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HomeMy WebLinkAboutCORRESPONDENCE - AGREEMENT MISC - FORT COLLINS ARCHERY ASSOCIATION FCAA (2)November 16, 2020
Fort Collins Archery Association
Attn: Troy Tafoya
PO Box 270493
Fort Collins, CO 80527
RE: Renewal of Services Agreement for the Operation of the Fort Collins Archery Range
Dear Mr. Tafoya:
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, February 20, 2021 through February
19, 2022.
2. Exhibit B, City Property, is hereby amended to include the following:
Maintenance Building. The FCAA donated the funding for the replacement of the
maintenance shed in 2020. Contents within that are not permanently attached are
property of FCAA as listed in Exhibit A. Upon termination of this agreement FCAA
will remove all property within 30 days of termination.
If the renewal is acceptable to your firm, please sign this letter in the space provided and attach a
current copy of insurance naming the City as an additional insured for General Liability and
Automobile within the next fifteen 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 Beth Diven, Buyer at bdiven@fcgov.com if you have any questions regarding this
matter.
Sincerely,
Gerry Paul
Purchasing Director
__________________________________________ ________________
Signature Date
(Please indicate your desire to renew by signing this letter and returning it to Purchasing Division
within the next fifteen days.)
GP: bd
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: F329317C-0FED-42F9-B342-C576552E1336
11/16/2020
3/3/2020
Leavitt Recreation & Hospitality Insurance, Inc.
942 14th Street
Sturgis SD 57785
Kelly Jones
(800)525-2060 (866)465-2797
kelly-jones@leavitt.com
Fort Collins Archery Association
P.O. Box 270493
Fort Collins CO 80525
Philadelphia Indemnity Insurance Company18058
19-20 POI
A
X
X PHPK2005807 7/1/2019 7/1/2020
1,000,000
100,000
5,000
1,000,000
2,000,000
2,000,000
IT IS UNDERSTOOD AND AGREED THAT THE CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED, BUT ONLY WITH
RESPECT TO ITS LIABILITY ARISING OUT OF THE ACTIVITIES OF THE NAMED INSURED.
City of Fort Collins
P.O. Box 580
Fort Collins, CO 80521-0580
Chris Hipple/MISHAE
The ACORD name and logo are registered marks of ACORD
CERTIFICATE HOLDER
© 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01)
AUTHORIZED REPRESENTATIVE
CANCELLATION
CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
JECT LOC
PRO-
POLICY
GEN'L AGGREGATE LIMIT APPLIES PER:
CLAIMS-MADE OCCUR
COMMERCIAL GENERAL LIABILITY
PREMISES (Ea occurrence) $
DAMAGE TO RENTED
EACH OCCURRENCE $
MED EXP (Any one person) $
PERSONAL & ADV INJURY $
GENERAL AGGREGATE $
PRODUCTS - COMP/OP AGG $
DED RETENTION $
CLAIMS-MADE
OCCUR
$
AGGREGATE $
UMBRELLA LIAB EACH OCCURRENCE $
EXCESS LIAB
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
INSR
LTR TYPE OF INSURANCE POLICY NUMBER
POLICY EFF
(MM/DD/YYYY)
POLICY EXP
(MM/DD/YYYY) LIMITS
PER
STATUTE
OTH-
ER
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE
E.L. DISEASE - POLICY LIMIT
$
$
$
ANY PROPRIETOR/PARTNER/EXECUTIVE
If yes, describe under
DESCRIPTION OF OPERATIONS below
(Mandatory in NH)
OFFICER/MEMBER EXCLUDED?
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED SCHEDULED
HIRED AUTOS
NON-OWNED
AUTOS AUTOS
AUTOS
COMBINED SINGLE LIMIT
BODILY INJURY (Per person)
BODILY INJURY (Per accident)
PROPERTY DAMAGE $
$
$
$
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.
INSD
ADDL
WVD
SUBR
N / A
$
$
(Ea accident)
(Per accident)
OTHER:
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.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must 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).
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
INSURED
PHONE
(A/C, No, Ext):
PRODUCER
ADDRESS:
E-MAIL
FAX
(A/C, No):
CONTACT
NAME:
NAIC #
INSURER A :
INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
INSURER(S) AFFORDING COVERAGE
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
INS025 (201401)
DocuSign Envelope ID: F329317C-0FED-42F9-B342-C576552E1336