Verizon Wireless Grant of Easement - Small Cell Equipment_Flora Park_InitiateCopyrighted
April 6, 2020
City of Dubuque Items to be set for Public Hearing # 2.
ITEM TITLE: Verizon Wireless Grant of Easement - Small Cell
Equipment in Flora Park
SUMMARY: City Manager recommending approval of a resolution
granting Bell Atlantic Mobile Systems LLC, d/b/a Verizon
Wireless, a 10 foot -wide easement from the public right-of-
way, across City of Dubuque property in Flora Park, to a
light pole to access and install underground utilities to
operate the small cell equipment on the light pole.
SUGGESTED DISPOSITION:
RESOLUTION Setting public hearing on the Grant of
Easement to Bell Atlantic Mobile Systems, LLC d/b/a
Verizon Wireless, for small cell equipment in Flora Park
Suggested Disposition: Receive and File; Adopt
Resolution(s), Set Public Hearing for April 20, 2020
ATTACHMENTS:
Description Type
Verizon Wireless Easement-MVM Memo City Manager Memo
Staff Memo Staff Memo
Resolution Setting Public hearing Resolutions
Grant of Easement Supporting Documentation
Masterpiece on the Mississippi
Dubuque
bitil
All-A.aia City
111111
2007.2012.2013
2017*2019
TO: The Honorable Mayor and City Council Members
FROM: Michael C. Van Milligen, City Manager
SUBJECT: Grant of Easement to Verizon Wireless for Small Cell Equipment in Flora
Park
DATE: March 25, 2020
Bell Atlantic Mobile Systems LLC, d/b/a Verizon Wireless, has requested a 10' wide
easement from the public right of way, across City of Dubuque property in Flora Park, to
a light pole to access and install underground utilities to operate the small cell
equipment on the light pole.
Senior Counsel Barry Lindahl recommends City Council approval of a resolution
granting the easement.
I concur with the recommendation and respectfully request Mayor and City Council
approval.
7--
Mic ael C. Van Milligen
MCVM:jh
Attachment
cc: Crenna Brumwell, City Attorney
Teri Goodmann, Assistant City Manager
Cori Burbach, Assistant City Manager
Barry Lindahl, Senior Counsel
WIT
Masterpiece on the Mississippi
BARRY A. LINDAHL, ESQ.
SENIOR COUNSEL
MEMO
To: Michael C. Van Milligen
City Manager
DATE: March 23, 2020
Dubuque
tard
AII•Ameriea City
1111'
2007.2012.2013
2017*2019
RE: Grant of Easement to Verizon Wireless for Small Cell Equipment in Flora
Park
Bell Atlantic Mobile Systems LLC, d/b/a Verizon Wireless, has requested the attached 10'
wide easement from the public right of way, across City of Dubuque property in Flora
Park, to a light pole to access and install underground utilities to operate the small cell
equipment on the light pole. A pole attachment permit was issued to Verizon Wireless on
March 21, 2019.
The easement has been approved by the Engineering and Leisure Services Departments,
as well as the City Attorney's Office.
I recommend that the attached resolution be submitted to the City Council for review and
approval.
BAL:tls
Attachment
cc: Crenna M. Brumwell, City Attorney
Marie Ware, Leisure Services Manager
Jon Dienst, Civil Engineer II
OFFICE OF THE CITY ATTORNEY DUBUQUE, IOWA
SUITE 330, HARBOR VIEW PLACE, 300 MAIN STREET DUBUQUE, IA 52001-6944
TELEPHONE (563) 583-4113 / FAX (563) 583-1040 / EMAIL balesq@cityofdubuque.org
RESOLUTION NO. 107-20
SETTING A PUBLIC HEARING ON THE GRANT OF EASEMENT TO BELL ATLANTIC
MOBILE SYSTEMS LLC, D/B/A VERIZON WIRELESS, FOR SMALL CELL
EQUIPMENT IN FLORA PARK
Whereas, the City of Dubuque, Iowa (City) is the owner of real property legally
described as:
ALL THAT PARCEL OF LAND IN THE TOWNSHIP OF DUBUQUE IN THE
COUNTY OF DUBUQUE AND STATE OF IOWA AS MORE FULLY
DESCRIBED IN DEED BOOK 154 PAGE 337 AND BOOK 154 PAGE 336
AND PARCEL # 1022481003, BEING KNOWN AND DESIGNATED AS:
DEED BOOK 154, PAGE 337:
LOT 2 OF SUB. OF LOT 2 OF LOT 1 OF LOT 1 OF LOT 1 OF LOT 3 OF
LOT 1 OF LOT 1 OF LOT 2 OF JOHN P, MATTEL'S SUBDIVISION IN
DUBUQUE TOWNSHIP, DUBUQUE COUNTY, IOWA, NOW IN THE CITY
OF DUBUQUE, IOWA.
DEED BOOK 154, PAGE 336:
LOT 1 OF SUB. OF LOT 2 OF LOT 1 OF LOT 1 OF LOT 1 OF LOT 3 OF
LOT 1 OF LOT 1 OF LOT 2 OF JOHN P. MATTEL'S SUBDIVISION IN
DUBUQUE TOWNSHIP, DUBUQUE COUNTY, IOWA, NOW IN THE CITY
OF DUBUQUE, IOWA, AND
LOT 2 OF SUB. OF LOT 1 OF LOT 1 OF LOT 1 OF LOT 1 OF LOT 3 OF
LOT 1 OF LOT 1 OF LOT 2 OF JOHN P. MATTEL'S SUBDIVISION IN
DUBUQUE TOWNSHIP, DUBUQUE
COUNTY, IOWA, NOW IN THE CITY OF DUBUQUE, IOWA.
(the Property); and
Whereas, Bell Atlantic Mobile Systems LLC, d/b/a Verizon Wireless, has requested a
10' wide easement from the public right of way, across City of Dubuque the Property in
Flora Park, as shown on the attached Grant of Easement, to a Tight pole to access and
install underground utilities to operate the small cell equipment on the Tight pole; and
Whereas, a pole attachment permit was issued to Verizon Wireless on March 21, 2019;
and
Whereas, the City Council finds that it is in the interests of the City of Dubuque to
approve the Grant the Easement.
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF
DUBUQUE, IOWA:
Section 1. The City of Dubuque intends to vacate and dispose of its interest in the
foregoing -described Property to Bell Atlantic Mobile Systems LLC, d/b/a Verizon Wireless
pursuant to the proposed Grant of Easement.
Section 2. The City Clerk is hereby authorized and directed to cause this Resolution and
a notice to be published as prescribed by Iowa Code Section 364.7 of a public hearing on
the City's intent to dispose of the foregoing -described Property, to be held on the 20th day
of April, 2020 at 6:30 p.m. in the City Council Chambers at the Historic Federal Building, 350
W. 6th Street, Dubuque, Iowa.
Section 3. That the notice of the proposed action shall be in substantially the form
attached hereto.
Passed, approved and adopted this 6th day of April 2020.
Roy 1. Buol, Mayor
Attest:
Kevin,: Firnstahl, City Clerk
GRANT OF NON-EXCLUSIVE EASEMENT
THIS GRANT OF NON-EXCLUSIVE EASEMENT ("Easement") is dated as of the
day of , 20_, by the City of Dubuque, Iowa (hereinafter "Grantor"),
and Bell Atlantic Mobile Systems LLC d/b/a Verizon Wireless (hereinafter "Grantee").
WHEREAS, Grantor is the owner of certain real property in Dubuque County, Iowa,
legally described in Exhibit "A" attached hereto (the "Property").
WHEREAS, Grantee will be installing and operating small cell equipment on, and
utilities to, the light pole (the "Pole") on the Property owned by Grantor, at the location described
in Exhibit "B" attached hereto, pursuant to the Pole Attachment Permit issued to Grantee on
March 21, 2019 by Interstate Power and Light Company d/b/a Alliant Energy (the "Permit").
WHEREAS, Grantor has agreed to convey to Grantee a non-exclusive access and utility
easement over, under and across Grantor's Property, as legally described in Exhibit "B" attached
hereto (the "Easement Area").
NOW, THEREFORE, for good and valuable consideration, the receipt and sufficiency of
which is hereby acknowledged, and in consideration of the mutual covenants contained herein,
the parties intending to be legally bound hereby agree as follows:
1. Grant of Easement. Grantor hereby grants to Grantee, its successors and assigns,
a non-exclusive access and utility easement over, under, and across the Easement Area for the
purposes of ingress and egress at all times during the term of the Permit, and for constructing,
maintaining, operating, repairing and replacing utility lines, including fiber optic cables and
conduits, to and from the Pole.
a. Each party shall utilize its estate in a manner which will minimize
interference with the other party's use of its estate.
b. Upon completion of construction, Grantee shall restore the
Easement Area to substantially its pre-existing condition.
2. Consideration. In consideration for the rights granted herein, a portion of
Licensor's Property will receive the benefits of enhanced wireless communications arising from
the operation of Licensee's communications equipment on the Pole. The design, construction,
equipment, installation, maintenance and removal of the communications equipment, utility
lines, cables and conduit shall be at Licensee's sole cost.
3. No Permanent Structures. Grantor hereby covenants for and on behalf of itself,
its heirs, successors or assigns, that neither it, nor any of them, shall construct or permit to be
constructed, any building or any other permanent structure within the Easement Area, or make
any permanent excavation, or permit any permanent excavation to be made within the Easement
Area.
4. Term. The easement, rights, and privileges herein granted shall be for a term
coinciding with the term of the Permit, including any renewals thereof, and shall, without any
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further action on the part of Grantor or Grantee, terminate immediately upon the termination of
said Permit. Upon termination of this Easement for any reason, at Grantor's request Grantee shall
execute and deliver a notice of termination in form suitable for recording in the official records
of the County.
5. Termination for Default. Upon Grantee's default hereunder, Grantor may deliver
to Grantee a written notice of default, stating with specificity the nature of Grantee's default. If
Grantee has not cured the default within a reasonable time (but not less than 30 days for a
monetary default and 60 days for a non -monetary default) after receipt of the notice of default,
Grantor may terminate this Easement effective immediately upon receipt by Grantee of Grantor's
written notice of termination.
6. Indemnification. Grantee agrees to indemnify, defend and hold Grantor harmless
from and against any direct injury, loss, damage or liability, costs or expenses (including
reasonable attorneys' fees and court costs) resulting from the negligence or willful misconduct of
Grantee, its employees, contractors or agents, except to the extent attributable to the negligence
or willful misconduct of Grantor, its employees, contractors or agents. Grantor agrees to
indemnify, defend and hold Grantee harmless from and against any and all direct injury, loss,
damage or liability, costs or expenses (including reasonable attorneys' fees and court costs)
resulting from the negligence or willful misconduct of Grantor, its employees, contractors or
agents, except to the extent attributable to the negligence or willful misconduct of Grantee, its
employees, contractors or agents.
7. Insurance. Grantee agrees at its own cost and expense to provide insurance as set
forth in the attached Insurance Schedule A, as such Schedule may from time to time be amended
by Grantee and Grantor. Grantee acknowledges that Grantor is a member of the Iowa
Communities Assurance Pool (ICAP) and Grantee acknowledges that Grantor 's insurance
coverage is subject to the terms of Grantor's ICAP Agreement. Grantee agrees that its approval
of any proposed amendment to the coverage limits in Insurance Schedule A will not be
unreasonably withheld, conditioned, or delayed. Grantor and Grantee each agree that it will
include the other party as an additional insured as their interests may appear under this Easement.
8. Assignment. This Easement may, with notice to Grantor, be sold, assigned or
transferred by Grantee without any approval or consent of the Grantor to the Grantee's principal,
affiliates, subsidiaries of its principal, or to any entity which acquires all or substantially all of
Grantee's assets in the market defined by the FCC in which the Property is located by reason of a
merger, acquisition or other business reorganization. As to other parties, this Easement may not
be sold, assigned or transferred without the written consent of Grantor, which consent will not be
unreasonably withheld, delayed or conditioned. No change of stock ownership, partnership
interest or control of Grantee or transfer upon partnership or corporate dissolution of Grantee
shall constitute an assignment hereunder. Grantee shall be released from its obligations
hereunder only with the prior written consent of Grantor.
9. Notices. All notices hereunder must be in writing and shall be deemed validly
given if sent by certified mail, return receipt requested or by commercial courier, provided the
courier's regular business is delivery service and provided further that it guarantees delivery to
the addressee by the end of the next business day following the courier's receipt from the sender,
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DBQ Spartan SC6 - Easement (GL#414615)
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addressed as follows (or any other address that the party to be notified may have designated to
the sender by like notice):
Grantor: City of Dubuque, Iowa
Attention: City Manager
50 West 13th Street
Dubuque, Iowa 52001
Grantee: Bell Atlantic Mobile Systems LLC
d/b/a Verizon Wireless
Attention: Network Real Estate
180 Washington Valley Road
Bedminster, New Jersey 07921
Notice shall be effective upon actual receipt or refusal as shown on the receipt obtained
pursuant to the foregoing.
10. Dominant and Servient Tenements. This Easement is granted for the benefit of
the Pole, and is appurtenant to the Pole. The Pole are the dominant tenement and the Property is
the servient tenement.
11. Entire Agreement. This Easement constitutes the entire agreement between
Grantor and Grantee relating to the above easement. Any prior agreements, promises,
negotiations or representations not expressly set forth in this Easement are of no force and effect.
12. Binding Covenants. The provisions herein shall be deemed covenants that run
with the land. This Easement shall be binding on and shall inure to the benefit of the heirs,
executors, administrators, successors and assigns of Grantor and Grantee.
13. Amendments. Any modification or other termination of this Easement shall
become effective only upon the execution by Grantor and Grantee of a written instrument.
14. Recording. Grantor agrees to execute a Memorandum of this Easement, and any
amended Memorandum of Easement reflecting any material modifications to this Easement,
which Grantee may record in the office of the County Clerk of Dubuque County, Iowa.
[SIGNATURE PAGE FOLLOWS]
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IN WITNESS WHEREOF, this Grant of Easement has been executed and delivered as of
the day and year first above written.
GRANTOR: City of Dubuque, Iowa
By:
Name:
Title:
Date:
GRANTEE: Bell Atlantic Mobile Systems LLC
d/b/a Verizon Wireless
By:
Name:
Title:
Date:
4
DBQ Spartan SC6 - Easement (GL#414615)
CORE/0762186.2998/ 156516883.3
EXHIBIT "A"
The "Property"
Property Address: 2635 Pennsylvania Avenue
State: Iowa
County: Dubuque
City: Dubuque
Parcel Number: 1022481003
Legal Description (if available):
ALL THAT PARCEL OF LAND IN THE TOWNSHIP OF DUBUQUE IN THE COUNTY OF
DUBUQUE AND STATE OF IOWA AS MORE FULLY DESCRIBED IN DEED BOOK 154
PAGE 337 AND BOOK 154 PAGE 336 AND PARCEL # 1022481003, BEING KNOWN AND
DESIGNATED AS:
DEED BOOK 154, PAGE 337:
LOT 2 OF SUB. OF LOT 2 OF LOT 1 OF LOT 1 OF LOT 1 OF LOT 3 OF LOT 1 OF LOT 1
OF LOT 2 OF JOHN P, MATTEL'S SUBDIVISION IN DUBUQUE TOWNSHIP, DUBUQUE
COUNTY, IOWA, NOW IN THE CITY OF DUBUQUE, IOWA.
DEED BOOK 154, PAGE 336:
LOT 1 OF SUB. OF LOT 2 OF LOT 1 OF LOT 1 OF LOT 1 OF LOT 3 OF LOT 1 OF LOT 1
OF LOT 2 OF JOHN P. MATTEL'S SUBDIVISION IN DUBUQUE TOWNSHIP, DUBUQUE
COUNTY, IOWA, NOW IN THE CITY OF DUBUQUE, IOWA, AND
LOT 2 OF SUB. OF LOT 1 OF LOT 1 OF LOT 1 OF LOT 1 OF LOT 3 OF LOT 1 OF LOT 1
OF LOT 2 OF JOHN P. MATTEL'S SUBDIVISION IN DUBUQUE TOWNSHIP, DUBUQUE
COUNTY, IOWA, NOW IN THE CITY OF DUBUQUE, IOWA.
Exhibit "A"
Page 1 of 1
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EXHIBIT "B"
The "Easement Area"
Property Address: 2635 Pennsylvania Avenue
State: Iowa
County: Dubuque
City: Dubuque
Parcel Number: 1022481003
Legal Description (if available):
A PART OF LOT 1 AND PART OF LOT 2 OF THE SUBDIVISION OF LOT 2 OF LOT 1 OF
LOT 1 OF LOT 1 OF LOT 3 OF LOT 1 OF LOT 1 OF LOT 2 OF JOHN P. METTEL'S
SUBDIVISION IN DUBUQUE TOWNSHIP, DUBUQUE COUNTY, IOWA DESCRIBED AS
FOLLOWS:
COMMENCING AT THE NW CORNER OF LOT 1 OF THE SUBDIVISION OF LOT 1 OF
LOT 2 OF SAID LOT 1 OF LOT 1 OF LOT 2 OF JOHN P. METTEL'S SUBDIVISION ON
THE EAST RIGHT OF WAY LINE OF GREEN STREET; THENCE S01°34'32"E ALONG
SAID EAST RIGHT OF WAY LINE, 45.25 FEET; THENCE S88°25'28"W, 50.00 FEET TO
THE WEST RIGHT OF WAY LINE OF SAID GREEN STREET TO THE POINT OF
BEGINNING; THENCE N76°22'38"W, 67.76 FEET; THENCE N13°37'22"E, 10.00 FEET;
THENCE S76°22'38"E, 65.04 FEET TO SAID WEST RIGHT OF WAY LINE; THENCE
S01°34'32"E ALONG SAID WEST RIGHT OF WAY LINE, 10.36 FEET TO THE POINT OF
BEGINNING, CONTAINING 0.02 ACRES.
Attach Drawing below if available: See Attached
Exhibit "B"
Page 1 of 2
DBQ Spartan SC6 - Easement (GL#414615)
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10' NON-EXCLUSIVE ACCESS & UTILITY
EASEMENT
PARENT PARCEL LINE
LOT 1 OF SUB.
OF LOT 2 OF LOT 1 OF LOT I OF LOT
OF LOT OF LOT 1 OF LOT I OF LOT2
OF JOHN P_ METTEL'S SUBDIVISION
N13' 37' 22"E
10.00'
z
071.1
N76'22'38"W
cc
0
67.76'
FOUND IRON
10' ACCESS & UTILITY EASEMENT
0.02 Ac.
PO8
LOT2 OF SUB.
OF LOT 20F LOT
OF LOT 10F LOT
OF LOT 30F LOT
OF LOT OF LOT2
OF JOHN P. METTEL'S
SUBDIVISION
LOT 2 OF SUB.
OFLOTIOF LOT
OF LOT I OF LOT
OF LOT OF LOT
OF LOT I OF LOT2
OF JOHN P. METTEL'S
SUBDIVISION
PARENT PARCEL LINE
PARENT PARCEL LINE
LOTI OF SUB.
OF LOT IOF LOT
OF LOT IOF LOT/
OFLOT3 OFLOT1
OFLOTIOFLOT2
OF JOHN P. METTEL'S
SUBDIVISION
�eC/0�7GHT OFFkHy0/7E
'%NNs
y< l/q/1/49
R,�yTD �q gVFNeF
• FOUND 1/2"REBAR
OR AS LABELED
POB
POT
POC
POINT OF BEGINNING
POINT OF TERMINATION
POINT OF COMMENCEMENT
DATE OF SURVEY 11/12/19
S76" 22' 38"E
65 04'
Sr 34' 32"E
10.36'
50.00' _
N88° 25' 28"E
PUBLIC RIGHT OF WAY LINE
RECORDED AS
UE UTILITY EASEMENT
UDE UTILITY & DRAINAGE
EASEMENT
YPC YELLOW PLASTIC CAP
PUBLIC RIGHT OF WAY LINE
OWNER CITY OF DUBUQUE
Parcel ID: 1022481003
Site Address:2635 PENNSYLVANIA
AVE
City: DUBUQUE
Zip: 52001
LOT IOE SUB.
OF LOT 1OF LOT
OF LOT2 OF LOT 1
OF LOT 10F LOT2
OF JOHN P. METTEL'S
SUBDIVISION
LOT2 OF SUB.
OF LOT OF LOTi
OF LOT2 OF LOTI
OF LOTI OF LOT2
OF JOHN P. METTEL'S
SUBDIVISION
LEGAL DESCRIPTION- 10' ACCESS & UTILITY EASEMENT
A part of Lot 1 and part of Lot 2 of the Subdivision of Lot 2 of Lot 1 of Lot
1 of Lot 1 of Lot 3 of Lot 1 of Lot 1 of Lot 2 of John P. Mettel's Subdivision
in Dubuque Township, Dubuque County, Iowa described as follows;
Commencing at the NW Corner of Lot 1 of the Subdivision of Lot 1 of Lot
2 of said Lot 1 of Lot 1 of Lot 2 of John P. Mettel's Subdivision on the east
right of way line of Green Street
thence S01 °34'32"E along said east right of way line, 45.25 feet;
thence S88°25'28"W, 50.00 feet to the west right of way tine of said
Green Street to the Point of Beginning;
thence N76'22'381W, 67.76 feet;
thence N13"37'22 E, 10.00 feet:
thence S76°22'38"E, 65.04 reef to said west right of way fine;
thence S01 °34'32"E along said west right of way fine, 10.36 feef to the
Point of Beginning, containing 0.02 acres.
BR
IN
ENGINEERING, I N C .
Drawing Title_
DBQ Spartan SC6
10'ACCESS & UTILITY EASEMENT
K \ProA514019-10 DRO SPARTAN SC6/514019-40 DBp SPARTAN SC6.dwg, 1 /20/2020 2 18.12 PM
Exhibit "B"
Page 2 of 2
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City of Dubuque Insurance Requirements for Lessees of City Property and Right of Way Licensees or
Permittees
INSURANCE SCHEDULE A
1. Grantee shall furnish a signed certificate of insurance to the City of Dubuque, Iowa for the coverage
required in Exhibit I upon the lease, license, or permit commencement. All lessees of City property
and right of way licensees or permittees shall submit an updated certificate annually. Each certificate
shall be prepared on the most current ACORD form approved by the Iowa Insurance Division or an
equivalent. Each certificate shall include a statement under Description of Operations as to why the
certificate was issued. Eg: Project # or lease of premises at or
construction of , or right of way permitted location and description
2. All policies of insurance required hereunder shall be with an insurer authorized to do business in
Iowa and all insurers shall have a rating of A- or better in the current A.M. Best's Rating Guide.
3. Each certificate shall be furnished to the
Department of the City of Dubuque.
4. The lessee, licensee, or permittee shall be required to carry the coverage/limits, or greater if required
by law or other legal agreement, in Exhibit I. Failure to provide the required coverage shall not be
deemed a waiver of such requirements by the City of Dubuque.
5. Failure to obtain or maintain the required insurance shall be considered a material breach of the
lease, license, or permit.
6. All required endorsements shall be attached to certificate.
7. Lessee, licensee, or permittee 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. Lessee, licensee, or permittee 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 lessee, licensee, or permittee.
Insurance Schedule "A"
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INSURANCE SCHEDULE A (Continued)
EXHIBIT I
A) COMMERCIAL GENERAL LIABILITY
General Aggregate Limit $3,000,000
Products -Completed Operations Aggregate Limit $2,000,000
Personal and Advertising Injury Limit $2,000,000
Each Occurrence $2,000,000
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 or its substantial equivalent.
2) Include ISO endorsement form CG 25 04 'Designated Location(s) General Aggregate Limit."
3) Be primary and non-contributory.
4) Include Preservation of Governmental Immunities Endorsement (Sample attached).
5) Deletes any fellow employee exclusion.
6) Include the City of Dubuque, including all its elected and appointed officials, its employees and
volunteers, boards, commissions as an additional insured as their interest may appear under this
Easement which includes ongoing operations and completed operations equivalent to CG2010 and
CG2037.
7) Policy shall include Waiver of Subrogation in favor of the City.
B) WORKERS' COMPENSATION 8. EMPLOYERS LIABILITY
Statutory benefits covering all employees injured on the job by accident or disease as prescribed by Iowa Code
Chapter 85 as amended.
Coverage A
Coverage B
Statutory —State of Iowa
Employers Liability
Each Accident $100,000
Each Employee -Disease $100,000
Policy Limit -Disease $500,000
Policy shall include a Waiver of Subrogation in favor of the City
C) PROPERTY INSURANCE REQUIRED BY LEASE, LICENSE, OR PERMIT
yes X no
Evidence of property coverage provided: yes
Included the City of Dubuque as Lender Loss Payable.
E) RIGHT-OF-WAY WORK ONLY:
UMBRELLA/EXCESS $2,000,000
X yes no
Umbrella/excess liability coverage must be at least following form with the underlying policies included herein.
Insurance Schedule "A"
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PRESERVATION OF GOVERNMENTAL IMMUNITIES ENDORSEMENT
1. Nonwaiver of Governmental Immunity. The insurer expressly agrees and states that the purchase of
this policy and the including of the City of Dubuque, Iowa as an Additional Insured does not waive any of the
defenses of governmental immunity available to the City of Dubuque. Iowa under Code of Iowa Section 670.4
as it is now exists and as it may be amended from time to time.
2. Claims Coverage. The insurer further agrees that this policy of insurance shall cover only those
claims not subject to the defense of governmental immunity under the Code of Iowa Section 670.4 as it now
exists and as it may be amended from time to time. Those claims not subject to Code of Iowa Section 670.4
shall be covered by the terms and conditions of this insurance policy.
3. Assertion of Government Immunity. The City of Dubuque, Iowa shall be responsible for asserting any
defense of governmental immunity, and may do so at any time and shall do so upon the timely written request
of the insurer.
4. Non -Denial of Coverage. The insurer shall not deny coverage under this policy and the insurer shall
not deny any of the rights and benefits accruing to the City of Dubuque, Iowa under this policy for reasons of
governmental immunity unless and until a court of competent jurisdiction has ruled in favor of the defense(s)
of governmental immunity asserted by the City of Dubuque, Iowa.
No Other Change in Policy. The above preservation of governmental immunities shall not otherwise change
or alter the coverage available under the policy.
SPECIMEN
(DEPARTMENT MANAGER: FILL IN ALL BLANKS AND CHECK BOXES)
Insurance Schedule "A"
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