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Home My WebLink AboutTATONKA CONTRACTORS, LLC - CONTRACT - RFP - 9459 PLAYGROUND SURFACING CONSTRUCTION SERVICESServices Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 1 of 108 SERVICES AGREEMENT WORK ORDER TYPE THIS AGREEMENT made and entered into the day and year set forth below, by and between THE CITY OF FORT COLLINS, COLORADO, a Municipal Corporation, hereinafter referred to as the "City" and TATONKA CONTRACTORS, LLC hereinafter referred to as "Service Provider". WITNESSETH: In consideration of the mutual covenants and obligations herein expressed, it is agreed by and between the parties hereto as follows: 1. Services to be Performed. a. This Agreement shall constitute the basic agreement between the parties for 9459 Playground Surfacing Construction Services. The conditions set forth herein shall apply to all services performed by the Service Provider on behalf of the City and particularly described in Work Orders agreed upon in writing by the parties from time to time. Such Work Orders, samples of which are attached hereto as Exhibit A & B, consisting of one (1) and ninety (90) pages and incorporated herein by this reference, shall include a description of the services to be performed, the location and time for performance, the amount of payment, any materials to be supplied by the City and any other special circumstances relating to the performance of services. A general scope of services is attached hereto as Exhibit C, consisting of four (4) pages, and incorporated herein by this reference. The only services authorized under this Agreement are those which are performed after receipt of such Work Order, except in emergency circumstances where oral work requests may be issued. Oral requests for emergency actions will be confirmed by issuance of a written Work Order within two (2) working days. Irrespective of references in Exhibit A & B to certain named third parties, Service Provider shall be solely responsible for performance of all duties hereunder. b. The City may, at any time during the term of a particular Work Order and without invalidating such Work Order, make changes to the scope of the particular services. Such changes shall be agreed upon in writing by the parties by Change Order, a sample of which is attached hereto in Exhibit B section 00950, consisting of one (1) page, and incorporated herein by this reference. 2. Changes in the Work. The City reserves the right to independently bid any services rather than issuing work to the Service Provider pursuant to this Agreement. Nothing within this Agreement shall obligate the City to have any particular service performed by the Service Provider. 3. Time of Commencement and Completion of Services. The services to be performed pursuant to this Agreement shall be initiated as specified by each written Work Order or oral DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 2 of 108 emergency service request. Oral emergency service requests will be acted upon without waiting for a written Work Order. Time is of the essence. 4. Contract Period. This Agreement shall commence August 1, 2022 and shall continue in full force and effect until July 31, 2023, unless sooner terminated as herein provided. In addition, at the option of the City, the Agreement may be extended for additional one year periods not to exceed four (4) additional one year periods. Renewals and pricing changes shall be negotiated by and agreed to by both parties only at the time of renewal. Written notice of renewal shall be provided to the Service Provider and mailed no later than thirty (30) days prior to contract end. 5. Delay. If either party is prevented in whole or in part from performing its obligations by unforeseeable causes beyond its reasonable control and without is fault or negligence, then the party so prevented shall be excused from whatever performance is prevented by such cause. To the extent that the performance is actually prevented, the Service Provider must provide written notice to the City of such condition within ten (10) days from the onset of such condition. 6. Early Termination by City/Notices. Notwithstanding the time periods contained herein, the City may terminate this Agreement at any time without cause by providing written notice of termination to the Service Provider. Such notice shall be mailed at least ten (10) days prior to the termination date contained in said notice unless otherwise agreed in writing by the parties. All notices provided under this Agreement shall be effective immediately when emailed or three business days from the date of the notice when mailed to the following addresses: Service Provider: City: Copy to: Tatonka Contractors, LLC Attn: James Ritzel 14555 Quail Run Rd Hudson, CO 80642 Tatonka2003@yahoo.com City of Fort Collins Attn: Jill Wuertz PO Box 580 Fort Collins, CO 80522 jwuertz@fcgov.com City of Fort Collins Attn: Purchasing Dept. PO Box 580 Fort Collins, CO 80522 purchasing@fcgov.com In the event of early termination by the City, the Service Provider shall be paid for services rendered to the date of termination, subject only to the satisfactory performance of the Service Provider's obligations under this Agreement. Service Provider shall submit a final invoice within ten (10) days of the effective date of termination. Undisputed invoices shall be paid Net 30 days of the date of the invoice. Such payment shall be the Service Provider's sole right and remedy for such termination. 7. Contract Sum. This is an open-end indefinite quantity Agreement with no fixed price. The actual amount of work to be performed will be stated on the individual Work Orders. The City makes no guarantee as to the number of Work Orders that may be issued or the actual amount of services which will in fact be requested. 8. Payments. DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 3 of 108 a. The City agrees to pay and the Service Provider agrees to accept as full payment for all work done and all materials furnished and for all costs and expenses incurred in performance of the work the sums set forth for the hourly labor rate and material costs, with markups, stated within the Bid Schedule Proposal Form, attached hereto as Exhibit D, consisting of one (1) page, and incorporated herein by this reference. b. Invoices shall be emailed to invoices@fcgov.com with a copy to the Project Manager. The cost of the work completed shall be paid to the Service Provider following the submittal of a correct itemized invoice by the Service Provider. Payment shall be made by the City only upon acceptance of the work by the City and upon the Service Provider furnishing satisfactory evidence of payment of all wages, taxes, supplies and materials, and other costs incurred in connection with the performance of such work. The City is exempt from sales and use tax. The City’s Certificate of Exemption license number is 09804502. A copy of the license is available upon written request. The City pays invoices on Net 30 days from the date of the invoice. 9. Appropriation. To the extent this Agreement or any provision in it constitutes a multiple fiscal year debt or financial obligation of the City, it shall be subject to annual appropriation by City Council as required in Article V, Section 8(b) of the City Charter, City Code Section 8-186, and Article X, Section 20 of the Colorado Constitution. The City shall have no obligation to continue this Agreement in any fiscal year for which no such supporting appropriation has been made. 10. Liquidated Damages. OWNER and CONTRCTOR recognize that time is of the essence of this Agreement and that OWNER will suffer financial loss if the Work is not completed within the times specified in the Work Order, plus any extensions thereof allowed in accordance with Article 12 of the General conditions. They also recognize the delays, expenses and difficulties involved in proving in a legal proceeding the actual loss suffered by OWNER if the Work is not completed on time. Accordingly, instead of requiring any such proof, OWNER and CONTRACTOR agree that as liquidated damages for delay (but not as penalty) CONTRACTOR shall pay OWNER the amount set forth in each Work Order. 11. City Representative. The City's representative will be shown on the specific Work Order and shall make, within the scope of his or her authority, all necessary and proper decisions with reference to the work requested. All requests concerning this Agreement shall be directed to the City Representative. 12. Independent Contractor. It is agreed that in the performance of any services hereunder, the Service Provider is an independent contractor responsible to the City only as to the results to be obtained in the particular work assignment and to the extent that the work shall be done in accordance with the terms, plans and specifications furnished by the City. 13. Subcontractors/subconsultants. Service Provider may not subcontract any of the Work set forth in the subsequent Work Orders without the prior written consent of the city, which shall not be unreasonably withheld. If any of the Work is subcontracted hereunder (with the DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 4 of 108 consent of the City), then the following provisions shall apply: (a) the subcontractor/subconsultant must be a reputable, qualified firm with an established record of successful performance in its respective trade performing identical or substantially similar work, (b) the subcontractor/subconsultant will be required to comply with all applicable terms of this Agreement, (c) the subcontract will not create any contractual relationship between any such subcontractor/subconsultant and the City, nor will it obligate the City to pay or see to the payment of any subcontractor/subconsultant, and (d) the work of the subcontractor/subconsultant will be subject to inspection by the City to the same extent as the work of the Service Provider. 14. Personal Services. It is understood that the City enters into the Agreement based on the special abilities of the Service Provider and that this Agreement shall be considered as an agreement for personal services. Accordingly, the Service Provider shall neither assign any responsibilities nor delegate any duties arising under the Agreement without the prior written consent of the city. 15. Acceptance Not Waiver. The City's approval or acceptance of, or payment for any of the services shall not be construed to operate as a waiver of any rights under the Agreement or of any cause of action arising out of the performance of this Agreement. 16. Warranty. a. Service Provider warrants that all work performed hereunder shall be performed with the highest degree of competence and care in accordance with accepted standards for work of a similar nature. b. Unless otherwise provided in the Agreement, all materials and equipment incorporated into any work shall be new and, where not specified, of the most suitable grade of their respective kinds for their intended use, and all workmanship shall be acceptable to City. c. Term of the warranty is in accordance with Exhibit E - Specifications attached hereto and incorporated by reference. 17. Default. Each and every term and condition hereof shall be deemed to be a material element of this Agreement. In the event either party should fail or refuse to perform according to the terms of this Agreement, such party may be declared in default thereof. 18. Remedies. In the event a party has been declared in default, such defaulting party shall be allowed a period of ten (10) days within which to cure said default. In the event the default remains uncorrected, the party declaring default may elect to (a) terminate the Agreement and seek damages; (b) treat the Agreement as continuing and require specific performance; or (c) avail themselves of any other remedy at law or equity. If the non-defaulting party commences legal or equitable actions against the defaulting party, the defaulting party shall be liable to the non-defaulting party for the non-defaulting party's reasonable attorney fees and costs incurred because of the default. 19. Entire Agreement; Binding Effect; Order of Precedence; Authority to Execute. This DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 5 of 108 Agreement, along with all Exhibits and other documents incorporated herein, shall constitute the entire Agreement of the parties regarding this transaction and shall be binding upon said parties, their officers, employees, agents and assigns and shall inure to the benefit of the respective survivors, heirs, personal representatives, successors and assigns of said parties. Covenants or representations not contained in this Agreement shall not be binding on the parties. In the event of a conflict between terms of the Agreement and any exhibit or attachment, the terms of the Agreement shall prevail. Each person executing this Agreement affirms that they have the necessary authority to sign on behalf of their respective party and to bind such party to the terms of this Agreement. 20. Indemnity/Insurance. a. The Service Provider agrees to indemnify and save harmless the City, its officers, agents and employees against and from any and all actions, suits, claims, demands or liability of any character whatsoever, brought or asserted for injuries to or death of any person or persons, or damages to property arising out of, result from or occurring in connection with the performance of any service hereunder. b. The Service Provider shall take all necessary precautions in performing the work hereunder to prevent injury to persons and property. c. Without limiting any of the Service Provider's obligations hereunder, the Service Provider shall provide and maintain insurance coverage naming the City as an additional insured under this Agreement of the type and with the limits specified within Exhibit F, consisting of one (1) page, attached hereto, and incorporated herein by this reference. The Service Provider before commencing services hereunder shall deliver to the City's Purchasing Director, purchasing@fcgov.com, P. O. Box 580, Fort Collins, Colorado 80522 one copy of a certificate evidencing the insurance coverage required from an insurance company acceptable to the city. 21. Law/Severability. The laws of the State of Colorado shall govern the construction, interpretation, execution, and enforcement of this Agreement. The Parties further agree that Larimer County District Court is the proper venue for all disputes. If the City subsequently agrees in writing that the matter may be heard in federal court, venue will be in Denver District Court. In the event any provision of this Agreement shall be held invalid or unenforceable by any court of competent jurisdiction, such holding shall not invalidate or render unenforceable any other provision of this Agreement. 22. Governmental Immunity Act. No term or condition of this Agreement shall be construed or interpreted as a waiver, express or implied, of any of the notices, requirements, immunities, rights, benefits, protections, limitations of liability, and other provisions of the Colorado Governmental Immunity Act, C.R.S. § 24-10-101 et seq. and under any other applicable law. 23. Prohibition Against Unlawful Discrimination. The City of Fort Collins, in accordance with the provisions of Title VI of the Civil Rights Act of 1964 (78 Stat. 252, 42 US.C. §§ 2000d to 2000d-4) and the Regulations, hereby notifies all bidders that it will affirmatively ensure that DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 6 of 108 any contract entered into pursuant to this advertisement, disadvantaged business enterprises will be afforded full and fair opportunity to submit bids in response to this invitation and will not be discriminated against on the grounds of race, color, or national origin in consideration for an award. The City strictly prohibits unlawful discrimination based on an individual’s gender (regardless of gender identity or gender expression), race, color, religion, creed, national origin, ancestry, age 40 years or older, marital status, disability, sexual orientation, genetic information, or other characteristics protected by law. For the purpose of this policy “sexual orientation” means a person’s actual or perceived orientation toward heterosexuality, homosexuality, and bisexuality. The City also strictly prohibits unlawful harassment in the workplace, including sexual harassment. Further, the City strictly prohibits unlawful retaliation against a person who engages in protected activity. Protected activity includes an employee complaining that he or she has been discriminated against in violation of the above policy or participating in an employment discrimination proceeding. The City requires its vendors to comply with the City’s policy for equal employment opportunity and to prohibit unlawful discrimination, harassment, and retaliation. This requirement applies to all third-party vendors and their subcontractors/subconsultants at every tier. 24. Dust Control. The Service Provider shall abide by the City of Fort Collins “Dust Control and Prevention Manual,” which is available for public download at https://www.fcgov.com/airquality/pdf/dust-prevention-and-control-manual.pdf, and is incorporated herein by this reference. The City of Fort Collins has implemented this manual for all projects performed for the City of Fort Collins or located within the City of Fort Collins City limits. 25. Colorado Open Records Act. The City is subject to Sec. 24-72-201 et seq. of the Colorado Revised Statute (CORA). This Agreement is subject to public disclosure in whole pursuant to CORA. 26. Special Provisions. Special provisions or conditions relating to the services to be performed pursuant to this Agreement are set forth in Exhibit E – Specifications, consisting of three (3) pages and Exhibit G - Confidentiality, consisting of one (1) page, and Exhibit B, Section 00700 General Conditions consisting of fifty-three (53) pages. [Signature Page Follows] DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 7 of 108 THE CITY OF FORT COLLINS, COLORADO By: Gerry Paul Purchasing Director Date: ATTEST: APPROVED AS TO FORM: TATONKA CONTRACTORS, LLC By: Printed: Title: Date: DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF James Ritzel 8/16/2022 Owner-Manager Assistant City Attorney 8/22/2022 City Clerk Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 8 of 108 EXHIBIT A WORK ORDER FORM (Short form) PURSUANT TO A MASTER AGREEMENT BETWEEN THE CITY OF FORT COLLINS AND TATONKA CONTRACTORS, LLC WORK ORDER NUMBER: PM's Tracking # PROJECT TITLE: ORIGINAL BID/RFP NUMBER & NAME: 9459 Playground Surfacing Construction Services MASTER AGREEMENT EFFECTIVE DATE: August 1, 2022 WORK ORDER COMMENCEMENT DATE: WORK ORDER COMPLETION DATE: MAXIMUM FEE: (time and reimbursable direct costs): PROJECT DESCRIPTION/SCOPE OF SERVICES: Service Provider agrees to perform the services identified above and on the attached forms in accordance with the terms and conditions contained herein and in the Master Agreement between the parties. In the event of a conflict between or ambiguity in the terms of the Master Agreement and this Work Order (including the attached forms) the Master Agreement shall control. The attached forms consisting of ( ) pages are hereby accepted and incorporated herein, by this reference, and Notice to Proceed is hereby given after all parties have signed this document. SERVICE PROVIDER: Date: James Ritzel, Owner ACCEPTANCE: Date: Jill Wuertz, Project Manager REVIEWED: Date: Adam Hill, Senior Buyer ACCEPTANCE: Date: Gerry Paul, Purchasing Director (if greater than $60,000) DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 9 of 108 EXHIBIT B WORK ORDER FORM (Construction over $100,000) CONSTRUCTION WORK ORDER FOR 9459 PLAYGROUND SURFACING CONSTRUCTION SERVICES WORK ORDER NO. TITLED (WORK ORDER TITLE) DATE: CONTRACTOR: TATONKA CONTRACTORS, LLC DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 10 of 108 TABLE OF CONTENTS AGREEMENT FORMS 00525 Work Order & Notice of Award 00530 Work Order Notice to Proceed 00600 Bonds and Certificates 00610 Performance Bond 00615 Payment Bond 00630 Certificate of Insurance 00635 Certificate of Substantial Completion 00640 Certificate of Final Acceptance 00650 Lien Waiver Release (CONTRACTOR) 00660 Consent of Surety 00670 Application for Exemption Certificate CONDITIONS OF THE CONTRACT 00700 General Conditions Exhibit GC-A GC-A1 - GC-A2 00800 Supplementary Conditions 00900 Addenda, Modifications and Payment 00950 Work Order Change Order Form 00960 Application for Payment DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 11 of 108 SECTION 00500 CONSTRUCTION WORK ORDER AGREEMENT FORMS 00525 Work Order, Notice of Award & Bid Schedule 00530 Work Order Notice to Proceed DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 12 of 108 SECTION 00525 WORK ORDER, NOTICE OF AWARD AND BID SCHEDULE TO (CONTRACTOR OR CM/GC): TATONKA CONTRACTORS, LLC WORK ORDER # & TITLE: PURCHASE ORDER: ORIGINAL BID/RFP # & TITLE: 9459 Playground Surfacing Construction Services ENGINEER: OWNER’S REPRESENTATIVE: NOTICE OF AWARD DATE: OWNER: City of Fort Collins (hereinafter referred to as OWNER) 1. WORK. You are hereby notified that your bid dated , for the above Work Order has been considered. Pursuant to your AGREEMENT with OWNER dated , you have been awarded a Work Order for this Work Order Description: A. See Section 01100 – Summary of Work. 2. CONTRACT PRICE, BONDS AND CERTIFICATES. The price of your Work Order is ($ ). Pursuant to the AGREEMENT and the Contract Documents, Performance and Payment Bonds and insurance are required. 3. CONTRACT TIMES. Pursuant to the AGREEMENT and the Contract Documents, the date for Substantial Completion of this Work Order is , and after Substantial Completion, the date for Final Completion is . 4. LIQUIDATED DAMAGES. OWNER and CONTRACTOR recognize that time is of the essence of this Agreement and that OWNER will suffer financial loss if the Work is not completed within the times specified in paragraph 3 above, plus any extensions thereof allowed in accordance with Article 12 of the General Conditions. They also recognize the delays, expenses and difficulties involved in proving in a legal proceeding the actual loss suffered by OWNER if the Work is not completed on time. Accordingly instead of requiring any such proof, OWNER and CONTRACTOR agree that as liquidated damages for delay (but not as penalty) CONTACTOR shall pay OWNER the amounts set forth hereafter. 1. Substantial Completion: ($500) for each calendar day or fraction thereof that expires after until the work is Substantially Complete. 2. Final Acceptance: After Substantial Completion ($500) for each calendar day or fraction thereof that expires after the period for Final Payment and Acceptance until the Work is ready for Final Payment and Acceptance. 5. PAYMENT PROCEDURES. CONTRACTOR shall submit Applications for Payment in accordance with Article 14 of the General Conditions. Applications for Payment will be processed by ENGINEER as provided in the General Conditions. DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 13 of 108 5.1 PROGRESS PAYMENTS. OWNER shall make progress payments on account of the Contract Price on the basis of CONTRACTOR's Application for Payment as recommended by ENGINEER, once each month during construction as provided below. All progress payments will be on the basis of the progress of the Work measured by the schedule of values established in paragraph 2.6 of the General Conditions and in the case of Unit Price Work based on the number of units completed, and in accordance with the General Requirements concerning Unit Price Work. 5.1.1 Prior to Substantial Completion, Owner will be entitled to withhold as contract retainage five percent (5%) of each progress payment, but, in each case, less the aggregate of payments previously made and less such amounts as ENGINEER shall determine, or OWNER may withhold, in accordance with paragraph 14.7 of the General Conditions. If , in the sole discretion of Owner, on recommendation of Engineer, Owner determines that the character and progress of the Work have been satisfactory to OWNER and ENGINEER, OWNER may determine that as long as the character and progress of the Work remain satisfactory to them, there will be no additional retainage on account of Work completed in which case the remaining progress payments prior to Substantial Completion will be in an amount equal to 100% of the Work completed. 95% of materials and equipment not incorporated in the Work (but delivered, suitably stored and accompanied by documentation satisfactory to OWNER as provided in paragraph 14.2 of the General Conditions) may be included in the application Section 00960. 5.1.2 Upon Substantial Completion payment will be made in an amount sufficient, if necessary, to increase total payments to CONTRACTOR to 95% of the Contract Price, less such amounts as ENGINEER shall determine or OWNER may withhold in accordance with paragraph 14.7 of the General Conditions or as provided by law. 5.2 FINAL PAYMENT. Upon Final Completion and Acceptance of the Work in accordance with paragraph 14.13 of the General Conditions, OWNER shall pay the remainder of the Contract Price as recommended by ENGINEER as provided in said paragraph 14.13. 6. CONTRACTOR'S REPRESENTATION. In order to induce OWNER to enter into this Agreement, CONTRACTOR makes the following representations: 6.1 CONTRACTOR has familiarized himself with the nature and extent of the Contract Documents, Work, site, locality, and with all local conditions and Laws and Regulations that in any manner may affect cost, progress, performance or furnishing of the Work. 6.2 CONTRACTOR has studied carefully all reports of explorations and tests of subsurface conditions and drawings of physical conditions which are identified in the Supplementary Conditions as provided in paragraph 4.2 of the General Conditions. 6.3 CONTRACTOR has obtained and carefully studied (or assumes responsibility for obtaining and carefully studying) all such examinations, investigations, explorations, tests, reports, and studies (in addition to or to DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 14 of 108 supplement those referred to in paragraph 6.2 above) which pertain to the subsurface or physical condition at or contiguous to the site or otherwise may affect the cost, progress, performance or furnishing of the Work as CONTRACTOR considers necessary for the performance or furnishing of the Work at the Contract Price, within the Contract Times and in accordance with the other terms and conditions of the Contract Documents, including specifically the provisions of paragraph 4.2 of the General Conditions; and no additional examinations, investigations, explorations, tests, reports, studies or similar information or data are or will be required by CONTRACTOR for such purposes. 6.4 CONTRACTOR has reviewed and checked all information and data shown or indicated on the Contract Documents with respect to existing Underground Facilities at or contiguous to the site and assumes responsibility for the accurate location of said Underground Facilities. No additional examinations, investigations, explorations, tests, reports, studies or similar information or data in respect of said Underground Facilities are or will be required by CONTRACTOR in order to perform and furnish the Work at the Contract Price, within the Contract Times and in accordance with the other terms and conditions of the Contract Documents, including specifically the provision of paragraph 4.3. of the General Conditions. 6.5 CONTRACTOR has correlated the results of all such observations, examinations, investigations, tests, reports and data with the terms and conditions of the Contract Documents. 6.6 CONTRACTOR has given ENGINEER written notice of all conflicts, errors or discrepancies that he has discovered in the Contract Documents and the written resolution thereof by ENGINEER is acceptable to CONTRACTOR. 7. CONTRACT DOCUMENTS. 7.1 The Contract Documents which comprise the entire Agreement between OWNER and CONTRACTOR concerning the Work consist of the General Conditions, Supplementary Conditions, those items included in the definition of “Contract Documents” in Article 1.10 of the General Conditions, and such other items as are referenced in this Article 7, all of which are incorporated herein by this reference. 7.2 Forms for use by CONTRACTOR in performing the Work and related actions in carrying out the terms of this Agreement are deemed Contract Documents and incorporated herein by this reference, and include, but are not limited to, the following: 7.2.1 Certificate of Substantial Completion 7.2.2 Certificate of Final Acceptance 7.2.3 Lien Waiver Releases 7.2.4 Consent of Surety 7.2.5 Application for Exemption Certificate 7.2.6 Application for Payment 7.3 Drawings, consisting of a cover sheet and sheets numbered as follows: DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 15 of 108 The Contract Drawings shall be stamped "Final for Construction" and dated. Any revisions made shall be clearly identified and dated. 7.4 The Contract Documents also include all written amendments and other documents amending, modifying, or supplementing the Contract Documents pursuant to paragraphs 3.5 and 3.6 of the General Conditions. 7.5 There are no Contract Documents other than those listed or incorporated by reference in this Article 7. The Contract Documents may only be amended, modified or supplemented as provided in paragraphs 3.5 and 3.6 of the General Conditions. 8. MISCELLANEOUS 8.1. Terms used in this Agreement which are defined in Article I of the General Conditions shall have the meanings indicated in the General Conditions. 8.2. No assignment by a party hereto of any rights under or interests in the Contract Documents will be binding on another party hereto without the written consent of the party sought to be bound; and specifically but not without limitations, moneys that may become due and moneys that are due may not be assigned without such consent (except to the extent that the effect of this restriction may be limited by law), and unless specifically stated to the contrary in any written consent to an assignment no assignment will release or discharge that assignor from any duty or responsibility under the Contract Document. 8.3. OWNER and CONTRACTOR each binds itself, its partners, successors, assigns and legal representatives to the other party hereto, its partners, successors, assigns and legal representatives in respect to all covenants, Agreement and obligations contained in the Contract Document. 9. EXECUTION. Three (3) copies of this proposed Work Order & Notice of Award, and accompanying amendments or supplements to the Contract Documents (except any applicable Drawings) incorporated herein, are provided. Three (3) sets of any applicable Drawings will be delivered separately or otherwise made available to you immediately. You must comply with the following conditions precedent within fifteen (15) days of the date of this Notice of Award, that is, by . A. You must deliver to OWNER three (3) fully-executed counterparts of this Work Order, including all amendments or supplements to the Contract Documents incorporated herein. Each Work Order must bear your signature as provided. B. You must deliver with the executed Work Order the Contract Security (Bonds) and insurance, as specified in the Agreement, this Work Order, the General Conditions (Article 5.1) and the Supplementary Conditions. Failure to comply with these conditions within the time specified will entitle OWNER to consider your Bid abandoned and to annul this Work Order & Notice of Award. Within ten (10) days after you comply with those conditions, OWNER will return to you one (1) fully-signed counterpart of this Work Order with any amendments or supplements to the Contract Documents attached. DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 16 of 108 CONTRACTOR’S NOTICE OF AWARD REPRESENTATION & EXECUTION: CONTRACTOR agrees to perform the services identified above, in accordance with the terms and conditions contained herein and in the AGREEMENT dated August 1, 2022, and the NOTICE OF AWARD dated , between the parties. In the event of a conflict between or ambiguity in the terms of the AGREEMENT or specific Work Orders, the AGREEMENT shall control. CONTRACTOR: TATONKA CONTRACTORS, LLC By: Date: Name: Title: DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 17 of 108 OWNER’S ACCEPTANCE & EXECUTION: This Work Order and the attached Contract Documents are hereby accepted and incorporated herein by this reference and the attached Notice to Proceed is hereby given. ACCEPTANCE: Date: _____ Jill Wuertz, Projects Manager OWNER: CITY OF FORT COLLINS ACCEPTANCE: ___________________________________________ Date: __________ Kelly DiMartino, Interim City Manager (if greater than $1,000,000) ACCEPTANCE: ___________________________________________ Date: __________ Gerry Paul, Purchasing Director (if greater than $60,000) APPROVED AS TO FORM: __________________________________ Date: __________ ATTEST: ___ ________________________________________ Date: __________ DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 18 of 108 BID SCHEDULE DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 19 of 108 SECTION 00530 WORK ORDER NOTICE TO PROCEED NOTICE TO PROCEED DATE: WORK ORDER TITLE: WORK ORDER NUMBER: ORIGINAL BID/RFP # & TITLE: 9459 Playground Surfacing Construction Services TO: Tatonka Contractors, LLC Attn: James Ritzel 1455 Quail Run Road Hudson, CO 80642 This notice is to advise you: That the Work Order and all amendments and supplements to the Contract Documents covering the above described Work have been fully executed by the CONTRACTOR and the OWNER. That the required CONTRACTOR's Performance and Payment Bonds and insurance have been received by the OWNER. That the OWNER has approved the said Work Order and Contract Documents. Therefore, as the CONTRACTOR for the above described Work, you are hereby authorized and directed to proceed within ( ) calendar days from receipt of this notice as required by the Work Order and the AGREEMENT. The dates for Substantial Completion and Final Acceptance shall be , and , respectively. Dated this _____________ day of ___________, _____. CITY OF FORT COLLINS (OWNER) By: ___________________________________________ ___________________________________________ Name & Title ACKNOWLEDGMENT OF NOTICE Receipt of the above Work Order Notice to Proceed is hereby acknowledged this _____________ day of ___________, _____. TATONKA CONTRACTORS, LLC (CONTRACTOR) By: ___________________________________________ ____James Ritzel - Owner_____________________________________ Name & Title DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 20 of 108 SECTION 00600 BONDS AND CERTIFICATES 00610 Performance Bond 00615 Payment Bond 00630 Certificate of Insurance 00635 Certificate of Substantial Completion 00640 Certificate of Final Acceptance 00650 Lien Waiver Release (CONTRACTOR) 00651 Lien Waiver Release (SUBCONTRACTOR) 00660 Consent of Surety 00670 Application for Exemption Certificate DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 21 of 108 SECTION 00610 PERFORMANCE BOND Bond No __ KNOW ALL MEN BY THESE PRESENTS: that (Firm) (Address) (an Individual), (a Partnership), (a Corporation), hereinafter referred to as the "Principal" and (Firm) (Address) hereinafter referred to as "the Surety", are held and firmly bound unto City of Fort Collins, 300 LaPorte Ave, Fort Collins, Colorado 80522 a (Municipal Corporation) hereinafter referred to as the "OWNER", in the penal sum of ($ ) in lawful money of the United States, for the payment of which sum well and truly to be made, we bind ourselves, successors and assigns, jointly and severally, firmly by these presents. THE CONDITIONS OF THIS OBLIGATION are such that whereas the Principal entered into a certain Agreement with the OWNER, dated the day of , 2 , for 9459 Playground Surfacing Construction Services a copy of which is hereto attached and made a part hereof, for the performance of The City of Fort Collins Work Order, titled , Work Order Number , dated the day of , , a copy of which is hereto attached and made a part hereof. NOW, THEREFORE, if the Principal shall well, truly and faithfully perform its duties, all the undertakings, covenants, terms, conditions and agreements of said Work Order and Agreement during the original term thereof, and any extensions thereof which may be granted by the OWNER, with or without Notice to the Surety and during the life of the guaranty period, and if the Principal shall satisfy all claims and demands incurred under such Work Order and Agreement, and shall fully indemnify and save harmless the OWNER from all cost and damages which it may suffer by reason of failure to do so, and shall reimburse and repay the OWNER all outlay and expense which the OWNER may incur in making good any default, then this obligation shall be void; otherwise to remain in full force and effect. PROVIDED, FURTHER, that the said Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration or addition to the terms of the Work Order and Agreement or to the Work to be performed thereunder or the Specifications accompanying the same shall in any way affect its obligation on this bond; and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the Work Order and Agreement or to the Work or to the Specifications. PROVIDED, FURTHER, that no final settlement between the OWNER and the CONTRACTOR shall abridge the right of any beneficiary hereunder, whose claim may be unsatisfied. PROVIDED, FURTHER, that the Surety Company must be authorized to transact business in the State of Colorado and be acceptable to the OWNER. DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 22 of 108 IN WITNESS WHEREOF, this instrument is executed in three (3) counterparts, each one of which shall be deemed an original, this _____ day of ___________, _____. IN PRESENCE OF: Principal (Title) (Title) (Corporate Seal) (Address) IN PRESENCE OF: Other Partners _____________________________ By: _____________________________ By: IN PRESENCE OF: Surety _____________________________ By: _____________________________ (Address) (Surety Seal) NOTE: Date of Bond must not be prior to date of Agreement. If CONTRACTOR is Partnership, all partners should execute Bond. DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 23 of 108 SECTION 00615 PAYMENT BOND Bond No __ KNOW ALL MEN BY THESE PRESENTS: that (Firm) (Address) (an Individual), (a Partnership), (a Corporation), hereinafter referred to as the "Principal" and (Firm) (Address) hereinafter referred to as "the Surety", are held and firmly bound unto City of Fort Collins, 300 LaPorte Ave, Fort Collins, Colorado 80522 a (Municipal Corporation) hereinafter referred to as the "OWNER", in the penal sum of ($ ) in lawful money of the United States, for the payment of which sum well and truly to be made, we bind ourselves, successors and assigns, jointly and severally, firmly by these presents. THE CONDITIONS OF THIS OBLIGATION are such that whereas the Principal entered into a certain Agreement with the OWNER, dated the day of , , for 9459 Playground Surfacing Construction Services, a copy of which is hereto attached and made a part hereof, for the performance of The City of Fort Collins Work Order, titled , Work Order Number , dated the day of , , a copy of which is hereto attached and made a part hereof. NOW, THEREFORE, if the Principal shall make payment to all persons, firms, subcontractors, and corporations furnishing materials for or performing labor in the prosecution of the Work provided for in such Work Order and Agreement and any authorized extension or modification thereof, including all amounts due for materials, lubricants, repairs on machinery, equipment and tools, consumed, rented or used in connection with the construction of such Work, and all insurance premiums on said Work, and for all labor, performed in such Work whether by subcontractor or otherwise, then this obligation shall be void; otherwise to remain in full force and effect. PROVIDED, FURTHER, that the said Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration or addition to the terms of the Work Order and Agreement or to the Work to be performed thereunder or the Specifications accompanying the same shall in any way affect its obligation on this bond; and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the Work Order and Agreement or to the Work or to the Specifications. PROVIDED, FURTHER, that no final settlement between the OWNER and the CONTRACTOR shall abridge the right of any beneficiary hereunder, whose claim may be unsatisfied. PROVIDED, FURTHER, that the Surety Company must be authorized to transact business in the State of Colorado and be acceptable to the OWNER. DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 24 of 108 IN WITNESS WHEREOF, this instrument is executed in three (3) counterparts, each one of which shall be deemed an original, this _____ day of ___________, _____. IN PRESENCE OF: Principal (Title) (Title) (Corporate Seal) (Address) IN PRESENCE OF: Other Partners _____________________________ By: _____________________________ By: IN PRESENCE OF: Surety _____________________________ By: _____________________________ (Address) (Surety Seal) NOTE: Date of Bond must not be prior to date of Agreement. If CONTRACTOR is Partnership, all partners should execute Bond. DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 25 of 108 SECTION 00630 CERTIFICATE OF INSURANCE CONTRACTOR shall insert his own standard form for Certificate of Insurance in accordance with the following: 1. The Contractor will provide, from insurance companies acceptable to the City, the insurance coverage designated hereinafter and pay all costs. Before commencing work under this bid, the Contractor shall furnish the City with certificates of insurance showing the type, amount, class of operations covered, effective dates and date of expiration of policies, and containing substantially the following statement: “The insurance evidenced by this Certificate will not reduce coverage or limits and will not be cancelled, except after thirty (30) days written notice has been received by the City of Fort Collins.” In case of the breach of any provision of the Insurance Requirements, the City, at its option, may take out and maintain, at the expense of the Contractor, such insurance as the City may deem proper and may deduct the cost of such insurance from any monies which may be due or become due the Contractor under this Agreement. The City, its officers, agents and employees shall be named as additional insureds on the Contractor’s general liability and automobile liability insurance policies for any claims arising out of work performed under this Agreement. 2. Insurance coverages shall be as follows: A. Workers' Compensation & Employer's Liability. The Contractor shall maintain during the life of this Agreement for all of the Contractor's employees engaged in work performed under this agreement: 1. Workers' Compensation insurance with statutory limits as required by Colorado law. 2. Employer's Liability insurance with limits of $100,000 per accident, $500,000 disease aggregate, and $100,000 disease each employee. B. Commercial General & Vehicle Liability. The Contractor shall maintain during the life of this Agreement such commercial general liability and automobile liability insurance as will provide coverage for damage claims of personal injury, including accidental death, as well as for claims for property damage, which may arise directly or indirectly from the performance of work under this Agreement. Coverage for property damage shall be on a "broad form" basis. The amount of insurance for each coverage, Commercial General and Vehicle, shall not be less than $1,000,000 combined single limits for bodily injury and property damage. In the event any work is performed by a subcontractor, the Contractor shall be responsible for any liability directly or indirectly arising out of the work performed under this Agreement by a subcontractor, which liability is not covered by the subcontractor's insurance. DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 26 of 108 SECTION 00635 CERTIFICATE OF SUBSTANTIAL COMPLETION TO: CITY OF FORT COLLINS (OWNER) WORK ORDER # & TITLE: DATE OF SUBSTANTIAL COMPLETION: ORIGINAL BID/RFP # & TITLE: 9459 Playground Surfacing Services PROJECT OR SPECIFIED PART SHALL LOCATION: Fort Collins, Colorado INCLUDE: OWNER: City of Fort Collins CONTRACTOR: Tatonka Contractors, LLC WORK ORDER DATE: The Work performed under this Work Order, pursuant to the Contract Documents, has been inspected by authorized representatives of the OWNER, CONTRACTOR, and the ENGINEER and the project (or specified part of the project, as indicated above) is hereby declared to be substantially completed on the above date. A tentative list of items to be completed or corrected is appended hereto. This list may not be exhaustive, and the failure to include an item on it does not alter the responsibility of the CONTRACTOR to complete all the Work in accordance with the Contract Documents. _____________________________ By: __________________________ ________ PROJECT MANAGER AUTHORIZED REPRESENTATIVE DATE The CONTRACTOR accepts the above Certificate of Substantial Completion and agrees to complete and correct the items on the tentative list within the time indicated. _____________________________ By: __________________________ ________ CONTRACTOR AUTHORIZED REPRESENTATIVE DATE The OWNER accepts the project or specified area of the project as substantially complete and will assume full possession of the project or specified area of the project at 12:01 a.m., on . The responsibility for heat, utilities, security, and insurance under the Contract Documents shall be as set forth under "Remarks" below. CITY OF FORT COLLINS ________ By: __________________________ ________ OWNER AUTHORIZED REPRESENTATIVE DATE REMARKS: _________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 27 of 108 SECTION 00640 CERTIFICATE OF FINAL ACCEPTANCE DATE: ________________, _____ TO: Gentlemen: You are hereby notified that on the day of , , the City of Fort Collins, Colorado, has accepted the Work completed by Tatonka Contractors, LLC, for the City of Fort Collins Work Order, titled , Work Order Number under 9459 Playground Surfacing Construction Services. A check is attached hereto in the amount of $ as Final Payment for all Work done, subject to the terms of the Contract Documents, including the Work Order, which is dated , and the AGREEMENT, which is dated . In conformance with the Work Order and Contract Documents for this project, your obligations and guarantees will continue for the specified time from the following date: ___________________, _____. Sincerely, City of Fort Collins OWNER By: ___________________________________________ ___________________________________________ Name & Title ATTEST: _________________________________________ ___________________________________________ Name & Title DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 28 of 108 SECTION 00650 LIEN WAIVER RELEASE (CONTRACTOR) TO: City of Fort Collins, Colorado (OWNER) FROM: Tatonka Contractors, LLC (CONTRACTOR) WORK ORDER TITLE: WORK ORDER NUMBER: ORIGINAL BID/RFP # & TITLE: 9459 Playground Surfacing Construction Services 1. The CONTRACTOR acknowledges having received payment, except retainage from the OWNER for all work, labor, skill and material furnished, delivered and performed by the CONTRACTOR for the OWNER or for anyone in the construction, design, improvement, alteration, addition or repair of the above described project. 2. In consideration of such payment and other good and valuable consideration, the receipt and adequacy of which are hereby acknowledged, the CONTRACTOR voluntarily waives all rights, claims and liens, including but not limited to, mechanic's liens, Miller Act claims (40 U.S.C.A. 270 a and b), stop notices, equitable liens and labor and material bond rights which the CONTRACTOR may now or may afterward have, claim or assert for all and any work, labor, skill or materials furnished, delivered or performed for the construction, design, improvement, alteration, addition or repair of the above described project, against the OWNER or its officers, agents, employees or assigns, against any fund of or in the possession or control of the OWNER, against the project or against all land and the buildings on and appurtenances to the land improved by the project. 3. The CONTRACTOR affirms that all work, labor and materials, furnished, delivered or performed to or for the construction, design, improvement, alteration, addition or repair of the project were furnished, delivered or performed by the CONTRACTOR or its agents, employees, and servants, or by and through the CONTRACTOR by various Subcontractors or materialmen or their agents, employees and servants and further affirms the same have been paid in full and have released in full any and all existing or possible future mechanic's liens or rights or claims against the project or any funds in the OWNER'S possession or control concerning the project or against the OWNER or its officers, agents, employees or assigns arising out of the project. 4. The CONTRACTOR agrees to defend and hold harmless the OWNER, the lender, if any, and the Surety on the project against and from any claim hereinafter made by the CONTRACTOR's Subcontractors, materialmen, employees, servants, agents or assigns against the project or against the OWNER or its officers, employees, agents or assigns arising out of the project for all loss, damage and costs, including reasonable attorneys fees, incurred as a result of such claims. 5. The parties acknowledge that the description of the project set forth above constitutes an adequate description of the property and improvements to which this Lien Waiver Release pertains. It is further acknowledged that this Lien Waiver Release is for the benefit of and DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 29 of 108 may be relied upon by the OWNER, the lender, if any, and Surety on any labor and material bonds for the project. Signed this ______ day of __________, ___. CONTRACTOR: Tatonka Contractors, LLC By: ___________________________________________ ___________________________________________ Name & Title ATTEST: _____________________________ Secretary STATE OF COLORADO ) )ss. COUNTY OF LARIMER ) Subscribed and sworn to before me this _________ day of __________, _____, by ________________________________________________________________. Witness my hand and official seal. My Commission Expires: ___________________________. _________________________ Notary Public DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 30 of 108 SECTION 00660 CONSENT OF SURETY TO: City of Fort Collins, Colorado (hereinafter referred to as the "OWNER") CONTRACTOR: Tatonka Contractors, LLC WORK ORDER # & TITLE: ORIGINAL BID/RFP # & TITLE: 9459 Playground Surfacing Construction Services CONTRACT DATE: WORK ORDER DATE: In accordance with the provisions of the Work Order and Contract between the OWNER and the CONTRACTOR as indicated above, for the Work Order titled on bond of , (Surety) _______________________________________ hereby approves of the Final Payment to the CONTRACTOR, and agrees that Final Payment to the CONTRACTOR shall not relieve the Surety Company of any of its obligations to the OWNER, as set forth in the said Surety Company's Bond. IN WITNESS WHEREOF, the Surety Company has hereunto set its hand this _________ day of _________ _, _____. ____________________________________________ (Surety Company) By: ________________________________________ (Name) Attorney-in-Fact ATTACH: Power of Attorney and Certificate of Authority of Attorney(s)-in-Fact. DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 31 of 108 SECTION 00670 APPLICATION FOR EXEMPTION CERTIFICATE DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 32 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 33 of 108 SECTION 00700 GENERAL CONDITIONS DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 34 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 35 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 36 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 37 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 38 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 39 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 40 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 41 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 42 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 43 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 44 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 45 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 46 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 47 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 48 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 49 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 50 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 51 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 52 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 53 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 54 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 55 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 56 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 57 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 58 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 59 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 60 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 61 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 62 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 63 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 64 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 65 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 66 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 67 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 68 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 69 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 70 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 71 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 72 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 73 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 74 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 75 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 76 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 77 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 78 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 79 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 80 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 81 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 82 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 83 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 84 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 85 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 86 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 87 of 108 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 88 of 108 SECTION 00800 SUPPLEMENTARY CONDITIONS Conditions of the Contract These Supplementary Conditions amend or supplement the General Conditions of the Construction Contract (EJCDC General Conditions 1910-8, 1990 edition, with City of Fort Collins Modifications, Rev. 9/94) and other provisions of the Contract Documents as indicated below. SC-1 DEFINITIONS SC-1.38. Add the following language to the conclusion of paragraph 1.38 of the General Conditions: 1.38. Substantial Completion. .... Substantial Completion is further defined as that degree of completion of the operating facilities or systems of the Project defined in the Work Order sufficient to provide the OWNER the full time, uninterrupted, continuous, beneficial operation of the modifications, and all inspections required have been completed and identified conditions corrected. SC-1.43.A. Add the following new paragraph immediately after paragraph 1.43 of the General Conditions: 1.43.A. Work Order--A written document executed by OWNER and CONTRACTOR that provides for the construction of a portion of the Work, pursuant to the Agreement and all as required by the Contract Documents, and that becomes a Contract Document when executed. SC-2 PRELIMINARY MATTERS SC-2.8. Delete paragraph 2.8 of the General Conditions entirely and replace it with the following paragraph: 2.8. Preconstruction Conference. Within ten days after the Contract Times for a Work Order start to run, but before any Work at the site is started, a conference attended by CONTRACTOR, ENGINEER and others as appropriate will be held to establish a working relationship among the parties as to the Work and to discuss the schedules referred to in paragraph 2.6, procedures for handling Shop Drawings and other submittals, processing Applications for Payment, and maintaining required records. SC-2.10. Add the following new paragraph immediately after paragraph 2.9 of the General Conditions: 2.10. Work Order Required for All Work. References to the Agreement in this Article 2 and in the General and Supplementary Conditions and Contract Documents notwithstanding, no Work shall be initiated or performed until CONTRACTOR has received a signed and executed Work Order, incorporating the Notice to Proceed, from DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 89 of 108 OWNER; and no provision of this Article 2 or of the General and Supplementary Conditions and Contract Documents shall permit or require any action of CONTRACTOR in the absence of a signed and executed Work Order. All provisions of this Article 2 and of the General and Supplementary Conditions and Contract Documents referencing the Agreement or other parts of the Contract Documents, or permitting or requiring any action of CONTRACTOR, shall be read as referencing and, as appropriate, requiring a signed and executed Work Order. SC-4 AVAILABILITY OF LANDS; SUBSURFACE AND PHYSICAL CONDITIONS; REFERENCE POINTS SC-4.2.1.2. Add the following new paragraph immediately following paragraph 4.2.1.2 of the General Conditions: 4.2.1.2.1. No drawing of physical conditions in or relating to existing surface or subsurface structures (except Underground Facilities referred to in paragraph 4.3) which are at or contiguous to the site have been utilized by the Engineer in preparation of the Contract Documents, except the following: SC-5 BONDS AND INSURANCE SC-5.4.7. Include the following parties or entities as additional insureds, as provided in paragraph 5.4.7 of the General Conditions: 5.4.7.1. City of Fort Collins, Colorado, 4316 LaPorte Avenue, Fort Collins, Colorado 80522 5.4.7.2. . SC-5.4.8.1. Add the following new paragraph immediately following paragraph 5.4.8 of the General Conditions: 9.4.8.1. Limits of Liability. The limits of liability for the insurance required by the paragraph numbers of the General Conditions listed below are as follows: For Paragraphs 5.02.A.1 and 5.02.A.2: Coverage A - Statutory Limits; Coverage B - $100,000 / $100,000 / $500,000. For Paragraphs 5.02.A.3 and 5.02.A.5: The Commercial General Liability policy will have limits of $1,000,000 combined single limits (CSL). This policy will include coverage for Explosion, Collapse, and Underground coverage unless waived by the Owner. For Paragraph 5.02.A.6: The Comprehensive Automobile Liability Insurance policy will have limits of $1,000,000 combined single limits (CSL). For Paragraph 5.02.B.3: This policy will include completed operations coverage / product liability coverage with limits of $1,000,000 combined single limits (CSL). This policy shall also include an Umbrella Excess Liability as follows: General liability and DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 90 of 108 automobile liability insurance in an amount not less than $1,000,000 per occurrence in excess of the above stated primary limits. SC-6 CONTRACTOR’S RESPONSIBILITIES SC-6.14.3. Add the following new paragraph immediately after paragraph 6.14.2 of the General Conditions: 6.14.3. The following Laws or Regulations are included in the Contract Documents as mandated by statute or for the convenience of the CONTRACTOR. Other Laws and Regulations apply which are not included herein, and are within the CONTRACTOR's duty and responsibility for compliance thereto: 6.14.3.1. Notice to owners of Underground Facilities is required prior to excavations in the vicinity of such facilities. 6.14.3.2. Unless otherwise decided by reason of the amount of the Contract Price involved, or other good reason, before or at the time that the contract is awarded to a corporation outside the State of Colorado, such corporation must carry out the proper procedure to become authorized to do business in the State of Colorado, designate a place of business therein, and appoint an agent for service of process. Such corporation must furnish the OWNER with a certificate from the Secretary of State of Colorado has been issued by its office and there shall also be procured from the Colorado Secretary of State of photostatic or certified copy of the designated of place of business and appointment of agent for service of process, or a letter from the Colorado Secretary of State that such designation of place of business and agent for service of process have been made. 6.14.3.3. The CONTRACTOR must conform to the rules and regulations of the Industrial Commission of Colorado. Particular reference is made to rules and regulations governing excavation Work adopted by the Industrial Commission of Colorado. SC-11 CHANGE OF CONTRACT PRICE SC-11.6.2.7. Add the following new paragraph to paragraph 11.6.2 of the General Conditions: 11.6.2.7. Cost of the Work. Allowances for profit, overhead and mark-up prescribed by Article 4 of the Agreement shall be used in lieu of any CONTRACTOR'S fee, overhead, profit or mark-up allowances as prescribed in paragraphs 11.6.2.1, 11.6.2.2, and 11.6.2.3. SC-12 CHANGE OF CONTRACT TIMES SC-12.3. Add the following language to the end of paragraph 12.3 of the General Conditions: 12.3. .... Lost days due to abnormal weather conditions will be allocated as required. DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 91 of 108 SC-14 PAYMENTS TO CONTRACTOR AND COMPLETION SC-14.1. Add the following language to the end of paragraph 14.1 of the General Conditions: 14.1. Schedule of Values. .... Progress payments on the fixed fee shall be in proportion to the cumulative actual Cost of the Work as a percentage of the Allowable Cost of the Work. An amount not to exceed fifteen (15%) percent of the fixed fee shall be advanced to the Contractor for mobilization in the first progress payment. DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 92 of 108 SECTION 00900 ADDENDA, MODIFICATIONS AND PAYMENT 00950 Change Order 00960 Application for Payment DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 93 of 108 SECTION 00950 CHANGE ORDER FORM CHANGE ORDER NO. CONTRACTOR: Tatonka Contractors, LLC WORK ORDER TITLE & NO. : ORIGINAL BID/RFP # & TITLE: 9459 Playground Surfacing Construction Services DESCRIPTION: 1. Reason for change: 2. Description of Change: 3. Change in Contract Cost: 4. Change in Contract Time: ORIGINAL CONTRACT COSTS $ ________________ TOTAL APPROVED CHANGE ORDER(S) $ ________________ TOTAL PENDING CHANGE ORDER(S) $ ________________ TOTAL THIS CHANGE ORDER $ ________________ TOTAL % OF ORIGINAL CONTRACT, THIS CO: _______________ % TOTAL % OF ORIGINAL CONTRACT, ALL CO’S: _______________ % ADJUSTED CONTRACT COST $ ________________ _________________ (Assuming all change orders approved) ACCEPTED BY: _____________________________________ DATE: ____________ James Ritzel - Owner ACCEPTED BY: _____________________________________ DATE: ____________ Jill Wuertz Project Manager REVIEWED BY: _____________________________________ DATE: ____________ Adam Hill Senior Buyer APPROVED BY: _____________________________________ DATE: ____________ (Gerry Paul Director of Purchasing if > $60,000) cc: City Clerk Architect/Engineer Finance Purchasing Project Manager Contractor DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 94 of 108 SECTION 00960 PAYMENT APPLICATION DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Official Purchasing Document Last updated 10/2017 Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 95 of 108 Section 00960 APPLICATION FOR PAYMENT PAGE 1 OF 4 OWNER: City of Fort Collins PROJECT: APPLICATION NUMBER: APPLICATION DATE: PERIOD BEGINNING: ENGINEER: CONTRACTOR: PERIOD ENDING: PROJECT NUMBER: CHANGE ORDERS Application is made for Payment as shown below in connection with Contract NUMBER DATE AMOUNT The present status of the account for this Contract is as follows: 1 2 Original Contract Amount: 3 Net Change by Change Order: Current contract Amount: $0.00 Total Completed and Stored to Date: Less Previous Applications: Amount Due this Application - Before Retainage: $0.00 Less Retainage: Net Change by Change Order $0.00 AMOUNT DUE THIS APPLICATION: $0.00 CERTIFICATION: The undersigned CONTRACTOR certifies that all obligations of CONTRACTOR incurred in connection with the Work have been satisfied as required in Paragraph 14.3. of the General Conditions of the Contract. The above Amount Due This Application is requested by the CONTRACTOR. Date: By: Payment of the above Amount Due This Application is recommended by the ENGINEER. Date: By: Payment of the above Amount Due This Application has been reviewed by the OWNER'S Project Manager. Date: By: Payment of the above Amount Due This Application is approved by the OWNER. Date: By: DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Official Purchasing Document Last updated 10/2017 Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 96 of 108 CONTRACT AMOUNTS APPLICATION FOR PAYMENT PAGE 2 OF 4 Work Completed Work Completed Work Completed Stored Bid This Month Previous Periods To Date Materials Total Item This Earned Percent Number Description Quantity Units Unit Price Amount Qty. Amount Qty. Amount Qty. Amount Period To Date Billed $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Official Purchasing Document Last updated 10/2017 Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 97 of 108 CHANGE ORDERS APPLICATION FOR PAYMENT PAGE 3 OF 4 Work Completed Work Completed Work Completed Stored Bid This Month Previous Periods To Date Materials Total Item This Earned Percent Number Description Quantity Units Unit Price Amount Qty. Amount Qty. Amount Qty. Amount Period To Date Billed $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTALS CHANGE ORDERS $0.00 $0.00 $0.00 $0.00 $0.00 PROJECT TOTALS $0.00 $0.00 $0.00 $0.00 $0.00 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Official Purchasing Document Last updated 10/2017 Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 98 of 108 STORED MATERIALS SUMMARY PAGE 4 OF 4 On Hand Received Installed On Hand Item Invoice Previous This This This Number Number Description Application Period Period Application $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTALS $0.00 $0.00 $0.00 $0.00 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Official Purchasing Document Last updated 10/2017 Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 99 of 108 EXHIBIT C SCOPE OF WORK I. PURPOSE The City of Fort Collins, Park Planning Department, is seeking proposals from qualified Service Providers to provide project management, design, and construction services for various playground surfacing projects throughout the City. The successful Service Provider will address all of the tasks, issues, and requested information in their proposal, possess the requisite skills, experience and manpower necessary to produce high quality projects on time and on budget, and be motivated to work with City staff, citizens, and to accomplish the project goals and objectives. II. BACKGROUND The City has historically demonstrated a need for on-call playground surfacing. Typical services requested include project design and/or construction of rubberized playground surfacing. This contract may be utilized by all City Departments and other governmental agencies. The City intends to award this agreement effective for a period of one year from the date on the Services Agreement, and may be renewable for four (4) additional one-year terms (one year at a time), at the option of the City. At time of renewal unit pricing can be negotiated with the City. Billings and payments will be made using the prices listed on the agreed to Price Schedule. In the event that a service is requested, which is not listed on the Price Schedule, the Contractor, and the City will negotiate an appropriate unit price for the service. A copy of the City's standard Professional Services Agreement is attached. III. SCOPE OF SERVICES A. Scope of Work On-Call Playground surfacing Installation and Design Services The Service Provider will work closely with City Project Managers to design conceptual, preliminary, and final improvement plans. The services to be provided will consist of, but not be limited to, the following: plan documents, renovation design and documentation, general notes, specifications, construction notes and details suitable for construction, and construction installation and observation services. The Service Provider may also assist in calculation of plan quantities, details, and other work related to producing plan documents. It is essential that the successful Service Provider’s product be compatible with Industry standards such as: • IPEMA certification • Aromatic urethane or Aliphatic urethane binder (in the top or wear layer only) • Standard manufacturers installation and materials warranty Additional requirements may include: • Attend coordination and review meetings • Coordination with other contractors (landscape, engineering, etc.) When the City provides survey data, that data will be provide in an ASCII file – comma delineated format (point number, northing, easting, elevation, description). DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Official Purchasing Document Last updated 10/2017 Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 100 of 108 For new projects, the Service Provider may be required to provide construction and/or design services. In such case, the Service Provider will work closely with a City Project Manager to produce the best possible product and within the budget constraints associated with that project. The City does not require specific design software to be used, but final drawings shall be submitted to the City in AutoCAD and as mylar documents. Our anticipated need for design and construction work is expected to be on an “as needed” basis. The Service Provider should expect that services required for individual projects could range up to 800 hours depending on the complexity of the project(s). The City is seeking Service Provider’s that can excel at delivering projects with complex requirements (City and Parks Standards etc.). Equally important is the Service Provider’s ability to quickly, efficiently and cost-effectively complete small, straightforward projects. B. Anticipated Schedule The following represents the City’s target schedule for the RFP. The City reserves the right to amend the target schedule at any time. • RFP issuance: June 27, 2022 • Question deadline: 3:00 PM MT on July 6, 2022 • Proposal due date: 3:00 PM MT (our clock) on July, 20, 2022 • Interviews (tentative): Week of August 2, 2022 • Award of Contract (tentative): Week of August 9, 2022 C. Interviews In addition to submitting a written proposal, the top-rated Service Providers may be interviewed by the RFP assessment team and asked to participate in an oral presentation to provide an overview of the company, approach to the project and to address questions. The evaluation criteria for the oral interviews will be the same as the criteria for the written evaluations and is included in Section V. Because of recent events involving COVID-19, the City may use non-traditional methods for the optional interview phase of the assessment process. The City will receive and score written proposals. However, instead of traditional in-person interviews for the optional interview session, the City may opt to use alternate methods including, but not limited to remote interviews through a platform such as Microsoft Teams or Zoom. D. Travel & Expenses Subject to the terms of the applicable Work Order, reasonable expenses will be reimbursable per the current rates found at www.gsa.gov. E. Subcontractors/Subconsultants Service Provider will be responsible for identifying any subcontractors and/or subconsultants in their proposal. Please note that the City will contract solely with the awarded Service Provider; therefore, subcontractors and/or subconsultants will be the responsibility of the Service Provider. F. Financial Qualifications (CONFIDENTIAL) DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Official Purchasing Document Last updated 10/2017 Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 101 of 108 Service Providers selected as finalists may be required to submit a banking reference and the most recent financial statement (audited preferred) including balance sheet and income statement, as well as a statement of cash flows (the “Financial Information”). G. Current standards All work and/or materials must meet current standards in force by recognized technical and professional societies, trade and materials supply associations, institutes and organizations, bureaus and testing laboratories, and national, federal, state, county, and local laws, codes and ordinances. H. Fees, Licenses, Permits The successful Service Provider shall be responsible for obtaining any necessary licenses, fees or permits without additional expense to the City. All vehicles and equipment shall be properly licensed and insured, carry the appropriate permits and be placarded as required by law. I. Laws and Regulations The Service Provider agrees to comply fully with all applicable local, State of Colorado and Federal laws and regulations and municipal ordinances to include American Disabilities Act (ADA). J. Work Orders The awarded Service Provider(s) will be required to sign the City’s Work Order Type Agreement, a sample of which is attached as Section VII for reference purposes. In the event that the City has agreements with multiple Service Providers for the Work, the City reserves the right to request proposals for individual Work Order assignments from the awarded Service Providers or assign Work Orders directly to a Service Provider at its sole discretion. Selection for individual Work Orders may be based on, but not limited to, availability, approach, prior experience, firm capability, and cost. Individual Work assignments will be requested and agreed to utilizing the City’s Work Order (included in the Agreement). Each Work Order must include a start and completion date, total cost and a Scope of Work. Subsequent supporting documentation pages may include a project schedule, deliverables, hours, cost detail supporting total cost, and personnel details. Fees outlined in the Work Order will conform with those stated in the Agreement. The maximum allowable Work Order must not exceed $300,000 unless authorized by the Purchasing Director. No Work Order over $7,500 will be considered valid until signed, at a minimum, by the Service Provider, project manager and Purchasing Department representative. Depending on the cost and nature of the Work, additional signature authorization may be required. Any changes to the dates, cost or scope of any Work Order must be agreed upon in writing utilizing the City’s Change Order (included in the Agreement) and will not be considered valid until signed, at a minimum, by the Service Provider, project manager and Purchasing Department representative. K. Invoicing and Payment Invoices should be emailed monthly to invoices@fcgov.com with a copy to the Project Manager. The cost of the work completed shall be paid to the Service Provider each month following the submittal of a correct invoice by the Service Provider indicating the project DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Official Purchasing Document Last updated 10/2017 Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 102 of 108 name, Purchase Order number, task description, hours worked, personnel/work type category, hourly rate for each employee/work type category, date of the work performed specific to the task, percentage of that work that has been completed by task, 3rd party supporting documentation with the same detail and a brief progress report. Payments will be made using the prices stated in the Work Order and Agreement. In the event a service is requested which is not stated in the Work Order and/or Agreement, the Service Provider and the City will negotiate an appropriate unit price for the service prior to the Service Provider initiating such work. The City pays invoices on Net 30 terms. L. COVID-19 Compliance The Service Provider and its subcontractors/consultants shall comply with all state, county, and local laws, ordinances, and public health orders established to reduce the spread of COVID-19, as applicable. The Service Provider shall ensure employees and subcontractors/subconsultants with COVID-19 symptoms do not report to the job site. Service Provider must organize work to ensure individuals minimize contact and maximize social distancing. Individuals must wear all standard worksite personal protective equipment (PPE). In addition, individuals should wear a mask or cloth face covering consistent with local public health recommendations and other applicable safety requirements. DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Official Purchasing Document Last updated 10/2017 Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 103 of 108 EXHIBIT D COMPENSATION DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Official Purchasing Document Last updated 10/2017 Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 104 of 108 EXHIBIT E SPECIFICATIONS POURED-IN-PLACE RUBBERIZED SURFACING MIMINUM GENERAL SPECIFICATIONS SCOPE OF WORK Supply all materials and labor required for poured-in-place rubberized safety surfacing. Surfacing shall be installed in an existing playground site, to be used as an entrance and access to play structures. Owner will provide maximum height of play structures. QUALIFICATIONS 1. Qualified installer must be a licensed contractor approved and trained by the manufacturer of the playground surfacing system. M. SUBMITTALS 1. Manufacturer must submit proof of compliance to: ♦ Certification by manufacturer that installer is an approved applicator of the playground surfacing system. ♦ U.S. Consumer Product Safety Commission publication entitled “Handbook for Public Playground Safety” ♦ American Society for Testing and Materials standard (ASTM) F1292 Standard Specification for Impact Attenuation of Surfacing Materials Within the Use Zone of Playground Equipment ♦ ASTM F1951 Standard Specification for Determination of Accessibility of Surface Systems Under and Around Playground Equipment ♦ Performance Requirements: Provide a 2 layer rubber-urethane playground surfacing system which has been designed, manufactured and installed to meet the following criteria: ♦ 1. Shock Attenuation (ASTM F1292): ♦ a. Gmax: Less than 200. ♦ b. Head Injury Criteria: Less than 1000. ♦ 2. Flammability (ASTM D2859): Pass. ♦ 3. Tensile Strength (ASTM D412): 60 psi (413 kPa). ♦ 4. Tear Resistance (ASTM D624): 140%. ♦ 5. Water Permeability: 0.4 gal/yd2/second. 2. Manufacturer’s written specifications and manufacturer’s sales brochure marked to annotate the specific product to be utilized. 3. Statement of compliance with volatile emission regulations for all components, including adhesive systems or binders. DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Official Purchasing Document Last updated 10/2017 Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 105 of 108 4. Materials Safety Data Sheet shall be submitted for the proposed product. 5. Manufacturer and installer must submit proof of liability insurance. 6. Guarantee and written warranty for materials and installation for no less than 10 years. 7. Submit a representative sample of the product and the recommended manufacturer’s installation instructions. SITE CONDITIONS If Installer is responsible for the completion of the subsurface in the area where the poured-in- place rubberized surfacing is to be applied, the Installer shall: 1. Establish and maintain required lines and elevations for grade. 2. Sub-base shall slope to provide positive drainage at a minimum of 1” per 10’ and shall not pond water at any location. 3. If surfacing is to be laid on a stone base, provide subsurface drainage where shown on plans. 4. Materials shall be delivered in clearly labeled unopened containers. 5. Materials shall be stored and handled in a manner that will insure protection from weather. 6. Materials stored on site shall be protected by use of barricades and fencing. 7. Environmental Requirements: Install surfacing system when minimum ambient temperature is 40 degrees F and maximum ambient temperature is 90 degrees F. Do not install in steady or heavy rain. PRODUCT Provide a base layer and top wearing course to meet critical fall height standards for CPSC and ASTM guidelines for maximum height of play structures provided by the owner. 1. Cast-in-place surfaces shall be manufactured on site of UV stabilized polyurethane and rubber granules, no less than specified thickness. 2. Basemat – 100% recycled SBR (Styrene Butadiene Rubber), free of all dust and extraneous fiber, metal and similar substances and urethane. Foam rubber fillers are not acceptable. 14% urethane, 86% rubber (based on entire rubber & urethane mix). 3. Top surface – 100% new EPDM (Ethylene Propylene Diene Monomer) rubber, peroxide cured, UV stabilized; size 1-3 mm. with aliphatic urethane binder. 18% urethane, 82% rubber (based on entire rubber & urethane mix). 4. Color to be determined by owner. EXECUTION When laying surfaces on a compacted stone base, proof-roll prepared sub-base surface immediately prior to paving to check for unstable loose areas and areas requiring additional compaction. Compact the base material as required to secure moisture content and a uniform compaction of not less than 90%. Compacted stone base should be water permeable and sub- grade should allow for free drainage by weeps and/or slumps. DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Official Purchasing Document Last updated 10/2017 Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 106 of 108 When laying surfaces on asphalt or concrete, be assured that the surface is fully cured for no less than 30 days for asphalt and 7 days for concrete, clean of dust and debris, oil free and dry. Fill and patch any surface irregularities with structural bonding type fillers. 1. Do not proceed with playground surfacing installation until all applicable site work, including substrate preparation, fencing, playground equipment installation and other relevant work, has been completed. 2. Notify owner of unsatisfactory conditions. Do not begin laying paving until deficient sub-base areas have been corrected and are ready to receive paving. 3. Plan the layout and placement of varying thickness zones by string line, chalk line and grade stakes to provide reference points throughout the installation process. 4. Follow manufacturer’s instructions for installation. • Basemat Installation: o Using screeds and hand trowels, install the basemat at a consistent density of 29 pounds, 1 ounce per cubic foot (466 kg/m3) to the specified thickness. o Allow basemat to cure for sufficient time so that indentations are not left in the basemat from applicator foot traffic or equipment. o Do not allow foot traffic or use of the basemat surface until it is sufficiently cured. • Primer Application: Using a brush or short nap roller, apply primer to the basemat perimeter and any adjacent vertical barriers such as playground equipment support legs, curbs or slabs that will contact the surfacing system at the rate of 300 ft2/gal (7.5 m2/L). • Top Surface Installation: o Using a hand trowel, install top surface at a consistent density of 58 pounds, 9 ounces per cubic foot (938 kg/m3) to a nominal thickness of 1/2″ (12.7 mm). o Allow top surface to cure for a minimum of 48 hours. o At the end of the minimum curing period, verify that the top surface is sufficiently dry and firm to allow foot traffic and use without damage to the surface. o Do not allow foot traffic or use of the surface until it is sufficiently cured. 5. Taper edges to existing, surrounding surfaces when shown on plan. 6. Finished site shall be free of tools, equipment, unused materials and debris; broom area clean. PROTECTION Contractor to provide fencing and barricades that shall protect finished surfaces. Owner will provide reasonable supervision on site after hours. Cure shall be no less than manufacturer’s recommendations. FINAL INSPECTION Manufacturer’s sales representative and/or installer must attend a follow up inspection with a City of Ft. Collin’s Certified Playground Safety Inspector prior to acceptance of the installation. DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Official Purchasing Document Last updated 10/2017 Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 107 of 108 EXHIBIT F INSURANCE REQUIREMENTS The Service Provider will provide, from insurance companies acceptable to the City, the insurance coverage designated hereinafter and pay all costs. Before commencing work under this bid, the Service Provider shall furnish the City with certificates of insurance showing the type, amount, class of operations covered, effective dates and date of expiration of policies. In case of the breach of any provision of the Insurance Requirements, the City, at its option, may take out and maintain, at the expense of the Service Provider, such insurance as the City may deem proper and may deduct the cost of such insurance from any monies which may be due or become due the Service Provider under this Agreement. Insurance certificates should show the certificate holder as follows: City of Fort Collins Purchasing Division PO Box 580 Fort Collins, CO 80522 The City, its officers, agents and employees shall be named as additional insureds on the Service Provider 's general liability and automobile liability insurance policies by marking the appropriate box or adding a statement to this effect on the certificate, for any claims arising out of work performed under this Agreement. Insurance coverages shall be as follows: A. Workers' Compensation & Employer's Liability. The Service Provider shall maintain during the life of this Agreement for all of the Service Provider's employees engaged in work performed under this agreement. Workers' Compensation & Employer’s Liability insurance shall conform with statutory limits of $100,000 per accident, $500,000 disease aggregate, and $100,000 disease each employee, or as required by Colorado law. B. General Liability. The Service Provider shall maintain during the life of this Agreement such General Liability as will provide coverage for damage claims of personal injury, including accidental death, as well as for claims for property damage, which may arise directly or indirectly from the performance of work under this Agreement. Coverage for property damage shall be on a "broad form" basis. The amount of insurance for General Liability, shall not be less than $1,000,000 combined single limits for bodily injury and property damage. C. Automobile Liability. The Service Provider shall maintain during the life of this Agreement such Automobile Liability insurance as will provide coverage for damage claims of personal injury, including accidental death, as well as for claims for property damage, which may arise directly or indirectly from the performance of work under this Agreement. Coverage for property damage shall be on a "broad form" basis. The amount of insurance for Automobile Liability, shall not be less than $1,000,000 combined single limits for bodily injury and property damage. In the event any work is performed by a subcontractor, the Service Provider shall be responsible for any liability directly or indirectly arising out of the work performed under this Agreement by a subcontractor, which liability is not covered by the subcontractor's insurance. DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Official Purchasing Document Last updated 10/2017 Services Agreement – Work Order Type RFP 9459 Playground Surfacing Construction Services Page 108 of 108 EXHIBIT G CONFIDENTIALITY IN CONNECTION WITH SERVICES provided to the City of Fort Collins (the “City”) pursuant to this Agreement (the “Agreement”), the Service Provider hereby acknowledges that it has been informed that the City has established policies and procedures with regard to the handling of confidential information and other sensitive materials. In consideration of access to certain information, data and material (hereinafter individually and collectively, regardless of nature, referred to as “information”) that are the property of and/or relate to the City or its employees, customers or suppliers, which access is related to the performance of services that the Service Provider has agreed to perform, the Service Provider hereby acknowledges and agrees as follows: That information that has or will come into its possession or knowledge in connection with the performance of services for the City may be confidential and/or proprietary. The Service Provider agrees to treat as confidential (a) all information that is owned by the City, or that relates to the business of the City, or that is used by the City in carrying on business, and (b) all information that is proprietary to a third party (including but not limited to customers and suppliers of the City). The Service Provider shall not disclose any such information to any person not having a legitimate need-to-know for purposes authorized by the City. Further, the Service Provider shall not use such information to obtain any economic or other benefit for itself, or any third party, except as specifically authorized by the City. The foregoing to the contrary notwithstanding, the Service Provider understands that it shall have no obligation under this Agreement with respect to information and material that (a) becomes generally known to the public by publication or some means other than a breach of duty of this Agreement, or (b) is required by law, regulation or court order to be disclosed, provided that the request for such disclosure is proper and the disclosure does not exceed that which is required. In the event of any disclosure under (b) above, the Service Provider shall furnish a copy of this Agreement to anyone to whom it is required to make such disclosure and shall promptly advise the City in writing of each such disclosure. In the event that the Service Provider ceases to perform services for the City, or the City so requests for any reason, the Service Provider shall promptly return to the City any and all information described hereinabove, including all copies, notes and/or summaries (handwritten or mechanically produced) thereof, in its possession or control or as to which it otherwise has access. The Service Provider understands and agrees that the City’s remedies at law for a breach of the Service Provider’s obligations under this Confidentiality Agreement may be inadequate and that the City shall, in the event of any such breach, be entitled to seek equitable relief (including without limitation preliminary and permanent injunctive relief and specific performance) in addition to all other remedies provided hereunder or available at law. DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF 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 8/16/2022 The Buckner Company of Colorado,LLC 6400 South Fiddlers Green Circle Suite 950 Greenwood Village CO 80111 Certificate Department 303-756-9909 Denver@Buckner.com Hartford Casualty Insurance Company 29424 6861 Owners Insurance Company 32700TatonkaContractors,LLC 14555 Quail Run Road Hudson CO 80642 Auto-Owners Insurance Company 18988 144575342 B X 1,000,000 X 300,000 10,000 1,000,000 2,000,000 X Y Y 74569271 10/20/2021 10/20/2022 2,000,000 B 1,000,000 X X X Y Y 5356927100 10/20/2021 10/20/2022 C X X 1,000,000Y53-569271-01 10/20/2021Y 10/20/2022 1,000,000 X 10,000 A XY34WECAK7WKY2/18/2022 2/18/2023 1,000,000 1,000,000 1,000,000 Certificate Holder is Additional Insured per General Liability form 55373 0517 on a Primary and Non-contributory basis per General Liability form CG2001 0413 and Business Auto form 58540 1219.Certificate Holder is Additional Insured per Business Auto form 58504 0115.Waiver of Subrogation applies per General Liability form 55091 0517,per Auto Liability form 58583 0115 and Workers'Compensation form WC000313.General Liability is per project per form 55200 0696. Additional Insured(s):City of Fort Collins,its officers,agents and employees City of Fort Collins Purchasing Division PO Box 580 Fort Collins CO 80522 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Countersigned by Authorized Representative Form WC 00 03 13 Printed in U.S.A. Process Date:01/03/22 Policy Expiration Date:02/18/23 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT Policy Number:34 WEC AK7WKY Endorsement Number: Effective Date:02/18/22 Effective hour is the same as stated on the Information Page of the policy. Named Insured and Address:TATONKA CONTRACTORS, LLC 14555 QUAIL RUN RD HUDSON CO 80642 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 shall not operate directly or indirectly to benefit anyone not named in the Schedule. SCHEDULE Any person or organization for whom you are required by contract or agreement to obtain this waiver from us. Endorsement is not applicable in KY, NH, NJ or for any MO construction risk DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1)The additional insured is a Named Insured under such other insurance; and (2)You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. CG 20 01 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Agency Code Policy Number43-0026-00 144643-57090238 55091 (5-17) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY PLUS COVERAGE 1.EXTENDED WATERCRAFT LIABILITY SECTION I - COVERAGES, COVERAGE A - BODILY INJURY AND PROPERTY DAMAGE LIA- BILITY, 2. Exclusions is amended. Exclusion g.(2) is deleted and is replaced by the following exclusion. (2)A watercraft you do not own that is: (a)Less than 50 feet long; and (b)Not being used to carry persons or property for a charge; 2.HIRED AUTO AND NON-OWNED AUTO LIABILITY Coverage for "bodily injury" and "property damage" liability provided under SECTION I - COVERAGES, COVERAGE A - BODILY INJURY AND PROP- ERTY DAMAGE LIABILITY, is extended as follows under this item, but only if you do not have any other insurance available to you which affords the same or similar coverage. Coverage We will pay those sums the insured becomes legally obligated to pay as damages because of "bodily injury" or "property damage" arising out of the main- tenance or use of an "auto": a.You do not own; b.Which is not registered in your name; or c.Which is not leased or rented to you for more than ninety consecutive days and which is used in your business. Exclusions With respect to only HIRED AUTO AND NON- OWNED AUTO LIABILITY, the exclusions which apply to SECTION I - COVERAGES, COVERAGE A - BODILY INJURY AND PROPERTY DAMAGE LIABILITY, other than the Nuclear Energy Liability Exclusion Endorsement, do not apply. The following exclusions apply to this coverage. This coverage does not apply to: a."Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" resulting from the use of reasonable force to protect persons or property. b.Any obligation of the insured under a workers compensation, disability benefits or unemploy- ment compensation law or any similar law. c.(1)"Bodily injury" or "property damage" arising out of the actual, alleged or threatened dis- charge, dispersal, seepage, migration, re- lease or escape of "pollutants": (a)That are, or are contained in any prop- erty that is: 1)Being transported or towed by, han- dled or prepared for placement into or upon, or taken from the "auto"; 2)Otherwise in the course of transit by you or on your behalf; or 3)Being disposed of, stored, treated or processed into or upon the "auto"; (b)Before such "pollutants" or property con- taining "pollutants" are moved from the place they are accepted by you or any- one acting on your behalf for placement into or onto the "auto"; or (c)After such "pollutants" or property con- taining "pollutants" are removed from the "auto" to where they are delivered, disposed of or abandoned by you or anyone acting on your behalf. Paragraph c.(1)(a) does not apply to "pol- lutants" that are needed or result from the normal mechanical, electrical or hydraulic functioning of the "auto" or its parts, if the discharge, release, escape, seepage, mi- gration or dispersal of such "pollutants" is directly from a part of the "auto" designed to hold, store, receive or dispose of such "pollutants" by the "auto" manufacturer. 55091 (5-17)Includes copyrighted material of Insurance Services Office, Inc., with its permission.Page 1 of 6 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Agency Code Policy Number43-0026-00 144643-57090238 55091 (5-17)Includes copyrighted material of Insurance Services Office, Inc., with its permission.Page 2 of 6 Paragraphs c.(1)(b) and c.(1)(c) do not ap- ply, if as a direct result of maintenance or use of the "auto", "pollutants" or property containing "pollutants" which are not in or upon the "auto", are upset, overturned or damaged at any premises not owned by or leased to you. The discharge, release, es- cape, seepage, migration or dispersal of the "pollutants" must be directly caused by such upset, overturn or damage. (2)Any loss, cost or expense arising out of any: (a)Request, demand or order that any in- sured or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of "pollutants"; or (b)Claim or "suit" by or on behalf of a gov- ernmental authority for damages be- cause of testing for, monitoring, cleaning up, removing, containing, treating, de- toxifying or neutralizing, or in any way responding to, or assessing the effects of "pollutants". d."Bodily injury" or "property damage" however caused, arising directly or indirectly, out of: (1)War, including undeclared or civil war; (2)Warlike action by a military force, including action in hindering or defending against an actual or expected attack, by any govern- ment, sovereign or other authority using mili- tary personnel or other agents; or (3)Insurrection, rebellion, revolution, usurped power, or action taken by governmental authority in hindering or defending against any of these. e."Bodily injury" or "property damage" for which the insured is obligated to pay damages by rea- son of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages: (1)Assumed in a contract or agreement that is an "insured contract", provided the "bodily injury" or "property damage" occurs subse- quent to the execution of the contract or agreement. However, if the insurance under this policy does not apply to the liability of the insured, it also does not apply to such liability assumed by the insured under an "insured contract". (2)That the insured would have in the absence of the contract or agreement. f."Property damage" to: (1)Property owned or being transported by, or rented or loaned to any insured; or (2)Property in the care, custody or control of any insured other than "property damage" to a residence or a private garage by a private passenger "auto" covered by this coverage. g.(1)"Bodily injury" to: (a)An "employee" of the insured arising out of and in the course of employment by the insured; or (b)The spouse, child, parent, brother or sis- ter of that "employee" as a consequence of Paragraph g.(1)(a). (2)This exclusion applies: (a)Whether the insured may be liable as an employer or in any other capacity; and (b)To any obligation to share damages with or repay someone else who must pay damages because of the injury. (3)This exclusion does not apply to: (a)Liability assumed by the insured under an "insured contract". (b)"Bodily injury" to any "employee" of the insured arising out of and in the course of his or her domestic employment by the insured unless benefits for such in- jury are in whole or in part either pay- able or required to be provided under any workers compensation law. Who Is An Insured With respect to only this coverage, SECTION II - WHO IS AN INSURED is deleted and replaced by the following provision. SECTION II - WHO IS AN INSURED a.Each of the following is an insured with respect to this coverage. (1)You. (2)Your partners if you are designated in the Declarations as a partnership or a joint venture. (3)Your members if you are designated in the Declarations as a limited liability company. (4)Your "executive officers" if you are desig- nated in the Declarations as an organization other than a partnership, joint venture or limited liability company. (5)Any person using the "auto" and any person or organization legally responsible for the use of an "auto" not owned by such person or organization, provided the actual use is with your permission. b.None of the following is an insured: (1)Any person engaged in the business of his or her employer with respect to "bodily in- jury" to any co-"employee" of such person injured in the course of employment. (2)Any person using the "auto" and any person other than you, legally responsible for its use with respect to an "auto" owned or reg- istered in the name of: DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Agency Code Policy Number43-0026-00 144643-57090238 55091 (5-17)Includes copyrighted material of Insurance Services Office, Inc., with its permission.Page 3 of 6 (a)Such person; or (b)Any partner or "executive officer" of yours or a member of his or her household; or (c)Any "employee" or agent of yours who is granted an operating allowance of any sort for the use of such "auto". (3)Any person while employed in or otherwise engaged in duties in connection with an "auto business", other than an "auto busi- ness" you operate. (4)The owner or lessee (of whom you are a sub-lessee) of a hired "auto" or the owner of an "auto" you do not own or which is not registered in your name which is used in your business or any agent or employee of any such owner or lessee. (5)Any person or organization with respect to the conduct of any current or past partner- ship or joint venture that is not shown as a Named Insured in the Declarations. Additional Definitions The following definition applies to only this coverage. "Auto business" means the business or occupation of selling, repairing, servicing, storing or parking "autos". Limits of Insurance With respect to only this coverage, SECTION III - LIMITS OF INSURANCE is deleted and replaced by the following provision. SECTION III - LIMITS OF INSURANCE a.The Limits of Insurance shown in the Declara- tions and the rules below fix the most we will pay regardless of the number of: (1)Insureds; (2)Claims made or "suits" brought; or (3)Persons or organizations making claims or bringing "suits". b.We will pay damages for "bodily injury" or "prop- erty damage" up to the limits of liability shown in the Declarations for this coverage. Such dam- ages shall be paid as follows: (1)When Hired Auto and Non-Owned Auto Each Occurrence Limit is shown in the Dec- larations, such limit is the total amount of coverage and the most we will pay for all damages because of or arising out of all "bodily injury" and "property damage" in any one "occurrence". (2)When Bodily Injury Hired Auto and Non- Owned Auto Each Occurrence Limit and Property Damage Hired Auto and Non- Owned Auto Each Occurrence Limit are shown in the Declarations: (a)The limit shown for Bodily Injury Hired Auto and Non-Owned Auto Each Occur- rence is the total amount of coverage and the most we will pay for all dam- ages because of or arising out of all "bodily injury" in any one "occurrence". (b)The limit shown for Property Damage Hired Auto and Non-Owned Auto Each Occurrence is the total amount of cover- age and the most we will pay for all damages because of or arising out of all "property damage" in any one "occur- rence". 3.BROADENED SUPPLEMENTARY PAYMENTS SUPPLEMENTARY PAYMENTS - COVERAGES A AND B, Paragraph 1.d. is amended. The amount we will pay for the actual loss of earn- ings is increased from $250 per day to $400 per day. 4.ADDITIONAL PRODUCTS-COMPLETED OPERA- TIONS AGGREGATE LIMIT If the endorsement, EXCLUSION - PRODUCTS COMPLETED OPERATIONS HAZARD, CG 21 04, is not attached to this policy, then the following pro- vision is added to SECTION III - LIMITS OF INSURANCE. Commencing with the effective date of this policy, we will provide one additional Products-Completed Operations Aggregate Limit, for each annual period, equal to the amount of the Products-Completed Operations Aggregate Limit shown in the Declara- tions. The maximum Products-Completed Opera- tions Aggregate Limit for any annual period will be no more than two times the original Products-Com- pleted Operations Aggregate Limit. 5.PERSONAL INJURY EXTENSION a.If the endorsement EXCLUSION - PERSONAL AND ADVERTISING INJURY, CG 21 38, is attached to this policy, then this provision, 5. PERSONAL INJURY EXTENSION, does not apply. b.If the endorsement EXCLUSION - PERSONAL AND ADVERTISING INJURY, CG 21 38, is not attached to this policy, then under SECTION V - DEFINITIONS, 14. "Personal and advertising injury" is deleted and replaced by the following definition. 14."Personal and advertising injury" means in- jury, including consequential "bodily injury", arising out of one or more of the following offenses: a.False arrest, detention or imprisonment; b.Malicious prosecution; c.The wrongful eviction from, wrongful en- try into, or invasion of the right of private DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Agency Code Policy Number43-0026-00 144643-57090238 55091 (5-17)Includes copyrighted material of Insurance Services Office, Inc., with its permission.Page 4 of 6 occupancy of a room, dwelling or prem- ises that a person occupies, committed by or on behalf of its owner, landlord or lessor; d.Oral or written publication, in any man- ner, of material that slanders or libels a person or organization or disparages a person's or organization's goods, pro- ducts or services; e.Oral or written publication, in any man- ner, of material that violates a person's right of privacy; f.The use of another's advertising idea in your "advertisement"; g.Infringing upon another's copyright, trade dress or slogan in your "advertisement"; or h.Discrimination, humiliation, sexual ha- rassment and any violation of civil rights caused by such discrimination, humilia- tion or sexual harassment. 6.BROADENED KNOWLEDGE OF OCCURRENCE SECTION IV - COMMERCIAL GENERAL LIABIL- ITY CONDITIONS, 2. Duties In The Event Of Oc- currence, Offense, Claim Or Suit is amended. The following condition is added. Paragraphs a. and b. of this condition will not serve to deny any claim for failure to provide us with notice as soon as practicable after an "occurrence" or an offense which may result in a claim: a.If the notice of a new claim is given to your "em- ployee"; and b.That "employee" fails to provide us with notice as soon as practicable. This exception shall not apply to you or to any offi- cer, director, partner, risk manager or insurance manager of yours. 7.DAMAGE TO PREMISES RENTED TO YOU a.SECTION I - COVERAGES, COVERAGE A - BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions is amended. (1)The last paragraph is deleted and replaced by the following paragraph. Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke or water damage to premises rented to you or temporarily occupied by you with permis- sion of the owner. A separate limit of insur- ance applies to this coverage as described in 7. DAMAGE TO PREMISES RENTED TO YOU, b. Limits of Insurance. (2)The following additional exclusions apply to "property damage" arising out of water damage to premises rented to you or temporarily occupied by you with permission of the owner. (a)"Property damage" to: 1)The interior of the premises caused by or resulting from rain or snow, whether driven by wind or not; or 2)Heating, air conditioning, plumbing or fire protection systems, or other equipment or appliances. (b)"Property damage" caused by or resulting from any of the following: 1) Mechanical breakdown, including bursting or rupture caused by centrifugal force; 2)Cracking, settling, expansion or shrinking; 3)Smoke or smog; 4)Birds, insects, rodents or other animals; 5)Wear and tear; 6)Corrosion, rust, decay, fungus, de- terioration, hidden or latent defect or any quality in property that causes such property to destroy or damage itself; or 7)Water that flows or leaks from any heating, air conditioning, plumbing or fire protection system caused by or resulting from freezing, unless: a)You make a reasonable effort to maintain heat in the building or structure; or b)You drain the equipment and shut off the water supply if the heat is not maintained. (c)"Property damage" caused directly or indirectly by any of the following: 1)Water that backs up from a drain or sewer; 2)Mud flow or mudslide; 3)Volcanic eruption, explosion or effusion; 4)Any earth movement, such as earth- quake, landslide, mine subsidence, earth sinking, earth rising or earth shifting; 5)Regardless of the cause, flood, surface water, waves, tides, tidal waves, storm surge, overflow of any body of water, or their spray, all whether wind driven or not; or 6)Water under the ground surface pressing on, or seeping or flowing through: a)Walls, foundations, floors or paved surfaces; DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Agency Code Policy Number43-0026-00 144643-57090238 55091 (5-17)Includes copyrighted material of Insurance Services Office, Inc., with its permission.Page 5 of 6 b)Basements, whether paved or not; or c)Doors, windows or other openings. (d)"Property damage" for which the insured is obligated to pay as damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the insured would have in the absence of this contract or agreement. b.Limits of Insurance With respect to this coverage only, under SEC- TION III - LIMITS OF INSURANCE, Paragraph 6. is deleted and replaced by the following Paragraph. 6.The most we will pay under Coverage A for damages because of "property damage" to premises rented to you or temporarily occu- pied by you with permission of the owner arising out of or caused by fire, lightning, explosion, smoke and water damage is the amount shown in the Declarations under Damage to Premises Rented to You. c.SECTION IV - COMMERCIAL GENERAL LIA- BILITY CONDITIONS, 4. Other Insurance, Paragraph b. is amended. The word fire is amended to include fire, lightning, explosion, smoke or water damage. 8.BLANKET ADDITIONAL INSURED - LESSOR OF LEASED EQUIPMENT a.(1)SECTION II - WHO IS AN INSURED is amended to include as an additional insured any person or organization with whom you have agreed: (a)In a written contract or agreement, exe- cuted prior to loss, to name as an addi- tional insured; or (b)In an oral contract or agreement, exe- cuted prior to loss, to name as an addi- tional insured only if a Certificate of Insurance was issued prior to loss indi- cating that the person or organization was an additional insured. (2)This provision applies only with respect to liability for: (a)"Bodily injury"; (b)"Property damage"; or (c)"Personal and advertising injury" caused in whole or in part, by your mainte- nance, operation or use of equipment leased to you by such person or organization. b.With respect to the insurance afforded to an additional insured, this insurance does not apply to any "occurrence" which takes place after the equipment lease expires. c.The following provision is added to SECTION III - LIMITS OF INSURANCE. The Limits of Insurance for the additional in- sured are those specified in the written contract or agreement between the insured and the les- sor, not to exceed the limits provided in this pol- icy. These limits are inclusive of and not in addi- tion to the Limits of Insurance shown in the Declarations. 9.BLANKET ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES a.SECTION II - WHO IS AN INSURED is amended to include as an additional insured any person or organization with whom you have agreed: (1)In a written contract or agreement, executed prior to loss, to name as an additional insured; or (2)In an oral contract or agreement, executed prior to loss, to name as an additional in- sured only if a Certificate of Insurance was issued prior to loss indicating that the per- son or organization was an additional insured but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you. b.This provision is subject to the following addi- tional exclusions. (1)Any "occurrence" which takes place after you cease to be a tenant in that premises. (2)Structural alterations, new constructions or demolition operations performed by or on behalf of the additional insured. c.The following provision is added to SECTION III - LIMITS OF INSURANCE. The Limits of Insurance for the additional in- sured are those specified in the written contract or agreement between the insured and the manager or lessor of the premises, not to ex- ceed the limits provided in this policy. These limits are inclusive of and not in addition to the Limits of Insurance shown in the Declarations. 10.NEWLY FORMED OR ACQUIRED ORGANIZA- TIONS SECTION II - WHO IS AN INSURED is amended. Paragraph 3. is deleted and replaced by the follow- ing provision. 3.Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company, and over which you maintain DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Agency Code Policy Number43-0026-00 144643-57090238 55091 (5-17)Includes copyrighted material of Insurance Services Office, Inc., with its permission.Page 6 of 6 ownership or majority interest, will qualify as a Named Insured if there is no other similar insur- ance available to that organization. However: a.Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the pol- icy period, whichever is earlier; b.Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization; and c.Coverage B does not apply to "personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability com- pany that is not shown as a Named Insured in the Declarations. 11.BLANKET WAIVER OF SUBROGATION SECTION IV - COMMERCIAL GENERAL LIABIL- ITY CONDITIONS is amended. The following provi- sion is added to 8. Transfer Of Rights of Recov- ery Against Others To Us. When you have agreed to waive your right of subro- gation in a written contract, executed prior to loss, with any person or organization, we waive any right to recovery we may have against such person or organization because of payments we make for in- jury or damage arising out of your ongoing opera- tions or "your work" done under a contract with that person or organization and included in the "products-completed operations hazard". All other policy terms and conditions apply. DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF Agency Code Policy Number43-0026-00 194643-57572464 55373 (5-17) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 55373 (5-17)Includes copyrighted material of Insurance Services Office, Inc., with its permission.Page 1 of 1 A.Under SECTION II - WHO IS AN INSURED is amended. The following provision is added. A person or organization is an Additional Insured, only with respect to liability caused, in whole or in part, by "your work" for that Additional Insured by or for you: 1.If required in a written contract or agreement; or 2.If required by an oral contract or agreement only if a Certificate of Insurance was issued prior to the loss indicating that the person or organiza- tion was an Additional Insured. B.SECTION III - LIMITS OF INSURANCE is amended. The following provision is added. The limits of liability for the Additional Insured are those specified in the written contract or agreement between the insured and the owner, lessee or con- tractor or those specified in the Certificate of Insur- ance, if an oral contract or agreement, not to exceed the limits provided in this policy. These limits are inclusive of and not in addition to the limits of insurance shown in the Declarations. C.SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS is amended. 1.The following condition is added to 4. Other Insurance. This insurance is primary for the Additional Insured, but only with respect to liability caused, in whole or in part, by "your work" for that Addi- tional Insured by or for you. Other insurance available to the Additional Insured will apply as excess insurance and not contribute as primary insurance to the insurance provided by this endorsement. 2.The following condition is added. Other Additional Insured Coverage Issued By Us If this policy provides coverage for the same loss to any Additional Insured specifically shown as an Additional Insured in another endorsement to this policy, our maximum limit of insurance under this endorsement and any other endorse- ment shall not exceed the limit of insurance in the written contract or agreement between the insured and the owner, lessee or contractor, or the limits provided in this policy, whichever is less. Our maximum limit of insurance arising out of an "occurrence", shall not exceed the limit of insurance shown in the Declarations, regard- less of the number of insureds or Additional Insureds. All other policy terms and conditions apply. DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF 58504 (1-15) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE - BLANKET COVERAGE This endorsement modifies insurance provided under the following: COMMERCIAL AUTO POLICY SECTION II - COVERED AUTOS LIABILITY COVER- AGE is amended. The following provision is added. Any person or organization is an insured for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an insured under SECTION II - COVERED AUTOS LIABILITY COVER- AGE, A. COVERAGE, 1. Who Is An Insured. All other policy terms and conditions apply. 58504 (1-15)Includes copyrighted material of Insurance Services Office, Inc., with its permission.Page 1 of 1 DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF DocuSign Envelope ID: 125468F2-0BA4-42A5-98B8-CA59802460BF