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HomeMy WebLinkAbout118873 FIRST NATIONAL BANK - CONTRACT - RFP - 8407 BANKING SERVICESServices Agreement
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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 FIRST NATIONAL BANK, 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 Services. The Service Provider 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. 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 January 1, 2017, and shall continue in
full force and effect until December 31, 2017, unless sooner terminated as herein
provided. In addition, this Agreement shall automatically renew for up to four (4) additional
one (1) year periods unless either party elects not to renew the Agreement. In such event,
the party electing not to renew the Agreement shall provide written notice to the other
party at least ninety (90) days prior to the anniversary date of the Agreement.
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:
First National Bank
Attn: Mark Driscoll
205 W Oak Street
Fort Collins, CO 80521
City of Fort Collins
Attn: Harold Hall
PO Box 580
Fort Collins, CO 80522
City of Fort Collins
Attn: Purchasing Dept.
PO Box 580
Fort Collins, CO 80522
DocuSign Envelope ID: 1C088A25-9658-4E6F-BD11-CA61F3BD91AC
Services Agreement
8407 Banking Services Page 2 of 14
In the event of early termination by the City, the Service Provider shall be paid for services
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, in accordance with the attached 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.
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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
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.
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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
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.
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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
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" - Confidentiality,
consisting of one (1) page, attached hereto and incorporated herein by this reference.
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THE CITY OF FORT COLLINS, COLORADO
By:
Gerry Paul
Purchasing Director
DATE:
ATTEST:
APPROVED AS TO FORM:
FIRST NATIONAL BANK
By:
Printed:
Title:
CORPORATE PRESIDENT OR VICE PRESIDENT
Date:
DocuSign Envelope ID: 1C088A25-9658-4E6F-BD11-CA61F3BD91AC
1/3/2017
Mark Driscoll
Colorado Market President
Assistant City Attorney
1/5/2017
City Clerk
Services Agreement
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EXHIBIT A
SCOPE OF SERVICES
DESCRIPTION OF ACCOUNTS AND SERVICES PROVIDED TO THE CITY
a. Overview of Current Banking Services
First National Bank of Fort Collins is the current provider of banking services for the City.
The current banking relationship includes the following accounts and services (detailed
descriptions provided below):
1. Item processing (credits and debits: including cash/ check clearing, Automated Clearing
House deposits – ACHs and Electronic Funds Transfers – EFTs).
2. Receipt/disbursement accounts and safety deposit boxes.
3. Out-going and incoming wire services.
4. Lock-box processing for utility payments and sales and use tax payments.
5. Daily armored car courier service.
6. Daily transfers via online cash management system.
7. Account statements, reports and account analysis.
b. Accounts and Services
i. Item processing
1. Receipts
Deposits are collected from several City locations and taken to the bank where they
are credited to the City’s checking account. The bank also credits payments
received from customer utility bills and sales tax receipts through a lock-box
arrangement with the City. The bank collects payments on behalf of the City in the
form of cash, check, account transfer, wire transfer, EFT and ACH.
2. Disbursements
The City processes its general payroll every two weeks and its pension payroll
monthly. City employees have the option of receiving their payroll in the form of a
paycard or a direct deposit. For direct deposit, the City provides the bank with a file
containing all account information, and the bank handles the transfer. The City
processes its accounts payable checks regularly on Thursday of each week.
ii. Accounts and Safety Deposit Boxes
1. Operating account
Primary depository account for utility payment receipts, sales tax receipts and
customer deposits/payments. This account is swept to a minimal balance each
morning into a local government investment pool.
2. Payroll account
Disbursement account used for bi-weekly and monthly payroll.
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3. Accounts payable account
Disbursement account used for all accounts payable checks, EFT, wires and ACH
withdrawals.
4. Additional special accounts
1. Self insurance account (payment of claims)
2. HOME program account (receipt of federal grant draws)
3. CDBG account (receipt of program income, grant draws, etc.)
4. Check clearing fund (receipts with insufficient funds, closed accounts, are debited
from this account)
5. Three checking accounts used for credit card receipts
6. Municipal Court checking account
5. Safety deposit boxes
One large (3” by 6” by 12”) box is required for use by the City.
iii. Wire services
The City uses the fed wire system as a primary form of payment distribution. Both
incoming and outgoing wires are handled by the City’s primary banking relationship.
iv. Lock box processing
The Lock box must have a Fort Collins postal address.
The City has a lock box arrangement with its current bank. Items are processed
centrally at the primary bank location and credited directly to the City’s account.
v. Armored Car Courier Service
The City’s current banking services includes an armored car courier service that picks up
deposits and receipts on a daily basis from the following locations. The deposits are
taken directly to the bank and credited to the City’s account.
ARMORED CAR COURIER SERVICE STOPS
DEPARTMENT SCHEDULE LOCATION
Accounting M-F 215 N Mason 5 250
Building Inspection M-F 281 N College 5 250
City Park Pool M-F 1599 City Park Dr 5 250
EPIC M-TH 1801 Riverside 4 200
Foothills Activity Center M-F Foothills Mall 5 250
Gardens @ Spring Creek Tues 2145 Centre Ave 1 50
Grandview Fri 1900 W Mountain Ave 1 50
Library M-F 301 E Olive 5 250
Lincoln Center T-F 417 W Magnolia 2 100
Mulberry Pool M-F (in season) 424 W Mulberry TBD 125
Municipal Court M-F 215 N Mason 5 250
Museum Tues 408 Mason Court 1 50
Natural Areas on call 1745 Hoffman-mill Rd TBD 20
Northside Aztlan M-F 112 E Willow St 5 250
Transfort Thurs 250 N Mason 1 50
Senior Center Wed 1200 Raintree Dr 1 50
Weekly
Frequency
Annual
Service
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Weekly Annual
DEPARTMENT SCHEDULE LOCATION FREQUENCY SERVICE
vi. On-Line Services
On-line services will include the ability to review balance reporting for all accounts (prior
day, current position, and lockbox availability), view disbursement account activity and
initiate stop-payments, generate wire and ACH and book and drawdown transfers, and
allow the setup of repetitive transfer templates.
vii. Account statements, reports, and account analysis
The bank provides:
Detailed account statements (hardcopy reports and data files) – Monthly.
Detailed account analysis – Monthly.
Electronic notification of ACH returns – as needed.
The bank calculates all costs for services that are off-set by an earnings credit from
compensating accounting balances. The account analysis statement depicts costs that
are directly related to the number of transactions (for example, lock box processing,
credit card processing, etc.).
City Park Pool M-F 1599 City Park Dr 5 250
EPIC M-TH 1801 Riverside 4 200
Foothills Activity Center M-F Foothills Mall 5 250
Gardens @ Spring Creek Tues 2145 Centre Ave 1 50
Grandview Fri 1900 W Mountain Ave 1 50
Library M-F 301 E Olive 5 250
Lincoln Center T-F 417 W Magnolia 2 100
Mulberry Pool M-F (in season) 424 W Mulberry TBD 125
Municipal Court M-F 215 N Mason 5 250
Museum Tues 408 Mason Court 1 50
Natural Areas on call 1745 Hoffman-mill Rd TBD 20
Northside Aztlan M-F 112 E Willow St 5 250
Transfort Thurs 250 N Mason 1 50
Senior Center Wed 1200 Raintree Dr 1 50
Parks Wed 413 S Bryon 1 50
Parking Services M-F 215 N Mason 5 250
Parks & Rec M-F 215 N Mason 5 250
PFA M 102 Remington St 1 50
Police M 2221 S Timberline Rd 1 50
CIS Revenue 2X/day M-F 222 Laporte 10 500
City Clerk Mon 300 Laporte 1 50
GOLF COURSES
Southridge on call 5750 S Lemay TBD 20
Collindale on call 1441 E Horsetooth TBD 20
City Park Nine on call 411 S Bryon TBD 20
Annual Total 3705
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EXHIBIT B
COMPENSATION
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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: 1C088A25-9658-4E6F-BD11-CA61F3BD91AC
No new insurance required
Services Agreement
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EXHIBIT D
CONFIDENTIALITY
IN CONNECTION WITH SERVICES provided to the City of Fort Collins (the “City”) pursuant to
this Agreement (the “Agreement”), the Service Provider 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 Service Provider has agreed to perform, the Service Provider
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 Service
Provider 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 Service Provider shall not disclose any such information to any
person not having a legitimate need-to-know for purposes authorized by the City. Further, the
Service Provider 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 Service Provider 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 Service Provider 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 Service Provider ceases to perform services for the City, or the City so
requests for any reason, the Service Provider 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 Service Provider understands and agrees that the City’s remedies at law for a breach of the
Service Provider’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: 1C088A25-9658-4E6F-BD11-CA61F3BD91AC
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.
12/27/2016
The Harry A. Koch Co.
P.O. Box 45279
Omaha NE 68145-0279
First National of Nebraska, Inc.
Attn: Risk & Insurance Dept
1620 Dodge St., Mail Stop 1151
Omaha NE 68197
Federal Insurance Company
Great Northern Insurance Company
20281
20303
402-861-7000 402-861-7111
1035631488
A 35757477 1/18/2016 1/18/2017 1000000
1000000
10000
1000000
2000000
Included
X
X
X
B
X
X X
73560467 1/18/2016 1/18/2017 1,000,000
A 71701763 1/18/2016 1/18/2017 X
500,000
500,000
500,000
RE: Banking Services Agreement. The City of Ft. Collins, its officers, agents and employees are named
as additional insured for general liability and auto liability as required by written contract executed
prior to a loss, but only insofar as loss or damage was the result of negligence of First National Bank,
a division of First National Bank of Omaha. First National Bank, a division of First National Bank of
Omaha is a named insured under the policies.
City of Fort Collins
Attn Gerry Paul
215 N Mason
Ft Collins CO 80524
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