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Signed Contract_Dupaco Voices, LLC Temporary Parking License Agrement for Parking Lot at 1100 Jackson St. Copyrighted J une 3, 2019 City of Dubuque Consent Items # 19. ITEM TITLE: Signed Contract(s) SUMMARY: Dupaco Voices, LLC Temporary Parking License Agreement for parking lot at 1100 Jackson Street. SUGGESTED DISPOSITION: Suggested Disposition: Receive and File ATTACHMENTS: Description Type DupacoVoices, LLC LicenseAgreement Supporting Documentation � � Dubuque � THE CITY C�F Transportation Services Department 811•dmerica� 950 Elm Street � �� � aT��<�n,:����,.� Dubuque,IA 52001 ������� Office(563)589-4341 � www.cityofdubuque.org il Masterpiece on the Mississip�i zoo�•zo�2 � 2b13^2017 'I TO: Michael C. Van Milligen, City Manager FFtOM: Renee Tyler, Director of Transportation Services � SUBJECT: Temporary Parking License Agreement With Dupaco Voices i � I DATE: May 30, 2019 I�I Purpose ' Exculcive lience for Dupaco to use the area of East 12t" and Elm Street for temporary � staging of constucion equipment and materials. I; �;i ;i c: Discussion �� � Consturcion on the Voices building is scheduled to begin June 1, 2019 through May 1, ! 2Gi�. Dupaco has requesied presmisssion to use this area for s�aging their � construction equipment and materials, storage of constrction equiopment and � materailas and parking for contractors duing this construction. i; a� Budget Impact � ; None !� r; Action Required � Signoff and approval by the City Manager to enter into this contract. p � �����h���g ° � � P ill� � � I� � i i il� I� �� I Ij i �� I� I 1 1 � � i 1 � � � 1 k� ; ;1 V �I1 � � � � i I i I i TEMPORARY PARKING LICENSE AGREEMENT � BETWEEN � THE CITY OF DUBUQUE, IOWA � AND �� DUPACO VOICES, LLC i� ,,� � � This Parking License Agreement (the Agreement) dated for reference purposes � the 1St day of June 2019, between the City of Dubuque, lowa, a municipal corporation � (City) and Dupaco Voices, LLC (Dupaco), an lowa limited liability company with its I� principal place of business in Dubuque, lowa. , � WHEREAS, City is the owner of a parking lot which includes the area (the I Licensed Area) shown on the attached Exhibit A and by reference incorporated herein ;�; as though fully set out herein; and I� li WHEREAS, City and Dupaco are desirous of entering into an agreement where �a City grants to Dupaco a license for the privilege of using the Licensed Area for providing ���� temporary staging of construction equipment and materials, storage of construction ;i equipment and materials, and parking for the contractors working on Dupaco's 'I renovation of the property located at ii LOT 1 WILMAC PLACE (1000 JACKSON STREET � 225 & 275 EAST i� 10TH1, � , � locally known as 1000 JACKSON STREET; ; � NOW THEREFORE, in consideration of the mutual covenants and a reements � g k set forth herein, City and Dupaco agree as follows: i SECTION 1. TERM OF AGREEMENT. Subject to Paragraph 12, City hereby grants �� to Dupaco an exclusive license to use the Licensed Area for temporary staging of �' construction equipment and materials, storage of construction equipment and materials, � and parking for contractors during construction on Dupaco's site from June 1, 2019 through May 1, 2020. The parties may agree to an extension to the License Agreement jl i� w�i�i�g. � � � SECTION 2. PARKING LICENSE USE FEE. The parking license use fee (the Fee) for the Licensed Area shall be a total of One Thousand Dollars ($1,000.00) for each � year of the agreement regardless of the space actually used by Dupaco. Payment is to be paid by Dupaco to City by July 1, 2019 and July 1St of each year after the agreement � is in force. � SECTION 3. USE OF PREMISES. 050619CMB � � � i �� i i ij I I� �� i Ilj� i I II � �I � i uI I� �i . ;1 II i ' y � � ��I� I � . . . . � I��I� I��I � � �� � � „ li !J � @ . . � . . .� � I� � � � I�i � I � li � i: � � �1 i If 3.1 Dupaco covenants and agrees to use and occupy the Licensed Area for � a the limited purposes of temporary staging of construction equipment and ;� materials, storage of construction equipment and materials, and parking for its �� contractors only. I� [' 3.2 Dupaco is prohibited from conducting construction and/or demolition work ��� in or on the Licensed Area. j i 3.3 Dupaco is prohibited from staging construction equipment and materials, � storing construction equipment, and parking vehicles in the Pine Street right-of- '�� way which is located between the Licensed Area and the railroad'tracks. �I �� 3.4 Dupaco shall not place or allow any signs on or in the Licensed Area ; without the prior written approval of the City Manager. � � 3.5 Dupaco shall not place or allow any structure on or in the Licensed Area. �i l 3.6 Dupaco may place crushed rock, subject to approval of the City Manager, i; on the Licensed Area to make the Licensed Area conducive for staging, storage, �i; and parking. � '�� � i� 3.7 Dupaco shall put in place temporary storm water controls in the Licensed Area, subject to the approval of the City Manager. f' ,l 3.8 Dupaco understands nothing contained in this License Agreement shall restrict the access of City of Dubuque staff and contractors from entering the Licensed Area to conduct inspections, maintenance, or repairs to City property. � � 3.9 Access to the Licensed Area is via East 12t" Street only. � SECTION 4. ASSIGNMENT AND SUBLETTING. Dupaco shall not assign or sublet �� this l�greement or the Licensed Area nor any portion thereof. � I SECTION 5. MAINTENANCE OF PROPERTIES. Dupaco shall be responsible for I snow and ice removal in the Licensed Area at its expense. � � SECTION 6. RESPONSIBILITY FOR ENFORCEMENT. City shall not be responsible in any manner for enforcement of Dupaco's privilege to use the Licensed Area. SECTION 7. DEFAULT. If Dupaco shall default in the payment of the Fee hereunder or any part thereof, or shall default in the performance of any of the other covenants herein contained, and such default shall continue for a period of thirty (30) days after written notice thereof, specifying the default complained of, mailed to Dupaco by United States certified mail, then City may, at its election, declare the terms of this Agreement ended and re-enter the Licensed Area, with or without process of law, and expel and remove Dupaco or any person or persons in or upon the Licensed Area, using such force as may be necessary under the circumstances; and if at any time, by reason of 2 i �i � � � � I ; � , �� - � �, , �� I� I � � ;� �; :; �� '�� ,� ; � ,;�. �, � � � �� ) - i � � I � ,, i �, � P � � i such default of Dupaco and the continuance thereof for such period of thirty (30) days '� after written notice has been given, said term shall be so ended, Dupaco hereby covenants and agrees to surrender and deliver up the Licensed Area peaceably to the City. � SECTION 8. FORCE MAJURE. A party's perFormance under this Agreement shall be ;; excused if, and to the extent that, the party is unable to perform because of actions due ' to causes beyond its reasonable control such as, but not limited to, acts of God, the acts of civil or military authority, loss of potable water source, floods, quarantine restrictions, � riots, strikes, commercial impossibility, fires, circumstances reasonably beyond the � control of the party obligated to perform, whether such other causes are related or '' unrelated, similar or dissimilar, to any of the foregoing. In the event of any such force �!,� majeure, the party unable to perform shall promptly notify the other party of the ;j existence of such force majeure and shall be required to resume performance of its �! obligations under this Agreement upon the termination of the aforementioned force �� majeure. I �i SECTION 9. INDEMNITY. Dupaco agrees to defend, indemnify, and hold harmless Ii City, its officers, agents; and employees, from any and all damages or claims 'I whatsoever by reason of Dupaco's use of the Licensed Area and further agrees to I�,i reimburse City for any and all damage to the Licensed Area resulting from the use of i� the Licensed Area for activities associated with Dupaco's construction project and �; business. City agrees to promptly give notice of any and all damages or claims and to ,�� permit Dupaco and/or its insurance carrier to investigate and defend the same. !' 1 SECTION 10. INSURANCE. Dupaco shall at all times during the term of this j Agreement provide insurance as set forth in Exhibit B which is the City's Insurance '� Schedule A as such Insurance Schedule A may from time to time be amended by City. �'� I� SECTION 11. SURRENDER OF PREMISES AT END OF TERM. Dupaco agrees that ��, upon termination ofi this Agreement it will surrender, yield up, and deliver the Licensed � �5 Area in good, clean condition, substantially similar to the condition of the Licensed Area �� at the time execution of this Agreement. This shall include a duty to remove any '� surFace material added and reseed the Licensed Area. � �E�TI^LV '�2. Y�R�IRf��'100�. Ciij1 iii�y iGi'r'ii�iai� �ri� R�j���r►��ri i�r a�iy �ea5ori, wi�r � or without cause, upon thirty (30) days written notice mailed to the Dupaco by United States certified mail. � 3 � i1 ii �n u , i � d � I i i �' , �� �� ii ,, 1 �� i. �, � � � �I 'I � �� , ��� � � � � � i CITY OF DUBUQUE, IOWA DUPACO VOICES, LLC '� � By: By: Michael C.Van Miiligen , (� Its: City Manager Its: 9�PS3�� � � `�°'�'� I� �� �/n�� � Date: � Date: / �� � 1 1 � � Attest: ':I Kev' S. irnstahl, City Clerk '� � � � �� � �� I�� � �� � , G � I� � , � � I i II � � � � 4 k w � � I f �i � � � � � � _ � � � � � � '� li ` il li � � � � , �i � � � 1 i i i I� '� � ii � I � �� i; I f I f� . . � . . � � . � �� � II FI i �I Ili I� � � C � � � �..yp � I� W �' ',n�4�D N�tQ4l �. I A .Y Oy�.si�N�� I @��L ep h. �4.fi���j`.M � . i Q� a�,6��bN . f :�F✓-�,.� � �u����`#n i� :M� � w �QU: i a If � � �97 !1 ,� � � � I� f� G �i 11 � � � � � � � �i � 4 � � 'i � �� � � � � � W "� '`� � I' QQ � � "' 1 F � •� I ❑ � i, m w ,••� � � � � = 6/� � � _ � � X Z � u � g �, W � � .r J *� � � �a�r U'� Ca y q ,� � ��'�� a �� Y � o I; '� �n �, ; M II � � � �' � a����`� � . �Y C �� � � � ��� ' . ;;� �N ,r` � , `j 1 .. �N � M � r�'r ' �� . � � h GQ N x � � � M T�� ��� II r ,�`'�.�� v � � � m �� k Q � � � � � '� _� � � � y ��#� y � _ �� . �� r i S.a � �l' `'�;''° �� ' F�3� . �"� .^ �li fS��y� s S�`• ��.� `N'y M � O; �'."3C� a �fi�TU . r .�. ...M:. s';4 s�' .as .�.� , � � �t . q" � a � � . tA N � ���:a s� . a ' 3: N � zz;s 3 �S .':# r ���' �:t �` �Y£ �i • � m p..b4� �r0 N t�.y r��iE � � �ix� �. p �n ��A 1'9 e:! a�. ��.1� �� xdi`� . . II N N N � j . . i" *'- ;.r } _a�;k; i� ,! � � I �' . . i •!i � 1 ,; h i� � �f N i P j� _ � � �,, !; 1 � �� � �� r ;{ `'a l; �� � � N FI � � � � � � � �� � �i 9 � � �� � � � N � � � � � � EXHIBIT B '�� INSURANCE SCHEDULE i� �II ,, City of Dubuque tnsr►rance Requirempnts far L�ssees of City Propertyrand I�ight of Way II �icensees orP�rmittees Ij 1NSURANCE SCHEL7�ULE A �i �i � 1. shall furnish a signe�cert4fica#e of insuranoe to the City of Dubuque,lowa for t�e �I coverage required in Ejchihi#9 prior io the 3ease,license,or permit commencemet�k.AEI lessees Qf �i City�property and righ#of way iicensees ar permittees shali submit an updated certificate II� anr�uaEly.E�ch certificate shall be prepared an the�ost currer�AC�RD�orm approved by the II lowa lnsurance Division or an equiv�leM.Each certificate shall incEude a staterr�nt u�der �� Descri�tion of Opera#ions as ta why the csrEificate v�as'rssuecl.E�: Praje�ct# ar kease r�f i premises at ar coi�tst�uc#ian o3 pr right uf way permiited I� . locatian arx9 c�escri�rti�n Lease F�qreeme�t dated = '�! � ��� , 2. Akl palicies of ins�rance requir�cl hereunder shali be wi#h an insurer authorizeti�a dc�husiness in ilj lawa and all insurers shali h�ve a rating of A or t�etter in th�currerrt A.M.6est's Rating Guid�. �! 3. Each certiticate shall be furnisheci to t�e bepartmert vi the Ciiy of Dubuq�€:, i{ li 4. The lessee,licensee,or permittee shall be r��ufred#c�carry th�mi�imum coverageAimifs,or 'I greater if required by law ar other�egal agreemer�,in�xtaibit I.��ilure to pravide ihe rQqu6r�d min�mum coverage shall not be deemed a waiver of such requ}remer�s i�+kMe Cit�+of Dubs�q�ae. �'i ii 5. Failure ta obtain ar rr�iritain the required�nsurance sha#I iae consid'ered a materi�i txeach af#1� ,� lease,Iic�ense,or perrrr�t I ii fi. A61 req�ired�ndoeserrrents s�ail be atlaGhed to certif�oate. ii i'� 7. Whenever a specific�SO form is referer�ced t�e current eciifion of the form snust be used unless i an eq�rivalent form is approued by the Finance Directc�r,The 9�ssee,lic�nsee,or permi�te�must ; . identify ar�d lis4 in wriiir�g a91 deviatdons and exciusiorts from the ISt�ft,rm. I Ii 8. Irt lessee's,liCer�sse's,or perrnittee's�imi�s of iiability are higher than the requlireti m�ni�um limits { th�n th�lessee's,lic�naee's,pr permikkee"s lim'rls shall be fhis agr�emenPs requir�d 9�rraits. ', i �. Lessee,licerosee,or permi�tee sha(I requFre adl sul�vn#ractars and sub•su�ar�actors tv o�tain J atid maintain during the petFormance of wark insurance far tiae cnvera�es descriE�d ir�this Insurance Schedule arad shail abtain cerfi�c�k�s af insurance irarn all such subcantractors and sub-sul�contractcars.Lessee,lic�nsee,r�r g�rmitte�agrees th�t it shall kre li�ble tor the failure c�f a suk�coiiiracYor and sub-subcarrtra�tor to ofatain and maintain s�h coveraga The City may j request a capy of s�ch certi�ir�aai�s from the lessee,licensse,or,perrnitfee. !i u � � h II n � � Page 1 of 4 5chedule A Lessess Of C�y Property;Right 4P Way Licerisees ar Psrmittees NovemFasr 2977 6 � , � � � � � � i� , i . � i I � �i ii �� �� i II �� r� , � I; i' i k�i Ij I�i � I li � �� fi � il � � � � � r li �' � � � � s � � � [ � � � � � f, Ij �i#y of i7ubUque Insuran�e Ftequirettien#s#ar L�ssees of City Property and Right of 1Nay Li�ensees or Fermittees � INSURANCE SCHEaULE A{Continued� � ��rsi�i j . �i ' A} �QNAIUIERCIAL�+I�NERAL LiA6I�.ITIf' i Generai Aggregafe Limit �2,t1b0,000 II Fro�ucts-Cornp��ted Opecatians Aggregate Limit �1,000,�00 ii F�ersnnai and Adverkising Injt�ry l,imit $1,Ob�,000 I E�ch�outr�nce $1,DDO,ODO ' Fire Dama�ge Limit�any ane�ecurren�� �50,400 Medical Paymerrts �9,OOQ i ;i , 1) v�ver��e sa�ill u�'vrriii�n�n ai�r�ccur�en��,i�c�i�iairris maae,iorm.i ne generai � I�abifty cc,uerage shall be writter�9n accord wi#h ISt�farm��OOD1 or business ;; kwners ftrrtn BP{)piJ2. A!I deviati�ns frarn the standatd ISJ cQmmer�lal general �� liability form CG tI0Q1,or Business c,wnsrs form�P OQQ2,shali be clearly !i identi�ed, � 2} Incl�ud�ISO endorseme�t f�+rrn C�25 U�"Designated Locatlan(s�General jI; ,���ee�ate Umit"- il 3� Ir�cl�de�nc{arsement i�dicating that coverage is pr�mary and non-contributary. li 4} Include Preservafiqn af GovemmerAa!Immunities�ndors�me�t(5ample II atk�Ohed}, I�I �) incl�ade additional insured endarseme�t fqr: , I�i The Cifij of CJubuque,irscludonq a!I its elecked�nd appai�ted c�ffiicia�s,all its '1 empla}rees and volunteers,all its boards,cor�missions ai7c�o�authorities and ;;� their b�ard meml�e:rs,employees and vQiur�teers.Use 18C7 for�CG 2010 (�!"!�tll�l�nr�r���trr�nr�,7 nr i�c�+,rv��j!dalapi ' 6) If lessee,license�,or�ermitte�ut3lizes Trikk�s or Segways in the canduct of � business,include an endorsement refiectin�that these veMfcfes are tnot excluded j from Gammerc9ai General Liability�average. � B) 'k�RKEIiS'GflNiP�tJSA?'ION�IE�fIPL0YER5 LtAB1LOTY I' Statutary benefits cQvering ail employees in�ured on the job by accider�t or diseas�as fI prescribed by Br�wa Cocie Chapfer 85 as arnende�i. Lj Coverage A 5tat�tary—State of lowa � i Covera�e 8 Em�ioyers Liabifity q' E�ch Ac�idenl $1t10,C1rJd Each Erti'dplo+,�ee-�isease �100,4�7Q E�nlicy Limit-[�isease �5f�,p00 f Frolicy.shalk inc6ude 1Naivar of�2igl�t#p F2ecover from C7khers entiorsement. � Nonelectir�n of Workers'Comper�saticsn or Empl�ers'Lial�lity Govera�e under Eowa Gc�de s�c.87.22 _yes _fprmatkached � �age 2 af 4 Schedule A Lessees Of Cdy Properiy;12ight Of Way LicQnsees or Psrmittees Nnvember 2017 � 7 �I m � � � � ;t I� �� ii � � � � !j �I i ; �� �� ��1 � � ;i li �I� a �I i; � iii � !� II� , � , � i n ;; ;, �, � !i ;, � � � � � �i i3 'I I� �' �� II � � � � NI R � I U � l � �'i City o€I�ubaque Insurance Requirements for Lessees af C�ty f'roperky and Right of lNay Licensees ar Permittees � INSURANCE SCHEDULE A (+Cnntin�ed) � ;� c� �n�vi�c�r�ra�ra�rA�.ir���i►��n�N�r��a���.�rr o��o�.�.ur��►r�uae�i�i�r � ;i Cvverage required: �yes i no i; �I Pplfution liability caverage sh�ll k�required if#he 6essee,Gant�actir�party,pr parmi#t�e �� h�s�ny p�r8ution exposur�!or ak�aCement of�aza�dnus vr cantaminat�d materi�ls ' incEuding,but no#limii�ed ko,pe#toleum praducts,�he remcavaS of lead,asbestos,ar PCBs. IT Pal4ukican praduci ancE coKnpleted operations coverage shall als+�k�e couered. i Eaah ciccurrence $2,O�Q,t7�0 I{ Policy Ag�regate $4,0�0 000 �i 1) Policy io inafude job site and t�ansportation cov�rage. � 2y fnclude addi#ianal insured far: Th�e Ci#y of Dubuque,in�luding all its elect�d and a�apoi�ted offc6als„afi its I ernpirayees and volunteers,al&its br�ar�is,cornm�ssicrns�r�dlar�arthori�ies and their bcaard members,empioyees and vcrlunteers.Use IS�7 torm GG 201�4. �l, (Ongc�ing operatians)as s�ated in At6)above or ifs ec{uiaalent. I� 9) Include Preservat�a�i of t3aven�me�tal Immunl�ies Erodorsemer� I� �1� F�rc�vide�virJerace af Ct�verage far 5 years after completian of prtajecl, II �}� PR�PERTY�NSURAN�E REQ�JI'R�Q 6Y L�AS�,LICENSI�,C�R PERA�IT I; II � .�Y� �� � � � �vidence o#property couerage prov�cied: „�yes li Iricluded the City ot Dubuque as Lender Loss Payabls. �{ i �I �} RIC;HT-Q�-VVAY 1Na32K L1NLY: i UMBRELLAIE?�aC��S $1,bQL1,00t3 � � r „�.yeS ____n° Umbrellatexcess liabiEaty coverage m�ast be at leas#follaw�ng f4�nn with the underlying j palicie9 includEd here[n. f, � Pc�g2 3 vf 4 Sce�edule A Lessees Of Ciky Praperty;Ftight Of Way Licensees or I'ermittees Novernber 2Q17 g i i � �i �,� � I� � M1 u � 1 i� I� � i 6� �, �� ; 'I 'i ji li ,; �� ti � f ;i :; � �� ; 1 � � II i I ;I 'I ;i � � � � � � � 1 � �ity of I]uBugue 4nsurance Requirements for Lessees of Ciiy Prnperty and Right of UVay N.icensees or Peranittees PRE aERVATIC3i� C�F Gf�VEFtNMENi"AL IM�VIUNI�'IES �ND�OFtSEMEN1" �' ,3 li ; 1. �lamvaiver of Governmerit�l fmrnuni ,The irr�urer expressly agrses and states#h�t the purohase � af#his policy and#h�irtc[udireg of t�e Clty of Qubuque, Ir�wa as an Additlanal ir�saared does not waive any � of the defienses of gavernmentai immunity avaiiable to the�ity of Dubuque,lawa under Code oF lowa � Secti4ra C�70.4 as it is now exi�ka and as it may be amend�d from time ta time. ;� � 2. Claims Cov�.,The insur�r f�rther�grees khet this policy of insurance shall crauer Qnlythose �� c3aims r�at subjeot t4 th�deferase of gauernmental immuniky under#he Gode of lowa Section 67�.4 as iC now exists and as i#rnay be amer�ded frorn time to time.'F�ose claims not subject ta Code of l�wa � wectiar�67�6.4 sh�l1 be covered by the tefms ersd condi#Ic�na of it�is insur�nce palicy. 3. Asse�kion of�ovemn�ent Imrnuniiu."fhe City c�f Llubuque,Icrwa shall be res�nsible for asseriing '; any def�r�s�ot gou�rnme�taf immuni�r,and may eka so a1 any time a�d shall do sa upon the#'srnely wrutten I �ec��st af�he insurar. � 4. �pn-[�eni�l qf CQv�raae.The irasu�er shall nat deny coverage under this po6oy an�the insur�a shall not d�r1y�r�y af th��ighfs and benefits�ccruir�g t�the City of C�ubuque, lawa unc�r this palicy fnr j �e�sans�f,gauernmental ir�r�unity�nless and aaMil a court of ccrmpetent Jurisdictian�s ruled in favc�r r�f � the defense(s)of governmertfal immunity asserted by#�City oP Qubuque, lowa. i � Np bth�r Chanqe�n Poli�.7 he abaue pres��vatian�f gvvernme�tal immunities shali not�therwuse oi�ar�ge or alier the cavera�ge available under th�policy. :� � � �� � � ���� � � i� � '1 , i� �� a {DEPARTMENT MANAG�R: F3LL 1N ALL B�LAMKS AND CHECi�BOXES) � � I Page�1 of�4 Schedule A Lessees Qf City Rraperty;Right C}f Way Licensees ar Permiriees November 2Q17 ; �@ @ 9 � � � � �� � � 1 1 � ;i H �i i :� I; � � �i �I �1 I ^ 'I � � � � � � � 7 u n i� i 9 � � � � i r, � � � ii �"'� � �+ p p�+p A�p gp���+ p� o+�rE��wwomrvl '`��� �,.r�fti���l4di�� �F��� MF �����11Ys:�F�F1M��� 0210112019 y THIS �ER7IFIGA7E IS ISSUEb AS A MATTER OF iMFARMATICIN OML�AND�D�tF�Rffi NO RtGW7�UFC►ii THE C6RTIFICATE HOLDER. THIS � C�I2TlflGi4TE ROES Nb'T AK�iCtMATISIELY` QR NEt3/1YIVELY AMENI7, EXTEND Oft XLIfR THE CqYE12AGE AFfORt1ED !�Y THfi 1'1?1IG065 ,� BELOW. TH#S CER?tFIGATE QF INSURANCE DOES Nt�T CONSTlTUTE A CQNTRACY 8E'iiyEEN 7HE 1&9UING fNaURER(S�, I�UYF141RiZE� ia REPRESENTATlNE 4iti PRODUCER,ANii THE C�RTiFICA7"E H04DER. :� (MFORTANT: I[#hp CeRlficate hold�r Is an ARDITIQNAt INSUR�tl,the potecy{iesj must�e�nddrsrd. N SU@I2C?GAT6�lN IS WAtVEd,�ub)act ta tha � tcrms end conditions of ihe poticy, certstn palicies may requlre an�ndorsempnt. A siatemene on th6s cartdiieste doas n�t rt�nfsar righ4a to ihe , ceROfleate halder in 11eu oY sush endarsemen!{sj� 1 j 4 vaonucE� � • L7Uf�AC01hlSURAPICE SERVICES LLC �.Na.EacY_55�551_2600.E2C[210.__.__._ i��,No) `a.63•582•5Q60.__.__ i �9J9 PENNSYL4�ANIA AVE .�K�'` .,____�._._...�.. i ' xgpa�ss;lh1SUHANGE�pZt7UP�RCq.GQld__._ . -- D1.1B11{�l�f�.IA 52Q�4-d179 PRODUCER .�UBTAAfER10l:__��_ -- i � � � INSUREH�S}AFF(SROING CQSYERAGE __ ... • NA1F Y � � .._.._______—_�__._----__----_._- ----.�.__..._^_—�._._._ _____�. �j , ovsusa¢o �►rsuaeaa WE.ST�ENO MUTUAI iNSUR�#NCE _ j; f3UpACQ HQLi?lhlG k.t� en�ur��a s: _.._ �____._�-^� .. _.�_ '' aUP.ACfl Vt31GES li.0 _ . - _ - {- `- y MlsuR�R C•� ...._,_ ___ .__.____._- -- -_-# _,___. PCD BOX 17$ �su�ea D ` _ S � !' DU8UC3UE,IA S�'004•0179 "'��� .__� ���. , � INSUR#Il E: � ..._.____.._<�....._�.._.___..,_.�. ____......._ . ii iasua�R�: RE1!l5l9NNUMBER� � i �;r�v�s�qr_.�c cF�gi��GAT�+N�t���R: . THIS t&7O GER71F1"7HAT THE Pi?L#CIES{?F lNSURAtdCE i.15'fED B�I.t3W MilVE 9EEN ISSUED TO TME INSURED NAMED A90VE F(}R THE PC�.1GY P�FtiOp � i ftd�°ifCA7El3. N07'1MTMSTAhtDihtG ANY REGtUlRCAAEN7,7Ef{M d7R CtN+�DITI�lN OF ANY CDl�ITRACT OR C)TWER pDCIMA�NT V477H R�SPEGT TQ WHICH THIS z GERTi�'ICATE kiAY SE 1$SU�D OR MAY PERTA�M. THE IN5URANCE AFFORCsEL?BY�'HE Pl?LiCiE$ DESCRIB�D HE}2EIN !S SUBJEGT Ti�R1-L THE'�R115, ;; E}CC4USIbNS ANt7 CDNC11'Tlt7N5 i'�&l9C►t POLICfES.tlMITS 8HC1M+N MAY NAVE BEETJ ltEaflCED�Y f+A1R ClA1A�S: �, ____..�..._____._,_ .______..._._ �IMBR � � ��. - �A'b�SUBfi-..__..��'•.�.•.� ,POL�Y EFf ;POLICY E7fP LiMI'PS . � LTR� '�PE OF INSURhNGE � p47ttCV MUMBER � �MVYY:I MM1D0 Y�_�{'.�' �� .. � - I_ cEra�w«u,�au.�r � . �Ot12812p19�0112812Q20 �cnoGcuaa�Nc:� 3 _.�.l.�ii9 ,� P ! ASS9493 1 �D',a�GE'ra �_�`X�c�r�a.+€�te�u c�KEsui.ur�urr �- 1 R _�?�M�€S L�.s.us��� s — li �* lewtns•�wn� ���joccu� �1 ^ �: ! �Mep�t�+»ew�am _�-s�•- �..� li .�.�.�_ _ ..... _ � � � � � j PERS{ANAt�$ADYlNJIH2Y...�.A.`�-�---- ����- Ij � � � f � _J j � � 'GENEfiAt.AGGF�6A7E �„S__.�--2G�-�+��- �� 1 C+�MI AGCaREGATE U1�1T APPtlES fiEl? � 1 'FFtCiDUC75�CUfARtpPAGG§S .._'�„Qj){}a�QQ . I;_ � � t ( j � '. i (� .s_"-- I, � .._.1 POLFCY`.__. �4 �1.4C • . i I . � :� � COk9BlNEO 51NGLE 1.{MIT I', �uvoMnan.g un���orr 3 It�^��0252548-22 ; �#Fa ar,�rae�,r} �5�. 1.49U.OW � `r°��,�ANY AUTD z�:�P i � � ;60p4Y INJURY(Per UDrsunJ =a �T .._._. ' �d...�wL4L>vYNEDnUT6S S � � � ' i90tl:1ilY�NJURY(P+ara�denii 3��.._...�_�._.� j - i sc���nu�.eonvaas � 1 � ' �r��aar�rzrv�rAw++:c � S 1 � :HiREo asur+9s ' � � j t�r scc�c asnr� ^._ �. } 3 I ` � ' �, . 1 NON-0YMEO AUTOS 0 S i E � P--- � """"'"_ ! -i , f � j � ��� �; , ! !X I UM8REl0.AL1A6 , � , .. . , � atir��r2a�s�o,r�sna�o �cb4ccu���,�E s 9�,t�oQ,poO. � �� t>Ccua � � 0252546�"c2 F C j��E%CE.SS4IAB T_ �..J.;CUtMS-MAUEi�v�I"'�; � � . AGGitE.GATL S �r����IQQ c. � • � h�� � � � � �DFOUCTfHLE i �__._,.�,�.__.__._ _..__��r_ � E RET6MIflON S i I � � � i �Wt?RK@115 COMPEN$A3'ION �. .� . i STA7U- N. ...» ,-. . . � �' }Alda�L�M!'IOY�RS'UAbiLRY r � � �.-t-T.UL.Y.}eL.uJL� -�a �� �MNY PI��,iPNiEYQ�'A73'TNERi67CECU71V6 Y J N� � � � �E.L�EAC3#ACC�'.NT,��� . .,. � `OfFICENMEb@JEREXGl170E�7� �;NiA;�� . i .! E.LOfS€ASE..FAEMPLt?4� 5.�.e�.._._... �IMand�texp M NH) � � i � . . ��' ;KylS.i!@SCtib8uf�0er ; E.4.QIS£ASE•Ppl.i�G�'lIIAIT S i b8 A f�'' I � I r � pESCRtPTYpN Oi OPER.aT�tHdB f LQCAri0N5 J KEHlC�ES Aaaeh AtDRD 18a,#qdivw�t Rtr»nha Sch•dui:,H man a aw i�vwpul+w!} � � � The City of Dubuque, 4ncluding a�ll its elected and appointed �rf�'icials, all its employees and volunteers, a17 its boards, commissi�ans and/or au�horities � and 2h�ir baard members> employees and va1uneeers. Voiees bu�7ding, 1Qth d+ �acksan Sts., tsub�aque, �A 52007. ,� 9 c���tFac�are NOLo�� cA����.ukrioa ., ' C!"d'1"tJF[3UBUOUE E��.Too�a�TNEREt4F�.lD6oCHCWlBI 6�OELNEREII IN�CORPI.ilCEfWITN Tti� ° - � � pOLICYPAGVISIi}N$. 50 W 13SH ST QUBUOUE.iR 'S�AD1 AUTMdAi7.E0iiEPRfSENTAi'VV£ . � i ����t'��e,�,�,�"e'�"' Q i986•1dlDA ACtaRp CORPC3RAT90N, lRll righta reservrd. RCqRC!2S�2tDO8109) The A�C1R[7 name and Iagcr are registered marks af AGOitp � � � � g��y ,i�+ p/� ,pwC ahne{rwipom�v++1 � ��� 4E1'4. 1 ��l�rM i E �� 1"'('ti.V��R 1 i �IM+ti7��4MNLG 02101t2019 I I� THIS CEFtTIF1CATE 15 1&SUEO AS A MATTER 4� IN�ORMA'�IC1M 4NLY AN[f GONFERS NC7 RtGMTS 11PON 7HI�C£R7IFIGATE MQLOER.7Mi5 � jI CEiiTIFICIITE C1U�S M1�"f AF�fRMATiVELY pR NEGATIVEI.Y AMENQ, 6?t7ENt�QR XLT�R THE COV�RJkC,E AFfORDE� BY TNE PQLICIES i � gELOW. 7M�S CERTIFiGA7E UP INSURAMC� i]OES NOT CpNST17UTE A GONFRAC7 BETWEEN THE iS6UtNG INS1lRER{8i� /►UTHORIZEU � � REi'RES@NTATtVE OR PRQdUCER,ANA TME CERTIFICATE H4LDER• �i !f thls eeskPfiCa;e)t bting pr�pa�d 1or a party who has�n irtsurabie intanrat ln ihe praperty,�lo nnf us�thia fornn. Use hCORD 27 a►ACQRCI 28. ; i c �rc PRbD9CER � . - .. DUPACO lNSUFiANG�SERVICES lLC ���� 563-557-76D0 EXT 2'!0 __- _---j�ac I+J: -. - ----_- : , ��uL�`Exll: .... ; , INSURIRNCE DUPAGfl.COM � 3999PENNSYL�ANIAAVE ��.__ _.-°�—.----_----- ------------._._ _ -. j []UBU(]UE,IA 52002 p���R �51�74MRtlt�: . . _ ___________ ._. � � . 1N$VR_ER{9)AfFORDlNGGOVERi�GE_� . MAIGI � . : I . _._.._. _ _......__ i � . ._.__.. _.�._----'�--• -�' �- ...__-__ .. -_ - � 'r . .. .. ._____._.�._._.._....._._..�:_, _.� . . �suREo MsuREt?_�;iNESTBEtJDMUTUALINSURANGE_---. .. � _. __�__... � ' _ ..__�_._..��_._--�_�, i _�� ' ; DUPACt}WDLDIN�LLC �+sukex e; ._ � __—__. --..�___------__.._.�.—__�.�,.._ � i� DUPACO VOICE�LLC p+aunrR c�,.._�`_._ ._.r_�_ _.___ -_�_ , � P�8{7X1T� wsuREau_—_. � �___ __._ .__ i il DU6UG}UE.iA 520C14-Oi79 pi_suREgE; __.____ F' `; __._—.._.__._ _ _ I1 COti►ERftGES CER7IFIGAtI�NUM9ER: �+suk�.a�: REV'iS10N NUM�ER: E I� �ec�7iotJ OF PFkEMlSES}DESCRIPtIQN Oi PppF'6RT'Y�AMach ACd1tA 1p1.Addltionat R�roa�f�ScMHu4r.il mon aWcr M tequMMf .� � �' � VOIG£S 6UILGING.1dTN 8 JAGKSON 875,C?UBUQUE.IA ` ;� [ THIS i3 TO GBRTIFY 7H+4T THE i?OLMGjES OF 1NSURANCE I,ISTED 6E40W HAVE BEEM ISSU�O 7A 7H�INSURED NAMEb ABbVE�OFC TNE POIICY i'�RIOD f � TWITkISTANC31N�AP1Y REQVIR�iAENT,T�RM C?R.CONRI'�►QN pF ANY CAN7RACT OR OZH�i2 pDGUMENi WITH ftESPECT TO WHICN�7NI5 II INDICA7E0.NO � CERTi�ICATE MAY 8E iSSUED OR MAY PERTAiN,TH�IIVSUftAiVCE A�FORDED BY TNE PdLICiES DESCRIBED HEREtN 15 SU&JECT 7C!Atl THE 7ER S, EXCLUSIQNS AND CONI39TIOhiS OP SUCH POLICiE�.LIM1T5 SHCIWN MAV HAVE BEEN R�OUCfi?BY PAIp Ct�+IM3. - __ ._ ----- Ii __...�....�..,_. ._..�_--�_._. 1 _-- � T _.____._�..._..___��.._.._.. _ _ � 1HSRI . . VW.ICY'EFFE�TNE POLICY EXPiRATJON GOVEREU PROPERTY 1.11M7b ; I I TYVE OF INStkR16NCE PDt4GY MUMBEX OATE i��DNYYS�� GA7E(MIWD21f WYY1 i I 3 iI tTR .. .��----' NYY� . � I }�," »w�piN� s _1;SDD�OpD �,_ j PtttSaiEFt'tv __ _ CAUSESL?F LQS5 :OFDJCTi$LES : ` . PERS�.lFJAd PRCWEATr' a _ __ � � •� E "_. . - _.� � � _ < < �@A�1C �BUiI OtNG �i � � 6d9iNE55�NGDME I �I e .--.- . '� . � � EJilRr4 EXaBNSE � � �$ROAd �� 4 �_.�.._---.�.._.._ t i�{�6PECIAL . �C6N7EN1'b ; . . � j � ,ftEN7AL VALUE �8 . . . � r i __.._.... .-�...----�-� ' !BiAMKE'T BUlLCNNG . .� �.. .._.. I . i f EAFiTlibllAK£ � _.��,.�k,.,,�Fae {11128t201$ Olt2$1202fl y.. ;.�...._ .. i� --- - ------ ( � � u�.n�ns:��na q::n�,n � , _: __ ___. � � ;��� .... � .. .� �`..r BLANKEi BLU4 B PP s '.. , __�_i ; !�t;I BUiIdBP9 FiiSk ; 37,Qt1D UDQ _..._ : _-�-�._��_ ._ --__; , � �- '� � . � NlI.ANp MkRWE j TYi'E OF GDUCY .. � _ �s ._.. .._._ � Co.USES C�`LQSS � I � _� . � � -_.. NAMED�pERtLS � PfJIICYN;lM&EA � '. �$ ----..�"„"'_.•... � �--� � �� I S h 1 J ,s._,_______ i � �CRIME . � . { . � ( — --"'_--.. : . � �1 aYpE{7F PCk�CY ' � ! . . .. ! i rs C t ` I BOk£R a YACNN#EIkY i . +S ,� _ . g i� ..�.�EfM9M'b�NT6REAKD4WN � � 'S �) � IS i i� � � � � BPECfAL CCNQiTWNS i Ot'NFJi 60YERACES(�tlaeh AC4RD tpi.I1d11iU0Ml rIClYlyfltf SChY1�YM�ii lnon��rare 7¢s,�uindj '.: o 1�OSS PAYEE/ADDITiONAL �NSURECt The City bf Dubuque, including all its elected and appo�nted offieials, all its employees and voiunteers, all its boards, commissions and/ar authorities and their board members, empluyees and valunteers, CEftTIFiCATE HQLC?fR CANGELLATION . StlIaULD ANY QF�N6 A6DVE C+ESCRl86D POI�ICI6S BE GM�GE4LE0 BEfORE 4 7HE E%PiRATIt7N DA7E Yi1EREG1F,NOT�CE iR"ILL 6E DEt1YERED W CITY QF pUBUf�UE AC�i�RDANCE WITN?'HE PGUCY PROY�SIQNS. � - �JO 1N 13T►1 ST� � AU'I'NDpt2ED RE.fiRESENTA7tVE � . '�. �U8UQIJE.IA 52007 �C� G�1995-20tT«1 AGCIRD CORFORkTIQN. All ri�hts reserved. ' AGC+Rp 24�2Dp9l09} The ACbRD name and logo are tegfstered marks a#ACORII i° i MM�..+w��11�� .�Fr,1lQ � � A MU4VA4�NSUAANC4 CbIM1PNtVY• � ;� WcsE Bend Mutual Tnsurh�ce Campanp 1900 S.18th Ave. {\Yrest BeeFd,�UI 53495 Endorsement Policy Change Summary Declarations --�-�---�-�--� - - - ¢- � Cu�tomer Piumber: 0110079384 Policy Period: 01/28/2019 to 01/28/2020 Poiicy Number: A559493 00 � at'i 2:01 AM Standard Time at Your Mailing Address Shown Below � Named Insured and Address: � Agency Name and Address 14075 !' Dupaco Holding, LLC QUPACQ lNSURANCE SERVICE� � 3299 Hillcrest Rd PQ BOX 179 f Dubuque, IA 52001 DUBUQUE, IA 52004 I 563-557-7600 � j ,� .���_._____�_.__.__..� �__.__�..._ II Chan es have been made to the above alic at our re uest ar at the re uest of our a ent. Please read them carefull � 9 P Y Y q q Y 9 Y� J ii Below find a summary of the changes to the Coverags Part impacted.All other terms, conditions, exclusions and provisions j; of the policy remain the same. See attached Declarations for details. ; ;j �'jl EfFective Date of Change: 05/01/2019 �; Coverage Part and Description of Change ji �l Coverage Fart �;{ 1 j Commercial General Liability Coverage � � � Added: � � � Location -460 E 12th St, Dubuque, iA 52001 �� ;� Summary � � I� The above changes result in the following Tota! Net Premium Change, Net AdditionaL $1 AO � including Taxes, Fees and Surcharges � , � . This is not a bill. i� Any premiun7 changes will be reflected on your next schedul�d invoice. � �� � � DPCS 01 04 14 05/10/2019 14:35:17 1tViE�T BENE! I h MUTUAI INSGAANCE CUlBPhNY• �West�end dvlazual tosucanca Carnpany 19Q0 5.1�cli Awe, j Wrsr Bcnd,1�+T 53095 Endorsement Commercial Lines Policy Declaration � Customer Number: 0110079384 Policy Period: 01/28/2019 to 01/28/2020 Policy Number: A559493 00 at 12:01 AM Standard Time at Your Mailing Address Shown Below Named Insured and Address: Agency Name and Address: 14075 � Dupaco Holding, LLC DUPACO INSURANCE SERVICES � 3299 Hillcrest Rd PO BOX 179 � Dubuque, IA 52001 DUBUQUE, IA 52004 563-557-7600 � � I � f In return for the payment of the premium, and subject to all the terms of this policy,we agree with you to provide the I� insurance as stated in this policv. ' - j This policy consists of the following coverage parts for which a premium is indicated. This premium may be subject to � adjustment. I� i I� Coverage Part Premium I� Commercial General Liability Coverage $34,431.00 II i' Total Premium: $34,431.00 � Tota► Including Taxes, Fees and Surcharges: $34,431.00 � � � This is not a bill. A billing invoice will be sent separately. , i See attached schedule for forms applicable to all coverage parts. !1 � � DCP 01 01 18 05/10/2019 14:35:17 � WEST BEND ` A MI/T4Al�NSUAANiE LOMPANf' Wesa aen�Ivlwcual Insurancs G�mpany 19005.18thRve. ! WrsxBcnd,vvisso9� Endorsement Commercial �ines Policy Declarations � Customer Number: 01100793�4 Palicy Period: 01/28/2019 to 01/28/2020 � Poficy Number: A559493 00 at 12:01 AM Standard Time at Your Mailing Address Shown Below i Named Insured and Address: Agency[dame and Address: 14075 ;I Dupaco Holding, LLC DUPACO INSURANCE SERVICES 3299 Hillcrest Rd PO BOX 179 Dubuque, IA 52001 DUBUQUE, IA 52004 '� 563-557-7600 ,� � � ��. �,I � � � � Loaation�Schetlule� � � � '�I Loc Address City County 5tate �ip i � li 1 902 White St Dubuque Dubuque IA 52001 �� � � � � � � � 2 990 White 5t Dubuque Dubuque IA 52001 '� ii 3 460 E 12th St Dubuque Dubuque IA 52001 ii ,'1 �i � � � � i j�i I� � � �� �� Il � i� i '� 1 . ,, � � � C ;, � � , � � � � DCP 03 04 14 � 05/10/2019 14:35:17 A � I 1ME�iT BEND I. A MUtl'UAl ItMafAhN[E f(YMMNY" West Rea�d Muival lnsuraoce Campany EIlC�01'S@I71211t 1900 S.18ch Av�. �Wese$end,Wl 5309$ N Commercial Lines Policy Declarations � ;� Customer Number: 0110079384 Policy Period: 01/28/2019 to 01/28/2020 ,� Policy Number: A559493 00 at 12:01 AM Standard Time at Your Mailing Address Shown Below :� Named Insured and Address: Agency Name and Address: 14075 ;� Dupaco Holding, LLC DUPACO INSURANCE SERVICES ,� 3299 Hillcrest Rd PO BOX 179 � Dubuque, IA 52001 DUBUQUE, IA 52004 � 563-557-7600 � ' '�� �) a � Forms Schedule j � Number �dition Description ,I� IL0017Z 1198 COMMON POLICY CONDITIONS � IL0021 0908 NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT(BROAD FORM) „ , IL0985Z 0115 DISCLOSURE PURSUANT TO TERRORISM RISK INSURANCE ACT W6660 0109 TWO OR MORE COVERAGE FORMS OR POLICIES iSSUED BY US '1 ij W6214 0417 MEMBERSHIP AND VOTING NOTICE I� IL0276Z 0908 IOWA CHANGES=CANCELLATION ANp NONRENEWAL �' c � � � � � ,� ,; ;i !i la �1 �; u ;l ,; � ;i :i il � ,� I�1 I � , � � DCP 04 04 14 05/10/2019 14:35:17 . � w I � WEST BENO ' A MVTVAL iN541RkNt[COHRAilY^ WesG 4end Musual lnsurance C:umpany ��aos.�aa,,�,�c. � W�ssrn�,vvt�3o�s Endorsement � Commercial General Liability Classification Schedule � Customer Number; 0110079384 Policy Period: 01/28/2019 to 01/28/2020 � � Pol@cy Number: A559493 00 at 12:01 AM Standard Time at Your Mailing Address Shown Below �i� _.___�� �� Named Insured anci Addr�ss. Agency �lame and Ad�lress: 14075 �' Dupaco Holding, LLC DUPACO INSURANCE SERVICES 3299 Hillcrest Rd PO BOX 179 Dubuque, IA 52001-3928 DUBUQUE, IA 52004 I' 563-557-7600 �[� Commercial General Liability Classifications ;� � Class ;j Loc Code Description Exposure Premium Basis Rate Premium Coverage i� �i 1 46622 Parking-private 8,003 Area 12.384 $99 Prem/Ops ! Included incle�ded Prod/Co ,( 11 2 46622 Parking-private 15,376 Area 12.381 $190 Prem/Ops !f Included Included Prod/Co I! �� � 1 91585 Contractors- 13,200,000 Total Cost 1.291 $17,041 Prem/Ops !i subcontracted work- in 1.275 $16,830 Prod/Co " connection with � � � � � � � � � . . � VVI Ijl16Al�1IV11� - i� reconstruction, repair ar � erection of buildings � � 3 49451 Vacant Land-dther than 1 Acres 0.720 $1 Prem/Qps � Not-For-Profit Inciuded Included Prod/Co � . q III II �� I � M , i� !� !I � � � ;I � � DCGL 02 04 14 05/10/2019 14:35:17 � tl I V�f EST BEN�1 � ; A MU74AL IIpSUAFNC�Cf1MPANY" j Wese 6e�ad Muttaal Insuwancc C.ompany 19005.18ohAvc. � WrstBenel,WT59�95 Endorsement Commercial General Liability Endorsements and Miscellaneous Premiums � Customer Number: 0110079384 Policy Period: 01/28/2019 to 01/28/2020 Policy Number: A559493 00 at 12:01 AM Standard Time at Your Mailing Address Shown Below � Named Insured and Address: Agency Name and Address: 14075 '�� Dupaco Holding, LLC DUPACO INSURANCE SERVICES ;} 3299 Hillcrest Rd PO BOX 179 ',{ Dubuque, IA 52001-3928 DUBUQUE, IA 52004 " 563-557-7600 � h h '� !I � . ���a"�svr�c��ie��� � � � I� Description Form Number Premium I� Voluntary Property Damage Coverage WB144 Included � ItAmendment-Who Is An Insured WB1460 Included Plus Pak- Liability WB2000GL $50 ',I� Miscellaneous Premiums � i Description Form Number Premium % ...�....,._� _�---�-___._._______�_�,......._._..�. �..., � Terrorism Risk Insurance Act $220 II� Total General Liability Premium: $34,431 I� y i � � 1 I � ri � a '1 � Y � i � , fi DCGL 03 04 14 05/10/2019 14:35:17 . � WEaT BEh1E7 � A MU1Vhl IN5URANCF COFYPANY� I Wrsc Bez�d Ivtuzual Insurance Company 190D S.18ih Ave. � Wesr Bend,Wt 53095 EC1C�OfS@I7T@Ilt � ; Commercial General Liability Forms Schedule il � i Customer Number: 0110079384 Policy Period: 01/28/2019 to 01/28/2020 ' Policy Number: A559493 00 at 12:01 AM Standard Time at Your Mailing Address Shown Below ! � � � Named Insured and Address: Agency Name and Address 14075 ' Dupaco Holding, LLC DUPACO INSURANCE SERVICES '� 3299 Hillcrest Rd PO BOX 179 � Dubuque, IA 52001-3928 DUBUQUE, IA 52004 � 563-557-7600 iJ �I '� � � � � � � Forms Schedule � � �� Number �dition Description 'i CG0001 0413 COMMERCIAL GENERAL LIABILITY COVERAGE FORM I� CG2106 0514 EXCLUSION -ACCESS OR DISCLOSURE OF CONFIDENTIAL OR PERSONAL I�� INFORMATION AND DATA-RELATED LIABILITY-WITH LIMITED BODILY INJURY EXCEPTION CG2109 0615 EXCLUSION—UNMANNED AIRCRAFT CG2147 1207 EMPLOYMENT-RELATED PRACTICES EXCLUSION CG2150Z 04�3 AMENDMENT OF LIQUOR LIABILITY EXCLUSION CG2162 0998 EXCLUSION -YEAR 2000 COMPUTER-RELATED AND OTHER ELECTRONIC PROBLEMS-WITH EXCEPTION FOR BODILY INJURY ON YOUR PREMISES CG2170 0115 CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM CG2425Z 1204 LIMITED FUNGI OR BACTERIA COVERAGE WB144 1099 VOLUNTARY PROPERTY DAMAGE COVERAGE WB1460 0118 AMENDMENT-WHO IS AN INSURED ' WB1468GL 0414 EXCLUSION -ASBESTOS OR ASBESTOS PRODUCTS � I WB2000GL 0118 PLUS PAK-LIABILITY ,� � � � I i � � DCGL 04 04 14 05/10/2019 14:35:17 � � � � �� � � � I� � , I I��� �a � �� �; h �i i,} �� i; I .i � � � � � i � � � � � � � � � r� i� ';a ; � � � � � � � , � � � t1 d �l , !1 II �