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HomeMy WebLinkAboutCORRESPONDENCE - RFP - 8557 ANTHRACITE AND SILICA SAND 2017 (3)June 23, 2020 Xylem Water Solutions USA, Inc Attn: Susan Button 26717 Network Place Chicago, IL 60673 RE: Renewal, 8557 Anthracite Coal and Silica Sand Dear Ms. Button: The City of Fort Collins wishes to extend the agreement term for the above captioned proposal per the existing terms and conditions and the following: 1) The term will be extended for one (1) additional year, September 18, 2020 through September 17, 2021. If the renewal is acceptable to your firm, please sign this letter in the space provided and include a current copy of insurance certificate naming the City as an additional insured for General and Automotive Liability within the next fifteen (15) days. If this extension is not agreeable with your firm, we ask that you send us a written notice stating that you do not wish to renew the contract and state the reason for non-renewal. Please contact Marisa Donegon, Buyer at (970) 416-4377 if you have any questions regarding this matter. Sincerely, Gerry S. Paul Director of Purchasing __________________________________________ ________________ Signature Date (Please indicate your desire to renew 8557 by signing this letter and returning it to Purchasing Division within the next fifteen days.) GSP:kr Financial Services Purchasing Division 215 N. Mason St. 2nd Floor PO Box 580 Fort Collins, CO 80522 970.221.6775 970.221.6707- fax fcgov.com/purchasing DocuSign Envelope ID: E26BA8C5-17EF-4ACF-8609-A52463F5A644 7/9/2020 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 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? 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: CARRIER: NEW HAMPSHIRE INSURANCE COMPANY / NAIC CODE: 23841� � POLICY: WC 020608520 (CA)� POLICY: WC 020608521 (FL) � 2 2 � POLICY: WC 020608517 (IL, KY, NC, NH, UT, VT)� New York POLICY: WC 020608516 (AOS) � CARRIER: NEW HAMPSHIRE INSURANCE COMPANY / NAIC CODE: 23841� CARRIER: NEW HAMPSHIRE INSURANCE COMPANY / NAIC CODE: 23841� � �� �� � WORKERS COMPENSATION:� Certificate of Liability Insurance CARRIER: NEW HAMPSHIRE INSURANCE COMPANY / NAIC CODE: 23841� CN108453421 CARRIER: NEW HAMPSHIRE INSURANCE COMPANY / NAIC CODE: 23841� � POLICY: WC 020608519 (MA, OH, WA, WI, WY)� � CARRIER: AMERICAN HOME ASSURANCE COMPANY / NAIC CODE: 19380� � POLICY: WC 020608522 (AZ, VA)� Marsh USA, Inc.� Leopold Products� Xylem Water Solutions USA, Inc.� Zelienople, PA 16063 227 South Division Street� CARRIER: ILLINOIS NATIONAL INSURANCE COMPANY/ NAIC CODE: 23817� �� 25 POLICY: WC 020608518 (NJ, PA)� DocuSign Envelope ID: E26BA8C5-17EF-4ACF-8609-A52463F5A644 (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) © 1988-2016 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 1,000,000 GL 6862456 Lauren Giagrande NYC-010128267-16 2,000,000 X 10/31/2019 19445 of Marsh USA Inc. N 10/31/2019 10/31/2019 X B 9 10/31/2020 B Lauren.Giangrande@marsh.com CA 5320316 (AOS) A 2,000,000 1,000,000 National Union Fire Ins. Co. 2,000,000 X X 07/08/2020 10/31/2019 City of Fort Collins is included as additional insured (except Workers Compensation) as required by written contract. X 10/31/2020 SIR: $1,000,000 Fort Collins, CO 80522 City of Fort Collins CA 5320318 (MA) B CN108453421-STND-GAW-19-20 10,000 10/31/2020 3,000,000 CA 5320317 (VA) 10/31/2020 2,000,000 1,000,000 2,000,000 SEE ACORD 101 1166 Avenue of the Americas Marsh USA, Inc. New York, NY 10036 Leopold Products Xylem Water Solutions USA, Inc. Zelienople, PA 16063 227 South Division Street 10/31/2019 PO Box 580 B Lauren Giangrande 10/31/2020 (212) 345-6000 See Acord 101 DocuSign Envelope ID: E26BA8C5-17EF-4ACF-8609-A52463F5A644