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SERVICES AGREEMENT
WORK ORDER TYPE
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 VERIS ENVIRONMENTAL, LLC 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. Services to be Performed.
a. This Agreement shall constitute the basic agreement between the parties for
services for Digester Cleaning Services at the City of Fort Collins’ Drake Wastewater
Treatment Facility. The conditions set forth herein shall apply to all services
performed by the Service Provider on behalf of the City and particularly described in
Work Orders agreed upon in writing by the parties from time to time. Such Work
Orders, a sample of which is attached hereto as Exhibit A, consisting of one (1) page
and incorporated herein by this reference, shall include a description of the services
to be performed, the location and time for performance, the amount of payment, any
materials to be supplied by the City and any other special circumstances relating to
the performance of services. No Work Order shall exceed sixty thousand ($60,000).
A general scope of services is attached hereto as Exhibit B, consisting of one (1)
page, and incorporated herein by this reference.
The only services authorized under this Agreement are those which are performed
after receipt of such Work Order, except in emergency circumstances where oral
work requests may be issued. Oral requests for emergency actions will be confirmed
by issuance of a written Work Order within two (2) working days. Irrespective of
references in Exhibit A to certain named third parties, Service Provider shall be
solely responsible for performance of all duties hereunder.
b. The City may, at any time during the term of a particular Work Order and without
invalidating the Agreement, make changes within the general scope of the particular
services assigned and the Service Provider agrees to perform such changed services.
2. Changes in the Work. The City reserves the right to independently bid any services rather
than issuing work to the Service Provider pursuant to this Agreement. Nothing within this
Agreement shall obligate the City to have any particular service performed by the Service
Provider.
3. Time of Commencement and Completion of Services. The services to be performed
pursuant to this Agreement shall be initiated as specified by each written Work Order or
oral emergency service request. Oral emergency service requests will be acted upon
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without waiting for a written Work Order. Time is of the essence.
4. Contract Period. This Agreement shall commence November 16, 2015 and shall
continue in full force and effect until November 15, 2016, unless sooner terminated as
herein provided. In addition, at the option of the City, the Agreement may be extended for
additional one year periods not to exceed four (4) additional one year periods. Renewals
and pricing changes shall be negotiated by and agreed to by both parties. Written notice
of renewal shall be provided to the Service Provider and mailed no later than thirty (30)
days prior to contract end.
5. Delay. If either party is prevented in whole or in part from performing its obligations by
unforeseeable causes beyond its reasonable control and without is 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 of such condition within fifteen (15) days
from the onset of such condition.
6. Early Termination by City/Notices. Notwithstanding the time periods contained herein, the
City may terminate this Agreement at any time without cause by providing written notice of
termination to the Service Provider. Such notice shall be mailed 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 address:
Service Provider: City: Copy to:
Veris Environmental, LLC
Attn: Robert Harlow, Jr.
53036 Hwy 71
Limon, CO 80828
City of Fort Collins
Attn: Ramon Arguello
PO Box 580
Fort Collins, CO 80522
City of Fort Collins
Attn: Purchasing Dept.
PO Box 580
Fort Collins, CO 80522
In the event of early termination by the City, the Service Provider shall be paid for services
rendered to the termination date, subject only to the satisfactory 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.
7. Contract Sum. This is an open-end indefinite quantity Agreement with no fixed price. The
actual amount of work to be performed will be stated on the individual Work Orders. The
City makes no guarantee as to the number of Work Orders that may be issued or the
actual amount of services which will in fact be requested.
8. Payments.
a. The City agrees to pay and the Service Provider agrees to accept as full payment for
all work done and all materials furnished and for all costs and expenses incurred in
performance of the work the sums set forth for the work as per the attached Exhibit B.
Payment shall be made by the City only upon acceptance of the work by the City and
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upon the Service Provider furnishing satisfactory evidence of payment of all wages,
taxes, supplies and materials, and other costs incurred in connection with the
performance of such work.
9. City Representative. The City's representative will be shown on the specific Work Order
and shall make, within the scope of his or her authority, all necessary and proper decisions
with reference to the work requested. All requests concerning this Agreement shall be
directed to the City Representative.
10. Independent Contractor. It is agreed that in the performance of any services hereunder,
the Service Provider is an independent contractor responsible to the City only as to the
results to be obtained in the particular work assignment and to the extent that the work
shall be done in accordance with the terms, plans and specifications furnished by the City.
11. Subcontractors. Service Provider may not subcontract any of the Work set forth in the
Exhibit A, Statement of Work without the prior written consent of the city, which shall not
be unreasonably withheld. If any of the Work is subcontracted hereunder (with the
consent of the City), 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, nor
will it obligate the City 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 to the same extent as the
work of the Service Provider.
12. Personal Services. It is understood that the City enters 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.
13. 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 under the Agreement
or of any cause of action arising out of the performance of this Agreement.
14. Warranty.
a. Service Provider warrants that all work performed hereunder shall be performed with
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.
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c. Service Provider warrants all equipment, materials, labor and other work, provided
under this Agreement, except City-furnished materials, equipment and labor, against
defects and non-conformances 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 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.
15. 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.
16. 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.
17. 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 representative, successors and assigns of said parties.
18. Indemnity/Insurance.
a. The Service Provider agrees to indemnify and save harmless the City, its 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 necessary precautions in performing the work
hereunder to prevent injury to persons and property.
c. Without limiting any of the Service Provider's obligations hereunder, the Service
Provider shall provide and maintain insurance coverage naming the City as an
additional insured under this Agreement of the type and with the limits specified within
Exhibit D, consisting of one (1) page, attached hereto and incorporated herein by this
reference.
19. Entire Agreement. This Agreement, along with all Exhibits and other documents
incorporated herein, shall constitute the entire Agreement of the parties. Covenants or
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representations not contained in this Agreement shall not be binding on the parties.
20. Law/Severability. This Agreement shall be governed in all respect by the laws of the State
of Colorado. 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.
21. 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
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
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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.
22. Special Provisions. Special provisions or conditions relating to the services to be
performed pursuant to this Agreement are set forth in Exhibit D - Confidentiality consisting
of one (1) page, attached hereto and incorporated herein by this reference.
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THE CITY OF FORT COLLINS, COLORADO
By:
Gerry Paul
Purchasing Director
DATE:
ATTEST:
City Clerk
APPROVED AS TO FORM:
Senior Assistant City Attorney
VERIS ENVIRONMENTAL, LLC
By:
Printed:
Title:
CORPORATE PRESIDENT OR VICE PRESIDENT
Date:
DocuSign Envelope ID: 45868588-7E15-4B6F-8D09-6E5984633ECF
CEO
11/20/2015
Robert Harlow, Jr.
11/20/2015
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EXHIBIT A
WORK ORDER FORM
PURSUANT TO AN AGREEMENT BETWEEN
THE CITY OF FORT COLLINS
AND
AGREEMENT DATED:
Work Order Number:
Purchase Order Number:
Project Title:
Original Bid/RFP Project Number & Name:
Commencement Date:
Completion Date:
Maximum Fee: (time and reimbursable direct costs):
Project Description:
Scope of Services:
Professional agrees to perform the services
identified above and on the attached forms in
accordance with the terms and conditions
contained herein and in the Professional
Services Agreement between the parties. In
the event of a conflict between or ambiguity in
the terms of the Professional Services
Agreement and this work order (including the
attached forms) the Professional Services
Agreement shall control.
The attached forms consisting of
( ) page(s) are hereby accepted and
incorporated herein, by this reference, and
Notice to Proceed is hereby given.
PROFESSIONAL
By:_______________________________
Date:_____________________________
CITY OF FORT COLLINS
Submitted By: _________________________
Project Manager
Date: _________________________
Reviewed by: _________________________
Water Reclamation/Biosolids Manager
Date: _________________________
Approved by: _________________________
Water Resources/Treatment Operations
Manager
Date: ________________________
Approved by: _________________________
Utilities General Manager
(over $1,000,000)
Date: ________________________
Approved by: _________________________
Purchasing Director (if over $60,000)
Date: _______________________
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EXHIBIT B
SCOPE OF WORK
Digester Cleaning Services are to include removal, transport and land application of biosolids
from an anaerobic digester at the City of Fort Collins Drake Water Reclamation Facility.
Digester contents may consist of thick biosolids, grit, trash and rags. Most of the digester
contents can be removed using wash water to break up the thicker layers and pumped into
water-tight tanker trucks for land application.
The City of Fort Collins Water Reclamation Facilities are ISO 14001 certified, and as such, the
City expects the Service Provider to comply with all regulatory requirements, take the necessary
steps to prevent pollution during the operation, and work to improve the process going forward.
Biosolids application is to be performed according to EPA 503 regulations. City will provide the
Service Provider a laboratory analytical data report of the biosolids prior to hauling. City will
provide high-pressure wash water to Service Provider at no charge. The Service Provider shall
separate out all non-biosolids material (rags, trash, grit, etc.) and place it in a dumpster provided
by the City. The dumpster will be emptied by the City, at City’s cost.
The Service Provider will provide the location of the final disposition of the biosolids, as well as
the current permit number for each digester cleaning prior to 10 days of applying the biosolids.
Service Provider agrees to notify City staff, provide spill control, and spill remediation services if
warranted.
If services are required in the following years, pricing will be negotiated as part of the Work
Order. 2015 Pricing for the work is as follows and it becomes the baseline for negotiation in the
succeeding years.
Mobilization and set-up: $4,800
Removal, Transportation& Land Application: $0.138 per gallon hauled & land applied
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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 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.
3. Environmental & Pollution Control Liability in the amount of $1,000,000 combined single
limits.
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New insurance
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EXHIBIT D
CONFIDENTIALITY
IN CONNECTION WITH SERVICES provided to the City of Fort Collins (the “City”) 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 or its 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 may be confidential and/or proprietary. The Service
Provider agrees to treat as confidential (a) all information that is owned by the City, or that
relates to the business of the City, or that is used by the City 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). 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. 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.
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 in writing of each such disclosure.
In the event that the Service Provider ceases to perform services for the City, or the City so
requests for any reason, the Service Provider shall promptly return to the City 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’s remedies at law for a breach of the
Service Provider’s obligations under this Confidentiality Agreement may be inadequate and that
the City 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.
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OP 10: KS
AC~RD. CERTIFICATE OF LIABILITY INSURANCE I DATE(MMIDDIYYYV)
~ 11/19/2015
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 tenns 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:
The Insurance Store, Inc.
rlJgN:o Extl: I FAX
PO Box 174 iAlc Nol:
Sidney, NE 69162 E.MAIL
ADDRESS:
Dennis R. Hicks
~~~~~~~~ ID#: PARKE-3
INSURERISIAFFORDINGCOVERAGE NAtC#
INSURED Veris Environmental LLC INSURERA: Employers Mutual Company 21415
53036 State Hwy 71 INSURERB:
Limon, CO 80828
INSURERC:
INSURERD:
INSURERE:
INSURERF:
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 ADDL U"H
IIr:g~%~1 1~~~~%WvYI LIMITS
LTR TYPEOFINSURANCE POLICYNUMBER
GENERALLIABILITY EACHOCCURRENCE $ 1,000,00(1
f---
A ~~~~~U?E~~~~nce\ 100,00(1
c-!- :3MMERCIAL GENERALLIABILITY X 4D13936 08/01/2015 08/01/2016 $
CLAIMS-MADE [!]OCCUR MEDEXP(Anyone person) $ 10,00(1
f--- 1,000,00(1
c-!- EXPLOSION, COLLAP
PERSONAL& ADV INJURY $
c-!- &UNDERGROUND HAZ
GENERALAGGREGATE $ 2,000,00(1
n'L AGGREME LIMITAPnS PER: PRODUCTS- COMP/OPAGG $ 2,000,00(1
POLICY X P'fR-i LOC
$
AUTOMOBILELIABILITY X
COMBINEDSINGLELIMIT
f--- (Ea accident) $ 1,000,00(1
A c-!- ANYAUTO 4E13936 08/01/2015 08/01/2016 BODILYINJURY(Per person) $
ALL OWNEDAUTOS BODILY INJURY(Per accident) $
f---
SCHEDULEDAUTOS PROPERTYDAMAGE
f--- $
c-!- HIREDAUTOS (PERACCIDENT)
X NON-OWNEDAUTOS
$
r----- $
COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -
AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION CONTRACT OR
AGREEMENT INCLUDING COMPLETED OPERATIONS - PRIMARY AND
NONCONTRIBUTORY
This endorsement modifies the insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
A. Section II - Who Is An Insured is amended to
include as an additional insured:
1. Any person or organization for whom you are
performing 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; and
2. Any other person or organization you are
required to add as an additional insured under
the contract or agreement described in
Paragraph 1. above.
Such person(s) or organization(s) 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:
a. Your acts or omissions; or
b. The acts or omissions of those acting on
your behalf;
in the performance of:
a. your ongoing operations for the additional
insured; or
b. "Your work" for the additional insured and
included in the "products - completed
operations hazard".
However, the insurance afforded to such additional
insured described above:
a. Only applies to the extent permitted by law;
and
b. Will not be broader than that which you are
required by the contract or agreement to
provide for such additional insured.
B. With respect to the insurance afforded to these
additional insureds, the following additional
exclusion applies:
This insurance does not apply to "bodily injury,"
"property damage" and "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.
This exclusion applies even if the claims against
any insured allege negligence or other wrongdoing
in the supervision, hiring, employment, training or
monitoring of others by the insured, if the
"occurrence" which caused the "bodily injury" or
"property damage", or the offense which caused the
COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DESIGNATED INSURED - PRIMARY AND NONCONTRIBUTORY
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
GARAGE COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the coverage form apply unless modified
by this endorsement.
This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured provision of
the coverage form. This endorsement does not alter coverage provided in the coverage form.
SCHEDULE*
Information re uired to com lete this schedule, if not shown above, will be shown in the Declarations.
Each person or organization indicated above is an
"insured" for Liability Coverage, but only to the extent
that person or organization qualifies as an "insured"
under the Who Is An Insured provision contained in
Section II of the coverage form.
The insurance provided to the person(s) or
organization(s) shown in the Schedule is Primary
Insurance and we will not seek contribution from any
other insurance available to that "insured".
CA 7266(07 -14) Includes copyrighted material of ISO Properties, Inc. with its permission. Page 1 of 1
DocuSign Envelope ID: 45868588-7E15-4B6F-8D09-6E5984633ECF
ACORDTM CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIODIVYYY)
11/1912015
PRODUCER
Pinnacol Assurance THIS CERTIFICATE IS ISSUED AS A MA TIER OF INFORMA TION ONLY
7501 E Lowry Blvd AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
Denver, CO 80230-7006 CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE
COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A:
Veris Environmental LLC Plnnacol Assurance 41190
53036 State Rd 71 INSURERB:
Limon, CO 80828 INSURERC:
INSURERD:
INSURERE:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDNG
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMMENT 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 ADD"L POliCY EFFECTIVE
POliCY EXPIRATION
LTR INSRD TYPE OF INSURANCE POliCY NUMBER DATE(MMIDOIYYYY)
DATE(MMIDOIYYYY) LIMITS
t- GENERAl UA8lLITY EACH OCCURRENCE
COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED
c-- D'CLAIMSMADE 0 OCCUR PREMISES
- MED EXp(Any one ~l
- PERSONAL & ADV INJURY
I GEN'L POliCY AGGREGATE il PROJECTnLOC LIMIT APPLiERS PER: PRODUCTS GENERAL AGGREGATE - COMPIOP AGG
_ AUTOIIOBILE LIABILITY COMBINED SINGLE LIMIT
-
ANY AUTO (Es AcddanJt
ALL OWNED AUTOS BODILY INJURY
SCHEDULED AUTOS (Per".,...,.,)
HIRED AUTOS BODILY INJURY
NON-QWNEDAUTOS (par accIdanl)
PROPERTY DAMAGE
(Par accIdanl)
~ GARAGE LIABLITY AUTO ONLY - EA ACCIDENT
ANY AUTO OTHER THAN EAACC
AUTO ONLY: AG~
R tJ EXCESSlUIIBRELLA DEDUCTIBLE OCCUR 0 UA8lUTY CLAIMS MADE AGGREGATE EACH OCCURRENCE
RETENTION S
WORKERS COMPENSATION AND 19WCSTATlJ.. UOTHER
A EMPLOYER'S LIABILITY
TORY LIMITS
ANY PROPRIETORIPARTNERlEXECUTIVE 4123044 05/01/2015 05/01/2016
E.L EACH ACCIDENT $1,000,000
OFFICERIMEMBER EXCLUDED?
E.L DISEASE - EA EMPLOYEE $1,000,000
~ yeo, pi•••• _be undar SPECIAL PROVISIONS below
E.L DISEASE - POliCY LIMIT $1000.000
OTHER
DESCRIPTION OF OPERAnoNSILOCATlONSNEHICLESIEXCLUSIONS ADDEO BY ENDORSEMENTISPECIAL PROVISIONS
CERTIFICATE HOLDER CANCELLATION
1657774 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEllED BEFORE
City of Fort Collins THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY Will ENDEAVORTO
PONAMEDTO Box 580 NOTIFY 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER
Ft Collins, CO 80522-0580 THE lEFT, BUT FAilURE TO NOTIFY SUCH NOTICE SHAll IMPOSE NO
OBLIGATION OR LIABILITY OF ANY KIND UPONTHECOMPANY, ITS AGENTS OR
CERTIFICATE HOLDER COpy
City of Fort Collins
PO Box 580
Ft Collins, CO 80522-0580
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A
statement on this certificate does not confer rights to the certificate holder in lieu of such
endorsement(s).
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).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract
between the issuing insurer(s), authorized representative or producer, and the certificate
holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded
by the policies listed thereon.
DocuSign Envelope ID: 45868588-7E15-4B6F-8D09-6E5984633ECF
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
Kyle Bailey
ACORD 25(2001/08) Underwriter ACORD CORPORATION 1988
DocuSign Envelope ID: 45868588-7E15-4B6F-8D09-6E5984633ECF
"personal and advertising injury", involved the
rendering of, or the failure to render, any
professional architectural, engineering or surveying
services.
C. With respect to the insurance afforded to these
additional insureds, the following is added to
Section 111- Limits Of Insurance:
The most we will pay on behalf of the additional
insured is the amount of insurance:
1. Required by the contract or agreement
described in Paragraph A.1.; or
2. Available under the applicable Limits of
Insurance shown in the Declarations;
whichever is less.
This endorsement shall not increase the applicable
Limits of Insurance shown in the Declarations.
D. The following is added to the Other Insurance
Condition and supersedes any provision to the
contrary:
Primary and Noncontributory Insurance
This insurance is primary to and will not seek
contribution from any other insurance available to
an additional insured under your policy provided
that:
(1) The additional insured is a Named Insured
under such other insurance; and
(2) You have agreed in writing in a contract or
agreement that this insurance would be primary
and would not seek contribution from any other
insurance available to the additional insured.
E. All other terms and conditions of this policy remain
unchanged.
CG7174.3(10-13) Includes copyrighted material of ISO Properties, Inc. with its permission. Page 1 of 1
DocuSign Envelope ID: 45868588-7E15-4B6F-8D09-6E5984633ECF
UMBRELLALIAB
~ OCCUR
EACHOCCURRENCE $ 4,000,00(1
- 4,000,00C
EXCESSLIAB CLAIMS-MADE
08/01/2015 08/01/2016
AGGREGATE $
A 4J13936
DEDUCTIBLE
$
-
X RETENTION $ 10,000 $
WORKERSCOMPENSATION I TORY WC STATU- LIMIT" I IOJ~-
AND EMPLOYERS'LIABILITY YIN
$
ANYPROPRIETORIPARTNERIEXECUTIV0E E.L. EACHACCIDENT
OFFICER/MEMBEREXCLUDED? N/A
E.L. DISEASE- EA EMPLOYEE $
(Mandatory in NH)
If yes, describeunder E.L. DISEASE- POLICYLIMIT $
DESCRIPTIONOF OPERATIONSbelow
08/01/2016 RENTED OR 200,00(1
A INLAND MARINE 4C13936 08/01/2015
DED 1,00(1
DESCRIPTIONOF OPERATIONS/ LOCATIONS/ VEHICLES (Attach ACORD101,Additional RemarksSchedule.if more space Is required)
THE CITY OF FORT COLLINS ITS OFFICERS'BAGENTS AND EMPLOYEES SHALL BE NAMES
AS ADDITIONAL INSURED ON GENERAL L1A ILiTY AND AUTO
CANCELLATION
@1988-2009ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
CATEHOLDER
ACORD 25 (2009/09)
CERTIFI
CITYOFF
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 AUTHORIZEDREPRESENTATIVE
Fort Collins, CO 80522-0580 ~K~
I
DocuSign Envelope ID: 45868588-7E15-4B6F-8D09-6E5984633ECF