HomeMy WebLinkAboutPeterson Contractors Inc-2/7/2011FORM OF CONTRACT
CONTRACT FOR THE CONSTRUCTION OF
F.Y. 2011 CATTLE CONGRESS STORM WATER PUMP STATION
CITY OF WATERLOO, IOWA
CONTRACT NO. 801
This contract made and entered into this day of
, 20\ , by and
between the City of Waterloo, Iowa, a Municipal Corporation, (hereinafter referred to
as City), and PETERSON CONTRACTORS, INC., of Reinbeck, Iowa, (hereinafter
referred to as Contractor), WITNESSETH:
PAR. 1
PAR. 2
PAR. 3
Contractor agrees to build and construct the F.Y. 2011 CATTLE
CONGRESS STORM WATER PUMP STATION (DIVISIONS 1 & 2 +
ALTERNATES A & B), CONTRACT NO. 801 , and furnish all necessary
tools, equipment, materials,. and labor necessary to do all the work called
for in the plans and specifications in a workmanshiplike manner and for
the prices set forth in Contractor's proposal, which was accepted by the
City, and which is understood and agreed to be a part of this contract.
It is understood and agreed that the resolution adopted by the City Council
ordering the construction of the improvement, the Notice to Contractors as
published, the Instruction to Bidders, the Form of Proposal, the
Construction and Maintenance Bonds, the Council Proceedings relating to
this matter, and the Plans and Specifications shall all be considered as
forming a part of the contract the same as though they were each set out
in said contract.
The Contractor agrees to furnish at its own cost and expense, all
necessary materials and labor for said work and to construct said
improvements in a thorough, substantial, and workmanlike manner, and in
strict accordance with the requirements of this contract, and of the plans
and specifications made a part hereof by reference, and to the satisfaction
and approval of the City and its engineer.
FORM OF CONTRACT PAGE 1 OF 5 PAGES
PAR. 4
PAR. 5
PAR. 6
PAR. 7
PAR. 8
PAR. 9
The Contractor agrees to perform said work and install said improvements
on the terms set out in bid or proposal to the City which has been
accepted by the City and which is by reference made a part of this
contract.
The Contractor agrees to commence said work within ten (10) working
days after receipt of "Notice to Proceed" and complete it on or before
August 30, 2011 , unless an extension of time is granted in writing by the
Council of the City.
Should the Contractor fail to complete said improvements in strict
accordance with the terms and conditions of this contract, or the plans and
specifications therefor promptly by the date herein specified, the City may
pay such additional sums as it may be required to pay by reason of the
failure of said contractor and deduct any and all such sums from any
amount then due the Contractor.
The Contractor agrees to comply with and obey all ordinances of the City
of Waterloo, Iowa, relating to the obstruction of streets and alleys, keeping
open passage ways for water, traffic, and protecting any excavations in
any street or alley, and maintaining proper and sufficient barricades with
lights and signals during all hours of darkness, to see that the backfilling is
properly done, and agrees to keep the City whole and defend any and all
suits that may be brought against the City by reason of any injuries that
may be sustained by any person or property allegedly caused by the
Contractor, or his agents, while work is done pursuant to this agreement.
The Contractor agrees that in the event a law suit is brought against the
City for damages allegedly sustained by reason of any act, omission or
negligence of the Contractor or its agents, or on account of any injuries
allegedly sustained by reason of any obstruction, hole, depression or
barrier placed or dug by the defendant or its agents, in the doing of the
work herein contracted for, that it will defend said suit and save the City
harmless therein, and in case judgment is rendered against the City, the
Contractor agrees to pay the same promptly. The Contractor agrees to
carry public liability insurance in a solvent company in a sufficient amount
to protect the City and those who use the streets of the City.
The City shall have the right to appoint one or more construction reviewers
who shall review the progress of the work in detail; also, to make any test
or any material to be used in such work. No material shall be used in any
work until the same has first been approved by the construction reviewer.
Such construction reviewer shall have full authority to pass judgment upon
all materials and upon the manner of doing the work, and their judgment
on rejecting any materials, substance, or manner of work shall be final
unless it is revoked or modified by the City Engineer.
FORM OF CONTRACT PAGE 2 OF 5 PAGES
PAR. 10
PAR. 11
PAR. 12
Any material, which has been rejected by the construction reviewer, shall
be at once removed from the line of work and shall not be again taken
thereon or placed with the material proposed to be used without the
written consent of the City Engineer.
The Contractor shall maintain no cause of action against the City on
account of delays and prosecution of work, but if said work is delayed by
the City, the Contractor shall have such extra time for completion of the
job as was lost by reason of the delay caused by the City.
The Contractor agrees to pay punctually all just claims of labor, material,
men, or subcontractors who shall perform labor or furnish materials
entering into this improvement. It is agreed that the City need not pay the
Contractor until all such claims are paid by the Contractor. It is agreed
that the City shall not be liable for said labor, material, or men under this
contract.
PAR. 13 The Contractor agrees to furnish the City, simultaneously with this
contract, a bond on a form to be provided by the City in the amount
provided by law as stated in the Notice to Bidders, which shall be for the
benefit of the City, and any and all persons injured by the breach of any of
the terms of this contract. Said bond shall be filed with the City Clerk and
shall be subject to the approval of the City Council, and is by reference
made a part of this contract.
PAR. 14
PAR. 15
The Contractor agrees that should it abandon work under this contract or
cease the prosecution thereof for a period of thirty (30) consecutive days
without reasonable cause, and should it fail to proceed with said work
within ten (10) days after a notice to continue or carry it on has been
mailed to it at the address given herein by the City, or after such notice
has been served on it, then the City may proceed to complete said work,
using any material, tools, or machinery found along said line of work,
doing the work either by contract or as it may elect, and the Contractor
and the sureties on its bond shall be liable to the City for the costs and
expenses so paid out. Said costs shall be retained by the City from any
compensation due, or to become due the Contractor, and may be
recovered by the City in an action upon Contractor's bond.
In consideration of the full compliance on the part of the Contractor with all
the provisions, stipulations, and conditions hereof, or contained in the
various instruments made a part of this contract by reference, and upon
completion and acceptance of said work, the City agrees to pay to the
Contractor, in the manner set out in the Notice to Contractors, the amount
of money due the Contractor for work performed and accepted, at the unit
prices set out in the Contractor's proposal, which has been accepted by
the City.
FORM OF CONTRACT PAGE 3 OF 5 PAGES
PAR. 16
PAR. 17
PAR. 18
PAR. 19
PAR. 20
PAR. 21
The total amount of the contract, based on the Engineer's estimates of
quantities and the Contractor's unit bid prices, and for which 100% surety
bond is required is $1,078,215.75.
After the completion of said work, the Contractor agrees to remove all
debris and clean up said streets, and to save the City harmless from any
damage allegedly resulting from a failure to clean up and remove the
debris or put the street back in a proper condition for travel.
This contract is not divisible, but in the event of a conflict between this
contract and the various instruments incorporated by reference, this
contract shall govern.
Before the Contractor shall be entitled to receive final payment for work
done under this contract, it shall execute and file a bond in the penal sum
of not Tess than 100% of the total amount of the contract, same to be
known as "Maintenance Bond," and which bond must be approved by the
City Council, and which bond is in addition to the bond given by the
Contractor to guarantee the completion of the work.
The Contractor shall maintain all work done hereunder in good order for
the period of two (2) years from and after the date it is accepted by the
Council of the City of Waterloo, Iowa. Said maintenance shall be made
without expense to the City or the abutting property. In the event of the
failure or default of the Contractor to remedy any or all defects appearing
in said work within a period of two (2) years from the date of its
acceptance by said Council, and after having been given ten (10) days
notice so to do by registered letter deposited in the United States Post
Office in said town, addressed to said contractor at the address herein
given, then the City may proceed to remedy such defects. The costs and
expenses thereof to be recovered from the Contractor and the sureties on
its maintenance bond by an action brought in any court of competent
jurisdiction.
The Contractor shall give notice to said City by registered letter directed to
the Mayor or City Clerk/Auditor thereof not more than four (4) and not less
than three (3) months prior to the expiration of the term during which the
Contractor is required to maintain said improvements, in good repair by
the terms of its Contract. The liability of the Contractor and of the sureties
on its bond for maintenance of the said improvements shall continue until
three (3) months after such notice has been given to the City, and, in any
event, until two (2) years after the acceptance of the work.
FORM OF CONTRACT PAGE 4 OF 5 PAGES
CITY OATERLOO, IOWA
ayor
City Clerk
AI, c-,,
eCI 1
S
Contract
BY: ClCIy. a03-11A-4-tv
Title:
Approved by the City Council of the City of Waterloo, Iowa, this
day of Ip Q , 20 V .
ATTEST: �.
, City Clerk
Waterloo, Iowa
FORM OF CONTRACT PAGE 5 OF 5 PAGES
PERFORMANCE BOND Bond No. 105464417
KNOW ALL MEN BY THESE PRESENTS:
That we, PETERSON CONTRACTORS, INC. , of Reinbeck, Iowa
(hereinafter called the Principal), and TRAVELERS CASUALTY AND SURELY COMPANY OF
of Hartford, CT
(hereinafter called the Surety), are held and firmly bound unto the City of Waterloo
(hereinafter called the Obligee), in the penal sum ONE MILLION SEVENTY-EIGHT
THOUSAND TWO HUNDRED FIFTEEN AND 751100 ----Dollars ($1,078,215.75 ),
lawful money of the United States, to payment of which sum, well and truly to be
made, the Principal here firmly binds himself/themselves, his/their heirs, executors,
and administrators, and the said Surety binds himself, his successors, assigns,
executors, and administrators, jointly and severally, firmly by these presents.
AMERICA
THE CONDITION OF THIS OBLIGATION is such that,
HEREAS the above bounden Principal did, on the 6 day of
, 2011, enter into a written contract with the City
of Waterloo, Iowan for the construction of F.Y. 2011 CATTLE CONGRESS STORM
WATER PUMP STATION (DIVISIONS 1 & 2 + ALTERNATES 1 & 2), CONTRACT
NO. 801 , a copy of which contract, together with all of its terms, covenants,
conditions, and stipulations, is incorporated herein and made a part hereof as full
and completely as if said contract were recited at length herein; and
WHEREAS, the Principal and Surety on this bond hereby agree to pay to all
persons, firms or corporations having contracts directly with the Principal or with
subcontractors, all just claims due them for labor performed or materials furnished in
the performance of the contract on account of which bond is given when the same
are not satisfied out of the portion of the contract price which the public corporation
is required to retain until completion of the public improvement, but the Principal and
Surety shall not be liable to said persons, firms, or corporation unless the claims of
said claimants against said portion of the contract price shall have been established
as provided by law.
Now, if the Principal shall in all respects fulfill his said contract according to
the terms and tenor thereof, and shall satisfy all claims and demands incurred for
the same, and shall fully indemnify and save harmless the Obligee from all costs
and damages which it may suffer by reason of failure to do so, and shall fully
reimburse and repay the Obligee all outlays and expenses which it may incur in
making good any such default, then the obligation is to be void and of no effect,
otherwise to remain in full force and effect.
FORM OF BOND PAGE 1 OF 2 PAGES
Every Surety on this bond shall be deemed and held, any contract to the
contrary notwithstanding, to consent without notice:
1. To any extension of time to the contract in which to perform the
contract.
2. To any change in the plans, specifications, or contract when such
change does not involve an increase of more than twenty percent
(20%) of the total contract price, and shall then be released only as to
such excess increase.
3. That no provision of this bond or of any other contract shall be valid
which limits to less than one (1) year from the time of the acceptance
of the work the right to sue on this bond for defect in workmanship or
material not discovered or known to the Obligee at the time such work
was accepted.
IN WITNESS WHEREOF, we have hereunto set our hands and seals this
day of , 20
PETERSON CONTRACTORS, INC.
Principal
By:(Z0-012-
a or clot\ \:)e-}exsort1
Pre s,de rr-1-
TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA
Surety
tf
omey-in-Fact - v; anrL s. R;1 ey
FORM OF BOND PAGE 2 OF 2 PAGES
PAYMENT BOND Bond No. 105464417
KNOW ALL MEN BY THESE PRESENTS: that
PETERSON CONTRACTORS, INC.
(Name of Contractor)
P.O. Box A, Reinbeck, IA 50669
a Corporation
and
(Address of Contractor)
, hereinafter called Principal,
(Corporation, Partnership or Individual)
TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA
(Name of Surety)
One Tower Square, Hartford, CT 06183
(Address of Surety)
hereinafter called Surety, are held and firmly bound unto CITY OF WATERLOO
(Name of Owner)
715 Mulberry Street, Waterloo, IA 50703
(Address of Owner)
One Million Seventy -Eight Thousand Two Hundred
hereinafter called OWNER, in the penal sum of Fifteen and 75/loo--Dollars, $(1,078,215.75 )
in lawful money of the United States, for the payment of which sum well and truly to be made,
we bind ourselves, successors, and assigns, jointly and severally, firmly by these presents.
THE CONDITION OF THIS OBLIGATION is such that whereas, the Principal entered into a
certain contract with the OWNER, dated the`- day of .v
20 11 , a copy of which is hereto attached and made a part hereof for the construction of: J
F.Y. 2011 CATTLE CONGRESS STORM WATER PUMP STATION (DIVISIONS 1 & 2 + ALTERNATES 1 & 2),
CONTRACT NO. 801
NOW, THEREFORE, if the Principal shall promptly make payment to all persons, firms,
SUBCONTRACTORS, and corporations furnishing materials for or performing labor in the
prosecution of the WORK provided for in such contract, and any authorized extension or
modification thereof, including all amounts due for materials, lubricants, oil, gasoline, coal and
coke, repairs on machinery, equipment and tools, consumed or used in connection with the
construction of such WORK, and all insurance premiums on said WORK, and for all labor,
performed in such WORK whether by SUBCONTRACTOR or otherwise, then this obligation
shall be void; otherwise to remain in full force and effect.
PROVIDED, FURTHER, that the said Surety for value received hereby stipulates and agrees
that no change, extension of time, alteration or addition to the terms of the contract or to the
WORK to be performed thereunder or the SPECIFICATIONS accompanying the same shall in
any wise affect its obligation on this BOND, and it does hereby waive notice of any such change,
extension of time, alteration or addition to the terms of the contract or to the WORK or to the
SPECIFICATIONS.
PROVIDED, FURTHER, that no final settlement between the OWNER and the CONTRACTOR
shall abridge the right of any beneficiary hereunder, whose claim may be unsatisfied.
IN WITNESS HEREOF, this instrument is executed in
which shall be deemed an original, this the
20 11 .
ATTEST:
elide
K t(Principal) Secretary
ctnctA
(SEAL)
Ne E
Witness as to Principal e_..cmh, �i , 'T-ct\K��-} s
P.O. Box A
(Address)
Reinbeck, IA 50669
ATTEST:
Witness as to Surety
ndy Bennett
Holmes Murphy & Associates, Inc.
(Address)
P.O. Box 9207, Des Moines, IA 50306-9207
Six (6) counterparts, each one of
(number)
day of.
PETERSON CONTRACTORS, INC.
By
Principal
C__A:7rc4e\\ C Qeier vl, ire. -5% f
P.0 Box A
(Address)
Reinbeck, IA 50669
TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA
Surety
By
/
Attomey-i Fact -
ianne S. Riley
Holmes Murphy & Associates, Inc.
(Address)
P.O. Box 9207, Des Moines, IA 50306-9207
NOTE: Date of BOND must not be prior to date of Contract.
If CONTRACTOR is Partnership, all partners should execute BOND.
TRAVELERS J
Attorney -In Fact No.
WARNING: THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER
POWER OF ATTORNEY
Farmington Casualty Company
Fidelity and Guaranty Insurance Company
Fidelity and Guaranty Insurance Underwriters, Inc.
St. Paul Fire and Marine Insurance Company
St. Paul Guardian Insurance Company
221980
St. Paul Mercury Insurance Company
Travelers Casualty and Surety Company
Travelers Casualty and Surety Company of America
United States Fidelity and Guaranty Company
Certificate No, 003874153
KNOW ALL MEN BY 1'HESE PRESENTS: That St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance Company and St. Paul Mercury Insurance
Company are corporations duly organized under the laws of the State of Minnesota, that Farmington Casualty Company, Travelers Casualty and Surety Company, and
Travelers Casualty and Surety Company of America are corporations duly organized under the laws of the State of Connecticut, that United States Fidelity and Guaranty
Company is a corporation duly organized under the laws of the State of Maryland, that Fidelity and Guaranty Insurance Company is a corporation duly organized under
the laws of the State of Iowa, and that Fidelity and Guaranty Insurance Underwriters, Inc., is a corporation duly organized under the laws of the State of Wisconsin
(herein collectively called the "Companies"), and that the Companies do hereby make, constitute and appoint
Craig E. Hansen, Dianne S. Riley, Jay D. Freiermuth, Brian M. Deimerly, Cindy Bennett, Anne Crowner, Laure K. Guisinger,
Tim McCulloh, and Stacy Venn
of the City of West Des Moines , State of Iowa , their true and lawful Attorney(s)-in-Fact,
each in their separate capacity if more than one is named above, to sign, execute, seal and acknowledge any and all bonds, recognizances, conditional undertakings and
other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of
contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law.
IN WITNESS WHEREOF, the Companieshave caused this instrument to be signed and their corporate seals to be hereto affixed, this 6th
day of
January LU0
State of Connecticut
City of Hartford ss.
Farmington Casualty Company
Fidelity and Guaranty Insurance Company
Fidelity and Guaranty Insurance Underwriters, Inc.
St. Paul Fire and Marine Insurance Company
St. Paul Guardian Insurance Company
St. Paul Mercury Insurance Company
Travelers Casualty and Surety Company
Travelers Casualty and Surety Company of America
United States Fidelity and Guaranty Company
By:
On this the 6th day of January 2010 before me personally appeared George W. Thompson, who acknowledged
himself to be the Senior Vice President of Farmington Casualty Company, Fidelity and Guaranty Insurance Company, Fidelity and Guaranty Insurance Underwriters,
Inc., St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance Company, St. Paul Mercury Insurance Company, Travelers Casualty and Surety
Company, Travelers Casualty and Surety Company of America, and United States Fidelity and Guaranty Company, and that he, as such, being authorized so to do.
executed the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer.
In Witness Whereof, I hereunto set my hand and official seal.
My Commission expires the 30th day of June, 2011.
58440-4-09 Printed in U.S.A.
V\W vti/" C .
`Mane C. Tetreault, Notary Public
WARNING: THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER
WARNING: THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER
This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of Farmington Casualty Company, Fidelity
and Guaranty Insurance Company, Fidelity and Guaranty Insurance Underwriters, Inc., St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance
Company, St. Paul Mercury Insurance Company, Travelers Casualty and Surety Company, Travelers Casualty and Surety Company of America, and United States
Fidelity and Guaranty Company, which resolutions are now in full force and effect, reading as follows:
RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President, any Vice President, any Second Vice
President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint Attorneys -in -Fact and Agents to act for and on behalf
of the Company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the
Company's seal bonds, recognizances, contracts of indemnity, and other writings obligatory in the nature of a bond, recognizance, or conditional undertaking, and any
of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her; and it is
FURTHER RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President may
delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided that each such delegation is in writing and a copy
thereof is filed in the office of the Secretary; and it is
FURTHER RESOLVED, that any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance, or conditional undertaking
shall be valid and binding upon the Company when (a) signed by the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice
President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the
Company's seal by a Secretary or Assistant Secretary; or (b) duly executed (under seal, if required) by one or more Attorneys -in -Fact and Agents pursuant to the power
prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority; and it is
FURTHER RESOLVED, that the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President, any Vice President,
any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to any Power of Attorney or to any
certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attorneys -in -Fact for purposes only of executing and attesting bonds
and undertakings and other writings obligatory in the nature thereof, and any such Power of Attomey or certificate bearing such facsimile signature or facsimile seal
shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding on
the Company in the future with respect to any bond or understanding to which it is attached.
I, Kori M. Johanson, the undersigned, Assistant Secretary, of Farmington Casualty Company, Fidelity and Guaranty Insurance Company, Fidelity and Guaranty Insurance
Underwriters, Inc., St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance Company, St. Paul Mercury Insurance Company, Travelers Casualty and
Surety Company, Travelers Casualty and Surety Company of America, and United States Fidelity and Guaranty Company do hereby certify that the above and foregoing
is a true and correct copy of the Power of Attorney executed by said Companies, which is in full force and effect and has not been revoked.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this
day of
2011
Kori M. Johans.W Assistant Secretary
To verify the authenticity of this Power of Attorney, call 1-800-421-3880 or contact us at www.travelersbond.com. Please refer to the Attorney -In -Fact number, the
above-named individuals and the details of the bond to which the power is attached.
WARNING: THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER
A �® CERTIFICATE OF LIABILITY INSURANCE
DATE 1/ a �'1
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
LSB Financial
219 Main Street
Cedar Falls, IA 50613
Phone: 319-268-4242 Fax: 319-268-4211
CONTACTNAME:
PHONE FAX
IA1C. No. Extl: (A/C, Nol:
E-MAIL
ADDRESS:
PRODUCER PETER -3
CUSTOMER ID #:
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURED
Peterson Contractors, Inc.
Reinbeck Motors, Inc.
PO Box A / 104 Blackhawk St
Reinbeck, IA 50669
INSURER A : Zurich American Ins Co
16535
INSURER B : Axis Surplus Insurance Co
26620
INSURER C:
07/01/11 P
INSURER D :
$ 1,000,000
INSURER E :
GE TO RENTEDA
PREMISES (Ea occurrence)
INSURER F :
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
TYPE OF INSURANCE
ADDL
NSR
SWVD
POLICY NUMBER
(MMIDUBR DIYYYY
YY)
POIJCY r
(MM/DDIYYYYI
LIMITS
GENERAL
LIABILITY
COMMERCIAL GENERAL LIABILITY
OCCUR
GL0926706500
07/01/10
07/01/11 P
EACH OCCURRENCE
$ 1,000,000
X
GE TO RENTEDA
PREMISES (Ea occurrence)
$ 300,000
CLAIMS -MADE
MED EXP (Any one person)
$ 10,000
X
Blnkt Contractual
PERSONAL & ADV INJURY
$ 1,000,000
X
XCU Coverage
GENERAL AGGREGATE
$ 2,000,000
GEN'L
AGGREGATE UMR APPLIES PER:
POLICY n 78-1: n LOC
PRODUCTS - COMP/OP AGG
$ 2,000,000
n
$
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
BAP92670660
07/01/10
07/01/11
COMBINED SINGLE LIMIT
(Ea accident)
$ 2,000,000
X
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
X
X
$
B
X
UMBRELLA UABI X
EXCESS LIAB
OCCUR
CLAIMS -MADE
EAU753420/01/2010
07/01/10
07/01/11
EACH OCCURRENCE
$ 1,000,000
AGGREGATE
$ 1,000,000
DEDUCTIBLE
RETENTION $ 10,000
$
X
$
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVEE.L.
OFFICER/MEMBER EXCLUDED?
(Mandatory In NH)
f yes, desaibe under
SPFCIAI PPM/MIMIC halnw
Y / N
N/A
WC9267067-00
07/01/10
07/01/11
X TORY LIM S OTT-
EACH ACCIDENT
$ 1,000,000
Y
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
A
A
Cargo
Rent/Lease Equip
MCP9267064-00
MCP9267064-00
07/01/10
07/01/10
07/01/11
07/01/11
800,000
1,000,000
DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required)
FOR THE PROJECT DESCRIBED AS 2011 CATTLE CONGRESS STORM WATER PUMP STATION, WATERLOO, IA, THE CITY OF WATERLOO, IA IS
NAMED AS AN ADDITIONAL INSURED PER WRITTEN CONTRACT REQUIREMENTS. PCI # J3340
CITY OF WATERLOO, IOWA
715 MULBERRY ST
WATERLOO, IA 50703
I
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE
POLICY PROVISIONS.
AUTIIORUDED REPRESENTATIVE
ACORD 25 (2009/09)
- 2009 ACORD GORPVRATION. All rights reserved.
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