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Improvement Contract_D&D Concrete for 2013 CDBG Curb Ramp InstalltionMasterpiece on the Mississippi Dubuque ***** All•AmericaCily IIE' 2012 TO: Kevin Firnstahl, CMC City Clerk FROM: Kerry Bradley, Engineering Secretary F;'° SUBJECT: 2013 CDBG Curb Access Ramp Installation Project DATE: October 23, 2013 Engineering Depa lent 50 W. 136 Street Dubuque, Iowa 52001 Office (563) 589 -4270 Fax (563) 589 -4205 www.cityofdubuque.org Attached are the Public Improvement Contracts between the City of Dubuque and D &D Concrete, Inc. of Dubuque, Iowa for the 2013 CDBG Curb Access Ramp Installation Project. Upon execution of the noted documents, please keep one copy for your records and return the other copies to the Engineering office for further processing. Service People Integrity Responsibility Innovation Teamwork CITY OF DUBUQUE, IOWA IMPROVEMENT CONTRACT THIS IMPROVEMENT CONTRACT the Contract), made in triplicate, dated for reference purposes the j5(' day of u(✓ , 2013, between the City of Dubuque, Iowa, by its City Manager, through authority conferred upon the City Manager by its City Council (City) and D & D Concrete, Inc., PO Box 3040, Dubuque IA 52004- 3040. 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 2013 CDBG CURB ACCESS RAMP INSTALLATION (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: November 15, 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 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 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 $19,353.75 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 four thousand dollars ($4,000.00 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 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 Council 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). The City of Dubuque and the Contractor agree to comply with all provisions of the Davis -Bacon Federal Prevailing Wage Act and related labor requirements and regulations and the Federal Wage Determination for this Project. The City of Dubuque and the Contractor agree that equipment or products authorized to be purchased with federal funding awarded for this contract must be American -made to the maximum extent feasible, in accordance with Public Law 103 -121, Sections 606 (a) and (b). CITY OF DUBUQUE, IOWA By City Manager CERTIFICATE OF CITY CLERK This is to certify that a certif d ,popy of the above Contract has been filed in my office onthe,' day of °. ,2013. Bond #2024685 CITY OF DUBUQUE, IOWA PERFORMANCE, PAYMENT AND MAINTENANCE BOND KNOWN ALL MEN BY THESE PRESENTS: That D & D Concrete, Inc. as Principal (Contractor) and West Bend Mutual Insurance Company as Surety are held firmly bound unto the City of Dubuque, Iowa (City), in the penal sum of $19,353.75 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 18th day of October duly attested and sealed. , 2013, and V' HEREAS, the said Contractor by a Contract dated this [ day of `` p� , 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 the 2013 CDBG CURB ACCESS RAMP INSTALLATION (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 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 18th day of October , 2013. CITY OF DUBUQUE, IOWA By: PRINCIPAL D&D Concrete City Maniger Contractor By: Owner Title SURETY By: West Bend Mutual Insurance Company S rety Company Signs e Jill Conrad Agent Title Dubuque, IA 52003 City, State, Zip Code 563-556-5441 Telephone ttA orn y In Fact Jill Conrad T BEND A MUTUAL INSURANCE COMPANY-` 2024685 Power of Attorney Know all men by these Presents, That West Bend Mutual Insurance Company, a corporation having its principal office in the City of West Bend, Wisconsin does make, constitute and appoint: JILL CONRAD lawful Attorney(s) -in -fact, to make, execute, seal and deliver for and on its behalf as surety and as its act and deed any and all bonds, undertakings and contracts of suretyship, provided that no bond or undertaking or contract of suretyship executed under this authority shall exceed in amount the sum of: Four Hundred Thousand Dollars ($400,000) This Power of Attorney is granted and is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of West Bend Mutual Insurance Company at a meeting duly called and held on the 21st day of December, 1999. Appointment of Attorney -In -Fact. The president or any vice president, or any other officer of West Bend Mutual Insurance Company may appoint by written certificate Attorneys -in -Fact to act on behalf of the company in the execution of and attesting of bonds and undertakings and other written obligatory instruments of like nature. The signature of any officer authorized hereby and the corporate seal may be affixed by facsimile to any such power of attorney or to any certificate relating therefore and any such power of attorney or certificate bearing such facsimile signatures or facsimile seal shall be valid and binding upon the company, and any such power so executed and certified by facsimile signatures and facsimile seal shall be valid and binding upon the company in the future with respect to any bond or undertaking or other writing obligatory in nature to which it is attached. Any such appointment may be revoked, for cause, or without cause, by any said officer at any time. In witness whereof, the West Bend Mutual Insurance Company has caused these presents to be signed by its president undersigned and its corporate -al to be hereto duly attested by its secretary this 1st dayof- - March, 2009. ,OVA► -INSU Attest `� RPORAT F Ja J. Pa. !':.$`: Kevin A. Steiner Se Mary SEAT, 61 Chief Executive Officer / President State of Wisconsin County of Washington On the 1st day of March, 2009 before me personally came Kevin A. Steiner, to me known being by duly sworn, did depose and say that he resides in the County of Washington, State of Wisconsin; that he is the President of West Bend Mutual Insurance Company, the corporation described in and which executed the above instrument; that he knows the seal of the said corporation; that the seal affixed to said instrument is such corporate seal; that is was so affixed by order of the board of directors of said corporation and that he signed. his name thereto by like order. .... .• () k -V. * NOTARY `: * . John F -Dt well 0,1 '' PUBLIC z' Executive Vice President - Chief Legal Officer .. ....,. ®2' Notary Public, Washington Co. WI • .9Fw1SG•.* My Commission is Permanent The undersigned, duly elected to the office stated below, now the incumbent in West Bend Mutual Insurance Company, a Wisconsin corporation authorized to make this certificate, Do Hereby Certify that the foregoing attached Power of Attorney remains in full force effect and has not been revoked and that the Resolution of the Board of Directors, set forth in the Power of Attorney is now in force. Signed and sealed at West Bend, Wisconsin this 18 day of October , 2013 cOP.PoRATF' SEAL u;'! ..... .44 ''C .. Y.: Dale J. Kent Executive Vice President - Chief Financial Officer NOTICE: Any questions concerning this Power of Attorney may be directed to thin Bond Manager at NISI, a division of West Bend Mutual Insurance Company 8401 Greenway Blvd. Suite 1100 I P.O. Box 620976 ( Middleton, WI 53562 I ph (608) 410 -3410 ( www.thesilverlining.com PROJECT INFORMATION REQUIREMENTS FOR STATE OF IOWA SALES TAX EXEMPTION CERTIFICATES FOR CONTRACTORS & SUBCONTRACTORS r.1 r,;' r iu G Submitting Department: live SNir�tf 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 Depattutent 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. (/P Apoirn,e Construction Project Name: 2013 CDBG Curb Access Ramp Installation Project Description: Installation of access curb ramps with associated excavation, 6" concrete, asphalt, detectable warnings, topsoil and seeding . Start Date (Bid let date): October 10, 2013 Completion Date: November 15, 2013 1. General Prime Contractor: 0 q ,0 0 -A UV- ii A. c Contact Name: ,'`\ /.7., C, Complete Address: (Include PO Box and Street Information) /' '36) ,r 3 tM t/a t,i -t, t.- 4i _ a It City, State, Zip Code Telephone Number: ' o - 1(—o 9 9 Federal I.D. Number: (or Include Social Security Number) ( / ° �j �p -- 9 5 % 7 7 Work Type to be Completed: Installation of access curb ramps with associated excavation, 6" concrete, asphalt, detectable warnings, topsoil and seeding 2. Subcontractor: Complete Address: (Include PO Box and Street Information) City, State, Zip Code Telephone Number: Federal LD. Number: (or Include Social Security Number) Work Type to be Completed: DXDCONC -01 JCONRAD AC' r•- LIABILITY INSURANCE DATE(MM /DD/YYYY) 10/18/2013 ADDL INSR 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 - TRICOR, Inc. - Dubuque 500 Iowa Street Dubuque, IA 52001 NAME: ACT Jill Conrad PHONE 563 556 -5441 FAX 608 723 -6440 (A/C, No, Ext): ( ) (NC, No): ( ) ADDRESS: Jconrad @tricorinsurance.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A:Acuity Insurance 14184 INSURED D &D Concrete, Inc. Keith & Michelle Dague P.O. Box 3040 Dubuque, IA 52004 INSURER B : 4/17/2014 INSURER C: $ 1,000,000 INSURER D : $ 100,000 INSURER E: $ 5,000 INSURER F : • 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 POLIC ES 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 INSR SUBR WVD POLICY NUMBER POLICY EFF (MM /DD/YYYY) POLICY EXP (MM /DDIYYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY X14978 4/17/2013 4/17/2014 EACH OCCURRENCE $ 1,000,000 PREM SESO(Ea occurrence) $ 100,000 MED EXP (Any one person) $ 5,000 CLAIMS -MADE X OCCUR PERSONAL &ADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 3,000,000 PRODUCTS - COMP/OP AGG $ 3,000,000 GEN'L AGGREGATE POLICY X LIMIT APPLIES PRO- X PER: LOC $ A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS X14978 4/17/2013 4/17/2014 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE X14978 4/17/2013 4/17/2014 EACH OCCURRENCE $ 3,000,000 AGGREGATE $ 3,000,000 $ DED X RETENTION $ 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 / A X14978 4/17/2013 4/17/2014 X WC STATU- TORY LIMITS OTH- ER E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) City of Dubuque, including all its elected officials, all its employees and volunteers, all its boards, commissions, and/or authorities and their board members, employees and volunteers are additional insured on a primary, non - contributory basis including ongoing and compl ops as required by written contract. A Waiver of Subro applies in favor of the City of Dubuque in regards to the GL and WC pol. Waiver of Govt. Immunities also applies. Notice of cancel is amended to 30 days per the attch form. Project: CDGB Curb Access Ramp Installation Fellow Employee Coverage is included CERTIFICATE HOLDER CANCELLATION City of Dubuque 50 W 13th Street Dubuque, IA 52001 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2010/05) ©1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD IOWA MEDICAL DEDUCTIBLE PROGRAM - CARRIER REIMBURSED WC 14 06 03(1 -11) DEDUCTIBLE ENDORSEMENT This endorsement applies only to the insurance pro- vided by Part One (Workers' Compensation Insur- ance) because Iowa is shown in Item 3A of the Information Page. 1. Part One (Workers' Compensation Insurance) applies only to benefits in excess of the de- ductible amount shown in the Schedule below. 2. This deductible applies separately to each medical -only claim for bodily injury by accident or disease. 3. We will pay the deductible amount for you, but you must reimburse us within 30 days after we send you notice that payment is due. If you fail to fully reimburse us, we may cancel the policy as provided in Part Six - Conditions, Section D Cancellation, of the policy. We may keep the amount of unearned premium that will reim- burse us for the payments we made. These rights are in addition to other rights we have to be reimbursed. 4. Only medical losses in excess of the chosen deductible amount and paid by us will be used for experience rating purposes. SCHEDULE Deductible Amount $500 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT WC 00 03 13(4 -84) We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or or- ganization named in the Schedule. This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us. This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule. SCHEDULE PORTZEN CONSTRUCTION CITY OF DUBUQUE CLINTON COMMUNITY COLLEGE PARTNERS, OFFICERS AND OTHERS EXCLUSION ENDORSEMENT The policy does not cover bodily injury to any person described in the Schedule. The premium basis for the policy does not include WC 00 03 08(4 -84) the remuneration of such persons. You will reimburse us for any payment we must make because of bodily injury to such persons. SCHEDULE Partners Officers KEITH DAGUE JEFF DAVIS MICHELLE DAGUE Others (3) Expenses and Income. We pay only soft cost expenses and loss of rental income incurred within 12 consecutive months after the loss to Buildings Un- der Construction or Installation Projects. 9. PROPERTY DEFINITIONS The following definitions are added: a. b. "Covered job site" means any location, job site or project where you are in the process of construction or installation. "Delay" means a delay in the construction, erection or fabrication of Buildings Under Construction or Installation Projects. SCHEDULE Limit of Insurance: $50,000 Deductible: $500 Premium Basis Estimate Payroll Plus 50% of the Cost $200,000 of Subcontracted Work Minimum Premium = $50 ADDITIONAL INSURED CITY OF DUBUQUE, IOWA This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM COMMERCIAL GENERAL LIABILITY COVERAGE PART BIS -PAK BUSINESS LIABILITY AND MEDICAL EXPENSES COVERAGE FORM 1. The City of Dubuque, Iowa, including all its elected and appointed officials, all its employ- ees and volunteers, all its boards, commissions and /or authorities and their board members, employees and volunteers, are included as ad- ditional insureds with respect to all work and services performed for them. This coverage shall be primary to the additional insureds and not contributing with any other insurance or similar protection available to the additional in- sureds, whether other available coverage be primary, contributing or excess. 2. The following applies when the City of Du- buque, Iowa is named as an additional insured: a. We expressly agree and state that the pur- chase of this policy and the naming of the City of Dubuque, Iowa as an additional in- sured does not waive any of the defenses of governmental immunity available to the City of Dubuque, Iowa under the Code of Iowa Section 670.4 as it now exists and as it may be amended from time to time. b. We further agree that this policy of insur- ance shall cover only those claims not sub- ject to the defense of governmental immu- nity under the Code of Iowa Section 670.4 as it now exists and as it may be amended Rate $1.100 Per $1,000 IL- 7063(7 -02) from time to time. Those claims not subject to the Code of Iowa Section 670.4 shall be covered by the terms and conditions of this policy. c. The City of Dubuque, Iowa shall be respon- sible for asserting any defense of govern- mental immunity, and may do so at any time and shall do so upon timely written request by us. d. We shall not deny coverage under this poli- cy and we shall not deny any of the rights and benefits accruing to the City of Du- buque, 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 im- munity asserted by the City of Dubuque, Iowa. e. We and the City of Dubuque, Iowa agree that the above preservation of governmental immunities shall not otherwise change or alter the coverage available under the poli- cy. 3. We will give thirty (30) days advance written notice of cancellation, nonrenewal, reduction in coverage or limits and /or material change by endorsement and ten (10) days written notice for nonpayment of premium to: City of Dubuque and Dubuque County, City Hall, 13th and Cen- tral, Dubuque, IA 52001. This endorsement su- persedes the standard cancellation statement on the Certificate of Insurance to which this endorsement is attached. CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM This endorsement modifies insurance provided under the following: BIS -PAK COVERAGE PART A. The following provisions are added and apply to Property and Liability Coverages if applica- ble: Cap On Certified Terrorism Losses "Certified act of terrorism" means an act that is certified by the Secretary of the Treasury, in concurrence with the Secretary of State and the Attorney General of the United States, to be an act of terrorism pursuant to the federal Terrorism Risk Insurance Act. The criteria con- tained in the Terrorism Risk Insurance Act for a certified act of terrorism include the following: 1. The act resulted in insured losses in excess of $5 million in the aggregate, attributable to all types of insurance subject to the Terror- ism Risk Insurance Act; and 2. The act is a violent act or an act that is dan- gerous to human life, property or infrastruc- ture and is committed by an individual or in- dividuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of B. - PROPERTY CB- 7296(1 -08) the United States Government by coercion. If aggregate insured losses attributable to ter- rorist acts certified under the Terrorism Risk Insurance Act exceed $100 billion in a Program Year (January 1 through December 31) and we have met our insurer deductible under the Ter- rorism Risk Insurance Act, we shall not be liable for the payment of any portion of the amount of such losses that exceeds $100 bil- lion, and in such case insured losses up to that amount are subject to pro rata allocation in accordance with procedures established by the Secretary of the Treasury. The following provision is added to the Deluxe Bis -Pak Property Coverage Form: APPLICATION OF OTHER EXCLUSIONS The terms and limitations of any terrorism ex- clusion, or the inapplicability or omission of a terrorism exclusion, do not serve to create cov- erage for any loss which would otherwise be excluded under this Coverage Form or Policy, such as losses excluded by the Nuclear Hazard Exclusion or the War And Military Action Exclu- sion. ADDITIONAL INSURED - COMPLETED OPERATIONS - PRIMARY AUTO- MATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU (OWNERS, LESSEES OR CONTRACTORS) This endorsement modifies insurance provided under the following: BIS -PAK BUSINESS LIABILITY AND MEDICAL EX- PENSES COVERAGE FORM 1. Who Is an Insured is amended to include as an additional insured any person(s) or organiza- tion(s) for whom you have performed oper- ations if you and such person(s) or organiza- tion(s) have agreed in writing in a contract or agreement that such person(s) or organiza- tion(s) be added as an additional insured on your policy for completed operations. Such person(s) or organization(s) is an addi- tional insured only with respect to liability in- cluded in the products- completed operations hazard for bodily injury or property damage caused, in whole or in part, by your work per- formed for that additional insured at the loca- tion designated and described in the contract or agreement. 2. The insurance does not apply to: a. Bodily injury or property damage which oc- CB- 7242(4 -10) curs prior to execution of the contract or agreement described in item 1; or b. Bodily injury or property damage that oc- curs after the time period during which the contract or agreement described in item 1 requires you to add such person or or- ganization onto your policy as an additional insured for completed operations; or c. Bodily injury or property damage arising out of the rendering of, or the failure to render, any professional, architectural, engineering or surveying services, including: (1) The preparing, approving or failing to prepare or approve maps, shop draw- ings, opinions, reports, surveys, field or- ders, change orders or drawings and specifications; and (2) Supervisory, inspection, architectural or engineering activities. 3. The insurance provided by this endorsement is primary and noncontributory. SCHEDULE Premises Building Description of Property Number Number 001 001 001 001 2006 KUBOTA KX 121 -3 MINI EXCAVATOR W/2 BUCKETS Premises Building Loss Payee Loan Number Number Number (Name and Address) Provision Applicable 001 001 EAST DUBUQUE SAVINGS BANK & ITS SUCCESSORS PO BOX 259 EAST DUBUQUE IL 61025 001 001 EDSB 475 CEDAR CROSS RD DUBUQUE IA 52003 ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU - PRIMARY This endorsement modifies insurance provided under the following: BIS -PAK BUSINESS LIABILITY AND MEDICAL EX- PENSES COVERAGE FORM 1. Who Is An Insured is amended to include as an additional insured any person or organiza- tion for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agree- ment that such person or organization be ad- ded as additional insured on your policy. Such person or organization is an insured only with respect to liability for bodily injury, property damage or personal and advertising injury caused, in whole or in part, by: a. Your acts or omissions; or b. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured. A person's or organization's status as an in- sured under this endorsement ends when your operations for that insured are completed. 2. With respect to the insurance afforded to these additional insureds, the following additional ex- clusions apply: This insurance does not apply to: a. Bodily injury, property damage, personal LOSS PAYABLE LOSS PAYABLE CB- 7191(4 -10) and advertising injury arising out of the ren- dering of, or the failure to render, any pro- fessional, architectural, engineering or sur- veying services, including: (1) The preparing, approving or failing to prepare or approve maps, shop draw- ings, opinions, reports, surveys, field or- ders, change orders or drawings and specifications; and Supervisory, inspection, architectural or engineering activities. b. Bodily injury or property damage occurring after: (2) (1) (2) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than ser- vice, maintenance or repairs) to be per- formed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or That portion of your work out of which the injury or damage arises has been put to its intended use by any person or organization other than another con- tractor or subcontractor engaged in per- forming operations for a principal as a part of the same project. 3. insurance provided by this endorsement is primary and noncontributory. The FELLOW EMPLOYEE COVERAGE This endorsement modifies insurance provided under the following: BIS -PAK BUSINESS LIABILITY AND MEDICAL EXPENSE COVERAGE FORM Paragraph 2a(1), under the Who Is an Insured Sec- tion is replaced by the following: Bodily injury or personal and advertising injury to you or a co- employee while in the course of his or her CB- 7054(9 -04) employment or performing duties related to the con- duct of your business, or the spouse, child, parent, brother or sister of that co- employee as a conse- quence of such bodily injury or personal and ad- vertising injury, or for any obligation to share dam- ages with or repay someone else who must pay damages because of the injury. This does not apply to your employees shown in the Schedule. SCHEDULE Employees