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HomeMy WebLinkAboutCORRESPONDENCE - PURCHASE ORDER - 9178179Utilities Work Order Form Official Purchasing Form Last updated 10/2017 WORK ORDER PURSUANT TO A MASTER AGREEMENT BETWEEN THE CITY OF FORT COLLINS AND ICON ENGINEERING INC. WORK ORDER NUMBER: MRD CLOMR-12-2017 PROJECT TITLE: Mulberry/Riverside Drainage Improvements CLOMR ORIGINAL BID/RFP NUMBER & NAME: 8073 Engineering Services For Future Water, Wastewater and Stormwater Facilities Capital Improvements MASTER AGREEMENT EFFECTIVE DATE: 5/15/16 ARCHITECT/ENGINEER: OWNER’S REPRESENTATIVE: Jason Stutzman WORK ORDER COMMENCEMENT DATE: November 2017 WORK ORDER COMPLETION DATE: March 2018 MAXIMUM FEE: (time and reimbursable direct costs): $26,305 PROJECT DESCRIPTION/SCOPE OF SERVICES: See Attached Service Provider agrees to perform the services identified above and on the attached forms in accordance with the terms and conditions contained herein and in the Master Agreement between the parties. In the event of a conflict between or ambiguity in the terms of the Master Agreement and this Work Order (including the attached forms) the Master Agreement shall control. The attached forms consisting of Seven (7) pages are hereby accepted and incorporated herein, by this reference, and Notice to Proceed is hereby given after all parties have signed this document. SERVICE PROVIDER: ICON ENGINEERING INC. By: Date: Name: Title: DocuSign Envelope ID: C514BE46-6BC4-43F4-83B0-3AAFA10C0784 Craig Jacobson 12/11/2017 Principal Utilities Work Order Form Official Purchasing Form Last updated 10/2017 OWNER’S ACCEPTANCE & EXECUTION: This Work Order and the attached Contract Documents are hereby accepted and incorporated herein by this reference. ACCEPTANCE: Date: Jason Stutzman, Project Manager REVIEWED: Date: Pat Johnson, Senior Buyer APPROVED AS TO FORM: Date: Name,City Attorney's Title (if greater than $1,000,000) ACCEPTANCE: Date: Owen Randall, Chief Engineer ACCEPTANCE: Date: Matt Fater, Intrm Wtr Eng Fld Svcs Op Mgr ACCEPTANCE: Date: Kevin Gertig, Utilities Executive Director (if greater than $1,000,000) ACCEPTANCE: Date: Gerry Paul, Purchasing Director (if greater than $60,000) ACCEPTANCE: Date: Darin Atteberry, City Manager (if greater than $1,000,000) ATTEST: Date: City Clerk (if greater than $1,000,000) DocuSign Envelope ID: C514BE46-6BC4-43F4-83B0-3AAFA10C0784 12/11/2017 N/A N/A N/A N/A N/A 12/12/2017 12/12/2017 12/12/2017 Utilities Work Order Form Official Purchasing Form Last updated 10/2017 ATTACHMENT A WORK ORDER SCOPE OF SERVICES DocuSign Envelope ID: C514BE46-6BC4-43F4-83B0-3AAFA10C0784 ICONENGINEERING, 7000 S. Yosemite Street, Suite 120, Centennial, INC. CO 80112 303.221.0802 | www.iconeng.com Planning | Design | Management December 8, 2017 Mr. Jason Stutzman Special Projects Manager City of Fort Collins Utilities RE: Proposal for Engineering Services: Mulberry and Riverside Stormwater Improvements CLOMR Preparation, Base Tactical Dear Jason, ICON Engineering is pleased to provide engineering services related to the preparation of a City of Fort Collins Conditional Letter of Map Revision (CLOMR) and project support from Base Tactical for the Mulberry and Riverside Stormwater Improvements project in Fort Collins. In general, tasks for this project will include: meetings and coordination; floodplain engineering of existing conditions and proposed changes; submittal of the related CLOMR materials and documentation required by the City of Fort Collins, updated floodplain development permit preparation, and limited on-call grant support and recommendations. Our work will be completed in accordance with the Scope of Services, Assumptions & Exclusions, Schedule, and Fee as defined below. SCOPE OF SERVICES 1.0 Meetings and Coordination  One additional project meeting and one additional conference call have been included to discuss and present results with the City of Fort Collins utilities staff. 2.0 Duplicate Effective Model ICON will obtain the Effective HEC-RAS model prepared by Anderson Consulting Engineers for the existing City floodplain documentation. ICON will create a Duplicate Effective HEC-RAS model through the project area using HEC-RAS (version 5.0.3). 3.0 Existing Conditions Model ICON will prepare an existing conditions HEC-RAS model for the project area. Task 3.0 items include:  Cross sections will be added into the model to more accurately analyze the floodplain.  The effective cross sections will be updated to include the topographic information that was obtained for the project (1-foot aerial mapping).  The existing conditions model will incorporate revised hydrology as documented by the Old Town Basin update prepared by ICON. No additional changes to the hydrology will be made with this submittal. The model updates will be prepared in NAVD 1988 vertical datum and the State Plane horizontal coordinate system. DocuSign Envelope ID: C514BE46-6BC4-43F4-83B0-3AAFA10C0784 ICONENGINEERING, INC. Page 2 of 3 P:\P\16009MRD\Amendments\ICON Proposal for MRD CLOMR and Grant Support.DOCX 4.0 Proposed Conditions Model ICON will update the existing conditions HEC-RAS model created in Task 4.0 to analyze the impacts of the proposed project. The model will be adjusted to reflect the reduction in flow from the proposed project as well as changes in topography anticipated with the project. The previously developed FLO-2D models developed for the project will be used to supplement the HEC- RAS modeling for documenting shallow flooding between detailed modeling reaches. A velocity depth product will be commuted to review the hazard conditions. 5.0 City of Fort Collins CLOMR Preparation ICON will prepare a CLOMR report meeting the City of Fort Collins requirements. Task 5.0 items include:  Report documentation regarding the preparation of the existing conditions floodplain analyses.  Report documenting regarding the proposed project floodplain analyses.  Preparation of a CLOMR Submittal, including: o Documentation Report Update o Comparison Tables (Proposed Project conditions) o Annotated Floodplain Map (Effective and Proposed Project conditions) 6.0 City of Fort Collins Review Submittals ICON will address review comments on the City of Fort Collins CLOMR package and resubmit. Task 6.0 items include:  Review submittals and Final Submittals to the City of Fort Collins.  Addressing review responses from the City of Fort Collins.  This scope assumes for 1 rounds of minor comments from the City. 7.0 Base Tactical Grant Support Refer to attached scope of services. Base Tactical (BASE) will assist with grant administration consulting as directed by the City for the project. The services that BASE will provide, may include the following activities. Additional services may be requested by the City:  Review procurement documents and contract documents  Assist the City of Fort Collins in writing a scope change request to include force account labor and materials into the reimbursable scope of work. Work will be performed in good faith regarding BASE’s knowledge and experience with federal grant procedures. Please note that the services of BASE do not provide a warranty or guarantee to the City regarding reimbursement for work for the project, contracting, payments or procurement. With respect to future FEMA or State audits or determinations, BASE will use best efforts to provide documentation and supporting arguments, but in no way is providing a warranty or guarantee on the outcomes. DocuSign Envelope ID: C514BE46-6BC4-43F4-83B0-3AAFA10C0784 ICONENGINEERING, INC. Page 3 of 3 P:\P\16009MRD\Amendments\ICON Proposal for MRD CLOMR and Grant Support.DOCX Craig Jacobson, PE Principal ICON Engineering, Inc. cjacobson@iconeng.com (303) 221-0802 Sincerely, ASSUMPTIONS & EXCUSIONS Assumptions and Exclusions, which support our proposed Scope of Services and accompanying Fee: - The proposed project will not be adjusted or re-designed with this scope. - Additional survey will not be required for this analysis. - The FEMA Poudre River floodplain will not be analyzed with this scope and permitted separately. - This work includes preparation of a Floodplain Development Permit on behalf of the project owners. Fees associated with the submittal of the permit are not included with this scope. - This does not include post project LOMR modeling. - See BASE exclusion in Section 7.0. SCHEDULE & FEES Consultant will complete the CLOMR and BCA within four (4) weeks of Notice to Proceed (NTP) from the City. BASE’s work will be on-call as required over the duration of the project. FEE Consultant will complete the Scope of Services for a total fee of $26,305. A breakdown of our hours and fees is attached. Thank you again for the continued opportunity to assist the City of Fort Collins with this important project. Please contact me with any questions about this proposal. DocuSign Envelope ID: C514BE46-6BC4-43F4-83B0-3AAFA10C0784 BASE Tactical Disaster Recovery PROFESSIONAL LOSS CONSULTANTS To: Craig Jacobson ICON Engineering, Inc. 7000 S. Yosemite Street, Suite 120 Centennial, CO 80112 From: Katie Wolff Base Tactical Disaster Recovery 3860 Carr Street Wheat Ridge, CO 80033 Date: November 27, 2017 RE: Mulberry Riverside Project City of Fort Collins And BASE Tactical Disaster Recovery, Inc. Thank you for allowing BASE Tactical Disaster Recovery Inc. (“BASE”) to submit this proposal for Grant Management Consulting Services for the City of Fort Collins, Colorado (“Applicant”) to ICON Engineering. Acceptance of this proposal will authorize BASE to begin grant administration consulting as directed by the Applicant for the project, titled, Mulberry Riverside Project. The services that BASE will provide, may include the following activities and additional services as requested by the Applicant: Ø Review procurement documents and contract documents Ø Assist the City of Fort Collins in writing a scope change request to include force account labor and materials into the reimbursable scope of work. BASE will perform our consulting services on an hourly basis, and our fees will be based on rates set forth in the attached Exhibit A. The hourly rates do not include federal standard mileage rates that will be charged per visit. 3860 Carr Street Wheat Ridge, CO 80033 (720) 788-2898 FAX (800) 862-4008 www.basetactical.com DocuSign Envelope ID: C514BE46-6BC4-43F4-83B0-3AAFA10C0784 The Applicant or its Agent will direct BASE for the tasks BASE will perform. The overall cost of this engagement is at all times subject to the Applicant’s desired level and length of BASE’s contract. Thank you again for the opportunity to assist the City of Fort Collins. If you have any questions or concerns, please don’t hesitate to call me at (720) 788-2898. Sincerely, Katie Wolff National Program Manager BASE Tactical Disaster Recovery AGREED TO AND APPROVED BY BY (NAME): SIGNATURE: TITLE: DATE: DocuSign Envelope ID: C514BE46-6BC4-43F4-83B0-3AAFA10C0784 Utilities Work Order Form Official Purchasing Form Last updated 10/2017 ATTACHMENT B WORK ORDER COST DETAIL DocuSign Envelope ID: C514BE46-6BC4-43F4-83B0-3AAFA10C0784 PROJECT NAME: Mulberry Riverside CLOMR and Grant Support CLIENT: City of Fort Collins PREPARED BY: JYM Principal Prof CAD/GIS Misc. CHECKED BY: CDJ Engineer Engineer Engineer Specialist Admin Direct DATE: 2017-12-08 I II IV I I Costs $169 $147 $124 $91 $65 $ Description Hours Hours Hours Hours Hours TOTALS 1. Meetings and Coordination a. Project Coordination Meetings (1) 4.0 $95 $771 b. Conference Calls (1) 2.0 $338 Task Subtotal $1,109 2. Duplicate Effective Model a. Duplicate Effective Model 1.0 2.0 $395 Task Subtotal $395 3. Existing Conditions Model a. Cross Section Adjustments 4.0 12.0 4.0 $2,440 b. Floodplain Delineation 2.0 4.0 $658 c. Floodway Delineation 2.0 2.0 $476 Task Subtotal $3,574 4. Proposed Conditions Model a. Cross Section Adjustments 4.0 2.0 $678 b. Floodplain Delineation 2.0 4.0 $658 c. Shallow Flooding Documentation 4.0 4.0 $860 Task Subtotal $2,196 5. City of Fort Collins CLOMR Preparation a. City CLOMR Report 4.0 8.0 2.0 $25 $2,125 b. Comparison Tables 4.0 $496 c. Annotated Floodplain Map 2.0 4.0 $658 Task Subtotal $3,279 6. City of Fort Collins Review Submittals a. Address review Comments 1 and re-submit 4.0 8.0 2.0 $25 $1,787 Task Subtotal $1,787 7. Base Tactical Grant Support a. As-needed Services $13,965 $13,965 Task Subtotal $13,965 Total Hours 10.0 25.0 36.0 26.0 0.0 $26,305 Total Project Costs $1,690 $3,675 $4,464 $2,366 $0 $14,110 $26,305 Page 1 P:\P\16009MRD\Amendments\MRD CLOMR Fees.XLSX DocuSign Envelope ID: C514BE46-6BC4-43F4-83B0-3AAFA10C0784 BASE Tactical Disaster Recovery Fee Schedule - City of Fort Collins EXHIBIT A Personnel Title Rate Dec-17 Jan-18 Total Hrs Cost John G. Levy Principle $450.00 0 2.5 2.5 $1,125.00 Katie P. Wolff Program Manager $214.00 40 20 60 $12,840.00 Total Cost $13,965.00 * Hourly rates do not include office supplies, copying, freight and computers. * Client shall provide an appropriate workspace that includes files for storing documents. *Hourly rates do not include the Standard Mileage Rate which will be charged per visit. DocuSign Envelope ID: C514BE46-6BC4-43F4-83B0-3AAFA10C0784 Utilities Work Order Form Official Purchasing Form Last updated 10/2017 ATTACHMENT C CERTIFICATE OF INSURANCE CONTRACTOR shall submit Certificate of Insurance in compliance with the Contract Documents. DocuSign Envelope ID: C514BE46-6BC4-43F4-83B0-3AAFA10C0784 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 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) VENDOR: ICON Engineering Inc. DATE ENTERED: REQ #: VENDOR #: FOR: ADDRESS: 7000 S. Yosemite Street, Suite 120 BID #: Centennial, CO 80112 INSTRUCTIONS: PHONE #: 303.221.0802 FAX #: VENDOR CONTACT: Craig Jacobson Today's Date: December 11, 2017 Date Approved: Ship To: Date Denied: Date Required: asap QUANTITY DESCRIPTION TOTAL PRICE 1 $26,305.00 Total $26,305.00 Requested By: Reviewed By: Jason Stutzman, Project Manager Authorized By: Mulberry/Riverside Drainage Improvements CLOMR 8073 Engineering Services For Future Water, Wastewater and Stormwater Facilities Capital Improvements CHARGE NUMBER CITY OF FORT COLLINS UTILITIES REQUISITION FORM Owen L. Randall, Chief Engineer Matt Fater, InterimManager, Water Engineering & Field Operations CLOMR Design Services 5040440016.521210.3 P.O. # DocuSign Envelope ID: C514BE46-6BC4-43F4-83B0-3AAFA10C0784 12/11/2017 12/12/2017 12/12/2017 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. 1/29/2017 Hall & Company 19660 10th Ave NE Poulsbo WA 98370 Icon Engineering Inc 7000 S Yosemite Street, Suite 120 Centennial CO 80112 RLI INSURANCE COMPANY 13056 Jim Ledbetter 360-626-2019 360-598-3703 jledbetter@hallandcompany.com 732 1672365311 A Professional Liab: Claims Made RDP0027679 1/30/2017 1/30/2018 $2,000,000 Per Claim $2,000,000 Aggregate Additional Insured Status is not available on Professional Liability Policy. Project: Mulberry & Riverside Drainage Design 16-009-MRD-352 City of Fort Collins Attn: Matt Fater 700 Wood Street Fort Collins CO 80525 DocuSign Envelope ID: C514BE46-6BC4-43F4-83B0-3AAFA10C0784 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 01/04/2017 (303) 799-0110 (303) 799-0156 22357 ICON Engineering Inc Douglas Williams 7000 S Yosemite St #120 Centennial, CO 80112 41190 A 2,000,000 34SBAPD8771 01/30/2017 01/30/2018 300,000 10,000 2,000,000 4,000,000 4,000,000 A 1,000,000 34SBAPD8771 01/30/2017 01/30/2018 A 2,000,000 34SBAPD8771 01/30/2017 01/30/2018 2,000,000 10,000 B 4077567 02/01/2017 02/01/2018 1,000,000 1,000,000 1,000,000 RE: Mulberry & Riverside Drainage Design 16-009-MRD-352 City of Fort Collins Attn: Matt Fater 700 Wood Street Fort Collins, CO 80525 ICONENG-01 DAWNG CCIG 5660 Greenwood Plaza Blvd. Suite 500 Greenwood Village, CO 80111 BethF@thinkccig.com The Hartford Insurance Group Pinnacol Assurance X X X X X X X DocuSign Envelope ID: C514BE46-6BC4-43F4-83B0-3AAFA10C0784