone dates for critical engagement
steps, most notably, the date of scheduled interviews, walk-throughs and fieldwork, and the date by which
Client must submit requested documentation.
Both parties agree to fulfill their responsibilities in meeting the milestone dates. Our engagement resources
and timelines are dependent on meeting these dates.
Unless otherwise expressly set forth herein, changes to the scope, timing, and/or cost of the Services set
forth in this Statement of Work will be subject to a mutually agreed upon Change Order executed by both
parties or, if more appropriate in the reasonable judgment of RSM, a separate Statement of Work executed
by both parties.
Page 266 of 750
City of Dubuque
October 22, 2025
Page 5 of 8
Timing
The engagement will begin at the earliest mutually agreeable date and will take an estimated ten (10) weeks
to complete
B. Engagement Team
Marni Rozen will be responsible for overseeing the engagement and the delivery of the Services to you.
Hailey Knight will coordinate all fieldwork and engagement communications. Other personnel at the
necessary skill and experience levels may be called upon to assist in this engagement as appropriate.
While we will attempt to comply with your requests for certain individuals, we retain the right to assign and
reassign our personnel, as appropriate, to perform the Services.
You acknowledge and agree that in addition to our personnel we may use our affiliate(s) located within or
outside the United States to assist us with the provision of the Services, which will result in such affiliate(s)
having access to and/or receiving certain protected and/or confidential information of yours. RSM shall
ensure that each such affiliate adheres to substantively the same confidentiality and disclosure
requirements applicable to RSM pursuant to this Statement of Work and the Agreement.
C. Client Acceptance of Work
Upon your receipt of any of our work under this Statement of Work, you are responsible for reviewing and
accepting such work in a timely manner, but in no event more than ten (10) business days from the date of
your receipt of such work. In the event you discover a failure of any of our work to conform to the
specifications set forth herein ("Nonconformity"), you will notify us in writing within ten (10) business days
from your receipt of such work, identifying with reasonable specificity the nonconforming portions of the
work ("Nonconformity Notice"). To the extent caused by our errors or omissions, we will use commercially
reasonable efforts to correct the Nonconformities stated in the Nonconformity Notice at no additional cost
to you. In all other cases, we shall use commercially reasonable efforts to correct such Nonconformities on
a time -and -material basis at the rates agreed upon in this Statement of Work. After we make such
corrections to the nonconforming work and make such work available to you for review, you will have five
(5) business days to review and accept such work. If any Nonconformities remain, the process stated above
will be repeated unless the parties mutually agree otherwise at such time.
D. Engagement Assumptions and Client Acknowledgements, Responsibilities, and
Representations
Our Services, Fees, and work schedule are based upon the following assumptions, acknowledgements,
representations, and understandings with you:
• Client will determine the extent of services it wishes RSM to provide and will undertake the
responsibilities set forth in this Statement of Work.
• Client will designate an employee or employees within its senior management who will make or obtain
all management decisions with respect to this Statement of Work on a timely basis.
Page 267 of 750
City of Dubuque
October 22, 2025
Page 6 of 8
• Client will ensure that we have access to personnel, facilities, computer systems, applications,
equipment, and data, including Third -Party Products, as is deemed reasonably necessary to perform
the Services, and that all levels of your employees and contractors will cooperate fully and timely with
us. We will let you know where we believe we are not getting the appropriate cooperation or direction.
The success of this engagement is dependent upon full openness, communications, cooperation, and
timely direction.
• Client acknowledges, understands, and agrees that it has the ultimate responsibility for ensuring the
accuracy of the materials generated by RSM and, as such, it will carefully review all such materials.
RSM shall not be liable or accountable for (i) any action reasonably taken or omitted by it in good faith
in accordance with directions, instructions, or advice of, or (ii) pursuant to any document which it
reasonably believes to be genuine and to have been delivered or signed by Client or any person acting
on the Client's behalf, including Client's counsel, accountants, investment advisors, or other advisors
or representatives.
• Client acknowledges, understands, and agrees that Client solely is responsible for procuring any
software, hardware, equipment, or other products reasonably required to perform the Services set forth
in this SOW, including entering into any licensing, subscription, end -user licensing, or other agreements
permitting the parties' use of and access to such software, hardware, equipment, or other products in
connection with the Services set forth herein. All such software, hardware, equipment, and other
products provided by Client to RSM for the Services shall be the property of Client.
• Client is entitled to request a delay or rescheduling of the engagement up to four (4) weeks in advance
of the agreed -upon milestone dates.
• Should Client request to postpone milestone dates, or delay or reschedule the engagement, less than
four (4) weeks in advance, Client may be subject to a rescheduling fee.
• Client agrees that all assumptions set forth in this Statement of Work are accurate and agrees to provide
us with such further information we may need and which we can rely on to be accurate and complete.
We will be entitled to rely on all of your decisions and approvals, and we will not be obligated to evaluate,
advise on, confirm, or reject such decisions and approvals.
• Client will evaluate the adequacy and results of services and will let us know immediately of any
problems or issues you perceive in our personnel, services, or deliverables.
The fulfillment and confirmation of these responsibilities, acknowledgements, and representations are
critical to the success of this engagement. The successful delivery of our Services, and the Fees charged,
are also dependent on your timely and effective completion of your responsibilities, the accuracy and
completeness of the assumptions, and timely decisions and approvals by your management. You will be
responsible for any delays, additional costs, or other liabilities caused by or associated with any deficiencies
in the assumptions or in carrying out your responsibilities.
Page 268 of 750
City of Dubuque
October 22, 2025
Page 7 of 8
E. Additional Understandings Arising from the Performance of Attest Services by RSM to
Client or an Affiliate of Client Under a Separate Engagement Agreement
In connection with the performance of these Services, Client agrees to make all management decisions
and perform all management functions; designate an individual who possesses suitable skills, knowledge,
and/or experience, preferably within senior management, to oversee such Services; evaluate the adequacy
and results of the Services performed; accept responsibility for the results of the Services; and establish
and maintain internal controls, including monitoring ongoing activities. We will not perform any management
functions, make management decisions, or otherwise perform in a capacity equivalent to that of an
employee or officer of Client.
F. Fees and Expenses
Based on our initial understanding of the engagement scope, we are estimating one hundred seventy-five
(175) to two hundred (200) hours of engagement work. The total estimated billings for the Services
described in this Statement of Work will range from $48,125 to $55,000, plus Expenses along with any
applicable taxes.
In addition to our Fees, you will be invoiced for (i) out-of-pocket expenses incurred in connection with the
Services, including, as applicable, amounts attributable to travel and meals, and expenses incurred by
RSM's subcontractors in connection with the provision of the Services, and (ii) a charge of 5% of the Fees
for indirect administrative expenses, such as technology, research and library databases, communications,
photocopying, postage and clerical assistance, security, privacy, automation, risk mitigation, regulatory
compliance requirements, peer quality reviews and engagement management oversight, RSM's
development library, and research and development team engagement involvement (collectively,
"Expenses"), along with any applicable taxes.
Travel time will be billed at 50% of our standard hourly rates and is in addition to the estimated Fees.
The Fees quoted in this Statement of Work will remain valid for sixty (60) days from the date of issuance.
You acknowledge that this is our good faith estimate based upon our understanding of the engagement
assumptions and the facts and circumstances we are aware of at this time. If the basis of our estimates is
inaccurate, the Fees and Expenses may be different from those we each anticipate. If circumstances are
encountered that affect our ability to proceed according to the plan outlined above, such as, scope changes,
loss of key Client personnel, unavailable information, or unforeseen circumstances or circumstances
beyond our reasonable control, we will inform you promptly and seek your approval for any changes in
scope, timing, or Fees that may result from such circumstances.
G. Invoice Address
Invoices for our Services rendered pursuant to this Statement of Work will be sent to:
Jlarson@cityofdubuque.org
Page 269 of 750
City of Dubuque
October 22, 2025
Page 8 of 8
H. Acknowledgement and Acceptance
By the signatures of their duly authorized representatives below, RSM and Client, intending to be legally
bound, acknowledge that they have read and agree to all of the provisions of this Statement of Work
(including any exhibits and attachments expressly incorporated herein or attached hereto) as of the SOW
Effective Date. RSM and Client, and each signatory below, hereby represent that said signatory is a duly
authorized representative of such party and has the requisite power and authority to bind such entity to the
terms set forth in this Statement of Work.
AGREED TO AND ACKNOWLEDGED BY:
RSM US LLP City of Dubuque
By: -� Q.�i By: k�4
Name: Marni Rozen Name: Michael C. Van Milligen
Title: Principal Title: City Manager
Date: October 22, 2025 Date: October 31, 2025
Statement of Work —Technology 02-05-24
Options to return signed contract:
1. DocuSign
2. Email: CPCClientProcessing(@rsmus.com
3. Fax: 877 281 9587
4. Mail: RSM US LLP, Attn: Client Resource
Center, 201 First Street SE, Suite 800,
Cedar Rapids, IA 52401
Page 270 of 750
14ill
vDESIGN
1268 Locust Street
Dubuque, Iowa 52001
563design.com
Task Order No. 04
563 Design, PLLC (CONSULTANT)
Project Name: Finance Department - Move to 7800 Chavenelle Road
Pursuant to Master Services Agreement dated May 1, 2025
Task Information
Task Name: Finance Department - 7800 Chavenelle Road
Task Description: Provide Architectural, Mechanical, Plumbing and Electrical Services for Bidding Documents
and Construction Administration for Tenant Improvements (Finance Department) located in the North-West
corner of building adjacent to the City of Dubuque's IT Department.
Mechanical Consultant - Delta 3
Plumbing Consultant - Delta 3
Electrical Consultant - DRJ
Scope of Services
Bidding Documents
o Drawings and Specifications to include Architectural, Mechanical, Plumbing and Electrical
drawings showing the tenant improvements for the approximate 5,300 SF area located on the
North-West portion of the building and approximately 700 SF of office remodel within the
existing IT Department. Documents will include the following scope of work:
■ Newfinishes throughout Finance Department
■ New finishes in remodeled portions of the IT Department
■ New carpet throughout entire IT Department
■ New doors and access control in areas discussed on site (currently 3 doors)
■ Modify existing conference room into two offices
■ HVAC, Plumbing and Electrical work as required
• Create 4 new offices and 1 conference room within existing IT Department
■ Coordination with Owner provided consultants and activities
• Owner to provide Division 00 of project manual
o Improvements to meet current code requirements where applicable to scope of work.
o Design to meet ADA requirements where applicable to scope of work.
Bidding/ Permitting
o Distribute Bid Documents (with City's assistance)
o Pre -Bid Meeting, Answer Request for Interpretation from Bidders
o Review Substitution Requests, Issue Addenda
o Conduct Bid Opening (with City's assistance)
o Submit Bid Tabulation and Recommendation to Owner
Page 271 of 750
City of Dubuque, Master Service Agreement -Task Order #04
Finance Department move to 7800 Chavenelle Road
Page 12
Construction Administration to include:
o Four site visits by the Architect, and a total of four site visits by the Architect's
consultants, additional visits will be billed as an additional service.
o Participate in the pre -construction meeting.
o The Architect and Architect's consultants shall respond to Contractor's request for additional
information about the Bidding Documents.
o The Architect and Architect's consultants shall review shop drawings and submittals to
confirm conformance with the construction documents and specifications.
o The Architect and Architect's consultants will review and certify contractor's monthly
applications for payment.
o The Architect and Architect's consultants will provide a punch list of outstanding items and
shall provide follow-up of outstanding items.
Schedule
- Bidding Documents: 4-6 weeks
- Bidding/Quotes: 4-8 weeks
- Construction Administration: 8-12 weeks
Compensation
CLIENT shall compensate CONSULTANTfor Services under this Task Order as follows:
Thirty -Five thousand, five hundred dollars ($35,000.00)
CONSULTANT: 563 Design, PLLC
dyxlt"� 11A 4;___
Andrew McCready, Architect
President
Date: October 23, 2025
CLIENT: City of Dubuque, Iowa
Insert Name: Michael C. Van Milligen
Insert Title: City Manager
Date: October 31, 2025
Page 272 of 750
Dubuque
THE CITY OF
DUB TE, lI
,II►
1007-2012.2013
Masterpiece on the Mississippi 2017•2019
City of Dubuque
WRRC Department
795 Julien Dubuque Dr
(address)
Dubuque, IA 52003
Phone # 563.589.4176
CITY OF DUBUQUE, IOWA
SHORT FORM
VENDOR SERVICE AGREEMENT
THIS VENDOR SERVICE AGREEMENT (the Contract), between the City of
Dubuque, Iowa (City), by its City Manager, through authority conferred upon the City
Manager by its City Council and
Midwest Injection, Inc (Vendor) at
'Vendor Name)
1621 McCabe Lane, PO Box 141, Cascade, IA 52033
(Vendor Address - City and State)
PROJECT TITLE:
Terminal Street Lift Station Bypass Pumping
(Project)
For and in consideration of the mutual covenants herein contained, the parties hereto
agree as follows:
VENDOR AGREES:
1. To furnish all material and equipment and to perform all labor necessary for:
building road/access to centrate tank, removing and disposing of material in the
centrate tank.
The work described above shall be completed at the following location(s):
Water & Resource Recovery Center and hauling to final disposal site.
The Project shall be completed in strict accordance with the terms as described in this
Contract; in strict accordance with the requirements of the laws of the State of Iowa
Page 1 of 20
Page 273 of 750
and ordinances of the City of Dubuque, just as much as if the detailed statements
thereof were repeated herein.
2. Contract Documents shall mean and include the following WHERE APPLICABLE:
Documents listed in bold should be attached to this document upon submission.
• Request for Proposal (or procurement documentation)
• This Contract;
• Ordinances and resolutions heretofore adopted by the City Council having to
do with this Project;
• The Vendor's Proposal;
• Plans and Specifications;
• General Requirements as adopted by the City Council for the Project;
• Terms and Conditions (Exhibit A); and
• INSURANCE — Please include one applicable Insurance Schedule:
o Insurance Schedule F for General Artisan or Trade Contractors or
Subcontractors (Exhibit B)
o Insurance Schedule G for Vendors (Exhibit C)
o Insurance Schedule J for Professional Services (Exhibit D)
Check Appropriate Box
Z Insurance Schedule F — General Artisan or Trade Contractors or
Subcontractors
❑ Insurance Schedule G — Vendors
❑ Insurance Schedule J — Professional Services
• Other:
3. All materials used by the Vendor on this Project shall be of the quality required by the
Contract Documents and shall be put in place in accordance with the Contract
Documents.
4. The Vendor shall remove any materials rejected by the City Manager as defective or
improper, or any of said work condemned as unsuitable or defective, and the same
shall be replaced or done anew to the satisfaction of the City Manager at the cost and
expense of the Vendor.
5. The Vendor has read and understands the Contract Documents and has examined
and understands the project description described in Section 1 of this Agreement and
any attached Special Conditions herein referred to and agrees not to plead
misunderstanding or deception because of estimates of quantity, character, location
or other conditions surrounding the same.
6. The Vendor shall fully complete the Project under this Contract on or before
November 28, 2025 (date)
Page 2 of 20
Page 274 of 750
7. Indemnification; Liability for City Damage
A. To the fullest extent permitted by law, the Contractor shall indemnify and hold
harmless the City from and against all claims, damages, losses and expenses,
including but not limited to attorneys' fees, arising out of or resulting from
performance of the 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 (other than the Project itself) including loss of use resulting therefrom,
but only to the extent caused in whole or in part by negligent acts or omissions of
the Contractor, the Contractor's subcontractor, or anyone directly or indirectly
employed by the Contractor or the Contractor's subcontractor or anyone for whose
acts the Contractor or the Contractor's subcontractor may be liable, regardless of
whether or not such claim, damage, loss or expense is caused in part by a party
indemnified hereunder.
B. The Contractor shall also be liable to the City for any damage to City property
arising out of or related to the Contractor's negligent performance of the Contract.
8. Prior to the commencement of any work on this Project and at all times during the
performance of this Contract, the Vendor shall provide evidence of insurance which
meets the requirements of the City's Insurance Schedule as indicated above and
attached hereto.
9. The Vendor agrees that no work under this Contract shall commence until the City has
authorized said work in writing. Any work started by the Vendor prior the City
authorization shall be considered unauthorized and done at the sole risk to the
Vendor.
10. Vendor will comply with all federal, state, and local laws and regulations in the
performance of this Contract.
11. The City may terminate this Contract with or without cause upon fourteen (14) days'
written notice delivered to the Vendor.
12. This Contract shall be governed by the laws of the State of Iowa and exclusive
jurisdiction and venue for any action arising out of or related to this Contract shall be
the Iowa District Court for Dubuque County.
Page 3 of 20
Page 275 of 750
THE CITY AGREES:
The City agrees to pay the Vendor for the work actually performed under this
Contract, up to the amount stated below, less any agreed damages provided for in the
Contract Documents.
CONTRACT AMOUNT $ 96,327.00
CITY OF DUBUQUE, IOWA VENDOR:
l
By: o 11/03/2025 Midwest Injection, Inc.
!� �" y =�
Michael C. Van Milligen Date Company Name
City Manager
By: 10/30/2025
Signature Date
Jake McAllister
Printed Name
President
Title
Page 4 of 20
Page 276 of 750
UZUMt lie Attea�
AGRICULTURE • INDUSTRIAL SERVICES • MUNICIPAL WASTE
RESIDUALS TRANSPORTATION
LAGOON CLEANING • DIGESTERS • LAND APPLICATIONS
1621 McCABE LANE -CASCADE, IA 52033 563-852-7125.563-852-6005 fax • 563-599-4122
MAILING ADDRESS: PO BOX 141 • CASCADE, IA 52033
10/22/2025
RE: Centrate Tank Cleanout
Thank you for the opportunity to submit a quote
Scope of Services
Biosolids removal and land application services and the normal labor, equipment,
supplies, and supervision as it so relates to such items per the RFP specs & drawings.
Pricing
Midwest Injection proposes the following lump sum price for the scope of services:
$96,327.00
Bid Assumptions:
• Bid includes building rock pad.
• Bid does not include removing rock pad after job is complete.
Commencement of work can be scheduled upon receipt of an executed purchase
agreement.
This proposal is valid for 30 days from the date of this proposal. Mobilization is included.
We appreciate the opportunity to submit this quote for your project and look forward to
working with you. Attached is our company biography, references, and qualifications.
You can also visit with us at www.midwestineection.com and like us on Facebook.
Sincerely,
Ja Ilister, CEO
Midwest Injection, Inc.
Page 277 of 750
Deron Muehring
From: Jamie Recker <Jamie@midwestinjection.com>
Sent: Thursday, October 30, 2025 8:45 AM
To: Deron Muehring
Cc: Adam Leeser
Subject: RE: Centrate Tank Cleaning
Caution! This message was sent from outside your organization. Never give your login
information and password over email!
Deron,
Our cost on building the access to the tank is $19,333
Our cost on removing & disposing of the material in the tank is $68,711
Let me know if you need anything else.
Thanks,
Jamie
From: Deron Muehring <Dmuehrin@cityofdubuque.org>
Sent: Wednesday, October 29, 2025 11:47 AM
To: Jamie Recker <Jamie@midwestinjection.com>
Cc: Adam Leeser <Aleeser@cityofdubuque.org>
Subject: RE: Centrate Tank Cleaning
Jamie,
Block sender I Report
Thanks for the quote. Can you break down for me the work/cost associated with building access to
tank and then the work/cost of removing and disposing of the material in the tank?
Thanks.
Deron
THE CF
D!Uj-
B E
Masterpiece on the Mississippi
Deron Muehring (he/him/his)
Water & Resource Recovery Center Director
City of Dubuque
795 Julien Dubuque Drive
Dubuque, Iowa 52003
O: 563.589.4177 1 dmuehrin(cD.cityofdubugue.org
6=OZnZoIY1�
From: Jamie Recker <Jamie@midwestiniection.com>
Sent: Wednesday, October 22, 2025 9:12 AM
Page 278 of 750
To: Deron Muehring <Dmuehrin@citVofdubugue.org>
Subject: Centrate Tank Cleaning
Good Morning Deron,
Please find attached our bid for cleaning the centrate tanks.
Thank You,
Jamie Recker
Midwest Injection
319.481.7681
1621 McCabe Lane
Cascade, IA 52033
midwestinjection.com
Page 279 of 750
EXHIBIT A
TERMS AND CONDITIONS
The following Terms and Conditions apply to City of Dubuque Transactions:
1. The City of Dubuque is exempt from federal excise tax and Iowa sales tax.
2. The City of Dubuque will not be responsible for payment for any goods delivered
without a purchase order.
3. The vendor will send a separate invoice for each purchase order number. All
invoices, packages, shipping notices, or the like affecting the order shall contain
the applicable purchase order number. The vendor is to submit original invoice to
the address shown in the SHIP TO section on the front of this order.
4. No freight or packing charges will be allowed by the City of Dubuque unless
specifically authorized.
5. It is understood by the vendor that the cash discount period to the City of Dubuque
will date from the receipt of the invoice or from the date of the receipt of the goods,
whichever is later.
6. The risk of loss of and damage to the goods which are the subject of this order,
regardless of the F.O.B. point, is and will remain with the vendor until the goods
are delivered to the destination set out in the order and accepted by the City of
Dubuque or the authorized City of Dubuque representative.
7. In the event of the vendor's failure to deliver as and when specified, or to perform
as and when specified, the City of Dubuque reserves the right to cancel this order,
or any part thereof, without prejudice to its other rights, and the vendor agrees that
the City of Dubuque may return part or all of any shipment so made and may
charge the vendor with any loss expense sustained as a result of such failure to
deliver or to perform.
8. In the event any article, service, or process sold, delivered and/or performed
hereunder is covered by any patent, copyright, or application for either, the vendor
will indemnify and save harmless the City of Dubuque from any and all loss, cost,
or expenses on account of any and all claims, suits, or judgments on account of
the use or sale of such article or the use of such service or process in violation of
such patent, copyright or application for either.
9. In the event any article, service, or process sold and delivered or sold and
performed hereunder is defective in any respect whatsoever, the vendor will
indemnify and save harmless the City of Dubuque from all loss or the payment of
all sums of money by reason of all accidents, injuries or damages to person or
property that may happen or occur in connection with the use or sale of such
article, or process and are contributed to by said defective condition.
Page 5 of 20
Page 280 of 750
10.The vendor agrees not to release any advertising copy mentioning the City of
Dubuque or quoting the opinion of any City of Dubuque employee without the prior
written authorization from the City of Dubuque.
11.The vendor represents and warrants that no federal or state statute or regulation,
or local municipal ordinance has been or will be violated in the manufacturing, sale
and delivery hereunder. If such violation has or does occur, the vendor will
indemnify and save harmless the City of Dubuque from all loss, penalties, or
payment of all sums of money on account of such violation.
12. The City of Dubuque may at any time insist upon strict compliance with these terms
and conditions notwithstanding any previous custom, practice, or course of dealing
to the contrary.
13. The terms and conditions of sale as stated in this order govern in the event of
conflict with any terms of the vendor's proposal, and are not subject to change by
reason of any written or verbal statements by the vendor or by any terms stated in
the vendor's acknowledgement unless same be accepted in writing by the City of
Dubuque.
14. Current Safety Data Sheets (SDS), when applicable to the order, must be provided
by the vendor in accordance with all regulations.
Page 6 of 20
Page 281 of 750
Class A:
Class B:
Class C:
EXHIBIT B
INSURANCE SCHEDULE F
Asbestos Removal
Fiber Optics
Sanitary Sewers
Asphalt Paving
Fire Protection
Sheet Metal
Concrete
Fireproofing
Site Utilities
Construction Managers
General Contractors
Shoring
Cranes
HVAC
Special construction
Culverts
Mechanical
Steel
Decking
Paving & Surfacing
Storm sewers
Demolition
Piles & Caissons
Structural Steel
Deconstruction
Plumbing
Trails
Earthwork
Retaining Walls
Tunneling
Electrical
Reinforcement
Water main
Elevators
Roofing
Chemical Spraying
Landscaping
Rough Carpentry
Doors, Window &
Masonry
Stump Grinding
Glazing
Vehicular Snow Removal
Tank Coating
Drywall Systems
Painting & Wall Covering
Tree Removal
Fertilizer Application
Pest Control
Tree Trimming
Geotech Boring
Scaffolding
Tuckpointing
Insulation
Sidewalks
Waterproofing
Finish Carpentry
Plastering
Well Drilling
Carpet Cleaning
Carpet & Resilient
Flooring
Caulking & Sealants
Acoustical Ceiling
Filter Cleaning
General Cleaning
Grass Cutting
Janitorial
Non Vehicular Snow &
Ice Removal
Office Furnishings
Power Washing
Tile & Terrazzo Flooring
Window Washing
Page 7 of 20
Page 282 of 750
INSURANCE SCHEDULE F (continued)
Contractor shall furnish a signed certificate of insurance to the department responsible for the contract for the
coverage required in Exhibit I prior to commencing work and at the end of the project if the term of work is longer
than 60 days. Contractors presenting annual certificates shall present a certificate at the end of each project with
the final billing. Each certificate shall be prepared on the most current ACORD form approved by the Iowa
Department of Insurance or an equivalent approved by the Director of Finance and Budget or Designee. The
certificate must clearly indicate the project number, project name, or project description for which it is being
provided Eg: Project # Project name: or Project Location at
795 Julien Dubuque Dr or construction of
2. All policies of insurance required hereunder shall be with an insurer authorized to do business in Iowa and all
insurers shall have a rating of A or better in the current A.M. Best's Rating Guide.
3. Each Certificate required shall be furnished to the WRRC Department of the City of Dubuque.
4. Failure to provide the coverages described in this Insurance Schedule shall not be deemed a waiver of these
requirements by the City of Dubuque. Failure to obtain or maintain the required insurance shall be considered a
material breach of this contract.
5. Contractor shall require all subcontractors and sub -subcontractors to obtain and maintain during the performance
of work insurance for the coverages described in this Insurance Schedule and shall obtain certificates of
insurance from all such subcontractors and sub -subcontractors. Contractor agrees that it shall be liable for the
failure of a subcontractor and sub -subcontractor to obtain and maintain such coverage. The City may request a
copy of such certificates from the Contractor.
6. All required endorsements shall be attached to the certificate. The certificate is due before the contract/agreement
can be approved.
7. Whenever an ISO form is referenced the current edition must be provided.
8. Contractor shall be required to carry the minimum coverage/limit, or greater if required by law or other legal
agreement, in Exhibit I - Insurance Schedule F. If the contractor's limits of liability are higher than the required
minimum limit, then the contractor's limits shall be this agreement's required limits.
9. Contractor shall be responsible for deductibles and self -insured retention for payment of all policy premiums and
other cost associated with the insurance policies required below.
10. All certificates of insurance must include agents name, phone number, and email address.
11. The City of Dubuque reserves the right to require complete, certified copies of all required insurance policies,
including endorsements, required by this Schedule at any time.
12. The City of Dubuque reserves the right to modify these requirements, including limits, based on changes in the
risk or other special circumstances during the term of the contract, subject to written mutual agreement attached
hereto.
Page 8 of 20
Page 283 of 750
INSURANCE SCHEDULE F (continued)
EXHIBIT I
A) COMMERCIAL GENERAL LIABILITY
General Aggregate Limit $2,000,000
Products -Completed Operations Aggregate Limit $2,000,000
Personal and Advertising Injury Limit $1,000,000
Each Occurrence $1,000,000
Fire Damage Limit (any one occurrence) $50,000
Medical Payments $5,000
1) Coverage shall be written on an occurrence, not claims made, form. The general liability
coverage shall be written in accord with ISO form CG 00 01 or business owners form BP 00 02.
All deviations from the standard ISO commercial general liability form CG 00 01 or business
owners form BP 00 02 shall be clearly identified.
2) Include ISO endorsement form CG 25 04 "Designated Location(s) General Aggregate Limit" or
CG 25 03 "Designated Construction Project(s) General Aggregate Limit" as appropriate.
3) Include endorsement indicating that coverage is primary and non-contributory.
4) Include Preservation of Governmental Immunities Endorsement. (Sample attached).
5) Include additional insured endorsement for:
The City of Dubuque, including all its elected and appointed officials, all its employees,
agents, and volunteers, all its boards, commissions and/or authorities and their board
members, employees, agents, and volunteers. Use ISO form CG 20 10 (Ongoing operations).
6) The additional insured endorsement shall include completed operations under ISO form CG 20
37 during the project term and for a period of two years after the completion of the project.
7) Policy shall include Waiver of Right to Recover from Others endorsement.
8) Policy shall include cancellation and material change endorsement providing 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
Finance Department, 50 West 13th Street Dubuque, Iowa 52001.
9) Contractor and subcontractor shall not use any drone without the prior written approval of the City
of Dubuque. Any drone usage must comply with above liability limits and the additional insured
endorsement must name the City of Dubuque with respect to aircraft liability coverage.
B) WORKERS' COMPENSATION & EMPLOYERS LIABILITY
Statutory Benefits covering all employees injured on the job by accident or disease as prescribed by Iowa
Code Chapter 85.
Coverage A Statutory —State of Iowa
Coverage B Employers Liability
Each Accident $100,000
Each Employee -Disease $100,000
Policy Limit -Disease $500,000
Policy shall include Waiver of Right to Recover from Others endorsement.
Coverage B limits shall be greater if required by the umbrella/excess insurer.
OR
If, by Iowa Code Section 85.1A, the Contractor is not required to purchase Workers' Compensation
Insurance, the Contractor shall have a copy of the State's Nonelection of Workers' Compensation or
Employers' Liability Coverage form on file with the Iowa
Workers' Compensation Insurance Commissioner, as required by Iowa Code Section 87.22. Completed
form must be attached.
Page 9 of 20
Page 284 of 750
C) AUTOMOBILE LIABILITY
Combined Single Limit $1,000,000
Coverage shall include all owned, non -owned, and hired vehicles. If the Contractor's business does not
own any vehicles, coverage is required on non -owned and hired vehicles.
1) Policy shall include Waiver of Right to Recover from Others endorsement.
D) UMBRELLA/EXCESS LIABILITY
The General Liability, Automobile Liability and Employer's Liability Insurance requirements may be
satisfied with a combination of primary and Umbrella or Excess Liability Insurance. If the Umbrella or
Excess Insurance policy does not follow the form of the primary policies, it shall include the same
endorsements as required of the primary policies including but not limited to Waiver of Subrogation and
Primary and Non-contributory in favor of the City.
All Class A contractors with contract values in excess of $10,000,000 must have umbrella/excess liability
coverage of $10,000,000.
All Class A and Class B contractors with contract values between $500,000 and $10,000,000 must have
umbrella/excess liability coverage of $3,000,000.
All Class A and B contractors with contract values less than $500,000 must have umbrella/excess liability
coverage of $1,000,000.
All Class C contractors are not required to have umbrella/excess liability coverage.
All contractors performing earth work must have a minimum of $3,000,000 umbrella regardless of the
contract value.
E) POLLUTION LIABILITY
Coverage required: _ Yes X No
Pollution liability coverage shall be required if project involves any pollution exposure for hazardous or
contaminated materials including, but not limited to, the removal of lead, asbestos, or PCB's. Pollution
product and complete operations coverage shall also be covered.
Each Occurrence $2,000,000
Policy Aggregate $4,000,000
1) Policy to include job site and transportation coverage.
2) Include additional insured for:
The City of Dubuque, including all its elected and appointed officials, all its employees,
agents, and volunteers, all its boards, commissions and/or authorities and their board
members, employees and volunteers. Use ISO form CG 20 10. (Ongoing operations) or its
equivalent and CG 20 37 (completed operations) or its equivalent.
3) Include Preservation of Governmental Immunities Endorsement.
4) Provide evidence of coverage for 5 years after completion of project.
5) Include endorsement indicating that coverage is primary and non-contributory.
6) Policy shall include waiver of right to recovery from others endorsement.
7) Pollution liability shall include ISP endorsement CA 99 48. Pollution Liability -Broadened Coverage
for Covered Autos, or equivalent endorsement if the contractor has vehicles that transport fuel
onto the Owner's property.
F) RAILROAD PROTECTIVE LIABILITY
Coverage required: _ Yes X No
Page 10 of 20
Page 285 of 750
Any contract for construction or demolition work on or within fifty feet (50') from the edge of the tracks of a
railroad and affecting any railroad bridge, trestle, tracks, roadbeds, tunnel, underpass, or crossing, for
which an easement, license or indemnification of the railroad is required, shall require evidence of the
following additional coverages.
Railroad Protective Liability:
each occurrence (per limits required by Railroad)
policy aggregate (per limits required by Railroad)
AND
An endorsement to the Commercial General Liability policy equal to ISO CG 24 17 (Contractual Liability -
Railroads). A copy of this endorsement shall be attached to the certificate of insurance.
Page 11 of 20
Page 286 of 750
Iowa Code Chapter 670, Liability of Governmental Subdivisions, provides cities with certain immunities which may be
available to you. Naming the City of Dubuque as an additional insured on your insurance as is requested by this
Insurance Schedule may result in your waiver of those immunities. If you would like to preserve those immunities, please
use this endorsement or an equivalent form. The preservation of immunities is for your benefit.
PRESERVATION OF GOVERNMENTAL IMMUNITIES ENDORSEMENT
1. Nonwaiver of Governmental Immunity. The insurer expressly agrees and states that the purchase of this policy
and the including of the City of Dubuque, 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 Coveraae. The insurer further agrees that this policy of insurance shall cover only those claims not subject
to the defense of governmental immunity under the Code of Iowa Section 670.4 as it now exists and as it may be
amended from time to time. Those claims not subject to Code of Iowa Section 670.4 shall be covered by the terms and
conditions of this insurance policy.
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 insurer.
4. Non -Denial of Coverage. The insurer shall not deny coverage under this policy and the insurer shall not deny any
of the rights and benefits accruing to the City of Dubuque, 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.
No Other Change in Policy. The above preservation of governmental immunities shall not otherwise change or alter the
coverage available under the policy.
SPECIMEN
(DEPARTMENT MANAGER: FILL IN ALL BLANKS AND CHECK BOXES)
Page 12 of 20
Page 287 of 750
EXHIBIT C
INSURANCE SCHEDULE G
1. Vendor shall furnish a signed certificate of insurance to the City of Dubuque, Iowa for the coverage required in
Exhibi ORD form
Desc
This Page
2. All poli nd all
insure
3. Each cNOT APPLICABLE
4. The s
legal a
such requirements by the City of Dubuque.
or other
3iver of
5. Failure to obtain or maintain the required insurance shall be considered a material breach of this agreement.
6. All required endorsements shall be attached to the certificate. The certificate is due before the contract/agreement
can be approved.
7. Whenever a specific ISO form is referenced the current edition of the form must be used unless an equivalent
form is approved by the Director of Finance and Budget. The service provider must identify or list in writing all
deviations and exclusions from the ISO form.
8. If vendor's limits of liability are higher than the required minimum limits then the vendor's limits shall be this
agreement's required limits.
9. Vendor shall require all subcontractors and sub -subcontractors to obtain and maintain during the performance of
work insurance for the coverages described in this Insurance Schedule and shall obtain certificates of insurance
from all such subcontractors and sub -subcontractors. Vendor agrees that it shall be liable for the failure of a
subcontractor and sub -subcontractor to obtain and maintain such coverage. The City may request a copy of such
certificates from the Vendor.
10. Vendor shall be responsible for deductibles/self-insured retention for payment of all policy premiums and other
costs associated with the insurance policies required below.
11. All certificates of insurance must include agents name, phone number, and email address.
12. The City of Dubuque reserves the right to require complete, certified copies of all required insurance policies,
including endorsements, required by this Schedule at any time.
13. The City of Dubuque reserves the right to modify these requirements, including limits, based on changes in the
risk or other special circumstances during the term of the agreement, subject to written mutual agreement
attached hereto.
Page 13 of 20
Page 288 of 750
INSURANCE SCHEDULE G (continued)
EXHIBIT I
A) COMMERCIAL GENERAL LIABILITY
This Page
NOT APPLICABLEY,
0002.
less
nit."
3) Include endorsement indicating that coverage is primary and non-contributory.
4) Include Preservation of Governmental Immunities Endorsement (Sample attached).
5) Include additional insured endorsement for:
The City of Dubuque, including all its elected and appointed officials, all its employees and
volunteers, all its boards, commissions and/or authorities and their board members,
employees and volunteers. Use ISO form CG 20 10 (Ongoing operations) or its equivalent.
6) Policy shall include Waiver of Right to Recover from Others endorsement.
7) Policy shall include cancellation and material change endorsement providing 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
Finance Department, 50 West 13th Street Dubuque, Iowa 52001.
B) WORKERS' COMPENSATION & EMPLOYERS LIABILITY
Statutory Benefits covering all employees injured on the job by accident or disease as prescribed by Iowa
Code Chapter 85.
Coverage A Statutory —State of Iowa
Coverage B Employers Liability
Each Accident $100,000
Each Employee -Disease $100,000
Policy Limit -Disease $500,000
Policy shall include Waiver of Right to Recover from Others endorsement.
Coverage B limits shall be greater if required by the umbrella/excess insurer.
OR
If, by Iowa Code Section 85.1A, the Vendor is not required to purchase Workers' Compensation
Insurance, the Vendor shall have a copy of the State's Nonelection of Workers' Compensation or
Employers' Liability Coverage form on file with the Iowa Workers' Compensation Insurance
Commissioner, as required by Iowa Code Section 87.22. Completed form must be attached.
Page 14 of 20
Page 289 of 750
INSURANCE SCHEDULE G (continued)
C)
91
E)
F)
POLLUTION LIABILITY
Coverage required
Yes X No
This Page
NOT APPLICABLE
pollution
oleum
and
employees and volunteers. Use ISO form CG 20 10. (Ongoing operations) or its equivalent
and CG 20 37(competed operations).
3) Include Preservation of Governmental Immunities Endorsement.
4) Provide evidence of coverage for 5 years after completion of project.
5) Include endorsement indicating that coverage is primary and non-contributory.
6) Policy shall include waiver of right to recovery from others endorsement.
PROFESSIONAL LIABILITY $1,000,000
Coverage required: _ Yes _ No
If the required policy provides claims -made coverage
1) The Retroactive Date must be shown and must be before the date of the agreement.
2) Insurance must be maintained and evidence of insurance must be provided for at least five (5)
years after completion of the work or services.
3) If coverage is canceled or non -renewed and not replaced with another claims -made policy form
with a Retroactive Date prior to the date of the agreement, the contractor must provide "extended
reporting" coverage for a minimum of five (5) years after completion of the work or services.
CYBER LIABILITY/BREACH $1,000,000
Coverage required: _ Yes X No
Coverage for First and Third Party breach liability including but not limited to lost data and restoration,
loss of income and cyber breach of information.
UMBRELLA/EXCESS $1,000,000
Coverage required: _ Yes _ No
The General Liability, Automobile Liability and Employer's Liability Insurance requirements may be
satisfied with a combination of primary and Umbrella or Excess Liability Insurance. If the Umbrella or
Excess Insurance policy does not follow the form of the primary policies, it shall include the same
endorsements as required of the primary policies including but not limited to Waiver of Subrogation and
Primary and Non-contributory in favor of the City.
Page 15 of 20
Page 290 of 750
Iowa Code Chapter 670, Liability of Governmental Subdivisions, provides cities with certain immunities which may be
available to you. Naming the City of Dubuque as an additional insured on your insurance as is requested by this
Insurance Schedule may result in your waiver of those immunities. If you would like to preserve those immunities, please
use this endorsement or an equivalent form. The preservation of immunities is for your benefit.
1. Nonw This Page s policy
and the includi
governmental i is and as it
may be amen
2. ClaimsNOT APPLICABLEnot subject
to the defense le
amended from ms and
conditions of t
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 insurer.
4. Non -Denial of Coverage. The insurer shall not deny coverage under this policy and the insurer shall not deny any
of the rights and benefits accruing to the City of Dubuque, 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.
No Other Change in Policy. The above preservation of governmental immunities shall not otherwise change or alter the
coverage available under the policy.
SPECIMEN
(DEPARTMENT MANAGER: FILL IN ALL BLANKS AND CHECK BOXES)
Page 16 of 20
Page 291 of 750
EXHIBIT D
INSURANCE SCHEDULE J
requirE than 60
days. th the final
billing. This Page artmentof
Insurai ide a
statern or Project
Locati
2. All pollNOT APPLICABLE-nd all
insure
3. Each
4. Failure to provide coverage required by this Insurance Schedule shall not be deemed a waiver of these
requirements by the City of Dubuque. Failure to obtain or maintain the required insurance shall be considered a
material breach of this agreement.
5. Contractors shall require all subconsultants and sub-subconsultants to obtain and maintain during the
performance of work insurance for the coverages described in this Insurance Schedule and shall obtain
certificates of insurances from all such subconsultants and sub-subconsultants. Contractors agree that they shall
be liable for the failure of a subconsultant and sub-subconsultant to obtain and maintain such coverages. The City
may request a copy of such certificates from the Contractor.
6. All required endorsements shall be attached to the certificate. The certificate is due before the contract/agreement
can be approved.
7. Whenever a specific ISO form is listed, required the current edition of the form must be used, or an equivalent
form may be substituted if approved by the Director of Finance and Budget and subject to the contractor
identifying and listing in writing all deviations and exclusions from the ISO form.
8. Contractors shall be required to carry the minimum coverage/limits, or greater if required by law or other legal
agreement, in Exhibit I. If the contractor's limits of liability are higher than the required minimum limits then the
provider's limits shall be this agreement's required limits.
9. Contractor shall be responsible for deductibles and self -insured retention for payment of all policy premiums and
other cost associated with the insurance policies required below.
10. All certificates of insurance must include agents name, phone number, and email address.
11. The City of Dubuque reserves the right to require complete, certified copies of all required insurance policies,
including endorsements, required by this Schedule at any time.
12. The City of Dubuque reserves the right to modify these requirements, including limits, based on changes in the
risk or other special circumstances during the term of the agreement, subject to written mutual agreement
attached hereto.
Page 17 of 20
Page 292 of 750
INSURANCE SCHEDULE J (continued)
Exhibit I
A) COMMERCIAL GENERAL LIABILITY
This Page
NOT APPLICABLElt�Y0002.
4) Include additional insured endorsement for:
The City of Dubuque, including all its elected and appointed officials, all its employees and
volunteers, all its boards, commissions and/or authorities and their board members, employees
and volunteers. Use ISO form CG 20 26.
5) Policy shall include Waiver of Right to Recover from Others endorsement.
6) Policy shall include cancellation and material change endorsement providing 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
Finance Department, 50 West 1311 Street Dubuque, Iowa 52001.
B) AUTOMOBILE LIABILITY
Combined Single Limit $1,000,000
Coverage shall include all owned, non -owned, and hired vehicles. If the Contractor's business does not
own any vehicles, coverage is required on non -owned and hired vehicles.
2) Policy shall include Waiver of Right to Recover from Others endorsement.
C) WORKERS' COMPENSATION & EMPLOYERS LIABILITY
Statutory Benefits covering all employees injured on the job by accident or disease as prescribed by Iowa
Code Chapter 85.
Coverage A Statutory —State of Iowa
Coverage B Employers Liability
Each Accident $100,000
Each Employee -Disease $100,000
Policy Limit -Disease $500,000
Policy shall include Waiver of Right to Recover from Others endorsement.
Coverage B limits shall be greater if required by the umbrella/excess insurer.
OR
If, by Iowa Code Section 85.1A, the Contractor is not required to purchase Workers' Compensation
Insurance, the Contractor shall have a copy of the State's Nonelection of Workers' Compensation or
Employers' Liability Coverage form on file with the Iowa Workers' Compensation Insurance
Commissioner, as required by Iowa Code Section 87.22. Completed form must be attached.
Page 18 of 20
Page 293 of 750
D) UMBRELLA/EXCESS LIABILITY $1,000,000
The General Liability, Automobile Liability and Employer's Liability Insurance requirements may be
satisfied with a combination of primary and Umbrella or Excess Liabilitv Insurance. If the Umbrella or
txcess insurance policy goes not toiiow the Corm of the primary policies, it shall include the same
E)
n and
e (5)
iform
dended
reporting" coverage for a minimum of five (5) years after completion of the work or services.
F) CYBER LIABILITY/BREACH $1,000,000
Yes X No
Coverage for First and Third Party breach liability including but not limited to lost data and restoration,
loss of income and cyber breach of information.
tic
This Page
NOT APPLICABLE„
Page 19 of 20
Page 294 of 750
Iowa Code Chapter 670, Liability of Governmental Subdivisions, provides cities with certain immunities which may be
available to you. Naming the City of Dubuque as an additional insured on your insurance as is requested by this
Insurance Schedule may result in your waiver of those immunities. If you would like to preserve those immunities, please
use this endorsement or an equivalent form. The preservation of immunities is for your benefit.
PRESERVATION OF GOVERNMENTAL IMMUNITIES ENDORSEMENT
1. NonwE
s policy
and the includi
This Page
governmental i
is and as it
may be amen
2. Claims
not subject
to the defenseAPPLICABLE)e
amended from
ms and
conditions of t
3. Assert efense of
governmental immunity and may do so at any time and shall do so upon the timely written request of the insurer.
4. Non -Denial of Coverage. The insurer shall not deny coverage under this policy and the insurer shall not deny any
of the rights and benefits accruing to the City of Dubuque, 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.
No Other Change in Policy. The above preservation of governmental immunities shall not otherwise change or alter the
coverage available under the policy.
SPECIMEN
(DEPARTMENT MANAGER: FILL IN ALL BLANKS AND CHECK BOXES)
Page 20 of 20
Page 295 of 750
Dubuque
THE CITY OF
�►II�InaO
DUBLIQUE
2007 2012.2013
Masterpiece on the Misslss1PP1 2017*2019
City of Dubuque
Engineering Department
50 W 13th Street
(address)
Dubuque, IA 52001
Phone # 563-589-4270
CITY OF DUBUQUE, IOWA
SHORT FORM
PUBLIC IMPROVEMENT CONTRACT
PROJECTS ESTIMATED AT LESS THAN $100,000.00
Check Appropriate Box
❑ Estimate under $25,000.00
❑ Estimate between $25,000.00 and $99,999.99
THIS PUBLIC IMPROVEMENT CONTRACT (the Contract), between the City of Dubuque, Iowa
(City), by its City Manager, through authority conferred upon the City Manager by its City Council and
Top Grade Excavating
(Contractor Name)
(Contractor's Address - City and State)
PROJECT TITLE: Catfish Creek Sanitary Utility Easement Stream Crossings Restoration
(Contractor) at
(Project)
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 restoration of vehicular stream crossings located withing sanitary sewer easement areas along Catfish Creek Middle Fork.
Contract shall include all costs of contractor staff, equipment, and materials, including furnishing and installing erosion stone
as needed estimated at $20/ton.
The work described above shall be completed at the following location(s):
Sanitary sewer easements located along Catfish Creek Middle Fork
The Project shall be constructed to the meet the requirements as described in this Contract; in
strict accordance with the requirements of the laws of the State of Iowa and ordinances of the
City of Dubuque, just as much as if the detailed statements thereof were repeated herein.
2. Contract Documents shall mean and include the following where applicable:
Page 296 of 750
Documents listed in bold should be attached to this document upon submission.
• Request for Bid or procurement documentation;
• This Contract;
• All ordinances and resolutions heretofore adopted by the City Council having to do with the
Project;
• The Contractor's Bid or procurement documentation;
• Consent Decree Certification Form, if applicable (Exhibit A);
• Bond Form, if applicable (Exhibit B);
• Plans and Specifications;
• SUDAS Standard Specifications (Current Edition) including but not limited to Division 1:
General Provisions and Covenants and the City of Dubuque Supplemental Specifications -
Division 1 (Current Edition);
• General Requirements as adopted by the City Council for the Project;
• Insurance Schedule F (Exhibit C); and
• Other
Is the project over $25,000.00?
❑ Yes El No
If yes, Bond Form is required, see Exhibit B.
3. All materials used by the Contractor in the Project shall be the best of their several kinds and
shall be put in place to the satisfaction of the City Manager.
4. The Contractor shall remove any materials rejected by the City Manager as defective or
improper, or any of said work condemned as unsuitable or defective, and the same shall be
replaced or done anew to the satisfaction of the City Manager at the cost and expense of the
Contractor.
5. Three (3%) of the Contract price may be retained by the City for a period of thirty (30) days after
final completion and acceptance of the Project by the City Manager to pay any claim that may
be filed within said time -for -labor and -materials done and furnished -in -connection with the
performance of this Contract and for a longer period if such claims are not adjusted within that
time, as provided in Iowa Code Chapter 573. The City shall also retain additional sums to protect
itself against any claim that has been filed against it for damages to persons or property arising
through the prosecution of the work and such sums shall be held by the City until such claims
have been settled, adjudicated or otherwise disposed of.
6. The Contractor has read and understands the Contract and the project description described in
Section 1 and the Contract Documents outlined in Section 2 and agrees not to plead
misunderstanding or deception.
7. The Contractor shall guarantee for a period of two years and make good any other defect in any
part of the Project due to improper construction or material performance notwithstanding the fact
that said Project may have been accepted and fully paid for by the City. The guarantee shall
commence on the date that the City pays full compensation for the complete performance of this
contract.
Page 297 of 750
8. The Contractor shall fully complete the Project under this Contract on or before
(DATE)
9. Indemnification from Third Party Claims; Liability for City Damage.
A. To the fullest extent permitted by law, Contractor shall defend, indemnify and hold harmless
City, its officers and employees, from and against all claims, damages, losses and expenses
claimed by third parties, but not including any claims, damages, losses or expenses of the
parties to this Contract, including but not limited to attorneys' fees, arising out of or resulting
from performance of this Contract, provided that such claim, damages, loss or expense is
attributable to bodily injury, sickness, disease or death, or injury to or destruction of property,
including loss of use resulting therefrom, but only to the extent caused in whole or in part by
negligent acts or omissions of Contractor, or anyone directly or indirectly employed by
Contractor or anyone for whose acts Contractor may be liable, regardless of whether or not
such claim, damage, loss or expense is caused in part by a party indemnified hereunder.
B. The Contractor shall also be liable to the City for any damage to City property arising out of
or related to the Contractor's negligent performance of the Contract.
10. Prior to the commencement of any work on the Project and at all times during the performance
of this Contract, the Contractor shall provide evidence of insurance which meets the
requirements of the City's Insurance Schedule F attached to this Contract as Exhibit C.
11. Permits and Licenses. Contractor further represents and warrants that Contractor will obtain all
necessary business permits and licenses that may be required to carry out the obligations
pursuant to this Contract, including any permits and licenses that might be required by the state
or locality in which Contractor performs the Services, and Contractor agrees to maintain, at
Contractor's sole expense, such required permits and licenses for the duration of the term(s) of
this Contract.
12. Legal Compliance. Contractor is responsible for compliance with all applicable laws, statutes,
rules, regulations, and ordinances which may apply to the performance of Contractor's
obligations under this Contract, including but not limited to the laws outlined in Exhibit c , and
hereby represents and warrants that Contractor is in compliance with the same as of the
Closing/Effective _ a e an urt er represents t at dunng the --Contractor-will remain -in
compliance. Contractor shall require all contractors and subcontractors providing services under
this Contract shall also certify compliance with this Section.
When Applicable:
Contractor further represents and warrants that Contractor has obtained all necessary business
permits and licenses that may be required to carry out the obligations pursuant to this Contract,
including any permits and licenses that might be required by the state or locality in which
Contractor performs the Services, and Contractor agrees to maintain, at Contractor's sole
expense, such required permits and licenses for the durations of the term(s) of this Contract.
13. The City may terminate this Contract with or without cause upon fourteen (14) days' written
notice delivered to the Contractor.
Page 298 of 750
14. This Contract shall be governed by the laws of the State of Iowa and exclusive jurisdiction and
venue for any action arising out of or related to this Contract shall be the Iowa District Court for
Dubuque County
15. The City is exempt from federal excise tax and Iowa sales tax.
16. In the event any article, service, or process sold, delivered and/or performed hereunder is
covered by any patent, copyright, or application for either, the Contractor will indemnify and
save harmless the City from any and all loss, cost, or expenses on account of any and all claims,
suits, or judgments on account of the use or sale of such article or the use of such service or
process in violation of any patent, copyright, or application.
17. The Contractor agrees not to release any advertising copy mentioning the City or quoting the
opinion of any City employee without prior written authorization from the City of Dubuque.
18. Current Safety Data Sheets (SDS), when applicable to the order, will be provided by the
Contractor in accordance with all regulations.
19. The terms and conditions of sale as stated in this order govern in the event of conflict with any
terms of the Contractor's proposal, and are not subject to change by reason of any written or
verbal statements by the Contractor or by and terms stated in the Contractor's acknowledgment
unless same be accepted in writing by the City.
20. The City of Dubuque, State of Iowa and Department of Justice have entered into a Consent
Decree requiring the City to complete certain capital improvements pursuant to an established
schedule and to comply with certain capital improvements pursuant to an established schedule
and to comply with certain reporting and recordkeeping requirements. One of the terms of the
Consent Order is for the City to advise contractors whose duties might reasonably include
compliance with any provision of the Consent Decree with a copy of the Consent Decree. The
City expects its contractors to comply with the Consent Decree and to assist the City in
complying with the Consent Decree. As a requirement of this Contract, the Contractor shall
execute and return to City Exhibit the Certification Form attached this this Contract as Exhibit
A.
❑ 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.
❑✓ 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.
Page 299 of 750
THE CITY AGREES:
The City agrees to pay the Vendor for the work actually performed under this Contract, up to the
amount stated below, less any agreed damages provided for in the Contract Documents.
CONTRACT AMOUNT: $ 15,000
CITY OF DUBUQUE, IOWA CONTRACTOR:
By. 11 /042025 Top Grade Excavating
chael C. Van Milligen Date Company Name
City Manager
By: 1��. � it - oK - as
Signature Date
3��,
Printed Name L
V , 4LC
Title
Page 300 of 750
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EXHIBIT A
CONSENT DECREE
RELATING TO THE
CITY OF DUBUQUE, IOWA
WATER & RESOURCE RECOVERY CENTER
AND
SEWER COLLECTION SYSTEM
NO CONTRACTOR OR CONSULTANT MAY PERFORM ANY WORK FOR THE CITY OF DUBUQUE
RELATED TO THE WATER & RESOURCE RECOVERY CENTER OR THE SEWER CONNECTION
SYSTEM UNLESS A SIGNED COPY OF THIS DOCUMENT IS RETURNED TO THE CITY OF DUBUQUE
ENGINEERING DEPARTMENT
The City of Dubuque, Iowa 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 No. Case 2:1 1-cv-0101 1-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 can be found at
http://www.cityofdubuque.orq/DocumentCenter/HomeNiew/3173. A paper copy is available upon request
from the City of Dubuque Engineering Department.
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 years after the termination of the Consent Decree, the City
shall retain, and shall 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
requirement shall apply regardless of any contrary City, corporate or institutional policies or procedures. At
any time during this information -retention period, upon request by the United States or the State, the City
shall 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 shall 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
shall deliver any such documents, records, or other information to the EPA or IDNR.
Page 301 of 750
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Certification by Contractor or Consultant
The undersigned, on behalf of the Contractor or Consultant, with full authority to act on behalf of the
Contractor or Consultant, certifies to the City of Dubuque as follows:
1. 1 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 No. 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.
The Contractor or Consultant 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 or Consultant's failure to comply with the Consent
Decree.
Contractor or Consultant:
Mr
Its:
Date:
Return signed copy to:
Engineering Department
50 W. 13th Street
Dubuque IA 52001
Page 302 of 750
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EXHIBIT B
PERFORMANCE, PAYMENT AND MAINTENANCE BOND
KNOW ALL BY THESE PRESENTS:
That we,
(hereinafter
Dubuque, Iowa,
any breach
as Principal
the "Contractor' or "Principal") and
, as Surety are held and firmly bound unto the City of
as Obligee (hereinafter referred to as "Owner"), and to all persons who may be injured by
of any of the conditions of this Bond in the penal sum of
dollars
), lawful money of the United States, for the payment of which sum, well and truly
to be made, we bind ourselves, our heirs, legal representatives and assigns, jointly or severally, firmly by
these presents.
The conditions of the above obligations are such that whereas said Contractor entered into a contract with
the Owner, bearing date the day of , 20, (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
Project detail the
following described improvements:
INSERT PROJECT DESCRIPTION
(Use description from Notice to Bidders)
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:
PERFORMANCE: The Contractor shall well and faithfully observe, perform, fulfill, and abide by each
and every covenant, condition, and part of said Contract and Contract Documents, by reference made
a part hereof, for the project, and shall indemnify and save harmless the Owner from all outlay and
expense incurred by the Owner by reason of the Contractor's default of failure to perform as required.
The Contractor shall also be responsible for the default or failure to perform as required under the
Contract and Contract Documents by all its subcontractors, suppliers, agents, or employees
furnishing materials or providing labor in the performance of the Contract.
2. PAYMENT: The Contractor and the Surety on this Bond hereby agreed to pay all just claims
submitted by persons, firms, subcontractors, and corporations furnishing materials for or performing
labor in the performance of the Contract on account of which this Bond is given, 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
Page 303 of 750
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is made a part hereof as though fully set out herein.
3. MAINTENANCE: The Contractor and the Surety on this Bond hereby agree, at their own expense:
A. To remedy any and all defects that may develop in or result from work to be performed under
the Contract Documents within the period of two (2) year(s) from the date of acceptance of the
work under the Contract, by reason of defects in workmanship, equipment installed, or materials
used in construction of said work;
B. To keep all work in continuous good repair; and
C. To pay the Owner's reasonable costs of monitoring and inspection to assure that any defects
are remedied, and to repay the Owner all outlay and expense incurred as a result of Contractor's
and Surety's failure to remedy any defect as required by this section.
Contractor's and Surety's Contract herein made extends to defects in workmanship or materials not
discovered or known to the Owner at the time such work was accepted.
4. GENERAL: Every Surety on this Bond shall be deemed and held bound, any contract to the contrary
notwithstanding, to the following provisions:
A. To consent without notice to any extension of time authorized in approved change orders to the
Contractor in which to perform the Contract;
B. To consent without notice to any change in the Contract or Contract Documents, authorized in
approved change orders which thereby increases the total contract price and the penal sum of
this Bond, provided that all such changes do not, in the aggregate, involve an increase of more
than twenty percent (20%) of the total contract price, and that this Bond shall then be released
as to such excess increase;
C. To consent without notice that this Bond shall remain in full force and effect until the Contract is
completed, whether completed within the specified contract period, within an extension thereof,
or within a period of time after the contract period has elapsed and the agreed 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 attorneys), and all costs and expenses of litigation as they are incurred by the Owner. It is
intended the Contractor and Surety will defend and indemnify the Owner on all claims made
against the Owner on account of Contractor's failure to perform as required in the Contract and
Contract Documents, that all agreements and promises set forth in the Contract and Contract
Documents, in approved change orders, and in this Bond will be fulfilled, and that the Owner
Page 304 of 750
SHEET NOT
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will be fully indemnified so that it will be put into the position it would have been in had the
Contract been performed in the first instance as required.
In the event the Owner incurs any "outlay and expense" in defending itself against any claim as to which the
Contractor or Surety should have provided the defense, or in the enforcement of the promises given by the
Contractor in the Contract, Contract Documents, or approved change orders, or in the enforcement of the
promises given by the Contractor and Surety in this Bond, the Contractor and Surety agree that they will
make the Owner whole for all such outlay and expense, provided that the Surety's obligation under this Bond
shall not exceed one hundred twenty-five percent (125%) of the penal sum of this Bond.
In the event that any actions or proceedings are initiated regarding this Bond, the parties agree that the venue
thereof shall be Dubuque County, State of Iowa. If legal action is required by the Owner to enforce the
provisions of this Bond or to collect the monetary obligation incurring to the benefit of the Owner, the Contractor
and the Surety agree, jointly, and severally, to pay the Owner all outlay and expense incurred therefor by the
Owner. All rights, powers, and remedies of the Owner hereunder shall be cumulative and not alternative and
shall be in addition to all rights, powers, and remedies given to the Owner, by law. The Owner may proceed
against surety for any amount guaranteed hereunder whether action is brought against the Contractor or
whether Contractor is joined in any such action(s) or not.
NOW THEREFORE, the condition of this obligation is such that if said Principal shall faithfully perform all the
promises of the Principal, as set forth and provided in the Contract, in the Contract Documents, and in this
Bond, then this obligation shall be null and void, otherwise it shall remain in full force and effect.
When a work, term, or phrase is used in this Bond, it shall be interpreted or construed first as defined in this
Bond, the Contract, or the Contract Documents; second, if not defined in the Bond, Contract, or Contract
Documents, it shall be interpreted or construed as defined in applicable provisions of the Iowa Code; third, if
not defined in the Iowa Code, it shall be interpreted or construed according to its generally accepted meaning
in the construction industry; and fourth, if it has no generally accepted 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.
Project No.
Witness our hands, this day of , 20_.
SURETY COUNTERSIGNED BY: PRINCIPAL:
Signature of Agent
Printed Name of Agent
Company Address
City, State, Zip Code
Company Telephone Number
Contractor
By:
Signature
Printed Name
Title
FORM APPROVED BY:
Page 305 of 750
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Representative for Owner
SURETY:
Surety Company
By:
Signature Attorney -in -Fact Officer
Printed Name of Attorney -in -Fact Officer
Company Name
Company Address
City, State, Zip Code
Company Telephone Number
Page 306 of 750
NOTE:
SHEET NOT
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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.
Page 307 of 750
Class A:
Class B:
Class C:
EXHIBIT C
INSURANCE SCHEDULE F
Asbestos Removal
Fiber Optics
Sanitary Sewers
Asphalt Paving
Fire Protection
Sheet Metal
Concrete
Fireproofing
Site Utilities
Construction Managers
General Contractors
Shoring
Cranes
HVAC
Special construction
Culverts
Mechanical
Steel
Decking
Paving & Surfacing
Storm sewers
Demolition
Piles & Caissons
Structural Steel
Deconstruction
Plumbing
Trails
Earthwork
Retaining Walls
Tunneling
Electrical
Reinforcement
Water main
Elevators
Roofing
Chemical Spraying
Masonry
Rough Carpentry
Doors, Window &
Vehicular Snow
Stump Grinding
Glazing
Removal
Tank Coating
Drywall Systems
Painting & Wall
Tree Removal
Fertilizer Application
Covering
Tree Trimming
Geotech Boring
Pest Control
Tuckpointing
Insulation
Scaffolding
Waterproofing
Finish Carpentry
Sidewalks
Well Drilling
Landscaping
Plastering
Carpet Cleaning
Carpet & Resilient
Flooring
Caulking & Sealants ---
Acoustical Ceiling
Filter Cleaning
General Cleaning
Grass Cutting
Janitorial
Non Vehicular Snow &
Ice Removal
Office Furnishings
Power Washing
Tile & Terrazzo
Flooring
Window Washing
Page 308 of 750
INSURANCE SCHEDULE F (continued)
1. Contractor shall furnish a signed certificate of insurance to the department responsible for the contract
for the coverage required in Exhibit I prior to commencing work and at the end of the project if the term
of work is longer than 60 days. Contractors presenting annual certificates shall present a certificate at
the end of each project with the final billing. Each certificate shall be prepared on the most current
ACORD form approved by the Iowa Department of Insurance or an equivalent approved by the Director
of Finance and Budget or Designee. The certificate must clearly indicate the project number, project
name, or project description for which it is being provided Eg: Project # Project
name: or Project Location at or
construction of
2. All policies of insurance required hereunder shall be with an insurer authorized to do business in Iowa
and all insurers shall have a rating of A or better in the current A.M. Best's Rating Guide.
3. Each Certificate required shall be furnished to the Department of the City of Dubuque.
4. Failure to provide the coverages described in this Insurance Schedule shall not be deemed a waiver of
these requirements by the City of Dubuque. Failure to obtain or maintain the required insurance shall
be considered a material breach of this contract.
5. Contractor shall require all subcontractors and sub -subcontractors to obtain and maintain during the
performance of work insurance for the coverages described in this Insurance Schedule and shall obtain
certificates of insurance from all such subcontractors and sub -subcontractors. Contractor agrees that it
shall be liable for the failure of a subcontractor and sub -subcontractor to obtain and maintain such
coverage. The City may request a copy of such certificates from the Contractor.
6. All required endorsements shall be attached to the certificate. The certificate is due before the
contract/agreement can be approved.
7. Whenever an ISO form is referenced the current edition must be provided.
8. Contractor shall be required to carry the minimum coverage/limit, or greater if required by law or other
legal agreement, in Exhibit I - Insurance Schedule F. If the contractor's limits of liability are higher than
the required minimum limit, then the contractor's limits shall be this agreement's required limits.
9. Contractor shall be responsible for deductibles and self -insured retention for payment of all policy
premiums and other cost associated with the insurance policies required below.
10. All certificates of insurance must include agents name, phone number, and email address.
11. The City of Dubuque reserves the right to require complete, certified copies of all required insurance
policies, including endorsements, required by this Schedule at any time.
12. The City of Dubuque reserves the right to modify these requirements, including limits, based on
changes in the risk or other special circumstances during the term of the contract, subject to written
mutual agreement attached hereto.
Page 309 of 750
INSURANCE SCHEDULE F (continued)
EXHIBIT I
A) COMMERCIAL GENERAL LIABILITY
General Aggregate Limit
$2,000,000
Products -Completed Operations Aggregate
Limit$2,000,000
Personal and Advertising Injury Limit
$1,000,000
Each Occurrence
$1,000,000
Fire Damage Limit (any one occurrence)
$50,000
Medical Payments
$5,000
1) Coverage shall be written on an occurrence, not claims made, form. The general liability
coverage shall be written in accord with ISO form CG 00 01 or business owners form BP
00 02. All deviations from the standard ISO commercial general liability form CG 00 01
or business owners form BP 00 02 shall be clearly identified.
2) Include ISO endorsement form CG 25 04 "Designated Location(s) General Aggregate
Limit" or CG 25 03 "Designated Construction Project(s) General Aggregate Limit" as
appropriate.
3) Include endorsement indicating that coverage is primary and non-contributory.
4) Include Preservation of Governmental Immunities Endorsement. (Sample attached).
5) Include additional insured endorsement for:
The City of Dubuque, including all its elected and appointed officials, all its
employees, agents, and volunteers, all its boards, commissions and/or authorities
and their board members, employees, agents, and volunteers. Use ISO form CG 20
10 (Ongoing operations).
6) The additional insured endorsement shall include completed operations under ISO form
CG 20 37 during the project term and for a period of two years after the completion of
the project.
7) Policy shall include Waiver of Right to Recover from Others endorsement.
8) Policy shall include cancellation and material change endorsement providing 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 Finance Department, 50 West 13th Street Dubuque, Iowa
52001.
9) Contractor and subcontractor shall not use any drone without the prior written approval
of the City of Dubuque. Any drone usage must comply with above liability limits and the
additional insured endorsement -must name -the -City of Dubuque with respect -to -aircraft
liability coverage.
B) WORKERS' COMPENSATION & EMPLOYERS LIABILITY
Statutory Benefits covering all employees injured on the job by accident or disease as
prescribed by Iowa Code Chapter 85.
Coverage A Statutory —State of Iowa
Coverage B Employers Liability
Each Accident $100,000
Each Employee -Disease $100,000
Policy Limit -Disease $500,000
Policy shall include Waiver of Right to Recover from Others endorsement.
Page 310 of 750
Coverage B limits shall be greater if required by the umbrella/excess insurer.
OR
If, by Iowa Code Section 85.1A, the Contractor is not required to purchase Workers'
Compensation Insurance, the Contractor shall have a copy of the State's Nonelection of
Workers' Compensation or Employers' Liability Coverage form on file with the Iowa
Workers' Compensation Insurance Commissioner, as required by Iowa Code Section 87.22.
Completed form must be attached.
C) AUTOMOBILE LIABILITY
Combined Single Limit $1,000,000
Coverage shall include all owned, non -owned, and hired vehicles. If the Contractor's business
does not own any vehicles, coverage is required on non -owned and hired vehicles.
1) Policy shall include Waiver of Right to Recover from Others endorsement.
D) UMBRELLA/EXCESS LIABILITY
The General Liability, Automobile Liability and Employer's Liability Insurance requirements may
be satisfied with a combination of primary and Umbrella or Excess Liability Insurance. If the
Umbrella or Excess Insurance policy does not follow the form of the primary policies, it shall
include the same endorsements as required of the primary policies including but not limited to
Waiver of Subrogation and Primary and Non-contributory in favor of the City.
All Class A contractors with contract values in excess of $10,000,000 must have
umbrella/excess liability coverage of $10,000,000.
All Class A and Class B contractors with contract values between $500,000 and $10,000,000
must have umbrella/excess liability coverage of $3,000,000.
All Class A and B contractors with contract values less than $500,000 must have
umbrella/excess liability coverage of $1,000,000.
All Class C contractors are not required to have umbrella/excess liability coverage.
All contractors performing earth work must have a minimum of $3,000,000 umbrella regardless
of the contract value.
E) POLLUTION LIABILITY
Coverage required: _Yes _ No
Pollution liability coverage shall be required if project involves any pollution exposure for
hazardous or contaminated materials including, but not limited to, the removal of lead, asbestos,
or PCB's. Pollution product and complete operations coverage shall also be covered.
Each Occurrence 1 $2,000,000
Page 311 of 750
Policy Aggregate $4,000,000
1) Policy to include job site and transportation coverage.
2) Include additional insured for:
The City of Dubuque, including all its elected and appointed officials, all its
employees, agents, and volunteers, all its boards, commissions and/or authorities
and their board members, employees and volunteers. Use ISO form CG 20 10.
(Ongoing operations) or its equivalent and CG 20 37 (completed operations) or its
equivalent.
3) Include Preservation of Governmental Immunities Endorsement.
4) Provide evidence of coverage for 5 years after completion of project.
5) Include endorsement indicating that coverage is primary and non-contributory.
6) Policy shall include waiver of right to recovery from others endorsement.
7) Pollution liability shall include ISP endorsement CA 99 48. Pollution Liability -Broadened
Coverage for Covered Autos, or equivalent endorsement if the contractor has vehicles
that transport fuel onto the Owner's property.
F) RAILROAD PROTECTIVE LIABILITY
Coverage required: _Yes _ No
Any contract for construction or demolition work on or within fifty feet (50') from the edge of the
tracks of a railroad and affecting any railroad bridge, trestle, tracks, roadbeds, tunnel,
underpass, or crossing, for which an easement, license or indemnification of the railroad is
required, shall require evidence of the following additional coverages.
Railroad Protective Liability:
$ each occurrence (per limits required by Railroad)
$ policy aggregate (per limits required by Railroad)
AND
An endorsement to the Commercial General Liability policy equal to ISO CG 24 17 (Contractual
Liability -Railroads). A copy of this endorsement shall be attached to the certificate of insurance.
Page 312 of 750
Iowa Code Chapter 670, Liability of Governmental Subdivisions, provides cities with certain immunities which
may be available to you. Naming the City of Dubuque as an additional insured on your insurance as is
requested by this Insurance Schedule may result in your waiver of those immunities. If you would like to
preserve those immunities, please use this endorsement or an equivalent form. The preservation of immunities
is for your benefit.
PRESERVATION OF GOVERNMENTAL IMMUNITIES ENDORSEMENT
1. Nonwaiver of Governmental Immunity. The insurer expressly agrees and states that the purchase of
this policy and the including of the City of Dubuque, 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 insurer further agrees that this policy of insurance shall cover only those claims
not subject to the defense of governmental immunity under the Code of Iowa Section 670.4 as it now exists
and as it may be amended from time to time. Those claims not subject to Code of Iowa Section 670.4 shall be
covered by the terms and conditions of this insurance policy.
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 insurer.
4. Non -Denial of Coverage. The insurer shall not deny coverage under this policy and the insurer shall not
deny any of the rights and benefits accruing to the City of Dubuque, 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.
No Other Change in Policy. The above preservation of governmental immunities shall not otherwise change or
alter the coverage available under the policy.
SPECIMEN
Page 313 of 750
JI �I \ I.I ".-ftI C
LEGAL COMPLIANCE
a) Title VI of the Civil Rights Act of 1964 (42 U.S.C. § 2000d et seq., 78 stat. 252), (prohibits
discrimination on the basis of race, color, national origin); and 49 CFR Part 21;
b) The Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, (42
U.S.C. § 4601), (prohibits unfair treatment of persons displaced or whose property has been
acquired because of Federal or Federal -aid programs and projects);
c) Federal -Aid Highway Act of 1973, (23 U.S.C. § 324 et seq.), (prohibits discrimination on the
basis of sex);
d) Section 504 of the Rehabilitation Act of 1973, (29 U.S.C. § 794 et seq.), as amended,
(prohibits discrimination on the basis of disability); and 49 CFR Part 27;
e) The Age Discrimination Act of 1975, as amended, (42 U.S.C. § 6101 et seq), (prohibits
discrimination on the basis of age);
f) Airport and Airway Improvement Act of 1982, (49 U.S.C. § 471, Section 47123), as amended,
(prohibits discrimination based on race, creed, color, national origin, or sex);
g) The Civil Rights Restoration Act of 1987, (PL 100-209); (broadened the scope, coverage and
applicability of Title VI of the Civil Rights Act of 1964 to include that entities that receive
federal funding must comply with civil rights legislation, including the Civil Rights Act of 1964,
the Age Discrimination Act of 1975, and Section 504 of the Rehabilitation Act of 1973, in all
operations, not just in the program or activity receiving federal funding);
h) Titles II and III of the Americans with Disabilities Act, which prohibit discrimination on the
basis of disability in the operation of public entities, public and private transportation systems,
places of public accommodation, and certain testing entities (42 U.S.C. §§ 12131 - 12189) as
implemented by Department of Transportation regulations at 49 C.F.R. Parts 37 and 38;
i) The Federal Aviation Administration's Non-discrimination statute (49 U.S.C. § 47123)
(prohibits discrimination on the basis of race, colorInationalorigin, and sex);
j) Section 1557of the Affordable Care Act (prohibits discrimination on the basis of national
origin);
k) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. § 1681 et seq.)
(prohibits discrimination because of sex in education programs or activities);
1) Drug Abuse Office and Treatment Act of 1972, as amended (21 U.S.C. § 1101 et seq.); and
m) Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970, as
amended (42 U.S.C. § 4541, et seq.).
Page 314 of 750
Docusign Envelope ID: C66D14F4-D31C-411E-B4CD-2BC524E07COC
CLINICAL AFFILIATION AGREEMENT
BETWEEN
THE EMS TRAINING SCHOOL, LLC,
dba SCHOOL OF EMS and dba Camsen Career Institute
AND
THE CITY OF DUBUQUE THROUGH ITS FIRE DEPARTMENT
I. PURPOSE OF AGREEMENT:
The purpose of this Field and Ride -Along Agreement (hereinafter
"Agreement") is to define the rights and responsibilities of The EMS Training
School, LLC, dba School of EMS and dba Camsen Career Institute
(hereinafter College), which provides education to health care students, and
the City of Dubuque, Iowa through its Fire Department (hereinafter DFD),
which provides supervised field resources and related experiences for
Paramedic and EMT training programs. College and DFD may be referred to
individually as a Party or collectively as the Parties.
II. PREAMBLE:
College shall have overall responsibility for the students' classroom instruction,
clinical experience, clinical evaluation and for informing students of all policies,
procedures, and protocols of the College. College shall designate a faculty
member to coordinate each College student's field experience at the DFD site.
DFD provides field experience in which students receive learning experiences,
under the direct supervision of a paramedic or other appropriate health
professional.
III. COLLEGE AGREES:
A. To provide classroom instruction, to coordinate clinical experience, to
ensure students are knowledgeable of all policies, procedures, and
protocols of the College, and to assume overall responsibility for students
throughout their classroom and clinical experience.
B. To provide students with education on blood -borne pathogens, infectious
diseases, and the application of standard precautions, including the use
of personal protective devices.
C. To establish policies and procedures to ensure each student completes
a 10-panel drug screen prior to beginning their clinical experience.
D. To have immunization policies and procedures in place for faculty and/or
students which address the following immunization standards:
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1. Two-step TB skin testing done within the past year; or if a positive
PPD history, a current negative chest x-ray report upon admission;
then a TB skin test yearly after admission.
2. Hepatitis B series, or a positive Hepatitis B Surface Antibody titer, or
a letter from the student's physician stating need for exemption.
3. Measles, mumps, rubella (MMR vaccine) two doses or titers of all
three diseases showing full immunity.
4. Chicken Pox (varicella) — proof of disease by physician
documentation, or a positive titer, or two doses of varicella vaccine.
5. Seasonal influenza vaccine — annual proof of immunization prior to
the conclusion of the first week of January classes.
E. To provide DFD with student names and field schedules at least one
week in advance of the start date of the field rotation, unless the DFD
elects to do its own scheduling of students, in which case the College's
responsibility will be limited to reviewing and communicating the
schedule to the student.
F. To participate in continuous planning with the DFD regarding desired
learning experiences for students.
G. To advise students they may participate in patient care only under the
direction and supervision of a College instructor, paramedic of the DFD,
or other qualified DFD personnel.
H. To inform students they are responsible for following the policies and
procedures of the DFD as well as applicable federal and state laws, rules
and regulations pertaining to health care facilities, including but not
limited to confidentiality policies pertaining to patient records and patient.
College faculty and students will maintain the confidentiality of all City
records, patients and clients that they encounter. Students and faculty
will sign Confidentiality Agreements prior to participating in their clinical
experience and shall be subject to the City's policies respecting the
confidentiality of medical information.
I. To communicate to faculty and students that the cost of transportation to
and from the DFD clinical site shall be the personal responsibility of the
faculty member and student.
J. To handle student discipline.
K. To maintain student background and child/adult abuse or neglect registry
check reports in a manner consistent with its internal record retention
policy. The reports may be provided to Clinical Site upon request if the
student to which the report relates provides his or her written
authorization. College will extend its best effort to obtain the written
authorization from the student, but if a student refuses or if the College
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is otherwise unable to obtain written authorization, College will not be
subject to any liability or penalty. College makes no representations or
warranties as to the accuracy of these documents.
L. College will inform students they must maintain an acceptable personal
appearance and shall wear the name tag provided by the College while
involved in field experience at the DFD site.
M. To provide all students with appropriate instruction in Standard
Precautions as defined by the Centers for Disease Control and
Prevention and have OSHA in-service documentation and in HIPAA
compliance, with such records to be provided to the DFD upon request.
N. College shall provide Health Insurance Portability and Accountability
(HIPAA), Family Educational Rights and Privacy Act (FERPA), and 42
CFR Part 2 training to all students and faculty members before they are
assigned to CITY.
IV. DFD AGREES:
A. To provide students field experience through participation in pre -hospital
care provided by DFD personnel, such experience to be mutually agreed
upon between the DFD and the College.
B. To provide College with the facts and circumstances upon which the DFD
personnel determine a College student shall be removed from
participation in clinical field experience.
C. To provide College with immediate notice of any injury to a student of the
College which occurs during the student's participation in prehospital
care provided by DFD personnel.
D. To designate a primary preceptor for responsibility in teaching,
coordinating, and directing the student's field experience who is certified
with the appropriate level of education and training and to allow each
preceptor an opportunity to attend preceptor training conducted by
College.
E. To inform College of student field experience schedules.
F. To schedule students for field experience time to assure appropriate
experience, subject to such scheduling being consistent with the DFD's
obligation to provide prehospital care to its citizens.
G. To identify and provide preceptors who will be responsible for providing
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the College with an evaluation of each student throughout the field
experience.
H. To retain ultimate responsibility for the quality and provision of patient
care at the DFD.
When reasonably possible, to obtain patient consent to participation in
the field education program and receipt of services from College
students.
J. To ensure that its staff meet minimum health standards.
K. To orient the student to the field site with specific information on standard
precautions including location and required use of personal protective
equipment in accordance with standard precaution regulations, provide
needle stick prevention procedures including location and use of sharps
containers, and proper reporting procedures for response to personal
exposure to an infectious disease.
L. To orient the student to the location of hazardous materials, handling,
disposing of and use of personal protective equipment, and location and
use of hazardous waste containers.
M. To submit a written evaluation of student performance in accordance with
procedures established by the College, if requested.
N. To provide adequate space, as available, for the College to use as
conference rooms during the practicum experience. Provision of such
space will be contingent upon availability of such space.
O. In the event student or College faculty requires immediate medical care,
Clinical Site will use its best efforts to arrange and/or provide necessary
care in a timely and appropriate manner. Clinical Site shall use its best
efforts to document the event and shall provide copies of all
documentation to College, subject to applicable legal or regulatory
requirements. Clinical Site shall be entitled to payment for any medical
care or services it provides either by:
1. College or its insurer if the student or College faculty is injured while
engaging in activities or behaviors within the scope of his or her
student or employee function, respectively, and if done in a safe,
prudent, and acceptable manner; or
2. Student or College faculty or his or her private health insurance
provider if the student or College faculty is injured while engaging in
activities or behaviors outside to the scope of his or her student or
employee function, respectively, or while engaging in activities or
behaviors within the scope of his or her student or employee function,
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respectively, but done in an unsafe, unacceptable, or negligent
manner.
P. Students shall be required to wear facial PPE while at Clinical Site.
Clinical Site shall have the responsibility of ensuring students comply
with this requirement. Any student who fails or refuses to wear facial
PPE may be asked to leave the Clinical Site. Facial PPE may include a
face mask and/or face shield or goggles. Additional PPE as deemed
necessary by Clinical Site may be required on a case by case basis. To
ensure compliance with Clinical Site standards which may continually
evolve in response to clinical research and pandemic conditions, Clinical
Site shall supply students with PPE which meets the standards
established by Clinical Site.
Q. With reasonable notice, to provide information on the DFD site, and, with
permission of the DFD Chief, permit inspection of the DFD site, by
individuals or agencies charged with the responsibility for accreditation
of the College and its education programs.
V. COLLEGE AND DFD AGREE:
A. Each Party will retain complete control over such activities of its own that
are outside the scope of this Agreement.
B. Students participating in activities covered by this Agreement will not
receive compensation or remuneration for the services performed
hereunder, other than specifically provided for herein.
C. College is not providing any services to DFD which would cause College
to be considered a Business Associate under the Health Insurance
Portability and Accountability Act (HIPAA) and therefore a Business
Associate Agreement between College and Clinical Site is unnecessary
D. Students participating in activities covered by this Agreement are for
purposes of HIPAA considered part of Clinical Site's "Workforce" (as that
term is defined at 45 CFR 160.103) and therefore a Business Associate
Agreement between College and Clinical Site is unnecessary.
E. Representatives from College and DFD will meet to review course
objectives and field experiences as reasonably required or requested by
either Party.
F. Changes to a field schedule shall be made by mutual agreement and,
when reasonably possible, in written form, between College faculty and
the appropriate DFD representative. Such changes should be made as
soon as possible prior to the time the schedule change is to become
effective.
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G. Services performed by students covered by this Agreement will be within
the established requirements of each student's educational program at
the College.
H. Students will work according to protocols or standard operating
procedures acceptable to both the College and the DFD.
Nothing in this Agreement is to be construed as requiring facilities or
personnel except what is otherwise deemed necessary for operation by
the DFD.
J. There will be no discrimination on the basis of race, national origin, color,
religion, creed, sex, age, race, disability, sexual orientation, national
origin, ancestry, gender identity, familial status, or any other category as
provided for in law.
K. The parties will conduct themselves in a manner which is consistent with
high standards of professionalism and business ethics.
L. DFD shall not be responsible for lost or damaged personal property of
the student.
M. The parties agree the placement of students for DFD field experience
shall be at the availability of the DFD.
VI. LIABILITY INSURANCE AND INDEMNIFICATION:
A. Each Party shall be responsible for its own acts and omissions and shall
be liable for payment of that portion of any and all claims, liabilities,
injuries, suits, and demands and expenses of all kinds that may result or
arise out of any malfeasance or neglect caused by said Party, its
employees, agents, or subcontractors, in the performance or omission of
any act or responsibility of said Party under this Agreement.
B. College shall ensure its students have professional liability insurance in the
appropriate amount prior to beginning clinical experience with the DFD.
C. To the extent of any legal liability of College for the negligent or tortious acts
of its students and faculty, College shall indemnify and save harmless City,
its employees, agents, and elected officials from loss, damages, expenses,
attorney fees and costs on account of the death, personal injury and property
damage to any person to the extent of available insurance coverages and
proceeds.
D. College shall maintain insurance in compliance with City Insurance
Schedule J, as attached.
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E. City shall maintain its membership in the Iowa Communities Assurance
Pool during the term of this Agreement and shall, upon request, provide
proof of said membership and coverage to College.
F. In the event that a claim is made against both Parties, it is the intent of
both Parties to cooperate in the defense of said claim and to cause their
insurers to do likewise. Both Parties shall, however, retain the right to
take any and all actions they believe necessary to protect their own
interests.
G. The College also agrees to provide each student with liability insurance
coverage in the amounts set out in the attached City Insurance Schedule,
at no cost to the DFD.
VII. TERM AND TERMINATION:
A. Term. This Agreement shall be effective September , 2025 for a
term of three (3) years and each year thereafter shall automatically renew
for an additional one-year term, unless this Agreement is terminated as
provided herein.
B. Termination. The Parties have the following rights regarding termination
of this Agreement and termination or suspension of a student's
participation under this Agreement:
1. Termination of Agreement Without Cause. This Agreement
may be terminated without cause at any time by a Party upon
ninety (90) days prior written notice to the other Party. In the event
that this Agreement is terminated pursuant to this paragraph, the
Parties hereby agree that no students participating in an ongoing
field experience will be denied the opportunity to complete such
field experience. In such event, all applicable provisions of this
Agreement, including the right to terminate any student pursuant
to Section VIII, shall remain in force during the extension period
from the effective date of termination, until the student's field
experience is completed.
2. Termination of Agreement With Cause. This Agreement may
be terminated by either Party in the event of an alleged material
breach by the other, upon thirty (30) days prior written notice given
by the non -breaching Party to the other Party, provided such
alleged breach is not cured within said thirty (30) day period.
3. Termination for Noncompliance. This Agreement may be
terminated immediately by either Party if this Agreement (a) is
determined to be in violation of, or (b) causes either Party to be in
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noncompliance with, federal or state rules or regulations
applicable to that Party.
4. Termination for Inconsistency with College Standards. This
Agreement may be terminated immediately by either Party upon
College providing written notice to DFD that a provision of the
contract is inconsistent with the Vision, Mission, Core Values
and/or Beliefs of the College or its affiliates.
Vill. DFD'S RIGHT TO TERMINATE OR SUSPEND STUDENTS:
DFD may dismiss a student from a field experience whose work, conduct, or
health is or is reasonably likely to be detrimental or disruptive to DFD. In the
event of such action, an immediate phone call will be placed to the College
explaining the action, followed by a written evaluation of the incident.
IX. MISCELLANEOUS PROVISIONS:
A. Compliance With and Construction of Law. Each Party shall comply
with all federal, state, and local laws, ordinances or regulations, Joint
Commission on the Accreditation of Healthcare Organizations (JCAHO)
or other applicable accrediting body standards and accepted standards
of practice applicable to student training, and if at any time the
Agreement does not conform thereto, it will be considered amended so
as to conform. This Agreement shall be governed and construed in
accordance with the laws of the State of Iowa. Words and phrases in
this Agreement shall be construed in the singular or plural number and
as masculine, feminine, or neuter gender, according to the context.
B. Jeopardy. Notwithstanding anything to the contrary contained in this
Agreement, if a Party's performance of this Agreement jeopardizes the
licensure of either Party, the participation of either Party in, or the
payment or reimbursement from, any governmental health care program,
the full accreditation of either Party by any applicable state or nationally
recognized accreditation organization, or the tax exempt status of either
Party, any of such Party's property or financing (or the interest income
thereon, as applicable), or will prevent or prohibit any physician, or any
other health care professionals or their patients from utilizing the services
of either Party, or if for any other reason said performance should be in
violation of any statute, ordinance, or be otherwise deemed illegal, or be
deemed unethical by any recognized body, agency or association in the
educational, medical or hospital fields, the affected Party may terminate
this Agreement immediately upon written notice or initiate negotiations
to resolve the matter and, if the Parties are unable to resolve the matter
within thirty (30) days thereafter, the affected Party may, at its option,
terminate this Agreement immediately.
s
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C. Independent Contractors. Each Party is a separate and independent
institution, and this Agreement shall not be deemed to create a
relationship of agency, employment or partnership between them. Each
Party understands and agrees that the agents or employees of each
Party are not employees or agents of the other Party. Services rendered
by students covered by this Agreement are considered to be educational
in nature. Nothing in the execution or performance of this Agreement
shall be construed to establish an employer -employee, agency,
partnership of joint venture relationship among the parties and their
affiliates.
D. Assignment. All or any portion of this Agreement, or of the rights, duties
and obligations hereunder, shall not be assigned by either Party without
the prior written consent of the other Party. Any purported assignment
in contravention of this provision shall be null and void.
E. Entire Agreement. This Agreement and each expressly referenced
exhibit represents the entire agreement between the Parties concerning
the subject matter. All prior understandings, representations and other
agreements between them with respect to the subject matter hereof are
either merged herein or superseded hereby.
F. Severability. In the event any provision of this Agreement is held invalid,
illegal or unenforceable, in whole or in part, the remaining provisions of
this Agreement shall not be affected thereby and shall continue to be
valid and enforceable.
G. Use of Name. Neither Party shall use the name, logo, or likeness of the
other Party, or the other Party's employee or agent, in any publicity or
advertising material without such other Party's express prior written
consent.
H. Third Party Beneficiaries. Failure of either Party to provide services
hereunder in a manner reasonably acceptable to the other shall
constitute a breach of this Agreement. The Parties specifically disclaim
any attempt, however, to establish any fixed contractual standards for
the quality and efficiency of care rendered by students in the service
tendered hereunder, and further specifically disclaim the existence of any
third party beneficiaries to any contractual standard of care, or the
existence of any other individual or entity who is intended to have a right
to enforce any provision of this Agreement.
Notices. Whenever written notice is required or permitted to be given by
either Party to the other, such notice shall have been deemed to have
been sufficiently given if personally delivered or deposited in the United
States mail in a properly stamped envelope, certified or registered mail,
return receipt requested, addressed to:
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For College: The EMS Training School, LLC,
dba School of EMS and dba Camsen Career Institute
Attn: Amber Jameson, Clinical Services Manager
115 Jordan Plaza Blvd, Suite 200
Tyler, TX 75704
For DFD: City of Dubuque Fire Department
Attn: Amy Scheller, Chief
11 West 9th Street
Dubuque, Iowa 52001
J. Amendment and Modification. This Agreement may only be amended
by mutual written agreement of the Parties hereto or their duly authorized
representatives and may not be amended or modified in any other
manner.
K. Authority. The persons signing this Agreement warrant that they have
full authority to do so and that the signature of each shall bind the Party
on whose behalf the person signs.
L. Waiver. The failure of either Party to insist in any one or more instances
upon performance of any terms or conditions of this Agreement shall not
be construed as a waiver of future performance of any such term,
covenant, or condition; but the obligations of such Party with respect
thereto shall continue in full force and effect.
M. Books and Records. To the extent applicable, the Parties agree to
comply with 42 U.S.C. section 1395x(v)(1)(1) and make available to
appropriate federal authorities the contract, books, documents, and
records reflecting the operation of the field education program for a
period of four (4) years from and after the termination of services under
this Agreement. Additionally, the Parties agree to comply with section
1861(b)(1)(1) of the Social Security Act and require all of their
subcontractors who perform services under this contract with the value
or cost of $10,000 or more over a twelve (12) month period to
contractually agree that, until the expiration of four (4) calendar years
after the furnishing of services under the subcontract, the subcontractor
shall make available, upon written request of the appropriate federal
authorities, the subcontract and books, documents and records of the
subcontractor that are necessary to verify the nature and extent of the
costs involved in the subcontract.
N. Non -Discrimination. Each Party agrees to be responsible for
compliance with all anti -discrimination laws applicable to its respective
activities arising under the terms of this Agreement. Neither Party will
discriminate against any student as provided for in federal and state law
or municipal code.
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O. Clinical Practice. No term of this Agreement is intended to directly or
indirectly, covertly or overtly require or solicit referral of patients in any
way, regardless of pay or source, including Medicare and/or Medicaid
patients.
P. Acknowledgment. By their execution of this Agreement, the Parties
stipulate and agree they have read the Agreement, understand the
Agreement, and agree to the statements and provisions contained
therein.
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IN WITNESS WHEREOF, the Parties hereto have executed this Agreement as of the
respective dates written below.
The EMS Training School, LLC,
d/b/a School of EMS
and d/b/a Camsen Career Institute
By: V, R6W
Signature
Name: TC Howard
Printed
Title: Chief Operating Officer
Date: 11/4/2025 1 18:13 CST
City of Dubuque
y �WAS
Fnture
Name: Michael C. Van Milligen
Printed
Title:
City Manager
Date: 10/16/2025
12
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EXHIBIT A
CITY INSURANCE SCHEDULE
City of Dubuque Insurance Requirements for Professional Services
INSURANCE SCHEDULE J
1. shall furnish a signed certificate of insurance to the City of Dubuque, Iowa for
the coverage required in Exhibit I prior to commencing work and at the end of the prcject if the
term of work is longerthan 80days_ Contractors presenting annual certificates shall present a
certificate at the end of each prcject with the final billing. Each certificate shall be prepared on
the most current ACORD form approved by the Iowa Department of Insurance or an equivalent
approved by the Director cf Finance and Budget. Each certificate shall include a statement under
Description of Operations as to why the certificate was issued_ Eg: Prcject # or Prcject
Location at or construction of
2_ All policies of insurance required hereunder shall be with an insurer authorized to do business in
Iowa and all insurers shall have a rating of A or better in the current A.M. Best's Rating Guide-
3- Each certificate shall be furnished to the Finance Department of the City of Dubuque-
4- Failure to provide coverage required by this Insurance Schedule shall not be deemed a waiverof
these requirements by the City of Dubuque. Failure to obtain or maintain the required insurance
shall be considered a material breach of this agreement.
5_ Contractors shall require all subconsultants and sub-subconsultants toobtain and maintain during
the performance of work insurance forthe coverages described in this Insurance Schedule and
shall obtain certificates of insurances from all such subconsultants and sub-subconsultants.
Contractors agree that they shall be liable for the failure of a subconsultant and sub-
subcon sultant to obtain and maintain such coverages_ The City may request a copy of such
certificates from the Contractor.
8. Al required endorsements shall be attached to the certificate. The certificate is due before the
contract/agreement can be approved.
7. Whenever a specific ISOform is listed, required the current edition of the form must be used, or
an equivalent form may be substituted If approved by the Director of Finance and Budget and
subject to the contractor identifying and listing in writing all deviations and exclusions from the
ISO form-
8- Contractors shall be required to carry the minimum coveragellimits, or greater if required by law
or other legal agreement, in Exhibit I_ If the contractor's limits of liability are higher than the
required minimum limits then the provider's limits shall bethis agreement's required limits.
9_ Contractor shall be responsible for deductibles and self -insured retention for paymentof all policy
premiums and other cost associated with the insurance policies required below_
10. Al certificates of insurance must include agents name, phone number, and email address_
11. The City of Dubuque reserves the right to require complete, certified copies of all required
insurance policies, including endorsements, required by this Schedule at any time_
12. The City of Dubuque reserves the right to modify these requirements, including limits, based on
changes in the risk or other special circumstances during the term of the agreement, subject to
written mutual agreement attached hereto.
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City of Dubuque Insurance Requirements for Professional Services
INSURANCE SCHEDULE J (continued)
Exhibit I
A) COMMERCIAL GENERAL LIABILITY
General Aggregate Limit $2,000,000
Products -Completed Operations Aggregate Limit $1,000,000
Personal and Advertising Injury Limit $1,000,000
Each Occurrence $1,000,000
Fire Damage Limit (any one occurrence) $50,000
Medical Payments $5,000
1) Coverage shall be written on an occurrence, not claims made, form. The general
liability coverage shall be written In accord with ISO form CG 00 01 or business
owners form BP 00 02. All deviations from the standard ISO commercial general
liability form CG 00 01, or business owners form BP 00 02, shall be clearly
identified.
2) Include endorsement indicating that coverage is primary and non-contributory.
3) Include Preservation of Governmental Immunities Endorsement. (Sample
attached).
4) Include additional insured endorsement for.
The City of Dubuque, including all its elected and appointed officials, all its
employees and volunteers, all its boards, commissions and/or authorities and
their board members, employees and volunteers. Use ISO form CG 20 26.
5) Policy shall Include Waiver of Right to Recoverfrom Others endorsement.
6) Policy shall include cancellation and material change endorsement providing
thirty (30) days advance written notice of cancellation, non -renewal, reduction in
insurance coverage andlor limits and ten (10) days written notice of non-payment
of premium shall be sent to: City of Dubuque Finance Department, 50 West 131^
Street Dubuque, Iowa 52001.
B) AUTOMOBILE LIABILITY
Combined Single Limit $1,000,000
Coverage shall Include all owned, non -owned, and hired vehicles. If the Contractor's
business does not own any vehicles, coverage is required on non -owned and hired
vehicles.
1) Policy shall include Waiverof Flight to Recoverfrom Others endorsement
C) WORKERS' COMPENSATION & EMPLOYERS LIABILITY
Statutory Benefits covering all employees injured on thejob by accident ordisease as
prescribed by Iowa Code Chapter 85.
Coverage A Statutory —State of Iowa
Coverage S Employers Liability
Each Accident $100,000
Each Employee -disease $100,000
Policy Limit -Disease $500,000
Policy shall include Waiverof Right to Recoverfrom Others endorsement.
Page 2 of 4 Schedule J Professional Services December2024
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City of Dubuque Insurance Requirements for Professional Services
Coverage B limits shall be greater if required by the umbrellafexcess insurer_
OR
ff, by Iowa Code Section 85.1A, the Contractor is not required to purchase Workers'
Compensation Insurance, the Contractor shall have a copy of the State's Nonelection of
Workers' Compensation or Employers' Liability Coverage form on file with the Iowa
Workers' Compensation Insurance Commissioner, as required by Iowa Code Section
8722. Completed form must be attached.
D) UMBRELLAIEXCESS LIABILITY $11000,000
The General Liability, Automobile Liability and Employer's Liability Insurance
requirements may be satisfied with a combination of primary and Umbrella or Excess
Liability Insurance. If the Umbrella or Excess Insurance policy does notfollow the form of
the primary policies, it shall include the same endorsements as required of the primary
policies including but not limited to Waiver of Subrogation and Primary and Non-
contributory in favorof the City.
E) PROFESSIONAL LIABILITY $2,000,000
ff the required policy provides claims -made coverage:
1) The Retroactive Date must be shown and must be before the date of the
agreement.
2) Insurance must be maintained and evidence of insurance must be provided for at
least five (5) years after completion of the work or services_
3) ff coverage is canceled or non -renewed and not replaced with another claims -
made policy form with a Retroactive Date prior to the date of the agreement, the
contractor must provide "extended reporting" coverage for a minimum of five (5)
years after completion of the work or services.
F) CYBER LIABILITYIBREACH $1,000,000
—Yes X No
Coverage for First and Third Party breach liability including but not limited to lost data and
restoration, loss of income and cyber breach of information.
Page 3 of 4 Schedule J Professional Services December2024
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City of Dubuque Insurance Requirements for Professional Services
Iowa Code Chapter 670, Liability of Governmental Subdivisions, provides cities with certain immunities
which may be available to you_ Naming the City of Dubuque as an additional insured on your insurance
as is requested by this Insurance Schedule may result in yourwaiverof those immunities_ If you would
like to preserve those immunities, please use this endorsement or an equivalentform. The preservation of
immunities is for your benefit.
PRESERVATION OF GOVERNMENTAL IMMUNITIES ENDORSEMENT
1. Nonwaiverof Governmental Immunitv.The insurer expressly agrees and states that the purchase
cf this policy and the including of the City of Dubuque, Iowa as an Additional Insured does not waive any
cf the defenses of governmental immunity available to the City of Dubuque, Iowa under Code cf Iowa
Section 670.4 as it now exists and as it may be amended from timeto time_
2. Claims Coverage. The insurerfurther agrees that this policy of Insurance shall coveronly those
claims not subject to the defense of governmental immunity under the Code of Iowa Section $70.4 as it
now exists and as it may be amended from time to time. Those claims not subject to Code of Iowa
Section 670.4 shall be covered by the terms and conditions of this insurance policy_
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 insurer.
4_ Non -Denial of Coverage_ The insurer shall not deny coverage underthis policy and the insurer
shall not deny any of the rights and benefits accruing to the City of Dubuque, Iowa underthis policy for
reasons of governmental immunity unless and until a court of competent jurisdiction has ruled In favor of
the defenses) of governmental immunity asserted by the City of Dubuque, Iowa_
No Other Change in PGlicy- The above preservation of governmental immunities shall not otherwise
change or alter the coverage available under the policy_
SPECIMEN
(DEPARTMENT MANAGER: FILL IN ALL BLANKS AND CHECK BOXES)
Page 4of4 Schedule Professional Services December2024
16
Page 330 of 750
Dubuque
THE C
DUUB*TE 1r11
2007-2012.2013
Masterpiece on the Miss1"5s1'pia1 2017*2019
City of Dubuque
Water Department
1902 Hawthorne Street
(address)
Dubuque, IA 52001
Phone # 563-589-4291
CITY OF DUBUQUE, IOWA
SHORT FORM
VENDOR SERVICE AGREEMENT
THIS VENDOR SERVICE AGREEMENT (the Contract), between the City of
Dubuque, Iowa (City), by its City Manager, through authority conferred upon the City
Manager by its City Council and
endor) at Environmental Management Services of Iowa, Inc.
endor Name
5170 Wolff Rd # 2, Dubuque, IA 52002
(Vendor Address - City and State)
PROJECT TITLE:
Eagle Point Water Treatment Plant Roof Rehabilitation - Asbestos Abatement (Project)
For and in consideration of the mutual covenants herein contained, the parties hereto
agree as follows:
VENDOR AGREES:
1. To furnish all material and eauir)ment and to Derform all labor necessary for:
Testing and removal and disposal of asbestos -containing materials on insulation covering roof drain piping from Roof No. 4 (3rd Floor Admin) of the Eagle Point
Water Treatment Plant Roof Rehabilitation Project, as described in proposal dated October 27, 2025.
The work described above shall be completed at the following location(s):
Eagle Point Water Treatment Plant (1902 Hawthorne Street, Dubuque, Iowa 52001)
The Project shall be completed in strict accordance with the terms as described in this
Contract; in strict accordance with the requirements of the laws of the State of Iowa
Page 1 of 20 Page 331 of 750
and ordinances of the City of Dubuque, just as much as if the detailed statements
thereof were repeated herein.
2. Contract Documents shall mean and include the following WHERE APPLICABLE:
Documents listed in bold should be attached to this document upon submission.
• Request for Proposal (or procurement documentation)
• This Contract;
• Ordinances and resolutions heretofore adopted by the City Council having to
do with this Project;
• The Vendor's Proposal;
• Plans and Specifications;
• General Requirements as adopted by the City Council for the Project;
• Terms and Conditions (Exhibit A); and
• INSURANCE — Please include one applicable Insurance Schedule:
o Insurance Schedule F for General Artisan or Trade Contractors or
Subcontractors (Exhibit B)
o Insurance Schedule G for Vendors (Exhibit C)
o Insurance Schedule J for Professional Services (Exhibit D)
Check Appropriate Box
El Insurance Schedule F — General Artisan or Trade Contractors or
Subcontractors
❑ Insurance Schedule G — Vendors
❑ Insurance Schedule J — Professional Services
• Other:
3. All materials used by the Vendor on this Project shall be of the quality required by the
Contract Documents and shall be put in place in accordance with the Contract
Documents.
4. The Vendor shall remove any materials rejected by the City Manager as defective or
improper, or any of said work condemned as unsuitable or defective, and the same
shall be replaced or done anew to the satisfaction of the City Manager at the cost and
expense of the Vendor.
5. The Vendor has read and understands the Contract Documents and has examined
and understands the project description described in Section 1 of this Agreement and
any attached Special Conditions herein referred to and agrees not to plead
misunderstanding or deception because of estimates of quantity, character, location
or other conditions surrounding the same.
6. The Vendor shall fully complete the Project under this Contract on or before
November 30, 2025 (date)
Page 2 of 20 Page 332 of 750
7. Indemnification; Liability for City Damage
A. To the fullest extent permitted by law, the Contractor shall indemnify and hold
harmless the City from and against all claims, damages, losses and expenses,
including but not limited to attorneys' fees, arising out of or resulting from
performance of the 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 (other than the Project itself) including loss of use resulting therefrom,
but only to the extent caused in whole or in part by negligent acts or omissions of
the Contractor, the Contractor's subcontractor, or anyone directly or indirectly
employed by the Contractor or the Contractor's subcontractor or anyone for whose
acts the Contractor or the Contractor's subcontractor may be liable, regardless of
whether or not such claim, damage, loss or expense is caused in part by a party
indemnified hereunder.
B. The Contractor shall also be liable to the City for any damage to City property
arising out of or related to the Contractor's negligent performance of the Contract.
8. Prior to the commencement of any work on this Project and at all times during the
performance of this Contract, the Vendor shall provide evidence of insurance which
meets the requirements of the City's Insurance Schedule as indicated above and
attached hereto.
9. The Vendor agrees that no work under this Contract shall commence until the City has
authorized said work in writing. Any work started by the Vendor prior the City
authorization shall be considered unauthorized and done at the sole risk to the
Vendor.
10. Vendor will comply with all federal, state, and local laws and regulations in the
performance of this Contract.
11. The City may terminate this Contract with or without cause upon fourteen (14) days'
written notice delivered to the Vendor.
12. This Contract shall be governed by the laws of the State of Iowa and exclusive
jurisdiction and venue for any action arising out of or related to this Contract shall be
the Iowa District Court for Dubuque County.
Page 3 of 20 Page 333 of 750
THE CITY AGREES:
The City agrees to pay the Vendor for the work actually performed under this
Contract, up to the amount stated below, less any agreed damages provided for in the
Contract Documents.
CONTRACT AMOUNT $ 1,265.00
CITY OF DUBUQUE, IOWA VENDOR:
By: 11 /06/2025 Environmental Management Services of Iowa, Inc.
ichael C. Van illigen Date Company Name
City Manager
By: 11 /05/25
Signa ure Date
Kim Koeller
Printed Name
President
Title
Page 4 of 20 Page 334 of 750
EXHIBIT A
TERMS AND CONDITIONS
The following Terms and Conditions apply to City of Dubuque Transactions:
1. The City of Dubuque is exempt from federal excise tax and Iowa sales tax.
2. The City of Dubuque will not be responsible for payment for any goods delivered
without a purchase order.
3. The vendor will send a separate invoice for each purchase order number. All
invoices, packages, shipping notices, or the like affecting the order shall contain
the applicable purchase order number. The vendor is to submit original invoice to
the address shown in the SHIP TO section on the front of this order.
4. No freight or packing charges will be allowed by the City of Dubuque unless
specifically authorized.
5. It is understood by the vendor that the cash discount period to the City of Dubuque
will date from the receipt of the invoice or from the date of the receipt of the goods,
whichever is later.
6. The risk of loss of and damage to the goods which are the subject of this order,
regardless of the F.O.B. point, is and will remain with the vendor until the goods
are delivered to the destination set out in the order and accepted by the City of
Dubuque or the authorized City of Dubuque representative.
7. In the event of the vendor's failure to deliver as and when specified, or to perform
as and when specified, the City of Dubuque reserves the right to cancel this order,
or any part thereof, without prejudice to its other rights, and the vendor agrees that
the City of Dubuque may return part or all of any shipment so made and may
charge the vendor with any loss expense sustained as a result of such failure to
deliver or to perform.
8. In the event any article, service, or process sold, delivered and/or performed
hereunder is covered by any patent, copyright, or application for either, the vendor
will indemnify and save harmless the City of Dubuque from any and all loss, cost,
or expenses on account of any and all claims, suits, or judgments on account of
the use or sale of such article or the use of such service or process in violation of
such patent, copyright or application for either.
9. In the event any article, service, or process sold and delivered or sold and
performed hereunder is defective in any respect whatsoever, the vendor will
indemnify and save harmless the City of Dubuque from all loss or the payment of
all sums of money by reason of all accidents, injuries or damages to person or
property that may happen or occur in connection with the use or sale of such
article, or process and are contributed to by said defective condition.
Page 5 of 20 Page 335 of 750
10. The vendor agrees not to release any advertising copy mentioning the City of
Dubuque or quoting the opinion of any City of Dubuque employee without the prior
written authorization from the City of Dubuque.
11.The vendor represents and warrants that no federal or state statute or regulation,
or local municipal ordinance has been or will be violated in the manufacturing, sale
and delivery hereunder. If such violation has or does occur, the vendor will
indemnify and save harmless the City of Dubuque from all loss, penalties, or
payment of all sums of money on account of such violation.
12. The City of Dubuque may at any time insist upon strict compliance with these terms
and conditions notwithstanding any previous custom, practice, or course of dealing
to the contrary.
13.The terms and conditions of sale as stated in this order govern in the event of
conflict with any terms of the vendor's proposal, and are not subject to change by
reason of any written or verbal statements by the vendor or by any terms stated in
the vendor's acknowledgement unless same be accepted in writing by the City of
Dubuque.
14. Current Safety Data Sheets (SDS), when applicable to the order, must be provided
by the vendor in accordance with all regulations.
Page 6 of 20 Page 336 of 750
EXHIBIT B
Class A:
Class B:
Class C:
INSURANCE SCHEDULE F
Asbestos Removal
Fiber Optics
Sanitary Sewers
Asphalt Paving
Fire Protection
Sheet Metal
Concrete
Fireproofing
Site Utilities
Construction Managers
General Contractors
Shoring
Cranes
HVAC
Special construction
Culverts
Mechanical
Steel
Decking
Paving & Surfacing
Storm sewers
Demolition
Piles & Caissons
Structural Steel
Deconstruction
Plumbing
Trails
Earthwork
Retaining Walls
Tunneling
Electrical
Reinforcement
Water main
Elevators
Roofing
Chemical Spraying
Landscaping
Rough Carpentry
Doors, Window &
Masonry
Stump Grinding
Glazing
Vehicular Snow Removal
Tank Coating
Drywall Systems
Painting & Wall Covering
Tree Removal
Fertilizer Application
Pest Control
Tree Trimming
Geotech Boring
Scaffolding
Tuckpointing
Insulation
Sidewalks
Waterproofing
Finish Carpentry
Plastering
Well Drilling
Carpet Cleaning
Carpet & Resilient
Flooring
Caulking & Sealants
Acoustical Ceiling
Filter Cleaning
General Cleaning
Grass Cutting
Janitorial
Non Vehicular Snow &
Ice Removal
Office Furnishings
Power Washing
Tile & Terrazzo Flooring
Window Washing
Page 7 of 20
Page 337 of 750
INSURANCE SCHEDULE F (continued)
Contractor shall furnish a signed certificate of insurance to the department responsible for the contract for the
coverage required in Exhibit I prior to commencing work and at the end of the project if the term of work is longer
than 60 days. Contractors presenting annual certificates shall present a certificate at the end of each project with
the final billing. Each certificate shall be prepared on the most current ACORD form approved by the Iowa
Department of Insurance or an equivalent approved by the Director of Finance and Budget or Designee. The
certificate must clearly indicate the project number, project name, or project description for which it is being
provided Eg: Project # Project name: Ea91ePom1Wale, T,ea..n Plant Roof RehaC0ta4on.Asbestos Abatement or Project Location at
or construction of
2. All policies of insurance required hereunder shall be with an insurer authorized to do business in Iowa and all
insurers shall have a rating of A or better in the current A.M. Best's Rating Guide.
3. Each Certificate required shall be furnished to the water Department of the City of Dubuque.
4. Failure to provide the coverages described in this Insurance Schedule shall not be deemed a waiver of these
requirements by the City of Dubuque. Failure to obtain or maintain the required insurance shall be considered a
material breach of this contract.
5. Contractor shall require all subcontractors and sub -subcontractors to obtain and maintain during the performance
of work insurance for the coverages described in this Insurance Schedule and shall obtain certificates of
insurance from all such subcontractors and sub -subcontractors. Contractor agrees that it shall be liable for the
failure of a subcontractor and sub -subcontractor to obtain and maintain such coverage. The City may request a
copy of such certificates from the Contractor.
6. All required endorsements shall be attached to the certificate. The certificate is due before the contract/agreement
can be approved.
Whenever an ISO form is referenced the current edition must be provided.
Contractor shall be required to carry the minimum coverage/limit, or greater if required by law or other legal
agreement, in Exhibit I - Insurance Schedule F. If the contractor's limits of liability are higher than the required
minimum limit, then the contractor's limits shall be this agreement's required limits.
9. Contractor shall be responsible for deductibles and self -insured retention for payment of all policy premiums and
other cost associated with the insurance policies required below.
10. All certificates of insurance must include agents name, phone number, and email address.
11. The City of Dubuque reserves the right to require complete, certified copies of all required insurance policies,
including endorsements, required by this Schedule at any time.
12. The City of Dubuque reserves the right to modify these requirements, including limits, based on changes in the
risk or other special circumstances during the term of the contract, subject to written mutual agreement attached
hereto.
Page 8 of 20
Page 338 of 750
INSURANCE SCHEDULE F (continued)
EXHIBIT I
A) COMMERCIAL GENERAL LIABILITY
General Aggregate Limit $2,000,000
Products -Completed Operations Aggregate Limit $2,000,000
Personal and Advertising Injury Limit $1,000,000
Each Occurrence $1,000,000
Fire Damage Limit (any one occurrence) $50,000
Medical Payments $5,000
1) Coverage shall be written on an occurrence, not claims made, form. The general liability
coverage shall be written in accord with ISO form CG 00 01 or business owners form BP 00 02.
All deviations from the standard ISO commercial general liability form CG 00 01 or business
owners form BP 00 02 shall be clearly identified.
2) Include ISO endorsement form CG 25 04 "Designated Location(s) General Aggregate Limit" or
CG 25 03 "Designated Construction Project(s) General Aggregate Limit" as appropriate.
3) Include endorsement indicating that coverage is primary and non-contributory.
4) Include Preservation of Governmental Immunities Endorsement. (Sample attached).
5) Include additional insured endorsement for:
The City of Dubuque, including all its elected and appointed officials, all its employees,
agents, and volunteers, all its boards, commissions and/or authorities and their board
members, employees, agents, and volunteers. Use ISO form CG 20 10 (Ongoing operations).
6) The additional insured endorsement shall include completed operations under ISO form CG 20
37 during the project term and for a period of two years after the completion of the project.
7) Policy shall include Waiver of Right to Recover from Others endorsement.
8) Policy shall include cancellation and material change endorsement providing 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
Finance Department, 50 West 13th Street Dubuque, Iowa 52001.
9) Contractor and subcontractor shall not use any drone without the prior written approval of the City
of Dubuque. Any drone usage must comply with above liability limits and the additional insured
endorsement must name the City of Dubuque with respect to aircraft liability coverage.
B) WORKERS' COMPENSATION & EMPLOYERS LIABILITY
Statutory Benefits covering all employees injured on the job by accident or disease as prescribed by Iowa
Code Chapter 85.
Coverage A Statutory —State of Iowa
Coverage B Employers Liability
Each Accident $100,000
Each Employee -Disease $100,000
Policy Limit -Disease $500,000
Policy shall include Waiver of Right to Recover from Others endorsement.
Coverage B limits shall be greater if required by the umbrella/excess insurer.
OR
If, by Iowa Code Section 85.1A, the Contractor is not required to purchase Workers' Compensation
Insurance, the Contractor shall have a copy of the State's Nonelection of Workers' Compensation or
Employers' Liability Coverage form on file with the Iowa
Workers' Compensation Insurance Commissioner, as required by Iowa Code Section 87.22. Completed
form must be attached.
Page 9 of 20
Page 339 of 750
C) AUTOMOBILE LIABILITY
Combined Single Limit $1,000,000
Coverage shall include all owned, non -owned, and hired vehicles. If the Contractor's business does not
own any vehicles, coverage is required on non -owned and hired vehicles.
1) Policy shall include Waiver of Right to Recover from Others endorsement.
D) UMBRELLA/EXCESS LIABILITY
The General Liability, Automobile Liability and Employer's Liability Insurance requirements may be
satisfied with a combination of primary and Umbrella or Excess Liability Insurance. If the Umbrella or
Excess Insurance policy does not follow the form of the primary policies, it shall include the same
endorsements as required of the primary policies including but not limited to Waiver of Subrogation and
Primary and Non-contributory in favor of the City.
All Class A contractors with contract values in excess of $10,000,000 must have umbrella/excess liability
coverage of $10,000,000.
All Class A and Class B contractors with contract values between $500,000 and $10,000,000 must have
umbrella/excess liability coverage of $3,000,000.
All Class A and B contractors with contract values less than $500,000 must have umbrella/excess liability
coverage of $1,000,000.
All Class C contractors are not required to have umbrella/excess liability coverage.
All contractors performing earth work must have a minimum of $3,000,000 umbrella regardless of the
contract value.
E) POLLUTION LIABILITY
Coverage required: x Yes _ No
Pollution liability coverage shall be required if project involves any pollution exposure for hazardous or
contaminated materials including, but not limited to, the removal of lead, asbestos, or PCBs. Pollution
product and complete operations coverage shall also be covered.
Each Occurrence $2,000,000
Policy Aggregate $4,000,000
1) Policy to include job site and transportation coverage.
2) Include additional insured for:
The City of Dubuque, including all its elected and appointed officials, all its employees,
agents, and volunteers, all its boards, commissions and/or authorities and their board
members, employees and volunteers. Use ISO form CG 20 10. (Ongoing operations) or its
equivalent and CG 20 37 (completed operations) or its equivalent.
3) Include Preservation of Governmental Immunities Endorsement.
4) Provide evidence of coverage for 5 years after completion of project.
5) Include endorsement indicating that coverage is primary and non-contributory.
6) Policy shall include waiver of right to recovery from others endorsement.
7) Pollution liability shall include ISP endorsement CA 99 48. Pollution Liability -Broadened Coverage
for Covered Autos, or equivalent endorsement if the contractor has vehicles that transport fuel
onto the Owner's property.
F) RAILROAD PROTECTIVE LIABILITY
Coverage required: _ Yes x No
Page 10 of 20
Page 340 of 750
Any contract for construction or demolition work on or within fifty feet (50') from the edge of the tracks of a
railroad and affecting any railroad bridge, trestle, tracks, roadbeds, tunnel, underpass, or crossing, for
which an easement, license or indemnification of the railroad is required, shall require evidence of the
following additional coverages.
Railroad Protective Liability:
each occurrence (per limits required by Railroad)
policy aggregate (per limits required by Railroad)
AND
An endorsement to the Commercial General Liability policy equal to ISO CG 24 17 (Contractual Liability -
Railroads). A copy of this endorsement shall be attached to the certificate of insurance.
Page 11 of 20
Page 341 of 750
Iowa Code Chapter 670, Liability of Governmental Subdivisions, provides cities with certain immunities which may be
available to you. Naming the City of Dubuque as an additional insured on your insurance as is requested by this
Insurance Schedule may result in your waiver of those immunities. If you would like to preserve those immunities, please
use this endorsement or an equivalent form. The preservation of immunities is for your benefit.
PRESERVATION OF GOVERNMENTAL IMMUNITIES ENDORSEMENT
1. Nonwaiver of Governmental Immunity. The insurer expressly agrees and states that the purchase of this policy
and the including of the City of Dubuque, 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 insurer further agrees that this policy of insurance shall cover only those claims not subject
to the defense of governmental immunity under the Code of Iowa Section 670.4 as it now exists and as it may be
amended from time to time. Those claims not subject to Code of Iowa Section 670.4 shall be covered by the terms and
conditions of this insurance policy.
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 insurer.
4. Non -Denial of Coverage. The insurer shall not deny coverage under this policy and the insurer shall not deny any
of the rights and benefits accruing to the City of Dubuque, 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.
No Other Change in Polices The above preservation of governmental immunities shall not otherwise change or alter the
coverage available under the policy.
SPECIMEN
(DEPARTMENT MANAGER: FILL IN ALL BLANKS AND CHECK BOXES)
Page 12 of 20
Page 342 of 750
EXHIBIT C
U
1.
a do h f is
a n c ifi to f i ur c o e ty D u e ow fo h o ra r
ui d i
h' it I No o e
nt ct o e e nt a c if' at h b r ar o th m t c rre
O f m
a ro ed y t I
a s an D' isi a q al t. ac ce ifi a al nc de s e en
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e n o f er
io a to y e e" c w si u. V nd S i e e d d
II li ' s in r
ce a re e u er al a it n ' su r th iz to o si s n
n all
i ur s al a a ti o o e er ' th c e A. . B st' ' g ui .
ac c ifi e a
e rh to a in c e rt en f e y D u e.
4.
h se is pr id
s II r uir d t c y t i m ov a /li is r ea r if e re y
w r o er
g ag a nt n
hi I. ai re p vi t re it i m ov a s II t d m
a' er
s h q' e nt
y he ity f b ue
it e t ob in r
in in e r qu" ed ' s n s II c si er a at is re h t' a e e
11 q' ed n rs
e s all a a e o t c if at c ifi to ' d b or th by ra
a e en
I a r ed
h e r p ifi
S or is of en d e rr t iti o e or m t u d le a e
iv nt
f m' a ro d
t ec r i n a B dg T e rvi p vi r use ify r I' i
ri ' g
de a s nd xc
si s f m e 0 or
8
If en or' i s
is i re ig r an e q' e i li its e h a or' li is al
a is
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li its
9
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or in o
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e ve g d cr' ed ' t' I ur c c d e d al bt n rtif' at o
is a e
f m I ch ub on c s d b- ub n ct s. a or gr s at ' sh b lia e r t f ' ur of
s co ra or d
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10
do sh b re
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as a oc' e i
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1
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1
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nc air a ore
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cir u a e ur' g et m t a e e, s je to ri n ut I re
e
tt a to
Page 13 of 20
Page 343 of 750
INSURANCE SCHEDULE G (continued)
X BI I
M E I N L BI T
e al g g e' it 2, 0 0
P d s- o le d er io gr at i t 0 ,0
e on a e si Try im' $ 0 0
c c rr c 11 0, 0
Fi D m e' i a o o ur nc $ ,0
e ca a e s $ 0
1) C er a a e rit n a oc rr c, n cl ' s a, f m h ge r is ' ity
ov ages I w'te in c tl "h O r 0 1 b in s n sf m 0
d iat' ns o th st d I m r" I ne I Iili fo 0, or u' e
ow er or B 0 2 b le y ' e " ie .
cI e O nd se a fo 2 0 ig to o ti (s a er A re to i
3 1 u e or nt " di tin th c er e ' purna a n -c ntr' it y.
nc d r e do of o rn a I I m iti E o e nt a pl tt h
cI a di " n in re en r m t f
T C' u e, ' cl in all ' e ct a po to off ial , al ' s p ye s d
of to s, I i b ra , c m' si s d/ a o' ie an h" b r e e
p e a v u er . U e l f m G 0 ( g 'ng pe ti s) r it e v nt
6) P cy a in d er f gh o c er o Ot rs n rs e
of s all ' cl e n la ' n no a ria h g n rs e p vi " g in (3 d s
a e it tic of an II on o re w , r u "on ' i it c o ra a d/ i is
an to (,1 d s it n is of n- ay en of e h b e to* it of ub qu
in ce a rt n 0 e 1 e u e, w 2 1.
O S, O P S I L S A LI
t to B e s c e' g a pl a in' re on e' b cid t d' ea a pr cr' ed y
d pt 8
o ra to for — at of w
v g p e Li ili
ci nt 10 ,0
ac E to ee is s $ 0 00
P is i" -D' e e 5 ,0
oli s II ' cl a aiv r o i t t ov fr h e do a nt
o r e E' s s all a ea r if a re y e m II ex s s er
O
I, y ow C e ec ' n .1 , t V d is of q" e o rc s e m n io
in ra ce e e or a a o of eta s on ec ' n rk s' o e ati o
m oy s' ab' ty ov a fo fil wi t to a or rs' o pe a ' n su n
m Is n a e ire b o C e ec ' n LM e f m u e tt e
Page 14 of 20
Page 344 of 750
INSURANCE SCHEDULE G (continued)
C L 1 IT
ve g e ire
s o
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s I d i
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a
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4, 0, 0
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Page 16 of 20
Page 346 of 750
EXHIBIT D
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Page 17 of 20
Page 347 of 750
INSURANCE SCHEDULE J (continued)
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Page 348 of 750
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Page 19 of 20
Page 349 of 750
Page 20 of 20
Page 350 of 750
QUOTE/ ENVIRONMENTAL MANAGEMENT SERVICES OF IOWA, INC.
CONTRACT 5170 Wolff Rd., Ste. 2, Dubuque, IA 52002-2573 www.emsofiowa.com
PHONE: (563) 583-0808 FAX: (563) 583-2206 EMAIL: emsi.asbestosservicesCa,aol.com
"Asbestos Inspections/Testing & Asbestos Abatement/Removal Services - Asbestos Licensed in Iowa, Illinois, & Wisconsin WY
PROPOSAL TO:
PHONE:
DATE:
City of Dubuque
(563) 513-5706
Attn: Nick Connolly
nconnoll2cityofdubuclue.org
October 27, 2025
STREET:
JOB:
50 West 131h Street
Asbestos Removal
CITY, STATE, ZIP:
JOB LOCATION:
City of Dubuque Water Treatment Center,
Dubuque, IA 52001
1902 Hawthorne St.. Dubuque. IA 52001
We hereby submit specifications and estimates for:
Sample collection, preparation, and asbestos analysis at an approved lab ................................. $30.00/sample
Removal and disposal of approximately 8 In. ft. of asbestos woolsfelt insulation on roof drain and one asbestos mudded
fitting on roof drain.
PriceComplete.................................................................................................. $1,175.00
NOTE: The above price includes the required Iowa DNR Asbestos Notification fee.
Special insurance requirements may require additional costs to be added to the project price.
The prices are not based on Prevailing Wage or Davis Bacon Wage Rates.
The quotes/prices do not include the cost of any air clearance samples if required, unless otherwise stated within this quote.
ROOF PROJECTS: EMSI's quotes do not include the removal of rubber or other types of non -asbestos roofing or insulation above asbestos roofing layers,
removal of layers of rooting located under asbestos roofing,and nd any covering of exposed areas after asbestos removal is completed
MASTIC/ADHESIVE REMOVAL PROJECTS: Due to the materials needed to be used to remove asbestos or non -asbestos mastics/adhesives,
Environmental Management Services of Iowa, Inc. (EMSI) will not be responsible for issues with adherence of new materials to surfaces after mastics/adhesives are
removed. The contractor/installer of new materials will be responsible for preparing surfaces for proper adherence of new materials and will be responsible for
adherence issues. EMSI will neutralize solvents to the best of ability, but cannot guarantee will resolve adherence issues.
All work will be performed in accordance with OSHA asbestos standard for construction industry, 29 CFR 1926,1101 and USEPA National Emissions Standard for
Hazardous Air Pollutants (NESHAPS). Asbestos Regulations, 40 CFR 61 Subpart A & M. All work will be performed by AHERA licensed individuals regularly
engaged in asbestos removal.
Payment to be made as follows: Down payment of 50% of quoted price prior to start may be required / Net 10 days / 1.5% Past Due
Iowa Contractors License No. 3401 Authorized Signature:
IL Asbestos Contractor Permit No. 500-0482
WI Contractor Permit No. 13150
Kim Koeller, President
NOTE: This proposal may be withdrawn if not accepted within 30 days.
Acceptance of Proposal
The above prices, specifications, and conditions are satisfactory
and are hereby accepted. You are authorized to do the work as
specified. Payment will be made as stated above.
Signature:
Date Accepted: Signature:
q
EMsI Thank you for the opportunity to provide a quote. If the quote is accepted, please return a signed and dated copy.
*Est. 1990 / Serving local communities for over 35 years!
Page 351 of 750
Dubuque
THE CITY OF
DUB E
IE�aeb
1I11I'
2007-2012.2013
2017*2019
Masterpiece on the Mississippi
City of Dubuque
Dept: Health Dept.
50 W. 13th Street
Dubuque, IA 52001
Phone # 563-589-4181
CITY OF DUBUQUE, IOWA
SHORT FORM
VENDOR SERVICE AGREEMENT
THIS VENDOR SERVICE AGREEMENT (the Contract), between the City of Dubuque, Iowa
(City), by its City Manager, through authority conferred upon the City Manager by its City Council and
Dubuque County E911 Board (Vendor) at
(Vendor Name)
14928 Public Safety Way, Dubuque, IA 52002
(Vendor Address - City and State)
PROJECT TITLE: Health Services - Animal Control 911 Radio Access Fee
(Project)
For and in consideration of the mutual covenants herein contained, the parties hereto agree as follows:
VENDOR AGREES:
1. To furnish all material and equipment and to perform all labor necessary for:
911 Radio Access Fees for City of Dubuque Animal Control
The work described above shall be completed at the following location(s):
N/A
The Project shall be completed in strict accordance with the terms as described in this Contract; in
strict accordance with the requirements of the laws of the State of Iowa and ordinances of the City
of Dubuque, just as much as if the detailed statements thereof were repeated herein.
Page 1 of 13
Page 352 of 750
2. Contract Documents shall mean and include the following where applicable:
Documents listed in bold should be attached to this document upon submission.
• Request for Proposal (or procurement documentation)
• This Contract;
• Ordinances and resolutions heretofore adopted by the City Council having to do with this
Project;
• The Vendor's Proposal;
• Plans and Specifications;
• General Requirements as adopted by the City Council for the Project;
• Terms and Conditions (Exhibit A); and
• Insurance Schedule G for Vendors (Exhibit B) or Insurance Schedule J for
Professional Services (Exhibit C).
Check Appropriate Box
0 Insurance Schedule G — Vendors
❑ Insurance Schedule J — Professional Services
• Other:
3. All materials used by the Vendor on this Project shall be of the quality required by the Contract
Documents and shall be put in place in accordance with the Contract Documents.
4. The Vendor shall remove any materials rejected by the City Manager as defective or improper, or
any of said work condemned as unsuitable or defective, and the same shall be replaced or done
anew to the satisfaction of the City Manager at the cost and expense of the Vendor.
5. The Vendor has read and understands the Contract Documents and has examined and understands
the project description described in Section 1 of this Agreement and any attached Special
Conditions herein referred to and agrees not to plead misunderstanding or deception because of
estimates of quantity, character, location or other conditions surrounding the same.
6. The Vendor shall fully complete the Project under this Contract on or before
June 30, 2026
(DATE)
7. Indemnification; Liability for City Damage
A. To the fullest extent permitted by law, the Contractor shall indemnify and hold harmless the City
from and against all claims, damages, losses and expenses, including but not limited to
attorneys' fees, arising out of or resulting from performance of the 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 (other than the Project itself) including loss of use resulting
therefrom, but only to the extent caused in whole or in part by negligent acts or omissions of the
Contractor, the Contractor's subcontractor, or anyone directly or indirectly employed by the
Contractor or the Contractor's subcontractor or anyone for whose acts the Contractor or the
Contractor's subcontractor may be liable, regardless of whether or not such claim, damage, loss
or expense is caused in part by a party indemnified hereunder.
B. The Contractor shall also be liable to the City for any damage to City property arising out of or
related to the Contractor's negligent performance of the Contract.
Page 2 of 13
Page 353 of 750
8. Prior to the commencement of any work on this Project and at all times during the performance of
this Contract, the Vendor shall provide evidence of insurance which meets the requirements of the
City's Insurance Schedule G or Insurance Schedule J attached to this Contract.
Check Appropriate Box
0 Insurance Schedule G — Vendors
❑ Insurance Schedule J — Professional Services
9. The Vendor agrees that no work under this Contract shall commence until the City has authorized
said work in writing. Any work started by the Vendor prior the City authorization shall be considered
unauthorized and done at the sole risk to the Vendor.
10. Vendor will comply with all federal, state, and local laws and regulations in the performance of this
Contract.
11. The City may terminate this Contract with or without cause upon fourteen (14) days' written notice
delivered to the Vendor.
12. This Contract shall be governed by the laws of the State of Iowa and exclusive jurisdiction and
venue for any action arising out of or related to this Contract shall be the Iowa District Court for
Dubuque County.
THE CITY AGREES:
Upon the completion of this Contract, and the acceptance of the Project by the City Manager,
the City agrees to pay the Vendor as full compensation for the complete performance of this Contract,
the amount stated below, less any agreed damages provided for in the Contract Documents.
CONTRACT AMOUNT $ $374.04
CITY OF DUBUQUE, IOWA
By: _
Ajjsz�,-
Rich-ael C. Van Milligen
City Manager
11 /06/2025
Date
VENDOR:
Dubuque County E911 Board
Company Name
By: Thomas I Bergerb 09-16-2025
Signature Date
Thomas I. Berger
Printed Name
Dubuque County 911 Board Chair
Title
Page 3 of 13
Page 354 of 750
EXHIBIT A
TERMS AND CONDITIONS
The following Terms and Conditions apply to City of Dubuque Transactions:
1. The City of Dubuque is exempt from federal excise tax and Iowa sales tax.
2. The City of Dubuque will not be responsible for payment for any goods delivered without a
purchase order.
3. The vendor will send a separate invoice for each purchase order number. All invoices, packages,
shipping notices, or the like affecting the order shall contain the applicable purchase order
number. The vendor is to submit original invoice to the address shown in the SHIP TO section
on the front of this order.
4. No freight or packing charges will be allowed by the City of Dubuque unless specifically
authorized.
5. It is understood by the vendor that the cash discount period to the City of Dubuque will date from
the receipt of the invoice or from the date of the receipt of the goods, whichever is later.
6. The risk of loss of and damage to the goods which are the subject of this order, regardless of
the F.O.B. point, is and will remain with the vendor until the goods are delivered to the destination
set out in the order and accepted by the City of Dubuque or the authorized City of Dubuque
representative.
7. In the event of the vendor's failure to deliver as and when specified, or to perform as and when
specified, the City of Dubuque reserves the right to cancel this order, or any part thereof, without
prejudice to its other rights, and the vendor agrees that the City of Dubuque may return part or
all of any shipment so made and may charge the vendor with any loss expense sustained as a
result of such failure to deliver or to perform.
8. In the event any article, service, or process sold, delivered and/or performed hereunder is
covered by any patent, copyright, or application for either, the vendor will indemnify and save
harmless the City of Dubuque from any and all loss, cost, or expenses on account of any and all
claims, suits, or judgments on account of the use or sale of such article or the use of such service
or process in violation of such patent, copyright or application for either.
9. In the event any article, service, or process sold and delivered or sold and performed hereunder
is defective in any respect whatsoever, the vendor will indemnify and save harmless the City of
Dubuque from all loss or the payment of all sums of money by reason of all accidents, injuries
or damages to person or property that may happen or occur in connection with the use or sale
of such article, or process and are contributed to by said defective condition.
10.The vendor agrees not to release any advertising copy mentioning the City of Dubuque or
quoting the opinion of any City of Dubuque employee without the prior written authorization from
the City of Dubuque.
Page 4 of 13
Page 355 of 750
11. The vendor represents and warrants that no federal or state statute or regulation, or local
municipal ordinance has been or will be violated in the manufacturing, sale and delivery
hereunder. If such violation has or does occur, the vendor will indemnify and save harmless the
City of Dubuque from all loss, penalties, or payment of all sums of money on account of such
violation.
12.The City of Dubuque may at any time insist upon strict compliance with these terms and
conditions notwithstanding any previous custom, practice, or course of dealing to the contrary.
13.The terms and conditions of sale as stated in this order govern in the event of conflict with any
terms of the vendor's proposal, and are not subject to change by reason of any written or verbal
statements by the vendor or by any terms stated in the vendor's acknowledgement unless same
be accepted in writing by the City of Dubuque.
14. Current Safety Data Sheets (SDS), when applicable to the order, must be provided by the vendor
in accordance with all regulations.
Page 5 of 13
Page 356 of 750
EXHIBIT B
INSURANCE SCHEDULE G
Vendor shall furnish a signed certificate of insurance to the City of Dubuque, Iowa for the coverage required in
Exhibit I prior to the contract commencement. Each certificate shall be prepared on the most current ACORD form
approved by the Iowa Insurance Division or an equivalent. Each certificate shall include a statement under
Description of Operations as to why the certificate was issued. Vendor Service Agreement dated
September 8, 2025
All policies of insurance required hereunder shall be with an insurer authorized to do business in Iowa and all
insurers shall have a rating of A or better in the current A.M. Best's Rating Guide.
3. Each certificate shall be furnished to the Finance Department of the City of Dubuque.
4. The service provider shall be required to carry the minimum coverage/limits, or greater if required by law or other
legal agreement, in Exhibit I. Failure to provide the required minimum coverage shall not be deemed a waiver of
such requirements by the City of Dubuque.
5. Failure to obtain or maintain the required insurance shall be considered a material breach of this agreement.
6. All required endorsements shall be attached to the certificate. The certificate is due before the contract/agreement
can be approved.
7. Whenever a specific ISO form is referenced the current edition of the form must be used unless an equivalent
form is approved by the Director of Finance and Budget. The service provider must identify or list in writing all
deviations and exclusions from the ISO form.
8. If vendor's limits of liability are higher than the required minimum limits then the vendor's limits shall be this
agreement's required limits.
9. Vendor shall require all subcontractors and sub -subcontractors to obtain and maintain during the performance of
work insurance for the coverages described in this Insurance Schedule and shall obtain certificates of insurance
from all such subcontractors and sub -subcontractors. Vendor agrees that it shall be liable for the failure of a
subcontractor and sub -subcontractor to obtain and maintain such coverage. The City may request a copy of such
certificates from the Vendor.
10. Vendor shall be responsible for deductibles/self-insured retention for payment of all policy premiums and other
costs associated with the insurance policies required below.
11. All certificates of insurance must include agents name, phone number, and email address.
12. The City of Dubuque reserves the right to require complete, certified copies of all required insurance policies,
including endorsements, required by this Schedule at any time.
13. The City of Dubuque reserves the right to modify these requirements, including limits, based on changes in the
risk or other special circumstances during the term of the agreement, subject to written mutual agreement
attached hereto.
Page 6 of 13
Page 357 of 750
INSURANCE SCHEDULE G (continued)
EXHIBIT I
A) COMMERCIAL GENERAL LIABILITY
General Aggregate Limit $2,000,000
Products -Completed Operations Aggregate Limit $1,000,000
Personal and Advertising Injury Limit $1,000,000
Each Occurrence $1,000,000
Fire Damage Limit (any one occurrence) $50,000
Medical Payments $5,000
1) Coverage shall be written on an occurrence, not claims made, form. The general liability
coverage shall be written in accord with ISO form CG 00 01 or business owners form BP 00 02.
All deviations from the standard ISO commercial general liability form CG 00 01, or Business
owners form BP 00 02, shall be clearly identified.
2) Include ISO endorsement form CG 25 04 "Designated Location(s) General Aggregate Limit."
3) Include endorsement indicating that coverage is primary and non-contributory.
4) Include Preservation of Governmental Immunities Endorsement (Sample attached).
5) Include additional insured endorsement for:
The City of Dubuque, including all its elected and appointed officials, all its employees and
volunteers, all its boards, commissions and/or authorities and their board members,
employees and volunteers. Use ISO form CG 20 10 (Ongoing operations) or its equivalent.
6) Policy shall include Waiver of Right to Recover from Others endorsement.
7) Policy shall include cancellation and material change endorsement providing 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
Finance Department, 50 West 13th Street Dubuque, Iowa 52001.
B) WORKERS' COMPENSATION & EMPLOYERS LIABILITY
Statutory Benefits covering all employees injured on the job by accident or disease as prescribed by Iowa
Code Chapter 85.
Coverage A Statutory —State of Iowa
Coverage B Employers Liability
Each Accident $100,000
Each Employee -Disease $100,000
Policy Limit -Disease $500,000
Policy shall include Waiver of Right to Recover from Others endorsement.
Coverage B limits shall be greater if required by the umbrella/excess insurer
OR
If, by Iowa Code Section 85.1A, the Vendor is not required to purchase Workers' Compensation
Insurance, the Vendor shall have a copy of the State's Nonelection of Workers' Compensation or
Employers' Liability Coverage form on file with the Iowa Workers' Compensation Insurance
Commissioner, as required by Iowa Code Section 87.22. Completed form must be attached.
Page 7 of 13
Page 358 of 750
INSURANCE SCHEDULE G (continued)
C) POLLUTION LIABILITY
Coverage required: —Yes x No
Pollution liability coverage shall be required if the lessee, contracting party, or permittee has any pollution
exposure for abatement of hazardous or contaminated materials including, but not limited to, petroleum
products, the removal of lead, asbestos, or PCBs. Pollution product and completed operations coverage
shall also be covered.
Each Occurrence $2,000,000
Policy Aggregate $4,000,000
1) Policy to include job site and transportation coverage.
2) Include additional insured for:
The City of Dubuque, including all its elected and appointed officials, all its employees and
volunteers, all its boards, commissions and/or authorities and their board members,
employees and volunteers. Use ISO form CG 20 10. (Ongoing operations) or its equivalent
and CG 20 37(competed operations).
3) Include Preservation of Governmental Immunities Endorsement.
4) Provide evidence of coverage for 5 years after completion of project.
5) Include endorsement indicating that coverage is primary and non-contributory.
6) Policy shall include waiver of right to recovery from others endorsement.
D) PROFESSIONAL LIABILITY $1,000,000
Coverage required: x Yes _ No
If the required policy provides claims -made coverage
1) The Retroactive Date must be shown and must be before the date of the agreement.
2) Insurance must be maintained and evidence of insurance must be provided for at least five (5)
years after completion of the work or services.
3) If coverage is canceled or non -renewed and not replaced with another claims -made policy form
with a Retroactive Date prior to the date of the agreement, the contractor must provide "extended
reporting" coverage for a minimum of five (5) years after completion of the work or services.
E) CYBER LIABILITY/BREACH $1,000,000
Coverage required: —Yes X No
Coverage for First and Third Party breach liability including but not limited to lost data and restoration,
loss of income and cyber breach of information.
F) UMBRELLA/EXCESS $1,000,000
Coverage required: —Yes X No
The General Liability, Automobile Liability and Employer's Liability Insurance requirements may be
satisfied with a combination of primary and Umbrella or Excess Liability Insurance. If the Umbrella or
Excess Insurance policy does not follow the form of the primary policies, it shall include the same
endorsements as required of the primary policies including but not limited to Waiver of Subrogation and
Primary and Non-contributory in favor of the City.
Please be aware that naming the City of Dubuque as an additional insured as is required by this Insurance Schedule may
result in the waiver of the City's governmental immunities provided in Iowa Code sec. 670.4. If you would like to preserve
those immunities, please use this endorsement or an equivalent form.
PRESERVATION OF GOVERNMENTAL IMMUNITIES ENDORSEMENT
Page 8 of 13
Page 359 of 750
1. Nonwaiver of Governmental Immunity. The insurer expressly agrees and states that the purchase of this policy
and the including of the City of Dubuque, 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 insurer further agrees that this policy of insurance shall cover only those claims not subject
to the defense of governmental immunity under the Code of Iowa Section 670.4 as it now exists and as it may be
amended from time to time. Those claims not subject to Code of Iowa Section 670.4 shall be covered by the terms and
conditions of this insurance policy.
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 insurer.
4. Non -Denial of Coverage. The insurer shall not deny coverage under this policy and the insurer shall not deny any
of the rights and benefits accruing to the City of Dubuque, 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.
No Other Change in Policy. The above preservation of governmental immunities shall not otherwise change or alter the
coverage available under the policy.
SPECIMEN
(DEPARTMENT MANAGER: FILL IN ALL BLANKS AND CHECK BOXES)
Page 9 of 13
Page 360 of 750
tau► LIQUo
,rf-TG CT'rY ov
�&17xr
DieuME 11111.1
2007.2012.2013
Masterpiece, on the & ssissir)P1 20 7a2019
City of Dubuque
Dept: Health Dept.
50 W. 13th Street
Dubuque, IA 52001
Phone # 563-589-4181
CITY OF DUBUQUE, IOWA
SHORT FORM
VENDOR SERVICE AGREEMENT
THIS VENDOR SERVICE AGREEMENT (the Contract), between the City of Dubuque, Iowa
(City), by its City Manager, through authority conferred upon the City Manager by its City Council and
Dubuque Regional Humane Society (Vendor) at
(Vendor Name)
4242 Chavenelle Rd., Dubuque, IA 52002
(Vendor Address - City and State)
PROJECT TITLE: City of Dubuque Veterinary Services
(Project)
For and in consideration of the mutual covenants herein contained, the parties hereto agree as follows:
VENDOR AGREES:
1. To furnish all material and equipment and to perform all labor necessary for:
Veterinary services for the City of Dubuque, as normally available and within the ability and capacity of Vendor.
Services beyond the Vendor's resources or expertise are not required under this Agreement.
The work described above shall be completed at the following location(s):
Dubuque Regional Humane Society
The Project shall be completed in strict accordance with the terms as described in this Contract; in
strict accordance with the requirements of the laws of the State of Iowa and ordinances of the City
of Dubuque, just as much as if the detailed statements thereof were repeated herein.
Page 1 of 13
Page 361 of 750
2. Contract Documents shall mean and include the following where applicable:
Documents listed in bold should be attached to this document upon submission.
• Request for Proposal (or procurement documentation)
• This Contract;
• Ordinances and resolutions heretofore adopted by the City Council having to do with this
Project;
• The Vendor's Proposal;
• Plans and Specifications;
• General Requirements as adopted by the City Council for the Project;
• Terms and Conditions (Exhibit A); and
• Insurance Schedule G for Vendors (Exhibit B) or Insurance Schedule J for
Professional Services (Exhibit C).
Check Appropriate Box
0 Insurance Schedule G —Vendors
❑ Insurance Schedule J — Professional Services
• Other:
3. All materials used by the Vendor on this Project shall be of the quality required by the Contract
Documents and shall be put in place in accordance with the Contract Documents.
4. The Vendor shall remove any materials rejected by the City Manager as defective or improper, or
any of said work condemned as unsuitable or defective, and the same shall be replaced or done
anew to the satisfaction of the City Manager at the cost and expense of the Vendor.
5. The Vendor has read and understands the Contract Documents and has examined and understands
the project description described in Section 1 of this Agreement and any attached Special
Conditions herein referred to and agrees not to plead misunderstanding or deception because of
estimates of quantity, character, location or other conditions surrounding the same.
6. The Vendor shall fully complete the Project under this Contract on or before
June 30, 2026
(DATE)
7. Indemnification; Liability for City Damage
A. To the fullest extent permitted by law, the Contractor shall indemnify and hold harmless the City
from and against all claims, damages, losses and expenses, including but not limited to
attorneys' fees, arising out of or resulting from performance of the 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 (other than the Project itself) including loss of use resulting
therefrom, but only to the extent caused in whole or in part by negligent acts or omissions of the
Contractor, the Contractor's subcontractor, or anyone directly or indirectly employed by the
Contracto�he Contras or's subcon a r or anyone for whos s fhe C rac r ®r�he
Contractor's subcontractor may be liable, regardless of whether or not such claim, damage, loss
or expense is caused in part by a party indemnified hereunder.
B. "The Contractor shall also be liable to the City for any damage to City property arising out of or
related to the Contractor's negligent performance of the Contract.
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Page 362 of 750
8. Prior to the commencement of any work on this Project and at all times during the performance of
this Contract, the Vendor shall provide evidence of insurance which meets the requirements of the
City's Insurance Schedule G or Insurance Schedule J attached to this Contract.
Check Appropriate Box
0 Insurance Schedule G — Vendors
❑ Insurance Schedule J — Professional Services
9. The Vendor agrees that no work under this Contract shall commence until the City has authorized
said work in writing. Any work started by the Vendor prior the City authorization shall be considered
unauthorized and done at the sole risk to the Vendor.
10. Vendor will comply with all federal, state, and local laws and regulations in the performance of this
Contract.
11. The City may terminate this Contract with or without cause upon fourteen (14) days' written notice
delivered to the Vendor.
12. This Contract shall be governed by the laws of the State of Iowa and exclusive jurisdiction and
venue for any action arising out of or related to this Contract shall be the Iowa District Court for
Dubuque County.
THE CITY AGREES:
Upon the completion of this Contract, and the acceptance of the Project by the City Manager,
the City agrees to pay the Vendor as full compensation for the complete performance of this Contract,
the amount stated below, less any agreed damages provided for in the Contract Documents.
CONTRACT AMOUNT $ 1,500* 'In the event that services required
exceed this amount, the parties agree
to renegotiate in good faith to amend
CITY OF DUBUQUE, IOWA VENDOR: the Agreement to cover any additional
costs incurred.
By: 11/06/2025 Dubuque Regional Humane Society
ichael C. Van Milligen Date Company Name
City Manager
By: , rwIrIn l a
ignature ilaig
Ko-v\ ass
Printed Name
Title
Page 3 of 13
Page 363 of 750
EXHIBIT A
TERMS AND CONDITIONS
The following Terms and Conditions apply to City of Dubuque Transactions:
1. The City of Dubuque is exempt from federal excise tax and Iowa sales tax.
2. The City of Dubuque will not be responsible for payment for any goods delivered without a
purchase order.
3. The vendor will send a separate invoice for each purchase order number. All invoices, packages,
shipping notices, or the like affecting the order shall contain the applicable purchase order
number. The vendor is to submit original invoice to the address shown in the SHIP TO section
on the front of this order.
4. No freight or packing charges will be allowed by the City of Dubuque unless specifically
authorized.
5. It is understood by the vendor that the cash discount period to the City of Dubuque will date from
the receipt of the invoice or from the date of the receipt of the goods, whichever is later.
6. The risk of loss of and damage to the goods which are the subject of this order, regardless of
the F.O.B. point, is and will remain with the vendor until the goods are delivered to the destination
set out in the order and accepted by the City of Dubuque or the authorized City of Dubuque
representative.
7. In the event of the vendor's failure to deliver as and when specified, or to perform as and when
specified, the City of Dubuque reserves the right to cancel this order, or any part thereof, without
prejudice to its other rights, and the vendor agrees that the City of Dubuque may return part or
all of any shipment so made and may charge the vendor with any loss expense sustained as a
result of such failure to deliver or to perform.
3. In the event any article, service, or process sold, delivered and/or performed hereunder is
covered by any patent, copyright, or application for either, the vendor will indemnify and save
harmless the City of Dubuque from any and all loss, cost, or expenses on account of any and all
claims, suits, or judgments on account of the use or sale of such article or the use of such service
or process in violation of such patent, copyright or application for either.
9. In the event any article, service, or process sold and delivered or sold and performed hereunder
is defective in any respect whatsoever, the vendor will indemnify and save harmless the City of
Dubuque from all loss or the payment of all sums of money by reason of all accidents, injuries
or damages to person or property that may happen or occur in connection with the use or sale
of such article, or process and are contributed to by said defective condition.
10.The vendor agrees not to release any advertising copy mentioning the City of Dubuque or
quoting the opinion of any City of Dubuque employee without the prior written authorization from
the City of Dubuque.
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Page 364 of 750
11.The vendor represents and warrants that no federal or state statute or regulation, or local
municipal ordinance has been or will be violated in the manufacturing, sale and delivery
hereunder. If such violation has or does occur, the vendor will indemnify and save harmless the
City of Dubuque from all loss, penalties, or payment of all sums of money on account of such
violation.
12.The City of Dubuque may at any time insist upon strict compliance with these terms and
conditions notwithstanding any previous custom, practice, or course of dealing to the contrary.
13.The terms and conditions of sale as stated in this order govern in the event of conflict with any
terms of the vendor's proposal, and are not subject to change by reason of any written or verbal
statements by the vendor or by any terms stated in the vendor's acknowledgement unless same
be accepted in writing by the City of Dubuque.
14. Current Safety Data Sheets (SDS), when applicable to the order, must be provided by the vendor
in accordance with all regulations.
Page 5 of 13
Page 365 of 750
EXHIBIT B
INSURANCE SCHEDULE G
1. Vendor shall furnish a signed certificate of insurance to the City of Dubuque, Iowa for the coverage required in
Exhibit I prior to the contract commencement. Each certificate shall be prepared on the most current ACORD form
approved by the Iowa Insurance Division or an equivalent. Each certificate shall include a statement under
Description of Operations as to why the certificate was issued. Vendor Service Agreement dated
September 2, 2025
2. All policies of insurance required hereunder shall be with an insurer authorized to do business in Iowa and all
insurers shall have a rating of A or better in the current A.M. Best's Rating Guide.
3. Each certificate shall be furnished to the Finance Department of the City of Dubuque.
4. The service provider shall be required to carry the minimum coverage/limits, or greater if required by law or other
legal agreement, in Exhibit I. Failure to provide the required minimum coverage shall not be deemed a waiver of
such requirements by the City of Dubuque.
5. Failure to obtain or maintain the required insurance shall be considered a material breach of this agreement.
6. All required endorsements shall be attached to the certificate. The certificate is due before the contractlagreement
can be approved.
7. Whenever a specific ISO form is referenced the current edition of the form must be used unless an equivalent
form is approved by the Director of Finance and Budget. The service provider must identify or list in writing all
deviations and exclusions from the ISO form.
8. If vendor's limits of liability are higher than the required minimum limits then the vendor's limits shall be this
agreement's required limits.
9. Vendor shall require all subcontractors and sub -subcontractors to obtain and maintain during the performance of
work insurance for the coverages described in this Insurance Schedule and shall obtain certificates of insurance
from all such subcontractors and sub -subcontractors. Vendor agrees that it shall be liable for the failure of a
subcontractor and sub -subcontractor to obtain and maintain such coverage. The City may request a copy of such
certificates from the Vendor.
10. Vendor shall be responsible for deductibles/self-insured retention for payment of all policy premiums and other
costs associated with the insurance policies required below.
11. All certificates of insurance must include agents name, phone number, and email address.
12. The City of Dubuque reserves the right to require complete, certified copies of all required insurance policies,
including endorsements, required by this Schedule at any time.
13. The City of Dubuque reserves the right to modify these requirements, including limits, based on changes in the
risk or other special circumstances during the term of the agreement, subject to written mutual agreement
attached hereto.
Page 6 of 13
Page 366 of 750
INSURANCE SCHEDULE G (continued)
EXHIBIT I
A) COMMERCIAL GENERAL LIABILITY
General Aggregate Limit $2,000,000
Products -Completed Operations Aggregate Limit $1,000,000
Personal and Advertising Injury Limit $1,000,000
Each Occurrence $1,000,000
Fire Damage Limit (any one occurrence) $50,000
Medical Payments $5,000
1) Coverage shall be written on an occurrence, not claims made, form. The general liability
coverage shall be written in accord with ISO form CG 00 01 or business owners form BP 00 02.
All deviations from the standard ISO commercial general liability form CG 00 01, or Business
owners form BP 00 02, shall be clearly identified.
2) Include ISO endorsement form CG 25 04 "Designated Location(s) General Aggregate Limit."
3) Include endorsement indicating that coverage is primary and non-contributory.
4) Include Preservation of Governmental Immunities Endorsement (Sample attached).
5) Include additional insured endorsement for:
The City of Dubuque, including all its elected and appointed officials, all its employees and
volunteers, all its boards, commissions and/or authorities and their board members,
employees and volunteers. Use ISO form CG 20 10 (Ongoing operations) or its equivalent.
6) Policy shall include Waiver of Right to Recover from Others endorsement.
7) Policy shall include cancellation and material change endorsement providing 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
Finance Department, 50 West 13th Street Dubuque, Iowa 52001.
B) WORKERS' COMPENSATION & EMPLOYERS LIABILITY
Statutory Benefits covering all employees injured on the job by accident or disease as prescribed by Iowa
Code Chapter 85.
Coverage A Statutory —State of Iowa
Coverage B Employers Liability
Each Accident $100,000
Each Employee -Disease $100,000
Policy Limit -Disease $500,000
Policy shall include Waiver of Right to Recover from Others endorsement.
Coverage B limits shall be greater if required by the umbrella/excess insurer.
OR
If, by Iowa Code Section 85.1A, the Vendor is not required to purchase Workers' Compensation
Insurance, the Vendor shall have a copy of the State's Nonelection of Workers' Compensation or
Employers' Liability Coverage form on file with the Iowa Workers' Compensation Insurance
Commissioner, as required by Iowa Code Section 87.22. Completed form must be attached.
Page 7 of 13
Page 367 of 750
INSURANCE SCHEDULE G (continued)
C) POLLUTION LIABILITY
Coverage required: Yes x No
Pollution liability coverage shall be required if the lessee, contracting party, or permittee has any pollution
exposure for abatement of hazardous or contaminated materials including, but not limited to, petroleum
products, the removal of lead, asbestos, or PCBs. Pollution product and completed operations coverage
shall also be covered.
Each Occurrence $2,000,000
Policy Aggregate $4,000,000
1) Policy to include job site and transportation coverage.
2) Include additional Insured for:
The City of Dubuque, including all its elected and appointed officials, all its employees and
volunteers, all its boards, commissions and/or authorities and their board members,
employees and volunteers. Use ISO form CG 20 10. (Ongoing operations) or its equivalent
and CG 20 37(competed operations).
3) Include Preservation of Governmental Immunities Endorsement.
4) Provide evidence of coverage for 5 years after completion of project.
5) Include endorsement indicating that coverage is primary and non-contributory.
6) Policy shall Include waiver of right to recovery from others endorsement.
D) PROFESSIONAL LIABILITY $1,000,000
Coverage required: x Yes — No
If the required policy provides claims -made coverage:
1) The Retroactive Date must be shown and must be before the date of the agreement.
2) Insurance must be maintained and evidence of insurance must be provided for at least five (5)
years after completion of the work or services.
3) If coverage Is canceled or non -renewed and not replaced with another claims. -made policy form
with a Retroactive Date prior to the date of the agreement, the contractor must provide "extended
reporting" coverage for a minimum of five (5) years after completion of the work or services.
E) CYBER LIABILITYIBREACH $1,000,000
Coverage required: ^ Yes X No
Coverage for First and Third Party breach liability including but not limited to lost data and restoration,
loss of income and cyber breach of information.
F) UMBRELLA/EXCESS $1,000,000
Coverage required: Yes X No
The General Liability, Automobile Liability and Employer's I -lability Insurance requirements may be
satisfied with a combination of primary and Umbrella or Excess Liability Insurance. If the Umbrella or
Excess Insurance policy does not follow the form of the primary policies, it shall include the same
endorsements as required of the primary policies including but not limited to Waiver of Subrogation and
Primary -and -Non -contributory -in -favor -of the -City. —
Please be aware that naming the City of Dubuque as an additional insured as is required by this Insurance Schedule may
result in the waiver of the City's governmental immunities provided in Iowa Code sec. 670.4. If you would like to preserve
those immunities, please use this endorsement or an equivalent form.
PRESERVATION OF GOVERNMENTAL IMMUNITIES ENDORSEMENT
Page 8 of 13
Page 368 of 750
1. Nonwaiver of Governmental Immunity. The insurer expressly agrees and states that the purchase of this policy
and the including of the City of Dubuque, 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 insurer further agrees that this policy of insurance shall cover only those claims not subject
to the defense of governmental immunity under the Code of Iowa Section 670.4 as it now exists and as it may be
amended from time to time. Those claims not subject to Code of Iowa Section 670.4 shall be covered by the terms and
conditions of this insurance policy.
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 insurer.
4. Non -Denial of Coverage. The insurer shall not deny coverage under this policy and the insurer shall not deny any
of the rights and benefits accruing to the City of Dubuque, 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.
No Other Change in Policy. The above preservation of governmental immunities shall not otherwise change or alter the
coverage available under the policy.
(DEPARTMENT MANAGER: FILL IN ALL BLANKS AND CHECK BOXES)
Page 9 of 13
Page 369 of 750
Page 370 of 750
MSA Addendum for Changes
Customer: City of Dubuque
Omnia Account #:
COMMUNICATION SERVICES
SOLUTION QUANTITY UNIT PRICE/mo. TOTAL
Additional Business Listings 68 $10.00/mo. $680.00/mo.
Total: $680.00/mo.
- Plus applicable Taxes and Fees- All other Terms & Conditions remain in effect.
Note: City of Dubuque is reducing the number of Additional Business Listings from 68
to 33. Updated Additional Business Listing(s) pricing below.
1of3
Page 371 of 750
(Updated Service Information):
COMMUNICATION SERVICES
SOLUTION QUANTITY UNIT PRICE/mo. TOTAL
Additional Business Listing 33 $330.00/mo. $330.00/mo.
Total: $330.00/mo.
INVESTMENT SUMMARY — MONTHLY RECURRING CHARGES (for services listed above)
TERM LENGTH: 36 MONTHS
MONTHLY RECURRING TOTAL CHARGES: (for services listed above) $330.00
- Plus applicable Taxes and Fees
- All other Terms & Conditions remain in effect.
EFFECTIVE DATE OF CHANGE: TBD
2of3
Page 372 of 750
jrj0K
IN WITNESS WHEREOF, ImOn and Customer have caused this Agreement
to be signed by their duly authorized representatives.
City of Dubuque
Name: Michael C. Van Milligen Name:
Title: City Manager Title:
Signature: �R,,.� �w,, �� Signature:
Date: 10/30/2025 Date:
ImOn Communications, LLC
Name: Matt Sevde Name:
Title: Business Sales Title:
Signature: 7e� 5" Signature:
Date: 11-13-2025 Date:
3of3
Page 373 of 750
This document authorizes ImOn Communications, LLC (Imon) to request and receive data and
billing information (including Customer Proprietary Network Information), a copy of records for the telephone numbers listed
including, but not limited to, associated line features from your existing provider, to investigate Customer's credit history to the full
extent permitted by applicable law, and to act as our representative for telecommunications. We are selecting ImOn as
the preferred provider for the following service(s) for the telephone number(s) listed:
Circuit Facility Assignment: Provided By Customer
F7X Local Exchange Service
(Local service only)
F7X IntraLATA Service
(Local Access Transport Area)
(Local long distance calls)
F7X International Service
(Calling outside of the United States)
F7X InterLATA Service
(Local Access Transport Area)
(Calling outside your local long distance area)
ImOn is authorized to notify our current local and/or long distance service providers of our telecommunications choices
for the above location and any indicated on attached Addendum.
We understand: 1) this authorization changes the selected service providers; 2) each telephone number may have only one
preferred provider for each service, and; 3) our current local service provider may apply a charge for this change.
I hereby authorize ImOn to make inquiries concerning my credit worthiness and hereby authorize financial institutions
vendors, and others to disclose credit information to ImOn.
Telephone Number(s)
��kl"'j City Manager
Custome Signat re & Title
City of Dubuque Michael C. Van Milligen
Print Customer Name
10/30/2025
Date
563-587-3600-3647
563-589-1738-1739
563-556-3057
563-587-3800-3811
563-589-4100-4107
563-556-3969
563-587-3813-3826
563-589-4110-4116
563-556-5328
563-587-3828-3835
563-589-4118-4135
563-582-1648
563-587-3838-3840
563-589-4137-4161
563-582-3681
563-587-3842-3854
563-589-4168-4169
563-583-1710
563-587-3856-3858
563-589-4171-4175
563-583-1832
563-589-0886-0887
563-589-4177-4178
563-583-4789
563-589-1720-1728
563-589-4180-4185
563-588-0714
563-589-1731-1732
563-589-4189-4208
563-589-0880
563-589-1734-1735
563-589-4210-4215
563-589-0892
563-589-4392-4405
563-589-4218-4226
563-589-0897
563-589-4407-4412
563-589-4227-4253
563-589-4297
563-589-4421-4423
563-589-4260-4291
563-589-4341
563-589-4427-4431
563-589-4293-4295
563-589-4354
563-589-4438-4439
563-589-4301-4307
563-589-4374
563-589-4443-4444
563-589-4309-4322
563-589-4425
563-589-4460-4461
563-589-4325-4339
563-589-4449
563-589-4466-4469
563-589-4343-4349
563-589-4454
563-589-4472-4476
563-589-4381-4382
563-589-4486
563-589-7844-7850
563-589-4384-4390
563-589-4497
563-589-7858-7860
563-589-7898-7899
563-589-7862-7866
563-690-6000-6075
563-589-7876-7879
563-690-6086-6256
563-589-7882-7883
563-690-6258-6350
563-589-7886-7887
563-690-6352-6739
L______ 563-589-7889-7891___________
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