Discussion and Consideration of Pay Application #9 – Miron Construction – Tiffin Recreation Center – Motion to Approve — K-3

ADDITIONAL REMARKS SCHEDULE AGENCY CUSTOMER ID: ZEPHALU-01 LOC #: 1 AGENCY TRICOR, LLC - Dubuque POLICY NUMBER SEE PAGE 1 CARRIER SEE PAGE 1 NAMED INSURED Zephyr Aluminum Products 555 Huff Dubuque, IA 52003 NAIC CODE SEE P 1 EFFECTIVE DATE: SEE PAGE 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 26 FORM TITLE: Certificate of Liability Insurance Description of Operations/Locations/Vehicles: written contract or agreement. Umbrella is follow form. A 30 day notice of cancel applies. Wavier of Governmental Immunities applies in favor of City of Tiffin. Stored Materials at 555 Huff St., Dubuque, IA: $91,000