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HomeMy WebLinkAboutMULTIPLE - CONTRACT - BID - 8373 CODE COMPLIANCE ON-CALL (3)Services Agreement 8373 Code Compliance On-Call Page 1 of 18 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 ROOTED COLORADO LLC, 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. Scope of Work. The Service Provider agrees to provide services in accordance with the Scope of Work attached hereto as Exhibit "A", consisting of five (5) pages and incorporated herein by this reference. Irrespective of references in Exhibit A to certain named third parties, Service Provider shall be solely responsible for performance of all duties hereunder. 2. Contract Period. This Agreement shall commence upon contract execution and shall continue in full force and effect until October 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 Service Provider and mailed no later than thirty (30) days prior to contract end. 3. Delay. If either party is prevented in whole or in part from performing its obligations by unforeseeable causes beyond its reasonable control and without its 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. 4. 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 Service Provider. 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: Service Provider: City: Copy to: Rooted Colorado LLC Attn: Josh Hodges 2525 Wood Valley Court Fort Collins, CO 80521 City of Fort Collins Attn: Eric Keselburg 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 DocuSign Envelope ID: 260D9ED4-B354-4AF4-94A3-1833F409C37C Services Agreement 8373 Code Compliance On-Call Page 2 of 18 rendered to the date of termination, 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. 5. Contract Sum. The City shall pay the Service Provider for the performance of this Contract, subject to additions and deletions provided herein, in accordance with Exhibit "B", consisting of three (3) pages, and incorporated herein by this reference. 6. City Representative. The City will designate, prior to commencement of the work, its representative who shall make, within the scope of his or her authority, all necessary and proper decisions with reference to the services provided under this agreement. All requests concerning this agreement shall be directed to the City Representative. 7. Independent Service provider. The services to be performed by Service Provider are those of an independent service provider and not of an employee of the City of Fort Collins. The City shall not be responsible for withholding any portion of Service Provider's compensation hereunder for the payment of FICA, Workmen's Compensation or other taxes or benefits or for any other purpose. 8. Subcontractors. Service Provider 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 Service Provider. 9. 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. 10. 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 or benefits provided to the City under this Agreement or cause of action arising out of performance of this Agreement. 11. 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 DocuSign Envelope ID: 260D9ED4-B354-4AF4-94A3-1833F409C37C Services Agreement 8373 Code Compliance On-Call Page 3 of 18 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. c. 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. 12. 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. 13. 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. 14. 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. 15. Indemnity/Insurance. a. 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 occurring in connection with the performance of any service hereunder. b. The Service Provider shall take all necessary precautions in performing the work hereunder to prevent injury to persons and property. c. Without limiting any of the Service Provider's obligations hereunder, the Service Provider shall provide and maintain insurance coverage naming the City as an DocuSign Envelope ID: 260D9ED4-B354-4AF4-94A3-1833F409C37C Services Agreement 8373 Code Compliance On-Call Page 4 of 18 additional insured under this Agreement of the type and with the limits specified within Exhibit C, 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 Purchasing Director, 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. 16. 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. 17. 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. 18. 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 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 DocuSign Envelope ID: 260D9ED4-B354-4AF4-94A3-1833F409C37C Services Agreement 8373 Code Compliance On-Call Page 5 of 18 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. 19. Special Provisions. Special provisions or conditions relating to the services to be performed pursuant to this Agreement are set forth in Exhibit "D" – Subcontractors, consisting of one (1) page; Exhibit “E” – Sample Billing Form, consisting of one (1) page; and Exhibit “F” – Sample Lien Release, consisting of one (1) page, attached hereto and incorporated herein by this reference. 20. Fugitive Dust Prevention and Control. The City of Fort Collins has adopted a Dust Prevention and Control Manual and can be found at the following link: http://www.fcgov.com/airquality/fugitive-dust.php. All operations conducted under this Agreement shall be performed in accordance with the stated procedures and requirements. DocuSign Envelope ID: 260D9ED4-B354-4AF4-94A3-1833F409C37C Services Agreement 8373 Code Compliance On-Call Page 6 of 18 THE CITY OF FORT COLLINS, COLORADO By: Gerry Paul Purchasing Director DATE: ATTEST: APPROVED AS TO FORM: ROOTED COLORADO LLC By: Printed: Title: Date: DocuSign Envelope ID: 260D9ED4-B354-4AF4-94A3-1833F409C37C 11/28/2016 Owner Josh Hodges Assistant City Attorney 12/6/2016 City Clerk Services Agreement 8373 Code Compliance On-Call Page 7 of 18 EXHIBIT A SCOPE OF WORK DEFINITIONS City Representative shall mean the Code Compliance Supervisor or their designated representative. Service Provider shall mean a successful bidder who has entered into a Services Agreement with the City of Fort Collins. EQUIPMENT REQUIRED The Service Provider shall submit a list of equipment that will be utilized to accomplish the work, defined as the industry standard for the P.T.O. horse power needed for the make and model of mower or snow removal equipment and shall be prepared to have equipment inspected and approved by the City's Representative. The City Representative shall make the final determination if the equipment made available by the Service Provider is sufficient to perform the work satisfactorily in a timely means. Inspections of equipment may be performed by the City Representative at any point during the contract. WORK DIVISION The City intends to award this bid, based on bid price and demonstrated capacity, to multiple Service Providers who may be responsible for one or more of the categories placed for bid. It is the intent of Community Development and Neighborhood Services Department to assign work equitably among Service Providers based on bid price and level of performance including quality and timeliness of work, however, there is no stated nor implied guarantee regarding the allocation of assigned work. The City reserves the right to accept or reject any or all bids, and to waive any informalities and irregularities in the bids. All Service Providers must have the equipment specified for the scope of the work in each category it chooses to bid. All work shall be performed under the direction of the City Representative, and in strict accordance with the bid specifications and the signed Services Agreement. The City Representative is authorized to assign jobs based on their sole discretion including their judgement what is in the best interest of the City. REGULATIONS All work must be done in compliance with all local/state/federal regulations. This includes having your vehicles current including Colorado Intrastate USDOT Carrier Identification Numbers and equipment above 500 lbs. must have current Special Mobile Equipment (SME) registration. All employees must be properly licensed and qualified to operate the equipment they work on. All employees must be hired and managed in accordance with all local/state/federal requirements. All equipment must be properly licensed and maintained. A violation of any applicable regulation will be grounds for termination. NOTIFICATION The City shall notify Service Provider verbally or in writing of services to be performed. Such notification shall include the location of such services and any other special circumstances relating to the services. DocuSign Envelope ID: 260D9ED4-B354-4AF4-94A3-1833F409C37C Services Agreement 8373 Code Compliance On-Call Page 8 of 18 The City Representative must be able to reach the Service Provider easily, be responded to within a reasonable time frame of two (2) hours. The Service Provider must have a mobile phone where messages can be left. If the City Representative is unable to reach a Service Provider when needed, the City Representative may use any Service Provider to perform any type of services under this Agreement, regardless of original assignment. Nothing within this Contract shall obligate the City to have any particular service performed by the Service Provider. SAFETY The Service Provider shall perform all work in a safe manner, and must ensure that proper safety gear is worn at all times. Personnel working on or near the road including the road shoulder or right-of-way must wear a Class III reflective safety vest and hard hats at all times. Personnel must wear eye and ear protection during weed whipping and while performing other tasks that create a hazard to the ears and eyes. PERFORMANCE The Service Provider shall perform each job required in the most efficient manner and at the lowest cost to the City. Any damage caused by the Service Provider in the performance of this contract shall be the sole responsibility of the Service Provider. The Service Provider shall be assigned each job by the City Representative, or his designate. A list noting the address of the job, and the date the job was given to the Service Provider shall be considered notice to proceed on each given job. At the time jobs are assigned, the City Representative shall give oral and/or written instructions as to how each job is to be performed. The Service Provider shall complete each job as assigned within forty-eight (48) hours of receiving the assignment. If the job is not completed within forty-eight (48) hours, the City Representative shall have the option of giving the assigned job to another Service Provider of the City’s choice, or allowing the original Service Provider complete the job. Should extenuating circumstances arise, such as severe weather, which prevents the Service Provider from completing the job on schedule, the Service Provider must immediately notify the City Representative, who shall decide if an extension shall be granted. If the Service Provider does not perform the job as instructed, they shall be called back to correct the job. The City shall not be charged for any corrections, and all corrections shall be made promptly and professionally. Failure to make corrections as specified will be cause to terminate the contract. Should the Service Provider arrive at a job site, to find the work partially done or in process, the Service Provider shall not begin work, and shall immediately notify the City Representative. Should a property owner or a resident request that the Service Provider stop work, the Service Provider shall immediately stop work, give the property owner/resident the City Representative's card or phone number, and immediately notify the City Representative. If possible the Service Provider should also obtain the name and number of the property owner/resident. DIGITAL PHOTOS All services performed under this contract require the use of a digital camera. A digital photo, DocuSign Envelope ID: 260D9ED4-B354-4AF4-94A3-1833F409C37C Services Agreement 8373 Code Compliance On-Call Page 9 of 18 with accurate date and time stamp, must be taken prior to, and upon completion, of all services performed. Photos must clearly represent the work performed. If photos do not meet the intended needs of the City Representative, the City Representative reserves the right to NOT pay invoices for that job site. CHANGES IN THE WORK The City may, at any time during the term of a particular work assignment and without invalidating the Contract, make changes within the general scope of the particular work assignment and the Service Provider agrees to perform such changed work. MATERIALS, EQUIPMENT AND LABOR The Service Provider undertakes and agrees to furnish and pay for all materials, supplies, labor, transportation, equipment, tools, consumables, services and supervision necessary to perform any services hereunder. ICE MELT The City understands that the application of Ice Melt may be a necessary tool to soften hard- packed snow and ice, however excessive use of Ice Melt will not be tolerated. If the excessive use of Ice Melt per job is determined excessive by the City Representative, an explanation of need may be required by the Service Provider. Disregard for the City Representative’s recommended quantity of Ice Melt may be cause for non-payment of invoice. MOVE-ON FEE A Move-On Fee is defined as de-mobilizing from one work site and re-mobilizing to a different work site greater than ¼ mile distance per City Representative directive, but no work is performed because the abatement has already been completed. In such cases, the Service Provider shall be allowed to charge one (1) Move-On Fee of $20.00. If multiple work sites are within a ¼ mile range and meet the Move-On Fee criteria, only one (1) Move-On Fee may be applied. HAZARD FEE The Service Provider shall be allowed to charge a “hazardous fee” of $50.00 on jobs where the rubbish contains potentially hazardous items. These items may include bedbugs, drug related materials/waste, excrement, insect infestation, etc. It will be the responsibility of the Service Provider to fully document the possible hazard with photos and narrative. DUST PREVENTION AND CONTROL MANUAL The City of Fort Collins has adopted a Dust Prevention and Control Manual. The manual can be found at: www.fcgov.com/dust. All operations conducted under this Agreement shall be performed in accordance with the stated procedures and requirements. SUB CONTRACTORS AND MATERIALS Any sub-contractor Service Provider intends to utilize under the Agreement must be approved by the City in writing prior to the start of any work by such sub-contractor. A list of all permitted sub-contractors (if applicable) and material suppliers (if any) must be submitted with the bid. The Service Provider shall not utilize the services of any sub-contractor not listed on the sub- contractor list as submitted in performing work pursuant to the Contract without the prior written consent of the City nor shall the Service Provider obtain supplies or equipment used in the performance of this contract unless such supplier is listed on the material list. The City reserves the right to deny use of sub-contractors hereunder at its sole discretion. DocuSign Envelope ID: 260D9ED4-B354-4AF4-94A3-1833F409C37C Services Agreement 8373 Code Compliance On-Call Page 10 of 18 RECORDS The Service Provider shall, at all times, maintain accurate work records, noting the address of the job, the City-assigned job number, digital photos (as required), the condition of the property, the hours worked, the number of employees used, the equipment used and any problems or unusual incidents. These work records may be requested and inspected at any time by the City Representative. BILLING Invoices shall be submitted on City-approved forms only, and each invoice shall be submitted with a lean-waiver release, if approved sub-contractors are used. Invoices shall reflect the equipment used, the number of people on site, and total time spent on site. Billings shall be submitted within seven (7) calendar days of job completion. Work shall be charged at the hourly rate associated with the most efficient type of work and the equipment used, as bid. All reasonable landfill and/or recycle fees will be reimbursed. However, landfill tickets must also be submitted with the invoice. Time spent driving from the job site to the landfill, and back to the job site shall be charged by the quarter hour, at the hourly rate submitted for light weed and rubbish removal. Move-on fees may also be included on the invoice, if appropriate (see above section for further information on Move-On Fees). The first flat tire incurred in the course of work (if the flat was caused by a hazard on a job site, and not in the public right-of-way) shall be reimbursed by the City, subject to City review and provided a receipt is submitted. Subsequent flat tires caused by hazards on the same job site shall be paid for by the Service Provider. All billing must accurately reflect the actual time worked. Non-accurate billings may be cause for termination of the contract. TERMINATION The City may terminate this contract for any reason with fifteen (15) days written notice to Service Provider. BIDS The City may complete such pre-award reference verification as it deems necessary to determine the ability of the Bidder to perform the work and the Bidder shall furnish to the City all such information and data as is reasonably required for this purpose. The City reserves the right to disqualify any bid if the evidence resulting from the City’s investigation shows, in the sole opinion of the City, that the Bidder is not properly qualified to perform the work described herein. Fill in all blanks on the Bid Forms. Failure to do so may result in a bid disqualification. Bids entered on forms where phraseology has been altered or where the documents have been otherwise altered may not be accepted. A list of sub-contractors must be submitted with all bids, signed supplemental instructions, and a workman's compensation waiver if deemed necessary. The successful bidder(s) shall be required to enter into the attached Services Agreement. LAWS AND REGULATIONS The Service Provider agrees to comply fully with all applicable state and federal laws and regulations and municipal ordinances. The Service Provider further agrees to comply fully with the Occupational Safety and Health Act, all regulations issued there under and all state laws and regulations enacted and adopted pursuant thereto. DocuSign Envelope ID: 260D9ED4-B354-4AF4-94A3-1833F409C37C Services Agreement 8373 Code Compliance On-Call Page 11 of 18 The Service Provider also agrees to require that all persons operating motorized equipment possess a valid drivers' license and that it will comply with Title 8, Article 12, C.R.S., the Colorado Youth Employment Opportunity Act of 1971. The Service Provider agrees to pay all state and federal social security, unemployment insurance and other taxes, assessments or contributions due and payable to the State of Colorado and/or the United States in connection with the work to be performed under this Contract, and the Service Provider shall hold the City harmless from any liability on account of any such taxes or assessments. DocuSign Envelope ID: 260D9ED4-B354-4AF4-94A3-1833F409C37C Services Agreement 8373 Code Compliance On-Call Page 12 of 18 EXHIBIT B COMPENSATION DocuSign Envelope ID: 260D9ED4-B354-4AF4-94A3-1833F409C37C Services Agreement 8373 Code Compliance On-Call Page 13 of 18 DocuSign Envelope ID: 260D9ED4-B354-4AF4-94A3-1833F409C37C Services Agreement 8373 Code Compliance On-Call Page 14 of 18 DocuSign Envelope ID: 260D9ED4-B354-4AF4-94A3-1833F409C37C Services Agreement 8373 Code Compliance On-Call Page 15 of 18 EXHIBIT C 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. DocuSign Envelope ID: 260D9ED4-B354-4AF4-94A3-1833F409C37C New insurance Services Agreement 8373 Code Compliance On-Call Page 16 of 18 EXHIBIT D SUBCONTRACTORS DocuSign Envelope ID: 260D9ED4-B354-4AF4-94A3-1833F409C37C Services Agreement 8373 Code Compliance On-Call Page 17 of 18 EXHIBIT E SAMPLE BILLING FORM CITY OF FORT COLLINS CODE COMPLIANCE ON-CALL BILLING INSTRUCTIONS AND INVOICE FORM Vendor Name: Phone Number: Address (Street & #): City, State, Zip Code: INVOICE NO: INVOICE DATE: BILLED TO: (City of Fort Collins) JOB NO: LOCATION: WORK COMPLETED (include dates/times, locations, materials, equipment used, and time per person): PHOTO DOCUMENTATION ATTACHED (Including date and time stamps) MOVE ON FEE (provide further documentation of addresses) $ TOTAL CHARGE: $ _______ DocuSign Envelope ID: 260D9ED4-B354-4AF4-94A3-1833F409C37C Services Agreement 8373 Code Compliance On-Call Page 18 of 18 EXHIBIT F SAMPLE LIEN RELEASE The undersigned, for good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, and intending to be contractually bound, hereby waives and releases to and for the benefit of the owners of any properties on which work was performed pursuant to the Contract for Code Compliance On-Call, by and between the undersigned and the City of Fort Collins, Colorado, all rights of the undersigned to claim a mechanic's lien pursuant to Colorado Revised Statutes, or any similar lien for work completed before ____ in conjunction with the property at the following address: and the undersigned hereby acknowledges the reliance of the owner or owners of such property and the City of Fort Collins, Colorado, upon the waiver and release herein contained. Name of Service Provider: Authorized Signature: Capacity (i.e., officer sole owner, partner): DocuSign Envelope ID: 260D9ED4-B354-4AF4-94A3-1833F409C37C 12/02/2016 Sample Insurance Group, LLC 325 Second Street Suite S PO Box 790 Monument CO 80132 Robert Sample 719-559-0706 (719) 559-0411 robertsample@sampleinsurance.net Rooted Colorado, LLC 2525 Woodvalley Court Fort Collins CO 80521 Scottsdale Insurance Company 41279 x x x x x CPS2554479 11/21/2016 11/21/2017 1,000,000 100,000 5,000 1,000,000 2,000,000 2,000,000 x x x 03997856-0 12/02/2016 12/02/2017 1,000,000 Snow removal and Landscaping Certificate Holder is named as an additional insured with respect to General Liability and Auto Liability City of Fort Collins Purchasing Department PO Box 580 Fort Collins, CO 80522 <RFS> ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? INSR ADDL SUBR LTR INSD WVD DATE (MM/DD/YYYY) PRODUCER CONTACT NAME: PHONE FAX (A/C, No, Ext): (A/C, No): E-MAIL ADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXP TYPE OF INSURANCE (MM/DD/YYYY) (MM/DD/YYYY) LIMITS AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRO- POLICY JECT LOC PRODUCTS - COMP/OP AGG $ OTHER: $ COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS (Per accident) $ OCCUR EACH OCCURRENCE $ CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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. 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: CERTIFICATE HOLDER CANCELLATION © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD CERTIFICATE OF LIABILITY INSURANCE