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Home My WebLink AboutCORRESPONDENCE - BID - 5694 BACKFLOW TESTING ANNUALAdministrative Services MAY 12 2003 Purchasing Division City of Fort Collins May 5, 2003 Pierre DeMiltt, LLC P.O. Box 164 Severance, CO 80546 Re: Bid #5694 Backflow Testing The City of Fort Collins has elected to renew Bid #5694 Backflow Testing for the City of Fort Collins with your firm. The terms and conditions of this renewal will be the same as stated in the original bid documents. If the renewal is acceptable to your firm, please sign this letter in the space provided and return along with a current copy of your insurance to the City of Fort Collins, Purchasing Division, before May 20, 2003. If delivered, please deliver to 215 North Mason Street, 2"d Floor, Fort Collins, CO 80524. If mailed, the mailing address is P.O. Box 580, Fort Collins, Colorado 80522-0580. If this renewal is not acceptable with your firm, please send us a written notice stating that you do not wish to renew the bid. If you have any questions regarding this renewal, please contact John Stephen, CPPB, Senior Buyer, at 970-221-6777. Sincerely, a es B. O'Neill II, CPPO, FNIGP Director of Purchasing and Risk Management gnature Date (Please indicate your desire to renew Bid #5694 by signing this letter and returning it with a current copy of insurance forms to Purchasing Division on or before May 20, 2003.) 215 North Mason Street • 2nd Floor • P.O. Box 580 • Fort Collins, CO 80522-0580 • (970) 221-6775 • FAX (970) 221-6707 May 08 03 09:08a P.1 CERTIFICATE OF LIABILITY INSURANCE American Family Insurance Company ❑ American Family Mutual Insurance Company if selection box is not checked. 6000 American Pky Madison, Wisconsin 53783-0001 Agent's Name, Address and Phone Number (Agt./Dist.) insured's Name and Address Terry Danielson (1381309) Pierre DeMilt 732 South Lemay Ave., Suite B P.O. BOx 179 Fort Collins, CO 80524 Severance, CO 80546-0179 9701226-0919 This certificate is issued as a matter of information only and confers no rights upon the Certificate Holder. This certificate does not amend. extend or alter the coverane, affnrdpd by the nnliripc u¢reri r.d.,... COVERAGES This is to certify that 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. POLICY TYPE TYPE OF INSURANCE POLICY NUMBER LIMITS OF LIABILITY Effective Expiration (Mo,Day,Yr) (Mo,Day,Yr) Homeowners/ Bodily Injury and Property Damage Mobilehomeowners Liability Each Occurrence Boatowners Liability Bodily Injury and Property Damage Each Occurrence Personal Umbrella Liability Bodily Injury and Property Damage Each Occurrence Farm/Ranch Liability Farm & Personal Liability Each Occurrence Farm Employer's Liability Each Occurrence Statutory ... . Workers Compensation and Each Accident Employers Liability + Disease - Each Employee Disease- Policy Limit General Liability General Aggregate $ 600,000 ® Commercial General 05-XB3199-01 1/1212003 1/12/2004 Products - Completed Operations Aggregate $ 600,000 Liability (occurrence) Personal and Advertising Injury $ 300,000 ❑ Each Occurrence $ 300,000 ❑ Damage to Premises Rented to You $ 100,000 Medical Expense (Any One Person) $ 5.000 Businessowners Liability Each Occurrence ++ Aggregate + + Liquor Liability Common Cause Limit Aggreg ate Limit Automobile Liability Bodily Injury - Each Person ❑ Any Auto Bodily Injury - Each Accident ❑ All Owned Autos Property Damage ❑ Scheduled Autos Bodily Injury & Property Damage Combined ❑ Hired Autos ❑ Nonowned Autos Excess Liability ❑ Commercial Blanket Excess Each Occurrence/Aggregate Other (Miscellaneous Coverages) DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/RESTRICTIONSISPECIAL ITEMS +The individual or partners shown as Insured—eleUed to be Carpentry covered as employees under this policy. ++ Products -Completed Operations aggregate is equal to each occurrence limit and is included in Policy 2ggreg2te. CERTIFICATE HOLDER'S NAME AND ADDRESS CANCELLATION City of Fort Collins Purchasing Dept 215 N. Mason Fort Collins, CO 80622 ❑ Should any of the above described policies be canceled before the expiration date thereof, the company will endeavor to mail •(10 days) written notice to the Certificate Holder named, but failure to mail such notice shall Impose no obligation or liability of any kind upon the company, its agents or representatives. •10 days unless different number of days shown- ® This certifies coverage on the date of Issue only. The above described polities are subject to cancellation in conformity with their terms and by the laws of the state of issue. r. DATE ISSUED 12ED REPRE AT1M 5/08/2003 n .�. w um v-cea, maureu, Agent V Stock No. 06668