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HomeMy WebLinkAboutContract - G-2 - BID - 9945 Hauling Services 2024 BID 9945 Hauling Services 2024 Page 18 of 23 SERVICES AGREEMENT 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 , 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. Scope of Services. The Service Provider agrees to provide services in accordance with the scope of services attached hereto as Exhibit A, consisting of four (4) pages and incorporated herein by this reference. Irrespective of references in Exhibit A to certain named third parties, Service Provider shall be solely responsible for performance of all duties hereunder. 2. Contract Period. This Agreement shall commence April 1st, 2024 and shall continue in full force and effect until March 31st, 2025, unless sooner terminated as herein provided. 3. Delay. If either party is prevented in whole or in part from performing its obligations by unforeseeable causes beyond its reasonable control and without its 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. 4. Early Termination by City. 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 delivered at least ten (10) days prior to the termination date contained in said notice unless otherwise agreed in writing by the parties. 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. 5. Notices. All notices provided under this Agreement shall be effective immediately when emailed or three (3) business days from the date of the notice when mailed to the following addresses: G-2 LLC DocuSign Envelope ID: 35D449E8-101F-452C-A370-BB2F3CE8CBBB BID 9945 Hauling Services 2024 Page 19 of 23 Service Provider: City: Copy to: Attn: City of Fort Collins Attn: James Reed PO Box 580 Fort Collins, CO 80522 Jreed@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. Such payment shall be the Service Provider's sole right and remedy for such termination. 6. Contract Sum. The City shall pay the Service Provider for the performance of this Contract, subject to additions and deletions provided herein, per the attached Exhibit B, consisting of two (2) pages, and incorporated herein by this reference. 7. City Representative. The City will designate, prior to commencement of the work, its representative who shall make, within the scope of his or her authority, all necessary and proper decisions with reference to the services provided under this agreement. All requests for contract interpretations, change order, and other clarification or instruction shall be directed to the City Representative. The initial City Representative for this agreement is James Reed and can be reached at jreed@fcgov.com. The Representative is subject to change by the City. 8. Independent Service Provider. The services to be performed by Service Provider are those of an independent service provider and not of an employee of the City of Fort Collins. The City shall not be responsible for withholding any portion of Service Provider's compensation hereunder for the payment of FICA, Workmen's Compensation or other taxes or benefits or for any other purpose. 9. Subcontractors. Service Provider may not subcontract any of the Work set forth in the Exhibit A, Statement of Work without the prior written consent of the city, which shall not be unreasonably withheld. If any of the Work is subcontracted hereunder (with the consent of the City), then the following provisions shall apply: (a) the subcontractor 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 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 and the City, nor will it obligate the City to pay or see to the payment of any subcontractor, and (d) the work of the subcontractor will be subject to inspection by the City to the same extent as the work of the Service Provider. 10. 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 Wellington, CO 80549 14003 North County Rd 7 Garrett Glascott G-2 LLC DocuSign Envelope ID: 35D449E8-101F-452C-A370-BB2F3CE8CBBB BID 9945 Hauling Services 2024 Page 20 of 23 consent of the City. 11. 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 or benefits provided to the City under this Agreement or cause of action arising out of performance of this Agreement. 12. Warranty. The Service Provider represents and warrants that all services provided hereunder will be performed in a good and workmanlike manner and in conformance to the requirements of this Agreement. Service Provider further warrants that as of the Effective Date it has, and that at all times during the term hereof it shall have and maintain, at its sole expense, all licenses, certifications, approvals, insurance, permits, and other authorizations required by law to perform its obligations hereunder. Any revocation, withdrawal or non- renewal of licenses, certifications, approvals, insurance, permits or any such similar requirements necessary for Service Provider to properly perform the terms of this Agreement is a material breach by Service Provider and constitutes grounds for termination of this Agreement. 13. 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. 14. 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 himself 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. 15. Binding Effect. This writing, together with the exhibits hereto, constitutes the entire agreement between the parties 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. 16. 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 DocuSign Envelope ID: 35D449E8-101F-452C-A370-BB2F3CE8CBBB BID 9945 Hauling Services 2024 Page 21 of 23 under this Agreement of the type and with the limits specified within Exhibit C, consisting of two (2) pages, attached hereto and incorporated herein by this reference. In the event the Service Provider is exempt from Workers’ Compensation, the Service Provider shall complete Exhibit D – Certificate of Exemption from Statutory Workers’ Compensation Law and Acknowledgement of Risk/Hold Harmless Agreement, 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, 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. 17. Entire Agreement. This Agreement, along with all Exhibits and other documents incorporated herein, shall constitute the entire Agreement of the parties. Covenants or representations not contained in this Agreement shall not be binding on the parties. 18. Law/Severability. The laws of the State of Colorado shall govern the construction interpretation, execution and enforcement of this Agreement. 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. 19. 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 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 Service Providers 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 Service Providers and their subcontractors at every tier. 20. Public Contracts for Services. The Service Provider verifies, warrants, and agrees that it is aware of, and if applicable shall comply with, C.R.S. Sec. 8-17.6-101 and -102 in its employment, contracting and subcontracting practices with respect to performing work under this Agreement. In the event the Service Provider fails to comply with any requirements of C.R.S. Sec. 8-17.6-101 and -102, the City may terminate this Agreement for breach and, if DocuSign Envelope ID: 35D449E8-101F-452C-A370-BB2F3CE8CBBB BID 9945 Hauling Services 2024 Page 22 of 23 so terminated, the Service Provider shall be liable for actual and consequential damages. 21. 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. 22. 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. 23. 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. DocuSign Envelope ID: 35D449E8-101F-452C-A370-BB2F3CE8CBBB BID 9945 Hauling Services 2024 Page 23 of 23 THE CITY OF FORT COLLINS, COLORADO By: Gerry Paul Purchasing Director DATE: COMPANY NAME By: Printed: Title: Date: 3/5/2024 Owner Garrett Glascott G-2 LLC DocuSign Envelope ID: 35D449E8-101F-452C-A370-BB2F3CE8CBBB 3/27/2024 BID 9945 Hauling Services 2024 Page 9 of 23 EXHIBIT A SCOPE OF WORK 1. Service Provider must be able to provide the equipment bid and a qualified driver Sunday through Saturday at any time, within twelve (12) hours of being called by the City Representative or designated Truck Boss. Phone contact with a company representative, qualified to dispatch equipment, must be available at all times. The City Representative will try to schedule night/weekend work in advance, if possible. Service Provider must own all trucks. 2. The equipment and the driver shall be used primarily to haul asphalt from various asphalt plants to the job site as directed by the City Representative. Material from the job site may also be hauled to various other job sites, or dump sites located around the City, as directed by the City Representative. Other City departments (other than Streets Department) may use this bid for hauling. Equipment and drivers shall report in at the time and location, as directed by the City Representative, mechanically sound and fully prepared to work a full day. Any tipping fees from the Larimer County landfill would be reimbursed at those fee rates (pass through) with included receipt. 3. All Drivers must have a valid CDL and be qualified to operate the equipment. Any driver who operates a commercial motor vehicle, as defined in §382.107, in intrastate or interstate commerce and is subject to the commercial driver’s license requirement of 49 CFR part 383 must be included in an alcohol and controlled substances testing program under the Federal Highway Administration’s rule. Documentation of proof must be submitted with this bid (see BID SUBMITTAL INSTRUCTIONS). 4. Drivers must be mentally and physically alert, and capable of maintaining safe control of their vehicle at all times. Drivers must be properly dressed for work in the construction environment. a. Hard Hats – American National Standards Institute (ANSI) approved, must be worn all times when outside a vehicle or equipment. b. Eye Protection – ANSI approved, must be worn when drivers are exposed to machines, equipment, or operations that present a potential eye injury. c. Footwear – suitable footwear that fits and provides adequate protection from hazards present at the construction site must be worn at all times. d. Safety Vests – ANSI Class II must be worn at all times on the job site or public right- of-way. Night work will require a Class III Safety Vest. e. Safety items listed in 4.a. thru 4.d. are the responsibility of the driver/Service Provider. f. No animals/pets are allowed on facilities or job sites. 5. All drivers must attend a Spring pre-construction meeting to review this scope of work. 6. All equipment must comply with all Department of Transportation (DOT), CDL, and any other local/State/Federal requirements including able to clear Port of Entry, Portable Scales, and possess current inspection stickers. Trucks must be equipped with an effective load covering DocuSign Envelope ID: 35D449E8-101F-452C-A370-BB2F3CE8CBBB BID 9945 Hauling Services 2024 Page 10 of 23 tarp, asphalt apron (asphalt lip), and backup alarms. Trucks shall always tarp all loads when hauling material. The City of Fort Collins reserves the right to inspect vehicles and to remove any truck from a jobsite that has equipment maintenance issues such as bald tires, leaks, and/or any issue which takes the equipment out of DOT compliance. Repeat issues of non-compliance may result in a suspension and/or contract termination. 7. All work shall be done in a professional, safe, courteous and efficient manner. The driver shall exercise the utmost courtesy to other drivers, the City, and the public. Foul language or gestures on the job and during radio communications is strictly prohibited. 8. Drivers must use appropriate sanitary facilities for restroom breaks as provided by the City on each job site or facility. 9. The City shall not be responsible for any equipment failures, damage to equipment, or maintenance required on the equipment. The Service Provider is responsible for all fuel required. 10. The City has adopted a “Limitation on Engine Idling” to discourage the idling of vehicle engines. The Service Provider must comply with turning off vehicles instead of idling for long periods (more than thirty seconds, as a general rule). The City also desires that Service Provider’s run biodiesel in their trucks. 11. Any damage caused by the Service Provider’s equipment or driver shall be the sole responsibility of the Service Provider. The Service Provider shall indemnify and hold harmless the City for any damage done by the Service Provider’s equipment/driver to any persons, property, or any part of the right-of-way. 12. At no time whatsoever shall the driver be considered or become a City employee. However, the driver must understand that their actions reflect upon the City. 13. The City will not guarantee hours. Service Providers will be used on an as-needed basis, based on rates, job site requirements, availability, type of equipment, and past performance in the event of a violation of the rules. The City reserves right to choose which Service Providers and trucks or tractor/trailers are utilized on each project that meets the best interests of the City. 14. In the event a Service Provider chooses to pull off a City project to work for another company or contractor, the City reserves the right to utilize other Service Providers in their place for the duration of the project at the City Representative’s discretion. Also, such Service Providers may not return to the project. Exceptions may be made at the City Representative’s discretion which may include mechanical breakdowns, illnesses, etc. 15. Hours worked must be approved at the end of each day by the City Representative. Hours will be counted from the time of arrival on the job site (not from the time of notification or departure time from the Service Provider’s site) and will end after the last load is unloaded. In the event, that a project is cancelled for the day and the City Representative is unable to provide a one-hour cancellation notice, the Service Provider shall be paid a one hour show up time. Service Provider will get signed out at the jobsite if empty and are not needed any DocuSign Envelope ID: 35D449E8-101F-452C-A370-BB2F3CE8CBBB BID 9945 Hauling Services 2024 Page 11 of 23 further. If you are loaded and need to dump at Hoffman Mill you will have ½ hour added for your time for travel. 16. The City shall have the option to proceed with calling the next available Service Provider if the lowest cost Service Provider with the required equipment is not available and/or cannot commit to support the project duration or other project requirements. In case of a tie based on the hourly rates quoted, the City Representative will alternate calling the tied Service Providers. At the discretion of the City, Service Providers who were not included in the original bid may be added to the Agreement but will be added to the end of the list, regardless of price, upon submission of all required documentation and subsequent approval by the City. While the City intends to select Service Providers for each project based on rates, job site requirements, Service Provider availability, and equipment, the City reserves the right to choose the Service Provider best qualified to perform the work in the City’s sole judgement and discretion. 17. The City will award to all responsive and responsible bidders. However, the City intends to prioritize and utilize Service Providers based on price, availability, responsiveness, and equipment. All equipment or subcontracted equipment needs to be included on the bid form at time of the bid, with all requirements listed in the Bid Submittal. If new equipment or subcontracted equipment is requested to be added by the Service Provider, Service Provider shall issue this information along with all Bid Submittal requirements to the City for their review and approval. If accepted the City will issue Service Provider an amendment to their contract and this newly added equipment will be placed at the end of the call list. 18. The Service Provider must provide Workman’s Compensation insurance in accordance with Exhibit C of the Services Agreement, unless he Service Provider has no employees as defined by the Workers’ Compensation Act of Colorado, C.R.S. §§ 8-40-101, et seq., (the “Act”). In such event, the Service Provider shall complete the workman’s compensation waiver (Exhibit D). The Service Provider must immediately notify the City of any changes to this status. 19. If changes occur, the Service Provider must provide a driver’s name with copy of CDL driver’s license, insurance including liability/workman’s compensation and proof of alcohol and controlled substances testing program under the Federal Highway Administration’s rule. It is the Service Provider’s responsibility to immediately send any changes in drivers to the City Purchasing department and include the required above documentation. Non- compliance may result in a suspension and/or contract termination. 20. The City of Fort Collins has adopted a Dust Prevention and Control Manual: http://www.fcgov.com/purchasing/pdf/dust_prevention_control_manual.pdf. All operations conducted under this Agreement shall be performed in accordance with the stated procedures and requirements. 21. Invoices & Payments: Invoices for services should be emailed upon completion of the Work, or as otherwise specified in the Agreement, to the City Representative and to invoices@fcgov.com. The cost of the work completed shall be paid to the Service Provider on Net 30 terms following the submittal of a City Representative approved invoice by the Service Provider indicating the Purchase Order number, project name and address, task description, hours worked, personnel/work type category, hourly rate for each employee/work type DocuSign Envelope ID: 35D449E8-101F-452C-A370-BB2F3CE8CBBB BID 9945 Hauling Services 2024 Page 12 of 23 category, date of the work performed specific to the task, percentage of that work that has been completed by task (if applicable), 3rd party supporting documentation with the same detail (if applicable) and a brief progress report (if applicable). 22. The City reserves the right to discipline companies for violations of these rules. The first violation may result in a written warning and removal from job site. Any subsequent violation may result in, depending on the violation, suspension and/or contract termination. In addition, the City reserves the right to suspend and/or terminate the contract for violations of the rules without a written warning depending on the severity of the violation and may result in an exclusion from participating in future bids for a period up to (3) years. DocuSign Envelope ID: 35D449E8-101F-452C-A370-BB2F3CE8CBBB BI D 9 94 5 Ha u l i n g S e r v i c e s 20 2 4 Pa g e 13 of 2 3 EX H I B I T B BI D S C H E D U L E - 99 4 5 Ha u l i n g S e r v i c e s 20 2 4 Yo u m a y a t t a c h a s e p a r a t e p a g e w i t h a n e q u i p m e n t l i s t i n c l u d i n g i n f o r m a t i o n s h o w n b e l o w -- Pl e a s e i n c l u d e S e r v i c e P r o v i d e r n a m e . EQ U I P M E N T YR MA K E MO D E L CU B I C YAR DS HP TR A I L E R YEA R & T Y P E (En d , B e l l y , Li v e Bo t t o m , Si d e , et c .) $/ H R . TR A C T O R / T R L T R U C K S w i t h t r a i l e r (No t p a i d f o r s e p a r a t e l y ) Ye a r Ty p e $ $ $ $ $ $ $ $ $ $ $ $ $ TA N D E M D U M P T R U C K S $ $ $ $ $ TA N D E M D U M P T R U C K S W / P U P $ $ $ $ 85 . 0 0 40 0 8 W9 0 0 Ke n w o r t h 19 8 6 85 . 0 0 47 5 8 37 9 Pe t e r b u i l t 19 9 9 DocuSign Envelope ID: 35D449E8-101F-452C-A370-BB2F3CE8CBBB BI D 9 94 5 Ha u l i n g S e r v i c e s 20 2 4 Pa g e 14 of 2 3 SK I D S T E E R w i t h O P E R A T O R $ $ $ $ BA C K H O E w i t h O P E R A T O R $ $ $ $ MI N I E X C A V A T O R w i t h O P E R A T O R $ $ $ $ *Fa i l u r e t o p r o v i d e s a i d e q u i p m e n t w i t h q u a l i f i e d d r i v e r s a s l i s t e d i n t h e b i d s u b m i t t e d m a y r e s u l t i n c o n t r a c t t e r m i n a t i o n. DocuSign Envelope ID: 35D449E8-101F-452C-A370-BB2F3CE8CBBB BID 9945 Hauling Services 2024 Page 8 of 23 BID AUTHORIZATION Service Provider hereby acknowledges receipt of the City of Fort Collins Invitation to Bid for 9945 Hauling Services 2024 and acknowledges that it has read and agrees to be fully bound by all of the terms, conditions and other provisions set forth in the Bid. Additionally, the Service Provider hereby makes the following representations to the City of Fort Collins: a. All of the statements and representations made in this Bid Submittal are true to the best of the Service Provider’s knowledge and belief. b. Service Provider commits that it is able to meet the terms by this Invitation to Bid. c. This Bid Submittal is a firm and binding offer, for a period of 90 days from the date hereof. d. Service Provider further agrees that the method of award is acceptable. e. Service Provider acknowledges no conflict of interest. f. Service Provider acknowledges receipt of addenda. Legal Firm Name: Physical Address: Remit to Address: Phone: Name of Authorized Agent of Firm: Signature of Authorized Agent: Primary Contact for Project: Title: Email Address: Phone: Cell Phone: NOTE: AUTHORIZATION IS TO BE SIGNED & RETURNED WITH YOUR BID. (970) 231-8878 garrettglascott@gmail.comOwner Garrett Glascott Garrett Glascott (970) 231-8878 14003 North County Road 7, Wellington CO 80549 14003 North County Road 7, Wellington CO 80549 G-2 LLC DocuSign Envelope ID: 35D449E8-101F-452C-A370-BB2F3CE8CBBB BID 9945 Hauling Services 2024 Page 15 of 23 EXHIBIT C INSURANCE REQUIREMENTS 1. 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, 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 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. The City, its officers, agents and employees shall be named as additional /insurers on the Service Provider '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 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: 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 Service Provider 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 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: 35D449E8-101F-452C-A370-BB2F3CE8CBBB 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-MAIL ADDRESS: 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 ER OTH- STATUTE PER LIMITS(MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) POLICY EFF POLICY NUMBERTYPE OF INSURANCELTR INSR 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 Fort Collins CO 80521 215 n. Mason 2nd floor CITY OF FORT COLLINS 1,000,000 05/01/202411/01/2023969152397Y8 198 A 10,000Tenants Liability 3,000,000 3,000,000 1,000,000 10,000 300,000 1,000,000 07/07/202407/07/2023ZK3003Y 8 8 8 A PROGRESSIVE 14184ACUITY A MUT INS CO 80549COWellington 14003 N County Road 7 G-2 LLC Sean@skieswest.com (970) 223-7611 RICHARD SHORTRIDGE 80524COFORT COLLINS 1531 RIVERSIDE AVE UNIT A SKIES WEST IS AGENCY INC. 3/14/2024 DocuSign Envelope ID: 35D449E8-101F-452C-A370-BB2F3CE8CBBB BID 9945 Hauling Services 2024 Page 17 of 23 EXHIBIT D CERTIFICATE OF EXEMPTION FROM STATUTORY WORKERS’ COMPENSATION LAW AND ACKNOWLEDGEMENT OF RISK/HOLD HARMLESS AGREEMENT I, __________________________, as an owner ☐ member  partner ☐ stockholder  (check one) in ______________________________________(insert business name), a Sole Proprietorship ☐ Limited Liability Company ☐ Partnership ☐ Corporation ☐ (check one), with a principal address of, _____________________________________certify to the City of Fort Collins, Colorado (the “City”) that the aforementioned business has no employees as defined by the Workers’ Compensation Act of Colorado, C.R.S. §§ 8-40-101, et seq., (the “Act”) other than those owners, members, partners, directors or other principals that have elected to be exempt from Workers’ Compensation coverage in accordance with Colorado law. On behalf of said business and its officers, agents, insurers, heirs, legal representatives, successors and assigns (collectively the “Business”), I warrant that I have full authority to execute this Exhibit on behalf of the Business. I warrant I understand the requirements of the Act with respect to providing Workers’ Compensation coverage for any employees of the Business. If the Business’s status changes in such a manner that requires Workers’ Compensation Insurance, the Business shall provide the City with a Certificate of Insurance evidencing proof of Workers’ Compensation Insurance coverage and Employer’s Liability Insurance coverage as required by the Agreement. The Business shall provide such Certificate of Insurance prior to the employees’ start of work for the City. On behalf of the Business, I acknowledge the Business may be contracting to engage in activities that involve a risk of personal injury, that the Business is capable of performing the activities, and that the Business shall take all necessary precautions to prevent injury. The Business does hereby waive, release and forever discharge and hold harmless the City, its officers, employees, agents and insurers from any and all liability, damages, claims, causes of action and demands with respect to any bodily injury, personal injury, illness, or death that may result from the performance of the Agreement, either in law or equity, whether caused by the negligence or breach of contract of the City its officers, employees, agents and insurers or otherwise. The Business also understands that the City, its officers, employees, agents and insurers do not assume any responsibility for, or obligation to, provide the Business with financial assistance or other assistance, including but not limited to medical, health, or disability insurance in the event of any bodily injury, personal injury, illness or death The Business agrees to defend, indemnify, and hold harmless the City from any and all such claims. As an independent contractor, the Business acknowledges that neither the Business nor any person employed by or serving the Business is entitled to workers’ compensation benefits from the City. The Business hereby waives any rights or claims to workers’ compensation benefits from the City and agrees to indemnify and hold the City harmless against any claims for such benefits by any officer, director, owner, employee, or servant of the Business or any other person claiming through the Business. By signing this Certificate, the Business acknowledges that it is responsible and liable for all work-related injuries, and further requests the City waive its requirement for evidence of Workers’ Compensation Insurance. BUSINESS: By: Printed: Title: Date: 3/5/2024 Owner Garrett Glascott G-2 LLC 14003 North County Rd 7, Wellington CO 80549 X G-2 LLC XGarrett Glascott DocuSign Envelope ID: 35D449E8-101F-452C-A370-BB2F3CE8CBBB