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468473 VEOLIA ES TECHNICAL SOLUTIONS LLC - CONTRACT - AGREEMENT MISC - VEOLIA ES TECHNICAL SOLUTIONS (2)
Official Purchasing Document Last updated 10/2017 Services Agreement - PFA MISC 2020 – PFA Foam Disposal Page 1 of 10 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 VEOLIA ES TECHNICAL SOLUTIONS 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 three (3) 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. Time of Commencement and Completion of Services. The services to be performed pursuant to this Agreement shall be initiated within ten (10) days following execution of this Agreement. Services shall be completed no later than June 30, 2020. Time is of the essence. Any extensions of the time limit set forth above must be agreed upon in a writing signed by the parties. 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: PFA: Copy to: Veolia ES Technical Solutions, LLC Attn: David Corabari 9131 E 96th Ave Henderson, CO 80640 Poudre Fire Authority Attn: Matt Housley 102 Remington Street Fort Collins, CO 80524 City of Fort Collins Attn: Purchasing Dept. PO Box 580 Fort Collins, CO 80522 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 DocuSign Envelope ID: FE355162-6F15-402D-8884-54AA5019BF3A Official Purchasing Document Last updated 10/2017 Services Agreement - PFA MISC 2020 – PFA Foam Disposal Page 2 of 10 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, Eight Thousand Three Hundred Eleven Dollars and Sixty-three Cents ($8,311.63) as per the attached Exhibit A, consisting of three (3) page(s), 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. 11. Warranty. DocuSign Envelope ID: FE355162-6F15-402D-8884-54AA5019BF3A Official Purchasing Document Last updated 10/2017 Services Agreement - PFA MISC 2020 – PFA Foam Disposal Page 3 of 10 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 WARRANTIES. Service Provider represents and warrants to City that: (a) Service Provider is generally engaged in the business of performing Work with respect to waste materials and has developed the requisite expertise to perform the particular Work agreed to by City and/or PFA and Service Provider hereunder; (b) all Service Provider vehicles and each facility utilized to perform Work hereunder shall have all permits, licenses, certificates or approvals required under applicable laws and regulations for such Work; and (c) Service Provider will perform Work for City and/or PFA in a safe and workmanlike manner, and in compliance with all statutes, ordinances, laws, orders, rules and regulations applicable to the Work. d. CITY AND/OR PFA WARRANTIES. The City and/or PFA represents and warrants to Service Provider that: a) City and/or PFA has all necessary authority to enter into this Agreement with respect to the such waste materials; (b) City and/or PFA is under no legal restraint which prohibits the transfer of possession of such waste materials to Service Provider; and (c) City and/or PFA shall comply with all applicable statutes, ordinances, laws, orders, rules and regulations. 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, DocuSign Envelope ID: FE355162-6F15-402D-8884-54AA5019BF3A Official Purchasing Document Last updated 10/2017 Services Agreement - PFA MISC 2020 – PFA Foam Disposal Page 4 of 10 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 Service Provider’s negligence or willful misconduct in the performance of any service hereunder. Service Provider shall have no obligation to indemnify the City and/or PFA for any loss or damage of any kind or nature, including death or injury resulting therefrom, caused by the City and/or PFA or anyone for whose acts either of them are liable, either individually or collectively. Except as provided in Section 1 herein, neither party shall be liable to the other for consequential damages, including loss of use or lost profits. Notwithstanding anything to the contrary in this Agreement, Service Provider’s aggregate liability arising out of services provided hereunder, other than transportation services provided by Service Provider or storage, treatment and/or disposal services provided by Service Provider at Service Provider’s locations, shall not exceed the greater of the aggregate fees paid in any calendar year hereunder or one million dollars ($1,000,000). 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 B, 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 reasonably 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 DocuSign Envelope ID: FE355162-6F15-402D-8884-54AA5019BF3A Official Purchasing Document Last updated 10/2017 Services Agreement - PFA MISC 2020 – PFA Foam Disposal Page 5 of 10 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 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: FE355162-6F15-402D-8884-54AA5019BF3A Official Purchasing Document Last updated 10/2017 Services Agreement - PFA MISC 2020 – PFA Foam Disposal Page 6 of 10 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: VEOLIA ES TECHNICAL SOLUTIONS LLC By: Printed: Title: CORPORATE PRESIDENT OR VICE PRESIDENT Date: Derek M Nelhuebel Sales Manager 5/20/2020 DocuSign Envelope ID: FE355162-6F15-402D-8884-54AA5019BF3A Assistant City Attorney ll 5/29/2020 5/29/2020 City Clerk Services Agreement - PFA MISC 2020 – PFA Foam Disposal Page 7 of 10 EXHIBIT A SCOPE OF SERVICES The Service Provider will aid the PFA in the remediation and appropriate disposal of PFA’s existing supply of MicroBlaze Out AR AFFF, a foam liquid concentrate, historically used for fire suppression purposes, which contains ingredients that have been identified as ground water contaminants thereby designating the product as hazardous waste. Scope of Work: The Service Provider will provide the following services: Provide drop off of totes. Totes are to be delivered to Fire Station 10 located at 2067 Vermont Drive, Fort Collins, CO 80525 and placed on the ramp located on the West side of the driveway. The drop off day should be scheduled in advance with project manager, Matt Housley. After receiving notice from PFA that filled totes are ready for pick-up, Service Provider will transport and dispose of PFOS/PFAS foam and impact water. Preparation packing slips, listing materials packed in each container. Proper labeling, according to state and federal regulations. Loading and transportation services via MCS-90 endorsed DOT transporter. Provide return manifest copies back to the generator within 45 days of shipment. Treatment and/or Disposal at a appropriate, licensed treatment/recycling facility. Complete tracking documentation following the disposition of materials. Veolia or an approved subcontractor will provide transportation of customer containers after waste has been approved. PFA employees will be responsible for loading foam and impact water into the provided totes. Service Provider will ensure that: All personnel are trained and authorized for Hazardous Waste Site Operations per OSHA’s 29CFR1910.120. Chemical Segregation for compatibility, hazard class and disposal requirements. Packaging in accordance with DOT regulations (49 CFR), and over packing, when required. Price Summary: Description Quantity Price UOM Total PFOS/PFAS - NON RCRA Solidification or Direct Landfill 4 $1,280.00 330 Gal Tote $5,131.43 New 330 Gal Tote - Poly Cage 4 $ 406.00 Each $1,624.00 LTL Transportation - Tote 4 $ 130.00 Container $ 520.00 Container Drop-off Transportatoin 1 $ 80.00 Stop $ 80.00 Energy and security surcharge $5,528.00 13% % of Invoice $ 956.21 Total $8,311.63 DocuSign Envelope ID: FE355162-6F15-402D-8884-54AA5019BF3A Services Agreement - PFA MISC 2020 – PFA Foam Disposal Page 8 of 10 This estimate observes the following general terms and conditions, if applicable: Energy and Security Surcharge (ESS): A fluctuating Energy and Security Surcharge (ESS), as quoted, will be applied to the total invoice. Veolia ES Technical Solutions, L.L.C. (Veolia) surcharge program is designed to recover those fuel, energy, security, and insurance costs that have or will impact our facility, field service, and transportation operations. Veolia will apply the surcharge percent based upon the date of shipment and type of service to each invoice, less any local, state, and federal taxes and or fees. Fuel and Energy, Security, and Insurance surcharge program defined within our program table is tied to the US Department of Energy on-highway national diesel fuel prices, as published at www.eia.doe.gov. It is applied the first Monday of each month, after 4:00 PM. EST. Fuel Surcharge Energy, Security, and Insurance Surcharge Bulk Shipments (% of Transportation Price) Container Shipments (% of Total Invoice) $2.00 $2.09 9.0% $2.00 $2.09 8.0% $2.10 $2.19 10.0% $2.10 $2.19 8.5% $2.20 $2.29 11.0% $2.20 $2.29 9.0% $2.30 $2.39 12.0% $2.30 $2.39 9.5% $2.40 $2.49 13.0% $2.40 $2.49 10.0% $2.50 $2.59 14.0% $2.50 $2.59 10.5% $2.60 $2.69 15.0% $2.60 $2.69 11.0% $2.70 $2.79 16.0% $2.70 $2.79 11.5% $2.80 $2.89 17.0% $2.80 $2.89 12.0% $2.90 $2.99 18.0% $2.90 $2.99 12.5% $3.00 $3.09 19.0% $3.00 $3.09 13.0% $3.10 $3.19 20.0% $3.10 $3.19 13.5% $3.20 $3.29 21.0% $3.20 $3.29 14.0% $3.30 $3.39 22.0% $3.30 $3.39 14.5% $3.40 $3.49 23.0% $3.40 $3.49 15.0% $3.50 $3.59 24.0% $3.50 $3.59 15.5% $3.60 $3.69 25.0% $3.60 $3.69 16.0% $3.70 $3.79 26.0% $3.70 $3.79 16.5% $3.80 $3.89 27.0% $3.80 $3.89 17.0% $3.90 $3.99 28.0% $3.90 $3.99 17.5% $4.00 $4.09 29.0% $4.00 $4.09 18.0% $4.10 $4.19 30.0% $4.10 $4.19 18.5% $4.20 $4.29 31.0% $4.20 $4.29 19.0% $4.30 $4.39 32.0% $4.30 $4.39 19.5% $4.40 $4.49 33.0% $4.40 $4.49 20.0% $4.50 $4.59 34.0% $4.50 $4.59 20.5% $4.60 $4.69 35.0% $4.60 $4.69 21.0% $4.70 $4.79 36.0% $4.70 $4.79 21.5% DocuSign Envelope ID: FE355162-6F15-402D-8884-54AA5019BF3A Services Agreement - PFA MISC 2020 – PFA Foam Disposal Page 9 of 10 $4.80 $4.89 37.0% $4.80 $4.89 22.0% $4.90 $4.99 38.0% $4.90 $4.99 22.5% $5.00 $5.09 39.0% $5.00 $5.09 23.0% Container Shipments: For container shipments, an Energy, Security, and Insurance surcharge percent will be applied to the entire invoice amount including the disposal, transportation, manpower and material costs less any local, state and federal taxes and or fees. Surcharge Note: For diesel fuel prices greater than $5.09 per gallon, the Fuel Surcharge (FS) will increase by 1.0% and the Energy, Security, and Insurance surcharge (ES&I) will increase by 0.5% for every $0.10 per gallon increase in fuel. Due to unusually high diesel fuel prices in California, the State average will be used for determining fuel surcharges applied to bulk shipments. DocuSign Envelope ID: FE355162-6F15-402D-8884-54AA5019BF3A Services Agreement - PFA MISC 2020 – PFA Foam Disposal Page 10 of 10 EXHIBIT B 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: FE355162-6F15-402D-8884-54AA5019BF3A ACORD V7 I ® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 12/13/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONALINSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Marsh USA, Inc. 540 W. Madison Street CONTACT NAME; PHONE FAX (NC. No. Ext): (NC, No): Chicago, IL 60661 E-MA'L , Attn: Veolia.CertRequest@rnarsh.com| Fax: 212-948-5053 ADDRESS- INSURER(S) AFFORDING COVERAGE NAIc # HEN-TS INSURER A : National Union Fire InsuranceCompanyOf Pittsburgh, 19445 INSURED . - Veolia ES Technical Solutions, LLC INSURER B ' New Hampshire Insurance 9131 East 96th Avenue INSURER c : N/A N/A Henderson,CO 80640 INSURER D : Lloyd's Syndicates623/2623 INSURER E : Illinois National InsuranceCompany 23817 INSURER F : COVERAGES CERTIFICATE NUMBER: CHI—00806564056 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITSSHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. '03? TYPE OF INSURANCE 1EEWV’B5 POLICY NUMBER (WEE/v55?) (Wiég/YPW LIMITS A X COMMERCIALGENERAL LIABILITY GL5425835 01/01/2020 01/01/2021 EACH OCCURRENCE $ 1,000,000 CLAIMS~MADEEOCCUR SSE/0,95%?Eii'gfi'39me) $ 1,000,000 % MED EXP (Any one person) $ _ PERSONAL & ADV INJURY s 1000000 10’000 SEMI AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 1900900 A POLICYD558-} I: Loc PRODUCTS - COMP/OP AGG $ 1000000 OTHER: $ A AUTOMOBILELIABILITY CA9767418 (AOS) 01/01/2020 01/01/2021 CEOaIIgEgFIIEEtFINGI—E LIMIT $ 1,000,000 A 7 ANYAUTO CA9767419 (MA) 01/01/2020 01/01/2021 BODILY]NJURY : EmNOESDONLY ESPESULED CA9767420 (VA) (Per person) $ 01/01/2020 01/01/2021 BODILYINJURY(per accident) $ AGENCY CUSTOMER ID: CN102584993 LOC #: Chicago ACORD ADDITIONAL REMARKS SCHEDULE Page __2_°f _2_ AGENCY NAMEDINSURED Marsh USA, Inc. Veoiia ES Technical Solutions, LLC 9131 East 96th Avenue POLICY NUMBER Henderson, 00 80640 CARRIER NAICCODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONALREMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Workers Compensation (Cont) Carrier: Insurance Company of the State of Pennsylvania Policy Number: WC 04601-2805 (MA, ND, OH, WA, W1, WY) EffectiveDate: 01/01/2020 ExpirationDate: 01/01/2021 Limit: SEE ABOVE Carrier: American Home Assurance (NAIC #19380) Policy Number: WC 04e91-2806(CA) EffectiveDate: 01/01/2020 Expiration Date: 01/01/2021 Limit: SEE ABOVE ACORD 101 (2008/01) © 2008 ACORDCORPORATION.All rights reserved. The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID: FE355162-6F15-402D-8884-54AA5019BF3A ENDORSEMENT This endorsement, effective 1 2:01 AM. 01/01/2020 forms a part of Policy No. CA 9767418 issued to: VEOLIA NORTH AMERICA, INC. By: NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED — WHERE REQUIRED UNDER CONTRACT OR AGREEMENT This endorsement modifies insarance provided under the fol/owing: BUSINESS AUTO COVERAGE FORM SCHEDULE ADDITIONAL INSURED: ANY PERSON OR ORGANIZATIONTO WHOM YOU ARE CONTRACTUALLYBOUND TO PROVIDE ADDITIONAL INSUREDSTATUS. BUT ONLY TO THE EXTENT AS SUCH PERSON‘S OR ORGANIZATION’S LIABILITY ARISING OUT OF USE OF A COVERED AUTO. I. SECTION II — COVERED AUTOS LIABILITY COVERAGE. A. Coverage. 1. - Who Is Insured. is amended to add: d. Any person or organization, shown in the schedule above, to whom you become oingated to Include as an additionai insured under this poIicy, as a resuit of any contract or agreement you enter into which requires you to furnish insurance to that person or organization of the type provided by this policy, but onIy with respect to Iiabiiity arising out of use of a covered "auto". However, the insurance provided will not exceed the Iesser of: (I) The coverage and/or limits of this poIicy, or {2) The coverage and/or Iimits required by said contract or agreement. '1 If Authorized HEDIESES‘IWUVQ 87950 (9/1 4) IncIudes copyrighted information of InsuranceServices with its permission. Office, Inc., Page 1 Of 1 DocuSign Envelope ID: FE355162-6F15-402D-8884-54AA5019BF3A POLICY NUMBER: GL 54268—35 COMMERCIALGENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies Insurance provided under the following: COMMERCIALGENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Personis) Or Organizationls) Location(s) Of Covered Operations Any person or organization whom you become obligated to include as an additional insured as a result of any contract or agreement you have entered into. Per the contract or agreement. information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for ”bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the locationis) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. if coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage“ occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional lnsured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a Page 2 of 2 C. With respect to the insurance afforded to these additionai insureds, the toiicwing is added to Section iii - Limits Of insurance: if coverage provided to the additionai insured is required by a contract or agreement, the most we wiii pay on behalf of the additionat insured is the amount of insurance: 1. Required by the contract or agreement; or © insurance Services Office, inc., 2012 2. Avaiiabie under the appiicabie Limits of insurance shown in the Deciarations; whichever is iess. This endorsement shalt not increase the appiicabie Limits of insurance shown in the Declarations. CG 20 1D 0413 DocuSign Envelope ID: FE355162-6F15-402D-8884-54AA5019BF3A POLICY NUMBER: GL 54268—35 COMMERCIALGENERAL LIABILITY CG 2O 37 O4 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED — OWNERS, LESSEES OR CONTRACTORS -— COMPLETED OPERATIONS This endorsement modifies insurance provided under the foilowing: COMMERCIALGENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organizatioms) Location And Description Of Completed Operations Any person or organization whom you become obligated to include as an additional insured as a result of any contract or agreement you have entered into. Per the contract or agreement information requiredto complete this Schedule, it not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Scheduie, but only with respect to liability for "bodliy injury" or "property damage" caused, in whoie or in part, by “your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products—completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. It coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additionai insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 370413 B. With respect to the insurance afforded to these additionai insureds, the foilowing is added to Section III — Limits 0t Insurance: if coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behaif of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Avaitable under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. © Insurance Services Office, Inc., 2012 Page 1 of 1 DocuSign Envelope ID: FE355162-6F15-402D-8884-54AA5019BF3A principal as a part of the same project. CG 20 to 04 13 © insurance Services Office, Inc, 2012 Page 1 of 2 DocuSign Envelope ID: FE355162-6F15-402D-8884-54AA5019BF3A HIRED NON-OWNED PROPERTY DAMAGE __ AUTOS ONLY AUTOS ONLY (Per accudent) $ s __ UMBRELLALIAB OCCUR EACH OCCURRENCE s EXCESS LIAB CLAIMS—MADE AGGREGATE s DED l l RETENTION s 35 B ngggfigfgeehggEfiaglf/pv WC 046—91-2802(AOS) 01/01/2020 01/01/2021 x STE‘ARTUTE I I ggH» B SE;EE%7§E%§§AE§%I%%€E§ECUTIVE NIA WC 046—91—2803 (AZ, IL, KY, NC, NH, 01/01/2020 01/01/2021 EL. EACHACCIDENT 3 1,000’000 (Mandatoryin NH) ' NJ, PA, UT, VA, VT) E.L. DISEASE - EA EMPLOYEE s 10001000 EESSCRIEPSigllgfi[O13 gPERATIONS below WC 046812804 (FL) 01/01/2020 0“01l2021 EL DISEASE - POLICY LIMIT 35 1900000 D Pollution Legal Liability W1 D4C8200401 01/01/2020 01/01/2021 Per Claim 1,000,000 Claims Made Form SIR $750,000 Aggregate 1,000,000 General Liabilityand Auto Liability. DESCRIPTION OF OPERATIONS] LOCATIONS I VEHICLES (ACORD 101, AdditionalRemarksSchedule,maybeattached if more space is required) City of Fort Collins, its officers, agents and employeesare included as additional insured where required by written contract but only for liabilityarising out of the operations of the named insured with respect to CERTIFICATE HOLDER CANCELLATION City of Fort Collins PurchasingDivision Attn: Ed Bonnette, CPM 215 North Mason PO. Box 580 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITHTHEPOLICYPROVISIONS. AUTHORIZEDREPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee ACORD 25 (2016/03) © 1988-2016 ACORDCORPORATION.All rights reserved. The ACORDnameand logo are registered marks of ACORD DocuSign Envelope ID: FE355162-6F15-402D-8884-54AA5019BF3A