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HomeMy WebLinkAboutCORRESPONDENCE - RFP - 9102 SUPERVISORY CONTROL AND DATA ACQUISITION (SCADA) SYSTEM SUPPORT SERVICES (2)Utilities Work Order Form Official Purchasing Form Last updated 10/2017 WORK ORDER PURSUANT TO A MASTER AGREEMENT BETWEEN THE CITY OF FORT COLLINS AND TETRA TECH, INC. WORK ORDER NUMBER: T-WRF-2020-7 PROJECT TITLE: DWRF Cogeneration Project Construction ORIGINAL BID/RFP NUMBER & NAME: 9102 Supervisory Control and Data Acquisition (SCADA) System Support Services MASTER AGREEMENT EFFECTIVE DATE: June 1, 2020 ARCHITECT/ENGINEER: Carollo Engineering, Inc. OWNER’S REPRESENTATIVE: Link Mueller WORK ORDER COMMENCEMENT DATE: September 28, 2020 WORK ORDER COMPLETION DATE: December 31, 2020 MAXIMUM FEE: (time and reimbursable direct costs): $85,960.00 PROJECT DESCRIPTION/SCOPE OF SERVICES: Programming integration of all aspects of the DWRF Cogeneration Project. See attached supporting documents. Service Provider agrees to perform the services identified above and on the attached forms in accordance with the terms and conditions contained herein and in the Master Agreement between the parties. In the event of a conflict between or ambiguity in the terms of the Master Agreement and this Work Order (including the attached forms) the Master Agreement shall control. The attached forms consisting of five (5) pages are hereby accepted and incorporated herein, by this reference, and Notice to Proceed is hereby given after all parties have signed this document. SERVICE PROVIDER: TETRA TECH, INC. By: Date: Name: Title: Page 1 of 11 DocuSign Envelope ID: 3E94D14D-D08E-402B-9DE8-C28C73EE463B Deborah Herman Project Manager October 5, 2020 Utilities Work Order Form Official Purchasing Form Last updated 10/2017 OWNER’S ACCEPTANCE & EXECUTION: This Work Order and the attached Contract Documents are hereby accepted and incorporated herein by this reference. ACCEPTANCE: Date: Link Mueller, Civil Engineer III REVIEWED: Date: Pat Johnson, Senior Buyer REQUISITION ENTERED: Date: ACCEPTANCE: Date: Jason Graham, Director, Water Reclamation & Biosolids ACCEPTANCE: Date: Matt Fater, Director, Civil Engineering ACCEPTANCE: Date: Mark Kempton, Interim Deputy Director, Water Resources & Treatment Operations ACCEPTANCE: Date: Andrew Gingerich, Interim Deputy Director, Water Engineering & Field Services ACCEPTANCE: Date: Theresa Connor, Interim Utilities Executive Director (if greater than $1,000,000) ACCEPTANCE: Date: Gerry Paul, Purchasing Director (if greater than $60,000) ACCEPTANCE: Date: Darin Atteberry, City Manager (if greater than $1,000,000) ATTEST: Date: City Clerk (if greater than $1,000,000) Page 2 of 11 DocuSign Envelope ID: 3E94D14D-D08E-402B-9DE8-C28C73EE463B Melissa Walker Coordinator, Finance October 2, 2020 October 5, 2020 October 5, 2020 October 7, 2020 October 6, 2020 October 7, 2020 October 7, 2020 October 7, 2020 Utilities Work Order Form Official Purchasing Form Last updated 10/2017 ATTACHMENT A WORK ORDER SCOPE OF SERVICES Page 3 of 11 DocuSign Envelope ID: 3E94D14D-D08E-402B-9DE8-C28C73EE463B Tetra Tech 1560 Broadway, Suite 1400 | Denver, CO 80202 Tel 303.825.5999 | Fax 303.825.0642 | tetratech.com September 21, 2020 9102 SCADA System Support Services - Work Order #2: Programming and Commissioning Support for DWRF Cogeneration System SCOPE OF WORK Scope Background: Drake Water Reclamation Facility (DWRF) currently is under construction with a Combined Heat and Power generation system running off conditioned Biogas from the plant’s anaerobic digesters. Programming support will include monitoring digester gas levels to control the feed rate of gas to generator sets (gensets). Additional programming will be required to monitor the boiler water temperature to control the flowrate of water to the gensets. Monitoring of the gas conditioning system, gensets, and low-voltage switchgear will also need to be coordinated. Scope: 1. Project Management Services a. Meeting between Tetra Tech, Project Team, and ICE Team to establish project goals and schedule. Confirm work order procedures and workflow. b. Development of comprehensive project work plan and communications plan c. Ongoing coordination with Tetra Tech, Carollo, and Fort Collins project team d. Biweekly conference calls with the Tetra Tech Project Manager and Technical Lead to track progress of all ongoing and anticipated work orders. The Tetra Tech Project Manager will prepare an agenda and minutes. The price proposal includes funding for six meetings. e. Preparation of a monthly status report and invoice for the overall project. The price proposal includes funding for three months, which is the anticipated duration of this work order. 2. Preliminary System Investigation a. Review control descriptions: i. Cogen Generator Control Description ii. Gas Conditioning Control Description iii. Hot Water Control Description iv. Cogen Electrical/Switchgear Control Description b. Review of relevant equipment and instrument submittals c. Field Investigation of existing PLCD41 and PLCD43 and review of drawings d. Field observation of existing controls of related equipment e. Review Drawing Set for Cogeneration System 3. Control Description Completion Page 4 of 11 DocuSign Envelope ID: 3E94D14D-D08E-402B-9DE8-C28C73EE463B Tetra Tech 2 a. Participate in review meetings with applicable parties to finalize the control descriptions b. Coordination with project team and Woodward to review generator controls and interconnections c. Coordination with project team and Unison to review gas conditioning controls and interconnections 4. System Confirmation and Design Documents a. Prepare I/O list i. Create BOM if additional modules are required b. Prepare loop diagrams c. Prepare HMI/PLC tag list i. Tag list to identify all information flow between PLCs (including vendor systems), along with communications method (hardwired, Ethernet IP, Modbus) ii. Tag list to follow City’s naming standards d. Revise control descriptions, including addition of I/O and tags e. I/O list, loop diagrams, tag list and control descriptions will all be reviewed by Fort Collins project team f. Meet with Project Team to resolve any questions and discrepancies g. Participate as needed in meetings with Operations staff to plan cutovers 5. Programming and Contractor Assistance a. Using the City’s PLC programming standards, incorporate the new PLC code in the existing D41 and D43 programming to execute the control narrative for the different systems b. Review PLC program with project team at two stages: i. Review logic for equipment controls ii. Review logic for integrated program iii. Revise and resubmit as needed c. Prepare detailed test plan, based on the final control descriptions d. Test the program on the City’s test station per the test plan e. Coordinate with electrical subcontractor and provide QA/QC review and support as needed. f. Coordinate with City’s ICE team for Iconics HMI development 6. Pre-Implementation Coordination a. Conference call to review the final workplan i. Confirm programming is complete and all necessary materials are in hand. ii. Confirm project equipment and process is ready for implementation iii. Confirm final cutover plan with operations staff b. Prepare detailed functional test plan i. Test each piece of equipment ii. Test all modes of operation Page 5 of 11 DocuSign Envelope ID: 3E94D14D-D08E-402B-9DE8-C28C73EE463B Tetra Tech 3 iii. Test startup and shutdown sequences iv. Test all interlocks 7. PLC Program addition a. Install new program in PLCD41 and PLCD43 b. Assist in functional testing of individual equipment associated with the program c. Assist in system commissioning including verification of start-up sequences, interlocks, and shut down sequences d. Turn equipment over to plant staff 8. Final Documentation, Training & Support a. Update the control descriptions b. Provide as-built loop drawings c. Turn over final PLC programs to the City d. Assist Project Manager in developing and conducting staff training on operation of the cogeneration system e. Provide support as needed Page 6 of 11 DocuSign Envelope ID: 3E94D14D-D08E-402B-9DE8-C28C73EE463B Utilities Work Order Form Official Purchasing Form Last updated 10/2017 ATTACHMENT B WORK ORDER SCOPE COST DETAIL Page 7 of 11 DocuSign Envelope ID: 3E94D14D-D08E-402B-9DE8-C28C73EE463B Price Summary / Totals Task Pricing Totals 85,960 Bill Rate > 185.00 185.00 180.00 130.00 130.00 230.00 Specify Add'l Fees on Setup 0 Technology Use Fee Proj Area > 85,960 Submitted to: City of Fort Collins (Attn: Josh Monsrud / Link Mueller) Contract Type: T&M Project Phases / Tasks From Thru Months 533 98 166 3 210 52 4 0.00% 84,360 - 1,600 - - 85,960 1 2 3 4 5 6 1 System Investigation 4 - 4 - - - - 740 - 80 - - 820 Review P&IDs - - Review Process Control Desc - - Review Equip Submittal data - - Field Investigation/Observation 4 4 740 80 820 2 System Confirmation & Design Docs 152 36 50 - 26 40 - 24,490 - 400 - - 24,890 Detailed Control Descriptions 16 16 2,960 2,960 I/O List 2 2 370 370 Bill of Materials 4 4 740 740 Loop Drawings 48 8 40 6,680 6,680 HMI/PLC Tag List 20 6 4 10 3,150 3,150 Coordination w vendor systems 24 12 12 3,780 160 3,940 Cutover planning 22 6 12 4 3,850 80 3,930 Review meetings 16 8 8 2,960 160 3,120 3 PLCD41 Programming & Contractor Coord 102 6 28 - 68 - - 15,130 - 240 - - 15,370 Equipment Programming 48 8 40 6,680 6,680 Interconnections Programming 16 4 12 2,300 2,300 Acceptance Testing 14 2 4 8 2,150 160 2,310 Control Panel QC & Equipment Checkout 8 8 1,480 80 1,560 Review meetings 16 4 4 8 2,520 2,520 4 PLCD43 Programming & Contractor Coord 86 6 24 - 56 - - 12,830 - 240 - - 13,070 Equipment Programming 36 4 32 4,900 4,900 Interconnections Programming 16 4 12 2,300 2,300 Acceptance Testing 14 2 4 8 2,150 160 2,310 Control Panel QC & Equipment Checkout 8 8 1,480 80 1,560 Review meetings 12 4 4 4 2,000 2,000 5 Cutover & Commissioning 68 4 24 - 40 - - 10,380 - 480 - - 10,860 Install & commission PLCD41 updates 34 2 12 20 5,190 240 5,430 Install & commission PLCD43 updates 34 2 12 20 5,190 240 5,430 6 Final Documentation, Training, Support 28 4 4 - 8 12 - 4,080 - - - - 4,080 Final control descriptions 10 4 2 4 1,630 1,630 As Built Loop Drawings 14 2 12 1,930 1,930 Training Assistance 4 4 520 520 7 Support 12 - - - 12 - - 1,560 - - - - 1,560 As-needed 12 12 1,560 1,560 8 Project Management & Planning 81 42 32 3 - - 4 15,150 - 160 - - 15,310 System Access & Cybersecurity 10 2 4 4 2,030 2,030 Review Condition Assessment 14 3 8 3 2,575 2,575 Biweekly Project Status Meetings 18 12 6 3,330 3,330 Invoicing & Monthly Reports 9 9 1,665 1,665 Work Order Setup 6 4 2 1,110 1,110 Upcoming Work Planning 24 12 12 4,440 160 4,600 Totals 533 98 166 3 210 52 4 0.00% 84,360 - 1,600 - - 85,960 Task Pricing Schedule Totals Work Days Off Work Days Total Labor Hrs Subs Travel Mat'ls & Equip ODCs Labor Utilities Work Order Form Official Purchasing Form Last updated 10/2017 ATTACHMENT C WORK ORDER SCOPE SCHEDULE DETAIL Page 9 of 11 DocuSign Envelope ID: 3E94D14D-D08E-402B-9DE8-C28C73EE463B DWRF Cogeneration Programming Project Project Set up and Coordination Comprehensive Project and Communications Planning SCADA Condition Assessment review Kickoff Meeting Monthly Project Status Reporting System Confirmation and Design Docs Detailed Control Descriptions I/O List & BOM Loop Drawings HMI/PLC Tag Lists D43 D41 Coordination w Vendor Systems (Woodward, Unison) Programming & Contractor Coordination Equipment Programming D43 D41 Interconnection Programming Control Panel QA and Checkout Program testing Program Installation and Commissioning Training Assistance and Final Documentation System Support As Needed Sep Oct Nov Dec 2020 9102 SCADA System Services Work Order #2: DWRF Cogeneration Programming Services Page 10 of 11 DocuSign Envelope ID: 3E94D14D-D08E-402B-9DE8-C28C73EE463B Utilities Work Order Form Official Purchasing Form Last updated 10/2017 ATTACHMENT D CERTIFICATE OF INSURANCE CONTRACTOR shall submit Certificate of Insurance in compliance with the Contract Documents. Page 11 of 11 DocuSign Envelope ID: 3E94D14D-D08E-402B-9DE8-C28C73EE463B Holder Identifier : FGHZ2 7777777707070700077761616045571110767717016204447207442027772507300072640577046230130777051513167400307177154633275103071372334671377610723511067402265607724011570076530076727242035772000777777707000707007 7777777707070700073525677115456000732101417137002007133327253162010071333262521730010713233625207311107132227253173001070223363530731110713333624306310107132237353163001077756163351765540777777707000707007 Certificate No : 570084053455 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 09/24/2020 IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. PRODUCER Aon Risk Insurance Services West, Inc. Los Angeles CA Office 707 Wilshire Boulevard Suite 2600 Los Angeles CA 90017-0460 USA PHONE (A/C. No. Ext): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # (866) 283-7122 INSURED INSURER A: Lexington Insurance Company 19437 INSURER B: Zurich American Ins Co 16535 INSURER C: American International Group UK Ltd AA1120187 INSURER D: INSURER E: INSURER F: FAX (A/C. No.): (800) 363-0105 CONTACT NAME: Tetra Tech, Inc. 1560 Broadway Suite 1400 Denver CO 48226 USA COVERAGES CERTIFICATE NUMBER: 570084053455 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested POLICY EXP (MM/DD/YYYY) POLICY EFF (MM/DD/YYYY) SUBR WVD INSR LTR ADDL TYPE OF INSURANCE INSD POLICY NUMBER LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR POLICY LOC EACH OCCURRENCE Blanket Notification to Others of Cancellation or Non-Renewal U-CA-832-A CW (01/13) Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Policy No. Eff. Date of Pol. Exp. Date of Pol. Eff. Date of End. Producer No. Add’l. Prem Return Prem. BAP 1857085-02 10/01/2020 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Commercial Automobile Coverage Part A. If we cancel or non-renew this Coverage Part by written notice to the first Named Insured, we will mail or deliver notification that such Coverage Part has been cancelled or non-renewed to each person or organization shown in a list provided to us by the first Named Insured if you are required by written contact or written agreement to provide such notification. However, such notification will not be mailed or delivered if a conditional notice of renewal has been sent to the first Named Insured. Such list: 1. Must be provided to us prior to cancellation or non-renewal; 2. Must contain the names and addresses of only the persons or organizations requiring notification that such Coverage Part has been cancelled or non-renewed; and 3. Must be in an electronic format that is acceptable to us. B. Our notification as described in Paragraph A. of this endorsement will be based on the most recent list in our records as of the date the notice of cancellation or non-renewal is mailed or delivered to the first Named Insured. We will mail or deliver such notification to each person or organization shown in the list: 1. Within seven days of the effective date of the notice of cancellation, if we cancel for non-payment of premium; or 2. At least 30 days prior to the effective date of: a. Cancellation, if cancelled for any reason other than nonpayment of premium; or b. Non-renewal, but not including conditional notice of renewal. C. Our mailing or delivery of notification described in Paragraphs A. and B. of this endorsement is intended as a courtesy only. Our failure to provide such mailing or delivery will not: 1. Extend the Coverage Part cancellation or non-renewal date; 2. Negate the cancellation or non-renewal; or 3. Provide any additional insurance that would not have been provided in the absence of this endorsement. D. We are not responsible for the accuracy, integrity, timeliness and validity of information contained in the list provided to us as described in Paragraphs A. and B. of this endorsement. All other terms and conditions of this policy remain unchanged. 10/01/2021 75272000 INCL DocuSign Envelope ID: 3E94D14D-D08E-402B-9DE8-C28C73EE463B WC 00 03 13 (Ed. 4-84)  1983 National Council on Compensation Insurance. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule ALL PERSONS AND/OR ORGANIZATIONS THAT ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT WITH THE INSURED, EXECUTED PRIOR TO THE ACCIDENT OR LOSS, THAT WAIVER OF SUBROGATION BE PROVIDED UNDER THIS POLICY FOR WORK PERFORMED BY YOU FOR THAT PERSON AND/OR ORGANIZATION POLICY NUMBER: WC 2540616-02 DocuSign Envelope ID: 3E94D14D-D08E-402B-9DE8-C28C73EE463B WC 42 03 04 B (Ed. 6-14) © Copyright 2014 National Council on Compensation Insurance, Inc. All Rights Reserved. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 42 03 04 B (Ed. 6-14) TEXAS WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement applies only to the insurance provided by the policy because Texas is shown in Item 3.A. of the Information Page We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule, but this waiver applies only with respect to bodily injury arising out of the operations described in the Schedule where you are required by a written contract to obtain this waiver from us. This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule. The premium for this endorsement is shown in the Schedule. Schedule 1. (☐) Specific Waiver Name of person or organization (☒) Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. 2. Operations: ALL PERSONS AND/OR ORGANIZATIONS THAT ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT WITH THE INSURED, EXECUTED PRIOR TO THE ACCIDENT OR LOSS, THAT WAIVER OF SUBROGATION BE PROVIDED UNDER THIS POLICY FOR WORK PERFORMED BY YOU FOR THAT PERSON AND/OR ORGANIZATION. 3. Premium: The premium charge for this endorsement shall be percent of the premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operations described. 4. Advance Premium: POLICY NUMBER: WC 2540616-02 DocuSign Envelope ID: 3E94D14D-D08E-402B-9DE8-C28C73EE463B WC 43 03 05 (Ed. 7-00) 2000 National Council on Compensation Insurance, Inc. WC 43 03 05 (Ed. 7-00) UTAH WAIVER OF SUBROGATION ENDORSEMENT This endorsement applies only to the insurance provided by the policy because Utah is shown in Item 3.A. of the Information Page. We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Our waiver of rights does not release your employees’ rights against third parties and does not release our authority as trustee of claims against third parties. Schedule ALL PERSONS AND/OR ORGANIZATIONS THAT ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT WITH THE INSURED, EXECUTED PRIOR TO THE ACCIDENT OR LOSS, THAT WAIVER OF SUBROGATION BE PROVIDED UNDER THIS POLICY FOR WORK PERFORMED BY YOU FOR THAT PERSON AND/OR ORGANIZATION. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY POLICY NUMBER: WC 2540616-02 DocuSign Envelope ID: 3E94D14D-D08E-402B-9DE8-C28C73EE463B 10/01/2019 028182375 DocuSign Envelope ID: 3E94D14D-D08E-402B-9DE8-C28C73EE463B WC 99 06 43 Page 1 of 1 (Ed. 01-13) Includes copyright material of the National Council on Compensation Insurance, Inc. used with its permission. 2012 Copyright National Council on Compensation Insurance, Inc. All Rights Reserved. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 43 BLANKET NOTIFICATION TO OTHERS OF CANCELLATION OR NONRENEWAL ENDORSEMENT This endorsement adds the following to Part Six of the policy. PART SIX CONDITIONS Blanket Notification to Others of Cancellation or Nonrenewal 1. If we cancel or non-renew this policy by written notice to you, we will mail or deliver notification that such policy has been cancelled or non-renewed to each person or organization shown in a list provided to us by you if you are required by written contract or written agreement to provide such notification. However, such notification will not be mailed or delivered if a conditional notice of renewal has been sent to you. Such list: a. Must be provided to us prior to cancellation or non-renewal; b. Must contain the names and addresses of only the persons or organizations requiring notification that such policy has been cancelled or non-renewed; and c. Must be in an electronic format that is acceptable to us. 2. Our notification as described in Paragraph 1. above will be based on the most recent list in our records as of the date the notice of cancellation or non-renewal is mailed or delivered to you. We will mail or deliver such notification to each person or organization shown in the list: a. Within seven days of the effective date of the notice of cancellation, if we cancel for non-payment of premium; or b. At least 30 days prior to the effective date of: (1) Cancellation, if cancelled for any reason other than nonpayment of premium; or (2) Non-renewal, but not including conditional notice of renewal. 3. Our mailing or delivery of notification described in Paragraphs 1. and 2. above is intended as a courtesy only. Our failure to provide such mailing or delivery will not: a. Extend the policy cancellation or non-renewal date; b. Negate the cancellation or non-renewal; or c. Provide any additional insurance that would not have been provided in the absence of this endorsement. 4. We are not responsible for the accuracy, integrity, timeliness and validity of information contained in the list provided to us as described in Paragraphs 1. and 2. above. All other terms and conditions of this policy remain unchanged. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective Policy No. Endorsement No. Insured Premium $ Insurance Company ZURICH AMERICAN INSURANCE COMPANY WC 1857087-02 DocuSign Envelope ID: 3E94D14D-D08E-402B-9DE8-C28C73EE463B DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG X X X X X GEN'L AGGREGATE LIMIT APPLIES PER: $2,000,000 $1,000,000 $10,000 $2,000,000 $4,000,000 $4,000,000 X,C,U Coverage B GLO181740602 10/01/2020 10/01/2021 PRO- JECT OTHER: AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY SCHEDULED AUTOS HIRED AUTOS ONLY NON-OWNED AUTOS ONLY BODILY INJURY ( Per person) PROPERTY DAMAGE (Per accident) X BODILY INJURY (Per accident) $5,000,000 B 10/01/2020 10/01/2021 COMBINED SINGLE LIMIT (Ea accident) BAP 1857085 02 EXCESS LIAB X OCCUR CLAIMS-MADE AGGREGATE EACH OCCURRENCE DED $10,000,000 $10,000,000 $100,000 UMBRELLA LIAB 10/01/2020 C 62785232 10/01/2021 X RETENTION X E.L. DISEASE-EA EMPLOYEE E.L. DISEASE-POLICY LIMIT E.L. EACH ACCIDENT $1,000,000 X OTH- ER B 10/01/2020 10/01/2021 PER STATUTE B WC185708702 10/01/2020 10/01/2021 $1,000,000 Y / N (Mandatory in NH) ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED? N N / A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY If yes, describe under DESCRIPTION OF OPERATIONS below $1,000,000 WC254061602 028182375 10/01/2019 10/01/2021 Each Claim Prof/Poll Liab Agggregate $1,000,000 A Env Contr Prof SIR applies per policy terms & conditions $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Job Description: 9102 SCADA System Support Services. City of Fort Collins is included as Additional Insured in accordance with the policy provisions of the General Liability and Automobile Liability policies as required by written contract. Stop Gap Coverage for the following states: OH, ND, WA, WY. CERTIFICATE HOLDER CANCELLATION CityREPRESENTATIVE of Fort Collins AUTHORIZED Attn: Purchasing Director PO Box 580 Fort Collins CO 80522 USA ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. DocuSign Envelope ID: 3E94D14D-D08E-402B-9DE8-C28C73EE463B Rate Esc. Labor Programming QA/QC (Astrid Fleischer) Programmer II (Phong Hoang) Senior CAD Designer (Kelly Kramer) Senior Cybersecurity Consultant (Bob George) Programming & Commissioning Support for DWRF Cogeneration System Total Price Pricing by Resource Project Manager (Deb Herman) Technical Lead (Corey Lamb) 6 Resource Fort Collins - DWRF Cogen System Price Proposal Labor Plan Tetra Tech - Confidential and Proprietary Page 1 of 1 Printed 9/21/2020 Page 8 of 11 DocuSign Envelope ID: 3E94D14D-D08E-402B-9DE8-C28C73EE463B