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Schroeder Construction Contract_Upper Bee Branch Creek Restoration ProjectMasterpiece on the Mississippi TO: Michael C. Van Milligen, City Manager FROM: Steve Sampson Brown, Project Manager DATE: October 18, 2012 SUBJECT: INTRODUCTION Dubuque All ctinny 2007 Upper Bee Branch Creek Restoration Project Schroeder Construction, Vendor Service Agreement CIP 720 -1654 Attached is the Vendor Services Agreement for geotechnical test pile installation and testing services between Jim Schroeder Construction, Inc. (Schroeder) and the City for the Upper Bee Branch Creek Restoration Project. DISCUSSION The attached proposal in the amount of $25,795.00 will provide for Schroeder to install a test pile adjacent to the proposed railroad bridge location. The measured results of the test pile installation will be used by the structural engineers to provide a more accurate and cost effective design of the Canadian Pacific railroad bridge. At this time, geotechnical information at the project site is incomplete. If a test pile is not installed during the design phase, engineers will have to base their bridge design on assumed soil support strengths. Having to use assumed soil strength information has two major detriments. Currently the pile driving depth to bedrock unknown thus an assumption will have to be made as part of the foundation design about the required pile length, which could vary +/- 20 feet. Since over 140 piles will need to be driven, during construction this could potentially result in a large change order related to the pile installation process if the assumed /designed pile lengths are inaccurate. Secondly, time to install individual piles can vary greatly based on soil type. A test pile will allow the project team to more accurately reflect the construction staging requirements in the bid documents. Having a better understanding of the pile installation time durations will allow the City's consulting engineers to provide a more accurate project cost estimate and phasing plan. In the attached documentation, the City's structural engineer for the project, IIW Engineers has provided a recommendation to proceed with the installation of a test pile. This Agreement has been reviewed and approved by City Attorney Barry Lindahl and the certificate of liability insurance has been reviewed by the Finance Director Ken Tekippe. ACTION TO BE TAKEN Execution of the Agreement for geotechnical test pile installation and testing services with Jim Schroeder Construction is requested. Upon execution of the attached documents, please return to the Engineering Department for further processing. cc: Gus Psihoyos — City Engineer Jenny Larson, Budget Director Deron Muehring, Civil Engineer 11 Attachments F: \PROJECTS \Bee Branch - Phase I(\ PSA Negotiations \Schroeder\2010_11 -22 MVM Memo Interm Soils Agreement.doc September 17, 2012 Mr. Deron Muehring, Civil Engineer City of Dubuque Engineering Department 50 W. 13th Street Dubuque, Iowa 52001 Re: Bee Branch Railroad Crossing Driven Test Pile IIW Project No. 06169.02 Dear Deron: IIW, P.C. has prepared the following to summarize findings and recommendations regarding the piling for the above referenced project. Our analysis is based on the 30% Submittal to CPRR on May 15th, 2012, the Geotechnical Engineering Report prepared by Terracon dated July 25th, 2012 and subsequent correspondence. The 30% Submittal provided an option for friction and/or end bearing H or pipe piles depending on the outcome of the Terracon subsurface exploration. Terracon provided recommendations for driven pile foundations based on previous borings taken in the vicinity and an additional boring located on the south side of the proposed bridge. Boring 5A, located on the south side of the proposed bridge encountered probable sandstone at 131 feet with a boring termination at 150 feet. Terracon recommended additional borings on the north side to verify the depth of rock, CPT soundings if friction piles are considered, static pile load test and monitoring of a test pile installation using a PDA. IIW performed a preliminary pile capacity analysis based on the design data provided by Terracon for comparison with pile loads. Based on the preliminary analysis, it appears friction piles will not be practical given the soil conditions, anticipated loads, pile size, pile spacing and potential site constraints. IIW contacted Terracon to clarify their recommendations and offer the following: 1. Additional Boring on North Side — the scope of services includes providing an additional boring on the north side of the proposed bridge. The boring would be taken to rock and sampled to confirm the depth and evaluate the rock quality. Based on Terracon's August 31st, 2012 supplemental proposal and subsequent correspondence, we requested and received confirmation of compliance with AREMA. The estimated cost excluding CPRR personnel costs, is approximately $6,000. Our recommendation is to hold on authorizing the additional boring unless there is a compelling reason to do otherwise. 2. CPT Soundings — since friction piles are not being considered at this time, this will not be required. 3. Static Pile Load Test — based on the soil conditions encountered and anticipated pile loads, the pile will be end- bearing and a static pile load test will not provide useful data for final IIW, P.C. www.iiwengr.com ARCHITECTURE CIVIL ENGINEERING CONSTRUCTION SERVICES ENVIRONMENTAL ENGINEERING LAND SURVEYING MUNICIPAL ENGINEERING STRUCTURAL ENGINEERING TRANSPORTATION ENGINEERING Dennis F. Waugh, PE/SE* Charles A. Cate, PE "* Gary D. SeJkora, PE Michael A. Jansen, PE/SE RonaldA Balmer, PE/SE/AIA Timothy J. Tranel, PE* John F. Wandsnider, PE Julie P. Neebel, PE James P. Kaune, PE Thomas J. Oster, PLS "* Wray A. Childers, PLS Geoffry T. Blandin, PE Mark C. Jobgen, PE Lauren N. Ray, PE/SE' Bradley J. Moot, PE/SE Cody T. Austin, PE* Marc D. Ruden, PE Mark R. Fassbinder, AIA* Michaal A. Ruden, NCARBiAIA" Craig J. Elskamp, AIA Robert W. Blok, PE Eric J. Helminiak, PE/SE* Steven J. Hunn, PE Jeffrey J. Brandt, PLS / RLS Craig L. Geiser, PLS / RLS Adam J. Mods, PE James P. Maloney, PE LEED AP " Retired 4155 Pennsylvania Avenue, Dubuque, IA 52002 -2628 • IP] 563.556.24641800.556.4481 a IF] 563.556.7811 IIW Bee Branch Railroad Crossing Test Pile September 17, 2012 Page 2 of 2 design and construction. Subsequently, we have not developed an estimate of cost for the static pile load test. 4. Test Pile Installation PDA Monitoring — the purpose is to evaluate the pile stress during driving and the data provided is specific to the equipment used to drive the test pile. Based on correspondence from Terracon, the estimated cost to perform PDA testing for one day and prepare a report is approximately $5,000. We do not anticipate pile driving stresses to be an issue based on the pile type and anticipated capacity required. In our opinion, if PDA monitoring is deemed necessary, it could be provided during the construction phase as a requirement in the contract documents. 5. Driven Test Pile — this would include a wave equation (WEAP) analysis, installation and visual monitoring of a driven steel H pile presumably to rock, and preparation of a report. The key objectives of this drivability analysis is to compare the driving conditions with the WEAP analysis, monitor vibration and displacement at select adjacent locations, and document the time required to drive the test pile, which will assist in predicting construction staging durations. Based on a recent discussion with Tom Goffinet, CPRR, we anticipate the test pile would be located near the southwest corner of the bridge. Based on correspondence from Terracon, we anticipate vibration monitoring devices on or near the adjacent "Glove Factory' building and adjacent to the railroad tracks. Terracon estimated the cost of the vibration monitoring for two locations for one day to be $3,500. We would estimate the cost for the driven test pile installation, monitoring and reporting would be approximately $30,000. Please refer to the attached Bee Branch Railroad Crossing Driven Test Pile contract documents distributed to Jim Schroeder Construction pursuant to our discussion. We appreciate the opportunity to provide professional services and feel free to contact our office if you have any questions. Thank you. Sincerely, IIW, P.C. I heresy certify that this engineering document was prepared by me and that I am a duly Licensed Professional Engineer under the Taws oij h 1a of lo ael A. Jansen, P.E., S.E. License # 12418 License Renewal 12 -31 -13 Enc. Date J 11111 �ISrte'., :/jai • 11 ®��� r/ 1! � 1,1003i or mew jn tri ;��1A90151t01� "Cq6 A411 CITY OF DUBUQUE, IOWA BEE BRANCH RAILROAD CROSSING DRIVEN TEST PILE BID FORM 1B BID PROPOSAL The bidder hereby certifies that the bidder is the only person or entity interested in this proposal as principal; that an examination has been made of the plans, specifications, and contract form, including the special provision contained herein, and of the site of the work, and the bidder understands that the quantities of work shown herein are approximate only and are subject to increase or decrease; and further understands that all quantities of work, whether increased or decreased, are to be performed at the unit price as stipulated herein; the bidder proposes to furnish all necessary machinery, equipment, tools, labor and other means of construction, and to furnish all materials specified in the manner and time prescribed and to do the work at the prices herein set out. The bidder further agrees to execute a formal contract within seven (7) days of the award of the contract by the City, and that the bidder will commence work on or about five (5) days after the date of the contract, and will complete the work stipulated in the contract documents. The bidder acknowledges receipt of the following addendum: Dated: Dated: Dated: PRINCIPAL: i rn .. rueole-r- n.sL Inc . Sbo S o fL SexsAid Address 6 -11v City Contractor Individual ( ) Partnership ( ) Corporation ( ) By: J TA , So3 Signature State Zip Pies r - cl -)4- II Title Date Note: To be completed by out of State bidders. The State of does ( ) / does not ( ) utilize a percentage preference for in . state bidders. The amount of preference is percent. Bid Proposal Page 2 of 2 BIDDER agrees to perform all the work described In the CONTRACT DOCUMENTS for the following unit prices or indicated sums: CITY OF DUBUQUE, IOWA BEE BRANCH RAILROAD CROSSING DRIVEN TEST PILE BID SCHEDULE NOTE: Bids shall EXCLUDE sales tax and all other applicable taxes and fees NO. DESCRIPTION QUANTITY 1 Mobilization / Demobilization 1 LS 2 HP 14x89 Steel Pile 140 LF TOTAL BID Bid Proposal Page 1 of 2 BID FORM IA UNIT PRICE TOTAL PRICE B -1 )31)155 °0 Masterpiece on the Mississippi City of Dubuque Engineering Dept. 50. W. 13th Street Dubuque, IA 52001 (563) 589 -4270 (563) 589 -4205 FAX CITY OF DUBUQUE, IOWA SHORT FORM VENDOR SERVICE AGREEMENT THIS VENDOR SERVICE AGREEMENT (the Contract), made in triplicate, between the City of Dubuque, Iowa (City), by its City Manager, through authority conferred upon the City Manager by its City Council and Jim Schroeder Construction, Inc. (Vendor Name) Bellevue, Iowa (Vendor Address — City and State) PROJECT TITLE: Bee Branch Railroad Crossing Driven Test Pile (Vendor) of the City of 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 Project): Installing a driven steel test pile in accordance with the attached drawing Sheet SB -1 and specification section 316216 Steel Piles. The work described above shall be completed at the following location(s): Southeast of the intersection of Kniest Street and Garfield Avenue on Canadian Pacific property If authorized or on City property as illustrated on the attached drawing Sheet SB -1. F -1 The Project shall be completed in strict accordance with the terms as described in this Contract; in strict accordance with the requirements of the laws of the State of Iowa and ordinances of the City of Dubuque, and in accordance with the Request For Proposal (RFP) Documents which provisions and documents are each and all hereby referred to and made a part of this Contract just as much as if the detailed statements thereof were repeated herein. 2. Contract Documents shall mean and include the following: This Contract; all ordinances and resolutions heretofore adopted by the City Council having to do with the Project; the Vendor's Proposal; and any Special Conditions, Plans and 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 of the quality required by the Contract Documents and shall be put in place in accordance with the Contract Documents. 4. The Vendor 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 -Vender, Not Applicable. 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 Manager 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 Contract Documents and has examined and understands the project description described in Section 1 and any attached Special Conditions 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. The Contractor shall fully complete the Project under this Contract on or before October 10, 2012. 8. To the fullest extent permitted by law, the Contractor shall indemnify and hold harmless the City, its officers and employees, from and against all claims, damages, losses and expenses, including but not limited to attorneys' 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. 9. Unless otherwise specified in the Contract Documents, prior to the commencement of any work on the Project and at all times during the performance of this Contract, the Contractor F -2 shall provide evidence of insurance which meets the requirements of the City's Insurance Schedule B for Professional Services attached hereto. 10. The Vendor agrees that upon execution of this contract by the City, the Vendor shall submit for the City's review and approval proof of insurance as specified in the attached City of Dubuque Insurance Schedule B dated October 2012, and that no work under this Contract shall commence on the Project until the City has issued a written "Notice to Proceed" to the Vendor. Additionally any work started by the Vendor prior the issuance of the Notice to Proceed shall be considered unauthorized and done at the sole risk to the Vendor and shall not be eligible for payment by the City. In the event the Vendor does not submit proof of insurance to City's sole satisfaction by November 1, 2012, this Contract shall terminate and be of no further force or effect. THE CITY AGREES: Upon the completion of the Contract, and the acceptance of the Project by the City Manager, the City agrees to pay the Contractor as full compensation for the complete performance of this Contract, the amount determined for the total work completed at the prices stated in the Vendor's Proposal and less any liquidated damages provided for in the Contract Documents. The work as stated in the Contract Documents is approximate only, and the final payment shall be made for the actual work completed as covered by the Contract. CONTRACT ESTIMATED AMOUNT $25,795.00 THE MAXIMUM CONTRACT AMOUNT SHALL BE LIMITED TO AN INCREASE OF (ZERO) 0% OF THE ABOVE LISTED ESTIMATED AMOUNT. CITY OF DUBUQUE, IOWA VENDOR: Jim Schroeder Construction, Inc. ) Michel C. Van Milligen , ate Dan Schroeder Date City Manager F -3 President VENDOR ACKNOWLEDGEMENT OF ATTACHED SPECIAL CONDITIONS: Dan Schroeder President Date City of Dubuque Insurance Requirements for General, Artisan or Trade Contractors, Subcontractors or Sub Subcontractors Class A: Class B: Class C: Concrete Decking Demolition Earthwork Electrical Insurance Schedule B Elevators Fiber Optics Fire Protection Fireproofing HVAC Chemical Spraying Deconstruction Doors, Window & Glazing Drywall Systems Fertilizer Application Acoustical Carpet & Resilient Flooring Caulking & Sealants General Cleaning Paving & Surfacing Piles & Caissons Plumbing Reinforcement Roofing Finish Carpentry Landscaping Painting & Wall Covering Pest Control Plastering Grass Cutting Janitorial Non Vehicular Snow & Ice Removal Sheet Metal Site Utilities Special construction Steel Structural Steel Rough Carpentry Stump Grinding Tree Trimming Waterproofing Office Furnishings Power Washing Tile & Terrazzo Flooring Window Washing 1. Contractor shall furnish a signed Certificate of Insurance to the City of Dubuque, Iowa for the coverage required in Exhibit I prior to commencing work and at the end of the project if the term of work is longer than 60 days. Providers presenting annual certificates shall present a Certificate at the end of each project with the final billing. Each Certificate shall be prepared on the most current ACORD form approved by the Iowa Department of Insurance or an equivalent. 2. All policies of insurance required hereunder shall be with a carrier authorized to do business in Iowa and all carriers shall have a rating of A or better in the current A.M. Best's Rating Guide. 3. Each Certificate shall be furnished to the contracting department of the City of Dubuque. 4. Failure to provide minimum coverage shall not be deemed a waiver of these requirements by the City of Dubuque. Failure to obtain or maintain the required insurance shall be considered a material breach of this agreement. 5, Subcontractors and sub subcontractor performing work or service shall provide a Certificate of Insurance in accord with their respective classification to their contractor. 6. All required endorsements to various policies shall be attached to Certificate of insurance. 7. Whenever a specific ISO form is listed, an equivalent form may be substituted subject to the provider identifying and listing in writing all deviations and exclusions that differ from the ISO form. 8. Provider shall be required to carry the minimum coverage /limits, or greater if required by law or other legal agreement, in Exhibit I. Page 1 of 4 Insurance - Schedule 8, General, Artisan Or Trade Contractors, Subcontractors Or Sub Subcontractors March, 2012 City of Dubuque Insurance Requirements for General, Artisan or Trade Contractors, Subcontractors or Sub Subcontractors Insurance Schedule B (continued) Exhibit I A) COMMERCIAL GENERAL LIABILITY General Aggregate Limit $2,000,000 Products - Completed Operations Aggregate Limit $2,000,000 Personal and Advertising Injury Limit $1,000,000 Each Occurrence $1,000,000 Fire Damage Limit (any one occurrence) $ 50,000 Medical Payments $ 5,000 a) Coverage shall be written on an occurrence, not claims made, form. All deviations from the standard ISO commercial general liability form CG 0001, or Business owners form BP 0002, shall be clearly identified. b) Include ISO endorsement form CG 25 04 "Designated Location(s) General Aggregate Limit" or CG 25 03 "Designated Construction Project (s) General Aggregate Limit" as appropriate. c) Include endorsement indicating that coverage is primary and non - contributory. d) Include endorsement to preserve Governmental Immunity. (Sample attached). e) Include additional insured endorsement for The City of Dubuque, including all its elected and appointed officials, all its employees and volunteers, all its boards, commissions and /or authorities and their board members, employees and volunteers, using ISO form CG 20 10. Ongoing operations. f) All contractors shall include The City of Dubuque (per the above verbiage) as an additional insured for completed operations under ISO form CG 2037 during the project term and for a period of two years after the completion of the project. B) AUTOMOBILE LIABILITY $1,000,000 (Combined Single Limit) C) WORKERS' COMPENSATION & EMPLOYERS LIABILITY Coverage A Coverage B Statutory—State of Iowa Employers Liability Each Accident $100,000 Each Employee- Disease $100,000 Policy Limit- Disease $500,000 a) Policy shall include an endorsement providing a waiver of subrogation to the City of Dubuque. b) Coverage B limits shall be greater if required by Umbrella Carrier. D) Umbrella Liability Class A $10,000.000 (General Contractor) Class A $3,000,000 (other Sub - Contractors) Class B $1,000,000 Class C -0- Page 2 of 4 Insurance - Schedule B, General, Artisan Or Trade Contractors, Subcontractors Or Sub Subcontractors March, 2012 City of Dubuque Insurance Requirements for General, Artisan or Trade Contractors, Subcontractors or Sub Subcontractors E) Railroad Protective Liability The Bee Branch Railroad Crossing Driven Test Pile project will be on or within 50 feet of a railroad, the following additional coverage applies: Railroad Protective Liability: $3,000,000/6,000,000 minimum. Higher Limits, if required by Iowa DOT or the railroad, supersede these minimum requirements. Include as an insured: "The City of Dubuque, including all its elected and appointed officials, all its employees and volunteers, all its boards, commissions and /or authorities and their board members, employees and volunteers ". Page 3 of 4 Insurance - Schedule B, General, Artisan Or Trade Contractors, Subcontractors Or Sub Subcontractors March, 2012 City of Dubuque Insurance Requirements for General, Artisan or Trade Contractors, Subcontractors or Sub Subcontractors Preservation of 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, 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 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 670.4 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 of 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, Iowa 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, Iowa. No Other Change in Policy. The above preservation of governmental immunities shall not otherwise change or alter the coverage available under the policy. SPLCIME\ Page 4 of 4 Insurance - Schedule B, General, Artisan Or Trade Contractors, Subcontractors Or Sub Subcontractors March, 2012 PROJECT INFORMATION REQUIREMENTS FOR STATE OF IOWA SALES TAX EXEMPTION CERTIFICATES FOR CONTRACTORS & SUBCONTRACTORS Submitting Department: ENGINEERING 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 Certificates 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. Sales tax exemption certificates are not provided to material suppliers. The general contractor and subcontractors can provide copies of the sales tax exemption certificates issued by the City to individual material suppliers. Construction Project Name: Bee Branch Railroad Crossing Driven Test Pile Project Description: Start Date (Bid let date): Completion Date: 1. General Prime Contractor: Contact Name: Jim Schroeder Construction, Inc. Complete Address: (Include PO Box and Street Information) 500 South Second Street City, State, Zip Code Bellevue, IA 52031 Telephone Number: 563 - 872 -5591 Federal I.D. Number: (or Include Social Security Number) 42- 0934134 Work Type to be Completed: 2. 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: 3. 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: lk_� /'7 /C l.L.O 10:Uf rstiiiJ•C 1L 1111iJ f "l rl4 11+ AccpRiff CERTIFICATE F LIABILire DATE (MM/DD /YYYY) 10/09 /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 1 -800 -247 -7756 Holmes Murphy & Assoc - WDM PO Box 9207 Des Moines, IA 50306 -9207 Gerald Johnson CONTACT PHONE FAX (A /C, No, Ext): (A /C, No): E -MAIL ADDRESS: INSURER(S)AFFORDINGCOVERAGE NAIC6 INSURERA: Bituminous Fire & Marine Insurance X INSURED Jim Schroeder Construction Inc. 500 South Second Street Bellevue, IA 52031 -1418 INSURERB:Alterre American Insurance Company 07/01/12 INSURER C: EACH OCCURRENCE INSURER0: X INSURER E: PREMISES Ea occurrence) INSURER F: COVERAGES CERTIFICATE NUMBER: 29608572 REV ISI0 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 IADUL INSR SUBR WVD POLICY NUMBER POLICY EFF (rv1M /OD /YYYY) POLICY EXP (MM /DD /YYYY) LIMITS A GENERAL LIABILITY X CLP 3573003 07/01/12 07/01/13 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence) $ 100, 000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 10,000 PERSONAL &ADV INJURY $1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO- JECT I I LOC PRODUCTS - COMP/OP AGG $2,000,000 $ A AUTOMOBILE LIABILITY CAP 3573006 07/01/12 07/01/13 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X X X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS HIRED AUTOS Comp $500 X g SCHEDULED AUTOS NON -OWNED AUTOS Coll $1,000 BODILY INJURY Per accident ( ) $ PROPERTY DAMAGE APeraccident) $ $ B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE MAXA3EC50000348 07/01/12 07/01/13 EACH OCCURRENCE $ 10,000,000 AGGREGATE $10,000,000 DED X RETENT ON $ 10,000 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY N /A WC 3573004 07/01/12 07/01/13 X WC STATU- TORY LIMITS OTH- ER.. ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? YIN E.L. EACH ACCIDENT $ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedure if more space Is required) Re: Vendor Service Agreement Additional Insured (CGL) City of Dubuque Engineering Department CERTIFICATE HOLDER CANCELLATION Attn: Michelle Knief City of Dubuque Engineering Department 50 W. 13th Street Dubuque, IA 52001 -4864 I USA 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 ��,2. �� /f�J'"' �1 ACORD 25 (2010/05) sgruberwdem 29608572 © 1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD