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HomeMy WebLinkAboutS D MYERS INC - CONTRACT - SOLE SOURCE - SD MYERS INCService Agreement – Work Order Type with Red Flags & Confidentiality SS 2015 – Oil Sampling from Live Substation Transformers Page 1 of 17 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 SD MYERS INC. 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 Sampling of Liquid Filled Electrical Equipment. 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 $75,000. The scope of services for 2015 is attached hereto as Exhibit “B”, consisting of five (5) pages, and incorporated herein by this reference. The 2015 work is representative of the general scope of services for future work. 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 without waiting for a written Work Order. Time is of the essence. DocuSign Envelope ID: 0060FB47-17B1-4B13-BFE1-CC57BB1F88F6 Service Agreement – Work Order Type with Red Flags & Confidentiality SS 2015 – Oil Sampling from Live Substation Transformers Page 2 of 17 4. Contract Period. This Agreement shall commence November 6, 2015 and shall continue in full force and effect until November 5, 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: SD Myers Inc. Attn: Risk Mgt. 180 South Avenue Tallmadge, OH 44278 City of Fort Collins Attn: Kevin Knotts 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 hourly labor rate and material costs, with markups, stated within the Analytical Services Quotation Form, attached hereto as Exhibit "C", consisting of two (2) pages, and incorporated herein by this reference. Payment shall be made by the City only upon acceptance of the work by the City and DocuSign Envelope ID: 0060FB47-17B1-4B13-BFE1-CC57BB1F88F6 Service Agreement – Work Order Type with Red Flags & Confidentiality SS 2015 – Oil Sampling from Live Substation Transformers Page 3 of 17 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 B, Scope 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. DocuSign Envelope ID: 0060FB47-17B1-4B13-BFE1-CC57BB1F88F6 Service Agreement – Work Order Type with Red Flags & Confidentiality SS 2015 – Oil Sampling from Live Substation Transformers Page 4 of 17 c. Unless otherwise specifically state in Service Provider’s Proposal, Service Provider warrants all equipment, materials, labor and other work, provided under this Agreement, except City-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 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. Project Indemnity and Insurance Responsibility. a. The Professional shall be responsible for the professional quality, technical accuracy, timely completion and coordination of all services provided or performed by Professional, as more fully described in the Statement of Work. These services may include analysis, documentation, report development, configuration, and scripting citizen access configuration to enable City to, including but not limited to, Professional document services, reports, modules, workflow processes, citizen access configuration and deployment, permits, scripting, and testing. Professional shall endeavor to promptly remedy and correct any errors, omissions, or other deficiencies not performed in accordance with the Statement of Work. b. 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 DocuSign Envelope ID: 0060FB47-17B1-4B13-BFE1-CC57BB1F88F6 Service Agreement – Work Order Type with Red Flags & Confidentiality SS 2015 – Oil Sampling from Live Substation Transformers Page 5 of 17 occurring in connection with the performance of any service hereunder. c. The Service Provider shall take all necessary precautions in performing the work hereunder to prevent injury to persons and property. d. 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. 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. 19. 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. 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 DocuSign Envelope ID: 0060FB47-17B1-4B13-BFE1-CC57BB1F88F6 Service Agreement – Work Order Type with Red Flags & Confidentiality SS 2015 – Oil Sampling from Live Substation Transformers Page 6 of 17 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. 22. Red Flags Rules. Service Provider must implement reasonable policies and procedures to detect, prevent and mitigate the risk of identity theft in compliance with the Identity Theft Red Flags Rules found at 16 Code of Federal Regulations part 681. Further, Service Provider must take appropriate steps to mitigate identity theft if it occurs with one or more of the City’s covered accounts and must as expeditiously as possible notify the City in writing of significant breeches of security or Red Flags to the Utilities or the Privacy Committee. 23. 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: 0060FB47-17B1-4B13-BFE1-CC57BB1F88F6 Service Agreement – Work Order Type with Red Flags & Confidentiality SS 2015 – Oil Sampling from Live Substation Transformers Page 7 of 17 THE CITY OF FORT COLLINS, COLORADO By: Gerry Paul Purchasing Director DATE: ATTEST: City Clerk APPROVED AS TO FORM: Assistant City Attorney SD MYERS INC. By: Printed: Title: CORPORATE PRESIDENT OR VICE PRESIDENT Date: DocuSign Envelope ID: 0060FB47-17B1-4B13-BFE1-CC57BB1F88F6 Sindi M. Harrison 11/17/2015 Risk Manager & Associate Legal Counsel 11/19/2015 Service Agreement – Work Order Type with Red Flags & Confidentiality SS 2015 – Oil Sampling from Live Substation Transformers Page 8 of 17 EXHIBIT A WORK ORDER FORM PURSUANT TO AN AGREEMENT BETWEEN THE CITY OF FORT COLLINS AND SD MYERS INC AGREEMENT DATED: Work Order Number: Purchase Order Number: Project Title: Original Bid/RFP Project # & Name: SS 2015 – Oil Sampling from Live Substation Transformers 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. SD MYERS INC. By:_______________________________ Date:_____________________________ CITY OF FORT COLLINS Submitted By: _________________________ Project Manager Date: _________________________ Reviewed by: _________________________ Date: _________________________ Approved by: _________________________ Date: ________________________ Approved by: _________________________ Utilities General Manager (over $1,000,000) Date: ________________________ Approved by: _________________________ Purchasing Director (if over $60,000) Date: _______________________ DocuSign Envelope ID: 0060FB47-17B1-4B13-BFE1-CC57BB1F88F6 Service Agreement – Work Order Type with Red Flags & Confidentiality SS 2015 – Oil Sampling from Live Substation Transformers Page 9 of 17 EXHIBIT B SCOPE OF WORK DocuSign Envelope ID: 0060FB47-17B1-4B13-BFE1-CC57BB1F88F6 Service Agreement – Work Order Type with Red Flags & Confidentiality SS 2015 – Oil Sampling from Live Substation Transformers Page 10 of 17 DocuSign Envelope ID: 0060FB47-17B1-4B13-BFE1-CC57BB1F88F6 Service Agreement – Work Order Type with Red Flags & Confidentiality SS 2015 – Oil Sampling from Live Substation Transformers Page 11 of 17 DocuSign Envelope ID: 0060FB47-17B1-4B13-BFE1-CC57BB1F88F6 Service Agreement – Work Order Type with Red Flags & Confidentiality SS 2015 – Oil Sampling from Live Substation Transformers Page 12 of 17 DocuSign Envelope ID: 0060FB47-17B1-4B13-BFE1-CC57BB1F88F6 Service Agreement – Work Order Type with Red Flags & Confidentiality SS 2015 – Oil Sampling from Live Substation Transformers Page 13 of 17 DocuSign Envelope ID: 0060FB47-17B1-4B13-BFE1-CC57BB1F88F6 Service Agreement – Work Order Type with Red Flags & Confidentiality SS 2015 – Oil Sampling from Live Substation Transformers Page 14 of 17 EXHIBIT C COMPENSATION DocuSign Envelope ID: 0060FB47-17B1-4B13-BFE1-CC57BB1F88F6 Service Agreement – Work Order Type with Red Flags & Confidentiality SS 2015 – Oil Sampling from Live Substation Transformers Page 15 of 17 DocuSign Envelope ID: 0060FB47-17B1-4B13-BFE1-CC57BB1F88F6 Service Agreement – Work Order Type with Red Flags & Confidentiality SS 2015 – Oil Sampling from Live Substation Transformers Page 16 of 17 EXHIBIT D 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. C. Errors & Omissions. The Professional shall maintain errors and omissions insurance in the amount of $1,000,000. DocuSign Envelope ID: 0060FB47-17B1-4B13-BFE1-CC57BB1F88F6 No new insurance required Service Agreement – Work Order Type with Red Flags & Confidentiality SS 2015 – Oil Sampling from Live Substation Transformers Page 17 of 17 EXHIBIT E 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. DocuSign Envelope ID: 0060FB47-17B1-4B13-BFE1-CC57BB1F88F6 CERTIFICATE HOLDER © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 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 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 (Attach ACORD 101, Additional Remarks Schedule, if more space is required) INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS WC STATU- TORY LIMITS 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) Schedule of Workers Compensation Policies LA Pol # 142863 eff 10/16/15 to 10/16/16 LWCC – NAIC 22350 TX Pol # SBP0001243324 10/01/15 to 10/01/16 Texas Mutual – NAIC 22945 FL Pol # 13UB2850C79315 10/01/15 to 10/01/16 Florida JUA – (State Fund) MI Pol # 6KUB5B62627115 10/01/15 to 10/01/16 Travelers Indemnity Insurance Co. – NAIC 25666 IN Pol # TARIN4839002 10/01/15 to 10/01/16 Technology Insurance – NAIC 42376 AL AZ IA IL KS OR SC VA Pol # WC534S535111015 10/01/15 to 10/01/16 Liberty Mututal Ins. Co – NAIC MO Pol # 6JUB5B61816615 10/01/15 to 10/01/16 Travelers Property & Casualty – NAIC 25666 NE Pol # 6KUB5B61815415 10/01/15 to 10/01/16 Travelers Indeminity Company – NAIC 25666 AR Pol # 266146401 10/01/15 to 10/01/16 Technology Insurance Company – NAIC 42376 CA Pol # 902930515 10/01/15 to 10/01/16 California State Compensation Insurance Fund (State Fund) TN Pol # WC231S6805777015 10/01/15 to 10/01/16 Liberty Mutual Insurance Company – NAIC 23035 NC Pol # 6JUB2E70726115 02/05/15 to 02/05/16 Travelers Indemnity Insurance Co. – NAIC 25666 DocuSign Envelope ID: 0060FB47-17B1-4B13-BFE1-CC57BB1F88F6 10/10/01/01/2015 2015 FEI-ECC1031703 DocuSign Envelope ID: 0060FB47-17B1-4B13-BFE1-CC57BB1F88F6 10/01/13 ECC1031701 10/01/2014 ECC1031702 10/01/2015 FEI-ECC1031703 DocuSign Envelope ID: 0060FB47-17B1-4B13-BFE1-CC57BB1F88F6 S. D. Myers, Inc. Endorsement Number: 6 ECC-320-0712 Automatic Waiver of Subrogation Endorsement This endorsement, effective 10/1/2012 attaches to and forms a part of Policy Number FEI-ECC-10317-00. This endorsement changes the Policy. Please read it carefully. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS POLLUTION LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: Any person(s) or organization(s) to whom the Named Insured agrees, in a written contract, to provide a waiver of subrogation. However, this status exists only for the project specified in that contract. The Company waives any right of recovery it may have against the person or organization shown in the above Schedule because of payments the Company makes for injury or damage arising out of the insured’s work done under a contract with that person or organization. The waiver applies only to the person or organization in the above Schedule. Under no circumstances shall this endorsement act to extend the policy period, change the scope of coverage or increase the Aggregate Limits of Insurance shown in the Declarations. 10/01/13 ECC1031701 10/01/2014 ECC1031702 10/01/2015 FEI-ECC1031703 10/01/2015 DocuSign Envelope ID: 0060FB47-17B1-4B13-BFE1-CC57BB1F88F6 S. D. Myers, Inc. Endorsement Number: 15 ECC-548-0712 Automatic Primary and Non-Contributory Insurance Endorsement Designated Work Or Project(s) This endorsement, effective 10/1/2012 attaches to and forms a part of Policy Number FEI-ECC-10317-00. This endorsement changes the Policy. Please read it carefully. SCHEDULE Name of Person or Organization: Any person(s) or organization(s) whom the Named Insured agrees, in a written contract, to provide Primary and/or Non-contributory status of this insurance. However, this status exists only for the project specified in that contract. In consideration of an additional premium of $Applied and notwithstanding anything contained in this policy to the contrary, it is hereby agreed that this policy shall be considered primary to any similar insurance held by third parties in respect to work performed by you under any written contractual agreement with such third party. It is further agreed that any other insurance which the person(s) or organization(s) named in the schedule may have is excess and non- contributory to this insurance. 10/01/13 ECC1031701 10/01/2014 ECC1031702 10/01/2015 FEI-ECC1031703 DocuSign Envelope ID: 0060FB47-17B1-4B13-BFE1-CC57BB1F88F6 S. D. Myers, Inc. Endorsement Number: 25 CG 20 37 10 01 Copyright, ISO Properties, Inc., 2000 Additional Insured – Owners, Lessees or Contractors – Completed Operations This endorsement, effective 10/1/2012 attaches to and forms a part of Policy Number FEI-ECC-10317-00. This endorsement changes the Policy. Please read it carefully. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: Location And Description of Completed Operations: Additional Premium: $Applied (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) Section II – Who Is An Insured is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of “your work” at the location designated and described in the schedule of this endorsement performed for that insured and included in the “products- completed operations hazard”. 10/01/13 ECC1031701 10/01/2014 ECC1031702 10/01/2015 FEI-ECC1031703 DocuSign Envelope ID: 0060FB47-17B1-4B13-BFE1-CC57BB1F88F6 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED AND RIGHTS OF RECOVERY AGAINST OTHERS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM A. Any person or organization whom you are required by contract to name as additional insured is an ''insured'' for LIABILITY COVERAGE but only to the extent that person or organizat ion qualifies as an ''insured'' under the WHO IS AN INSURED provision of Section II - LIABILITY COVERAGE. B. For any person or organization for whom you are required by contract to provide a waiver of subrogation, the Loss Condition - TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US is applicable. Form HA 99 13 01 87 Printed in U.S.A. Policy Number 20UENZQ6852 Effective Effective 10/10/01/01/2012 13 to - 10/10/01 01/14 2013 Policy Number 20UENZQ6852 Effective 10/10/01/01/2014 2015 Expiration 10/01/2015 DocuSign Envelope ID: 0060FB47-17B1-4B13-BFE1-CC57BB1F88F6 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Form IH 03 13 06 11 Page 1 of 1 © 2011, The Hartford NOTICE OF CANCELLATION TO CERTIFICATE HOLDER(S) This policy is subject to the following additional Conditions: A. If this policy is cancelled by the Company, other than for nonpayment of premium, notice of such cancellation will be provided at least thirty (30) days in advance of the cancellation effective date to the certificate holder(s) with mailing addresses on file with the agent of record or the Company. B. If this policy is cancelled by the Company for nonpayment of premium, or by the insured, notice of such cancellation will be provided within (10) days of the cancellation effective date to the certificate holder(s) with mailing addresses on file with the agent of record or the Company. If notice is mailed, proof of mailing to the last known mailing address of the certificate holder(s) on file with the agent of record or the Company will be sufficient proof of notice. Any notification rights provided by this endorsement apply only to active certificate holder(s) who were issued a certificate of insurance applicable to this policy's term. Failure to provide such notice to the certificate holder(s) will not amend or extend the date the cancellation becomes effective, nor will it negate cancellation of the policy. Failure to send notice shall impose no liability of any kind upon the Company or its agents or representatives. Policy Policy Number Number 20UENZQ6852 Effective Effective 10/10/01/01/13 2012-to 10/10/01/01/14 2013 Policy Number 20UENZQ6852 Effective 10/10/10/01/01/01/2014 2015 2015 Expiration 10/01/2015 DocuSign Envelope ID: 0060FB47-17B1-4B13-BFE1-CC57BB1F88F6 S. D. Myers, Inc. Endorsement Number: 1 ECC-315-0712 Common Policy Conditions Endorsement This endorsement, effective 10/1/2012 attaches to and forms a part of Policy Number FEI-ECC-10317-00. This endorsement changes the Policy. Please read it carefully. In consideration of the premium charged, and notwithstanding anything contained in this policy to the contrary, it is hereby agreed that all coverage parts included in this policy are subject to the following conditions: A. CANCELLATION The named insured may cancel this policy by mailing to the Company written notice stating when thereafter such cancellation shall become effective. The Company may cancel this policy by mailing to the named insured, at the mailing address specified the Declarations, written notice stating when not less than thirty (30) days thereafter such cancellation shall become effective, except in the event of the named insured's nonpayment of premium, not less than ten (10) days advance notice of cancellation shall be given. The mailing of notice as aforesaid, shall be sufficient proof of either party's intent to cancel. The effective date of cancellation specified in such notice shall terminate this policy period. Delivery of such notice shall be equivalent to mailing. If the named insured cancels, the earned premium shall be computed in accordance with the customary short rate table. If the Company cancels, the earned premium shall be computed pro rata. The Company will tender any return premium subject to retaining a minimum earned premium equal to 25% of the amount specified in the Declarations. Premium adjustment may be made either at the time cancellation is effective or as soon as practicable thereafter, but tender of the unearned premium or return of this policy, shall not be conditions precedent to cancellation hereunder. B. CHANGES No provision of this policy may be amended, waived or otherwise changed, except by endorsement hereto. 10/01/13 ECC1031701 10/01/2014 ECC1031702 10/01/2015 FEI-ECC1031703 DocuSign Envelope ID: 0060FB47-17B1-4B13-BFE1-CC57BB1F88F6 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. INSR ADDL WVD SUBR N / A $ $ (Ea accident) (Per accident) 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). The ACORD name and logo are registered marks of ACORD 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. 11/17/2015 J. Smith Lanier & Co.-Atlanta 11330 Lakefield Drive Bldg 1, Suite 100 Duluth GA 30097 S. D. Myers, Inc. 180 South Avenue Tallmadge OH 44278 Admiral Insurance Company Hartford Fire Insurance Co. Assigned Risk 24856 19682 770-476-1770 770-476-3651 1858429439 A ECC1031703 10/1/2015 10/1/2016 1,000,000 50,000 5,000 1,000,000 2,000,000 2,000,000 X X X X 50,000 B X X X 0 deductible 20UENZQ6852 10/1/2015 10/1/2016 1,000,000 A X X X 10,000 EXS1031803 10/1/2015 10/1/2016 6,000,000 6,000,000 C SEEATTACHED 10/1/2015 10/1/2016 X 1,000,000 1,000,000 1,000,000 A Cont Pollution Liability Professional Liability ECC1031703 10/1/2015 10/1/2016 $1,000,000 ea occ $1,000,000 ea occ $50,000 ded $1,000,000 agg $1,000,000 agg Certificate Holder is named as additional insured as per written contract, but only with respects to the General Liability and Auto Liability insurance and subject to the provisions and limitations of the policy. Waiver of Subrogation applies for auto liability and general liability as required by written contract. Coverage is primary and non-contributory as requred by written contract. No deductible applies to Auto liability or Workers Compensation/Employers Liability. Excess is follow form. City of Fort Collins PO Box 580 Fort Collins CO 80522 DocuSign Envelope ID: 0060FB47-17B1-4B13-BFE1-CC57BB1F88F6