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Contracted Services Agreement - Crescent Community Health Center Copyright 2014 City of Dubuque Consent Items # 18. ITEM TITLE: Contracted Services Agreement- Crescent Community Health Center SUMMARY: City Manager recommending approval of the Contracted Services Agreement with Crescent Community Health Center for Fiscal Year 2017. SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Approve ATTACHMENTS: Description Type MVM Memo City Manager Memo Staff Memo Staff Memo Crescent Agreement Supporting Documentation THE CITY OF Dubuque DBgkEmerica CiryUr Masterpiece on the Mississippi 2007-2012-2013 TO: The Honorable Mayor and City Council Members FROM: Michael C. Van Milligen, City Manager SUBJECT: Contracted Services Agreement — Crescent Community Health Center DATE: June 13, 2016 During the Fiscal Year 2017 budget process, the Mayor and City Council provided $22,500 for the Contracted Services Agreement with Crescent Community Health Center. This is a reduction of$2,500 from the Fiscal Year 2015 funded amount. Most contracted service agencies received a 10% reduction in their service contract in Fiscal Year 2016 and this continues in Fiscal Year 2017. Budget Director Jennifer Larson is recommending execution of the attached contract with Crescent Community Health Center. I concur with the recommendation and respectfully request Mayor and City Council approval. Mich el C. Van Milligen MCVM/jml Attachment cc: Barry Lindahl, City Attorney Cindy Steinhauser, Assistant City Manager Teri Goodmann, Assistant City Manager Jenny Larson, Budget Director Mary Rose Corrigan, Public Health Specialist THE CITY OF Dubuque UBE I erica .i Masterpiece on the Mississippi 2007-2012-2013 TO: Michael C. Van Milligen, City Manager FROM: Jennifer Larson, Budget Director SUBJECT: Contracted Services Agreement — Crescent Community Health Center DATE: June 13, 2016 Attached for City Council approval is the Contracted Services Agreement with Crescent Community Health Center for Fiscal Year 2017. The adopted Fiscal Year 2017 operating budget reflects a payment of$22,500 to Crescent Community Health Center, for financial assistance to cover operating expenses of that organization. This is a reduction of $2,500 from Fiscal Year 2015 funded amount. Most contracted service agencies received a 10% reduction in their service contract in Fiscal Year 2016 and this continue in Fiscal Year 2017. Crescent Community Health Center utilizes these funds to provide access to primary medical and dental care to underserved community members. It is my recommendation that the City Council approves the attached Contracted Services Agreement with Crescent Community Health Center, and authorizes the Mayor to execute the contract on behalf of the City. JML Attachment AGREEMENT BETWEEN THE CITY OF DUBUQUE, IOWA AND CRESCENT COMMUNITY HEALTH CENTER THIS AGREEMENT, dated for reference purposes the 1st day of July, 2016, is made and entered into by and between the City of Dubuque, Iowa (City) and Crescent Community Health Center(Agency). WHEREAS, City desires to engage the service of Agency to provide access to primary medical and dental care to underserved community members; and WHEREAS, Agency is willing to provide such services to City upon the terms and conditions set forth herein. NOW THEREFORE, the parties hereto agree as follows: 1. Scope of Service Agency shall provide access and affordable medical care to underserved community members and comply with City Council goals and priorities set forth in Attachment A. 2. City Responsibilities City designates the Public Health Specialist to act as its representative with respect to the work to be performed under this Agreement, and such person shall have authority to transmit instructions, receive information, interpret and define City's policies and provide decisions in a timely manner pertinent to the work covered by this Agreement until Agency has been advised in writing by City that such authority has been revoked. 3. Time of Performance The term of this Agreement shall be from July 1, 2016 through June 30, 2017. 4. Compensation City shall pay Agency $22,500 as compensation for the services provided by Agency, which payment shall constitute full and complete compensation for such services. The compensation shall be paid by City to Agency upon receipt by City of a requisition for such sum from Agency. 5. Audit and Evaluation Inasmuch as the funds to be provided to Agency by City are public funds, the Agency agrees that it will maintain books of account in accordance with Generally Accepted Accounting Standards together with necessary documentation to support all expenditures. The records of Agency, including payroll accounts and other records of disbursements and receipts, and other records relating to the performance of the activities herein specified, shall be made available for inspection by City or any Certified Public Accountant acting on its behalf, in order to ascertain performance of Agency under this Agreement. Agency agrees to retain such records for not less than three (3) years. 6. Reporting and Monitoring Agency shall render to the Public Health Specialist a monthly written report detailing its activities related to the use of City funds provided to Agency. Such report shall include a performance report on the program(s)supported by City funds and a financial report on the use of City funds, which shall be rendered no later than the fourth Thursday of the succeeding month. A written annual report shall be submitted to the City Council within sixty (60) days of year end. The annual report shall include a performance report on the program(s) supported by City funds and a financial report on the use of City funds. If Agency has an annual audit performed, Agency shall provide City a copy of the annual audit report within three months of year-end. 7. Discrimination In carrying out the services under this Agreement, Agency shall not discriminate against any employee or applicant for employment because of race, creed, color, sex, age, national origin, religion, sexual orientation, gender identity, or disability. Agency shall take affirmative action to ensure that applicants for employment are employed and that employees are treated during employment without regard to race, creed, color, sex, age, national origin, religion, sexual orientation, gender identity, or disability. Such action shall include, but not be limited to, the following: employment, upgrading, demotion or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. Agency assures that all qualified applicants will receive consideration for employment without regard to race, creed, color, sex, age, national origin, religion, sexual orientation, gender identity or disability. Agency agrees and will undertake whatever affirmative measures are necessary so that no person shall be excluded from participation in, be denied the benefits of, nor be subjected to discrimination under any program or activities funded in whole or in part with any of the funds made available to Agency under the terms of this Agreement because of race, color, creed, religion, sex, national origin, age, sexual orientation, or disability. 1 8. Termination of Agreement If, through any cause, Agency shall fail to fulfill in a timely and proper manner its obligations under this Agreement, or if the Agency shall violate any of the covenants, agreements or stipulations of this Agreement, City shall thereupon have the right to terminate this Agreement by giving written notice to Agency of such and specifying the effective date thereof not less than thirty days before the effective date of such termination. If Agency shall fail to cure its default to the satisfaction of City in City's sole discretion within such thirty day period, this Agreement shall be deemed terminated at the end of such thirty day period without further action of either party. Upon termination of this Agreement, Agency shall return to City all unexpended funds and/or any funds utilized for purposes other than stated in the Agreement. 9. Assignability Agency shall not assign any interest in this Agreement without the prior written approval of City. 10. Insurance At the time of execution of this Agreement by Agency, Agency shall provide City copies of Agency's insurance certificates showing compliance with the insurance requirements of Insurance Schedule D, included as Attachment B. CITY OF DUBUQUE, IOWA CRESCENT COMMUNITY HEALTH CENTER t ki, 0. / Roy D. vol, Mayor Ju e Woodyard, Exec ti e Director Witness: A.r-- Aro Kevi irnstahl, it, o erk =i5 B E CITY COUNCIL ' Masterpiece on the Mississippi GOALS & P R I O R I T I E S Each year, the Dubuque City Council completes its annual goal-setting sessions. Over the course of two days in August 2015 and another session in October, City Council members reaffirmed the 15-year vision statement, mission statement, and goals. They also identified priorities for a 2015-2017 policy agenda. 2030 VISION STATEMENT CITY MISSION STATEMENT The city of Dubuque is a progressive,sustainable city with a strong diversified economy The Citys Mission is to deliver excellent municipal services and expanding global connections.The Dubuque community is an inclusive community that support urban living and a sustainable city plan for the celebrating culture and heritage and has actively preserved our Masterpiece on the communitys futire and facilitate access to critical human Mississippi.Dubuque citizens experience heathy living and retirement through quality, services which result in financially sound government and livable neighborhoods with an abundance of fun things to do;and are engaged in the citizens getting services and value for their tax dollar. community,achieving goals through partnerships.Dubuque City government is financially sound and is providing services with citizens getting value for their tax dollar. FIVE-YEAR COMMUNITY GOALS FIVE-YEAR CITY GOALS FIVE-YEAR ORGANIZATIONAL GOAL FOR ' SUSTAINABLE DUBUQUE Organization' • Economic Prosperity Partnenng for a Better I • Social/Cultural Vibrancy Improved Connectivity— • Environmental Integrity Transportation and Telecommunications 2015-2017 POLICY AGENDA TOP PRIORITIES (in alphabetical order) HIGH PRIORITIES (in alphabetical order) • East-West Corridor Study Implementation • Central Iowa Water Association Goal.Improved ConnectivityKeylssues:Property Goat.PknnedandManagedGroRMKeyissues.Annexation,funding, aquisltion,environmental assessment funding for water infrastucture design and construction of roundabouts • City Economic Development • Environmental Stewardship Commission Goat.EconomxProspenlyKeylssues.Review staffing levels and (Community Resiliency Commission) partners,funding,goals and performance expectations Goat.EnvironmentaYEcobgicallydegnlyKeylssues. • Citywide Flower Planting Program Purpose and role of commission,determine process for Goal.Pannenng for a BetterDubuque Key Issues.Policy on use of community engagement,size and diverse volunteers,policy of locabon(s)for existing or new plantings and type representation of community, staff support and funding of plant(annual vs. perennial),funding and hiring freeze, on-going • Historic Millwork District Parking(470 spaces) operation and maintenance costs Goat.ImprovedCamec§t*Key1ss s.Land acquisition, • Comprehensive Plan funding Goat.Pbnned and ManagedGroRMKeyissues.Funding,community • Inclusive Dubuque Action Plan assessment and input process Goal.SonaPCutturel VibrancyKeylssues:Community • Debt Reduction Policy engagement process on development of action plan for Goat.Finanaady Respombk City Government andHghPenormanre priority areas,City role as a partner in implementation of OrganizadonKeyissues.EALcation for general public and for city staff, action plan continued implementation of strategic debt reduction • Street Maintenance Program • Methane Gas Plan Goat.Improved Connech*Keyissues.Evaluate existing Goal.EmhD=entaYEcoloocallntegntyKeylssues.Identify service level targets,Funding to restore or expand service oppo tmities for methane gas reuse in city operations including level targets Bio CNG, development agreement for methane gas reuse • Survel lance Cam era Funding Goat.SoaaYOukdal VwrancyKeylssues.Evaluate types of cameras for fuWre purchase,funding and location of additional cameras,use and storage of data and information 2015-2017 MANAGEMENT AGENDA Financially Responsible City Government and • GDDC Sustainable Innovation High Performance Organization • Industrial Park Development Police Officers Recruitment and Reterdion • National lrcidefiVeN Report Succession Planning Process:Development best practices assessment • Skate Park Nonemergency mobileiportable units:Replacement • Police Review Bed Prances Affordable Care Act Payroll software update and IRS data reporting • Open Budgj Expenditures software 2015-2017 MANAGEMENT IN PROGRESS 2015-2017 MAJOR PROJECTS Economic Prosperity Goal Environmental/Ecological Integrity Goal • Riverbed Leases Green Aley Projects(73 alleys) • City Leases AgeemeN with Board of Realtors Bee Branch Projai(Gafield to Comiskey) • An Service Expansion Advocacy Energy Efficient Street Lights • Dubuque miPStrategic Plan • HOPE Program Evaluation Report Partneringfor a Better Dubuque Goal • South Port'Ervironmerdal Assessment Comiskey Pard lmprwemerds Community Engagement,Design • NorthwestMenal Trail—Bergfeld Recreation Trail Connection Environmental/Ecological Integrity Goal Bunker Hol Golf Course IrigatlonImprovemerrts(Phase 1 firsthal • RecyctingPlot Program Carts Dish butlon(400) Improved Connectivity. Transportation • Path FawardAr Qualify Plan Implementation • Community Ch mate Action and Resiliency Plan-50% Green Wacker and HER Trade Signalizalion Project House Gas Reduction by 2D3D Update Wil bur Street Paid ning Wall • FalslOilslGrease(FOG)Program lnspuctions and Progress Report Intermodal Transportation Facility:Opening • Lead and Healthy Homes:Grant North Caecade Road Phase1 • Iowa Economic Development Authority Community Energy Utility Edension Project to Airport Management Program Final Report Alport Terminal:Open • Southwest Mesal Portent Design,Land Acquisition,English Road Construction Social/Cultural Vibrancy Goal Road to Arbor Terminal • Campaign for Grade Level Reading Program Americorps Program, Summer Learning Program • Voluntary Compliance Agreement Action Plan Repot(HUD Approval),Training for Departments For more information,call 563 569 4120 or • Fair Housing Training Annual visit wwwcitvofdubuauecre/councilaoals • Housing Choice Voucher Program Grain Application • Affirmative Fair Housing:Vrdeo/Treining Updates, Fair Housing Report and Action Plan • Interoulturel Competency Program within City Government Recruitment and Rated ion • Leadership Enrichment After School Program TEAP):Grant • Imeroultoml Competency Program for Community:School District, S U S T A I N A B L E Non Profit and Community Organizations,Businesses Train the Trainer CJ • Multicultural Family Center:Director Hiring DUBUQUE Planned and Managed Growth Goal viable • livable • equitable • Flood Wall Evaluation Study • AlliaN Energy Plan)Site Acquisition • SomseofIncome Work Group Report Partnering for a Better Dubuque Goal FIN V I"ROWN M E N T i INTEGRITY'• •' '' • Sister City Program:Visit to the City,Strategic Plan • GDDCBmadbandlRber Optic Vendor Engagement • Four Mounds Foundation HEARTProgrm Report • City Volunteers for Economic Opportunity Program Tool kit for ECNOMIC volunteers)internships,volunteer positions in department,United _• Way Volunteer Matching Software VIBRANCY • Purchase of Service Data Collection,Training for Purchase of Service Providers, Reporting mechanism Improved Connectivity. Transportation and Telecommunications www.sustainabledubugue.ora • SmalerTrensportation Program:Research,Report Rev. 1/15/16 ATTACHMENT B City of Dubuque Insurance Requirements for Special Event Permits Insurance Schedule D 1. shall furnish a signed Certificate of Insurance to the City of Dubuque, Iowa for the coverage required in Exhibit I prior to effective date of permit. Each Certificate shall be prepared on the most current ACORD form approved by the Iowa Department of Insurance or an equivalent. Each certificate shall include a statement under Description of Operations as to why issued. Eg: Project # or Lease of premises at or construction of 2. All policies of insurance required hereunder shall be with a carrier authorized to do business in Iowa and all carriers shall have a rating of A or better in the current A.M. Best's Rating Guide. 3. Each Certificate shall be furnished to the contracting department of the City of Dubuque. 4. Failure to provide minimum coverage shall not be deemed a waiver of these requirements by the City of Dubuque. Failure to obtain or maintain the required insurance shall be considered a material breach of this agreement. 5. All required endorsements to various policies shall be attached to Certificate of insurance. 6. Whenever a specific ISO form is listed, an equivalent form may be substituted subject to the provider identifying and listing in writing all deviations and exclusions that differ from the ISO form. 7. Provider shall be required to carry the minimum coverage/limits,or greater if required by law or other legal agreement, in Exhibit 1. 8. Whenever an ISO form is referenced the current edition of the form must be used. City of Dubuque Insurance Requirements for Special Event Permits Insurance Schedule D (continued) Exhibit I A) COMMERCIAL GENERAL LIABILITY General Aggregate Limit $2,000,000 Products-Completed Operations Aggregate Limit $1,000,000 Personal and Advertising Injury Limit $1,000,000 Each Occurrence $1,000,000 Fire Damage Limit(any one occurrence) $ 50,000 Medical Payments $ 5,000 a) Coverage shall be written on an occurrence, not claims made,form. All deviations from the standard ISO commercial general liability form CG 0001, or Business owners form BP 0002,shall be clearly identified. b) Include endorsement indicating that coverage is primary and non-contributory. c) Include an endorsement that deletes any fellow employee exclusion.d) Include additional insured endorsement for: The City of Dubuque, including all its elected and appointed officials,all its employees and volunteers, all its boards, commissions and/or authorities and their board members,employees and volunteers. Use ISO form CG 2026. B) AUTOMOBILE LIABILITY $1,000,000(Combined Single Limit) C) LIQUOR LIABILITY $1,000,000 (only if alcoholic beverages served) THE CITY OF I*JI 1111 ,w> ,,,,,,.„„„.„ DUB ' -di E Masterpiece on the Mississippi COALS & PRIORITIES _ yea ✓ "O " ` ue,Ctt Council co etes Its anntaal=oal settin 'sessions Over the course oft ro Each yearn fihe ubuq y rnpl g g days In August 2015 and another session In October CltyCouncll members reaffirmed the 15 year vision r statement,mission statement, and£goals They'al so identified priorities fora1015 2017 policy agenda ".._.,_"£1. 2030 VISION STATEMENT CITY MISSION STATEMENT The city of Dubuque is a progressive,sustainable city with a strong diversified economy The City's Mission is to deliver excellent municipal services and expanding global connections.The Dubuque community is an inclusive community that support urban living and a sustainable city plan for the celebrating culture and heritage and has actively preserved our Masterpiece on the community's future and facilitate access to critical human Mississippi.Dubuque citizens experience healthy living and retirement through quality, services which result in financially sound government and livable neighborhoods with an abundance of fun things to do;and are engaged in the citizens getting services and value for their tax dollar. community,achieving goals through partnerships.Dubuque City government is financially sound and is providing services with citizens getting value for their tax dollar. / of � ' ��,27::::::::::::411::„:,,,,-,-,,F,,:!yr,f,-,tY,,,,E.A.,,,RAPR„ft.:,,_:0„:6,,A,hriti!"-,iTikl-I,N:v,:A4,1:m,-,0,,e,,,,r10, ; 014 � � ��j -, " -� i.� � ; � ?y/ � / /_/ s�¢ 2015-2017 POLICY AGENDA TOP PRIORITIES (in alphabetical order) ? HIGH PRIORITIES (in alphabetical order) • East-West Corridor Study Implementation • Central Iowa Water Association Goal:Improved Connectivity Key Issues:Property Goal:Planned and Managed Growth Key Issues:Annexation,funding, aquisition,environmental assessment,funding for water infrastucture design and construction of roundabouts • City Economic Development * Environmental Stewardship Commission Goal:Economic Prosperity Key Issues:Review staffing levels and (Community Resiliency Commission) partners,funding,goals and performance expectations Goal:Environmental/Ecological Integrity Key Issues: • Citywide Flower Planting Program Purpose and role of commission,determine process for Goal:Partnering for a Better Dubuque Key Issues:Policy on use of community engagement,size and diverse volunteers,policy of location(s)for existing or new plantings and type representation of community,staff support and funding of plant(annual vs. perennial),funding and hiring freeze,on-going • Historic Millwork District Parking(470 spaces) operation and maintenance costs Goal:Improved Connectivity Key Issues:Land acquisition, • Comprehensive Plan funding Goal:Planned and Managed Growth Key Issues:Funding,community • Inclusive Dubuque Action Plan assessment and input process Goal:Social/Cultural Vibrancy Key Issues:Community ▪ Debt Reduction Policy engagement process on development of action plan for Goal:Financially Responsible City Government and High Performance priority areas,City role as a partner in implementation of Organization Key Issues:Education for general public and for city staff, action plan continued implementation of strategic debt reduction • Street Maintenance Program • Methane Gas Plan Goal:Improved Connectivity Key Issues:Evaluate existing Goal:Environmental/Ecological Integrity Key Issues:Identify service level targets,Funding to restore or expand service opportunities for methane gas reuse in city operations including level targets i Bio CNG,development agreement for methane gas reuse • Surveillance Camera Funding Goal:Social/Cultural Vibrancy Key Issues:Evaluate types of cameras for future purchase,funding and location of additional cameras,use and storage of data and information AC® CERTIFICATE OF LIABILITY INSURANCE DATE IMM/DD/YYYY) ‘kw../-- 6/13/2016 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 Mike Felderman CONTACT NAME: Mike Felderman English Insurance Agency, Inc. PHONE o.Ext): (563)557-7440 jAAic ,No):(563)563-9142 0'Connor & English Insurance ADDRIESS:mfelderman@english-insurance.com 1545 Associates Dr. , Suite 103 INSURER(S)AFFORDING COVERAGE NAIC# Dubuque IA 52002 INSURER Nest Bend Mutual Insurance Company 15350 INSURED INSURER B Markel Insurance 38970F Crescent Community Health Center INSURER C: 1789 Elm St INSURERD: Ste A INSURER E Dubuque IA 52001-2256 INSURERF: COVERAGES CERTIFICATE NUMBER:16-17 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 ADDL SUBR POLICY EFF POLICY EXP LTR, TYPE OF INSURANCE INSD WVD POLICY NUMBER JMM/DD/YYYYUMM/DD/YYYYL LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE X OCCUR PARENTED 300,000 PREEMISMIS ES((Ea occurrence) $ X A112090 3/6/2016 3/6/2017 MED EXP(Any one person) _ $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GE AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO LOC PRODUCTS-COMP/OPAGG $ 3,000,000 PRO- JECT _ OTHER: Employee Benefits $ AUTOMOBILE LIABILITY (Ea aBINEDtSINGLE LIMIT $ 1,000,000 A ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED A112090 3/6/2016 3/6/2017 BODILY INJURY(Pident) $ AUTOS AUTOS (Per _ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS (Per accident) • Hired/Non-owned Phys Dmg $ Included X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED X RETENTION$ waived A112090 3/6/2016 3/6/2017 $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE - E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? n N/A B (Mandatory in NH) WC0169478-01 3/6/2016 3/6/2017 E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES IACORD 101,Additional Remarks Schedule,may be attached if more space is required) The certificate holder is included as an additional insured to general liability by Endorsement #BP0450Y-Additional Insured - Owners, Lessees or Contractors-Schedule Person or Organization. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Dubuque THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 50 West 13th Street ACCORDANCE WITH THE POLICY PROVISIONS. Dubuque, IA 52001 AUTHORIZED REPRESENTATIVE Mike Felderman/BRENDA �� ��e�` ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS0251201401/