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HomeMy WebLinkAbout465997 MICHAEL BAKER JR INC - CONTRACT - RFP - 8331 BRIDGE INSPECTION, MAINTENANCE, REPAIR & REPLProfessional Services Agreement – Work Order Type 8331 Bridge Inspection, Maintenance, Repair & Replacement Program Page 1 of 13 PROFESSIONAL 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 MICHAEL BAKER INTERNATIONAL, 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 any project Work Orders for 8331 bridge Inspection, Maintenance, Repair & Replacement Program, issued by the City. A blank sample of a work order is attached hereto as Exhibit "A", consisting of one (1) page and is incorporated herein by this reference. A general scope of services is attached hereto as Exhibit “B", consisting of two (2) pages and is incorporated herein by this reference. The City reserves the right to independently bid any project rather than issuing a Work Order to the Professional for the same pursuant to this Agreement. Irrespective of references in Exhibit A to certain named third parties, Professional shall be solely responsible for performance of all duties hereunder. 2. The Work Schedule. The services to be performed pursuant to this Agreement shall be performed in accordance with the Work Schedule stated on each Work Order. 3. Time of Commencement and Completion of Services. The services to be performed pursuant to this Agreement shall be initiated as specified on each Work Order. Time is of the essence. Any extensions of any time limit must be agreed upon in writing by the parties hereto. 4. Contract Period. This Agreement shall commence September 1, 2016, and shall continue in full force and effect until August 31, 2017, 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 Professional and mailed no later than thirty (30) days prior to contract end. 5. Early Termination by City/Notice. 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 address: DocuSign Envelope ID: 08606A72-3668-4990-BA25-D349DAC61AA5 Professional Services Agreement – Work Order Type 8331 Bridge Inspection, Maintenance, Repair & Replacement Program Page 2 of 13 Professional: City: Copy to: Michael Baker International Attn: David Nemovitz 165 S Union Blvd., Ste 200 Lakewood, CO 80228 City of Fort Collins Attn: Jin Wang 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. 6. Design, Project Insurance 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 agrees that it is responsible for and will ensure that the design Work under any Work Order complies with the 2010 ADA (American with Disabilities Act) Standards for Accessible design, separate from and in addition to building codes compliance. This includes ensuring that change orders or other changes comply with the 2010 ADA Standards. 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 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 “D”, consisting of one (1) page, attached hereto and incorporated herein. 7. Compensation. In consideration of services to be performed pursuant to this Agreement, the City agrees to pay Professional on a time and reimbursable direct cost basis designated in Exhibit "C", consisting of two (2) pages, attached hereto and incorporated herein by this reference. At the election of the City, each Work Order may contain a maximum fee, which shall be negotiated by the parties hereto for each such Work Order. 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 to the Work Order and upon approval of the Professional's direct 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. 8. City Representative. The City will designate, prior to commencement of work, its project representative who shall make, within the scope of his or 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 DocuSign Envelope ID: 08606A72-3668-4990-BA25-D349DAC61AA5 Professional Services Agreement – Work Order Type 8331 Bridge Inspection, Maintenance, Repair & Replacement Program Page 3 of 13 Representative. 9. Project Drawings. Upon conclusion of the project and before final payment, the Professional shall provide the City with reproducible drawings of the project containing accurate information on the project as constructed. Drawings shall be of archival, prepared on stable mylar base material using a non-fading process to provide for long storage and high quality reproduction. "CD" disc of the as-built drawings shall also be submitted to the owner in and AutoCAD version no older then the established city standard. 10. Monthly Report. Commencing thirty (30) days after Notice to Proceed is given on any Work Order and every thirty days thereafter, Professional is required to provide the City Representative with a written report of the status of the work with respect to the Work Order, Work Schedule and other material information. Failure to provide any required monthly report may, at the option of the City, suspend the processing of any partial payment request. 11. 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. 12. 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. 13. Personal Services. It is understood that the City enters into this 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 this Agreement without the prior written consent of the City. 14. 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 DocuSign Envelope ID: 08606A72-3668-4990-BA25-D349DAC61AA5 Professional Services Agreement – Work Order Type 8331 Bridge Inspection, Maintenance, Repair & Replacement Program Page 4 of 13 construed to operate as a waiver of any rights or benefits provided to the City under this Agreement. 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. 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 representatives, successors and assigns of said parties. 18. 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. 19. 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. 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. DocuSign Envelope ID: 08606A72-3668-4990-BA25-D349DAC61AA5 Professional Services Agreement – Work Order Type 8331 Bridge Inspection, Maintenance, Repair & Replacement Program Page 5 of 13 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. 20. 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: 08606A72-3668-4990-BA25-D349DAC61AA5 Professional Services Agreement – Work Order Type 8331 Bridge Inspection, Maintenance, Repair & Replacement Program Page 6 of 13 THE CITY OF FORT COLLINS, COLORADO By: Gerry Paul Purchasing Director DATE: ATTEST: City Clerk APPROVED AS TO FORM: Senior Assistant City Attorney MICHAEL BAKER INTERNATIONAL By: Printed: Title: CORPORATE PRESIDENT OR VICE PRESIDENT Date: DocuSign Envelope ID: 08606A72-3668-4990-BA25-D349DAC61AA5 Vice President David Jula 9/15/2016 9/16/2016 Professional Services Agreement – Work Order Type 8331 Bridge Inspection, Maintenance, Repair & Replacement Program Page 7 of 13 EXHIBIT A WORK ORDER FORM PURSUANT TO AN AGREEMENT BETWEEN THE CITY OF FORT COLLINS AND MICHAEL BAKER INTERNATIONATION DATED: Work Order Number: Purchase Order Number: Project Title: 8331 Bridge Inspection, Maintenance, Repair & Replacement Program 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 ___ (_) pages are hereby accepted and incorporated herein, by this reference, and Notice to Proceed is hereby given. PROFESSIONAL By:_______________________________ Date:_____________________________ CITY OF FORT COLLINS By:_________________________________ Project Manager Date: ______________________________ By: _______________________________ Gerry Paul Purchasing Director (over $60,000.00) Date: ____________________________ DocuSign Envelope ID: 08606A72-3668-4990-BA25-D349DAC61AA5 Professional Services Agreement – Work Order Type 8331 Bridge Inspection, Maintenance, Repair & Replacement Program Page 8 of 13 EXHIBIT B GENERAL SCOPE OF SERVICES The City has approximately 200 minor bridges of which about 132 are inspected. Inspection cycles of these bridges vary between 12 and 24 months. Bridge inspections are typically scheduled between October 15 and April 15. Currently, it is anticipated that about 70 bridges will be scheduled for each inspection cycle. The list of bridges to be inspected during each period will be determined by the City. Unscheduled inspection of bridges may be required from time to time as directed by the City. All bridges for the purpose of this proposal are minor bridges. The City defines a minor bridge as a bridge having a clear span from four feet to 20 feet. All consultants submitting proposals shall be pre-qualified with CDOT for BI-Bridge Inspection, BD-Bridge Design, and SE-Structural Engineering. Some of the City bridges are considered confined space. Consultants inspecting such bridges must be trained to work in confined space. Prior to any confined space bridge inspection, consultants shall provide the City with a letter stating that the personnel inspecting confined space bridges are trained to work in confined space. These confined space bridges may or may not require permitting. Evaluation of structure below three feet of water is required where applicable. Inspection shall consist of any appropriate method, short of employing diving or remote submersibles. The consultant shall investigate the foundation conditions by probing and/or feeling for undercutting of the foundation or other problems such as deterioration of foundation elements. Bridge design services may be required from time to time. Type of design will vary, from repair and widening, to full replacement bridge. The City will provide the consultant with any existing plan and information that is available. 1.1 Scope of Services The services will consist of the following: A. Complete inspection, rating, and reporting of bridges in the inspection list provided by the City. B. The consultant shall insure that bridges are properly posted and signed. Photo documentation of the posting sign shall be included with each inspection report. C. The consultant shall conduct the work in accordance with all governing safety rules and regulations applicable to the work. D. The consultant shall be responsible for providing updated Average Daily Traffic “ADT’s”. E. Recommendation for re-rating, repairs and safety improvement with associated cost estimate. F. On call services for any bridge related design. DocuSign Envelope ID: 08606A72-3668-4990-BA25-D349DAC61AA5 Professional Services Agreement – Work Order Type 8331 Bridge Inspection, Maintenance, Repair & Replacement Program Page 9 of 13 1.2 Inspection Standards The work shall be carried out in accordance with the following documents and revisions thereto: A. CDOT Pontis Bridge Inspection Manual (The City is not switching to the new inspection reporting for minor bridges) B. AASHTO Manual for Condition Evaluation of Bridges C. Bridge Inspection Reference Manual D. Recording and Coding Guide for the structure Inventory and Appraisal of Nation’s Bridges (Report No. FHWA-PD-96-0010) E. Any other applicable documents approved by the City. 1.3 Inspection Submittal A. One printed copy of bridge inspection reports. Rating and photos pages shall be in color. B. One PDF file of the bridge inspection report for each bridge inspected. C. Digital photos with description as file name. D. Electronic sketches of all the bridges. E. PDF of rating calculation where applicable. F. Pontis tables of the following, in Access or Excel: i. bridge ii. eleminsp iii. insp_wcand iv. inspevnt v. roadway vi. userbrdg G. Recommendations for re-rating of bridges, if any. H. Repairs and safety improvement recommendations with cost estimate. DocuSign Envelope ID: 08606A72-3668-4990-BA25-D349DAC61AA5 Professional Services Agreement – Work Order Type 8331 Bridge Inspection, Maintenance, Repair & Replacement Program Page 10 of 13 EXHIBIT C COMPENSATION DocuSign Envelope ID: 08606A72-3668-4990-BA25-D349DAC61AA5 Professional Services Agreement – Work Order Type 8331 Bridge Inspection, Maintenance, Repair & Replacement Program Page 11 of 13 DocuSign Envelope ID: 08606A72-3668-4990-BA25-D349DAC61AA5 Professional Services Agreement – Work Order Type 8331 Bridge Inspection, Maintenance, Repair & Replacement Program Page 12 of 13 EXHIBIT D 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. C. Errors & Omissions. The Professional shall maintain errors and omissions insurance in the amount of $1,000,000. DocuSign Envelope ID: 08606A72-3668-4990-BA25-D349DAC61AA5 No new insurance required Professional Services Agreement – Work Order Type 8331 Bridge Inspection, Maintenance, Repair & Replacement Program Page 13 of 13 EXHIBIT E 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: 08606A72-3668-4990-BA25-D349DAC61AA5 Holder Identifier : 7777777707070700077761616045571110767717016204447207442027772507300072640577046230130777451517127444707137154237631103075736330235377610763511067406665207364015570076130076727242035772000777777707000707007 7777777707070700073525677115456000722000507037112007132337353072001071332263421731010702223625217310007033237253172000071322373430731100712333734216210007022236252173100077756163351765540777777707000707007 Certificate No : 570063541742 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 09/02/2016 IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or 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). 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. PRODUCER Aon Risk Services Central, Inc. Pittsburgh PA Office Dominion Tower, 10th Floor 625 Liberty Avenue Pittsburgh PA 15222-3110 USA PHONE (A/C. No. Ext): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # (866) 283-7122 INSURED INSURER A: Liberty Mutual Fire Ins Co 23035 INSURER B: Liberty Insurance Corporation 42404 INSURER C: National Union Fire Ins Co of Pittsburgh 19445 INSURER D: Lloyd's Syndicate No. 2623 AA1128623 INSURER E: INSURER F: FAX (A/C. No.): (800) 363-0105 CONTACT NAME: Michael Baker International, Inc. 165 S. Union Blvd, Suite 200 Lakewood CO 80228 USA COVERAGES CERTIFICATE NUMBER: 570063541742 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. Limits shown are as requested POLICY EXP (MM/DD/YYYY) POLICY EFF (MM/DD/YYYY) SUBR WVD INSR LTR ADDL TYPE OF INSURANCE INSD POLICY NUMBER LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR POLICY LOC EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG X X X X GEN'L AGGREGATE LIMIT APPLIES PER: $2,000,000 $100,000 $5,000 $2,000,000 $4,000,000 $4,000,000 A TB2681004145716 08/30/2016 08/30/2017 PRO- JECT OTHER: AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY SCHEDULED AUTOS HIRED AUTOS ONLY NON-OWNED AUTOS ONLY BODILY INJURY ( Per person) PROPERTY DAMAGE (Per accident) X BODILY INJURY (Per accident) $2,000,000 A 08/30/2016 08/30/2017 COMBINED SINGLE LIMIT (Ea accident) AS2-681-004145-726 EXCESS LIAB X OCCUR CLAIMS-MADE AGGREGATE EACH OCCURRENCE DED $10,000,000 $10,000,000 $10,000 UMBRELLA LIAB 08/30/2016 C BE060476715 08/30/2017 X RETENTION X E.L. DISEASE-EA EMPLOYEE E.L. DISEASE-POLICY LIMIT E.L. EACH ACCIDENT $1,000,000 X OTH- ER PER STATUTE B 08/30/2016 08/30/2017 AOS B WC7681004145786 08/30/2016 08/30/2017 $1,000,000 Y / N (Mandatory in NH) ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED? N / A N WI WORKERS COMPENSATION AND EMPLOYERS' LIABILITY If yes, describe under DESCRIPTION OF OPERATIONS below $1,000,000 WA768D004145776 QC1602675 08/31/2016 08/31/2017 Per Claim Professional & Pollution Aggregate $5,000,000 D E&O-PL-Primary SIR applies per policy terms & conditions $5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) For Named Insured Only: Attn: David Neurovitz City of Fort Collins, its officers, agents and employees are included as Additional Insured with respect to the General Liability and Automobile Liability policies, per written contract with the Named Insured. CERTIFICATE HOLDER CANCELLATION CityREPRESENTATIVE of Fort Collins AUTHORIZED Attn: Steve McQuilkin PO Box 580 Fort Collins CO 80522 USA ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. DocuSign Envelope ID: 08606A72-3668-4990-BA25-D349DAC61AA5