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HomeMy WebLinkAboutCORRESPONDENCE - RFP - 8115 ENGINEERING SERVICES FOR WATER RECLAMATION & BIOSOLIDS FACILITY DESIGN & CONSTRUCTION (9)Utilities Work Order Form Official Purchasing Form Last updated 10/2017 WORK ORDER PURSUANT TO A MASTER AGREEMENT BETWEEN THE CITY OF FORT COLLINS AND CAROLLO ENGINEERS, INC. WORK ORDER NUMBER: UC-WRF-2020-3 PROJECT TITLE: UDWRF Carbon Addition Phase 1 Construction ORIGINAL BID/RFP NUMBER & NAME: U8115, Engineering Services for Water Reclamation and Biosolids Facility Design and Construction Services MASTER AGREEMENT EFFECTIVE DATE: USeptember 21, 2015 ARCHITECT/ENGINEER: UCarollo Engineers, Inc. OWNER’S REPRESENTATIVE: UChristina Schroeder WORK ORDER COMMENCEMENT DATE: UMarch 2, 2020 WORK ORDER COMPLETION DATE: USeptember 20, 2020 MAXIMUM FEE: (time and reimbursable direct costs): U$136,087.00 PROJECT DESCRIPTION/SCOPE OF SERVICES: UEngineering Support Services during construction associated installation of an external carbon source storage and dosage system for nutrient removal to meet new effluent discharge limits. See attached supporting documentation. Service Provider agrees to perform the services identified above and on the attached forms in accordance with the terms and conditions contained herein and in the Master Agreement between the parties. In the event of a conflict between or ambiguity in the terms of the Master Agreement and this Work Order (including the attached forms) the Master Agreement shall control. The attached forms consisting of four (4) pages are hereby accepted and incorporated herein, U U by this reference, and Notice to Proceed is hereby given after all parties have signed this document. SERVICE PROVIDER: Carollo Engineers, Inc. By: Date: Name: Title: Page 1 of 10 DocuSign Envelope ID: CE5245AF-122A-4D61-836D-FD0883C0D554 Jason Garside Vice President April 13, 2020 Ron Burdick Senior Vice President April 13, 2020 Utilities Work Order Form Official Purchasing Form Last updated 10/2017 OWNER’S ACCEPTANCE & EXECUTION: This Work Order and the attached Contract Documents are hereby accepted and incorporated herein by this reference. ACCEPTANCE: Date: Christina Schroeder, Civil Engineer III REVIEWED: Date: Pat Johnson, Senior Buyer REQUISITION ENTERED BY: Date: ACCEPTANCE: Date: Jason Graham, Plant Director, Water Reclamation & Biosolids Division ACCEPTANCE: Date: Matt Fater, Director, Civil Engineering ACCEPTANCE: Date: Carol Webb, Deputy Director, Water Resources & Treatment Operations ACCEPTANCE: Date: Theresa Connor, Deputy Director, Water Engineering & Field Services ACCEPTANCE: Date: Kevin Gertig, Utilities Executive Director (if greater than $1,000,000) ACCEPTANCE: Date: Gerry Paul, Purchasing Director (if greater than $60,000) ACCEPTANCE: Date: Darin Atteberry, City Manager (if greater than $1,000,000) Page 2 of 10 Melissa Walker April 9, 2020 DocuSign Envelope ID: CE5245AF-122A-4D61-836D-FD0883C0D554 April 13, 2020 April 13, 2020 April 14, 2020 April 15, 2020 April 15, 2020 April 16, 2020 April 16, 2020 Utilities Work Order Form Official Purchasing Form Last updated 10/2017 ATTACHMENT A WORK ORDER SCOPE OF SERVICES Page 3 of 10 DocuSign Envelope ID: CE5245AF-122A-4D61-836D-FD0883C0D554 pg. 1 Fort Collins Utilities Scope of Work – Carbon Phase 1 Project – Engineering Construction Services FINAL 2-12-20 The City of Fort Collins (City) through the assistance of Carollo Engineers (Consultant and Engineer of Record) and Hydro Construction Company (Contractor) has completed the design for the implementation of the proposed Carbon Storage and Feed system at the Drake Water Reclamation Facility (DWRF) in support of meeting new phosphorous effluent limits by April 2021. The proposed Carbon Storage and Feed system will consist of facilities required to store and feed MicroC to the North Process Train (NPT) and the South Process Train (SPT). The system includes storage tanks, feed pumps and appurtenances, chemical feed piping, electrical and instrumentation, and ancillary equipment. The purpose of this Work Order is to provide the engineering services during construction (ESDC), including resident engineering, for the proposed the proposed Carbon Addition Design project (Project). The construction of the Project is estimated to occur from March 2, 2020 to October 31, 2020 (approximately 8 month total duration). The scope of work is divided into the following tasks and subtasks, summarized below: Task 1 - Project Coordination Task 1.1 – Kick-off and Progress Meetings Consultant will prepare agenda, facilitate meeting, and document minutes for construction kick- off meeting. Consultant will prepare agenda, facilitate meeting, and document minutes for fourteen (14), 0.5-hour construction progress meetings (bi-weekly over 7 month duration) – meetings may be combined with Sidestream or Cogeneration construction progress meetings. Consultant Project Manager or Project Engineer will facilitate all meetings in person. Consultant's engineering discipline staff will participate via conference call or be in attendance at the progress meetings based on the topics of discussion - it is assumed that one (1) discipline engineer will be required to attend one (1) coordination meeting per month for a total of seven (7), 1.0-hour meetings, and will also participate in one (1) coordination meeting per month via conference call. Task 1.2 – Consultant Progress Reporting Consultant invoices will be submitted monthly in accordance with City payment protocols. Each invoice will be submitted with a progress report detailing the work executed during the invoice period and work remaining. Task 2 - Resident Engineering Task 2.1 – Site Observations and Coordination Consultant will perform site visits to observe construction activities and coordinate with City and Contractor. Consultant will perform periodic site visits (combined with progress meetings if possible), and as needed to observe key construction activities and testing. It is assumed that Consultant will spend approximately twelve (12) hours per month on site observation and coordination. Task 2.2 – Contractor Schedule Review Consultant will review Contractor baseline and progress schedules for compliance with project milestones, and communicate to City any potential issues perceived. Page 4 of 10 DocuSign Envelope ID: CE5245AF-122A-4D61-836D-FD0883C0D554 pg. 2 Task 2.3 – Pay Application Review Consultant will review Contractor pay application to assess progress related to request payment. Consultant will communicate progress assessment to City. City will perform balance of pay application review and process pay application. Task 2.4 – Compliance Testing Review Consultant will review results from materials and other testing results to confirm compliance with contract requirements. Actual materials testing to be provided by others. Task 2.5 – Start-Up/Commissioning Planning and Support Consultant shall coordinate with City and Contractor to develop start-up/commissioning plan, including development of checklist for tracking status. Consultant will participate in start- up/commissioning, document results, and confirm compliance with contract requirements. Consultant will confirm that proper operating parameters are being met, suggest adjustments, review applicable performance data, and provide written confirmation that specific process, system, or equipment is functioning as designed. Consultant’s electrical engineer shall provide startup assistance to City and Contractor on programming and controls equipment installed under this project. Consultant assumes that Project Engineer will be onsite for forty (40) hours during start-up/testing, and Electrical and Instrumentation Engineer onsite for forty (40) hours. Task 3 - Engineering Services during Construction Task 3.1 - Shop Drawing Review Consultant assumes reviews of up to forty (40) shop drawing submittals. Consultant estimates that each shop drawing submittal will require an average of three (3) hours to receive, process, review, verify, respond, document, and return. It is assumed that Contractor will administer shop drawing Task 3.2 - Interpretations/Clarifications and Work Change Directives Consultant assumes that up to eight (8) interpretations and clarifications of contract documents are required. Consultant estimates that each interpretation and clarification will require up to six (6) hours to research, respond, and document. Consultant assumes development of up to six (6) work change directives (WCD). Consultant anticipates that each WCD will require eight (8) hours to research, prepare engineering, respond, and document. Task 3.3 - Record Drawings Consultant shall develop Record Drawings based on the field hand markups. Record Drawings will be compiled and delivered within thirty (30) calendar days following Substantial Completion. Consultant shall provide a signed Colorado Department of Public Health and Environment (CDPHE) Construction As-Approved Certification Form. ATTACHMENTS: 1. Labor Hours and Engineering Fee. Page 5 of 10 DocuSign Envelope ID: CE5245AF-122A-4D61-836D-FD0883C0D554 Utilities Work Order Form Official Purchasing Form Last updated 10/2017 ATTACHMENT B WORK ORDER SCOPE COST DETAILS Page 6 of 10 DocuSign Envelope ID: CE5245AF-122A-4D61-836D-FD0883C0D554 FINAL - 2/12/20 CARBON PH1 PROJECT (CONSTRUCTION PHASE) LABOR HOURS AND ENGINEERING FEE Senior Professional Lead Project Professional Project Professional Professional (PE + Mech) Disciplines (Structural+Arch) Disciplines (EIC) Disciplines (Civil, HVAC, Demo) Senior Technician Technician Document Processing/Clerical Billing Rate $253 $234 $221 $186 $186 $186 $162 $177 $125 $96 Task 1 - Project Coordination 2 56 0 48 8 48 0 0 0 10 172 $33,914 $0 $0 $0 $1,300 $2,012 $37,226 Task 1.1 – Kick-off and Progress Meetings 0 48 0 48 8 48 0 0 0 6 158 $31,152 $0 $0 $0 $1,300 $1,849 $34,301 Task 1.2 – Consultant Progress Reporting 2 8 0 0 0 0 0 0 0 4 14 $2,762 $0 $0 $0 $0 $164 $2,926 Task 2 - Resident Engineering 0 28 0 96 0 76 0 0 0 4 204 $38,928 $0 $0 $0 $500 $2,387 $41,815 Task 2.1 – Site Observations and Coordination 0 8 0 36 0 36 0 0 0 0 80 $15,264 $0 $0 $0 $0 $936 $16,200 Task 2.2 – Contractor Schedule Review 0 4 0 4 0 0 0 0 0 0 8 $1,680 $0 $0 $0 $0 $94 $1,774 Task 2.3 – Pay Application Review 0 8 0 8 0 0 0 0 0 0 16 $3,360 $0 $0 $0 $0 $187 $3,547 Task 2.4 – Compliance Testing Review 0 0 0 8 0 0 0 0 0 0 8 $1,488 $0 $0 $0 $0 $94 $1,582 Task 2.5 – Start-Up/Commissioning Planning and Support 0 8 0 40 0 40 0 0 0 4 92 $17,136 $0 $0 $0 $500 $1,076 $18,712 Task 3 - Engineering Services During Construction 0 18 0 106 16 106 0 40 0 0 286 $53,700 $0 $0 $0 $0 $3,346 $57,046 Task 3.1 - Shop Drawing Review 0 8 0 50 8 50 0 0 0 0 116 $21,960 $0 $0 $0 $0 $1,357 $23,317 Task 3.2 - Interpretations/Clarifications and Work Change Directives 0 8 0 40 8 40 0 16 0 0 112 $21,072 $0 $0 $0 $0 $1,310 $22,382 Task 3.3 - Record Drawings 0 2 0 16 0 16 0 24 0 0 58 $10,668 $0 $0 $0 $0 $679 $11,347 PROJECT TOTALS - TASKS 1-3 2 102 0 250 24 230 0 40 0 14 662 $126,542 $0 $0 $0 $1,800 $7,745 $136,087 TOTAL COST LABOR HOURS PROJECT COSTS Total Direct Labor Hours Total Labor Cost Ditesco Lithos King Surveying Other Direct Costs (ODCs) PECE Page 7 of 10 DocuSign Envelope ID: CE5245AF-122A-4D61-836D-FD0883C0D554 Utilities Work Order Form Official Purchasing Form Last updated 10/2017 ATTACHMENT C WORK ORDER SCHEDULE DETAIL Page 8 of 10 DocuSign Envelope ID: CE5245AF-122A-4D61-836D-FD0883C0D554 DWRF Carbon Addition Phase 1 Carollo Engineering Support During Construction Project Schedule SCHEDULE Mar-20 Apr-20 May-20 Jun-20 Jul-20 Aug-20 Sep-20 Oct-20 Construction Support Key Dates: Commencement Date: 3/2/2020 Completion Date: 10/31/2020 Page 9 of 10 DocuSign Envelope ID: CE5245AF-122A-4D61-836D-FD0883C0D554 Utilities Work Order Form Official Purchasing Form Last updated 10/2017 ATTACHMENT D CERTIFICATE OF INSURANCE CONTRACTOR shall submit Certificate of Insurance in compliance with the Contract Documents. Page 10 of 10 DocuSign Envelope ID: CE5245AF-122A-4D61-836D-FD0883C0D554 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? INSR ADDL SUBR LTR INSD 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 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 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 $ PRO- POLICY JECT LOC PRODUCTS - COMP/OP AGG $ OTHER: $ COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY 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 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN INSURED: Carollo Engineers, Inc. PROFESSIONAL LIABILITY AND POLLUTION INCIDENT LIABILITY INSURANCE POLICY POLICY: AEH 288354410 EFFECTIVE: 7/4/2019 NOTICE ENDORSEMENT - CANCELLATION OR NON-RENEWAL We agree with you that your Policy is amended to include the following additional provisions. 1. Your Policy will not be: Canceled by us until we provide at least: 10 days prior written notice if we cancel your Policy for Non-payment of Premiums; 30 days prior written notice if we cancel your Policy for the following reasons: any reason other than non-payment of premiums ----- Non-renewed by us until at least ______ days prior written notice is given to the person or entity named in 2 below. 2. Person or Entity: All other terms and conditions of the Policy remain unchanged. This endorsement, which forms a part of and is for attachment to the Policy issued by the designated insurers, takes effect on the effective date of said Policy at the hour stated in said Policy and expires concurrently with said Policy unless another effective date is shown above. Attachment Code: D573119 Certificate ID: 16520972 DocuSign Envelope ID: CE5245AF-122A-4D61-836D-FD0883C0D554 NOTICE OF CANCELLATION TO CERTIFICATEHOLDERS It is understood and agreed that: If you have agreed under written contract to provide notice of cancellation to a party to whom the Agent of Record has issued a Certificate of Insurance, and if we cancel a policy term described on that Certificate of Insurance for any reason other than nonpayment of premium, then notice of cancellation will be provided to such Certificateholders at least 30 days in advance of the date cancellation is effective. If notice is mailed, then proof of mailing to the last known mailing address of the Certificateholder on file with the Agent of Record will be sufficient to prove notice. Any failure by us to notify such persons or organizations will not extend or invalidate such cancellation, or impose any liability or obligation upon us or the Agent of Record. CNA68021XX (2-13) Policy No: 6050490267 Page 1 Endorsement No: Effective Date: 12/31/2019 Insured Name: Carollo Engineers, Inc. © CNA All Rights Reserved. Attachment Code: D573121 Certificate ID: 16520972 DocuSign Envelope ID: CE5245AF-122A-4D61-836D-FD0883C0D554 NOTICE OF CANCELLATION TO CERTIFICATEHOLDERS It is understood and agreed that: If you have agreed under written contract to provide notice of cancellation to a party to whom the Agent of Record has issued a Certificate of Insurance, and if we cancel a policy term described on that Certificate of Insurance for any reason other than nonpayment of premium, then notice of cancellation will be provided to such Certificateholders at least 30 days in advance of the date cancellation is effective. If notice is mailed, then proof of mailing to the last known mailing address of the Certificateholder on file with the Agent of Record will be sufficient to prove notice. Any failure by us to notify such persons or organizations will not extend or invalidate such cancellation, or impose any liability or obligation upon us or the Agent of Record. CNA68021XX (2-13) Policy No: 6050490317 Page 1 Endorsement No: Effective Date: 12/31/2019 Insured Name: Carollo Engineers, Inc. © CNA All Rights Reserved. Attachment Code: D573122 Certificate ID: 16520972 DocuSign Envelope ID: CE5245AF-122A-4D61-836D-FD0883C0D554 NOTICE OF CANCELLATION TO CERTIFICATEHOLDERS It is understood and agreed that: If you have agreed under written contract to provide notice of cancellation to a party to whom the Agent of Record has issued a Certificate of Insurance, and if we cancel a policy term described on that Certificate of Insurance for any reason other than nonpayment of premium, then notice of cancellation will be provided to such Certificateholders at least 30 days in advance of the date cancellation is effective. If notice is mailed, then proof of mailing to the last known mailing address of the Certificateholder on file with the Agent of Record will be sufficient to prove notice. Any failure by us to notify such persons or organizations will not extend or invalidate such cancellation, or impose any liability or obligation upon us or the Agent of Record. All other terms and conditions of the policy remain unchanged. This endorsement, which forms a part of and is for attachment to the policy issued by the designated insurers, takes effect on the Policy Effective date of said policy at the hour stated in said policy, unless another effective date (the endorsement effective date) is shown below, and expires concurrently with said policy unless another expiration date is shown below. CNA68021XX (2-13) Policy No: WC 6050490270; WC 6050490298 Page 1 Endorsement No: Effective Date: 12/31/2019 Insured Name: Carollo Engineers, Inc. © CNA All Rights Reserved. Attachment Code: D573124 Certificate ID: 16520972 DocuSign Envelope ID: CE5245AF-122A-4D61-836D-FD0883C0D554 CNA CNA PARAMOUNT Blanket Additional Insured - Owners, Lessees or Contractors - with Products-Completed Operations Coverage Endorsement This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART It is understood and agreed as follows: I. WHO IS AN INSURED is amended to include as an Insured any person or organization whom you are required by written contract to add as an additional insured on this coverage part, but only with respect to liability for bodily injury, property damage or personal and advertising injury caused in whole or in part by your acts or omissions, or the acts or omissions of those acting on your behalf: A. in the performance of your ongoing operations subject to such written contract; or B. in the performance of your work subject to such written contract, but only with respect to bodily injury or property damage included in the products-completed operations hazard, and only if: 1. the written contract requires you to provide the additional insured such coverage; and 2. this coverage part provides such coverage. II. But if the written contract requires: A. additional insured coverage under the 11-85 edition, 10-93 edition, or 10-01 edition of CG2010, or under the 10¬01 edition of CG2037; or B. additional insured coverage with "arising out of language; or C. additional insured coverage to the greatest extent permissible by law; then paragraph I. above is deleted in its entirety and replaced by the following: WHO IS AN INSURED is amended to include as an Insured any person or organization whom you are required by written contract to add as an additional insured on this coverage part, but only with respect to liability for bodily injury, property damage or personal and advertising injury arising out of your work that is subject to such written contract. III. Subject always to the terms and conditions of this policy, including the limits of insurance, the Insurer will not provide such additional insured with: A. coverage broader than required by the written contract; or B. a higher limit of insurance than required by the written contract. IV. The insurance granted by this endorsement to the additional insured does not apply to bodily injury, property damage, or personal and advertising injury arising out of: A. the rendering of, or the failure to render, any professional architectural, engineering, or surveying services, including: 1. the preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and 2. supervisory, inspection, architectural or engineering activities; or B. any premises or work for which the additional insured is specifically listed as an additional insured on another endorsement attached to this coverage part. V. Under COMMERCIAL GENERAL LIABILITY CONDITIONS, the Condition entitled Other Insurance is amended to add the following, which supersedes any provision to the contrary in this Condition or elsewhere in this coverage part: Primary and Noncontributory Insurance With respect to other insurance available to the additional insured under which the additional insured is a named insured, this insurance is primary to and will not seek contribution from such other insurance, provided that a written contract requires the insurance provided by this policy to be: 1. primary and non-contributing with other insurance available to the additional insured; or 2. primary and to not seek contribution from any other insurance available to the additional insured. But except as specified above, this insurance will be excess of all other insurance available to the additional insured. Attachment Code: D573129 Certificate ID: 16520972 DocuSign Envelope ID: CE5245AF-122A-4D61-836D-FD0883C0D554 VI. Solely with respect to the insurance granted by this endorsement, the section entitled COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: The Condition entitled Duties In The Event of Occurrence, Offense, Claim or Suit is amended with the addition of the following: Any additional insured pursuant to this endorsement will as soon as practicable: 1. give the Insurer written notice of any claim, or any occurrence or offense which may result in a claim; 2. send the Insurer copies of all legal papers received, and otherwise cooperate with the Insurer in the investigation, defense, or settlement of the claim; and 3. make available any other insurance, and tender the defense and indemnity of any claim to any other insurer or self-insurer, whose policy or program applies to a loss that the Insurer covers under this coverage part. However, if the written contract requires this insurance to be primary and non-contributory, this paragraph 3. does not apply to insurance on which the additional insured is a named insured. The Insurer has no duty to defend or indemnify an additional insured under this endorsement until the Insurer receives written notice of a claim from the additional insured. VII. Solely with respect to the insurance granted by this endorsement, the section entitled DEFINITIONS is amended to add the following definition: Written contract means a written contract or written agreement that requires you to make a person or organization an additional insured on this coverage part, provided the contract or agreement: A. is currently in effect or becomes effective during the term of this policy; and B. was executed prior to: 1. the bodily injury or property damage; or 2. the offense that caused the personal and advertising injury; for which the additional insured seeks coverage. Any coverage granted by this endorsement shall apply solely to the extent permissible by law. All other terms and conditions of the Policy remain unchanged. This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. CNA75079XX (10-16) POLICY NUMBER: 6050490317 EFFECTIVE DATE: 12/31/2019 INSURED: CAROLLO ENGINEERS, INC. INSURANCE COMPANY: The Continental Insurance Co. Attachment Code: D573129 Certificate ID: 16520972 DocuSign Envelope ID: CE5245AF-122A-4D61-836D-FD0883C0D554 Named Insured: Carollo Engineers, Inc. Policy Number: 6050490267 Effective Date: 12/31/2019 ADDITIONAL INSURED – PRIMARY AND NON-CONTRIBUTORY It is understood and agreed that this endorsement amends the BUSINESS AUTO COVERAGE FORM as follows: SCHEDULE Name of Additional Insured Persons Or Organizations ANY PERSON OR ORGANIZATION ON WHOSE BEHALF YOU ARE REQUIRED UNDER A WRITTEN CONTRACT OR AGREEMENT. 1. In conformance with paragraph A.1.c. of Who Is An Insured of Section II – LIABILITY COVERAGE, the person or organization scheduled above is an insured under this policy. 2. The insurance afforded to the additional insured under this policy will apply on a primary and non- contributory basis if you have committed it to be so in a written contract or written agreement executed prior to the date of the "accident" for which the additional insured seeks coverage under this policy. All other terms and conditions of the Policy remain unchanged. CNA 71527XX (Ed. 10/12) Attachment Code: D573125 Certificate ID: 16520972 DocuSign Envelope ID: CE5245AF-122A-4D61-836D-FD0883C0D554 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 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 CERTIFICATE OF LIABILITY INSURANCE Lockton Companies 444 W. 47th Street, Suite 900 Kansas City MO 64112-1906 (816) 960-9000 CAROLLO ENGINEERS, INC. 2795 MITCHELL DR. WALNUT CREEK CA 94598-1601 American Casualty Company of Reading, PA 20427 Continental Casualty Company 20443 The Continental Insurance Company 35289 National Fire Insurance Co of Hartford 20478 Valley Forge Insurance Company 20508 X X 1,000,000 1,000,000 25,000 1,000,000 2,000,000 2,000,000 X X X 1,000,000 XXXXXXX XXXXXXX XXXXXXX DED: COMP/COLL 1,000 XXXXXXX XXXXXXX XXXXXXX N X X 1,000,000 1,000,000 1,000,000 PROFESSIONAL LIABILITY UNLIMITED PRIOR ACTS EACH CLAIM: $1,000,000; AGGREGATE: $1,000,000 E 6050490267 12/31/2019 12/31/2020 A 6050490317 12/31/2019 12/31/2020 D AEH 288354410 7/4/2019 7/4/2020 B WC 6050490270 12/31/2019 12/31/2020 C WC 6050490298 12/31/2019 12/31/2020 NOT APPLICABLE 7/4/2020 1472613 Y N Y N N 4/13/2020 N N 16520972 16520972 XXXXXXX CITY OF FORT COLLINS P.O. BOX 580 FORT COLLINS CO 80522 THIS CERTIFICATE SUPERSEDES ALL PREVIOUSLY ISSUED CERTIFICATES FOR THIS HOLDER, APPLICABLE TO THE CARRIERS LISTED AND THE POLICY TERM(S) REFERENCED. 8115 ENGINEERING SERVICES FOR WATER RECLAMATION AND BIOSOLIDS FACILITY DESIGN & CONSTRUCTION SERVICES. CAROLLO PROJECT #: 10103A.00. CITY OF FORT COLLINS, ITS OFFICERS, AGENTS AND EMPLOYEES ARE ADDITIONAL INSUREDS AS RESPECTS GENERAL LIABILITY, AS REQUIRED BY WRITTEN CONTRACT. X See Attachments DocuSign Envelope ID: CE5245AF-122A-4D61-836D-FD0883C0D554