Improvement Contract_2021 Airport Parking Lot Resurfacing ProjectCity of Dubuque
City Council Meeting
Consent Items # 15.
Copyrighted
October 4, 2021
ITEM TITLE: Improvement Contracts / Performance, Payment and Maintenance
Bonds
SUMMARY: McDermott Excavating Company for the South Gate Drive to Simpson
Street Water Main Project; River City Paving for the 2021 Airport Parking
Lot Resurfacing Project.
SUGGESTED Suggested Disposition: Receive and File; Approve
DISPOSITION:
ATTACHMENTS:
Description
South Gate Drive to Simpson Street Water Main
Project
2021 Airport Parking Lot Resurfacing Project
Type
Supporting Documentation
Supporting Documentation
SECTION 00500
Page 1 of 6
PUBLIC IMPROVEMENT (CONTRACT
SECTION 00500
2021 AIRPORT PARKING LOT RESURFACING PROJECT
THIS IMPROVEMENT CONTRACT (the Contract), made in triplicate, dated for references
purposes the 16th day of September 2021 between the City of Dubuque, Iowa, by its City Manager,
through authority conferred upon the City Manager by its City Council (City), and River City Paving
(Contractor).
For and in consideration of the mutual covenants herein contained, the parties hereto agree as
follows:
CONTRACTOR AGREES:
1. To furnish all material and equipment and to perform all labor necessary for the
2021 AIRPORT PARKING LOT RESURFACING PROJECT.
2. CONTRACT DOCUMENTS
A. The Contract Documents consist of the following:
1. Project Title Page (Section 00100).
2. Project Directory Page (Section 00101).
3. This Public Improvement Contract (Section 00500).
4. Performance, Payment, and Maintenance Bond (Section 00600).
5. Out -of -State Contractor Bond (Section 00610).
6. Other Bonds:
a. (Bond Name)_ (pages _ to _ , inclusive).
b. (Bond Name)_ (pages_ to _ , inclusive).
C. (Bond Name)_ (pages_ to _ , inclusive).
7. The Iowa Statewide Urban Design And Specifications (SUDAS) 2017 Edition.
8. CITY OF DUBUQUE Supplemental Specifications 2017 Edition.
9. Other Standard and Supplementary Specifications as listed on the Title Page of the
Contract Document Manual.
10. Special Provisions included in the project Contract Document Manual.
11. Drawings —Sheet No. through No. (00 pages) or drawings consisting of sheets
bearing the following general title: 2021 AIRPORT PARKING LOT RESURFACING
PROJECT
12. Addenda (numbers _ to _ , inclusive).
13. Insurance Provisions and Requirements (Section 00700).
14. Sales Tax Exemption Certificate (Section 00750).
15. Site Condition Information (Section 00775).
16. Construction Schedule and Agreed Cost of Delay (Section 00800).
SECTION! OO500
Page 2 of 6
'17. Erosion Control Certificate (Section 00900).
18. Consent Decree (Section 01000).
19.Other Project Information and Permits (Sections 01100 - 00000).
20. Exhibits to this Contract (enumerated as follows):
a. Contractor's Bid (pages to inclusive).
b. Bidder Status Form (Section 00460).
c. The following documentation that must be submitted by Contractor prior to Notice of
Award.
i. Contractor Background Information Form (Section 00471)
ii.
21. The following which may be delivered or issued on or after the Effective Date of the
Agreement:
a. Notice to Proceed (Section 00850).
b. Project Certification Page (Section 00102).
c. Change Orders (Not attached to this agreement).
There are no other Contract Documents. The Contract Documents may only be amended,
modified, or supplemented as provided in General Conditions.
3. All materials used by the Contractor in the Project must be of the quality required by the Contract
Documents and must be installed in accordance with the Contract Documents.
4. The Contractor must remove any materials rejected by the City as defective or improper, or any
of said work condemned as unsuitable or defective, and the same must be replaced or redone
to the satisfaction of the City at the sole cost and expense of the Contractor.
5. Five percent (5%) of the Contract price will be retained by the City for a period of thirty (30) days
after final completion and acceptance of the Project by the City Council to pay any claim by any
party that may be filed for labor and materials done and furnished in connection with the
performance of this Contract and for a longer period if such claims are not adjusted within that
thirty (30) day period, as provided in Iowa Code Chapter 573 or Iowa Code Chapter 26. The City
will also retain additional sums to protect itself against any claim that has been filed against it for
damages to persons or property arising through the prosecution of the work and such sums will
be held by the City until such claims have been settled, adjudicated or otherwise disposed of.
6. The Contractor has read and understands the Contract Documents herein referred to and agrees
not to plead misunderstanding or deception related to estimates of quantity, character, location,
or other conditions for the Project.
7. In addition to any warranty provided for in the specifications, the Contractor must also fix any
other defect in any part of the Project, even if the Project has been accepted and fully paid for
by the City. The Contractor's maintenance bond will be security for a period of two years after
the issuance of the Certificate of Substantial Completion.
SECTION 00500
Page 3 of 6
8. The Contractor must fully complete the Project under this Contract on or before the date
indicated in the Construction Schedule and Agreed Cost of Delay Section of the Contract
Documents.
9. INDEMNIFICATION FROM THIRD PARTY CLAIMS. To the fullest extent permitted by law,
Contractor 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 there from, but only to the
extent caused in whole or in part by negligent acts or omissions of Contractor, or anyone directly
or indirectly employed by Contractor or anyone for whose acts Contractor may be liable,
regardless of whether or not such claim, damage, loss or expense is caused in part by a party
indemnified hereunder.
10. The Contractor hereby represents and guarantees that it has not, nor has any other person for
or in its behalf, directly or indirectly, entered into any arrangement or Contract with any other
Bidder, or with any public officer, whereby it has paid or is to pay any other Bidder or public
officer any sum of money or anything of value whatever in order to obtain this Contract; and it
has not, nor has another person for or in its behalf directly or indirectly, entered into any
Contractor arrangement with any other person, firm, corporation or association which tends to
or does lessen or destroy free competition in the award of this Contract and agrees that in case
it hereafter be established that such representations or guarantees, or any of them are false, it
will forfeit and pay not less than ten percent (10%) of the Contract price but in no event less than
$2,000.00 (Two Thousand Dollars) to the City.
11. The surety on the Bond furnished for this Contract must, in addition to all other provisions, be
obligated to the extent provided for by Iowa Code 573.6 relating to this Contract, which provisions
apply to said Bond.
12. The Contractor agrees, and its Bond is surety therefore, that after the Certificate of Substantial
Completion has been issued by the City, it will keep and maintain the Project in good repair for
a period of two (2) years.
13. The Project must be constructed in strict accordance with the requirements of the laws of the
State of Iowa, and the United States, and ordinances of the City of Dubuque, and in accordance
with the Contract Documents.
A. All applicable standards, orders, or regulations issued pursuant to the Clean Air Act of 1970
(42 U. S. C. 1958 (H) et. seq.) and the Federal Water Pollution Act (33 U. S. C. 1368 et.
seq.) as amended, Executive Order 11738, and Environmental Protection Agency
regulations (40 CFR, Part 15). Contractor must comply with Section 103 and 107 of the
Contract Work Hours and Safety Standards Act (40 USC 327-330) and Department of Labor
Regulations (29 CFR, Part 5).
B. TheICamity nd4he-GGRtraster-agree tO GeMp4y w4h--all-prQvisiens4--the Davos BaG^n Federal
P-r-L- iliRg-Wary aad-the Fe de aWuage
Determonat+er ia�jeet
C. Equipment or--pr-educA&-aver zed4e-be-pur44as,ed--wF th--federal undOg riled-.for-th s
Oentraet mi4&t-b Gan -made to the- +r-Hume-x-tent-feasible,-mac-EerdanGe-vAth-Rablio
Law=1-03Sec ior4s-646(a}-aPd-(b-y
SECTION 00500
Page 4 of 6
D. The City of Dubuque in accordance with Title VI of the Civil Rights Act of 1964, 78 Stat. 252,
42 U.S.C. 2000d-2000d-4 and Title 49, Code of Federal Regulations, Department of
Transportation, Subtitle A, Office of the Secretary, Part 21, Nondiscrimination in Federally
assisted programs of the Department of Transportation issued pursuant to such Act, hereby
notifies all bidders that it will affirmatively insure that in any contract 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.
CERTIFICATION BY CONTRACTOR
The undersigned, on behalf of the Contractor, with full authority to act on behalf of the Contractor,
certifies to the City of Dubuque as follows:
I have received a copy of the Consent Decree in the case of The United States of
America, and the State of Iowa v. The City of Dubuque, Iowa, Civil Action Number Case
2:11-cv-01011-EMJ, Civil Action Number 2008V00041, DOJ Case Number 90-5-1-1-
09339, United States District Court for the Northern District of Iowa.
2. All work performed will be in conformity with the provisions of the Consent Decree.
3. All documents reports, data, records, or other information (including documents,
records, or other information in electronic form) that relate in any manner to the
performance of obligations under the Consent Decree, including any underlying
research and analytical data, will be retained as required by the Consent Decree.
4. The Contractor agrees to defend, indemnify, and hold harmless the City, its officers,
agents, or employees from and against any claims, including penalties, costs and fees
as provided in the Consent Decree, relating to, or arising out of the Contractor's failure
to comply with the Consent Decree.
CONTRACTOR:
_ N/A
Contractor
By -.-
Signature
Printed Name
Title
Date
SECTION 00500
Page 5 of 6
'THE CITY AGREES:
'14. Upon the completion of the Contract, and the acceptance of the Project by the City Council,
and subject to the requirements of law, the City agrees to pay the Contractor as full
compensation for the complete performance of this Contract, the amount determined for the
total work completed at the price(s) stated in the Contractor's Bid Proposal and less any
Agreed Cost of Delay provided for in the Contract Documents.
CONTRACT AMOUNT $ 116,316.31
CITY OF DUBUQUE, IOWA:
City Manager's Office
Dep ent J p
By: ��1'
Sign ture
Michael C. Van Milligen
Printed Name
City Manager
Title
September 25, 2021
Date
CONTRACTOR:
River City Paving
Contr for
By: k—'
X! nature r�
Printed Name
Ke e, /iC r, o.&, t
Title
_9--/6- zVz
Date
___= END OF SECTION 00500 =___
Bond No. 30136605
SECTION 00600
Page 1 of 4
PERFORMANCE, PAYMENT AND MAINTENANCE BOND
SECTION 00600
KNOW ALL BY THESE PRESENTS:
That we, River City Paving Division of Mathy Construction Company y as
Principal (hereinafter the "Contractor' or `Principal°) and western Surety Company _
as Surety are held and firmly bound unto the
City of Dubuque, Iowa, as Obligee (hereinafter referred to as "Owner"), and to all persons who
may be injured by any breach of any of the conditions of this Bond in the penal sum of One
hundred sixteen thousand, three hundred sixteen dollars and thirty-one cents ($116,316.31).
lawful money of the United States, for the payment of which sum, well and truly to be made, we
bind ourselves. our heirs, legal representatives and assigns jointly or severally, firmly by these
presents.
The conditions of the above obligations are such that whereas said Contractor entered into a
contract with the Owner, bearing date the 1Cth day of September , 2021.
(hereinafter the 'Contract") wherein said Contractor undertakes and agrees to construct the
following project in accordance with the Contract Documents, and to faithfully perform all the
terms and requirements of said Contract within the time therein specified, in a good and
workmanlike manner, and in accordance with the Contract Documents. The Contract Documents
for the 2021 AIRPORT PARKING LOT RESURFACING PROJECT detail the following
described improvements.
This project will provide for the milling of 1-1/2" of existing HMA pavement and
resurfacing of 2" of HMA pavement in the areas indicated in the contract
documents. Total SY of milling and resurfacing equals 6788,22 SY. Construction
will need to be phased to accommodate use of the parking lots. Contractor will
coordinate access with Dubuque Airport Staff
It is expressly understood and agreed by the Contractor and Surety in this Bond that the following
provisions are a part of this Bond and are binding upon said Contractor and Surety, to -wit
PERFORMANCE: The Contractor shall well and faithfully observe perform.. fulfill, and
abide by each and every covenant, condition, and part of said Contract and Contract
Documents, by reference made a part hereof, for the project, and shall indemnify and save
harmless the Owner from all outlay and expense incurred by the Owner by reason of the
Contractor's default of failure to perform as required The Contractor shall also be
responsible for the default or failure to perform as required under the Contract and Contract
Documents by all its subcontractors, Suppliers, agents, or employees furnishing materials
or providing labor in the performance of the Contract.
PAYMENT: The Contractor and the Surety on this Bond hereby agreed to pay all just
claims submitted by persons, firms, subcontractors, and corporations furnishing materials
for or performing labor in the performance of the Contract on account of which this Bond is
given, including but not limited to claims for all amounts due for labor, materials, lubricants,
oil, gasoline, repairs on machinery, equipment. and tools, consumed or used by the
SECTION 00600
Page 2 of 4
Contractor or any subcontractor, wherein the same are not satisfied out of the portion of the
contract price the Owner is required to retain until completion of the improvement, but the
Contractor and Surety shall not be liable to said persons, firms or corporations unless the
claims of said claimants against said portion of the contract price shall have been
established as provided by law. The Contractor and Surety hereby bind themselves to the
obligations and conditions set forth in Chapter 573 of the Iowa Code, which by this
reference is made a part hereof as though fully set out herein
3. MAINTENANCE: The Contractor and the Surety on this Bond hereby agree, at their own
expense
A To remedy any and all defects that may develop in or result from work to be
performed under the Contract Documents within the period of two (2) year(s) from the
date of acceptance of the work under the Contract, by reason of defects in
workmanship, equipment installed, or materials used in construction of said work:
B. To keep all work in continuous good repair; and
C To pay the Owner's reasonable costs of monitoring and inspection to assure that any
defects are remedied, and to repay the Owner all outlay and expense incurred as a
result of Contractor's and Surety's failure to remedy any defect as required by this
section.
Contractor's and Surety's Contract herein made extends to defects in workmanship or
materials not discovered or known to the Owner at the time such work was accepted.
4. GENERAL: Every Surety on this Bond shall be deemed and held bound, any contract to the
contrary notwithstanding, to the following provisions:
A. To consent without notice to any extension of time authorized in approved change
orders to the Contractor in which to perform the Contract.
B. To consent without notice to any change in the Contract or Contract Documents,
authorized in approved change orders which thereby increases the total contract price
and the penal sum of this Bond provided that all such changes do not. in the
aggregate, involve an increase of more than twenty percent (20%) of the total contract
price, and that this Bond shall then be released as to such excess increase.-
C. To consent without notice that this Bond shall remain in full force and effect until the
Contract is completed, whether completed within the specified contract period, within
an extension thereof, or within a period of time after the contract period has elapsed
and the liquidated damage penalty is being charged against the Contractor.
SECTION 00600
Page :3of4
The Contractor and every Surety on the Bond shall be deemed and held bound, any contract to the
contrary notwithstanding, to the following provisions:
D. That no provision of this Bond or of any other contract shall be valid that limits to less
than five (5) years after the acceptance of the work under the Contract the right to sue
on this Bond.
E. That as used herein, the phrase "all outlay and expense" is not to be limited in any
way but shall include the actual and reasonable costs and expenses incurred by the
Owner including interest benefits, and overhead where applicable. Accordingly. "all
outlay and expense' would include but not be limited to all contract or employee
expense, all equipment usage or rental, materials, testing, outside experts, attorney's
fees (including overhead expenses of the Owner's staff attorneys), and all costs and
expenses of litigation as they are incurred by the Owner. It is intended the Contractor
and Surety will defend and indemnify the Owner on all claims made against the
Owner on account of Contractor's failure to perform as required in the Contract and
Contract Documents, that all agreements and promises set forth in the Contract and
Contract Documents, in approved change orders, and in this Bond will be fulfilled, and
that the Owner will be fully indemnified so that it will be put into the position it would
have beer) in had the Contract been performed in the first instance as required.
In the event the Owner incurs any "outlay and expense" in defending itself against any claim as to
which the Contractor or Surety should have provided the defense or in the enforcement of the
promises given by the Contractor in the Contract. Contract Documents, or approved change
orders, or in the enforcement of the promises given by the Contractor and Surety in this Bond, the
Contractor and Surety agree that they will make the Owner whole for all such outlay and expense,
provided that the Surety's obligation under this Bond shall not exceed one hundred twenty-five
percent (125%) of the penal sum of this Bond.
In the event that any actions or proceedings are initiated regarding this Bond the parties agree that
the venue thereof shall be Dubuque County, State of Iowa. If legal action is required by the Owner
to enforce the provisions of this Bond or to collect the monetary obligation incurring to the benefit of
the Owner, the Contractor and the Surety agree, jointly and severally, to pay the Owner all outlay
and expense incurred therefor by the Owner. All rights, powers, and remedies of the Owner
hereunder shall be cumulative and not alternative and shall be in addition to all rights. powers, and
remedies given to the Owner, by law. The Owner may proceed against surety for any amount
guaranteed hereunder whether action is brought against the Contractor or whether Contractor is
joined in any such action(s) or not
NOW THEREFORE, the condition of this obligation is such that if said Principal shall faithfully
perform all the promises of the Principal, as set forth and provided in the Contract, in the Contract
Documents, and in this Bond, then this obligation shall be null and void, otherwise it shall remain in
full force and effect.
When a work, term, or phrase is used in this Bond, it shall be interpreted or construed first as
defined in this Bond, the Contract, or the Contract Documents; second, if not defined in the Bond,
Contract, or Contract Documents, it shall be interpreted or construed as defined in applicable
provisions of the Iowa Code; third, if not defined in the Iowa Code, it shall be interpreted or
SECTION 00600
Page 4 of 4
construed according to its generally accepted meaning in the construction industry; and fourth, if it
has no generally accepted meaning in the construction industry, it shall be interpreted or construed
according to its common or customary usage
Failure to specify or particularize shall not exclude terms or provisions not mentioned and shall not
limit liability hereunder. The Contract and Contract Documents are hereby made a part of this
Bond
Project No. 3902664
Witness ot.tr hands, in triplicate, this 17th
SURETY COUNTERSIGNED BY:
NA
Signature of Agent
Printed Name of Agert
Company Address
City, State., Zip code
Company Telephone Number
PRINCIPAL:
River City Paving Division of Mathy Construction Company
Contractor
By. -- /��
S r.alwe
Printed Name
NOTE:
day of September 2021
Title
FORMS APPROVED �BY:
14
Rep esentative for Owner
SURETY:
Western Surety Company
Suety Company
By' -- ---
Sign akrre Attorney -in -Fact Officer
Donna M Planeta
Printed Name of Attorney -in -Fact Officer
Western Surety Company
Company Name
151 N.Frankhn St.
Company Address
CHICAGO. IL 60606
City. State, Zip Code
(312) 822.5000
Company Telephone Number
1. All signatures on this performance, payment, and maintenance Bond must be original
signatures in ink; copies, facsimile. or electronic signatures will not be accepted
2. This Bond must be sealed with the Surety's raised, embossing seal
3. The name and signature of the Surety's Attorney-in-Fact/Officer entered on this Bond
must be exactly as listed on the Certificate or Power of Attorney accompanying this
Bond.
___= END OF SECTION 00600 =___
NOTARY ACM,:^tiC1'd 11,94:Yyt.MEINT OF SURETY:
State of Com1ectiCut
County of I Iartford ss.
On this the 17tn day of September , 20 21 , before nee, Timothy S. 1-Iufiinan, the
undersigned officer, personally appeared Donna M Planeta , known to tile
(or satisfactorily proven) to be the person whose name is Subscribed as Attorney -In -Fact
for Western Surety Company , and acknowledged that
S/Ile executed the same as the let of his/her principal for the purposes therein contained.
In witness whereof I hereunto Set my hand_
Signature of Notary Public
Date Commission Expires: February 28, 2026
Timothy S. HufGnan
Printed Name of Notary
TIMOTHY 5. HUFF'MAN
NOTARY P(IBLIC - Cl' : 93092
My Commissiorl Expires Feb. 28, 2026
Western Surety Company
POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY -IN -FACT
Know All Men By These Presents, That WESTERN SURETY COMPANY, a South Dakota corporation, is a duly organized and existing corporation
having its principal office in the City of Sioux Falls, and State of South Dakota, and that it does by virtue of the signature and seal herein affixed hereby
make, constitute and appoint
Aimee R Perondine, Joshua Sanford, Michelle Anne McMahon, Donna M Planeta, Bethany
Stevenson, Bryan M Caneschi, Rebecca M Josephson, Individually
of Hartford, CT, its true and lawful Attomey(s)-in-Fact with full power and authority hereby conferred to sign, seal and execute for and on its behalf bonds,
undertakings and other obligatory instruments of similar nature
- In Unlimited Amounts -
and to bind it thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of the corporation and all the acts of said
Attorney, pursuant to the authority hereby given, are hereby ratified and confirmed.
This Power of Attorney is made and executed pursuant to and by authority of the By -Law printed on the reverse hereof, duly adopted, as indicated, by
the shareholders of the corporation.
In Witness Whereof, WESTERN SURETY COMPANY has caused these presents to be signed by its Vice President and its corporate seal to be
hereto affixed on this 23rd day of July, 2021.
WESTERN SURETY COMPANY
s S..RETY
PPOP.1 "W'
=ant o:
!,, S CA
cySOG,
aul T. Bruflat, Vice President
State of South Dakota 1
J? ss
County of Minnehaha
On this 23rd day of July, 2021, before me personally came Paul T. Bruflat, to me known, who, being by me duly sworn, did depose and say: that he
resides in the City of Sioux Falls, State of South Dakota; that he is the Vice President of WESTERN SURETY COMPANY described in and which executed
the above instrument; that he knows the seal of said corporation; that the seal affixed to the said instrument is such corporate seal; that it was so affixed
pursuant to authority given by the Board of Directors of said corporation and that he signed his name thereto pursuant to like authority, and acknowledges
same to be the act and deed of said corporation.
My commission expires
..........................
M. BENT
NOTARY PUBLIC(RI
March 2, 2026 ± sEAL SOUTH DAKOTA sFe'
..... .................
M. Bent, Notary Public
CERTIFICATE
I, L. Nelson, Assistant Secretary of WESTERN SURETY COMPANY do hereby certify that the Power of Attorney hereinabove set forth is still in
force, and further certify that the By -Law of the corporation printed on the reverse hereof is still in force. In testimony whereof I have hereunto subscribed
my name and affixed the seal of the said corporation this 17th day of September, 2021.
,Qas•••••••....ON WESTERN SURETY COMPANY
cs �VTM DPµ�,+�``•
"w"unxwN
27
L. Nelson, Assistant Secretary
Form F4280-7-2012
Go to www.cnasuretv.com > Owner / Obligee Services > Validate Bond Coverage, if you want to verify bond authenticity.
B. Solely with respect to the insurance afforded to any additional insured referenced in Section A. of this endorsement,
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 failure to render, any professional architectural, engineering or surveying services including:
,1. The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field
orders, change orders or drawings and specifications; or
2. Supervisory, inspection, architectural or engineering activities.
This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision,
hiring, employment, training or monitoring of others by that insured, if the 'occurrence" which caused the "bodily injury"
or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or
the failure to render any professional architectural, engineering or surveying services.
C. Solely with respect to the coverage provided by this endorsement, the following is added to Paragraph 2. Duties In The
Event Of Occurrence, Offense, Claim Or Suit of Section IV— Commercial General Liability Conditions:
The additional insured must see to it that:
(1) We are notified as soon as practicable of an "occurrence" or offense that may result in a claim;
(2) We receive written notice of a claim or "suit" as soon as practicable; and
(3) A request for defense and indemnity of the claim or "suit" will promptly be brought against any policy issued by
another insurer under which the additional insured may be an insured in any capacity. This provision does not
apply to insurance on which the additional insured is a Named Insured if the written contract or written
agreement requires that this coverage be primary and non-contributory.
D. Solely with respect to the coverage provided by this endorsement:
1. The following is added to the Other Insurance Condition of Section IV — Commercial General Liability
Conditions:
Primary and Noncontributory insurance
This insurance is primary to and will not seek contribution from any other insurance available to an additional
insured provided that:
a. The additional insured is a Named Insured under such other insurance., and
b. You are required by written contract or written agreement that this insurance be primary and not seek
contribution from any other insurance available to the additional insured.
2. The following paragraph is added to Paragraph 4.b. of the Other Insurance Condition under Section IV —
Commercial General Liability Conditions:
This insurance is excess over:
Any of the other insurance, whether primary, excess, contingent or on any other basis, available to an additional
insured, in which the additional insured on our policy is also covered as an additional insured on another policy
providing coverage for the same 'occurrence", offense, claim or "suit". This provision does not apply to any
policy in which the additional insured is a Named Insured on such other policy and where our policy is required
by a written contract or written agreement to provide coverage to the additional insured on a primary and non-
contributory basis.
E. This endorsement does not apply to an additional insured which has been added to this Coverage Part by an
endorsement showing the additional insured in a Schedule of additional insureds, and which endorsement applies
specifically to that identified additional insured.
F. Solely with respect to the insurance afforded to an additional insured under Paragraph A.3. or Paragraph A.4. of this
endorsement, the following is added to Section III — Limits Of Insurance:
Additional Insured — Automatic — Owners, Lessees Or Contractors Limit
The most we will pay on behalf of the additional insured is the amount of insurance:
U-GL-2162 'N (02/19)
age 3 of 4
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
1. Required by the written contract or written agreement referenced in Section A. of this endorsement; or
2. Available under the applicable Limits of Insurance shown in the Declarations,
whichever is less.
This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations.
All other terms, conditions, provisions and exclusions of this policy remain the same.
U-GL-2162-A CW (02/19)
Page 4 of 4
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13
(Ed. 4-84)
WAIVER OF OUR RIGHT'TO RECOVER FROM OTHERS ENDORSEMENT
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce
our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you
perform work under a written contract that requires you to obtain this agreement from us.)
This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
Schedule
ALL PERSONS AND/OR ORGANIZATIONS THAT ARE REQUIRED BY WRITTEN
CONTRACT OR AGREEMENT WITH THE INSURED, EXECUTED PRIOR TO THE
ACCIDENT OR LOSS, THAT WAIVER OF SUBROGATION BE PROVIDED UNDER THIS
POLICY FOR WORK PERFORMED BY YOU AND FOR THAT PERSON AND/OR
ORGANIZATION
This araiorswrwt dmgm the Polley to which h Is attadW and Is a fecOn an the data Wwjsd unless oftrrwhie etaW.
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Er9brs W"W t i=tf'&AW 1 z. o i 2WO Pdby NO. wC 5944 7 n-1;? Endorsement No.
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IrOSUMMO GCntpany Zurich American Ins;urancr-; Company CoUdWWO'od BY
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Waiver Of Subrogation (Blanket) Endorsement
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ZURICH
Policy No.
lift. Date of Pol.
I qi. Date of Pol.
LIT. Date of I:nd.
Producer
Addl Prem
Return PI"Cm.
LO 5944715-12
12/01 /2020
THIS ENDORSEMENT CHANGES THE: POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the:
Commercial General Liability Coverage Part
The followin- is added to the Transfer Of Rights Of Recovery Against Others To Us Condition:
If you are required by a written conU-act or aLfreement. which is executed before a loss. to waive your ri(Ihts of rec0very from
others; we agree to waive our rights of' recoverv. This waiver of rights shall not be construed to be a waiver With respect to any
other operations in which the insured has no contractual interest.
t 1-G1..-925-13 CW ( 12/0 1 )
Page 1 01, 1
SECTION 00750
Page 2 of 5
PROJECT INFORMATION REQUIREMENTS FOR
STATE OF IOWA SALES TAX EXEMPTION CERTIFICATES
FOR CONTRACTORS & SUBCONTRACTORS
Submitting Department: City of Dubuque — Engineering Department
Department Contact: Jon Dienst
Project CIP Number(s): 3902664
Please complete this form in its entirety and submit along with the executed Contract, Bonds and
Certificate of Insurance. Upon receipt, the City Finance Department will work with the Iowa
Department of Revenue to issue Sales Tax Exemption Certificates to the approved contractor(s) to
allow for the purchase or inventory withdrawal of materials for the specified Project free from State
of Iowa Sales Tax.
Sales tax exemption certificates are not provided to material suppliers.
The Contractor and subcontractors can provide copies of the sales tax exemption certificates issued by the
City to individual material suppliers.
Project Name:
Project Description:
2021 AIRPORT PARKING LOT RESUFACING
This project will provide for the milling of 1-1/2" of
existing HMA pavement and resurfacing of 2" of
HMA pavement in the areas indicated in the contract
documents. Total SY of milling and resurfacing equals
6788.22 SY. Construction will need to be phased to
accommodate use of the parking lots. Contractor will
coordinate access with Dubuque Airport Staff. _
Start Date (Bid Opening Date): September 9, 2021
Final Completion Date: _ November 15, 2021
1. General Prime Contractor:
River City Paving
Contact Name:
Kevin J. Kueter
Complete Address:
(Include PO Box and Street Information)
City, State, Zip Code
PO BOX 1430
Dubuque, Iowa, 52004-1430
Telephone Number:
608-568-3433
Federal I.D. Number:
(or Include Social Security Number)
39-0752519
Work Type to be Completed:
Asphalt Pavinq
SECTION 00750
Page 4 of 5
2.
Subcontractor:
Selco
Complete Address:
(Include PO Box and Street Information)
15 South Main Street
City, State, Zip Code
Dubuque, Iowa 52001
Telephone Number:
563-556-2434
Federal I.D. Number:
42-1020126
(or Include Social Security Number)
Work Type to be Completed:
Traffic Control and Striping
3. 1 Subcontractor:
W.K. Construction
Complete Address:
4262 'twin Valley Road
(Include PO Box and Street Information)
City, State, Zip Code
Middleton, Wi. 53562
Telephone Number:
Federal I.D. Number:
39-1418888
(or Include Social Security Number)
Work Type to be Completed:
Pavement Scarification
5. Subcontractor: _
Complete Address:
(Include PO Box and Street Information)
City, State, Zip Code
Telephone Number:
Federal I.D. Number:
(or Include Social Security Number)
Work Type to be Completed: