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Improvement Contract_Performance Bonds_McDermott Excavating, Millwork District Temp Parking LotCITY OF DUBUQUE, IOWA IMPROVEMENT CONTRACT THIS IMPROVEMENT CONTRACT (the Contract), made in triplicate, dated for reference purposes the 16th day of May , 2012, between the City of Dubuque, Iowa, by its City Manager, through authority conferred upon the City Manager by its City Council (City) and McDermott Excavating of the City of Dubuque, IA). 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 Millwork Temporary Parking Lot Project (the Project). The Project shall be made to the established grade and to the grades as shown on the profiles and cross - sections on file in the City Engineer's office for this Project, in strict accordance with the requirements of the laws of the State of Iowa and ordinances of the City of Dubuque relating to public works, and in accordance with the Contract Document shall of which provisions and documents are each and all hereby referred to and made a part of this Contract just as much as if the detail statements thereof were repeated herein. 2. Contract Documents shall mean and include the following: All ordinances and resolutions heretofore adopted by the City Council having to do with the Project; the Notice to Bidders; the Contractor's Proposal; and the Plans, Specifications, and General Requirements as adopted by the City Council for the Project. 3. All materials used by the Contractor in the Project shall be the best of their several kinds and shall be put in place to the satisfaction of the City Manager. 4. The Contractor shall remove any materials rejected by the City Manager as defective or improper, or any of said work condemned as unsuitable or defective, and the same shall be replaced or done anew to the satisfaction of the City Manager at the cost and expense of the Contractor. 5. Five percent (5 %) of the Contract price shall 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 that may be filed within said time 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 time, as provided in Iowa Code Chapter 573. The City shall 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 shall be held by the City until such claims have been settled, adjudicated or otherwise disposed of. 6. The Contractor has read and understands the specifications including General Requirements and has examined and understands the plans herein referred to and agrees not to plead misunderstanding or deception because of estimates of quantity, character, location or other conditions surrounding the same. 7. In addition to the guarantee provided for in the specifications, the Contractor shall also make good any other defect in any part of the Project due to improper construction notwithstanding the fact that said Project may have been accepted and fully paid for by the City, and the Contractor's bond shall be security therefore. 8. The Contractor shall fully complete the Project under this Contract on or before: June 30, 2012. 9. To the fullest extent permitted by law, the Contractor shall indemnify and hold harmless the City from and against all claims, damages, losses and expenses, including but not limited to attorney fees, arising out of or resulting from performance of the 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 (other than the Project itself) including loss of use resulting there from, but only to the extent caused in whole or in part by negligent acts or omissions of the Contractor, the Contractor's subcontractor, or anyone directly or indirectly employed by the Contractor or the Contractor's subcontractor or anyone for whose acts the Contractor or the Contractor's subcontractor may be liable, regardless of whether or not such claim, damage, loss or expense is caused in part by a party indemnified hereunder. THE CITY AGREES: Upon the completion of the Contract, and the acceptance of the Project by the City, the City agrees to pay the Contractor as full compensation for the complete performance of this Contract, the amount determined for the total number of units completed at the unit prices stated in the Contractor's Proposal and less any liquidated damages provided for in the Contract Documents. The number of units stated in the plans and specifications is approximate only and the final payment shall be made by the work covered by the Contract. CONTRACT AMOUNT $ 40,680.65 (Insert Contract Amount) FURTHER CONDITIONS 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 agreement 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 agreement or arrangement with any other person, firm, corporation or association which tends to or does lessen or destroy free competition in the letting 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 Tess than ten percent (10 %) of the Contract price but in no event be less than $ 4,068.06 (Four Thousand Sixty -Eight and 06/100 Dollars) as liquidated damages to the City. The surety on the bond furnished for this Contract, shall 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. The Contractor agrees, and its bond shall be surety therefore, that it will keep and maintain the Project in good repair for a period of two years after acceptance of the same by the City Council and its bond shall be security therefore. The Contractor agrees, and its bond shall be surety therefore, that it will keep and maintain the Project in good repair for a period of two years after acceptance of the same by the City and its bond shall be security therefore. The City of Dubuque and the Contractor agree to comply with 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 shall 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). CITY OF DUB QUE, IOWA By City 4anager PRINCIPAL By: Contractor S Title BIDDER NAME: City of Dubuque - Engineering Division Bid Proposal McDermott Excavating BID PROPOSAL FOR: MILLWORK TEMPORARY PARKING LOT PROJECT BID ITEM DESCRIPTION UNIT BID FORM 1A DATE: 5/2/2012 ESTIMATED QUANTITY BID UNIT COST TOTAL COST MILLWORK TEMPORARY PARK IN G -LOT - BASE BID 1 Mobilization, Bonds, Insurance LS 1 $3,728.00 $3,728.00 2 Erosion Control LS 1 $450.00 $450.00 3 Existing Pavement Removal SY 1,215 $1.52 $1,846.80 4 Earthwork and Grading CY 222 $10.50 $2,331.00 5 Pavement Markings & Handicap Signagi LS 1 $675.00 $675.00 6 Normal Duty Pavement (4- inches modified subbase with 2 1/2- inches HMA SY 2,755 $10.21 $28,128.55 7 Heavy Duty Pavement (6- inches modified subbase with 4- inches HMA) SY 230 $15.31 $3,521.30 MILLWORK TEMPORARY PARKING L OT - ALTERNATE BID 1 Mobilization, Bonds, Insurance 2 Erosion Control 3 Existing Pavement Removal 4 Earthwork and Grading 5 Pavement Markings & Handicap Signage 6 Seal Coat Pavement BASE BID TOTAL: (Bid Items No.1 to 7 Total) $40,680.65 LS 1 $2,650.00 $2,650.00 LS 1 $450.00 $450.00 SY 1,215 $1.52 $1,846.80 CY 222 $10.50 $2,331.00 LS 1 $675.00 $675.00 SY 2,985 $6.05 $18,059.25 ALTERNATE BID TOTAL: (Bid Items No.1 to 6 Total) $26,012.05 CITY OF DUBUQUE, IOWA PERFORMANCE, PAYMENT AND MAINTENANCE BOND KNOWN ALL MEN BY THESE PRESENTS: That McDermott Excavating as Principal (Contractor) and Merchants Bonding Company (Mutual) as Surety are held firmly bound unto the City of Dubuque, Iowa (City), in the penal sum of $ 40,680.65 the same being 100% of the total price of the Contract for the Project herein referred to, lawful money of the United States of America, well and truly to be paid to said City of Dubuque, and to all other parties who, under the provisions of the laws of Iowa, are intended to be protected and secured hereby for which payment we bind ourselves, our heirs, executors, successors and assigns, jointly and severally by these presents. Dated at Dubuque, Iowa, this 30th day of May , 2012, and duly attested and sealed. WHEREAS, the said Contractor by a Contract dated May 16, 2012, incorporated herein by reference, has agreed with said City of Dubuque to perform all labor and furnish all materials required to be performed and furnished for the Millwork Temporary Parking Lot Project (the Project) according to the Contract and Construction Documents prepared therefore. It is expressly understood and agreed by the Contractor and Surety bond that the following provisions are a part of this Bond and are binding upon said Contractor and Surety, to -wit: 1. PERFORMANCE BOND: 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 City from all outlay and expense incurred by the City 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. 2. PAYMENT BOND: The Contractor and the Surety shall 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 Contractor or any subcontractor, wherein the same are not satisfied out of the portion of the contract price which the City 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, Code of Iowa, which by this reference is made a part hereof as though fully set out herein. 3. MAINTENANCE BOND: The Contractor and the Surety 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 within the period of two (2) year(s) from the date of acceptance of the work under the Contract by the City of Dubuque, Iowa, by reason of defects in workmanship or materials used in construction of said work; B. To keep all work in continuous good repair; and C. To pay the City the reasonable costs of monitoring and inspection to assure that any defects are remedied, and to repay the City 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 agreement herein made extends to defects in workmanship or materials not discovered or known to the City at the time such work was accepted. NOW, THEREFORE, the condition of this obligation is such that if the said Contractor shall perform all of the work contemplated by the Contract in a workmanlike manner and in strict compliance with the plans and specifications, and will pay all claims for labor and materials used in connection with said Project, to indemnify the said City for all damages, costs and expense incurred by reason of damages to persons or property arising through the performance of said Contract, and will reimburse the City for any outlay of money which it may be required to make in order to complete said Contract according to the Construction Documents and will maintain in good repair said Project for the period specified in the Contract where this bond is obligated for maintenance, and will faithfully comply with all of the provisions of Section 573 of the Code of Iowa, then this obligation shall be null and void, otherwise it shall remain in full force and effect. All the conditions of this bond must be fully complied with before the Contractor or the Surety will be released. The Contract, Contractor's Proposal, and Construction Documents shall be considered as a part of this Bond just as if their terms were repeated herein. Dated at Dubuque, Iowa this 30th day of May , 2012. CITY OF DUBUQUE, IOWA By: City Manager PRINCIPAL W id e-V D4t - EXCavedi Contractor Signature By: Title SURETY By: Merchants Bonding Company (Mutual) Su ompany Signature Attorney -In -Fact Title Dubuque, IA 52001 City, State, Zip Code 563 - 583 -5775 Telephone Attorney In Fact CITY OF DUBUQUE, IOWA SALES USE TAX EXEMPTION CERTIFICATE The City of Dubuque, as a designated exempt entity awarding construction contracts on or after January 1, 2003, may issue special exemption certificates to Contractors and subcontractors, allowing them to purchase, or withdraw from inventory, materials for the contract free from sales tax pursuant to Iowa Code Sections: 422.42 (15) & (16), and 422.47 (5). This special exemption certificate may also allow a manufacturer of building materials to consume materials in the performance of a construction contract without owing tax on the fabricated cost of those materials. If the jurisdiction, at its option, decides to utilize this exemption option, it will so state by special provision and publication in the Notice of Hearing and Letting. 1. Upon award of contract, the Jurisdiction will register the contract, Contractor, and each subcontractor with the Iowa Department of Revenue and Finance; and distribute tax exemption certificates and authorization letters to the Contractor and each subcontractor duly approved by the Jurisdiction in accordance with Section 1030, 1.10, B. These documents allow the Contractor and subcontractors to purchase materials for the contract free from sales tax. The Contractor and subcontractors may make copies of the tax exemption certificate and provide a copy to each supplier providing construction material. These tax exemption certificates and authorization letters are applicable only for the work under the contract. 2. At the time the Contractor requests permission to sublet in accordance with said Section 1030, 1.10, B, the Contractor shall provide a listing to the Jurisdiction identifying all subcontractors, including the Federal Employer Identification Number (FEIN) for the Contractor and all subcontractors, as well as the name, address, telephone number, and a representative of the organization which will perform the work, a description of the work to be sublet, and the associated cost. 3. The Contractor and each subcontractor shall comply with said Iowa Code Sales Tax requirements, shall keep records identifying the materials and supplies purchased and verify that the were used on the contract, and shall pay tax on any materials purchased tax -free and not used on the contract. PROJECT INFORMATION REQUIREMENTS FOR STATE OF IOWA SALES TAX EXEMPTION CERTIFICATES FOR CONTRACTORS & SUBCONTRACTORS Submitting Department: Please complete this form in its entirety and submit along with the executed Construction Contracts, Bonds and Certificate of Insurance. Upon receipt, the City Finance Department will work with the Iowa Department of Revenue to issue Sales Tax Exemption Certificate(s) to the approved Contractor(s) to allow for the purchase or inventory withdrawal of materials for the specified Construction Project free from State of Iowa Sales Tax. Construction Project Name: Millwork Temporary Parking Lot Project Project Description: Installation of temporary asphalt parking lot, including: Erosion Control - Existing asphalt pavement removal Earthwork and Grading Curb saw cut to accommodate parking lot entrance - Placement and compaction of modified subbase stored on site - 4" thickness - Placement and compaction of 1.5" HMA binder course and 1" HMA surface course - Pavement Markings and Handicap Signage Restoration /Seeding Start Date (Bid let date): May 2,2012 Completion Date: June 30, 2012 July 31, 2012 per Change Order #1 1. General Prime Contractor: McDennott Excavating Contact Name: Herb Dolphin Complete Address: (Include PO Box and Street Information) 14407 Highway 20 West City, State, Zip Code Dubuque, Iowa 52003 Telephone Number: 563- 583 -4633 39- 1872711 Federal I.D. Number: (or Include Social Security Number) Work Type to be Completed: Excavating 2. Subcontractor: Ri ver Ci ty Pavi ng P.O. Box 1430 11 I 1J ' t o 1 a a- i 1 Dubuque, Iowa 52004 -1430 Complete Address: (Include PO Box and Street Information) City, State, Zip Code Telephone Number: 563- 582 -8334 39- 0752519 Federal I.D. Number: (or Include Social Security Number) Work Type to be Completed: Materials /Hot Mix, Asphalt PROJECT INFORMATION PAGE 2 3. Subcontractor: Kluesner Construction, Inc. Complete Address: (Include PO Box and Street Information) 1007 1st Ave. NW Telephone Number: City, State, Zip Code Farley, Iowa 52046 Telephone Number: 563- 744 -3422 Federal I.D. Number: (or Include Social Security Number) 42- 1463491 Work Type to be Completed: Pavement Markings 4. 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: 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: 6. 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: PROJECT INFORMATION PAGE 3 7. 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: 8. 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: 9. 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: 10. 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: '`` /J CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD /YYYY) 5/30/2012 TIi!S 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: If the certificate 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 certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Wallis Kunnert Price & Smith Inc. 890 Main St. P.O. Box 176 Dubuque IA 52004 -0176 CONTACT Linda Caspersen PHONE No. Ext1: (563) 583 -5775 (A/C. No): (563) 583 -5779 ADDRESS:lindac @wkpsins.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA:Cincinnati Insurance Co. 10677 INSURED McDermott Excavating 14407 Hwy 20 West Dubuque IA 52003 -9709 INSURERB:Cincinnati Indemnity Company 23280 INSURER C: 1/1/2013 INSURER D: $ 1,000,000 INSURER E : $ 100, 000 INSURERF: _ $ 5,000 CERTIFICATE NUMBER:CL1253001955 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED 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. INSR TYPE OF INSURANCE ASR SWVD POLICY NUMBER (MM/DCDIYYYY) (POLICY / D/YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY ENP0060480 1/1/2012 1/1/2013 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100, 000 MED EXP (Any one person) _ $ 5,000 CLAIMS -MADE X OCCUR PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OP AGG $ 2,000,000 GE 'L AGGREGATE POLICY X LIMIT APPLIES JF51 PER: LOC $ p' AUTOMOBILE X LIABILITY ANY AUTO ALLOWNED AUTOS HIRED AUTOS x X SCHEDULED AUTOS NON -OWNED AUTOS EBA0060480 1/1/2012 1/1/2013 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE accident) $ ,(Per BFDOC $ 0 A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE ENP0060481 1/1/2012 1/1/2013 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10, 000, 000 $ DED X 0 RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y N N / A wC1896366 -05 1/1/2012 1/1/2013 X WC STATU- TQRY LIMITS OTH- ER E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE - EA EMPLOYEE $ 100,000 E.L. DISEASE - POLICY LIMIT $ 500, 000 DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Job: Millwork Temporary Parking Lot Project. Additional Insured for this job ONLY: City of Dubuque per GA 4113 11/99 & GA 443 1/95. Also attached are Forms GA 4094 10 /01, WC 00 03 13, Govenmental Immunities Endorsement and CG 25 03 3/97. A 30 day notice of cancellation will be given to the Cert. Holder if any of these policies cancels. Except for non - payment, which is 10 days. CERTIFICATE HOLDER CANCELLATION The City of Dubuque 50 West 13th St. Dubuque, IA 52001 -4864 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE J Allen Wallis III, /L ACORD 25 (2010/05) INS025 (201005).01 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD A °® CERTIFICATE OF LIABILITY INSURANCE DATE(MWDD/YYYY) 5/30/2012 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: If the certificate 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 certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Wallis Kunnert Price & Smith Inc. 890 Main St. P.O. Box 176 Dubuque IA 52004 -0176 CONTACT Linda Caspersen NAME: P fPHON No. Ext): (563) 583 -5775 fAIC.No): (563) 583 -5779 ADDRESS:lindac @wkpsins.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA:Cincinnati Insurance Co. 10677 INSURED McDermott Excavating 14407 Hwy 20 West Dubuque IA 52003 -9709 INSURERB:Cincinnati Indemnity Company 23280 INSURER C: 1/1/2013 INSURER D: $ 1,000,000 INSURER E : 100 000 $ r INSURERF: $ 5,000 CL1253001955 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED 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. INSR LTR TYPE OF INSURANCE ADDL AI SR SUBR SWVD POLICY NUMBER POLICY EFF (MMIDD/YYYY) POLICY EXP (MM/D /D/YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY ENP0060480 1/1/2012 1/1/2013 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) 100 000 $ r MED EXP (Any one person) $ 5,000 CLAIMS - MADE X OCCUR PERSONAL 8, ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OP AGG $ 2,000,000 GEN'L AGGREGATE 7 POLICY X LIMIT APPLIES PER: JE n LOC $ A AUTOMOBILE X LIABILITY ANY AUTO ALLOWNED AUTOS HIRED AUTOS X X SCHEDULED AUTOS NOTOSWNED EBA0060480 1/1/2012 1/1/2013 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ BFDOC $ 0 A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE ENP0060481 1/1/2012 1/1/2013 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 $ DED X RETENTION$ 0 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE (Mandatory In NH) EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A WC1846366 -05 1/1/2012 1/1/2013 x WC STATU- TORY LIMITS OTH- ER E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE - EA EMPLOYEE $ 100 000 r E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Job: Millwork Temporary Parking Lot Project. Additional Insured for this job ONLY: City of Dubuque per GA 4113 11/99 & GA 443 1/95. Also attached are Forms GA 4094 10 /01, WC 00 03 13, Govenmental Immunities Endorsement and CG 25 03 3/97. A 30 day notice of cancellation will be given to the Cert. Holder if any of these policies cancels. Except for non - payment, which is 10 days. CERTIFICATE HOLDER CANCELLATION The City of Dubuque 50 West 13th St. Dubuque, IA 52001 -4864 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE J Allen Wallis III, /L ACORD 25 (2010/05) NS025 (201005)01 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION - YOUR WORK This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization (Additional Insured): The City of Dubuque, including all its elected and appointed officials, all its employees and volunteers, all its boards, commissions & /or authorities and their board members, employees and volunteers.. 50 West 13th Dubuque, IA 52001 WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of "your work" for that Additional Insured by you or on your behalf. GA 411311 99 Includes copyrighted material of Insurance Services Office, Inc., with its permission. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (Form A) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Location of Covered Operations: Dubuque, IA Name of Person or Organization (Additional Insured): The City of Dubuque, including all its elected and appointed officials, all employees and volunteers, all its boards, commissions & /or authorities and their board _members, employees and volunteers. 50 West 13th St. Dubuque, IA 52001 Premium Basis Bodily Injury and Property Damage Liability Cost Rates (Per $1000 of cost) Advance Premium $ INCL. (If no entry appears above, information required to complete this endorsement will be shown tions as applicable to this endorsement.) 1. WHO IS AN INSURED (Section II) is amended to include as an insured the person or organi- zation (called "additional insured ") shown in the Schedule but only with respect to liability arising out of: A. Your ongoing operations performed for the additional insured(s) at the location designated above; or B. Acts or omissions of the additional in- sured(s) in connection with their general supervision of such operations. 2. With respect to the insurance afforded these additional insureds, the following additional provisions apply: A. Exclusions b., c., g., h.(1), j., k., 1. and n. under COVERAGE A- BODILY INJURY AND PROPERTY DAMAGE LIABILITY (Section I - Coverages do not apply. B. Additional Exclusions. This insurance does not apply to: (1) "Bodily injury" or "property damage" for which the additional insured(s) are obligated to pay damages by reason of the assumption of liability in a contract or agreement. This ex- clusion does not apply to liability for damages that the additional in- sured(s) would have in the absence of the contract or agreement. Contains copyrighted material of Insurance Services Office, Inc., with its permission. Copyright, Insurance Services Office, Inc., 1992 GA 443 01 95 its in the Declara- (2) "Bodily injury" or "property damage" occurring after: (3) (a) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the site of the covered operations has been completed; or (b) That portion of "your work" out of which the injury or damages arises has been put to its in- tended use by any person or or- ganization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. "Bodily injury" or "property damage" arising out of any act or omission of the additional insured(s) or any of their "employees ", other than the general supervision by the additional insured(s) of your ongoing opera- tions performed for the additional in- sured(s). (4) "Property damage" to: Page 1 of 2 (a) Property owned, used or occu- pied by or rented to the addi- tional insured(s); (b) Property in the care, custody, or control of the additional in- sured(s) or over which the addi- tional insured(s) are for any pur- GA 443 01 95 pose exercising physical control; or (c) Any work, including materials, parts or equipment furnished in connection with such work, which is performed for the addi- tional insured(s) by you. Contains copyrighted material of Insurance Services Office, Inc., with its permission. Copyright, Insurance Services Office, Inc., 1992 Page 2 of 2 GOVERNMENTAL IMMUNITIES ENDORSEMENT 1. Nonwaiver of Governmental Immunity. The insurance carrier expressly agrees and states that the purchase of this policy and the including of the City of Dubuque, IA as an Additional Insured does not waive any of the defenses of governmental immunity available to the City of Dubuque, Iowa under Code of Iowa Section 670.4 as it is now exists and as it may be amended from time to time. 2. Claims Coverage. The 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. Those claims not subject to Code of Iowa Section 670.04 shall be covered by the terms and conditions of this insurance policy. 3. Assertion of Government Immunity. The City of Dubuque, Iowa shall be responsible for asserting any defense of governmental immunity, and may do so at any time and shall do so upon the timely written request for the insurance carrier. 4. Non - Denial of Coverage. 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, IA under this policy for reasons of governmental immunity unless and until a court of competent jurisdiction has ruled in favor of the defense(s) of governmental immunity asserted by the City of Dubuque, IA. 5. No Other Change in Policy. The insurance carrier and the City of Dubuque, Iowa agree that the above preservation of governmental immunities shall not otherwise change or alter coverage available under the policy THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Projects: Millwork Temporary Parking Lot Project Dubuque, TA (If no entry appears above, information required to complete this endorsement will be shown in the Declara- tions as applicable to this endorsement). A. For all sums which the insured becomes legally ignated construction project shown in the obligated to pay as damages caused by "occur- Schedule above. rences" under COVERAGE A (SECTION 1), and for all medical expenses caused by accidents 4. The limits shown in the Declarations for under COVERAGE C (SECTION I), which can Each Occurrence, Fire Damage and Medi- be attributed only to ongoing operations at a cal Expense continue to apply. However, single designated construction project shown in instead of being subject to the General Ag- the Schedule above: gregate Limit shown in the Declarations, such limits will be subject to the applicable 1. A separate Designated Construction Proj- Designated Construction Project General ect General Aggregate Limit applies to Aggregate Limit. each designated construction project, and that limit is equal to the amount of the Gen- B. For all sums which the insured becomes legally eral Aggregate Limit shown in the Declare- obligated to pay as damages caused by "occur - tions. rences" under COVERAGEA (SECTION 1), and for all medical expenses caused by accidents 2. The Designated Construction Project Gen- under COVERAGE C (SECTION 1), which can - eral Aggregate Limit is the most we will pay not be attributed only to ongoing operations at a for the sum of all damages under single designated construction project shown in COVERAGE A, except damages because the Schedule above: of "bodily injury" or "property damage" in- cluded in the "products- completed opera- '1. Any payments made under COVERAGE A tions hazard ", and for medical expenses for damages or under COVERAGE C for under COVERAGE C regardless of the medical expenses shall reduce the amount number of: available under the General Aggregate Limit or the Products - Completed Opera - a. Insureds; tions Aggregate Limit, whichever is applica- b. Claims made or "suits" brought; or ble; and c. Persons or organizations making claims or bringing "suits ". 3. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the Desig- nated Construction Project General Aggre- gate Limit for that designated construction project. Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated Construction Project General Aggregate Limit for any other des- CG 25 03 03 97 2. Such payments shall not reduce any Des- ignated Construction Project General Ag- gregate Limit. C. When coverage for liability arising out of the "products- completed operations hazard" is pro- vided, any payments for damages because of "bodily injury" or "property damage" included in the "products- completed operations hazard" will reduce the Products - Completed Operations Ag- gregate Limit, and not reduce the General Ag- gregate Limit nor the Designated Construction Project General Aggregate Limit. Copyright, Insurance Services Office, Inc., 1996 Page 1 of 2 D. If the applicable designated construction project has been abandoned, delayed, or abandoned and then restarted, or if the authorized con- tracting parties deviate from plans, blueprints, designs, specifications or timetables, the project CG 25 03 03 97 E. will still be deemed to be the same construction project. The provisions of Limits of Insurance (SECTION 111) not otherwise modified by this endorsement shall continue to apply as stipulated. Copyright, Insurance Services Office, Inc„ 1996 Page 2 of 2 CERTIFICATE OF CITY CLERK This is to certify that a certified copy of the above Contract has been filed in my office on the -74rM day of , 2012. CD LO LL 0 k -1—r is h L. G I soy. F -)-. c.:-k, Gack.