Improvement Contract_Selco Inc, for 2013 Pavement Marking ProjectCITY OF DUBUQUE, IOWA
COMPETITIVE QUOTATION
PUBLIC SERVICE CONTRACT
THIS PUBLIC SERVICE CONTRACT (the Contract), made in triplicate, dated for
reference purposes the 25th day of April, 2013, between the City of Dubuque, Iowa (City), by its
City Manager, through authority conferred upon the City Manager by its City Council and Selco,
Inc. (the Contractor) of the City of Dubuque, Iowa.
PROJECT TITLE: 2013 Pavement Marking Project (the Project)
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):
As detailed in the Construction Documents Manual.
The work described above shall be completed at the following location(s):
As detailed in the Construction Documents Manual.
The Project shall be performed 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 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 Service Contract; all
ordinances and resolutions heretofore adopted by the City Council having to do with the
Project; the Contractor's Proposal; and the conditions described in the Contract, including
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 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 may 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 Project Document Manual 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 August 31,
2013.
8. 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.
8. 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
shall provide evidence of insurance which meets the requirements of the City's Insurance
Schedule for Artisan Contractors or General Contractors.
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 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 contract, special conditions and
contractors proposal is approximate only and the final payment shall be made by the work
covered by the Contract.
CONTRACT ESTIMATED AMOUNT $ 77,699.56
THE MAXIMUM CONTRACT AMOUNT SHALL BE LIMITED TO AN INCREASE OF 10% OF
THE ABOVE LISTED ESTIMATED 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 less than ten percent (10 %) of the Contract price but in no event be
Tess than $500.00 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 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 DUBUQUE, IOWA
By
City Manager
PRINCIPAL
Contractor
By. !%d1
Signature
CERTIFICATE OF CITY CLERK
This is to certify that a certified copy of the above Contract has been filed in my
office on the da y of / �'
,�1,�- , 2013.
Kevin S. Firn affil, City Clerk
CITY OF DUBUQUE, IOWA
PERFORMANCE, PAYMENT AND MAINTENANCE BOND
KNOWN ALL MEN BY THESE PRESENTS: That Selco, Inc. as Principal
(Contractor) and Merchants Bonding Company as Surety are held firmly bound unto the
City of Dubuque, Iowa (City), in the penal sum of $77,699.56, 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 13th day of May
duly attested and sealed.
WHEREAS, the said Contractor by a Contract dated Agri 1 25, 2013,
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 2013
Pavement Marking 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
, 2013, 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
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 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 13th day of May , 2013.
CITY OF DUBUQUE, IOWA PRINCIPAL:
By:
c5-e"..-ko
Contractor
By: /14/14,11
Signature
Title
SURETY:
Merchants Bonding Company (Mutual)
ompa
ignature
Scott A. DeSousa
Attorney -in -Fact
Title
Dubuque, IA. 52001
City, State, Zip Code
563 - 556 -0272
Telephone
Attorney In -Fact
MERC TS
BONDING COMPANY „,
POWER OF ATTORNEY
Know All Persons By These Presents, that MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING,
INC., both being corporations duly organized under the laws of the State of Iowa (herein collectively called the "Companies "),
and that the Companies do hereby make, constitute and appoint, individually,
Mark J Phalen; Scott A DeSousa; Terrance J Friedman
of Dubuque and State of IA their true and lawful Attorney -in -Fact, with full power
and authority hereby conferred in their name, place and stead, to sign, execute, acknowledge and deliver in their behalf as surety
any and all bonds, undertakings, recognizances or other written obligations in the nature thereof, subject to the limitation that any
such instrument shall not exceed the amount of:
TWO MILLION, FIVE HUNDRED THOUSAND ($2,500,000.00) DOLLARS
and to bind the Companies thereby as fully and to the same extent as if such bond or undertaking was signed by the duly
authorized officers of the Companies, and all the acts of said Attorney -in -Fact, pursuant to the authority herein given, are
hereby ratified and confirmed.
This Power -of- Attorney is made and executed pursuant to and by authority of the following By -Laws adopted by the Board of
Directors of the Merchants Bonding Company (Mutual) on April 23, 2011 and adopted by the Board of Directors of Merchants National
Bonding, Inc., on October 24, 2011.
"The President, Secretary, Treasurer, or any Assistant Treasurer or any Assistant Secretary or any Vice President shall have
power and authority to appoint Attorneys -in -Fact, and to authorize them to execute on behalf of the Company, and attach the
seal of the Company thereto, bonds and undertakings, recognizances, contracts of indemnity and other writings obligatory in
the nature thereof.
The signature of any authorized officer and the seal of the Company may be affixed by facsimile or electronic transmission to
any Power of Attorney or Certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance,
or other suretyship obligations of the Company, and such signature and seal when so used shall have the same force and
effect as though manually fixed."
In Witness Whereof, the Companies have caused this instrument to be signed and sealed this 10th day of February
„e10114q .0....O.,
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%,• 2 03 • c'3' . .."4E,,,,2‘.... 1933 ®.c
STATE OF IOWA
COUNTY OF POLK ss.
On this 10th day of February , 2012, before me appeared Larry Taylor, to me personally known, who being by me duly sworn did
say that he is President of the MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC.; and
that the seals affixed to the foregoing instrument is the Corporate Seals of the Companies; and that the said instrument was signed and
sealed in behalf of the Companies by authority of their respective Boards of Directors.
In Testimony Whereof, I have hereunto set my hand and affixed my Official Seal at the City of Des Moines, Iowa, the day and year
first above written.
, 2012 .
MERCHANTS BONDING COMPANY (MUTUAL)
MERCHANTS NATIONAL BONDING, INC.
By
President
MARANDA GREENWALT
i F Commission Number 770312
My Commission Expires
owr• October 28, 2014
Notary Public, Polk County, Iowa
STATE OF IOWA
COUNTY OF POLK ss.
I, William Warner, Jr., Secretary of the MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC.,
do hereby certify that the above and foregoing is a true and correct copy of the POWER -OF- ATTORNEY executed by said Companies,
which is still in full force and effect and has not been amended or revoked.
In Witness Whereof, I have hereunto set my hand and affixed the seal of the Companies on
13thday of
May , 2013, ,,
1011 "'..,,. \0 Cp ••
• G _o- `h ; may; r`; -o- ®"
Y �• Secretary
=j • 2ut?3 :',��= ° °yJ. 1933 , ti°
this
POA 0014 (11/11)
CITY OF DUBUQUE, IOWA
SALES AND 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 they were used on the contract, and shall pay tax on
any materials purchased tax -free and not used on the contract.
4. 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.
PROJECT INFORMATION REQUIREMENTS FOR
STATE OF IOWA SALES TAX EXEMPTION CERTIFICATES
FOR CONTRACTORS & SUBCONTRACTORS
Submitting Department: Engineering
Contact: Troy Kress
CIP: 3002245
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.
Construction Project Name:
2013 Pavement Marking Project
Project Description:
Painting of the centerlines, lane lines, and edge lines, as well as
transverse markings including arrows, crosswalks, and other
associated symbols, markings and curb markings. Removal of existing
pavement markings may also be required.
Start Date (Bid let date):
April 25, 2013
Completion Date:
August 31, 2013
1.
General Prime Contractor:(
i .,g,_
Contact Name:
cue(c. LOD l
Complete Address:
(Include PO Box and Street Information)
`
City, State, Zip Code
, > ,i -c
Telephone Number:
c isr - t ®a.Lt: - k--(
Federal I.D. Number:
(or Include Social Security Number)
_
"' a.--- t a— 0 c
Work Type to be Completed:
®) 0 _,:v,..„--k- -c -a v
2. Subcontractor:
kiLAA
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:
Ki to
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:
SPECIAL PROVISIONS
An out -of -State contractor, before commencing a contract in excess of $5,000.00, shall,
pursuant to Iowa Code 91C.7(2), file a bond with the Division of Labor Services of the
Department of Employment Services. The Surety Bond shall be executed by a Surety
Company authorized to do business in the State of Iowa, and the bond shall be
continuous in nature until canceled by the Surety with not less than 30 days written
notice to the contractor and to the Division of Labor Services of the Department of
Employment Services indicating the Surety's desire to cancel the bond. The bond shall
be in the sum of the greater of the following amounts:
a. $1,000.00
b. 5% of the contract price
Release of the bond shall be conditioned upon the payment of all taxes, including
contributions due under the unemployment compensation insurance system, penalties,
interest, and related fees, which may accrue to the State of Iowa or its subdivision on
account of the execution and performance of the contract. If any time during the term of
the bond the Department of Revenue and Finance determines that the amount of the
bond is not sufficient to cover the tax liabilities accruing to the State of Iowa or its
subdivision, the Department will require the bond to be increased by an amount the
Department deems sufficient to cover the tax liabilities accrued and to accrue under the
contract, as provided under Iowa Code 91C.7(2).
If it is determined that this subsection may cause denial of Federal Funds which would
otherwise be available, or would otherwise be inconsistent with requirements of Federal
law, this section shall be suspended, but only the extent necessary to prevent denial of
the funds or to eliminate the inconsistency with Federal requirements.
C ®
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.
CERTIFICATE OF LIABILITY INSURANCE
DATE (MM /DD /YYYY)
5/13/2013
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
Friedman Insurance, Inc.
880 Locust Street - Suite 200
P 0 Box 759
Dubuque IA 52004 -0759
INSURED
SELCO
15 S. Main Street
Dubuque
COVERAGES
IA 52001
CERTIFICATE NU
BER:13 -14
CONTACT Steve SC.uete
NAME:
PHONE
E -MAIL
ADDRESS:
(563)556 -0272
FAX
A/C No
(563)556 -4425
INSURER(S) AFFORDING COVERAGE
INSURER A:WeStfie1d. Companies
INSURER B:
INSURER C:
INSURER D:
INSURER E:
INSURER F :
NAIC #
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
ADDL
InsR
SUER
WVD
POLICY NUMBER
POLICY EFF
(MM/DDIYYYY)
POLICY EXP
(MMIDDIYYYY)
LIMITS
A
GENERAL
X
LIABILITY
COMMERCIAL GENERAL LIABILITY
TRA3107184
1/1/2013
1/1/2014
EACH OCCURRENCE
$ 1,000,000
DAMAGE TO RENTED
PREMISES (Ea occurrence)
$ 100 000
NIEDEXP (Any one person)
$ 5,000
CLAIMS -MADE
X
OCCUR
PERSONAL &ADVINJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS COMP/OP AGG
$ 2,000,000
GEN'L
AGGREGATE
POLICY
X
LIMIT APPLIES
PRO
PER:
LOC
$
AUTOMOBILE
X
LIABILITY
ANY AUTO
ALL OWNED
AUTOS
HIRED AUTOS
SCHEDULED
AUTOS
NON -OWNED
AUTOS
TRA3107184
1/1/2013
1/1/2014
COMBINED SINGLE LIMIT
(Ea accident)
$ 1,000,000
$
BODILY INJURY (Per person)
BODILYINJURY(Peraccident)
$
PROPERTY DAMAGE
(Per accident)
$
Hired/borrowed
$ 1 000 000
A
X
UMBRELLA LIAB
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
TRA3107184
1/1/2013
1/1/2014
EACH OCCURRENCE
$ 3,000,000
AGGREGATE
$ 3,000,000
$
DED
X
RETENTION$ 0
A
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
NIA
r$TCP5361095
1/1/2013
1/1/2014
x
WC STATU-
TORY LIMITS
OTH-
ER
E.L. EACH ACCIDENT
$ 1,000,000
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
E.L. DISEASE - POLICY LIMIT
$ 1, 000 , 000
DESCRIPTION OF OPERATIONS/LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
THE CITY OF DUBUQUE IS AN ADDITIONAL INSURED ON GENERAL LIABILITY POLICIES INCL. ONGOING & COMPLETED
OPERATIONS COVERAGE EQUIVILANT TO ISO CG 2010 0704 & CG 2037 0704. GENERAL LIABILITY POLICY IS PRIMARY &
NON - CONTRIBUTING. FORM CG 2503 0397 "DESIGNATED PROJEC__TSfP GENERAL LIABILITY AGGREGATE LIMIT SHALL BE
INCLUDED. GOVERNMENTAL IMMUNITIES ENDORSEMENT IS INCLUDED. ALL POLICIES SHALL BE ENDORSED TO PROVIDE 30
DAYS ADVANCE NOTICE OF CANCELLATION TO CITY OF DUBUQUE. PROJECT: 2013 -14 PAVEMENT MARKING PROJECT.
CERTIFICATE HOLDER
CITY OF DUBUQUE
CITY HALL
50 W 13TH STREET
DUBUQUE, IA 52001
CANCELLATION
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
Scott DeSousa, CIC /ASS
ACORD 25 (2010/0
INS025 (201005).01
}
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