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Terracon Consultants, Inc._Monitoring Well Installations 25 Main St.Masterpiece on the Mississippi Dubuque kitlig Al- Amedcacity 2007 TO: The Honorable Mayor and City Council Members FROM: Michael C. Van Milligen, City Manager SUBJECT: Terracon Consultants, Inc. - Monitoring Well Installations 25 Main DATE: September 27, 2011 Terracon Consultants, Inc. has been contracted by Phillips Services Corporation and Earthgrains Baking Companies to investigate petroleum contamination at 25 Main Street. Four monitoring wells would need to be placed in the public right -of -way of Main, Harrison, and Jones Streets. Soil sampling and installation of the wells will be in accordance with the Iowa Department of Natural Resources guidelines. City Engineer Gus Psihoyos recommends City Council approval for the Mayor to execute a License Agreement for Site Assessments for the monitoring well installation on City property by Terracon Consultants, Inc. I concur with the recommendation and respectfully request Mayor and City Council approval. Mic g n ael C. Van Milligen MCVM:jh Attachment cc: Barry Lindahl, City Attorney Cindy Steinhauser, Assistant City Manager Gus Psihoyos, City Engineer Masterpiece on the Mississippi TO: Michael C. Van Milligen, City Mana er FROM: Gus Psihoyos, City Engineer SUBJECT: Terracon Consultants, Inc. - Monitoring Well Installations 25 Main DATE: September 27, 2011 INTRODUCTION Dubuque Itittgg AN-Ametica chy 1 2007 This is in response to a request from Terracon Consultants, Inc. of Des Moines, Iowa, to install 4 monitoring wells on public right -of -way as part of a Tier 2 assessment at 25 Main Street. This assessment is result of contamination from the previously removed diesel tanks on Earthgrains property. DISCUSSION Terracon Consultants, Inc. has been contracted by Phillip Services Corporation and Earthgrains Baking Companies to investigating petroleum contamination at 25 Main Street and is proposing to install 4 monitoring wells in the public right -of -way of Main, Harrison, and Jones Street as shown on the attached map. Soil sampling and installation of the wells will be in accordance with the Iowa Department of Natural Resources guidelines. Wells will be set to a depth of approximately 15' to 20' below grade with a flush mounted lid set in concrete. Periodic water levels and ground water samples will take place once wells are installed. Once assessments are completed the wells will be abandoned in accordance with IDNR regulations. The City Council's approval would be in the form of a License Agreement for Site Assessment between Terracon Consultants, Inc. and the City. The attached License Agreement outlines the responsibility of Terracon Consultants, Inc., provides indemnity to the City, and requires proof of liability insurance for placement of monitoring well equipment on City right -of -way. The License Agreement provides that the City shall have no liability for any environmental contamination occurring on the project's property, on City property, or on adjacent private property as a result of this activity. . RECOMMENDATION All appropriate documents, including the City's License Agreement, a map of well locations, and proof of liability insurance have been submitted by Terracon Consultants, Inc. have been approved by City staff. would, therefore, recommend that the City Council adopt the attached resolution authorizing the Mayor to execute the attached License Agreement for Site Assessment. BUDGET IMPACT This request does not have any budget impact for the City. ACTION TO BE TAKEN The City Council is requested to adopt the attached resolution authorizing the Mayor to execute the City's License Agreement for Site Assessment for the monitoring well installation on City property by Terracon Consultants, Inc. Prepared by Jane Smith, Engineering Assistant cc: Jon Dienst, PE Jane Smith, EAII 2 . RECOMMENDATION All appropriate documents, including the City's License Agreement, a map of well locations, and proof of liability insurance have been submitted by Terracon Consultants, Inc. have been approved by City staff. I would, therefore, recommend that the City Council adopt the attached resolution authorizing the Mayor to execute the attached License Agreement for Site Assessment. BUDGET IMPACT This request does not have any budget impact for the City. ACTION TO BE TAKEN The City Council is requested to adopt the attached resolution authorizing the Mayor to execute the City's License Agreement for Site Assessment for the monitoring well installation on City property by Terracon Consultants, Inc. Prepared by Jane Smith, Engineering Assistant cc: Jon Dienst, PE Jane Smith, EAII 2 RESOLUTION NO. 342 -11 AUTHORIZING LICENSE AGREEMENT FOR SITE ASSESSMENT BETWEEN THE CITY OF DUBUQUE AND TERRACON CONSULTANTS, INC. TO INSTALL MONITORING WELLS ON PUBLIC RIGHT -OF -WAY AT 25 MAIN STREET Whereas, Terracon Consultants, Inc., (Terracon) on behalf of Phillip Services Corporation (PSC) and Earthgrains Baking Companies ( Earthgrains), has requested permission from the City of Dubuque to install four monitoring wells on City right -of -way 25 Main Street including Main, Harrison and Jones Streets in Dubuque, Iowa, for the purpose of evaluating impacted groundwater that may be associated with the previously removed diesel tanks; and Whereas, the License Agreement for Site Assessment has been prepared outlining the responsibilities of Terracon for the installation of monitor wells and in the performance of water sampling on public right -of -way; and Whereas, the performance of the activities of Terracon will be at no cost or expense to the City, and all work will be performed by Terracon, or its employees, agents or subcontractors; and Whereas, it is the desire of the City Council to approve said License Agreement for Site Assessment for the installation of monitoring wells in the public right -of -way as requested. NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF DUBUQUE, IOWA: Section 1. The License Agreement for Site Assessment be and the same is hereby approved. Section 2. That the Mayor be and is hereby authorized to execute said License Agreement for and on behalf of the City Council. Passed, approved and adopted this 2011. Attest: alp vin S. Firnstahl, City Clerk 3rd day of October 0/i0 Roy D. Buol, Mayor If to the Licensee: Terracon Consultants, Inc 600 SW 7th Street, Suite M Des Moines, Iowa 50309 (515) 244 -3184 Fax: (515) 244 -5249 Such notices shall be delivered or sent by mail. Notices shall be deemed given when placed in the mail, postage paid. 12. The undersigned warrant that they have full power and authority to execute and deliver this Agreement. City further warrants that it has full power and authority to bind the current and future invitees on City Properties. IN WITNESS HEREOF, Terracon Consultants, Inc, and City have executed two (2) original copies of this Agreement on the dates specified immediately adjacent to their respective signatures. _ /.q ,Da C fJ GI- /7 f ( LICENSEE BO--c. Date: 9'2 3 .'2 0 /i Rev. BL 5/06 7/2011 CITY OF DUBUQUE, IOWA LICENSO By: D. Buol, Mayor Date: October 3, 2011 ATTEST: Kevins .Fi stahl, City Clerk September 23, 2011 Engineering Department City of Dubuque 50 West 13th Street Dubuque, IA 52001 -4864 RE: Right of Way Application Earthgrains Baking Companies 25 Main Street, Dubuque, Iowa Registration No. 8607011 Terracon Project No. 08117054 To Whom It May Concern: LUST No. 9LTO74 lierracon Terracon Consultants, Inc. (Terracon) is pleased to submit the enclosed Right of Way application package. Terracon is currently conducting an investigation of petroleum contamination at the above referenced site through a Tier 2 assessment. Concentrations noted in soil and groundwater samples collected on site indicated that additional delineation of the impacts is needed. Terracon has proposed to install several monitoring wells within the City right of ways along Main, Harrison, and Jones Street as noted on the attached map (PMW -1 through PMW -5). Following approval of the application and prior to installation of the wells, Terracon shall also acquire an excavation permit through the City. During installation of the monitoring wells, soil samples will be collected and the wells will be set according to Iowa Department of Natural Resources (IDNR) guidance. Each well will be completed with an expandable J -plug and bolt down man way set in concrete flush to grade. Once assessment and subsequent monitoring are complete as approved by the IDNR, the wells will be abandoned according to IDNR guidance and the area returned to previous condition. Until the wells are abandoned, Terracon will need to access them periodically to collect water levels and /or groundwater samples. If you have any questions or comments regarding this report, please contact Jesse Nelson at (515) 244 -3184 or via email at jmnelson @terracon.com. Sincerely, Terracon Consultants, Inc. /7 Jesse M. Nelson, CGP Environmental Project Manager Enclosure Dennis R. Sensenbrenner, P.G. Environmental Department Manager Tetracon Consultants Inc. 600 SW Seventh St. Suite M Des Moines, IA 50309 P [515] 244 -3184 F [515] 244 -5249 Geotechnical • Environmental • Construction Materials • Facilities LICENSE AGREEMENT FOR SITE ASSESSMENT THIS AGREEMENT is entered by and between Terracon Consultants, Incorporated (Licensee) and the City of Dubuque, Iowa (City), this 23`d day of September, 2011. WHEREAS, Licensee has entered into a contract with Phillip Services Corporation (PSC) and Earthgrains Baking Companies (Earthgrains) to investigate potential petroleum contamination at the facility located at 25 Main Street Dubuque, Iowa 52001 also listed under the UST Registration Number 8607011 and LUST Number 9LT074; and WHEREAS, pursuant to said contract, Licensee will assess and investigate said site to determine the presence of petroleum contamination by taking soil samples and installing groundwater monitoring wells (the Activities), all in contemplation of the preparation and submission of a Site Clean -Up Report (SCR) to the Iowa Department of Natural Resources by the Licensee; and WHEREAS, the investigation of said site, listed in Exhibit A attached hereto (Project Properties), will in many instances involve the investigation of adjacent City - owned property, or City -owned street or alley right -of -way, (City Property or the City Properties); and WHEREAS, the Licensee's performance of the Activities herein provided will be at no cost or expense to City and it is recognized that all work will be performed by Licensee or its employees, agents, or subcontractors; and WHEREAS, it is the desire and intention of Licensee and City to make this mutual agreement with respect to access to City Properties and with respect to the Activities to be conducted upon the said City Properties. NOW, THEREFORE, for and in consideration of the mutual covenants and undertakings hereinafter made by City and Licensee, the said parties do hereby agree as follows: 1. City hereby grants to Licensee, its contractors, subcontractors, and their employees and agents, a temporary license to enter upon City Properties adjacent to Project Properties for the performance of the assessment and investigation activities described hereinbelow (the Activities), and the right to enter shall continue in effect until December 31, 2011. If at that time Licensee has not completed all Activities required of it under its contract with PSC and Earthgrains, City may, through its City Council, extend this License Agreement for such additional period or periods of time to reasonably complete the Activities. The expiration of this License notwithstanding, Licensee shall retain its obligations with respect to the maintenance and removal of monitoring wells until such time as those obligations are satisfied, all as provided in Paragraph 5 hereof. 2. City represents and warrants that it owns and is lawfully possessed of all streets and alley rights -of -way adjacent to the Property Properties and that it has full authority to grant and enter into this License Agreement, provided, however, that Licensee shall be obligated to obtain permission from the Iowa Department of Transportation before conducting any of the Activities hereafter enumerated upon State highway right -of -way within the City of Dubuque. 3. The assessment and investigation activities (the Activities) to be undertaken by Licensee may include the following: Licensee agrees that its entry upon the City Properties shall be limited to the performance of said Activities. Licensee further agrees to undertake and complete the said Activities upon the City Properties in a prudent and responsible manner, and in accordance with all applicable laws and regulations of City, the state of Iowa, and the United States, and in accordance with all applicable orders, directives and regulations of IDNR or other governmental agencies having jurisdiction of the Activities. 4. Licensee agrees to notify City, at the time it picks up Excavation Permits for particular Project Properties, of its intent to commence the Activities upon specific City Properties. Licensee agrees not to conduct soil borings or to install groundwater monitoring wells upon the paved portion of any street or in any street or highway median, without special written authorization from City's Public Works Director. As to privately owned "underground facilities" located upon City Property, Licensee agrees to follow the procedures provided in Chapter 480 of the Iowa Code regarding obtaining locator service prior to the commencement of excavation or drilling activities, and that its responsibility and liability for damage to such facilities shall be determined in accordance with the provisions of that Chapter. As to City owned or operated "underground facilities ", (including but not limited to sewer, water, electric, electronic communications, and traffic control), City agrees that appropriate City departments or agencies will provide locator services for its underground facilities as required by Chapter 480 of the Iowa Code. Licensee, its agents, employees, contractors or subcontractors, agrees that its responsibility and liability for damage to underground facilities owned or operated by City, shall be determined in accordance with the provisions of Chapter 480 of the Iowa Code. 5. Within a reasonable time after completion of each step of any of the Activities on City Properties, Licensee shall cause any tools, equipment, materials except for any groundwater monitoring wells placed hereon to be removed, and shall restore said Properties to the condition they were in prior to commencement of said Activities. The obligation to remove and properly abandon each particular groundwater monitoring well upon City Properties shall remain the responsibility of Licensee until each such monitoring well is properly removed and abandoned as required by applicable state or federal law or regulation, as evidenced by a well closure report issued by a certified well driller. Alternatively, the obligation of Licensee with regard to particular monitoring wells shall be deemed discharged upon City's Public Works Director's receipt, acceptance, and execution of an agreement, in form acceptable to City's Legal Department, executed by the owner of the adjacent Project Property, pursuant to which the said property owner agrees to accept responsibility for the operation and maintenance of said monitoring well and for its removal and abandonment as above provided. Licensee agrees that City may retain its License Agreement for Site Assessment, hold harmless, and maintain on file certificates of liability insurance until its obligation to remove monitoring wells is deemed discharged as herein provided. Licensee agrees that unless deemed discharged it will promptly remove and properly abandon any monitoring well located upon City Property when it is notified by City that the City Property upon which the well is located is required for municipal purposes, including but not limited to street, sewer, traffic control, or water utility construction or repair. City agrees to review the proposed location of monitoring wells, if provided in advance of their installation, and to advise Licensee if a proposed monitoring well location will conflict with planned construction activities. City's failure to advise of such conflicts shall not excuse Licensee of its obligation to remove monitoring wells to accommodate such construction activities by City. The parties further agree that unless Licensee is deemed discharged, then in the event Licensee fails to properly maintain any monitoring well or the area immediately adjacent thereto, or fails to remove a monitoring well after being advised that the City Property upon which it is located is required for municipal purposes, City may either (a) deny Licensee access thereto, or (b) declare the said monitoring well a nuisance, cause same to be removed, and assess the costs of abatement against the Licensee, or against the Project Property or Properties for whose benefit the well was installed, all as provided in Iowa Code Section 364.12. 6. This Agreement is intended and shall be construed only as a temporary license to enter and conduct the Activities upon City Properties and not as a grant of easement or any other interest therein. 7. This Agreement shall be binding upon the parties hereto and upon their respective successors, representatives, heirs, and assigns. This agreement shall also be binding upon all current and future invitees on City Properties, if any. 8. Licensee agrees to the extent Licensee is negligent to defend, indemnify, and hold harmless City, its officers, agents, and employees from and against all manner of actions, liabilities, claims, causes of action, suits, debts, accounts, losses, damages, and attorneys' fees including but not limited to property damage or bodily injury, including death at anytime resulting therefrom, incurred by City, its officers, agents, or employees, caused by Licensee or its officers, agents, employees, contractors, or subcontractors, or by any third party, arising out of the performance of the Activities upon City Property by Licensee, or arising out of the existence, operation, maintenance, or removal of monitoring wells on City Property by Licensee, or arising out of or occasioned by Licensee's failure to perform any act as herein required. 9. Licensee shall purchase and maintain insurance as set forth in the attached Insurance Schedule through the duration of this Agreement. 10. Upon request by the City, Licensee agrees to provide to the City, within 10 days of request, copies of: (a) all reports, including raw sampling data, which it has therefore made or shall thereafter make to PSC, Earthgrains, IDNR, or any other governmental agency; and (b) all correspondence, including further orders or directives, which it received from PSC, Earthgrains, IDNR, or any other governmental agency; relating to assessment or remediation of any particular Project Property or to adjacent City Properties. 11. Notices, reports, or correspondence required to be given or sent by this Agreement shall be directed to the following: If to the City: Engineering Department City of Dubuque 50 W. 13th Street Dubuque, IA 52001 -4864 (563) 589 -4270 Fax: (563) 589 -4205 RESOLUTION NO. AUTHORIZING LICENSE AGREEMENT FOR SITE ASSESSMENT BETWEEN THE CITY OF DUBUQUE AND TERRACON CONSULTANTS, INC. TO INSTALL MONITORING WELLS ON PUBLIC RIGHT -OF -WAY AT 25 MAIN STREET Whereas, Terracon Consultants, Inc., (Terracon) on behalf of Phillip Services Corporation (PSC) and Earthgrains Baking Companies ( Earthgrains), has requested permission from the City of Dubuque to install four monitoring wells on City right -of -way 25 Main Street including Main, Harrison and Jones Streets in Dubuque, Iowa, for the purpose of evaluating impacted groundwater that may be associated with the previously removed diesel tanks; and Whereas, the License Agreement for Site Assessment has been prepared outlining the responsibilities of Terracon for the installation of monitor wells and in the performance of water sampling on public right -of -way; and Whereas, the performance of the activities of Terracon will be at no cost or expense to the City, and all work will be performed by Terracon, or its employees, agents or subcontractors; and Whereas, it is the desire of the City Council to approve said License Agreement for Site Assessment for the installation of monitoring wells in the public right -of -way as requested. NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF DUBUQUE, IOWA: Section 1. The License Agreement for Site Assessment be and the same is hereby approved. Section 2. That the Mayor be and is hereby authorized to execute said License Agreement for and on behalf of the City Council. Passed, approved and adopted this day of 2011. Attest: Kevin S. Firnstahl, City Clerk Roy D. Buol, Mayor A C) °Y CERTIFICATE OF LIABILITY INSURANCE I /1/2012 1 DATE22/20MID 1D ice' 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 POUCIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: H the certificate holder Is an ADDITIONAL INSURED, the policy(les) the terms and conditions of the policy, certain policies may require an endorsement certificate holder In Wu of such endorsement(s). must be endorsed. If SUBROGATION 13 WAIVED, subject to rights to the A statement on this certificate does not confer PRODUCER Lockton Companies, LLC -1 Kansas City 444 W. 47th Street, Suite 900 Kansas Cry MO 64112 -1906 (816) 960 - 9000 1.14 "CT A • r , X o, Est): iAlC, NO }, S: INSUREItl81 AFFORDENG COVERAGE NAME INSURER A : American International Insurance Company 32220 INSURED TERRACON CONSULTANTS, INC. 1344054 600 SW 7TH ST., SUITE M DES MOINES IA 50309 INSURER B: INSURER C : S XXXXXXX INSURER D: S XXXXXXX INSURER E : S XXXX INSURER F • S )00000( COVERAGES TERC001 PC CERTIFICATE NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM 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. TYPE OF INSURANCE Elt0. Ige POUCY NUMBER AN^ A ^ MD% LIMITS GENERAL — LIABILITY COMMERCIAL GENERAL LIABILITY JCLAIMS-MADE OCCUR NOT APPLICABLE r OCCURRENCFb S XXXXXXX �,�y (iE TQ�!E NTE I S XXXXXXX MEDESXEPS (My ono person) S XXXX PERSONAL & ADV INJURY S )00000( GENERAL AGGREGATE S )RXXXXX PRODUCTS - COMP/OP AGO 8 XXXXXXX GEN'L AGGREGATE UNIT APPLIES PER: —1 POLICYn 2CT n LOC AUTOMOBILE .� UABIUTY AANLLY AUTO ALIT O HIRED AUTOS _ NpN taMuLED NON-0 NNED A�� NOT APPLICABLE USINGLE LIMIT , 00000X( BODILY INJURY (Per person) $ XXXXXXX 800ILY INJURY (Per scolded S XXXXXXX OW amidst) S X IXXXX S — UMBRELLA LIAR EXCESS U _OCCUR CLAMS -MADE NOT APPLICABLE EACH OCCURRENCE S XXXXXXX AGGREGATE $ XXXXXXX [ RETENTION S S woluDIDt AND EMPLO LIABILITY ANY PROPRIETORTARTIFIVEXECIftNE Y❑ OFFICERAGEIMIER EXCLUDED? MywIM�s� yIs NN) DEMotl OPOtATIONS beam N/A NOT APPLICABLE we iAr IT�Y 'TSI 1 RR El EACHACCIOEM �����r S XXXX.XXX El DwaAR -EA EMPLOYEE XXXXXXX f XX3 (XX Iii. papas -POLICY LIMIT a XXX) J(X A CONTRACTOR'S POLLUTION LIABILITY Y N CPO 1330339 1/1/2011 1/1/2012 52,000,000 EACH OCCURRENCE AND S4,000,000 IN THE ANNUAL AGREGATE. DESCRIPTION OF OPERA/10,1S I LOCATIONS / VEHICLES NACach ACORD 101, Addlthrnal Ramada Scheduled/ more apt Is required) THIS CERTIFICATE SUPERSEDES ALL PREVIOUSLY ISSUED CERTIFICATES FOR THIS HOLDER, APPUCAELE TO THE CARRIERS LIST AND THE POLICY TERM(S) REFERENCED. RE: PROJECT #08117054• PHILLIPS SERVICE CORPORATION - EARTHGRAINS BAKING COMPANY ADDITIONAL TIER 2 DELINEATION. CITY OF DUBUQUE, ALL ITS ELECTED AND APPOINTED OFFICIALS, ALL ITS EMPLOYEES AND VOLUNTEERS ALL ITS $IpIINCLUDING INSURREEDS AS RESPECTS TODCOONIRACTOR'SSPPOL �ONNLLIABI TTY, AS REQUIRED ED BYIR�TTEENDCONTRA ARE AD�DTITONAL CERTIFICATE HOLDER CANCELLATION See Attachment 11444931 CITY OF DUBUQUE 50 WEST 13 STREET DUBUQUE IA 52001 SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE LDIPItATION DATE THEREOF, NOTICE WILL BE DEUVERED IN ACCORDANCE WITH THE POUCY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2010105) A®9 -2010 AC ORPORATION. All rights reserved The ACORD name and logo are registered marks of ACORD CITY OF DUBUQUE, IOWA GOVERNMENTAL IMMUNITIES ENDORSEMENT The insurance carrier expressly agrees and states that the purchase of this policy and the naming of the City of Dubuque, Iowa as an Additional Insured does not waive any of the defenses of govemmental 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. The insurance carrier 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. 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. 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 reason 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. Miscellaneous Attachment : M46790 Certificate ID : 11444931 AcciRtr CERTIFICATE OF LIABILITY INSURANCE/// /2012 DATE (MMIDD4Y Y) 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 POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: H the certlfIcate 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 certlflcate does not confer rights to the certificate holder In lieu of Duch endorsement(s). PRODUCER Lockton BR'S, LLC-1 Kansas City 444 W. 47th Street, Suite 900 Kansas C ty MO 64112 -1906 (816)960-N00 ..,. ' • . k FJ�( No' EA): Wc, No): 4 INSUItEl1[SI AFFORDING COVERAGE NAIC e INSURER A : Media Specialty Insurer= Coelpany 26883 POURED TERRACON CONSULTANTS, INC. 12315 600 SW 7TH ST., SUITE M DES MOINES IA 50309 INSURER B : * *AN Ale COMPANY (A XV) PROP3779274 INSURER C : Travelers P1opsny Caeerq Co el America 25674 *awns', D : The Travelers Indemnity Company 25658 INSURER E : $ 300,000 INSURER F : s 5,000 C CERTIFlCATE NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM 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. TYPE OF INSURANCE pU Ve POUCY NUMBER I]EIAIODIIfY' 11211gM WITS A GENERALLIASIUTY X COMMERCIAL GENERAL LIABILITY y N PROP3779274 1/1/2011 1/1/2012 • • ;• m • s 1,000,000 ' " -i ~F'3 I aenarwloa1 $ 300,000 paw EXP (Any ere pwron) s 5,000 I CLAIMS -MADE X OCCUR X CONTR'L LIABILITY PERSONAL a ADV INJURY 8 1,000,000 GENERAL AGGREGATE 8 2,,000 PRODUCTS - COMPIOP AGG $ 2,000,000 GENL AGGREGATE LIMIT APPLIES PER: 7 POLICY/ i I 7a n LOC 8 c IUJTOMOf0.EUABRJTY X — X ANY AUTO ALL OWNED AHIRfEODSAUTOS — — X NCpFN UIUI EEO AUCO,S N N TC2J-CAP- 13133858 1/1/2011 1/1/2012 V=SINGLEUMIT 8 1,000.000 BODILY INJURY (Pr pawn) $ } }( BODILY INJURY (Per accident ;ar rtl $ XXXXXXX $ XXXXXXX :XXXXXXX $ 5,000,000 A A X X MOREL"UNE EXCESS LEAS X OCCUR CLAIMS -MADE N N PROU1920977 (EXCLUDES PROF. LIAB.) 1/1/2011 1/1/2012 EACH OCCURRENCE AGGREGATE $ 5,000,000 I RETENTION 8 $ XXXXXXX c D tV01tl TION AND BIPLOYERVuast •f ANY O�l� taindowy In laq ECCLUOmt L iJ OF CPEPIATIONS Wow NIA y TRJ- UB- 131J3846 AZ,OR,WI) TC2KUBI31J3742((AOS) 1/1/2011 1/1/2011 1/1/2012 1/1/2012 X PION I- s 1,000,000 ,J..r c. ACCIDENT Fi Deem- EADIPLOYEE ; 1,000,000 ILL aswrt- ►oucrw-r s 1,000,000 THIS DESCRIPTOR TESUPERSEDES ALL PREVIOUSLY ISSUED CERTIFICATES FOR Meelonsl Remits HOLDER, APPU�CABLLE TO THE CARRIERS LISTED AND THE POLICY TERM(S) REFERENCED. RE: PROJECT /08111054; PHILLIPS SERVICE CORPORATION - EARTHGRAINS BAKING COMPANY ADD ITTONAL TIER 2 DELINEATION. CITY OF DIJB R INCLUIHNG ALL ITS ELECTED AND APPOINTED OFFICLALS, ALL TES EMPLOYEES AND VOLUNTEERS,_ ALL ITS BOARDS COMMISSIONS AND/OR AUTHORITIES AND THEIR BOARD MEN ERS _EMPLOYEES AND VOLUNTEERS ARE ADDITIONAL INSREDS AS RESPECTS TO GENERAL LIABILITY, THIS COVERAGE IS PRIMARY AND NON - CONTRIBUTORY AS REQUIRED BY WRITTEN CONTRACT. WAIVER OF SUBROGATION APPLIES TO WORKERS COMPENSATION WHERE ALLOWED BY STATE LAW AND AS REQUIRED BY WRITTEN CONTRACT. CERTIFICATE HOLDER CANCELLATION See Attachments 11444926 CITY OF DUBUQUE 50 WEST 13 STREET DUBUQUE IA 52001 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POUCY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2010/05) ®0 -2010 AC ORPORATION. Ali lights reserved The ACORD name and logo are registered marks of ACORD This endorsement, effective 12:01 am, Forms a part of Policy No: PROP 3779274 Issued to: TERRACON CONSULTANTS, INC. By: CHARTIS SPECIALTY INS. CO. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED / PRIMARY COVERAGE ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY In consideration of an additional premium of $ 0 it is hereby agreed that the following is included as an Additional Insured as respects Coverage A and B but only as respects liability arising out of your work for the Additional Insured by or for you. Additional Insured: AS REQUIRED BY WRITTEN CONTRACT. This does not apply to bodily injury or property damage arising out of the sole negligence or willful misconduct of, or for defects in design fumished by, the Additional Insured. As respects the coverage afforded the Additional Insured, this insurance is primary and non - contributory, and our obligations are not affected by any other insurance carried by such Additional Insured whether primary, excess, contingent, or on any other basis. This endorsement does not increase the Company's limits of liability as specified in the Declarations of this policy. All other terms, conditions, and exclusions shall remain the same. AUTHORIZED REPRESENTATIVE or countersignature (in states where applicable) 90667 (04/06) CI2791 Miscellaneous Attachment : M67290 Certificate ID : 11444926 1 CITY OF DUBUQUE, IOWA GOVERNMENTAL IMMUNITIES ENDORSEMENT The insurance carrier expressly agrees and states that the purchase of this policy and the naming 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. The insurance carrier 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. 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. 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 reason 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. Miscellaneous Attachment : M46790 Certificate ID : 11444926 POLICY NUMBER: PROP3779274 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COVERAGES A,B, AND C AMENDATORY ENDORSEMENT- AGGREGATE LIMITS OF INSURANCE PER LOCATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY AND PROFESSIONAL LIABILITY POLICY It is hereby agreed as follows: I. Solely with respects to COVERAGES A, B, and C, the general aggregate limit under SECTION III- LIMITS OF INSURANCE applies separately to each of your locations owned, occupied or rented by you and the limit is equal to the amount of the general aggregate limit shown in the declarations. 11. For the purposes of this endorsement SECTION VI- DEFINITIIONS is amended by the addition of the following definition: Location means premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right -of -way of a railroad. 97211 (1/08) C13420 Attachment Code : D461890 Certificate ID : 11444926 4 iF- PMW2 V t 5K REMOVED GASOLINE PUMP ISLAND REMOVED PMW1 MW-8 PUMP ISLAND IREMOVED MW-2 MW-7 1 -1 10K REMOVEn FGASOLINE C_ 0 MW-9 MW-6 1gi REMOVED VMW5 L g, MW -4 0 0mw-10 a \ \ 5K FILLED IN PLAC HEATING 01 N n � _ A as PMWS 0 NORTH 100' APPROXIMATE DRAWING SCALE 'Prged No. 08117054 prood ow Drawn By: JMN KEK Fef� lama: 08117054-01.dwq 1 .put Name. FIGURE 5 07/18/11 iTerracon Consulting Engineers and Scientists 600 SW 7TH STREET DES MOINES, IOWA 50309 PH. (515) 244-31134 FAX. (515) 2445249 \ \ 1_ �__ # v �..4� .4� PMW4 1 v '_= I < # LEGEND - BOUNDARY OF ASSESSED AREA —v —v —v — - WATER —s —s —■ — - SEWER S- MONITORING WELLS EARTHGRAINS BAKING COMPANY 25 MAIN STREET DUBUQUE. IOWA FIG. No. 5