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HomeMy WebLinkAbout507709 SERVPRO OF FORT COLLINS - CONTRACT - RFP - 8116 PFA & CITY RESTORATION SERVICESServices Agreement- 8116 PFA and City Emergency Restoration Services Page 1 of 18 SERVICES 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", as agent, on behalf of the Poudre Fire Authority (PFA), and D&A Enterprises Inc., dba Servpro of Fort Collins, a Colorado Corporation, hereinafter referred to as "Service Provider". WITNESSETH: In consideration of the mutual covenants and obligations herein expressed, it is agreed by and between the parties hereto as follows: 1. Scope of Services. The Service Provider agrees to provide services in accordance with the Scope of Services attached hereto as Exhibit "A", consisting of four (4) pages and incorporated herein by this reference. 2. Contract Period. This Agreement shall commence upon signing, and shall continue in full force and effect until July 31, 2016, unless sooner terminated as herein provided. In addition, at the option of the City and/or PFA, the Agreement may be extended for additional one year periods not to exceed four (4) additional one year periods. Written notice of renewal shall be provided to the Service Provider and mailed no later than thirty (30) days prior to contract end. 3. 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, the Service Provider must provide written notice to the City and PFA of such condition within fifteen (15) days from the onset of such condition. 4. Early Termination by City/Notice. Notwithstanding the time periods contained herein, the City and/or PFA may terminate this Agreement at any time without cause by providing written notice of termination to the Service Provider. 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 following addresses: Service Provider: City: Copy to: Servpro of Fort Collins Attn: Daniel Jeffries 308 North Link Lane Fort Collins, CO 80524 Poudre Fire Authority Attn: Ralph Kettle 321 Country Club Road Fort Collins, CO 80524 City of Fort Collins Attn: Purchasing Dept. PO Box 580 Fort Collins, CO 80522 In the event of early termination by the City and/or PFA, the Service Provider shall be paid for services rendered to the date of termination, subject only to the satisfactory DocuSign Envelope ID: 7FD6161D-62A7-47AA-B329-8BC883952385 Services Agreement- 8116 PFA and City Emergency Restoration Services Page 2 of 18 performance of the Service Provider's obligations under this Agreement. Such payment shall be the Service Provider's sole right and remedy for such termination. 5. Contract Sum. This is to be a Zero-Cost Contract with the City and PFA. The City, PFA and the property owners receiving the emergency restoration services shall not be invoiced for the cost of any services provided pursuant to this Agreement. 6. City Representative. The City and/or PFA will designate, prior to commencement of the work, its representative 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 and/or PFA Representative. 7. Independent Service provider. The services to be performed by Service Provider are those of an independent service provider and not of an employee of the City of Fort Collins or the PFA. The City and/or PFA shall not be responsible for withholding any portion of Service Provider's compensation hereunder for the payment of FICA, Workmen's Compensation or other taxes or benefits or for any other purpose. 8. Subcontractors. Service Provider may not subcontract any of the Work set forth in the Exhibit A, Scope of Services, without the prior written consent of the City and/or PFA, which shall not be unreasonably withheld. If any of the Work is subcontracted hereunder (with the consent of the City and/or PFA), then the following provisions shall apply: (a) the subcontractor must be a reputable, qualified firm with an established record of successful performance in its respective trade performing identical or substantially similar work, (b) the subcontractor will be required to comply with all applicable terms of this Agreement, (c) the subcontract will not create any contractual relationship between any such subcontractor and the City and/or PFA, nor will it obligate the City and/or PFA to pay or see to the payment of any subcontractor, and (d) the work of the subcontractor will be subject to inspection by the City and/or PFA to the same extent as the work of the Service Provider. 9. Personal Services. It is understood that the City and PFA enter into the Agreement based on the special abilities of the Service Provider and that this Agreement shall be considered as an agreement for personal services. Accordingly, the Service Provider shall neither assign any responsibilities nor delegate any duties arising under the Agreement without the prior written consent of the City and/or PFA. 10. 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 and/or PFA under this Agreement or cause of action arising out of performance of this Agreement. 11. Warranty. a. Service Provider warrants that all work performed hereunder shall be performed with DocuSign Envelope ID: 7FD6161D-62A7-47AA-B329-8BC883952385 Services Agreement- 8116 PFA and City Emergency Restoration Services Page 3 of 18 the highest degree of competence and care in accordance with accepted standards for work of a similar nature. b. Unless otherwise provided in the Agreement, all materials and equipment incorporated into any work shall be new and, where not specified, of the most suitable grade of their respective kinds for their intended use, and all workmanship shall be acceptable to City and/or PFA. c. Service Provider warrants all equipment, materials, labor and other work, provided under this Agreement, except City and/or PFA -furnished materials, equipment and labor, against defects and nonconformances in design, materials and workmanship/workwomanship for a period beginning with the start of the work and ending twelve (12) months from and after final acceptance under the Agreement, regardless whether the same were furnished or performed by Service Provider or by any of its subcontractors of any tier. Upon receipt of written notice from City and/or PFA of any such defect or nonconformances, the affected item or part thereof shall be redesigned, repaired or replaced by Service Provider in a manner and at a time acceptable to City and/or PFA. 12. 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. 13. 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. 14. Binding Effect. This writing, together with the exhibits hereto, constitutes the entire agreement between the parties and shall be binding upon said parties, their officers, employees, agents and assigns and shall inure to the benefit of the respective survivors, heirs, personal representatives, successors and assigns of said parties. 15. Indemnity/Insurance. a. The Service Provider agrees to indemnify and save harmless the City and/or PFA, their officers, agents and employees 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. b. The Service Provider shall take all reasonable precautions in performing the work hereunder to prevent injury to persons and property. DocuSign Envelope ID: 7FD6161D-62A7-47AA-B329-8BC883952385 Services Agreement- 8116 PFA and City Emergency Restoration Services Page 4 of 18 c. Without limiting any of the Service Provider's obligations hereunder, the Service Provider shall provide and maintain insurance coverage naming the City and PFA as an additional insured under this Agreement of the type and with the limits specified within Exhibit “B”, consisting of one (1) page, attached hereto and incorporated herein by this reference. The Service Provider 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. Service Provider Personnel. Service Provider shall control the conduct and demeanor of its agents and employees. The Service Provider agrees to provide to the City and/or PFA, at all times, a current list of employees, volunteers and other representatives or agents of Service Provider that will be working on behalf of Service Provider in providing services to the City and PFA under this Agreement. The Service Provider and the City and PFA acknowledge and agree that certain services provided by Service Provider will require that employees or agents of Service Provider act in positions of trust which may entail the handling of City property, or direct contact with members of the general public. Accordingly, Service Provider agrees that all employees, volunteers, and other representatives or agents of the Service Provider in positions of trust, as described in Exhibit “C”, consisting of two (2) pages, attached hereto and incorporated herein by this reference, shall be screened using the background screening procedure described on Exhibit C, 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 Service Provider shall require the completion and execution of the Disclosure Form, attached hereto as Exhibit “D”, 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 D. The City and/or PFA 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. Service Provider acknowledges that in such event, by providing such assistance to Service Provider, the City and/or PFA 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 Service Provider shall hold the City and/or PFA harmless for any injury or loss resulting therefrom. In the event that a background check, or any other information available to the Service Provider or the City and/or PFA, 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 members of the general public, such individual shall not be employed or allowed to volunteer in 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 DocuSign Envelope ID: 7FD6161D-62A7-47AA-B329-8BC883952385 Services Agreement- 8116 PFA and City Emergency Restoration Services Page 5 of 18 persons participating in programs or services provided under this Agreement. Upon objection from the City and/or PFA 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 Service Provider, the Service Provider 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. If the City and/or PFA so requests, Service Provider agrees to supply and require its employees to wear suitable attire and to wear or carry badges or other suitable means of identification, the form for which shall be subject to prior and continuing approval of the City and/or PFA. 17. Entire Agreement. This Agreement, along with all Exhibits and other documents incorporated herein, shall constitute the entire Agreement of the parties. Covenants or representations not contained in this Agreement shall not be binding on the parties. 18. 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. 19. 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 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 DocuSign Envelope ID: 7FD6161D-62A7-47AA-B329-8BC883952385 Services Agreement- 8116 PFA and City Emergency Restoration Services Page 6 of 18 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. 20. Special Provisions. Special provisions or conditions relating to the services to be performed pursuant to this Agreement are set forth in Exhibit "E" - Confidentiality, consisting of one (1) page, attached hereto and incorporated herein by this reference. DocuSign Envelope ID: 7FD6161D-62A7-47AA-B329-8BC883952385 Services Agreement- 8116 PFA and City Emergency Restoration Services Page 7 of 18 CITY OF FORT COLLINS, COLORADO a municipal corporation By:_______________________________ Gerry Paul Director of Purchasing and Risk Management Date:_____________________________ POUDRE FIRE AUTHORITY By: _________________________________ Tom DeMint, Fire Chief Date: ______________________________ ATTEST: _________________________________ City Clerk APPROVED AS TO FORM: ________________________________ Assistant City Attorney D&A ENTERPRISES INC., DBA SERVPRO OF FORT COLLINS By:_______________________________ __________________________________ PRINT NAME __________________________________ TITLE (Corporate President or Vice President) Date:_____________________________ DocuSign Envelope ID: 7FD6161D-62A7-47AA-B329-8BC883952385 7/22/2015 Corporate President Daniel Jeffries 7/23/2015 7/24/2015 Services Agreement- 8116 PFA and City Emergency Restoration Services Page 8 of 18 EXHIBIT A SCOPE OF SERVICES I. INTRODUCTION The City of Fort Collins (City), specifically Fort Collins Police Services (Police), on behalf of Poudre Fire Authority (PFA), are partnering with the Service Provider to provide emergency restoration services for businesses and homes or properties, after an emergency response to prevent further damage or loss. The Service Provider will furnish all labor, materials, and equipment to safely and efficiently provide emergency restoration services to properties as necessary to mitigate loss. This is to be a Zero-Cost Contract with PFA and the City. PFA and the City are not to be invoiced for the cost of emergency restoration services. The benefit for the selected Service Provider is the potential to generate contracting jobs with property owners. The selected Service Provider will not offer, negotiate, propose, repair, or perform reconstruction work during the emergency phase of the incident. II. WORK SPECIFICATIONS AND GENERAL REQUIREMENTS A. PFA and/or the City will call the Service Provider when emergency restoration service is required. Required services are to be provided within one hour from the time of dispatch and Service Provider shall perform the services as defined by PFA and/or the City. Calls for assistance must be answered live or returned within five (5) minutes. The home/business owner will ultimately have the choice of using the Service Provider for further services. PFA and/or the City will not be responsible for any actions or activities once the initial emergency service is complete. B. The Service Provider is to only seek reimbursement for emergency restoration services directly from insurance companies at reasonably prevailing market rates. The Service Provider will not seek reimbursement from non- insured or under insured occupants and will provide emergency restoration services regardless of the occupant’s insurance coverage/status. Service Provider will be required to observe a twenty four (24) hour waiting period from time of notification before contracting with the home or business owner for restoration services beyond the scope of the emergency service call. C. Service Provider must have a valid Contractor’s License to conduct business in Fort Collins, Timnath, LaPorte and Larimer County. D. Service Provider must provide service twenty four (24) hours a day, seven (7) days a week, fifty two (52) weeks a year, at the convenience of the PFA and/or the City. E. Service Provider must make any additional services available in a timely manner; such as, but not limited to, arranging for heavy equipment to be delivered to the scene, as required by PFA and/or the City. F. Work completed is subject to final inspection/certification by the appropriate agency (i.e., PFA, City, County, State Health, etc.) having oversight for such compliance. DocuSign Envelope ID: 7FD6161D-62A7-47AA-B329-8BC883952385 Services Agreement- 8116 PFA and City Emergency Restoration Services Page 9 of 18 G. Only those building openings as directed by PFA and/or the City will be secured. H. Service Provider, when providing a service which has been ordered, shall report to PFA and/or the City any condition which may require additional services to safely secure the building, in the event the building is deemed structurally unsafe. I. Service Provider must keep a ready supply of materials for twenty four (24) hour response needs. Materials required for emergency restoration services include, but are not limited to:  Plywood sheet must be a minimum of 7/16" thickness CDX or OSB, unpainted.  Standard Framing Studs shall be 2”x 4”x 8’  Fasteners shall be 2" to 2 1/4" dry wall screws.  Fixing must be on 6" centers.  Sign postings as needed, no permit required. J. Service Provider must have access to sufficient security fencing with controlled access gates for up to a one (1) acre perimeter for securing larger building, such as apartment buildings. K. Due care shall be exercised to avoid damage to existing improvements, facilities, adjacent property and real or personal property that is adjacent to areas being restored. L. Should work be performed by other firms within or adjacent to the limits of the premises specified, or should work of any other nature be underway by other firms within the area of service, Service Provider shall cooperate with all such other firms so that any delay or hindrance to their work will be avoided. PFA and the City reserve the right to perform other services or additional work at or near the site. M. Service Provider is responsible to furnish proper supervision for services that shall oversee and coordinate activities to ensure services are being performed lawfully, promptly, safely and fully. N. There is no guarantee to Service Provider of any minimum number of emergency responses. At this time, the type and number of specific incidents which may be performed under this Agreement are unknown. Due to the size of PFA and Police jurisdiction and the extensive nature of the operation, the potential for a significant number of incidents exists. For planning purposes, PFA and the City estimate the need for approximately 30-40 responses per year. O. All Service Provider responders shall display company identification and name badges and include company name on panels or fixtures affixed to the property being restored. P. Service Provider is to provide an itemized account of all hourly labor expenses and direct expenses incurred, as requested by PFA and/or the City. III. Construction and Remodeling Contracting Provisions A. PERMITS: Service Provider shall be responsible for obtaining any and all permits (including the cost thereof) required to perform installations. Installations shall be in complete compliance with all applicable Building and Fire Codes. DocuSign Envelope ID: 7FD6161D-62A7-47AA-B329-8BC883952385 Services Agreement- 8116 PFA and City Emergency Restoration Services Page 10 of 18 B. RIGHT TO INSPECT: PFA and the City shall at all times have the right to inspect the work and materials used in the construction of the improvements. The Service Provider shall furnish all reasonable aid and assistance required for the proper examination of the work and all parts thereof. Such inspection shall not relieve the Service Provider from the obligation to construct the improvements strictly in accordance with the approved plans and specifications of the City of Fort Collins Building Services, the Larimer County Building Department and/or PFA Community Safety Services. C. PROTECTION OF PROPERTY: The Service Provider shall assume full responsibility and expense for the protection of all public and private property, structures, water mains, sewers, utilities, etc., both above and below ground, at or near the site or sites of the work being performed under the contract, or which are in any manner affected by the prosecution of the work or the transportation of men/women and materials in connection therewith. The Service Provider shall give reasonable written notice in advance to the Department of the City having charge of any property or utilities owned by the City and to other owner or owners of public or private property or utilities when they will be affected by the work to be performed under the contract, and shall make all necessary arrangements with such department, departments, owner or owners for the removal and replacement or protection of such property or utilities. D. METHODS OF OPERATION: Construction work started by the Service Provider on any unit of his/her contract must be continuously and actively prosecuted with an optimum complement of workmen/workwomen and equipment to expedite completion in the shortest possible time. The Service Provider shall organize to do this construction eight (8) hours per day, including weekends and holidays. E. TRADE WORKERS: All work shall be accomplished by licensed contractors in the trades required and in an orderly and responsible manner in accordance with recognized trade standards. At the discretion of PFA and/or the City, the Service Provider acknowledges and agrees that certain services provided by the Service Provider will require that employees and agents of the Service Provider act in positions of trust which may entail the handling of City property and direct contact with members of the general public. Accordingly, the Service Provider agrees that all employees and other representatives or agents of the Service Provider shall be screened using the City’s contractual background screening procedure, with such costs associated with said screenings to be fully paid by the Service Provider. F. MATERIAL DISPOSAL: Premises shall be kept clean and neat. Materials, scrap and equipment not having further use at the site shall be promptly removed from the job site. Disposal of Service Provider's waste materials in the City's containers is prohibited unless prior written permission by the City has been granted. G. OSHA GUIDELINES: The Service Provider shall be familiar with, and operate within, the guidelines as set forth by the Occupational Safety and Health Act (OSHA). H. VENDOR EQUIPMENT: For all operations requiring the placement and movement of the Service Provider's equipment, Service Provider shall observe and exercise and compel his/her employees to observe and exercise, all necessary caution and discretion so as to avoid injury to persons, damage to property of any and all kinds, and annoyance to or undue interference with the movement of the public and PFA and/or City personnel. All ladders, scaffolding or other devices used to reach the DocuSign Envelope ID: 7FD6161D-62A7-47AA-B329-8BC883952385 Services Agreement- 8116 PFA and City Emergency Restoration Services Page 11 of 18 surface of objects not otherwise accessible, shall be of sound construction, firm and stable, and shall be maintained in good condition. All such equipment shall be moved onto the areas where they are required; placed, shifted where necessary, and removed from the areas in such a manner as to provide maximum safety to persons and property and cause the least possible interference with the normal usage of such areas by the public and PFA and/or City personnel. IV. SERVICE BOUNDRIES The area to be serviced consists of approximately 235 square miles in and around the City of Fort Collins, CO. In general, the district is bounded on the west by a line equal to Redstone Canyon, on the east by a line approximately four miles into Weld County, on the north by approximately Larimer County Road 60E, and on the south by Larimer County Road 30. The map below demonstrates the boundaries of the PFA district. DocuSign Envelope ID: 7FD6161D-62A7-47AA-B329-8BC883952385 Services Agreement- 8116 PFA and City Emergency Restoration Services Page 12 of 18 EXHIBIT B 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 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: 7FD6161D-62A7-47AA-B329-8BC883952385 No new insurance Services Agreement- 8116 PFA and City Emergency Restoration Services Page 13 of 18 EXHIBIT C Policy: Service Provider Personnel Conduct and Demeanor, and Background Screening for Positions of Trust. Under the terms and conditions of this Agreement with the City and PFA, Service Provider shall control the conduct and demeanor of their employees, volunteers, and other representatives or agents of the Service Provider that will be working on behalf of the Service Provider in providing services to the City and PFA. The Service Provider agrees to provide to the City and PFA, at all times, a current list of employees, volunteers, and other representatives or agents of Service Provider that will be working on behalf of the Service Provider in providing services to the City and PFA under this Agreement, and that all such employees, volunteers, and other representatives or agents of Service Provider agree to adhere to the “Behavior/Standards of Personal Conduct and Performance.” Service Provider, the City and PFA also hereby acknowledge and agree that certain services provided by the Service Provider will require that specified employees, volunteers, and other representatives or agents of the Service Provider act in “positions of trust” which can include the handling of City property, or direct contact with youth and members of the general public. Accordingly, Service Provider agrees that all specified employees, volunteers, or other representatives or agents of Service Provider in positions of trust shall be screened/investigated at the expense of the Service Provider using the City’s contracted background screening/investigation procedure as described in the Agreement; and that the results of such background screening/investigation shall be provided to the City and/or PFA prior to any such persons participation in the provision of services, as described in the Agreement. Service Provider shall require the completion and execution of the Disclosure form for all specified employees, volunteers, and other representatives or agents of Service Provider. 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 Service Provider 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 and PFA as a result of past employment or contractual relationships the employee, volunteer, or other representative or agent has had with the Service Provider or the City and/or PFA. The City and/or PFA will provide assistance in completing the background screening/investigation, including providing the completed Disclosure form to an outside vendor for a confidential records check. Service Provider acknowledges that by providing such assistance the City and PFA 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 Service Provider shall hold the City and PFA harmless for any injury or loss resulting therefrom. The City and/or PFA may, at its discretion, object to any assignments of Service Provider 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 DocuSign Envelope ID: 7FD6161D-62A7-47AA-B329-8BC883952385 Services Agreement- 8116 PFA and City Emergency Restoration Services Page 14 of 18 making the adverse decision, the City and/or PFA will attempt to provide Service Provider with a copy of the consumer report/criminal history. Service Provider’s Process for Obtaining Background Screening/Investigation Information: 1.Once an employee, volunteer, other representative or agent has been selected by the Service Provider, the employee, volunteer, other representative or agent (applicant) shall complete the background screening/investigation form, which is titled “DISCLOSURE TO EMPLOYEE/VOLUNTEER REGARDING PROCUREMENT OF A CONSUMER REPORT (INCLUDING CRIMINAL HISTORY REPORT AND EMPLOYMENT HISTORY REVIEW)”. 2.When the employee, volunteer, other representative or agent (applicant) has completed and signed the form, the Service Provider shall initial and date the bottom of the form, giving the bottom copy of the form to the applicant. The Service Provider 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 Service Provider keeps one copy of the form and forwards the original signed copy of the form to the City and/or PFA. Once the information is entered, 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 Service Provider unless an applicant receives a negative report within four days from the time that the information is entered. Therefore, the applicant may begin assignment for the Service Provider after four days unless the Service Provider is notified otherwise. However, be aware that it is possible that a negative report can be received after four days, and the situation will be addressed at that time. DocuSign Envelope ID: 7FD6161D-62A7-47AA-B329-8BC883952385 Services Agreement- 8116 PFA and City Emergency Restoration Services Page 15 of 18 EXHIBIT D 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 Service Provider, Service Provider and the City of Fort Collins (City), and/or Poudre Fire Authority (PFA), 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/or PFA and the Service Provider will attempt to provide you and the Service Provider 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 Service Provider 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 Service Provider. 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 State Zip 2.__________________________________________________________________________ Address ____________________________________________________________________________ City 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: 7FD6161D-62A7-47AA-B329-8BC883952385 Services Agreement- 8116 PFA and City Emergency Restoration Services Page 16 of 18 A SUMMARY OF YOUR RIGHTS UNDER THE FAIR CREDIT REPORTING ACT DocuSign Envelope ID: 7FD6161D-62A7-47AA-B329-8BC883952385 Services Agreement- 8116 PFA and City Emergency Restoration Services Page 17 of 18 DocuSign Envelope ID: 7FD6161D-62A7-47AA-B329-8BC883952385 Services Agreement- 8116 PFA and City Emergency Restoration Services Page 18 of 18 EXHIBIT E CONFIDENTIALITY IN CONNECTION WITH SERVICES provided to the City of Fort Collins (the “City”), as agent, on behalf of the Poudre Fire Authority (the “PFA”) pursuant to this Agreement (the “Agreement”), the Service Provider hereby acknowledges that it has been informed that the City has established policies and procedures with regard to the handling of confidential information and other sensitive materials. In consideration of access to certain information, data and material (hereinafter individually and collectively, regardless of nature, referred to as “information”) that are the property of and/or relate to the City and/or PFA or their employees, customers or suppliers, which access is related to the performance of services that the Service Provider has agreed to perform, the Service Provider hereby acknowledges and agrees as follows: That information that has or will come into its possession or knowledge in connection with the performance of services for the City and/or PFA may be confidential and/or proprietary. The Service Provider agrees to treat as confidential (a) all information that is owned by the City and/or PFA, or that relates to the business of the City and/or PFA, or that is used by the City and/or PFA in carrying on business, and (b) all information that is proprietary to a third party (including but not limited to customers and suppliers of the City and/or PFA). The Service Provider shall not disclose any such information to any person not having a legitimate need-to- know for purposes authorized by the City and/or PFA. Further, the Service Provider shall not use such information to obtain any economic or other benefit for itself, or any third party, except as specifically authorized by the City and/or PFA. The foregoing to the contrary notwithstanding, the Service Provider understands that it shall have no obligation under this Agreement with respect to information and material that (a) becomes generally known to the public by publication or some means other than a breach of duty of this Agreement, or (b) is required by law, regulation or court order to be disclosed, provided that the request for such disclosure is proper and the disclosure does not exceed that which is required. In the event of any disclosure under (b) above, the Service Provider shall furnish a copy of this Agreement to anyone to whom it is required to make such disclosure and shall promptly advise the City and/or PFA in writing of each such disclosure. In the event that the Service Provider ceases to perform services for the City and/or PFA, or the City and/or PFA so requests for any reason, the Service Provider shall promptly return to the City and/or PFA any and all information described hereinabove, including all copies, notes and/or summaries (handwritten or mechanically produced) thereof, in its possession or control or as to which it otherwise has access. The Service Provider understands and agrees that the City and/or PFA’s remedies at law for a breach of the Service Provider’s obligations under this Confidentiality Agreement may be inadequate and that the City and/or PFA shall, in the event of any such breach, be entitled to seek equitable relief (including without limitation preliminary and permanent injunctive relief and specific performance) in addition to all other remedies provided hereunder or available at law. DocuSign Envelope ID: 7FD6161D-62A7-47AA-B329-8BC883952385 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 POLICY PRO- 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) POLICY NUMBER: COMMERCIAL GENERAL LIABILITY RGL 2018 05/14 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED – OWNERS, LESSEES OR CONTRACTORS – AUTOMATIC STATUS WHEN REQUIRED IN DISASTER, WATER OR FIRE REMEDIATION AGREEMENT WITH YOU This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Schedule Name Of Additional Insured Person(s) Or Organization(s): Location(s) Of Covered Operations Any site where work is performed by the named insured or on behalf of the named insured. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II – Who is An Insured is amended to include as an additional insured any person or organization for whom you are performing disaster, water or fire remediation operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured only with respect to liability for “bodily injury”, “property damage” or “personal and advertising injury” caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured. A person’s or organization’s status as an additional insured under this endorsement ends when your operations for that additional insured are completed. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: 1. “Bodily injury”, “property damage” or “personal and advertising injury” arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b. Supervisory, inspection, architectural or engineering activities. RGL 2018 05/14 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 2 RGL111598 City of Fort Collins PO Box 580 Ft Collins CO 80522 25643650 | 10019 | 14/15 GL POLL MPL LSRL | Danielle Kerr | 7/20/2015 4:49:21 PM (EDT) | Page 2 of 3 This certificate cancels and supersedes ALL previously issued certificates. DocuSign Envelope ID: 7FD6161D-62A7-47AA-B329-8BC883952385 COMMERCIAL GENERAL LIABILITY RGL 2018 05/14 2. “Bodily injury” or “property damage” occurring after: a. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or b. That portion of “your work” out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C. COMMERCIAL GENERAL LIABILITY CONDITIONS – Duties In The Event of Occurrence, Offense, Claim or Suit (Section IV.2) is amended to add the following: e. An additional insured under this endorsement will as soon as practicable: (1) Give written notice of an occurrence or an offense to us which may result in a claim or "suit" under this insurance; (2) Tender the defense and indemnity of any claim or "suit" to us for a loss we cover under this Coverage Part; (3) Tender the defense and indemnity of any claim or "suit" to any other insurer which also has insurance for a loss we cover under this Coverage Part; and (4) Agree to make available any other insurance, which the additional insured has for a loss we cover under this Coverage Part. We have no duty to defend or indemnify an additional insured under this endorsement until we receive written notice of a claim or "suit" from the additional insured. D. COMMERCIAL GENERAL LIABILITY CONDITIONS – Other Insurance (Section IV.4) are deleted and replaced with the following: a. This insurance is excess over any other insurance naming the additional insured as an insured whether primary, excess, contingent or on any other basis unless a written contract or written agreement specifically requires that this insurance be either primary or primary and noncontributing to the additional insured's own coverage. This insurance is excess over any other insurance to which the additional insured has been added as an additional insured by endorsement. b. When this insurance is excess, we will have no duty under Coverages A or B to defend the additional insured against any "suit" if any other insurer has a duty to defend the additional insured against that "suit" If no other insurer defends, we will undertake to do so, but we will be entitled to the additional insured's rights against all those other insurers. When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (1) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (2) The total of all deductible and self-insured amounts under all that other insurance. We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part RGL 2018 05/14 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 2 25643650 | 10019 | 14/15 GL POLL MPL LSRL | Danielle Kerr | 7/20/2015 4:49:21 PM (EDT) | Page 3 of 3 This certificate cancels and supersedes ALL previously issued certificates. DocuSign Envelope ID: 7FD6161D-62A7-47AA-B329-8BC883952385 INSR ADDL SUBR LTR INSR WVD DATE (MM/DD/YYYY) PRODUCER CONTACT NAME: PHONE FAX (A/C, No, Ext): (A/C, No): E-MAIL ADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXP TYPE OF INSURANCE (MM/DD/YYYY) (MM/DD/YYYY) LIMITS GENERAL LIABILITY AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) AUTHORIZED REPRESENTATIVE INSURER(S) AFFORDING COVERAGE NAIC # Y / N N / A (Mandatory in NH) ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? EACH OCCURRENCE $ DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $ CLAIMS-MADE OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ PRO- $ POLICY JECT LOC COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS (Per accident) $ OCCUR EACH OCCURRENCE $ CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WC STATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE This page has been left blank intentionally. DocuSign Envelope ID: 7FD6161D-62A7-47AA-B329-8BC883952385 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 POLICY PRO- 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) POLICY NUMBER: COMMERCIAL GENERAL LIABILITY RGL 2018 05/14 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED – OWNERS, LESSEES OR CONTRACTORS – AUTOMATIC STATUS WHEN REQUIRED IN DISASTER, WATER OR FIRE REMEDIATION AGREEMENT WITH YOU This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Schedule Name Of Additional Insured Person(s) Or Organization(s): Location(s) Of Covered Operations Any site where work is performed by the named insured or on behalf of the named insured. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II – Who is An Insured is amended to include as an additional insured any person or organization for whom you are performing disaster, water or fire remediation operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured only with respect to liability for “bodily injury”, “property damage” or “personal and advertising injury” caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured. A person’s or organization’s status as an additional insured under this endorsement ends when your operations for that additional insured are completed. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: 1. “Bodily injury”, “property damage” or “personal and advertising injury” arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b. Supervisory, inspection, architectural or engineering activities. RGL 2018 05/14 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 2 RGL111598 City of Fort Collins PO Box 580 Ft Collins CO 80522 25643650 | 10019 | 14/15 GL POLL MPL LSRL | Danielle Kerr | 7/20/2015 4:49:21 PM (EDT) | Page 2 of 3 This certificate cancels and supersedes ALL previously issued certificates. DocuSign Envelope ID: 7FD6161D-62A7-47AA-B329-8BC883952385 COMMERCIAL GENERAL LIABILITY RGL 2018 05/14 2. “Bodily injury” or “property damage” occurring after: a. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or b. That portion of “your work” out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C. COMMERCIAL GENERAL LIABILITY CONDITIONS – Duties In The Event of Occurrence, Offense, Claim or Suit (Section IV.2) is amended to add the following: e. An additional insured under this endorsement will as soon as practicable: (1) Give written notice of an occurrence or an offense to us which may result in a claim or "suit" under this insurance; (2) Tender the defense and indemnity of any claim or "suit" to us for a loss we cover under this Coverage Part; (3) Tender the defense and indemnity of any claim or "suit" to any other insurer which also has insurance for a loss we cover under this Coverage Part; and (4) Agree to make available any other insurance, which the additional insured has for a loss we cover under this Coverage Part. We have no duty to defend or indemnify an additional insured under this endorsement until we receive written notice of a claim or "suit" from the additional insured. D. COMMERCIAL GENERAL LIABILITY CONDITIONS – Other Insurance (Section IV.4) are deleted and replaced with the following: a. This insurance is excess over any other insurance naming the additional insured as an insured whether primary, excess, contingent or on any other basis unless a written contract or written agreement specifically requires that this insurance be either primary or primary and noncontributing to the additional insured's own coverage. This insurance is excess over any other insurance to which the additional insured has been added as an additional insured by endorsement. b. When this insurance is excess, we will have no duty under Coverages A or B to defend the additional insured against any "suit" if any other insurer has a duty to defend the additional insured against that "suit" If no other insurer defends, we will undertake to do so, but we will be entitled to the additional insured's rights against all those other insurers. When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (1) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (2) The total of all deductible and self-insured amounts under all that other insurance. We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part RGL 2018 05/14 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 2 25643650 | 10019 | 14/15 GL POLL MPL LSRL | Danielle Kerr | 7/20/2015 4:49:21 PM (EDT) | Page 3 of 3 This certificate cancels and supersedes ALL previously issued certificates. DocuSign Envelope ID: 7FD6161D-62A7-47AA-B329-8BC883952385 INSR ADDL SUBR LTR INSR WVD DATE (MM/DD/YYYY) PRODUCER CONTACT NAME: PHONE FAX (A/C, No, Ext): (A/C, No): E-MAIL ADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXP TYPE OF INSURANCE (MM/DD/YYYY) (MM/DD/YYYY) LIMITS GENERAL LIABILITY AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) AUTHORIZED REPRESENTATIVE INSURER(S) AFFORDING COVERAGE NAIC # Y / N N / A (Mandatory in NH) ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? EACH OCCURRENCE $ DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $ CLAIMS-MADE OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ PRO- $ POLICY JECT LOC COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS (Per accident) $ OCCUR EACH OCCURRENCE $ CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WC STATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE This page has been left blank intentionally. DocuSign Envelope ID: 7FD6161D-62A7-47AA-B329-8BC883952385 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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. 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: CERTIFICATE HOLDER CANCELLATION © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD ACORDTM CERTIFICATE OF LIABILITY INSURANCE 7/21/2015 BB&T Insurance Services, Inc. 3605 Glenwood Ave Raleigh, NC 27612 919 716-9777 919 716-9777 D & A Enterprises Inc 308 N Link Lane Fort Collins, CO 80524 Liberty Mutual Insurance Compan 23043 A X X X X BAS56325461 09/20/2014 09/20/2015 1,000,000 ** Supplemental Name ** D & A Enterprises Inc DBA Servpro of Fort Collins Certificate Holder included as Additional Insured with respect to business automobile coverage. City of Fort Collins Purchasing PO Box 580 Fort Collins, CO 80522 1 of 1 #S14513750/M13996612 Client#: 1547900 02SPDAENT WEB 1 of 1 #S14513750/M13996612 DocuSign Envelope ID: 7FD6161D-62A7-47AA-B329-8BC883952385 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. 7/20/2015 Affinity Insurance Services, Inc. SERVPRO Franchisee Insurance Center 159 E. County Line Road Hatboro, PA 19040 866-231-2006 800-567-4028 LIC#: CA 0795465 - PA 14210 Anne Cassidy SERVPRO Franchisee Insurance Center RRRGInsurance@aon.com D & A Enterprises, Inc. 308 N. Link Lane Fort Collins CO 80524 25643650 dba Servpro of Fort Collins City of Fort Collins PO Box 580 Ft Collins CO 80522 ** Supplemental Name ** D & A Enterprises, Inc. certificate holder is additional insured as respects general liability A RGL111598 9/20/2014 9/20/2015 $2,000,000 $100,000 ✓ $5,000 ✓ $2,000,000 $5,000,000 $5,000,000 B ✓ BE 060600216 9/20/2014 9/20/2015 $2,000,000 $2,000,000 A CPL RPU111191 9/20/2014 9/20/2015 PER OCC: $2,000,000 AGG: $5,000,000 A Misc Professional Liability RMPL110881 9/20/2014 9/20/2015 PER OCC: $250,000 AGG: $250,000 A Limited Service & Repair Liability RLS111456 9/20/2014 9/20/2015 PER OCC: $250,000 AGG: $250,000 C Bailees CI 3006864739 9/20/2014 9/20/2015 LIMIT: $200,000 / DEDUCTIBLE: $1,000 Restoration Risk Retention Group 12209 National Union Fire Insurance Co. 19445 Allied Insurance Co. (Nationwide) 42579 25643650 | 10019 | 14/15 GL POLL MPL LSRL | Danielle Kerr | 7/20/2015 4:49:21 PM (EDT) | Page 1 of 3 This certificate cancels and supersedes ALL previously issued certificates. DocuSign Envelope ID: 7FD6161D-62A7-47AA-B329-8BC883952385 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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. 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: CERTIFICATE HOLDER CANCELLATION © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD ACORDTM CERTIFICATE OF LIABILITY INSURANCE 7/21/2015 BB&T Insurance Services, Inc. 3605 Glenwood Ave Raleigh, NC 27612 919 716-9777 919 716-9777 D & A Enterprises Inc 308 N Link Lane Fort Collins, CO 80524 Liberty Mutual Insurance Compan 23043 A X X X X BAS56325461 09/20/2014 09/20/2015 1,000,000 ** Supplemental Name ** D & A Enterprises Inc DBA Servpro of Fort Collins Certificate Holder included as Additional Insured with respect to business automobile coverage. City of Fort Collins Purchasing PO Box 580 Fort Collins, CO 80522 1 of 1 #S14513750/M13996612 Client#: 1547900 02SPDAENT WEB 1 of 1 #S14513750/M13996612 DocuSign Envelope ID: 7FD6161D-62A7-47AA-B329-8BC883952385 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. 7/20/2015 Affinity Insurance Services, Inc. SERVPRO Franchisee Insurance Center 159 E. County Line Road Hatboro, PA 19040 866-231-2006 800-567-4028 LIC#: CA 0795465 - PA 14210 Anne Cassidy SERVPRO Franchisee Insurance Center RRRGInsurance@aon.com D & A Enterprises, Inc. 308 N. Link Lane Fort Collins CO 80524 25643650 dba Servpro of Fort Collins City of Fort Collins PO Box 580 Ft Collins CO 80522 ** Supplemental Name ** D & A Enterprises, Inc. certificate holder is additional insured as respects general liability A RGL111598 9/20/2014 9/20/2015 $2,000,000 $100,000 ✓ $5,000 ✓ $2,000,000 $5,000,000 $5,000,000 B ✓ BE 060600216 9/20/2014 9/20/2015 $2,000,000 $2,000,000 A CPL RPU111191 9/20/2014 9/20/2015 PER OCC: $2,000,000 AGG: $5,000,000 A Misc Professional Liability RMPL110881 9/20/2014 9/20/2015 PER OCC: $250,000 AGG: $250,000 A Limited Service & Repair Liability RLS111456 9/20/2014 9/20/2015 PER OCC: $250,000 AGG: $250,000 C Bailees CI 3006864739 9/20/2014 9/20/2015 LIMIT: $200,000 / DEDUCTIBLE: $1,000 Restoration Risk Retention Group 12209 National Union Fire Insurance Co. 19445 Allied Insurance Co. (Nationwide) 42579 25643650 | 10019 | 14/15 GL POLL MPL LSRL | Danielle Kerr | 7/20/2015 4:49:21 PM (EDT) | Page 1 of 3 This certificate cancels and supersedes ALL previously issued certificates. DocuSign Envelope ID: 7FD6161D-62A7-47AA-B329-8BC883952385