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HomeMy WebLinkAboutCORRESPONDENCE - AGREEMENT MISC - CLEAN AIR LAWN CARE (3)March 1, 2016 Clean Air Lawn Care of Fort Collins, LLC Attn: Justin Reynier justin@cleanairlawncare.com 321 Del Clair Rd. Fort Collins, CO 80525 RE: Renewal, Clean Air Agreement dated 4/18/2014 Dear Mr. Reynier: The City of Fort Collins wishes to extend the agreement term for the above captioned project per the existing terms and conditions and the following: 1) The term will be extended for one (1) additional year, April 13, 2016 through April 12, 2017. If the renewal is acceptable to your firm, please sign this letter in the space provided and attach a current copy of insurance naming the City as an additional insured for General and Automotive Liability, within the next fifteen days. If this extension is not agreeable with your firm, we ask that you send us a written notice stating that you do not wish to renew the contract and state the reason for non-renewal. Please contact Jill Wilson, Buyer at (970) 221-6216 if you have any questions regarding this matter. Sincerely, Gerry S. Paul Director of Purchasing __________________________________________ ________________ Signature Date (Please indicate your desire to renew by signing this letter and returning it to Purchasing Division within the next fifteen days.) GSP:jg Financial Services Purchasing Division 215 N. Mason St. 2nd Floor PO Box 580 Fort Collins, CO 80522 970.221.6775 970.221.6707- fax fcgov.com/purchasing DocuSign Envelope ID: AB2773E1-E68F-44B4-BC3A-D903B7F98BC2 3/1/2016    ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? INSR LTR DATE (MM/DD/YYYY) INSURED TYPE OF INSURANCE POLICY NUMBER LIMITS GENERAL LIABILITY AUTOMOBILE LIABILITY GARAGE LIABILITY WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE INSURER A: INSURER B: INSURER C: INSURER D: INSURER E: EACH OCCURRENCE $ DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $ CLAIMS MADE OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ PRO- POLICY JECT LOC COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO ALL OWNED AUTOS BODILY INJURY (Per person) $ SCHEDULED AUTOS HIRED AUTOS BODILY INJURY (Per accident) $ NON-OWNED AUTOS PROPERTY DAMAGE (Per accident) $ AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ WC STATU- TORY LIMITS OTH- ACORD 25 (2009/01) on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER IMPORTANT If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may This Certificate of Insurance 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. require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement DocuSign Envelope ID: AB2773E1-E68F-44B4-BC3A-D903B7F98BC2 ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # COVERAGES CERTIFICATE HOLDER CANCELLATION CERTIFICATE OF LIABILITY INSURANCE ADD'L INSRD PRODUCER $ DATE (MM/DD/YYYY) POLICY EFFECTIVE DATE (MM/DD/YYYY) POLICY EXPIRATION EXCESS / UMBRELLA LIABILITY Y / N (Mandatory in NH) © 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORD 25 (2009/01) A 1001486 132849.3 04-06-2009 03/01/2016 State Farm Insurance 106 E Olive Street Fort Collins, CO 80524 970-482-1936 Justin Reynier 321 Del Clair Rd Fort Collins, CO 80525 State Farm Mutual Automobile Insurance Company 25178 25143 5,000 3638801c0506 09/05/2015 03/05/2016 3668766d1706a 10/17/2015 04/17/2016 1,000,000 2008 Chevy C1500 vin number 1gcec14088z199223 2007 Toyota Tacoma vin number 5tenx22n87z404700 Listed as additional insured: City of Fort Collins 281 N. College Ave. Fort Collins, CO 80524 30 Chip Beake DocuSign Envelope ID: AB2773E1-E68F-44B4-BC3A-D903B7F98BC2                                                                                   !"                      #"$%&%'"(#(&)"%$*+%'(,)-    "$%.*(&/(%,01,"2%%-+',%+#   ,123%&"" "$%"%'0,)-+&-+("(-,#"$%.*(&/&%'")(-.*(&(%,0)/'%41('%)-%-+',%0%-",")"%0%-"-"$(,&%'"(#(&)"%+%,-"&-#%''(5$",""$% &%'"(#(&)"%$*+%'(-*(%1#,1&$%-+',%0%-",                                                                                                                  6                                                !       " #  $!% !        !       !    ! %          &    !% '     " !  !       !"     !#   &     &  ( )* ! # !    +            7       8  ,,'  ,!! '- )-+)"'/(-  1 2 )%  ) . 3    . /*0    ""  +  ! ""  +  ! ""    +                                      9:9++("(-)*%0)';,&$%+1*%0)/2%)"")&$%+(#0'%,.)&%(,'%41('%+        ###   !+!     + !, ##  # ###   4  &  ! ' 2 * ( )*     !#   !  * 3       !+!  #5 ### !    + &                   6      <=<:9>:9 ?9@AA <:9>  **'(5$",'%,%'B%+       $%-)0%)-+*5)'%'%5(,"%'%+0)';,# ) *6  " 789 ! )* : 3 % ;8 /**  0 * <%  =9988 978.344.4200 contactus@insurancebee.com Hiscox Insurance Company Inc. 10200 03/01/2016 Clean Air Lawn Care of Fort Collins LLC 321 Del Clair Rd Fort Collins CO 80525 Y N 32125947-GL The City Of Fort Collins is included as additional insured as their interest may appear as required by written contract. The City Of Fort Collins 281 N. College Ave. Fort Collins CO 80524 A X X X 03/04/2016 03/04/2017 1,000,000 100,000 5,000 1,000,000 2,000,000 S/T Gen. Agg. DocuSign Envelope ID: AB2773E1-E68F-44B4-BC3A-D903B7F98BC2