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Improvement Contract/Bond_Portzen Construct_N. Grandview/Loras Blvd Intersection Improvements Copyrighted August 21, 2017 City of Dubuque Consent Items # 30. ITEM TITLE: Improvement Contracts / Performance, Payment and Maintenance Bonds SUMMARY: Midwest Concrete, Inc. for 2017 Asphalt Overlay Ramp Project Three; Portzen Construction, Inc. for N. Grandview Ave./Loras Blvd. Intersection Improvements Project. SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Approve ATTACHMENTS: Description Type Contract/Bond Midwest Concrete, Inc. Supporting Documentation Contract/Bond Portzen Construction, Inc. Supporting Documentation SECTION 00500 Page 1 of 6 PUBLIC IMPROVEMENT CONTRACT SECTION 00500 N. Grandview Avenue at Loras Boulevard Intersection Improvements THIS IMPROVEMENT CONTRACT (the Contract), made in triplicate, dated for references purposes the 101L day of August 2017 between the City of Dubuque, Iowa, by its City Manager, through authority conferred upon the City Manager by its City Council (City), and Portzen Construction, Inc. (Contractor). For and in consideration of the mutual covenants herein contained, the parties-hereto agree as follows: CONTRACTOR AGREES: 1. To furnish all material and equipment and to perform all labor necessary for the N. Grandview Avenue at Loras Boulevard Intersection Improvements (Project). 2. CONTRACT DOCUMENTS A. The Contract Documents consist of the following: 1. Project Title Page (Section 00100). 2. Project Directory Page (Section 00101). 3. This Public Improvement Contract (Section 00500). 4. Performance, Payment, and Maintenance Bond (Section 00600). 5. Out-of-State Contractor Bond (Section 00610). 6. Other Bonds: a. (Bond Name)_ (pages-to- , inclusive). b. (Bond Name) (pages_to_ , inclusive). C. (Bond Name)_ (pages_to_ , inclusive). 7. The Iowa Statewide Urban Design And Specifications (SUDAS) 2017 Edition. 8. CITY OF DUBUQUE Supplemental Specifications 2017 Edition. 9. Other Standard and Supplementary Specifications as listed on the Title Page of the Contract Document Manual. 10.Special Provisions included in the project Contract Document Manual. 11.Drawings-Sheet No. A.01 through No. V.01 (46 pages) or drawings consisting of sheets bearing the following general title: N. Grandview Avenue at Loras Boulevard Intersection Improvements 12.Addenda (numbers 1 to 1 , inclusive). 13.Insurance Provisions and Requirements (Section 00700). 14.Sales Tax Exemption Certificate (Section 00750). 15.Site Condition Information (Section 00732875). 16.Construction Schedule and Agreed Cost of Delay (Section 00800). 17.Erosion Control Certificate (Section 00900). SECTION 00500 ti Page 2 of 6 18.Consent Decree (Section 01000). 19.Other Project Information and Permits (Section 01100 - 00000). 20.Exhibits to this Contract (enumerated as follows): a. Contractor's Bid (pages_to_, inclusive). b. Bidder Status Form (Section 00460). c. Contractor Background Information Form (Section 00471) d. Targeted Small Business Form (TSB) e. The following documentation that must be submitted by Contractor prior to Notice of Award. i. ii. iii. e. None. 21.The following which may be delivered or issued on or after the Effective Date of the Agreement: - I a. Notice to Proceed (Section 00850). b. Project Certification Page (Section 00102). c. Change Orders (Not attached to this agreement). There are no other Contract Documents. The Contract Documents may only be amended, modified, or supplemented as provided in General Conditions. 3. All materials used by the Contractor in the Project must be of the quality required by the Contract Documents and must be installed in accordance with the Contract Documents. 4. The Contractor must remove any materials rejected by the City as defective or improper, or any of said work condemned as unsuitable or defective, and the same must be replaced or redone to the satisfaction of the City at the sole cost and expense of the Contractor. 5. Five percent (5%) of the Contract price will be retained by the City for a period of thirty (30) days after final completion and acceptance of the Project by the City Council to pay any claim by any party that may be filed for labor and materials done and furnished in connection with the performance of this Contract and for a longer period if such claims are not adjusted within that thirty (30) day period, as provided in Iowa Code Chapter 573 or Iowa Code Chapter 26. The City will also retain additional sums to protect itself against any claim that has been filed against it for damages to persons or property arising through the prosecution of the work and such sums will be held by the City until such claims have been settled, adjudicated or otherwise disposed of. 6. The Contractor has read and understands the Contract Documents herein referred to and agrees not to plead misunderstanding or deception related to estimates of quantity, character, location or other conditions for the Project. 7. In addition to any warranty provided for in the specifications, the Contractor must also fix any other defect in any part of the Project, even if the Project has been accepted and fully paid for by the City. The Contractor's maintenance bond will be security for a period of two years after the issuance of the Certificate of Substantial Completion. SECTION 00500 Page 3 of 6 8. The Contractor must fully complete the Project under this Contract on or before the date indicated in the Construction Schedule and Agreed Cost of Delay Section of the Contract Documents. 9. INDEMNIFICATION FROM THIRD PARTY CLAIMS. To the fullest extent permitted by law, Contractor shall defend, indemnify and hold harmless City, its officers and employees, from and against all claims, damages, losses and expenses claimed by third parties, but not including any claims, damages, losses or expenses of the parties to this Contract, including but not limited to attorneys'fees, arising out of or resulting from performance of this Contract, provided that such claim, damages, loss or expense is attributable to bodily injury, sickness, disease or death, or injury to or destruction of property, including loss of use resulting there from, but only to the extent caused in whole or in part by negligent acts or omissions of Contractor, or anyone directly or indirectly employed by Contractor or anyone for whose acts Contractor may be liable, regardless of whether or not such claim, damage, loss or expense is caused in part by a party indemnified hereunder. 10. The Contractor hereby represents and guarantees that it has not, nor has any other person for or in its behalf, directly or indirectly, entered into any arrangement or Contract with any other Bidder, or with any public officer, whereby it has paid or is to pay any other Bidder or public officer any sum of money or anything of value whatever in order to obtain this Contract; and it has not, nor has another person for or in its behalf directly or indirectly, entered into any Contractor arrangement with any other person, firm, corporation or association which tends to or does lessen or destroy free competition in the award of this Contract and agrees that in case it hereafter be established that such representations or guarantees, or any of them are false, it will forfeit and pay not less than ten percent (10%)of the Contract price but in no event less than $2,000.00 (Two Thousand Dollars)to the City. 11. The surety on the Bond furnished for this Contract must, in addition to all other provisions, be obligated to the extent provided for by Iowa Code 573.6 relating to this Contract, which provisions apply to said Bond. 12. The Contractor agrees, and its Bond is surety therefore, that after the Certificate of Substantial Completion has been issued by the City, it will keep and maintain the Project in good repair for a period of two (2) years. 13. The Project must be constructed in strict accordance with the requirements of the laws of the State of Iowa, and the United States, and ordinances of the City of Dubuque, and in accordance with the Contract Documents. A. All applicable standards, orders, or regulations issued pursuant to the Clean Air Act of 1970 (42 U. S. C. 1958 (H) et. seq.) and the Federal Water Pollution Act (33 U. S. C. 1368 et. seq.) as amended, Executive Order 11738, and Environmental Protection Agency regulations (40 CFR, Part 15). Contractor must comply with Section 103 and 107 of the Contract Work Hours and Safety Standards Act (40 USC 327-330) and Department of Labor Regulations (29 CFR, Part 5). B. The City and the Contractor agree to comply with all provisions of the Davis-Bacon Federal Prevailing Wage Act, if applicable, and related labor requirements and regulations and the Federal Wage Determination for this Project. C. Equipment or products authorized to be purchased with federal funding awarded for this Contract must be American-made to the maximum extent feasible, in accordance with Public Law 103-121, Sections 606(a) and (b). SECTION 00500 Page 4 of 6 D. The City of Dubuque in accordance with Title VI of the Civil Rights Act of 1964, 78 Stat. 252, 42 U.S.C. 2000d-2000d-4 and Title 49, Code of Federal Regulations, Department of Transportation, Subtitle A, Office of the Secretary, Part 21, Nondiscrimination in Federally assisted programs of the Department of Transportation issued pursuant to such Act, hereby notifies all bidders that it will affirmatively insure that in any contract entered into pursuant to this advertisement, minority business enterprises will be afforded full opportunity to submit bids in response to this invitation and will not be discriminated against on the grounds of race, color, national origin, sex, age, or disability in consideration for an award. CONSENT DECREE RELATING TO THE PROJECT 14. ❑ THIS CONTRACTOR IS PERFORMING WORK FOR THE CITY OF DUBUQUE RELATED TO THE WATER& RESOURCE RECOVERY CENTER OR THE SANITARY SEWER COLLECTION SYSTEM. THEREFORE, THE CONSENT DECREE AND THIS SECTION ARE APPLICABLE. CITY CONTRACTOR THIS CONTRACTOR IS NOT PERFORMING WORK FOR THE CITY OF DUBUQUE RELATED TO THE WATER & RESOURCE RECOVERY CENTER OR THE SANITARY SEWER COLLECTION SYSTEM. THEREFORE THE CONSENT DECREE AND THIS SECTION ARE NOT APPLICABLE. The City has entered into a Consent Decree in the case of The United States of America, and the State of Iowa v. The City of Dubuque, Iowa, Civil Action Number Case 2:11-cv-01011-EMJ, Civil Action Number 2008V00041, DOJ Case Number 90-5-1-1-09339, United States District Court for the Northern District of Iowa. The provisions of the Consent Decree apply to and are binding upon the City and its officers, directors, employees, agents, servants, successors, assigns, and all persons, firms and corporations under contract with the City to perform the obligations of the Consent Decree. The City is required to provide a copy of the Consent Decree to any contractor or consultant retained to perform work required by the Consent Decree. A copy of the Consent Decree is included in the Contract Documents and can be viewed at http://www.cityofdubugue.org/DoeumentCenter/Home/View/3173. A hard copy is available upon request at the City's Engineering Department Office. The City must condition any contract to perform work required under the Consent Decree upon performance of the work in conformity with the provisions of the Consent Decree. The Consent Decree also provides that until five (5) years after the termination of the Consent Decree, the City must retain, and must instruct its contractors and agents to preserve, all non-identical copies of all documents, reports, data, records, or other information (including documents, records, or other information in electronic form) in its or its contractors' or agents' possession or control, or that come into its or its contractors' or agents' possession or control, and that relate in any manner to the City's performance of its obligations under this Consent Decree, including any underlying research and analytical data. This information-retention period, upon request by the United States or the State, the SECTION 00500 . Page 5 of 6 City must provide copies of any documents, reports, analytical data, or other information required to be maintained under the Consent Decree. At the conclusion of the information-retention period, the City must notify the United States and the State at least ninety (90) Days prior to the destruction of any documents, records, or other information subject to such requirements and, upon request by the United States or the State, the City must deliver any such documents, records, or other information to the EPA or IDNR. CERTIFICATION BY CONTRACTOR The undersigned, on behalf of the Contractor, with full authority to act on behalf of the Contractor, certifies to the City of Dubuque as follows: 1. I have received a copy of the Consent Decree in the case of The.United States of America, and the State of Iowa v. The City of Dubuque, Iowa, Civil Action Number Case 2:1 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. 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, Iii records, or other information in electronic form)that relate in any manner to the performance of obligations under the Consent Decree, including any underlying research and analytical data, will be retained as required by the Consent Decree. 4. The Contractor agrees to defend, indemnify, and hold harmless the City, its officers, agents, or employees from and against any claims, including penalties, costs and fees as provided in the Consent Decree, relating to or arising out of the Contractor's failure to comply with the Consent Decree. CONTRACTOR: Contractor BY: N/A Signature Printed Name Title Date SECTION 00500 Page 6 of 6 THE CITY AGREES: 15. Upon the completion of the Contract, and the acceptance of the Project by the City Council, and subject to the requirements of law,the City agrees to pay the Contractor as full compensation for the complete performance of this Contract,the amount determined for the total work completed at the price(s)stated in the Contractor's Bid Proposal and less any Agreed Cost of Delay provided for in the Contract Documents. CONTRACT AMOUNT$ 328,276.28 CITY OF DUBUQUE, IOWA: C!ly Manager's Office Department By: Signature Michael C.Van Mfifigen Printed Name City Manage Title tooh Date f CONTRACTOR: Portzen Construction, Inc. Con BY: Signature Michael J Portzen Printed Name Vice President Title August 11, 2017 -6ate END OF SECTION 00500 SECTION 00600 Bond #54-218368 Pagel of PERFORMANCE, PAYMENT AND MAINTENANCE BOND SECTION 00600 KNOW ALL BY THESE PRESENTS: That we, Portzen Construction, Inc., as Principal (hereinafter the "Contractor" or "Principal") and United Fire & Casualty Company as Surety are held and firmly bound unto the City of Dubuque, Iowa, as Obligee (hereinafter referred to as "Owner"), and to all nprqr)n-,, whn may be iniured by anv breach of any of the conditions of this Bond in the penal sum oft,(SEE BACK SIDE OF THIS PAGE) ($328,276.28), 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 101L day of August 2017, (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 the N. Grandview Avenue at Loras Boulevard Intersection Improvements detail the following described improvements: The project provides for construction of traffic signal improvements and related work at N. it Grandview Avenue and Loras Boulevard. The project will include: * New traffic signals with mastarms at North Grandview Avenue and Loras Boulevard * Precast concrete bases for the traffic signals * ADA pedestrian accessible curb ramps * 4" and 6" PCC sidewalk replacement in conjunction with ADA pedestrian access ramp work * 8" PCC doweled pavement at Loras Boulevard * Modification to an existing Century Link vault to accommodate new grades in the street and sidewalk * 12 LF of 6" watermain and associated valves and fittings and a fire hydrant. * Storm sewer intakes and related pipe are to be installed under this project * Fiber optic conduit, vaults and fiber optic/traffic signal hand holes are to be installed. The conduit is seven way futurepath conduit. It is expressly understood and agreed by the Contractor and Surety in this Bond that the following provisions are a part of this Bond and are binding upon said Contractor and Surety, to-wit: 1. PERFORMANCE: The Contractors hall 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 SECTION 00600 Page 2 of 4 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 Contracto'r and Surety shall not be liable to said persons,firms, or corporations unless the claims of said claimants against said portion of the contract price shall have been established as provided by law. The Contractor and Surety hereby bind themselves to the obligations and conditions set forth in Chapter 573 of the Iowa Code, which by this reference is made a part hereof as though fully set out herein. 3. MAINTENANCE: The Contractor and the Surety on this Bond hereby agree, at their own expense: A. To remedy any and all defects that may develop in or result from work to be performed under the Contract Documents within the period of two (2) year(s) from the date of acceptance of the work under the Contract, by reason of defects in workmanship, equipment installed, or materials used in construction of said work; B. To keep all work in continuous good repair; and C. To pay the Owner's reasonable costs of monitoring and inspection to assure that any defects are remedied, and to repay the Owner all outlay and expense incurred as a result of Contractor's and Surety's failure to remedy any defect as required by this section. II 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 j' 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; SECTION 00600 Page 3 of 4 C. To consent without notice that this Bond shall remain in full force and effect until the Contract is completed, whether completed within the specified contract period, within an extension thereof, or within a period of time after the contract period has elapsed and the liquidated damage penalty is being charged against the Contractor. The Contractor and every Surety on the Bond shall be deemed and held bound, any contract to the contrary notwithstanding, to the following provisions: D. That no provision of this Bond or of any other contract shall be valid that limits to less than five (5)years after the acceptance of the work under the Contract the right to sue on this Bond. E. That as used herein,the phrase"all outlay and expense" is not to be limited in any way, but shall include the actual and reasonable costs and expenses incurred by the Owner including interest, benefits, and overhead where applicable. Accordingly, "all outlay and expense" would include but not be limited to all contract or employee expense, all equipment usage or rental, materials,testing, outside experts, attorney's fees (including overhead expenses of the Owner's staff attorneys), and all costs and expenses of litigation as they are incurred by the Owner. It is intended the Contractor and Surety will defend and indemnify the Owner on all claims made against the Owner on account of Contractor's failure to perform as required in the Contract and Contract Documents, that all agreements and promises set forth in the Contract and Contract Documents, in approved change orders, and in this Bond will be fulfilled, and that the Owner will be fully indemnified so that it will be put into the position it would have been in had the Contract been performed in the first instance as required. In the event the Owner incurs any "outlay and expense" in defending itself against any claim as to which the Contractor or Surety should have provided the defense, or in the enforcement of the promises given by the Contractor in the Contract, Contract Documents, or approved change orders, or in the enforcement of the promises given by the Contractor and Surety in this Bond, the Contractor and Surety agree that they will make the Owner whole for all such outlay and expense, provided that the Surety's obligation under this Bond shall not exceed one hundred twenty-five percent (125%) of the penal sum of this Bond. In the event that any actions or proceedings are initiated regarding this Bond, the parties agree that the venue thereof shall be Dubuque County, State of Iowa. If legal action is required by the Owner to enforce the provisions of this Bond or to collect the monetary obligation incurring to the benefit of the Owner, the Contractor and the Surety agree, jointly, and severally, to pay the Owner all outlay and expense incurred therefor by the Owner. All rights, powers, and remedies of the Owner hereunder shall be cumulative and not alternative and shall be in addition to all rights, powers, and remedies given to the Owner, by law. The Owner may proceed against surety for any amount guaranteed hereunder whether action is brought against the Contractor or whether Contractor is joined in any such action(s) or not. NOW THEREFORE, the condition of this obligation is such that if said Principal shall faithfully perform all the promises of the Principal, as set forth and provided in the Contract, in the Contract Documents, and in this Bond, then this obligation shall be null and void, otherwise it shall remain in full force and effect. SECTION 00600 Page 4 of 4 When a work, term, or phrase is used in this Bond, it shall be interpreted or construed first as defined in this Bond, the Contract, or the Contract Documents; second, if not defined in the Bond, Contract, or Contract Documents, it shall be interpreted or construed as defined in applicable provisions of the Iowa Code; third, if not defined in the Iowa Code, it shall be interpreted or construed according to its generally accepted meaning in the construction industry; and fourth, if it has no generally accepted meaning in the construction industry, it shall be interpreted or construed according to its common or customary usage. 4 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. !i Project No. 3002559 I� Witness our hands, in triplicate, this 10th clayof August , 2017_ SURETY COUNTERSIGNED BY: `title it Signature of e t (FORM AP ?IED BY: Terrance J Friedman Printed Name of Agent Represelitative for Owner 880 Locust St - Ste 200 SURETY: Company address Unit ire & Casualty Company Dubuque, Iowa 52001 surety o pa City,State,Zip Code By: 563-556-0272 ysig reAttomey-in-FactOfficer Company Telephone Number Scott A DeSousa PRINCIPAL: Printed Name ofAttomey-in-Fact Officer Friedman Insurance Inc Portzen Construction Inc Company Name Cont7k� 880 Locust St - Ste 200 By Company Address signature Dubuque,.. Iowa 52001 Michael J Portzen city,state,Zip Code Printed Name Vice President 563-556-0272 Company Telephone Number i SECTION 00600 Page 5 of 4 NOTE: 1 All signatures on this performance, payment, and maintenance Bond must be original signatures in ink; copies, facsimile, or electronic signatures will not be accepted. Z This Bond must be sealed with the Surety's raised, embossing seal. 3. The name and signature of the Surety's Attorney-in-Fact/Officer entered on this Bond must be exactly as listed on the Certificate or Power of Attorney accompanying this Bond. END OF SECTION 00600 UNTTEA FIRE&C7.ASUALTY CUMPAlti C1AAIft RA PIlS,IA 1. UNITED ETRE 11 DEMI- Ooiii 1`►Y,.wEBS'T .. T Iuguuies Surety Aepait>xient NAICIAI PAG"ZFIC I PSiJRANE COMPANY;RUCKLII�I,CA; 1I8 Second Ace SE 1 CERTIFIED CO , OFP, zElt 01 AT �R1 EY Color Raprd: IA-52401 .1 Itorigrnal"on file at Home Office of`Cornpany See'Certification) �'. w ASL PERSONS B - THESE PRESENTS,That UIW ED Fes"&`CASUALTY COMPANY;a corp�iiation duly oxganaz_. .", �existin I under Etre laws of the:State o Iowa Ul*TITI D EIRE&11�1DEMNITY COIv0t &W- a corporation duly &iii an. existing under-f c l..Qibf the S'fate.of Texas and"FINANCIAI"rPACIF,Itw INSUR: I . ""'COMPANY, a Corporation duly' rgantzed and existing iiticlex'the laws of the Siate of California herein"collectively callF1 I ed'the Coria es)r and Navin their:co orae head'carters in Cedar Rapids",State of"Tow°,does make;constitute.and a Xrit TERRANt E J.:; FRIEI3INAN �" O T A L}E, , IUI: ; ; 1.J FHA EN DANA YIEI l IK; SNII2L �' IN; SHANNON, EACH pig INbT�1"ID.UALLY of" RU.BU4UE IA I I i :their tr, 'a ,lawful Attortiey(s) iri Fact�?ith 1111",po�Ilwer anti authority hereby conferred to sign sial and execute in its behalf all lawful bonds undertalimgs. 11 and o, er obligatory tnstraments of snnilar nature provided that no"single obligation shall excoed $5b 000=,:000 OQ and to bind the Companies thereNi O fully and to tho sam­111e:exte11, nt as if such mstrurrients vtiert signed;by,the,duly authanzed',Acers of the 6%`n"'nies and all of the acts of said lttome ursuarit to the authorit :Itereb tVen anal he" :Iratzfied end confirmed I y;p Y y y The Authority hereby granted is con1.t1.mu1.ous and shall retnaii m full force aril effect viiia!revoked by UNITED FIRE&,CASUALTY COMPANY, UNIIDFTRE&INDIGINITY COMPANY ANIS FINANCIAL IxACIFIC:INSURANGE CCMPATVY This Power of Attorney is made and executed pursuant fo and by authority of the,fallowing bylaux duly adopted ori W, 1S 2R13,by the Boards of Directors of UNITED"FIRE & CASUAI TY 866 iik ; UNITED FIRE'&INDEMNITY COMPANY, and FINANCIAL PARI K INSURANCE COMPAI`TY I "Article VI—Surety Bonds and Undertakings" 1 a Section;Z Appointment of Attoniey-in-Fact "The President or any Vice President, or any other officer of the Companies,may,from time to time, appoint by written certificates attorneys-in4act to act in behalf of";.the Companies",n the execution of policies of iiisuranc , bonds; . undertakI. �gs and other obligatory instruments of like nature. The signature of any officer.authorized,hereby,and the Corporate sear may be affixed;iy facsimile to any power of attorney ox sFeeial power of attorney or certification;of either authorized hereby, such si izatu I and seal,I when so ascii,being;adopted by the Companies as the original,siguAture'of.;such officer and the original seal�of the Companies to: 1 Valid and' binding upon the Gompanies with the sai te`force and effect as though.manually,affixed. Such attorneys-in=fact,subject to the hmitat. , set11 :forth Zn3 theta'respective,certificates=.of authoI'llrity shall have fulls power fo°bind the„Companies:by"their"signature and execution of anysiich instruments olid to attach the seal of the Companies thereto. The President"or'any,Vice President the"Board of Directors or stay other officer of. the Cariipanios stay at any time reI'llvoke ali;power and authority previously"g"iven to any attorne11 y-in-fact.. �,NP41.K7ilf - .. . ;',, 11 - �,,� & ,,�� " �„�,��;Np ;ti,,,� ,1., ��f��Nsu,i,, IN WITNESS tiVF3EREOF the COMPANIES have each caused these presents to .0 signed by its w1 co. ,��� `' P�`�vFFoRRgtie vice-president an its,corporate seal to be hereto�affixed this°]5th day of October, "2013 N eeaaeca�E o tQ co. A,* F a cofuonAre a F C 11 I a z ;u �u�Yz? O= UNITED FIRE&CASUAI TY COMPANY1­1 { ., sEni sAti a (sea = UNITED FIRE 8t INDEMNITY COMPANY ?- 0l:0 V ''���s raa�ExP��� °gUFOFr`�° �`�' FINANCIAL PACIFTG INSURANCE:GOMPANY j .i�ll)i nti' � - N7Hrpmu�faV "�ilgrn7munUaaa��� I 1, - State of Iowa County of Linn,ss Vice President On 15th; day Of October, 2013 before me personally came Dennis J. Richmann to ,c known mho being by me duly sworn did depose and'say,that he resides ori Cedar Rapids, State of Iowa that lie is a V"ice President of UNITED.' FIR,1&CASUALTY COMPATJY,a Vice-President of UNITED FIRE&INDEMNITY COMPANY and°`Vice Prestderit of FINANCIAL,PACIFIC :INSURANC1.E COMPANY the corporations described to Arid whichexecufed t1­1he above ins-1�7trument,that he!mows theseal bf said corporattonsaithat the' sial affixed to the;saicl tnstrurnertt#s such corporate seal,that tt was so affixed pursuant to authonty given by the Board of Directors ttf:said,corp.orations;< attd that lie signed°"1us naxrte theretopursuatst to iie'authartt ,orad acknowledges satiie tit be the act otic!deed tt .satd corporations ae Jt{drth A ©outs J'� r Iowa Notarial Seal + Cotnmtssiora number t73Q49 o-wk Cdly CommtssFon,Exptres 04/?3/2Q18 s. Notary Pub1tC ; -" My commission expires 04'I, , , 18 I,David A Lange; Secretary of UI ITEI: FIRE&CASUALTY CQMPAN and Assistant secretary of" ITED FIRE iii IN EMi�ItY COMPANY, Arid Assistant Secretary of FTNANGIAL PACIFIC INSUItAI�ICE CQIvTPAN ',do hereby certify that I leave compared the farugoing copy of tl Power of Atta,r::y and affidavit,and the copy of rite Section of the bylaws and resolutions of said Corporations as'"sef forth in.said,Power"o1.f Attorney,with the tJRIGII ALS ON FILE 1... IE Itt ME OFFICE'OF SATI}.. R 1 I kA ... A and that the same ars*correct transcripts thereof end of the whole of"the said originals andthat the.said Power of Attorney'has not been.11 revoked and is naw iti<full force and effect I 11Sri testiniony h r. I hive hereunto sat scribed ray name and afFi ed the"cerrporate seal o,:. ,e said`Carporations this' :�;Oth day of AU9d. .: ACC>ryj�-�e� DATE(MMIDDIYYYY) � i1....,..V1../.RiJ CERTIFICATE OF LIABILITY INSURANCE 8/10/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to ¢ the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT qI NAME: Pam BUchholtz Friedman Insurance, Inc. P"oNE 563-556-0272 FPx 563-556-4425 PO Box 759 aIc "° Dubuque IA 52004-0759 Ep AILss.buchholtzp@friedman-group.com I INSURERS AFFORDING COVERAGE NAIL# INSURERA:United Fire&Casualty 13021 INSURED PORTCON-02 INSURER B: Portzen Construction Inc INSURERC: 205 Stone Valley Dr. Dubuque IA 52003 INSURER D INSURER E: ) INSURER F: COVERAGES CERTIFICATE NUMBER: 1071500032 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS !� CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. li INSR R POLICY EFF POLICY EXP j LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y 60456157 12/31/2016 12/31/2017 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE XI OCCUR PREMISES Ea occurrence $100,000 MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 I' GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY a JECT PRO-- LOC PRODUCTS-COMP/OP AGG $2,000,000 i OTHER: $ A AUTOMOBILE LIABILITY Y 60456157 12/31/2016 12/31/2017 COMBINED SINGLE LIMIT $ Ea accident 1,000,000 k X ANY AUTO BODILY INJURY(Per person) $ AUTOWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS HIRED AUTOS NON-OWNED I PROPERTY DAMAGE $ AUTOS Per accident Jul/Ulm $100,000 A X UMBRELLA LIAB X OCCUR Y Y 60456157 12/31/2016 12/31/2017 EACH OCCURRENCE $10,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $10,000,000 DED I X RETENTION$10,000 $ A WORKERS COMPENSATION Y 30303343 12/31/2016 12/31/2017 X PER ETH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $500,000 OFFICER/MEMBER EXCLUDED? NI N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $500,000 u If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1 $500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Project: N.Grandview Avenue at Loras Boulevard Intersection Improvements. 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 are listed as Additonal Insured on a primary&non-contributory basis for on-going and completed operations with respect to general liability as provided by endorsements CG7103 and CG7150. Fellow Employee Exclusion amended as provided by endorsement CG7103. Governmental Immunities in favor of the additional insured for the general liability as provided by endorsement CG7163.Waiver of Subrogation in favor of the additional insured is included for the general liability and workers compensation as provided by endorsements CG7103 and CG7163 and WC000313. CERTIFICATE HOLDER CANCELLATION : I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Dubuque THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 50 W 13th Street ACCORDANCE WITH THE POLICY PROVISIONS. Dubuque IA 52001 1 I AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Y i I CG 71 03 02 15 ULTRA LIABILITY PLUS ENDORSEMENT I COMMERCIAL GENERAL LIABILITY EXTENSION ENDORSEMENT SUMMARY OF COVERAGES This is a summa of the various additional coverages and coverage modifications I summary g g provided by this endorsement. No coverage is provided by this summary. * Extended Property Damage * Expanded Fire Legal Liability to include Explosion, Lightning and Sprinkler Leakage * Coverage for non-owned watercraft is extended to 51 feet in length * Property Damage - Borrowed Equipment * Property Damage Liability - Elevators Coverage D -Voluntary Property Damage Coverage $5,000 Occurrence with a$10,000 Aggregate • Coverage E - Care, Custody and Control Property Damage Coverage ;I $25,000 Occurrence with a $100,000 Aggregate - $500 Deductible * Coverage F- Electronic Data Liability Coverage -$50,000 Coverage G - Product Recall Expense $25,000 Each Recall Limit with a $50,000 Aggregate - $1,000 Deductible h * Coverage H -Water Damage Legal Liability -$25,000 Increase in Supplementary Payments: Bail Bonds to$1,000 * Increase in Supplementary Payments; Loss of Earnings to $500 * For newly formed or acquired organizations - extend the reporting requirement to 180 days Broadened Named Insured —� Automatic Additional Insured - Owners, Lessees or Contractors -Automatic Status When Required in Construction Agreement With You Automatic Additional Insured -Vendors * Automatic Additional Insured - Lessor of Leased Equipment Automatic Status When Required in Lease /agreement r With You •Automatic Additional Insured - Managers or Lessor of Premises Y Additional Insured - Engineers, Architects or Surveyors Not Engaged by the Named Insured { •Additional Insured -Employee Injury to Another Employee *Automatically included -Aggregate Limits of Insurance (per location) Automatically included -Aggregate Limits of Insurance (per project) * Knowledge of occurrence - Knowledge of an "occurrence", "claim or suit" by your agent, servant or employee shall not in itself constitute knowledge of the named insured unless an officer of the named insured has received such notice from the agent, servant or employee --- * Blanket Waiver of Subrogation j * Liberalization Condition * Unintentional failure to disclose all hazards. If you unintentionally fail to disclose any hazards existing at the inception date of your policy, we will not deny coverage under this Coverage Form because of such failure. However, this { provision does not affect our right to collect additional premium or exercise our right of cancellation or non-renewal * Mobile equipment to include snow removal, road maintenance and street cleaning equipment less than 1,000 lbs GVW I Bodily Injury Redefined �I I REFER TO THE ACTUAL ENDORSEMENT FOLLOWING ON PAGES 2 THROUGH 12 FOR CHANGES AFFECTING YOUR INSURANCE PROTECTION CG 71 03 02 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 12 i . ` CG 71 030215 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ |TCAREFULLY. ULTRA LIABILITY YTY PLUS ENDORSEMENT This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SECTION I - COVERAGES A. The following changes are made at COVERAGE A' BODILY INJURY AND PROPERTY DAMAGE L|AB!L|TY 1. Extended Property Damage At 2. Exclusions exclusion a. Expected or Intended Injury is rap|omod with the following: "Bodily injury" o/"property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use ofreasonable force to protect poneuna or property. 2. Expanded Fire Legal Liability At 2. Exclusions the last paragraph is deleted and replaced by the following: Exclusions o. through n. do not apply to damage by fire. explosion, |ightn|ng, smoke resulting from such fire, exp|oaion, or lightning or sprinkler leakage to premises while rented to you or temporarily occupied by you with permission of this owner. Aeepanyte limit of insurance applies to this coverage as described in SECTION O| ~ LIMITS OF INSURANCE. S. Non-Owned Watercraft At 2. Exclusions exclusion 9. /\iro/aft. Auto Or Watercraft (2) (m) is deleted and replaced by the following: (a) Less than 51 feet long; 4. Property Damage — Borrowed Equipment At 2. Exclusions the following in added to paragraph (4) of exclusion j. Damage To Property: This exclusion does not apply ho 'property damage" toborrowed equipment while atajobaite and while not being used to perform operations. The most we will pay for "property damage" to any one piece of borrowed equipment under this coverage is $25,000 per occurrence. The insurance afforded under this provision is excess over any valid and collectible property insurance (including deductible) available to the |neumd, whether pr}mary, exceoo. contingent nronany other basis. 5. Property Damage Liability —E|wvatura At 2. Exclusions the following is added to paragraphs (3). (4) and (S) of exclusion j. Damage To Prop": This exclusion does not apply to "property damage" resulting from the use ofelevators. However, any insurance provided for such "property damage" is excess over any valid and co||eobb|o property insurance (including deductible) available to the insunad, whether primary, exceoo, contingent or on any other basis, B. The following omvensgeo are added: 1. COVERAGE D -VOLUNTARY PROPERTY DAMAGE COVERAGE "Property damoge" to property ofothers caused bythe insured: a. While inyour possession; or b. Arising out of"your*nrk~ Coverage applies at the request of the inuured, whether or not the insured is legally obligated to pay, For the purposes ofthis Voluntary Property Damage Coverage only: Exclusion j. Damage to Property is deleted and nap\amyd by the following: CG 71 03O2 15 Includes copyrighted material of Insurance Sami000 Office, Inc., with its permission. Page 2of12 CG 71 03 02 15 j. Damage to Property "Property damage" to: (1) Property held by the insured for servicing, repair, storage or sale at premises you own, rent, lease, operate or use, (2) Property transported by or damage caused by any "automobile", "watercraft" or"aircraft" you own, hire or lease; (3) Property you own, rent, lease, borrow or use. The amount we will pay is limited as described below in SECTION iII - LIMITS OF INSURANCE For the purposes of this Voluntary Property Damage Coverage, our right and duty to defend ends when we have paid the Limit of Liability or the Aggregate Limit for this coverage. I 2. COVERAGE E -CARE, CUSTODY AND CONTROL PROPERTY DAMAGE COVERAGE For the purpose of this Care, Custody and Control Property Damage Coverage only: a. Item (4) of Exclusion 1. does not apply. The amount we will pay is limitedas described below in SECTION III - LIMITS OF INSURANCE � For the purposes of this Care, Custody and Control Property Damage Coverage, our right and duty to defend ends when we have paid the Limit of Liability or the Aggregate Limit for this coverage. 3. COVERAGE F -ELECTRONIC DATA LIABILITY COVERAGE For the purposes of this Electronic Data Liability Coverage only: a. Exclusion p. of Coverage A— Bodily Injury And Property Damage Liability in Section I — Coverages is replaced by the following: 2. Exclusions This insurance does not apply to: ga. Electronic Data G Damages arising out of the loss of, loss of use of, damage to, corruption of, inability to access, or inability to manipulate "electronic data" that does not result from physical injury-to,-tangible .property. However, this exclusion does not apply to liability for damages because of"bodily injury" b. "Property Damage" means: (1) Physical injury to tangible property, including ail resulting loss of use of that property. All such loss of use t shall be deemed to occur at the time of the physical injury that caused it; or II (2) Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the time of the "occurrence" that caused it; or j (3) Loss of, loss of use of,, damage to, corruption of, inability to access or inability to properly manipulate "electronic data", resulting from physical injury to tangible property. All such loss of"electronic data" shall j be deemed to occur at the time of the "occurrence" that caused it. k For the purposes of this Electronic Data Liability Coverage, "electronic data" is not tangible property, The amount we will pay is limited as described below in SECTION III -LiMITS OF INSURANCE 4. COVERAGE G -PRODUCT RECALL EXPENSE a. Insuring Agreement (1) We will pay 90%0 of "product recall expense" you incur as a result of a "product recall" you initiate during the coverage period. (2) We will only pay for "product recall expense" arising out of "your products" which have been physically relinquished to others. The amount we will pay is limited as described below in SECTION IiI - LIMITS OF INSURANCE CG 71 03 02 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 12 e I CG 71 03 02 15 b. Exclusions This insurance does not apply to "product recall expense" arising out of: (1) Any fact, circumstance or situation which existed at the inception date of the policy and which you were aware of, or could reasonably have foreseen that would have resulted in a "product recall". (2) Deterioration, decomposition or transformation of a chemical nature, except if caused by an error in the manufacture, design, processing, storage, or transportation of"your product" (3) The withdrawal of similar products or batches that are not defective, when a defect in another product or batch has been found. (4) Acts, errors or omissions of any of your employees, done with prior knowledge of any of your officers or directors. (5) Inherent vice, meaning a natural condition of property that causes it to deteriorate or become damaged. (6) "Bodily Injury" or"Property Damage". (7) Failure of"your product" to accomplish its intended purpose, including any breach of warranty of fitness, quality, efficacy or efficiency, whether written or implied. (8) Loss of reputation, customer faith or approval, or any costs incurred to regain customer market, or any other consequential damages. (9) Legal fees or expenses. (10) Damages claimed for any loss, cost or expense incurred by you or others for the loss of use of "your product". (11) "Product recall expense" arising from the "product recall' of any of "your products" for which coverage is excluded by endorsement. (12) Any "product recall' initiated due to the expiration of the designated shelf life of"your product". 5. COVERAGE H -WATER DAMAGE LEGAL LIABILITY The Insurance provided under Coverage H (Section E) applies to "property damage" arising out of water damage to premises that are both rented to and occupied by you. The Limit under this coverage shall not be in addition to the Damage To Premises Rented To You Limit. The amount we will pay is limited as described below in SECTION III -LIMITS OF INSURANCE C. SUPPLEMENTARY PAYMENTS - COVERAGES A AND B is amended: 1. To read SUPPLEMENTARY PAYMENTS 2. Bail Bonds item 1.b. is amended as follows: b. Up to $1,000 for cost of ball bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily injury Liability Coverage applies. We do not have to furnish these bonds. 3. Loss of Earnings Item 1.d, is amended as follows: d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or"suit", including actual loss of earnings up to $500 a day because of time off from work. 4. The following language is added to Item 1. However, we shall have none of the duties set forth above when this insurance applies only for Voluntary Property Damage Coverage and/or Care, Custody or Control Property Damage Coverage and we have paid the Limit of Liability or the Aggregate Limit for these coverages. CG 71 03 02 15 Includes copyrighted material of Insurance Services Office, inc., with its permission. Page 4 of 12 I i l CC 71 03 02 15 SECTION 11- WHO IS AN INSURED A. The following change is made: Extended reporting requirements Item 3.a. is deleted and replaced by the following a. Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier. B. The following provisions are added: 4. BROAD FORM NAMED INSURED Item 1.f. is added as follows: f. Any legally incorporated entity of which you own more than 50 percent of the voting stock during the policy period only if there is no other similar insurance available to that entity. However: (1) Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired more than 50 percent of the voting stock; and (2) Coverage B does not apply to "personal and advertising injury" arising out of an offense committed before you acquired more than 50 percent of the voting stock. I 5. Additional Insured - Owners, Lessees or Contractors -Automatic Status When required in Construction j or Service Agreement With You a. Any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy is an insured. Such person or organization is an additional insured only with respect to your liability for "bodily injury", "property damage" or "personal and advertising injury" which may be imputed to that person or organization directly arising out of: I. Your acts or ornissions; or j 2. The acts or omissions of those acting on your behalf; in the performance Of your ongoing operations for the additional insured. However, the insurance afforded tO such additional insured: 1. Only applies to the extent permitted by law; and 2. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. i b. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: f This insurance does not apply to: 1. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or j the failure to render, any professional architectural, engineering or surveying services, including: I' a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, N surveys, field orders, change orders or drawings and specifications; or b. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional architectural, engineering or surveying services. 2. "Bodily injury" or"property damage" occurring after: a. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or ;i CG 71 03 02 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 12 e CG 71 03 02 15 b. That portion of"your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. 6. Additional Ensured -Vendors a. Any person(s) or organization(s) (referred to throughout this additional coverage as vendor), but only with respect to "bodily injury" or "property damage", which may be imputed to that person(s) or organization(s) k arising out of "your products" shown with the Schedule which are distributed or sold in the regular course of the vendor's business is an insured. However: ji (1) The insurance afforded to such vendor only applies to the extent permitted by law; and (2) If coverage provided to the vendor is required by a contract or agreement, the insurance afforded to such vendor will not be broader than that which you are required by the contract or agreement to provide for �{ such vendor. �! b. With respect to the insurance afforded to these vendors, the following additional exclusions apply: it (1) This insurance afforded the vendor does not apply to: (a) "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; (b) Any express warranty unauthorized by you; (c) Any physical or chemical change in the product made intentionally by the vendor; (d) Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container. (e) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to l make or normally undertakes to make in the usual course of business, in connection with the P distribution or sale of products. (f) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product, j (g) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor. (h) "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: i. The exceptions contained in Sub-paragraphs d. or f.; or il. Such inspections, adjustments, tests or servicing as the.vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of I the products. (2) This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. 7. Additional Insured — Lessor of Leased Equipment — Automatic Status When Required in Lease h' Agreement With You a. Any person(s) or organization(s) from whom you lease equipment when you and such person(s) or organization(s) have agreed in writing in a contract or agreement that such person(s) or organization(s) be added as an additional insured on your policy. Such person(s) or organization(s) is an insured only with respect to your liability for "bodily injury" "property damage" or "personal and advertising injury" directly arising out of the maintenance, operation or use of equipment leased to you, which may be imputed to such person or organization as the lessor of equipment. CG 71 03 02 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 6 of 12 i e X s G I GG 71 03 02 15 k However, the insurance afforded to such additional insured: (1) Only applies to the extent permitted by law; and (2) Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. i A person's or organization's status as an additional insured under this endorsement ends when their contract or agreement with you for such leased equipment ends. b. With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after the equipment lease expires. 4 S. Additional insured —Managers or Lessors of Premises 1 a. Any person(s) or organization(s), but only with respect to liability arising out of the ownership, maintenance or use of that pari of the premises leased to you and subject to the following additional exclusions: This insurance does not apply to: F (1) Any "occurrence" which takes place after you cease to be a tenant in that premises. (2) Structural alterations, new construction or demolition operations performed by or on behalf of the person(s) or organization(s) afforded coverage by this additional coverage. However: (1) The insurance afforded to such additional insured only applies to the extent permitted by law; and (2) If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. g. Additional Insured - Engineers, Architects or Sunireyors Not Engaged by the Famed Insured a. Any architects, engineers or surveyors who are not engaged by you are insureds, but only with respect to liability for "bodily injury" or "property damage" or "personal and advertising injury" which may be imputed to { that architect, engineer or surveyor arising out of: (1) Your acts or omissions; or (2) Your acts or omissions of those acting on your behalf; it in the performance of your ongoing operations performed by you or on your behalf. But only if such architects, engineers or surveyors, while not engaged by you, are contractually required to be added as an additional insured to your policy. V, However, the insurance afforded to such additional insured: �! (1) Only applies to the extent permittedby law; and b (2) Will not be broader.than that which you are required by the contract or agreement to provide for such additional insured. d b. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of or failure to render any professional services, including: (1) The preparing, approving, or falling to prepare or approve, maps, drawings, opinions, reports, surveys, N change orders, designs or specifications; or (2) Supervisory, inspection or engineering services. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional services. GG 71 03 02 15 Includes copyrighted material of Insurance Services.Office, Inc., with its permission. Mage 7 of 12 h i �I F l f F i CG 71 03 02 15 ! 10. Additional Insured - Employee Injury to Another Employee With respect to your "employees" who occupy positions which are supervisory in nature: Paragraph 2.a.(1) of SECTION It —WHO IS A NAMED INSURED is amended to read: a. 'Bodily injury" or"personal and advertising injury" (1) To you, to your partners or members (if you are a partnership or joint venture), or to your members (if you are a limited liability company); (2) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in paragraph (1)(a) above; or I (3) Arising out of his or her providing or failing to provide professional healthcare services. Paragraph 3.a, is deleted. For the purpose of this Item 10 only, a position is deemed to be supervisory in nature if that person performs principle work which is substantially different from that of his or her subordinates and has authority to hire, direct, discipline or discharge. I SECT19N N HI LI Q° OF I URANCE A. The following Items are deleted and replaced by the following: ; 2. The General Aggregate Limit is the most we will pay for the sum of: a. Medical expenses under Coverage C; I i b. Damages under Coverage A, except damages because of "bodily injury" or "property damage" included in the "products-completed operations hazard"; and c. Damages under Coverage B; and d. Damages under Coverage K j i 3. The Products-Completed Operations Aggregate Limit is the most we will pay under Coverage A for damages because of "bodily injury" and "property damage" included in the "products-completed operations hazard" and Coverage G. 6. Subject to 5. above, the Damage to Premises Rented to You Limit is the most we will pay under Coverage A for damages because of "property damage" to any one premises, while rented to you, or in the case of damage by fire, explosion, lightning, smoke resulting from such fire, explosion, or lightning or sprinkler leakage while rented to you or temporarily occupied by you with permission of the owner. B. The following are added: S. Subject to Paragraph 5. of SECTION III — LIMITS OF INSURANCE $25,000 is the most we will pay under Coverage H for Water Damage Legal Liability. g. Coverage G - Product Recall Expense Aggregate Limit $50,000 Each Product Recall Limit $25,000 a. The Aggregate Limit shown above is the most we will pay for the sum of all "product recall expense" you incur as a result of all "product recalls" you initiate during the endorsement period. b. The Each Product Recall Limit shown above is the most we will pay, subject to the Aggregate and $1,000 deductible, for "product recall expense" you incur for any one "product recall" you initiate during the endorsement period. We will only pay for the amount of Product Recall Expenses which are in excess of the deductible amount. The deductible applies separately to each Product Recall. The limits of insurance will not be reduced by the amount of this deductible. We may, or will if required by law, pay all or any part of any deductible amount. Upon notice of our payment of a deductible amount, you shall promptly reimburse us for the part of the deductible amount we paid. CG 71 03 02 15 Includes copyrighted material of insurance Services Office, Inc., with its permission. Page 8 of 12 i CC 71 03 02 15 10. Aggregate Limits of Insurance (Per Location) j t The General Aggregate Limit applies separately to each of your "locations" owned by or rented to you or j temporarily occupied by you with the permission of the owner. i "Location" means premises involving the same or connecting lots, or premises whose connection is interrupted r only by a street, roadway, waterway or right-of-way of a railroad. i 11. Aggregate Limits of Insurance (Per Project) The General Aggregate Limit applies separately to each of your projects away from premises owned by or rented to you. 12. With respects to the insurance afforded to additional insureds afforded coverage by items 5 through 10 of k SECTION If —WHO IS AN INSURED above, the following is added: � The most we will pay on behalf of the additional insured is the amount of insurance: a. Required by the contract or agreement; b. Available under the applicable Limits of Insurance shown in the Declarations; Whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. i 13. Subject to 5. of SECTION III — LIMITS OF INSURANCE, a $5,000 "occurrence" limit and a $10,000 "aggregate" � limit is the most we will pay under Coverage A for damages because of "property damage" covered under Coverage D -voluntary Property Damage Coverage. For the purposes of this voluntary Property Damage Coverage, our right and duty to defend ends when h we have paid the Limit of Liability or the Aggregate Limit for this coverage. i� I 14. Subject to 5. of SECTIO III — LIrMTS OF INSURANCE, a $25,000 "occurrence limit and a $100,000 "aggregate" limit is the most we will pay under Coverage E - Care, Custody and Control Coverage regardless of the number of: a. Insureds; I! Io. Claims made or "suits" brought; or it c. persons or organizations making claims or bringing "suits". Deductible - Our obligation to pay damages on your behalf applies only to the amount of damages in excess of $500. q u. This deductible applies to all damages because of "property damage" as the result of any one "occurrence" regardless of the number of persons or organizations who sustain damages because of that "occurrence". We may pay any part or all of the deductible amount to effect settlement of any claim or "suit" and upon ' notification of the action taken, you shall promptly reimburse us for such part of the deductible amount as has been paid by us. 6 As respects this coverage "Aggregate" is the maximum amount we will pay for all covered "occurrences" during one policy period. i For the purposes of this Care, Custody and Control Property Damage Coverage, our right and duty to defend ends when we have paid the Limit of Liability or the Aggregate Limit for this coverage. � 15. Subject to 5. of SECTION [if — LiMITS OF INSURANCE, the most we will pay for "property damage" under Coverage F - Electronic Data Liability Coverage for loss of "electronic data" is $50,000 without regard to the number of'occurrences". I a CG 71 03 02 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 9 of 12 VI V V V I I h h, CC 71 03 02 15 SECTION IV a COMMERCIAL GENERAL LIABILITY CONDITIONS A. The following conditions are amended: 1. Knowledge of Occurrence a. Condition 2., Items a. and b. are deleted and replaced by the following: (1) Duties In The Event Of Occurrence, Offense, Claim Or Suit (a) You must see to it that we are notified as soon as practicable of an 'occurrence" or an offense which may result in a claim. Knowledge of an 'occurrence" by your agent, servant or employee shall not in itself constitute knowledge of the named insured unless an officer of the named insured has received such notice from the agent, servant or employee. To the extent possible, notice should include: I. How, when and where the "occurrence" took place; Ii. The names and addresses of any injured persons and witnesses, and I Iii. The nature and location of any injury or damage arising out of the "occurrence" or offense. (b) If a claim is made or"suit is brought against any insured, you must: i. Immediately record the specifics of the claim or "suit" and the date received; and Ii. Notify us as soon as practicable. You must see to it that we receive written notice of the claim or "suit' as soon as practicable. Knowledge of a claim or "suit' by your agent, servant or employee shall not in itself constitute knowledge of the named insured unless an officer of the named insured has received such notice from thea ` or employee. gent; servant 2. Where Broad Foran Named Insured is added in SECTION Il — WHO IS AN INSURED of this endorsement, Condition 4. Other Insurance b. Excess Insurance (1).(a) is replaced by the following: (a) Any of the other insurance, whether primary, excess, contingent or on any other basis, that is available to an insured solely by reason of ownership by you of more than 50 percent of the voting stock, and not withstanding any other language in any other policy. This provision, does not apply to a policy written to apply specifically in excess of this policy. B. The following are added: 1. Condition (a) of 2.c. I (5) Upon our request, replace or repair the property covered under Voluntary Property Damage Coverage at your actual cost, excluding profit or overhead. 10. Blanket Waiver Of Subrogation We waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of: premises owned or occupied by or rented or loaned to you, ongoing operations performed by you or on your behalf, done under a contract with that person or organization, "your work", or "your products". We waive this right where you have agreed to do so as part of a written contract, executed by you before the "bodily injury" or "property damage" occurs or the "personal injury" or "advertising j injury" offense is committed. 11. Liberalization If a revision to this Coverage Part, which would provide more coverage with no additional premium becomes effective during the policy period in the state designated for the first Named Insured shown in the Declarations, your policy will automatically provide this additional coverage on the effective date of the revision. 12. Unintentional Failure to Disclose All Hazards Based on our reliance on your representations as to existing hazards, if you unintentionally should fail to disclose all such hazards at the inception date of your policy, we will not deny coverage under this Coverage Part because of such failure. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non-renewal. f' I E CC 71 03 02 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 10 of 12 I i' i I CG 71 03 02 15 13. The following conditions are added in regard to Coverage G - Product Recall Expense: In event of a "product recall', you must: a. See to it that we are notified as soon as practicable of a "product recall'. To the extent possible, notice I should include how, when and where the "product recall' took place and estimated "product recall expense". t b. Take all reasonable steps to minimize "product recall expense". This will not increase the limits of insurance. c. If requested, permit us to question you under oath at such times as may be reasonably required about any matter relating to this insurance or your claim, including your books and records. Your answers must be signed. d. Permit us to inspect and obtain other information proving the loss. You must send us a signed, sworn I statement of loss containing the information we request to investigate the claim. You must do this within 60 4 days after our request, l e. Cooperate with us in the investigation or settlement of any claim. f. Assist us upon our request, in the enforcement of any rights against any person or organization which may be liable to you because of loss to which this insurance applies. SECTION ® DERNITIONS A. At item 12. Mobile Equipment the wording at f.(1) is deleted and replaced by the following: f.(1) Equipment designed primarily for: (a) Snow removal; (b) Road maintenance, but not construction or resurfacing; or (c) Street cleaning; except for such vehicles that have a gross vehicle weight less than 1,000 Ibs which are not designed for highway use. S. item 3. "bodily injury" is deleted and replaced with the following: 3. "bodily injury" means physical injury, sickness or disease sustained by a person. This includes mental anguish, mental injury, shock, fright or death that results from such physical injury, sickness or disease. h C. The following definitions are added for this endorsement only: j 23. "Electronic data" means information, facts or programs stored as or on, createdor used on, or transmitted to or from computer software, including systems and applications software, hard or floppy disks, CD-P,OMS, tape drives, cells, data processing devices or any other media which are used with electronically controlled f equipment. 24. "Product recall" means a withdrawal or removal from the market of "your product" based on the determination by you or any regulatory or governmental agency that: y a. The use or consumption of "your product" has caused or will cause actual or alleged "bodily injury" or "property damage`; and I b. Such determination requires you to recover possession or control of "your product" from any distributor, 4 purchaser or user, to repair or replace "your product", but only if "your product" is unfit for use or consumption, or is hazardous as a result of: (1) An error or omission by an insured in the design, manufacturing, processing, labeling, storage, or transportation of"your product"; or (2) Actual or alleged intentional, malicious or wrongful alteration or contamination of "your product" by someone other than you. Y CG 71 €13 02 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 11 of 12 C 4 u i l CG 71 03 02 15 25. "Product recall expense" means reasonable and necessary expenses for: a. Telephone, radio and television communication and printed advertisements, including stationery, envelopes and postage. I b. Transporting recalled products from any purchaser, distributor or user, to locations designated by you. c. Remuneration paid to your employees for overtime, as well as remuneration paid to additional employees or independent contractors you hire. d. Transportation and accommodation expense incurred by your employees. e. Rental expense incurred for temporary locations used to store recalled products. f. Expense incurred to properly dispose of recalled products, including packaging that cannot be reused. g. Transportation expenses incurred to replace recalled products. h. Repairing, redistributing or replacing covered recalled products with like products or substitutes, not to exceed your original cost of manufacturing, processing, acquisition and/or distribution. f These expenses must be incurred as a result of a "product recall". i ,II i i i I I i I I CG 71 03 02 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 12 of 12 I ,II . t f i i IL 71 05 10 14 I THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION l f This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART COMMERCIAL UMBRELLA COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: 4 (1) The additional insured is a Named Insured under such other insurance; (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured; (3) The additional insured gives us prompt written notice of any "occurrence" which may result in a claim and prompt written notice of "suit"; (4) The additional insured immediately forwards all legal papers to us, cooperates in the investigation or settlement of the claim or defense against the "suit', and otherwise complies with policy conditions. (5) The additional insured must tender the defense and indemnity of any claim or "suit" to any other insurer which also insures against a loss we cover under this policy. This includes, but is not limited to, any insurer which has issued a policy of insurance in which the additional insured qualifies as an insured. For the purpose of this requirement, the term "insures against' refers to any self-insurance and to any insurer which issued a policy of insurance that may provide coverage for the loss, regardless of whether the additional insured has actually requested that the insurer ' provide the additional insured with a defense and/or indemnity under that policy of insurance. (6) The additional insured agrees to make available any other insurance that the additional insured has for a loss we cover under this policy. I b d h y� u IL 71 05 10 14 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 WC ed 03 13 (4-gq,) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following"attaching clause"need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on at 12:01 A.M. standard time, forms a part of (DATE) Policy No. of the j (NAME OF INSURANCE COMPANY) i Issued to I f Premium i Authorized Representative We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us. This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule. Schedule I I i I WC 00 03 13 (4-84) Copyright 1982, 1983 National Council on Compensation Insurance. I CG 71 50 U215 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ |TCAREFULLY. CONTRACTORS BLANKET ADDITIONAL INSURED ~ UK0[FED PRODUCTS ~ C[)MPLETED OPERATIONS COVEP.8,GE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Terms and provisions of this endorsement shall supercede any inconsistent language in any other coverage form 1. A. Section || — Who Is An Insured is amended to include an on additional insured any person or organization whom you are required to add as on additional insured on this policy under a written contract or written agreement; but the written contract or written agreement must be: i. Currently in effect or becoming effective during the term of this policy; and 2. Executed prior hothe "bodily injury", or"property damage". B. The additional insured status will apply only with respect to your liability for "bodily injury" or "property damage" which may be imputed to that peruun(a) or organization(s) directly arising out of "your work" at the location designated and described in the written contract or written agreement performed for that additional insured and only for that liability included in the "products-completed operations hazard''. However: 1. The insurance afforded to such additional insureds only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. C. When coverage provided under this endorsement does apply to "bodily injury" or "property damage" arising out of the ^pmducto+comp|ob»d operations hazard": 1. Such coverage will not apply subsequent to the first to occur oftho following: a. The expiration ofthe period of time required by the written contract or written agreement; b. Five years from the completion of "your work" on on the project that is the subject of the written contract or written agreement, o. The expiration of any applicable statute of limitations or statute of repose with respect to claims arising out of "your work^ 2. With respect to the insurance afforded to these additional ineunydo, the following is added to Section W| ' Limits Of Insurance: If coverage provided to the additional insured is required by acontnsot or agreement, the most we will pay on beha|f of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or .2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement ohoU not increase the applicable Limits of Insurance shown in the Declarations, 3. With mop*ot to the insurance afforded to any additional insured under this endorsement, the following additional exclusionary language shall apply: This insurance does not apply to "bodily injury" or "property damage" arising out ofthe rendering of or the failure to render, any professional anchiteoture, engineering or surveying services, including: ' a. The proparing, approving, or failing to prepare or appmve, mape, shop dnswinge, opinions, nypo�a surveys, #o|d ondero, change orders nrdrawings and specifications; or ' b. Supervisory, inspection, architectural orengineering activities. CG 71 50 02 15 |no|udoe copyrighted material of Insurance Services Offinu. Inc., with its permission. Page i of COMMERCIAL AUTO CA 73 41 03 17 i THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. I I GARAGE OPERATIONS - PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION j This endorsement modifies insurance provided under the following: I GARAGE COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. The following is added to the Other Insurance 1. Such "Insured" is a Named Insured under such Condition in the Garage Coverage Form and other insurance; and supersedes any provision to the contrary: 2. You have agreed in writing in a contract or This Coverage Form's "Garage Operations" — agreement that this insurance would be primary and would not seek contribution from any other "Covered Autos" and "Garage Operations" — Other insurance available to such "insured". Than "Covered Autos" are primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that: j i I CA 73 41 03 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 I 60410305 CG 71 63 04 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CITY OF DUBUQUE, IOWA ADDITIONAL INSURED ENDORSEMENT i This endorsement modifies insurance provided under the following: s COMMERCIAL GENERAL LIABILITY COVERAGE PART PREMIUM 250 The City of Dubuque, Iowa, including all its elected and appointed officials, all its employees and volunteers, all its boards, commissions and/or authorities and their board members, employees, and p volunteers, are included as Additional Insureds with respect to liability arising out of the Insured's u work and/or services performed for the City of Dubuque, Iowa. This coverage shall be primary to the j Additional Insureds, and not contributing with any other insurance or similar protection available to r the Additional Insureds, whether other available coverage be primary, contributing or excess. V i CITY OF DUBUQUE, IOWA GOVERNMENTAL IMMUNITIES ENDORSEMENT (For use when including the City as an Additional Insured) 1. Nonwaiver of Government Immunity. The insurance carrier expressly agrees and states that the purchase of this policy and the including of the City of Dubuque, Iowa as an Additional Insured j does not waive any of the defenses of governmental immunity available to the City of Dubuque, r Iowa under Code of Iowa Section 570.4 as it now exists and as it may be amended from time to time. 2. Claims Coverage. The insurance carrier further agrees that this policy of insurance shall cover only those claims not subject to the defense of governmental immunity under the Code of Iowa t Section 570.4 as it now exists and as it may be amended from time to time. , 3. Assertion of Government Immunity. The City of Dubuque, Iowa shall be responsible for asserting any defense of governmental immunity, and may do so at any time and shall do so upon the timely written request of the insurance carrier. Nothing contained in this endorsement shall prevent the carrier from asserting the defense of governmental immunity on behalf of the City of Dubuque, Iowa. 4. Non-Denial of Coveraae. The insurance carrier shall not deny coverage under this policy and the insurance carrier shall not deny any of the rights and benefits accruing to the City of Dubuque, Iowa under this policy for reasons of governmental immunity unless and until a court of competent jurisdiction has ruled in favor of the defense(s) of governmental immunity asserted by the City of Dubuque, Iowa. I 1 1 CG 71 63 04 09 Page 1 of 2 i R s CG 71 63 04 09 5. No Other Change in Policy. The insurance carrier and the City of Dubuque, Iowa agree that the above preservation of governmental immunities shall not otherwise change or alter the coverage available under the policy. CITY OF DUBUQUE, IOWA CANCELLATION AND MATERIAL CHANGES ENDORSEMENT Thirty (30) days Advance Written Notice of Cancellation, Non-Renewal, Reduction in insurance coverage and/or limits and ten (10) days written notice of non-payment of premium shall be sent to:of Dubuque, 50 W. 13th St., Dubuque, Iowa 52001. This endorsement supersedes the standard' cancellation statement on the Certificate of Insurance to which this endorsement is attached. Note-. Endorsements above per 'Urban Standard Specifications For Public Improvements', Addendum No. 2 effective July 24, 2001. CG 71 63 04 09 Page 2 of 2 l i p, yl' THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CA 71 41 1 ft 11 LAND IMPROVEMENT CONTRACTORS ASSOCIATION (LICA) u BUSINESS AUTO ULTRA ENDORSEMENT d This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM I COVERAGE INDEX r Description Page tl TEMPORARY SUBSTITUTE AUTO PHYSICAL DAMAGE DRIVE OTHER CAR COVERAGE 1 BROAD FOR[ INSURED 2 EMPLOYEES AS INSUREDS —ADDITIONAL INSUREp STATUS BY CONTRACT, AGREEMENT OR PERMIT 2 AMENDED FELLOW EMPLOYEE EXCLUSION 2 TOWING AND LABOR PHYSICAL DAMAGE ADDITIONAL TRANSPORTATION EXPENSE COVERAGE 3 EXTRA,EXPENSE -THEFT f RENTAL REIMBURSEMENT AND ADDITIONAL TRANSPORTATION EXPENSE 3 PERSONAL EFFECTS COVERAGE AUDIO,VISUAL AND DATA. ELECTRONIC EQUIPMENT COVERAGE 4 AIRBAG ACCIDENTAL DISCHARGE 4 AUTO LOAN/LEASE TOTAL LOSS PROTECTION ENDORSEMENT 4 GLASS REPAIR— DEDUCTIBLE AMENDMENT AMENDED DUTIES IN THE�EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS 5 WAIVER OF SUBROGATION REQUIRED BY CONTRACT 5 UNINTENTIONAL FAILURE TO DISCLOSE HIRED, LEASER, REN I ED'OR BORROWED AUTO PHYSICAL DAMAGE S EXTENDED CANCELLATION CONDITION EXTENDED MEDICAL PAYMENT COVERAGE, UNINSURED AND UNDERINSURED S MOTORISTS COVERAGE EXTENDED PHYSICAL DAMAGE COVERAGE LIBERALIZATION 6 k The COVERAGE INDEX set forth above is informational only and grants no coverage. Terms set forth in (Bald Italics) are likewise for information only and by themselves shall be deemed to grant no coverage. r A. TEMPORARY SUBSTITUTE AUTO PHYSICAL because of its breakdown, repair, servicing, "loss", or DAMAGE destruction. SECTION I —COVERED AUTOS, paragraph C. Certain B. DRIVE OTHER CAR COVERAGE Trailers, Mobile Equipment and Temporary Substitute Autos is amended by adding the following at The following language is added to SECTION I e the end of the existing language: COVERED AUTOS- as paragraph D. Drive Other Car If Physical Damage Coverage is provided under this Coverage, Coverage form for an "auto" you own, the Physical If Liability Coverage is provided by this Coverage Form, i Damage coverages provided for that owned "auto" are any "auto" you don't own, hire or borrow is a covered I extended to any "auto" you do not own while used with "auto"for Liability Coverage while being used by: the permission of its owner as a temporary substitute for the covered "auto" you own that is out of service CA 71 41 10 11 Includes Copyrighted material of Insurance Services Office, Inc. with its permission. Pagel of 6 3 i l C l i CA 71 41 10 11 I 1. You, if you are designated in the Declarations as (4) 180 days or more after its acquisition or an Indvidual; formation by you, unless you have given us 2. Your partners or members, if you are designated notice of the acquisition or formation. in the Declarations as a partnership or joint Coverage does not apply to "bodily injury"or"property f venture; damage" that results from an accident that occurred before you formed or acquired the organization. 3. Your members or managers, if you are designated in the Declarations as a limited (Employee as Insureds) liability company; f. Any employee of yours while acting in the course of 4. Your "executive officers", if you are designated your business or your personal affairs while using a in the Declarations as an organization other than covered "auto" you do not own, hire or borrow, an individual partnership, joint venture or limited (Addltlonal Insured Status by Contract, Agreement liability company; and or Permit) 5. The spouse of an person named in B.1 through p y P g g. Any person or organization.whom you are required...:. li E. 4. while a resident of the same household, to add as an additional insured,on this policy under a written contract or agreement; but the written except: contract or agreement must be: a. Any "auto" owned by that individual or by (1) Currently in effect or becoming etieetive during any member of his or her household. the term of this policy; and b. Any "auto" used by that individual or his or (2) Executed prior to the"bodily injury or `property her spouse while working in a business of damage". selling, servicing, repairing or parking "autos". The additional insured status will apply only with respect "Executive officer" means a person holding any of to your liability for "bodily injury" or "property damage the officer positions created by your charter, which may be imputed to that person(s) or constitution, by-laws or any other similar governing organization(s) directly arising out of the ownership, document. maintenance or use of the covered "autos" at the C. BROADENED LIABILITY COVERAGES bcation(s)designated, if any. Coverage provided by this endorsement will not exceed SECTION It — LIABILITY COVERAGE RAGin Paragraph A. the limits of liability required by the written contract or Coverage at 1. Who Is An Insu€�ed is amended to written agreement even if the limits of liability stated in include the following: the policy exceed those limits. This endorsement shall (Broad Form Insured not increase the limits stated in Section II. C. Limits of d. Any legally incorporated subsidiary in which you own Insurance. more than 50% of the voting stock on the effective For any covered "auto" you own this Coverage Form date of the Coverage Form. However, the Named provides primary coverage, Insured does not include any subsidiary that is an D. AMENDED FELLOW EMPLOYEE EXCLUSION "insured" under any other automobile policy or would be an "insured" under such a policy but for its Only with respect to your "employees" who occupy termination or the exhaustion of its Limit of positions which are supervisory in nature, SECTION 11. Insurance, LIABILITY B. Exclusion S. Fellow Employee is e. Any organization that is acquired or formed by you, replaced by: during the term of this policy and over which you S. Fellow Employee maintain majority ownership. However, the Named "Bodily Injury": Insured does not include any newly formed or acquired organization: (a) To you, or your partners or members (if you (1) That is a joint venture or partnership, are a partnership or joint venture), or to your members (if you are limited liability (2) That is an"insured" under any other policy, company); (3) That has exhausted its Limit of Insurance under (b) To your "executive officers" and directors (if any other policy, or you are an organization other than a partnership, joint venture, or limited liability company)but only with respect to CA 71 41 1011 Includes Copyrighted material of Insurance Services Office, Inc.with its permission. Page 2 of 6 I i i CA 7141 10 11 performance of their duties as your officers the expense of returning that stolen auto to you. or directors; The limit for this coverage extension is$5,000. (c) For which there is an obligation to share (RENTAL REIMBURSEMENT AND ADDITIONAL damages with or repay someone else who TRANSPORTATION EXPENSE) must pay damages because of the injury described in paragraph a and b above; or d. Rental Reimbursement ( ) Arising out of his or her providing or fWe will d ailing to provide Renfai Reimbursement and provide professional health care services. Additional Expense coverage`only for those pl7ysi I . [Damage coverages for which a For purposes of this endorsement, a position is deemed premium is shown in the Declarations or to be supervisory in nature if that person performs schedule pages. Coverage applies only to a principle work which is substantially different from that of covered "auto" of the private passenger or light his or her subordinates and has authority to hire, truck (10,000 lbs. or less gross vehicle weight) transfer, direct, discipline or discharge. type for which Physical Damage coverages E. BROADENED PHYSICAL DAMAGE COVERAGES apply, (1) We will pay for auto rental expense and the SECTION III PHYSICAL DAMAGE COVERAGE expense incurred by you because of "loss„ Coverage is amended as follows: to remove and transfer your materials and (TOWING AND LABOR) equipment from a covered "auto" to a ' covered "auto." Payment applies in addition 2. Towing and Labor to the otherwise applicable coverage you We will pay towing and labor costs incurred, up to the have on a covered "auto." No deductible limits shown below, each time a covered "auto"classified applies to this coverage. and rated as a private passenger type, "fight truck" or (2) We will pay only for expenses incurred "medium truck"is disabled: during the policy period and beginning 24 (a) For private passenger type vehicles or "fight hours after the "loss'and ending, regardless trucks" we will pay up to $75 per of the policy's expiration, with the lesser of disablement. "Light trucks" have a gross the following number of days: vehicle weight (G l) of 10,000pounds or (a) The number of days reasonably less. required to repair or replace the covered II (b) For "medium trucks" we will pay up to $150 "auto." If "loss" is caused by theft, this per disablement. "Medium trucks" have a number of days is added to the number gross vehicle weight G of days it takes to locate the covered g g ( of 10,001 lbs. to "auto" and return it to you, or 20,000 pounds. However, the labor (b)must be performed at the place of 30 days. w disablement. (3) Our payment is limited to the lesser of the (PHYSICAL DAMAGE ADDITIONAL following amounts: TRANSPORTATION EXPENSE COVERAGEII (a) Necessary and actual expenses 4. Coverage Extensions incurred; or i a. Transportation Expense is amended to provide (b) $35 per day. the following limits: (c) This coverage does not apply while We will pay up to $50 per day to a maximum of$1,000, there are spare or reserve "autos" All other terms and provisions of this section remain available to you for your operations. applicable. (d) If "loss" results from the total theft of a i (EXTRA EXPENSE- THEF7) covered "auto of the private passenger or light truck type, we will pay under this The following language is added to 4. Coverage coverage only that amount of your rental Extensions: reimbursement expense which is not c. Theft Recovery Expense already provided for under the SECTION III — PHYSICAL DAMAGE COVERAGE, If you have purchased Comprehensive A. Coverage, 4. Coverage Extensions, Coverage on an "auto"that is stolen,we will pay a.Transportation Expenses, CA 7141 10 11 Includes Copyrighted material of Insurance Services Office, Inc, with its permission. Page 3 of 6 l E i 3 i p 1 u CA 71 41 10 11 i (PERSONAL EPI-'PCTS COVERAGE) An integral part of the sante unit housing any sound reproducing equipment 1 e. Personal Effects designed solely for the reproducing of If you have purchased Comprehensive sound if the sound reproducing Coverage on this policy for an "auto" you own equipment is permanently installed in and that "auto" is stolen, we will pay, without the covered "auto";and application of a deductible, up to $500 for Permanently installed in the opening of Personal Effects stolen with the "auto". The the dash or console normally used by insurance provided under this provision is r excess over any other collectible insurance. For the manufacturer .or the installation of a radia, this coverage extension, Personal Effects means tangible property that is worn or carried (4) With respect to this coverage, the most we by an "insured". Personal Effects does not will pay for all `"loss" of audio, visual or data include tools, jewelry, guns, musical electronic equipment and any accessories instruments, money, or securities. used with this equipment as a result of any (AUDIO, VISUAL.AND DATA ELECTRONICone"accident" is the lesser of, EQUIPMENT CC3ta`ERAGE) (a) The actual cash value of the damaged (Deletion of Addis Visual EquipmentExclusion) or stolen property as of the time of the "loss"; f. Audio,Visual and Data Electronic Equipment (b; The cost of repairing or replacing the Coverage, damaged or stolen property with other We will pay for "loss" to any electronic property of like kind and quality; or equipment that receives or transmits audio, $1,0DO, visual or data signals and thatisnot designed minus a deductible of$100. solely for the reproduction of sound. This coverage applies only if the equipment is An adjustment for depreciation and physical permanently installed in a covered "auto" at the condition will be made in determining actual time of the "loss"or the equipment is removable cash value at the time of loss. If a repair or from a housing unit which is permanently replacement results in better than like kind installed in a covered "auto" at the time of the or quality, we will not pay for the amount of ".`loss", and such equipment is designed to be the betterment, solely operated by use of the power from the If there is other coverage provided for audio, „auto's"electricsl system, in or upon the covered auto." visual and data electronic equipment, the " coverage provided herein is excess over any (1 j We will pay with respect to a covered "auto" other collectible insurance. for "loss" to any accessories used with the AitAG ACCIDENTAL DISCHARGE) equipment described above. However, this does not include tapes, F. SECTION IIl d- PHYSICAL DAMAGE COVERAGE, records or discs. B. Exclusions is amended as follows: (2) In addition to the exclusions that apply to The following language is added to Exclusion 3.: Physical Damage Coverage with exception of the exclusion relating to audio, visual and if you have purchased Comprehensive or Collision data electronic equipment, the following Coverage under this policy,this exclusion does not apply exclusions also apply: to mechanical breakdown relating to the accidental discharge of an air bag. This coverage applies only to a (3) We will not pay for any electronic equipment covered auto you own and is excess of any other or accessories used with such electronic collectible insurance or warranty. No deductible applies equipment that are: to this coverage. (aj Necessary for the normal operation of G. AUTO LOAN/LEASE TOTAL LOSS PROTECTION the covered "auto"for the monitoringof SECTION III — PHYSICAL DAMAGE COVERAGE— C. the covered"auto's"operating system;; or Limit of Insurance is amended by adding the following (b� Both: language: I CA 71 41 14 11 includes Copyrighted material of Insurance Services Office, Inc.with its permission. Page 4 of 6 I I i r CA 71 41 10 11 4. In the event of a total ,loss,, to a covered "auto" shown in the Schedule pages, subject at the time of (5) Your officials, trustees, board members or ' insurance manager, if you are a not-for-profit file "loss" to a loan or lease, we will pay any unpaid organization. amount due on the lease or loan for a covered "auto" less: I. WAIVER OF SUBROGATION REQUIRED BY a. The amount paid under the Physical Damage CONTRACT 4 Coverage Section of the policy; and Under SECTION, iV, BUSINESS AUTO CONDITIONS, A. Loss Conditions 5. Transfer of Rights of b. Any: Recovery Against Others to Us the following (1) Overdue lease / loan payments at the time language is added: of the"loss"; However,we waive any rights of recovery we may have against the person or organization with whom you (2) Financial penalties imposed under a lease l for excessive use, abnormal wear and tear have agreed in writing in a contract, agreement or for high mileage. Permit, to provide insurance such as is afforded under the Policy to, which this -endorsement is (3) Security deposits not returned by the lessor; attached. This provision does not apply unless the written contract or written agreement has been (4) Costs for extended warranties, Credit Life executed, or permit has been issued, prior to the Insurance, Health, Accident or Disability "bodily injury"or"property damage." insurance purchased with the loan or lease; and J. UNINTENTIONAL FAILURE TO DISCLOSE i (5) Carry-over balances from previous loans or Under SECTION IV—BUSINESS AUTO CONDITIONS leases, Subsection B. General Conditions, the following is added to 2. Concealment, Misrepresentation Or (GLASS REPAIR—DEDUCTIBLE AMENDMENT) Fraud: Under D., Deductible in SECTION Ill. PHYSICAL Your unintentional error in disclosing, or failing to DAMAGE COVERAGE is amended by adding the disclose, any material fact existing at the effective following: date of this Coverage Form, or during the policy r Any deductible shown in the Declarations as period in connection with any additional hazards, will � applicable to the covered "auto" will not apply to not prejudice your rights under this Coverage Form. ! glass breakage if the damaged glass is repaired, K. HIRED, LEASED, RENTED OR BORROWED G rather than replaced. AUTO PHYSICAL DAMAGE H. AMENDED DUTIES IN THE EVENT OF Under SECTION IV® BUSINESS AUTO CONDITIONS ACCIDENT, CLAIM, SUIT OR LOSS B.General Conditions 5. Other Insurance Under SECTION iV — BUSINESS AUTO CONDITIONS, Paragraph 5.b.is replaced by the following: Subsection A., Lass Conditions, the following is b. (1) For "Comprehensive" and "Collision" Auto added to paragraph 2. Duties In The Event of Physical Damage provided by this endorsement, k Accident, Suit or Loss: the following are deemed to be covered "autos„ d. Knowledge of any "accident," "claim,,, "suit" or you own: "loss" will be deemed knowledge by you when (a.)Any Covered "auto" you lease, hire, rent or notice of such "accident,," "claim,," "suit" or "loss" borrow; and has been received by: i (b.)Any Covered "auto" hired or rented by your a (1) You, if you are an individual, "employee" under a contract in that i (2) Any partner or insurance manager if you are individual "employee's" name, with your a partnership; permission, while performing duties related to the conduct of your business. (3) An executive officer or insurance manager, if However, any "auto" that is leased, hired, rented or you are a corporation; borrowed with a driver is not a covered "auto" i (4) Your members, managers or insurance ( 2)if you are a iimited liability (2} Limit of insurance Far This Section company; or The most we will pay for any one "loss" is the lesser of the following: CA 71 41 10 11 Includes Copyrighted material of Insurance Services Office, Inc.with its permission. Page 5 of 6 k i I CA 714110 11 (a) $50,000 per accident,or 5. The "family member' of any person named in 1 through 4 above while "occupying" a covered (b) actual cash value at the time of loss, or .,auto" or while a pedestrian when struck by an (c) cost of repair. "auto" you do not own, any "auto" not owned by minus a $500 deductible. An adjustment for that individual or not owned by any "family depreciation and physical condition will be made member." in determining actual cash value in the event of "Executive officer" means a person holding any of a total loss. No deductible applies to "loss" the officer positions created by your charter, caused by fire or lightning. constitution, by-laws or any other similar governing (3) This Hired Auto Physical Damage coverage is document. excess over any other collectible insurance. "Family member" means a person related to the (4) definitions For This Section individual named in the Declarations by blood, marriage or adoption who is a resident of the ` (a) Comprehensive Coverage: from any cause except the covered "auto's" collision with individual's household, including a ward or foster another object or the covered "auto's" child. overturn. We will pay glass breakage, "loss" "Occupying" means in, upon, getting in, on, out or caused by hitting a bird or animal and, "loss" off. caused by failing objects or missiles. N. EXTENDED PHYSICAL DAMAGE COVERAGE i (b) Collision Coverage: caused by the covered "auto's" collision with another object or by if Physical Damage Coverage is provided by the the covered `'auto's" overturn. Coverage Form to which this endorsement attaches, any private passenger type 'auto" you don't own, it L. EXTENDED CANCELLATION CONDITION hire or borrow is a covered "auto" for Physical A. under CANCELLATION, of the COMMON Damage Coverage while in the care, custody or POLICY CONDITIONS form, item .b. is control of any individual named in B.I.through E.4, replaced by the following: or his or her spouse while a resident of the same household except: c. 80 days before the effective date of �! cancellation if we cancel for any other a. Any "auto" owned by that individual or by any reason member of his or her household. M. EXTENDED AUTO MEDICAL PAYMENTS AND b. Any "auto" used by that individual or his or her UNINSURED AND UNDERINSURED MOTORIST spouse while working in a business of selling, COVERAGE servicing, repairing or parking"autos". If Auto Medical Payments Coverage, Uninsured Our obligation to pay for repair, return or to replace Motorists Coverage or Underinsured Motorists damaged or stolen property will be reduced by a Coverage is provided by endorsement to the deductible equal to the amount of the largest Coverage Form to which this endorsement deductible shown for any owned private passenger attaches, the following qualify as an "insured" for type ',auto" applicable to Physical Damage f each coverage provided: Coverage. If there are no private passenger type 1. You, if you are designated in the Declarations as "autos", the deductible shall be $50 for an Individual; Comprehensive and $100 for Collision Coverage. No deductible will apply to "loss" caused by fire or 2. Your partners or members, if you are designated lightning, in the Declarations as a partnership or joint l venture; O. LIBERALIZATION 3. Your members or managers, if you are If we revise this endorsement to provide greater designated in the Declarations as a limited coverage without additional premium charge, we will liability company; automatically provide the additional coverage to all endorsement holders as of the day the revision is 4. Your "executive officers", if you are designated effective in your state. in the Declarations as an organization other than an individual partnership, joint venture or limited liability company; and CA 71 41 10 11 Includes Copyrighted material of Insurance Services Office, Inc.with its permission. Page 6 of 6 I i i WC 00 03 13 (4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. 4 (The following"attaching clause"need be completed only when this endorsement is issued subsequent to preparation of the policy.) N This endorsement, effective on at 12:01 A.M. standard time, forms a part of (DATE) Policy No. of the (NAME OF INSURANCE COMPANY) issued to Premium S Authorized Representative We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us. a This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule. Schedule I' I� i �6 4 I i B WC 00 03 13 (4-84) Copyright 1982, 1983 National Council on Compensation Insurance. I �I