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HomeMy WebLinkAboutCORRESPONDENCE - RFP - 8109 CAFE CONCESSION - FORT COLLINS MUSEUM OF DISCOVERY (3)Concession Agreement – 8109 Café Concession Page 1 of 18 CONCESSION AGREEMENT THIS AGREEMENT made and entered into the day and year set forth below by and between THE CITY OF FORT COLLINS, COLORADO, a Municipal Corporation, hereinafter referred to as the "City" and Flat-Hat Coffee LLC, a Colorado Limited Liability Company, hereinafter referred to as "Concessionaire." WITNESSETH: 1. Premises covered by Concession Agreement The premises covered by this Agreement shall be the Fort Collins Museum of Discovery (Museum), located at 408 N. Mason Street, Fort Collins, Colorado 80524. 2. Term The initial term of this Agreement shall begin on June 1, 2015 and end May 31, 2016 unless terminated sooner as herein provided. At the sole discretion of the City, this Agreement may be extended for additional one-year terms, up to four (4) additional one-year terms. Written notice of renewal will be provided to the Concessionaire and sent no later than thirty (30) days prior to contract end. 3. Services The Concessionaire agrees to provide services in accordance with the Scope of Services attached hereto as Exhibit “A”, consisting of two (2) pages and incorporated herein by this reference, and by the terms specified in this Agreement. 4. Licenses, permits, and taxes The Concessionaire shall obtain and pay for all licenses, permits and taxes, required by law or necessary for the operation of the concession at the Museum; including, but not limited to Sales/Use Tax License and a Larimer County Health Permit. Any such licenses or permits held by the Concessionaire in connection with the concession are to be surrendered by the Concessionaire at the time of termination of the Agreement and the Concessionaire expressly agrees to surrender all of such licenses or permits and not oppose any new license or permit applications by such person as the City may select. The Concessionaire shall collect and remit sales taxes on all taxable sales in the manner prescribed by law. 5. Contingency In the event the Concessionaire is not able to obtain all licenses and permits required to operate the concession at the Museum, this Agreement shall become null and void and both parties shall be released from further obligations under this Agreement. 6. Regulations and Administration The Concessionaire must conduct all concession operations in accordance with all applicable ordinances, laws, statutes, rules and regulations of any authority having lawful jurisdiction over the premises. The City will designate, prior to commencement of the work, its representative DocuSign Envelope ID: 7614EAA7-07D8-4458-A975-05A09D92C223 Concession Agreement – 8109 Café Concession Page 2 of 18 who shall make, within the scope of his or her authority, all necessary and proper decisions with reference to the services provided under this Agreement. All requests concerning this Agreement shall be directed to the City Representative. 7. Pricing Prices charged for food and beverages provided by the Concessionaire must be approved by the Executive Directors of the Museum. 8. Concession Fee The concession fee for the initial one (1) year term shall be $3,000. The annual concession fee shall be $6,000 thereafter in the event the parties renew the Agreement. All such sums shall be payable annually to the Museum, with payment due forty-five (45) days after the anniversary date of the Agreement. 9. Reporting and Payment The Concessionaire shall keep adequate and proper business records which will include all expenses and receipts of the concession operation. Upon the City's request, all such records shall be made open and available for inspection and audit by the City. The Concessionaire shall maintain daily sales records, itemized by the type of food and beverage and payment, in electronic format. The Concessionaire shall provide the Museum a sales report quarterly, by the 10th day of the month following the close of the quarter. The Concessionaire will give the Executive Directors of the Museum an annual sales report summary, due by January 31st of each year of the Agreement, detailing sales by the café and private events. Failure to pay charges or provide sales reports may result in termination of the Agreement. 10. Equipment and Supplies The Concessionaire shall be responsible for providing all supplies, inventory and miscellaneous equipment required to operate the concession. The Concessionaire shall also provide and pay for all telephones, cash registers, POS System, credit card machine. In addition to the Concession Space, the Museum shall provide the following:  Equipment listed on attached Exhibit “B”, consisting of one (1) page and incorporated herein by reference;  Lighting fixtures for general area illumination;  Tables and seating for the area; and  Heat and air conditioning 11. Dress Code Business casual dress code is required for all Staff working in the café and is subject to approval by the City. Name tags are required to be displayed at all times, as approved by the Executive Directors of the Museum. DocuSign Envelope ID: 7614EAA7-07D8-4458-A975-05A09D92C223 Concession Agreement – 8109 Café Concession Page 3 of 18 12. Advertising Any advertising done by the Concessionaire requires the written permission of the Executive Directors of the Museum. 13. Utilities, Maintenance and Janitorial Duties 13.1 Utilities. The Museum shall pay all charges for water, storm water, sewer, gas, trash collection, recycling, basic facility security system, natural gas and electric services to the Concession Space. 13.2 Maintenance and Repair. The Museum shall maintain and repair the Concession Space and Museum owned equipment and fixtures. Concessionaire shall submit all requests for repairs or maintenance to the Museum Representative. 13.3 Cleaning and Janitorial. The Concessionaire shall keep the Concession Space and its fixtures clean and in good sanitary condition as required by the ordinances, resolutions, statutes and health, sanitary and police regulations of the City of Fort Collins, County of Larimer and State of Colorado. 13.4 Trash. The Concessionaire is responsible for the ongoing cleanliness of the Concession Space in order to provide a clean and orderly appearance for patrons including but not limited to, removal of all food and drink containers including plates, napkins, eating utensils, bottles and cups, and proper disposal into recycling, composting and trash bins in the designated garbage collection area, and removing trash accumulations in designated trash containers. Trash will not be allowed to travel through the Museum to designated trash containers. 14. Independent Contractor The services to be performed by Concessionaire are those of an independent service provider and not of an employee of the City of Fort Collins or the Museum. The City shall not be responsible for withholding any portion of Concessionaire’s compensation hereunder for the payment of FICA, Workmen's Compensation or other taxes or benefits or for any other purpose. 15. Insurance Requirements 15.1 The Concessionaire agrees to indemnify and save harmless the City, its officers, agents and employees, as well as the Fort Collins Museum of Discovery, a Nonprofit Partner, against and from any and all actions, suits, claims, demands or liability of any character whatsoever brought or asserted for injuries to or death of any person or persons, or damages to property arising out of, result from or occurring in connection with the performance of any service hereunder. DocuSign Envelope ID: 7614EAA7-07D8-4458-A975-05A09D92C223 Concession Agreement – 8109 Café Concession Page 4 of 18 15.2 The Concessionaire shall take all necessary precautions in performing the work hereunder to prevent injury to persons and property. 15.3 Without limiting any of the Concessionaire's obligations hereunder, the Concessionaire shall provide and maintain insurance coverage naming the City and the Fort Collins Museum of Discovery, a Nonprofit Partner, as an additional insured under this Agreement of the type and with the limits specified within Exhibit “C”, consisting of one (1) page, attached hereto and incorporated herein by this reference. The Concessionaire, before commencing services hereunder, shall deliver to the City's Director of Purchasing and Risk Management, P. O. Box 580 Fort Collins, Colorado 80522 one copy of a certificate evidencing the insurance coverage required from an insurance company acceptable to the City. 16. Concessionaire Personnel Concessionaire shall control the conduct and demeanor of its agents and employees. The Concessionaire agrees to provide to the City at all times a current list of employees, volunteers and other representatives or agents of Concessionaire that will be working on behalf of Concessionaire in providing services to the City under this Agreement. The Concessionaire and the City acknowledge and agree that certain services provided by Concessionaire will require that employees and volunteers of Concessionaire act in positions of trust which will entail the handling of and accounting for funds of the City and City property, or direct contact with youth and other members of the general public. Accordingly, Concessionaire agrees that all employees, volunteers, and other representatives or agents of the Concessionaire in positions of trust, as described in Exhibit “D”, consisting of two (2) pages, attached hereto and incorporated herein by this reference, shall be screened using the background screening procedure described on Exhibit D, and that the results of such background screening shall be provided to the City prior to any such persons participation in the provision of services hereunder. The Concessionaire shall require the completion and execution of the Disclosure Form, attached hereto as Exhibit “E”, consisting of three (3) pages and incorporated herein by this reference, and shall provide to the employee/volunteer the Summary of Rights under the Fair Credit Reporting Act, included as part of Exhibit E. The City may provide assistance in completing the background investigation, including providing information from the completed disclosure form to an outside vendor for a confidential records check. Concessionaire acknowledges that in such event, by providing such assistance to Concessionaire the City assumes no responsibility for the timeliness, accuracy or completeness of the background investigation, or for the direct or indirect consequences resulting from the same, and Concessionaire shall hold the City harmless for any injury or loss resulting therefrom. In the event that a background check, or any other information available to the Concessionaire or the City, raises questions about the trustworthiness, fitness for provision of services under this Agreement, competence or suitability of any individual for a position of trust of any kind, including handling of funds, City equipment or property, or working with youths or other members of the general public, such individual shall not be employed or allowed to volunteer in DocuSign Envelope ID: 7614EAA7-07D8-4458-A975-05A09D92C223 Concession Agreement – 8109 Café Concession Page 5 of 18 connection with the services or activities required or permitted under this Agreement, or in a manner that would permit contact by that person with the funds, equipment, property associated with the provision of services hereunder, or persons participating in programs or services provided under this Agreement. Upon objection from the City concerning trustworthiness, fitness for provision of services under this Agreement, competence or suitability of any individual for a position of trust of any kind, or concerning conduct, demeanor or competence of any employee or volunteer of Concessionaire, the Concessionaire shall immediately take all lawful steps to remove the cause of the objection or to remove such individual from the performance of any services provided hereunder. 17. General Conditions 17.1 This Agreement may not be enlarged, modified or altered except in writing, signed by the parties as an amendment hereto. 17.2 No waiver of any breach of this Agreement shall be held or construed to be a waiver of any subsequent breach thereof. 17.3 It is expressly understood and agreed by and between the parties hereto that in the performance of the terms and conditions of this Agreement, time is of the essence. 17.4 The location assigned is not transferable to another Concessionaire. 17.5 Fixtures and Improvements: 17.5.1 The Concessionaire agrees that all auxiliary equipment needed to operate the concession shall be installed at its expense. Prior to making any and all improvements on said premises, the Concessionaire agrees to obtain the written approval of the City. 17.5.2 Upon the termination of this Agreement the Concessionaire shall remove any fixtures or improvements made by it to the Concession Space. However, the Concession Space must be restored to as good a condition as the premises were in at the time the Concessionaire took possession thereof. 17.6 This Agreement shall be binding upon and inure to the benefit of the heirs, successors, and assigns of the parties hereto. 17.7 Any notice required or desired to be given under this Agreement will be considered delivered to the other party upon hand delivery or upon its deposit in DocuSign Envelope ID: 7614EAA7-07D8-4458-A975-05A09D92C223 Concession Agreement – 8109 Café Concession Page 6 of 18 the United States mail, postage prepaid, sent by registered mail, addressed to the other party at the following address: City: Concessionaire: Museum: City of Fort Collins Purchasing Division P.O. Box 580 Fort Collins, CO 80522 Flat-Hat Coffee LLC Attn: Eric Wisner 1637 Tanglewood Dr. Fort Collins, CO 80525 Fort Collins Museum of Discovery Attn: Cheryl Donaldson 408 N Mason Street Fort Collins, CO 80524 Notwithstanding the time periods contained herein, either party may terminate this Agreement at any time without cause by providing written notice of termination to the other party. Such notice shall be delivered at least fifteen (15) days prior to the termination date contained in said notice unless otherwise agreed in writing by the parties. All notices provided under this Agreement shall be effective when mailed, postage prepaid and sent to the above address. 18. Assignment The Concessionaire shall neither assign any of the rights nor delegate any of the duties imposed upon it under the provisions of this Agreement without having first obtained the written permission of both the City and Museum. 19. Default Each and every term and condition hereof shall be deemed to be a material element of this Agreement. In the event either party should fail or refuse to perform according to the terms of this Agreement, such party may be declared in default thereof. 20. Remedies In the event a party has been declared in default, such defaulting party shall be allowed a period of ten (10) days within which to cure said default. In the event the default remains uncorrected, the party declaring default may elect to (a) terminate the Agreement and seek damages; (b) treat the Agreement as continuing and require specific performance; or (c) avail himself of any other remedy at law or equity. If the non-defaulting party commences legal or equitable actions against the defaulting party, the defaulting party shall be liable to the non-defaulting party for the non-defaulting party's reasonable attorney fees and costs incurred because of the default. 21. Law/Severability The laws of the State of Colorado shall govern the construction interpretation, execution and enforcement of this Agreement. In the event any provision of this Agreement shall be held invalid or unenforceable by any court of competent jurisdiction, such holding shall not invalidate or render unenforceable any other provision of this Agreement. 22. Prohibition Against Employing Illegal Aliens Pursuant to Section 8-17.5-101, C.R.S., et. seq., Concessionaire represents and agrees that: 22.1 As of the date of this Agreement: DocuSign Envelope ID: 7614EAA7-07D8-4458-A975-05A09D92C223 Concession Agreement – 8109 Café Concession Page 7 of 18 1. Concessionaire does not knowingly employ or contract with an illegal alien who will perform work under this Agreement; and 2. Concessionaire 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 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. 22.2 Concessionaire 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. 22.3 Concessionaire 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. 22.4 If Concessionaire obtains actual knowledge that a subcontractor performing work under this Agreement knowingly employs or contracts with an illegal alien, Concessionaire shall: 1. Notify such subcontractor and the City within three (3) days that Concessionaire 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 (3) days of receiving the notice required pursuant to this section the subcontractor does not cease employing or contracting with the illegal alien; except that Concessionaire 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. 22.5 Concessionaire 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. 22.6 If Concessionaire 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, Concessionaire shall be liable for actual and consequential damages to the City arising out of Concessionaire’s violation of Subsection 8-17.5-102, C.R.S. DocuSign Envelope ID: 7614EAA7-07D8-4458-A975-05A09D92C223 Concession Agreement – 8109 Café Concession Page 8 of 18 22.7 The City will notify the Office of the Secretary of State if Concessionaire violates this provision of this Agreement and the City terminates the Agreement for such breach. 23. Special Provisions Special provisions or conditions relating to the services to be performed pursuant to this Agreement are set forth in Exhibit "F", consisting of one (1) page, attached hereto and incorporated herein by this reference. CITY OF FORT COLLINS, COLORADO a municipal corporation By:_______________________________ Gerry Paul Director of Purchasing and Risk Management Date:_____________________________ ATTEST: _________________________________ City Clerk APPROVED AS TO FORM: ________________________________ Deputy City Attorney FLAT-HAT COFFEE LLC By:_______________________________ __________________________________ PRINT NAME __________________________________ TITLE Date:_____________________________ DocuSign Envelope ID: 7614EAA7-07D8-4458-A975-05A09D92C223 Eric Wisner Eric Wisner 5/29/2015 insurance 6/1/2015 Concession Agreement – 8109 Café Concession Page 9 of 18 EXHIBIT A SCOPE OF SERVICES I. INTRODUCTION The City of Fort Collins (City) has partnered with the Concessionaire to operate and manage a prepared packaged food and non-alcoholic beverage café concession at the designated Concession Space in the Fort Collins Museum of Discovery (Museum). A. The Facility The Fort Collins Museum of Discovery, located at 408 North Mason Street, Fort Collins, CO 80524, is a museum featuring innovative exhibits highlighting cultural and scientific achievements through hands-on exhibits and artifact based experiences. This facility is 47,000 sq. ft. and is a LEED Platinum building. The museum has two (2) years of visitation data; year one, the Museum saw over 115,000 visitors and year two, the museum saw over 92,000 visitors. In addition to exhibits there is a research center, gift shop, café, digital dome, classrooms, rooftop deck and outdoor experiences area. The café has a separate entrance and is part of the free zone in the Museum. B. The Museum’s Mission The Museum creates meaningful opportunities for people of all ages to learn, reflect, and have fun through hands-on and collections-based explorations in science and culture. The overarching theme of the Museum is sustainability; sustainability of self, environment and community. The café should reflect these values in its service to visitors. II. SCOPE OF SERVICES The Concessionaire will be responsible for providing all staff, prepared packaged food, and non- alcoholic beverages. The café is approximately 400 sq. ft. with an additional 400 sq. ft. of indoor and outdoor seating. Additional areas in the Museum that might be available for café use includes: the classrooms and patio, outdoor spaces, lobby, and the rooftop observation deck. The Concessionaire will be responsible for providing all food for the café; however Concessionaire will not be required to provide catering services for the Museum outside of the café. The Concessionaire will be required to work in cooperation with catering services, special event alcoholic beverage services and vending machine operations. The Concessionaire understands that the Fort Collins Museum of Discovery is a museum artifact-based institution that has delicate exhibits in the facility and will manage its operations in a manner that will not compromise the integrity of the artifact collection or exhibits. The City encourages the use of disposable cups, plates, napkins and eating utensils that are either compostable or recyclable. The City also encourages the use of coffee that is grown and marketed sustainably. The City recommends the Concessionaire incorporate the Dietary Guidelines for Americans, as outlined on www.health.gov/dietaryguidelines. The Dietary Guidelines encourage Americans to focus on eating a healthy diet; one that focuses on foods and beverages that help achieve and maintain a healthy weight, promote health, and prevent disease. DocuSign Envelope ID: 7614EAA7-07D8-4458-A975-05A09D92C223 Concession Agreement – 8109 Café Concession Page 10 of 18 The Concession Space must be fully staffed and operational during operating hours of the Museum and all scheduled events as required by the Museum Executive Directors and/or the Museum Event Coordinator. Museum hours are Tuesday – Saturday 10 a.m. to 5 p.m. but an earlier start time may be negotiated and mutually agreed upon. As this is a new service, the estimated combined annual gross revenue for the café concession operation is unknown. DocuSign Envelope ID: 7614EAA7-07D8-4458-A975-05A09D92C223 Concession Agreement – 8109 Café Concession Page 11 of 18 EXHIBIT B EQUIPMENT INVENTORY (SUPPLIED BY THE MUSEUM) ITEM 1: REACH IN REFRIGERATOR Quantity: One (1) ITEM 2: UNDERCABINET REFRIGERATOR Quantity: One (1) ITEM 3: UNDERCABINET ICE MAKER Quantity: One (1) ITEM 4: COFFEE GRINDER Quantity: One (1) ITEM 5: REFIRGERATED DISPLAY CABINET Quantity: One (1) ITEM 6: MICROWAVE Quantity: One (1) ITEM 7: CONVEYOR TOASTER Quantity: One (1) ITEM 8: REACH IN DISPLAY FREEZER Quantity: One (1) ITEM 9: REACH IN COLD DRINK DISPLAY REFRIGERATOR Quantity: One (1) DocuSign Envelope ID: 7614EAA7-07D8-4458-A975-05A09D92C223 Concession Agreement – 8109 Café Concession Page 12 of 18 EXHIBIT C INSURANCE REQUIREMENTS 1. The Service Provider 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 Service Provider 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 Service Provider, 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 Service Provider under this Agreement. The City, its officers, agents and employees and the Fort Collins Museum of Discovery, a Nonprofit Partner, shall be named as additional insureds on the Service Provider'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 Service Provider shall maintain during the life of this Agreement for all of the Service Provider'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 Service Provider 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 Service Provider 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: 7614EAA7-07D8-4458-A975-05A09D92C223 Concession Agreement – 8109 Café Concession Page 13 of 18 EXHIBIT D Policy: Contractor Personnel Conduct and Demeanor, and Background Screening for Positions of Trust. Under the terms and conditions of each respective Contractor’s Agreement with the City, all Recreation Professionals and Restaurant/Snack Bar Concessionaires shall control the conduct and demeanor of their employees, volunteers, and other representatives or agents of the Contractor that will be working on behalf of the Contractor in providing services to the City. The Contractor agrees to provide to the City at all times a current list of employees, volunteers, and other representatives or agents of Contractor that will be working on behalf of the Contractor in providing services to the City under their Agreement, and that all such employees, volunteers, and other representatives or agents of Contractor agree to adhere to the “Behavior/Standards of Personal Conduct and Performance.” Contractors and the City also hereby acknowledge and agree that certain services provided by the Contractor will require that specified employees, volunteers, and other representatives or agents of the Contractor act in “positions of trust” which can include the handling of and/or accounting for funds of the City and/or of City property, or direct contact with youth and members of the general public. Accordingly, each Contractor agrees that all specified employees, volunteers, or other representatives or agents of Contractor in positions of trust shall be screened/investigated at the expense of the Contractor using the City’s contracted background screening/investigation procedure as described in each respective contractor’s Agreement; and that the results of such background screening/investigation shall be provided to the City prior to any such persons participation in the provision of services, as described in each respective contractor’s Agreement. Each Contractor shall require the completion and execution of the Disclosure/Waiver form for all specified employees, volunteers, and other representatives or agents of Contractor. The purpose of this form is to provide the necessary information about an applicant and permission to review confidential information for a complete and thorough background screening/investigation. The Contractor shall provide to all said employees, volunteers, and other representatives or agents a Summary of Rights under the Fair Credit Reporting Act. The background screening/investigation shall include, but is not necessarily limited to, checking arrests and/or conviction records, driving records, credit history, education, previous employment and volunteer work and other records as may be appropriate, and references, including review of any records of information available to the City as a result of past employment or contractual relationships the employee, volunteer, or other representative or agent has had with the Contractor or the City. The City will provide assistance in completing the background screening/investigation, including providing the completed disclosure form to an outside vendor for a confidential records check. Contractor acknowledges that by providing such assistance the City assumes no responsibility for the timeliness, accuracy or completeness of the background screening/investigation, or for the direct or indirect consequences resulting from the same, and the Contractor shall hold the City harmless for any injury or loss resulting therefrom. The Contractor shall make job assignments and responsibility assignments based upon and in consideration of the background screening/investigation, and shall not permit any person to perform any position for which such person’s character or suitability are reasonably in question based upon the information obtained in connection with a background screening/investigation. DocuSign Envelope ID: 7614EAA7-07D8-4458-A975-05A09D92C223 Concession Agreement – 8109 Café Concession Page 14 of 18 The City may, in its discretion, object to any assignments of Contractor Personnel to positions of trust, as based upon the background screening/investigation. In the event that information from the report is utilized in whole or in part in making an adverse decision with regard to potential employment/volunteer/representative/agent status, before making the adverse decision, the City will attempt to provide Contractor with a copy of the consumer report/criminal history. Specified employees, volunteers, and other representatives or agents of Contractors identified at this time to be in positions of trust shall include, but are not necessarily limited to, all top assistants, area or section managers, lesson providers, personnel that directly handle and/or account for City funds; and those positions that can work individually with youth or members of the general public. Contractor Process for Obtaining Background Screening/Investigation Information 1. Once an employee, volunteer, other representative or agent has been selected by the Contractor, the employee, volunteer, other representative or agent (applicant) shall complete the background screening/investigation form, which is titled “Disclosure to Prospective Employees, Volunteers, or Other Representatives or Agents of Contractors Regarding Procurement of a Consumer Report (including a criminal history report).” 2. When the employee, volunteer, other representative or agent (applicant) has completed and signed the form, the Contractor shall initial and date the bottom of the form, giving the bottom copy of the form to the applicant. The Contractor shall also give to the applicant at this time a summary of his/her rights under the Federal Fair Credit Reporting Act. The Fair Credit Reporting Act also imposes requirements and procedures related to any adverse decisions based upon credit information. 3. The Contractor keeps one copy of the form and forwards the original signed copy of the form to the Golf Division Administrative office. In order to expedite the processing time, the Contractor may also FAX a copy or bring the original copy of the form to the golf Division Administrative Aide. Once the Administrative Aide enters the form information into the computer, it takes three to four days for the City’s contracted background screening/investigation firm to perform their service. 4. Because of the large number of applicants being screened using this similar process, there shall be no notification to the Contractor unless an applicant receives a negative report within four days of the time that the Administrative Aide enters the information into the computer. Therefore, the applicant may begin assignment for the Contractor after four days unless the Contractor is notified otherwise. However, be aware that it is possible that the City could receive a negative report after four days, and will address the situation at that time. DocuSign Envelope ID: 7614EAA7-07D8-4458-A975-05A09D92C223 Concession Agreement – 8109 Café Concession Page 15 of 18 EXHIBIT E DISCLOSURE TO EMPLOYEE/VOLUNTEER REGARDING PROCUREMENT OF A CONSUMER REPORT (INCLUDING CRIMINAL HISTORY REPORT AND EMPLOYMENT HISTORY REVIEW) In connection with your status as a prospective employee, volunteer, or other representative or agent of the Contractor, Contractor and the City of Fort Collins (City) may procure a consumer report/criminal history on you as part of the process of considering your candidacy for said status. The investigation conducted in conjunction with the report may include an investigation of your personal employment/volunteer history, education, financial, and credit records, public records concerning your driving record, civil and criminal court records, county, state, and Federal tax liens, notices of default and bankruptcies, and other records as may be appropriate. In the event that information from the report is utilized in whole or in part in making an adverse decision with regard to your potential employment/volunteer/representative/agent status, before making the adverse decision, the City and the Contractor will attempt to provide you and the Contractor with a copy of the consumer report/criminal history and a description in writing of your rights under the Federal Fair Credit Reporting Act. The Fair Credit Reporting Act gives you specific rights in dealing with consumer reporting agencies. A copy of A SUMMARY OF YOUR RIGHTS UNDER THE FAIR CREDIT REPORTING ACT is attached to this document. By your signature below, you hereby authorize the Contractor and/or the City to obtain a consumer report and/or an investigative report about you in order to consider your status as a prospective employee, volunteer, or other representative or agent for the Contractor. Applicant's Name: ______________________________________________________ (Please Print) Date of Birth: _______________ Social Security #:_______________________ Applicant's Address: _____________________City/State/Zip:___________________________ Signature:_____________________________ Signature of Parent or Guardian (if applicant is under age 18): __________________________ Other Names Used in the Last Seven (7) Years: ____________________________________ ___________________________________________________________________________ Previous Out-of-State Address(es) in the Past Seven (7) Years: 1.__________________________________________________________________________ Address ___________________________________________________________________________ City County State Zip 2.__________________________________________________________________________ Address ____________________________________________________________________________ City County State Zip Please list any additional addresses on the back of this page. Give this disclosure with a copy of A Summary of Rights Under the Fair Credit Reporting Act to applicant. Retain a copy of the release for your records, and provide a copy of the release to the City of Fort Collins. DocuSign Envelope ID: 7614EAA7-07D8-4458-A975-05A09D92C223 Concession Agreement – 8109 Café Concession Page 16 of 18 DocuSign Envelope ID: 7614EAA7-07D8-4458-A975-05A09D92C223 Concession Agreement – 8109 Café Concession Page 17 of 18 DocuSign Envelope ID: 7614EAA7-07D8-4458-A975-05A09D92C223 Concession Agreement – 8109 Café Concession Page 18 of 18 EXHIBIT F AFFIDAVIT PURSUANT TO C.R.S. 24-76.5-103 I, __________________, swear or affirm under penalty of perjury under the laws of the State of Colorado that (check one): ___ I am a United States citizen, or ___ I am a Permanent Resident of the United States, or ___ I am lawfully present in the United States pursuant to Federal law. I understand that this sworn statement is required by law because I have applied for a public benefit. I understand that state law requires me to provide proof that I am lawfully present in the United States prior to receipt of this public benefit. I further acknowledge that making a false, fictitious, or fraudulent statement or representation in this sworn affidavit is punishable under the criminal laws of Colorado as perjury in the second degree under Colorado Revised Statute 18-8- 503 and it shall constitute a separate criminal offense each time a public benefit is fraudulently received. ___________________________ _______________ Signature Date DocuSign Envelope ID: 7614EAA7-07D8-4458-A975-05A09D92C223 SUMMARY OF INSURANCE FOR: FLAT HAT COFFEE LLC Prepared:5/29/2015 1637 TANGLEWOOD DR FORT COLLINS CO 80525 Phone: FAX: BY: HOME OFFICE HARTFORD FIRE INSURANCE CO 250768 PO BOX 33015 SAN ANTONIO TX 78265 Phone: FAX: ACCOUNT POLICY RECAP Policy Number Eff Date Exp Date Premium . Spectrum 76 SBU UI0070 07012015 07012016 $521.00 Sentinel Ins Co LTD POLICY DETAIL Policy . Spectrum Property Coverages - Form Limit Deductible Location 001 Building 001 408 MASON CT FORT COLLINS, CO 80524-4421 Comm'l Liability Coverages - Applicable to all policy locations Each Occurrence $1,000,000 Damage to Premises Rented to You $1,000,000 Medical Expense (Any One Person) $10,000 Personal & Advertising Injury $1,000,000 General Aggregate $2,000,000 Product/Complet Operation Aggregate $2,000,000 Hired Non-Owned Auto Liability $1,000,000 EMPL PRACTICES LIAB COVG $10,000 CYBERFLEX COVERAGE TERRORISM DATA BREACH RESPONSE EXPENSE COVG $10,000 $1,000 DATA BREACH DEFENSE & LIAB COVG $50,000 Class Description Detail Code Premium Basis LOCATION 001 Coffee Shop With No Cooking 42381 $60,000 This summary and its attachments provides high level overview of policy coverages and does not include all conditions, limitation or exclusion. Please refer to the actual policy forms for detailed coverages, limits and deductibles. DocuSign Envelope ID: 7614EAA7-07D8-4458-A975-05A09D92C223 HARTFORD FIRE INSURANCE CO PO BOX 33015 SAN ANTONIO TX 78265 FLAT HAT COFFEE LLC 1637 TANGLEWOOD DR FORT COLLINS CO 80525 ACORD 25 (2014/01) DocuSign Envelope ID: 7614EAA7-07D8-4458-A975-05A09D92C223 CERTIFICATE.OF.LIABILITY.INSURANCE AH DATE (MM/DD/YYYY) R076 6/1/2015 THIS CERTIFICATEIS 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 SUBROGATIONIS 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). PRODUCER CONTACT NAME: HARTFORD FIRE INSURANCE CO PHONE (A/C, No, Ext): FAX (A/C, No): 250768 P: F: E-MAIL ADDRESS: PO BOX 33015 INSURER(S) AFFORDING COVERAGE NAIC# SAN ANTONIO TX 78265 INSURER A : Sentinel Ins Co LTD INSURED INSURER B : INSURER C : FLAT HAT COFFEE LLC INSURER D : 1637 TANGLEWOOD DR INSURER E : FORT COLLINS CO 80525 INSURER F : COVERAGES CERTIFICATE NUMBER: 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. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $1,000,000 A X General Liab X 76 SBU UI0070 07/01/2015 07/01/2016 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY PRO- JECT X LOC PRODUCTS - COMP/OP AGG $2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $1,000,000 ANY AUTO BODILY INJURY (Per person) $ A ALL OWNED AUTOS SCHEDULED AUTOS X 76 SBU UI0070 07/01/2015 07/01/2016 BODILY INJURY (Per accident) $ X HIRED AUTOS X NON-OWNED AUTOS HARTFORD FIRE INSURANCE CO PO BOX 33015 SAN ANTONIO TX 78265 City of Fort Collins PO BOX 580 FORT COLLINS CO 80522 ACORD 25 (2014/01) DocuSign Envelope ID: 7614EAA7-07D8-4458-A975-05A09D92C223 CERTIFICATE.OF.LIABILITY.INSURANCE AH DATE (MM/DD/YYYY) R076 6/1/2015 THIS CERTIFICATEIS 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 SUBROGATIONIS 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). PRODUCER CONTACT NAME: HARTFORD FIRE INSURANCE CO PHONE (A/C, No, Ext): FAX (A/C, No): 250768 P: F: E-MAIL ADDRESS: PO BOX 33015 INSURER(S) AFFORDING COVERAGE NAIC# SAN ANTONIO TX 78265 INSURER A : Sentinel Ins Co LTD INSURED INSURER B : INSURER C : FLAT HAT COFFEE LLC INSURER D : 1637 TANGLEWOOD DR INSURER E : FORT COLLINS CO 80525 INSURER F : COVERAGES CERTIFICATE NUMBER: 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. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $1,000,000 A X General Liab X 76 SBU UI0070 07/01/2015 07/01/2016 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY PRO- JECT X LOC PRODUCTS - COMP/OP AGG $2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $1,000,000 ANY AUTO BODILY INJURY (Per person) $ A ALL OWNED AUTOS SCHEDULED AUTOS X 76 SBU UI0070 07/01/2015 07/01/2016 BODILY INJURY (Per accident) $ X HIRED AUTOS X NON-OWNED AUTOS PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY N/ A PER STATUTE OTH- ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) Y/N E.L. EACH ACCIDENT $ E.L. DISEASE- EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Those usual to the Insured's Operations. Certificate Holder is an Additional Insured per the Business Liability Coverage Form SS0008 and Automobile Liabilty Form attached to this policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins PO BOX 580 FORT COLLINS, CO 80522 AUTHORIZED REPRESENTATIVE © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID: 7614EAA7-07D8-4458-A975-05A09D92C223 PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY N/ A PER STATUTE OTH- ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) Y/N E.L. EACH ACCIDENT $ E.L. DISEASE- EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Those usual to the Insured's Operations. Certificate Holder is an Additional Insured per the Business Liability Coverage Form SS0008 and Automobile Liabilty Form attached to this policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins PO BOX 580 FORT COLLINS, CO 80522 AUTHORIZED REPRESENTATIVE © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID: 7614EAA7-07D8-4458-A975-05A09D92C223