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CORRESPONDENCE - BID - 8096 FIBER OPTIC SPLICING & RELATED SERVICES (5)
March 14, 2018 Backbone Fiber Systems LLC Attn: Solomon Howes PO Box 7312 Loveland, CO 80537 RE: Renewal, 8096 Fiber Optic Splicing & Related Services Dear Mr. Howes: The City of Fort Collins wishes to extend the agreement term for the above captioned proposal per the existing terms and conditions and the following: 1) The term will be extended for one (1) additional year, June 10, 2018 through June 9, 2019. If the renewal is acceptable to your firm, please sign this letter in the space provided and include a current copy of insurance certificate naming the City as an additional insured for General and Automotive Liability within the next fifteen (15) days. If this extension is not agreeable with your firm, we ask that you send us a written notice stating that you do not wish to renew the contract and state the reason for non-renewal. Please contact Pat Johnson, CPPB, Senior Buyer at (970) 221-6816 if you have any questions regarding this matter. Sincerely, Gerry S. Paul Director of Purchasing __________________________________________ ________________ Signature Date (Please indicate your desire to renew 8096 by signing this letter and returning it to Purchasing Division within the next fifteen days.) GSP:kr Financial Services Purchasing Division 215 N. Mason St. 2nd Floor PO Box 580 Fort Collins, CO 80522 970.221.6775 970.221.6707- fax fcgov.com/purchasing DocuSign Envelope ID: 83E7DCEF-CA9C-4EA3-83EA-8CE5903993F4 3/14/2018 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? INSR ADDL SUBR LTR INSD WVD 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 $ CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO- LOC JECT PRODUCTS - COMP/OP AGG OTHER: $ COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (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 DocuSign Envelope ID: 83E7DCEF-CA9C-4EA3-83EA-8CE5903993F4 DocuSign Envelope ID: 83E7DCEF-CA9C-4EA3-83EA-8CE5903993F4 DocuSign Envelope ID: 83E7DCEF-CA9C-4EA3-83EA-8CE5903993F4 DocuSign Envelope ID: 83E7DCEF-CA9C-4EA3-83EA-8CE5903993F4 DocuSign Envelope ID: 83E7DCEF-CA9C-4EA3-83EA-8CE5903993F4 DocuSign Envelope ID: 83E7DCEF-CA9C-4EA3-83EA-8CE5903993F4 DocuSign Envelope ID: 83E7DCEF-CA9C-4EA3-83EA-8CE5903993F4 DocuSign Envelope ID: 83E7DCEF-CA9C-4EA3-83EA-8CE5903993F4 DocuSign Envelope ID: 83E7DCEF-CA9C-4EA3-83EA-8CE5903993F4 DocuSign Envelope ID: 83E7DCEF-CA9C-4EA3-83EA-8CE5903993F4 DocuSign Envelope ID: 83E7DCEF-CA9C-4EA3-83EA-8CE5903993F4 DocuSign Envelope ID: 83E7DCEF-CA9C-4EA3-83EA-8CE5903993F4 DocuSign Envelope ID: 83E7DCEF-CA9C-4EA3-83EA-8CE5903993F4 7501 E Lowry Blvd Denver, CO 80230-7006 303-361-4000 / 800-873-7242 www.pinnacol.com Backbone Fiber Systems LLC P.O. Box 413 Loveland, CO 80539 Hub International/BW 1125 17th St. Ste 900 Denver, CO 80202 (970) 223-0924 7501 E Lowry Blvd Denver, CO 80230-7006 Page 1 of 1 P ISA - 05/02/2017 18:19:50 4164180 49037172 359-B NCCI #: WC000313B Policy #: 4164180 ENDORSEMENT: Blanket Waiver of Subrogation Effective Date:May 1, 2017 Expires on: May 1, 2018 Pinnacol Assurance has issued this endorsement May 2, 2017 We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. SCHEDULE To any person or organization when agreed to under a written contract or agreement, as defined above and with the insured, which is in effect and executed prior to any loss. DocuSign Envelope ID: 83E7DCEF-CA9C-4EA3-83EA-8CE5903993F4 DocuSign Envelope ID: 83E7DCEF-CA9C-4EA3-83EA-8CE5903993F4 DocuSign Envelope ID: 83E7DCEF-CA9C-4EA3-83EA-8CE5903993F4 DocuSign Envelope ID: 83E7DCEF-CA9C-4EA3-83EA-8CE5903993F4 DocuSign Envelope ID: 83E7DCEF-CA9C-4EA3-83EA-8CE5903993F4 DocuSign Envelope ID: 83E7DCEF-CA9C-4EA3-83EA-8CE5903993F4 DocuSign Envelope ID: 83E7DCEF-CA9C-4EA3-83EA-8CE5903993F4 DocuSign Envelope ID: 83E7DCEF-CA9C-4EA3-83EA-8CE5903993F4 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 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). COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) $ $ $ $ $ The ACORD name and logo are registered marks of ACORD 12/14/2017 (303) 252-3761 (866) 243-0727 13021 Backbone Fiber Systems, LLC P.O. Box 413 Loveland, CO 80539 41190 A 1,000,000 X 60423554 12/01/2017 12/01/2018 100,000 5,000 1,000,000 2,000,000 2,000,000 A 1,000,000 X 60423554 12/01/2017 12/01/2018 A 5,000,000 60423554 12/01/2017 12/01/2018 5,000,000 B 4164180 05/01/2017 05/01/2018 1,000,000 1,000,000 1,000,000 City of Fort Collins is additional insured herein for general liability and auto liability. City of Fort Collins 215 North Mason Street, 2nd Fl P.O. BOX 580 Fort Collins, CO 80522-0580 BACKFIB-02 VSCOGGINS HUB International Insurance Services (COL) Barb Arnold Barbara.arnold@hubinternational.com United Fire & Casualty Pinnacol Assurance Company X X X X X X X X X DocuSign Envelope ID: 83E7DCEF-CA9C-4EA3-83EA-8CE5903993F4