HomeMy WebLinkAbout374454 ARTHUR J GALLAGHER RISK MGT SERVICES - PURCHASE ORDER - 5501035rP
City of Fort Collins
Page Number: 1
City of Fort Collins
Date: 02/10/05
Purchase Order Number: 5501035
Delivery Date: 02/10/05 Buyer/10,
NEILL,JAMES
Purchase Order number must appear on invoices, packing lists, labels, bills f lading, and all correspondence.
Note:
Line Qty/Units / Description Extended Price
1 Pol#ewc005901
2 Pol#445D5944
Inv#85968
Inv# 84192
267,999.17
36,332.00
3 Pol#19BY103115953BCM 6,322.00
Inv#84190
4 Pol#8752796 68,777.00
Inv # 84432
6 Pol#Broke/opeosal
40,000.00
Inv# 84189
per insurance P-895
Total $419,430.17
City of Fort CoWirif Director of Purchasing and Risk Management City of Fort Collins
This order is r1QVvalid over $2000 unless signed by James B. O'Neill II, CPPO, FNIGP Accounting Department
City of Fort Collins Purchasing, PO Box 580, Fort Collins, CO 80522-0580 PO Box 580
Phone: 970-221-6775 Fax: 970-221-6707 Email: info@ci.fort-collins.co.us Fort Collins, CO 80522-0580
AIg"i'HUR Jd GALLAGHER & CO-IDENVIEr"
POST OFFICE BOX 24809
G,-)O DENVER, CC) 80224
I"K (303)773-9999
City of Fort Collins
P.O. Box 580
Fort Collins, CO 80522
Client: City of Fort Collins
85968 01/01/2005 Policy change
City of Fort Collins
1271
01 /20/2005
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Invoice #85968
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Policy #EWC005901 01/01/2004-04/15/2005
Midwest Employers Casualty Co
Workers Compensation - Extend polic
until 4/15/05
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Gallagher receives usual and customary brokerage commissions or fees (and occasionally fees in addition to coma
for its services. In addition to such fees and commissions, Gallagher may also receive compensation in other form
more details, please see the Gallagher website at www.ajg.com or contact your Gallagher representative.
(303)773-9999
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City of Fort Collins
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P.O. Box 580
Fort Collins CO 80522
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Invoice #84432
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Client: City of Fort Collins
84432 01/01/2005 Policy change
1 (303)773-9999
AFW 301 1393
CU-1tj Scl cu"s, Dn.
Lexington Insurance Company
Commercial Property - Extended policy to
4/15/05.
Colorado Surplus Fee
Colorado Surplus Tax
74,083.00
74.08
2,222.49
V,
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AHTHUR J. ' AU A(-M�01�-
D17F '1,0`24809 PH. (303) 7 /Q 99919
City of Fort Collins
P.O. Box 580
Fort Collins, CO 80522
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Client: City of Fort Collins
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Policy #BROKER FEE 01/01/2004-04
Broker Fee/ Claims Fee Company
84189 01/01/2004 Renew policy Gallagher Agency Fee
(303)773-9999
11,400.00
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, A THUI-I J, G21ALI AGHER * Co-DENVEH
POST OFFICE FsOy"' 24809
DENVER, CC) ioe24
F"i+ (303) 7-/'il-999U
City of Fort Collins
P.O. Box 580
Fort Collins, CO 80522
J
City of Fort Clio lins
1271
12/0312004
Ty Pixler
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Invoice #84192
11 A W P R F T') Rl! "I ftf 1 1
Client: City of Fort Collins
Policy #445D5944 01/01/2004-04/15/200
Travelers Prop & Casualty Comp
84192 01/01/2005 Policy change Boiler & Machinery - Extend policy to
4/15/05
(303)773-9999
10,355.00
AFVV301 1393 E-EU-1 ?-. ' L ')F1
Arrmun J. GALLAGHEP & M.).-DENVEF
P -�Sl OFF-` [110148"C'
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DIEi,JVER, CO 802-24
PH. (303) 773-g999
City of Fort Collins
P.O. Box 580
Fort Collins, CO 80522
Client: City of Fort Collins
(303)773-9999
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City Fort Collins
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12/03/2004
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Invoice #84190
1-96Y103115953BCM
5
15/05 1,698.00
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1, 659. 00-'
AFW301 7393