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463375 POUDRE VALLEY HEALTH SYSTEMS - CONTRACT - AGREEMENT MISC - POUDRE VALLEY HEALTH SYSTEM FOUNDATION
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 Poudre Valley Health System Foundation, hereinafter referred to as "Service Provider". W ITNESSETH: In consideration of the mutual covenants and obligations herein expressed, it is agreed by and between the parties hereto as follows: Scope of Services. The Service Provider agrees to provide services in accordance with the scope of services attached hereto as Exhibit "A", consisting of one (1) page and incorporated herein by this reference. 2. Contract Period. This Agreement shall commence upon the date of execution shown on the signature page of this Agreement and shall continue in full force and effect until June 15, 2011, 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 fifteen (15) days from the onset of such condition. 4. Early Termination by City/Notice. 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 fifteen (15) days prior to the termination date contained in said notice unless otherwise agreed in writing by the parties. All notices provided under this Agreement shall be effective when mailed, postage prepaid and sent to the following addresses: SA rev03/10 Client#.- 12582 PVHEA ACORD,. CERTIFICATE OF LIABILITY INSURANCE 10010412010 PRODUCER Flood & Peterson Ins., Inc. Corporate Mailing Address: p g P. O. Box 578 Greeley, CO 80632 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 Poudre Valley Health Care, Inc. dba Poudre Valley Health System 2315 E Harmony Road, Suite 200 Fort Collins, CO 80528-8620 INSURER A- Copic Companies INSURERS: Safety National Casualty Compan INSURERc: Federal Insurance Company INSURERD: INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMMD POLICY EXPIRATION DATE MMIDD LIMITS A GENERAL LIABILITY HCC0008522 04/01/2010 04/01/2011 EACHOCCURRENCE S11,000,000 DAMAGE TO RENTED $500000 X COMMERCIAL GENERAL LIABILITY A{EDEXP(Anyone person) $5000 X CLAIMS MADE DIOCCUR PERSONAL& ADV INJURY S11,000,000 X Malpractice Liability Included GENERAL AGGREGATE s3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $1 000000 POLICY JE T LOG AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Eaacddenl) $ BODILY INJURY (Perperson) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Perecddent) $ HIRED AUTOS NON-OWNEDAUTOS PROPERTYDAMAGE (Per acddent) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHERTHAN EA ACC S ANYAUTO $ AUTO ONLY: AGG A EXCESSAJMBRELLA LIABILITY UCC0009293 04101/2010 04/01/2011 EACHOCCURRENCE $10 000 000 X I OCCUR F-ICLAJhIS MADE AGGREGATE $1 O 00O 000 S $ HDEDUCTIBLE $ X RETENTION $ 10,000 B WORKERS COMPENSATION AND SP4041767 04101/2010 04/01/2011 X WCSTATU• FR E.L. EACH ACCIDENT 51,000 OOO EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTNE OFFtCERIAIEAIBEREXCLUDED? Excess Coverage E.L. DISEASE - EAEMPLOYEE $1 000.000 y MSPECIAL PROVISIONS DetaN E.L. DISEASE - POLICYLIAIIT $1 00O 000 C OTHER Directors & 68006562 04101/2010 04101/2011 $11,000,000 Limit Officers Liab $150,000 Retention DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES/ EXCLUSIONS ADDED BY ENDORSEMENT ISPECIAL PROVISIONS Health Professional Liability - Persons Included (if applicable): Professional employees of the named insured, other than physicians Professional students of the named insured, other than residents Volunteers of the named insured, other than physicians and residents (See Attached Descriptions) nia:\117Le1i\I�:C�1I193:( City of Fort Collins Purchasing & Risk Management PO Box 580 Ft Collins, CO 80522 LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION THEREOF. THE ISSUING INSURER WILL R009MRR4tMAIL .10_ DAYS WRITTEN :E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.Xjj3tRAIktXj0MQ)0Q00ftM)( I R MRX71K>r6XTdADtRRXtP30KMX>pJiX1?fX XIHlPXIRi01iROt6CIGRR9Wf31CKTi)dRRAC66%�iitXX REPRESENTATIVE ACORD 25 (2001108)1 of 3 #S5667281M519368 NIK © ACORD CORPORATION 1988 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. ACORD 25-S (2001108) 2 of 3 #S566728fM519368 'DESCRIPTIONS (Contlnued.from Page 1.) RE: Bicycle and Pedestrian Education Coalition (SPEC) The City of Fort Collins, its officers, agents and employees are included as additional insured, but only as respects liability arising out of work performed by the named Insured. AMS 25.3 (2001108) 3 Ot 3 45565728IM519368 I- JE�!,Fo® CERTIFICATE OF LIABILITY INSURANCE OP ID P6 DATE (.WDDWW) I 10/04/l0 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. IMPORTANT: if the certificate holder is an ADDITIONAL INSURED, the pol(cy(ies) must 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 endorsemont(s). PRODUCER Brown & Brown Inc 125 S Howes, 5th Floor NAME: PHONE ac No Ext : (arc, No ADDRESS: P O BOX 2226 Fort Collins CO 80522-2226 PRODUCER CUSTOMERID#: PVHEA-1 Phone:970--482-7747 Fax:970-484-4165 INSURER(S) AFFORDING COVERAGE NAICIf INSURED INSURERA: Empire Fire & Harine insurance 21326 Poudre Valley Health Care Inc: 2315 E. Harmon Rd. Suite 200 Fort Collins CO 80k8-8620 INSURERB: INSURERC: INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 MAYBE ISSUEOOR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TOALL THE TERMS, EXCLUSiONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE INSR WVD POL[CYNUMBER (MMIDDIYYYY) (MMIDD LIMITS GENERAL LIABILITY EACHOCCURRENCE $ PREMISES (Ea occurrence $ COMMERCIAL GENERAL LIABILITY CLAIMS -MADE n OCCUR MED EXP (Any one person) $ PERSONAL&AOVINJURY S GENERAL AGGREGATE $ GENLAGGREGATE LIMIT APPLIES PER: PRODUCTS-C,OMPrOPAGG $ POLICY PRO- JECT n LOC $ A AUTOMOBILE LIABILITY ANY AUTO CL317374 05/01/10 Os/01/11 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ X SCHEDULEDAUTOS X HIREDAUTOS X PROPERTY DAMAGE (Peraccident) $ X NON-OWNEDAUrOS $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR Id CLAIMS -MADE AGGREGATE $ DEDUCTIBLE $ S RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y r N ANY PROPRIETORrPARTNERfEXECUTI OFFICERIMEMBEREXCLUDED? /A TAT - I IOTH- TORY LIMITS I I ER E.LEACH ACCIDENT $ E.LDISEASE- EAEMPLOYE $ (Mandatory In NH) If qqes, describe under DESCRIPTIONOFOPERATIONS below E.LDISEASE- POLICY LIMIT $ DESCRIPTION OF OPERATIONS r LOCATIONS! VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is requtred) RE: Bicycle & Pedestrian Education Coalition The City of Fort Collins and The State of Colorado are included as additional insured regarding commercial automobile liability. CERTIFICATE HOLDER CANCELLATION The City of Fort Collins Purchasing Department P O Box 280 FCITX28 I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE — "8"009 ACORD CORPORATION. All riahts reserved ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD City: Copy to: Service Provider: City of Fort Collins City of Fort Collins Poudre Valley Health System Foundation Attn: Purchasing Attn: Matthew Wempe Attn: Ruth Lytle-Barnaby PO Box 580 PO Box 580 2315 E. Harmony Road, Suite 200 Fort Collins, CO 80522 Fort Collins, CO 80522 Fort Collins, Co 80528 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. 5. Contract Sum. The City shall pay the Service provider for the performance of this Contract, subject to additions and deletions provided herein, the sum of Twelve Thousand Dollars ($12,000.00). 6. 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 concerning this agreement shall be directed to the City Representative. 7. 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. 8. 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 consent of the City. 4 SA rev03/10 9. 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. 10. Warranty. a. Service Provider warrants that all work performed hereunder shall be performed with the highest degree of competence and care in accordance with accepted standards for work of a similar nature. b. Unless otherwise provided in the Agreement, all materials and equipment incorporated into any work shall be new and, where not specified, of the most suitable grade of their respective kinds for their intended use, and all workmanship shall be acceptable to City. C. Service Provider warrants all equipment, materials, labor and other work, provided under this Agreement, except City -furnished materials, equipment and labor, against defects and nonconformances in design, materials and workmanship/workwomanship for a period beginning with the start of the work and ending twelve (12) months from and after final acceptance under the Agreement, regardless whether the same were furnished or performed by Service Provider or by any of its subcontractors of any tier. Upon receipt of written notice from City of any such defect or nonconformances, the affected item or part thereof shall be redesigned, repaired or replaced by Service Provider in a manner and at a time acceptable to City. 11. 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. 12. 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 3 SA rev03/10 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. 13. Bindin i 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. 14. 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 under this Agreement of the type and with the limits specified within Exhibit B, 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 Director of Purchasing and Risk Management, 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. 15. 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. 16. 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 4 SA rev03/10 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. 17. Prohibition Aqainst Employing Illegal Aliens. Pursuant to Section 8-17.5-101, C.R.S., et. seq., Service Provider represents and agrees that: a. As of the date of this Agreement: 1. Service Provider does not knowingly employ or contract with an illegal alien who will perform work under this Agreement; and 2. Service Provider will participate in either the e-Verify program created in Public Law 208, 104th Congress, as amended, and expanded in Public Law 156, 108th Congress, as amended, administered by the United States Department of Homeland Security (the "e-Verify Program") or the Department Program (the "Department Program"), an employment verification program established pursuant to Section 8-17.5-102(5)(c) C.R.S. in order to confirm the employment eligibility of all newly hired employees to perform work under this Agreement. b. Service Provider shall not knowingly employ or contract with an illegal alien to perform work under this Agreement or knowingly enter into a contract with a subcontractor that knowingly employs or contracts with an illegal alien to perform work under this Agreement. c. Service Provider is prohibited from using the e-Verify Program or Department Program procedures to undertake pre -employment screening of job applicants while this Agreement is being performed. d. If Service Provider obtains actual knowledge that a subcontractor performing work under this Agreement knowingly employs or contracts with an illegal alien, Service Provider shall: 1. Notify such subcontractor and the City within three days that Service Provider has actual knowledge that the subcontractor is employing or contracting with an illegal alien; and 2. Terminate the subcontract with the subcontractor if within three days of receiving the notice required pursuant to this section the subcontractor does not cease 5 SA rev03/10 employing or contracting with the illegal alien; except that Service Provider shall not terminate the contract with the subcontractor if during such three days the subcontractor provides information to establish that the subcontractor has not knowingly employed or contracted with an illegal alien. e. Service Provider shall comply with any reasonable request by the Colorado Department of Labor and Employment (the "Department") made in the course of an investigation that the Department undertakes or is undertaking pursuant to the authority established in Subsection 8-17.5-102 (5), C.R.S. f. If Service Provider violates any provision of this Agreement pertaining to the duties imposed by Subsection 8-17.5-102, C.R.S. the City may terminate this Agreement. If this Agreement is so terminated, Service Provider shall be liable for actual and consequential damages to the City arising out of Service Provider's violation of Subsection 8-17.5-102, C.R.S. g. The City will notify the Office of the Secretary of State if Service Provider violates this provision of this Agreement and the City terminates the Agreement for such breach. 18. Special Provisions. Special provisions or conditions relating to the services to be performed pursuant to this Agreement are set forth in Exhibit C — Required Contract Provisions for Federal - Aid Construction Contracts, consisting of nine (9) pages, attached hereto and incorporated herein by this reference. C. SA rev03/10 CITY OF FORT COLLINS, COLORADO a municipal corporation By: \ c� Jame 'B. 'Neill II, CPPO, FNIGP Director of Purchasing and Risk Management Date: Poudre Valley Health System Foundation By: ��du,� Q-4p - �,� Rat K Lv -t` e - &,r-no .Li PRINT NAME CORPORATE PRESIDENT OR VICE PRESIDENT Date: ATTEST: (Corporate Seal) CORPORATE SECRETARY SA rev03/10 EXHIBIT A SCOPE OF SERVICES The Poudre Valley Health System Foundation, through the Healthier Communities Coalition of Larimer County (HCC) will convene and lead the Bicycle and Pedestrian Education Coalition (BPEC). BPEC, led by HCC and the Colorado Injury Control Research Center,. will. develop an evaluation survey for teachers, school officials, parents, and volunteers participating in Safe Routes to School bicycle and pedestrian education classes and the "train the trainers" program training materials. A. The training materials, at a minimum, will include: i. Proper bicycle helmet fitting ii. Bicycle and pedestrians laws, rights, and responsibilities iii. A-B-C bicycle quick check iv. Practical pedestrian practice and on -bike bike safety course B. HCC will provide the City written materials outlining the specific content and teaching methods developed by the BPEC. 2. HCC will coordinate with City staff on marketing and outreach of the Safe Routes to School program when necessary to fulfill BPEC activities and goals. This coordination may include: A. Publications B. Parent and school staff meetings C. Coordination with local health and wellness experts 3. HCC is responsible for coordinating on -going and post -program evaluation of the BPEC with the Colorado Injury Control Research Center (CICRC). This includes the overall success of the BPEC using process evaluation indicating satisfaction, participation, and effectiveness. In addition, the evaluation must include measuring the number of overall program objectives that were met by the end of the school year. 4. The City of Fort Collins will compensate HCC in an amount not to exceed $12,000.00 for work performed during the 2010-11 school year. Payments to HCC will be made after the work outlined in the scope of work is performed and the invoice approved by the City. The invoice shall meet the following two criteria: A. Fulfills Colorado Department of Transportation invoicing requirements for the federal Safe Routes to School program. B. Consistent with the grant scope of work and the City of Fort Collins service agreement. Rev?/2009 EXHIBIT B 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 be cancelled or materially altered, except after ten (10) 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 insureds 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: 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 $500,000 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. Rev7/2009