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
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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 :
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INSURER D:
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INSURER E :
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INSURER F •
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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
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52,000,000 EACH OCCURRENCE AND
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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
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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
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POUCY NUMBER
I]EIAIODIIfY'
11211gM
WITS
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GENERALLIASIUTY
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GENL AGGREGATE LIMIT APPLIES PER:
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—
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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
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PUMP ISLAND
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PMW1
MW-8
PUMP ISLAND
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MW-7
1 -1
10K REMOVEn
FGASOLINE
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0
MW-9
MW-6
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NORTH
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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
\ \
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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