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CORRESPONDENCE - AGREEMENT MISC - RAFTELIS FINANCIAL CONSULTANTS INC
June 8, 2020 Raftelis Financial Consultants, Inc. dba Raftelis Attn: Peiffer Brandt 26 E Hollister Street Cincinnati, OH 45219 RE: Contract Renewal, Executive Evaluation Process Dear Mr. Brandt: 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, August 1, 2020 through July 31, 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 Buyer, Beth Diven at (970) 221-6216 if you have any questions regarding this matter. Sincerely, Gerry S. Paul Director of Purchasing __________________________________________ ________________ Signature Date (Please indicate your desire to renew this agreement 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: 4E0B7EB3-5AF1-490B-908D-13FD419F6F2E 6/12/2020 INSR ADDL SUBR LTR INSR WVD DATE (MM/DD/YYYY) PRODUCER CONTACT NAME: PHONE FAX (A/C, No, Ext): (A/C, No): E-MAIL ADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXP TYPE OF INSURANCE (MM/DD/YYYY) (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE INSURER(S) AFFORDING COVERAGE NAIC # Y / N N / A (Mandatory in NH) ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $ PRO- OTHER: JECT LOC COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS AUTOS ONLY HIRED PROPERTY DAMAGE $ AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE $ CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ If yes, describe under This page has been left blank intentionally. DocuSign Envelope ID: 4E0B7EB3-5AF1-490B-908D-13FD419F6F2E DocuSign Envelope ID: 4E0B7EB3-5AF1-490B-908D-13FD419F6F2E DocuSign Envelope ID: 4E0B7EB3-5AF1-490B-908D-13FD419F6F2E DocuSign Envelope ID: 4E0B7EB3-5AF1-490B-908D-13FD419F6F2E DocuSign Envelope ID: 4E0B7EB3-5AF1-490B-908D-13FD419F6F2E DocuSign Envelope ID: 4E0B7EB3-5AF1-490B-908D-13FD419F6F2E DocuSign Envelope ID: 4E0B7EB3-5AF1-490B-908D-13FD419F6F2E DocuSign Envelope ID: 4E0B7EB3-5AF1-490B-908D-13FD419F6F2E DocuSign Envelope ID: 4E0B7EB3-5AF1-490B-908D-13FD419F6F2E DocuSign Envelope ID: 4E0B7EB3-5AF1-490B-908D-13FD419F6F2E DocuSign Envelope ID: 4E0B7EB3-5AF1-490B-908D-13FD419F6F2E DocuSign Envelope ID: 4E0B7EB3-5AF1-490B-908D-13FD419F6F2E DocuSign Envelope ID: 4E0B7EB3-5AF1-490B-908D-13FD419F6F2E DocuSign Envelope ID: 4E0B7EB3-5AF1-490B-908D-13FD419F6F2E DocuSign Envelope ID: 4E0B7EB3-5AF1-490B-908D-13FD419F6F2E DocuSign Envelope ID: 4E0B7EB3-5AF1-490B-908D-13FD419F6F2E DocuSign Envelope ID: 4E0B7EB3-5AF1-490B-908D-13FD419F6F2E DocuSign Envelope ID: 4E0B7EB3-5AF1-490B-908D-13FD419F6F2E DocuSign Envelope ID: 4E0B7EB3-5AF1-490B-908D-13FD419F6F2E DocuSign Envelope ID: 4E0B7EB3-5AF1-490B-908D-13FD419F6F2E DocuSign Envelope ID: 4E0B7EB3-5AF1-490B-908D-13FD419F6F2E DocuSign Envelope ID: 4E0B7EB3-5AF1-490B-908D-13FD419F6F2E DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ POLICY NON-OWNED SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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. 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 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 any rights to the certificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD ACORDTM CERTIFICATE OF LIABILITY INSURANCE National Fire Insurance Co. of Hartford Continental Insurance Company American Casualty Company of Reading PA Continental Casualty Company 1/17/2020 Cameron M Harris & Co, LLC Div USI Ins 6100 Fairview Road Ste 1400 Charlotte, NC 28210 Linda Rolfe 980-265-5804 linda.rolfe@usi.com Raftelis Financial Consultants, Inc. 227 West Trade Street, Ste. 1400 Charlotte, NC 28202 20478 35289 20427 20443 A X X 6076000011 01/21/2020 01/21/2021 1,000,000 500,000 15,000 1,000,000 2,000,000 2,000,000 D X X 6076000025 01/21/2020 01/21/2021 1,000,000 B X X X 10000 6076000039 01/21/2020 01/21/2021 5,000,000 5,000,000 C N 6076000042 6076305637 01/21/2020 01/21/2020 01/21/2021 01/21/2021 x 1,000,000 1,000,000 1,000,000 D Prof. Liability 652071235 01/21/2020 01/21/2021 $5,000,000 Occurrence $5,000,000 Aggregate As required by written contract, the City of Fort Collins is named as Additional insured on a Primary Non-Contributory basis with Waiver of Subrogation in regards to General Liability per CNA74879XX, CNA83700XX, CNA75014XX as well as Auto Liability with Waiver of Subrogation per CNA68021XX, WC000313, CC68021A, to the extent provided in these forms. Umbrella Follows Form. City of Fort Collins P. O. Box 580 Fort Collins, CO 80522 1 of 1 #S27725107/M27719207 Client#: 1722483 RAFTEFIN PCCZP 1 of 1 #S27725107/M27719207 DocuSign Envelope ID: 4E0B7EB3-5AF1-490B-908D-13FD419F6F2E