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Contract/Bond_Tschiggfrie Excavating for 17th St. Railroad Crossing Exploration Excavation Copyrighted December 16, 2019 City of Dubuque Consent Items # 26. ITEM TITLE: ImprovementContracts / Performance, Paymentand Maintenance Bonds SUMMARY: Sheets Design Build, LLC forthe Multicultural Family Center Expansion & Renovation; Tschiggfrie Excavating Co. for 17th Street Railroad Crossing Exploratory Excavation; A-One Geothermal, I nc. for 17th Street Railroad Crossing Exploratory HDD Excavation. SUGGESTED DISPOSITION: Suggested Disposition: Receiveand File;Approve ATTACHMENTS: Description Type ContracVBond Sheets Design Build, LLC Supporting Documentation ContracVBond Tschiggfrie E�avating Co. Supporting Documentation ContracVBondA-One Geothermal, Inc. Supporting Documentation TI l�CITY OF �� '"'�"� �'�'� City of Dubuque ��' �"' � Engineering Dept. �.-..� 50.W. 13`h Street Mirstc�r•��iecc c�ft tlic�Missis4i�pi Dubuque, IA 52001 (563)589-4270 CITY OF DUBUQUE, IOWA SHORT FORM VENDOR SERVICE AGREEMENT THIS VENDOR SERVICE AGREEMENT (the Contract), made in triplicate, between the City of Dubuque, lowa (City), by its City Manager, through authority conferred upon the City Manager by its City Council and Tschiggfrie Excavating Co. (Vendor Name) 425 Julien Drive,Dubuque,IA 52003 (Vendor Address-City and State) PROJECT TITLE: 17TH STREET RAILROAD CROSSING EXPLORATORY EXCAVATION For and in consideration of the mutual covenants herein contained, the parties hereto agree as fol lows: VENDOR AGREES: 1. To furnish all material and e ui ment and to erform all labor necessar for the Pro'ect : See Exhibit A attached for work involved in the F'roject. The work described above shall be com leted at the followin location s : East of the Canadian Pacific Railway tracks @ the former 17th Street location. The Project shall be completed in strict accordance with the terms as described in this Contract; in strict accordance with the requirements of the laws of the State of lowa and ordinances of the City of Dubuque, just as much as if the detailed statements thereof were repeated herein. Page 1 of 4 2. Contract Documents shall mean and include the following: This Contract; all ordinances and resolutions heretofore adopted by the City Council having to do with this Project; the Vendor's Proposal; and any, Plans and Specifications and General Requirements as adopted by the City Council for the Project which are listed in the Special Conditions section of this Contract. 3. All materials used by the Vendor on this Project shall be of the quality required by the Contract Documents and shall be put in place in accordance with the Contract Documents. 4. The Vendor shall remove any materials rejected by the City Manager as defective or improper, or any of said work condemned as unsuitable or defective, and the same shall be replaced or done anew to the satisfaction of the City Manager at the cost and expense of the Vendor. 5. The Vendor has read and understands the Contract Documents and has examined and understands the project description described in Section 1 of this Agreement and any attached Special Conditions herein referred to and agrees not to plead misunderstanding or deception because of estimates of quantity, character, location or other conditions surrounding the same. 6. The Vendor shall fully complete the Project under this Contract on or before December 20. 2019 . (DATE) 7. INDEMNIFICATION FROM THIRD PARTY CLAIMS. To the fullest extent permitted by law, Vendor shall defend, indemnify and hold harmless City, its officers and employees, from and against all claims, damages, losses and expenses claimed by third parties, but not including any claims, damages, losses or expenses of the parties to this Contract, including but not limited to attorneys' fees, arising out of or resulting from performance of this Contract, provided that such claim, damages, loss or expense is attributable to bodily injury, sickness, disease or death, or injury to or destruction of property, including loss of use resulting therefrom, but only to the extent caused in whole or in part by negligent acts or omissions of Vendor, or anyone directly or indirectly employed by Vendor or anyone for whose acts Vendor may be liable, regardless of whether or not such claim, damage, loss or expense is caused in part by a party indemnified hereunder. 8. Unless otherwise specified in the Contract Documents, prior to the commencement of any work on this Project and at all times during the performance of this Contract, the Vendor shall provide evidence of insurance which meets the requirements of the City's Insurance Schedule attached to this Contract and listed in the Special Conditions section. 9. The Vendor agrees that no work under this Contract shall commence on the Project until the City has issued a written "Notice to Proceed" to the Vendor. Any work started by the Vendor prior the issuance of the Notice to Proceed shall be considered unauthorized and done at the sole risk to the Vendor. 10. The City of Dubuque in accordance with Title VI of the Civil Rights Act of 1964, 78 Stat. 252, 42 U.S.C. 2000d-2000d-4 and Title 49, Code of Federal Regulations, Department of Transportation, Subtitle A, Office of the Secretary, Part 21, Nondiscrimination in Federally assisted programs of the Department of Transportation issued pursuant to such Act, hereby notifies all bidders that it Page 2 of 4 will affirmatively insure that in any contract entered into pursuant to this advertisement, minority business enterprises will be afforded full opportunity to submit bids in response to this invitation and will not be discriminated against on the grounds of race, color, national origin, sex, age, or disability in consideration for an award. THE CITY AGREES: Upon the completion of this Contract, and the acceptance of the Project by the City Manager, the City agrees to pay the Vendor as full compensation for the complete performance of this Contract, the amount determined for the total work completed at the prices stated in the Vendor's Proposal and less any liquidated damages provided for in the Contract Documents. The work as stated in the Contract Documents is approximate only, and the final payment shall be made for the actual work completed as listed below in this Contract. CONTRACT AMOUNT $ 13,617.00 THE MAXIMUM CONTRACT AMOUNT SHALL BE LIMITED TO AN INCREASE OF 20 % OF THE ABOVE LISTED ESTIMATED AMOUNT CITY OF D UQUE, IOWA VENDOR: By: ~�—�—��- �=�( 1 f / Tschiggfrie Excavating Co. Micha I C. Van Milligen Da e Co any Name City Manager ��.N--.�, gy: 12-4-2019 �igna �re Date Randy C Steffen Printed Name General Superintendent - Estimator Title VENDOR ACKNOWLEDGEMENT OF ATTA , D SPECIAL CONDITIONS: ,�.,.� BY� � 12-4-2019 Signa re Date Ran�y C Steffen Printed Name General Superintendent - Estimator Title Page 3 of 4 The followin Special Conditions shall a I to this Pro'ect: CONTRACTOR SHALL OBTAIN INSURANCE MEETING SCHEDULE F ATTACHED CONTRACTOR SHALL OBTAIN INSURANCE MEETING CPR RPL POLICY ATTACHED CONTRACTOR SHALL COMPLY WITH SAFETY REQUIREMENTS ATTACHED REV 07/18 Page 4 of 4 vMo�'itaNno�anonsna N _ _ 3/IbfIBf10 d0 All] � �W Q On5 � ZQ F� SNOIltl�Ol NOIltlAtl]X3 At101tlNOldX3 =N W p Q U m 3'i1d021d ONV Ntlld °�o W �o = N 133�J1S H1LL � N Q W 3iva I �Bo&t � � 6� �$ � � � � o o m m m m r�- �D �D N II1 N N N ��y��a s�� o � �'3��3 t�58:3� '"'�-5 ��W N��= p S��xB ��w=� �� »k"�� r s�{n� g�'"�� CP�4 �s�� `4�� ri a W �� 05 ��g m w o € '��4 ,u�. � .EteLL �.'x3 � im o o � - �� O N m� V<u N� ZF - O Q� �� ` NLL m> _ �F y�� _ �Q U2 _ a's Wa Fw '�' � a "w � wi xw — -�-- o� ---�o-o"-4 �N v� e� w F n.; �?o i'� o iw � �� - � @"< �� a �'� 66'665 v�i � `J°� _ $<r `�' x a � � a - W '° �s /� W O ._._. . / .F T "'_ '_ o �� t� a � �� _ vy �, � z��eoe o �; ' oa //// + � _ s ."-.= � .:....:.o. :..:... -� ._-- �s _._ z_ �,.'--_-__ __ � .:_ -�.._ , .,;�. � ��' a __._`.`':.'y,_.. � � ��" � � ' � o i��`,� W ' � a 'I w . _ _�.. -. • - - - �—�3snoNlro sr.� N �� I['609 v�i N cai o a `.� �r Z � Q Nu � asnoHiro y�, � � � 0 i "^� W zo �� j 3NfjMY11 dJ � 3NI'NIYiI d7�� U �Z �� o ANM7YY 7Li�1'd N1'p�j U I w w-�i Z �. � I . . � NIVW aiu v~i levM Ol0 z y � w �� B6'809 0 � a� s 7-- c ..__�� — T �� 8 ' `` ^ � > � � - - .. .— r � � � U II ` �2�� 1 r 1 u - � - � £L'!09 u�i � � � P � H ' � W V ~ � W � 33 � � �� 4 _- S l 3 9 " � � £0'!09 0 � —. _ _ __ .� ' � + I o ? 8 � � E I i � m � — . 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I%N ��j . `IJ'J' �� — �• ul W� �Q� 1.73ats r�� ' ,:.�� .��'+r�c.�. : � i o � o �n o u, o �n o ,n � � � o o m m m . � ' � � . � � � � � � � I ' � City of Dubuque Insurance Requirements for General, Artisan or Trade Contractors, Subcontractors or Sub-Subcontractors INSURANCE SCHEDULE F Class A: Asbestos Removal Fiber Optics Sanitary Sewers Asphalt Paving Fire Protection Sheet Metal Concrete Fireproofing Site Utilities Construction Managers General Contractors Shoring Cranes HVAC Special construction Culverts Mechanical Steel Decking Paving &Surfacing Storm sewers Demolition Piles&Caissons Structural Steel Deconstruction Plumbing Trails Earthwork Retaining Walls Tunneling Electrical Reinforcement Water main Elevators Roofing Class B: Chemical Spraying Landscaping Rough Carpentry Doors,Window& Masonry Stump Grinding Glazing Vehicular Snow Removal Tank Coating Drywall Systems Painting &Wall Covering Tree Removal Fertilizer Application Pest Control Tree Trimming Geotech Boring Scaffolding Tuckpointing Insulation Sidewalks Waterproofing Finish Carpentry Plastering Well Drilling Class C: Carpet Cleaning General Cleaning Power Washing Carpet&Resilient Grass Cutting Tile&Terrazzo Flooring Flooring ,Janitorial Window Washing Caulking &Sealants Non Vehicular Snow& Acoustical Ceiling Ice Removal Filter Cleaning Office Furnishings Page 1 of 6 Schedule F, General,Artisan or Trade Contractors, Subcontractors or Sub Subcontractors May 2019 City of Dubuque Insurance Requirements for General, Artisan or Trade Contractors, Subcontractors or Sub Subcontractors INSURANCE SCHEDULE F (continued) 1. Contractor shall furnish a signed certificate of insurance to the department responsible for the contract for the coverage required in Exhibit I prior to commencing work and at the end of the project if the term of work is longer than 60 days. Contractors presenting annual certificates shall present a certificate at the end of each project with the final billing. Each certificate shall be prepared on the most current ACORD form approved by the lowa Department of Insurance or an equivalent approved by the Director of Finance and Budget or Designee. The certificate must clearly indicate the project number, project name, or project description for which it is being provided Eg: Project# PI'Of 0Ct fl8f'f10: l7th St.RR Crossing Exploratory Excavation OC Project Location at or construction of 2. All policies of insurance required hereunder shall be with an insurer authorized to do business in lowa and all insurers shall have a rating of A or better in the current A.M. Best's Rating Guide. 3. Each Certificate required shall be furnished to the EnQ�neer�nA Department of the City of Dubuque. 4. Failure to provide the coverages described in this Insurance Schedule shall not be deemed a waiver of these requirements by the City of Dubuque. Failure to obtain or maintain the required insurance shall be considered a material breach of this contract. 5. Contractor shall require all subcontractors and sub-subcontractors to obtain and maintain during the performance of work insurance for the coverages described in this Insurance Schedule and shall obtain certificates of insurance from all such subcontractors and sub-subcontractors. Contractor agrees that it shall be liable for the failure of a subcontractor and sub-subcontractor to obtain and maintain such coverage. The City may request a copy of such certificates from the Contractor. 6. All required endorsements to various policies shall be attached to the certificate of insurance. 7. Whenever an ISO form is referenced the current edition must be provided. 8. Contractor shall be required to carry the minimum coverage/limit, or greater if required by law or other legal agreement, in Exhibit I - Insurance Schedule F. If the contractor's limits of liability are higher than the required minimum limit then the contractor's limits shall be this agreemenYs required limits. � 9. Contractor shall be responsible for deductibles and self-insured retention. Page 2 of 6 Schedule F, General,Artisan or Trade Contractors,Subcontractors or Sub Subcontractors May 2019 City of Dubuque Insurance Requirements for General, Artisan or Trade Contractors, Subcontractors or Sub Subcontractors INSURANGE SCHEDULE F (continued) EXHIBIT I A) COMMERCIAL GENERAL LIABILITY General Aggregate Limit $2,000,000 Products-Completed Operations Aggregate Limit $2,000,000 Personal and Advertising Injury Limit $1,000,000 Each Occurrence $1,000,000 Fire Damage Limit (any one occurrence) $50,000 Medical Payments $5,000 1) Coverage shall be written on an occurrence, not claims made, form.The general liability coverage shall be written in accord with ISO form CG 00 01 or business owners form BP 00 02. All deviations from the standard ISO commercial general liability form CG 00 01 or business owners form BP 00 02 shall be clearly identified. 2) Include ISO endorsement form CG 25 04"Designated Location(s) General Aggregate LimiY'or CG 25 03"Designated Construction Project(s) General Aggregate Limit"as appropriate. 3) Include endorsement indicating that coverage is primary and non-contributory. 4) Include Preservation of Governmental Immunities Endorsement. (Sample attached). 5) Include additionai insured endorsement for: The City of Dubuque, including all its elected and appointed officials, all its employees and volunteers, all its boards, commissions and/or authorities and their board members, employees and volunteers. Use ISO form CG 20 10 (Ongoing operations). 6) The additional insured endorsement shall include completed operations under ISO form CG 20 37 during the project term and for a period of two years after the completion of the project. 7) Policy shall include Waiver of Right to Recover from Others endorsement. B) WORKERS' COMPENSATION �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 Liability Each Accident $100,000 Each Employee-Disease $100,000 Policy Limit-Disease $500,000 Policy shall include Waiver of Right to Recover from Others endorsement. Coverage B limits shall be greater if required by the umbrella/excess insurer. OR Nonelection of Workers' Compensation or Employers' Liability Coverage under lowa Code sec. 87.22. Completed form must be attached. Page 3 of 6 Schedule F, General,Artisan or Trade Contractors,Subcontractors or Sub Subcontractors May 2019 City of Dubuque Insurance Requirements for General,Artisan or Trade Contractors, Subcontractors or Sub Subcontractors INSURANCE SCHEDULE F (continued) C) AUTOMOBILE LIABILITY Combined Single Limit $1,000,000 D) UMBRELLA/EXCESS LIABILITY Umbrella liability coverage must be at least following form with the underlying policies included herein (General Liability, Automobile,Workers Compensation). All Class A contractors with contract values in excess of$10,000,000 must have umbrella/excess liability coverage of$10,000,000. All Class A and Class B contractors with contract values between $500,000 and $10,000,000 must have umbrella/excess liability coverage of$3,000,000. All Class A and B contractors with contract values less than $500,000 must have umbrella/excess liability coverage of$1,000,000. All Class C contractors are not required to have umbrella/excess liability coverage. All contractors performing earth work must have a minimum of$3,000,000 umbrella regardless of the contract value. E) POLLUTION LIABILITY Coverage required: _yes X no Pollution liability coverage shall be required if project involves any pollution exposure for hazardous or contaminated materials including, but not limited to, the removal of lead, asbestos, or PCB's. Pollution product and complete operations coverage shall also be covered. Each Occurrence $2,000,000 Policy Aggregate $4,000,000 1) Policy to include job site and transportation coverage. 2) Include additional insured for: The City of Dubuque, including all its elected and appointed officials, all its employees and volunteers, all its boards,commissions and/or authorities and their board members, employees and volunteers. Use ISO form CG 20 10. (Ongoing operations)or its equivalent and CG 20 37 (completed operations) or its equivalent. 3) Include Preservation of Governmental Immunities Endorsement. 4) Provide evidence of coverage for 5 years after completion of project. Page 4 of 6 Schedule F, General,Artisan or Trade Contractors, Subcontractors or Sub Subcontractors May 2019 City of Dubuque Insurance Requirements for General, Artisan or Trade Contractors, Subcontractors or Sub Subcontractors INSURANCE SCHEDULE F (continued) F) RAILROAD PROTECTIVE LIABILITY Coverage required: �yes _no Any contract for construction or demolition work on or within fifty feet(50')from the edge of the tracks of a railroad and affecting any railroad bridge, trestle, tracks, roadbeds, tunnel, underpass, or crossing, for which an easement, license or indemnification of the railroad is required, shall require evidence of the following additional coverages. Railroad Protective Liability: $5,000,000 E:ach occurrence(per limits required by Railroad) $10,000,000 E�olicy aggregate (per limits required by Railroad) OR An endorsement to the Commercial General Liability policy equal to ISO CG 24 17 (Contractual Liability-Railroads). A copy of this endorsement shall be attached to the certificate of insurance. Page 5 of 6 Schedule F, General,Artisan or Trade Contractors, Subcontractors or Sub Subcontractors May 2019 '�� CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 12/09/2019 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 POLtCIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 1-800-300-0325 NAMEACT Shelby Greiner HO1tR2S Murphy & ASSOC - CR PHONE FAX ��Nq.�U: 319-896-7715 __.jA/c,Nol: 866-231-7822 201 First Street SE, Suite 700 E-MAIL SGreiner@holmesmu h com ADDRESS: rP Y• Cedar Rapids, IA 52401 INSURER(S)AFFORDINGCOVERAGE NAIC# Kari Coolinq INSURERA: BITCO National Insurance Co 20109 INSURED INSURER B: BITCO GAlIAYdl Insurance Co 20095 Tschiggfrie Excavating Co INSURER C: 425 Julien DubUqu2 Dr INSURERD: DubUque, IA 52003-7997 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: 5�892893 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMFNT, TFRM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. �LTR TYPE OF INSURANCE ADDL SUBR pOLICY NUMBER M�DY EFP 'POL pY EXP LIMITS A GENERALLIABILITY CLP 3686806 10/O1/19 10/O1/20 EACHOCCURRENCE $ 1,000,000 }{ DAMAGETO REN D 300,000 COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ CLAIMS-MADE � OCCUR MED EXP(Any ane person) $ 10,000 PERSONALRADVINJURY $ 1,000,000 GENERALAGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY X PRO- LOC $ B AUTOMOBILE LIABILITY CAP 3686805 10/O1/19 10/O1/20 COMBINED SINGLE LIMIT Ea accident 1,0 0 0,0 0 0 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED Pe�accdentDAMAGE $ X HIREDAUTOS X AUTOS $ B X UMBRELLALIAB X OCCUR CUP 2817510 10/O1/19 10/O1/20 EACHOCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,OOO,O00 DED X RETENTION$1 O,000 $ B WORKERSCOMPENSATION WC 3686SO7 10/O1/19 10/O1/20 X WCSTATU- OTH- AND EMPLOYERS'LIABILITY y�N T RY MI ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,OOO OFFICER/MEMBER EXCLUDED? � N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below •E.L.DISEASE-POLICY LIMIT $ i I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) The City of Dubuque, including all its elected and appointed officials, all its employees and volunteers, all its board commissions and/or authorities and their board members, employees and volunteers are included as Additional Insureds on the General Liability as required by written contract with the insured, per policy terms and conditions. The General Liability and Workers Compensation includes a Waiver of Subrogation in favor of the additional insureds as required by written contract with the insured, per policy terms and conditions. Project: 17th St RR Crossing Exploratory Excavation CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Dubuque THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Engineering Department ACCORDANCE WITH THE POLICY PROVISIONS. 50 W. 13th Street AUTHORIZED REPRESENTATIVE Dubuque, IA 52001 �t.t,.' COO.Q_aw._,a USA �•J O 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD sbellcr Policy# CLP 3 673 413 IVI�NU9CRIPT ENDORSE�IENT MAN.��1-GOV. IMM. -CIY OF DUBUQUE, IOWA MAN ��l- GOV. IMMUNITIES-CITY OF DUBUQUE, IOWA THE FOLLOWING CHANGES HAVE BEEN MADE TO YOUR POLICY. PLEASE READ CAREFULLY. CITY OF DUBUQUE 50 W. 13TH STREET DUBUQUE, IA 52001 l. NONWAIVER OF GOUERNMENT IMMUNITY: THE INSURANCE CARRIER EXPRESSLY AGREES AND STATE THAT THE PURCHASE OF THIS POLICY AND THE INCLUDING OF THE CITY OF DUBUQUE, IOWA AS AN ADDITIONAL INSURED DOES NOT WAIVE ANY OF THE DEFENSES OF GOVERNMENTAL IMMUNITY AVAILABLE TO THE CITY OF DUBUQUE, IOWA UNDER CODE OF IOWA SECTION 670.4 AS IT NOW EXISTS AND AS IT MAY BE AMENDED FROM TIME TO TIME. 2. CLAIMS COVERAGE. THE INSURANCE CARRIER FURTHER AGREES THAT THIS POLICY OF INSURANCE SHALL COVER ONLY THOSE CLAIMS NOT SUBJECT TO THE DEFENSE OF GOVERNMENTAL IMMUNITY UNDER CODE OF IOWA SECTION 670.4 AS IT NOW EXISTS AND AS IT MAY BE AMENDED FROM TIME TO TIME. 3. ASSERTION OF GOVERNMENTAL IMMUNITY. THE CITY OF DUBUQUE, IOWA SHALL BE RESPONSIBLE FOR ASSERTING ANY DEFENSE OF GOVERNMENTAL IMMUNITY, AND MAY DO SO AT ANY TIME AND SHALL DO SO UPON THE TIMELY WRITTEN REQUEST OF THE INSURANCE CARRIER. NOTHING CONTAINED IN THIS ENDORSEMENT SHALL PREVENT THE CARRIER FROM ASSERTING THE DEFENSE OF GOVERNMENTAL IMMUNITY ON BEHALF OF THE CITY OF DUBUQUE, IOWA. 4. NON DENIAL OF COVERAGE. THE INSURANCE CARRIER SHALL NOT DENY COVERAGE UNDER THIS POLICY AND THE INSURANCE CARRIER SHALL NOT DENY ANY OF THE RIGHTS AND BENEFITS ACCRUING TO THE CITY OF DUBUQUE, IOWA UNDER THIS POLICY FOR REASONS OF GOVERNMENTAL IMMUNITY UNLESS AND UNTIL A COURT OF COMPETENT JURISDICTION HAS RULED IN FAVOR OF THE DEFENSE(S) OF GOVERNMENTAL IMMUNITY ASSERTED BY THE CITY OF DUBUQUE, IOWA. 5. NO OTHER CHANGE IN POLICY. THE INSURANCE CARRIER AND THE CITY OF DUBUQUE, IOWA AGREE THAT THE ABOVE PRESERVATION OF GOVERNMENTAL IMMUNITIES SHALL NOT OTHERWISE CHANGE OR ALTER THE COUERAGE AVAILABLE UNDER THE POLICY. MAI�CO(01/02) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TRANSPORTATION CONTRACTORS EXTENDED LIABILITY COVERAGE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM It is agreed that the provisions listed below apply only upon the entry of an � in the box next to the caption of such provision. A. � Partnership and Joint Venture Extension N. �Construction Project General Aggregate Limits B. � Contractors Automatic Additional Insured O. � Fellow Employee Coverage Coverage—Ongoing Operations P. � Property Damage Liability-Elevators C. �Automatic Waiver of Subrogation Q. � Property Damage to the Named Insured's Work D. ❑X Extended Notice of Cancellation, Nonrenewal R �Care, Custody or Control E. �X Unintentional Failure to Disclose Hazards S � Electronic Data Liability Coverage F. � Broadened Mobile Equipment T. �Consolidated Insurance Program G. � Personal and Advertising Injury-Contractual Residual Liability Coverage Coverage U. �Automatic Additional Insureds—Managers or H. � Nonemployment Discrimination Lessors of Premises I. � Liquor Liability V. �Automatic Additional Insureds—State or Governmental Agency or Political Subdivisions— J. � Broadened Conditions Permits or Authorizations K. �Automatic Additional Insureds—Equipment W �Contractors Automatic Additional Insured Leases Coverage—Completed Operations L. � Suits Against Dredges and Barges X. �Additional Insured—Engineers, Architects or Surveyors M. � Insured Contract Extension-Railroad Property and Construction Contracts A. PARTNERSHIP AND JOINT VENTURE EXTENSION The following provision is added to SECTION II -WHO IS AN INSURED: The last full paragraph which reads as foliows: No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations. is deleted and replaced with the following: GL-3086 (09/11) -1- With respect to the conduct of any past or present joint venture or partnership not shown as a Named insured in the Declarations and of which you are or were a partner or member, you are an insured, but only with respect to liability arising out of"your work" on behalf of any partnership or joint venture not shown as a Named Insured in the Declarations, provided no other similar liability insurance is available to you for "your work" in connection with your interest in such partnership or joint venture. B. CONTRACTORS AUTOMATIC ADDITIONAL INSURED COVERAGE—ONGOING OPERATIONS SECTION II — WHO IS AN INSURED is amended to include as an additional insured any person or organization who is required by written contract to be an additional insured on your policy, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the project(s) designated in the written contract. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to"bodily injury" or"property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s)at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. This insurance is excess of all other insurance available to the additional insured, whether primary, excess, contingent or on any other basis, unless the written contract requires this insurance to be primary. In that event, this insurance will be primary relative to insurance policy(s) which designate the additional insured as a Named Insured in the Declarations and we will not require contribution from such insurance if the written contract also requires that this insurance be non-contributory. But with respect to all other insurance under which the additional insured qualifies as an insured or additional insured, this insurance will be excess. C. AUTOMATIC WAIVER OF SUBROGATION Item 8. of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, is deleted and reptaced with the following: 8. Transfer of Rights of Recovery Against Others to Us and Automatic Waiver of Subrogation. a. If the insured has rights to recover all or part of any payment we have made under this Coverage Form, those rights are transferred to us. The insured must do nothing after loss to impair those rights. At our request, the insured will bring "suiY' or transfer those rights to us and help us enforce them. b. If required by a written contract executed prior to loss, we waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of"your work"for that person or organization. GL-3086 (09/11) -2- D. EXTENDED NOTICE OF CANCELLATION, NONRENEWAL Item A.2.b. of the COMMON POLICY CONDITIONS, is deleted and replaced with the following: A.2.b. 60 days before the effective date of the cancellation if we cancel for any other reason. Item 9. of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, is deleted and replaced with the following: 9. WHEN WE DO NOT RENEW a. If we choose to nonrenew this policy, we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 60 days before the expiration date. b. If we do not give notice of our intent to nonrenew as prescribed in a. above, it is agreed that you may extend the period of this policy for a maximum additional sixty (60) days from its scheduled expiration date. Where not otherwise prohibited by law, the existing terms, conditions and rates will remain in effect during that extension period. It is further agreed that so long as it is not otherwise prohibited by law, this one time sixty day extension is the sole remedy and liquidated damages available to the insured as a result of our failure to give the notice as prescribed in 9.a. above. E. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS Although we relied on your representations as to existing and past hazards, if unintentionally you should fail to disclose all such hazards at the inception date of your policy, we will not deny coverage under this Coverage Form because of such failure. F. BROADENED MOBILE EQUIPMENT Item 12.b. of SECTION V -DEFINITIONS, is deleted and replaced with the following: 12.b. Vehicles maintained for use solely on or next to premises, sites or locations you own, rent or occupy. G. PERSONAL AND ADVERTISING INJURY -CONTRACTUAL COVERAGE Exclusion 2.e.of SECTION I, COVERAGE B is deleted. H. NONEMPLOYMENT DISCRIMINATION Unless "personal and advertising injury" is excluded from this policy: Item 14. of SECTION V- DEFINITIONS, is amended to include: "Personal and advertising injury" also means embarrassment or humiliation, mental or emotional distress, physical illness, physical impairment, loss of earning capacity or monetary loss, which is caused by"discrimination." SECTION V-DEFINITIONS, is amended to include: "Discrimination" means the unlawful treatment of individuals based on race, color, ethnic origin, age, gender or religion. GL-3086 (09/11) -3- Item 2. Exclusions of SECTION I, COVERAGE B, is amended to include: "Personal and advertising injury" arising out of"discrimination" directly or indirectly related to the past employment, employment or prospective employment of any person or class of persons by any insured; "Personal and advertising injury" arising out of"discrimination" by or at your, your agents or your "employees"direction or with your, your agents or your"employees" knowiedge or consent; "Personal and advertising injury" arising out of "discrimination" directly or indirectly related to the sale, rental, lease or sub-lease or prospective sale, rental, lease or sub-lease of any dwelling, permanent lodging or premises by or at the direction of any insured. Fines, penalties, specific performance or injunctions levied or imposed by a governmentaf entity, or governmental code, law, or statute because of"discrimination." I. LIQUOR LIABILITY Exclusion 2.c. of SECTlON I, COVERAGE A, is deleted. J. BROADENED CONDITIONS Items 2.a. and 2.b. of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, are deleted and replaced with the following: 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit: a. You must see to it that we are notified of an "occurrence" or an offense which may result in a claim as soon as practicable after the "occurrence" has been reported to you, one of your officers or an "employee" designated to give notice to us. Notice should include: (1) How, when and where the "occurrence" or offense took place; (2) The names and addresses of any injured persons and witnesses; and (3) The nature and location of any injury or damage arising out of the "occurrence" or offense. b. If a claim is made or"suit" is brought against any insured, you must: (1) Record the specifics of the claim or "suit" and the date received as soon as you, one of your officers, or an "employee" designated to record such information is notified of it; and (2) Notify us in writing as soon as practicable after you, one of your officers, your legal department or an "employee" you designate to give us such notice learns of the claims or"suit." Item 2.e. is added to SECTION IV-COMMERCIAL GENERAL LIABILITY CONDITIONS: 2.e. If you report an "occurrence" to your workers compensation insurer which develops into a liability claim for which coverage is provided by the Coverage Form, failure to report such "occurrence" to us at the time of "occurrence" shall not be deemed in violation of paragraphs 2.a., 2.b., and 2.c. However, you shall give written notice of this "occurrence"to us as soon as you are made aware of the fact that this "occurrence" may be a liability claim rather than a workers compensation claim. GL-3086 (09/11) -4- K. AUTOMATIC ADDITIONAL INSUREDS -EQUIPMENT LEASES SECTION II - WHO IS AN INSURED is amended to include any person or organization with whom you agree in a written equipment lease or rental agreement to name as an additional insured with respect to liability for"bodily injury", "property damage" or"personal and advertising injury"caused, at least in part, by your maintenance, operation, or use by you of the equipment leased to you by such person or organization, subject to the following additional exclusions. The insurance provided to the additional insured does not apply to: 1. "Bodily injury" or"property damage"occurring after you cease leasing the equipment. 2. "Bodily injury" or"property damage"arising out of the sole negligence of the additional insured. 3. "Property damage"to: a. Property owned, used or occupied by or rented to the additional insured; or b. Property in the care, custody or control of the additional insured or over wriich thie additional insured is for any purpose exercising physical control. This insurance is excess of all other insurance available to the additional insured,whether primary, excess, contingent or on any other basis, unless the written contract requires this insurance to be primary. In that event, this insurance will be primary relative to insurance policy(s) which designate the additional insured as a Named Insured in the Declarations and we will not require contribution from such insurance if the written contract also requires that this insurance be non-contributory. But with respect to all other insurance under which the additional insured qualifies as an insured or additional insured, this insurance will be excess. L. SUITS AGAINST DREDGES AND BARGES We agree that any"suit" in rem against any dredge or barge owned, operated by or for you, and used in your operations, shall in all respects be treated in the same manner as though the "suit" were against you. This coverage is excess over and above any specific insurance on any dredge or barge owned, operated by or for you, and used in your operations. M. INSURED CONTRACT EXTENSION - RAILROAD PROPERTY AND CONSTRUCTION CONTRACTS Item 9.of SECTION V- DEFINITIONS, is deleted and replaced with the following. 9. "Insured Contract" means: a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract"; b. A sidetrack agreement; c. Any easement or license agreement; d. An obligation, as required by ordinance, to indemnify a municipality, except in connection with work for a municipality; e. An elevator maintenance agreement; GL-3086 (09/11) -5- f. That part of any other contract or agreement pertaining to your business (including an indemnification of a municipality in connection with work performed for a municipality) under which you assume the tort liability of another party to pay for "bodily injury" or "property damage" to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f. does not include that part of any contract or agreement: (1) That indemnifies an architect, engineer or surveyor for injury or damage arising out of: (a) Preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (b) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or damage; or (2) Under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the insured's rendering or failure to render professional services, inciuding those listed in (1) above and supervisory, inspection, architectural or engineering activities. N. CONSTRUCTION PROJECT GENERAL AGGREGATE LIMITS This modifies SECTION III -LIMITS OF INSURANCE. A. For all sums which can be attributed only to ongoing operations at a single construction project for which the insured becomes legally obligated to pay as damages caused by an "occurrence" under SECTION I - COVERAGE A, and for all medical expenses caused by accidents under SECTION I -COVERAGE C: 1. A separate Construction Project General Aggregate Limit applies to each construction project, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. 2. The Construction Project General Aggregate Limit is the most we will pay for the sum of all damages under COVERAGE A, except damages because of "bodily injury" or "property damage" included in the "products-completed operations hazard," and for medical expenses under COVERAGE C regardless of the number of: a. Insureds; b. Claims made or"suits" brought; or c. Persons or organizations making claims or bringing "suits." 3. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the Construction Project General Aggregate Limit for that construction project Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Construction Project General Aggregate Limit for any other construction project. 4. The limits shown in the Declarations for Each Occurrence, Fire Damage and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Construction Project General Aggregate Limit. GL-3086 (09/11) -6- B. For all sums which cannot be attributed only to ongoing operations at a single construction project for which the insured becomes legally obligated to pay as damages caused by an "occurrence" under SECTION I - COVERAGE A, and for all medical expenses caused by accidents under SECTION 1-COVERAGE C: 1. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shail reduce the amount available under the General Aggregate Limit or the Products-Completed Operations Aggregate Limit, whichever is applicable; and 2. Such payments shall not reduce any Construction Project General Aggregate Limit. C. Payments for damages because of "bodily injury" or "property damage" included in the "products-completed operations hazard" will reduce the Products-Completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Construction Project General Aggregate Limit. D. If a construction project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project. E. The provisions of SECTION III - LIMITS OF INSURANCE not otherwise modified by this endorsement shall continue to be applicable. O. FELLOW EMPLOYEE COVERAGE Exclusion 2.e. Employers Liability of SECTION I, COVERAGE A, is deleted and replaced with the following: 2.e. "Bodily injury" to (1) An "employee" of the insured arising out of and in the course of: (a) Employment by the insured; or (b) Performing duties related to the conduct of the insured's business; or (2) The spouse, child, parent, brother or sister of that "employee" as a consequence of paragraph (1) above. This exclusion applies: (1) Whether the insured may be liable as an employer or in any other capacity; and (2) To any obligation to share damages with or repay someone else who must pay damages because of the injury. This exclusion does not apply to: (1) Liability assumed by the insured under an "insured contract"; or (2) Liability arising from any action or omission of a co-"employee" while that co"employee" is either in the course of his or her employment or performing duties related to the conduct of your business. GL-3086 (09/11) -7- Item 2.a. (1)(a) of SECTION II -WHO IS AN INSURED, is deleted and replaced with the following: 2.a. (1)(a) To you, to your partners or members (if you are a partnership or joint venture) or to your members (if you are a limited liability company), or to your "volunteer workers" while performing duties related to the conduct of your business. P. PROPERTY DAMAGE LIABILITY-ELEVATORS "Property damage" liability is changed as follows: 1. Exclusions 2.j.(3) and 2.j.(4) of SECTION I, COVERAGE A, do not apply to the use of elevators. 2. The insurance afforded by reason of this provision is excess over any valid and collectible property insurance (including any deductible portion thereof) available to the insured whether primary, excess, contingent or on any other basis, and the OTHER INSURANCE condition is changed accordingly. Q. PROPERTY DAMAGE TO THE NAMED INSURED'S WORI4 Exclusion I of SECTION I, COVERAGE A. is deleted and replaced with the following: I. Damage to Your Work "Property damage" to "your work" arising out of it or any part of it and included in the "products completed operation hazard." This exclusion applies only to that portion of any loss in excess of$50,000 per occurrence if the damaged work and the work out of which the damage arises was performed by you. This exclusion does not apply if the damaged work or the work out of which the damage arises was performed on your behalf by a subcontractor. R. CARE, CUSTODY OR CONTROL Exclusion 2.j.4 of SECTION I, COVERAGE A. is deleted and replaced with the following: 2.j.4 Personal property in the care, custody or control of the insured. However, for personal property in the care, custody or control of you or your "employees," this exclusion applies only to that portion of any loss in excess of $25,000 per occurrence, subject to the following terms and conditions; (a) The most that we will pay under this provision as an annual aggregate is $100,000, regardless of the number of occurrences. (b) This provision does not apply to "employee" owned property or any property that is missing where there is not physical evidence to show what happened to the property. (c) The aggregate limit for this coverage provision is part of the General Aggregate Limit and SECTION III -LIMITS OF INSURANCE is changed accordingly. (d) In the event of damage to or destruction of property covered by this exception, you shall, if requested by us, replace the property or furnish the labor and materials necessary for repairs thereto, at actual cost to you, exclusive of prospective profit or overhead charges of any nature. GL-3086 (09/11) -8- (e) $2,500 shall be deducted from the total amount of all sums you became obligated to pay as damages on account of damage to or destruction of all property of each person or organization, including the loss of use of that property, as a result of each "occurrence." Our limit of liability under the endorsement as being applicable to each "occurrence" shall be reduced by the amount of the deductible indicated above; however, our aggregate limit of liability under this provision shall not be reduced by the amount of such deductible. The conditions of the policy, including those with respect to duties in the event of"occurrence," claims or "suiY' apply irrespective of the application of the deductible amount. We may pay any part or all of the deductible amount to effect settlement of any claim or"suit" and, upon notification of the action taken, you shall promptly reimburse us for such part of the deductible amount as has been paid by us. S. ELECTRONIC DATA LIABILITY COVERAGE 1. Exclusion 2.p. Electronic Data of SECTION I, COVERAGE A, is deleted and replaced with the following: 2.p. Damages arising out of the loss of, loss of use of, damage to, corruption of, inability to access, or inability to manipulate"electronic data"that does not result from physical injury to tangible property. 2. The following definition is added to SECTION V—DEFINITIONS: "Electronic data" means information, facts or programs stored as or on, created or used on, or transmitted to or from computer software (including systems and applications software), hard or floppy disks, CD-ROMS, tapes, drives, cells, data processing devices or any other media which are used with electronically controlled equipment. 3. For the purposes of this coverage, the definition of "property damage" in SECTION V — DEFINITIONS is replaced by the following: "Property damage" means: a. Physical injury to tangible property, including all resulting loss of use of that property. All sucri loss of use shall be deemed to occur at the time of the physical injury that caused it; b. Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the time of the "occurrence"that caused it; or c. Loss of, loss of use of, damage to, corruption of, inability to access, or inability to properly manipulate "electronic data", resulting from physical injury to tangible property. All such loss of "electronic data" shall be deemed to occur at the time of the "occurrence" that caused it. For the purposes of this insurance, "electronic data" is not tangible property. T. CONSOLIDATED INSURANCE PROGRAM RESIDUAL LIABILITY COVERAGE With respect to "bodily injury", "property damage", or `personal and advertising injury" arising out of your ongoing operations; or operations included within the "products-completed operations hazard", the policy to which this coverage is attached shall apply as excess insurance over coverage available to "you" under a Consolidated Insurance Program (such as an Owner Controlled Insurance Program or Contractors Controlled Insurance Program). Coverage afforded by this endorsement does not apply to any Consolidated Insurance Program involving a "residential project" or any deductible or insured retention, specified in the Consolidated Insurance Program. GL-3086 (09/11) -9- The following is added to Section V—Definitions "Residential project" means any project where 30% or more of the total square foot area of the structures on the project is used or is intended to be used for human residency. This includes but is not limited to single or multifamily housing, apartments, condominiums, townhouses, co-operatives or planned unit developments and appurtenant structures (including pools, hot tubs, detached garages, guest houses or any similar structures). A "residential projecY' does not include military owned housing, college/university owned housing or dormitories, long term care facilities, hotels, motels, hospitals or prisons. All other terms, provisions, exclusions and limitations of this policy apply. U. AUTOMATIC ADDITIONAL INSUREDS -MANAGERS OR LESSORS OR PREMISES SECTION II—WHO IS AN INSURED is amended to include: Any person or organization with whom you agree in a written contract or written agreement to name as an additional insured but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises, designated in the written contract or written agreement, that is leased to you and subject to the following additional exclusions: This insurance does not apply to: 1. Any"occurrence"which takes place after you cease to be a tenant in that premises. 2. Structural alterations, new construction or demolition operations performed by or on behalf of the additional insured listed in the written contract or written agreement. This insurance is excess of all other insurance available to the additional insured, whether primary, excess, contingent or on any other basis, unless the written contract requires this insurance to be primary. In that event, this insurance will be primary relative to insurance policy(s) which designate the additional insured as a Named Insured in the Declarations and we will not require contribution from such insurance if the written contract also requires that this insurance be non-contributory. But with respect to all other insurance under which the additional insured qualifies as an insured or additional insured, this insurance will be excess. V. AUTOMATIC ADDITIONAL INSUREDS—STATE OR GOVERNMENTAL AGENCY OR POLITICAL SUBDIVISIONS—PERMITS OR AUTHORIZATIONS SECTION II — WHO IS AN INSURED is amended to include any state or governmental agency or subdivision or political subdivision with whom you are required by written contract, ordinance, law or building code to name as an additional insured subject to the following provisions: This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. This insurance does not apply to: 1. "Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the federal government, state or municipality; or 2. "Bodily injury" or "property damage" included within the "products-completed operations hazard". This insurance is excess of all other insurance available to the additional insured, whether primary, excess, contingent or on any other basis, unless the written contract requires this insurance to be primary. In that event, this insurance will be primary relative to insurance policy(s) which designate the additional insured as a Named Insured in the Declarations and we will not require contribution GL-3086 (09/11) -10- from such insurance if the written contract also requires that this insurance be non-contributory. But with respect to all other insurance under which the additional insured qualifies as an insured or additional insured, this insurance will be excess. W. CONTRACTORS AUTOMATIC ADDITIONAL INSURED COVERAGE—COMPLETED OPERATIONS SECTION II — WHO IS AN INSURED is amended to include as an additional insured any person or organization who is required by written contract to be an additional insured on your policy for completed operations, but only with respect to liability for"bodily injury" or"property damage"caused, in whole or in part, by "your work" at the project designated in the contract, performed for that additional insured and included in the "products-completed operations hazard". This insurance is excess of all other insurance available to the additional insured, whether primary, excess, contingent or on any other basis, unless the written contract requires this insurance to be primary. In that event, this insurance will be primary relative to insurance policy(s) which designate the additional insured as a Named Insured in the Declarations and we will not require contribution from such insurance if the written contract also requires that this insurance be non-contributory. But with respect to all other insurance under which the additional insured qualifies as an insured or additional insured, this insurance will be excess. X. ADDITIONAL INSURED— ENGINEERS, ARCHITECTS OR SURVEYORS SECTION II — WHO IS AN INSURED is amended to inciude as an additional insured any architect, engineer or surveyor who is required by written contract to be an additional insured on your policy, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury"caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations performed by you or on your behalf. This includes such architect, engineer or surveyor, who may not be engaged by you, but is contractually required to be added as an additional insured to your policy. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury"arising out of the rendering of or the failure to render any professional services, including: 1. The preparing, approving, or failing to prepare or approve maps, drawings, opinions, reports, surveys, change orders, designs or specifications; or 2. Supervisory, inspection or engineering services. This insurance is excess of all other insurance available to the additional insured, whether primary, excess, contingent or on any other basis, unless the written contract requires this insurance to be primary. In that event, this insurance will be primary relative to insurance policy(s) which designate the additional insured as a Named Insured in the Declarations and we will not require contribution from such insurance if the written contract also requires that this insurance be non-contributory. But with respect to all other insurance under which the additional insured qualifies as an insured or additional insured, this insurance will be excess. GL-3086 (09/11) -11- WiOR�S C�ONPOVSATION AND ENPLOYERS lJABILITY INS'IJRANCE POLICY W�C 00 0313 Ed.484� WAIVER OF OUR PoGHT TO RECOVER FF�OM OTHERS ENDORSEIUF.M We have the right to reoover our paymer�s from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization narr�ed in the Schedule. (This agreemer�t applies only to the extent that you perform v�rork under a written cbntract that requires you to obtain this agreemerrt from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Scfiedule ANY PERSON OR ORGANIZATION FOR WHOM YOU ARE PERFORMING OPERATIONS IF YOU AND SUCH PERSON OR ORGANIZATION HAVE AGREED TO A WAIVER OF SUBROGATION IN A WRITTEN CONTRACT OR AGREEMENT SIGNED BY YOU AND ALL OTHER PARTIES TO THAT WRITTEN CONTRACT OR AGREEMENT PRIOR TO ANY LOSS FOR WHICH A WAIVER IS REQUIRED. This endorsemer� changes the policy to which it is attached and is effective on the date issued unless othenNise stated. (The ir�formation below is required only when this c�idorsement is issued subsequer�t to prepar�tion of the policY•) Endorsement Effective Policy No. Endorsemerit I�b. Insured Premium Insuranoe Company Couritersigned by W�C 00 0313 (Ed.484) Copyright 1983 National Council on Corrper�.sation Insurance City of Dubuque Insurance Requirements for General, Artisan or Trade Contractors, Subcontractors or Sub Subcontractors PRESERVATION OF GOVERNMENTAL IMMUNITIES ENDORSEMENT 1. Nonwaiver of Governmental Immunit . The insurer expressly agrees and states that 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 insurer further agrees that this policy of insurance shall cover only those claims not subject to the defense of governmental immunity under the Code of lowa 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 Government Immunitv. 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 insurer. 4. Non-Denial of Coverape. The insurer shall not deny coverage under this policy and the insurer shall not deny any of the rights and benefits accruing to the City of Dubuque, lowa under this policy for reasons of governmental immunity unless and until a court of competent jurisdiction has ruled in favor of the defense(s)of governmental immunity asserted by the City of Dubuque, lowa. No Other Chanae in Policv. The above preservation of governmental immunities shall not otherwise change or alter the coverage available under the policy. (DEPARTMENT MANAGER: FILL IN ALL BLANKS AND CHECK BOXES) Page 6 of 6 Schedule F, General,Artisan or Trade Contractors, Subcontractors or Sub Subcontractors May 2019 12/4/2019 RRPBind ��,� RRP eQuote Bound Confirmation Account Name:Tschiggfrie Escavating Company Submission Status:Bound GL Policy Number: Submission No.:151135 GL Limit:1,000,000 UMB Limit:10,000,000 You have bound this RRP submission. Policies will be issued as described below. You may wish to print this page as confirmation. Contractor Name: Tschiggfrie Escavating Company Policy Effective Date: 12/04/2019 Contract/Project No.: DBQ-17TH Agent Name: Holmes Murphy &Associates Project Cost: 8,117 Project Cost Within 50 Feet: 8,117 Date of Activity: 12/04/2019 Commission: 15°/a Billing Type: Agency Bill - Full Payment Issuing Company: The Travelers Indemnity Company � Policy No. � Named Insured � Limits(OOOs) � Premium* ' SPS-4P42154A-IND Soo Line Railroad Company d/b/a Canadian Pacific 5000/10000 $5,000 � "'A change in the total cost of construction may result in a change in the rate used in our calculations, and result in a change in the premium shown in this proposal. Legal Notices ' ,:��: i� . i:.. .. .. , . . . https:!/clocpnew.travelers.com/CLRRPIRRPBind.aspx?SubmID=151135&UserType=CAg&PrintView=YES �� Eng�neer�n�5e-��ices j Etruct��re;��rciecks A ' Suite 9GG L2G�cuth 6th 5* �� i'�•i:nnearci�;,h9hJ 55��2 INSURANCE Rfq,�11RE�1ilENTS RAILRC7AD�R{3TE�TIVE LIABILITY • Worker's compensation insurance which fully meets the requirements of any Worker's compensation law in force at the location where the work is performed, including the requirements of any occupational disease law. • Automobile Liability insurance covering all owned, non-owned an hired vehicles engaged in or about thP work site, with a combined sin�le limit of$1,000,000. • Comprehensive general liability insurance with a combined single limit of not less than $2,000,000 per occurrence and $5,000,000 aggregate. • Railroad protective liability insurance (occurrence form) , in the name of the Soo Line R�ilroad Company d/b/a Canadian Pacific,with limits of $5,000,000 per occurrence and $10,000,000 aggregate for bodily injury (including death) and property damage. Before Licensee is allowed to enter the property, Licensor must receive and approve certificates of insurance evidencing the workers compensation, comprehensive general liability, and automobile insurance and stating that such coverage will not be cancelled or materially changed without ten days written notice being given to Licensor. Licensor must also receive and approve either the railroad protective liability policy or a binder evidencing that coverage is in effect. All of the required policies shall be issued by insurers acceptable to Licensor and shall be acceptable to Licensor in both form and substance. Licensee shall not enter the Property until all of the required policies have been approved in writing by Licensor. The automobile and comprehensive general liability policies shall be endorsed to add Licensor as an additional insured and to waive subrogation against Licensor. The comprehensive general liability policy shall include a contractual liability endorsement covering Licensee's obligations under this Agreement. If the policies are procured by Licensee's contractor, Licensee shall be added as an additional insured under such policies. If the contractor uses and subcontractors(s), the contractor shall provide the required insurances and shall, in addition, either; equivalent to that described herein or (ii) obtain endorsement to the required policies naming the subcontractor(s) as additional insured parties. N� CANAD„�.N Form SC2-US �i� � PACIFIC ��s CONTRACTOR SAFETY BRIEFING CARD (US) �� (applies to all non Canadian Pacific personnel) Canadian Pacific (CP) is committed to provide a safe and healthy working environment for all Railway and Contractor employees and welcomes you to its property. This document provides you with general orientation information and basic safety requirements that must be adhered to when working on the railway's property. Full requirements are contained in the"Mininnim Safety Requirements for Contractors Working on Railway Property." CANADIAN PACIFIC'S MINIMUM SAFETY REQIJIREMENTS F❑R C❑NTRACT❑RS WORKING ❑N RAILWAY PROPERTY IS THE MINIMUM SAFETY RE[ILJIREMENTS TO BE FOLLOWED AT ALL TIMES. Note- Prior to the commencement of any work at the worksite,a local safety orientation must be conducted iu conjunction with Canadian Pacific and shall include the following: • Hazard identificationh-isk assessment of hazards inherent in the work to be undertaken or generated by the work processes to be used. •Various controls used to mitigate risk of the hazards present both as a result of the railway and contractor work processes. • Local communication procedures including emergency call-out/response. •Local evacuation procedures. Qualifications and Personal Conduct: • Contractor employees must be fully qualified and experienced in the work to be done. • All contractors employed by CP to perforn� work along the right-of-way or work foul (i.e. within 4 feet of the nearest rail) of any track must comply with On-Track Safety Rules (i.e. in accordance with the Federal Railroad Administration's (FRA) On-Track Safety Rules). The Contractor is responsible for the qualification, training and certification of it's employees. • The use and/or possession of any di�.ig or alcoholic beverage is prohibited. • The use of drugs, medication or mood-altering agents, including those prescribed by a doctor, which will adversely affect the ability to work safely, is prohibited. • Smoking is prohibited in all buildings and where there is a risk of fire or explosion. Personal Protective Equipment and Clothing: • ANSI approved equipment to be worn at all times includes: - Steel toe safety boots. - Hard-hats. - Safety glasses with peimanently attached side shields. - High visibility vests. • ANSI approved equipment to be available and worn when site conditions or regulations reqtiire inchides: - Fall protection equipment as required by applicable codes. -Testing, monitoring and rescue equipment where confined spaces are encountered. -Welding goggles, gloves and chaps. - Respirators appropriate for the hazard present. - Hearing protection to be worn in all designated locations and as per all applicable codes and regulations. • Clothing: - Shirts with sleeves must be worn at all times. - Pants must be at least ankle length. Protection of Railway Traffic and Property: • The work shall be organized and executed in such a manner as to ensure no interference with the safety of railway operations. • The railway shall deterniine where Hag persons are required to protect railway operations and atrange for it. • Unless authorized in writing, no temporary structures, material or equipment shall be installed closer than 12 feet to the nearest rail. • During the passage of trains or track units, the Contractor's equipment shall not be operated when within 50 feet of the t�•ack unless specifically authorized. Dur- ing such times, the operator of the equipment shall secure/lower equipment to the ground and vacate the equipment and stand well clear of the track(at least 20 feet back where possible) until the entire train/equipment has passed the work site. When working in multi-track territory operators shall exit to the non-live side of the track and position themselves in a safe area 20 feet from the track as a minimum where possible(do not stand on or between adjacent traeks). • Unless authorized in writing, Contractor employees are not permitted to operate or ride any CP rolling stock. • Unless authorized in writing, operating CP vehicles is prohibited. • The use of CP tools and materials is not permitted. • Altering, obstnicting or operating any components of track, bridges, signals or other railway equipmeut is prohibited unless specifically authorized and qualified. Site Conditions and Work Site Safety: • Prior to commencing any work, the Contractor shall ensure that he has taken the time to identify all site conditions that may be a hazard or a potential hazard inchiding the location of underground services aud overhead power lines. • Railway pole lines carry electric power and should be treated as any other power line. • When required by CP or by the Contractor,job briefings must be conducted,which all Contractor's supervisors, employees and sub-contractors must attend. When railway employees are assigned to provide track protection, daily job briefings are mandatory and these railway employees must be included in the briefing. • All equipment and materials are to be secured and stored well clear of all tracks. Sightlines at grade crossings must not be obscured. • All mobile equipment must be equipped with beacons and backup alarms. • All lifting apparatus such as steel cables, nylon slings, chains, shackes, etc., must be safety certified. • Excavations shall not be left unattended unless they are properly protected; and the CP supervisor shall be notified. • Be conscious to protect the natural, physical and biological environment of the work site, and comply with all environmental regulations. • Advise the CP Supervisor in charge, of all hazardous materials that will be used in the work in accordance with OSHA's Hazard Communication Standard and make the latest Material Safety Data Sheets (MSDS) available. Injury and Emergent Situations: • Immediately advise the CP supervisor in charge, of all injuries on the site. • In the case of an emergency where a hazardous condition may affect the safe passage of trains, immediately report the condition to the CP supervisor. • If the CP supervisor is not immediately available, the Contractor shall: - for emergencies (i.e. incidents, injuries, fire, etc.); - for hazards relating to the safe passsage of trains; - for spills Call the Operations Center Minneapolis at 1-800-766-HELP(1-800-766-4357) - for hazards or incidents requiring CP Police Services, call 1-800-716-9132 • In the event of a hazardous condition, make every safe and practicable attempt to stop trains well in advance of the hazardous area. Compliance with CP's Minimum Safety Requirements for Contractors: • Non-compliance to CP's Minumum Safety Requirements for Coutractois Working on Railway Property will result in the closing down of the work site and the contractor's personnel will be rec�uired to leave railway property. Safety & Environmental Services-April 2007 Calgary,Alberta i - . , �: � � � � � � � � � �� MINIMUM SAFETY REQUIREMENTS FOR CONTRACTORS WORl�ING ON RAILWAY PROPERTY April 2007 Initialed by: Canadian Pacific's Minimum Safety Requirements for Contractors Working on Railway Property is the minimum safety requirements to be followed at all Times. Note— Prior to the commencement of any work at the worksite, a local safety orientation must be conducted in conjunction with Canadian Pacific and shall include the following: • Hazard identification/risk assessment of hazards inherent in the work to be undertaken or generated by the work processes to be used. • Various controls used to mitigate risk of the hazards present both as a result of the railway and contractor work processes. • Local communication procedures including emergency call-out/response. • Local evacuation procedures. Initialed by: 2 TABLE OF CONTENTS SR1INTRODUCTION.......................................................................................................... 4 SR2GENERAL.....................................................................................................................4 SR3PERSONAL ATTIRE...................................................................................................4 SR4 PERSONAL PROTECTIVE EQUIPMENT...............................................................4 SR5PERSONAL CONDUCT............................................................................................. 5 SR6 PROTECTION OF RAILWAY TRAFFIC AND PROPERTY................................. 6 SR7 TRAIN MOVEMENTS AND WORKING NEAR TRACKS .................................... 7 SR8 TOOLS, EQUIPMENT AND MACHINERY.............................................................. 9 SR9CRANES...................................................................................................................... 10 SR10 CLEANUP, ENVIRONMENT AND FIRE PREVENTION .................................... 1 l SR11 HAZARDOUS MATERIALS and RESPONSIBLE CARE.................................. 11 SR12 FIRST AID, INCIDENT AND ACCIDENT REPORTING ..................................... 12 SR13JOB BRIEFINGS ....................................................................................................... 13 SR14 CONTRACTOR SAFETY POLICY......................................................................... 14 SR15 CONSTRUCTION SAFETY PLAN ......................................................................... 14 SR16 COMPLIANCE WITH SAFETY REQUIREMENTS............................................. 16 TABLE A - EMERGENCY INFORMATION SHEET Initialed by: 3 SR1 INTRODUCTION 1.1 At Canadian Pacific ("CP"), safety is an integral part of the way we do business. We expect everyone working on Canadian Pacific's property ("Railway propert�') to be unconditionally committed to safety. Safety must be given top priority and will take precedence over deadlines, production schedules, and all other considerations. SR2 GENERAL 2.1 The Contractor shall be solely responsible for the safety of it's agents, employees and subcontractors ("Contractor Personnel"). 2.2 The Contractor shall comply with all applicable health and safety legislation, regulations and codes applicable to the work. 2.3 The Contractor shall ensure that all Contractor's Personnel comply with the following safety requirements when working on Railway property. The Contractor shall have a copy of the following documents on site at all times: 2.3.1 Canadian Pacific's Minimum Safety Requirements for Contractors Working on Railway Property. 2.3.2 Contractor's construction safety plan pursuant to section SR15(if applicable). 2.3.3 Contractor's Emergency Information Sheet pursuant to section SR15. 2.3.4 Contractor's safety policies, rules and work procedures pursuant to SR14. 2.4 Access to Railway property for any Contractor Personnel is at CP's sole discretion. Such access is only for the purpose of Contractor Personnel performing services for CP, and only for the duration of Contractor's contract with CP. The Contractor shall ensure that Contractor Personnel wear appropriate Contractor photo identification and/or visitor tags while on Railway property, and have appropriate documentation to verify the services being performed for CP. The Contractor shall ensure that Contractor Personnel comply with CP's instructions regarding security restrictions or other restrictions resulting from emergent conditions. SR3 PERSONAL AITIRE 3.1 The Contractor shall ensure that Contractor Personnel wear clothing required by applicable legislation, regulation and codes and is suitable to perform job functions safely, protect against hazards to the skin and adequate for existing weather conditions. SR4 PERSONAL PROTECTNE EQUIPMENT 4.1 The Contractor shall ensure that Contractor Personnel wear personal protective equipment required by applicable legislation, regulations, codes and as necessary to protect against personal injuries while on Railway property, and in accordance with this Article SR4. All personal protective equipment shall be approved by the Canadian Standards Associations (CSA) or by the American National Standards Institute (ANSI), and shall be in good condition and be properly fitted. Initialed by: 4 4.2 The following mandatory protective equipment shall be supplied by the Contractor at its own expense, and Contractor shall ensure that it is worn by Contractor Personnel on Railway property: 4.2.1 Safety hard hat shall be worn at all times, except inside enclosed vehicles or equipment. 4.2.2 Safety boots shall be worn at all times. They must have puncture resistant soles and meet CSA Z195 Grade One Green Triangle (Canada), or US ANSI Z41, Section 5 standards. 4.2.3 Safety glasses with permanently attached side shields that meet CSA Standard 94.3 (in Canada)and ANSI Standard 87.1 (in the US)must be worn at all times, except inside office buildings***and inside enclosed cabs of vehicles. ""Safety glasses as specified above must be worn in office buildings,if the task being perFormed,results in a risk of injury to the eyes(i.e.construction related tasks,working with electrical hazards,etc.). Additional eye and face protection equipment is to be worn as determined necessary by the Contractor, based upon the contractor's risk assessment. Under special circumstances, whereby, the wearing of safety glasses will hinder specialized work being performed by the contractor or that the safety can be improved for the contracted employee(s) by varying from the standard outline above, the wearing of such will be determined by the Contractor, based upon the contractor's risk assessment. 4.2.4 Hearing protectors shall be worn in all designated locations and as required by any applicable governing legislation, regulations, and codes. 4.2.5 Appropriate respirators shall be worn whenever work processes create airborne particulates(i.e.dust, mist, vapour or fumes). 4.2.6 High visibility fluorescent work wear with reflective striping (CSA (Canada) or ANSI (US)approved preferred)shall be worn when-on Railway property. High visibility work wear must not be covered by other clothing or equipment, except where necessary for safety reasons such as where fall protection or pole climbing equipment is being used. SR5 PERSONAL CONDUCT 5.1 Entry upon Railway property when in possession of, or under the influence of intoxicants, narcotics, controlled substances or medication which may in any way adversely affect alertness, concentration, reaction response time or safety is prohibited. Contractors must have appropriate programs and processes in place to ensure that Contractor Personnel are in compliance with this requirement. 5.2 Possessing or using any alcoholic beverage or drug is prohibited when working on Railway property: Initialed by: 5 5.3 CP is committed to providing and maintaining a work environment that supports the dignity of all individuals and will not tolerate any discrimination, harassment or violence in the workplace. Contractor shall ensure that Contractor Personnel conduct themselves in a manner consistent with these principles. 5.4 Smoking is prohibited in all buildings and on all Railway property, except where CP management has designated an outdoor smoking area. SR6 PROTEC110N OF RAILWAY TRAFFIC AND PROPERTY 6.1 The work shall be organized and executed in such a manner as to ensure no interference with the regularity and safety of railway operations. No step in any sequence of operations which might either directly or indirectly affect the regularity or safety of railway traffic shall be started until approval of the project manager has been obtained. No temporary structure, materials, or equipment shall be permitted closer than 12 feet (3.66 meters) to the nearest rail of any track without prior approval in writing of the project manager. 6.2 No work shall be done on or above, or use made of, any trackage without approval by the project manager and then only under the direct supervision of a qualified CP flagperson, or unless they are specifically authorized and qualified to perform said work. 6.3 The Contractor shall, at all times, conduct its operations in a wholly responsible manner to avoid damage to the CP's trackage or property. 6.4 Signs, signals and flags necessary for the safe operation of the railway shall not be obstructed, removed, relocated, or altered in any way without proper authorization. Blue flag protection on tracks signifies CP employees are on, under or between rolling stock equipment. Blue flags are important safety devices and must not be touched or obstructed. 6.5 Only qualified personnel are permitted to operate switches, derails, electric locking mechanisms or other appliances. The Contractor shall keep equipment, material and Contractor Personnel clear of this equipment at all times. Neither the Contractor nor Contractor Personnel shall operate or tamper with any signal or communication systems or any other railway safety devices unless specifically authorized and qualified. 6.6 While railway traffic is passing through, within 50 feet of the work area, the mechanisms for securing rotating equipment must be used to prevent rotational movement. Buckets on shovels must be lowered to the ground to rest. Operators shall get out of their equipment and position themselves in a safe area 20 feet from the track as a minimum where possible. When working in multi-track territory Operators shall exit to the non-live side of the track and position themselves in a safe area 20 feet from the track as a minimum where possible (do not stand on or between adjacent tracks). 6.7 Construction equipment parked on Railway property on nights or weekends shall be secured in a safe position well clear of all tracks to prevent accidental contact with trains and moving equipment and to not restrict train crew sightlines. As much as possible, materials shall be stored in locations where they are not subject to public viewing in Initialed by: 6 order to prevent vandals from using them to cause derailments or damage to Railway property. Scrap materials shall be disposed of as soon as possible. The Contractor shall consult with CP personnel to determine the best location to store equipment and materials. 6.8 Before starting excavation operations, the Contractor shall ascertain that there are no underground wires, fibre optic cables, pipelines or other facilities which could be damaged or , if present, that such installations are properly protected. Fibre optic cables are present on most segments of the right-of-way. Prior to commencing any excavation, the Contractor shall contact the proper authority to obtain the necessary permit and to locate and protect such cables. Excavations shall not be left unattended unless they are properly protected; and the CP supervisor shall be notified. 6.9 Railway pole lines carry electric power and should be treated as any other power lines. 6.10 Any Contractor Personnel discovering a hazardous or potentially unsafe condition which may affect the safe passage of railway traffic must advise CP immediately: In Canada— Network Management Centre (NMC) Calgary 1-800-795-7851 In the US—Operations Centre Minneapolis— 1-800-SOO-HELP (1-800-766-4357) SR7 TRAIN MOVEMENTS AND WORFdNG NEAR TRACKS 7.1 The Contractor shall ensure that all Contractor Personnel are aware of and comply with the following safety rules which apply to working near railway tracks: 7.1.1 Personnel shall be alert to train movement shall expect the movement of trains, engines, cars, or other moveable equipment at any time, on any track, and in any direction, even cars on sidings that appear to be stationary or in storage. Stay at least 50 feet (15 meters) away from the ends of stationary cars when crossing the track, and never climb on, under or between cars. To cross tracks, personnel shall look both ways, and if the tracks are clear, walk at a right angle to them. 7.1.2 Personnel shall not rely on others to protect them from train movement. The responsibility is theirs for safety on the railway. 7.1.3 Personnel shall not stand on the track in front of an approaching engine, car or other equipment. 7.1.4 Personnel shall be aware of the location of structures or obstructions where clearances are close. 7.1.5 Personnel shall not stand or walk on railroad tracks, either between the rails or on the ends of ties unless absolutely necessary. Personnel shall stay clear of tracks whenever possible. Initialed by: � 7.1.6 -�Within the United States, "ON TRACK SAFETY" rules apply. This is a set of rules, which were developed and promulgated by the Federal Railroad Administration (FRA 49 CFR Part 214, Subpart C - Roadway Worker Protection Regulations). The On Track Safety rules apply to contractors to a railroad who perform inspection, maintenance or repair to railroad facilities. These rules and procedures must be complied with to work on or near Railroad property. Specific training and obedience to these rules and procedures are a requirement of the FRA. Significant willful fines can result from the violation of these rules. �Please refer to Canadian Pacific's General Requirement for Contractors On Track Safety Procedures. Contractors will not be allowed to foul a track unless: o They have been properly advised of the On Track Safety awareness procedures; o A railway employee who is qualified to provide protection is present at the work site. Fouling Track- The placement of an individual or an item of equipmenf in such proximity to a frack that the individual or equipmenf could be struck by a moving train or track unit or in any case within four(4)feet of the field side of the nearest rail. 7.1.7 No work activities or processes are allowed within 50 feet (15 meters) of the track centerline while trains are passing through the work site unless specifically authorized. Personnel shall always, where possible, stand at least 20 feet back from the track(s), to prevent injury from flying debris or loose rigging. Also, personnel shall observe the train as it passes and be prepared to take evasive action in the event of an emergency. 7.1.8 Personnel shall not remain in a vehicle that is within 50 feet (15 meters) of a passing train, and shall not drive near moving trains. Personnel shall move vehicles away from the tracks at least 50 feet (15.24 meters) unless specifically authorized, or park the vehicle away from the tracks and walk to a safe distance whenever trains pass. 7.1.9 Personnel shall not stand on or between adjacent tracks in multiple track territory when a train is passing. Personnel shall be especially alert in yards and terminal areas as engines may be pushing cars, cars may be moving without any engine attached and engine/cars change tracks often. 7.1.10 Personnel shall not walk, stand or sit on the rails. As the rail surface can be extremely slippery, personnel must step over the rails when crossing tracks. Personnel shall also be aware railway ties can also be slippery and that railway ballast can shift while walking on top of it. Personnel shall stay away from track switches as remotely operated switch points can move unexpectedly with enough force to crush ballast rock. Initialed by: � Personnel shall stay away from any other railway devices they are unsure of. Personnel shall not disturb or foul the ballast at any time. 7.1.11 Personnel shall not foul the track with any piece of equipment without a CP flagperson and proper protection. 7.1.12 Certain projects will require the assistance of a qualified flagperson. The decision as to where flagpersons are required rests with CP. One week advance notice is required before entering Railway property so that flagging protection requirements may be determined and arranged for. 7.1.13 Good communication between Contractor Personnel and CP's flagperson is imperative. Everyone must have knowiedge of the flagging limits, time limits and location to clear for any train movements. CP's flagperson will be responsible for clearing any movement of workers and equipment near the tracks, no matter how minor. 7.1.14 Contractor Personnel shall not interFere with a CP's flagperson who is communicating by radio with the dispatcher or other CP employees. Personnel shall wait until the flagperson is finished and able to give them full attention. Personnel shall not assume a move is cleared by something overheard on a radio conversation. 7.1.15 Personnel shall not move equipment across the tracks except at established road crossings, or unless under the protection and authorization of a CP flagperson and only if the job site has been properly prepared for such a move. Tracked equipment will require a CP flagperson any time railroad tracks are crossed. 7.1.16 Personnei shall not move equipment across railroad bridges or through tunnels, except as expressly agreed by CP, and under such conditions as stipulated by CP, including without limitation, a CP flagperson. 7.1.17 The Contractor shall keep all Contractor personnel informed of current weather conditions. Personnel shall stay alert for possible high water conditions or flash floods. During severe weather conditions: • Personnel shall be prepared to take cover in the event of a tornado. • Personnel shall not work while lightning is occurring; � If storm conditions arise unexpectedly, Contractor Personnel shall ensure that equipment is in the ciear of the tracks and secured before seeking cover. Contractor Personnel shall stay away from railroad tracks when visibility is poor, such as during fog or blizzard conditions. SR8 TOOLS,EQUIPMENTAND MACHINERY 8.1 All Contractor equipment, machinery and highway vehicles must: Initialed by: 9 • Be in good working order (including lights and safety devices such as back-up alarms}and properly serviced and maintained; • Be safe for their proposed use; • Be equipped with appropriate emergency equipment (examples include fire extinguisher,first aid kit;)based upon Contractor's risk assessment; • Comply with all applicable legisiation, regulations and codes. 8.2 Drivers of highway vehicles must be in possession of a valid driver's license of the proper class of the vehicle being operated. The use of seat belts is mandatory for all drivers and passengers. Operators of vehicles and construction equipment must keep their headlights on at all times and observe all facility/area's speed limits and traffic rules. Unless otherwise posted, the speed limit on the CP's roads is 15 mph (24 km/h) or less as conditions warrant. 8.3 Unless authorized in writing, contractors' employees are not permitted to operate or ride on any CP rolling stock and shall not be carried in CP vehicles except in case of an emergency or unless specifically authorized. 8.4 Tools must be used only for the purpose for which they are designed. Defective tools must be repaired or replaced. 8.5 Machinery and equipment must be operated and maintained only by persons properly trained and qualified for that duty. 8.6 All equipment shall be in compliance with applicable legislation, regulations and codes and be equipped with appropriate safety apparatus. In particular, all mobile equipment, including excavators, shall be equipped with beacons and backup alarms. 8.7 The Contractor shall provide adequate lighting when performing work between sunset and sunrise. SR9 CRANES 9.1 The Contractor shall ensure that its cranes and their operation by Contractor Personnel are in compliance with applicable legislation, regulations and codes and be equipped with appropriate safety apparatus. A copy of the latest annual crane inspection shall be provided to CP prior to the commencement of work. 9.2 All cranes shall be equipped with anti-two-blocking devices and safety latches on every hook. 9.3 All lifting apparatus such as steel cables, nylon slings, chains, shackles, etc., must be safety certified. 9.4 The Contractor shall conduct any work in proximity to power lines in such a manner that permits/procedures as required under applicable legislation, regulations and codes are adhered to. Initialed by: 1� 9.5 While railway traffic is passing through the work area, loads on cranes must be lowered to the ground to rest. Cranes without bucket or load must have their load line tightened or retracted to prevent movement. 9.6 Cranes parked on Railway property on nights or weekends shall be secured in a safe position well clear of all tracks to prevent accidental contact with trains and moving equipment and to not restrict train crew sightlines. Consult with CP personnel to determine the best location to store equipment and materials. Crane booms shall be lowered onto ground supports so that it will be impossible for them to rotate and cause a track to be fouled. SR10 CLEANUP,ENVIRONMENT AND FIRE PREVENTION 10.1 The Contractor shall take care to avoid any hazardous, unsafe, unhealthy or environmentally unsound condition, activity or spill on Railway property. The Contractor shall maintain Railway property in a tidy condition and free from the accumulation of waste products and debris. The Contractor shall not permit any debris, products used in the work, or water used to rinse out equipment, to be discharged or spilled on Railway property or into any adjacent lands, ditches, streams, ponds, sewers, etc. 10.2 The Contractor shall ensure that Contractor Personnel take all necessary precautions to prevent fires. All flammable material such as paper, rubbish, sawdust, oily or greasy rags, etc. must be kept away from buildings, structures and other facilities subject to fire damage. All flammable material must be disposed of daily by Contractor. 10.3 Storing or transporting fuel or gasoline in unapproved containers is prohibited. 10.4 If possible, the use of cutting or welding torches must be avoided during the last one-half hour of shifts. 10.5 Suitable, charged fire extinguishers and/or full water pump cans must be readily available at all times on the work site. Where the Contractor is working on the right-of- way or other property where a fire risk exists, the Contractor shall have appropriate fire prevention and suppression plan (including emergency numbers for CP, local firefighters and fire control districts) as well as such additional fire fighting equipment and trained Contractor Personnel on site, as required by provincial regulations, codes and guidelines. 10.6 CPR's representative must be advised promptly of any fire. Such fire must be fully extinguished or protection provided prior to leaving the work site. 10.7 Upon completion of the work, the Contractor shall remove his surplus materials and equipment from Railway property. The Contractor shall also remove all waste products and debris, including rinse out water, and leave Railway property clean and suitable for occupancy. SR11 HAZARDOUS MATERIALS and RESPONSIBLE CARE 11.1 If chemicals are required by the Contractor to carry out its contractual obligations, the Contractor must ensure that the transport, label, use and storage of any chemicals are in accordance with all applicable laws, regulations and codes. Initialed by: 1 1 11.2 For ail chemicals to be used, the Contractor must have available on site the latest Material Safety Data Sheet (MSDS) and provide CP with a list of employees' names who have been trained in Workplace Hazardous Materials Information System (WHMIS), or in OSHA's Hazard Communication Standard. 11.3 A current emergency response plan must be maintained by the Contractor and made available upon request to CP. Emergency response plans must include at a minimum: • Contractor reporting procedures in the event of an incident or spill; • Emergency response contacts and phone numbers; • Incident reporting phone numbers including phone numbers for CP incident reporting and local CP personnei. Any Contractor Personnel discovering a hazardous or potentially unsafe condition which may affect the safe passage of railway traffic or reporting an emergency or spill must advise CP immediately at: In Canada, Network Management Centre(NMC)Calgary 1-800-795-7851 In the US, Operations Center Minneapolis—1-800-SOO-HELP(1-800-766-4357) Canadian Pacific Police Services—1-800-716-9132 11.4 In the event of an incident or spill, The Contractor must take all reasonable actions to contain the spill and respond in accordance with its emergency response plan. 11.5 The Contractor shall dispose of all chemicals and surplus waste materials in accordance with all relevant legislation, regulations and codes. 11.6 In addition to compliance with all applicable legislation, regulations and codes and as part of CP's commitment to Responsible Care (an initiative by the chemical industry to which CP is a Responsible Care partner), contractors must have appropriate systems and controls in place to mitigate potential environmental, health and safety risks while using chemicals on Railway property. CP will provide Contractor with information regarding Responsible Care upon request from Contractor. SR12 FIRST AID,INCIDENT AND ACCIDENT REPORl1NG 12.1 The Contractor must have a first aid kit, of a size suitable for the crew, available in the immediate vicinity of the work site. It must be examined by the Contractor prior to the commencement of work, after each use and regularly each month to ensure that it is properly equipped. Any missing or altered articles must be promptly replaced by the Contractor. 12.2 Where required, other first aid equipment such as stretchers, emergency showers, eye wash stations, etc. must be made available by Contractor at the work site. Initialed by: 12 12.3 All accidents, personal injury, occupational illness, damage to Railway property or customer property, and incidents, such as environmental spills, must be reported promptly by the Contractor to CP. The Contractor shall provide CPR with as much detailed information as possible, including: • Time of incident; • Location of incident; • Extent of injuries and/or damage; • Description of incident including the cause of incident, if known; and • Contractor's name and telephone number. Canadian Pacific Emergency Numbers In Canada, Network Management Centre(NMC)Calgary 1-800-795-7851 In the US, Operations Center Minneapolis—1-800-SOO-HELP(1-800-766-4357) Canadian Pacific Police Seroices—1-800-716-9132 In the event of an environmental spill or any spill that could have a negative impact on the environment,the Contractor shall also provide CP with the following information: • Description of location and surrounding area, including any sensitive environmental areas nearby(e.g., rivers, parks, sewers); • Type and quantity of substance released; • Cause of spill or deposit, if known; and • Details of any immediate action taken or action proposed to be taken to contain spill and recover substance. 12.4 Security concerns and security incidents (i.e, theft, vandalism, bribery, stalking, assault or other incidents that may cause injury or prope►ty damage, or involve criminal activity) must be reported by Contractor to the Canadian Pacific Police Service 1-800-716-9132. SR13 JOB BRIEFINGS 13.1 When required by CP or by the Contractor, a job briefing must be conducted. 13.2 The Contractor Personnel performing services on Railway property must participate in the job briefing and any such individuals who are not able to be present at the main briefing, must attend a separate briefing. Contractor must ensure that all Contractor Initialed by: �3 Personnel on the work site understand the content of the job briefing. CP representative(s) or designates may attend at CP's sole discretion and shall include the participation of the CP Flagperson if present at the worksite. 13.3 The following topics should be covered in the job briefing: • Tasks to be accomplished; • Work location; • Contractor Personnel responsibilities; • Equipment to be used; • Specific safety reminder due to a hazardous condition; • Identification of all potential hazards specific to the area(s) in which they will be working and the tasks they are performing; • Special instructions due to an unusual situation or practice; • Type of track protection along with it's time and physical limits and identification of CP's employee responsible for the protection; • Emergency response plan/evacuation procedures. SR14 CONTRACTOR SAFETY POLICY 14.1 Prior to the commencement of any work, the Contractor shall provide CP with its applicable safety policies, rules and procedures. SR15 CONSTRUCTION SAFEfY PLAN 15.1 Prior to commencement of any construction work, the Contractor shall provide CP with a Construction Safety Plan. 15.2 The Construction Safety Plan shall: 15.2.1 List and define the construction methods that will be used for each major phase of the work and describe the process and safety procedures to be incorporated. 15.2.2 Integrate the necessary safeguards to be implemented in the work's planning schedules. 15.2.3 List all safety activities and their frequency including: • Contractor Personnel's Review of: ■ Canadian Railway's Minimum Safety Requirements for Contractors Working on Railway Property; Initialed by: I 4 ■ Contractor's Safety Plan; ■ Contractor's Emergency Information Sheet, and Emergency Response Plan; • Contractor Personnel Orientation Meetings; • Site Hazard Assessments; • Site Inspections and Monitoring; • Safety Meetings. 15.2.4 Provide for each piece of heavy equipment to be used, such as loaders, excavators and cranes, a summary of the Contractor Personnel's experience, past performance and safety tests, and list of previous accidents resulting from the equipment's operation. 15.2.5 Provide the layout of temporary construction buildings and facilities, including how the Contractor will ensure safe use. 15.2.6 Provide details of emergency procedures for work near or over water. Emergency equipment such as ring buoys, floating vests and, if physically possible, a powered boat must be readily available in the downstream vicinity of the work site. 15.2.7 Provide details of safety procedures for blasting work. Explosive materials must be handled, stored and used in accordance with all applicable legislation, regulations and codes. 15.2.8 Provide details of safety procedures for work in confined spaces including: • Atmosphere test results; • Evaluation of hazard within the confined space; • Procedures for entering/existing the confined space; • Required protection equipment; • Emergency procedures and equipment. Prior to entry of any Contractor Personnel into a confined space, Contractor shall conduct such testing, and obtain such permits as required under applicable legislation, regulations and codes. Contractor shall ensure Contractor Personnel wear such additional protective equipment as determined necessary by the Contractor, based upon the Contractor's risk assessment of the space (examples include full body harness, approved respirators, etc.). Initialed by: 15 15.2.9 Provide the layout of cranes, proposed lifting procedures and other pertinent information such as cranes' capacity charts, working radius, loads, possible obstacles or site restrictions, etc. 15.2.10 Provide an Emergency Information Sheet for notifying medical assistance, emergency transportation and direction of rescue operations, including the information identified in appended Table A. Copies of this document shall be present on site at all times and be in a location readily accessible to all Contractor Personnel on the site. Its content shall be reviewed at the beginning of each week and when job location changes. The Contractor must ensure that ail Contractor Personnel on the work site are familiar with its contents. 15.3 The Safety Plan shall also include drawings and specifications prepared, sealed and signed by a qualified professional engineer, for each of the following items, whenever applicable to the work: 15.3.1 Details of the design, erection, use and inspection of fall prevention structures such as scaffolding, work platforms and other staging. These are mandatory wherever Contractor Personnel are working at heights in excess of 8 feet (2.44 meters), in Canada or 10 feet (3.05 meters), in the USA, above the nearest permanent safe level or where a drowning hazard exists. This requirement does not apply where pre-engineered scaffolding is used as a fall prevention device; provided it is used in accordance with the manufacturer specifications and is designed to meet all applicable legislation, regulations and codes. Details of fall protection systems when it is physically impossible to provide safe fall prevention structures or when working on a temporary structure more than 20 feet (6.10 meters) in Canada and as per health and safety legislation, regulations and codes applicable to the work in the US, above the nearest permanent safe level. Personal fall protection equipment shall include a CSA or ANSI approved full body harness, lanyard and shock-absorbing device, attached to a CSA or ANSI approved or engineered anchored lifeline or fixed anchor. The system shall also provide a retrieval device or equipment readily available on the work site. Safety nets are acceptable in lieu of personal fall protection equipment, if it is impracticable to use a fall protection system. The Contractor shall also provide a fall rescue plan to be used in accordance with any fall protection plan as required. 15.3.2 Details of shoring systems for excavations, which may endanger nearby Contractor Personnel or structures. Shoring systems shall be designed to comply with applicable legislation, regulations and codes. Excavations must be properly covered or barricaded with appropriate reflective equipment. Lights or flares must be used where practicable. SR16 COMPLIANCE WITH SAFETY REQUIREMENTS 16.1 If ever the Contractor's Personnel do not comply with the safety requirements, the Contractor's site supervisor will be reminded of the requirements by the CP's representative. If Contractor Personnel refuses to comply with the safety requirements, the Contractor will be required to ensure that such Contractor Personnel immediately Initialed by: �h leave the property, failing which CP maintains the right to require the Contractor Personnel to immediately leave the property. Any working procedures not conforming to the safety requirements will result in the closing down of the work site. 16.2 CP will not accept any claims for delays or lost time due to safety compliance or procedures issues. The above provisions and requirements may be amended from time to time by Canadian Pacific. Initialed by: 1� TABLE A-EMERGENCY INFORMATION SHEET WORK SITE INFORMATION Work Site Location: (Mileage, Subdivision) (Address, Number and Street) Contractor' Supervisor: (Name) (Title) Site Telephone: Emergency Site Access Route: (Provide sketch-Snow�ng access roads,physical landmarks to guide EMS to location� Nearest Town: Certified First Aid Attendant: Location of First Aid Supplies at Site: Location of Fire Extinguishing Equipment: EMERGENCY CONTACT INFORMATION EMERGENCY CONTACTS PHONE LOCATION Railway Traffic Controller: ( ) Firefighter: ( ) Police: ( ) Ambulance: ( ) Hospital: ( ) Physician: ( ) Aircraft Service, (if applicable): ( ) Watercraft Service, (if applicable): ( ) Stretcher location at site: ( ) Location of WHIMS data sheets: ( ) Type and location of retrieval systems at bridges, (if applicable): ( ) Type and location of emergency equipment for work near or over � � water, (if applicable): Employee(s) responsible for rescue operations, (if applicable): ( ) Designated Evacuation Vehicle: ( ) Emergency Evacuation Route, (Provide sketch): ( ) UTILITIES INFORMATION UTILITIES CONTACT PHONE LOCATION Natural Gas: ( ) Electrical: ( ) Fibre Optic Line: Water& Sewer: ( ) Telephone: ( ) Cable System: ( ) Qualified employee(s) in: ( ) Confined Space Entry, (if applicable): ( ) Equipment requirements for Confined Space Entry, (if applicable): ( ) All job sites will be open to audits by CP Safety and Health representatives. Date: Signed: t;�.�nrf<.t�;��'��'s �t�,��::-vi�� Initialed by: 1 �.�� ,r �'°`.3 �, ,., � ,,,�, .�, +' ` , ��p ;'�" 4 � ��Jz�ii�� ,��qu� �r, �'.�. ��x ��1� ' .� �r , � .�f ��q��, ��+: �� q��, �A ��4 �� 4 ,� s � 3 r. � ;, _ � � ,. � � � _ ��' � � . �-.:. d ' �.�,�; � '� h �� } ��7•7��t� ��; (�� 57-7�� ` � �. i� �. .} �, ��f (� � '� 1 ° 9 � Y j � f, y� 9 To: CITY OF DUBUQUE-ENGINEERING DEPT. Contact: Eric Vieth-Deron Muehring Address: 50 W. 13th St. Phone: (563)589-4270 Dubuque,IA 52001 Fax: (563)589-4205 Project Name: Dbq-17th Street Excavation-Bore Under Railroad Tracks Bid Number: Project Location: Dbq-17th Street Excavation-Bore Under Railroad Tracks,Dubuque, Bid Date: 11/7/2019 IA Line# Item# Item Descri tion Estimated uanti Unit Unit Price Total Price 1 -17th Excavation 1 Mobilization-General 1.00 LS $575.00 $575.00 2 Railroad Protective Insurance 1.00 LS $5,500.00 $5,500.00 3 Excavation And Backfill 17th Street Outlet 1.00 LS $7,100.00 $7,100.00 Structure-20 X 50 To Elevation 596+50- Approx 950 Cy 4 Stone Base-Pad 6"Depth 20.00 TON $22.10 $442.00 Total Price for above 1-17th Excavation Items: $13,617.00 Notes: • The followina items are included in this auote: ' Not Included: Any Testing or Sampling of Materials ' Not Included: Removal of Hazardous or Contaminated materials • Not Included: Erosion Control • All costs will be based on actual quantities installed • Not Included: Retaining Walls ACCEPTED: CONFIRMED: The above prices,specifications and conditions are satisfactory Tschiggfrie Exc.Co. and hereby accepted. Buyer: � _�. Signature: Authorized Signature: � Date of Acceptance: Estimator: Randy Steffen (563)590-1502 rsteffen@tschiggfrie.net 11/7/2019 2:20:08 PM Page 1 of 1