HomeMy WebLinkAboutCORRESPONDENCE - BID - 8722 FOAM INJECTION PAVEMENT LIFT PROJECTMarch 10, 2020
Northern Colorado Mud Jacking
Attn: Jeremy Bair
1675 Falcon Ridge Dr.
Fort Collins, CO 80528
RE: Contract Renewal, 8722 - Foam Injection Pavement Lift Project
Dear Mr. Bair:
The City of Fort Collins wishes to extend the agreement term for the above captioned proposal
per the existing terms and conditions and the following:
1) The term will be extended for one (1) additional year, June 15, 2020 through June 14,
2021.
If the renewal is acceptable to your firm, please sign this letter in the space provided and
include a current copy of insurance certificate naming the City as an additional insured
for General and Automotive Liability within the next fifteen (15) days.
If this extension is not agreeable with your firm, we ask that you send us a written notice stating
that you do not wish to renew the contract and state the reason for non-renewal.
Please contact Elliot Dale, Senior Buyer at (970) 221-6777 if you have any questions regarding
this matter.
Sincerely,
Gerry S. Paul
Director of Purchasing
__________________________________________ ________________
Signature Date
(Please indicate your desire to renew 8722 by signing this letter and returning it to Purchasing
Division within the next fifteen days.)
GSP:kr
Financial Services
Purchasing Division
215 N. Mason St. 2nd Floor
PO Box 580
Fort Collins, CO 80522
970.221.6775
970.221.6707- fax
fcgov.com/purchasing
DocuSign Envelope ID: 825EE2A3-F287-47E6-8B55-004E543E7C4F
3/10/2020
DocuSign Envelope ID: 825EE2A3-F287-47E6-8B55-004E543E7C4F
Policy Number: 417 1851-D11-06B
Prepared March 5, 2020
Page number 1 of 4
1004584 143599 201 11-01-2015
AT1
State Farm Mutual Automobile Insurance Company
PO Box 853919
Richardson, TX 75085-3919
A-2359 A
BAIR, JEREMY
1675 FALCON RIDGE DR
FORT COLLINS CO 80528-5104
AUTO RENEWAL
PREMIUM PAID: $371.61
DO NOT PAY.
Your premium is billed through the State Farm Payment Plan
State Farm Payment Plan Number: 1176224220
Your State Farm Agent
BISCHOFF INS AGCY INC
Office: 970-223-9400
Address: 1300 OAKRIDGE DR STE 100
FORT COLLINS, CO 80525-5749
If you have a new or different car, have added any drivers, or have moved,
please contact your agent.
Thank you for choosing State Farm.
Policy Number: 417 1851-D11-06B
Policy Period: April 11, 2020 to October 11, 2020
Vehicle:
2003 DODGE RAM 3500
Principal Driver:
JEREMY BAIR
Based on your driving record, you have our Accident-Free
Discount for preferred customers.
When you provide a check as payment, you authorize us
either to use information from your check to make a
one-time electronic fund transfer from your account or to
process the payment as a check transaction. When we use
information from your check to make an electronic fund
transfer, funds may be withdrawn from your account as soon
as the same day we receive your payment, and you will not
receive your check back from your financial institution.
Access your digital insurance cards, request
roadside assistance, connect with your agent,
keep tabs on your State Farm Bankfi accounts
and more from our State Farmfi mobile app.
If you havent already, download it today.
Text [MOBILE] to 78836.
Get your hands on
help anytime.
TP40
DocuSign Envelope ID: 825EE2A3-F287-47E6-8B55-004E543E7C4F
Policy Number: 417 1851-D11-06B
Prepared March 5, 2020
Page number 2 of 4
VEHICLE INFORMATION
Review your policy information carefully. If anything is incorrect, or if there are any changes to your vehicle information, please
let us know right away.
Vehicle Description
Vehicle Identification
Number (VIN) Who principally drives this vehicle?
How is this vehicle normally used?
National average: 12,000 miles driven
annually per vehicle
2003 DODGE RAM 3500 3D7LU38C13G794899 JEREMY BAIR, a divorced male, who will
be age 45 as of April 11, 2020.
To Work, School or Pleasure. Driven 7,500
miles or less annually.
Other Household Vehicle(s)
Your premium may be influenced by other State Farm
policies that currently insure the following vehicle(s)
in your household:
2012 AUDI A4
2011 NISSAN GT-R
2008 DUCATI HYPMD 1100
Premium Adjustment
Each year, we review our medical payments and personal
injury protection coverages claim experience to determine
the vehicle safety discount that is applied to each make and
model. In addition, we review the comprehensive, collision,
bodily injury and property damage claim experience
annually to determine which makes and models have
earned decreases or increases from State Farm’s standard
rates. If any changes result from our reviews, adjustments
are reflected in the rates shown on this renewal notice.
Annual Mileage Verification
Your auto insurance rates have been reduced through our
low mileage rating. To ensure we’ve priced our insurance
coverage accurately, we verify odometer readings through a
third party provider. If we’re unable to verify the information
needed, we may follow up with you to provide your
odometer reading information. Please contact your State
Farm agent with questions.
DRIVER INFORMATION
Assigned Driver(s)
The following driver(s) are assigned to the vehicle(s) on this policy.
Name
Age as of
April 11, 2020 Gender
Marital
Status
JEREMY BAIR 45 Male Divorced
Principal Driver & Assigned Drivers
For each automobile, the Principal Driver is the individual
who most frequently drives it.
Each driver is designated as an Assigned Driver on the
household automobile that they most frequently drive. Your
premium may be influenced by the information shown for
these drivers.
IMPORTANT NOTICE REGARDING YOUR PREMIUM
State Farm works hard to offer you the best combination of
price, service, and protection. The amount you pay for
Policy Number: 417 1851-D11-06B
Prepared March 5, 2020
Page number 3 of 4
IMPORTANT NOTICE REGARDING YOUR PREMIUM continued
You have the right to request, no more than once during a
12-month period, that your policy be re-rated using a current
credit-based insurance score. The resulting impact due to
the credit portion of the re-rated insurance score will not
increase your premium; however, your overall premium may
decrease, remain the same, or increase due to other factors
impacting your total premium.
COVERAGE AND LIMITS See your policy for an explanation of these coverages.
A Liability
Bodily Injury 1,000,000/1,000,000
Property Damage 1,000,000 $194.98
D 500 Deductible Comprehensive $65.89
G 500 Deductible Collision $66.50
H Emergency Road Service $3.73
U Uninsured Motor Vehicle
Bodily Injury 25,000/50,000 $40.01
$371.11
Colorado Theft Prevention Authority Fee $0.50
Total Premium $371.61
If any coverage you carry is changed to give broader
protection with no additional premium charge, we will give
you the broader protection without issuing a new policy,
starting on the date we adopt the broader protection.
DISCOUNTS These adjustments have already been applied to your premium.
Multiple Line P
Multicar P
Accident-Free P
Annual Mileage P
Total Discounts $291.83
SURCHARGES AND DISCOUNTS
AUTOMOBILE RATING PLAN - Applies to private
passenger cars only.
Accident-Free Discount › Once your policy has been in
force for at least three years with no chargeable accidents,
you may qualify for our Accident-Free Discount. Once you
qualify, this discount applies as long as there are no
chargeable accidents, and may even increase over time.
Good Driving Discount - Newer policyholders who do not
yet qualify for our Accident-Free Discount (available after
three years with no chargeable accidents) may already be
receiving a Good Driving Discount. This discount continues
to apply until your policy qualifies for the Accident-Free
Discount as long as there are no chargeable accidents and
no new drivers. If you add new drivers, they must also
qualify in order for your Good Driving Discount to continue.
Chargeable Accidents - For new policies, an accident is
chargeable if it results in $1,000 or more of damage to any
property. For renewal policies, an accident is chargeable if
State Farm pays at least $1,000 (for accidents occurring on
or after April 1, 1999) under property damage liability and
collision coverages for an at-fault accident.
(continued on next page)
DocuSign Envelope ID: 825EE2A3-F287-47E6-8B55-004E543E7C4F
Policy Number: 417 1851-D11-06B
Prepared March 5, 2020
Page number 4 of 4
Surcharges › If there are chargeable accidents, you may
lose your Good Driving Discount or Accident-Free Discount
and receive accident surcharges. But if the accident is the
first to become chargeable in nine years and this policy has
been in force for at least that long, the Accident-Free
Discount will continue and no surcharge will apply. The
surcharge for each accident depends upon the number and
timing of the accidents, and each accident surcharge will
remain in effect up to three years.
Surcharges will be removed if the company is given
satisfactory evidence that the driver involved is no longer a
member of the household or will not be driving the car in the
future. If that driver is insured on another State Farm policy,
his or her driving record will be considered in the rating of
the other policy.
These discounts and surcharges do not apply to all
coverages. For complete details, see your State Farm agent.
ADDITIONAL INFORMATION
If any information on this renewal notice is incomplete or
inaccurate, or if you want to confirm the information we have
in our records, please contact your agent. For additional
information regarding discounts or coverages, see your
State Farm agent or visit statefarm.comfi.
Buying a new car? Remember to contact your agent!
When you buy an additional car or one that replaces a car already on your policy, you need to report the change to your agent
promptly. Even though the dealership you purchased the car from may offer to notify your agent or insurance company, you, as
the named insured, are responsible for reporting all changes to your auto policy. By contacting your agent, you can help:
� avoid any complications or lack of coverage in the event of an accident or loss,
� avoid insurance verification problems with a lienholder, the police, or the department of motor vehicles, and
� ensure that you receive any new discounts you may be entitled to.
Your current State Farm policy automatically provides certain coverages for a new or replacement car for up to a specified, limited
number of days after you take possession of the car. Please refer to your policy for the number of days that applies in your state.
If you have any questions about coverage for a newly acquired car, please contact your State Farm agent.
Disclaimer: This message is provided for informational purposes only and does not grant any insurance coverage. The terms and
conditions of coverage are set forth in your State Farm Car Policy booklet, the most recently issued Declarations Page, and any
applicable endorsements.
DocuSign Envelope ID: 825EE2A3-F287-47E6-8B55-004E543E7C4F
Policy Number: 417 1851-D11-06B
Prepared September 4, 2019
Page number 1 of 4
1004584 143599 201 11-01-2015
AT1
State Farm Mutual Automobile Insurance Company
PO Box 853919
Richardson, TX 75085-3919
A-2359 A
BAIR, JEREMY
1675 FALCON RIDGE DR
FORT COLLINS CO 80528-5104
AUTO RENEWAL
PREMIUM PAID: $358.81
DO NOT PAY.
Your premium is billed through the State Farm Payment Plan
State Farm Payment Plan Number: 1176224220
Your State Farm Agent
BISCHOFF INS AGCY INC
Office: 970-223-9400
Address: 1300 OAKRIDGE DR STE 100
FORT COLLINS, CO 80525-5749
If you have a new or different car, have added any drivers, or have moved,
please contact your agent.
Thank you for choosing State Farm.
Policy Number: 417 1851-D11-06B
Policy Period: October 11, 2019 to April 11, 2020
Vehicle:
2003 DODGE RAM 3500
Principal Driver:
JEREMY BAIR
Based on your driving record, you have our Accident-Free
Discount for preferred customers.
When you provide a check as payment, you authorize us
either to use information from your check to make a
one-time electronic fund transfer from your account or to
process the payment as a check transaction. When we use
information from your check to make an electronic fund
transfer, funds may be withdrawn from your account as soon
as the same day we receive your payment, and you will not
receive your check back from your financial institution.
Your auto insurance premium is $358.81.
Did you know you may qualify for a discount?
Call State Farmfi Agent BISCHOFF INS AGCY INC at
970-223-9400
DocuSign Envelope ID: 825EE2A3-F287-47E6-8B55-004E543E7C4F
Policy Number: 417 1851-D11-06B
Prepared September 4, 2019
Page number 2 of 4
VEHICLE INFORMATION
Review your policy information carefully. If anything is incorrect, or if there are any changes to your vehicle information, please
let us know right away.
Vehicle Description
Vehicle Identification
Number (VIN) Who principally drives this vehicle?
How is this vehicle normally used?
National average: 12,000 miles driven
annually per vehicle
2003 DODGE RAM 3500 3D7LU38C13G794899 JEREMY BAIR, a divorced male, who will
be age 45 as of October 11, 2019.
To Work, School or Pleasure. Driven 7,500
miles or less annually.
Other Household Vehicle(s)
Your premium may be influenced by other State Farm
policies that currently insure the following vehicle(s)
in your household:
2012 AUDI A4
2011 NISSAN GT-R
1988 PONTIAC FIREBIRD
2008 DUCATI HYPMD 1100
Premium Adjustment
Each year, we review our medical payments and personal
injury protection coverages claim experience to determine
the vehicle safety discount that is applied to each make and
model. In addition, we review the comprehensive, collision,
bodily injury and property damage claim experience
annually to determine which makes and models have
earned decreases or increases from State Farm’s standard
rates. If any changes result from our reviews, adjustments
are reflected in the rates shown on this renewal notice.
Annual Mileage Verification
Your auto insurance rates have been reduced through our
low mileage rating. To ensure we’ve priced our insurance
coverage accurately, we verify odometer readings through a
third party provider. If we’re unable to verify the information
needed, we may follow up with you to provide your
odometer reading information. Please contact your State
Farm agent with questions.
DRIVER INFORMATION
Assigned Driver(s)
The following driver(s) are assigned to the vehicle(s) on this policy.
Name
Age as of
October 11, 2019 Gender
Marital
Status
JEREMY BAIR 45 Male Divorced
Principal Driver & Assigned Drivers
For each automobile, the Principal Driver is the individual
who most frequently drives it.
Each driver is designated as an Assigned Driver on the
household automobile that they most frequently drive. Your
premium may be influenced by the information shown for
these drivers.
IMPORTANT NOTICE REGARDING YOUR PREMIUM
State Farm works hard to offer you the best combination of
Policy Number: 417 1851-D11-06B
Prepared September 4, 2019
Page number 3 of 4
IMPORTANT NOTICE REGARDING YOUR PREMIUM continued
you drive, how your car is used, who drives the car, and
information from consumer reports.
You have the right to request, no more than once during a
12-month period, that your policy be re-rated using a current
credit-based insurance score. The resulting impact due to
the credit portion of the re-rated insurance score will not
increase your premium; however, your overall premium may
decrease, remain the same, or increase due to other factors
impacting your total premium.
COVERAGE AND LIMITS See your policy for an explanation of these coverages.
A Liability
Bodily Injury 1,000,000/1,000,000
Property Damage 1,000,000 $187.35
D 500 Deductible Comprehensive $63.31
G 500 Deductible Collision $63.91
H Emergency Road Service $3.73
U Uninsured Motor Vehicle
Bodily Injury 25,000/50,000 $40.01
$358.31
Colorado Theft Prevention Authority Fee $0.50
Total Premium $358.81
If any coverage you carry is changed to give broader
protection with no additional premium charge, we will give
you the broader protection without issuing a new policy,
starting on the date we adopt the broader protection.
DISCOUNTS These adjustments have already been applied to your premium.
Multiple Line P
Multicar P
Accident-Free P
Annual Mileage P
Total Discounts $279.82
SURCHARGES AND DISCOUNTS
AUTOMOBILE RATING PLAN - Applies to private
passenger cars only.
Accident-Free Discount › Once your policy has been in
force for at least three years with no chargeable accidents,
you may qualify for our Accident-Free Discount. Once you
qualify, this discount applies as long as there are no
chargeable accidents, and may even increase over time.
Good Driving Discount - Newer policyholders who do not
yet qualify for our Accident-Free Discount (available after
three years with no chargeable accidents) may already be
receiving a Good Driving Discount. This discount continues
to apply until your policy qualifies for the Accident-Free
Discount as long as there are no chargeable accidents and
no new drivers. If you add new drivers, they must also
qualify in order for your Good Driving Discount to continue.
Chargeable Accidents - For new policies, an accident is
chargeable if it results in $1,000 or more of damage to any
property. For renewal policies, an accident is chargeable if
State Farm pays at least $1,000 (for accidents occurring on
(continued on next page)
DocuSign Envelope ID: 825EE2A3-F287-47E6-8B55-004E543E7C4F
Policy Number: 417 1851-D11-06B
Prepared September 4, 2019
Page number 4 of 4
or after April 1, 1999) under property damage liability and
collision coverages for an at-fault accident.
Surcharges › If there are chargeable accidents, you may
lose your Good Driving Discount or Accident-Free Discount
and receive accident surcharges. But if the accident is the
first to become chargeable in nine years and this policy has
been in force for at least that long, the Accident-Free
Discount will continue and no surcharge will apply. The
surcharge for each accident depends upon the number and
timing of the accidents, and each accident surcharge will
remain in effect up to three years.
Surcharges will be removed if the company is given
satisfactory evidence that the driver involved is no longer a
member of the household or will not be driving the car in the
future. If that driver is insured on another State Farm policy,
his or her driving record will be considered in the rating of
the other policy.
These discounts and surcharges do not apply to all
coverages. For complete details, see your State Farm agent.
ADDITIONAL INFORMATION
If any information on this renewal notice is incomplete or
inaccurate, or if you want to confirm the information we have
in our records, please contact your agent. For additional
information regarding discounts or coverages, see your
State Farm agent or visit statefarm.comfi.
Buying a new car? Remember to contact your agent!
When you buy an additional car or one that replaces a car already on your policy, you need to report the change to your agent
promptly. Even though the dealership you purchased the car from may offer to notify your agent or insurance company, you, as
the named insured, are responsible for reporting all changes to your auto policy. By contacting your agent, you can help:
� avoid any complications or lack of coverage in the event of an accident or loss,
� avoid insurance verification problems with a lienholder, the police, or the department of motor vehicles, and
� ensure that you receive any new discounts you may be entitled to.
Your current State Farm policy automatically provides certain coverages for a new or replacement car for up to a specified, limited
number of days after you take possession of the car. Please refer to your policy for the number of days that applies in your state.
If you have any questions about coverage for a newly acquired car, please contact your State Farm agent.
Disclaimer: This message is provided for informational purposes only and does not grant any insurance coverage. The terms and
conditions of coverage are set forth in your State Farm Car Policy booklet, the most recently issued Declarations Page, and any
applicable endorsements.
DocuSign Envelope ID: 825EE2A3-F287-47E6-8B55-004E543E7C4F
price, service, and protection. The amount you pay for
automobile insurance is determined by many factors such
as the coverages you have, where you live, the kind of car
(continued on next page)
DocuSign Envelope ID: 825EE2A3-F287-47E6-8B55-004E543E7C4F
automobile insurance is determined by many factors such
as the coverages you have, where you live, the kind of car
you drive, how your car is used, who drives the car, and
information from consumer reports.
(continued on next page)
DocuSign Envelope ID: 825EE2A3-F287-47E6-8B55-004E543E7C4F