HomeMy WebLinkAbout2025-09-15 I01E_02 SE LA Grant Pkwy-SE Esker Ridge Dr Traffic Signal_Approve Contract, BondAGENDA ITEM:
CITY OF WAUKEE, IOWA
CITY COUNCIL MEETING COMMUNICATION
MEETING DATE: September 15, 2025
AGENDA ITEM:Consideration of approval of a resolution approving contract and bond
[SE L.A. Grant Parkway & SE Esker Ridge Drive Traffic Signal Project]
FORMAT:Resolution
SYNOPSIS INCLUDING PRO & CON:
FISCAL IMPACT INCLUDING COST/BENEFIT ANALYSIS:$ 235,174.21
COMMISSION/BOARD/COMMITTEE COMMENT:
STAFF REVIEW AND COMMENT:
RECOMMENDATION: City staff recommends approving contract and bond with Iowa
Signal, Inc., of Grimes, IA, in the amount of $ 235,174.21.
ATTACHMENTS: I. Proposed resolution
II. Contract, Bond
PREPARED BY: Becky Schuett
REVIEWED BY:
I1E2
RESOLUTION 2025-
RESOLUTION APPROVING CONSTRUCTION CONTRACT
AND BOND FOR THE SE LA GRANT PKWY & SE ESKER
RIDGE DR. TRAFFIC SIGNAL
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF WAUKEE, STATE
OF IOWA:
That the construction contract and bond executed and insurance coverage for the
construction of certain public improvements described in general as the SE LA Grant Pkwy & SE
Esker Ridge Dr. Traffic Signal, and as described in detail in the plans and specifications heretofore
approved, and which have been signed by the Mayor and Clerk on behalf of the City be and the
same are hereby approved as follows:
Contractor:Iowa Signal, Inc.,of Grimes, IA
Amount of bid:$235,174.21
Bond surety:Old Republic Surety Company
Date of bond:September 2, 2025
Portion of project:All construction work
PASSED AND APPROVED this 15th day of September, 2025.
Mayor
ATTEST:
City Clerk
CONTRACT
CONTRACT NO.
DATE crab /15-
THIS CONTRACT, made and entered into this, the day of 2025, by and
between the City of Waukee, lowa, by its Mayor, upon order of its City Council
hereinafter called the "Owner", and
lowa Siqnal, Inc. , hereinafter called the "Contractor".
WITNESSETH:
The Contractor hereby agrees to complete the work comprising the below referenced
improvements as specified in the Contract Documents, which are officially on file with
the City in the office of the City Clerk . This contract includes all Contract
Documents.
The term "Contract Documents" means and includes the following:
Notice of Public Hearing
Notice to Bidders
Instructions to Bidders
Proposal
Bid Bond
Contract
Performance Bond
Regulations of the Contract
Supplemental Regulations
Special Conditions
Detailed Specifications
Plans Numbered A.1 through 5.1
Standard Drawings
Addenda Number 1 through 2
Change Orders Number through
Notice to Proceed
Contract Page 1 of 6
The work under this contract shall be constructed in accordance with the current
editions of the City of Waukee Specifications for Public Improvements and SUDAS
Standard Specifications, and as further modified by the supplemental specifications and
special provisions included in said contract documents. The Contractor further agrees
to complete the work in strict accordance with said contract documents, and to
guarantee the work as required by law, for the time required in said contract documents,
after its acceptance by the City.
This contract is awarded and executed for completion of the work specified in the
contract documents for the bid prices shown on the Proposal, which were proposed by
the Contractor in its proposal submitted in accordance with the Notice to Bidders and
Notice of Public Hearing for the following described improvements:
Removal of the existing span-wire traffic signal and construction of a new traffic
signal at the intersection of SE LA Grant Pkwy and SE Esker Ridge Dr.
The Contractor agrees to perform said work for and in consideration of the City's
payment of the bid amount of TWO HUNDRED THIRTY-FIVE THOUSAND ONE
HUNDRED SEVENTY-FOUR AND 21/100 DOLLARS ($235,174.21) which amount shall
constitute the required amount of the performance, maintenance, and payment bond.
The Contractor hereby agrees to commence work under this contract on or before a
date to be specified in a written notice to proceed by the City and to fully complete the
project by Auqust 3, 2026; and to pay damages for noncompliance with said completion
provisions at the rate of seven hundred and fifty ($750) for each calendar day thereafter
that the work remains incomplete.
IN WITNESS WHEREOF, the Parties hereto have executed this instrument, in triplicate
on the date first shown written.
Contract Page 2 of 6
CITY OF WAUKEE, IOWA
CONTRACTOR
Courtney Clarke, Mayor
lowa Siqnal, Inc.
Contractor
(Seal)
ATTEST:
BV
Signature
P(rt Wr, P
Title
3711 SE Capitol Circle
Street Address
Rebecca D. Schuett, City Clerk
Grimes, IA 50111
City, State, Zip Code
515-249-5076
Telephone
CONTRACTOR PUBLIC REGISTRATION INFORMATION TO Be Provided By:
1. All Contractors: The Contractor shall enter its Public Registration Number {:=Q 9 ";-
'i 7 5 issued by the lowa Commissioner of Labor pursuant to Section 91C.5 of the
lowa Code.
2. Out of State Contractors:
A. Pursuant to Section 91C.7 of the lowa Code, an out-of-state contractor, before
commencing a contract in excess of five thousand dollars in value in lowa, shall
file a bond with the division of labor services of the department of workforce
development. It is the contractor's responsibility to comply with said Section
91 C.7 before commencing this work.
Contract Page 3 of 6
B. Prior to entering into contract, the designated low bidder, if it is a corporation
organized under the laws of a state other than lowa, shall file with the Engineer a
certificate from the Secretary of the State of lowa showing that it has complied
with all the provisions of Chapter 490 of the lowa Code, or as amended,
governing foreign corporations.
Note: All signatures on this contract must be original signatures in ink; copies, facsimile, or
electronic signatures will not be accepted.
CORPORATE ACKNOWLEDGMENT:
State of "'f (> I.,) (,
Pc xi<County)
) SS
On this S day of S <.,it/-,-bi br.- , 20 4-before me, the undersigned, a Notary Public in and for
the State of I/)).),- , personally appeared (-,Ot,, ,.i, 7 r-sk and , to
me known, who, being by me duly sworn, did say that they are the Prp,,,l,. y , and
respectively, of the corporation executing the foregoing instrument; that
(no seal has been procured by) (the seal affixed thereto is the seal of) the corporation; that said
instrument was signed (and sealed) on behalf of the corporation by authority of this Board of
of the instrument to be the voluntary act and deed of the corporation, by it and by them
voluntarily executed.
i5 4.pC(,:;-91;$""7'a';"177N6
July 25, 2@2-7
Notary Public in and for the State of
My commission expires 'J, r,, ,7b'-
liwc
, 20 !7
Contract Page 4 of 6
PARTNERSHIP ACKNOWLEDGMENT:
State of
County)
) SS
On this day of , 20 before me, the undersigned, a Notary Public in and for
to me personally known,the State of , personally appeared
who, being by me duly sworn, did say that the person is one of the partners of
a partnership, and that the instrument was signed on behalf of the
partnership by authority of the partners and partner and the partner acknowledged the
execution of the instrument to be the voluntary act and deed of the partnership, by it and by the
partner voluntarily executed.
Notary Public in and for the State of
My commission expires
INDMDUAL ACKNOWLEDGMENT:
State of
) SS
County)
On this day of
the State of
20 before me, the undersigned, a Notary Public in and for
ANDpersonally appeared
to me personally known to be the identical person(s) named in and who
executed the foregoing instrument and acknowledged that (he) (she) (they) executed the
instrument as (his) (her) (their) voluntary act and deed.
Notary Public in and for the State of
My commission expires
Contract Page 5 of 6
LIMITED LIABILITY COMP ANY ACKNOWLEDGMENT:
State of
) SS
County)
On this 20 before me, the undersigned, a Notary Public in and for
the State of , personally appeared to me personally known,
who, being by me duly sworn, did say that the person is of said
, that (the seal affixed to said instrument is the seal of said OR no seal
has been procured by the said) , and that the instrument was signed and
sealed on behalf of the said , by authority of its managers and the said
acknowledged the execution of the instrument to be the voluntary act and
by it voluntarily executed.deed of said
day of
Notary Public in and for the State of
My commission expires , 20
Contract Page 6 of 6
PERFORMANCE, PAYMENT, AND MAINTENANCE BOND
SURETY BOND N0. 746304"l
KNOW ALL BY THESE PRESENTS:
That we, Iowa Signal, Inc., as Principal (hereinafter the "Contractor" or "Principal" and
()1(1 Bpip11H1;(-, Siirety (',omphny , as Surety are held and firnnly bound unto
Warikee, Iowa, as Obligee (hereinafter referred to as "the Owner"), and to all persons who may
be injured by any breacli of any of the conditions of tliis Bond in the penal sum of
HUNDRED THIRTY-FIVE THOUSAND ONE HUNDRED SEVENTY-FOUR AND 21/100
DOLLARS ($235, 174.21), lawful money of the United States, for the payment of wl'iich sum,
well and truly to be made, we bind ourselves, our heirs, legal representatives and assigns, jointly
or severally, firn'ily by tliese presents.
The conditions of the above obligations are such that whereas said Contractor entered into a
contract witli the Owner, bearing date tl'ie 2nd day of September , 2025,
hereinafter the "Contract") wherein said Contractor undertakes and agrees to construct tl'ie
following described improvements:
Removal of the existing span-wire traffic signal and construction of a new traffic signal at
the intersection of SE LA Grant Pkwy and SE Esker Ridge Dr.
and to faithfiilly perform all the terms and reqriirements of said Contract witliin the time therein
specified, in a good and workinanlike manner, and in accordance with the Contract Documents.
Provided, liowever, that one year after the date of acceptance as complete of the work under the
above referenced Contract, the maintenance portion of this Bond shall continue in force but the
penal sum for maintenance shall be reduced to the sum of TWO HUNDRED THIRTY-FIVE
THOUSAND ONE HUNDRED SEVENTY-FOUR AND 21 /100 DOLLARS ($235,174.21i, WhiCh
is the cost associated witli those items sliown on the proposal and in the Contract that require a
maintenance bond period in excess of one year.
It is expressly understood and agreed by tlie Contractor and Surety in this bond that the following
provisions are a part of this Bond and are binding upon said Contractor and Surety, to-wit:
1. PERFOCE: The Contractor shall well and faithfully observe, perfonn, fulfill,
and abide by each and every covenant, condition, and part of said Contract and Contract
Documents, by reference made a part hereof, for tlie above referenced improvements, and
shall indemnify and save liarmless the Owner from all outlay and expense incurred by the
Owner by reason of tlie Contractor's default of failure to perform as required. The
contractor sliall also be responsible for tlie default or failure to perform as required under
the Contract and Contract Documents by all its subcontractors, suppliers, agents, or
employees fumishing materials or providing labor in tlie performance of the Contract.
PPM Bonds Page 1 of 5
PERFORMANCE, PAYMENT, AND MAINTENANCE BOND
In tl'ie event tliat any actions or proceedings are initiated regarding tliis Bond, tl'ie parties agree
that tlie venue thereof sl'iall be Dallas County, State of Iowa. If legal action is required by the
Owner to enforce the provisions of this Bond or to collect tlie monetary obligation incurring to
the benefit of the Owner, the Contractor and the Surety agree, jointly, and severally, to pay the
Owner all outlay and expense incurred therefor by tlie Owner. All rights, powers, and remedies
of tlie Owner liereunder shall be cumulative and not alternative and shall be in addition to all
rights, powers, and remedies given to the Owner, by law. The Owner may proceed against
surety for any amount guaranteed hereunder wliether action is brought against the Contractor or
whetl'ier tlie Contractor is joined in any sucli action(s) or not.
NOW THEREFORE, tlie condition of this obligation is sucli that if said Principal shall faithfully
perform all the promises of the Principal, as set fortli and provided in the Contract, in the
Contract Documents, and in this Bond, then tliis obligation shall be null and void, otherwise it
shall remain in full force and cffcct.
When a work, term, or phrase is rised in tliis Bond, it shall be interpreted or construed first as
defined in this Bond, the Contract, or tlie Contract Documents; second, if not defined in the
Bond, Contract or Contract Documents, it shall be interpreted or construed as defined in
applicable provisions of the Iowa Code; third, if not defined in tlie Iowa Code, it shall be
interpreted or construed according to its generally accepted meaning in the construction industry;
and fourth, if it has no generally accepted meaning in the construction industry, it shall be
interpreted or construed according to its coinmon or customary usage.
Failure to spccify or particularize shall not exclude tems or provisions not mentioned and sliall
not limit liability hereunder. Tlie Contract and Contract Documents are liereby made a part of
this Bond.
PPM Bonds Page 4 of 5
PERFORMANCE, PAYMENT, AND MAINTENANCE BOND
PrOjeCtNO. 125.0322.01
Witness our hands, in triplicate, this 2nd day of September , 2025
SURETY COUNTERSIGNED BY: PRINCIPAL:
Signature of Agent
Printed Name of Agent
Company Name
lowa Siqnal, Inc.
Contractor
By: \.
Signature
Wayne Lesley, President
Title
Company Address SURETY:
City, State, Zip Code
Company Telephone Number
Old Republic Surety Company
//'/-///
signtio?ney-in7VIA Resi4Agent
Krista K Kroeger
Printed Name of Attorney-in-Fact & IA Resident Agent
FORM APPROVED BY:
Attorney for Owner
Jester Insurance Services, Inc.
Company Name
611 5th Ave Suite 150
Company Address
Des Moines, IA 50309
City, State, Zip Code
515-350-7662
Company Telephone Number
NOTE:
1. All signatures on tliis perfonnance, payment, and maintenance bond must be original signatures in ink; copies,
facsiinile, or electronic signatures will not be accepted.
2. Tliis bond must be sealed with the Surety's raised, embossing seal.
3. The Certificate Or POWer Of Attorney accompanying thiS band IriuSt be Valid On itS faCe and sealed With tile Surety's
raised, embossing seal.
4. Tlie name and signatiire of the Surety's Attomey-in-Fact/Officer entered on this bond must be exactly as listed on the
Certificate or Power of Attorney accompanying tliis bond.
PPM Bonds Page 5 of 5
: OLD REPUBLIC SURETY COMPANY
** ***
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS: That OLD REPUBLIC SURETY COMPANY, a Wisconsin stock insurance corporation, does make, constitute and
appoint: KRISTA K. KROEGER, LISA FRENCH, JANELLE I. FRIEDMAN, NOLAN G. GRIMM, HEITH HOCKENBERRY
DALE A. ANDERSON, MARK STEARNS, EMILEE COOK of DES MONINES, IA
its true and lawful Attorney(s)-in-Fact, with full power and authority for and on behalf of the company as surety, to execute and
deliver and affix the seal of the company thereto (if a seal is required), bonds, undertakings, recognizances or other written obligations in the nature thereof,
(other than bail bonds, bank depository bonds, mortgage deficiency bonds, mortgage guaranty bonds, guarantees of /nsfa//ment paper and note
guaranty bonds, self-insurance workers compensation bonds guaranteeing payment of benefits, orblacklungbonds),asfollows:
ALL WRITTEN INSTRUMENTS
and to bind OLD REPUBLIC SURETY COMPANY thereby, and all of the acts of said Attorneys-in-Fact, pursuant to these presents, are ratified and confirmed.
This appointment is made under and by authority of the board of directors at a special meeting held on February 18, 1982.
This Power of Attorney is signed and sealed by facsimile under and by the authority of the following resolutions adopted by the board of directors of the OLD
REPUBLIC SURETY COMPANY on February 18,1982.
RESOLVED that, the president, any vice-president or assistant vice president, in coryjunction with the secretary or any assistant secretary, may appoint
attorneys-in-fact or agents with authority as defined or limited in the instrument evidencing the appointment in each case, for and on behalf of the company to
execute and deliver and affix the seal of the company to bonds, undertakings, recognizances, and suretyship obligations of all kinds; and said officers may
remove any such attorney-in-fact or agent and revoke any Power of Attorney previously granted to such person.
RESOLVED FURTHER, that any bond, undertaking, recognizance, or suretyship obligation shall be valid and binding upon the Company
(i) when signed by the president, any vice president or assistant vice president, and attested and sealed (if a seal be required) by any secretary or assistant
secretary or
(ii) when signed by the president, any vice president or assistant vice president, secretary or assistant secretary, and countersigned and sealed (if a seal be
required) by a duly authorized attorney-in-fact or agent: or
(iii) when duly executed and sealed (if a seal be required) by one or more attorneys-in-fact or agents pursuant to and within the limits of the authority
evidenced by the Power of Attorney issued by the company to such person or persons.
RESOLVED FURTHER that the signature of any authorized officer and the seal of the company may be affixed by facsimile to any Power or Attorney or
certification thereoT authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the company; and such
signature and seal when so used shall have the same force and effect as though manually affixed.
IN WITNESS WHEREOF, OLD REPUBLIC SURETY COMPANY has caused these presents to be signed by its proper officer, and its corporate seal to be
affixedthis 22nd rlpsrnf Augusi 2022
'o tl)ln ' YV
OLD REPUBLIC SURETY COMPANY
STATE OF WISCONSIN, COUNTY OF WAUKESHA - SS
On this 22nd rlqv of August22nd rlqv of Augus[ , 2Q, personally came before mFl Alan PaVl!C
Karen J Haffner,:,1-,(1 , to me known to be the individuals and officers of the OLD REPLIBLIC SURETY COMPANY
who executed the above instrument, and they each acknowledged the execution of the same, and being by me duly sworn, did severally depose and say: that
they are the said officers of the corporation aforesaid, and that the seal affixed to the above instrument is the seal of the corporation, and that said corporate seal
and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority of the board of directors of said corporation.
K%!m;pu!
September2nd
40-ffl3
ORSC 22262 (3-06)
Jester Insurance Services, Inc.
DATE iMMlDD/YYYY)
09/02/2025
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLCER. 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 have ADDITIONAL INSLIRED provisions or be endorsed.
If SLIBROGATION 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
Jester Insurance Services
611 5th Ave
Suite 150
DesMoines 14 50309
cNAME,oNTAcT Krista Kroeger
j)l
'A
10Th
IC,:,Ext): (515)350-7662 I(AjC,No)p"'x, (515)350-7662
Al
HA
IDF ,EssL, kkroeger@Jesterinsurance.com
INSURER(S) APFORDING COVERAGE NAIC #
INSURERA: Cincinnati Insurance Co 10677
1N8URED
lowa Signal, Inc.
3711 SE Capitol Circle
Grimes IA 50ffl
INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSiURER F :
COVERAGES CERTIFICATE NUMBER: 2024/25 Master REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISStlED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
iNoiCATED. 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 POLICIE:3. LIMITS SHOWN MAY HAVE BEEN REDU(ED BY PAID CLAIMS.
INSR
LTR TfPE OF INSURANCE
AuUl
1N8D
!'U)IN
WVD POLICY NUMBER
POLICY EFF
IMMiDD/YYYY)
POLICY EXP
(MM{DDNYYY)LIMIIS
A
x COMMERCIAL GENERAL LIABILITI
ICLAIMS-MADE [gl occus
EPPO510474 tl/01/2024 11/01/2025
EACH OCCURRENCE $ i,000,000
DAMAGE TO RENTED
PREMISES iEa occunence)$ 500,000
MED EXP (Any one person)$ 10,000
PERSONAL & ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
epOoTHuEcRy X j;(3 [ LOC
GENERAL AGGREGATE $ 2,000,000
PRODUCT8 - COMPIOP AGG $ 2,000,000
$
A
AUTOMOBILE LIABILITY
7qrryquro
OWNED rascheout_eo_ AuTOS ONLY LJ AuTOS
HIRED II NON-OWNED_ AuTOS ONLY 1_J AuTOS ONLY
EPPO510474 11/01/2024 11/01/2025
COMBINED SINGLE LIMIT
iEa accldentl 5 1,000,000
BODILY INJURY iPer person)s
BODILY INJURY (Per accident)$
PROPERTf DAMAGE
(Per accldent)s
$
A
x UMBRELLA LIAB
EXCE8S LIAB
x OCCUR
CLAIMS-MADE EPPO510474 11/01/2024 11/01/2025
EACH OCCURRENCE $ 5,000,000
AGGREGATE $ 5,000,000
DED I I RETENTIJN $$
A
WOF!KER8 COMPENSATION
AND tiMPLOYER8a LIABILIT/ y { N
:p;7i::gl,I':3;(47:%il%l:g:ECuTlVE [,
(Mandatory In NH)
If yes. dssc+lbe under
DESCRIPTION OF OPERATIONS below
N IA EWCO510473 11/01/2024 11/01/2025
XI S\XTuTE I I PF:"-
E.L. EACH ACCIDENT $ 500,000
E.L. DISEASE - EA EMPLOYEE $ 500,000
E.L. DISEASE - POLICY LIMIT $ 500,000
DESCRIPTION OF OF'ERATIONS I LOCATION!5 l VEHICLnEi IACORD 101 Additional Remarks Schedule, may be adached IT more space Is required)
CERTIFICATE HOLDER CANCELLATION
City of Waukee
203 Hickman Road
Waukee IA 50263
I
SHOULD ANY OF THE ABOVE DESCRIBED POLIC1E8 BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AuTHORIZEO REPRESENTATIVE
,,2q,,
@ 1988-2 €H6 ACORD CORPORATION. All rights reserved.
ACORD 25 (2018/03)The ACORD name and logo are registered marks of ACORD
DATE (MW/DD)
09/02/2025
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLCER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BEIOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTlanlTE 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 have ADDITIONAL INSLIRED provisions or 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
Jester Insurance Services
611 5thAve
Suite 150
DesMoines IA 50309
Cal
NAINW,TAcT Krista Kroeger
I
I
Pt
'A
:)h
A,Extl: (515)350-7662 iQNo, (515)350-7662
E-I
AD
IAI
OFLEss, kkroeger@]esterinsurance.com
INSURER(S) AFFORDING COVERAGE NAIC#
1HBpg@B4, Clnctnnai: Insurance CO 10677
INSuRED
lowa Signal, Inc.
3711 SE Capitol Circle
Grimes IA 50111
INSLIRER B :
INSLIRER C :
INSURER D :
INSURER E :
INSURER F :
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSuRED NAMED ABOVE FOR THE POLICY PERIOD
INDICATEa 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 SLIBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLlClEi3. LIMITS SHOWN MAY HAVE BEEN REDIJC;ED BY PAID CLAIMS.
1N8R
LTR TYPE OF INSURANCE
AUuL
1N8D
Su)4%
WVD POLICY NUMBER
POLICY EFF
iMMIDD/'m'Y)
POLICY EXP
iMNUDD/YYYY)LIMITS
A
x COMMERCIAL GENERAL LIABILITY
lcuixs-vhoe [X occus
EPPO510474 11/01/2024 11/01/2025
EACH OCCURRENCE $ 1 ,000,000
DAMAGE TO FIENTED
PREMISES lEa occunence)$ 500,000
MED EXP (Any one person)$ 10,000
PERSONAL & ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER
epOoTHuEc; [gi j:(9; @X LOC
GENERAL AGGREGATE $ 2,000,000
PRODUCTS - COMPIOP AGG $ 2,000,000
$
A
AUTOMOBILE LIABILITY
)( ANYAUTO
OWNED rl SCHEDULED_ AUTOS ONLY LJ AuTOS
HIRED II NON-OWNED_ ALITOS ONLY 1_J AuTOS ONLY
EPPO510474 11/01/2024 11/01/2025
COMBINED SINGLE LIMIT
(Ea accldent)$ 1 ,000,000
BODILY INJURY (Per person)$
BODILY INJLIRY (Per accldent)$
PROPERTY DAMAGE
iPet accldent)$
$
A
x UMBRELLA LIAB
EXCESS LIAB
x OCCUR
CIAIMS-MADE EPPO510474 11/01/2024 11/01/2025
EACH OCCURRENCE $ 5,000,000
AGGREGATE $ 5,000,000
DED I I RETENTI:IN S $
A
WOF!KERS COMPEN8AT10N
AND EMPLOYER8a LIABILITY y / N
%:ai:;g:q;(47;%il%l:g:ECUTIVE [,
(Mandatory In NH)
IT yes, descrlbe under
DESCRIPTION OF OPERATIONS below
N /A EWCO510473 11/01/2024 11/01/2025
XI STAuTE I I gR"-
E.L. EACH ACCIDENT $ 500,000
E.L. DISEASE-EA EMPLOYEE $ 500,000
E.L. DISEASE-POLICY LIMIT $ 500,000
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD l01 Additional Remarks Schedule, may be a fached if more space is required)
CERTIFICATE HOLDER
CERTIFICATE NUMBER: 2024/25 Master REVISION NUMBER:
CANCELLATION
City of Waukee
203 Hickman Road
Waukee IA 50263
I
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE OELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AuTHORIZED REPRESENTATIVE
2______-
@ 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2(H 6/03)The ACORD name and logo are registered marks of ACORD
DATE (MM7DD/YYYY)
09/02/2025
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLCER. 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 ISSLIING INSURER(S), AuTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
INIPORTANT: If the certificate holder is an ADDITIONAL INSLIRED, the policy(ies) must have ADDITIONAL INSURED provisions or 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 suct endorsement(s).
PRODUCER
Jester Insurance Services
al1 5thAve
Suite 150
DesMoines IA 50309
Cal
NAI jE,TAcT Krista Kroeger
I
I
PH
'Al
I
PolExt): (515)350-7662 ip(ilNO,, (515)350-7662
IE-I
At
14
OFLEss, kkroeger@jesterinsurance.com
INSURER(S) AFFORDING COVERA(iE NAIC #
INSuRERA: Cincinnati Insurance Co 10677
lN8uRED
lowa Signal, Inc.
3711 SE Capitol Circle
Grimes IA 50ffi
INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSuED TO THE INSuRED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDINGANYREQUIREMENT,TERMORCONDITIONOFANYCONTRACTOROTHERDOCUMENTWITHRESPECTTOWHICHTHIS
CERTIFICATE MAY BE ISSuED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SLIBJECT TO ALL THE TERMS,
E,'-CLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUC:ED BY PAID CLAIMS.
INSR
LTR TfPE OF INSURANCE
AULIL
INSD
SUHH
WVD POLICY NLIMBER
POLICY EFF
(MMIDD/YYYY)
POLICY EXP
(NIMIDD/YYYY)L1MIT8
A
x COMMERCIAL C,ENERAL LIABILITY
lcuixs-xqoe [X occus
EPPO510474 11/01/2024 11/01/2025
EACH OCCURRENCE $ i,000,000
DAMAGE TO RENTED
PREM18ES (Ea occugence)$ 500,000
MED EXP (Any one person)$ 10,000
PERSONAL & ADV INJURY $ 1,000,000
GEll'L AGGREGATE LIMIT APPLIES PER:
eOpoT:iEc; [gi 3:g; @X LOC
GENERAL AGGREGATE $ 2,000,000
PRODUCTS - COMPVOP AGG $ 2,000,000
$
A
ALITOMOBILE LIABILITY
)( xriyouro
owxeo scheouieo_ AuTOS ONLY u AUTOS
HIRED n NON-OWNED_ AuTOS ONLY I_J AuTOS ONLY
EPPO510474 11/01/2024 11/01/2025
COMBINED SINGLE LIMIT
(Ea accident)$ 1,000,000
BODILY INJIIRY (Per person)$
BODILY INJURY (Per accldenD s
PROPERTY DAMAGE
(Per accldent)$
$
A
x UMBRELLA LIAB
EXCESS LIAB
x OCCUR
CLAIMS.MADE EPPO510474 IUOI/2024 11/01/2025
EACH OCCURRENCE $ 5,000,000
AGGREGATE $ 5,000,000
DED I I RETENTI)N S $
A
WORKERS COMPENSATION
AND EMPLOYERSa LIABILITY Y , N
AN;f,PR;P.F4ET%I:IgRTl%l:EXECUTIVE Q
(Mandatoiy In NH)
IT yes, descrlbe under
DESCRIPTION OF OPERATIONS below
NIA EWCO510473 11/01/2024 11/01/2025
XI S\XTUTE I I ER"-
E.L. EACH ACCIDENT $ 500,000
E.L. DISEASE - EA EMPLOYEE $ 500,000
E.L. DISEASE - POLICY LIMIT $ 500,000
DESCRIPTION OF OPERAT10N8 I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be a :tached iT more space is required)
CERTIFICATE HOLDER
CERTIFICATE NUMBER: 2024/25 MaSt"r REVISION NUMBER:
CANCELLATION
City of Waukee
203 Hickman Road
Waukee IA 50263
I
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLE:D BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
ALITHORIZED REPRESENTATIVE
.?__=
@ 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03)The ACORD name and logo are registered marks of ACORD
DATE (MMtDD/YYYY)
09/02/2025
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOL[ER. 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), ALITHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTAN T) If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or 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 suct endorsement(s).
PRODUCER
Jester Insurance Services
611 5thAve
Suite 150
DesMoines 14 50309
CO
NA N,,TAcT Krista Kroeger
?t
'A
)N
:, I AiExtl: (515)350-7662 i7:,,X,o, (515)350-7662
E.1
At
AAI
DRLEss, kkroeger@jesterinsurance.com
INSURER(S) AFFORDING COVERAGE NAIC#
jNSuRERA: C:nc:nna$i Insurance CO 10677
INSuRED
lowa Signal, Inc.
3711 SE Capitol Circle
Grimes IA 50111
INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
COVERAGES
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 TfPE OF INSURANCE
AuL)L
INSD
!:iUdH
WVD POLICY NUMBER
POLICY EFF
(MMiDD/'m'Q
POLICY EXP
(MM/DD/YYYY)LIMITS
A
x COMMERCIAL GENERAL LIABILITY
lcuivs-vqoe [X occus
EPPO510474 11/01/2024 11/01/2025
EACH OCCLIRRENCE $ 1,000,000
DAMAGE TO RENTED
PREMISES iEa occunence)$ 500,000
MED EXP (Any one person)$ 10,000
PERSONAL & ADV INJURY $ 1,000,000
GErl'L AGGREGATE LIMIT APPLIES PER
eOpoTHuEc; [X j:(9; @X LOC
GENERAL AGGREGATE $ 2,000,000
PRODUCTS - COMP/OP AGG $ 2,000,000
$
A
AUTOMOBILE LIABILITY
)( qxyxu'ro
OWNED SCHEDULED_ AUTOS ONLY IJ AuTOS
HIRED II NON-OWNED__ ALITOS ONLY 1_J AuTOS ONLY
EPPO510474 11/01/2024 11/01/2025
COMBINED SINGLE LIMIT
(Ea accldent)$ I ,000,000
BODILY INJURY (Per person)$
BODILY INJIIRY kPey accldent)s
PROPERTY DAMAGE
iPei accldent)s
$
A
x UMBRELLA LIAB
EXCESS LIAEI
X OCCLIR
CLAIMS-MADE EPPO510474 1UOi/2024 11/01/2025
EACH OCCURRENCE $ 5,000,000
AGGREGATE $ 5,000,000
DED I I RETENTIIN S $
A
WOF!KERS COMPENSATION
AND EMPLOYERS' LIABILITY Y , N
"'i:Hg';'H;'%'X:'c'u'A'HgHECuT"E Q
(Mandatory In NH)
It yes, descrlbe under
DESCRIPTION OF OPERATIONS below
N /A EWCO510473 11/01/2024 11/01/2025
XI s'Aure I I gXH-
E.L. EACH ACCIDENT $ 500,000
E.L. DISEASE - EA EMPLOYEE $ 500,000
E.L. DISEASE - POLICY LIMIT $ 500,000
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES iACORD 101, Additional Remarks SChtidulO, mad be a taChed if mane apace i8 required)
CERTIFICATE HOLDER
CERTIFICATE NUMBER: 2024/25 Master REVISION NUMBER:
CANCELLATION
City of Waukee
203 Hickman Road
Waukee 14 50263
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.
, ,,"';"a> 7"'k."' f y=.' !=j , _:." ' ,..-'
%-" lu '
ALITHORIZED REPRESENTATIVE
@ 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03)The ACORD name and logo are registered marks of ACORD