Contracted Services Agreement — Crescent Community Health CenterCity of Dubuque
City Council
CONSENT ITEMS # 14.
Copyrighted
July 20, 2026
ITEM TITLE: Contracted Services Agreement — Crescent Community
Health Center
SUMMARY: City Manager recommending City Council approve the
attached Contracted Services Agreement with Crescent
Community Health Center and authorize the Mayor to
execute the contract on behalf of the City.
SUGGUESTED Receive and File; Approve
DISPOSITION:
ATTACHMENTS:
1. MVM Memo Contracted Services Agreement — Crescent Community Health Center
2. 2026.07.13 FY27 MVM Memo Contracted Services Agreement - Crescent
Community Health Center
3. NEED MAYOR SIGNATURE 2026.07.13 FY27 Crescent Community Health Ctr
contracted services agreement - 071526
Page 740 of 1061
THE CITY OF
Dubuque
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Masterpiece on the Mississippi
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2017202019
TO: The Honorable Mayor and City Council Members
FROM: Michael C. Van Milligen, City Manager
SUBJECT: Contracted Services Agreement — Crescent Community Health Center
DATE: July 14, 2026
Public Health Director Mary Rose Corrigan is recommending City Council approve the
attached Contracted Services Agreement with Crescent Community Health Center and
authorize the Mayor to execute the contract on behalf of the City.
The adopted Fiscal Year 2027 operating budget reflects payments of $25,000 to
Crescent Community Health Center each year for financial assistance to cover
operating expenses relating to access to affordable medical, dental, and behavioral
health care to underserved populations, with a focus on dental care, and $25,000 for the
services related to health, wellness, and chronic disease. Crescent will engage
vulnerable and underserved populations to facilitate the needs and gaps identified in the
most current Community Needs Assessment and Health Improvement Plan.
I concur with the recommendation and respectfully request Mayor and City Council
approval.
Mic ael C. Van Milligen
MCVM:sv
Attachment
cc: Crenna Brumwell, City Attorney
Cori Burbach, Assistant City Manager
Mary Rose Corrigan, Public Health Director
Page 741 of 1061
Dubuque
THE CITY OF
AII�A�eriea City
DUB E
2007.2012.2013
Masterpiece on the Mississippi 2017*2019
TO: Michael C. Van Milligen, City Manager
FROM: Mary Rose Corrigan, Public Health Director
SUBJECT: Contracted Services Agreement — Crescent Community Health Center
DATE: July 13, 2026
INTRODUCTION
Attached for City Council approval is the Contracted Services Agreement with Crescent
Community Health Center for Fiscal Year 2027.
DISCUSSION
Crescent Community Health Center furthers the City of Dubuque Goals (1) Partnership
for a Better Dubuque: Building our community that is viable and livable. (2) Vibrant
Community: Healthy and Safe. Crescent Community Health Center utilizes these funds
to provide access to primary medical, dental, and behavioral health care to underserved
community members and improve community health. With Crescent's dental expansion,
some outcomes are added to demonstrate improved dental care access.
The adopted Fiscal Year 2027 operating budget reflects payments of $25,000 to
Crescent Community Health Center each year for financial assistance to cover
operating expenses relating to access to affordable medical, dental, and behavioral
health care to underserved populations, with a focus on dental care, and $25,000 for the
services related to health, wellness, and chronic disease. Crescent will engage
vulnerable and underserved populations to facilitate the needs and gaps identified in the
most current Community Needs Assessment and Health Improvement Plan.
The reporting requirements are as follows:
1. Progress reports will be submitted quarterly.
2. Reports will be submitted using a form on the City's website.
3. Reports will include equity and key performance indicators and outcomes.
4. Audit reports are due within 60 days of audit completion.
Crescent will track measures for all patients and provide annual trend data when
available. Achieving a healthy lifestyle and reducing risk factors for chronic disease
Service People Integrity Responsibility Innovation Teamwork
Page 742 of 1061
contributes to a "vibrant community." Individuals who effectively participate in wellness
services can manage and improve chronic conditions, obesity, mood disorders,
communicable illness, etc. They are better able to learn, contribute, care for others,
participate in the workforce, and contribute to the community.
RECOMMENDATION
I recommend that the City Council approve the attached Contracted Services
Agreement with Crescent Community Health Center and authorize the Mayor to execute
the contract on behalf of the City.
MRC:cm
Service People Integrity Responsibility Innovation Teamwork
Page 743 of 1061
AGREEMENT
BETWEEN
THE CITY OF DUBUQUE, IOWA
AND
CRESCENT COMMUNITY HEALTH CENTER
THIS AGREEMENT, dated for reference purposes, the 13th day of July 2026, is made and
entered into by and between the City of Dubuque, Iowa (City) and Crescent Community Health Center
(Agency).
WHEREAS, City desires to engage the service of Agency to provide access to primary medical,
dental, and behavioral health care to underserved community members; and
WHEREAS, Agency is willing to provide such services to City upon the terms and conditions set
forth herein.
NOW THEREFORE, the parties hereto agree as follows:
Scope of Service
Agency shall:
a) Further the City of Dubuque Goal: Partnership for a Better Dubuque: Building a vibrant
community that is healthy and safe.
b) Provide access and affordable medical, dental, and behavioral health care to
underserved community members, focusing on vulnerable and underserved residents
who often face service barriers and who lack resources and comply with City Council
goals and priorities set forth in Attachment A and with focus on dental care access as
stated in the Community Needs Assessment and Improvement Plan.
c) Offer general illness and obesity prevention services through Wellness Center staff
person who performs health and exercise coaching, nutrition education, obesity
reduction programs, nicotine cessation programs, and stress management, and officer
primary medical/dental care plus wellness services as listed in Attachment B: and
d) Support the City's efforts to be a viable and livable, and equitable community, and to
improve health and safety.
2. City Responsibilities
City designates the Public Health Director 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 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.
3. Time of Performance
Page 744 of 1061
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The term of this Agreement shall be from July 1, 2026, through June 30, 2027.
Compensation
City shall pay Agency $50,000 as compensation for the services provided by Agency, July 1,
2026- June 30, 2027, related to access of affordable primary care, dental care, and wellness
services which payment shall constitute full and complete compensation for such services.
Services and outcomes will be reported using patient KPI's along with disaggregated data as
listed in Attachment B.
The compensation shall be paid by City to Agency upon receipt by City of a requisition for such
sum from Agency.
Audit and Evaluation
Inasmuch as the funds to be provided to Agency by City are public funds, Agency agrees that it
will maintain books of account in accordance with Generally Accepted Accounting Standards
together with necessary documentation to support all expenditures. The records of Agency,
including payroll accounts and other records of disbursements and receipts, and other records
relating to the performance of the activities herein specified, shall be made available for
inspection by City or any Certified Public Accountant acting on its behalf, in order to ascertain
performance of Agency under this Agreement. Agency agrees to retain such records for not
less than three (3) years.
Reporting and Monitoring
Agency shall comply with the City of Dubuque's Reporting and Monitoring requirements
by using the following link to submit quarterly online reports detailing Agency activities
related to the use of City funds provided to Agency:
https://www.citVofdubugue.org/FormCenter/Budget-15/Contracted-Services-
Performance-Report-208
The online quarterly reports shall be due on Feb 15. 2027, April 15, 2027, and July 15,
2027. Such reports shall include a performance report on the program(s) supported by
City funds and a financial report on the use of City funds.
If Agency has an annual audit performed, Agency shall provide City a copy of the annual
audit report within 60 days of audit completion. The Audit shall be submitted as either an
electronic or paper document to the Public Health Director
Discrimination
In carrying out the services under this Agreement, Agency shall not discriminate against any
employee or applicant for employment because of race, creed, color, sex, age, familial status,
national origin, religion, sexual orientation, gender identity, or physical/mental disability. Agency
shall take affirmative action to ensure that applicants for employment are employed and that
employees are treated during employment without regard to race, creed, color, sex, age, familial
status, national origin, religion, sexual orientation, gender identity, or physical/mental disability.
Such action shall include, but not be limited to, the following: employment, upgrading, demotion
or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other
Page 745 of 1061
forms of compensation; and selection for training, including apprenticeship. Agency assures
that all qualified applicants will receive consideration for employment without regard to race,
creed, color, sex, age, familial status, national origin, religion, sexual orientation, gender identity
or physical/mental disability.
Agency agrees and will undertake whatever affirmative measures are necessary so that no
person shall be excluded from participation in, be denied the benefits of, nor be subjected to
discrimination under any program or activities funded in whole or in part with any of the funds
made available to Agency under the terms of this Agreement because of race, creed, color, sex,
age, familial status, national origin, religion, sexual orientation, gender identity, or
physical/mental disability.
8. Termination of Aareement
If, through any cause, Agency shall fail to fulfill in a timely and proper manner its obligations
under this Agreement, or if the Agency shall violate any of the covenants, agreements or
stipulations of this Agreement, City shall thereupon have the right to terminate this Agreement
by giving written notice to Agency of such and specifying the effective date thereof not less than
thirty days before the effective date of such termination. If Agency shall fail to cure its default to
the satisfaction of City in City's sole discretion within such thirty -day period, this Agreement shall
be deemed terminated at the end of such thirty -day period without further action of either party.
Upon termination of this Agreement, Agency shall return to City all unexpended funds and/or
any funds utilized for purposes other than stated in the Agreement.
9. Assignability
Agency shall not assign any interest in this Agreement without the prior written approval of City.
10. Insurance
At the time of execution of this Agreement by Agency, Agency shall provide City copies of
Agency's insurance certificates showing compliance with the insurance requirements of
Insurance Schedule J, included as Attachment C.
Page 746 of 1061
CITY OF DUBUQUE, IOWA
David Resnick
Mayor Pro Tem
Witness:
Adrienne Breitfelder, City Clerk
CRESCENT COMMUNITY HEALTH CENTER
G
Chad Wolbers
CEO
ATTACHMENT A
The Dubuque City Council completed its annual goal -setting sessions on Thursday, Sept. 25, THE CITY OF
2025. Over the course of three evening sessions, City Council members affirmed the 15-year DUB E
vision statement and mission statement and identified seven five-year goals for the city. They
also identified top and high priorities for a 2025-2026 policy agenda as well as in -progress Masterpiece on the Mississippi
projects and capital projects for 2025-2026.
POLICY AGENDA Policy agenda items are issues that need direction or a policy decision by the City Council,
or need a major funding decision by the City Council, or issues that need City Council
leadership in the community or with other governmental bodies. The policy agenda is
divided into top priorities and high priorities.
2025 - 2027 Top Priorities (in alphabetical order)
■ Commercial Air Service Future: Strategy and Action Plan
to Sustain and Expand
■ Comprehensive Fire Station Location and Facilities Study
■ Fire Department Staffing Increases
■ Police Department: Full Staffing and Hiring
■ Sanitary Sewer Investments and Implementation
• Catfish Creek Sanitary Sewer Project
• Cedar Street Lift Station and Force Main
• Chaplain Schmitt Island Sanitary Sewer
• Cooper Place/Maiden Lane Project
• Grove Terrace Project
• Harvard Street Project
• Hempstead Street Project
• Sanitary Sewer Force Main Stabilization Project
• Sanitary Sewer Consent Decree Compliance
• Terminal Street Lift Station and Force Main
• Other Projects
■ Sports Complex Development
■ Stormwater Management Investments and
Implementation:
• 17th and Elm Street Stormwater Project
• 17th and Locust Street Stormwater Project
• Bee Branch Gate & Pump Station Project
• Detention Ponds Maintenance
• Individual Neighborhood Investments
• Kaufmann Avenue Storm Sewer Improvements
■ Street Maintenance/Rehabilitation Program
2025 - 2027 High Priorities (in alphabetical order)
■ Continued Implementation of Central Avenue
Revitalization Plan
■ Downtown Master Plan Update
■ Dubuque Law Enforcement Center (DLEC) Short -
Term Facility Enhancements and Future Plan
■ East-West Corridor/Roundabouts Projects
■ Next Phases of Chaplain Schmitt Island
Development
■ Parks and Recreation Master Plan Adoption and
Implementation
■ Water Resource and Recovery Center Facility and
Process Improvements and Odor Reduction
r QIy. G I -tu VI I VV I
VISION & MISSION
2040 Vision Statement
Dubuque 2040 is a sustainable and resilient city, an inclusive and
equitable community where ALL are welcome. Dubuque 2040 has
preserved our Masterpiece on the Mississippi, has a strong, diverse
economy and expanding connectivity. Our residents experience
healthy living and active lifestyles; have choices of quality, affordable,
livable neighborhoods; have an abundance of diverse, fun things to do;
and are successfully and actively engaged in the community.
Mission Statement
Dubuque city government is progressive and financially sound with
residents receiving value for their tax dollars and achieving goals through
partnerships. Dubuque city government's mission is to deliver excellent
municipal services that support urban living; contribute to an equitable,
sustainable city; plan for the community's future; and facilitate access to
critical human services.
FIVE-YEAR GOALS
■ Healthy and Safe Community
■ Financially Responsible, High -Performance City Organization:
Sustainable, Equitable, and Effective Service Delivery
■ Robust Local Economy:
Diverse Businesses and Jobs with Economic Prosperity
■ Livable Neighborhoods and Housing:
Great Place to Live
■ Sustainable Environment:
Preserving and Enhancing Natural Resources
■ Connected Community:
Equitable Transportation, Technology Infrastructure, and Mobility
■ Diverse Arts, Culture, Parks, and Recreation Experiences and
Activities
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MANAGEMENT IN PROGRESS & MAJOR PROJECTS
Under each City Council goal are items listed as Management in Progress
and Major Projects. These are items and projects that are underway and
budgeted. Staff is implementing and providing updates to City Council.
Healthy and Safe Community
Management in Progress
• Access, Belonging and Community Action Plans
• Community Risk Reduction Program Implementation
• Fire Explorer Program Development
• License Plate Reader Camera Deployments
• New Emergency Responder Computer -Aided Dispatch (CAD)
System Implementation
• Police Radios Upgrade Implementation
• Public Health Preparedness Emergency Response Plan Update
• Traffic and Security Camera Deployments and Upgrades
Major Projects
• Fire Stations Improvement Projects
• Crescent Community Health Center Facilities and Services
Expansion
Financially Responsible, High -Performance
City Organization
Management in Progress
• Adopt-A-Spot/Volunteer Management Hub Site GIS Application
• City Bond Rating: Updated Credit Rating and Bond Sale
• City Departments Safety Program: Funding for OSHA Compliance
• City Facilities Integrated Access Control Project
• City Hall and City Hall Annex Renovations
• City Website ADA Compliance
• Enterprise Asset Management System and Work Order System
Funding and Implementation Plan
• Enterprise Resource Planning (ERP) Software Implementation
• Federal Legislative Advocacy Agenda and Action Plan
• Historic Federal Building Upgrades
• Human Resources Information System (HRIS) Implementation
• Multicultural Family Center Management and Staffing Review
• Organizational Culture Continuous Improvement: Exit Interviews
• State Legislative Advocacy Agenda and Action Plan 2026
• Succession Plan for Intergovernmental Relations Position
Major Projects
• Multicultural Family Center Elevator
• City Data Center Phase 2
Robust Local Economy
Management in Progress
• Business Incentives Policies and Processes Review
• Chaplain Schmitt Island Development: Hotel Project
• Comprehensive Hotel Attraction/Incentive Policy
(Continued on page 4.)
Page 750 of 1061
• Electronic Bidding Software Implementation
• Field of Dreams: Next Steps for City Support
• Minority and/or Women -owned Business Enterprise
(MWBE) Procurement Policy
• Port of Dubuque New Hotel Development: City Actions
• Poverty Prevention and Reduction Plan Update
• River Cruise Ship Docking Project
Livable Neighborhoods and Housing
Management in Progress
• Unified Development Code Update and Adoption
• Historic Millwork District Development Update
• Neighborhood Associations Development: Activation/
Expansion
• Terminus Software Implementation for City Permits
• Permitting and Inspection Software Implementation
• New Housing Development Status Updates
— Sustainable Environment
Management in Progress
• Electric Bus Acquisition and Charging Station
• Emerald Ash Borer Recovery: Funding for Stump
Removal, Planting, and Related Sidewalk
Replacement
• Green Alley Maintenance and Performance
Evaluation
• Sewer System Infrastructure Asset Master Plan
Development and Adoption
• Branching Out Dubuque Tree Planting Program
• Water Department 2025 Consumer Confidence
Report
• Water and Resource Recovery Center (WRRC) 2025
Explosion Recovery Completion
• WRRC Fats, Oils, and Greases (FOG) Program Review
• WRRC High -Strength Waste Receiving and Storage
Project
• WRRC HVAC Mini -Split System Installation
• WRRC State -Certified Lab Expansion
Major Projects
• Auburn St. and Custer St. Water Main, Sanitary Sewer,
and Street Reconstruction
• City -Wide Fiber Project: Water Department Pump,
Stations, Tanks, and Towers
• Green Alley Project: 15th St. to 17th St. between Iowa
St. and Central Ave.
• Lead Water Service Lines Replacement Phase 1
• N. Cascade Rd./Southwest Arterial Water and Sewer
Main Extensions from Edval Ln. to N. English Mill Rd.
• Rockdale Rd. Stormwater Project
• Water Department Deep Well No. 7 Rehabilitation
• Water Department New Deep Well No. 11 (part of PFAS
Remediation Plan)
• Water Department SCADA (Supervisory Control and
Data Acquisition) Overhaul
• Water Main Creek Crossing Restoration Project
Connected Community
Management in Progress
• Jule Federal Transportation Administration Areas of
Persistent Poverty Planning Grant
• Parking System and Technology Upgrade and Installation
• Smart Parking and Mobility Study Implementation
• STREETS (Smart Traffic Routing with Efficient and Effective
Traffic System) Program Funding and Implementation
Major Projects
• 14th St. Railroad Overpass and 16th St. Corridor Complete
Streets Improvements
• Airport General Aviation Apron Reconstruction
• Airport Taxiway Alpha Construction
• Chaplain Schmitt Island Trail Project (Federal Community
Project Grant)
• Fiber Optic Connections to Data Center
• Relocation of Fiber Optics on Julien Dubuque Bridge
• Southwest Arterial Intelligent Transportation System (ITS)
Project
• US 20/Northwest Arterial Intersection Iowa DOT Project
• Wildwood Dr. Bridge Replacement
Diverse Arts, Culture, Parks, & Recreation
Experiences & Activities
Management in Progress
• Comiskey Park Phase 2 Upgrades: Parking and Amenities
• Community Cultural Experiences and Programming
• Historic Millwork District Green Space Plan
• Eagle Point Park Historic Structures Assessment and
Report
• Friends of Eagle Point Park Organization Development
• Eagle Point Park Fall 2025 Clean -Up
Major Projects
• Jackson Park Restrooms
• ImOn Ice Arena Dehumidification System
• Rustic Point Park Completion
• South Pointe Park Completion
• Eagle Point Park Water Tower Destruction
• Chaplain Schmitt Island Amphitheater
Page 75100W h25
ATTACHMENT B
Crescent will evaluate impact as part of desired outcome measures for patients including but not
limited to:
• Decrease in BMI in Wellness Center participants
• Increase in number of referrals to Wellness Center
• Increase in number of patients who complete Wellness Center orientation and can use
equipment
• Increase in number of patients who are utilizing Wellness Center
• Increase in percentage of patients with diabetes who have gained control of their condition
• Increase in percentage of patients with hypertension who have controlled blood pressure
• Increase in percentage of children who received a weight assessment and participated in
physical activity and nutrition counseling if needed
• Increase in growth of patient volume, particularly vulnerable populations
Crescent will track measures for all patients and provide annual trend data when available. Achieving
a healthy lifestyle and reducing risk factors for chronic disease contributes to a "vibrant community."
Individuals who effectively participate in wellness services can manage and improve chronic
conditions, obesity, mood disorders, communicable illness, etc. They are better able to learn,
contribute, care for others, participate in the workforce, and contribute to the community.
Page 752 of 1061
Attachment C
City of Dubuque Insurance Requirements for Professional Services
CITY OF DUBUQUE INSURANCE SCHEDULE J
CCHC 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 Chief Financial Officer.
Each certificate shall include a statement under Description of Operations as to why the certificate was
issued. Eg: Project # or Project Location at
construction of
or
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.
Each certificate shall be furnished to the Finance Department, 50 West 131h Street, Dubuque, Iowa 52001.
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 certificate of insurance. The certificate is due before the
contract/agreement can be approved.
7. Whenever a specific ISO form is listed, the current edition of the form must be used, or an equivalent form
may be substituted if approved by the Chief Financial Officer and subject to the contractor identifying and
listing in writing all deviations and exclusions from the ISO form.
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.
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 mutual agreement of
the parties.
Page 753 of 1061
City of Dubuque Insurance Requirements for Professional Services
CITY OF DUBUQUE 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 (anyone 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 from BP
00 02. All deviations from the standard ISO commercial general liability form CG 00 01, or
business owners from 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 13`" 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
Page 754 of 1061
City of Dubuque Insurance Requirements for Professional Services
CITY OF DUBUQUE INSURANCE SCHEDULE J
(continued)
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 as amended.
Coverage A Statutory —State of Iowa
Coverage B Employers Liability
Each Accident $100,000
Each Employee - Disease $100,000
PolicyLimit— 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 851.A, 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.
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 Non -Contributory in favor of the City of Dubuque, the Dubuque Regional
Airport, and the Dubuque Regional Airport Commission.
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.
Page 755 of 1061
City of Dubuque Insurance Requirements for Professional Services
CITY OF DUBUQUE INSURANCE SCHEDULE J
(continued)
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 756 of 1061
City of Dubuque Insurance Requirements for Professional Services
CITY OF DUBUQUE SCHEDULE J
(continued)
Iowa Code Chapter 670, Liability of Governmental Subdivisions, provides cities with certain
immunities which may be available to you. Naming the City of Dubuque 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 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 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 anytime 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.
5. 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 757 of 1061