HomeMy WebLinkAbout111183 COULSON EXCAVATING CO INC - CONTRACT - AGREEMENT MISC - COULSON EXCAVATING INCCONTRACT FORM FOR IMPROVEMENTS TO
FORT COLLINS-LOVELAND MUNICIPAL AIRPORT
LOVELAND,COLORADO
AIP PROJECT NO. 3-08-0023-20
THIS CONTRACT, made and entered into this ?7 day of 2006,
by and between the Cities of Loveland and Fort Collins, hereinafter referred to as the
"Owner" and Coulson Excavating Co.
Second Party, hereinafter referred to as the "Contractor".
WITNES SETH:
Article 1. STATEMENT OF THE WORK. The Contractor shall furnish all labor and
materials and perform all work for improvements to Fort Collins -Loveland Municipal Airport,
Taxiway A Rehabilitation and Commercial Apron Hardstand, under AIP Project
No. 3-08-0023-20, for awarded Federal Schedules I. II and III for a total of $4,623.166.00,
Non -Federal Schedules V and VI for a total of $191 301.50 and the Non -Federal Maintenance
of the Schedule IV work area for a total of $93,650.00. All work will be performed in strict
accordance with the Contract Documents, Plans, and Specifications, as issued in the "Issue for
Construction", prepared by CH2M HILL, for improvements to Fort Collins -Loveland
Municipal Airport. The Contractor shall complete this work within 98 calendar days, from the
effective date of the Notice to Proceed, not counting non -working days during a planned
Winter Shutdown.
Article 2. It is hereby further agreed, that, in consideration of the faithful performance of the
work by the Contractor, the Owner shall pay the Contractor the compensation due him by
reason of said faithful performance of the work, at stated intervals and in the amounts certified
by the ENGINEER in accordance with the provisions of this Contract.
Article 3. It is hereby further agreed, that, in the completion of the work and its acceptance by
the Owner, all sums due the Contractor by reason of its faithful completion of the work,
taking into consideration additions to or deductions from the Contract price by reason of
"Force Account" work authorized under this Contract in accordance with the provisions of
this Contract, will be paid the Contractor by the Owner after said completion and acceptance.
Final acceptance cannot be made by the Owner until any and all proper legal advertisements
have been made. All payments shall be made in accordance with Colorado Revised
Statute 38-26-107.
Article 4. It is hereby further agreed that any reference herein to the "Contract" shall include
all "Contract Documents" as the same are listed and described in the General Provisions,
issued in connection with the improvements to Fort Collins -Loveland Municipal Airport,
Taxiway A Rehabilitation and Commercial Apron Expansion, under AIP Project No. 3-08-
0023-20, and said "Contract Documents" are hereby made a part of this Contract as fully as if
set out at length herein.
DEN/334833.A1 AUGUST 15, 2006
0051112 1 CONTRACT FORM
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Airport.
AIP Project Number: 3-OM023-20
The following are Additional Insureds as respects General Liability only
if required by written contract and coverage applies only as respects
work performed by the insured for the Additional Insureds. All coverage
terms, conditions and exclusions of the policy apply.
The Certificate Holder is an Additional Insured on the Automobile
Liability only to the extent they meet the definition of an insured in
the policy, which provides in pertinent part that an insured includes
anyone liable for the conduct of another insured but only to the extent
of that liability. All coverage terms, conditions and exclusions of the
policy apply. Consult the policy to determine the extent of coverage, If
any.
Additional Insureds: City of Loveland, Colorado and City of Ft. Collins,
Colorado.
The Additional Insured endorsement which is referenced above under " fype
of Insurance -General Liability" is attached.
' The following cancellation conditions always apply:
-10 days for non-payment of premium
- If policy shown, 10 days for Workers' Compensation for fraud;
material misrepresentation; non-payment of premium; other reasons
approved by the Commissioner of Insurance
..: .:. (c
A MC 95l1911fli/1141
I N S U ,.2E D : Coulson Excavating Co. , Inc.
Additional Insured - Automatic - Owners, Lessees Or
Contractors - Broad Form
Policy No. RU. Date of POL J Erp. Date of Pol I Eff. Date of End. Producer Add'L Preen Return Rem,
QA3883949-60 5/7/06 5/1/07 5/7/06 - of Colorado included
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the:
Commercial General Liability Coverage Part
A. WHO IS AN INSURED (Section II) is amended.to include as an insured any person or organization whom you are re-
quired to add as an additional insured on this policy under a written contract or written agreement.
B. The insurance provided to additional insureds applies only to 'bodily injury", "property damage" or "personal and adver-
tising injury" covered under Section I, Coverage A, BODILY INJURY AND PROPERTY DAMAGE LIABILITY and
Coverage B, PERSONAL AND ADVERTISING INJURY LIABILITY, but only if:
1. The 'bodily injury" or `property damage" results from your negligence; and
2. The "bodily injury", "property damage" or "personal and advertising injury" results directly from:
a. Your ongoing operations; or
It. "Your work" completed as included in the "products -completed operations hazard",
performed for the additional insured, which is the subject of the written contract or written agreement.
C. However, regardless of the provisions of paragraphs A. and B. above:
1. We will not extend any insurance coverage to any additional insured person or organization:
a. That is not provided to you in this policy; or
b. That is any broader coverage than you are required to provide to the additional insured person or organization
in the written contract or written agreement; and
2. We will not provide Limits of Insurance to any additional insured person or organization that exceed the lower of:
a. The Limits of Insurance provided to you in this policy; or
b. The Limits of Insurance you are required to provide in the written contract or written agreement.
D. The insurance provided to the additional insured person or organization does not apply to:
1. "Bodily injury', "property damage" or "personal and advertising injury" that results solely from negligence of the ad-
ditional insured; or
U-GL.U75-A CW (9/03)
Pagel of;
Includes copyrighted material of Insurance Services Office, Inc, with its permission.
INSURED COPY
2. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering or failure to
render any professional architectural, engineering or surveying services including:
a: The preparing, approving, or failing to prepare or approve maps, shop drawing;;, opinions, reports, surveys,
field orders, change orders or drawings and specifications; and
1). Snpervisoiy, inspection,.arcliitectiral or engineering activities.
V. The ;W(lil.ional insured must sec w iL Lhat:
I. WC arc notilled as Noon it.,; pracbcablu of an "oCCln-fence" of of unse that may rwinll in it claim:
2. We rcceivc wriltun nobce of a claim or "snit" as soon w; pradJuible; and
'I. A regOC.SL f(If dca'cn:a, and indcnuiil.y of Hit; claim or "sail" will pronyltly be broug.hl. against any policy issued by
aRUl.bei' iII5n1'C.I' under wbich Lhc; siddil.ianal insured also has rights as an insorcd or additional ip"alred. _
If. TlIc insurance provided by this endo"Gincnl is primary insuruam and we, will Rol seek conLributicni from any other
insurance available to any additional :insured person or organization unless die other insurance is providind by a con-
h-actor other..than you for the same. gperatimis and job..location...Then we.will share with that. other insurance by the
method drscribed'in paragraph 4.e: of SECVON IV - COMM I RCIAL GENERAL LIABILITY CONDITIONS.
Any provisions in. this (:overage; .1 art. nog changed by Hie; terms and conditions of rliis cadoasenuenl. coati- lee to apply as
wril.l e n.
J-GL-1175-A-CVV (9/03)
?age 2 of 2
a
INSURED COPY
Change Order
Number 1
August 4; 2006
PROJECT TITLE AND NUMBER. ,()t1fi: Airport_Improvemrents
PURCHASE ORDER NUMBER:
1. Reason for Change ----- %xiuce tiu euntract amount to be under the total funds appropriated by the
Cities at time of the signed contract.
2. Description of Change — Remove 10,450 tans of asphalt and 631 tors .of biturninaus. material
from Schedule I of the project.
3> Change in Contract Cost: (594172.0(0)
4, Change is Contract -Time— None
Original Contract Cost. 34.908 1 I7.50
Total Approved Change Orders: 0100
Totai Pending Change Orders:. 0.0i)
Total This Change Order: S. f5)4.172 00)
Adjusted Cantraer Cost: $4.313,945:50
(assu-min.g all chai�ed Orden are approved..
i
SuMrilittedbv: v+1 I '^ Date: 4/
Project `Manager
Reviexed Approvedby: Date -
Di
Approves bv, ............ -..._..... :. - .-._..._ Date:
City I4ianager (if applicable)
This:cllmigm order is:accep,ted.andxhe contract is arneitd.W* tt*j mii'imn thereto. t ial�iy
2006
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Article 5. It is hereby further agreed that the FAA General Provisions, the FAA Special
Provisions, and the Project Special Provisions issued in connection with the improvements to
Fort Collins -Loveland Municipal Airport, Taxiway A Rehabilitation and Commercial Apron
Expansion, under AIP Project No. 3-08-0023-20, are hereby made a part of this Contract as
fully as if set out at length herein.
Article 6. Contract Clauses and Requirements for Construction Contracts.
A. General and Labor Clauses for All Construction Contracts and Subcontracts.
1. Airport Improvement Program Project. The work in this Contract is included
in Airport Improvement Program Project No. 3-09-0023-20 which is being
undertaken and accomplished by the Owner in accordance with the terms and
conditions of a grant agreement between the Owner and the United States
under the Title 49_U.S.C. Subtitle VII and the Rules and Regulations of the
Federal Aviation Administration pursuant to which the United States has
agreed to pay a certain percentage of the costs of the project that are
determined to be allowable project costs under the Act. The United States is
not a party to this contract and no reference in this contract to the FAA or any
representative thereof, or to any rights granted to the FAA or any
representative thereof, or the United States, by the Contract, makes the United
States a party to this contract.
2. Consent to Assignment. The Contractor shall obtain the prior written consent
of the Owner to any proposed assignment of any interest in or part of this
Contract.
3. Convict Labor. No convict labor shall be employed under this contract.
4. Veteran's Preference. In the employment of labor (except in executive,
administrative, and supervisory positions), preference shall be given to
qualified individuals who have served in the military service of the United
States [as defined in Section 101 (1) of the Soldiers' and Sailors' Civil Relief
Act of 1940, as amended, 50 App. U.S.C. 511 (1)] and have been honorably
discharged from the service, except that preference may be given only where
that labor is available locally and the individual is qualified to perform the work
to which the employment relates.
5. Withholding, Owner from Contract. Whether or not payments or advances to
the Owner are withheld or suspended by the FAA, the Owner may withhold or
cause to be withheld from the Contractor so much of the accrued payments or
advances as may be considered necessary to pay laborers and mechanics
employed by the Contractor or any subcontractor on the work the full amount
of wages required by this contract.
6. Nonpayment of Wages. If the Contractor or any subcontractor fails to pay any
laborer or mechanic employed or working on the site of the work any of the
wages required by this contract, the Owner may, after written notice to the
DEN/334833.A1 AUGUST 15, 2006
0051112 2 CONTRACT FORM
Contractor, take such action as may be necessary to cause the suspension of
any further payment or advance of funds until the violations cease.
7. FAA Inspection and Review. The Contractor shall allow any authorized
representative of the FAA to inspect and review any work or materials used in
the performance of this contract_
8. Subcontracts. The Contractor shall insert in each of his subcontracts the
provisions contained in paragraphs 1, 3, 4, 5, 6, and 7 of this section and also a
clause requiring the subcontractors to include these provisions in any lower tier
subcontracts which they may enter into, together with a clause requiring this
insertion in any further subcontracts that may in turn be made.
9. Contract Termination: A breach of paragraphs 6, 7, and/or 8 may be grounds
for termination of the Contract.
B. Bonding Clauses for Construction Contracts and Subcontracts:
The Contractor agrees to furnish a performance bond for 100 percent of the
Contract price. This bond is one that is executed in connection with a contract
to secure fulfillment of all the Contractor's obligation under such contract.
2. The Contractor agrees to furnish a payment bond for 100 percent of the
Contract price. This bond is one that is executed in connection with a contract
to assure payment as required by law of all persons supplying labor and
material in the execution of the work provided for in the Contract.
C. Lobbying and Influencing Federal Employees:
No Federal appropriated funds shall be paid, by or on behalf of the Contractor,
to any person for influencing or attempting to influence an officer or employee .
of any agency, a Member of Congress, an officer or employee of Congress, or
an employee of a Member of Congress in connection with the awarding of any
Federal contract, the making of any Federal Grant, the making of any Federal
loan, the entering into of any cooperative agreement, and the extension,
continuation, renewal, amendment, or modification of any Federal contract,
grant, loan, or cooperative agreement.
2. If any funds other than Federal appropriated funds have been paid or will be
paid to any person for influencing or attempting to influence an officer or
employee of any agency, a Member of Congress, an officer or employee of
Congress, or an employee of a Member of Congress in connection with any
Federal contract, grant, loan, or cooperative agreement, the Contractor shall
complete and submit Standard Form-LLL, "Disclosure of Lobby Activities," in
accordance with its instructions.
3. The Contractor shall require that the language of paragraphs I and 2 of this
section be included in the award documents for all subawards at all tiers
(including subcontracts, subgrants, and contracts under grants, loans, and
DEN/334833.A1 AUGUST 15, 2006
00511I2 3 CONTRACT FORM
cooperative agreements) and that all subrecipients shall certify and disclose
accordingly.
D. Miscellaneous Clause Requirements for All Construction Contracts and Subcontracts
Unless Otherwise Indicated. During the performance of this contract, the Contractor,
for itself, its assignees and successors in interest (hereinafter referred to as the
"Contractor") agrees as follows:
Compliance with Regulations. The Contractor shall comply with the
Regulations relative to nondiscrimination in federally assisted programs of the
Department of Transportation (hereinafter "DOT") Title 49, Code of Federal
Regulations, Part 21, as they may be amended from time to time (hereinafter
referred to as the Regulations), which are incorporated by reference and made
a part of this contract.
2. Nondiscrimination. The Contractor, with regard to the work performed by it
during the contract, shall not discriminate on the grounds of race, sex, age,
color, or national origin in the selection and retention of subcontractors,
including procurement of materials and leases of equipment. The Contractor
shall not participate either directly or indirectly in the discrimination prohibited
by Section 21.5 of the Regulations, including employment practices when the
contract covers a program set forth in Appendix B of the Regulations.
3. Solicitations for Subcontractors Including Procurement of Materials and
Equipment. In all solicitations either by competitive bidding or negotiation
made by the Contractor for work to be performed under a subcontract,
including procurement of materials or leases of equipment, each potential
subcontractor or supplier shall be notified by the Contractor of the
Contractor's obligations under this contract and the Regulations relative to
nondiscrimination on the grounds of race, sex, age, color, or natural origin.
4. Information and Reports. The Contractor shall provide all information and
reports required by the Regulations or directive issued pursuant hereto, and
shall permit access to its books, records, accounts, other sources of
information and its facilities as may be determined by the Owner or the FAA to
be pertinent to ascertain compliance with such Regulations, orders and
instructions. Where any information required of a Contractor is in the exclusive
possession of another who fails or refuses to furnish this information, the
Contractor shall so certify to the Owner or the FAA as appropriate, and shall
set forth what efforts it has made to obtain the information.
5. Sanctions for Noncompliance. In the event of the Contractor's noncompliance
with the nondiscrimination provisions of this contract, the Owner shall impose
such contract sanctions as it or the FAA may determine to be appropriate,
including, but not limited to:
a) Withholding of payments to the Contractor under the contract until the
Contractor complies, and/or
DEN/334833.A1 AUGUST 15, 2006
00511I2 4 CONTRACT FORM
b) Cancellation, termination or suspension of the contract, in whole or in
part.
6. Incorporation of Provisions. The Contractor shall include the provisions of
paragraphs D.1. through 5. in every subcontract, including procurement of
materials and leases of equipment, unless exempt by the Regulations or
directives issued pursuant thereto. The Contractor shall take such action with
respect to any subcontract or procurement as the Owner or the FAA may
direct as a means of enforcing such provisions including sanctions for
noncompliance. Provided, however, that, in the event a Contractor becomes
involved in, or is threatened with, litigation with a subcontractor or supplier as
a result of such direction, the Contractor may request the Owner to enter into
such litigation to protect the interests of the Owner and, in addition, the
Contractor may request the United States to enter into such litigation to
protect the interests of the United States.
7. Breach of Contract Terms Sanctions — 49 CFR Part 18. Any Violation or
breach of the terms of this contract on the part of the
Contractor/Subcontractor may result in the suspension or termination of this
contract or such other action which may be necessary to enforce the rights of
the parties of this Contract.
8. Termination of Contract — 49 CFR Part 18
a) The Owner may, by written notice, terminate this contract in whole or
in part at any time, either for the Owner's convenience or because of
failure to fulfill the contract obligations. Upon receipt of such notice
services shall be immediately discontinued (unless the notice directs
otherwise) and all materials as may have been accumulated in
performing this contract, whether completed or in progress, delivered
to the Owner.
b) If the termination is for the convenience of the Owner, an equitable
adjustment in the contract price shall be made, but no amount shall be
allowed for anticipated profit on unperformed services.
c) If the termination is due to failure to fulfill the Contractor's obligations,
the Owner may take over the work and prosecute the same to
completion by contract or otherwise. In such case, the Contractor shall
be liable to the Owner for any additional cost occasioned to the Owner
thereby.
d) If, after notice of termination for failure to fulfill contract obligations, it
is determined that the Contractor had not so failed, the termination
shall be deemed to have been effected for the convenience of the
Owner. In such event, adjustment in the contract price shall be made as
provided in paragraph D.8.b) of this clause.
DEN/334833.A1 AUGUST 15, 2006
00511I2 5 CONTRACT FORM
e) The rights and remedies of the Owner provided in this clause are in
addition to any other rights and remedies provided by law or under this
contract.
9. Rights to Inventions/Materials. All rights to inventions and materials generated
under this contract are subject to regulations issued by the FAA and the
recipient of the Federal grant under which this contract is executed.
Information regarding these rights is available from the FAA and the Owner.
10. Inspection of Records — 49 CFR Part 19. The Contractor shall maintain an
acceptable cost accounting system. The Owner, the FAA, the Comptroller
General of the United States shall have access to any books, documents, paper,
and records of the Contractor which are directly pertinent to the specific
contract for the purposes of making an audit, examination, excerpts, and
transcriptions. The Contractor shall maintain all required records for three
years after the Owner makes final payment and all other pending matters are
closed.
Article 7. The Contractor agrees to accept as his full and only compensation for the
performance of all the work required under this contract such sum or sums of money as may
be proper in accordance with the price or prices set forth in the Contractor's proposal
attached hereto and made a part hereof covering all of the items.
Article 8. To the extent allowed by law, the Contractor agrees to indemnify, defend, and hold
harmless the Owner, from any and all claims and damages to property and injury to persons
which may arise both of and during operations under this Contract, whether such operations
be by the Contractor or by any subcontractor or anyone directly or indirectly employed by the
Contractor or any other employee or person employed or engaged on or about, or in
connection with, the construction.
Article 9.To the extent this Contract constitutes a multiple fiscal year debt or financial
obligation of the City of Loveland or the City of Fort Collins, it shall be subject to annual
appropriation pursuant to their respective charters and Article X, Section 20 of the Colorado
Constitution. Neither the City of Loveland nor the City of Fort Collins shall have any
obligation to continue this Contract in any fiscal year in which no such appropriation is made.
Article 10. Venue and jurisdiction of any action will only be brought in the District Court in
and for the Eight (8`s) Judicial District (Fort Collins, Larimer County, CoIorado).
Article 11. In the event of a breach of this Contract, the breaching party shall pay to the non -
breaching party all reasonable attorney fees, cost, and other expenses, incurred by the non -
breaching parry enforcing its rights as a result of said breach.
DEN/334833.A1 AUGUST 15, 2006
00511I2 6 CONTRACT FORM
Total estimated cost for Taxiway A Rehabilitation and Commercial Apron Expansion under
AIP Project No. 3-08-0023-20, thereof to be a total of four million — nine hundred eiszht
thousand -one hundred seventeen dollars and fifty cents ($4,908.117.5R
IN WITNESS WBEREOF, The First Party and the Second Party, respectively have caused
this Contract to be duly executed the day and year first herein written in six (6) copies, all of
which to all intents and purposes shall be considered as the original.
APWVED AS TO FORM
BY: W&& G�`/Y 0
A_ccieTANT rrry ATTORNEY
hrOMx.`IrS
ATTEST:
By G
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Title
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COLO?
OWNER, First Party
City of Loveland
p City of Fort 11pollins
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Second Party
By Z01�
END OF SECTION
DEN/334833.A1 AUGUST 15, 2006
00511I2 7 CONTRACT FORM
Mante, 9n7sc
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ACORD- CERTIFICATE OF LIABILITY
INSURANCE
08124/06°"YYY
PRODUCER
HRH of Colorado
720 S. Colorado Blvd Ste 600 N
P.O. Box 469025
Denver, CO 80246-9025
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 COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
Coulson Excavating Co., Inc.
3609 North County Road #13
Loveland, CO 80638
INSURERA Zurich -American Ins. Co.
16535
INSURERB: RSUI Indemnity Company
22314
INSURER C:
INSURER D:
INSURER E
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTVWTHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENTWTH RESPECTTO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. '
INSR
LTR
kDDL
NSR1
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE IMMIDDIM
POLICY EXPIRATION
LIMITS
A
GENERAL LIABILITY
GL03888949
05/07/06
05101/07
EACH OCCURRENCE
:1 000 OOD
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE OCCUR
-EAAPREMI ETORENTER n
f100000
MEDDP(AAy,omparaon)
S10.000
PERSONAL 8 ADV INJURY
S1 1 000 1 000
AI# U-GL-1175 A
CW (09/031
GENERAL AGGREGATE
s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER-
PRODUCTS-CONIP/OPAGG
S2000000
POLICY X PRO- X LOC
A
AUTOMOBILEL"LITY
X
ANY AUTO
BAP3888950
05/07/06
05/01/07
CO
$10000MBIINEDSINGLELIMIT 00
BODILY INJURY
(Per Person)
S
ALL OWNED AUTOS
SCHEDULED AUTOS
X
BODILY INJURY
(Per accident)
S
HIRED AUTOS
NON -OWNED AUTOS
X
PROPERTY DAMAGE
Reraeadent)
S
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
S
OTHER THAN EA ACC
AUTO ONLY: AGG
S
ANY AUTO
S
B
EXCESSAJMBRELLA LIABILITY
NHA216462
05/07/D6
05/01/07
EACH OCCURRENCE
S5,000,000
X OCCUR F1 CLAIMS MADE
AGGREGATE
$5 000 000
S
$
DEDUCTIBLE
S
RETENTION S
A
WORKERS COMPENSATION AND
WC3888959
05/07/06
05/01/07
TH-
X WC STATU- OFR
EMPLOYERS' LIABILITY
ANY PROPRIEIOR/PARTNERIEXECUTIVE
EL EACH ACCIDENT
41 000,000
EL. DISEASE-EAEM PLOYEE:1,200,000
OFMCERIMEMSER EXCLUDED?
It yes descrlbe under
SPECIAL PROVISIONS baba
E.L. DISEASE -POLICY LIMIT
51,000 000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS VEHICLES J EXCLUSIONS ADDED BY ENDORSEMENT ISPECIAL PROVISIONS
REVISED CERTIFICATE: All previously issued certificates are null and void for this
Chertificate Holder/Project.
Project Description: Improvements to Fort Collins -Loveland Municipal
(See Attached Descriptions)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Loveland, Colorado and
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL Rat DAYS WRITTEN
City of Ft. Collins, Colorado
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
500 East Third Street
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
Loveland, CO B0537
REPRESENTATIVES.
AUTHORD:® REPRESENTATIVE
wwrcU 40 (LUU I/UU/ 1 of 3 #S3UZ246/M291240 MAS a ACORD CORPORATION 1938
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
AUUKU 25S (2UU7/U8) 2 of 3 #S302246/M291240