HomeMy WebLinkAboutRESOLUTION NO. 2020-100 RESOLUTION NO. 2020-100
RESOLUTION TO APPROVE PAY APPLICATION NO. 7 FROM
KLEIMAN CONSTRUCTION, INC. FOR THE 2020 PUMP HOUSE AND
SITE IMPROVEMENTS PROJECT
WHEREAS, the City Council of Fairfax, Iowa has contracted with Kleiman
Construction, Inc. for the 2020 Pump House and Site Improvements project; and
WHEREAS,Hall&Hall Engineers has recommended approval of Pay Application No.
7 from Kleiman Construction, Inc. for a current payment due of$182,507.64.
NOW,THEREFORE,BE IT RESOLVED,by the City Council of the City of Fairfax,
Iowa, to approve Pay Application No. 7 from Kleiman Construction, Inc. for the 2020 Pump
House and Site Improvements project and issue a check for $182,507.64.
BE IT FURTHER RESOLVED, by the Fairfax City Council of the City of Fairfax,
Iowa, that the Mayor and City Clerk/Treasurer are hereby authorized and directed to execute
said resolution.
Passed and approved this 10"' day of November, 2020.
AYES: Otto, Daly, Pacha, Volk, and Wainwright
NAYS: None
Burnell G. Frieden, Mayor
ATTEST:
.g
Cy hia Stimson, City Clerk/Treasurer
KLEIMAN CON STRUCTION, INC.
6205 LOCUST RD. S.W. 'LETTER OF TRANSMITTAL
CEDAR RAPIDS, IA 52404
PH:(319) 364-8864
FX:(319) 364-6721 DATE: 11.5.2020 JOB NO.: 4004
ATTN: Jon Larson
TO: Hall &Hall Engineers
RE: Hall&Hall Engineers#6950-19-03—
1860 Boyson Road City of Fairfax—
Pun r House&Site Improvements
Hiawatha IA 52233
WE ARE SENDING YOU:
® Attached ❑ Under separate cover via the following itelus:
❑ Shop drawings ❑ Prints ❑ Plans
❑ Samples ❑ Specifications ❑ Cop.y of letter
❑ Submittals ® ELECTRONICALLY SUBMITTED ❑
QTY
Application and Certificate for Payment AIA Document G702-October
THESE ARE TRANSMITTED as checked below:
For approval ❑ Approved as submitted ❑ Resubmit❑ copies for approval
® For,tour files ❑ Approved as noted ❑ Submit ❑ copies for distribution
❑ As requested ❑ Returned for corrections ❑ Retuni ❑ corrected prints
❑ For review and comment ❑ PRINTS RETURNED AFTER LOAN TO US
❑ FOR BIDS DUE ® For Further Processing
REMARK:
COPY TO: Cite of Fairfax— SIGNED:
Pune House& Site Improvements
Ann M. Frese, ontnacts Administrator
If enclosures are not as noted,kincal,notify us at once.
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(MM DDIYY
CERTIFICATE OF LIABILITY INSURANCE FDATE1/M/2020YY)
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 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 such endorsement(s).
PRODUCER NAME:
TrueNorth TrueNorth Risk Management
---
PO Box 1863 PHONE . 319-366-2723 Fvc No: 877 810-6374
500 First Street SE ADDRIESS, certs truenortheom anies.com
Cedar Rapids IA 52406-1863 INSURERS AFFORDING COVERAGE NAIC4
INSURER A:The Cincinnati Insurance Coma 10677
INSURED KLEIGON-01 INSURER 13:The Cincinnati Indemnity Coma 23280
Kleiman Construction Inc
6205 Locust Rd SW INSURER C:
Cedar Rapids IA 52404- INSURER D:
INS URER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER:644217667 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 SUER POLICY EFF POLICY EXP -"-
LTR POLICYNUMSER MM/oDwYYY MMIDDIYYYY LIMITS
A X COMMERCIALGENERAL LIABILITY Y Y EPP 0518035 1/1/2020 1/1/2021 EACH OCCURRENCE S1.000,000
F71 -0
CLAIMS-MADE X OCCUR PAMAGETO RENTED
REMISES Ea occurrence S100,000
MED EXP(Any one person) S10,000
PERSONAL&ADV INJURY $1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
POLICY�PE0 EILOC
PRODUCTS-COMP/OP AGG $2,000,000
OTHER: S
A AUTOMOBILE LIABILITY Y Y ESA 05180351/1f2020 1/1/2021 COMBINED SINGLE LIMIT $1,000,000
Ea accident _
JX ANY AUTO BODILY INJURY(Per poison) S
OWNED SCHEDULED
AUTOS ONLY AUTOS BODILYINJURY(Peraccident) S
HIRED X NON-OWNED PROPERTYOAMAGE S
AUTOS ONLY AUTOS ONLY Per accadenf
S
A X UMSRELLALIAB X OCCUR Y Y EPP 0518035 1/1/2020 1/1/2021
EACH OCCURRENCE $10,000,000
EXCESS LIAR CLAIMS-MADE AGGREGATE S 10,000,000
DED X I RETENTIONS n S
S WORKERS COMPENSATION Y EWC 0518036 1/1/2020 1/N2021 X STATUTE EERH
AND EMPLOYERS'LIABILITY Y i N
ANYPROPRILT'ORIPARTNLPJ'x CUIIVL E.E.EACH ACCIDENT S500,000
OFFICER/MEMSEREXCLUOED7 EflNIA
(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $500,000
If as,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE•POLICY LIMIT $500,000
DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES(ACORD 101,Additional Remarks Schedule,may he attached if more space is required)
If"Y"is indicated above for add'!insd forms Gen Liab#GA472(premises and completed operations),Auto Liab#A288 applies. If"Y"is indicated above for
waiver of subrogation forms Gen Liab#GA233,Auto Liab#A288 and WC#WC000313 4-84(IA only)applies. Coverage Is extended for work performed under
written contract with the above named insured.
Kathleen Kleiman-Excluded
Project:Hail&Hall Engineers#6950.19-03-City of Fairfax-Pump House&Site Improvements
Control/Integration Equipment for the 2020 Pump House&Site Improvements—$70,389 stored at 6205 Locust Rd SW.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fairfax ACCORDANCE WITH THE POLICY PROVISIONS.
300 80th Street Court
PO Box 337
Fairfax IA 52228 AUTHORIZEDREPRESENTATIVE
USA
to 1988.2015 ACORD CORPORATION, All rights reserved.
ACORD 25(2016143) The ACORD name and logo are registered marks of ACORD
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