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HomeMy WebLinkAboutCORRESPONDENCE - RFP - 9071 CONSTRUCTION SERVICES FOR HALLIGAN WATER SUPPLY PROJECTUtilities Work Order Form Official Purchasing Form Last updated 10/2017 WORK ORDER PURSUANT TO A MASTER AGREEMENT BETWEEN THE CITY OF FORT COLLINS AND DRAGADOS-PULICE JOINT VENTURE WORK ORDER NUMBER: D-HWSP-2020-07 PROJECT TITLE: Halligan Project 01 – Kick-off Partnering & Planning ORIGINAL BID/RFP NUMBER & NAME: 9071 Halligan Water Supply Project MASTER AGREEMENT EFFECTIVE DATE: June 22, 2020 ARCHITECT/ENGINEER: NA OWNER’S REPRESENTATIVE: Linsey Chalfant WORK ORDER COMMENCEMENT DATE: July 15, 2020 WORK ORDER COMPLETION DATE: October 31, 2020 MAXIMUM FEE: (time and reimbursable direct costs): $38,135.00 PROJECT DESCRIPTION/SCOPE OF SERVICES: Scope of work for work order 01 includes kick-off partnering and planning. 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 eleven (11) pages are hereby accepted and incorporated herein, by this reference, and Notice to Proceed is hereby given after all parties have signed this document. SERVICE PROVIDER: Dragados-Pulice Joint Venture By: Date: Name: Title: Page 1 of 16 DocuSign Envelope ID: 39D9ABDE-0D3B-438A-A58B-B3B231ED42FE Executive VP July 14, 2020 Ramon Fiuza Steve Campbell July 14, 2020 CMGC Advisor 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: Linsey Chalfant, Civil Engineer III REVIEWED: Date: Pat Johnson, Senior Buyer REQUISITION ENTERED BY: Date: Melissa Walker, Coordinator, Finance ACCEPTANCE: Date: Matt Fater, Director, Civil Engineering ACCEPTANCE: Date: Andrew Gingerich, Interim Deputy Director, Water Engineering & Field Services ACCEPTANCE: ACCEPTANCE: Date: ACCEPTANCE: Date: Gerry Paul, Purchasing Director (if greater than $60,000) ACCEPTANCE: Date: Darin Atteberry, City Manager (if greater than $1,000,000) ATTEST: Date: City Clerk (if greater than $1,000,000) Page 2 of 16 Eileen Dornfest, Halligan Project Manager Carol Webb, Deputy Director, Water Resources & Treatment Operations Date: DocuSign Envelope ID: 39D9ABDE-0D3B-438A-A58B-B3B231ED42FE July 13, 2020 July 14, 2020 July 14, 2020 July 15, 2020 July 14, 2020 July 16, 2020 July 15, 2020 Utilities Work Order Form Official Purchasing Form Last updated 10/2017 ATTACHMENT A WORK ORDER COST OF SERVICES Page 3 of 16 DocuSign Envelope ID: 39D9ABDE-0D3B-438A-A58B-B3B231ED42FE 555 Anton Blvd. Suite 1000 | Costa Mesa, CA. 92626 | Phone: (949) 490-1800 June 17, 2020 City of Fort Collins Water Engineering Capital Projects 700 Wood Street Fort Collins, CO 80522 Attention: Linsey R. Chalfant Subject: Work Order #1 Dear Linsey, Dragados-Pulice Joint Venture has reviewed the scope of work for Work Order #1 Kick-off Partnering / Planning and proposes an allowance of $38,135.00; see Attachment 1. A high level schedule for this work order tasks is included as Attachment 2. If you have questions, please contact us. Sincerely, Dragados-Pulice Joint Venture Manuel Morejon Project Manager Attachments: (1) Green Sheets (2) Schedule Page 4 of 16 DocuSign Envelope ID: 39D9ABDE-0D3B-438A-A58B-B3B231ED42FE PROJECT: Proposal Date: Code: 9071 PWO: 1 WO #: 1 Pay Est.: Description: Qty: Unit: Unit Price: Total $: Item 1: $ - $ 7,650.00 Item 2: $ - $ 3,000.00 Item 3: $ - $ 2,370.00 Item 4: $ - $ 9,495.00 Item 5: $ - $ 1,460.00 Item 6: $ - $ 3,800.00 Item 7: $ - $ 3,000.00 Item 8: $ - $ 7,360.00 Item 9: $ - $ - Item 10: $ - $ - Item 11: $ - $ - Item 12: $ - $ - Item 13: $ - $ - Item 14: $ - $ - Item 15: $ - $ - Item 16: $ - $ - Item 17: $ - $ - Item 18: $ - $ - Item 19: $ - $ - Item 20: $ - $ - Total: Partnering / Planning $ 38,135.00 Other Coordination Schedule Review Drilling Plan Input/Review Onboarding-review Miscelaneous Documents or Information Preparation for Work Order #2 - Summer Drilling Operations Halligan Water Supply Project COST BREAKDOWN Partnering Kick-Off Meeting (Video-Call July 15, 16 or 17) Weekly 1 hour Meetings Bi-weekly Technical Meetings 6/8/2020 Overall Description: Partnering / Planning Page 5 of 16 Revised: 7/14/17 DocuSign Envelope ID: 39D9ABDE-0D3B-438A-A58B-B3B231ED42FE PROJECT: Proposal Date: Work Date: Code: 9071 PWO: 1 WO #: 1 Pay Est.: PRODUCTION UNITS : UOM: STAFF REG OT CODE TITLE NAME HOURS RATE RATE TOTAL ST01 Project Manager Manuel Morejon 6 250 250 $ 1,500.00 ST02 Senior Technical AdvisorRafael Ibáñez 6 230 230 $ 1,380.00 ST03 Dam Construction ExpertDwain Sanders 6 220 220 $ 1,320.00 ST05 Senior Project Engineer Stanley Ellis, PE 6 165 165 $ 990.00 ST12 CMGC Advisor Steve Campbell 6 250 250 $ 1,500.00 ST07 Safety Manager Lisa Orgera 6 160 160 $ 960.00 STAFF SUBTOTAL $ 7,650.00 REIMBURSABLE EXPENSES TYPE UNIT RATE REIMBURSABLE EXPENSES SUBTOTAL $ - LABOR REG REG OT DT OT DT Craft DESCRIPTION HOURS RATE RATE RATE TOTAL LABOR SUBTOTAL $ - 0% LABOR SURCHARGE $ - LABOR TOTAL $ - SUBCONTRACTOR UNIT RATE $ - SUBCONTRACTOR SUBTOTAL $ - EQUIPMENT REG OT HOURS RATE RATE TOTAL EQUIPMENT SUBTOTAL $ - HAUL UNIT RATE $ - TRUCKING SUBTOTAL $ - MATERIALS OR SUPPLIERS UNIT RATE $ - $ - $ - OUTSIDE MATERIALS SUBTOTAL $ - NOTES: 18% LABOR MARKUP $ - 18% EQUIPMENT & MATERIALS MARKUP $ - 18% SUBCONTRACT MARKUP $ - 3% BOND AND INSURANCE MARKUP $ - TOTAL WORK $ 7,650.00 UNIT PRICE WORK $ - Signed (Contractors Representative) Signed (City Representative) QTY OT HOURS QTY QTY DESCRIPTION DESCRIPTION QTY Halligan Water Supply Project COST BREAKDOWN PROJECT: Proposal Date: Work Date: Code: 9071 PWO: 1 WO #: 1 Pay Est.: PRODUCTION UNITS : UOM: STAFF REG OT CODE TITLE NAME HOURS RATE RATE TOTAL ST01 Project Manager Manuel Morejon 12 250 250 $ 3,000.00 STAFF SUBTOTAL $ 3,000.00 REIMBURSABLE EXPENSES TYPE UNIT RATE REIMBURSABLE EXPENSES SUBTOTAL $ - LABOR REG REG OT DT OT DT Craft DESCRIPTION HOURS RATE RATE RATE TOTAL LABOR SUBTOTAL $ - 0% LABOR SURCHARGE $ - LABOR TOTAL $ - SUBCONTRACTOR UNIT RATE $ - SUBCONTRACTOR SUBTOTAL $ - EQUIPMENT REG OT HOURS RATE RATE TOTAL EQUIPMENT SUBTOTAL $ - HAUL UNIT RATE $ - TRUCKING SUBTOTAL $ - MATERIALS OR SUPPLIERS UNIT RATE $ - $ - $ - OUTSIDE MATERIALS SUBTOTAL $ - NOTES: 18% LABOR MARKUP $ - 18% EQUIPMENT & MATERIALS MARKUP $ - 18% SUBCONTRACT MARKUP $ - 3% BOND AND INSURANCE MARKUP $ - TOTAL WORK $ 3,000.00 UNIT PRICE WORK $ - Signed (Contractors Representative) Signed (City Representative) QTY Halligan Water Supply Project COST BREAKDOWN HOURS 6/8/2020 Item 2 Description: Weekly 1 hour Meetings OT DESCRIPTION QTY DESCRIPTION QTY OT DESCRIPTION HOURS HOURS DESCRIPTION QTY PROJECT: Proposal Date: Work Date: Code: 9071 PWO: 1 WO #: 1 Pay Est.: PRODUCTION UNITS : UOM: STAFF REG OT CODE TITLE NAME HOURS RATE RATE TOTAL ST01 Project Manager Manuel Morejon 0 250 250 $ - ST02 Senior Technical Advisor Rafael Ibáñez 6 230 230 $ 1,380.00 ST05 Senior Project Engineer Stanley Ellis, PE 6 165 165 $ 990.00 STAFF SUBTOTAL $ 2,370.00 REIMBURSABLE EXPENSES TYPE UNIT RATE REIMBURSABLE EXPENSES SUBTOTAL $ - LABOR REG REG OT DT OT DT Craft DESCRIPTION HOURS RATE RATE RATE TOTAL LABOR SUBTOTAL $ - 0% LABOR SURCHARGE $ - LABOR TOTAL $ - SUBCONTRACTOR UNIT RATE $ - SUBCONTRACTOR SUBTOTAL $ - EQUIPMENT REG OT HOURS RATE RATE TOTAL EQUIPMENT SUBTOTAL $ - HAUL UNIT RATE $ - TRUCKING SUBTOTAL $ - MATERIALS OR SUPPLIERS UNIT RATE $ - $ - $ - OUTSIDE MATERIALS SUBTOTAL $ - NOTES: 18% LABOR MARKUP $ - 18% EQUIPMENT & MATERIALS MARKUP $ - 18% SUBCONTRACT MARKUP $ - 3% BOND AND INSURANCE MARKUP $ - TOTAL WORK $ 2,370.00 UNIT PRICE WORK $ - Signed (Contractors Representative) Signed (City Representative) QTY Halligan Water Supply Project COST BREAKDOWN HOURS 6/8/2020 Item 3 Description: Bi-weekly Technical Meetings OT DESCRIPTION QTY HOURS DESCRIPTION QTY DESCRIPTION QTY PROJECT: Proposal Date: Work Date: Code: 9071 PWO: 1 WO #: 1 Pay Est.: PRODUCTION UNITS : UOM: STAFF REG OT CODE TITLE NAME HOURS RATE RATE TOTAL ST01 Project Manager Manuel Morejon 10 250 250 $ 2,500.00 ST02 Senior Technical Advisor Rafael Ibáñez 10 230 230 $ 2,300.00 ST03 Dam Construction ExpertDwain Sanders 1 220 220 $ 220.00 ST05 Senior Project Engineer Stanley Ellis, PE 1 165 165 $ 165.00 ST06 Quality Manager Tom Reynoldson 1 175 175 $ 175.00 ST07 Safety Manager Lisa Orgera 1 160 160 $ 160.00 ST08 Environmental Manager Jason Phillips 1 175 175 $ 175.00 STAFF SUBTOTAL $ 5,695.00 REIMBURSABLE EXPENSES TYPE UNIT RATE Allowance ALL $ 2,000.00 $ 2,000.00 Allowance ALL $ 500.00 $ 500.00 Allowance ALL $ 1,000.00 $ 1,000.00 Allowance ALL $ 300.00 $ 300.00 REIMBURSABLE EXPENSES SUBTOTAL $ 3,800.00 LABOR REG REG OT DT OT DT Craft DESCRIPTION HOURS RATE RATE RATE TOTAL LABOR SUBTOTAL $ - 0% LABOR SURCHARGE $ - LABOR TOTAL $ - SUBCONTRACTOR UNIT RATE $ - SUBCONTRACTOR SUBTOTAL $ - EQUIPMENT REG OT HOURS RATE RATE TOTAL EQUIPMENT SUBTOTAL $ - HAUL UNIT RATE $ - TRUCKING SUBTOTAL $ - MATERIALS OR SUPPLIERS UNIT RATE $ - $ - $ - OUTSIDE MATERIALS SUBTOTAL $ - NOTES: 18% LABOR MARKUP $ - 18% EQUIPMENT & MATERIALS MARKUP $ - 18% SUBCONTRACT MARKUP $ - 3% BOND AND INSURANCE MARKUP $ - TOTAL WORK $ 9,495.00 UNIT PRICE WORK $ - Signed (Contractors Representative) Signed (City Representative) QTY Halligan Water Supply Project COST BREAKDOWN HOURS PROJECT: Proposal Date: Work Date: Code: 9071 PWO: 1 WO #: 1 Pay Est.: PRODUCTION UNITS : UOM: STAFF REG OT CODE TITLE NAME HOURS RATE RATE TOTAL ST01 Project Manager Manuel Morejon 4 250 250 $ 1,000.00 ST02 Senior Technical Advisor Rafael Ibáñez 2 230 230 $ 460.00 STAFF SUBTOTAL $ 1,460.00 REIMBURSABLE EXPENSES TYPE UNIT RATE REIMBURSABLE EXPENSES SUBTOTAL $ - LABOR REG REG OT DT OT DT Craft DESCRIPTION HOURS RATE RATE RATE TOTAL LABOR SUBTOTAL $ - 0% LABOR SURCHARGE $ - LABOR TOTAL $ - SUBCONTRACTOR UNIT RATE $ - SUBCONTRACTOR SUBTOTAL $ - EQUIPMENT REG OT HOURS RATE RATE TOTAL EQUIPMENT SUBTOTAL $ - HAUL UNIT RATE $ - TRUCKING SUBTOTAL $ - MATERIALS OR SUPPLIERS UNIT RATE $ - $ - $ - OUTSIDE MATERIALS SUBTOTAL $ - NOTES: 18% LABOR MARKUP $ - 18% EQUIPMENT & MATERIALS MARKUP $ - 18% SUBCONTRACT MARKUP $ - 3% BOND AND INSURANCE MARKUP $ - TOTAL WORK $ 1,460.00 UNIT PRICE WORK $ - Signed (Contractors Representative) Signed (City Representative) QTY Halligan Water Supply Project COST BREAKDOWN HOURS 6/8/2020 Item 5 Description: Schedule Review OT DESCRIPTION QTY HOURS DESCRIPTION QTY DESCRIPTION QTY DESCRIPTION PROJECT: Proposal Date: Work Date: Code: 9071 PWO: 1 WO #: 1 Pay Est.: PRODUCTION UNITS : UOM: STAFF REG OT CODE TITLE NAME HOURS RATE RATE TOTAL ST01 Project Manager Manuel Morejon 8 250 250 $ 2,000.00 ST02 Senior Technical Advisor Rafael Ibáñez 4 230 230 $ 920.00 ST03 Dam Construction ExpertDwain Sanders 4 220 220 $ 880.00 STAFF SUBTOTAL $ 3,800.00 REIMBURSABLE EXPENSES TYPE UNIT RATE REIMBURSABLE EXPENSES SUBTOTAL $ - LABOR REG REG OT DT OT DT Craft DESCRIPTION HOURS RATE RATE RATE TOTAL LABOR SUBTOTAL $ - 0% LABOR SURCHARGE $ - LABOR TOTAL $ - SUBCONTRACTOR UNIT RATE $ - SUBCONTRACTOR SUBTOTAL $ - EQUIPMENT REG OT HOURS RATE RATE TOTAL EQUIPMENT SUBTOTAL $ - HAUL UNIT RATE $ - TRUCKING SUBTOTAL $ - MATERIALS OR SUPPLIERS UNIT RATE $ - $ - $ - OUTSIDE MATERIALS SUBTOTAL $ - NOTES: 18% LABOR MARKUP $ - 18% EQUIPMENT & MATERIALS MARKUP $ - 18% SUBCONTRACT MARKUP $ - 3% BOND AND INSURANCE MARKUP $ - TOTAL WORK $ 3,800.00 UNIT PRICE WORK $ - Signed (Contractors Representative) Signed (City Representative) QTY Halligan Water Supply Project COST BREAKDOWN HOURS 6/8/2020 Item 6 Description: Drilling Plan Input/Review OT DESCRIPTION QTY HOURS DESCRIPTION QTY DESCRIPTION QTY PROJECT: Proposal Date: Work Date: Code: 9071 PWO: 1 WO #: 1 Pay Est.: PRODUCTION UNITS : UOM: STAFF REG OT CODE TITLE NAME HOURS RATE RATE TOTAL ST01 Project Manager Manuel Morejon 12 250 250 $ 3,000.00 STAFF SUBTOTAL $ 3,000.00 REIMBURSABLE EXPENSES TYPE UNIT RATE REIMBURSABLE EXPENSES SUBTOTAL $ - LABOR REG REG OT DT OT DT Craft DESCRIPTION HOURS RATE RATE RATE TOTAL LABOR SUBTOTAL $ - 0% LABOR SURCHARGE $ - LABOR TOTAL $ - SUBCONTRACTOR UNIT RATE $ - SUBCONTRACTOR SUBTOTAL $ - EQUIPMENT REG OT HOURS RATE RATE TOTAL EQUIPMENT SUBTOTAL $ - HAUL UNIT RATE $ - TRUCKING SUBTOTAL $ - MATERIALS OR SUPPLIERS UNIT RATE $ - $ - $ - OUTSIDE MATERIALS SUBTOTAL $ - NOTES: 18% LABOR MARKUP $ - 18% EQUIPMENT & MATERIALS MARKUP $ - 18% SUBCONTRACT MARKUP $ - 3% BOND AND INSURANCE MARKUP $ - TOTAL WORK $ 3,000.00 UNIT PRICE WORK $ - Signed (Contractors Representative) Signed (City Representative) QTY Halligan Water Supply Project COST BREAKDOWN HOURS 6/8/2020 Item 7 Description: Onboarding-review Miscelaneous Documents or Information OT DESCRIPTION QTY HOURS DESCRIPTION QTY DESCRIPTION QTY DESCRIPTION OT PROJECT: Proposal Date: Work Date: Code: 9071 PWO: 1 WO #: 1 Pay Est.: PRODUCTION UNITS : UOM: STAFF REG OT CODE TITLE NAME HOURS RATE RATE TOTAL ST01 Project Manager Manuel Morejon 16 250 250 $ 4,000.00 ST02 Senior Technical Advisor Rafael Ibáñez 8 230 230 $ 1,840.00 ST03 Dam Construction ExpertDwain Sanders 4 220 220 $ 880.00 ST07 Safety Manager Lisa Orgera 4 160 160 $ 640.00 STAFF SUBTOTAL $ 7,360.00 REIMBURSABLE EXPENSES TYPE UNIT RATE REIMBURSABLE EXPENSES SUBTOTAL $ - LABOR REG REG OT DT OT DT Craft DESCRIPTION HOURS RATE RATE RATE TOTAL LABOR SUBTOTAL $ - 0% LABOR SURCHARGE $ - LABOR TOTAL $ - SUBCONTRACTOR UNIT RATE $ - SUBCONTRACTOR SUBTOTAL $ - EQUIPMENT REG OT HOURS RATE RATE TOTAL EQUIPMENT SUBTOTAL $ - HAUL UNIT RATE $ - TRUCKING SUBTOTAL $ - MATERIALS OR SUPPLIERS UNIT RATE $ - $ - $ - OUTSIDE MATERIALS SUBTOTAL $ - NOTES: 18% LABOR MARKUP $ - 18% EQUIPMENT & MATERIALS MARKUP $ - 18% SUBCONTRACT MARKUP $ - 3% BOND AND INSURANCE MARKUP $ - TOTAL WORK $ 7,360.00 UNIT PRICE WORK $ - Signed (Contractors Representative) Signed (City Representative) QTY Halligan Water Supply Project COST BREAKDOWN HOURS 6/8/2020 Item 8 Description: Preparation for Work Order #2 - Summer Drilling Operations OT DESCRIPTION QTY HOURS DESCRIPTION QTY Utilities Work Order Form Official Purchasing Form Last updated 10/2017 ATTACHMENT B WORK ORDER SCHEDULE OF SERVICES Page 14 of 16 DocuSign Envelope ID: 39D9ABDE-0D3B-438A-A58B-B3B231ED42FE ID WBS Name Duration Start Finish Predecessors 0 0 HALLIGAN WATER SUPPLY PROJECT 54 daysWed 6/17/20 Mon 8/31/20 1 1 WORK ORDER #1 PARTNERING / PLANNING 54 days Wed 6/17/20 Mon 8/31/20 2 1.1 Partnering Kick-Off Meeting (Video-Call July 15, 16 or 17) 3 days Wed 7/15/20 Fri 7/17/20 3 1.2 Weekly 1 hour Meetings 54 days Wed 6/17/20 Mon 8/31/20 4 1.3 Bi-weekly Technical Meetings 54 days Wed 6/17/20 Mon 8/31/20 5 1.4 Other Coordination 54 days Wed 6/17/20 Mon 8/31/20 6 1.5 Schedule Review 1 day Tue 7/7/20 Tue 7/7/20 7 1.6 Drilling Plan Input/Review 1 day Wed 7/15/20 Wed 7/15/20 8 1.7 Onboarding-review Miscelaneous Documents or Information 2 days Thu 6/25/20 Fri 6/26/20 9 1.8 Preparation for Work Order #2 - Summer Drilling Operations 2 days Tue 8/4/20 Wed 8/5/20 15 22 29 6 13 20 27 3 10 17 24 31 7 June July August 2020 9071 Contractor Services for Halligan Water Supply Project DATE: 06-17-2020. SCHEDULE 1 / 1 Page 15 of 16 DocuSign Envelope ID: 39D9ABDE-0D3B-438A-A58B-B3B231ED42FE Utilities Work Order Form Official Purchasing Form Last updated 10/2017 ATTACHMENT C CERTIFICATE OF INSURANCE CONTRACTOR shall submit Certificate of Insurance in compliance with the Contract Documents. Page 16 of 16 DocuSign Envelope ID: 39D9ABDE-0D3B-438A-A58B-B3B231ED42FE Holder Identifier : 7777777707070700077763616065553330742516667305577407762315770625032071741557376120100777070423275733107237150310071200077404113126347500772621337443657407362031772036710077727252025773110777777707000707007 6666666606060600062606466204446200600222424006222206000226260060222060020262620402200600002626024222206022206062262000062002042622402200622200424204000206020026260002400066646062240664440666666606000606006 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 07/11/2020 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). 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. PRODUCER Aon Risk Services Northeast, Inc. New York NY Office One Liberty Plaza 165 Broadway, Suite 3201 New York NY 10006 USA PHONE (A/C. No. Ext): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # (212) 441-1000 INSURED INSURER A: Liberty Insurance Corporation 42404 INSURER B: XL Insurance America Inc 24554 INSURER C: INSURER D: INSURER E: INSURER F: FAX (A/C. No.): CONTACT NAME: Dragados-Pulice Joint Venture 555 Anton Blvd, Suite 1000 Costa Mesa CA 92626 USA COVERAGES CERTIFICATE NUMBER: 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested POLICY EXP (MM/DD/YYYY) POLICY EFF (MM/DD/YYYY) SUBR WVD INSR LTR ADDL TYPE OF INSURANCE INSD POLICY NUMBER LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR POLICY LOC EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY Excess Liability Program AGENCY CUSTOMER ID: ADDITIONAL REMARKS SCHEDULE LOC #: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance EFFECTIVE DATE: CARRIER NAIC CODE POLICY NUMBER AGENCY NAMED INSURED See Certificate Number: See Certificate Number: Aon Risk Services Northeast, Inc. 980000043978 Page _ of _ Dragados USA Inc XL Insurance America Inc Policy No.US00084611LI20A $5,000,000 each occurrence/aggregate excess of underlying General Liability, Auto Liability & Workers Compensation The Ohio Casualty Insurance Company Policy No. ECO2158726153 $15,000,000 each occurrence/aggregate excess of $5,000,000 Primary Excess ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID: 39D9ABDE-0D3B-438A-A58B-B3B231ED42FE GENERAL AGGREGATE PRODUCTS - COMP/OP AGG X X X X GEN'L AGGREGATE LIMIT APPLIES PER: $5,000,000 $1,000,000 $10,000 $5,000,000 $10,000,000 $10,000,000 A TB7611B6N3Q4030 06/01/2020 06/01/2021 PRO- JECT OTHER: AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY SCHEDULED AUTOS HIRED AUTOS ONLY NON-OWNED AUTOS ONLY BODILY INJURY ( Per person) PROPERTY DAMAGE (Per accident) X X BODILY INJURY (Per accident) $2,000,000 A 06/01/2020 06/01/2021 Comp/Coll $5000 COMBINED SINGLE LIMIT (Ea accident) AS7-611-B6N3Q4-020 EXCESS LIAB X OCCUR CLAIMS-MADE AGGREGATE EACH OCCURRENCE DED $5,000,000 $5,000,000 UMBRELLA LIAB 06/01/2020 B US00084611LI20A 06/01/2021 RETENTION X E.L. DISEASE-EA EMPLOYEE E.L. DISEASE-POLICY LIMIT E.L. EACH ACCIDENT $1,000,000 X OTH- ER A 06/01/2020 06/01/2021 PER STATUTE $1,000,000 Y / N (Mandatory in NH) ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED? N N / A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY If yes, describe under DESCRIPTION OF OPERATIONS below $1,000,000 WC7611B6N3Q4010 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Halligan Water Supply Project. The Landowners’ Association for Phantom Canyon Ranches, Calloway Hill Preserve, LLC, Geo. A. Henderson Co., Inc., and Chris Vandemoer, James R. and Nancy E. Carpenter, City of Fort Collins, The Nature Conservancy and North Poudre Irrigation Company are included as Additional Insured in accordance with the policy provisions of the General Liability and Automobile Liability policies as required by written contract. City of Fort Collins is granted a Waiver of Subrogation as respects the General Liability, Auto Liability, Workers Compensation and Excess Liability in accordance with the policy provisions. CERTIFICATE HOLDER CANCELLATION CityREPRESENTATIVE of Fort Collins AUTHORIZED Attn: City's Purchasing Director P. O. Box 580 Fort Collins, Colorado 80522 USA ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. DocuSign Envelope ID: 39D9ABDE-0D3B-438A-A58B-B3B231ED42FE DESCRIPTION QTY DESCRIPTION OT HOURS 1. PM and other Technical K-Staff reviewing Drilling Plan 2. 3. 4. 5. 6. 7. 8. 9. 10. Page 13 of 16 DocuSign Envelope ID: 39D9ABDE-0D3B-438A-A58B-B3B231ED42FE HOURS 1. PM's hours reviewing Project Doc/Info 2. 3. 4. 5. 6. 7. 8. 9. 10. Page 12 of 16 DocuSign Envelope ID: 39D9ABDE-0D3B-438A-A58B-B3B231ED42FE DESCRIPTION OT HOURS 1. AECOM Drilling Plan review and input (report) 2. 3. 4. 5. 6. 7. 8. 9. 10. Page 11 of 16 DocuSign Envelope ID: 39D9ABDE-0D3B-438A-A58B-B3B231ED42FE OT HOURS 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 1. AECOM schedule review 2. 3. 4. 5. 6. 7. 8. 9. 10. Page 10 of 16 DocuSign Envelope ID: 39D9ABDE-0D3B-438A-A58B-B3B231ED42FE 6/8/2020 Item 4 Description: Other Coordination OT DESCRIPTION QTY HOURS DESCRIPTION QTY DESCRIPTION QTY DESCRIPTION OT HOURS Reproduction Cost 1 Airfare 1 Car Rental and Fuel 1 Hotel/Lodging/Meals 1 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 1. PM and Senior Technical Advisor: 10 hours for other coordination subjects 2. Other K-Staff: 1 hours for other coordination subjects 3. Estimated 1 jobsite visit of PM and Senior Technical Adivsor 4. 5. 6. 7. 8. 9. 10. Page 9 of 16 DocuSign Envelope ID: 39D9ABDE-0D3B-438A-A58B-B3B231ED42FE DESCRIPTION OT HOURS 1. June, July and August: 12 weeks, 6 technical meetings 2. Via Teleconference 3. Manuel's time in item 3, weekly meetings 4. Rafael and Stan initially considered to attend these meetings 5. 6. 7. 8. 9. 10. Page 8 of 16 DocuSign Envelope ID: 39D9ABDE-0D3B-438A-A58B-B3B231ED42FE 1. June, July and August: 12 weeks 2. Via Teleconference 3. 4. 5. 6. 7. 8. 9. 10. Page 7 of 16 DocuSign Envelope ID: 39D9ABDE-0D3B-438A-A58B-B3B231ED42FE 6/8/2020 Partnering Kick-Off Meeting (Video-Call July 15, 16 or 17) Item 1 Description: HOURS OT HOURS DESCRIPTION DESCRIPTION 1. Kick-Off Partnering Via Teleconference, 3 days x 2 hours x 5 K-personnel 2. 3. 4. 5. 6. 7. 8. 9. 10. Page 6 of 16 DocuSign Envelope ID: 39D9ABDE-0D3B-438A-A58B-B3B231ED42FE