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HomeMy WebLinkAboutCORRESPONDENCE - RFP - 8115 ENGINEERING SERVICES FOR WATER RECLAMATION & BIOSOLIDS FACILITY DESIGN & CONSTRUCTION (4)Utilities Work Order Form Official Purchasing Form Last updated 10/2017 WORK ORDER PURSUANT TO A MASTER AGREEMENT BETWEEN THE CITY OF FORT COLLINS AND CAROLLO ENGINEERS, INC. WORK ORDER NUMBER: UC-WRF-2019-02 PROJECT TITLE: UDWRF Digester 612 Lid Construction ORIGINAL BID/RFP NUMBER & NAME: U8115, Engineering Services for Water Reclamation and Biosolids Facility Design and Construction Services MASTER AGREEMENT EFFECTIVE DATE: USeptember 21, 2015 ARCHITECT/ENGINEER: UCarollo Engineers, Inc. OWNER’S REPRESENTATIVE: UChristina Schroeder WORK ORDER COMMENCEMENT DATE: UJanuary 21, 2019 WORK ORDER COMPLETION DATE: UAugust 31, 2019 MAXIMUM FEE: (time and reimbursable direct costs): U$142,674.00 PROJECT DESCRIPTION/SCOPE OF SERVICES: USupport services associated with construction of the digester 612 lid. See attached supporting documentation. Service Provider agrees to perform the services identified above and on the attached forms in accordance with the terms and conditions contained herein and in the Master Agreement between the parties. In the event of a conflict between or ambiguity in the terms of the Master Agreement and this Work Order (including the attached forms) the Master Agreement shall control. The attached forms consisting of UfourU (4) pages are hereby accepted and incorporated herein, by this reference, and Notice to Proceed is hereby given after all parties have signed this document. SERVICE PROVIDER: Carollo Engineers, Inc. By: Date: Name: Title: Page 1 of 10 DocuSign Envelope ID: E94F879A-65DA-4CCA-B4E1-D856692EE7DC Vice President January 17, 2019 Jason Garside Ron Burdick Vice President January 17, 2019 Utilities Work Order Form Official Purchasing Form Last updated 10/2017 OWNER’S ACCEPTANCE & EXECUTION: This Work Order and the attached Contract Documents are hereby accepted and incorporated herein by this reference. ACCEPTANCE: Date: Christina Schroeder, Civil Engineer III REVIEWED: Date: Pat Johnson, Senior Buyer APPROVED AS TO FORM: Date: Name,City Attorney's Title (if greater than $1,000,000) ACCEPTANCE: Date: Jason Graham, Plant Director - Water Reclamation & Biosolids Division ACCEPTANCE: Date: Owen Randall, Civil Engineering Director ACCEPTANCE: Date: Carol Webb, Deputy Director - Water Resources & Treatment Operations ACCEPTANCE: Date: Kevin Gertig, Utilities Executive Director (if greater than $1,000,000) ACCEPTANCE: Date: Gerry Paul, Purchasing Director (if greater than $60,000) ACCEPTANCE: Date: Darin Atteberry, City Manager (if greater than $1,000,000) ATTEST: Date: City Clerk (if greater than $1,000,000) Page 2 of 10 DocuSign Envelope ID: E94F879A-65DA-4CCA-B4E1-D856692EE7DC January 16, 2019 January 17, 2019 January 25, 2019 January 17, 2019 January 28, 2019 January 28, 2019 Utilities Work Order Form Official Purchasing Form Last updated 10/2017 ATTACHMENT A WORK ORDER SCOPE OF SERVICES Page 3 of 10 DocuSign Envelope ID: E94F879A-65DA-4CCA-B4E1-D856692EE7DC pg. 1 Scope of Work – Digester 612 Lid Replacement Project - ESDC 1-11-19 The City of Fort Collins (City) through the assistance with Carollo Engineers (Consultant and Engineer of Record) and Hydro Construction Company (Contractor) has completed the design for the implementation of the replacement of Digester 612 Lid replacement, as well as piping modifications within the Digester 612 and Digester Building. The purpose of this Work Order is to provide the engineering services during construction (ESDC), including resident engineering, for the proposed Digester Lid 612 Replacement project (Project). The construction of the Project is estimated to occur from January 15, 2019 to August 31, 2019 (7.5 month total duration). The scope of work is divided into the following major tasks, summarized below: Task 1 - Project Administration and Coordination Task 1.1 - Coordination Meetings Prepare for and participate in thirty (30), 1-hour meetings (weekly over 7.5 month duration) with the Project Team to coordinate construction activities. Consultants Project Manager will participate in three (3) meetings per month via conference call and attend (one) 1 meeting per month in person. Consultant's engineering discipline staff will be in attendance at the coordination meetings based on the topics of discussion - it is assumed that one (1) discipline staff member will be required to attend one (1) coordination meeting per month for a total of six (6), 1-hour meetings, and will also participate in one (1) coordination meeting per month via conference call. It is assumed that the discipline engineer will participate in site coordination/inspection activities following the monthly meeting for a duration of two (2) hours per site visit. It is also assumed that the coordination meetings will be combined with meeting on other construction projects that are anticipated to be occurring during the same period as Project. Task 1.2 - Progress Reporting Invoices will be submitted monthly in accordance with City payment protocols. Each invoice will be submitted with a progress report detailing the work executed during the invoice period and work remaining. Task 2 - Resident Engineer Resident Engineering services will be provided by Ditesco, a subconsultant to Consultant. Ditesco's scope of services is attached. Task 3 - Engineering Services during Construction Task 3.1 - Shop Drawing Review Consultant assumes reviews of up to eight (8) shop drawing submittals with each shop drawing submittal assumed to require an average of eight (8) hours to receive, process, review, verify, respond, document, and return. Page 4 of 10 DocuSign Envelope ID: E94F879A-65DA-4CCA-B4E1-D856692EE7DC pg. 2 Task 3.2 - Interpretations/Clarifications and Work Change Directives Consultant assumes that up to five (5) interpretations and clarifications of design documents are required. Consultant estimates that each interpretation and clarification will require up to four (4) hours to research, respond, and document. Consultant assumes that up to two (2) Work Change Directives (WCD) are required. Consultant estimates that each WCD will require up to eight (8) hours to research, respond, and document. Task 3.3 - Start-Up/Commissioning Assistance Consultant shall provide startup assistance to City and Contractor on critical process, systems, and equipment installed under this work order. Consultant assumes that an Electrical and Instrumentation Engineer onsite for a total of eight (8) hours; and a Mechanical Engineer or Structural Engineer onsite for a total of sixteen (16) hours. Task 3.4 - Record Drawings Consultant shall develop Record Drawings based on the field hand markups provided by Contractor. Page 5 of 10 DocuSign Envelope ID: E94F879A-65DA-4CCA-B4E1-D856692EE7DC Utilities Work Order Form Official Purchasing Form Last updated 10/2017 ATTACHMENT B WORK ORDER SCOPE COST DETAILS Page 6 of 10 DocuSign Envelope ID: E94F879A-65DA-4CCA-B4E1-D856692EE7DC 1/11/2019 DWRF DIGESTER 612 LID REPLACEMENT PROJECT (CONSTRUCTION PHASE) LABOR HOURS AND ENGINEERING FEE Senior Professional Project Manager Project Professional Professional (PE) Disciplines (EIC) Disciplines (HVAC) Disciplines (staff engineers) Senior Technician Technician Document Processing/Clerical Billing Rate $238 $219 $206 $171 $171 $171 $147 $162 $110 $96 Task 1 - Project Coordination 4 47 36 36 16 0 0 0 0 1 140 $27,649 $0 $0 $0 $400 $1,638 $29,687 Task 1.1 - Coordination Meetings and Site Visits 2 40 36 36 16 0 0 0 0 0 130 $25,544 $0 $0 $0 $400 $1,521 $27,465 Task 1.2 - Progress Reporting 2 7 0 0 0 0 0 0 0 1 10 $2,105 $0 $0 $0 $0 $117 $2,222 Task 2 - Resident Engineering 0 0 0 0 0 0 0 0 0 0 0 $0 $77,163 $0 $0 $0 $0 $77,163 Task 2.1 - Resident Engineering (Ditesco) 0 0 0 0 0 0 0 0 0 0 0 $0 $77,163 $0 $0 $0 $0 $77,163 Task 3 - Engineering Services During Construction 0 18 54 52 26 0 0 16 16 5 187 $33,236 $0 $0 $0 $400 $2,188 $35,824 Task 3.1 - Shop Drawing Review 0 8 24 24 8 0 0 0 0 0 64 $12,168 $0 $0 $0 $0 $749 $12,917 Task 3.2 - Interpretations/Clarifications and Work Change Directives 0 4 12 12 8 0 0 0 0 0 36 $6,768 $0 $0 $0 $0 $421 $7,189 Task 3.3 - Start-Up/Commissioning Assistance 0 2 8 8 8 0 0 0 0 0 26 $4,822 $0 $0 $0 $400 $304 $5,526 Task 3.4 - Record Drawings 0 4 10 8 2 0 0 16 16 5 61 $9,478 $0 $0 $0 $0 $714 $10,192 PROJECT TOTALS - TASKS 1-3 4 65 90 88 42 0 0 16 16 6 327 $60,885 $77,163 $0 $0 $800 $3,826 $142,674 TOTAL COST LABOR HOURS PROJECT COSTS Total Direct Labor Hours Total Labor Cost Ditesco Lithos King Surveying Other Direct Costs (ODCs) PECE Page 7 of 10 DocuSign Envelope ID: E94F879A-65DA-4CCA-B4E1-D856692EE7DC Page 1 of 5 2133 South Timberline Road – Suite 110 Fort Collins, CO 80525 ditescoservices.com Delivery by email to: Jason Garside JGarside@carollo.com January 5, 2019 Revised January 11, 2019 Mr. Jason Garside Carollo Engineers, Inc. 390 Interlocken Crescent Ste 800 Broomfield, CO 80021 RE: Scope of Services Drake Water Reclamation Facility – Digester Lid 612 Dear Jason: Thank you for giving Ditesco the opportunity to provide resident engineering services for the City of Fort Collins Drake Water Reclamation Facility – Digester Lid 612 Replacement Project. Please find attached our proposed scope of work to support a new task order. Please let me know if you have any questions or require further information regarding this proposal, I can be reached by phone at 970.690.1889 and email jill.burrell@ditescoservices.com. Sincerely, Jill Burrell, P.E. Enc. Scope of Services Cc: Keith Meyer file DocuSign Envelope ID: E94F879A-65DA-4CCA-B4E1-D856692EE7DC Page 2 of 5 Exhibit A City of Fort Collins Utilities Digester Lid 612 Replacement Resident Engineering/Construction Management Scope of Services Project Understanding The City of Fort Collins (COFC) Utilities Department is planning to replace the existing floating digester lid on Digester 612. The existing lid will be replaced with a new Ovivo floating digester lid. The replacement project will also include demolition and replacement of existing mechanical components, repair to the interior of Digester 612, and installation of new pressure relief mechanical equipment and gas piping. Ditesco will be acting as Resident Engineer, working directly with Hydro Construction, Carollo, and the City of Fort Collins. Phase: Pre-Construction (Task 1) • During the pre-construction phase, Ditesco will photograph and/or video the existing project conditions within the construction limits. These photographs and video will be stored by Ditesco for use (as needed) during the closeout stage of the project. • We will review and comment on the contractor’s overall project schedule prior to the pre-construction meeting. We will ensure a logical, defined CPM schedule is established with an overall baseline for progress measurement. Phase: Construction (Task 2) During this phase Ditesco will provide part time Resident Engineering services to assist in work coordination and ensure compliance with contract documents/specifications. • Our staff will coordinate, attend, and document one pre-construction meeting. • We will conduct weekly progress meetings on site with the general contractor and their subcontractors. We will provide meeting minutes for all meetings. • We will review and recommend approval of pay applications to the City of Fort Collins, review and manage contract changes for approval by the City, generate and coordinate responses to RFIs and provide for overall administration of the construction contract. Here, this work task includes review and monitoring of overall job costs through the monthly variance report and pending issues log. • Our staff will perform daily site inspections to ensure quality construction and conformity to the plans and specifications. Inspections will include all specialty inspections required of the project including structural steel and concrete, and mechanical systems. We will provide field engineering support addressing field changes quickly to avoid construction delays. We will provide Carollo and the City with monthly reports documenting the contractors work progress, contract times and other pertinent information. We will also document daily work progress in the form of daily logs. • Ditesco staff will review all material test reports. We will comment on reports not meeting specifications and recommend remediation measures, if necessary. We will coordinate with Team Industrial Services to complete Mag Particle and X-Ray testing for weld inspections on the new Digester lid. • We will maintain a photographic record of the project documenting pre-construction, construction and post construction conditions. This work is completed as part of the daily log record and on Procore and will include brief descriptions of the photograph with a time and date reference. • We will maintain project records including contracts, schedules (overall job and three-week look-ahead), progress meeting minutes, material test results, weekly reports, correspondence, pay applications, change orders, routine photographs, submittals, RFIs, permits, commissioning records and post construction close- DocuSign Envelope ID: E94F879A-65DA-4CCA-B4E1-D856692EE7DC Page 3 of 5 out paperwork (punch lists, lien waivers, substantial completion/final acceptance). We will maintain this documentation through Procore, our electronic document management system. • We will conduct a final punch list walk through and start up sessions for the new lid. Formal start up, testing and training work is anticipated to include all instrumentation and mechanical equipment as well as the Digester lid. Ditesco personnel will coordinate on-site training with City Operations and Maintenance staff by each supplier/manufacturer. • Ditesco personnel will ensure that an as-built plan set is maintained and transmitted to Carollo upon completion of the project. This will be an electronic redlined drawing set maintained by our staff and will be coordinated with plan changes that may be documented by the general contractor. We will also ensure accurate O&M manuals are transmitted to the City upon completion of the project. Phase: Post Construction (Task 3) • During the Post Construction Phase Ditesco staff will compile all job records for submission to the City. We will also participate in an 11th and 23rd month warranty walkthrough of the project. Deliverables • Deliverables will include full project documentation presented electronically via flash drive (or other form, if requested): cost information, construction correspondence, pay applications, change orders, field orders, work change directives, schedules, submittals, requests for information, transmittals, reports, photographs, meeting notes, record drawings and other relevant information produced throughout the construction phase. Schedule The anticipated schedule for construction is as follows: Construction: January to August 2019 Fee Estimate We have based our fee estimate on the following assumptions of the project schedule. • 7.5 months total construction project timeframe • Construction to begin January 2019 with completion by August 2019 • Office trailer and internet/phone service provided by Contractor or City • Copier/scanner/printer provided by Contractor or City Estimated Fee: $65,498.00 Estimated Reimbursable Expenses: $ 7,991.00 Total: $73,489.00 A detailed task breakdown is included. Please find this on page 5 of this scope of work proposal. The fee shown above is to be billed on a time and material not to exceed basis based on the rates shown in the table on page 4 and 5 of this proposal. All reimbursable expenses will be billed at direct cost. DocuSign Envelope ID: E94F879A-65DA-4CCA-B4E1-D856692EE7DC Page 4 of 5 Ditesco 2015-2016 Wage Rate Schedule Principal: $130.00 - $145.00 per hour Project Manager: $100.00 - $140.00 per hour Construction Manager/Resident Engineer: $110.00 - $130.00 per hour Project Engineer $95.00 - $110.00 per hour Engineer: $75.00 to 100.00 per hour Administrative: $60.00 to $75.00 per hour Mileage Reimbursement: $0.75 per mile Subconsultant Markup: 5% of cost All other costs at direct expense Terms 30 days net DocuSign Envelope ID: E94F879A-65DA-4CCA-B4E1-D856692EE7DC City of Fort Collins - DWRF Digester Lid 612 January 2019 to August 2019 1/11/2019 Project Manager Resident Engineer Administrative Jill Burrell Jenna Beairsto Cassidy Hill (hrs) (hrs) (hrs) $120 $110 $65 Task 1: Preconstruction $450 1.6 Preconstruction Photographs and Video 0 2 0 $220 1.8 Schedule review 1 1 0 $230 Task 2: Construction $62,128 1.1 Review Construction Contracts 0 1 0 $110 1.2 Review Construction Plans and Specifications 1 4 0 $560 1.3 Create and compile job files 0 8 0 $880 1.7 Preconstruction Meeting (minutes, contact lists, etc.) 2 3 4 $770 1.9 Submittal/shop drawing coordination and record keeping 2 16 8 $2,514 1.10 Construction progress meetings (1 per week for 7.5 months) 24 48 64 $12,289 1.11 Monthly Reports 0 4 11 $1,159 1.12 Contract Management (pay applications, change orders, etc.) 4 8 0 $1,292 1.13 RFI Response 0 15 0 $1,672 1.14 Resident Engineering (RE: 2 Hours/Day) 64 239 0 $33,995 1.15 Daily Construction Logs 0 40 0 $4,389 1.16 Job Files (test reports, minutes, correspondence, photos, etc.) 0 8 4 $1,138 2.1 Start Up and Testing 4 8 0 $1,360 Task 3: Post Construction $2,920 3.1 Punch list walk through 2 4 0 $680 3.2 Record Drawing Compilation 0 4 0 $440 3.3 Close out paperwork (substantial and final completion, etc.) 0 2 0 $220 3.4 Project Close Out (compilation of files, photos, job records, etc.) 0 6 4 $920 3.5 Warranty walkthrough (11th and 23rd months) 0 6 0 $660 Reimbursable Expenses Mileage @ $0.58 per mile $741 Photocopies, project binders/files, etc. $500 Materials Testing - Team Industrial Services $6,750 Work Effort Subtotal 103 427 95 $65,498 Subtotal Reimbursable Items $7,991 Contract Total $73,489 Cost per labor category $12,370 $46,939 $6,189.30 Effort (days) 13 53 12 Effort (weeks) 3 11 2 Effort (hours per day) 0.65 2.67 0.60 FTE 0.08 0.33 0.07 Assumptions: - 7.5 month construction phase - Daily resident engineering effort (0.25 time) - Construction start date - Mid January 2019 - Construction end date - August 2019 Phase/Task Description Task Total Page 5 of 5 DocuSign Envelope ID: E94F879A-65DA-4CCA-B4E1-D856692EE7DC 5095 Paris Street, Denver, CO 80239 Phone: (720)579-0660 Fax: (720) 859-7753 December 31, 2018 TO: Ditesco Project & Construction Services 2133 S. Timberline Road, Unit 110 Fort Collins, CO 80525 970-632-5068 (Office) 970-690-1889 (Cell) jill.burrell@ditescoservices.com Attention: Jill Burrell Estimate #: 111818-236 (10) Subject: Provide Inspection Services City of Fort Collins Drake Water Reclamation Facility Digester Lid 612 Location: Fort Collins, CO Dear: Jill, TEAM INDUSTRIAL SERVICES is pleased to submit the following Time & Material pricing estimate for MT & RT testing on the City of Fort Collins Drake Water Reclamation Facility Digester Lid 612 at the Ditesco shop in Fort Collins, CO. We trust the information provided is complete and sufficient for your evaluation and consideration. Should you have any questions or require additional information, please do not hesitate to contact us at (707) 748-5800. We assure you of our prompt attention. Thank you for considering TEAM INDUSTRIAL SERVICES for your Inspection requirements. We look forward to working with Ditesco Project & Construction Services on this project. Sincerely, Brian E Gailey Account Manager Brian.gailey@teaminc.com Cell: 720-388-9187 "Safety First In Everything We Do" DocuSign Envelope ID: E94F879A-65DA-4CCA-B4E1-D856692EE7DC Scope of Work: Provide Labor, Equipment and consumable materials to perform the following inspections.  Mag Particle testing on 20% of all welds  X-Ray Testing on all full penetration welds * See attachment #1 – Floating Gas Holding Digester Cover Shop Drawings Team to provide:  A 2 Man inspection Crew  Darkroom with Camera and power generation  Magnetic particle testing equipment  MT & RT consumables Shift rate pricing is based on the following considerations:  Crew will be working 4 each, Monday ~ Friday non-holiday 10 hour dayshifts that include travel.  This work DOES NOT take prevailing wages into consideration; if prevailing wages are required, the labor rates will be compliant with the applicable wage determination for the area plus markup. Budgetary Time & Material cost for the work as outlined above @ $ 6,746.00 NOTE: TEAM INDUSTRIAL SERVICES, Inc.‟s pricing is in strict accordance with this proposal and any additional manpower and or equipment required for any additional work outside what has been described in the extent of work, delays beyond TEAM INDUSTRIAL SERVICES control, insufficient quantities or insufficient time required to perform daily work as noted in this quotation, and additional call-outs will be extra. TERMS:  Prices quoted herein are valid for a period of 90 days from the date of this proposal.  Payment terms are Net 30 days from the date of TEAM INDUSTRIAL SERVICES invoice.  TEAM INDUSTRIAL SERVICES does not involve itself in „Pay When Paid‟ contracts unless specifically requested by the Customer under separate letter.  TEAM INDUSTRIAL SERVICES Standard Terms for contract work shall apply.  No provision has been made for retention of payments by CUSTOMER.  Any Change in the scope of work as detailed in this proposal will allow TEAM INDUSTRIAL SERVICES to revise its quotation. NOTICE Purchaser must indicate the scope of work, including: (i) As to inspection services, the method(s) of inspection (i.e., radiography, ultrasonic examination, magnetic particle examination, visible and fluorescent liquid examination, metallography/replication, hydrostatic testing, tank inspection and engineering services, destructive testing, and/or metallurgical and chemical analysis). However, TISI will use reasonable efforts to assist in the selection of such method(s) and to locate or measure discontinuities or characteristics of the type, which normally can be located or measured. DocuSign Envelope ID: E94F879A-65DA-4CCA-B4E1-D856692EE7DC Utilities Work Order Form Official Purchasing Form Last updated 10/2017 ATTACHMENT C WORK ORDER SCHEDULE DETAIL Page 8 of 10 DocuSign Envelope ID: E94F879A-65DA-4CCA-B4E1-D856692EE7DC Jan-19 Feb-19 Mar-19 Apr-19 May-19 Jun-19 Jul-19 Aug-19 Construction Support Key Dates: Commencement Date: 01/21/2019 Completion Date: 08/31/2019 Digester 612 Lid Replacement Carollo Construction Support Services Project Schedule SCHEDULE Page 9 of 10 DocuSign Envelope ID: E94F879A-65DA-4CCA-B4E1-D856692EE7DC Utilities Work Order Form Official Purchasing Form Last updated 10/2017 ATTACHMENT D CERTIFICATE OF INSURANCE CONTRACTOR shall submit Certificate of Insurance in compliance with the Contract Documents. Page 10 of 10 DocuSign Envelope ID: E94F879A-65DA-4CCA-B4E1-D856692EE7DC Subject: Date: No. of Pages: Phone: Sender: URL: MAIL Certificate of Insurance DOCUMENT Delivery by ecertsonline™ THIS MESSAGE IS INTENDED FOR THE USE OF THE INDIVIDUAL OR ENTITY TO WHICH IT IS ADDRESSED AND MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. IF THE READER OF THE MESSAGE IS NOT THE INTENDED RECIPIENT, OR THE EMPLOYEE OR AGENT RESPONSIBLE FOR DELIVERING THE MESSAGE TO THE INTENDED RECIPIENT, YOU ARE HEREBY NOTIFIED THAT ANY DISSEMINATION, DISTRIBUTION OR COPYING OF THIS COMMUNICATION IS STRICTLY PROHIBITED. IF YOU HAVE RECEIVED THIS COMMUNICATION IN ERROR, PLEASE NOTIFY US IMEDIATELY BY TELEPHONE, AND RETURN THE ORIGINAL MESSAGE TO US AT THE ABOVE ADDRESS VIA REGULAR POSTAL SERVICE. Certificate of Insurance Delivered by ecertsonline™ Insurance Visions, Inc. All rights reserved. Risk Strategies Company 2040 Main Street, Suite 450 Irvine, CA 92614 949-242-9240 www.risk-strategies.com 12/19/2018 Attached is your renewal certificate of insurance. If you have any questions, please email Sherry Young at syoung@risk-strategies.com. City of Fort Collins P.O. Box 580 Fort Collins CO 80522 Sherry Young 10 Cert No. 46014063 - Carollo Engineers, Inc. - Renewal Certificate of Insurance DocuSign Envelope ID: E94F879A-65DA-4CCA-B4E1-D856692EE7DC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME: CONTACT (A/C, No): FAX E-MAIL ADDRESS: PRODUCER (A/C, No, Ext): PHONE INSURED COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ PROPERTY DAMAGE $ BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOS ONLY AUTOS NON-OWNED OWNED SCHEDULED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? Blanket Additional Insured - Owners, Lessees or Contractors - with Products-Completed Operations Coverage Endorsement CNA75079XX (1-15) Policy No: Page 1 of 2 Endorsement No: Effective Date: Insured Name: Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART It is understood and agreed as follows: I. The WHO IS AN INSURED section is amended to add as an Insured any person or organization whom the Named Insured is required by written contract to add as an additional insured on this coverage part, including any such person or organization, if any, specifically set forth on the Schedule attachment to this endorsement. However, such person or organization is an Insured only with respect to such person or organization’s liability for: A. unless paragraph B. below applies, 1. bodily injury, property damage, or personal and advertising injury caused in whole or in part by the acts or omissions by or on behalf of the Named Insured and in the performance of such Named Insured’s ongoing operations as specified in such written contract; or 2. bodily injury or property damage caused in whole or in part by your work and included in the products-completed operations hazard, and only if a. the written contract requires the Named Insured to provide the additional insured such coverage; and b. this coverage part provides such coverage. B. bodily injury, property damage, or personal and advertising injury arising out of your work described in such written contract, but only if: 1. this coverage part provides coverage for bodily injury or property damage included within the products completed operations hazard; and 2. the written contract specifically requires the Named Insured to provide additional insured coverage under the 11-85 or 10-01 edition of CG2010 or the 10-01 edition of CG2037. II. Subject always to the terms and conditions of this policy, including the limits of insurance, the Insurer will not provide such additional insured with: A. coverage broader than required by the written contract; or B. a higher limit of insurance than required by the written contract. III. The insurance granted by this endorsement to the additional insured does not apply to bodily injury, property damage, or personal and advertising injury arising out of: A. the rendering of, or the failure to render, any professional architectural, engineering, or surveying services, including: 1. the preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and 2. supervisory, inspection, architectural or engineering activities; or B. any premises or work for which the additional insured is specifically listed as an additional insured on another endorsement attached to this coverage part. IV. Notwithstanding anything to the contrary in the section entitled COMMERCIAL GENERAL LIABILITY CONDITIONS, the Condition entitled Other Insurance, this insurance is excess of all other insurance available to the additional insured whether on a primary, excess, contingent or any other basis. However, if this insurance Carollo Engineers, Inc. 6050490317 12/31/2018 46014063 | *18-19 GL-AL-UL-WC-PL ($1M/$1M) | Sherry Young | 12/19/2018 11:55:10 AM (PST) | Page 2 of 9 DocuSign Envelope ID: E94F879A-65DA-4CCA-B4E1-D856692EE7DC Blanket Additional Insured - Owners, Lessees or Contractors - with Products-Completed Operations Coverage Endorsement CNA75079XX (1-15) Policy No: Page 2 of 2 Endorsement No: Effective Date: Insured Name: Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. is required by written contract to be primary and non-contributory, this insurance will be primary and non- contributory relative solely to insurance on which the additional insured is a named insured. V. Solely with respect to the insurance granted by this endorsement, the section entitled COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: The Condition entitled Duties In The Event of Occurrence, Offense, Claim or Suit is amended with the addition of the following: Any additional insured pursuant to this endorsement will as soon as practicable: 1. give the Insurer written notice of any claim, or any occurrence or offense which may result in a claim; 2. except as provided in Paragraph IV. of this endorsement, agree to make available any other insurance the additional insured has for any loss covered under this coverage part; 3. send the Insurer copies of all legal papers received, and otherwise cooperate with the Insurer in the investigation, defense, or settlement of the claim; and 4. tender the defense and indemnity of any claim to any other insurer or self insurer whose policy or program applies to a loss that the Insurer covers under this coverage part. However, if the written contract requires this insurance to be primary and non-contributory, this paragraph (4) does not apply to insurance on which the additional insured is a named insured. The Insurer has no duty to defend or indemnify an additional insured under this endorsement until the Insurer receives written notice of a claim from the additional insured. VI. Solely with respect to the insurance granted by this endorsement, the section entitled DEFINITIONS is amended to add the following definition: Written contract means a written contract or written agreement that requires the Named Insured to make a person or organization an additional insured on this coverage part, provided the contract or agreement: A. is currently in effect or becomes effective during the term of this policy; and B. was executed prior to: 1. the bodily injury or property damage; or 2. the offense that caused the personal and advertising injury for which the additional insured seeks coverage. Any coverage granted by this endorsement shall apply solely to the extent permissible by law. All other terms and conditions of the Policy remain unchanged. This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. Carollo Engineers, Inc. 6050490317 12/31/2018 46014063 | *18-19 GL-AL-UL-WC-PL ($1M/$1M) | Sherry Young | 12/19/2018 11:55:10 AM (PST) | Page 3 of 9 DocuSign Envelope ID: E94F879A-65DA-4CCA-B4E1-D856692EE7DC Waiver of Transfer of Rights of Recovery Against Others to the Insurer Endorsement This endorsement modifies insurance provided under the following: COMMERICAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name of Person Or Organization Blanket where required by written contract. (Information required to complete this Schedule, if not shown above, will be shown in the Declarations.) Under COMMERCIAL GENERAL LIABILITY CONDITIONS, it is understood and agreed that the condition entitled Transfer Of Rights Of Recovery Against Others To Us is amended by the addition of the following: With respect to the person or organization shown in the Schedule above, the Insurer waives any right of recovery the Insurer may have against such person or organization because of payments the Insurer makes for injury or damage arising out of the Named Insured’s ongoing operations or your work included in the products-completed operations hazard. All other terms and conditions of the Policy remain unchanged. This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. CNA75008XX (10-16) Policy No: Endorsement No: Effective Date: Insured Name: Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. 12/19/2018 Carollo Engineers, Inc. 6050490317 46014063 | *18-19 GL-AL-UL-WC-PL ($1M/$1M) | Sherry Young | 12/19/2018 11:55:10 AM (PST) | Page 4 of 9 DocuSign Envelope ID: E94F879A-65DA-4CCA-B4E1-D856692EE7DC CNA68021XX (2-13) Policy No: Page 1 Endorsement No: Effective Date: Insured Name: © CNA All Rights Reserved. NOTICE OF CANCELLATION TO CERTIFICATEHOLDERS It is understood and agreed that: If you have agreed under written contract to provide notice of cancellation to a party to whom the Agent of Record has issued a Certificate of Insurance, and if we cancel a policy term described on that Certificate of Insurance for any reason other than nonpayment of premium, then notice of cancellation will be provided to such Certificateholders at least 30 days in advance of the date cancellation is effective. If notice is mailed, then proof of mailing to the last known mailing address of the Certificateholder on file with the Agent of Record will be sufficient to prove notice. Any failure by us to notify such persons or organizations will not extend or invalidate such cancellation, or impose any liability or obligation upon us or the Agent of Record. Carollo Engineers, Inc. 6050490317 12/31/2018 City of Fort Collins P.O. Box 580 Fort Collins CO 80522 46014063 | *18-19 GL-AL-UL-WC-PL ($1M/$1M) | Sherry Young | 12/19/2018 11:55:10 AM (PST) | Page 5 of 9 DocuSign Envelope ID: E94F879A-65DA-4CCA-B4E1-D856692EE7DC Named Insured: Policy Number: Effective Date: ADDITIONAL INSURED – PRIMARY AND NON-CONTRIBUTORY It is understood and agreed that this endorsement amends the BUSINESS AUTO COVERAGE FORM as follows: SCHEDULE Name of Additional Insured Persons Or Organizations ANY PERSON OR ORGANIZATION ON WHOSE BEHALF YOU ARE REQUIRED UNDER A WRITTEN CONTRACT OR AGREEMENT. 1. In conformance with paragraph A.1.c. of Who Is An Insured of Section II – LIABILITY COVERAGE, the person or organization scheduled above is an insured under this policy. 2. The insurance afforded to the additional insured under this policy will apply on a primary and non- contributory basis if you have committed it to be so in a written contract or written agreement executed prior to the date of the "accident" for which the additional insured seeks coverage under this policy. All other terms and conditions of the Policy remain unchanged. CNA 71527XX (Ed. 10/12) Carollo Engineers, Inc. 6050490267 12/31/2018 46014063 | *18-19 GL-AL-UL-WC-PL ($1M/$1M) | Sherry Young | 12/19/2018 11:55:10 AM (PST) | Page 6 of 9 DocuSign Envelope ID: E94F879A-65DA-4CCA-B4E1-D856692EE7DC CNA68021XX (2-13) Policy No: Page 1 Endorsement No: Effective Date: Insured Name: © CNA All Rights Reserved. NOTICE OF CANCELLATION TO CERTIFICATEHOLDERS It is understood and agreed that: If you have agreed under written contract to provide notice of cancellation to a party to whom the Agent of Record has issued a Certificate of Insurance, and if we cancel a policy term described on that Certificate of Insurance for any reason other than nonpayment of premium, then notice of cancellation will be provided to such Certificateholders at least 30 days in advance of the date cancellation is effective. If notice is mailed, then proof of mailing to the last known mailing address of the Certificateholder on file with the Agent of Record will be sufficient to prove notice. Any failure by us to notify such persons or organizations will not extend or invalidate such cancellation, or impose any liability or obligation upon us or the Agent of Record. Carollo Engineers, Inc. City of Fort Collins P.O. Box 580 Fort Collins CO 80522 6050490267 12/31/2018 46014063 | *18-19 GL-AL-UL-WC-PL ($1M/$1M) | Sherry Young | 12/19/2018 11:55:10 AM (PST) | Page 7 of 9 DocuSign Envelope ID: E94F879A-65DA-4CCA-B4E1-D856692EE7DC Carollo Engineers, Inc. 6050490270 12/31/2018 12/31/2018 6050490298 American Casualty Company of Reading, PA Valley Forge Insurance Company 46014063 | *18-19 GL-AL-UL-WC-PL ($1M/$1M) | Sherry Young | 12/19/2018 11:55:10 AM (PST) | Page 8 of 9 Workers Compensation DocuSign Envelope ID: E94F879A-65DA-4CCA-B4E1-D856692EE7DC PROFESSIONAL LIABILITY AND POLLUTION For All the Commitments you Make INCIDENT LIABILITY INSURANCE POLICY INSURED: Policy Effective Endorsement Number NOTICE ENDORSEMENT – CANCELLATION OR NON-RENEWAL We agree with you that your Policy is amended to include the following additional provisions. 1. Your Policy will not be: XX Cancelled by us until we provide at least: 10 days prior written notice if we cancel your Policy for Non-payment of Premium; 30 days prior written notice if we cancel your Policy for The following reasons: Any reason other than non-payment of premium. ___ Non-renewed by us until at least ___ days prior written notice is given to the person or entity named in 2. below. 2. Person or Entity: All other terms and conditions of the Policy remain unchanged. This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy and expires concurrently with said Policy unless another effective date is shown above. By Authorized Representative __James F. Willging_____________________ (No signature is required if issued with the Policy or if it is effective on the Policy Effective Date) James F. Willging Countersigned by Authorized Representative 256423 (Ed. 10/05) Carollo Engineers, Inc. AEH288354410 7/4/2018 City of Fort Collins P.O. Box 580 Fort Collins CO 80522 46014063 | *18-19 GL-AL-UL-WC-PL ($1M/$1M) | Sherry Young | 12/19/2018 11:55:10 AM (PST) | Page 9 of 9 DocuSign Envelope ID: E94F879A-65DA-4CCA-B4E1-D856692EE7DC (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT ER OTH- STATUTE PER (MM/DD/YYYY) LIMITS POLICY EXP (MM/DD/YYYY) POLICY EFF LTR TYPE OF INSURANCE POLICY NUMBER INSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB EACH OCCURRENCE $ AGGREGATE $ $ OCCUR CLAIMS-MADE DED RETENTION $ PRODUCTS - COMP/OP AGG $ GENERAL AGGREGATE $ PERSONAL & ADV INJURY $ MED EXP (Any one person) $ EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES (Ea occurrence) $ COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 12/19/2018 Risk Strategies Company 2040 Main Street, Suite 450 Irvine, CA 92614 949-242-9240 www.risk-strategies.com CA DOI License No. 0F06675 Michael Christian Risk Strategies Company syoung@risk-strategies.com Carollo Engineers, Inc. 2700 Ygnacio Valley Road, #300 Walnut Creek CA 94598 46014063 ✓ ✓ Construction Services. Carollo Project #: 10103A.00. City of Fort Collins, its officers, agents and employees are included as additional insured as City of Fort Collins P.O. Box 580 Fort Collins CO 80522 Projects as on file with the insured including but not limited to: 8115 Engineering Services for Water Reclamation and Biosolids Facility Design & additional insureds with respects to General & Auto Liability. $1,000,000 $1,000,000 $25,000 $1,000,000 $2,000,000 $2,000,000 $1,000,000 Ded: Comp/Collision $1,000 $1,000,000 $1,000,000 $1,000,000 Each Claim: $1,000,000 Aggregate: $1,000,000 Deductible: $400,000 A ✓ 6050490317 12/31/2018 12/31/2019 ✓ ✓ Deductible $0 ✓ E 6050490267 12/31/2018 12/31/2019 ✓ ✓ ✓ B 6050490270 12/31/2018 12/31/2019 ✓ ✓ C 6050490298 12/31/2018 12/31/2019 N Deductible: $0 D Professional Liability AEH288354410 7/4/2018 7/4/2019 Unlimited Prior Acts Continental Insurance Company 35289 American Casualty Company of Reading, PA 20427 Valley Forge Insurance Company 20508 Continental Casualty Company 20443 National Fire Insurance Co of Hartford 20478 46014063 | *18-19 GL-AL-UL-WC-PL ($1M/$1M) | Sherry Young | 12/19/2018 11:55:10 AM (PST) | Page 1 of 9 DocuSign Envelope ID: E94F879A-65DA-4CCA-B4E1-D856692EE7DC