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Home My WebLink AboutCORRESPONDENCE - BID - 7355 HAULING SERVICEShtq)s://webniail.frii.com/?—Lask--imil&—framed=]& action --get& rnbo.. hftps://webmail.frii.com/?—task--niail&—kamed—I r Collins April 8, 2013 Mudrunner Trucking Attn: Larry Richardso NC,( 3121 19 Fort Collins, CO 80524 RE: 7355 Hauling Services 2012 Dear Mr. Richardson: APR 12 2013 Financial Services Purchasing Division 215 N. Mason St. 2n° Floor PO Box 580 Fort Collins, CO 80522 970.221.6775 970.221.6707-fax rcgov.com/purchasing The City of Fort Collins wishes to extend the agreement term for the above captioned proposal per the existing terms and conditions. The term will be extended for one (1) additional year, April 1, 2013 through March 31, 2014. If the renewal is acceptable to your firm, please sign this letter in the space provided include a current copy of insurance naming the City as an additional insured and return all documents to the City of Fort Collins, Purchasing Division, P. O. Box 580, Fort Collins, CO 80522, within the next fifteen days. If this extension is not agreeable with your firm, we ask that you send us a written notice stating that you do not wish to renew the contract and state the reason for non -renewal. Please contact John Stephen, CPPO, LEED AP, Senior Buyer at (970) 221-6777 if you have any questions regarding this matter. S cerel St John D. Stephen, CPPO, LEED AP Interim Director of Purchasing and Risk Management (Please indicate your desire to renew 7355 by signing this letter and returning it to Purchasing Division within the next fifteen days.) I of 1 4/10/2013 11:03 AM https:Hwebmail.frii.conV?_task=mail&_framed=l&_action=get&_mbo... https://webniail.frii.com/?_task=mail&_framed=l&_action=get&_mbo... AC4ORve CERTIFICATE OF LIABILITY INSURANCE °ATE (MxoDnY Y, 04/10/2013 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 policy(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 endorsement(s). PRODUCER CONTACT RAME: JOHN C. BECKETT 6 ASSOCIATES, INC. P"ONEN,. (970) 484-2805 �M, q,t (no)_ 41MI Etimebeckettinsurance.com MikIL 220 Smith Street DDR:: vflooucER RLARRY RICHARDSON cesrUMER m_ _ Ft. Collins _ _ _ _ _ CO___B_O__5_24_—_ INSURERS) AFFORDING COVERAGE _ NAIC_A__ INSURED - - _ INSURER A Artisan & Truckers Casualty Co 10194 LARRY RICHARDSON DBA MUDRUNNER TRUCKING _INSURER B: 3121 N COUNTY RD 19 INSURER C INSURER D : �— INSURER E FORT COLLINS CO 80524- 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 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR 'A001- SUOfl ' POLICY EFF POIICV EMP LTq TYPE OF INSURANCE INSR WVD POLICY NUMBERMA,OOM'Y MMOOMTW LIMITS A 1UENEI LIABILITY 107882402-2 3/15/201303/15/2014 EACH OCCURRENCE Is 1,000,000 X- COMMERCIALGENEPALUABIUTY - / / PREMM IGSESORENTED (Ea occurrence) f 100,000 'CLAIMS -MADE X OCCUR / / / / I MED EXP(Am am person) f 5,000 _ 1,000,000 _CS_ if AGO' 2,000,000 O ENL AGGREGATE LIMIT APPLIES PER: / / / / PRODUOTSOCOMWOTP If 2,000,000 X POUCY PRO- JECT LAC A (AUTOMOBILE Lue EITY Y 07882402-2 03/15/2013 03/15/2014 CO MBINED SINOLE LIMIT �= 300,000 IJ ANY AUTO / / / / (Ea wcd.Q - ALLOWNEDAUTOS BODILY INJURY (Per person f BODILY INJURY (Per accideno i X SCFEDLAEDAUTOS . / / / / PROPERTY DAMAGE f HIREDAUFOS (Per accident X NON-OWNEDAUTOS l UMBRELLA LNUB `J OCCUR I NO cOVERAGE / / / / I EACH OCCURRENCE is EXCESS LIAR CLAIMS -MADE _ _ / / / / ' AGGREGATE f / / / / ... _ _ . _I — DEDUCTIBLE f- RETENTION WORKERS CONFENSATION 90 COVERAGE / / / / WC STATU OTH- µD ENIOERe 1.11.1r Y.N / / ___.TOFN,UMFTS___ ER_`I_ ANY PROPRIETOIL / / E.LEACHACCICENT XLUDEI£FECUTNE WLELB EA E].CWDEDi �iNiA / / / / IS nand (MeWiwrim NH) El, OSFASE- EA EMPLOYEE f Be - � �� / / / / - __ � - TIONDuper DESCRIPTION OF OPERATIONS belay DES � EL. DISEASE -POLICY UMR S NO COVERAGE DESCRIPTION LF OPERATIONS I LOCATIONS I VEHICLES (Al. ACORD 1D1, /tl3NonL Rema4s acM1slu4, it m_re yaw is ,qul,Ml Certificate holder is also additional insured per written contract arising ont of the operations of the named lLgllred. Vehicle is 1995 Kenworth W90 VIN: 11KWDB9XOSS649318. L.NIVL.CLLM I IV IV r ) - (970) 221-6775 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. CITY OF FORT COLLINS ACCOUNTING S PURCHASING DEPT PO BOX 580 FORT COLLINS CO 80522-0580 ACORD 25 t2009m91 AUTHORIZED RREEP-ROEESSEEWAATT�^NEE 105fRSri arnnn rnGmnGAT1411,1 All Ann" ..c..v.w INS026 (200909) The ACORD name and logo are registered marks of ACORD 1 of 1 4/ 10/2013 2:34 PM EDERAL DRUGTESTING CUSTODYAND CONTROL FORM f;.' et T 1Rf1l i; €flI f 1 1 1 jj i �tjyQ}] t %jI 11 i' i rr �*rr iM(� -�75, �fr� I401214SPECIMEN ID NO. ;, MtCA 1 ,;,a4 STEP t: COMPLETED BY COLLECTOR OR EMPLOYER REPRESENTATIVE A. Employer Name, Address, I.D. No. Mud LAB ACCESSION NO. B. MRO Name, Address, Phone No. and Fax No. P a $P'l"'TWNi; .l(f itu t i,'42S11102c 1. F;); t;tOf3){t5y `;i[;sl:'4!i.7±S-F� t'sE f:i:'•ft;t Quest Diagnostics 800-877-7484 C. Donor SSN or Employee I.D. No. 5 v t\ l] J �o 1 1 D. SpecifyTesting Authority: ❑ HHS ❑ NRC ;XOT —Specify DOT Agency: LRIMCSA ❑ FAA ❑ FRA ❑ FTA ❑ PHMSA ❑ USCG E. Reason forTest le -employment El Random ❑ Reasonable Suspicion/Cause ❑ Post Accident El Return to Duty ❑ Follow-up ❑ Other (specify) F. DrugTests to be Performed: IPTHC, COC, PCP, OPI, AMP ❑THC & CDC Only ❑ Other (specify) fit:l.E L I O1�S1 L G. Collection Site Name:., _ -. Collection Site Code: Address: - 1 �Q.... .. Collector Phone No.: City, State and Zip: Collector Fax No.: STEP 2: COMPLETED BY COLLE OR make remarks when appropriate) Collector reads specimen temperature within 4 minutes. Temnerature between 90° and 100° F? FKes ❑ No. Enter Remark Collection: Eeplit ❑ Simole ❑ None Provided, Enter Remark I ❑ Observed, (Enter Remark) STEP 3: Collector affixes bottle seal(s) to bottle(s). Collector dates seal(s). Donor initials seal(s). Donor completes STEP 5 on Copy 2 (MRO Copy) STEP 4: CHAIN OF CUSTODY - INITIATED BY COLLECTOR AND COMPLETED BYTEST FACILITY Icertifyt h specimeagiven tome by the donor identified in thecertification section on Copy2ofthisfirm was SPECIMEN BOTTLE(S) RELEASEDTO: collet la f ei andreleasedto the DeliverySewicenotedin accordance with applicable Federalrequirements. ❑ Quest Diagnostics Courier X �^-'-"'•� dEx ❑ Other 1 / w Signature or Collector �r (Print) Collevor's Name (First, MI, Lest) Date IMolDay ,) Time of Collection Name of Delivery Service STEP 5: COMPLETED BY DONOR I certify that I provided my urine specimen to the collector; that 1 have not adulterated it in any manner,' each specimen bottle used was sealed with a tamper -evident seal in my presence; and than the information provided on this form and on the label affixed to each specimen bottle is correct. Signature of Donor (P INT) Donor's Name (First, MI, Last) Data IMo. ayN, ) 'Y �y-y _ `� k ( ) Daytime Phone No r1 Evening Phone No. Date of elnh Mo. Day Yr. After the Medical Review Officer receives the test results for the specimen identified by this form, he/she may contact you to ask about prescriptions and over-the-counter medications you may have taken. Therefore,you may want to make a list of those medications for your own records.THIS LIST IS NOT NECESSARY. If you choose to make a list, do so either on a separate piece of paper or on the back of your copy (Copy 5). — DO NOT PROVIDE bier o: In accordance with applicable Federal requirements, my ❑ NEGATIVE ❑ POSITIVE for: ❑ DILUTE ❑ REFUSALTOTEST because —check reason(s) below: ❑ ADULTERATED (adulterant/reason): ❑ SUBSTITUTED ❑ OTHER raat�Irev� �-a X of Medical Review Officer ❑ TEST CANCELLED In accordance with applicable Federal requirements, my verification for split specimen (if tested) is: ❑ RECONFIRMED for: ❑ TEST CANCELLED ❑ FAILEDTO RECONFIRM for: REMARKS: X If Signature of Medical Review Officer (PRINT) Medical Review Officer's Name (First. MI, Lest) Data (Mo.IDeyNn) Apr 24 13 04:47p MOBILE LAB INC 9702780663 Mobile Lab 5016 Lynnwood Court, Loveland, CO 80537 Phone (970) 391-9677 Fax (970) 278-0663 Drug free WorkPlace, TPA, and Consortium manaaeme, City of Ft Collins Attn: Transportation April 24, 201 Larry Richardson of Mud Runner Trucking requested that I notify to Mobile Lab Highway Consortium. Mud Runner Trucking is a m consortium and their program is renewable annually on April 22. 1 provides employee training, along with supporting documentation holders employed with this company. Mobile Lab also provides the random program for drug and alcohol D.O.T. guidelines, and keeps on file the results relating to drug and testing. The DHHS certified laboratory is: Quest Diagnostics 10101 Renner Blvd. Lenexa, KS 66219 The MRO is: W PCI A.A. Armstrong M.D. 1321 Broadway Scottsbluff, NE 69361 In the event of a D.O.T. audit Mobile Lab would be willing to provide company with the desired records with this client's permission. Sincerelnos Michael Sloan, CfTPA in regards er of the ile Lab CDL per p.1