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HomeMy WebLinkAboutCORRESPONDENCE - BID - 7327 FLEET FUEL 2012 (4)March 9, 2015 Hill Petroleum Attn: Bryant Gimlin bgimlin@hillpet.com 6501 Ralston Rd Arvada, CO 80002 RE: Renewal - 7327 Fleet Fuel Dear Mr. Gimlin: The City of Fort Collins wishes to extend the agreement term for the above captioned proposal per the existing terms and conditions and the following: The term will be extended for one (1) additional year, March 5, 2015 through March 4, 2016. If the renewal is acceptable to your firm, please sign this letter in the space provided and include a current copy of insurance certificate naming the City as an additional insured for General and Automotive Liability within the next fifteen (15) 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 Doug Clapp, Senior Buyer at (970) 221-6776 if you have any questions regarding this matter. Sincerely, Gerry S. Paul Director of Purchasing and Risk Management __________________________________________ ________________ Signature Date (Please indicate your desire to renew 7327 by signing this letter and returning it to Purchasing Division within the next fifteen days.) GSP: jg Financial Services Purchasing Division 215 N. Mason St. 2nd Floor PO Box 580 Fort Collins, CO 80522 970.221.6775 970.221.6707- fax fcgov.com/purchasing DocuSign Envelope ID: 52FCB0CA-F9CC-4A03-8874-2DFEB24E582B 3/20/2015 The ACORD name and logo are registered marks of ACORD CERTIFICATE HOLDER © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) AUTHORIZED REPRESENTATIVE CANCELLATION CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) JECT LOC POLICY PRO- GEN'L AGGREGATE LIMIT APPLIES PER: CLAIMS-MADE OCCUR COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $ DAMAGE TO RENTED EACH OCCURRENCE $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ DED RETENTION $ CLAIMS-MADE OCCUR $ AGGREGATE $ UMBRELLA LIAB EACH OCCURRENCE $ EXCESS LIAB DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS PER STATUTE OTH- ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $ $ $ ANY PROPRIETOR/PARTNER/EXECUTIVE If yes, describe under DESCRIPTION OF OPERATIONS below (Mandatory in NH) OFFICER/MEMBER EXCLUDED? WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED HIRED AUTOS NON-OWNED AUTOS AUTOS AUTOS COMBINED SINGLE LIMIT BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE $ $ $ $ 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. INSD ADDL WVD SUBR N / A $ $ (Ea accident) (Per accident) OTHER: 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). COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: INSURED PHONE (A/C, No, Ext): PRODUCER ADDRESS: E-MAIL FAX (A/C, No): CONTACT NAME: NAIC # INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : INSURER(S) AFFORDING COVERAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 12/31/2014 TrueNorth 500 1st St SE Cedar Rapids IA 52401 Hill Enterprises, Inc 6301 Ralston Road Arvada CO 80002 Nationwide Agribusiness Insurance C Pinnacol Assurance Company Farmland Mutual Insurance Company 28223 41190 13838 319-366-2723 319-862-0612 certs@truenorthcompanies.com HILLENT-01 1450473087 A CPP104980A 1/1/2015 1/1/2016 1,000,000 100,000 5,000 1,000,000 2,000,000 2,000,000 X X A X CPP104980A 1/1/2015 1/1/2016 1,000,000 A X X X 0 CU104980B 1/1/2015 1/1/2016 5,000,000 5,000,000 B N 4148287 6/1/2014 6/1/2015 X 500,000 500,000 500,000 C Transportation COP104980A 1/1/2015 1/1/2016 Limit Deductible 100,000 5,000 If Yes is indicated above for add'l insd forms Gen Liab #CGLB303 0413 and Auto #CA001 1013. If Yes is indicated above for waiver of subrogation forms Gen Liab #CGLB304 0310, Auto Liab #CCAB234 1013 and WC #WC000313 04/04 applies. Umbrella is following form per policy provisions, conditions and exclusions. Coverage is extended for work performed and required under written contract with the above named insured. City of Fort Collins Financial Services Purchasing Division PO Box 580 Fort Collins CO 80522 DocuSign Envelope ID: 52FCB0CA-F9CC-4A03-8874-2DFEB24E582B