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Improvement Contract, Bond_Eagle Point Water Plant Well Fields Electrical Upgrade 2013CITY OF DUBUQUE, IOWA EAGLE POINT WATER PLANT WELL FIELDS ELECTRICAL UPGRADE 2012 IMPROVEMENT CONTRACT THIS IMPROVEMENT CONTRACT (the Contract), made in triplicate, dated for reference purposes the 19th day of November, 2012, between the City of Dubuque, Iowa, by its City Manager, through authority conferred upon the City Manager by its City Council (City) and Price Industrial Electric, Inc. (Contractor), 1482 Hawkeye Drive, Hiawatha, Iowa 52233. 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 Eagle Point Water Plant Well Fields Electrical Upgrade 2012 (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 Documents 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 complete the project within 90 consecutive calendar days. The project will be temporarily suspended after substantial completion to allow for completion of seeding and /or PCC patch replacement in the spring of 2013, and completed by March 31, 2013. 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 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. THE CITY AGREES: Upon the completion of the Contract, and the acceptance of the Project by the City Council, 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 $196,475.00 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 less than ten percent (10 %) of the Contract price but in no event be less than $200.00 (Two Hundred 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. CITY OF DUBUQUE, IOWA By Michael C. Van Milligen City Manager PRINCIPAL: Price Industrial Electric, Inc. Contractor: CERTIFICATE OF CITY CLERK This is to certify that a certified copy of the above Contract has been filed in my office on the _ - 5- ` I day of /j /e ,> // , 20/ . Kevi i 1irnstahl, pity ClOrk-7 BIDDER agrees to perform all the work described In the CONTRACT DOCUMENTS for th owlag unit prices or /ndk.ated sums: CITY OF DUBUQUE, IOWA EAGLE POINT WATER P T FIELDS ELECTRICAL UPGRADE 2012 BID SCHEDULE NOTE: Bids shall EXCLUDE sales tax and all other applicable taxes and fees J FNO. DESCRIPTION F: QUANTITY 1 Mobillzallon & MIscelleneaus 1 LS 2 4 HDPE Electrical Conduit (Mot. Directional Bare, Conductors, Ground, and Tracer Wire) 3,980 IF Concrete Eiectrical Vault (Complete) (incl. Concrete Vault, 3 Galvantzeid Conduit, Excavation, Tracer Wire Terminal Box, Grounding and All Fittings Required) 10 EA - t Concrete Electrical Vault at Levee Location (Complete) (incl. 4 Concrete Vault, Galvanized Condult, Excavation, Tracer Wire Terminal Box, Grounding and M Fittings Requiter)) 1 EA 5 Cable Terminations at Eagle Pant Water Plant (Complete) 3 EA L B Cable Terminations at Well Fields (Complete) 3 EA L7 Abandon Existing Electrical Vault (Complete) 1 EA 8 16° Steel Casing, Juiced & Bored, 0.250° Thickness (Md. Casing Spacers) 60 LF ..-. ....:, 9 Boring Set-up for Railroad Crossing 1 LS 10 Coerdination with Railroad at Crossing 1 LS 11 Remove and Replace PCC Pavement 40 SY 12 Traffic Control 1 LS 13 Remove, Salv , and Reinstall Chain Link Far= 30 LF 14 Remove, Salvage, and Reinstall Wood Fence 35 LF 15 Exploratory Excavation 5 HRS TOTAL OF L SE sin This bid schedule accompanies the proposal of BID FORM 1A UNIT TOTAL PRICE PRICE — r / L.( &C-0 1-1S- 770 f.Lf CITY OF DUBUQUE, IOWA EAGLE POINT WATER PLANT WELL FIELDS ELECTRICAL UPGRADE 2012 BID FORM IB SID 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. Accompanying this proposal in a separate envelope is a cashier's or certified check payable to the City Treasurer, City of Dubuque, drawn on a bank in Iowa or a bank chartered under the laws of the United States, in the amount of ten percent (10%) of the bid submitted; or a bid bond in the penal sum of ten percent (1O%) of the bid submitted executed by the bidder and an acceptable corporate surety. It is understood that this proposal guarantee will be retained in the event the formal contract or bond is not executed, if award is made to the undersigned. The bidder further agrees to execute a formal contract and bond, if required by the contract documents, within seven (7) days of the award of the contract by the City Council, and that the bidder will commence work on or about ten (10) days after the date of the contract, and will complete the work within the specified contract period or pay the liquidated damages stipulated in the contract documents. The bidder acknowledges receipt of the following addendum: Dated: / 4c3 Dated: Dated: PRINCIPAL: Contractor ' Address .„7 individual ( ) Partnership ( ) Corporation ( ) h/ City Lf "--) - State Zip -Th 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 B-2 Bond No. 2165049 CITY OF.::D.UBUQUE, IOWA EAGLE POINT WATER PLANT WELL FIELDS ELECTRICAL UPGRADE 2.012 PERFORMANCE, PAYMENT AND .MAINTENANCE BOND :KNOWN ALL MEN BY THESE. PRESENTS: That Price Industrial Electric, inc. as Principal (Contractor). and .North. American SpecialtyInsurance Company as Surety are held firmly bound- unto::theCity of Dubuque !owa (City), in the penal sum of $196,475.00 herein:referred to, lawful money of the United States. of Ainerica, well and truly to be paid to said: City of Dubuque, and to all other parties who, under the provisions of the laws of lows; 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 this 19th day of November , 2012, and duly attested and sealed. WHEREAS, the said Contractor by a Contract dated November 19, 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 Eagle Point Water Plant Well Fields Electrical Upgrade 2012 (the Project) according to the Contract Documents prepared therefore. It is expressly understood and agreed by the Contractor and Surety that the following provisions are a part of this_ Bond and are .binding..u.pon_ 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 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 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 ail just claims submitted by persons, firms, subcontractors, and corporations furnishing materials for or performing Tabor in the performance of the Contract an 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 asprovided 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. G -1 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) years from the date of .acceptance of the work under the Contract by the City Council of 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 workrrianlhke manner and in strict compliance with the plans and specifications, and will pay ali:,claims for labor :and materials used in connection with Said Project, to indeiiiriify 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 .reirribursethe 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 corrmlied with before the Contractor or the Surety will be released, The Qontract and Contract Doounients shall be dOnaidered:aaa:Part-ofihis Bond .11.* as :if :their. terrns.wet!.,rePeated.herein: • Oatedthis 19th. day of November , 2012. CITY OF DUBUct0E, fOJWA By: City.Mana.ger 0-3 PRINCIPAL; Price industrial.Electrio,,Ino. SURETY: • • North American. Specialty InsurneCompany igna ire Anne Crowner, Attorney-in-Fact Title Holmes Murphy & Associates, Inc. P.O. Box 9207, Des Moines, IA 50306-9207 City, State, Zip Code (515) 223-6800 Telephone Anne Crowner Attorney !n-Fact NAS SURETY GROUP NORTH AMERICAN SPECIALTY INSURANCE COMPANY WASHINGTON INTERNATIONAL INSURANCE COMPANY GENERAL POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS, THAT North American Specialty Insurance Company, a corporation duly organized and existing under laws of the State of New Hampshire, and having its principal office in the City of Manchester, New Hampshire, and Washington International Insurance Company, a corporation organized and existing under the laws of the State of New Hampshire and having its principal office in the City of Schaumburg, Illinois, each does hereby make, constitute and appoint: JAY D. FREIERMUTH, CRAIG E. HANSEN, BRIAN M. DEIMERLY, SHIRLEY S. BARTENHAGEN, CINDY BENNETT, ANNE CROWNER, TIM McCULLOH, STACY VENN, LACEY CRAMBLIT and LAURE GUISINGER JOINTLY OR SEVERALLY Its true and lawful Attorney(s) -in -Fact, to make, execute, seal and deliver, for and on its behalf and as its act and deed, bonds or other writings obligatory in the nature of a bond on behalf of each of said Companies, as surety, on contracts of suretyship as are or may be required or permitted by law, regulation, contract or otherwise, provided that no bond or undertaking or contract or suretyship executed under this authority shall exceed the amount of: FIFTY MILLION ($50,000,000.00) DOLLARS This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of Directors of both North American Specialty Insurance Company and Washington International Insurance Company at meetings duly called and held on the 9th of May, 2012: "RESOLVED, that any two of the Presidents, any Managing Director, any Senior Vice President, any Vice President, any Assistant Vice President, the Secretary or any Assistant Secretary be, and each or any of them hereby is authorized to execute a Power of Attorney qualifying the attorney named in the given Power of Attorney to execute on behalf of the Company bonds, undertakings and all contracts of surety, and that each or any of them hereby is authorized to attest to the execution of any such Power of Attorney and to attach therein the seal of the Company; and it is FURTHER RESOLVED, that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile, and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be binding upon the Company when so affixed and in the future with regard to any bond, undertaking or contract of surety to which it is attached." Steven P. Anderson, Senior Vice President of Washington International Insurance Company & Senior Vice President of North American Specialty Insurance Company By David M. Layman, Vice President of Washington International Insurance Company & Vice President of North American Specialty Insurance Company O 314NA( �(�' pkPORq �S 0 1. SEAL' i2 IN WITNESS WHEREOF, North American Specialty Insurance Company and Washington International Insurance Company have caused their official seals to be hereunto affixed, and these presents to be signed by their authorized officers this20t1 day of June 2012 State of Illinois County of Cook ss: North American Specialty Insurance Company Washington International Insurance Company On this 20th day of June , 2012 , before me, a Notary Public personally appeared Steven P. Anderson , Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and David M. Layman , Vice President of Washington International Insurance Company and Vice President of North American Specialty Insurance Company, personally known to me, who being by me duly sworn, acknowledged that they signed the above Power of Attorney as officers of and acknowledged said instrument to be the voluntary act and deed of their respective companies. "OFFICIAL SEAL" DONNA D. SKLENS Notary Public, State of Illinois My Commission Expires 10/06/2015 i /1 Qp U�� h Donna D. Sklens, Notary Public I, Jeffrey Goldberg , the duly elected Assistant Secretary of North American Specialty Insurance Company and Washington International Insurance Company, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney given by said North American Specialty Insurance Company and Washington International Insurance Company, which is still in full force and effect. IN WITNESS WHEREOF, I have set my hand and affixed the seals of the Companies this 19th day of November , 20 12 . Jeffrey Goldberg, Vice President & Assistant Secretary of Washington International Insurance Company & North American Specialty Insurance Company i. ®' LIABILITY INSURANCE DATE (MM /DD/YYYY) 12/13/2012 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 - 300 -0325 Holmes Murphy & Assoc - CR 500 1st Avenue NE, Suite 300 Cedar Rapids, IA 52401 Koleen Janney CONTACT NAME: PHONE FAX (AIC, No. Extl: (A /C, No): E-MAIL ADDRESS: PRODUCER CUSTOMER ID #: INSURER(S) AFFORDING COVERAGE NAIC # INSURED Price Industrial Electrical Inc. Price Projects MX 1482 Hawkeye Drive Hiawatha, IA 52233 INSURER A: EMCASCO Insurance Company 01/01/13 INSURERB: Employers Mutual Casualty Company $ 1,000,000 INSURERC: ACUITY A MUT INS CO 14184 INSURERD: EMC PROP & CAS INS CO 25186 INSURER E : X INSURER F : $ 5,000 COVERAGES CERTIFICATE NUMBER: 30655564 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. MSR LTR TYPE OF INSURANCE INSR SWVD POLICY NUMBER POLICY EFF POLICY EXP (MM /DDIYYW) (MM /DD/YYYY) LIMITS A GENERALLIABILITY COMMERCIAL GENERAL LIABILITY OCCUR 3D17184 01/01/12 01/01/13 EACHOCCURRENCE $ 1,000,000 X DAMAGE TO RENTED PREMISES (Ea occurrence) $ 50, 000 CLAIMS -MADE X MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2000000 POLICY X PRO- JECT X LOC $ B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 3E17184 01/01/12 01/01/13 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X X $ $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 3J17184 01/01/12 01/01/13 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10, 000, 000 DEDUCTIBLE RETENTION $ 10,000 $ X $ c WORKERSCOMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS Y / N N / A L15743 01/01/12 01/01/13 X TORYLIMITS OTH- ER E.L. EACH ACCIDENT $ 1,000,000 N E.L. DISEASE - EA EMPLOYEE $ 1,000,000 below E.L. DISEASE - POLICY LIMIT $1,000,000 A D Property Leased /Rented Equipment 3A17184 3C17184 01/01/12 01/01/12 01/01/13 01/01/13 Building /Contents 1,252,433 Any One Item 200,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) 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 and IIW, P.C. are additional insured on general liability including completed operations on a primary and non contributory basis as required by written contract with the insured, per policy terms and conditions. Waiver of subrogation on Work Comp in favor of City of Dubuque as required by written contract with the insured, per policy terms and conditions. Governmenta Immunity applies. Waiver of Governmental Immunity applies in favor of the City of Dubuque. RE: Eagle Point Water Plant CERTIFICATE HOLDER CANCELLATION City of Dubuque Contracting Dept 50 West 13th Street Dubuque, IA 52001 -4845 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 )Li.„ kjanney ACORD 25 (2009/09) 30655564 © 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD COMMERCIAL INTERLINE THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GOVERNMENTAL ENTITY AS ADDITIONAL INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM_ MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM COMMERCIAL GENERAL LIABILITY COVERAGE FORM COMMERCIAL UMBRELLA COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of each Coverage Form to which it is attached apply unless modified by this endorsement. SCHEDULE* Municipality: Mailing Address: J *If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement. Coverage Forms to which this endorsement is attached: The following provisions apply to each Coverage Form shown in the Schedule: A. CANCELLATION AND MATERIAL CHANGES PROVISION Thirty (30) days Advance Written Notice of Cancellation; (45) days Advance Written Notice of Non - Renewal, Reduction in insurance coverage and /or limits; and ten (10) days written notice of cancellation solely for non - payment of premium shall be sent to the address shown in the Schedule. B. ADDITIONAL INSURED PROVISION The municipality shown in the Schedule, including all its elected and appointed officials, all its "employees" and "volunteer workers," all its boards, commissions and /or authorities and their boards members, "employees," and "volunteer workers," are included as Additional Insureds with respect to liability arising out of the Insured's work and /or services performed for the municipality shown in the Schedule. This coverage shall be primary to the Additional Insureds, and not contributing with any other insurance or similar protection available to the Additional Insureds, whether other available coverage be primary, contributing or excess. C. GOVERNMENTAL IMMUNITIES PROVISION 1. Nonwaiver of Government Immunity. The insurance carrier expressly agrees and states that the purchase of this policy and the including of the municipality shown in the Schedule as an Additional Insured does not waive any of the defenses of governmental immunity available to them under Code of Iowa Section 670.4 as it 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. 3. Assertion of Government Immunity. The municipality shown in the Schedule 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. Nothing contained in this endorsement shall prevent the carrier from asserting the defense of governmental immunity on behalf of the municipality shown in the Schedule. 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 municipality shown in the Schedule 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 municipality. 5. No Other Change in Policy. The insurance carrier and the municipality shown in the Schedule agree that the above preservation of governmental immunities shall not otherwise change or alter the coverage available under the policy. IL7305(7 -09) Includes copyrighted material of ISO Properties, Inc. with its permission. Page 1 of 1 A CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD /YYYY) 12/12/2012 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 1S 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 - 300 -0325 Holmes Murphy & Assoc - CR 500 1st Avenue NE, Suite 300 Cedar Rapids, IA 52401 CONTACT NAME: PHONE (NC, No. Ext): FAX (A/C, No): E -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : EMCASCO INS CO 21407 INSURED Canadian Pacifc Railway 201 Marquetee Ave South Minneapolis, MN 55402 INSURER B : INSURER C: INSURER D : INSURER E : INSURER F : MBER: 30624626 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 INSR WVD POLICY NUMBER (MM% IDYIYYYYY) (MM /DD /YYYY) LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES (Ea occurrence) $ MED EXP (Any one person) $ CLAIMS -MADE OCCUR PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP /OP AGG $ GE 'L AGGREGATE POLICY LIMIT APPLIES PRO JECT PER: LOC $ AUTOMOBILE _ LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS AUTOSWNED COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ (PerraccidentDAMAGE ) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below YIN N / A WC STATU- TORY LIMITS OTH- ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ A Railroad Liability 4X85237 12/06/12 12/06/13 Agg /Occ 6M /3M DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION City of Dubuque Contracting Dept 50 West 13th Street Dubuque, IA 52001 -4845 ACORD 25 (2010/05) kj anney 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 USA © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD