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Improvement Contracts_Ted Stackis Construction for Fire Hydrant Painting Phase 4Masterpiece on the Mississippi TO: Michael C. Van Milligen, City Manager FROM: Bob Green, Water Department Manage SUBJECT: Fire Hydrant Painting Program Phase 4 Contract Signatures - CIP 740-2201 DATE: December 5, 2013 Dubuque ***** All-Amenca City 11111r 2007 • 2012 2013 DISCUSSION: The purpose of this memorandum is to request your signature on the following contract documents to award Phase 4 of the Fire Hydrant Painting Program to Ted Stackis Construction of Dubuque, Iowa. This phase of the program is for priming and repainting approximately 600 public fire hydrants in the amount of $88,426.00 (Fund balance $113,755.24). City Attorney Barry Lindahl and Finance Director Ken TeKippe have reviewed this agreement, bonds and insurance schedules and find them to be acceptable. ACTION: The city's consultant firm, IIW Engineering of Dubuque, staff and I are requesting your approval by signature to accept this contract. Please sign the attached documents as marked so that we may proceed with this project. Staff and I are available to meet with you at your convenience to discuss and answer any questions that you may have with this. Attachments cc: Michael Brekke, Water Distribution Supervisor File CITY OF DUBUQUE, IOWA FIRE HYDRANT REPAINTING PROJECT PHASE 4 2013/2014 IMPROVEMENT CONTRACT THIS IMPROVEMENT CONTRACT (the Contract), made in triplicate, dated for reference purposes the 28th day of October, 2013, between the City of Dubuque, Iowa, by its City Manager, through authority conferred upon the City Manager by its City Council (City) and Ted Stackis Construction (Contractor). 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 Fire Hydrant Repainting Project Phase 4 2013/2014. All work shall be completed according to the specification requirements 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: Any ordinances and resolutions heretofore adopted by the City Council having to do with the Project; the Request for Quotations; the Contractor's Proposal; and the Specifications, and General Requirements as prepared for the City 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 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 specifications 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 within 90 calendar days. 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, Toss or expense is attributable to bodily injury, sickness, disease or death, or injury to or destruction of property including loss of use resulting there from, but only to the extent caused in whole or in part by negligent acts or omissions of the Contractor, the Contractor's subcontractor, or anyone directly or indirectly employed by the Contractor or the Contractor's subcontractor or anyone for whose acts the Contractor or the Contractor's subcontractor may be liable, regardless of whether or not such claim, damage, loss or expense is caused in part by a party indemnified hereunder. THE CITY AGREES: Upon the completion of the Contract, and the acceptance of the Project by the City, the City agrees to pay the Contractor as full compensation for the complete performance of this Contract, the amount determined for the total number of units completed at the unit prices stated in the Contractor's Proposal and less any liquidated damages provided for in the Contract Documents. The number of units stated in the specifications is approximate only and the final payment shall be made by the work covered by the Contract. CONTRACT AMOUNT $88,426.00. 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 Tess 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 and its bond shall be security therefore. CITY OF DUBUQUE, IOWA By City Manager PRINCIPAL: By: l= j) J Contractor: Ted Stackis Construction Signature S Title CERTIFICATE OF CITY CLERK This is p, certify that a c rt fied cop . of the above Contract has been filed in my office on the `,- ') day of , 20,E :--?) . Kevin $.Firnstahl, City 'Ierk AC0. is CERTIFICATE OF LIABILITY INSURANCE 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. DATE (MM /DD /YYYY) 11/12/2013 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 BRADLEY BECK MCDONALD INS 198 LOCUST ST Dubuque, IA 52001 CONTACT NAME: PHONE 563- 583 -0638 (A/C, No, Ext): FAX E -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC# INSURER A Pekin Insurance INSURED TED STACKIS DBA Stackis Construction 206 SAUNDERS ST. DUBUQUE, IA 52001 INSURER B : INSURER C INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR SUER WVD POLICY NUMBER POLICY EFF (MM /DD/YYYY) POLICY EXP (MM /DD/YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY X CL0012032 -3 10/02/13 10/02/14 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 5,000 PERSONAL &ADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE X POLICY X LIMIT APPLIES PRO T F JEC PER: LOC PRODUCTS - COMP /OP AGG $ 2,000,000 $ A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS .,,, }[ AUTOS NON -OWNED AUTOS 00P642874 10/02/13 10/02/14 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 OCCUR CLAIMS -MADE U0012032 10/02/13 10/02/14 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ DED X RETENTION $ 10 , 0 0 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 ¥IN Y N/A 00WC76729 10/02/13 10/02/14 X v WC TORY LIMITS - OTH- ER E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 E.L. DISEASE - POLICY LIMIT $ 500,000 A For;Phase 4 City Of Dubuque Fire Hydrant Repainting Project IIW Project# 13138 -01 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) The City Of Dubuque is listed as additional insured on General Liability policies including ongoing & completed operations coverage equivalant to CG 2010 0704 & CG2037 0704.General Liability is primary & non- contributing.CG2503 0397 "Designated Projects" general libility aggregate is included Govermenyal immunities is included. (Cont.) CERTIFICATE HOLDER CANCELLATION City Of Dubuque 50 West 13th St. 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. AUTH9R1ZE REPRESENTATIVE ACORD 25 (2010/05) ©1988- 20101ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DATE(MM /DD /YYYY) CERTIFICATE OF LIABILITY INSURANCE 11/12/2013 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 BRADLEY BECK MCDONALD INS 198 LOCUST ST Dubuque, IA 52001 CONTACT NAME: PHONE 563 - 583 -0638 (A/C No Ext): FAX (A/C,No)563- 556 -8817 E -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC# INSURER A Pekin Insurance INSURED TED STACKIS DBA STACKIS CONSTRUCTION Stackis Construction 206 SAUNDERS ST. DUBUQUE, IA 52001 INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD - POLICY NUMBER POLICY EFF (MM /DD/YYYY) POLICY EXP (MM /DD /YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL 1CLAIMS-MADE LIABILITY X OCCUR X CL0012032 -3 10/02/13 10/02/14 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL &ADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE X POLICY X LIMIT APPLIES PRO JECT PER: LOC PRODUCTS - COMP /OP AGG $ 2,000,000 $ A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X ]g SCHEDULED AUTOS NON -OWNED AUTOS 00P642874 10/02/13 10/02/14 COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ 1,000,000 (Per accident) BODILY INJURY (Pidt $ 1,000,000 PROPERTY DAMAGE (Per accident) $ 1,000,000 A X UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE U0012032 10/02/13 10/02/14 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ DED RETENT ON $ 10,000 $ 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 Y N/A 0 0 WC7 6 7 2 9 10/02/12 10/02/13 X WCSTATU- 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 / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, f more space is required) Waiver of Subrogation in favor of the City of Dubuque on workers compensation is included, IIIW P.C. as additional insured as primary & non - contributory CERTIFICATE HOLDER CANCELLATION City Of Dubuque 50 West 13th St Dubuque, Ia. 52001 Attn;Tom Freund SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ©1988 -2010 CORD CORPORATION. All rights reserved. ACORD25(2010/05) The ACORD name and logo are registered marks of ACORD freyond the expected.8 PEKIN® I N S U R A N C E PEKIN INSURANCE COMPANY (A STOCK COMPANY) HOME OFFICE 2505 COURT STREET PEKIN, ILLINOIS 61558 COMMERCIAL LINES POLICY COMMON DECLARATIONS N POLICY POLICY NO: 02,0177306 -0 NAME AND ADDRESS OF INSURED: STACKIS CONSTRUCTION TED STACKIS DBA 206 SAUNDERS DUBUQUE, IA 52001 09/19/13 RITE OF POLICY NO: CL0012032 AGENT: 00- 03801 -000 BRADLEY- BECK -MC DONALD INSURAN POLICY PERIOD: FROM 10/02/13 `ID 10/02/14 AT 12:01 A.M. STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE. BUSINESS DESCRIPTION: CARPENTRY- RESIDENTIAL IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PARTS FOR WHICH A PREMIUM IS INDICATED. THIS PREMIUM MAY BE SUBJECT TO ADJUSTMENT. COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL INLAND MARINE COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART PREMIUM PA DATE. 1,0 PLAN: ANNUAL DIRELI BIT1, 13 1,295.00 441.00 202.00 TOTAL 1,938.00 COUNTERSIGNED 00- 03801 -000 BRADLEY'' °:ECK -MC DO SURAN THESE DECLARATIONS, TOGETHER WITH THE COMMON POLICY CONDITIONS AND COVERAGE FORM(S) AND ANY ENDORSEMENT(S), COMPLETE THE ABOVE NUMBERED POLICY. COVERAGE FORMS THAT APPLY TO THE ENTIRE POLICY FOLLOW THIS DECLARATIONS. COVERAGE FORMS THAT APPLY ONLY TO A PARTICULAR COVERAGE PART FOLLOW THE APPLICABLE COVERAGE PART DECLARATIONS. Includes copyrighted material of Insurance Services Office, Inc. with its permission. IL 0019 1211 COMMISSION RAPE: 20 AGENT'S COPY CL0177306 -0 THIS ENDORSEMENT IS ATTACHED TO AND MADE PART OF YOUR POLICY IN RESPONSE TO THE DISCLOSURE REQUIREMENTS OF THE TERRORISM RISK INSURANCE ACT. THIS ENDORSEMENT DOES NOT GRANT ANY COVERAGE OR CHANGE THE TERMS AND CONDITIONS OF ANY COVERAGE UNDER THE POLICY. DISCLOSURE PURSUANT TO TERRORISM RISK INSURANCE ACT SCHEDULE Terrorism Premium (Certified Acts) $ 12.00 This premium is the total Certified Acts premium attributable to the following Coverage Part(s), Coverage Form(s) and /or Policy(s): General Liability $ 6.00 Inland Marine $ 5.00 Property $ 1.00 Effective January 1, 2006, Terrorism Risk Insurance Program has terminated with respect to (therefore no longer applies to) Commercial Crime and Garage Coverages. No premium is charged for these coverages. In accordance with the Terrorism Risk Insurance Act, we have offered you coverage for losses resulting from an act of terrorism, as defined in the act. You may accept or reject this offer. In the states of Illinois & Iowa, if your policy contains the Commercial Property Coverage Part, and in the state of Wisconsin, if your policy contains the Commercial Property and /or the Inland Marine Coverage Part, a rejection of this offer still provides coverage for fire losses resulting from a certified act of terrorism. Therefore, if you reject the offer of terrorism coverage, that rejection does not apply to fire losses resulting from a certified act of terrorism. Coverage for such fire loss will still be provided in your policy. If you reject the offer described above for terrorism coverage, a premium is still due. To determine this premium charge, multiply the applicable terrorism premium for the Property Coverage and /or Inland Marine Coverage as described above, by .60. Example: $20.00 x .60 = $12.00 Additional information, if any, concerning the terrorism premium: Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Disclosure Of Premium In accordance with the federal Terrorism Risk Insurance Act, we are required to provide you with a notice disclosing the portion of your premium, if any, attributable to coverage for terrorist acts certified under the Terrorism Risk Insurance Act. The portion of your premium attributable to such coverage is shown in the Schedule of this endorsement or in the policy Declarations. B. Disclosure Of Federal Participation In Payment Of Terrorism Losses The United States Government, Department of the Treasury, will pay a share of terrorism losses insured under the federal program. The federal share equals 85% of that portion of the amount of such insured losses that exceeds the applicable insurer retention. However, if aggregate insured losses attributable to terrorist acts certified under IL 09 85 01 08 the Terrorism Risk Insurance Act exceed $100 billion in a Program Year (January 1 through December 31), The Treasury shall not make any payment for any portion of the amount of such losses that exceeds $100 billion. C. Cap On Insurer Participation In Payment Of Terrorism Losses If aggregate insured losses attributable to terrorist 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 Terrorism Risk Insurance Act, we shall not be liable for the payment of any portion of the amount of such losses that exceeds $100 billion, 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. Copyright, ISO Properties, Inc., 2007 Page 1 of 1 AGENT'S COPY PEKIN INSURANCE COMPANY (A STOCK COMPANY) HOME OFFICE 2505 COURT STREET PEKIN, ILLINOIS 61558 COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS NEW POLICY NAMED INSURED: STACK'S CONSTRUCTION POLICY NO: CL0177306 -0 TED STACK'S DBA LIMITS OF INSURANCE: GENERAL AGGREGATE LIMIT (OTHER THAN PRODUCTS- COMPTRTED OPERATIONS) $ 2,000,000. PRODUCTS- COMPTETED OPERATIONS AGGREGATE LIMIT 2,000,000. PERSONAL & ADVERTISING INJURY LIMIT (ANY ONE PERSON OR ORGANIZATION) 1,000,000. EACH OCCURRENCE LIMIT 1,000,000. DAMAGE TO PREMISES RENTED TO YOU LIMIT (ANY ONE PREMISES) 100,000. MEDICAL EXPENSE LIMIT (ANY ONE PERSON) 5,000. FORM OF BUSINESS: INDIVIDUAL DEDUCTIBLE: $0 DEDUCTIBTF. APPLIES TO THIS COVERAGE PART OTHER ENDORSEMENTS AND FORMS ATTACHED TO THIS COVERAGE PART: 000001 1001 OG0005 0605 CG0062 1202 CG0068 0509 CG2132 0509 CG2147 0798 S 08 CG2176 0108 CG2186 1204 CG218 '107 CG2196 0305 CG2294 1001 "CG2503 0509`' CG5012 1194 CG5021 0107 CG5023 0107 CG5029 0605 CG5034 0605 CG5042 0313 CG5044 0313 IL0017 1198 IL0019 1211 IL0021 0498 IL0276 0300 IL0985 0108 001696 0611 1997 0312 481T 1078 LOCATION OF ALL PREMISES THAT THIS COVERAGE PART APPLIES TO: 01 206 SAUNDERS ST, DUBUQUE, IA CG 00 05 06 05 PAGE 1 OF 2 AGENTS COPY Beyond the expected.® I N S U R A N C E PEKIN INSURANCE COMPANY (A STOCK COMPANY) HOME OFFICE 2505 COURT STREET PEKIN, ILLINOIS 61558 COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS N POLICY NAMED INSURED: STACKIS CONSTRUCTION POLICY NO: CL0177306 -0 TED STACKIS DEA LOC. CLASSIFICATION CODE PREMIUM RATE ADVANCE PREMIUM NO. NO. BASIS PREM ISES/ PRODUCTS/ OPERATIONS COM PLETED OPERATIONS 01 PER PROJECT AGGREGATE 44444 T- 1 400.000 $ 400.00 01 CARPENTRY- RESIDENTIAL PRO 91340 P- 45500 5.825 $ 265.00 01 CARPENTRY- RESIDENTIAL PRO 91340 P- 45500 9.311 01 ADDITIONAL INSURED 01 49950 T- 1 50.000 $ 50.00 01 ADDITIONAL INSURED 02 49950 T- 1 50.000 $ 50.00 01 ADDITIONAL INSURED 03 49950 T- 1 100.000 TERRORISM RISK INSURANCE CG 00 05 06 05 $ 6.00 $ 424.00 $ 100.00 PAGE 2 OF 2 AGENTS COPY PEKIN INSURANCE COMPANY (A STOCK COM PA NY) HOME OFFICE 2505 COURT STREET PEKIN, ILLINOIS 61558 COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS NEW POLICY NAMED INSURED: STACKIS CONSTRUCTION POLICY NO: CL0177306 -0 ADDITIONAL INTEREST LOC NO. NAMEIADDRESS TYPE OF INTEREST 01 001 CITY OF DUBUQUE, INCLUDING ALL ITS RTECTED & ADDITIONAL INSURED APPOINTED OFFICIALS, ALL ITS EMPLOYEES &VOLUNTEERS, ALL ITS BOARDS, COMMISSIONS & /OR 50 W 13TH STREET DUBUQUE IA 52001 01 002 IIW P.C. 4155 PFNSYLVANIA DUBUQUE IA 52002 01 003 CITY OF DUBUQUE, INCLUDING ALL ITS FTFCTED & APPOINTED OFFICIALS, ALL ITS EMPLOYEES &VOLUNTEERS, ALL ITS BOARDS, COMMISSIONS & /OR 50 W 13TH STREET DUBUQUE IA 52001 CG 75 00 02 93 ADDITIONAL INSURED ADDITIONAL INSURED AGENT'S COPY CL0177306 -0 AMENDMENT OF POLICY This endorsement, effective 10/02/13 forms a part of policy No. CL0177306- 0 issued to STACKIS CONSTRUCTION TED STACKIS DBA by PEKIN INSURANCE COMPANY It is agreed that as of the effective date of this endorsement this policy is amended in the following particulars: CITY OF DUBUQUE, IOC 50 W 13 STREET DUBUQUE IA 52001 GOVERNMENTAL IMMUNITIES ENDORSEMENT THE BELOW WORDING AMENDS THE GENERAL LIABILITY SECTION AS FOLLOWS NONWAIVER OF GOVERNMENTAL IMMUNITY. WE EXPRESSLY AGREE & STAl'E THAT THE PURCHASE OF THIS POLICY & THE NAMING OF THE CITY OF DUBUQUE, IOTA AS AN ADDITIONAL INSURED DOES NOT WAIVE ANY OF THE DEFENSES OF GOVERNMENTAL IMMUNITY AVAILABTR TO THE CITY OF DUBUQUE, IOWA UNDER CODE OF IOWA SECTION 670.4 AS IT NOW EXISTS & AS IT MAY BE AMENDED FROM TIME TO TIME. CLAIMS COVERAGE. WE FURTHER AGREE 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 & AS IT MAY BE AMENDED FROM TIME TO TIME. ASSERTION OF GOVERNMENTAL IMMUNITY. THE CITY OF DUBUQUE, IOWA SHALL BE RESPONSIBTE FOR ASSERTING ANY DEFENSE OF GOVERNMENTAL IMMUNITY, & MAY DO SO AT ANY TIME & 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 CITY OF DUBUQUE, IOWA. NON - DENIAL OF COVERAGE. WE SHALL NOT DENY COVERAGE UNDER THIS 481T (10 -78) AGENT'S COPY CL0177306 -0 AMENDMENT OF POLICY This endorsement, effective 10/02/13 forms a part of policy No. CL0177306- 0 issued to STACKIS CONSTRUCTION TED STACKIS DBA by PEKIN INSURANCE COMPANY It is agreed that as of the effective date of this endorsement this policy is amended in the following particulars: POLICY & WE SHALL NOT DENY ANY OF THE RIGHTS & BENEFITS ACCRUING TO THE CITY OF DUBUQUE, IOWA UNDER THIS POLICY FOR REASONS OF GOVERNMENTAL IMMUNITY UNLESS & UNTIL A COURT OF COMPETENT JURISDICTION HAS RULED IN FAVOR OF THE DEFENSE(S) OF GOVERNMENTAL IMMUNITY ASSERTED BY THE CITY OF DUBUQUE, IOWA. NO OTHER CHANGE IN POLICY. WE & THE CITY OF DUBUQUE AGREE THAT THE ABOVE PRESERVATION OF GOVERNMENTAL IMMUNITIES SHALL NOT OTHERWISE CHANGE OR ALTER THE COVERAGE AVAILABTR UNDER THE POLICY. 481T (10 -78) AGENT'S COPY 09/19/13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Project(s): tT 07- eCaQutiE Et 144 OflAr i RE:i3AW T L1 Pk_ofE (X P4-45E- 4 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under Section 1 - Coverage A, and for all medical expenses caused by accidents under Section I - Coverage C, which can be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: 1. A separate Designated Construction Project General Aggregate Limit applies to each designated construction project, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. 2. The Designated Construction Project General Aggregate Limit is the most we will pay for the sum of all damages under Coverage A, except damages because of "bodily injury" or "property damage" included in the "products- completed operations hazard ", and for medical expenses under Coverage C regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits ". CG 25 03 05 09 3. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the Designated Construction Project General Aggregate Limit for that designated construction project. Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated Construction Project General Aggregate Limit for any other designated construction project shown in the Schedule above. 4. The limits shown in the Declarations for Each Occurrence, Damage To Premises Rented To You and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated Construction Project General Aggregate Limit. B. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under Section 1 - Coverage A, and for all medical expenses caused by accidents under Section 1 Coverage C, which cannot be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: Copyright, Insurance Services Office, Inc., 2008 Page 1 of 2 AGENT'S COPY 00WC76729E WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT 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 organization named in the. Schedule. (This agreement applies only to the extent that you perform work under a written co ntract 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. CITY OF DUBUQUE 350 W 6TH ST STE 312 DUBUQUE IA 52001 WC 00 03 13 (04 -84) Schedule Copyright 1983 National Council on Compensation Insurance. AGENT'S COPY CITY OF DUBUQUE - WATER DEPARTMENT FIRE HYDRANT REPAINTING PROJECT PHASE 4 2013/2014 BIDDER agrees to perform all the work described in the CONTRACT DOCUMENTS for the following unit prices or indicated sums: NOTE: Bids shall EXCLUDE sales tax and all other applicable taxes and fees BID SCHEDULE (BID FORM 1A) NO, DESCRIPTION QUANTITY UNIT PRICE TOTAL PRICE 1 Mobilization and Miscellaneous - 1 LS Lump Sum Co OCR , °b 2 Traffic Control 1 LS Lump Sum 6000 3 Fire Hydrant Surface Preparation & Repainting 600 EA * 1'W> o ; ^r ) 4 Supplemental Surface Preparation 40 HOURS L\Q 00. 1 00 Po X 5 Abrade "New" Hydrant Surfaces 60 EA �� � 2. ,LIC .) ,c° TOTAL OF BID FOR PHASE 4 FIRE HYDRANT REPAINTING This bid schedule is submitted by: t� � �' -c� `c c `�d �0 ,a Contractor Name The bidder shall submit the Bid Proposal form (page B -2) with this Bid Schedule The bidder's Iowa Registration Number is: 0 (ILj 5(03 The City of Dubuque Water Department reserves the right to increase or decrease the number of hydrants painted subsequent to receipt of bids in order to comply with budget limits and project completion. Bid Proposal Page 1 of 2 Bond No. T238196 CITY OF DUBUQUE, IOWA FIRE HYDRANT REPAINTING PROJECT PHASE 4 2013/2014 PERFORMANCE, PAYMENT AND MAINTENANCE BOND KNOWN ALL MEN BY THESE PRESENTS: That Ted Stackis Construction as Principal (Contractor) and Employers Mutual Casualty Company as Surety are held firmly bound unto the City of Dubuque, Iowa (City), in the penal sum of $88,426.00 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 21st day of November , 201.3 and duly attested and sealed. WHEREAS, the said Contractor by a Contract dated October 28, 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 Fire Hydrant Repainting Project Phase 4 2013/2014 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 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 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 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) years from the date of acceptance of the work under the Contract by the City of Dubuque, Iowa, by reason of defects in workmanship or materials used in construction of said work; B. To keep all work in continuous good repair; and C. To pay the City the reasonable costs of monitoring and inspection to assure that any defects are remedied, and to repay the City all outlay and expense incurred as a result of Contractor's and Surety's failure to remedy any defect as required by this section. Contractor's and Surety's agreement herein made extends to defects in workmanship or materials not discovered or known to the City at the time such work was accepted. NOW, THEREFORE, the condition of this obligation is such that if the said Contractor shall perform all of the work contemplated by the Contract in a workmanlike manner and in strict compliance with the plans and specifications, and will pay all claims for labor and materials used in connection with said Project, to indemnify the said City for all damages, costs and expense incurred by reason of damages to persons or property arising through the performance of said Contract, and will reimburse the City for any outlay of money which it may be required to make in order to complete said Contract according to the Construction Documents and will maintain in good repair said Project for the period specified in the Contract where this bond is obligated for maintenance, and will faithfully comply with all of the provisions of Section 573 of the Code of Iowa, then this obligation shall be null and void, otherwise it shall remain in full force and effect. All the conditions of this bond must be fully complied with before the Contractor or the Surety will be released. The Contract and Contract Documents shall be considered as a part of this Bond just as if their terms were repeated herein. Dated at Dubuque, Iowa this 21st day of November , 20 13. CITY OF DUBUQUE, IOWA By: City IVI:nager PRINCIPAL. Ted StaOis Co z_zA` S gnature struction Title SURETY: Frnpl oyPrs Mtitnal Casualty Company By: 7. Sigpfait u re Bond Field Underwriter Title Des Moines, Iowa 50309 City, State, Zip Code 515/345-2689 Telephone Leroy J. Bottley TTT, AFSB Attorney In-Fact THE FACE AND REVERSE OF THIS DOCUMENT HAVE A COLORED FLAG ON WHITE PAPER /EMC Insurance Companies® No. A30890 P.O. Box 712 • Des Moines, IA 50306 -0712 CERTIFICATE OF AUTHORITY INDIVIDUAL ATTORNEY -IN -FACT KNOW ALL MEN BY THESE PRESENTS, that: 1. Employers Mutual Casualty Company, an Iowa Corporation 2. EMCASCO Insurance Company, an Iowa Corporation 3. Union Insurance Company of Providence, an Iowa Corporation 4. Illinois EMCASCO Insurance Company, an Iowa Corporation hereinafter referred to severally as "Company" and collectively as "Companies ", each does, by these presents, make, constitute and appoint: LEROY J. BOTTLEY, III 5. Dakota Fire Insurance Company, a North Dakota Corporation 6. EMC Property & Casualty Company, an Iowa Corporation 7. Hamilton Mutual Insurance Company, an Iowa Corporation its true and lawful attorney -in -fact, with full power and authority conferred to sign, seal, and execute its lawful bonds, undertakings, and other obligatory instruments of a similar nature as follows: ANY AND ALL BONDS and to bind each Company thereby as fully and to the same extent as if such instruments were signed by the duly authorized officers of each such Company, and all of the acts of said attorney pursuant to the authority hereby given are hereby ratified and confirmed. The authority hereby granted shall expire APRIL 1, 2014 unless sooner revoked. AUTHORITY FOR POWER OF ATTORNEY This Power -of- Attorney is made and executed pursuant to and by the authority of the following resolution of the Boards of Directors of each of the Companies at a regularly scheduled meeting of each company duly called and held in 1999: RESOLVED: The President and Chief Executive Officer, any Vice President, the Treasurer and the Secretary of Employers Mutual Casualty Company shall have power and authority to (1) appoint attorneys -in -fact and authorize them to execute on behalf of each Company and attach the seal of the Company thereto, bonds and undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof; and (2) to remove any such attorney -in -fact at any time and revoke the power and authority given to him or her. Attorneys -in -fact shall have power and authority, subject to the terms and limitations of the power -of- attorney issued to them, to execute and deliver on behalf of the Company, and to attach the seal of the Company thereto, bonds and undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof, and any such instrument executed by any such attorney -in -fact shall be fully and in all respects binding upon the Company. Certification as to the validity of any power -of- attorney authorized herein made by an officer of Employers Mutual Casualty Company shall be fully and in all respects binding upon this Company. The facsimile or mechanically reproduced signature of such officer, whether made heretofore or hereafter, wherever appearing upon a certified copy of any power -of- attorney of the Company, shall be valid and binding upon the Company with the same force and effect as though manually affixed. IN WITNESS THEREOF, the Companies have caused these presents to be signed for each by their officers as shown, and the Corporate seals to be hereto affixed this 6th day of FEBRUARY , 2013 0/NEs,t� CERTIFICATE certify that the foregoing resolution of the Boards of Directors by each of the Companies, FEBRUARY 6, 2013 on behalf of: LAUREL A. BLOSS Commission Number 183662 My Comm. Exp. Mart 3, 2014 Bruce G. Kelley, Chairman of Companies 2, 3, 4, 5 & 6; President of Company 1; Vice Chairman and CEO of Company 7 Michael Freel Assistant Vice President/ Assistant Secretary On this 6th day of FEBRUARY AD 2013 before me a Notary Public in and for the State of Iowa, personally appeared Bruce G. Kelley and Michael Freel, who, being by me duly sworn, did say that they are, and are known to me to be the Chairman, President, Vice Chairman and CEO, and /or Assistant Vice President/Assistant Secretary, respectively, of each of The Companies above; that the seals affixed to this instrument are the seals of said corporations; that said instrument was signed and sealed on behalf of each of the Companies by authority of their respective Boards of Directors; and that the said Bruce G. Kelley and Michael Freel, as such officers, acknowledged the execution of said instrument to be the voluntary act and deed of each of the Companies. My Commission Expires March 13, 2014. 0 Q J I, James D. Clough, V'ce President of the Companies, do hereby and this Power of Attorney issued pursuant thereto on LEROY J. BOTTLEY, III Notary Public in and for the State of Iowa are true and correct and are still in full force and effect. In Testimony Whereof I have subscribed my name and affixed the facsimile seal of each Company this 21 B t- day of November , 2013 7832 (5-07) SIXTH "For verification of the authenticity of the Power of Attorney you may call (515) 345-2689.' Vice President