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Home My WebLink About441289 AMERICAN POWER WASH - INSURANCE CERTIFICATEVOYVO➢IC ST FARM SOS 692 1666 05/09/08 02:21pm P. 003 VVr VP/oo rnl 11.11 'ITA 1IU 000 vVo, JLAIL I-Anl IP UUl ACOR/.-, CERTIFICATE INSURANCE � DATE(MMIDDUYYY) OF LIABILITY 05/08/2008 PBODUGER VOyvodic Insurance Agency Inc THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 16728 F Smoky Hill Rd Unit 11F Aurora, CO 80015 QINSURERS HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, AFFORDING COVERAGE NAICR IIIBURCO American Pallet a, Truck e6i1 LLC 3700 Canal Or INSURER A; 81ale Farm PiYe SDO CeBUBIty Company 261A3 I INSURER B: - --' - '_'-- --- 25143 Ft Collins, CO 80524 INSURER C. INSURER D' INSURER E'. IKON/tl:L•[Hy,9 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 PFRTAIN, THE INSURANCE AFFORDED BY THE POLICICS DESCRIBED HEREIN IS SUBJECT T'O ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, POLICY EIFF§X FOLICYEMPIMT H LYq Tvve [� I POLICY NUMO6R DATE MLDBD T£ MMIOOtYY LIMITS A Y GENERAL X LIABILITY COMAYftCIAL G£NEM(�LLIAGILITY CIAIMSMADE UOCCUR 96-J46611.1 01ro7/2008 01l0712009 EACH OCCURRENCE S i.000000.00 O RENTED -DAAMETPREd G$(Eoo Ol _ OLEO E%P Any one-p.,ron S 300.000.00 _ 5 5,000.00 PENSOaAI S ADY INJURY S 1,000,000.00 GENERALAGGREGATE. S 2,000,000.00 GEN'L AGGREGATE LJMIT APPLIES PER; PRODUCTS.COMPIOPAGG S Z,000AOO.00 X POLICv P. ROLGc .. .. L-AUTOMOBILE LWBIHTY ANY AUTO COMBINED SINGLE LIMIT IEa.,IdPUB S BODILY INJURY ALL OWNED AUTOS SCHEDULED AUTOS 1 I (Per pere001 S BODILY INJURY IPet BCCMBOII I L HIRED AUTOS NOR -OWNED AUTOS PROPERTYDAMAGE (Pn acodtlAl) S I GARA6ELIA00.1TY AUTO ONLY -EA ACCIDENT S OTHFRTHAN EA ACC i S,.„ ANY AUTO 13 TOONLY: AGO EXCESSNMBRELLA LIAGHRY EACH OCCURRENCE 5 _ AGGREGATE OCCUR �CLAIId.4'MADC S S - PEDUCTIBLE ^-- 1 RETENTIDN __S WORKERS COMPENSATION AND WG STAi DIN ER.. _. WPLOYERS•LADILITY ._.I. ECEACH ACCIDENT ..... S ANY PROPRIETORIPARTNERIE%ECUTIVE OFFIL MhbkBER C:%CLVOEOY E.L. DISEASE -EA EMPLOYEE S a, 11 yvecR. APPR P SI Or 9PECIPL PRGViSION3 BO ow --"-' $_ - EL.OISEASE.-POLICY LIMN OMER DESCRIPTION OF OPERATIONS I LOCATIONS I VEIOCLEA I LXOLUSIOND ADDeD OY ENDORSEMENT f SPECIAL PROVISIONS Truck wash and power washing The City of Ft Collins, its Officers, Agents and Employees Director of Purchasing and Risk Management P O BOX 580 FL Collins, CO U0522.0680 SHOULD ANVOF THE ABOVE DESDRmBO POLICIES BE CANCELLED BEFORE THE EXPIMCON DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL V_ DAYS WRITTEN NOTICE TO THE CERTISCATE HOLDER NAMEO TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR VOVVOOIC ST FARM 20S 699 SEES 06/09!09 02:21pm P. 004 05/09/08 FRI 1.1:11 FAX 970 995 4557 STATE FARIII 10002 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on Ihis certificate does not confer rights to the Certificate holder in lieu of such endorsement(s). If SUBROGATION I5 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. VOYVDDIC ST FARM SOS 699 IF66 OS/OS/OS 02:21pm P. 002 j ._.. vevvOnlc 9T norm,, emit 653 1G66 0o/09/P18 11.: 15am r. fdm2 CERTIFICATE OF INSURANC E Tbs Certifies that [ STATE FARM FIRE AND I:ASUALTY COMPANY. Blounington, Illinois 0 STATE FARM GFNIiRAI_ .WSURANCE COMPANY, Bloomington, Illinois insures the following pnBcyholdw for the coverapeF indlei'ted below. Name ofpollcyholdar AMERICAN YALL,ET &- 91113AY OUT, LLC Address of policyholder PO BOX 1357. CASTLE ROC:X_ CC), 80101-73`i_u__T�,-. w_ Location of oporationg _ 3700 CANZ\.T_DRIVE FUR'C COLL11a5_ CO 80524 ' Ocscrlpticn of operations The polieles titled below have been issued to the poli(yhvldor for the policy periods shown The fnsurance desedbod In these policies ;a subject to all the., terms excluxlonss and conditions of toot _pollneS. The limits of liab,l t) shown may have been reduced by angpaid Claims_ TE OLICY NUMBER F INSURA—NC[�EfFgc6vFp ODate YEPxEpRvIaG:iDon Data at hcU�Mm1Tni$nqOPoL5Aol9io1UTY period) p Compete, BODILY NJURY AND 0'7 PROPERTY DAMAGE I9 Products - Completed OpCratl(1les Contractna) Liability L] Undergmund Hazard Cu.rerage Fitch Occurrence S1,0001000 Famonal Injury ❑Adverllbing Injury General Aggregate ❑ Exptoslon hlazard Coverage Products - Completed ❑ Collapse Hazard Coverage Operartons Aggregate $ 2 ,.0001 000 0 General Aggregate: Limit applies to each ptolact 0 DXCESS LIARtL I rYEttcc6ve Date Expiration ❑ Umbrella Dete (Combined aSinngle timid Gacn Occurrence $ _-..— 73 Other Aggregate $ �- _ Pad I STATUTORY Pad 7-RODILYINJURY - Workers' Compensation t and Employers Liability Each Accident Pot.ICY NUMBER TYPE OF INSURANCE POLICY PERIOD� I LIMITS OF UARIUTY Effective Date Ex ,cotton Late nt bagenning of pollcyprrlodl 10-67:1264 E2306 AitT 1114SURPd4CF I)rl.i 7 OGLJlr OB,��. If a.ry of the del.ebed policies are canceled before its expiation dale, State Fame will try to mail a written online to the certifICAm holder 30 days before cancellation. If. however, we (ail to mail such notice, no om,ganon or liability will be imposed on State Farm or its agents of rvprssvntaelvas. Name end Address of Certificate Holder CITY I E. DIRE.CTOR. OF PURCHASING I.NO�7i9 ./�z /G-[•ri/t'�_ R Y.8X MANAGEMRNT Eigr nlu•e or Avlhonx ep.aean;atrvc PO BOX SILO FUR?' r,'OL.111NS I CO BD522 T,tl% 55a-BrN n>aB Printeo In U. S.A. Dole VOYVODIC ST FARM 809 696 1666 06/09108 10:62am P. 00Z 05/D9/2008 10:23 9703301480 STATE FARM FIRE PAGE 01 PE-6609 SECTION II ADDITIONAL INSURED ENDORSEMENT Page I Of I Policy No. 96.14-661 f I Named Insured: AMERICAN PALLET & TRUCK Ix WASH LLC 3100 CANAL DR FORT COLLINS CO 80524-8535 Additional Insured (include address): THE CITY OF FT COLLINS IT OFFICERS, AGENTS & EMPLOYEES DIRECTOR OF PURCHASING AND RISK MGMT PO OOX 580 FORT COLLINS CO 80522-0580 WHO IS AN INSURED, under SECTION II DESIGNATION OF INSURED, is amended to Include as an insured the Additional Insured shown above, but only to the extent (hat liability is imposed on that Additional Insured solely because of your work performed for that Additional Insured shown above. Any insurance provided to the Additional Insured shall only apply with respect to a claim made or suit brought for damages for which you are provided coverage. The Primary Insurance coverage below applies only when there is an "X" in the box. Ll Primary Insurance. The Insurance provided to the Additional Insured shown above shall be primary insurance. Any insurance carried by. the Additional Insured shall be noncontributory with respect to coverage provided to you. All other provisions of the policy apply. re-6609 May 8, 2008 BID AWARD CLARIFICATION FOR BID 6098--PRESSURE WASHING FOR DOWNTOWN AND OLD TOWN SQUARE American Power Wash Original Bid Schedule Price was $25,401 and per square foot price was $.01499 Revised Bid Schedule Price is $27,477.55 and per square foot price was $.01499 The low responsive responsible bidder, American Power Wash, did not include some frequencies that the City had in the specifications. This increase was based on their per square foot price. JDS