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CORRESPONDENCE - PURCHASE ORDER - 9201149
CONSTRUCTION WORK ORDER FOR 9005 HAIL DAMAGE ROOF REPLACEMENT AND REPAIR PROJECT WORK ORDER NO. 6 TITLED 835 WOOD STREET ROOF REPLACEMENT DATE: June 29, 2020 CONTRACTOR: AAA Roofing and Construction, LLC DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 TABLE OF CONTENTS AGREEMENT FORMS 00525 Work Order & Notice of Award 00530 Work Order Notice to Proceed 00600 Bonds and Certificates 00610 Performance Bond 00615 Payment Bond 00630 Certificate of Insurance 00635 Certificate of Substantial Completion 00640 Certificate of Final Acceptance 00650 Lien Waiver Release (CONTRACTOR) 00651 Lien Waiver Release (SUBCONTRACTOR) 00660 Consent of Surety 00670 Application for Exemption Certificate CONDITIONS OF THE CONTRACT 00700 General Conditions Exhibit GC-A GC-A1 - GC-A2 00800 Supplementary Conditions 00900 Addenda, Modifications and Payment 00950 Work Order Change Order Form 00960 Application for Payment DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 SECTION 00500 CONSTRUCTION WORK ORDER AGREEMENT FORMS 00525 Work Order, Notice of Award & Bid Schedule 00530 Work Order Notice to Proceed DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 SECTION 00525 WORK ORDER, NOTICE OF AWARD AND BID SCHEDULE TO: AAA Roofing and Construction, LLC (hereinafter referred to as CONTRACTOR) WORK ORDER # & TITLE: Work Order 6 - 835 Wood Street Roof Replacement PURCHASE ORDER: ORIGINAL BID/RFP # & TITLE: 9005 Hail Damage Roof Replacement and Repair Project ENGINEER: Brian Hergott OWNER’S REPRESENTATIVE: Matt Schaefer NOTICE OF AWARD DATE: June 29, 2020 OWNER: City of Fort Collins (hereinafter referred to as OWNER) 1. WORK. You are hereby notified that your bid dated June 12, 2020, for the above Work Order has been considered. Pursuant to your AGREEMENT with OWNER dated December 15, 2019, you have been awarded a Work Order for this Work Order Description: A. Project Description: Roof replacement at Fleet Service Facility – 835 Wood Street. B. Scope of Services: Contractor shall complete all Work as specified in this agreement for the roof replacement of buildings located at 835 Wood Street. Work shall include all necessary labor, materials, and equipment (except items provided by Owner) to complete the work. The Contractor shall furnish the City of Fort Collins with a performance and payment bond along with builder’s risk insurance and provide the Owner with a certificate of insurance with the correct limits. The Scope of Work has been altered from the document developed by Unified Building Science (UBS) as published with RFP 9005. The altered scope of work requires an overlany of existing roof with ISO flute filler insultation, cover board and TPO membrane. 2. CONTRACT PRICE, BONDS AND CERTIFICATES. The price of your Work Order is One Hundred Forty-Six Thousand Two Hundred Forty Six Dollars and Seven Cents ($146,246.07). Pursuant to the AGREEMENT and the Contract Documents, Performance and Payment Bonds and insurance are required. 3. CONTRACT TIMES. Pursuant to the AGREEMENT and the Contract Documents, the date for Substantial Completion of this Work Order is August 31, 2020, and after Substantial Completion, the date for Final Completion is September 30, 2020. 4. LIQUIDATED DAMAGES. OWNER and CONTRACTOR recognize that time is of the essence of this Agreement and that OWNER will suffer financial loss if the Work is not completed within the times specified in paragraph 3 above, plus any extensions thereof allowed in accordance with Article 12 of the General Conditions. They also recognize the DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 delays, expenses and difficulties involved in proving in a legal proceeding the actual loss suffered by OWNER if the Work is not completed on time. Accordingly, instead of requiring any such proof, OWNER and CONTRACTOR agree that as liquidated damages for delay (but not as penalty) CONTACTOR shall pay OWNER the amounts set forth hereafter. 1) Substantial Completion: Five Hundred ($500) for each calendar day or fraction thereof that expires after August 31, 2020 until the work is Substantially Complete. 2) Final Acceptance: After Substantial Completion Three Hundred ($300) for each calendar day or fraction thereof that expires after the 30 calendar day period for Final Payment and Acceptance until the Work is ready for Final Payment and Acceptance. 5. PAYMENT PROCEDURES. CONTRACTOR shall submit Applications for Payment in accordance with Article 14 of the General Conditions. Applications for Payment will be processed by ENGINEER as provided in the General Conditions. 5.1 PROGRESS PAYMENTS. OWNER shall make progress payments on account of the Contract Price on the basis of CONTRACTOR's Application for Payment as recommended by ENGINEER, once each month during construction as provided below. All progress payments will be on the basis of the progress of the Work measured by the schedule of values established in paragraph 2.6 of the General Conditions and in the case of Unit Price Work based on the number of units completed, and in accordance with the General Requirements concerning Unit Price Work. 5.1.1 Prior to Substantial Completion, Owner will be entitled to withhold as contract retainage five percent (5%) of each progress payment, but, in each case, less the aggregate of payments previously made and less such amounts as ENGINEER shall determine, or OWNER may withhold, in accordance with paragraph 14.7 of the General Conditions. If , in the sole discretion of Owner, on recommendation of Engineer, Owner determines that the character and progress of the Work have been satisfactory to OWNER and ENGINEER, OWNER may determine that as long as the character and progress of the Work remain satisfactory to them, there will be no additional retainage on account of Work completed in which case the remaining progress payments prior to Substantial Completion will be in an amount equal to 100% of the Work completed. 95% of materials and equipment not incorporated in the Work (but delivered, suitably stored and accompanied by documentation satisfactory to OWNER as provided in paragraph 14.2 of the General Conditions) may be included in the application Section 00520 Page 3 for payment. 5.1.2 Upon Substantial Completion payment will be made in an amount sufficient, if necessary, to increase total payments to CONTRACTOR to 95% of the Contract Price, less such amounts as ENGINEER shall determine or OWNER may withhold in accordance with paragraph 14.7 of the General Conditions or as provided by law. 5.2 FINAL PAYMENT. Upon Final Completion and Acceptance of the Work in accordance with paragraph 14.13 of the General Conditions, OWNER shall DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 pay the remainder of the Contract Price as recommended by ENGINEER as provided in said paragraph 14.13. 6. CONTRACTOR'S REPRESENTATION. In order to induce OWNER to enter into this Agreement, CONTRACTOR makes the following representations: 6.1 CONTRACTOR has familiarized himself with the nature and extent of the Contract Documents, Work, site, locality, and with all local conditions and Laws and Regulations that in any manner may affect cost, progress, performance or furnishing of the Work. 6.2 CONTRACTOR has studied carefully all reports of explorations and tests of subsurface conditions and drawings of physical conditions which are identified in the Supplementary Conditions as provided in paragraph 4.2 of the General Conditions. 6.3 CONTRACTOR has obtained and carefully studied (or assumes responsibility for obtaining and carefully studying) all such examinations, investigations, explorations, tests, reports, and studies (in addition to or to supplement those referred to in paragraph 6.2 above) which pertain to the subsurface or physical condition at or contiguous to the site or otherwise may affect the cost, progress, performance or furnishing of the Work as CONTRACTOR considers necessary for the performance or furnishing of the Work at the Contract Price, within the Contract Times and in accordance with the other terms and conditions of the Contract Documents, including specifically the provisions of paragraph 4.2 of the General Conditions; and no additional examinations, investigations, explorations, tests, reports, studies or similar information or data are or will be required by CONTRACTOR for such purposes. 6.4 CONTRACTOR has reviewed and checked all information and data shown or indicated on the Contract Documents with respect to existing Underground Facilities at or contiguous to the site and assumes responsibility for the accurate location of said Underground Facilities. No additional examinations, investigations, explorations, tests, reports, studies or similar information or data in respect of said Underground Facilities are or will be required by CONTRACTOR in order to perform and furnish the Work at the Contract Price, within the Contract Times and in accordance with the other terms and conditions of the Contract Documents, including specifically the provision of paragraph 4.3. of the General Conditions. 6.5 CONTRACTOR has correlated the results of all such observations, examinations, investigations, tests, reports and data with the terms and conditions of the Contract Documents. 6.6 CONTRACTOR has given CITY REPRESENTATIVE written notice of all conflicts, errors or discrepancies that he has discovered in the Contract Documents and the written resolution thereof by CITY REPRESENTATIVE is acceptable to CONTRACTOR. 7. CONTRACT DOCUMENTS. 7.1 The Contract Documents which comprise the entire Agreement between OWNER and CONTRACTOR concerning the Work consist of the General DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 Conditions, Supplementary Conditions, those items included in the definition of “Contract Documents” in Article 1.10 of the General Conditions, and such other items as are referenced in this Article 7, all of which are incorporated herein by this reference. 7.2 Forms for use by CONTRACTOR in performing the Work and related actions in carrying out the terms of this Agreement are deemed Contract Documents and incorporated herein by this reference, and include, but are not limited to, the following: 7.2.1 Certificate of Substantial Completion 7.2.2 Certificate of Final Acceptance 7.2.3 Lien Waiver Releases 7.2.4 Consent of Surety 7.2.5 Application for Exemption Certificate 7.2.6 Application for Payment 8. MISCELLANEOUS 8.1. Terms used in this Agreement which are defined in Article I of the General Conditions shall have the meanings indicated in the General Conditions. 8.2. No assignment by a party hereto of any rights under or interests in the Contract Documents will be binding on another party hereto without the written consent of the party sought to be bound; and specifically but not without limitations, moneys that may become due and moneys that are due may not be assigned without such consent (except to the extent that the effect of this restriction may be limited by law), and unless specifically stated to the contrary in any written consent to an assignment no assignment will release or discharge that assignor from any duty or responsibility under the Contract Document. 8.3. OWNER and CONTRACTOR each binds itself, its partners, successors, assigns and legal representatives to the other party hereto, its partners, successors, assigns and legal representatives in respect to all covenants, Agreement and obligations contained in the Contract Document. 9. EXECUTION. Work Order Documents must be executed in DocuSign within fifteen (15) calendar days of the date of this Notice of Award. Contractor shall attach Payment and Performance Bonds and Certificate of Insurance (COI) to the Work Order Document in DocuSign. In addition, one original set of executed Bonds and COI shall be provided to the Buyer. Failure to comply with these conditions within the time specified will entitle OWNER to consider your Bid abandoned and to annul this Work Order & Notice of Award. Within ten (10) days after you comply with those conditions, OWNER will return to you one (1) fully-signed counterpart of this Work Order with any amendments or supplements to the Contract Documents attached. DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 CONTRACTOR’S NOTICE OF AWARD REPRESENTATION & EXECUTION: CONTRACTOR agrees to perform the services identified above, in accordance with the terms and conditions contained herein and in the AGREEMENT dated December 15, 2019, and the NOTICE OF AWARD dated June 29, 2020, between the parties. In the event of a conflict between or ambiguity in the terms of the AGREEMENT or specific Work Orders, the AGREEMENT shall control. CONTRACTOR: AAA Roofing and Construction, LLC By: Date: Name: Title: DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 7/7/2020 Joshua Morales Owner OWNER’S ACCEPTANCE & EXECUTION: This Work Order and the attached Contract Documents are hereby accepted and incorporated herein by this reference and the attached Notice to Proceed is hereby given. ACCEPTANCE: ______________________________________ Date: ____________ Matt Schaefer, Project Manager REVIEWED: _________________________________________ Date: ____________ Jake Rector, Senior Buyer APPROVED AS TO FORM: _____________________________ Date: ____________ ACCEPTANCE: ______________________________________ Date: ____________ Gerry Paul, Purchasing Director (if greater than $60,000) ATTEST: ___________________________________________ Date: ____________ DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 7/7/2020 7/7/2020 Assistant City Attorney ll 7/7/2020 7/8/2020 7/8/2020 City Clerk SCOPE OF WORK AND BID SCHEDULE DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 1 CO_835_WOOD_ST General DESCRIPTION QNTY UNIT 1. Dumpster load - Approx. 12 yards, 1-3 tons of debris 1.00 EA 2. Telehandler/forklift (per week) 1.00 WK 3. Commercial Supervision / Project Management - per hour 40.00 HR Main Building Roof DESCRIPTION QNTY UNIT 4. Remove Additional charge for high roof (2 stories or greater) 196.62 SQ 5. Additional charge for high roof (2 stories or greater) 196.62 SQ 6. Clean with pressure/chemical spray 19,662.00 SF 7. Elastomeric roof primer 19,662.00 SF 8. Elastomeric roof coating - Rib roof 19,662.00 SF Exterior DESCRIPTION QNTY UNIT Damage to north metal panels was not from DOL Ice Skating Shed DESCRIPTION QNTY UNIT 9. Remove Laminated - comp. shingle rfg. - w/ felt 1.50 SQ 10. Laminated - comp. shingle rfg. - w/out felt 1.67 SQ 11. Roofing felt - 15 lb. 1.50 SQ 12. R&R Ridge cap - composition shingles 12.33 LF 13. R&R Drip edge 48.00 LF Santa Shed DESCRIPTION QNTY UNIT DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 2 CO_835_WOOD_ST Page: 2 CONTINUED - Santa Shed DESCRIPTION QNTY UNIT 14. Remove Laminated - comp. shingle rfg. - w/ felt 3.00 SQ 15. Laminated - comp. shingle rfg. - w/out felt 3.33 SQ 16. Roofing felt - 15 lb. 3.00 SQ 17. Roll roofing 0.72 SQ Valley 18. R&R Ridge cap - composition shingles 25.50 LF 19. R&R Drip edge 68.00 LF 20. R&R Roof vent - turtle type - Metal 2.00 EA 21. R&R Gutter / downspout - aluminum - up to 5" 10.00 LF 22. Prime & paint gutter / downspout 10.00 LF East Shed DESCRIPTION QNTY UNIT 23. Remove 3 tab - 25 yr. - composition shingle roofing - incl. felt 2.40 SQ 24. 3 tab - 25 yr. - comp. shingle roofing - w/out felt 2.67 SQ 25. Roofing felt - 15 lb. 2.40 SQ 26. R&R Ridge cap - composition shingles 20.00 LF 27. R&R Drip edge 20.00 LF 28. R&R Gutter / downspout - aluminum - up to 5" 29.00 LF 29. Prime & paint gutter / downspout 29.00 LF Shed at Spill Station DESCRIPTION QNTY UNIT 30. Remove 3 tab - 25 yr. - composition shingle roofing - incl. felt 1.60 SQ 31. 3 tab - 25 yr. - comp. shingle roofing - w/out felt 2.00 SQ 32. Roofing felt - 15 lb. 1.60 SQ 33. R&R Ridge cap - composition shingles 16.00 LF 34. R&R Drip edge 52.00 LF DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 Roof Replacement Proposal 835 Wood Street. Fort Collins, Colorado We appreciate the opportunity to earn your business. Our company strives for quality workmanship, competitive pricing, and complete customer satisfaction. The terms of the following roofing contract are valid for 30 days after date of issuance. SCOPE OF WORK: • Pull roofing permit and Performance bond (included) • Overlay existing metal roofs • Install ISO flute filler on Pro-panel • Install new ½” Dens Deck cover board mechanically fastened • Install new 24gauge C-channel at perimeter for reinforced edge • Install new 60mil GAF TPO Rhino Bonded into Purlins • Install drip edge, pipe boots, venting, and other roof accessories per local code • Remove and replace out building with Class 4 shingles and accessories • Remove and replace gutters and downspouts per insurance scope of work • Remove and replace furnace vent caps • Provide 5yr workmanship warranty, and 20yr NO DOLLAR LIMIT warranty from manufacturer, limited lifetime warranty on Owens corning shingles The above referenced job will be completed for $146,246.07 This price includes all material, labor, equipment, dump fees and Taxes to perform said job. Any additional work that is not stated in the contract will require a change order and an additional charge to the contract. This contract is between the owner(s) as described above and AAA Roofing & Construction, LLC. By signing below the Owner agrees to pay the amount quoted above for the work done as described in the Scope of Work per the payment terms described above and is authorizing commencement of work. There will be a 3% convenience charge fee of the total contract added to the price if customer is paying by any major Credit Card company. Schedule of work determined by availability of materials, acts of god, weather, etc. Please call with any questions 970-682-0010 First Owner Signature First Owner Printed Name Date Authorized Representative Authorized Representative Name Date AAA Roofing & Construction DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 1 AAA Roofing & Construction Roofing Contractor Client: City of Fort Collins Hail Roof Replacement Property: 835 Wood Street Fort Collins , CO 80521 Operator: JOSH Estimator: Joshua Morales Business: (970) 682-0010 E-mail: josh@aaaroofing- construction.com Company: AAA Roofing and Construction Business: 1326 Bowwood Ct Loveland, CO 80538 Type of Estimate: Hail Date Entered: 2/23/2020 Date Assigned: Date Est. Completed: 2/23/2020 Date Job Completed: Price List: COFC8X_SEP19 Labor Efficiency: Restoration/Service/Remodel Estimate: 2020-02-23-2027 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 2 AAA Roofing & Construction Roofing Contractor 2020-02-23-2027 6/12/2020 Page: 2 2020-02-23-2027 Overlay Main building DESCRIPTION QTY REMOVE REPLACE TAX TOTAL 1. Single ply membrane - 196.62 SQ 0.00 340.40 0.00 66,929.45 Mechanically attached - 60 mil 2. Additional charge for high roof (2 196.62 SQ 0.00 25.43 0.00 5,000.05 stories or greater) 3. R&R Aluminum termination bar / 80.00 LF 0.55 2.24 0.00 223.20 flashing for membrane roofs 4. Bid Item- Flute Filler 196.62 EA 0.00 69.75 0.00 13,714.25 5. Glass mat gypsum - 1/2" - primed 196.62 SQ 0.00 176.73 0.00 34,748.65 6. Drip edge - PVC/TPO clad metal 600.00 LF 0.00 4.19 0.00 2,514.00 7. Curb flashing - PVC/TPO 80.00 LF 0.00 16.33 0.00 1,306.40 8. R&R Flashing - pipe jack - split 10.00 EA 6.54 71.43 0.00 779.70 boot 9. 2" x 4" lumber - treated (.667 BF 600.00 LF 0.00 2.70 0.00 1,620.00 per LF) 10. Bid Item-C chanel 400.00 EA 0.00 4.00 0.00 1,600.00 11. Commercial Supervision / Project 80.00 HR 0.00 65.54 0.00 5,243.20 Management - per hour 12. Telehandler/forklift (per week) - 2.00 WK 0.00 1,166.20 0.00 2,332.40 no operator 13. Bid Item-Performance Bond 1.00 EA 0.00 3,251.78 0.00 3,251.78 14. Taxes, insurance, permits & fees 1.00 EA 0.00 1,901.10 0.00 1,901.10 (Bid Item) Totals: Overlay Main building 0.00 141,164.18 Out buildings DESCRIPTION QTY REMOVE REPLACE TAX TOTAL 15. Remove Laminated - comp. 1.50 SQ 51.97 0.00 0.00 77.96 shingle rfg. - w/ felt 16. Laminated - High grd - impact 2.00 SQ 0.00 290.62 0.00 581.24 resist shingle - w/ felt 17. Taxes, insurance, permits & fees 1.00 EA 0.00 183.00 0.00 183.00 (Bid Item) 18. R&R Ridge cap - composition 12.33 LF 2.53 4.06 0.00 81.25 shingles 19. R&R Drip edge 48.00 LF 0.31 2.16 0.00 118.56 20. Remove Laminated - comp. 3.00 SQ 51.97 0.00 0.00 155.91 shingle rfg. - w/ felt DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 3 AAA Roofing & Construction Roofing Contractor 2020-02-23-2027 6/12/2020 Page: 3 CONTINUED - Out buildings DESCRIPTION QTY REMOVE REPLACE TAX TOTAL 21. Laminated - High grd - impact 3.33 SQ 0.00 290.62 0.00 967.76 resist shingle - w/ felt 22. Remove Roll roofing 0.72 SQ 38.10 0.00 0.00 27.43 23. R&R Ridge cap - composition 25.50 LF 2.53 4.06 0.00 168.05 shingles 24. R&R Roof vent - turtle type - 2.00 EA 8.34 54.49 0.00 125.66 Metal 25. R&R Gutter / downspout - 10.00 LF 0.47 6.43 0.00 69.00 aluminum - up to 5" 26. Prime & paint gutter / downspout 10.00 LF 0.00 1.57 0.00 15.70 27. Remove 3 tab - 25 yr. - 2.40 SQ 49.35 0.00 0.00 118.44 composition shingle roofing - incl. felt 28. Laminated - High grd - impact 3.00 SQ 0.00 290.62 0.00 871.86 resist shingle - w/ felt 29. R&R Drip edge 20.00 LF 0.31 2.16 0.00 49.40 30. R&R Gutter / downspout - 29.00 LF 0.47 6.43 0.00 200.10 aluminum - up to 5" 31. Prime & paint gutter / downspout 29.00 LF 0.00 1.57 0.00 45.53 32. Remove 3 tab - 25 yr. - 1.60 SQ 49.35 0.00 0.00 78.96 composition shingle roofing - incl. felt 33. Laminated - High grd - impact 2.00 SQ 0.00 290.62 0.00 581.24 resist shingle - w/ felt 34. R&R Ridge cap - High profile - 16.00 LF 2.53 6.01 0.00 136.64 composition shingles 35. R&R Drip edge 52.00 LF 0.31 2.16 0.00 128.44 36. R&R Ridge cap - composition 20.00 LF 2.53 4.06 0.00 131.80 shingles 37. R&R Drip edge 68.00 LF 0.31 2.16 0.00 167.96 Totals: Out buildings 0.00 5,081.89 Line Item Totals: 2020-02-23-2027 0.00 146,246.07 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 4 AAA Roofing & Construction Roofing Contractor 2020-02-23-2027 6/12/2020 Page: 4 Summary Line Item Total 146,246.07 Replacement Cost Value $146,246.07 Net Claim $146,246.07 Joshua Morales DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 5 AAA Roofing & Construction Roofing Contractor 2020-02-23-2027 6/12/2020 Page: 5 Recap of Taxes DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 6 AAA Roofing & Construction Roofing Contractor 2020-02-23-2027 6/12/2020 Page: 6 Recap by Room Estimate: 2020-02-23-2027 Overlay Main building 141,164.18 96.53% Out buildings 5,081.89 3.47% Subtotal of Areas 146,246.07 100.00% Total 146,246.07 100.00% DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 7 AAA Roofing & Construction Roofing Contractor 2020-02-23-2027 6/12/2020 Page: 7 Recap by Category Items Total % GENERAL DEMOLITION 848.18 0.58% HEAVY EQUIPMENT 2,332.40 1.59% PERMITS AND FEES 2,084.10 1.43% FRAMING & ROUGH CARPENTRY 1,620.00 1.11% LABOR ONLY 5,243.20 3.59% PAINTING 61.23 0.04% ROOFING 115,240.16 78.80% SOFFIT, FASCIA, & GUTTER 250.77 0.17% USER DEFINED ITEMS 18,566.03 12.70% Subtotal 146,246.07 100.00% DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 SECTION 00530 WORK ORDER NOTICE TO PROCEED NOTICE TO PROCEED DATE: WORK ORDER TITLE: 835 Wood Street Roof Replacement WORK ORDER NUMBER: 6 ORIGINAL BID/RFP # & TITLE: 9005 Hail Damage Roof Replacement and Repair Project TO: AAA Roofing and Construction, LLC Attn: Joshua Morales 201 East 4th Street Loveland, CO 80537 This notice is to advise you: That the Work Order and all amendments and supplements to the Contract Documents covering the above described Work have been fully executed by the CONTRACTOR and the OWNER. That the required CONTRACTOR's Performance and Payment Bonds and insurance have been received by the OWNER. That the OWNER has approved the said Work Order and Contract Documents. Therefore, as the CONTRACTOR for the above described Work, you are hereby authorized and directed to proceed within ( ) calendar days from receipt of this notice as required by the Work Order and the AGREEMENT. The dates for Substantial Completion and Final Acceptance shall be , and , respectively. Dated this _____________ day of ___________, _____. CITY OF FORT COLLINS (OWNER) By: ___________________________________________ ___________________________________________ Name & Title ACKNOWLEDGMENT OF NOTICE Receipt of the above Work Order Notice to Proceed is hereby acknowledged this _____________ day of ___________, _____. AAA ROOFING AND CONSTRUCTION, LLC (CONTRACTOR) By: ___________________________________________ Name & Title DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 SECTION 00600 BONDS AND CERTIFICATES 00610 Performance Bond 00615 Payment Bond 00630 Certificate of Insurance 00635 Certificate of Substantial Completion 00640 Certificate of Final Acceptance 00650 Lien Waiver Release (CONTRACTOR) 00651 Lien Waiver Release (SUBCONTRACTOR) 00660 Consent of Surety 00670 Application for Exemption Certificate DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 SECTION 00610 PERFORMANCE BOND Bond No KNOW ALL MEN BY THESE PRESENTS: that AAA Roofing and Construction, LLC 201 East 4th Street Loveland, CO 80537 (an Individual), (a Partnership), (a Corporation), hereinafter referred to as the "Principal" and (Firm) (Address) hereinafter referred to as "the Surety", are held and firmly bound unto City of Fort Collins, 300 LaPorte Ave, Fort Collins, Colorado 80522 a (Municipal Corporation) hereinafter referred to as the "OWNER", in the penal sum of One Hundred Forty-Six Thousand Two Hundred Forty Six Dollars and Seven Cents ($146,246.07) in lawful money of the United States, for the payment of which sum well and truly to be made, we bind ourselves, successors and assigns, jointly and severally, firmly by these presents. THE CONDITIONS OF THIS OBLIGATION are such that whereas the Principal entered into a certain Agreement with the OWNER, dated the 15th day of December , 2019, for 9005 Hail Damage Roof Replacement and Repair Project a copy of which is hereto attached and made a part hereof, for the performance of The City of Fort Collins Work Order, titled 835 Wood Street Roof Replacement, Work Order Number 6, dated the 29th day of June, 2020, a copy of which is hereto attached and made a part hereof. NOW, THEREFORE, if the Principal shall well, truly and faithfully perform its duties, all the undertakings, covenants, terms, conditions and agreements of said Work Order and Agreement during the original term thereof, and any extensions thereof which may be granted by the OWNER, with or without Notice to the Surety and during the life of the guaranty period, and if the Principal shall satisfy all claims and demands incurred under such Work Order and Agreement, and shall fully indemnify and save harmless the OWNER from all cost and damages which it may suffer by reason of failure to do so, and shall reimburse and repay the OWNER all outlay and expense which the OWNER may incur in making good any default, then this obligation shall be void; otherwise to remain in full force and effect. PROVIDED, FURTHER, that the said Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration or addition to the terms of the Work Order and Agreement or to the Work to be performed thereunder or the Specifications accompanying the same shall in any way affect its obligation on this bond; and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the Work Order and Agreement or to the Work or to the Specifications. PROVIDED, FURTHER, that no final settlement between the OWNER and the CONTRACTOR shall abridge the right of any beneficiary hereunder, whose claim may be unsatisfied. PROVIDED, FURTHER, that the Surety Company must be authorized to transact business in the State of Colorado and be acceptable to the OWNER. DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 IN WITNESS WHEREOF, this instrument is executed in three (3) counterparts, each one of which shall be deemed an original, this _____ day of ___________, _____. IN PRESENCE OF: Principal (Title) (Title) (Corporate Seal) (Address) IN PRESENCE OF: Other Partners By: By: IN PRESENCE OF: Surety By: (Address) (Surety Seal) NOTE: Date of Bond must not be prior to date of Agreement. If CONTRACTOR is Partnership, all partners should execute Bond. DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 SECTION 00615 PAYMENT BOND Bond No KNOW ALL MEN BY THESE PRESENTS: that AAA Roofing and Construction, LLC 201 East 4th Loveland, CO 80537 (an Individual), (a Partnership), (a Corporation), hereinafter referred to as the "Principal" and (Firm) (Address) hereinafter referred to as "the Surety", are held and firmly bound unto City of Fort Collins, 300 LaPorte Ave, Fort Collins, Colorado 80522 a (Municipal Corporation) hereinafter referred to as the "OWNER", in the penal sum of One Hundred Forty-Six Thousand Two Hundred Forty Six Dollars and Seven Cents ($146,246.07) in lawful money of the United States, for the payment of which sum well and truly to be made, we bind ourselves, successors and assigns, jointly and severally, firmly by these presents. THE CONDITIONS OF THIS OBLIGATION are such that whereas the Principal entered into a certain Agreement with the OWNER, dated the 15th day of December, 2019, for 9005 Hail Damage Roof Replacement and Repair Project, a copy of which is hereto attached and made a part hereof, for the performance of The City of Fort Collins Work Order, titled 835 Wood Street Roof Replacement, Work Order Number 6, dated the 29th day of June, 2020, a copy of which is hereto attached and made a part hereof. NOW, THEREFORE, if the Principal shall make payment to all persons, firms, subcontractors, and corporations furnishing materials for or performing labor in the prosecution of the Work provided for in such Work Order and Agreement and any authorized extension or modification thereof, including all amounts due for materials, lubricants, repairs on machinery, equipment and tools, consumed, rented or used in connection with the construction of such Work, and all insurance premiums on said Work, and for all labor, performed in such Work whether by subcontractor or otherwise, then this obligation shall be void; otherwise to remain in full force and effect. PROVIDED, FURTHER, that the said Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration or addition to the terms of the Work Order and Agreement or to the Work to be performed thereunder or the Specifications accompanying the same shall in any way affect its obligation on this bond; and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the Work Order and Agreement or to the Work or to the Specifications. PROVIDED, FURTHER, that no final settlement between the OWNER and the CONTRACTOR shall abridge the right of any beneficiary hereunder, whose claim may be unsatisfied. PROVIDED, FURTHER, that the Surety Company must be authorized to transact business in the State of Colorado and be acceptable to the OWNER. DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 IN WITNESS WHEREOF, this instrument is executed in three (3) counterparts, each one of which shall be deemed an original, this _____ day of ___________, _____. IN PRESENCE OF: Principal (Title) (Title) (Corporate Seal) (Address) IN PRESENCE OF: Other Partners By: By: IN PRESENCE OF: Surety By: (Address) (Surety Seal) NOTE: Date of Bond must not be prior to date of Agreement. If CONTRACTOR is Partnership, all partners should execute Bond. DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 SECTION 00630 CERTIFICATE OF INSURANCE CONTRACTOR shall insert his own standard form for Certificate of Insurance in accordance with the following: 1. The Contractor 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 Contractor 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 Contractor, 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 Contractor under this Agreement. The City, its officers, agents and employees shall be named as additional insureds on the Contractor’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 Contractor shall maintain during the life of this Agreement for all of the Contractor'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 Contractor 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 Contractor 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: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 SECTION 00635 CERTIFICATE OF SUBSTANTIAL COMPLETION TO: CITY OF FORT COLLINS (OWNER) WORK ORDER # & TITLE: Work Order 6 - 835 Wood Street Roof Replacement DATE OF SUBSTANTIAL COMPLETION: ORIGINAL BID/RFP # & TITLE: 9005 Hail Damage Roof Replacement and Repair Project PROJECT OR SPECIFIED PART SHALL LOCATION: Fort Collins, Colorado INCLUDE: OWNER: City of Fort Collins CONTRACTOR: AAA Roofing and Construction, LLC WORK ORDER DATE: June 29, 2020 The Work performed under this Work Order, pursuant to the Contract Documents, has been inspected by authorized representatives of the OWNER, CONTRACTOR, and the ENGINEER and the project (or specified part of the project, as indicated above) is hereby declared to be substantially completed on the above date. A tentative list of items to be completed or corrected is appended hereto. This list may not be exhaustive, and the failure to include an item on it does not alter the responsibility of the CONTRACTOR to complete all the Work in accordance with the Contract Documents. _____________________________ By: __________________________ ________ PROJECT MANAGER AUTHORIZED REPRESENTATIVE DATE The CONTRACTOR accepts the above Certificate of Substantial Completion and agrees to complete and correct the items on the tentative list within the time indicated. _____________________________ By: __________________________ ________ CONTRACTOR AUTHORIZED REPRESENTATIVE DATE The OWNER accepts the project or specified area of the project as substantially complete and will assume full possession of the project or specified area of the project at 12:01 a.m., on . The responsibility for heat, utilities, security, and insurance under the Contract Documents shall be as set forth under "Remarks" below. CITY OF FORT COLLINS ________ By: __________________________ ________ OWNER AUTHORIZED REPRESENTATIVE DATE REMARKS: _________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 SECTION 00640 CERTIFICATE OF FINAL ACCEPTANCE DATE: ________________, _____ TO: AAA Roofing and Construction, LLC Gentlemen: You are hereby notified that on the day of , , the City of Fort Collins, Colorado, has accepted the Work completed by AAA Roofing and Construction, LLC, for the City of Fort Collins Work Order, titled 835 Wood Street Roof Replacement, Work Order Number 6 under 9005 Hail Damage Roof Replacement and Repair Project. A check is attached hereto in the amount of $ as Final Payment for all Work done, subject to the terms of the Contract Documents, including the Work Order, which is dated June 29, 2020, and the AGREEMENT, which is dated December 15, 2019. In conformance with the Work Order and Contract Documents for this project, your obligations and guarantees will continue for the specified time from the following date: ___________________, _____. Sincerely, City of Fort Collins OWNER By: ___________________________________________ ___________________________________________ Name & Title ATTEST: _________________________________________ ___________________________________________ Name & Title DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 SECTION 00650 LIEN WAIVER RELEASE (CONTRACTOR) TO: City of Fort Collins, Colorado (OWNER) FROM: AAA Roofing and Construction, LLC (CONTRACTOR) WORK ORDER TITLE: 835 Wood Street Roof Replacement WORK ORDER NUMBER: 6 ORIGINAL BID/RFP # & TITLE: 9005 Hail Damage Roof Replacement and Repair Project 1. The CONTRACTOR acknowledges having received payment, except retainage from the OWNER for all work, labor, skill and material furnished, delivered and performed by the CONTRACTOR for the OWNER or for anyone in the construction, design, improvement, alteration, addition or repair of the above described project. 2. In consideration of such payment and other good and valuable consideration, the receipt and adequacy of which are hereby acknowledged, the CONTRACTOR voluntarily waives all rights, claims and liens, including but not limited to, mechanic's liens, Miller Act claims (40 U.S.C.A. 270 a and b), stop notices, equitable liens and labor and material bond rights which the CONTRACTOR may now or may afterward have, claim or assert for all and any work, labor, skill or materials furnished, delivered or performed for the construction, design, improvement, alteration, addition or repair of the above described project, against the OWNER or its officers, agents, employees or assigns, against any fund of or in the possession or control of the OWNER, against the project or against all land and the buildings on and appurtenances to the land improved by the project. 3. The CONTRACTOR affirms that all work, labor and materials, furnished, delivered or performed to or for the construction, design, improvement, alteration, addition or repair of the project were furnished, delivered or performed by the CONTRACTOR or its agents, employees, and servants, or by and through the CONTRACTOR by various Subcontractors or materialmen or their agents, employees and servants and further affirms the same have been paid in full and have released in full any and all existing or possible future mechanic's liens or rights or claims against the project or any funds in the OWNER'S possession or control concerning the project or against the OWNER or its officers, agents, employees or assigns arising out of the project. 4. The CONTRACTOR agrees to defend and hold harmless the OWNER, the lender, if any, and the Surety on the project against and from any claim hereinafter made by the CONTRACTOR's Subcontractors, materialmen, employees, servants, agents or assigns against the project or against the OWNER or its officers, employees, agents or assigns arising out of the project for all loss, damage and costs, including reasonable attorneys fees, incurred as a result of such claims. 5. The parties acknowledge that the description of the project set forth above constitutes an adequate description of the property and improvements to which this Lien Waiver Release pertains. It is further acknowledged that this Lien Waiver Release is for the benefit of and DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 may be relied upon by the OWNER, the lender, if any, and Surety on any labor and material bonds for the project. Signed this ______ day of __________, ___. CONTRACTOR: AAA Roofing and Construction, LLC By: ___________________________________________ ___________________________________________ Name & Title ATTEST: _____________________________ Secretary STATE OF COLORADO ) )ss. COUNTY OF LARIMER ) Subscribed and sworn to before me this _________ day of __________, _____, by ________________________________________________________________. Witness my hand and official seal. My Commission Expires: ___________________________. _________________________ Notary Public DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 SECTION 00650 LIEN WAIVER RELEASE (SUBCONTRACTOR) TO: City of Fort Collins, Colorado (OWNER) FROM: AAA Roofing and Construction, LLC (CONTRACTOR) WORK ORDER TITLE: 835 Wood Street Roof Replacement WORK ORDER NUMBER: 6 ORIGINAL BID/RFP # & TITLE: 9005 Hail Damage Roof Replacement and Repair Project 1. The Subcontractor acknowledges having received payment from the CONTRACTOR for all work, labor, skill and material furnished, delivered and performed by the Subcontractor for the CONTRACTOR or for anyone in the construction, design, improvement, alteration, addition or repair of the above described project. 2. In consideration of such payment and other good and valuable consideration, the receipt and adequacy of which are hereby acknowledged, the Subcontractor voluntarily waives all rights, claims and liens, including but not limited to, mechanic's liens, Miller Act claims (40 U.S.C.A. 270 a and b), stop notices, equitable liens and labor and material bond rights which the Subcontractor may now or may afterward have, claim or assert for all and any work, labor, skill or materials furnished, delivered or performed for the construction, design, improvement, alteration, addition or repair of the above described project, against the CONTRACTOR or its officers, agents, employees or assigns, against the project or against all land and the buildings on and appurtenances to the land improved by the project. 3. The Subcontractor affirms that all work, labor and materials, furnished, delivered or performed to or for the construction, design, improvement, alteration, addition or repair of the project were furnished, delivered or performed by the Subcontractor or its agents, employees, and servants, or by and through the Subcontractor by various sub- subcontractors or materialmen or their agents, employees and servants, and further affirms the same have been paid in full and have released in full any and all existing or possible future mechanic's liens or rights or claims against the project or against the CONTRACTOR or its officers, agents, employees or assigns arising out of the project. 4. The Subcontractor agrees to defend and hold harmless the CONTRACTOR, the lender, if any, and the Surety on the project against and from any claim hereinafter made by the Subcontractor's sub-subcontractors, materialmen, employees, servants, agents or assigns against the project or against the CONTRACTOR or OWNER, lender or Surety or their officers, employees, agents or assigns arising out of the project for all loss, damage and costs, including reasonable attorneys fees, incurred as a result of such claims. 5. The parties acknowledge that the description of the project set forth above constitutes an adequate description of the property and improvements to which this Lien Waiver Release pertains. It is further acknowledged that this Lien Waiver Release is for the benefit of and may be relied upon by the CONTRACTOR, OWNER, the lender, if any, and Surety on any labor and material bonds for the project. DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 Signed this ______ day of _________, ___. SUBCONTRACTOR: By: ___________________________________________ ___________________________________________ Name & Title ATTEST: _____________________________ Secretary STATE OF COLORADO ) )ss. COUNTY OF LARIMER ) Subscribed and sworn to before me this _________ day of __________, _____, by __________________________________________________________________. Witness my hand and official seal. My Commission Expires: ___________________________. __________________________________ Notary Public DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 SECTION 00660 CONSENT OF SURETY TO: City of Fort Collins, Colorado (hereinafter referred to as the "OWNER") CONTRACTOR: AAA Roofing and Construction, LLC WORK ORDER # & TITLE: Work Order 6 - 835 Wood Street Roof Replacement ORIGINAL BID/RFP # & TITLE: 9005 Hail Damage Roof Replacement and Repair Project CONTRACT DATE: December 15, 2019 WORK ORDER DATE: June 29, 2020 In accordance with the provisions of the Work Order and Contract between the OWNER and the CONTRACTOR as indicated above, for the Work Order titled 835 Wood Street Roof Replacement on bond of , (Surety) _______________________________________ hereby approves of the Final Payment to the CONTRACTOR, and agrees that Final Payment to the CONTRACTOR shall not relieve the Surety Company of any of its obligations to the OWNER, as set forth in the said Surety Company's Bond. IN WITNESS WHEREOF, the Surety Company has hereunto set its hand this _________ day of ____________________, _____. ____________________________________________ (Surety Company) By: ________________________________________ (Name) Attorney-in-Fact ATTACH: Power of Attorney and Certificate of Authority of Attorney(s)-in-Fact. DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 SECTION 00670 APPLICATION FOR EXEMPTION CERTIFICATE DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 SECTION 00700 GENERAL CONDITIONS DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 SECTION 00800 SUPPLEMENTARY CONDITIONS Conditions of the Contract These Supplementary Conditions amend or supplement the General Conditions of the Construction Contract (EJCDC General Conditions 1910-8, 1990 edition, with City of Fort Collins Modifications, Rev. 9/94) and other provisions of the Contract Documents as indicated below. SC-1 DEFINITIONS SC-1.38. Add the following language to the conclusion of paragraph 1.38 of the General Conditions: 1.38. Substantial Completion. .... Substantial Completion is further defined as that degree of completion of the operating facilities or systems of the Project defined in the Work Order sufficient to provide the OWNER the full time, uninterrupted, continuous, beneficial operation of the modifications, and all inspections required have been completed and identified conditions corrected. SC-1.43.A. Add the following new paragraph immediately after paragraph 1.43 of the General Conditions: 1.43.A. Work Order--A written document executed by OWNER and CONTRACTOR that provides for the construction of a portion of the Work, pursuant to the Agreement and all as required by the Contract Documents, and that becomes a Contract Document when executed. SC-2 PRELIMINARY MATTERS SC-2.8. Delete paragraph 2.8 of the General Conditions entirely and replace it with the following paragraph: 2.8. Preconstruction Conference. Within ten days after the Contract Times for a Work Order start to run, but before any Work at the site is started, a conference attended by CONTRACTOR, ENGINEER and others as appropriate will be held to establish a working relationship among the parties as to the Work and to discuss the schedules referred to in paragraph 2.6, procedures for handling Shop Drawings and other submittals, processing Applications for Payment, and maintaining required records. SC-2.10. Add the following new paragraph immediately after paragraph 2.9 of the General Conditions: 2.10. Work Order Required for All Work. References to the Agreement in this Article 2 and in the General and Supplementary Conditions and Contract Documents notwithstanding, no Work shall be initiated or performed until CONTRACTOR has received a signed and executed Work Order, incorporating the Notice to Proceed, from DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 OWNER; and no provision of this Article 2 or of the General and Supplementary Conditions and Contract Documents shall permit or require any action of CONTRACTOR in the absence of a signed and executed Work Order. All provisions of this Article 2 and of the General and Supplementary Conditions and Contract Documents referencing the Agreement or other parts of the Contract Documents, or permitting or requiring any action of CONTRACTOR, shall be read as referencing and, as appropriate, requiring a signed and executed Work Order. SC-4 AVAILABILITY OF LANDS; SUBSURFACE AND PHYSICAL CONDITIONS; REFERENCE POINTS SC-4.2.1.2. Add the following new paragraph immediately following paragraph 4.2.1.2 of the General Conditions: 4.2.1.2.1. No drawing of physical conditions in or relating to existing surface or subsurface structures (except Underground Facilities referred to in paragraph 4.3) which are at or contiguous to the site have been utilized by the Engineer in preparation of the Contract Documents, except the following: SC-4.5.2. Add the following language which was previously deleted: 4.5.2. CONTRACTOR shall immediately: (i) stop all Work in connection with such hazardous condition and in any area affected thereby (except in an emergency as required by paragraph 6.23), and (ii) notify OWNER and ENGINEER (and therefore confirm such notice in writing). OWNER shall promptly consult with ENGINEER (and thereafter confirm such notice in writing). OWNER shall promptly consult with ENGINEER concerning the necessity for OWNER to retain a qualified expert to evaluate such hazardous condition or take corrective action, if any. CONTRACTOR shall not be required to resume Work in connection with such hazardous condition or in any such affected area until after OWNER has obtained any required permits related thereto and delivered to CONTRACTOR special written notice: (i) specifying that such condition and any affected area is or has been rendered safe for the resumption of Work, or (ii) specifying any special conditions under which such Work may be resumed safely. If OWNER and CONTRACTOR cannot agree as to entitlement to or the amount or extent of an adjustment, if any, in Contract Price or Contract Times as a result of such Work stoppage or such special conditions under which Work is agreed by CONTRACTOR to be resumed, either party may make a claim therefor as provided in Articles 11 and 12. SC-4.5.3. Add the following language which was previously deleted: 4.5.3. If after receipt of such special written notice CONTRACTOR does not agree to resume such work based on a reasonable belief it is unsafe, or does not agree to resume such Work under such special conditions, the OWNER may order such portion of the Work that is in connection with such hazardous condition or in such affected area to be deleted from the Work. If OWNER and CONTRACTOR cannot agree as to entitlement to or the amount or extent of an adjustment, if any, in Contract Price or DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 Contract Times as a result of deleting such portion of the Work, then either party may make a claim therefor as provided in articles 11 and 12. OWNER may have such deleted portion of the Work performed by OWNER’s own forces or others in accordance with Article 7. SC-4.5.4. For the avoidance of doubt, SC-4.5.4 is stricken and not incorporated into the General Conditions. SC-4.5.5. Add the following language which was previously deleted: 4.5.5. The provisions of paragraphs 4.2 and 4.3 are not intended to apply to Asbestos, PCBs, Petroleum, Hazardous Waste or Radioactive Material uncovered or revealed at the site. SC-5 BONDS AND INSURANCE SC-5.4.7. Include the following parties or entities as additional insureds, as provided in paragraph 5.4.7 of the General Conditions: 5.4.7.1. City of Fort Collins, Colorado, 4316 LaPorte Avenue, Fort Collins, Colorado 80522 5.4.7.2. . SC-5.4.8.1. Add the following new paragraph immediately following paragraph 5.4.8 of the General Conditions: 9.4.8.1. Limits of Liability. The limits of liability for the insurance required by the paragraph numbers of the General Conditions listed below are as follows: For Paragraphs 5.02.A.1 and 5.02.A.2: Coverage A - Statutory Limits; Coverage B - $100,000 / $100,000 / $500,000. For Paragraphs 5.02.A.3 and 5.02.A.5: The Commercial General Liability policy will have limits of $1,000,000 combined single limits (CSL). This policy will include coverage for Explosion, Collapse, and Underground coverage unless waived by the Owner. For Paragraph 5.02.A.6: The Comprehensive Automobile Liability Insurance policy will have limits of $1,000,000 combined single limits (CSL). For Paragraph 5.02.B.3: This policy will include completed operations coverage / product liability coverage with limits of $1,000,000 combined single limits (CSL). This policy shall also include an Umbrella Excess Liability as follows: General liability and automobile liability insurance in an amount not less than $1,000,000 per occurrence in excess of the above stated primary limits. DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 SC-6 CONTRACTOR’S RESPONSIBILITIES SC-6.14.3. Add the following new paragraph immediately after paragraph 6.14.2 of the General Conditions: 6.14.3. The following Laws or Regulations are included in the Contract Documents as mandated by statute or for the convenience of the CONTRACTOR. Other Laws and Regulations apply which are not included herein, and are within the CONTRACTOR's duty and responsibility for compliance thereto: 6.14.3.1. Notice to owners of Underground Facilities is required prior to excavations in the vicinity of such facilities. 6.14.3.2. Unless otherwise decided by reason of the amount of the Contract Price involved, or other good reason, before or at the time that the contract is awarded to a corporation outside the State of Colorado, such corporation must carry out the proper procedure to become authorized to do business in the State of Colorado, designate a place of business therein, and appoint an agent for service of process. Such corporation must furnish the OWNER with a certificate from the Secretary of State of Colorado has been issued by its office and there shall also be procured from the Colorado Secretary of State of photostatic or certified copy of the designated of place of business and appointment of agent for service of process, or a letter from the Colorado Secretary of State that such designation of place of business and agent for service of process have been made. 6.14.3.3. The CONTRACTOR must conform to the rules and regulations of the Industrial Commission of Colorado. Particular reference is made to rules and regulations governing excavation Work adopted by the Industrial Commission of Colorado. SC-11 CHANGE OF CONTRACT PRICE SC-11.6.2.7. Add the following new paragraph to paragraph 11.6.2 of the General Conditions: 11.6.2.7. Cost of the Work. IN the event of a change order, allowances for profit, overhead and mark-up shall be negotiated by the parties. Notwithstanding, in no event shall the CONTRACTOR'S fee, overhead, profit or mark-up allowances exceed the amounts stated in paragraphs as prescribed in paragraphs 11.6.2.1, 11.6.2.2, and 11.6.2.3. SC-11.9.3.4. Add the following at the conclusion of paragraph 11.9.3.4 of the General Conditions: 11.9.3.4. The adjustment in Contract Price for the items deleted or added will be revised and documented by a change order. SC-12 CHANGE OF CONTRACT TIMES SC-12.3. Add the following language to the end of paragraph 12.3 of the General Conditions: DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 PROJECT TIME EXTENSIONS FOR ABNORMAL WEATHER CONDITIONS This provision specifies the procedure for the determination of time extensions for abnormal weather conditions in accordance with the Contract Documents. In order for the Owner to award a time extension to the Contractor and pay for additional general conditions for abnormal weather conditions, the following conditions must be satisfied: 1. The weather experienced at the Project site during the Contract period must be found to be abnormal weather, that is, more severe than the adverse weather anticipated for the Project location during the Contract period. 2. The abnormal weather must actually cause a delay to the completion of the Project. The delay must be beyond the control and without the fault or negligence of the Contractor. 3. For an abnormal weather conditions delay to count, it must prevent work on Critical Path activities for 50 percent or more of the Contractor's scheduled work crew, for 50 percent or more of the day. 4. The weather must exceed the schedule of monthly adverse weather condition delays based on National Oceanic and Atmospheric Administration (NOAA) historical data for the Project location as stated below. This will constitute the baseline for monthly weather time evaluations. The Contractor's progress schedule must reflect these anticipated adverse weather delays in all- weather dependent activities. MONTHLY ANTICIPATED ADVERSE WEATHER DELAY WORK DAYS BASED ON (5) DAY WORK WEEK. JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC 5 4 3 3 4 4 5 5 3 2 3 5 Upon acknowledgment of the Notice to Proceed (NTP) and continuing throughout the Contract, the Contractor will record on their daily report, the occurrence of adverse and subsequent abnormal weather conditions and resultant impact to normally scheduled work. Actual abnormal weather condition delay days must prevent work on Critical Path activities for 50 percent or more of the Contractor's scheduled work crew, for 50 percent or more of the day. The number of abnormal weather condition delay days shall be days in excess of the actual adverse weather within the designated month, and be calculated chronologically from the first to the last day of each month, and be recorded as full days. Unutilized adverse weather days do not carry-forward or accumulate. The Contractor is to notify the Owner at the end of each month in writing of the number of actual abnormal weather delays they incurred for the month. If the number of actual abnormal weather delay days exceeds the number of anticipated adverse weather delay days listed above, the Project Manager will review the Contractor’s documentation and give full consideration for equivalent fair weather work days, and track the days on a log. If all four conditions listed above are satisfied, the Owner will issue a change order to the Contractor for the additional days to the project schedule and the general conditions associated with these abnormal weather days. SC-13. 12.1 Remove and Replace Correction / Warranty period DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 A. Special Warranty: Manufacturer agrees to repair or replace components of roofing system that fail in materials or workmanship within specified warranty period. 1. Special warranty includes roof membrane, base flashings, roof insulation, fasteners, cover boards, vapor retarder, substrate board, roof pavers, and other components of roofing system. 2. Warranty Period: 20 years from date of Substantial Completion. • 110 mph wind speed warranty B. Special Project Warranty: Submit roofing Installer's warranty, on warranty form at end of this Section, signed by Installer, covering the Work of this Section, including all components of roofing system such as roof membrane, base flashing, roof insulation, fasteners, cover boards, substrate boards, vapor retarders, roof pavers and/or walkway products, for the following warranty period: 1. Warranty Period: Two years from date of Substantial Completion. SC-14 PAYMENTS TO CONTRACTOR AND COMPLETION SC-14.1. Add the following language to the end of paragraph 14.1 of the General Conditions: 14.1. Schedule of Values. .... Progress payments on the fixed fee shall be in proportion to the cumulative actual Cost of the Work as a percentage of the Allowable Cost of the Work. An amount not to exceed fifteen (15%) percent of the fixed fee shall be advanced to the Contractor for mobilization in the first progress payment. DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 SECTION 00900 ADDENDA, MODIFICATIONS AND PAYMENT 00950 Change Order 00960 Application for Payment DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 SECTION 00950 CHANGE ORDER FORM CHANGE ORDER NO. CONTRACTOR: AAA Roofing and Construction, LLC WORK ORDER TITLE & NO. : Work Order 6 - 835 Wood Street Roof Replacement ORIGINAL BID/RFP # & TITLE: 9005 Hail Damage Roof Replacement and Repair Project DESCRIPTION: 1. Reason for change: 2. Description of Change: 3. Change in Contract Cost: 4. Change in Contract Time: ORIGINAL CONTRACT COSTS $ ________________ TOTAL APPROVED CHANGE ORDER(S) $ ________________ TOTAL PENDING CHANGE ORDER(S) $ ________________ TOTAL THIS CHANGE ORDER $ ________________ TOTAL % OF ORIGINAL CONTRACT, THIS CO: _______________ % TOTAL % OF ORIGINAL CONTRACT, ALL CO’S: _______________ % ADJUSTED CONTRACT COST $ ________________ _________________ (Assuming all change orders approved) ACCEPTED BY: _____________________________________ DATE: ____________ Contractor's Representative ACCEPTED BY: _____________________________________ DATE: ____________ Project Manager REVIEWED BY: _____________________________________ DATE: ____________ Title: APPROVED BY: _____________________________________ DATE: ____________ Title: APPROVED BY: _____________________________________ DATE: ____________ (Purchasing Agent if > $60,000) cc: City Clerk Architect/Engineer Finance Purchasing Project Manager Contractor DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 SECTION 00960 PAYMENT APPLICATION APPLICATION FOR PAYMENT PAGE 1 OF 4 OWNER: City of Fort Collins PROJECT: APPLICATION NUMBER: APPLICATION DATE: PERIOD BEGINNING: ENGINEER: CONTRACTOR: PERIOD ENDING: PROJECT NUMBER: CHANGE ORDERS Application is made for Payment as shown below in connection with Contract NUMBER DATE AMOUNT The present status of the account for this Contract is as follows: 1 2 Original Contract Amount: 3 Net Change by Change Order: Current contract Amount: $0.00 Total Completed and Stored to Date: Less Previous Applications: Amount Due this Application - Before Retainage: $0.00 Less Retainage: Net Change by Change Order $0.00 AMOUNT DUE THIS APPLICATION: $0.00 CERTIFICATION: The undersigned CONTRACTOR certifies that all obligations of CONTRACTOR incurred in connection with the Work have been satisfied as required in Paragraph 14.3. of the General Conditions of the Contract. The above Amount Due This Application is requested by the CONTRACTOR. Date: By: Payment of the above Amount Due This Application is recommended by the ENGINEER. Date: By: Payment of the above Amount Due This Application has been reviewed by the OWNER'S Project Manager. Date: By: Payment of the above Amount Due This Application is approved by the OWNER. Date: By: DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 CONTRACT AMOUNTS APPLICATION FOR PAYMENT PAGE 2 OF 4 Work Completed Work Completed Work Completed Stored Bid This Month Previous Periods To Date Materials Total Item This Earned Percent Number Description Quantity Units Unit Price Amount Qty. Amount Qty. Amount Qty. 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Amount Qty. Amount Qty. Amount Period To Date Billed $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTALS CHANGE ORDERS $0.00 $0.00 $0.00 $0.00 $0.00 PROJECT TOTALS $0.00 $0.00 $0.00 $0.00 $0.00 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 STORED MATERIALS SUMMARY PAGE 4 OF 4 On Hand Received Installed On Hand Item Invoice Previous This This This Number Number Description Application Period Period Application $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTALS $0.00 $0.00 $0.00 $0.00 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 06/24/2020 Brown & Brown of Colorado, Inc. 4532 Boardwalk Dr., Suite 200 Fort Collins CO 80525 Matthew Laine (970) 482-7747 (970) 484-4165 certificates@bbcolorado.com AAA Roofing & Construction 1326 Bowwood Ct Loveland CO 80538 Clear Blue Specialty Insurance Company 37745 Owners Insurance Company 32700 CL2031889323 A AR01RS200013701 03/15/2020 03/15/2021 1,000,000 100,000 5,000 1,000,000 2,000,000 2,000,000 B 5228118600 04/23/2020 04/23/2021 1,000,000 City of Fort Collins 281 N College Ave Fort Collins CO 80521 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME: CONTACT (A/C, No): FAX E-MAIL ADDRESS: PRODUCER (A/C, No, Ext): PHONE INSURED COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. OTHER: (Per accident) (Ea accident) $ $ N / A AAA Roofing & Construction 00311684 Brown & Brown of Colorado, Inc. 25 Certificate of Liability Insurance: Notes The Following Form May Apply When Required By Written Contract: General Liability: Waiver of Subrogation - Form CG 24 04 Additional Insured (Lessor of Leased Equipment) - Form CG 20 34 Additional Insured Completed Operations (Owners, Lessees or Contractors) - Form CG 20 37 Additional Insured Ongoing Operations (Owners, Lessees or Contractors) - Form CG 20 10 Primary & Non Contributory - Form CG 20 01 Commercial Auto: Waiver of Subrogation Blanket Additional Insured ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved. THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: FORM TITLE: ADDITIONAL REMARKS ADDITIONAL REMARKS SCHEDULE Page of AGENCY CUSTOMER ID: LOC #: AGENCY CARRIER NAIC CODE POLICY NUMBER NAMED INSURED EFFECTIVE DATE: DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 A X Pinnacol Assurance 41190 Pinnacol Assurance 7501 E. Lowry Blvd. Denver, CO 80230-7006 AAA Roofing and Construction, LLC 1326 Bowwood Court Loveland, CO 80538 07/07/2020 4211226 07/01/2020 07/01/2021 1,000,000 1,000,000 1,000,000 Day Larsen Pedersen Insurance, Inc. 2098895 City of Fort Collins 281 N college Ave Fort Collins, CO 80521 shelby@aaaroofing-construction.com Unless otherwise stated in the policy provisions, coverage in Colorado only. DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT (CONT) CERTIFICATE HOLDER COPY City of Fort Collins 281 N college Ave Fort Collins, CO 80521 DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4 SUBR WVD ADDL INSD 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. $ $ $ PROPERTY DAMAGE $ BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOS ONLY AUTOS NON-OWNED OWNED SCHEDULED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT ER OTH- STATUTE PER (MM/DD/YYYY) LIMITS POLICY EXP (MM/DD/YYYY) POLICY EFF LTR TYPE OF INSURANCE POLICY NUMBER INSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB EACH OCCURRENCE $ AGGREGATE $ $ OCCUR CLAIMS-MADE DED RETENTION $ PRODUCTS - COMP/OP AGG $ GENERAL AGGREGATE $ PERSONAL & ADV INJURY $ MED EXP (Any one person) $ EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES (Ea occurrence) $ COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY DocuSign Envelope ID: 05E4121F-D03B-45DA-80A2-2BFC46B6BAF4