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581197 MINERVA BUNKER GEAR REPAIR - CONTRACT - RFP - 8786 BUNKER GEAR INSPECTION, CLEANING & REPAIR SER
Official Purchasing Document Last updated 10/2017 Services Agreement - PFA 8786 Bunker Gear Repair Page 1 of 15 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 MINERVA BUNKER GEAR CLEANERS OF COLORADO CORP., 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) 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 September 15, 2018 and shall continue in full force and effect until September 14, 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: Minerva Bunker Gear Cleaners of Colorado Corp. Attn: Joseph Xiras 3301 S. Field Street Lakewood, CO 80227 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: 746A5E2B-813C-4C92-B405-9A1CF6A25C4D Official Purchasing Document Last updated 10/2017 Services Agreement - PFA 8786 Bunker Gear Repair Page 2 of 15 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, per the attached Exhibit B, consisting of four (4) page(s), 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. 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 DocuSign Envelope ID: 746A5E2B-813C-4C92-B405-9A1CF6A25C4D Official Purchasing Document Last updated 10/2017 Services Agreement - PFA 8786 Bunker Gear Repair Page 3 of 15 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. 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 DocuSign Envelope ID: 746A5E2B-813C-4C92-B405-9A1CF6A25C4D Official Purchasing Document Last updated 10/2017 Services Agreement - PFA 8786 Bunker Gear Repair Page 4 of 15 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 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 DocuSign Envelope ID: 746A5E2B-813C-4C92-B405-9A1CF6A25C4D Official Purchasing Document Last updated 10/2017 Services Agreement - PFA 8786 Bunker Gear Repair Page 5 of 15 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: 746A5E2B-813C-4C92-B405-9A1CF6A25C4D Official Purchasing Document Last updated 10/2017 Services Agreement - PFA 8786 Bunker Gear Repair Page 6 of 15 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: MINERVA BUNKER GEAR CLEANERS OF COLORADO CORP. By: Printed: Title: CORPORATE PRESIDENT OR VICE PRESIDENT Date: DocuSign Envelope ID: 746A5E2B-813C-4C92-B405-9A1CF6A25C4D Joseph Xiras President 9/19/2018 Assistant City Attorney ll 9/19/2018 9/20/2018 City Clerk Official Purchasing Document Last updated 10/2017 Services Agreement - PFA 8786 Bunker Gear Repair Page 7 of 15 EXHIBIT A SCOPE OF SERVICES I. BACKGROUND & OBJECTIVE / OVERVIEW The PFA conducts an equipment audit each spring to identify bunker gear needing repair. Service Provider will be responsible for repairing the identified items. While the majority of the Work will occur in the spring, the PFA will also have as-needed, small batch repairs throughout the year. Service Provider will conduct all repairs in accordance with the National Fire Protection Agency (NFPA) 1851 Standard on Selection, Care and Maintenance of Protective Ensembles for Structural Fire Fighting and Proximity Fire Fighting, Current Edition (NFPA 1851). II. SCOPE OF WORK A. Scope of Work Service Provider will provide services to maintain firefight bunker gear in compliance with NFPA 1851. If the requirements change, the Service Provider’s process will be brought into compliance with the new requirements within one year or as specified by the NFPA, whichever is shorter. Requested services may include, but are not limited to, any or all of the following services: 1. Maintenance of Firefighter Bunker Gear a. Inspection & Evaluation Both the outer shell and liner system for all gear shall be inspected, at no cost, for structural integrity problems and areas requiring special attention. Thermal liners shall be inspected for loss of quilting threads. Excessively large areas where quilt stitching is broken or missing can indicate the need to replace the liner. Stress areas are generally considered to be the corners of pockets and flaps, the base of the fly, the top and bottom of the storm flap, and any place where the stitching begins or ends. If repair is needed to comply with NFPA standards, the Service Provider must contact the Project Manager with an estimate before any repairs may begin. Any garment, which is deemed to have excessive repair costs, or being un-repairable and/or structurally unfit for firefighting, shall not be cleaned and shall be returned tagged as being non NFPA Compliant, at no cost, with a recommendation to replace the garment. b. Testing Service Provider should have the ability to provide Fluid Extract Testing, NFPA 5903 Vertical Flame Test, T.P.P. Test, Trap Tear and Shear Strength Test via an independent laboratory, approved by the Department of Environmental Resources. Service Provider’s independent laboratory must utilize licensed chemical consultants and industrial hygienists that comply with current NFPA and Industry standards, such as the manufacturers of all bunker gear. Service Provider should have the capability of performing appropriate test to determinate the compliant of moisture barrier and thermal liner. DocuSign Envelope ID: 746A5E2B-813C-4C92-B405-9A1CF6A25C4D Official Purchasing Document Last updated 10/2017 Services Agreement - PFA 8786 Bunker Gear Repair Page 8 of 15 c. Cleaning & Decontamination Cleaning services will include, but are not limited to, the thorough cleaning of protective ensembles or elements such as coats, trousers, coveralls, and hoods (all types of outer shell, moisture barrier and thermal liner combinations) by washing with cleaning agents or specialized cleaning to remove hazardous materials or body fluids in full compliance with NFPA 1851, Current Edition and manufacturer’s guidelines. Service Provider should have liability insurance for cleaning protective clothing and for the repair or replacement of ensembles and ensemble elements damaged in laundry, or from wash water contamination. Service Provider will replace all ensembles and ensemble elements damaged in laundry, or from wash water contamination. Service Provider will take all reasonable precautions to protect its personnel from contaminant exposures while handling ensembles and ensemble elements. Service Provider will provide verification that all chemicals used in the cleaning process are approved by the original manufacturer of the bunker gear. Service Provider will take all appropriate steps to prevent cross contamination between any and all products laundered in the facility. Service Provider will test ensembles or ensemble elements after decontamination to ensure that decontaminated ensembles or ensemble elements are truly decontaminated and safe to wear. Ensembles and ensemble elements shall be cleaned and decontaminated only with like elements, including but not limited to outer shells with outer shells, liners with liners, hoods with hoods, etc. Garment liner systems shall be removed if possible and cleaned separately to avoid contamination with the debris found in the shell. Since the moisture barrier will limit the flow of water through the outer shell fabric, removing the liner will result in better cleaning. Separating the liner from the outer shell will also reduce drying time. To prevent the spread of disease or infections through cross contamination, soiled elements should not be cleaned with other items of clothing or laundry. The cleaning process should remove all contaminants from the normal course of firefighting activities including gear heavily contaminated with tar, oil, fuels, grease, resins, gasoline, acid, asbestos, paint biological contaminants and others hazardous materials which requires special handling. The process used for cleaning must not void fiber manufacturer’s warranty. The cleaning process must be approved and recommended by all major fiber, liner and turnout-gear manufactures. Service Provider should have the capability to restore Water-repellent Properties of Ensembles and Ensemble Elements. Each garment, both outer shell and liner system, must be cleaned, decontaminated, deodorized and must have water repellant/soil release reapplied. The cleaning process must not harm the fire retardancy of the gear or damage the fabrics in any way. DocuSign Envelope ID: 746A5E2B-813C-4C92-B405-9A1CF6A25C4D Official Purchasing Document Last updated 10/2017 Services Agreement - PFA 8786 Bunker Gear Repair Page 9 of 15 Service Provider should not use any chlorine, caustic detergents, solvent or any other chlorinated solvent that shall damage or degrade the fire protective fibers, liners, reflective trim or leather enforcements. Service Provider must not use temperatures exceeding 105 degrees Fahrenheit in the cleaning process. All garments are to be hung dry away from exposure to sunlight or ultraviolet light. Contaminants, when removed from the gear, along with effluents shall be properly disposed of in accordance with all local, state and Federal codes and regulations, latest editions. d. Repairs All repairs will be NFPA-compliant and third-party certified. Service Provider must be Third Party Certified to repair and perform resealing operations. All garments repaired must be returned tagged, “NFPA compliant.” All repairs performed on gear will be listed in detail. All thread used will be 100% Nomex and meet “Major A-Seam” requirements. Service Provider must be capable of providing a full range of repair service including but not limited to the following: Replacement of reflective trim Replacement of leather reinforcements Repair of rips, tears, and burn holes Repair and/or replacement of hardware Replacement or repair of zipper or velcro closures Additions of all types of pockets Repair of both moisture barrier and thermal liner materials Custom alterations (i.e. lengthen and shorten coats, sleeves, pant legs and waist adjustments) All moisture barrier repairs, must be performed by the manufacturer or a verified ISP. Moisture barrier materials are found in collars, collar closure systems, and other assemblies, including, but not limited to, storm flaps and sleeve wells. Broken zippers should be repaired, provided that doing so will not cause a breach to any moisture barrier material and will not affect the garment integrity. Damaged or broken hooks and loops should be replaced provided that doing so will not cause a breach to any moisture barrier material and will not affect the garment integrity. e. Storage Ensembles and ensemble elements must be stored away from ultraviolet (UV) light, such as fluorescent light, especially from sunlight. Ensembles and ensemble elements must be completely dry before storing. Ensembles and ensemble DocuSign Envelope ID: 746A5E2B-813C-4C92-B405-9A1CF6A25C4D Official Purchasing Document Last updated 10/2017 Services Agreement - PFA 8786 Bunker Gear Repair Page 10 of 15 elements must be stored in accordance with NFPA1971, Standard on Protective Ensembles for Structural Fire Fighting and Proximity Fire Fighting. Ensembles and ensemble elements should not be stored in areas where they will come in contact with hydraulic fluids, solvents, hydrocarbons, hydrocarbon vapors, or other contaminants. 2. Pick up & Delivery of Garments Service Provider will provide door-to-door pick-up and delivery of garments to the PFA Warehouse at 3400 W Vine Drive, Fort Collins, CO 80521. Service Provider will complete all requested work and deliver the finished product to PFA within 15 calendar days of pick-up of the garments. III. ADDITIONAL REQUIREMENTS A. Minimum Qualifications Service Provider must be a verified Independent Service Provider, (ISP), Third Party Verified. Verification must be provided by an accredited organization to perform the services described herein. Services will be performed by Service Provider employees properly trained by manufacturers and certified to provide the services described herein. All work will be performed in full compliance with NFPA 1851. B. Current standards Service Provider must be familiar with the requirements of NFPA 1971, Standard on Protective Ensembles for Structural Fire Fighting and Proximity Fire Fighting, and NFPA 1581, Standard on Fire Department Infection Control Program, as well as federal, state and local regulations. Service Provider will comply will all applicable federal, state and local wastewater discharge regulations and standards. C. Fees, Licenses, Permits The Service Provider shall be responsible for obtaining any necessary licenses, fees or permits without additional expense to the City. All equipment shall be properly licensed and insured, carry the appropriate permits and be placarded as required by law. D. Laws and Regulations The Service Provider agrees to comply fully with all applicable State of Colorado and Federal laws and regulations and municipal ordinances. E. Invoicing and Payment Invoices for services should be emailed monthly to invoices@fcgov.com with a copy to the Project Manager. The cost of the work completed shall be paid to the Service Provider each month following the submittal of an itemized invoice by the Service Provider. Payments will be made using the prices listed on the agreed-to Price Schedule. In the event a service is requested which is not listed on the Price Schedule, the Service Provider and the City will negotiate an appropriate unit price for the service prior to Service Provider initiating such work. The City pays invoices on Net 30 terms. DocuSign Envelope ID: 746A5E2B-813C-4C92-B405-9A1CF6A25C4D Official Purchasing Document Last updated 10/2017 Services Agreement - PFA 8786 Bunker Gear Repair Page 11 of 15 EXHIBIT B COMPENSATION DocuSign Envelope ID: 746A5E2B-813C-4C92-B405-9A1CF6A25C4D Official Purchasing Document Last updated 10/2017 Services Agreement - PFA 8786 Bunker Gear Repair Page 12 of 15 DocuSign Envelope ID: 746A5E2B-813C-4C92-B405-9A1CF6A25C4D Official Purchasing Document Last updated 10/2017 Services Agreement - PFA 8786 Bunker Gear Repair Page 13 of 15 DocuSign Envelope ID: 746A5E2B-813C-4C92-B405-9A1CF6A25C4D Official Purchasing Document Last updated 10/2017 Services Agreement - PFA 8786 Bunker Gear Repair Page 14 of 15 DocuSign Envelope ID: 746A5E2B-813C-4C92-B405-9A1CF6A25C4D Official Purchasing Document Last updated 10/2017 Services Agreement - PFA 8786 Bunker Gear Repair Page 15 of 15 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: 746A5E2B-813C-4C92-B405-9A1CF6A25C4D The ACORD name and logo are registered marks of ACORD CERTIFICATE HOLDER © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) AUTHORIZED REPRESENTATIVE CANCELLATION CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) JECT LOC PRO- POLICY GEN'L AGGREGATE LIMIT APPLIES PER: CLAIMS-MADE OCCUR COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $ DAMAGE TO RENTED EACH OCCURRENCE $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ DED RETENTION $ CLAIMS-MADE OCCUR $ AGGREGATE $ UMBRELLA LIAB EACH OCCURRENCE $ EXCESS LIAB DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS PER STATUTE OTH- ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $ $ $ ANY PROPRIETOR/PARTNER/EXECUTIVE If yes, describe under DESCRIPTION OF OPERATIONS below (Mandatory in NH) OFFICER/MEMBER EXCLUDED? WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED HIRED AUTOS NON-OWNED AUTOS AUTOS AUTOS COMBINED SINGLE LIMIT BODILY INJURY (Per person) CERTIFICATE OF INSURANCE This certifies that STATE FARM FIRE AND CASUALTY COMPANY, Bloomington, Illinois STATE FARM GENERAL INSURANCE COMPANY, Bloomington, Illinois insures the following policyholder for the coverages indicated below: Name of policyholder MINERVA BUNKER GEAR CLEANERS OF COLORADO CORP Address of policyholder 3301 S FIELD ST LAKEWOOD CO 80227-4607 LAKEWOOD CO 80227-4607 Location of operations City of Ft.Collins, 215 N.Mason St, 2nd Floor,80522 Description of operations Pick up/Delivery of municipal uniforms:cleaning/repairs The policies listed below have been issued to the policyholder for the policy periods shown. The insurance described in these policies is subject to all the terms exclusions, and conditions of those policies. The limits of liability shown may have been reduced by any paid claims. POLICY NUMBER TYPE OF INSURANCE POLICY PERIOD Effective Date Expiration Date LIMITS OF LIABILITY (at beginning of policy period) Comprehensive BODILY INJURY AND Business Liability PROPERTY DAMAGE This insurance includes: Products - Completed Operations Contractual Liability Underground Hazard Coverage Each Occurrence $ Personal Injury Advertising Injury General Aggregate $ Explosion Hazard Coverage Products - Completed Collapse Hazard Coverage Operations Aggregate $ General Aggregate Limit applies to each project EXCESS LIABILITY POLICY PERIOD Effective Date Expiration Date BODILY INJURY AND PROPERTY DAMAGE (Combined Single Limit) Umbrella Each Occurrence $ Other Aggregate $ Part 1 STATUTORY Part 2 BODILY INJURY Workers’ Compensation and Employers Liability Each Accident $ Disease Each Employee $ Disease - Policy Limit $ POLICY NUMBER TYPE OF INSURANCE POLICY PERIOD Effective Date Expiration Date LIMITS OF LIABILITY (at beginning of policy period) 4455419D0306 2016 Ram Pro. 04/03/18 10/03/18 1 MILLION coll $500 0 comp $500 If any of the described policies are canceled before its expiration date, State Farm will try to mail a written notice to the certificate holder days before cancellation. If, however, we fail to mail such notice, no obligation or liability will be imposed on State Farm or its agents or representatives. Name and Address of Certificate Holder City of Fort Collins Attn: City Purchasing Director PO Box 580 Fort Collins,CO 80522 558-994 a 2-90 Printed in U.S.A. _____________________________________________________ Signature of Authorized Representative _____________________________________________________ Title _____________________________________________________ Date DocuSign Envelope ID: 746A5E2B-813C-4C92-B405-9A1CF6A25C4D BODILY INJURY (Per accident) PROPERTY DAMAGE $ $ $ $ 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. INSD ADDL WVD SUBR N / A $ $ (Ea accident) (Per accident) OTHER: THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: INSURED PHONE (A/C, No, Ext): PRODUCER ADDRESS: E-MAIL FAX (A/C, No): CONTACT NAME: NAIC # INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : INSURER(S) AFFORDING COVERAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INS025 (201401) 9/12/2018 Irving Weber Associates Inc 180 East Main Street Suite 208 Smithtown NY 11787 Lorraine Swenson (800)243-1811 (631)913-6003 LSwenson@iwains.com Minerva Bunker Gear Cleaners Of Colorado Corp. 3301 S. Field Street Lakewood CO 80227 Security National Ins Company 19879 18/19 LIAB A X X X SBP1343100 02 10/12/2018 10/12/2019 1,000,000 300,000 5,000 1,000,000 2,000,000 2,000,000 A SWC1173554 1/9/2018 1/9/2019 500,000 500,000 500,000 City of Fort Collins is included as Additional Insured in regard to General Liability as required by written contract, subject to the policy terms, conditions and limitations. The insurance evidenced by this certificate will not reduce coverage or limits and will not be cancelled, except after thirty days written notice has been received by the City of Fort Collins Adam Weber/SHEILA City of Fort Collins Attn: City Purchasing Director P.O. Box 580 Fort Collins, CO 80522 DocuSign Envelope ID: 746A5E2B-813C-4C92-B405-9A1CF6A25C4D