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HomeMy WebLinkAboutCORRESPONDENCE - AGREEMENT MISC - MISCELLANEOUS 2020 AGREEMENT - NAMASTE SOLAR ELECTRIC, INC. October 13, 2021 Namaste Solar Electric, Inc. Attn: David Henry 6707 Winchester Circle #700 Boulder, CO 80301 RE: Renewal, Miscellaneous Agreement - Namaste Solar Electric, Inc. Dear Mr. Henry: The City of Fort Collins wishes to extend the agreement term for the above captioned proposal per the existing terms and conditions and the following: 1) The term will be extended for one (1) additional year, December 28, 2021 through December 27, 2022. If the renewal is acceptable to your firm, please sign this letter in the space provided and include a current copy of insurance certificate naming the City as an additional insured for General and Automotive Liability within the next fifteen (15) days. If this extension is not agreeable with your firm, we ask that you send us a written notice stating that you do not wish to renew the contract and state the reason for non-renewal. Please contact JD McCune, Buyer at (970) 416-4377 or jmccune@fcgov.com if you have any questions regarding this matter. Sincerely, Gerry S. Paul Director of Purchasing __________________________________________ ________________ Signature Date (Please indicate your desire to renew this agreement by signing this letter and returning it to Purchasing Division within the next fifteen days.) GSP:kr Financial Services Purchasing Division 215 N. Mason St. 2nd Floor PO Box 580 Fort Collins, CO 80522 970.221.6775 970.221.6707- fax fcgov.com/purchasing DocuSign Envelope ID: 17CBA59C-0EEE-48E4-8CAD-BCA5BEC58A35 11/1/2021 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 1/6/2021 IMA,Inc.-Colorado Division 1705 17th Street,Suite 100 Denver CO 80202 IMA Denver Team 303-534-4567 DenAccountTechs@imacorp.com AMCO Insurance Company 19100 NAMASOL Allied World Assurance Company (U.S.)Inc.19489NamasteSolarElectricInc. 6707 Winchester Circle Boulder CO 80301 Nationwide Mutual Insurance Company 23787 Depositors Insurance Company 42587 *Pinnacol Assurance 41190 Zurich American Insurance Company 16535 1198129889 D X 1,000,000 X 100,000 5,000 1,000,000 2,000,000 X X ACPGLDO3028544150 1/1/2021 1/1/2022 2,000,000 C 1,000,000 X X X ACPBA3038544150 1/1/2021 1/1/2022 Uninsured Motorist 1,000,000 A X X 5,000,000ACPCAA30285441501/1/2021 1/1/2022 5,000,000 E F X N 4188331 C007994403 1/1/2021 1/1/2021 1/1/2022 1/1/2022 1,000,000 1,000,000 1,000,000 B Professional Liability Claims Made Retro Date:08/24/09 03093580 1/1/2021 1/1/2022 Aggregate Occurrence Deductible $2,000,000 $2,000,000 $25,000 Pollution Liability Coverage:Policy #03093580 Effective Dates:01/01/21 -01/01/22 Insurer B:See Above $1,000,000 Per Claim;$1,000,000 Aggregate;$15,000 Deductible Retro Date:08/24/09 Builder's Risk Coverage:Policy #QT6606J780787TIL21 Effective Dates:01/01/21 -01/01/22 Insurer:Travelers Property Casualty Co of America $5,000,000 Any One Location Limit;$5,000,000 Per Disaster Limit;$1,500,000 Temp Loc./Transit Limit;$5,000 Deductible;SPC FORM/RC See Attached... City of Fort Collins PO Box 580 Fort Collins CO 80522 USA DocuSign Envelope ID: 17CBA59C-0EEE-48E4-8CAD-BCA5BEC58A35 ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved. THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER:FORM TITLE: ADDITIONAL REMARKS ADDITIONAL REMARKS SCHEDULE Page of AGENCY CUSTOMER ID: LOC #: AGENCY CARRIER NAIC CODE POLICY NUMBER NAMED INSURED EFFECTIVE DATE: NAMASOL 1 1 IMA,Inc.-Colorado Division Namaste Solar Electric Inc. 6707 Winchester Circle Boulder CO 80301 25 CERTIFICATE OF LIABILITY INSURANCE City of Fort Collins,its officers,agents and employees are included as Additional Insureds on the General andAutomobile Liability Policies if required by written contract or agreement and with respect to work performed by Insured subject to the policy terms and conditions. DocuSign Envelope ID: 17CBA59C-0EEE-48E4-8CAD-BCA5BEC58A35 DocuSign Envelope ID: 17CBA59C-0EEE-48E4-8CAD-BCA5BEC58A35 DocuSign Envelope ID: 17CBA59C-0EEE-48E4-8CAD-BCA5BEC58A35 DocuSign Envelope ID: 17CBA59C-0EEE-48E4-8CAD-BCA5BEC58A35 DocuSign Envelope ID: 17CBA59C-0EEE-48E4-8CAD-BCA5BEC58A35 DocuSign Envelope ID: 17CBA59C-0EEE-48E4-8CAD-BCA5BEC58A35 DocuSign Envelope ID: 17CBA59C-0EEE-48E4-8CAD-BCA5BEC58A35 DocuSign Envelope ID: 17CBA59C-0EEE-48E4-8CAD-BCA5BEC58A35 DocuSign Envelope ID: 17CBA59C-0EEE-48E4-8CAD-BCA5BEC58A35 DocuSign Envelope ID: 17CBA59C-0EEE-48E4-8CAD-BCA5BEC58A35 DocuSign Envelope ID: 17CBA59C-0EEE-48E4-8CAD-BCA5BEC58A35 DocuSign Envelope ID: 17CBA59C-0EEE-48E4-8CAD-BCA5BEC58A35 DocuSign Envelope ID: 17CBA59C-0EEE-48E4-8CAD-BCA5BEC58A35 DocuSign Envelope ID: 17CBA59C-0EEE-48E4-8CAD-BCA5BEC58A35 7501 E. Lowry Blvd. Denver, CO 80230-7006 303.361.4000 / 800.873.7242 Pinnacol.com Namaste Solar Electric Inc. 6707 Winchester Circle Suite 700 Boulder, CO 80301 IMA, Inc 1705 17th Street Suite 100 Denver, CO 80202 (303) 534-4567 7501 E. Lowry Blvd Denver, CO 80230-7006 Page 1 of 1 P ISA -01/02/2019 18:22:26 4188331 53007223 359-B NCCI #: WC000313B Policy #: 4188331 ENDORSEMENT:Blanket Waiver of Subrogation We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. SCHEDULE To any person or organization when agreed to under a written contract or agreement, as defined above and with the insured, which is in effect and executed prior to any loss. Pinnacol Assurance has issued this endorsement January 2, 2021 Effective Date:January 1, 2021 Expires on: January 1, 2022 DocuSign Envelope ID: 17CBA59C-0EEE-48E4-8CAD-BCA5BEC58A35