Loading...
HomeMy WebLinkAboutCORRESPONDENCE - AGREEMENT MISC - VEOLIA ES TECHNICAL SOLUTIONS (6)January 15, 2020 Veolia ES Technical Solutions Inc Attn: Tom Anckner 9131 E 96th Ave Henderson, CO 80640 RE: Renewal, Miscellaneous Agreement - HHW Event Hosting Dear Mr. Anckner: 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: 1) The term will be extended for one (1) additional year, April 1, 2020 through March 31, 2021. If the renewal is acceptable to your firm, please sign this letter in the space provided and include a current copy of your 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 Ed Bonnette, C.P.M., CPPB, Senior Buyer at (970) 416-2247 if you have any questions regarding this matter. Sincerely, Gerry S. Paul Director of Purchasing __________________________________________ ________________________ Signature Date (Please indicate your desire to renew this agreement by signing this letter and returning it to Purchasing Division within the next fifteen days.) GSP:kr 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: E553B69E-9022-4CBE-9F78-431FC68933DB 1/21/2020 ACORD V7 I ® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 12/13/2019 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 ADDITIONALINSURED, 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). PRODUCER Marsh USA, Inc. 540 W. Madison Street CONTACT NAME; PHONE FAX (NC. No. Ext): (NC, No): Chicago, IL 60661 E-MA'L , Attn: Veolia.CertRequest@rnarsh.com| Fax: 212-948-5053 ADDRESS- INSURER(S) AFFORDING COVERAGE NAIc # HEN-TS INSURER A : National Union Fire InsuranceCompanyOf Pittsburgh, 19445 INSURED . - Veolia ES Technical Solutions, LLC INSURER B ' New Hampshire Insurance 9131 East 96th Avenue INSURER c : N/A N/A Henderson,CO 80640 INSURER D : Lloyd's Syndicates623/2623 INSURER E : Illinois National InsuranceCompany 23817 INSURER F : COVERAGES CERTIFICATE NUMBER: CHI—00806564056 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. LIMITSSHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. '03? TYPE OF INSURANCE 1EEWV’B5 POLICY NUMBER (WEE/v55?) (Wiég/YPW LIMITS A X COMMERCIALGENERAL LIABILITY GL5425835 01/01/2020 01/01/2021 EACH OCCURRENCE $ 1,000,000 CLAIMS~MADEEOCCUR SSE/0,95%?Eii'gfi'39me) $ 1,000,000 % MED EXP (Any one person) $ _ PERSONAL & ADV INJURY s 1000000 10’000 SEMI AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 1900900 A POLICYD558-} I: Loc PRODUCTS - COMP/OP AGG $ 1000000 OTHER: $ A AUTOMOBILELIABILITY CA9767418 (AOS) 01/01/2020 01/01/2021 CEOaIIgEgFIIEEtFINGI—E LIMIT $ 1,000,000 A 7 ANYAUTO CA9767419 (MA) 01/01/2020 01/01/2021 BODILY]NJURY : EmNOESDONLY ESPESULED CA9767420 (VA) (Per person) $ 01/01/2020 01/01/2021 BODILYINJURY(per accident) $ AGENCY CUSTOMER ID: CN102584993 LOC #: Chicago ACORD ADDITIONAL REMARKS SCHEDULE Page __2_°f _2_ AGENCY NAMEDINSURED Marsh USA, Inc. Veoiia ES Technical Solutions, LLC 9131 East 96th Avenue POLICY NUMBER Henderson, 00 80640 CARRIER NAICCODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONALREMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Workers Compensation (Cont) Carrier: Insurance Company of the State of Pennsylvania Policy Number: WC 04601-2805 (MA, ND, OH, WA, W1, WY) EffectiveDate: 01/01/2020 ExpirationDate: 01/01/2021 Limit: SEE ABOVE Carrier: American Home Assurance (NAIC #19380) Policy Number: WC 04e91-2806(CA) EffectiveDate: 01/01/2020 Expiration Date: 01/01/2021 Limit: SEE ABOVE ACORD 101 (2008/01) © 2008 ACORDCORPORATION.All rights reserved. The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID: E553B69E-9022-4CBE-9F78-431FC68933DB ENDORSEMENT This endorsement, effective 1 2:01 AM. 01/01/2020 forms a part of Policy No. CA 9767418 issued to: VEOLIA NORTH AMERICA, INC. By: NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED — WHERE REQUIRED UNDER CONTRACT OR AGREEMENT This endorsement modifies insarance provided under the fol/owing: BUSINESS AUTO COVERAGE FORM SCHEDULE ADDITIONAL INSURED: ANY PERSON OR ORGANIZATIONTO WHOM YOU ARE CONTRACTUALLYBOUND TO PROVIDE ADDITIONAL INSUREDSTATUS. BUT ONLY TO THE EXTENT AS SUCH PERSON‘S OR ORGANIZATION’S LIABILITY ARISING OUT OF USE OF A COVERED AUTO. I. SECTION II — COVERED AUTOS LIABILITY COVERAGE. A. Coverage. 1. - Who Is Insured. is amended to add: d. Any person or organization, shown in the schedule above, to whom you become oingated to Include as an additionai insured under this poIicy, as a resuit of any contract or agreement you enter into which requires you to furnish insurance to that person or organization of the type provided by this policy, but onIy with respect to Iiabiiity arising out of use of a covered "auto". However, the insurance provided will not exceed the Iesser of: (I) The coverage and/or limits of this poIicy, or {2) The coverage and/or Iimits required by said contract or agreement. '1 If Authorized HEDIESES‘IWUVQ 87950 (9/1 4) IncIudes copyrighted information of InsuranceServices with its permission. Office, Inc., Page 1 Of 1 DocuSign Envelope ID: E553B69E-9022-4CBE-9F78-431FC68933DB POLICY NUMBER: GL 54268—35 COMMERCIALGENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies Insurance provided under the following: COMMERCIALGENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Personis) Or Organizationls) Location(s) Of Covered Operations Any person or organization whom you become obligated to include as an additional insured as a result of any contract or agreement you have entered into. Per the contract or agreement. information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for ”bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the locationis) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. if coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage“ occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional lnsured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a Page 2 of 2 C. With respect to the insurance afforded to these additionai insureds, the toiicwing is added to Section iii - Limits Of insurance: if coverage provided to the additionai insured is required by a contract or agreement, the most we wiii pay on behalf of the additionat insured is the amount of insurance: 1. Required by the contract or agreement; or © insurance Services Office, inc., 2012 2. Avaiiabie under the appiicabie Limits of insurance shown in the Deciarations; whichever is iess. This endorsement shalt not increase the appiicabie Limits of insurance shown in the Declarations. CG 20 1D 0413 DocuSign Envelope ID: E553B69E-9022-4CBE-9F78-431FC68933DB POLICY NUMBER: GL 54268—35 COMMERCIALGENERAL LIABILITY CG 2O 37 O4 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED — OWNERS, LESSEES OR CONTRACTORS -— COMPLETED OPERATIONS This endorsement modifies insurance provided under the foilowing: COMMERCIALGENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organizatioms) Location And Description Of Completed Operations Any person or organization whom you become obligated to include as an additional insured as a result of any contract or agreement you have entered into. Per the contract or agreement information requiredto complete this Schedule, it not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Scheduie, but only with respect to liability for "bodliy injury" or "property damage" caused, in whoie or in part, by “your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products—completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. It coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additionai insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 370413 B. With respect to the insurance afforded to these additionai insureds, the foilowing is added to Section III — Limits 0t Insurance: if coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behaif of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Avaitable under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. © Insurance Services Office, Inc., 2012 Page 1 of 1 DocuSign Envelope ID: E553B69E-9022-4CBE-9F78-431FC68933DB principal as a part of the same project. CG 20 to 04 13 © insurance Services Office, Inc, 2012 Page 1 of 2 DocuSign Envelope ID: E553B69E-9022-4CBE-9F78-431FC68933DB HIRED NON-OWNED PROPERTY DAMAGE __ AUTOS ONLY AUTOS ONLY (Per accudent) $ s __ UMBRELLALIAB OCCUR EACH OCCURRENCE s EXCESS LIAB CLAIMS—MADE AGGREGATE s DED l l RETENTION s 35 B ngggfigfgeehggEfiaglf/pv WC 046—91-2802(AOS) 01/01/2020 01/01/2021 x STE‘ARTUTE I I ggH» B SE;EE%7§E%§§AE§%I%%€E§ECUTIVE NIA WC 046—91—2803 (AZ, IL, KY, NC, NH, 01/01/2020 01/01/2021 EL. EACHACCIDENT 3 1,000’000 (Mandatoryin NH) ' NJ, PA, UT, VA, VT) E.L. DISEASE - EA EMPLOYEE s 10001000 EESSCRIEPSigllgfi[O13 gPERATIONS below WC 046812804 (FL) 01/01/2020 0“01l2021 EL DISEASE - POLICY LIMIT 35 1900000 D Pollution Legal Liability W1 D4C8200401 01/01/2020 01/01/2021 Per Claim 1,000,000 Claims Made Form SIR $750,000 Aggregate 1,000,000 General Liabilityand Auto Liability. DESCRIPTION OF OPERATIONS] LOCATIONS I VEHICLES (ACORD 101, AdditionalRemarksSchedule,maybeattached if more space is required) City of Fort Collins, its officers, agents and employeesare included as additional insured where required by written contract but only for liabilityarising out of the operations of the named insured with respect to CERTIFICATE HOLDER CANCELLATION City of Fort Collins PurchasingDivision Attn: Ed Bonnette, CPM 215 North Mason PO. Box 580 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITHTHEPOLICYPROVISIONS. AUTHORIZEDREPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee ACORD 25 (2016/03) © 1988-2016 ACORDCORPORATION.All rights reserved. The ACORDnameand logo are registered marks of ACORD DocuSign Envelope ID: E553B69E-9022-4CBE-9F78-431FC68933DB