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Home My WebLink AboutCORRESPONDENCE - SOLE SOURCE - RONALD TREIBER - GRAZING SERVICES ON CROSSBELL RANCH (2)Official Purchasing Document Last updated 1/19/2022 Page 1 of 1 AMENDMENT #1 AGREEMENT BETWEEN THE CITY OF FORT COLLINS AND RONALD TREIBER This First Amendment (Amendment #1) is entered into by and between the CITY OF FORT COLLINS (the “City”) and RONALD TREIBER (the “Service Provider”). WHEREAS, the Service Provider and the City entered into an Agreement effective April 1, 2019 (the “Agreement”); and WHEREAS, Service Provider and the City desire to amend the Agreement to change the compensation terms and renew the agreement. NOW, THEREFORE, in consideration of the foregoing recitals and the mutual promises herein contained, the parties agree as follows: 1. Paragraph 5, Contract Sum, is hereby revised and replaced as follows: 5. Contract Sum. This is a zero-sum Agreement wherein any benefits to either party are negated by each party’s losses. Therefore, no exchange of funds will occur. 2. The Agreement shall be renewed for an additional one year term, April 1, 2022 through March 31, 2023. Except as expressly amended by this Amendment #1, all other terms and conditions of the Agreement shall remain unchanged and in full force and effect. In the event of a conflict between the terms of the Agreement and this Amendment #1, this Amendment #1 shall prevail. IN WITNESS WHEREOF, the parties have executed this First Amendment the day and year shown. CITY OF FORT COLLINS: By: Gerry Paul Purchasing Director Date: RONALD TREIBER: By: Printed: Ronald Treiber Date: DocuSign Envelope ID: 9B2F4018-00C1-4961-B131-C24F3BD52558 2/7/20222/8/2022 -------------------- This Summary Produced on 02/16/2021 -------------------- Policy No: CS203707 FB No: 0408235 Status: Inforce Insured: RONALD TREIBER PO BOX 1523 hPhone: (970)482-5092 LAPORTE, CO 80535 wPhone: (970)227-7867 Agent: MARK FIRMERY Office: 035 wPhone: (970)482-3952 -------------------------------------------------------------------------------- CS203707-25 03/25/2021 - 03/25/2022 Chg: 03/25/2021 Total Premium: $15,420.00 Total Discounts: $6,832.00 Orig. Eff. Date: 03/25/1991 Discounted Premium: $8,588.00 Loss Score: 867 Loss Score Date: 12/30/2019 Estimated Loss Ratio: 0.00% Property Coverage $2,686 Liability Coverage $343 (Other Than Motor Vehicle) Motor Vehicle Coverage $3,252 Motor Vehicle Policy Level Coverage: Optional UM/UIM BI $300,000/$500,000 $1,280 Farm/Personal Property Floater $714 Umbrella $313 Policy Level Endorsements: P-5020 Loss Deductible Clause INCL CS-0608 Exclusion - Seed Producers or Distributors INCL CS-II (01-15) INCL Location Summary: Loc #: 1 Risk(s): 1 1724 N OVERLAND TRAIL FT COLLINS CO 80521 SEC 33 TWSP 8N RNG 69W LARIMER, CO Loc #: 1 Risk(s): 22, 33 SEC 33 TWSP 8N RNG 69W LARIMER, CO Loc #: 2 Risk(s): 4, 10 SEC 33 TWSP 8N RNG 69W LARIMER, CO ******************************************************************************** Discounts Applied: Premium Size: $268.00 Multi Car: $558.00 Fleet: $244.00 Protective Device: $79.00 Adult At Home: $150.00 Valued Customer: $2,805.00 Property Valued Customer: $2,481.00 Utility: $247.00 ******************************************************************************** Dwelling DocuSign Envelope ID: 9B2F4018-00C1-4961-B131-C24F3BD52558 Section Total: $1,359 001 03/25/2021-03/25/2022 (I ) CS-3 BRICK 1978 $1,359.00 Territory: 38-LARIMER Coverages: Dwelling Amount: $483,977 Dwelling Extension: No Coverage Loss of Use: Incl Personal Property: $241,989 Peril Group: Custom Deductible: 1000/2500 Const./YOC: Brick/1978 Roof Type: Hail-Resistive or Tile Protection Class: 04 Location of Insured Premises: Loc #: 1 1724 N OVERLAND TRAIL FT COLLINS CO 80521 SEC 33 TWSP 8N RNG 69W LARIMER, CO Endorsements: P-4009 Extended Dwelling Replacement Cost $10 HO 290 Replacement Cost Contents INCL Discounts: Protective Devices $79.00 Adult At Home $150.00 Premium Size $175.00 Valued Customer $2,481.00 ******************************************************************************** Farm Buildings and Other Structures Section Total: $537 004 03/25/2021-03/25/2022 (I ) 22X34 MACHINE SHED $14.00 Territory: 38-LARIMER Coverages: Description of Property: 22X34 MACHINE SHED Limit of Ins.: $6,488 Peril Group: Fire Deductible: 1000 Const./YOC: Frame/1950 Bldg. Class: C Location of Insured Premises: Loc #: 2 SEC 33 TWSP 8N RNG 69W LARIMER, CO Discounts: Premium Size $1.00 010 03/25/2021-03/25/2022 (I ) 27X64 HAY STORAGE $97.00 Territory: 38-LARIMER Coverages: Description of Property: 27X64 HAY STORAGE DocuSign Envelope ID: 9B2F4018-00C1-4961-B131-C24F3BD52558 Limit of Ins.: $8,110 Peril Group: Extended Deductible: 1000 Const./YOC: Frame/1988 Bldg. Class: C Location of Insured Premises: Loc #: 2 SEC 33 TWSP 8N RNG 69W LARIMER, CO Discounts: Premium Size $9.00 022 03/25/2021-03/25/2022 (I ) SHOP 40X48 $308.00 Territory: 38-LARIMER Coverages: Description of Property: SHOP 40X48 Limit of Ins.: $28,963 Peril Group: Broad Deductible: 1000 Const./YOC: Frame/1996 Bldg. Class: B Location of Insured Premises: Loc #: 1 SEC 33 TWSP 8N RNG 69W LARIMER, CO Discounts: Premium Size $2.00 033 03/25/2021-03/25/2022 (I ) GARAGE $118.00 Territory: 38-LARIMER Coverages: Description of Property: GARAGE Limit of Ins.: $10,000 Peril Group: Broad Deductible: 500 Const./YOC: Masonry/2003 Bldg. Class: A Location of Insured Premises: Loc #: 1 SEC 33 TWSP 8N RNG 69W LARIMER, CO Discounts: Premium Size $1.00 ******************************************************************************** Unscheduled Farm Personal Property - Extended Peril Group Applies Section Total: $790 015 03/25/2021-03/25/2022 (I ) MISC EQUIP $257.00 Territory: 38-LARIMER Coverages: Limit of Insurance: $73,600 UFPP Deductible: 1000 DocuSign Envelope ID: 9B2F4018-00C1-4961-B131-C24F3BD52558 016 03/25/2021-03/25/2022 (I ) HARVESTED CROPS $140.00 Territory: 38-LARIMER Coverages: Limit of Insurance: $40,000 UFPP Deductible: 1000 017 03/25/2021-03/25/2022 (I ) MOBILE AGRICULTURE $172.00 Territory: 38-LARIMER Coverages: Limit of Insurance: $49,300 UFPP Deductible: 1000 043 03/25/2021-03/25/2022 (I ) LIVESTOCK $221.00 Territory: 38-LARIMER Coverages: Limit of Insurance: $50,100 UFPP Deductible: 500 ******************************************************************************** Liability - (Other Than Motor Vehicle) Coverage Section Total: $343 011 03/25/2021-03/25/2022 (I ) LIABILITY $343.00 Territory: 38-LARIMER Coverages: Limits of Liability Each Person Each Occurrence Combined Single Limit No Coverage $500,000 Medical Payments to Others $1,000 $10,000 Fire Legal Liability (Farm Structures) No Coverage $25,000 Location of Insured Premises: Acres Bldgs. Twsp. Range County 1,000 0 7N 70W LARIMER, CO 200 0 8N 69W LARIMER, CO 70 0 8N 69W LARIMER, CO 50 12 08N 69W LARIMER, CO 540 0 7 70 LARIMER, CO ______ 1,860 Total Acres Endorsements: CS164 Snowmobiles and 4-Wheel All Terrain $45 2012 POLARIS RANGER 800 X, 4XATH76A7C4278056 CS313 Lessor Additional Insured $29 CS313 Lessor Additional Insured $29 CS-0608 Exclusion - Seed Producers or Distributors INCL Discounts: Premium Size $1.00 Additional Interests: CITY OF FORT COLLINS (Lessor-Additional Insured) PO BOX 580 FORT COLLINS, CO 80522 DocuSign Envelope ID: 9B2F4018-00C1-4961-B131-C24F3BD52558 CHARLES MESERLIAN (Lessor-Additional Insured) 700 N COLLEGE FT COLLINS, CO 80524 ******************************************************************************** Motor Vehicle Coverage Section Total: $4,532 Motor Vehicle Coverage: $3,252 Motor Vehicle Policy Level Coverage: $1,280 Vehicle Level Coverages: BI $300,000/$500,000 PD $100,000 Policy Drivers: RONALD TREIBER Driver DOB: 09/17/xxxx DrLic: xxxxx1080 SSN: xxx-xx-1350 Violation: SPEED 10-19 OVER LIMIT 08/28/2002 KATHY TREIBER Driver DOB: 12/06/xxxx DrLic: xxxxx1255 SSN: xxx-xx-6608 ANGELA EVANNE DICK Driver DOB: 11/15/xxxx DrLic: xxxxx0725 SSN: xxx-xx-8111 Violation: SPEEDING 5-9 OVER LIMIT 02/24/2014 044 03/25/2021-03/25/2022 (I ) 2000 DODG RAM 3500 $361.00 Territory: 10-GREELEY/LONGMONT Vin: 1B7MF3368YJ136240 Symbol: 20 Type: PP DRIVER INFO DRIVER SEX MAR BIRTH OPER CLASS DrvLic# PTS NAME 007 F S 11/15/xxxx P UA31 xxxxx0725 0 ANGELA EVANNE DICK Coverages: BI $208 PD $118 Optional Medical $5,000 $35 Optional Comp No Coverage Optional Collision No Coverage Discounts: Multi Car $58.03 Fleet $27.18 Valued Customer $380.00 045 03/25/2021-03/25/2022 (I ) 1980 INTERNATIONAL TRUCK $150.00 Territory: 10-GREELEY/LONGMONT Vin: DF227KGB21059 Symbol: 00 Type: HN DRIVER INFO DRIVER SEX MAR BIRTH OPER CLASS DrvLic# PTS NAME Coverages: BI $61 PD $60 Optional Medical $5,000 $29 Optional Comp No Coverage DocuSign Envelope ID: 9B2F4018-00C1-4961-B131-C24F3BD52558 Optional Collision No Coverage Discounts: Multi Car $25.00 Fleet $11.00 051 03/25/2021-03/25/2022 (I ) 2012 CHEV SILVERADO K2500 $934.00 Territory: 10-GREELEY/LONGMONT Vin: 1GC1KXCG5CF243014 Symbol: 22 Type: PU DRIVER INFO DRIVER SEX MAR BIRTH OPER CLASS DrvLic# PTS NAME 003 M S 09/17/xxxx P UAD1 xxxxx1080 0 RONALD TREIBER Coverages: BI $221 PD $126 Optional Medical $5,000 $37 Optional Comp 500/100 $272 Optional Collision 500 $268 Endorsements: AUR-1 Limited Rental Expense Coverage $10 Discounts: Multi Car $165.02 Farm Utility $110.43 Fleet $69.56 Valued Customer $1,081.00 Additional Interests: BANK OF AMERICA (Loss Payee) PO BOX 2759 JACKSONVILLE, FL 32203-2759 054 03/25/2021-03/25/2022 (I ) 2014 GMC SIERRA K1500 SLT $1,158.00 Territory: 10-GREELEY/LONGMONT Vin: 3GTU2VEC6EG544629 Symbol: 35 Type: PU DRIVER INFO DRIVER SEX MAR BIRTH OPER CLASS DrvLic# PTS NAME 004 M M 12/06/xxxx P UAD1 xxxxx1255 0 KATHY TREIBER Coverages: BI $225 PD $128 Optional Medical $5,000 $38 Optional Comp 500/100 $388 Optional Collision 500 $369 Endorsements: AUR-1 Limited Rental Expense Coverage $10 Discounts: Multi Car $205.13 Farm Utility $137.27 Fleet $86.48 Valued Customer $1,344.00 Additional Interests: WELLS FARGO DEALER SERVICES (Loss Payee) Loan#: 8763591971 PO BOX 29296 DocuSign Envelope ID: 9B2F4018-00C1-4961-B131-C24F3BD52558 PHOENIX, AZ 85038-9296 055 03/25/2021-03/25/2022 (I ) 2011 INTL 4000 4400 $649.00 Territory: 10-GREELEY/LONGMONT Vin: 1HTMKAAN7BH326736 Symbol: 23 Type: MN DRIVER INFO DRIVER SEX MAR BIRTH OPER CLASS DrvLic# PTS NAME Coverages: BI $35 PD $35 Optional Medical $5,000 $21 Optional Comp 1000/1000 $326 Optional Collision 1000 $232 Discounts: Multi Car $105.00 Fleet $50.00 Additional Interests: BANK OF COLORADO (Loss Payee) 1102 E LINCOLN AVE FORT COLLINS, CO 80524-2521 ******************************************************************************** Farm/Personal Property Floater Coverage Section Total: $714 048 03/25/2021-03/25/2022 (I ) PORTABLE FENCING $540.00 Territory: 38-LARIMER Coverages: Class: Blanket Miscellaneous Farm Personal Property Description: PORTABLE FENCING Limit of Insurance: $12,500 Deductible: 100 Discounts: Premium Size $60.00 052 03/25/2021-03/25/2022 (I ) 2012 POLARIS RANGER 800 XP EFI VIN# 4XATH76 $174.00 Territory: 38-LARIMER Coverages: Class: Recreational Vehicles Limit of Insurance: $8,925 Deductible: 250 Discounts: Premium Size $19.00 ******************************************************************************** Farm & Ranch Umbrella Section Total: $313 056 03/25/2021-03/25/2022 (I ) UMBRELLA $313.00 Territory: 38-LARIMER DocuSign Envelope ID: 9B2F4018-00C1-4961-B131-C24F3BD52558 Limit of Liability Each Occurrence $1,000,000 Aggregate $1,000,000 Retained Limit $1,000 Schedule of Underlying Insurance Type of Policy Policy # Liability Limits in Thousands Company Bodily Prop BI & PD Injury Damage Comb --------------------------------------------------------------------------------------------- Personal Auto Split CS203707 300/500 100 Colorado Farm Bureau Insurance Company Farm Liability CS203707 500 Colorado Farm Bureau Insurance Company Endorsements: UE0002 Lead Liability Exclusion INCL UE0003 Employment Related Practices Exclusion INCL UE0074-1 Recreational Vehicles INCL UE0079-1 Punitive Damages Exclusion INCL UE0152-1 Automobile Liability Following Form Endorseme INCL UE0207 Communicable Disease Exclusion INCL CS-0608 Exclusion - Seed Producers or Distributors INCL This display is representative of the coverage provided under the Policy. Please refer to the actual contract for complete coverages, terms, exclusions and conditions. ############################################################################################## DocuSign Envelope ID: 9B2F4018-00C1-4961-B131-C24F3BD52558