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HomeMy WebLinkAboutMINES AND ASSOCIATES INC - CONTRACT - RFP - 8977 - BENEFITS - EMPLOYEE ASSISTANTANCE PROGRAMPage 1 of 11 CITY OF FORT COLLINS POLICE SERVICES SERVICES AGREEMENT This Agreement is made as of September 18, 2020 by and between Mines and Associates, INC. (MINES), with its principal place of business at 10367 W. Centennial Rd. Suite 100, Littleton, Colorado 80127 and the City of Fort Collins (CITY), a municipal corporation, with its principal place of business at 300 Laporte Ave, Fort Collins, CO 80521. 1. PURPOSE The purpose of this Agreement is to set forth the terms and conditions pursuant to which MINES will provide services specified in Section 3 herein, as a behavioral health administrative services organization for the CITY. The services provided pursuant to this Agreement are in addition to those services MINES provides pursuant to the Services Agreement between MINES and CITY, dated January 1, 2020. 2. TERM AND TERMINATION A. This Agreement shall become effective as of the Effective Date hereof and shall remain in full force and effect for a period of twelve (12) Months (the “Initial Term “). Upon the expiration of the Initial Term, this Agreement may be extended at the option of the CITY for additional one-year periods not to exceed three (3) additional one (1) year periods. Renewals and pricing changes shall be negotiated by and agreed to by both parties and can be done annually with 90 days’ notice. Written notice of renewal shall be provided to MINES and mailed no later than thirty (30) days prior to contact term end. B. Delay. If either party is prevented in whole or in part from performing its obligations by unforeseeable causes beyond its reasonable control and without its fault or negligence, then the party so prevented shall be excused from whatever performance is prevented by such cause. To the extent that the performance is actually prevented MINES must provide written notice to the CITY of such condition within fifteen (15) days from the onset of such condition. C. Early Termination. Notwithstanding the time periods contained herein, the Agreement may be terminated by either party with no less than ninety (90) days prior notice. Provided, however, either party shall have the right to terminate this Agreement, in the event of a material breach of this Agreement by the other party which is not cured within thirty (30) days of written notice. All notices provided under this Agreement shall be effective when mailed, postage prepaid and sent to the following addresses: MINES: CITY: Copy to: Mines & Associates Attn: Daniél C. Kimlinger 10367 West Centennial Road Suite 100 Littleton, CO 80127 (303) 832-1068 info@minesandassociates.com Or Staff as assigned City of Fort Collins Attn: Joaquin Garbiso PO Box 580 Fort Collins, CO 80522 City of Fort Collins Attn: Purchasing Dept. PO Box 580 Fort Collins, CO 80522 In the event of early termination by the CITY, MINES shall be paid for services rendered to the date of termination, subject only to the satisfactory performance of MINES's obligations under this Agreement. Such payment shall be MINES's sole right and remedy for such termination. DocuSign Envelope ID: AF29AC32-CA9A-4AD5-AC8C-9006FE523D30 Page 2 of 11 3. STATEMENT OF WORK (SOW) MINES shall perform the following mental health check-up services each Agreement year: A. Provide up to 2 sessions per calendar year (but no more than 1 session every 4 months) face-to-face, or telephone appointments/sessions, per Police Services employee only for a mental health check-up. B. In the event that the operations of MINES services are substantially interrupted by acts of war, fire, insurrection, riot, earthquakes, communication equipment failure beyond MINES control or other acts of nature or any cause that is not the fault of MINES or is beyond reasonable control of MINES, MINES shall be relieved of its obligations as to those affected operations and only those affected portions of this Agreement for the duration of such interruption. C. The records of MINES will be the property of Mines and Associates, INC. unless otherwise stipulated and subject to appropriate Federal and State Law, including HIPAA, regarding such CITY files. 4. EXCLUDED SERVICES The following services are excluded from employee assistance contracts and MINES will have no obligation to provide any of the following services in conjunction with this Agreement. A. Pre-employment assessments for security personnel and other personnel as requested from time to time. These are available as a separate service and fee. B. Psychological, psychiatric, neurological, educational, IQ or neuropsychological testing. C. Remedial and social skills education services, such as evaluation or treatment of learning disabilities, learning disorders, academic skill disorders, language, disorders, intellectual disabilities, motor skill disorders, deaf education, blind education, communication disorders, behavioral training, attention deficit disorders, or cognitive rehabilitation. D. Fitness for duty evaluations. These are available as a separate service and fee. E. EAP services are excluded under this Agreement. EAP services include assessment and triage of chronic or acute mental disorders, psychological issues, addictions, or disorders that need the attention of a medical doctor. Treatment in an EAP model is not clinically appropriate for the above listed conditions. F. Court ordered counseling or evaluation for any reason including but not limited to child custody, domestic violence, DUI’s, or other legal matters. Referrals for these types of services will be made outside the MINES system. G. Evaluations related to determinations or excuses for leave of absence or time off. These are a subset of Fitness for Duty and billed separately. H. Workers’ Compensation evaluations or treatment. These services are available as a separate service and fee. I. Inpatient, day treatment, partial care, residential or intensive outpatient services associated with psychological or substance abuse diagnoses. J. Services by providers who are not part of the MINES EAP or PPO network and services not authorized by MINES. K. Medication or medication management. L. Examination and diagnostic services in connection with obtaining employment or a particular employment assignment, admission to or continuing in school, securing any kind of license or certificate (including professional licenses), or obtaining any kind of insurance coverage. DocuSign Envelope ID: AF29AC32-CA9A-4AD5-AC8C-9006FE523D30 Page 3 of 11 M. Testimony in legal proceedings or creation of records for legal proceedings or other preparation for legal proceedings. These services are available as a separate service and fee paid in advance by the party requesting them. N. Guidance on workplace issues when the employee or participant sues or threatens to sue the employer. O. Acupuncture, massage therapy, play therapy, biofeedback or hypnotherapy. 5. CONSIDERATION A. In consideration of MINES' performance pursuant to this Agreement, CITY agrees to pay MINES $100 per session identified in Section 3. The payment of these Costs shall commence on the Effective Date of this Agreement. Testimony in legal proceedings or creation of records for legal proceedings or other preparation for legal proceedings are billed at $500.00 per hour with a ten-hour minimum retainer paid in advance by the requesting party. B. MINES shall invoice CITY for the number of sessions occurring in the immediately preceding month, and terms of payment are net 30 days. C. CITY shall not share in the profits or losses of MINES from this Agreement. D. Upon prior written approval by CITY, CITY will reimburse for reasonable travel expenses outside the state of Colorado. These expenses may include such items as mileage (determined by IRS regulations), meals, hotel, and airfare. E. MINES reserves the right to charge a maximum of 8% annual interest for any undisputed outstanding fees that remain unpaid beyond the due date. 6. INDEPENDENT CONTRACTOR A. The parties expressly understand and agree that MINES is acting as an independent contractor unrelated to CITY. Nothing in this Agreement is intended to create a relationship, express or implied, of employer-employee or principal-agent between MINES and CITY or between CITY and any individual employed or provided to work under this Agreement by MINES. B. CITY shall have no direction and control over MINES or MINES employees, agents, subcontractors or the manner and method utilized by MINES and is interested only in results obtained by MINES. MINES shall determine and have sole discretion over the manner and methods utilized to achieve the results desired by CITY and shall be solely responsible for the direction, control and supervision of its acts and those of its agents, employees and subcontractors incident to the performance of this Agreement. MINES shall not have nor shall it represent itself as having any authority to make contracts in the manner of or binding on CITY or to pledge CITY credit or to extend credit in CITY name. CITY shall not have the authority to make contracts or extend credit for MINES. C. MINES has sole responsibility to determine those matters governing the employment terms and conditions for its employees working under this Agreement, including but not limited to selection, hiring, discipline, grievance resolution, pay, benefits and supervision and control of its employees. CITY has no authority or rights and shall not share or have any responsibility in the determination of such matters for such employees. D. CITY agrees not to hire or contract directly with MINES employees or former MINES employees for at least one year after the termination of this Agreement for employee assistance services, managed mental health care, or preferred provider services, or to share proprietary information with any other vendor of these services except as may be required by law. DocuSign Envelope ID: AF29AC32-CA9A-4AD5-AC8C-9006FE523D30 Page 4 of 11 7. LIABILITY FOR EXPENSES A. All expenses in any way pertaining to the provision of services under this Agreement shall be assumed solely by MINES; provided, however, CITY shall incur any and all preapproved expenses for advertising or marketing the program to its employees. MINES agrees that it shall assume sole responsibility for receiving funds and paying all expenses of every kind and nature incurred directly or indirectly under this Agreement. Except as otherwise noted in Sections 5.D, above, CITY assumes no financial responsibility of any kind or nature relative to the Agreement other than as set forth herein. 8. INDEMNIFICATION AND LIMITATION OF LIABILITY A. Each party hereto agrees to be responsible to the fullest extent allowed by law for its own wrongful or negligent acts or omissions, or those of its officers, agents, or employees. It is expressly understood and agreed that nothing contained in this Agreement shall be construed as an express or implied waiver by the CITY, its officers, agents or employees of the protections and limitations of liability set forth in the Colorado Governmental Immunity Act, C.R.S. §§ 24-10-101, et seq., or as otherwise provided by law. B. Notwithstanding anything in this Agreement to the contrary, each party’s liability to the other party hereunder shall be limited to the amount of actual damages suffered by the other party and, in no event, shall either party be responsible or liable for any consequential, punitive, indirect or any similar type of damages, suffered by the other party, even though such other similar types of damages may have been foreseeable hereunder. C. In no event whatsoever shall either party be liable for indirect, consequential, exemplary, punitive, or special damages. 9. INSURANCE A. MINES shall maintain during the full term of this Agreement, and any extension thereof, liability insurance to cover the liability of MINES as set forth in Appendix A. Before commencing services, MINES shall deliver to the CITY’s Purchasing Director, P. O. Box 580, Fort Collins, Colorado 80522, one copy of a certificate evidencing, at a minimum, the insurance coverage required and naming the CITY as additional insured under this Agreement. 10. RELEASES, LICENSES, PERMITS A. MINES shall obtain all releases, licenses, permits or other authorizations required to fulfill its obligations under this Agreement and shall indemnify and hold harmless CITY from all claims, demands, liability, suits or proceedings arising out of a failure to obtain required releases, licenses, permits or authorization. 11. PATIENT-MENTAL HEALTH CLINICIAN PRIVILEGE CITY acknowledges and agrees that all information and results or examinations or treatments performed pursuant to the provisions of this Agreement shall be subject to the Mental Health Clinician Patient Privilege prohibiting unauthorized release of professional information or communication. In the case of worker's compensation cases where the employee has made application, confidentiality is waived. 12. RELEASE OF MEDICAL INFORMATION A. CITY agrees that no information or communication made known to MINES or subcontractors during the performance of services pursuant to this Agreement shall be disclosed or released to any third party, excluding persons or departments within CITY or its affiliates designated or with a need to receive such information, pursuant to any request, demand, subpoena or order for such information without the clinician first notifying CITY and making reasonable efforts to notify the patient, or his DocuSign Envelope ID: AF29AC32-CA9A-4AD5-AC8C-9006FE523D30 Page 5 of 11 personal representative, of such request, demand, subpoena or order. The purpose of such notice is to afford the patient, his personal representative and/or CITY a reasonable opportunity to prevent the unauthorized disclosure of such information. B. CITY agrees, during the full term of this Agreement, MINES shall have the right to designate and make public that the CITY is a client of MINES. 13. CHANGES A. CITY may order minor/nominal changes to the work that are not inconsistent with the Statement of Work. No adjustment shall be made to the consideration, term, or other provisions of this Agreement for such changes. B. CITY may submit a written change order to the Statement of Work that is not currently contemplated with the Statement of Work. If such changes affect the stated term, consideration or other provisions of this Agreement, MINES may request amendment of the affected provisions and adjust the pricing accordingly. C. No services which require an additional cost or fee shall be provided by MINES without prior written authorization by the CITY’s designated representative (“Designated Representative“) with the exception of the trauma services, additional training, and organizational psychology fees which are billed on an hourly or daily basis and can be requested by telephone. CITY shall submit in writing prior to the starting date of the Agreement the names of its designated representatives and can change these designated representatives at anytime during the Agreement through written notification. D. Neither party shall make substitutions for any material or equipment specified in the Agreement without the prior express written approval of the Designated Representatives. E. MINES has the right to request changes to Program Costs, consideration (as described in Section 5.A of this Agreement), or other fees following the Initial Term and at the time of annual renewal of the contract as long as MINES contacts the CITY by email or courier no later than ninety (90) calendar days prior to the renewal date explaining the proposed changes and giving the CITY a reasonable amount of time and opportunity to review the requested changes. Should the CITY agree to the changes, such changes shall be agreed to in writing by both parties via the annual renewal or by Amendment. 14. CONFIDENTIAL INFORMATION A. All data, records, lists of employees and employers and all other information which may come into the possession of MINES or of which MINES may acquire knowledge by attending meetings of CITY in any way by reason of its relationship are confidential, and no information from such records, lists or data shall be divulged by MINES except as authorized by CITY or as required by governmental authority. In the event of a demand for information by a governmental authority and to the extent legally permissible, no information shall be disclosed without prior notice and consent of CITY, which consent shall not be unreasonably withheld B. Confidential Information shall also include any and all information, documentation, or material that has or could have commercial value or other utility in the business and/or services in which the disclosing party is engaged. Confidential Information may be in oral, visual, or graphic form and, for purposes of this Agreement, shall include any and all information relating to MINES’ services and provider network, to which CITY may gain access. Except as required by law, the party receiving Confidential Information, under this Agreement, shall not, without the prior written approval of the disclosing party, use for the receiving party’s own benefit, publish, copy, or otherwise disclose to DocuSign Envelope ID: AF29AC32-CA9A-4AD5-AC8C-9006FE523D30 Page 6 of 11 any third party, or permit the use by any third party for their benefit or to the detriment of the disclosing party, any such Confidential Information. C. Confidential Information shall also consist of any Protected Health Information (“PHI“), as that term is described under the Health Insurance Portability and Accountability ACT of 1996 (“HIPAA“) and the parties agree that they shall undertake and implement any actions required by HIPAA, concerning the disclosure, receipt, handling, maintenance and disposition of any PHI, to the extent applicable under this Agreement. 15. NOTICES All matters of an administrative or contractual nature pertaining to this Agreement including but not limited to the issuance of notices, amendments, time extensions, requests for changes and any other contractual correspondence, including exchange of signed signature pages of this Agreement, shall be directed to the parties via first class prepaid postage (return receipt requested), electronic mail, or prepaid courier service (via UPS), as set forth in Paragraph 2.C. 16. AMENDMENT This Agreement may be amended only by the mutual written consent of both parties. 17. ASSIGNMENT Neither party shall have the right or power to assign or subcontract its rights or obligations hereunder without the express written consent of the other party, which consent shall not be unreasonably withheld, except that no such consent will be required in connection with a merger, reorganization or sale of all or substantially all of such party’s stock or assets. Any attempt to do so without such consent shall be null and void and shall give the other party the right to cancel and terminate this Agreement. In the event consent is properly given, the provisions of this Agreement shall bind and inure to the benefit of the parties hereto and their respective successors and assigns. Notwithstanding anything in this Section 17, to the contrary, CITY agrees that MINES may use subcontractors as part of the MINES national services provider network. MINES’ subcontractors will be required to comply with all applicable terms of this Agreement, to include, but not limited to Sections 8- Indemnification, 9- Insurance and 14- Confidential Information 18. GOVERNING LAW AND VENUE This Agreement shall be deemed to have been made and accepted in Larimer County, Colorado, and the laws of the State of Colorado shall govern any interpretations or constructions of the Agreement. Any action pertaining to this Agreement shall be commenced and prosecuted in the courts of Larimer County, Colorado, and each party submits to the jurisdiction of said courts and waives the right to change venue. DocuSign Envelope ID: AF29AC32-CA9A-4AD5-AC8C-9006FE523D30 Page 7 of 11 19. AUTHORITY A. CITY and MINES each warrants that it has the full authority and power to enter into and perform under this Agreement and to make all representations warranties and grants as set forth herein. B. CITY and MINES each warrants that the individual executing this Agreement on its behalf is properly authorized to bind CITY and MINES respectively to the terms of this Agreement. 20. WAIVER Either party's failure in any one or more instances to insist upon strict performance of any of the terms and conditions of this Agreement or to exercise any right herein conferred shall not be construed as a waiver or relinquishment of that right or of such parties right to assert or rely upon the terms and conditions of this Agreement. Any express waiver of a term of this Agreement shall not be binding and effective unless made in writing and properly executed by the waiving party. 21. USE OF NAMES A. CITY agrees that MINES may use the name, logo, service marks or any other name or mark of CITY without prior written consent when done so in order to complete any term listed in the Statement of Work. MINES may not use this Agreement as an endorsement of MINES work without CITY’s prior written consent. CITY hereby consents that MINES may identify CITY as a customer of MINES in both its literature and general discussions with others, and that MINES may indicate the type of work MINES has performed or is performing for CITY, subject to the limitations of confidentiality set forth elsewhere in this Agreement. CITY agrees to serve as a reference regarding MINES’s work provided that any contact of CITY, by others, seeking such reference are reasonably limited in number and duration. B. MINES grants CITY authorization for the limited, revocable, nonexclusive, non-transferable usage of MINES’ logo for the purposes of providing relevant information regarding MINES’ service offerings. 21. SEVERABILITY The invalidity or unenforceability of any other provision, unless the unenforceable provision materially alters a party's obligations or responsibilities under this Agreement, shall not affect the validity or enforceability of any other provision. Subject to the foregoing, any invalid or unenforceable provision shall be deemed severed from this Agreement to the extent of its invalidity or unenforceability, and this Agreement shall be construed and enforced as if the Agreement did not contain that particular provision to the extent of its invalidity or unenforceability. 22. NON-COMPETE CITY agrees that during the full term of this Agreement and for a period of one (1) year following the termination of this Agreement, it shall not enter any contractual arrangement with, or actively solicit any member or participant of MINES’ services provider network, or other CITY companies, for the purpose of rendering services comparable to those rendered under this Agreement. Notwithstanding the foregoing, this paragraph shall not prohibit: (i) a party offering employment to and/or hiring a person with whom such party has had contact regarding possible employment prior to the date hereof; (ii) any general advertising or solicitation by a party that is not specifically targeted at employees of the other party or its subsidiaries or by the party’s hiring of any employee of the other party as a result of such employee’s response to such general advertising or solicitation; or (iii) a party offering employment to a person referred to such party by search firms, employment agencies or other similar entities. DocuSign Envelope ID: AF29AC32-CA9A-4AD5-AC8C-9006FE523D30 Page 8 of 11 23. LEGAL REMEDIES Either party may pursue any and all remedies available at law or at equity. The prevailing party is entitled to receive attorneys’ fees, court costs and other such awards as deemed appropriate by the court. 24. SURVIVAL The terms, conditions and provisions set forth in Sections 8 and 14 shall survive the termination of this Agreement. 25. NO STRICT CONSTRUCTION The language used in this Agreement shall be deemed to be the language chosen by the Parties to express their mutual intent, and no rule of strict construction shall be applied against any party. The Parties have participated jointly in the negotiation and drafting of this Agreement. In the event of an ambiguity or question of intent or interpretation, this Agreement shall be construed as if drafted jointly by the Parties, and no presumption or burden of proof shall arise favoring or disfavoring any party by virtue of the authorship of any of the provisions of this Agreement. 26. COUNTERPART SIGNATURES This Agreement may be executed in any number of counterparts, and each counterpart hereof shall be deemed to be an original instrument, but all counterparts hereof, taken together, shall constitute but a single instrument. 27. SUCCESSORS AND ASSIGNS This Agreement shall be binding upon and shall inure to the benefit of the respective successors and assigns of the Parties hereto. 28. INTEGRATION OF UNDERSTANDING This Agreement, together with all Schedules, Appendices and/or Exhibits attached hereto, constitutes the entire Agreement between the parties, relating to its subject matter. Any prior contracts, agreements, promises, negotiations, or representations not expressly set forth in this Agreement are hereby superseded and replaced and shall be of no further force and effect. 29. ACCEPTANCE NOT WAIVER. The CITY's approval or acceptance of, or payment for any of the services shall not be construed to operate as a waiver of any rights or benefits provided to the CITY under this Agreement or cause of action arising out of performance of this Agreement. 30. PROHIBITION AGAINST EMPLOYING ILLEGAL ALIENS. Pursuant to Section 8-17.5-101, C.R.S., et. seq., Service Provider represents and agrees that: a. As of the date of this Agreement: 1. Service Provider does not knowingly employ or contract with an illegal alien who will perform work under this Agreement; and 2. Service Provider will participate in either the e-Verify program created in Public Law 208, 104th Congress, as amended, and expanded in Public Law 156, 108th Congress, as amended, administered by the United States Department of Homeland Security (the “e-Verify Program”) or the Department Program (the “Department Program”), an employment verification program DocuSign Envelope ID: AF29AC32-CA9A-4AD5-AC8C-9006FE523D30 Page 9 of 11 established pursuant to Section 8-17.5-102(5)(c) C.R.S. in order to confirm the employment eligibility of all newly hired employees to perform work under this Agreement. b. Service Provider shall not knowingly employ or contract with an illegal alien to perform work under this Agreement or knowingly enter into a contract with a subcontractor that knowingly employs or contracts with an illegal alien to perform work under this Agreement. c. Service Provider is prohibited from using the e-Verify Program or Department Program procedures to undertake pre-employment screening of job applicants while this Agreement is being performed. d. If Service Provider obtains actual knowledge that a subcontractor performing work under this Agreement knowingly employs or contracts with an illegal alien, Service Provider shall: 1. Notify such subcontractor and the CITY within three days that Service Provider has actual knowledge that the subcontractor is employing or contracting with an illegal alien; and 2. Terminate the subcontract with the subcontractor if within three days of receiving the notice required pursuant to this section the subcontractor does not cease employing or contracting with the illegal alien; except that Service Provider shall not terminate the contract with the subcontractor if during such three days the subcontractor provides information to establish that the subcontractor has not knowingly employed or contracted with an illegal alien. e. Service Provider shall comply with any reasonable request by the Colorado Department of Labor and Employment (the “Department”) made in the course of an investigation that the Department undertakes or is undertaking pursuant to the authority established in Subsection 8-17.5-102 (5), C.R.S. f. If Service Provider violates any provision of this Agreement pertaining to the duties imposed by Subsection 8-17.5-102, C.R.S. the CITY may terminate this Agreement. If this Agreement is so terminated, Service Provider shall be liable for actual and consequential damages to the CITY arising out of Service Provider’s violation of Subsection 8-17.5-102, C.R.S. g. The CITY will notify the Office of the Secretary of State if Service Provider violates this provision of this Agreement and the CITY terminates the Agreement for such breach. DocuSign Envelope ID: AF29AC32-CA9A-4AD5-AC8C-9006FE523D30 Page 10 of 11 SIGNATURE PAGE IN WITNESS WHEREOF, the undersigned hereunto set their hands and seals as of the Effective Date set forth above. MINES AND ASSOCIATES, INC. ________________________ Daniél C. Kimlinger CITY OF FORT COLLINS ____________________________ Gerry Paul, Purchasing Director APPROVED AS TO FORM _______________________________ DocuSign Envelope ID: AF29AC32-CA9A-4AD5-AC8C-9006FE523D30 Assistant City Attorney ll Page 11 of 11 APPENDIX A Insurance Requirements 1. MINES will provide, from insurance companies acceptable to the CITY, the insurance coverage designated hereinafter and pay all costs. Before commencing work under this bid, MINES 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 below that which is outlined below 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 MINES, 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 MINES under this Agreement. The CITY, its officers, agents and employees shall be named as additional insureds on MINES '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. MINES shall maintain during the life of this Agreement for all of MINES'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 Liability. MINES shall maintain during the life of this Agreement such commercial general 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 coverage, Commercial General, shall not be less than $1,000,000 combined single limits for bodily injury and property damage. DocuSign Envelope ID: AF29AC32-CA9A-4AD5-AC8C-9006FE523D30 01/13/2020 Moody Insurance Agency, Inc. 8055 East Tufts Avenue Suite 1000 Denver CO 80237 Gabriel Negron-Rodriguez (303) 824-6600 (303) 370-0118 certrequest@moodyins.com Mines and Associates, Inc 10367 W. Centennial Road, Suite 100 Littleton CO 80127 Citizens Ins Co of America 31534 Pinnacol Assurance 41190 Lloyds of London 20-21 Master A OB4A81393004 01/01/2020 01/01/2021 1,000,000 300,000 5,000 1,000,000 2,000,000 A OB4A81393004 01/01/2020 01/01/2021 1,000,000 A OB4A81393004 01/01/2020 01/01/2021 1,000,000 1,000,000 B N 4198078 01/01/2020 01/01/2021 500,000 500,000 500,000 C Professional Liability Cyber Liability PGIARK0163008 01/01/2020 01/01/2021 Occ/Agg $1M/$3M Limit 1,000,000 ***For Info Only*** 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? (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: AF29AC32-CA9A-4AD5-AC8C-9006FE523D30