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RFP - 8645 EMPLOYEE DISCIPLINARY HEARING OFFICER (2)
Official Purchasing Document Last updated 10/2017 Services Agreement – HR Solutions 8645 Employee Disciplinary Hearing Officer Page 1 of 12 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"; the POUDRE FIRE AUTHORITY, hereinafter referred to as the “PFA”, for which the City is acting on behalf of; and HR SOLUTIONS & SERVICES LLC, 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 two (2) page(s) 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 March 1, 2018, and shall continue in full force and effect until February 28, 2019, 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: HR Solutions & Services, LLC Attn: Tracey Robinson PO Box 64106 Colorado Springs, CO 80962 City of Fort Collins Attn: Jeff Hubach PO Box 580 Fort Collins, CO 80522 City of Fort Collins Attn: Purchasing Dept. PO Box 580 Fort Collins, CO 80522 DocuSign Envelope ID: 651F4810-86D4-43B6-ADC2-A298E66D5C9D Official Purchasing Document Last updated 10/2017 Services Agreement – HR Solutions 8645 Employee Disciplinary Hearing Officer Page 2 of 12 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, One Hundred Fifty Dollars ($150.00) per hour in accordance with the attached Exhibit B, consisting of one (1) page, and incorporated herein by this reference. 6. City Representative. The City 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: 651F4810-86D4-43B6-ADC2-A298E66D5C9D Official Purchasing Document Last updated 10/2017 Services Agreement – HR Solutions 8645 Employee Disciplinary Hearing Officer Page 3 of 12 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: 651F4810-86D4-43B6-ADC2-A298E66D5C9D Official Purchasing Document Last updated 10/2017 Services Agreement – HR Solutions 8645 Employee Disciplinary Hearing Officer Page 4 of 12 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 Provider DocuSign Envelope ID: 651F4810-86D4-43B6-ADC2-A298E66D5C9D Official Purchasing Document Last updated 10/2017 Services Agreement – HR Solutions 8645 Employee Disciplinary Hearing Officer Page 5 of 12 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. 19. Special Provisions. Special provisions or conditions relating to the services to be performed pursuant to this Agreement are set forth in Exhibit D - Confidentiality, consisting of one (1) page, and Exhibit E – Designation by City Manager, consisting of one (1) page, attached hereto and incorporated herein by this reference. DocuSign Envelope ID: 651F4810-86D4-43B6-ADC2-A298E66D5C9D Official Purchasing Document Last updated 10/2017 Services Agreement – HR Solutions 8645 Employee Disciplinary Hearing Officer Page 6 of 12 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: HR SOLUTIONS & SERVICES LLC By: Printed: Title: CORPORATE PRESIDENT OR VICE PRESIDENT Date: DocuSign Envelope ID: 651F4810-86D4-43B6-ADC2-A298E66D5C9D Tracey P. Robinson Owner 3/26/2018 3/30/2018 Assistant City Attorney 4/2/2018 City Clerk Official Purchasing Document Last updated 10/2017 Services Agreement – HR Solutions 8645 Employee Disciplinary Hearing Officer Page 7 of 12 EXHIBIT A SCOPE OF SERVICES Service Provider attorney, Tracey Robinson, will provide the services of a hearing officer pursuant to The City of Fort Collins Personnel Policies and Procedures adopted by the City Manager, Appeal Policies and Procedures adopted by the City Manager, and the Collective Bargaining Agreement between the City and the Fraternal Order of Police on an as needed basis. Pursuant to those documents (as currently in place, proposed, or amended), a classified employee (includes both police and non-police employees) who receives major discipline may appeal the disciplinary decision to the City Manager who shall appoint a hearing officer licensed to practice law in the state of Colorado and who is not a City employee to conduct the post- decision hearing. No other attorney with the Service Provider’s firm is authorized to provide the afore mentioned services under this agreement. This Agreement is not an exclusive arrangement and the City has engaged in other agreement(s) under this solicitation. The hearing officer will make detailed written findings of fact and conclusions of law as to cause for the discipline and the level of discipline imposed and will present the findings and conclusions to the City Manager for his/her final decision. The hearing officer will report directly to the City Manager. Pursuant to the CBA, the Service Provider will participate on a three- member panel to review the sufficiency of an investigation into discrimination or retaliation allegations made by a collective bargaining unit member. The Poudre Fire Authority (PFA), through its Fire Chief, may also utilize Service Provider to provide the services of a hearing officer to conduct hearings in appeals of major disciplinary matters pursuant to the provisions of PFA personnel rules and regulations. The hearing officer will make detailed written findings as to cause for the discipline and the level of discipline imposed and will present the findings to the Fire Chief for his/her final decision. The hearing officer will report directly to the Fire Chief. NOTE: the PFA is a separate legal entity from the City and it utilizes the City’s Purchasing Division for the provision of purchasing services pursuant to intergovernmental agreement. SERVICES REQUIRED Conduct post-disciplinary appeal hearings in Fort Collins pursuant to the City's Personnel Policies and Procedures, the Collective Bargaining Agreement with the FOP, the Appeal Policies and Procedures adopted by the City Manager, and the PFA Personnel Rules and Regulations, as applicable. Meeting rooms, staff support, and recordings of the hearing will be provided by the City or PFA as applicable. Issue a written decision containing detailed findings and recommendations to the City Manager or Fire Chief, as applicable. Responsible for preparation of all written documents associated with the decision. Participate on a three-member investigation review panel to determine whether an investigation into allegations of discrimination or retaliation is sufficient in accordance with procedures described in the CBA. TIME COMMITMENT Hearings may take one or more days to complete. The hearing officer will be expected to spend time prior to the hearing reviewing submittals. The hearing officer will be expected to rule on pre-hearing matters in advance of the hearing. The hearing officer will be expected to issue a detailed written decision within a reasonable time after the hearing. DocuSign Envelope ID: 651F4810-86D4-43B6-ADC2-A298E66D5C9D Official Purchasing Document Last updated 10/2017 Services Agreement – HR Solutions 8645 Employee Disciplinary Hearing Officer Page 8 of 12 Participation on a three-member review panel may require review of voluminous records and may take one or more days to complete. The Service Provider will be expected to act in accordance with procedures described in the CBA. QUALIFICATIONS Attorney licensed to practice law in the State of Colorado. Experience in participating in / conducting employment disciplinary hearings for municipalities/fire authorities preferred. Experience in employment law matters including workplace investigations into discrimination and retaliation allegations. Ability to learn, interpret, understand, and make impartial decisions based on the City's Personnel Policies and Procedures, the City Code and Charter, the PFA Personnel Rules and Regulations, and federal and state laws and constitutions. Ability to communicate effectively, both orally and in writing, with the City Manager/Fire Chief, City/PFA staff, and attorneys. Ability to read and comprehend detailed documents. Ability to work well under pressure and deal with stressful situations and conflict with confidence and in a tactful manner. DocuSign Envelope ID: 651F4810-86D4-43B6-ADC2-A298E66D5C9D Official Purchasing Document Last updated 10/2017 Services Agreement – HR Solutions 8645 Employee Disciplinary Hearing Officer Page 9 of 12 EXHIBIT B COMPENSATION Service Provider will charge $150 per hour for time spent preparing for the hearing, conducting the hearing and then writing a detailed decision after the hearing (and the receipt of any post- hearing submittals if applicable). Service Provider understands that hearings may take one (1) or more days to complete and will spend a reasonable amount of time to sufficiently carry out these duties. Service Provider will charge $150 per hour for time spent as an investigation review panel member reviewing the sufficiency of investigation, participating on the review panel and rendering an opinion as to the sufficiency/insufficiency of the investigation. Service Provider understands that participation on an investigation review panel may take one (1) or more days to complete and will spend a reasonable amount of time to sufficiently carry out these duties. Service Provider will not charge any other fees or costs that may be associated with providing hearing officer services. There will be no charge for accepting an assignment, scheduling hearing dates, requesting prehearing information or documentation, routine correspondence or communication with the City Manager/Fire Chief/PFA staff or attorneys, and/or any other associated costs (including no charge for any travel expenses, copy charges, or other office administrative expenses related to providing hearing officer or investigation review panel member services). Service Provider will adhere to a deliverables schedule as may be specified by the City and/or PFA for providing hearing officer services. DocuSign Envelope ID: 651F4810-86D4-43B6-ADC2-A298E66D5C9D Official Purchasing Document Last updated 10/2017 Services Agreement – HR Solutions 8645 Employee Disciplinary Hearing Officer Page 10 of 12 EXHIBIT C INSURANCE REQUIREMENTS 1. The Service Provider will provide, from insurance companies acceptable to the City, the insurance coverage designated hereinafter and pay all costs. Before commencing work under this bid, the Service Provider shall furnish the City 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, at its option, may take out and maintain, at the expense of the Service Provider, such insurance as the City 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, 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: 651F4810-86D4-43B6-ADC2-A298E66D5C9D Official Purchasing Document Last updated 10/2017 Services Agreement – HR Solutions 8645 Employee Disciplinary Hearing Officer Page 11 of 12 EXHIBIT D CONFIDENTIALITY IN CONNECTION WITH SERVICES provided to the City of Fort Collins (the “City”), as agent, on behalf of the Poudre Fire Authority (the “PFA”) pursuant to this Agreement (the “Agreement”), the Service Provider hereby acknowledges that it has been informed that the City has established policies and procedures with regard to the handling of confidential information and other sensitive materials. In consideration of access to certain information, data and material (hereinafter individually and collectively, regardless of nature, referred to as “information”) that are the property of and/or relate to the City and/or PFA or their employees, customers or suppliers, which access is related to the performance of services that the Service Provider has agreed to perform, the Service Provider hereby acknowledges and agrees as follows: That information that has or will come into its possession or knowledge in connection with the performance of services for the City and/or PFA may be confidential and/or proprietary. The Service Provider agrees to treat as confidential (a) all information that is owned by the City and/or PFA, or that relates to the business of the City and/or PFA, or that is used by the City and/or PFA in carrying on business, and (b) all information that is proprietary to a third party (including but not limited to customers and suppliers of the City and/or PFA). The Service Provider shall not disclose any such information to any person not having a legitimate need-to-know for purposes authorized by the City and/or PFA. Further, the Service Provider shall not use such information to obtain any economic or other benefit for itself, or any third party, except as specifically authorized by the City and/or PFA. The foregoing to the contrary notwithstanding, the Service Provider understands that it shall have no obligation under this Agreement with respect to information and material that (a) becomes generally known to the public by publication or some means other than a breach of duty of this Agreement, or (b) is required by law, regulation or court order to be disclosed, provided that the request for such disclosure is proper and the disclosure does not exceed that which is required. In the event of any disclosure under (b) above, the Service Provider shall furnish a copy of this Agreement to anyone to whom it is required to make such disclosure and shall promptly advise the City and/or PFA in writing of each such disclosure. In the event that the Service Provider ceases to perform services for the City and/or PFA, or the City and/or PFA so requests for any reason, the Service Provider shall promptly return to the City and/or PFA any and all information described hereinabove, including all copies, notes and/or summaries (handwritten or mechanically produced) thereof, in its possession or control or as to which it otherwise has access. The Service Provider understands and agrees that the City and/or PFA’s remedies at law for a breach of the Service Provider’s obligations under this Confidentiality Agreement may be inadequate and that the City and/or PFA shall, in the event of any such breach, be entitled to seek equitable relief (including without limitation preliminary and permanent injunctive relief and specific performance) in addition to all other remedies provided hereunder or available at law. DocuSign Envelope ID: 651F4810-86D4-43B6-ADC2-A298E66D5C9D Official Purchasing Document Last updated 10/2017 Services Agreement – HR Solutions 8645 Employee Disciplinary Hearing Officer Page 12 of 12 EXHIBIT E DESIGNATION BY CITY MANAGER As City Manager for the City of Fort Collins, Colorado and pursuant to the City of Fort Collins City Code Section 2-567; Section 9.3.6.D of the City’s Personnel Policies and Procedures; and Article 36(G) of the Collective Bargaining Agreement between the City of Fort Collins and the Northern Colorado Lodge #3, Colorado Fraternal Order of Police, I hereby designate attorney Tracey Robinson of HR Solutions Services, LLC, to serve as a hearing officer in accordance with the aforementioned documents. DARIN A. ATTEBERRY City Manager By: ______________________________________ Date: _____________________ DocuSign Envelope ID: 651F4810-86D4-43B6-ADC2-A298E66D5C9D 4/1/2018 CERTIFICATE.OF.LIABILITY.INSURANCE RDH DATE (MM/DD/YYYY) R054 3/26/2018 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: NORTHEAST AGENCIES INC/PHS PHONE (A/C, No, Ext): (866) 467-8730 FAX (A/C, No): (888) 443-6112 210500 P:(866) 467-8730 F:(888) 443-6112 E-MAIL ADDRESS: 301 WOODS PARK DRIVE INSURER(S) AFFORDING COVERAGE NAIC# CLINTON NY 13323 INSURER A : Hartford Casualty Ins Co 29424 INSURED INSURER B : INSURER C : HR SOLUTIONS & SERVICES, LLC INSURER D : PO BOX 64106 INSURER E : COLORADO SPRINGS CO 80962 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 CLAIMS-MADE X OCCUR 01 SBA RE4382 DAMAGE TO RENTED PREMISES (Ea occurrence) $300,000 A X General Liab X 03/19/2018 03/19/2019 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 X LOC PRODUCTS - COMP/OP AGG $2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $1,000,000 ANY AUTO 01 SBA RE4382 BODILY INJURY (Per person) $ A OWNED AUTOS ONLY SCHEDULED DocuSign Envelope ID: 651F4810-86D4-43B6-ADC2-A298E66D5C9D DocuSign Envelope ID: 651F4810-86D4-43B6-ADC2-A298E66D5C9D AUTOS 03/19/2018 03/19/2019 BODILY INJURY (Per accident) $ X HIRED AUTOS ONLY X 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. The City of Fort Collins its officers, agents, and its employees are Additional Insured per the Business Liability Coverage Form SS 00 08, and the Hired Auto and Non-Owned Auto Endorsement SS 04 38 attached to this Policy. Notice of Cancellation will be provided in accordance with Form SS1223, attached to this policy. CERTIFICATE HOLDER CANCELLATION CITY OF FORT COLLINS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ATTN: PURCHASING 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: 651F4810-86D4-43B6-ADC2-A298E66D5C9D