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HomeMy WebLinkAboutCORRESPONDENCE - AGREEMENT MISC - LEWIS TENNIS LLC (2)June 15, 2016
Lewis Tennis LLC
Attn: Mr. Larry Lewis larry@lewistennis.com
PO Box 1207
LaPorte, CO 80535
RE: Renewal, Misc. Agreement - Tennis Concessions
Dear Mr. Lewis:
The City of Fort Collins wishes to extend the agreement term for the above captioned
proposal per the existing terms and conditions and the following:
1) The term will be extended for one (1) additional year, September 6, 2016 through
September 5, 2017.
If the renewal is acceptable to your firm, please sign this letter in the space provided
and include a current copy of insurance certificate naming the City as an
additional insured for General and Automotive Liability within the next fifteen (15)
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 this Tennis Concession Agreement 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: 4F6E7F1B-ED34-414B-8A15-D67BB94CB76D
6/22/2016
The ACORD name and logo are registered marks of ACORD
CERTIFICATE HOLDER
© 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01)
AUTHORIZED REPRESENTATIVE
CANCELLATION
CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
JECT LOC
POLICY PRO-
GEN'L AGGREGATE LIMIT APPLIES PER:
CLAIMS-MADE OCCUR
COMMERCIAL GENERAL LIABILITY
PREMISES (Ea occurrence) $
DAMAGE TO RENTED
EACH OCCURRENCE $
MED EXP (Any one person) $
PERSONAL & ADV INJURY $
GENERAL AGGREGATE $
PRODUCTS - COMP/OP AGG $
DED RETENTION $
CLAIMS-MADE
OCCUR
$
AGGREGATE $
UMBRELLA LIAB EACH OCCURRENCE $
EXCESS LIAB
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
INSR
LTR TYPE OF INSURANCE POLICY NUMBER
POLICY EFF
(MM/DD/YYYY)
POLICY EXP
(MM/DD/YYYY) LIMITS
PER
STATUTE
OTH-
ER
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE
E.L. DISEASE - POLICY LIMIT
$
$
$
ANY PROPRIETOR/PARTNER/EXECUTIVE
If yes, describe under
DESCRIPTION OF OPERATIONS below
(Mandatory in NH)
OFFICER/MEMBER EXCLUDED?
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED SCHEDULED
HIRED AUTOS
NON-OWNED
AUTOS AUTOS
AUTOS
COMBINED SINGLE LIMIT
BODILY INJURY (Per person)
BODILY INJURY (Per accident)
PROPERTY DAMAGE $
$
$
$
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSD
ADDL
WVD
SUBR
N / A
$
$
(Ea accident)
(Per accident)
OTHER:
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
INSURED
PHONE
(A/C, No, Ext):
PRODUCER
ADDRESS:
E-MAIL
FAX
(A/C, No):
CONTACT
NAME:
NAIC #
INSURER A :
INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
INSURER(S) AFFORDING COVERAGE
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
INS025 (201401)
6/21/2016
Ewing-Leavitt Insurance Agency
4025 St. Cloud Dr.
Suite 100
Loveland CO 80538
CL Central
(970)679-7333 (866)456-4265
Lewis Tennis LLC
P O Box 1207
Laporte CO 80535
Auto Owners 18988
CL1662101614
A
X
X
X
X 74687368 7/15/2016 7/15/2017
1,000,000
50,000
5,000
1,000,000
2,000,000
2,000,000
Prop Damage Agg 2,000,000
A
x x
74687368 7/15/2016 7/15/2017
City of Fort Collins is named as an Additional Insured as per written contract.
Casi zcPetrie/CAPETR
City of Fort Collins
PO Box 580
Fort Collins, CO 80522
(970)221-6782
DocuSign Envelope ID: 4F6E7F1B-ED34-414B-8A15-D67BB94CB76D