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509811 DUNCAN & ASSOCIATES - CONTRACT - SOLE SOURCE - DUNCAN ASSOCIATES
Professional Services Agreement SS 2016 – Capital Fee Expansion Study Page 1 of 10 PROFESSIONAL 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" and DUNCAN ASSOCIATES, hereinafter referred to as "Professional". 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 Professional agrees to provide services in accordance with the scope of services attached hereto as Exhibit "A", consisting of three (3) pages, and incorporated herein by this reference. 2. Contract Period. This Agreement shall commence upon execution by all parties and shall continue in full force and effect until April 30, 2016, unless sooner terminated as herein provided 3. Early Termination by City. 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 Professional. 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: Professional: City: Copy to: Duncan Associates Attn: Clancy Mullen 1617 W 9th Street Austin, TX 78703 City of Fort Collins Attn: Tiana Smith 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 any such early termination by the City, the Professional shall be paid for services rendered prior to the date of termination, subject only to the satisfactory performance of the Professional's obligations under this Agreement. Such payment shall be the Professional's sole right and remedy for such termination. 4. Design, Project Indemnity and Insurance Responsibility. The Professional shall be responsible for the professional quality, technical accuracy, timely completion and the coordination of all services rendered by the Professional, including but not limited to designs, plans, reports, specifications, and drawings and shall, without additional compensation, promptly remedy and correct any errors, omissions, or other deficiencies. The Professional shall indemnify, save and hold harmless the City, its officers and employees in accordance with Colorado law, from all damages whatsoever claimed by third parties against the City; and for the City's costs and reasonable attorney’s fees, DocuSign Envelope ID: 544A7B72-93AC-4C6B-B514-0BC4AE18BFB2 Professional Services Agreement SS 2016 – Capital Fee Expansion Study Page 2 of 10 arising directly or indirectly out of the Professional's negligent performance of any of the services furnished under this Agreement. The Professional shall maintain insurance in accordance with Exhibit B, consisting of one (1) page, attached hereto and incorporated herein. 5. Compensation. In consideration of the services to be performed pursuant to this Agreement, the City agrees to pay Professional a fixed fee in the amount of Twenty Four Thousand Five Hundred Twenty Five Dollars ($24,525) in accordance with Exhibit “A”, consisting of three (3) pages, attached hereto and incorporated herein. Monthly partial payments based upon the Professional's billings and itemized statements are permissible. The amounts of all such partial payments shall be based upon the Professional's City-verified progress in completing the services to be performed pursuant hereto and upon the City's approval of the Professional's actual reimbursable expenses. Final payment shall be made following acceptance of the work by the City. Upon final payment, all designs, plans, reports, specifications, drawings, and other services rendered by the Professional shall become the sole property of the City. 6. City Representative. The City has designated Tiana Smith its project representative who shall make, within the scope of her authority, all necessary and proper decisions with reference to the project. All requests for contract interpretations, change orders, and other clarification or instruction shall be directed to the City Representative. 7. Independent Contractor. The services to be performed by Professional are those of an independent contractor and not of an employee of the City of Fort Collins. The City shall not be responsible for withholding any portion of Professional's compensation hereunder for the payment of FICA, Workers' Compensation, other taxes or benefits or for any other purpose. 8. Subcontractors. Professional 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 Professional. 9. Personal Services. It is understood that the City enters into the Agreement based on the special abilities of the Professional and that this Agreement shall be considered as an agreement for personal services. Accordingly, the Professional shall neither assign any responsibilities nor delegate any duties arising under the Agreement without the prior written consent of the City. DocuSign Envelope ID: 544A7B72-93AC-4C6B-B514-0BC4AE18BFB2 Professional Services Agreement SS 2016 – Capital Fee Expansion Study Page 3 of 10 10. Acceptance Not Waiver. The City's approval of drawings, designs, plans, specifications, reports, and incidental work or materials furnished hereunder shall not in any way relieve the Professional of responsibility for the quality or technical accuracy of the work. 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 under this Agreement. 11. 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. 12. 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. 13. 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. 14. 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. 15. Prohibition Against Employing Illegal Aliens. Pursuant to Section 8-17.5-101, C.R.S., et. seq., Professional represents and agrees that: a. As of the date of this Agreement: 1. Professional does not knowingly employ or contract with an illegal alien who will perform work under this Agreement; and 2. Professional 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. DocuSign Envelope ID: 544A7B72-93AC-4C6B-B514-0BC4AE18BFB2 Professional Services Agreement SS 2016 – Capital Fee Expansion Study Page 4 of 10 b. Professional 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. Professional 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 Professional obtains actual knowledge that a subcontractor performing work under this Agreement knowingly employs or contracts with an illegal alien, Professional shall: 1. Notify such subcontractor and the City within three days that Professional 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 Professional 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. Professional 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 Professional 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, Professional shall be liable for actual and consequential damages to the City arising out of Professional’s violation of Subsection 8-17.5-102, C.R.S. g. The City will notify the Office of the Secretary of State if Professional violates this provision of this Agreement and the City terminates the Agreement for such breach. 16. Special Provisions. Special provisions or conditions relating to the services to be performed pursuant to this Agreement are set forth in Exhibit "C" - Confidentiality, consisting of one (1) pages, attached hereto and incorporated herein by this reference. DocuSign Envelope ID: 544A7B72-93AC-4C6B-B514-0BC4AE18BFB2 Professional Services Agreement SS 2016 – Capital Fee Expansion Study Page 5 of 10 THE CITY OF FORT COLLINS, COLORADO By: Gerry Paul, Purchasing Director DATE: ATTEST: City Clerk APPROVED AS TO FORM: Assistant City Attorney DUNCAN ASSOCIATES By: Clancy Mullen, Principal Date: DocuSign Envelope ID: 544A7B72-93AC-4C6B-B514-0BC4AE18BFB2 1/27/2016 Acting on behalf of 2/1/2016 Professional Services Agreement SS 2016 – Capital Fee Expansion Study Page 6 of 10 EXHIBIT A SCOPE OF WORK Project Understanding and Approach The purpose of this project is to update the City’s capital expansion fees for neighborhood parks, community parks, trails, fire, police and general government facilities. Our understanding is that the City desires to have a thorough revaluation of the methodologies used in light of current development trends, statutory requirements, and community needs. The City is approaching the build-out of the Growth Management Area (GMA), and instead of primarily greenfield, suburban development, the City is increasingly seeing infill projects, redevelopment and transit-oriented development. The City also would like to be able to compare its fees to those charged by other Colorado jurisdictions. Task 1: Project Organization/Data Collection This task will involve data collection and project organization for the update of the expansion fee program. Upon notice to proceed, the consultant will work with the City’s project manager to schedule a meeting with key members of City staff. Duncan Associates would participate via teleconference or Skype. The consultant will gather available information related to the project, identify major policy issues involved in updating the impact fee program, coordinate staff and consultant responsibilities and establish the project schedule. The City should provide the consultant team, without charge, copies of all relevant plans, studies and documents needed to perform the scope of work. At the conclusion of the task, the consultant will prepare a memorandum summarizing the organizational framework for the project and listing additional data to be provided by the City. Deliverables: Project Organization Meeting Project Organization Memorandum Task 2: Capital Expansion Fee Assessment Report In this task, the consultant will prepare an assessment report that describes and evaluates the City’s existing capital expansion fee program, identifies modifications and alternatives, and recommends a course of action to guide the update. The assessment will be closely coordinated with City staff via regular conference calls. The assessment will evaluate all of the components of the capital expansion fees, including levels of service, capital improvements plans and project listings, potential service are boundaries, development requirements, and cost elements included in the fee calculation. The assessment will summarize population, housing and employment growth projections. Potential service area (or assessment district) boundaries may be identified. It will include a review of similar fee amounts charged by other Front Range or Colorado jurisdictions. DocuSign Envelope ID: 544A7B72-93AC-4C6B-B514-0BC4AE18BFB2 Professional Services Agreement SS 2016 – Capital Fee Expansion Study Page 7 of 10 An initial draft of the assessment report will be prepared for review by the City’s executive team, including key personnel from Management, Engineering, Finance, Budget and Legal departments. Following conference calls and/or in-person meetings with staff and review of written comments, the consultant team will prepare a final draft. The report may be presented to the City Council if significant policy issues are identified, or it may simply be incorporated into the update study to be prepared in Task 3 and used to guide that task. Deliverables: Staff Review Draft of Assessment Report Final Draft of Assessment Report Task 3: Capital Expansion Fee Update This task entails the preparation of the capital expansion fee update study. The study will include all of the elements mandated by Colorado statutes and impact fee case law, including compliance with the dual rational nexus test. These elements include an inventory of existing capital facilities; the cost of improvements required to remedy any existing service deficiencies; the proportionate share of the cost of improvements required to accommodate increased service demands; and appropriate revenue credits to ensure that new development is not charged more than its proportionate share of the cost of new facilities. The analysis will include a table that establishes the number of service units and amount of facility demand associated with different land use types. The study will include a net unit cost schedule that represents the maximum fees that could be charged. The study will follow the recommendations of the assessment report, as modified by direction provided by City staff or City Council. It will also incorporate the analysis and data provided by the assessment report. The study will clearly describe the methodologies, formulas and calculations used to determine the updated fees. The report will document all assumptions, analysis, findings and recommendations, with technical documentation included in appendices. It will include an executive summary and conclusion. In addition to the updating the fees, the study will include a review of available construction cost indices that could be used in the annual inflation adjustment between updates. An initial draft of the study will be provided for staff review. After the receipt of comments and discussions with staff on any needed changes, a revised draft will be prepared for public review. If any changes are required following public input or Council direction prior to adoption, a final draft will be prepared. Deliverables: Staff Review Draft Capital Expansion Fee Study Public Review Draft Capital Expansion Fee Study Final Draft Capital Expansion Fee Study Task 4: Public Meetings Throughout the project, the consultant will be available to attend and participate in local meetings with stakeholders, advisory bodies, the City Council and/or the public as desired by the City. Consultant will provide presentation materials for such meetings. Deliverables: Attendance at Public Meetings DocuSign Envelope ID: 544A7B72-93AC-4C6B-B514-0BC4AE18BFB2 Professional Services Agreement SS 2016 – Capital Fee Expansion Study Page 8 of 10 Time Schedule The City desires to have the update study completed by about the middle of March 2016, with adoption to occur by about the end of June 2016. The proposed schedule shown below would accommodate that with delivery of the public draft of the update study by mid-March. Meeting this schedule would require prompt delivery by staff of required data and comments on draft reports. Budget The consultant cost for the proposed scope of services, excluding meeting attendance, is a fixed-fee of $24,525, as broken down by task below. The County would be billed monthly, based on the percentage completion of each task. Consultant attendance at meetings and presentations would be billed at a flat rate of $2,500 per meeting, inclusive of all travel expenses. Task Amount 1: Project Organization $1,400 2: Assessment Report $3,000 3: Fee Update Study $20,125 4. Public Meetings* * Total (excl. Meetings) $24,525 * flat rate of $2,500 per meeting, including travel costs Additional services would be provided on a time-and-expense basis, or for a fixed-fee as may be negotiated with the City. Duncan Associates’ hourly rates are $195 for James B. Duncan $175 for Clancy Mullen and Kirk Bishop, $125 for Jody Maas, and $225 for Eric Kelly. DocuSign Envelope ID: 544A7B72-93AC-4C6B-B514-0BC4AE18BFB2 Professional Services Agreement SS 2016 – Capital Fee Expansion Study Page 9 of 10 EXHIBIT B INSURANCE REQUIREMENTS 1. The Professional 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 Professional 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 Professional, 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 Professional under this Agreement. The City, its officers, agents and employees shall be named as additional insureds on the Professional '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 Professional shall maintain during the life of this Agreement for all of the Professional'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 Professional 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 Professional 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: 544A7B72-93AC-4C6B-B514-0BC4AE18BFB2 No new insurance required Professional Services Agreement SS 2016 – Capital Fee Expansion Study Page 10 of 10 EXHIBIT C CONFIDENTIALITY IN CONNECTION WITH SERVICES provided to the City of Fort Collins (the “City”) pursuant to this Agreement (the “Agreement”), the Professional 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 Professional has agreed to perform, the Professional 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 Professional 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 Professional shall not disclose any such information to any person not having a legitimate need-to-know for purposes authorized by the City. Further, the Professional 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 Professional 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 Professional 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 Professional ceases to perform services for the City, or the City so requests for any reason, the Professional 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 Professional understands and agrees that the City’s remedies at law for a breach of the Professional’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: 544A7B72-93AC-4C6B-B514-0BC4AE18BFB2 CERTIFICATE.OF.LIABILITY.INSURANCE GLW DATE (MM/DD/YYYY) R022 1/27/2016 THIS CERTIFICATEIS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATIONIS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: USI COLORADO LLC/PHS PHONE (A/C, No, Ext): (866) 467-8730 FAX (A/C, No): (888) 443-6112 341438 P:(866) 467-8730 F:(888) 443-6112 E-MAIL ADDRESS: PO BOX 33015 INSURER(S) AFFORDING COVERAGE NAIC# SAN ANTONIO TX 78265 INSURER A : Sentinel Ins Co LTD 11000 INSURED INSURER B : Hartford Ins. of the Midwest 37478 JAMES DUNCAN & ASSOCIATES INC DBA INSURER C : DUNCAN ASSOCIATES INSURER D : 17409 RUSH PEA CIR INSURER E : AUSTIN TX 78738 INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $2,000,000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $1,000,000 A X General Liab X 34 SBA PR9629 09/29/2015 09/29/2016 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 POLICY X PRO- JECT LOC PRODUCTS - COMP/OP AGG $4,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $2,000,000 ANY AUTO BODILY INJURY (Per person) $ A ALL OWNED AUTOS SCHEDULED AUTOS 34 SBA PR9629 09/29/2015 09/29/2016 BODILY INJURY (Per accident) $ X HIRED AUTOS X NON-OWNED AUTOS DocuSign Envelope ID: 544A7B72-93AC-4C6B-B514-0BC4AE18BFB2 PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY N/ A X PER STATUTE OTH- ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) Y/N E.L. EACH ACCIDENT $500,000 B 34 WBC CB4367 09/29/2015 09/29/2016 E.L. DISEASE- EA EMPLOYEE $500,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Those usual to the Insured's Operations. Notice of Cancellation will be provided in accordance with Form SS1223, attached to this policy. CERTIFICATE HOLDER CANCELLATION CITY OF FORT COLLINS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ATTN: PURCHASING PO BOX 580 FORT COLLINS, CO 80522 AUTHORIZED REPRESENTATIVE © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID: 544A7B72-93AC-4C6B-B514-0BC4AE18BFB2