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HomeMy WebLinkAbout103508 DJ'S SPORT SHOPPE INC - CONTRACT - RFP - 8593 EXERCISE WEAR FOR PFAServices Agreement 8593 Exercise Wear for PFA Page 1 of 13 SERVICES AGREEMENT THIS AGREEMENT made and entered into the day and year set forth below by and between THE CITY OF FORT COLLINS, COLORADO, a Municipal Corporation, hereinafter referred to as the "City", as agent, on behalf of the Poudre Fire Authority (PFA), and D.J.’S SPORT SHOPPE INC., hereinafter referred to as "Service Provider". WITNESSETH: In consideration of the mutual covenants and obligations herein expressed, it is agreed by and between the parties hereto as follows: 1. Scope of Services. The Service Provider agrees to provide services in accordance with the scope of services attached hereto as Exhibit "A", consisting of four (4) pages and incorporated herein by this reference. Irrespective of references in Exhibit A to certain named third parties, Service Provider shall be solely responsible for performance of all duties hereunder. 2. Contract Period. This Agreement shall commence upon execution by all parties, and shall continue in full force and effect until October 31, 2018, unless sooner terminated as herein provided. In addition, at the option of the City and/or PFA, the Agreement may be extended for additional one year periods not to exceed four (4) additional one year periods. Renewals and pricing changes shall be negotiated by and agreed to by both parties. Written notice of renewal shall be provided to the Service Provider and mailed no later than thirty (30) days prior to contract end. 3. Delay. If either party is prevented in whole or in part from performing its obligations by unforeseeable causes beyond its reasonable control and without its fault or negligence, then the party so prevented shall be excused from whatever performance is prevented by such cause. To the extent that the performance is actually prevented, the Service Provider must provide written notice to the City and PFA of such condition within fifteen (15) days from the onset of such condition. 4. Early Termination by City/Notice. Notwithstanding the time periods contained herein, the City and/or PFA may terminate this Agreement at any time without cause by providing written notice of termination to the Service Provider. Such notice shall be delivered at least fifteen (15) days prior to the termination date contained in said notice unless otherwise agreed in writing by the parties. All notices provided under this Agreement shall be effective when mailed, postage prepaid and sent to the following addresses: Service Provider: City: Copy to: D.J.’s Sport Shoppe Inc. Attn: Laura Bell 1225 Red Cedar Circle, Unit F Fort Collins, CO 80524 Poudre Fire Authority Attn: Murray Anduss 102 Remington Street Fort Collins, CO 80524 City of Fort Collins Attn: Purchasing Dept. PO Box 580 Fort Collins, CO 80522 DocuSign Envelope ID: F4320A5F-A905-4EFF-85C7-D588909544E4 Services Agreement 8593 Exercise Wear for PFA Page 2 of 13 In the event of early termination by the and/or PFA, the Service Provider shall be paid for services rendered to the date of termination, subject only to the satisfactory performance of the Service Provider's obligations under this Agreement. Such payment shall be the Service Provider's sole right and remedy for such termination. 5. Contract Sum. The City and/or PFA shall pay the Service Provider for the performance of this Contract, subject to additions and deletions provided herein, in accordance with the attached Exhibit "B", consisting of two (2) pages, and incorporated herein by this reference. 6. City Representative. The and/or PFA will designate, prior to commencement of the work, its representative who shall make, within the scope of his or her authority, all necessary and proper decisions with reference to the services provided under this agreement. All requests concerning this agreement shall be directed to the City and/or PFA Representative. 7. Independent Service provider. The services to be performed by Service Provider are those of an independent service provider and not of an employee of the City of Fort Collins or the Poudre Fire Authority. The City and/or PFA shall not be responsible for withholding any portion of Service Provider's compensation hereunder for the payment of FICA, Workmen's Compensation or other taxes or benefits or for any other purpose. 8. Subcontractors. Service Provider may not subcontract any of the Work set forth in the Exhibit A, Statement of Work without the prior written consent of the City and/or PFA, which shall not be unreasonably withheld. If any of the Work is subcontracted hereunder (with the consent of the City and/or PFA), then the following provisions shall apply: (a) the subcontractor must be a reputable, qualified firm with an established record of successful performance in its respective trade performing identical or substantially similar work, (b) the subcontractor will be required to comply with all applicable terms of this Agreement, (c) the subcontract will not create any contractual relationship between any such subcontractor and the City and/or PFA, nor will it obligate the City and/or PFA to pay or see to the payment of any subcontractor, and (d) the work of the subcontractor will be subject to inspection by the City and/or PFA to the same extent as the work of the Service Provider. 9. Personal Services. It is understood that the City and PFA enter into the Agreement based on the special abilities of the Service Provider and that this Agreement shall be considered as an agreement for personal services. Accordingly, the Service Provider shall neither assign any responsibilities nor delegate any duties arising under the Agreement without the prior written consent of the City and/or PFA. 10. Acceptance Not Waiver. The City's approval or acceptance of, or payment for any of the services shall not be construed to operate as a waiver of any rights or benefits provided to the City and/or PFA under this Agreement or cause of action arising out of performance of this Agreement. DocuSign Envelope ID: F4320A5F-A905-4EFF-85C7-D588909544E4 Services Agreement 8593 Exercise Wear for PFA Page 3 of 13 11. Warranty. a. Service Provider warrants that all work performed hereunder shall be performed with the highest degree of competence and care in accordance with accepted standards for work of a similar nature. b. Unless otherwise provided in the Agreement, all materials and equipment incorporated into any work shall be new and, where not specified, of the most suitable grade of their respective kinds for their intended use, and all workmanship shall be acceptable to City and/or PFA. c. Service Provider warrants all equipment, materials, labor and other work, provided under this Agreement, except City and/or PFA -furnished materials, equipment and labor, against defects and nonconformances in design, materials and workmanship/workwomanship for a period beginning with the start of the work and ending twelve (12) months from and after final acceptance under the Agreement, regardless whether the same were furnished or performed by Service Provider or by any of its subcontractors of any tier. Upon receipt of written notice from City and/or PFA of any such defect or nonconformances, the affected item or part thereof shall be redesigned, repaired or replaced by Service Provider in a manner and at a time acceptable to City and/or PFA. 12. Default. Each and every term and condition hereof shall be deemed to be a material element of this Agreement. In the event either party should fail or refuse to perform according to the terms of this agreement, such party may be declared in default thereof. 13. Remedies. In the event a party has been declared in default, such defaulting party shall be allowed a period of ten (10) days within which to cure said default. In the event the default remains uncorrected, the party declaring default may elect to (a) terminate the Agreement and seek damages; (b) treat the Agreement as continuing and require specific performance; or (c) avail himself of any other remedy at law or equity. If the non-defaulting party commences legal or equitable actions against the defaulting party, the defaulting party shall be liable to the non-defaulting party for the non-defaulting party's reasonable attorney fees and costs incurred because of the default. 14. Binding Effect. This writing, together with the exhibits hereto, constitutes the entire agreement between the parties and shall be binding upon said parties, their officers, employees, agents and assigns and shall inure to the benefit of the respective survivors, heirs, personal representatives, successors and assigns of said parties. 15. Indemnity/Insurance. a. The Service Provider agrees to indemnify and save harmless the City and/or PFA, their officers, agents and employees against and from any and all actions, suits, claims, demands or liability of any character whatsoever brought or asserted for injuries to or death of any person or persons, or damages to property arising out of, result from or occurring in connection with the performance of any service hereunder. DocuSign Envelope ID: F4320A5F-A905-4EFF-85C7-D588909544E4 Services Agreement 8593 Exercise Wear for PFA Page 4 of 13 b. The Service Provider shall take all necessary precautions in performing the work hereunder to prevent injury to persons and property. c. Without limiting any of the Service Provider's obligations hereunder, the Service Provider shall provide and maintain insurance coverage naming the City and PFA as an additional insured under this Agreement of the type and with the limits specified within Exhibit C, consisting of one (1) page, attached hereto and incorporated herein by this reference. The Service Provider before commencing services hereunder, shall deliver to the City's Purchasing Director, P. O. Box 580, Fort Collins, Colorado 80522 one copy of a certificate evidencing the insurance coverage required from an insurance company acceptable to the City. 16. Entire Agreement. This Agreement, along with all Exhibits and other documents incorporated herein, shall constitute the entire Agreement of the parties. Covenants or representations not contained in this Agreement shall not be binding on the parties. 17. Law/Severability. The laws of the State of Colorado shall govern the construction interpretation, execution and enforcement of this Agreement. In the event any provision of this Agreement shall be held invalid or unenforceable by any court of competent jurisdiction, such holding shall not invalidate or render unenforceable any other provision of this Agreement. 18. Prohibition Against Employing Illegal Aliens. Pursuant to Section 8-17.5-101, C.R.S., et. seq., Service Provider represents and agrees that: a. As of the date of this Agreement: 1. Service Provider does not knowingly employ or contract with an illegal alien who will perform work under this Agreement; and 2. Service Provider will participate in either the e-Verify program created in Public Law 208, 104th Congress, as amended, and expanded in Public Law 156, 108th Congress, as amended, administered by the United States Department of Homeland Security (the “e-Verify Program”) or the Department Program (the “Department Program”), an employment verification program established pursuant to Section 8-17.5-102(5)(c) C.R.S. in order to confirm the employment eligibility of all newly hired employees to perform work under this Agreement. b. Service Provider shall not knowingly employ or contract with an illegal alien to perform work under this Agreement or knowingly enter into a contract with a subcontractor that knowingly employs or contracts with an illegal alien to perform work under this Agreement. c. Service Provider is prohibited from using the e-Verify Program or Department Program procedures to undertake pre-employment screening of job applicants while this Agreement is being performed. d. If Service Provider obtains actual knowledge that a subcontractor performing work under this Agreement knowingly employs or contracts with an illegal alien, Service DocuSign Envelope ID: F4320A5F-A905-4EFF-85C7-D588909544E4 Services Agreement 8593 Exercise Wear for PFA Page 5 of 13 Provider shall: 1. Notify such subcontractor and the City within three days that Service Provider has actual knowledge that the subcontractor is employing or contracting with an illegal alien; and 2. Terminate the subcontract with the subcontractor if within three days of receiving the notice required pursuant to this section the subcontractor does not cease employing or contracting with the illegal alien; except that Service Provider shall not terminate the contract with the subcontractor if during such three days the subcontractor provides information to establish that the subcontractor has not knowingly employed or contracted with an illegal alien. e. Service Provider shall comply with any reasonable request by the Colorado Department of Labor and Employment (the “Department”) made in the course of an investigation that the Department undertakes or is undertaking pursuant to the authority established in Subsection 8-17.5-102 (5), C.R.S. f. If Service Provider violates any provision of this Agreement pertaining to the duties imposed by Subsection 8-17.5-102, C.R.S. the City may terminate this Agreement. If this Agreement is so terminated, Service Provider shall be liable for actual and consequential damages to the City arising out of Service Provider’s violation of Subsection 8-17.5-102, C.R.S. g. The City will notify the Office of the Secretary of State if Service Provider violates this provision of this Agreement and the City terminates the Agreement for such breach. DocuSign Envelope ID: F4320A5F-A905-4EFF-85C7-D588909544E4 Services Agreement 8593 Exercise Wear for PFA Page 6 of 13 THE CITY OF FORT COLLINS, COLORADO By: Gerry Paul Purchasing Director DATE: POUDRE FIRE AUTHORITY By: _________________________________ Tom DeMint, Fire Chief Date: ______________________________ ATTEST: APPROVED AS TO FORM: D.J.’S SPORT SHOPPE INC. By: Printed: Title: CORPORATE PRESIDENT OR VICE PRESIDENT Date: DocuSign Envelope ID: F4320A5F-A905-4EFF-85C7-D588909544E4 10/27/2017 Vice President LAURA BELL Assistant City Attorney 10/27/2017 10/27/2017 City Clerk Services Agreement 8593 Exercise Wear for PFA Page 7 of 13 EXHIBIT A SCOPE OF SERVICES Service Provider shall supply specified exercise wear to PFA. Continuity of supply and uniform appearance for the specified exercise wear is a primary concern for PFA. Exercise wear covered under this program will be selected by the Project Manager from the items represented on the Pricing Schedule. Item will be purchased on an as needed basis throughout the life of the contract; however the attached pricing schedule is indicative of annual order quantities. PROJECT PERSONNEL: This project will be managed by Laura Bell and production will be done by Scott Bell. AVAILABILITY/LEAD TIME: Once the order is received it takes 2-3 weeks to be delivered. Service Provider usually turns it around within the 2 weeks but allows for the 3rd week in case there are shortages in products. Service Provider has a wide variety of warehouses in which it get products from that it usually does not have that issue. METHODS AND APPROACH: Service Provider does not have a relationship with the actual manufacturer of the garments. However, Service Provider has long time relationships with the distributors of the products. Service Provider has been doing business with the suppliers for 30+ years. Should Service Provider have any problems with the product or order received, the distributors make it right immediately. Distributors have several warehouses in many different locations that ensures the Service Provider can fill large orders within a few days. Service Provider is solely family owned and operated and takes pride in providing quality garments with quality prints and embroidery. Everything is counted and checked when received, it is then counted and inspected again before production. After production it is inspected and counted again, and then once again when it is packaged for delivery. Every box is clearly marked and organized as to what each box contains. During the inspections, if Service Provider finds anything wrong with the product or logo, Service Provider replaces it immediately - if the City orders 100 pieces, the City receives 100 pieces. Upon receipt of the product, should the City find anything wrong with any of the garments, Service Provider will correct and replace it. DocuSign Envelope ID: F4320A5F-A905-4EFF-85C7-D588909544E4 Services Agreement 8593 Exercise Wear for PFA Page 8 of 13 CLOTHING SPECIFICATIONS: 1. T-Shirts & Sweatshirts All t-shirts and sweatshirts (crew and hooded) described as follows will have the following logo layouts for the front and back. FRONT BACK A. 6.1 oz. Beefy-T w/ pocket short sleeve, Regular Navy, 100% cotton, 4 color logo print front right chest, 1 color full back print  Small x 100  Medium x 200  Large x 500  X-large x 400  XX-large x 200 B. Hanes w/pocket long sleeve, Regular Navy, 100% cotton, 4 color logo, print front right chest, 1 color full back print  Small x 50  Medium x 100  Large x 100  X-large x 50 B. Sport Tek 6.2 oz. 60/40 Jersey 9” shorts w/ side pockets, True Navy, 4 color logo left leg print  Small x 50  Medium x 100  Large x 100  X-large x 100  XX-large x 50 C. Hanes Ultimate 9.7 oz. Cotton Crewneck Sweatshirt, Regular Navy, 90/10, 4 color logo print right chest, 1 color full back print  Small x 10  Medium x 50  Large x 50  X-large x 40 DocuSign Envelope ID: F4320A5F-A905-4EFF-85C7-D588909544E4 Services Agreement 8593 Exercise Wear for PFA Page 9 of 13  XX-large x 20 D. Hanes Ultimate 9.7 oz. Cotton Pullover Hooded Sweatshirt, Regular Navy, 90/10, 4 color logo print right chest, 1 color full back print  Small x 10  Medium x 50  Large x 50  X-large x 100  XX-large x 10 2. Job Shirt w/ Canvas Details A. 5.11 Job Shirt with Canvas Details, Style #72321, Color: Fire Navy (720), 82/18 Cotton/poly blend, 6 color Poudre Fire Authority logo embroidered left chest, first initial and last name (and title if a Captain or Chief) embroidered in red on right chest, PFA Fire/Rescue reflective full back (see images below).  Small x 20  Medium x 40  Large x 40  X-large x 40  XX-large x 20 FRONT BACK DocuSign Envelope ID: F4320A5F-A905-4EFF-85C7-D588909544E4 Services Agreement 8593 Exercise Wear for PFA Page 10 of 13 3. Cotton/Poly Sweat Pants VOS Sports #200 – Adult Hem Bottom w/ Zipper, 80/20, Navy, 4 color logo screen print on left leg (see image below). A. VOS Sports #200 – Adult Hem Bottom w/ Zipper, 80/20, Navy  Small x 20  Medium x 40  Large x 70  X-large x 50  XX-large x 20 DocuSign Envelope ID: F4320A5F-A905-4EFF-85C7-D588909544E4 Services Agreement 8593 Exercise Wear for PFA Page 11 of 13 EXHIBIT B PRICING SCHEDULE Description Size Estimated Quantity Per Unit Purchase Price Extended Total Small 100 $7.90 $ 790.00 Medium 200 $7.90 $ 1,580.00 Large 500 $7.90 $ 3,950.00 X-large 400 $7.90 $ 3,160.00 XX-large 200 $9.65 $ 1,930.00 Small 50 $8.65 $ 432.50 Medium 100 $8.65 $ 865.00 Large 100 $8.65 $ 865.00 X-large 50 $8.65 $ 432.50 Small 50 $10.85 $ 542.50 Medium 100 $10.85 $ 1,085.00 Large 100 $10.85 $ 1,085.00 X-large 100 $10.85 $ 1,085.00 XX-large 50 $11.85 $ 592.50 Small 10 $12.05 $ 120.50 Medium 50 $12.05 $ 602.50 Large 50 $12.05 $ 602.50 X-large 40 $12.05 $ 482.00 XX-large 20 $15.45 $ 309.00 Small 10 $17.30 $ 173.00 Medium 50 $17.30 $ 865.00 Large 50 $17.30 $ 865.00 X-large 100 $17.30 $ 1,730.00 XX-large 10 $20.30 $ 203.00 Item # A. 6.1 oz. Beefy-T w/ pocket short sleeve, Regular Navy, 100% cotton, 4 color logo print front right chest, 1 color full back print 1 A 1 E E. Hanes Ultimate 9.7 oz. Cotton Pullover Hooded Sweatshirt, Regular Navy, 90/10, 4 color logo print right chest, 1 color full back print Hanes w/pocket long sleeve, Regular Navy, 100% cotton, 4 color logo, print front right chest, 1 color full back print 1 B C. Sport Tek 6.2 oz. 60/40 Jersey 9” shorts w/ side pockets, True Navy, 4 color logo left leg print 1 C Hanes Ultimate 9.7 oz. Cotton Crewneck Sweatshirt, Regular Navy, 90/10, 4 color logo print Services Agreement 8593 Exercise Wear for PFA Page 12 of 13 Small 20 $68.00 $ 1,360.00 Medium 40 $68.00 $ 2,720.00 Large 40 $68.00 $ 2,720.00 X-large 40 $68.00 $ 2,720.00 XX-large 20 $70.00 $ 1,400.00 Small 20 $16.65 $ 333.00 Medium 40 $16.65 $ 666.00 Large 70 $16.65 $ 1,165.50 X-large 50 $16.65 $ 832.50 XX-large 20 $17.75 $ 355.00 5.11 Job Shirt, Style# 72321, Job Shirt with Canvas Details, Color: Fire Navy (720). 6 color Poudre Fire Authority logo embroidered left chest, first initial and last name (and title if a Captain or Chief) embroidered in red on right chest, PFA Fire/Rescue reflective full back 2 A VOS Sports #200 Sweatpants, hem bottom with zipper, 80/20, Navy, 4 color logo screen print on left leg 3 A DocuSign Envelope ID: F4320A5F-A905-4EFF-85C7-D588909544E4 Services Agreement 8593 Exercise Wear for PFA Page 13 of 13 EXHIBIT C INSURANCE REQUIREMENTS 1. The Service Provider will provide, from insurance companies acceptable to the City and/or PFA, the insurance coverage designated hereinafter and pay all costs. Before commencing work under this bid, the Service Provider shall furnish the City and/or PFA with certificates of insurance showing the type, amount, class of operations covered, effective dates and date of expiration of policies, and containing substantially the following statement: “The insurance evidenced by this Certificate will not reduce coverage or limits and will not be cancelled, except after thirty (30) days written notice has been received by the City of Fort Collins.” In case of the breach of any provision of the Insurance Requirements, the City and/or PFA, at its option, may take out and maintain, at the expense of the Service Provider, such insurance as the City and/or PFA may deem proper and may deduct the cost of such insurance from any monies which may be due or become due the Service Provider under this Agreement. The City and PFA, its officers, agents and employees shall be named as additional insureds on the Service Provider 's general liability and automobile liability insurance policies for any claims arising out of work performed under this Agreement. 2. Insurance coverages shall be as follows: A. Workers' Compensation & Employer's Liability. The Service Provider shall maintain during the life of this Agreement for all of the Service Provider's employees engaged in work performed under this agreement: 1. Workers' Compensation insurance with statutory limits as required by Colorado law. 2. Employer's Liability insurance with limits of $100,000 per accident, $500,000 disease aggregate, and $100,000 disease each employee. B. Commercial General & Vehicle Liability. The Service Provider shall maintain during the life of this Agreement such commercial general liability and automobile liability insurance as will provide coverage for damage claims of personal injury, including accidental death, as well as for claims for property damage, which may arise directly or indirectly from the performance of work under this Agreement. Coverage for property damage shall be on a "broad form" basis. The amount of insurance for each coverage, Commercial General and Vehicle, shall not be less than $1,000,000 combined single limits for bodily injury and property damage. In the event any work is performed by a subcontractor, the Service Provider shall be responsible for any liability directly or indirectly arising out of the work performed under this Agreement by a subcontractor, which liability is not covered by the subcontractor's insurance. DocuSign Envelope ID: F4320A5F-A905-4EFF-85C7-D588909544E4 New insurance CERTIFICATE.OF.LIABILITY.INSURANCE DEK DATE (MM/DD/YYYY) R076 10/27/2017 THIS CERTIFICATEIS 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). PRODUCER CONTACT NAME: THE INSURANCE SHOP LLC/PHS PHONE (A/C, No, Ext): FAX (A/C, No): (888) 443-6112 532259 P: F:(888) 443-6112 E-MAIL ADDRESS: PO BOX 29611 INSURER(S) AFFORDING COVERAGE NAIC# CHARLOTTE NC 28229 INSURER A : Twin City Fire Ins Co INSURED INSURER B : INSURER C : DJS SPORT SHOPPE INC INSURER D : 1225 RED CEDAR CIR 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 LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 100,000 100,000 500,000 CLAIMS-MADE X OCCUR 84 SBU BA4186 DAMAGE TO RENTED PREMISES (Ea occurrence) $1,000,000 A X General Liab X 10/27/2017 10/27/2018 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY PRO- JECT LOC PRODUCTS - COMP/OP AGG $2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $1,000,000 ANY AUTO CERTIFICATE.OF.LIABILITY.INSURANCE DEK DATE (MM/DD/YYYY) R076 10/27/2017 THIS CERTIFICATEIS 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). PRODUCER CONTACT NAME: THE INSURANCE SHOP LLC/PHS PHONE (A/C, No, Ext): FAX (A/C, No): (888) 443-6112 532259 P: F:(888) 443-6112 E-MAIL ADDRESS: PO BOX 29611 INSURER(S) AFFORDING COVERAGE NAIC# CHARLOTTE NC 28229 INSURER A : Twin City Fire Ins Co INSURED INSURER B : INSURER C : DJS SPORT SHOPPE INC INSURER D : 1225 RED CEDAR CIR 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 LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 100,000 100,000 500,000 CLAIMS-MADE X OCCUR 84 SBU BA4186 DAMAGE TO RENTED PREMISES (Ea occurrence) $1,000,000 A X General Liab X X 10/27/2017 10/27/2018 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY PRO- JECT LOC PRODUCTS - COMP/OP AGG $2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $1,000,000 ANY AUTO 84 SBU BA4186 BODILY INJURY (Per person) $ A A OWNED AUTOS ONLY SCHEDULED AUTOS 10/27/2017 10/27/2018 BODILY INJURY (Per accident) $ X X HIRED AUTOS ONLY NON-OWNED AUTOS ONLY PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY N/ A PER STATUTE OTH- ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) Y/N E.L. EACH ACCIDENT $ E.L. DISEASE- EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins is included as an Additional Insured with respect to General Libility and Auto Liability. CERTIFICATE HOLDER CANCELLATION 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 PO BOX 580 FORT COLLINS, CO 80522 AUTHORIZED REPRESENTATIVE © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID: F4320A5F-A905-4EFF-85C7-D588909544E4 84 SBU BA4186 BODILY INJURY (Per person) $ A A OWNED AUTOS ONLY SCHEDULED AUTOS 10/27/2017 10/27/2018 BODILY INJURY (Per accident) $ X X HIRED AUTOS ONLY NON-OWNED AUTOS ONLY PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY N/ A PER STATUTE OTH- ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) Y/N E.L. EACH ACCIDENT $ E.L. DISEASE- EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Those usual to the Insured's Operations. Certificate Holder is an Additional Insured per the Business Liability Coverage Form SS0008 attached to this policy. CERTIFICATE HOLDER CANCELLATION 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 PO BOX 580 FORT COLLINS, CO 80522 AUTHORIZED REPRESENTATIVE © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID: F4320A5F-A905-4EFF-85C7-D588909544E4 right chest, 1 color full back print 1 D DocuSign Envelope ID: F4320A5F-A905-4EFF-85C7-D588909544E4