BVM-PHS Grant of Sanitary Sewer Easement_Initiate Copyrighted
September 8, 2020
City of Dubuque Items to be set for Public Hearing # 1.
City Council Meeting
ITEM TITLE: BVM-PHS Grant of Sanitary Sewer Easement
SUM MARY: City Manager recommending that the City Council set a public hearing for
September 21, 2020, to grant a private sanitary sewer easement across
City-owned property along Julien Dubuque Drive to BVM-PHS Senior
Housing, I nc. as part of the Mt. Carmel Campus improvements project.
RESOLUTION of Intent to dispose of City interest by Grant of
Easement for sanitary sewer utility to BVM-PHS Senior Housing, I nc.
across part of lot 1-2-1 of the NW Fractional Quarter of the NE Quarter
and part of Lot 2-1 of the NE Fractional Quarter of the NW Quarter,
Section 6, T88N, R3E, lying north of Julien Dubuque Drive, Dubuque
County, I owa
SUGGESTED Receive and File;Adopt Resolution(s), Set Public Hearing for
DISPOSITION: September21, 2020Suggested Disposition:
ATTACHMENTS:
Description Type
BVM-PHS Grant of Sanitary Sewer Easement-MVM City Manager Memo
Memo
Staff Memo Staff Memo
Resolution Resolutions
Grant of Easement Supporting Documentation
Area Map Supporting Documentation
Dubuque
THE CITY OF �
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TO: The Honorable Mayor and City Council Members
FROM: Michael C. Van Milligen, City Manager
SUBJECT: Grant of Easement to BVM-PHS Senior Housing, Inc.
DATE: September 1, 2020
City Engineer Gus Psihoyos recommends the City Council set a public hearing for
September 21, 2020, to grant a private sanitary sewer easement across City-owned
property along Julien Dubuque Drive to BVM-PHS Senior Housing, Inc. as part of the
Mt. Carmel Campus improvements project.
I concur with the recommendation and respectfully request Mayor and City Council
approval.
�
Mic ael C. Van Milligen
MCVM:jh
Attachment
cc: Crenna Brumwell, City Attorney
Teri Goodmann, Assistant City Manager
Cori Burbach, Assistant City Manager
Gus Psihoyos, City Engineer
Dubuque
THE CITY OF �
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TO: Michael C. Van Milligen, City Manager
FROM: Gus Psihoyos, City Engineer
SUBJECT: Grant of Easement to BVM-PHS Senior Housing, Inc.
DATE: August 31, 2020
INTRODUCTION
This is in response to a request from BVM-PHS Senior Housing, Inc. for the granting of
private sanitary sewer easement across City owned property along Julien Dubuque
Drive as part of the Mt. Carmel Campus improvements project.
DISCUSSION
BVM-PHS Senior Housing, Inc. is proposing to improve the Mt. Carmel Campus by
adding new skilled nursing, assisted living, memory care facilities (Phase 1
improvements), and independent senior living units (Phase 2 improvements) over the
next several years.
By resolution number 274-19, the City approved a Memorandum of Agreement with
BVM-PHS for the construction of a proposed sanitary sewer extension to serve the
existing mother house building and the new skilled nursing, assisted living, and memory
care facilities at the Mt. Carmel Campus. The approved MOU states that BVM-PHS will
construct a private sewer from the BVM Phase 1 facilities to Julien Dubuque Drive. The
City will then construct a public sewer from the existing sewer serving Shady Oaks to
the end of the private BVM-PHS sewer along Julien Dubuque Drive. The City has
completed the construction of the public sewer along Julien Dubuque Drive.
The BVM-PHS private sewer will run thru City owned property along Julien Dubuque
Drive. The attached exhibit shows the City owned property and the proposed private
easement. BVM-PHS has submitted construction plans for the improvements and
associated work on the City owned property. City Engineering has reviewed and
approved the drawings.
RECOMMENDATION
I would recommend that the "Grant of Easement" for sanitary sewer utility for the
proposed private sanitary sewer main thru the City owned property on Julien Dubuque
Drive forwarded to City Council to be set for public hearing.
ACTION REQUESTED
The attached resolution should be submitted to the City Council for consideration and to
set a public hearing on September 21, 2020 for the granting of easement to BVM-PHS
Senior Housing, Inc. for a private sanitary sewer utility thru City owned property on
Julien Dubuque Drive.
Prepared by Nate Kieffer, PLS, PE
cc:
2
Prepared by: R. Nate Kieffer, City of Dubuque, 50 W. 13th Street, Dubuque, IA 52001 (563) 589-4270
Return to: R. Nate Kieffer, City of Dubuque, 50 W. 13th Street, Dubuque, IA 52001 (563) 589-4270
RESOLUTION NO. 279-20
RESOLUTION OF INTENT TO DISPOSE OF CITY INTEREST BY GRANT OF EASEMENT FOR
SANITARY SEWER UTILITY TO BVM-PHS SENIOR HOUSING, INC. ACROSS PART OF LOT 1-2-
1 OF THE NW FRACTIONAL QUARTER OF THE NE QUARTER AND PART OF LOT 2-1 OF THE
NE FRACTIONAL QUARTER OF THE NW QUARTER, SECTION 6, T88N, R3E, LYING NORTH OF
JULIEN DUBUQUE DRIVE, DUBUQUE COUNTY, IOWA
Whereas, BVM-PHS Senior Housing, Inc. has requested a "Grant of Easement" for sanitary sewer
utility across Part of Lot 1-2-1 of the NW Fractional Quarter of the NE Quarter and Part of Lot 2-1 of the
NE Fractional Quarter of the NW Quarter, Section 6, T88N, R3E, lying North of Julien Dubuque Drive,
Dubuque County, Iowa, for a private sanitary sewer main; and
Whereas, by Resolution Number 274-19, the City has approved a Memorandum of Agreement with
BVM-PHS Senior Housing, Inc., which requires the granting of said utility easement by the City to B V IV1-
PHS Senior Housing, Inc.; and
Whereas, IIW, PC has prepared and submitted to the City Council an exhibit showing the easement
area for the proposed private sanitary sewer main across Part of Lot 1-2-1 of the NW Fractional Quarter
of the NE Quarter and Part of Lot 2-1 of the NE Fractional Quarter of the NW Quarter, Section 6, T88N,
R3E, lying North of Julien Dubuque Drive, Dubuque County, Iowa.
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF DUBUQUE,
IOWA:
Section 1. That the City of Dubuque intends to grant an easement for sanitary sewer utility to BVM-
PHS Senior Housing, Inc. across Part of Lot 1-2-1 of the NW Fractional Quarter of the NE Quarter and
f1_.1 of Lot n A of the w I1'� Fractional
/1 of �I w I� n I /� Section
- i -
Part Lot 2-1 the NE Fractional Quarter the NW Quarter, Section 6, T88N, R3E, lying North of
Julien Dubuque Drive, Dubuque County, Iowa, as shown on the attached Exhibit A.
Section 2. That a public hearing on the intent to dispose of City interest by Grant of Easement for
Sanitary Sewer Utility to BVM-PHS Senior Housing, Inc. across Part of Lot 1-2-1 of the NW Fractional
Quarter of the NE Quarter and Part of Lot 2-1 of the NE Fractional Quarter of the NW Quarter, Section
6, T88N, R3E, lying North of Julien Dubuque Drive, Dubuque County, Iowa, is hereby set for the 21 st
day of September 2020, by virtual means, beginning at 6:30 p.m., and the City Clerk be and is hereby
authorized and directed to cause a notice of public hearing on the intent to dispose of said interest to
be published in the manner as prescribed by law.
Passed, approved and adopted this 8th day of September 2020.
Roy D. Buol, Mayor
Attest:
Kevin$ S. Firnstahl, MC, 'i y Clerk
Prepared by: Nate Kieffer 50 W. 13t" Street Dubuque lowa 52001 (563-589-4270)
Return to: Nate Kieffer 50 W. 13t" Street Dubuque lowa 52001 (563-589-4270)
GRANT OF EASEMENT FOR SANITARY SEWER UTILITY
For and in consideration of the sum of One Dollar ($1.00) and other good and
valuable consideration, the receipt whereof is hereby acknowledged, the City of
Dubuque ("Grantor"), of Dubuque County, State of lowa, does hereby grant, sell and
convey to BVM-PHS Senior Housing, Inc. ("Grantee"), its lessees, licensees,
successors and assigns, from the date hereof, an easement through, under and
across the following described real estate situated in Dubuque, lowa, to wit:
PART OF LOT 1-2-1 OF THE NW FRACTIONAL QUARTER OF THE
NE QUARTER AND PART OF LOT 2-1 OF THE NE FRACTIONAL
QUARTER OF THE NW QUARTER, SECTION 6, T88N, R3E, LYING
NORTH OF JULIEN DUBUQUE DRIVE, DUBUQUE COUNTY, IOWA,
AS SHOWN ON THE ATTACHED EASEMENT EXHIBIT.
Said easement shall be as shown on the attached Easement Exhibit, for the purpose
of constructing and maintain a private sanitary sewer main and all appurtenances in
connection therewith (the Improvements), along with the right, privilege and authority
to survey, inspect, construct, reconstruct, alter, maintain, operate, repair, replace,
patrol and remove said Improvements. Said easement shall also include the right to
cut, trim or remove trees, bushes and roots as may be required incident to rights given
herein. Grantee shall have the right of ingress and egress to and from the said lines
of Grantee over the lands of Grantor so that Grantee may go to and from said
Improvements from the public roads adjacent to Grantor's lands. In exercising is
rights of ingress and egress Grantee shall, whenever practical, use existing roads or
lanes and shall repair any damage caused thereby.
Along with the right to occupy the temporary construction easement area(s) as shown
on the attached Easement Exhibit until the completion of the project Improvements.
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It is the intention of the parties hereto that Grantor is hereby conveying the uses
herein specified without divesting itself, its heirs or assigns, of the right to use and
enjoy the above described premises: PROVIDED, however, such use shall not, in the
judgment of said Grantee, interFere with or endanger the construction, safety,
operation or maintenance of said Improvements, and provided further that no building
shall be constructed on the easement without written permission from Grantee.
Grantee, its successors and assigns, agrees to pay for any damage caused to the
land, fences, or other personal property of Grantor from the construction, operations
or maintenance of said Improvements.
The City reserves unto itself the perpetual right for the purpose of erecting, installing,
constructing, reconstructing, maintaining, owning, operating and repair of storm and
sanitary sewers, watermain, pavement, street lights, gas, telephone, television, fiber
optics cable, and electrical lines above or below said private sanitary sewer main as
such utilities would not interFere with the existence of the private sanitary sewer main.
Indemnification. Grantee shall defend, indemnify and hold harmless Grantor, its
officers, agents and employees from and against any claim and cost of any kind,
including without limitation, attorneys' fees and consulting fees, arising out any
surveying, inspection, construction, reconstruction, alteration, replacement,
maintenance, operation, repair, patrol or removal of said Improvements. This
obligation shall survive the termination of this Grant of Easement.
Insurance. Grantee shall provide insurance as set forth in the attached Insurance
Schedule during surveying, inspection, construction, reconstruction, alteration
replacement, maintenance, operation, repair, patrol or removal of said Improvements.
To have and to hold unto the said Grantee forever, and the undersigned does hereby
expressly covenant that Grantor is the owner in fee of said real estate and has good
right to execute this Grant or Easement.
Dated at Dubuque, lowa this day of , 2020.
[SIGNATURE PAGES TO FOLLOW]
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CITY OF DUBUQUE
By:
Roy Buol, Mayor
NOTARY PUBLIC
STATE OF IOWA,
COUNTY OF DUBUQUE, SS:
On this day of , 2020 before me, the undersigned, a Notary
Public in and for said County, in said State, personally appeared Roy Buol, Mayor of
the City of Dubuque, who executed the within and foregoing instrument and
acknowledged that he executed the same as his voluntary act and deed on behalf of
the Grantor.
Notary Public In and For Said State
3
ACCEPTANCE OFEASEMENT
BVM-PHS Senior Housing, Bnc. accepts the terms and conditions of the Grant of
Easement.
BVM-PHS SENIOR HOUSING, INC.
BY� ��ev�—
Alan Stache, Secretary
NOTARY PUBLIC
STATE OF IOWA )
) SS.
COUNTY OF DUBUQUE )
On this � day of .)�-1 Yl(.. , 2020, before me, the undersigned, a Notary
Public in and for said County, in said State, personally appeared Alan Stache,
Secretary, who executed the within and foregoing instrument and acknowledged that
he/she executed the same as his/her voluntary act aqd deed on behalf of BVM-PHS
SENIOR HOUSING, INC. / �
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Not ry Public In and For aid St
'�.•` `• LpRI HES5ELIN0
�: Commission Nur�ber 74�OB0
�o,,. My Comm. Exp. 2j�
4
EXHIBIT A
5
P LAT OF EASEM EN T
A 20-FOOT PERMANENT SANITARY SEWER EASEMENT LYING WITHIN LOT 1 -2-1 OF THE NW FRACT.1 /4-NE1 /4
AND LOT 2-1 OF THE NE FRACT.1 /4-NW1 /4 OF SECTION 6, T88N, R3E OF THE 5th P.M., LYING NORTH OF
W JULIEN DUBUQUE DRIVE, IN THE CITY OF DUBUQUE, DUBUQUE COUNTY, IOWA
�
�
�
o LOT 2, CARMEL HEIGHTS N0. 2
� POINT OF � I S87'15'13"W LEGAL DESCRIPTION:
� S8C'59�'��'O��W 57Z.`5`�' BEGINNING . �'r:g4'� � ��0.�]rj� � _ A 20-FOOT PERMANENT SANITARY SEWER EASEMENT LYING
o S$.��O5+4S��W � 477.75' •� WITHIN LOT 1-2-1 OF THE NW FRACT.1/4 OF THE NE1/4 AND
LOT 2-1 OF THE NE FRACT.1/4 OF THE NW1/4, IN SECTION 6,
� �ZG.BO� � r• ^'� . NORTH LINE T88N, R3E OF THE 5th P.M., LYING NORTH OF JULIEN
Op - DUBUQUE DRIVE, IN THE CITY OF DUBUQUE, DUBUQUE COUNTY,
r �„� � : LOT 1-2-1 Z IOWA, THE CENTERLINE OF WHICH IS MORE PARTICULARLY
� NO CAP a- d- N �' POINT OF O DESCRIBED AS FOLLOWS:
� � :t � COMMENCEMENT N COMMENCING AT THE NORTHEAST CORNER OF SAID LOT 1-2-1;
Z • z 0 '' � NORTHEAST CORNER pp
(!1 � LOT 1-2-1 OF THE �V Z THENCE WESTERLY ALONG THE NORTH LINE OF SAID LOT
, • NW FRACT.1�4-NE1�4, �`? �� r 1-2-1, AND ALONG THE SOUTH LINE OF LOT 2 OF CARMEL
r O 2O PERMANENT �' sECTioN 6, T88N, R3E � n�� HEIGHTS N0. 2 IN THE CITY OF DUBUQUE, IOWA, THE
p N SANITARY SEWER �D .� FOLLOWING TWO (2) COURSES: THENCE SOUTH 8Z DEGREES
� � EASEMENT �y �. - � � 15 MINUTES 13 SECONDS WEST, 160.75 FEET; THENCE SOUTH
W -i� 86 DEGREES 59 MINUTES 40 SECONDS WEST, 94.80 FEET TO
N � , • ,� � ��O THE POINT OF BEGINNING;
Z
O m h� d� Z = THENCE SOUTHWESTERLY ALONG THE CENTERLINE OF SAID
LOT 2-1 OF THE �y •' LOT 1-2-1 OF THE 'P w� r^ 20-FOOT WIDE SANITARY SEWER EASEMENT, THE FOLLOWING
� NE FRACT.1/4—NW1/4 CENTERLINE �ry • m� THREE (4) COURSES: THENCE SOUTH 04 DEGREES 42
o W SEC. F), T88N, R3E SANITARY SEWER ' NW FRACT.1/4—NE1/4 ^ MINUTES 38 SECONDS WEST, 113.53 FEET; THENCE SOUTH 26
SEC. 6, T88N, R3E W DEGREES 09 MINUTES 00 SECONDS WEST, 329.53 FEET;
� THENCE SOUTH 74 DEGREES 00 MINUTES 36 SECONDS WEST,
o � 0�' � 168.95 FEET; THENCE SOUTH 75 DEGREES 26 MINUTES 05
C+� SECONDS WEST 85.15 FEET TO THE POINT OF TERMINATION OF
� � �'' � SAID CENTER�INE AT THE NORTH RIGHT OF WAY LINE OF
N JULIEN DUBUQUE DRIVE, SAID POINT LYING SOUTH 86 DEGREES
m ^ cp'� . 05 MINUTES 20 SECONDS EAST, 182.93 FEET FROM THE
cn -P �cV • FOUND 5�8" REBAR SOUTHEAST CORNER OF LOT 1-2 OF INLAND MOLASSES PLACE
-� W ��, .�' WITH RED PLASTIC � + IN THE CITY OF DUBUQUE, IOWA.
CAP N0. 9651
m � � . CONTAINING 13,943 SQUARE FEET, MORE OR LESS, AND
� / SUBJECT TO EASEMENTS, RESERVATIONS, RESTRICTIONS, AND
„w � � NORTH � RIGHT-OF-WAYS RECORD AND NOT OF RECORD.
� SOUTHEAST CORNER S �•QO�36 . �� R.O.W. /
, SAID EASEMENT LYING TEN (10) FEET ON EITHER SIDE OF THE
Y� LOT 1-2 OF INLAND „ 1 ,68.9�'J S LINE � / ABOVE DESCRIBED CENTERLINE, THE LINES OF WHICH SHALL BE
_ ? MOLASSES PLACE �,26'Q�"J w � . S �. -� � � / i � LENGTHENED OR SHORTENED ACCORDWGLY TO TERMINATE AT
/ THE PROPERTY LINES OF THE HEREIN DESCRIBED LOTS.
cn � o _ 1 51 �Fj �('�i • o. �
� � � �' % 5 � � � �
�� o � � w �� 182.93' —. �
z�w ��` Q � � --�86'05'2Q"E N DUBUQUE DRIVE � � / GRAPHIC SCALE
i � J � m — JULIE
�Z � � � � z N — — — — (66� R.O.W.) �• �' 0 100 200 NOTE:
� .�. o o w Q� POINT OF _ --- �' THIS SURVEY IS SUBJECT TO
v�� � Z J N TERMINATION�- - - — RESTRICT ONS AND VATIONS,
z � I �a-
� v � � � Q N� `f 1" = 100� RIGHTS-OF-WAY OF RECORD
` � � � m a Z N N LEGEND AND NOT OF RECORD.
rn z `` z� � � �' w �'r' � DRAWING MAY HAVE BEEN REDUCED
°7 w � o �- c� Z � ¢ ,�r� PROPERTY BOUNDARY
X o z o�o = o m Z Q �o � � � LOT/RIGHT-OF-WAY LINE NORTH
� j � �o v o � � �w� _.� _�� _� _ __.� PERMANENT EASEMENT
������������1�� I HEREBY CERTIFY THAT THIS LAND SURVEYING DOCUMENT WAS PREPARED ��w,P.c.
� N � � _ � O � a�w — • _ • — SECTION LINE ``��`��``\``�`����'�',',����i��� DRECTiPERSO AL�SUPERVISONRA DATHAT I AM A DULY LICEN ED LA DY • ♦ CON TRUNTCI'ON ERVCES
� z � z CENTERLINE
� �- U Z �" } Z = m O �` ` '�, '� SURVEYOR UNDER THE LAWS OF THE STATE OF IOWA.
0 o w � � w o �� = SEC. SECTION DATE OF SURVEY: ; *;'' ; � ;
J J (n J Z U II� 7 =� � R.O.W. RIGHT-OF-WAY _ i ENVIftONMENTALENGWEERING
AUGUST 10 2020 _ � JOHN M. � _ FOR uw� P.C. LANDSURVEYING
( ) RECORDED AS � � � � MUNICIPALENGMEERING
TOTAL PERMANENT =� � TRANMER _ �= s,���T��EN��NEER�N�
FOUND 5/8" IRON REBAR INTEGRITY.EXPERTISE.SOLUTIONS 'R
WITH YELLOW PLASTIC CAP N0. 4850 =� � �= $ � Q iahNSPOHiATIONENGINEERIM
EASEMENT AREA: ; LS 12631 ; �. � .
� O O O o c � OR AS NOTED 13 943 SQ. FT. =.y�;� `�:j`� JOHN . ANMER DATE DRAWN DMK PLAT N0. 13-IA-20
� � � ai u�'i n. - FOUND CONCRETE MONUMENT � ��'�,`rF��'��������``�� J���`�� LICENSE N0. 12631 MY LICENSE RENEWAL DATE IS 12/31/2020 CHECKED JMT PROJ. N0. 18092
� o o� �'. i E WITH BRASS CAP OR AS NOTED �'�.� L q N D 5.��� �n7E s-io-zo SHEET i ot t
� '" � � � � , �����/����i������������ \ PAGES OR SHEETS COVERED 8Y THIS SEAL THIS SHEET ONLY
J d � (n (n U P:�18�[K32�aitAWlNG5�5l1RVEY�18092 SANITARY
INSURANCE SCHEDULE
6
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# Project name: or
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. BesYs Rating Guide.
3. Each Certificate required shall be furnished to the 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
INSURANCE 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 LimiY' as appropriate.
3) Include endorsement indicating that coverage is primary and non-contributory.
4) Include Preservation of Governmental Immunities Endorsement. (Sample
attached).
5) Include additional 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) UMBRELLAIEXCESS 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 _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:
$ each occurrence (per limits required by Railroad)
$ policy 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
City of Dubuque Insurance Requirements for General, Artisan or Trade Contractors,
Subcontractors or Sub Subcontractors
PRESERVATION OF GOVERNMENTAL IMMUNITIES ENDORSEMENT
1. Nonwaiver of Governmental Immunitv. 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 Coveraqe. 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 Coveraae. 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 Chanqe 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
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