Contract/Bond_Gansen Excavating for Creek Wood Park Copyrighted
August 6, 2018
City of Dubuque Consent Items # 42.
ITEM TITLE: Improvement Contracts / Performance, Payment and
Maintenance Bonds
SUMMARY: Drew Cook and Sons Excavating, Co., Inc. for the Flora
Park Maintenance Building Exterior Waterproofing Project;
Gansen Excavating, Inc. for Creek Wood Park; Gronen
Restoration for the Eagle Point Park Indian Room Roof
Replacement Project.
SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Approve
ATTACHMENTS:
Description Type
Gansen Excavating Contract and Bond Supporting Documentation
Gronen Restoration Contract and Bond Supporting Documentation
Drew Cook and Sons Construction Contract and Bond Supporting Documentation
SECTION 00500 J
Page 1 of 6 ,
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PUBLIC IMPROVEMENT CONTRACT �
SECTION 00500
� CREEK WOOD PARK �
THIS IMPROVEMENT CONTRACT (the Contract), made in triplicate, dated for references W
purposes the day of 2018 between the City of Dubuque, lowa, by its City Manager, �
through authority conferred upon the City Manager by ita City Council (City), and Gansen ;Y�
Excavating Inc. (Contractor). �,
For and in consideration of the mutual covenants herein contained, the parties hereto agree �
as follows �'
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CONTRACTOR AGREES: ;
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1. To furnish all material and equipment and to perform all labor necessary for the t
Creek Wood Park (Project). �
2. CONTRACT DOCUMENTS j�
A. The Contract Documents consist of the following: �
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1. Project Title Page (Section 00100). i
2. Project Directory Page (Section 00101): -+
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3. This Public Improvement Contract (Section 00500). �I;
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4. Performance, Payment, and Maintenance Bond (Section 00600). ��
5. Out-of-State Contractor Bond (Section 00610). �
6. Other Bonds: N/A, i
7. The lowa Statewide Urban Design And Specifications (SUDAS) 2017 Edition.
8. CITY OF DUBIJQUE Supplemental Specifications 2017 Edition. ��
9. Other Standard and Supplementary Specifications as listed on the Title Page of the
Contract Document ManuaL �
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10.Special Provisions included in the project Gontract Document Manual. i,
11.Drawing�-Sheet No.A.01 through No.U.06 (14 pages) or drawings consisting of �
sheets bearing the following general title: j
Creek Wood Park Project �
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 00775).
16.Construction Schedule and Agreed Cost of Delay (Section 00800). �
17.Erosion Control Certificate (Section 00900). �
18.Consent Decree (Section 01000). �
19.Other Project Information and Permits (Section 01100 - 00000). p
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SECTION 00500
Page 2 of 6
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. The following documentation that must be submitted by Contractor prior to Notice ,
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of Award.
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ii. �
iii.
e. None.
21.The following which may be delivered or issued on or after the Effective Date of the
Agreement: a
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, ��
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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 wilf 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 lowa Code Chapter 573 or lowa Code Chapter 26.
The City will also retain additional �ums 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.
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.
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SECTION 00500
Page 3 of 6
9. INDEMNIFICATtON FROM THIRD PARTY CLAIMS. To the fullest extent permitted by law, ��
Contractor shall defend, indemnify and hold harmJess City, its officers and employees, from i?
and against all claims, damages, losses and expenses claimed by third parties, but not 1
including any claims, damages, losses or expenses of the parties to this Contract, including '�
but nof 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 b� negligent acts or omissions of f�
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. !�
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10. The Contractor hereby represents and guarantees that it has not, nor has any other person �
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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 '1
public officer any sum of money or anything of value whatever in order to obtain this Contract; �'
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and it has not, nor has another person for or in its behalf directly or indirectly, entered into ;I
any Contractor arrangement with any other person, firm, corporation or association which '
fiends to or does lessen or destroy free competition in the award of this Contract and agrees �
that in case it hereafter bs 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 �I
in no event less than $2,000.00 (Two Thousand Dollars) to the City. I�
11. The surety on the Bond furnished for this Contract must, in addition to all other provisions, I��'
b� �blig�ted t� the Pxt�nt �ro��ided f�r by lowa Gode 573.6 relating to this G�ntract, 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 Cify, 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 lowa, and the United States, and ordinances of the City of Dubuque, and in �
accordance with the Contract Docurr�ents. �
A. All applicable standards, orders, or regulateons essued 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).
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
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SECTION 00500
Page 4 of 6
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 I
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 ofi race, color, national origin, sex, age, or disability
in consideration for an award. i�
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CONSENT DECREE
RELATING TO THE PROJECT f,
14. THIS CONTRACTOR IS PERFORMING WORK FOR THE CITY OF DUBUQUERELATED TO �
� THE WATER& RESOURCE RECOVERY CENTER OR THE SANITARY SEWER ra
COLLECTION SYSTEM. THEREFORE, THE CONSENT DECREE AND THIS SECTION ARE "
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APPLICABLE. I'
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�n °' � CITY , �° :� CONTRACTOR �{
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� THIS CONTRACTOR IS NOT PERFORMING WORK FOR THE CITY OF DUBUQUE I�I
� 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 ir��o � Cer��enf DeePee i� tr�e case oi�he llnited �t�tes of Arnerica, and #he �tate �
of Iowa v. The City of Dubuque, lowa, 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 lowa. 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�/lwww citvofd�abuque:org/Documer�tCenfier/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 wi.th 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 requesf by the United States or the State, the
City must provide copies of any documents, reports, analytical data, or other information required to be
maintained under the Consent Decree. At the conclusion of the information-retention period, the City
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SECTION 00500
Page5of6
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 lowa v. The City of Dubuque, lowa, 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 lowa: '
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2. All work performed will be in conformity with the provisions of the Consent Decree. i
3. All documents reports, data, records, or other information (including documents, {
records, or nther information in electronic form) that relate in any manner to the
perfarmance 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, i'
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:
Gansen Excavatinq Inc.
Contractor
. By: ��,�'�--
Signature
Rich Gansen �
Printed Name
Owner/President
Title
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Date
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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 $119,886.73 �
is
:
CITY OF DUBUQUE, IOWA:
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Department i
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By: ��'_'"'�`m� ;i
Signatu e �
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Michael VanMilliqen �
Printed Name j
Citv Manaaer li
� Title � � � � � � �
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Date i
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CONTRACTOR:
Gansen Excavatinq Inc.
Contractor
By: A
ignature
�iCh GaP1Se11 �
Printed Name
Owner/President
Title
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Date �
___= END OF SECTION 00500 =___
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SECTION 00600
Page 1 of 4
PERFORMANCE, PAYMENT AND MAINTENANCE BOND �
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SECTION 00600
KNOW ALL BY THESE PRESENTS:
That we, Gansen Excavatina Inc., as Principal (hereinafter the "Contractor° or `PrincipaP')
and , as Surety
are held and firmly bound unto the City of Dubuque, lowa, as Obligee (hereinafter referred to as
"Owner"), and to all persons who may be injured by any breach of any of the conditions of this Bond I
in the penal sum of One Hundred Nineteen Thousand Eight Hundred Sixty-Six and 73/100 dollars
�$119,866.73), 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.
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The conditions of the above obligations are such that whereas said Contractor entered into a �
contract with the Owner, bearing date the day of 2018, (her�inafter the "Contract") !
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wherein said Contractor undertakes and agrees to construct the following project in accordance
with the Confiract Documents, and to faithfully perform all the terms and requirements of said �I
Contract within the time therein specified, in a good and workmanlike manner, and in accordance '
with the Contract Documents. The Contract Documents for Creek Wood Park Project detail the
following described irrmprovements:
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This project will involve the site grading and base preparation for new park playground �
equipment, disconnection of an existing water service connection, site grading and
installation of sidewafk, installation of electrical control box and park lighting, coordination
with park equipment supplier associated with the installation of playground equipment and
rubberized safety surfacing, final site grading, planting of trees, perianal plugs, native
grasses and turF grass.
It is expressly understood and agreed by the Gontractor�nd���rety in this Bond that the following �
provisions are a part of this Bond and are binding upon �aid--Contractor and Surety, to-wit:
1. PERFORMANCE: The Contractor shall well and faithfully observe, perform,fulfill, and abide
by each and every covenant, condition; and part of said Contract and Contract Documents,
by reference made a part hereof, for the project, and shall indemnify and save harmless the
Owner from all outlay and expense incurred by the Owner by reason of the Contractor's
default of failure to perform as required. The Contractor shall also be responsible for the
default or failure to perForm as required under the Contract and Contract Documents by all
its subcontractors, suppliers, agents, or employees furnishing materials or providing labor in
the perFormance of the Contract.
2. PAYMENT: The Contractor and the Surety on this Bond hereby agreed to pay all just claims
submitted by persons, firms, subcontractors, and corporations furnishing materials for or
performing labor in the performance of the Contract on account of which this Bond is given,
including but not limited to claims for all amounts due for labor, materials, lubricants, oil,
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SECTION 00600
Page 2 of 4
gasoline, repairs on machinery, equipment, and tools, consumed or used by the Contractor
or any subcontractor, wherein the same are not satisfied out of#he portion of the contract
price the Owner is required to retain until completion of the improvement, but#he Contractor
and Surety shall not be liable to said persons, firms, or corporations unless the claims of said
claimants against said portion of the contract price shall have been established as provided
by law. The Contractor and Surety hereby bind themselves to the obligations and conditions
set forth in Chapter 573 of the lowa Code, which by this reference is made a part hereof as �
thaugh fully set out herein. �
3. ` MAINTENANCE: The Contractor and the Surety on this Bond hereby agree, at their own
expense: I
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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; �
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B. To keep all work in continuous good repair; and ;
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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 Gontractor's and Surety's failure to remedy any defect as required by this �
section. J
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Contractor's and Surefiy'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. �
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4. GENERAL: Every Su:rety on this Bond shall be deemed and held bound, any contract to the �
contra;ry notwithstandmg, 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,
a��th�r��Pr� in approved change orders which thereby increases the total contract price
and the penal sum of this Bond, provided that all such changes d4 not, in the aggregate,
involve an increase of more than twenty percent (20%)of the total contract price, and
that this Bond shalf then be released as to such excess increase;
C. To consent without notice that this Bond shall remain in full force and effect until the
Contract is completed, whether completed within the specified contract period, within
an extension thereof, or within a period of time after the contract period has elapsed
and the liquidated damage penalty is being charged against the Contractor,
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SECTION 00600
Page 3 of 4
The Contractor and every Surety on the Bond shall be deemed and held bound, any contract to the
contrary notwithstanding, to the following provisions
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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. �
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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 ren#al, 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 �
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of Contractor's failure to perForm as required in the Con#ract and Contract Documents, ti
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 I;
fully indemnified so that it will be put into the position it would have been in had the ii
Contract been performed in the first instance as required. '
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In the event the Owner incurs any "outlay and expense" in defending itself against any claim as to !;
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which the Contractor or Surety should have provided the defense, or in the enforcement of the �
pr�mise��i��n b�th� �ontractor ir� the Gontract, Contract Documents, or�ppro�led 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, i
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 lowa. 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
here�nder shall be cumulative and.not alternative,and shall b� 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 whe#her action is brought against the Contractor or whether Contractor is
joined in any such action(s) or not.
NOW THEREFORE,the condition of this obligation is such that if said Principal shall faithfully perform
all the promises of the Principal, as set forth and provided in the Contract, in the Contract Documents,
and in this Bond, then this obligation shall be null and void, otherwise it shall remain in full force and
effect. �
When a work, term, or phrase is used in this Bond, it shall be interpreted or construed first as defined
in this Bond, the Contract, or the Contract Documents; second, if not defined in the Bond, Contract,
or Contract Documents, it shall be interpreted or construed as defined in applicable provisions ofithe
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SECTION 00600
Page 4 of 4
lowa Code; third, if not defined in the lowa Code, it shall be interpreted or construed according to its
generally accepted meaning in the construction industry; and fourth, if it has no generally accepted
meaning in the construction industry, it shall be interpreted or construed according to its common or
customary usage.
Failure to specify or particularize shall not exclude terms or provisions not mentioned and shall not
limit liability hereunder. The Contract and Contract Documents are hereby made a part of this Bond. '
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Project No. 3602375 . �
Witness our hands, in triplicate, this day of , 2018.
SURETY COUNTERSIGNED BY: Title
Signature of,4gent FORM APPROVED BY:
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Printed Name of Agent Representative for Owner ��
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� �_ � SURETY: � � !j
Company Address" �
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Surety Company �
City,State,Zip Code � � � � �
B�; ,
Signature Attorney-in-Fact Officer �
G9mpany Telephone Number
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Printed Name of Attorney-in-Fact Officer a
PRINCIPAL: 1
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Company Name �
Contractor �
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By: Company Address �
Signature
City,State,Zip Code
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Printed Name . �
Company Telephone Number
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1. All signatures on this performance, payment, and maintenance Bond must be original
signatures in ink; copies, facsimile, or electronic signatures will not be accepted.
2. This Bond must be sealed with the Surety's raised, embossing seal,
3. The name and signature of the Surety's Attorney-in-Fact/Officer entered on this Bond
must be exactly as listed on the Certificate or Power of Attorney accompanying this
Bond.==== END OF SECTION 00600 =___
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OUT-OF-STATE CONTRACTUR BOND
An out-of-state Contractor must either file a surety Bond, as provided in lowa Code section 91C.7,
with the lowa Division of Labor Services in the amount of twenty-five thousand dollars ($25,000) for
a one (1) year period or must provide a statement to the lowa Division of Labor Services that the
contractor is prequalified to Bid on projects for the lowa Department of Transportation pursuant to �
lowa Code Section 314.1 �
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An out-of-state Contractor, before commencing a contract in excess of five thousand dollars �
($5,000) in value of lowa, must file a Bond with the lowa Division of Labor Services of the lowa
Department of Workforce Development. A Surety Bond filed pursuant to lowa Code section 91 C.2 �
must be executed by a surety company authorized to do business in this state, and the Bond,must �
be continuous in nature until canceled by the Surety with not less than thirty (30) days; written notice
to the contractor and to the Division of Labor Services of the lowa Department of Workforce
Development in dictating the surety's desire to cancel the Bond. The Surety company is liable under �
the Bond for any contract commenced after the cancellation of the Bond. The Bond must be in the g
sum of the greater of the following: ��
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(1) One thousand dollars ($1,000.00); or ��
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(2) Five percent (5%) of the contract price �
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An out-of-state Contractor may file a blar�ket Bond in an amounfi at least equal to fifty thousand
dollars 50 000 for a two 2 ear eriod in lieu of filin an individual Bond for each Contract. The �
($ , ) � ) Y p 9 �
Division of Labor Services of the lowa Department of Workforce �7evelopment may increase the
Bond amount after a hearing.
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INSURANCE PROVISIONS
City of Dubuque Insurance Requirements for General, Artisan or Trade
Contractors, Subcontractors or Sub Subcontractors �
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Insurance Schedule F
class A:
Asbestos Removal Fiber Optics Sanitary Sewers
Asphalt Paving Fire Protection Sheet Metal
Concrete Fireproofing Site Utilities a
Construction Managers General Contractors Shoring �
Cranes HVAC Special Construction !
Culverts Mechanical Steel ��
Decking Paving & SurFacing Storm sewers
Demolition Piles & Caissons Structural Steel �'
(l.
Deconstruction Plumbing Trails r
u
Earthwork Reinforcement Tunneling II
Electrical Retaining Walls Water main
Elevators Roofing
Class �: �
Chemical Spraying Masonry Stump Grinding �
Doors, Window & Glazing Vehicular Snow Removal Tank Coating "
Drywall Systems Painting & Wall Covering Tree Removal �
Fertilizer Application Pest Control Tree Trimming
Finish Carpentry Scaffolding Tuckpointing
Geotech Boring Sidewalks Waterproofing
Insulatimn Pla�tering Well Drilling
Landscaping Rough Carpentry Pavement Marking
Class C:
Carpet Cleaning Power Washing
Carpet & Resilient Tile & Terrazzo Flooring
Flooring Window Washing
Caulking & Sealants
Acoustical Ceiling
Filter Cleaning
General Cleaning
Grass Cutting
Janitorial
Non-Vehicular Snow & Ice
Removal
Office Furnishings
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INSTRUCTIONS FOR INSURANCE SUBMITTAL:
1. Contractor shall furnish a signed Cerkificate of Insurance to the City of Dubuque, lowa for the �
coverage required in Exhibit I prior to commencing any work and at the end of the project if
the term of work is longer than sixty (60) days, Providers presenting annual certificates shall
present a Certificate at the end of each project with the final billing. Each Certificate shall �
be prepared on the most current ACORD form approved by the lowa Department of
Insurance or an equivalent. The issued certificate must clearly indicate the project number, �
project name, or project description for which it is being provided. For example: 1
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- Project No. CIP No. 360-2375
Project Name: Creek Wood Park '
2. All policies of insurance required hereunder shall be with a carrier authorized to do business If'
in lowa and all carriers shall have a rating of A or better in the current A.M. Best's Rating ��
Guide. �
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3. Each Certificate required shall be furnished to the City of Dubuque Engineering Department. '�
II�4. Failure to provide minimum coverage shall not be de�med a waiver of these requirements
by the City of Dubuque. Failure to obtain or maintain the required insurance shall be �I
considered a material breach of this Contract. ;
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5. Subcontractor(s) and sub subcontractor(s) performing work or service shall provide a �
GArtificat� �f lr�s!�ranc� in, accord v�ith it� r�sp�ctive classifica�tio� to its c�ntr�ctar, The �ity
of Dubuque may request a copy of a subcontractor(s) Certificate of Insurance from the
general contractor.
6. All required endorsements to various policies shall be attached to the Certificate of ,
Insurance. '
7. Whenever an ISO form is referenced the current edition must be used. ��j
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8. Provider�hall be required to carry the minimum coverage/limits, or greater if required by law �
or other legal agreement, in Exhibit I — Insurance Schedule B. If the provider's limit of liability
is higher than the required minimum limit, then the provider's limit shall be this agreement's
required limit.
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Exhibit I
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insurance Schedule F (continued)
A) COMMERCIAL GENERAL LIABILITY ` ,
General Aggregate Limit $2,000,000
Products-Completed Operations Aggregate Limit $2,000,000
Personal and Advertising Injury Limit $1,000,000
Each Occurrence $1,000,000
: Fire Damage Limit (any one occurrence) $ 50,000
Medical Payments $ 5,000
1) Coverage shall be written on an occurrence, not claims made, form. All
deviations from the standard ISO commercial general liability form CG 0001, or
Business owners form BP 0002, shall be clearly identified.
� 2) Include ISO endorsement form CG 25 04 "Designated Location(s) General
Aggregate Limit° or CG 25 03 `°Designated Construction Project(s) General
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Aggregate Limit as appropriate. ,
3) Include endorsement indicating that coverage is primary and non-contributory.
4) Include endorsement to preserve Governmental Immunity. (Sample attached). ���
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5) Include additional insured endorsement for: !
The City of Dubuque, inctuding all its elected and appointed officials, all its I
employees and volunteers, all its boards, commissions and/or authorities and
their board mernbers, err�plcyee� and v�lunteer�. U�e !S� forrn GG 20 1�
(ongoing operations). �
6) The additional insured endorsement shall include completed operations under
ISO form CG 2037 during the project term and for a period of two (2) years after
the completion of the.,project.
7) Policy shall include Waiver of Right to Recover from Others endorsement.
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B) WORKERS' GOMFENSATION & EMPLOYERS LIABILITY
Statutory Benefits covering all employees injured on the job by accident or disease as ,
prescribed by lowa Code Chapter 85.
Coverage A Statutory - State of lowa �
Coverage B Employers �iability
Each Accident $100,000 '
Each Employee-Disease $100,000
Policy Limit-Disease $500,000
Policy shall include Waiver of Right to Recover from Others endorsement.
Coverage B limits shall be greater if required by the umbrella/excess insurer. �
Nonelection of Workers' Compensation or Employers' Liability Coverage under lowa �
Code sec. 87.22 �
Yes No Form attached �
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C) AUTOMOBILE LIABILITY �
Combined Single Limit $1,000,000 �
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D) UMBRELLA/EXCESS LIABILITY
Umbrella liability coverage must be at least following form with the underlying policies i
included herein.
All Class A contractors with contract values in excess of $10;000,000 must have a
umbrella/excess liability coverage of$10,000,000. �
All Class A and Class B contractors with contract values between $500,000 and �
$10,000,000 must have umbrella/excess liability coverage of$3,000,000. "�
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- All Class A and B contractors with contract values less than $500,000 must have ��
umbrella/excess liability coverage of$1,000,000. 4
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All Class C contractors are not required to have umbrella/excess liability coverage. �
All contractors performing earth work must have a minimum of $3,000,000 umbrella �
regardless of the contract value.
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E� ENVIRONMENTAL IMPAIRMENT LIABILITY OR POLLUTION LIABILITY '
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Coverage required: Yes X No �
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Pollution Liabiiity coverage shall be provided by the prime/general contractor if project �
involves any pollution exposures including abatement of hazardous or contaminated 1
materials including, but not limited to, the removal of lead, asbestos, or PCB's. �;
Pollution product and complete operations coverage shall also be covered.
Each occurrence $2,000,000 �
Policy aggregate $4,000,000
1) Policy to include�premises and transportation coverage.
2) Include additional insured for:
The City of Dubuque, including all its elected and appointed officials, all its
employees and volunteers, all its boards, commissions and/or authorities
and their board members, employees and volunteers. Use ISO form CG
2010 (ongoing operations) as stated in A(6) above or its equivalent.
3) Include preservation of Governmental Immunity Endorsement. �
4) Provide evidence of coverage for 5 years after completion of project.
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F) RAILROAD PROTECTIVE LIABILITY
Coverage required: Yes X No �
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Any Contract for construction or demolition work on or within Fifty feet (50') from the
edge of the tracks of a railroad and effecting any railroad bridge or trestle, tracks,
roadbeds, tunnet, underpass, or crossing for which an easement or license or
indemnification of the railroad is required, shall require evidence of the following
additional coverages.
Railroad Protective Liability:
$ 2,000,000 each occurrence (per limits required by Railroad)
$ 4,000,000 policy aggregate (per Iimits required by Railroad)
OR
An endorsement to the Commercial General Liability policy equal to ISO CG 2417
(Contractual Liability-Railroads). A copy of this endorsement shall be attached to the
Certificate of fnsurance.
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City of Dubuque Insurance Requirements for General;Artisan or Trade Contractors,
Subcontractors or Sub Subcontractors
PRESERVATION OF GOVERNMENTAL IMMUNITIES ENDORSEMENT '
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1. Nonwaiver of Governmental Immunitv. The insurance carrier expressly agrees and states that !I
the purchase of this policy and the including of the City of Dubuque, lowa as an Additional
Insured does not waive any of the defenses of governmental immunity available to the City of �
Dubuque, lowa under Code of lowa Section 670.4 as it is now exists and as it may be amended
from time to time.
2. Claims Coveraae. The insurance carrier further agrees that this policy of insurance shall cover ij
only those claims not subject to the defense of governmental immunity under the Code of Iowa �
Section 670.4 as it now exists and as it may be amended from time to time. Those claims not �,
subject to Code of lowa Section 670.4 shall be covered by the terms and conditions of this �
insurance policy. �
3. Assertion of Governmental Immunity. The City of Dubuque, lowa 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. i
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4. Non-Denial of Coveraqe. 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, lowa under this policy for reasons of governmental immunity unless and until a court �
o�corn�e#entjurisdicti�n has r�led in fa�or of th� �efen��(�) of g�vernmental immunity asserted �
by the City of Dubuque, lowa.
No Other Chanqe in Policv. The above preservation of governmental immunities shall not otherwise
change or alter the coverage available under the policy.
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SECTON 00750 �
Page 1 of 5
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SALES AND USE TAX EXEMPTION CERTIFICATE i
SECTON 00750
The City of Dubuque, as a designated exempt entity awarding construction contracts, will issue
special exemption certificates to contractors and subcontractors, allowing them to purchase, or
withdraw from inventory, materials for the Contract free from sales tax pursuant to lowa Code �
Sections: 422.42 (15) & (16), and 422.47 (5). The special exemption certificate will also allow a
manufacturer of building materials to consume materials in the performance of a construction
contract without owing tax on the fabricated cost of those materials.
1. These tax exemption certificates and authorization letters are applicable only for the �
work under the contract. The Contractor and each subcontractor �nall comply with said j
lowa Code Sales Tax requirements, shall keep records identifying the materials and �
supplies purchased and verify that they were used on the contract, and shall pay tax on
any materials purchased tax-free and not used on the contract. i
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2. Upon award of Contract the City will register the Contract, Contractor, and each ;
subcontractor with the lowa Department of Revenue and Finance; and distribute tax :;�
exemption certificates and authorization letters to the Contractor and each i
subcontractor. �
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SECTON 00750
Page2of5
PROJECT INFORMATION REQUIREMENTS FOR
STATE OF IOWA SALES TAX EXEMPTION CERTIFICATES
FOR CONTRACTORS & SUBCONTRACTORS ��
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Submitting Department: Leisure Services
Department Contact: Steve Fehsal
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Project CIP Number(s): 3602375 �
Please complete this form in its entirety and submit along with the executed Contract, Bonds and
Certificate of Insurance. Upon receipt, the City Finance Department will work with the lowa a
Department of Revenue to issue Sales Tax Exemption Certificates to the approved confiractor(s) to ;
allow for the purchase or inventory withdrawal of materials for the specified Project free from State Ij
of lowa Sales Tax. j
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Sales tax exemptian certificates are not provided to material suppliers. - �
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The Gontractor and subcontractors can provide copies of the sales tax exemption certificates issued by the a
City to individual material suppliers.
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Project Name: Creek Wood Park Project �
Project Description: This project will involve the site grading
and base preparation for new park
�playground equipment, disconnection'of,an
existing water service �onnection,`site ;
grading and installation of sidewalk; ;
, installation of electrical control box and �
ark li `htm coordination with ark ; . '
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equipment supplier associated with the ` i�
� installation of pla�rground equipmenf and _��;� � �
rubberized safety surFacin,g, fnal site � � �
grading, planting of"trees,'perianal.plugs, ;
nati�e "rasses and t�irF rass ;::; �
Start Date Bid Openin Date : June,14; 2018 _
Final Completion Date: ` � �� ''� '
1. General Prime Contractor: Gansen Excavating Inc.
Contact Name: Rich Gansen, Owner/President
Complete Address: 12198 Skyline Road
(Include PO Box and Street Information)
City, State, Zip Code Dubuque, IA 52003
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SECTON 00750
Page 3 of 5
Telephone Number: 563.556.0083
Federal I.D. Number: -�, � �r���� �
(or Include Social Security Number)
Work Type to be Completed: � �c.GZ-�r°�1� 4 ��`�- � �� , �
Y"-CV11�i�1�l�E'� ��`�"� �����C�` �i
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SECTON 00750
Page 4 of 5
2. Subcontractor: (,�, S � � I '�
Complete Address: �.� ���1� l�l� ����l!�
(Include PO Box and Street Information) ^�� �( /�� �
City, State, Zip Code / , � Ga� /�I ,,�C�(��'-�
Telephone Number: ��-� ��fs'-��`�� �
Federal I.D. Number: , I� �,������
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(or Include Social Security Number) �� ;
Work Type to be Compieted: - I
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3. Subcontractor: ° �{.r� ��"lr� S �
Complete Address: �,�, ,��J� c��b
(Include PO Box and Street Information)
City, State, Zip Code � 1��JY�°1 l I� ��'�� h
Telephone Number: ��y �" 1��� ;;
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Federal I.D. Number: ������. �j ;1
(or Include Social Security Number) ��� / �
Work Type to be Completed: `
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4. Subcontractor: 11f� l�6Z�''l ��� '
����let� ��c�r��s; , � g � �
(Include PO Box and Street Information) ��� ������`��`�,�` ��
City, State, Zip Code !� .���L��,
Telephone Number: ����.- �a��� �?�'�C.�
Federal I.D. Number: . � /a�,.,�� �
(or Include Social Security Number)
Work Type to be Completed: •
L-�'�t���-,�,�f�
5. �ubcontractor: �C�'! ���` �
Complete Address / �, (� �y� � ��
(Include PO Box and Street Information) /°� �� `����"'� ' '" '� �
Cit , State, Zip Code 6�� � I,�} �C�C7l
Telephone Number: ,�' �- ��5��'/.� � C�
Federal I.D. Number: ��� I ���--���
(or lnclude Social Security Number)
Work Type to be Completed:
����� ���� SI �-
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SECTON 00750 �
Page 5 of 5
6. Subcontraetor: c��1 / (,,,���" ,,�' � �
Complete Address: f�"��i�,�f��� �y�� ii
(Include PO Box and Street I�formation) �
Cit , State, Zi Code J���� /,�. /� ���� '
Telephone Number: ���—;� —�% � " �3
Federal I.D. Number: �������,����f a
(or Include Social Security Number)
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Work Type to be Completed: ���.�..���f, ����, � j
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7. Subcontractor:
Complete Address:
(Include PO Box and Street Information) ;�
City, State, Zip Code � f�
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Telephone Number: '
Federal I.D. Number: ;�
(or Include Social Security Number) f
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Work Type to be Completed: ��
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8. Subcontractor: !�
Complete Address �
(Include PO Box and Street Information) °
Cit , State, Zi Code
Telephone Number:
Federal I.D. Number: �
(or Include Social Security Number) �
Work Type to be Completed:
. �
9. Subcoretractor:
Complete Address:
(Include PO Box and Street Information)
City, State, Zip Code
Telephone Number:
Federal I.D. Number:
(or Include Social Security Number)
Work Type to be Completed:
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SECTON 00750
Page 6 of 5
10. Subcontractor:
Complete Address
(Include PO Box and Street Information)
Cit , State, Zip Code
Telephone Number:
Federal I.D. Number: �
(or Include Sociai Security Number)
Work Type to be Completed:
11. Subcontractor:
Complete Address
(Inciude PO Box and Street Information)
City; State, Zip Code
Telephone Number: �
Federal I.D. Number: ;�
(or Include Social Security Number) ��
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Work Type to be Completed: �
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12. Subcontractor:
Complete Address.
(Include PO Box and Street Information) �
City, State, Zip Code -
Telephone Number: �,
D. Number: ';
Federal I. �
(or Include Social Security Number) I
P
Work Type to be Completed: I
13. �ubcontractor:
Complete Address:
(Include PO Box and Street Information)
Cit , State, Zip Code
Telephone Number:
Federal I.D. Number: '
(or Include Social Security Number)
Work Type to be Completed:
_== END OF SECTION OOY�50 =___
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CONSTRUCTION SCHEDULE AND AGREED COSTS OF DELAY '
SCHEDULE:
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CALENDAR DAY SCHEDULE: �
Work required by the Contract Documents shall commence within ten (10) calendar days after Notice ��
to Proceed has been issued and shall be Substantially Complete by September 10th, 2018 and Finally �
Complete by November 5th, 2018.
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AGREED COSTS OF DELAY:
Time is of the essence of the Contract. As defay in the diligent prosecution of the work may
inconvenience the public, obstruct traffic, interFere with business, and/or increase costs to the City �
such as engineering, administration, and inspection, it is important that the work be prosecuted �
vigorously to final completion.
An extension of the contract period may be granted by the City for any of the following reasons:
1. Additional work resulting from a modification of the Contract Documents by approved change I
order.
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2. Delays caused by the City. �
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3. Other reasons beyond the control of the Contractor, which in the City's opinion, would justify I
such.
Should the Contractor, or in case of default the Surety, fail to complete the work within the specified
Substantial and Final �ompletion Dates, a deduction at the daily rate for agreed costs of delay will {
be made for each and every calendar day or working day, whichever is specified, such that the work
remains uncompleted. The Contractor or the Contractor's Surety shall be responsible for all costs
incidental to the completion of the work, and shall be required to pay the City the following daily costs:
A. For each calendar day that any work remains uncompleted beyond the Final Completion
date the contractor will be assessed and shall pay, 400.00 per calendar day, not as a
penalty but as predetermined and Agreed Cost of Delay until Final Completion
requirements are met.
Permitting the Contractor to continue and finish the Work, or any part of it, after the expiration of the
Final Completion dates or Milestone Dates or extension thereof shall in no way operate as a waiver
on the part of the City of any of its rights or remedies under the contract, including its right to Agreed
Cost of Delay pursuant to this provision. FurthermQr�,�he ass�sment of Agreed Cost of Delay shall
not constitute a waiver of the City's right to collect any additional damages which fihe City may sustain
by failure of the Contractor to carry out the terms of the Contract.
The Agreed Cost of Delay rates specified in the Contract Documents is hereby agreed upon as the
true and actual damages due the City for loss to the City and to the public due to obstruction of traffic,
interference with business, and/or increased costs to the City such as engineering, administration,
construction, and inspection after the expiration of the contract times, or extension thereof. Such
Agreed Cost of Delay will be separately invoiced to the Contractor, and final payment will be withheld
from the Contractor until payment has been made of this invoice for the agreed cost of delay. The
Contractor and its surety shall be liable for any agreed cost of delay in excess of the amount due the
Contractor.
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Bond No. IAC588372
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P'ERF�J�I111A.N�1� P'Al1(II11��1� �irl� N'1��Crf�I'�1'��►��� �C3t�t� �
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Kh�t��J A�L B�' Tf�E�� f�RE�E�iT�; �
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Th�t we, �anserr �xc�vatiE�q ln�W, as Prir�cipal ���re�n���r t�� "�r��tractor,, ar "Princip�l"} 4�
��q� MerChants Bonding Company s �� `������ ,
are h�f�! ar�d firmly k��rur��S untc� the t�ifiy c�f C7��buqu�, law�, as E.�l�lir��e (h�r��r�after r�ferred ta a� ;
"€�uvner"), and tcs aRl perse�r�s wha may bc �nj�r��6 �y �rry �r�`��c� ���r�l�f th� �c�nt�i�ican� taf tflis L�an�! �
in th� p�r��C Sum �� �ne ti�trrr�red �C�n����n Thc����r�d Ei�� Hundred �i�tV-�E� �nd 7�(1C}(� doi��rs
��'�1�,8�i6.;��, �awful rtssa�ey c�f th� t�niteci �t��e�«; fc�r tl�e payrr�er�� ca�v�rhich su,m, w�l! and firu�y tc� i
b� r�ad�, �� bEnd c;ursaEve�, e��r'h�irs; P�e��l ��p�es��t�tive�and �ssic�ns,j�ic�tly c�rsev�ra6Cy,firmG� 1
by the�e presents. �
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Th� conc9i�i�r�s �f the ���v� ����g�tir��� ar� such �I��� ��i�er��� s��d ��ntr�ctc�r entere� int� a i
carrt�act w�t� t9�e �wra�r; k���rir�g dat� t�r� 1���ciay c�f�itl�' �01�, �h�r�ir�aft�r th� "C�rtt��ct"} i
whereir� �aici Cofit��rt�r w�nd.er��ke� ��d ��;���s t� �c�r��tru�t the fa��a��v��� pr�ject in acc�rd�r�c� Is
v�if�t t�ie �c�ntrack dc�r,�amer�ts, �r�d �� �aiihfiuily p�rFc�rr�i ��I th� terr�s� �nc! requi�err��nt:� c�f s��d ,
c�
�ontr�ct within t��� ti�re �i�ere`sr� �p��ift�d, ia�r a gc�taci �r�d wc�r4�rn�nlik� mar�ner, �nd irr acc�ard�r�ce ��,
with the t�ontr�ct C�ocun���tis. T�� �ontr�ct �c�e��a�€�er�fs ficar Cre:ek Wa�c� F'�rk �raj��t detail tl�e j
;
fQllow�nr.�. d�scrit�es� impr�v�ments; �
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T#�r� project�+ril! inv�a8v� th��site; c�r�dir�� �nc4 �ase �r���r�t�on fr�r�ew park �€aygrc�un� �
�quipr�enf, d��c�nn�c�ic�� c�F�n �xis�.��� ��t����rvi��co�r��ctic���, sif� �r�di�o� �r�d i
insta��atic�n ���icie�val�, ir�s��61��i�ar� �f�l�:ctrir�l �c�ntrrf k��� �r�d ��rk [igh�i��tc�, ccs�r�inatsi�r� I
wst�t p�rlc �quipt�ent�uppiier �s�:������d v�ith t��� �rrs�al4��it�n ofi�I�ygrr�u�e� �qui�n��s�fi �nc! {
ruhb�r�r�� s�f�fiy �urf�ci�7go f�nal sit� �r�dir��, pl�r�tir�g �f tr�es, ��ri��r�� plt�gs; n�tive �
�rass�s �n�4 turf�r�ss. �
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It is e�pi�es�fy urrder�t�ad �r�s� ��r��� by t�r� �c�ntr-�c��r ara�i ����`�ty ir7 thi� Bc����ci �ha�ti�e�c�lfn�rir;� fl
pr�visia�s�r� � p�r�of this ���cS �nd �r� �in�in� ���r� s�id C�ntr��t�r�r�� ��srety�, ����ti�: �
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�1. PE��'t���AN��: ih�C�nf:r��l�����I!v��ll�nd fait�if�l�y r��serv�, perfarm,iu��ils, and �bi�3e
by e�c�r �nd �v�ry cav�n�r��; �a���it�a�, �.r�d ��r#af�;�ic� �csr�tract ��d C;�ntr�ct C3c�cum�ntsx
by r�f�renc� m�de � p�rt hereof, fcar tl�e proj��f, �nc� �h�11 ir��err�r��f�°and save h�rr�6e�s the
C7uvner fr�rr� a11 c�utlay ��d e���ns� €��urrrrec� k�� t�re Cfwrr�r �y re��an �f th� G€�r�tr�c�ar's
��f��lt �� �ailure t� perFt��m as rec�uirec�. ��� �antractc�r sh�l1 �Isa �e re�pr�ri�i�i� fc�r the
cief�uli: sar #�ilur� tc� �erfc�rm as req�.sired E�nc���-��� �or�tr�ac� �r�c� C�r�fract Dacurrtents �Sy afl
its s�rb�ar�tractars, suppli�rs, ac�ents, or�rr�pdayees furr�i���r�g rm�teri��� or�ravidi�g labc�r in
the per�rrrm�nc�c�f tf�� Cantract.
�;. P�YNI��1T. Th� �cantr��tar an� ti���urety an��i����it� h�reby�c�r��d t� �a�ali jtast claims
su�rr�ifted b�r p�rscans, �rrns, �ubc�arstractc�rs, anr� cc�rpe�r�tcc�ns f�rnisl�i�t� materials for� �ar
perfit�rming (�b�r in the pe�t�r�n�nc�:af th� C�c�n�r�ct ar� �ccc��.��t caf e��hich this i�c�nd is giver�,
irtci��3ing �ut �s�t firr�ited tc� clair��� ��ar �i� �rr��,unts d�se far 1��or, rrraferial�, ��bricants, oii,
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gasal�ne, repairs an machinery, equipment, �n€�t�oG�, cansl�r�e�! ar�sed by th� C�c�ntr�ctor jl
r�r �rry subcc�ntr�ctc�r, whererrt the ��m� �c� nc�t sat�sfec� vut �f�he partian �� th� car�tract �
price the C3�vner is r�quired to retain until carn�al�fior� saf the imprc�vemer�#, �ut the Cc�ntrac��rr
and S�ret�sha!( r�at be Iiatafe fic�saict �ersc�ns,�rms, c�r carpcarati�ns un�ess ti�e cf�lm�t�f saic3 !�
cl�imants a��inst s�id pc�rtion �f tl�e carrtr�c# pric� shali hav� �e�n est�blished as pr�vided ��
by laav, The Gontr��fc�r�rtci Sur�ty h�re�y bi��therrss��v�s�a t1i��b�igatiar���r�d cc�r��i�ion�
s�f�t�rth in �:h�p�e� �73 af the (+��+rr� C��e, wi�ic� k�y th�s r�f�renc�: is m�d�� p�rt h�re�af a�
t#��ugh f�afly set t��t herein.
3. i'�A,I(�T��Jr�,h�C�: Th� �ant�ackar and �he Sur�fiy c�� t3��� B€�n� P�ereby agr��, at t��ir r�uvra I
�xpense; �
;
, A. Ta r�rn�c�y ar�y�nd �II d���cts �hat ��ay c��v�Iop fr� �r r�s�Ct fr�r�� wc�r�c��� be }��rFc�rme� �
und�r �he Cr�ntract d�c�r�rer��� �nrit€�irt th� �eric�c� caf �wa (�) y��r��} frcrm t��� �at� �f
�cc�pt��c� of the ��r�+rk un+�er fi�e �c�r�trac�, �ay r����c�n afi d�f��f� in w�r�smans€�ip, ;
�quipr�e�t i�7st�lled, e�r �tateri�l� �secf �r� cc�rsst��tctic�n �f��i� w�rk; J
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;
B. Tc� k���a�l wa�� in c�ntfirruou� g�od r�p�ir; �r��f 1
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G. Tc� pay t�� C�w��er's rea�cn���e cr�sf� of mc�¢�iitcarir�c� anr� i��s�ectdon to �ssur� ihat ar�y '
defects ar� r�ernedi�d, arari tc� r�pay th� �wner �II o�tl�y �nd �x��nse incurr�d �s a �{
result �f �cs�fr�ct�r°� an� �ur��r� fi��[€,�r� �� remedy �r�y c����ct as requir�� by t�is ;i
��c�ior�, �i
�;
��ntracfc�r's a��! S��r�ety'� C�r�tr�ct �er�irr mad� ex��nds t�a de���ts in wor�rr�aP�ship or ��
��
rrt�teri�Js r�c��dis��rr�r�d c�r kn�wrr to �he t�w�er at the��rn� �ucE� �nrcar�<t��s acc�pted. �
�
4. �E�IEF�,L� Every��rety on th;s �canc! �E�all b�: cf�emed and hei�4 �c�u�c£, �n��e�ntract t� tt�e �,.
crntrary nc�iw��hst�n�€�n�, to �r����slf�v�i��� presvi�i�r��: �
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�. "re� cons�r�t �rith�:�.at no�i�� tc� ar7y �xt�r��i�n �fi �i�rre autF�c�ri��d ir� a��raved ch�nc�e '�
orders�� fihe Gc�r�t��ctar irr whicf�ta �e��rr� th� ��+�-�tr�€�t, I
�r To cQnserrt wit�aut ncrfic� �o ��ry �han�� iri t�� ��r�tr���t t�r� ��ratr��t �acuments,
autt7�riz�d it� �pprc�rred �F��ng� c�r��rs�i�ic�t��re3�y ir��re�s�s �E�e �ca�a! ��n�r�ct price
and t3��penal sum taf this Band,pr�vid�d�����fl �ucii�h�r�c�es dc�r�at, ir�th���c�r�c�ate,
i�iuc�(ve ��r�n����s� of mvr� tf��n tw�rtfiy ��r�ent (�i�%) c��'�h� �t�f�i cs���tr�ct pr'sc�:, �nd
t�at this �c�r�d sh�l�th�r� b���le�s�d ���a �uch exces� ir�cr����;
C. Tr� cor�s�nt without r��fic� th�t t�is ��nd ���al[ r�rr��in ir� full fc�rc� �s�c� �ffect until t�e
Contr�ct is cornplet�d, v�rh�ther cor��p��t�d �vitf�ir€ tE�� s��ci�i�c� �c�r�tr�ct ��ric�d, within
an �xtee�si�rn th�r�of, c�r withir� a peric�c� s�f �im� ��t�r tF�� ccn�r�ct pe�oci 4��s elapsed
�nd the liquid�ted damage p�naEty i��eing �hargec����ir��t tf�� Ca�tr�ctar.
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�aC��� ���
Th� Contr�ctor �nd ev�ry �ur�ty c��r tl�e �on�i s��[! �e d���ed and E�eld bc�unc�, arry co�tr�c� tc� the
cr�ntrary nofiwiti�standing, tc� tl��fc�l��wing pr��visi�ns: '
�� T�r�t �c� pr�ruision af this Ban� c�r af�r�y ��f���` cc�ntract �haiC be valic� tY�at �irr��fis to I�ss
thar� f�v� (�� years��€�r the acc��t�ra�e c�f the wc�rk ur�der t�e Cc�ntr�ct�he ri�ht tc� su� �
on this�ar�d. C
E. Th�t as ��ed ��r�irt, the pl�r�s� "al� �utEay�n� ex�en�e" is �ot tc�ta� lirrrified in ar7y w�y,
b��t s�ail irtclud�th� a��u�l �r�c� rea�c�nabE� costs and ex�r�r�se� ir-��urr��i �y th��Jwr�er
incfudir�� inteeest, b�ne�it�, ����i c�verh��c�where�ppfi��b�e. Ac��arc9ir�gly, "a11 autlay anc� �
expen�,e" wc�talt� in�l�ad� but ��� b� limit�d t� a�i �cantr��t or �mpl�yee exp�ns�; a11
��uipmen�us�ge ar rental, rrr��tes�i�l�,te�ting, c�t�ts[d��xperts, attc�rr�ey's f�es (inc(ud�ng
�v�rhead e�p�r�se� c�f ttr� �wn�r'� st�f� atti��n�y�}, �nd �Il �ost� �nc� expens�s af
litig�t�on �s they �r� in�urr�d �y t�s� C:�v����r. ft is i�t�r�ded �I�� �c�n�rac�r�r ar�cl ��rety
will d�fend and �ndemni�y�the C��vne�on �i� clairns�ac�� a+��ir�st ti�� C�Uvner on �ccount �
�f Canfra�tc�r's f�il�r� tra perfcrr� �s re�u�recl in the �;+�ntra�t�r�d 4��rttr�c:��oc.�mer�fis, I
th�t all �gr�c�r���r�rts ar�d prnrr�i��s ���fc��th ir� tf�e C�f-ttr�ct�r�c� Cc��tr�ct C�ocurrtents, in �
ap�rcav�t� cl�ai�ge arders, �nd ��7 this ��nd �,ri�i be �ial�€�ed, and td���tk�� C�+rvn�r w�ll b� ;
�ully ind�mni��� sc� th�t it vuill f�� put int� t�e pos�tic�r� if w�au�d ���v� ��en in �ad the �
�r�r�tr�c� b�;en per�c�rrr��ci €rr t�7e �rst instar�c� �s requtir�d. �
in t�e �v�nt t�r� C7v��a�r �nc�,�r� �r�y "��tl�y �n� �x��ns�° ir� �efer��6n� rtse�����i�st any clair� �� t�
�
�;vt�ich t��� Cc�ntr�ct�rr or �ur�ety sh�u3c� hav� prtavicled �f�� def�n��, c�r sr� tl�� enf�rcement c�f t�� fj
prami��s c��ven by�E���:���tr`��tca� in the Cc�n€rac�, �;o{�tract�t�ciam�:r���, �r���rc�v�d ���ange c�r��r�, �
or irr t�e e�i�arceme�� r�f f�� �rarr�ise� �iven by the (�c�rr�r��t�r �r�d �ur�;ty in il-�i� B�nd, th�
Crantractc���nd �urety agre� t���� t�r�y wil� n�ak� th� CC�wr��� wh�ie f�r �II :�E.��,t� c�utiay a��3 exp�nse,
�r���ic��d that the �ur�ty's cabEi�ati�rs u��d�r this �or�c� s���11 n�t ��r�;e�d csr�� I�ur�tc�t��� tv�er�ty-�ive �
p�rc�nt���5%� nf the p�nal s�rn �f this Bc���d.
u
Cn t�te �vent th�t�n4# �c�i��s �r prc�c��din,�s �r� irtiti�t��f r�g�s-ciing thi� �c��o�#, th� p�rti�s agre� t9-��t I
the ver��a� th�r�cif s��lf �ae �u#�uc�ue ���r��y, �t�tc� o� I�w�. if 9�ga� �c�i�n i� r�quir�d �y the �wr�er
fa �nft�rc� the ps`�visic�ns �if tYris Sc�nc� �ir�� �c�1S���fii�� �'�t�net�ry �abl#��ti�sr� �r��urrin� t� �he b�n�fi� �a�
th� C�w��r, the �c��tr�ct�ar and f�e S�re�y �gr��; jc�intly, �nc� �ev�r�lly„ tc� ��y ��� �wner �li c��tlay
�nd expens� incs.��-red therefc�r i�y tt�a� C�v�ner, AI! r'sc�Y�ts, pc�w�;rs, �nd r�rr��+�'ses of �he ��uner
hereunder �h�kl t�� c�arriui��iv� �r�d n�t �Iternativ� ��d sh�.�l �� in ae��i°s�icari ta a61 rights, powers, �nd
rem�di�s g�v�n fic; the C7lnrner, kay I�w. Th� C�ws��r �r�ay �rcac;�eci ac�air��t surety fc�r �r�y am�urst
�u�ran�eed t�eo�eur�d��� wh�Yher �ctyc�n i� �r�ru�ht �g�in�� t�� �..;s�r��r�ctc;r r�r wh�th�;r �c�r���-ac�or is
joine�i in �ny such �cfi�r�{�}�r�cat.
I��VV T�I�R���F�E,th�cc�ndit��n cs�thi�c�b�€g�tiran i�s�cl�tf��t i�said€�ri��ip�l�hal1 f�ifhfullY per�carr�7
aC!the �r�a�r�ises of the Prirrcip�f, �s��tfc�rth�ra� prcavEdecl in th��c��tra��, ir�th�Cantr�ct dQcumer�ts,.
a�d in fihps E3c�nd, ther� th�s abEic��tic�n sh��l be r�ull �nd vc�id, c�th��wise ifi �I�all r�rr�ain in full for�e �nc�
effect.
W�er� �work, terrr�, or�hr��� is u�ed ir�r this ��s�d, it shal6 R�� int�rpreR�d �r con��ru�d first�s defined
in fihis Bancf, the Cantr�ct, or th� Ca�rtr�c� C�oc�r���r�t�; s�cc�r►c�, if n�f ��fir�eci �r� th� B�nd, Contra�t,
ar Cc�ntract acrcuments, it sh�(1 b�; €r�terprete�3 or cQnstrued ��defr€ed in ���lic�ble �rav�sicans of the
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SECT�C}N D06�d1
Pa�e 4 of 4 �
1c�w� Cod�; �hird, if not c9e�ned �n t�e low� Cc�d�, it shaif be infi�r�ret�d c,r ccarastru�d a�card�ng to its �
genera€ly accept�c! m��r�i�rg in the �anstru�ti�rr� ierdustry; :ar�cf �ourkh, i� it �as rsr� g�ner�ify ac��pted �
m��nin� in tl�e construetian Er�d�stry, �� s�al( be interprek�d €�r c�nsfrued �c�ordir�r� to €�s cr�mrnon c�r
customary us�ge. �
�
F�ilure to specify o� par�i�ulariz� s��li n�t excEude terrn� ar�rav�si�rn� r��t r�enfi��rt�c� ar�d shal! r�ot
[imit liabilit�l�er�ur�d�r. �rr� Cc�ritract a�d �r��lrac;t C��rcumer�t;��re F��r�by m�ad�� p�rt�f thi� Bond.
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Proj��t(��a. 3602�75 �
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Ull�tness ��r h�r�ds, i� tripficat�; this /�� �� ���+of ���lr� , 2(���. I
��F��TY C(Jl���'���[���I� �Y: Tit�� I
F��NN� ArF�ff��C��EC► °(: ;i
S'rgnature of Agent j
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�epresent�iive far C?wner i'
Prin#ed�I�me crf/�gent ;I
�����': ��
C�mpany A;cl�ress !;
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Merchants Bonding Company 1
Sureky C:ca�?pany - ------- �
Cif�,Sl�t2,Zip Cor�e �
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---- - �i�n�kur�x�,rtarney-in-�=ack C7Pf'sc�r �
Gampany T�I�phane Number �
Kim Hess �1
� f�rl�tac�1V��rile af Attaro7e�y kr�Fac�C3ffioer ,
F��v9��1�'�E�; i
Tricor _
Gansen Excavating Inc -"�� �`�"-"' �
Ct�m�any k�am�
Con�racEor
600 Star Brewery Drive Ste 110 �
B�; ��. ' _��i�"�� ��ar7���any A�dre�ss� � i
S cn2tur� '
��•�� �� � y� Dubuque, IA 52001
°.`- City,��atC:,Zip GOd� �
Print�d Nam� �
563-556-5441
._. Cam3��rr�y Tele{�htrne s�i�rs�ber -----.—_� ,
N�T�:
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1. ,�i! �ignati�rr�� ar� tl��� perfarrnar�ce, p�ym�n�, �rrd �nair�fer��nce Bc�nr� rnust be origin�l
sign�tur�� it� i�k; cr�pi��, fa�sirniie, or�lectrt�nj��ic����Ur�s w�l9 r�crt ��accepted.
�. Th�s ��r�� m��t b� seaE�d with th� Sur�ty's ��i���„ err�b��sing se�l.
3. Th� r��rr�e and signatur� e�f the �u�e�y'� At��rr�eymir�-��actf�f�ic�er er�t�re� can �hi� ��nd 1
mus� k�e �xactly a� fisted �,n th� �;erfiifc�t� ar P�w�r �� �1ttr�r�ne� ��cc�mp�nyin� tl�i� I
Bc�n�1.�.��� � �� ���TI�P� 0���0 ���o
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MERCHANT_� �
BON DI NG COM ['ANY>�= !
POWER OF ATTORNEY ��i
Know All Persons By These Presents,that MERCHANTS BONDING COMPANY(MUTUAL)and MERCHANTS NATIONAL BONDING,INC., '
both being corporaqons of the State ot lowa(herein colleotively called the"Companies")do hereby make,constiiute and appoint,individualiy,
�
Kim tless �I
their true and lawful Attomey(s)-in-Faci, to sign its name as surery(ies) and to execute, seal and acknowledge any and all bonds, undertakings, • +
contracts and other wrftten instrumenls in the nalure thereof, on behalF o( the Companies in lheir business ot guaranteeing the fidelity ��
of persons, guaranteeing the performance oi contracls and executing or guaranteeing bonds and undertakings required or permitted in any i!
actions or proceedings allowed by law. rj
This Power-of-Attomey is granted and is signed and sealed by facsimile under and by aulhority of Ihe followinc� By-Laws adopled tiy the Board ��
of Directors of Merchants Bonding Company (Muival)on April 23, 2011 and amended August 14, 2015 and adopted by the Board of Directors �i
of MerchanlsNalional Bonding,lnc.,on October 18,2015. �
"The President,Secrelary,Treasurer, or any Assistant Treasurer or any Assistant Secretary or any Vice President shall have power antl aulhoriry �
to appoint Attomeys-in-Fact,and to authorize them to execute on behal(of the Company,and attach the seal of the Company thereto, bonds and
undertakings,recognizances,contracts of Endemniry and other writings obligatory in the nature thereof." I
"The signature of any authorized officer and the seal of the Company may be affixed by facsimile or etectronic Uansmission io any Power of Attomey
or CertifiCation thereof authorizing the execution and detivery of any bond, undertakEng, recognizance, or other sureryship obligations of the '
Company,and such signature and seal when so used shaA have lhe same(orce and effeci as lhough manually fixed." �
In wnnection with obligations in favor of the Florida Department of Transportation only,it is agreed that ihe power and aut hority hereby given lo lhe �
Atlomey-in-Fact includes any and all consents for the release of retained percentages and/or final eslimales on engineering and construction `
contrects requfred by the State of Florida Department of Transportation. It is futly undersiood that consenting to the Stale o(Florida Department �
pf Transportation making payment of the final estimate to the Contractor and/or its assignee, shall not retieve this surety company of any of !
its obligations under ils bond. �
In connectionwith obligalions inYavo�af lhe Kentucky Department of Highways only,il is agreed that the power and authority hereby given ;I
to the Atlomey-in-Fact cannol be modified or revoked unless prior written personal noiice of such intenl has tieen given to the Commissioner- i{
Department of Hiphways of lhe Commonwealth of Kentucky at leasl thiriy(30)days prior to the modification or revocation. �
In Witness 1Nhereof,the Companies have caused this instrument to be signed and sealed this 9th day of July � 2018 • �{
��Jn�.�.�..�� ..,...� i
;'�'���,��''��6+�� :���`�r�V��'�� MERCHAN7S BONDING COMPANY(MU7UAL) '
+�y;•vO�P�R-4j:•.y; :��VO�P�9-9�,;.���; MERCHANT NATIONALBONDING,INC.
�c:2� P o_ p';G: 'c";'? *^:
;�,�� 2003 :��� :a' 1933 ��c: sy � �
d'• '� �y �
. vd. .a� �
••o�k•• .• ' `
., ,•�• .�'�: ,�{y..�..••�,.•' President �
. �STATE OF IOWA ��`"'•""'��� ��� "
COUNTY OF�AILAS ss. •• �
On this this 9th day of july , 2d18 , betore me appeared Larry Taylor,to me personaAy known,who being by me duty swom �
did say lhat he is President of MERCHANTS BONDING COMPANY (MUTUAL)and MERCHANTS NATIONAL BONDING, INC.; and that the
seals a(tixed 90 the foregoing instrument are the Corporate Seals of the Companies;and thal the said instrument was signed and sealed in behalf
of the Companies by authoriry of their respective Boards of Directors.
tiP��A�s ALICIA K.GRAM
o�p Commission Number 767430
Z�`: My Commission Expires ' �_
,Q,,,,P Aprii 1,2020
Notary Public
(Expiration of nolary's commission
does not invaGdate this instrument)
I,William Warner,Jr.,Secretary oi MERCMANTS BONDING COMPANY(MUTUAL)and MERCHANTS NATIONAL BONDING,INC.,do hereby
certify that the above and fpregoinp is a true and correct copy of the POWER-OF-ATTORNEY executed by said Companies,which is slitl in fufl
force and effect and has not been amended or revoked. f
In Witness Whereof,I have hereunto set my hand and affixed the seal of the Companies on this d���day of ��F� , 2018 .
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:�y.y0Rp�0/�,V-.Q,Z.:' ;�,o���iP099A9y�; �/ . �Q,'�
,2:2 ..o_ Tv:�: ;��'�:'a _o_ �,';"`� �'T� <�Lr���.
;v'' 2003 �5 � �'0C�'. ',�33 �'•�: Secretary
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POA 001$ (3I17) ,•''•��•••••���Y • •
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,� �,�---� GANSEXC-01 AHENDRICKS i�
A�'ORO� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYW)
�.._--� 06/26/2018
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(5),AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER � CONTACT �
NAME:
TRICOR,Inc.-Dubuque '
600 Star Brewery Dr., (aic°,NN,ext�:(563)556-5441 jnic,No�:(608)723-6440
Suite 110 aoDRIESS:
Dubuque,IA 52001 l
INSURER S AFFORDING COVERAGE NAIC#
INSURER A:14CUIt 14184 �
INSURED INSURER 8�: I
Gansen Excavating,Inc. '�
Richard Gansen wsuReR c: i,
12198 Skyline Rd irusuReR�: !�
Dubuque,IA SZ003 INSURER E: ��
INSURER F: I�
il
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: �a
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD E�
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS I�
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, �
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADDL SUBR POLICY EFF POLICY EXP '
TYPE OF INSURANCE POLICY NUMBER LIMITS j�
LT N WVD M /DD/YYYY MM/D /
A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE g ��OOO�OOO ;�
CLAIMS-MADE �OCCUR K53731 01/01/2018 01/01/2019 DAMAGETORENTED ��p��00
PREMI E Ea occurrence $
MED EXP An�one erson $ 5,��� I
1,000,000 �
PERSONAL&ADV INJURY 3 I�
2,��0,0�0
GEN'L AGGREGATE LIMIT APPLIES PER: - GENERAL AGGREGATE 3 �
X POLICY�jECT � LOC PRODUCTS-COMP/OP AGG $ Z,OOO,OOO i
OTHER: S i�
A AUTOMOBILE LlABILlTY EOM�BcN�eDt51NGLE LIMIT $ 'I,OOO,OOO ��
ANYAUTO K53731 01/01/2018 01/01/2019 '
BODILY INJURY Per�erson $
. x OWNED SCHEDULED
Al1TOS ONLY AUTOS BODILY INJURY Per accident $ �
X AUTOS ONLY X A�TOS ONLY (Per°accRdentDAMAGE i� �
$ I
� a UMBRELLA�IAB X OCCUR EACH OCCURRENCE $ S,OOO,OOO �
X EXCESS LIAB CLAIMS-MADE K53731 01/01�/2018 01/01/2019 AGGREGATE � $ 5'���'��� I
DED � RETENTION$ � $ �
A WORKERS COMPENSATION � X
AND EMPLOYERS'LIABILITY STATUTE E�RH
K53731 01/01/2018 01/01/2019 1,000,000
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED?
. (MandatoryinNH) � N,A E.L.DISEASE-EAEMPLOYEE $ �,���,��� �
f yes,describe under 1,000,000
DESCRIPTION OF OPERATIONS below E.L.DISEASE-FOLICY LIMIT h
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DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
Project#3602375;Creek Wood Park,1798 Creek Wood Drive,Dubuque,IA
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 additional insured on the general liability policy for ongoing and completed operations,on a primary and
non-contributory basis,as required by written contract.General Liability general aggregate limit applies per project.Governmental Immunities endorsement
included.Fellow employee endorsement included.Waiver of subrogation in favor of City of Dubuque applies on workers compensation.Umbrella follows
form.
CERTIFICATE HOLDER CANCELLATION �
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Cit of Dubu ue THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Y q ACCORDANCE WITH THE POLICY PROVISIONS.
50 W 13th Street
Dubuque,lA 52001
Al1THORIZED REPRESENTATIVE
h�'.C.�c t. �'"" -
ACORD 25(2016/03) O 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD �
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after the Coverage Part has been ir� the creation of the loss if: '�
effact for one ye�r or one palicy term, (�) The loss aras� out af � pattern af crimi� �
whicheuer fs I�ss. n�! domesti� vialence; and
(2) Natwithstanding the limitations stated in (2) The perpetratar of the loss is criminally �
c(1} above, we may cancel the Cov- prasecuted for the act causing the loss.
erage Part in accordance with the �
terms of the Cancellation Gondition. �• '��'� p�Y � ����m pursuant to paragr�ph Sb,
aur paym�nt to the insured is limited to that �`
6. The following exclu�ian is added to item 2 un- insured's insurable int�rest in the property �
der Property Exclusions in the Deluxe Bis-Pak less any payrnents we first made ta a mart- �
F'roperty Coverage Forrn: �II,
gagee c�r other party with a legai secured �i�
a, We will not pay far lass ar damage arising interest in the prap�rty. In no event will we
out of any act committed: pay more than the Limit of lnsurarrce. �
(1} By or at the direction of any insured; 7. The Bis-Pak Business Liability and Medical Ex- j,
�nd pens�� �auerage Fctrm is amended as fc�ll�ws: ;
(2) With the wntent to cause a loss, The term "'spause" is replaced by the following: �
b. However, this exclusian will nat �pply to Spouse or p�rty to a civfl uninn recognized I
deny payment to an innocent ca-insured und�r Illinois law, 'li
wha did nat cooperate ir� or conkribu�e to �
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ADDIT{ONAL INSURED CITY q�DUBUQUE, 1l�WA IL-7063(7-a2} i
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This endorsernent rr�odifies insurance provided under fram time to tirn�. Those claims not subject �
the following: tc� tf7e Cade of lowa Section 670.4 shali be "
BUSWESS AUTa COVERAGE FC1RM covered by the terms and canditions af this �j
C�MMEFiCIAL G�NERAL LIABILI7Y CC7UEF�AGE PAFtT pe�licy. �
81S-PAK�USkNESS Llt181LITY AND MEDICAL c. Th� City of I�ubuque, lowa shall be respan- �
EXPENSES COVERAGE F�RM sible for asserking any defense af gavern- Ij
1, The City of Dubuque, lowa, including �EI its rr�ental immunity, and m�y do sa at any ;
elected and appointed officials, all its employ_ time and shall do so upon tim�ly written '
ees and valunteers, all its baards, commi�sions request t�y us. �
and(or authoriti�s and their board members, d, N/� ���I{ not derry coverage under this poli- j
amployees and volunteers, are includ�d as ad- cy and we �hall not deny any of the rights °�
ditional insureds wilh respect to all work and and ben�fit� accruing to the City of Du- j
services perfr�rmed for them. This coverage �uque, lowa und�r this polic;� for r�asons of �
shall be prirrtary to the additional insureds �nd governmental immunity unfess and until a
not contrit�uting with any other insurance ar caurt of cnmpetent jurisdictipn ha� rul�tl in
sirnilar pratection available fa the addition�E in- f�vor of the defense(s) of governmenta! im-
sureds, whether other available coverage be munity asserted by fhe Ciky of Dubuque, ,
�rimary, contributing or excess. `�y��,
2. The fallowing applies when the City of Du- e. We and th� City of Dubuque, Pr�wa agree
buque; lowa is named as an addikinnal insured: that the abave presenration afi governmental �
a, We expressly agree and stake that th� pur- immunities shal! not otheru�ise change ar �
chase of this palicy and the naming �f the after the coverage availabl� under the poli- �
City af Dubuque, lawa as an additionai in- �Y�
sured does not vuaive any af the defenses 3. We will give thirty (30j days advance written
af governmental imt�r°tunity available ta the notice of cancellatian, ncanrenewal, re�uction ir�
Cify of C?ubuque, lowa under the Cade of caverage ar limi�s andJar material change by
lowa Section 674.4 as it now exists and as �ndorsement and ten (10} days written notice
it may be amended from tirne to time. for nc�npayment ofi premium to: Gity of Dubuque
b. We further agree that this poficy of insur- and Dubuque County, City Hal1, 13th and Cen- �
ance shal[ caver only those claims not �ub- trai, (�ubuque, IA 5200i. This endorsement su-
ject to the defense of gpvernmental immu_ persedes the standard canceffation skatement
nity under the Code of lowa 5ection 670,4 on the Certificate of Insurance ko which this fl
as it naw exists and as it may be amend�d endprsement is attached.
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ADDITIONAL INSURED-CGMPLETED OPERATfONS-PRIMARY AUTO- CR-7242(5-13� �
MATIC STATUS WM�N �EC�UIRED IN GONSTRUC71C3N AGREEME�lT WITH - �
Yt]U t(�WNERS, LESS��S OR CONTRACT{�RSy
i"his endorsement modifies insurance provided und�r 2. The insurance does n�t appiy ko:
the faliowing; a. Bpd1)y fnjury or property damage which oc- I
BIS-PAK BUSINESS LIABILITYRND MEDlGAL EX- curs prior to execution of the contract or
PENSES COVERAGE FQRM agreement described in item 1; or
1. Wha is An Insured is amended to include as I
an additional insured: b, Bodily injury or properly damage that oc- �
curs after the time period during which tf�e a
a, Any person(s} or carganizatian(s) far wham contr�ct or agreement described in item 1 j
you have pert'ormed aperatians if y�u and requir�s you ta add such person or ar- '
such person{sj or organizatian(s) hav� ganization anto yaur policy as an additiona� ,
agreed in writing in a cantracfi or agreement insured for campleted �perations; or a
thaf such person(s} ar organization(s} be �, gQdily injury ar property damage arising out �
added as an additional insured on your poli-
�f the rendering of, or the failur� to render,
cy for cornpleted operatic�ns; and �
any profess�anal, architectural, �ngineering !
b. Any other person or organizakian yau are or surveying senrices, ineluding: �
required ta add as an additionaf insured 1 The re arin a '
under the ccantract or agreement described � 7 p p 9� pproving or faifinc� ta ,
prepare or approve maps, shop draw- '
in paragraph a above. ings, opinions, reports, surveys, field or- �
Such person(s) or organization(s} is an addi- ders, change orders or dr�wings and ;
tiona! insurad only with respect ta liability in- specifications; and �
cluded in the praducts-compteted aperatians ;:
hazard for badily injury Qr prop�r�y damage �2) �upervisory, inspection, archifectural or �
, �ngineering aativities. �
aaused, in who�e c�r in part, by your work per- I
formed far that additional insured at #he laca- �• Ths insurance pravided by this endarsement is 1
tian designsted and described in the con#ract ar primary and nonconkributory. ,i
agreement, '�
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FUNGI OR �ACTERIA EXCLUSI�N (LIABILETY) CB-0577(4-10) �
This endors�ment modifies in�uranc� provided undsr (2)Any los�, cost cr expenses arising out of `i
the foflawing: the abating, testing for, t7roni.toring, cieaning ;
BIS-PAK BU�INESS LIABILI7Y AN�7 MEDlCAL EX- up, rerrlaving, cDntaining, treating, detox- i
PENSES COVERAGE FORM ifying, neutralizing, rem�diafing or disposing �
A. The following exclusion is added ta Paragraph c�f, or in any way r�sponding ta, or assess-
� under Exclusions: ing the effects of, funr�! nr bacteria, by any
Fungi or Bacteria insured or by any other persan ar entity. �
This excBusion does naf appiy ta any fungi or �
(1) Bod11y injury, property damage, persona!in- bacteria that are, are on, or ar� ccsntained in, a �
jury or advertising injury which wauld nat gooc! ar product intended fc�r bc�dily consump-
have occurred, in whole ar in part, but for $�pn
the actual, alleged or threatened inhalation
of, ingestion of, contact with, exposure tca, g• The fa6lowing definitian is add�d tc� Liability and
existerrce of, or presence af, any fungi or Medical Expenses f�efinitians:
bacteria on or within a building or structure, `Fungf" mear�s any type or form of fungus,
including its contents, regardless af whether including mo(d ar mildeuv and any mycotoxins,
any othsr cause, event, rnaterial or product spor�s, scents ar by-products prcaduced ar re-
contributed concurrently or "sn any sequence leased by fungi,
to such injury or damage.
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(3) Expenses and Incame. We pay only a. "Covered job srte° rneans any location, job �
soft cosf expenses and loss of rantal site ar project w,here you are in the praces5 ;�
incame incurred within 12 cansecutive of constructian or installation. j
months atter the loss to Buildings lJn- �, °pelay" means a delay in the construcfion, 1
der Constructian or Instailation Projects. erection or fabricatian af Buildings Under i;
9. PFtOPERN D��INITIdNS GanStruction or Installakion Projects. _
y
The fallawing definitions are added: ,_
scr�Eou�e 'j
l.imit of Insurance:$50,OU� �'
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Deductible:�2�d I
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1�remium Basis Eskirn�te Rate '1
Payrall Plus 50%of the Cast $335,393 $1.t344 �
of Subcontracted Work Per v1,QQ0 �
Minimum Pr�mi�rn= $50 ;a
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ADDI'f10NAl.IN�URED-C7WNERS, LESSEES OR Ct�NT�AGTt}R5- CB-7191{5-13) 'i
AUT�MA71C STATUS V1fHEN REQUIR�L? IN CONSTRl1CTION j
Af�REEM�NT WITH YOU-PRIMARY �;
This endorsement modifies insurance pravided under This insurancs does ncat apply to; �Ij
the following: a. E�c�dily injury, property damage, personal �
LP5-PF,lf B!lSI�1ES5!IA�ILITY Ai�L MEDlrAi Ex_ ��d advertisirag in/�:ry�ri�ing out nf the rer� "
PENSES COVERAGE FORM dering of, or the failure to render, any pro- jl
1, Who !s An Insured is amended to include as fessional, architectural, engineering ar sur- �;
an additional insured: veying services, including: �
a. Any person ar organization for whc�m you (1} The preparing, approving or failing ta ;j
are performing aperations when you and prepare �sr approue maps, shflp draw- I
such psrson ar org�nization have agreed in ings, opinions, reports, surveys, field or- I
writing in a cQntract or agreement that such ders, change orciers or drawings �nd �!
person or organizaticsn be added as addi- specificatians; and
tianal insured on yaur palicy; and (2) Supervisory, inspection, architecturai nr
b, Any a#her person or organization you are engineering activities. �
required ta add as an atiditianal insured b. Badily injury or property damage occurring
under the contract or agreement deseribed �fter: �
in paragrapn a above.
5ueh erson or or anization is an insured oni ��� A�� °�Qrk, including materials, parts or
P � �' equipmerst furnished in �onnection with
with respect to liability fior bodlly injury, properfy such work,on the praject(other than ser-
damage or personal and advertrsing injury vice, maintenance or re�airs) to be per-
caused, in whole �r ira part, by; formed by or on beh�lf of the additianal
a. Your aats or omissians; or insured{s) at the locatia�n csf the covered
b. The acts or omissions af those acting on �pEr�tions has been completed;or
your behalf; (2) "fhat portipn of ycrur work out of which
in the pertormance of your ongoing operations the injury c�r damage aris�s has been
for the additional insured. put to its intended use by �ny persan
or organizatian other than another can-
A person's or organizatian's s#atus as an in- tractor or subcantractor engaged in per-
sured under this endorsernent ends when your fc�rming operations for a principal as a
operatians for that insured are completed. part of the same project.
2. Wifh respect tv the insurance affarded to these 3. The insurance pravided by this endorsemenf is
additianal insureds, the fallowing additional ex- pr9mary and nancontributory.
clusions apply:
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mailing address. We will maintain proaf of 3. If ws fail ta provide the natice of nnnrenewal as
_ mailing of the nonrenewal notice. !�n exact required, the policy will still terminate an its
and unaltered copy of such nc,tice wllf also expiration date if:
be sent to the named insured's producer, if a. Yau natify us ar the producer who procured
known, or the producer of record at tl�e last this podicy that you do not want the palicy I
knawn rnai3ing address. The named in- renewed; or �
sured's producer, if known, or the producer �
of record may apt tc� accept notification �� �'�u fafl to pay aIl premiums when due; or
electrqnically. c. You o�tain other insurance as a replace- '
2. Ou� natice af nonrenewa! wil( state our reasons ment of the policy. !
for not renewing. ji
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RREMfUM DISGC}UNT ENDORSEMENT N�C DO 04 q6A(8-95a ;�
The premiurn for this policy and the policies, if any, ca(culation of premium discount wii! be det�rrr�ined �
listed in item 3 of the Schedule may be eligible for a by our manuais and your prernium basis as deter- I!
discount. This endorsement shaws your estimated min�cf by audit. Premium subject to r�trospectiv� '
discount in iiems '1 or 2 af the Schedul�, The final rating is not subject to premium ciiscount I�
SCMEDULE � I
1. Sfafie Pr+emiurn Discount �;
First NexY A1ext BaCance ;
$1Ci,Q170 S79D,�600 51,56D;000 �
IQWA 17.0°l0 9.9% 11.$°l0 12.3% �
fLLfh101S Q.0 9.7 11.3 12.3 i
2. Average percentage discount ... , .. .. .., . ... . .. .. . . .. N!A
3. Other policies: ;
4, If there are no entri�s fn ftems 1, 2 and 3 af the Schedule, see the Premium piscaunt �
Endorsement atkached to your policy number: �
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WAIVER C►F OUR RIGtiT TO RECOVER FRaNi OTHERB ENDOR�EMEHT wc�o as fs(a-�a)
We have the right to rec�ver our payments firom under a written contract that requires yau to obtain
anyone Ifable far an injury covered by this policy, We this agre�ment fram us.
wil[ nat enforce our right against the perspn or rar- '�his agr�ement shall not operate directly ar indirecfly
ganization named in the Schedule. This agreement tc� benefit any one� no# named in khe Schedule.
applies anly to the extent that yr�u perforrn work
SCHEDULE 4
GITY C7F DUBUQUE
RIV�R CIT�STONE D[VISIU�!t7F MATHY GC?NSTRUCTIQN CC7
PORT2EN CONSTRUCTION INC,PC7R1"ZEN�EASING!NC Pt�R"I"ZEN C3U9LDlNG
FIRM LLC
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FELLOW EMPLOY�E COVERAGE �g.70�q�gpqy
This endorsement modif�es irasurance prr�vided under employment or performing duties refa#ed to #he con-
the following: duct of yaur busin�ss, or the spouse, child, parent,
B1S-PAK BUSIM1fESS LIABILiTYAND MEDICAL EXPEh�SE brother or sis#er of th�t co-emptoyee �s a conse- !
COVERAGE FORM quence of such badily fnjury ar personal and ad- !j
Paragraph 2a(1), under the Who Is an Insured Se�- �P��ising injury, or for any obligation t� s�are dam- '
tion is replaced by fhe following: ages with ar repay someon� els� wha must pay �
damages because af the injury. Thi� does nat apPly
Bodily injury or Aersvn�l and adverfi�ing fnJury ta you tn yaur employees shown in the Schedule.
Qr a eo-employee while in the ccsurse of his ar her
SGHEDULE
Employees
ALL CJF YC1UR EPAPLpY�ES �
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advertising injury arising out of an offense to the canduct of any current ar past partnership,
commit#ed before you acquired ar formed joint venture or limited liability company that is not
the organization. shown as a Named Insurad in the Declarations.
No person or organization is an insured with respect
LIABILITY AND MEDICAL EXPENSES LIMlTS OF INSURANCE �
1. The Limits of Insurance shown in the C7eclara- most we will pay fnr injury or damage under �
tions and the rules below fix the most we will the products-campleted operatians hazard �
pay regardless of the number af: arising from all occurrences during the poli-
a. insureds: cy perind.
b. Claims rnade or suits brought; or b. The G�neral Aggregate Limifi shown in the
c. Persons or organizations making claims or Q�clarations is the most we will pay for the
bringing suits. sum af all damages because of all: �
1 Bodi1 in crr ra ert dama e and �
2. The most we will pay for the sum of all dam- ( ) Y � Y� p 1� y g
ages because of all: medical expenses arising from all oc- �
a. Bodily injury, property damage and medical cc�rrar7ces during the policy year. Ti�is �
Iimit applies separately to: `
expenses arising aut of any ane occur- �
re��ce; and (a) Each lac�fiion owned by or rented
b. Personal and adverfising injury sustained by to you. R location is a premises j
any one persan or organizatinn; invalving the same or connecting !l;
lots, ar a premises whose conneo- �,j
is the Liability and Medical Expenses Limit tion is interrupted only by a street, ��
shown in the �eclarations. But the most we wilt roadway, w�terway or right-of-way �
pay for all medical expenses because of bodily of a railroad; and �
injury sustained by any one persan is the Medi- ��
cal Expenses Limit shown in the Declarations. (b} �ach of yc�ur projects away from a �
3. The most we wiil pay under Business Liabilify lacation owned by or rented to you;
Coverage for damages because of property °r �
damage to a pr�mises while rented tca you or in (2) P�rsonal and advertrsing ir�jury arising
the case af a fire whii� rented to you c�r tem- out of all offenses corr�mitted during the
porarily occupied by yau with permission of the policy period.
owner is the applicable Damage To Pr�mises
Rented Ta Yau Limit shown for that premises The Limits caf lnsurance of this pniicy apply sepa-
in the Declarations. For a premises temporarily rately to each cansecutiue annual periad and to any
accupied by you, the applicable limit will b� the remaining period of less than 12 months, starting
Damage To Premises Rented To You Limit with the beginning of the policy period shown in the
shown in the Declarations. Declarations, unless the policy p�riad is extended
4. Aggregate Limits after issuanc� far an additional period of less than
12 months. In that case, the additional period will be
a. The Products-Completed Operations Aggre- deemed part of the last preceding p�riod for pur-
g�te Limi� shown in the Declarations is the poses of determining the Limits of lnsurance.
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LIABILITY AND MEDI�AL EXPENSES GEtVERAL CONDITION�
We have no duty to provide cover�ge under thss offense which m�y resuBt in a claim. l�o the
Coverage Part unless you and any nther involved extent possible, notice sh�uld include:
insured have fully complied with the Canditions con- �1) Haw, when and where the occurrence
tained in this Coverage Part. or offense tnok place;
1. Bankruptcy (2) The names and addresses ofi any in-
Bankruptcy or insalvency of the insured or af jured persans and witnesses; and
the insured's estate wili nat relieve us af our (3) The nature and location of any injury or
obligations under this palicy. damage arising aut of the occurrence
2. Duties in the Event af Occurrence, Offense, or offiense.
Claim or 5uit b. If a claim is made or surt is brought against
a. You must see to it that we are notified as �ny insured, you must;
soon as practicable of an occurrence or an (1) Immediat�ly record the specifics of the
CB-0006(12-12) Page 11 of 15
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