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604005 HRQ HOLDINGS LLC - CONTRACT - RFP - 7642 JOB ANALYSIS, PERFORMANCE & LEARNING COMPETEN
Agreement Amendment #14 7642 Job Analysis, Performance & Learning Competency Assessment Page 1 of 6 Amendment #14 to the Services Agreement between The City of Fort Collins and hrQ Holdings LLC This Fourteenth Amendment (“Amendment #14”) is entered into by and between hrQ Holdings LLC (the “Service Provider”) and the City of Fort Collins, Colorado (the “City”). WHEREAS, the Service Provider and the City are parties to a Services Agreement dated August 25, 2014; and WHEREAS, the Service Provider and the City amended said Services Agreement on February 27, 2015 (Amendment #01), March 17, 2015 (Amendment #02), February 25, 2016 (Amendment #03), May 26, 2016 (Amendment #04), July 27, 2016 (Amendment #05), and February 16, 2017 (Amendment #06), March 9, 2017 (Amendment #07); October 19, 2017 (Amendment #08); January 3, 2018 (Amendment #09); March 13, 2018 (Amendment #10); May 12, 2018 (Amendment #11); June 13, 2018 (Amendment #12); July 24, 2018 (Amendment #13); and WHEREAS, the Services Agreement and Amendments #01-13 are hereafter referred to as the “Agreement”; and WHEREAS, the City desires and the Service Provider agrees to revise and replace the Statement of Work set forth in Amendment #11, pursuant to the Agreement terms and new Statement of Work attached hereto; NOW, THEREFORE, in consideration of the foregoing recitals and the mutual promises herein contained, the parties agree as follows: 1. Statement of Work. Appendix “A”, Revised Statement of Work – Amendment #14, is added by this Amendment #14 and replaces the Statement of Work set forth in Amendment #11, per the attached document consisting of four (4) pages. 2. Contract Sum. The City agrees to pay the Service Provider a total fee not to exceed Eighty Thousand Dollars ($80,000) for the work under Amendment #14. The Service Provider will invoice in accordance with the payment plan set forth in the attached Appendix A. Each payment shall be subject to the City’s review and approval. 3. Prior Payments. The City and Service Provider acknowledge that a total sum of Eleven Thousand Nine Hundred Two Dollars and Sixty-Six Cents ($11,902.66) was invoiced to the City and paid to the Service Provider for Work completed under Amendment #11 prior to this Amendment #14. The City and Service Provider acknowledge and agree that all services and monies owed under the terms of Work completed under Amendment #11 have been fulfilled and no outstanding commitments by either party remain. Except as expressly amended by this Amendment #14, all other terms and conditions of the Agreement, as amended by Amendments #01, #02, #03, #04, #05, #06, #07, #08, #09, #10, #11, #12, and #13 shall remain in full force and effect. DocuSign Envelope ID: 9AC4ABE2-EAA5-4411-B3D4-F5F75488F43A Agreement Amendment #14 7642 Job Analysis, Performance & Learning Competency Assessment Page 2 of 6 IN WITNESS WHEREOF, the parties have executed this Amendment the day and year shown. THE CITY OF FORT COLLINS, COLORADO By:________________________________ Gerry Paul Purchasing Director Date: ______________________________ hrQ HOLDINGS LLC By: Printed: Title: Date: DocuSign Envelope ID: 9AC4ABE2-EAA5-4411-B3D4-F5F75488F43A Managing Partner Brian Wilkerson 1/21/2019 1/21/2019 Agreement Amendment #14 7642 Job Analysis, Performance & Learning Competency Assessment Page 3 of 6 APPENDIX A REVISED STATEMENT OF WORK – AMENDMENT #14 DocuSign Envelope ID: 9AC4ABE2-EAA5-4411-B3D4-F5F75488F43A Agreement Amendment #14 7642 Job Analysis, Performance & Learning Competency Assessment Page 4 of 6 DocuSign Envelope ID: 9AC4ABE2-EAA5-4411-B3D4-F5F75488F43A Agreement Amendment #14 7642 Job Analysis, Performance & Learning Competency Assessment Page 5 of 6 DocuSign Envelope ID: 9AC4ABE2-EAA5-4411-B3D4-F5F75488F43A Agreement Amendment #14 7642 Job Analysis, Performance & Learning Competency Assessment Page 6 of 6 DocuSign Envelope ID: 9AC4ABE2-EAA5-4411-B3D4-F5F75488F43A ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? INSR ADDL SUBR LTR INSD WVD PRODUCER CONTACT NAME: PHONE FAX (A/C, No, Ext): (A/C, No): E-MAIL ADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXP TYPE OF INSURANCE (MM/DD/YYYY) (MM/DD/YYYY) LIMITS AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE EACH OCCURRENCE $ CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO- LOC JECT PRODUCTS - COMP/OP AGG OTHER: $ COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) $ $ OCCUR EACH OCCURRENCE CLAIMS-MADE AGGREGATE $ DED RETENTION $ PER OTH- STATUTE ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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. 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 have ADDITIONAL INSURED provisions or 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: CERTIFICATE HOLDER CANCELLATION ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) $ $ $ $ $ The ACORD name and logo are registered marks of ACORD PPISANO 12/20/2018 HRQINC0-01 B UMB549926006 A PRA590792106 C WC064842506 A PRA590792106 A PRA590792106 1,000,000 1,000,000 1,000,000 5,000,000 5,000,000 2,000,000 1,000,000 2,000,000 Owner’s & Contractor 10,000 100,000 1,000,000 ABUSIVE ACTS AN 1,000,000 1,000,000 X X X X X X X X X A PRA590792106 12/31/2018 12/31/2019 12/31/2018 12/31/2019 12/31/2018 12/31/2019 12/31/2018 12/31/2019 12/31/2018 12/31/2019 12/31/2018 12/31/2019 City of Fort Collins named as additional insured as respects to general and auto liability. CTK North American Insurance Services, LLC / INSURICA 1240 North Lakeview Avenue, #240 Anaheim, CA 92807 (714) 779-2000 (714) 779-4129 City of Fort Collins P.O. Box 580 Fort Collins, CO 80522 hrQ, Inc. 2859 Umatilla Street Denver, CO 80211 Zurich American Insurance Co. of IL American Guarantee and Liability Ins. Co. Great American Insurance Company 27855 26247 16691 X X Y $5,000 Deductible $1M/$2M w/$5k ded. Crime 1,000,000 Professional Liab DocuSign Envelope ID: 9AC4ABE2-EAA5-4411-B3D4-F5F75488F43A