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HomeMy WebLinkAboutCORRESPONDENCE - RFP - 8073 ENGINEERING SERVICES FOR WATER, WASTEWATER & STORMWATER FACILITIES CAPITAL IMPROVEMENTS PROJECTS (12)Utilities 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 Phase 3 - 04-2018 PROJECT TITLE: Mulberry/Riverside Drainage Improvements Phase 3 ORIGINAL BID/RFP NUMBER & NAME: 8073 Engineering Services For Future Water, Wastewater and Storm Water Facilities Capital Improvements MASTER AGREEMENT EFFECTIVE DATE: 5/15/16 ARCHITECT/ENGINEER: OWNER’S REPRESENTATIVE: Jason Stutzman WORK ORDER COMMENCEMENT DATE: April 2018 WORK ORDER COMPLETION DATE: March 2019 MAXIMUM FEE: (time and reimbursable direct costs): $169,655 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 Twelve (12) 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: 32A51903-2D5A-489F-AA3F-A27B269EE8D7 5/1/2018 Craig Jacobson 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: Theresa Connor, Water 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: 32A51903-2D5A-489F-AA3F-A27B269EE8D7 5/2/2018 N/A N/A N/A N/A 5/3/2018 5/4/2018 5/4/2018 5/4/2018 Utilities Work Order Form Official Purchasing Form Last updated 10/2017 ATTACHMENT A WORK ORDER SCOPE OF SERVICES DocuSign Envelope ID: 32A51903-2D5A-489F-AA3F-A27B269EE8D7 ICONENGINEERING, 7000 S. Yosemite Street, Suite 120, Centennial, INC. CO 80112 303.221.0802 | www.iconeng.com Planning | Design | Management Exhibit A Scope of Work Mulberry / Riverside Drainage Improvements – Phase III City of Fort Collins 5-1-18 ICON Engineering, Inc. is pleased to provide this scope-of-services for engineering services related to the Mulberry / Riverside Drainage Improvements – Phase III Project. The proposed work shall include: outfall restoration design, bidding procedures for the storm sewer portions of the project, construction support for both the storm sewer and outfall phases of the project, and project closeout, including a City Letter of Map Revision (LOMR). The scope of each work phase is described as follows: A. Bid Procedures 1. As part of this phase of the project, ENGINEER shall: a. Attend pre-bid meeting; b. Attend partnering meeting with for construction services contract; c. Assist with RFI’s and Addendums; d. Assist with submittal reviews following award; e. Make drawing adjustments and address City questions B. Construction Services – Bid Contract Phase 2. As part of this phase of the project, ENGINEER shall: a. Attend weekly progress meeting (up to 10 meetings); b. Consult with City & Owners Representative (Assumed 6 hours weekly); c. Provide grant support via Base Tactical C. Closeout – Bid Contract Phase 3. As part of this phase of the project, ENGINEER shall: a. Assist the City in a walkthrough to determine final punch list items b. Preparation and submittal of a City of a LOMR for the proposed floodplain changes. Our scope assumes as-built information will be provided by the DocuSign Envelope ID: 32A51903-2D5A-489F-AA3F-A27B269EE8D7 ICONENGINEERING, INC. Page 2 of 2 P:\P\16009MRD\Final Contract\Phase 3\Riverside Mulberry Drainage Improvements - Phase 3 Proposal.docx contractor and up to two (2) rounds of minor comments will be made from City utility staff. c. Provide grant support via Base Tactical D. Outfall Restoration Design 4. As part of this phase of the project, ENGINEER shall: a. Attend up to four (4) project meetings with Utilities and other City departments; b. Coordinate design changes with the City, as required; c. Prepare project alternatives for design changes at the outfall, including a riprap rundown approach; d. Upon selection of a final alternative, prepare final design drawings and updates to the project specifications, as required. e. Complete a geotechnical review for the design changes (see separate scope from Lithos Engineering) f. Provide updated landscape design (see separate scope from DHM Design) g. Provide permit assistance or revisions (see separate scope from ERO Resources) E. Construction Services – Outfall 5. As part of this phase of the project, ENGINEER shall: a. Make up to six (6) site visits to help coordinate the project with City crews; b. Prepare site observation reports; c. Assist the City in a walkthrough to determine final punch list items. Project Fees & Schedule: Project fees are proposed to be $169,655. A breakdown of proposed fees is attached. This project is anticipated to be completed by the end of the grant cycle in March 2019. DocuSign Envelope ID: 32A51903-2D5A-489F-AA3F-A27B269EE8D7 Utilities Work Order Form Official Purchasing Form Last updated 10/2017 ATTACHMENT B WORK ORDER COST DETAIL DocuSign Envelope ID: 32A51903-2D5A-489F-AA3F-A27B269EE8D7 ICON ENGINEERING, INC. PROJECT NAME: Mullberry / Riverside Storm Sewer Project - Phase 3 Construction & Outfall Restoration CLIENT: City of Fort Collins - Mr. Jason Stutzman Craig J. Kent B. Jackie M Jeremy D. Wyatt TBD PREPARED BY: CDJ Principal Prof Prof Prof Engineer Engineer Engineer CAD/GIS Admins Misc. CHECKED BY: KDB Engineer Engineer III Engineer II Engineer I IV II I Specialist Assistant Direct DATE: April 20, 2018 $169 $157 $147 $135 $127 $106 $92 $91 $65 Costs Description Hours Hours Hours Hours Hours Hours Hours Hours Hours TOTALS A BID PROCEDURES 1. Attend Pre-bid Meeting 4.0 4.0 $90 $1,394 2. Attend Partnering Meeting 4.0 4.0 $90 $1,394 2. RFI's and Addendums 12.0 $1,884 3. Submittal Review 16.0 $2,512 4. Drawing Adjustments & Questions 2.0 12.0 $2,222 Task Subtotal $9,406 B CONSTRUCTION SERVICES - BID CONSTRACT PHASE 1. Weekly Progress Meetings (10 meetings) 20.0 40.0 $900 $10,560 2. Consultation with City & Owners Representative (6 hours weekly) 60.0 $9,420 3. Base Tactical $73,814 $73,814 Task Subtotal $93,794 C CLOSEOUT 1. Punch List & walkthrough 2.0 6.0 $1,280 3. LOMR Preparation 12.0 40.0 4.0 12.0 $5 $9,513 Task Subtotal $10,793 D OUTFALL RESTORATION DESIGN 1. Project Meetings & Coordination (4 Meetings) 12.0 8.0 $360 $3,644 2. Riprap Rundown Hydraulic Calculations 4.0 8.0 12.0 $90 $3,294 3. Project Alternative Development 4.0 20.0 $5 $3,821 4. Final Design Plan Preparation 14.0 40.0 16.0 $10,102 5. Geotechncial Review (Lithos) $13,394 $13,394 6. Landscape Design (DHM) $7,800 $7,800 7. Permitting Review (ERO) $4,000 $4,000 Task Subtotal $46,055 E OUTFALL RESTORATION CONSTRUCTION (4 Weeks) 1. Site Visits (6 Visits) 8.0 32.0 $540 $6,916 2. Observation Reports (6 Reports) 2.0 6.0 $17 $1,297 3. Closeout 4.0 4.0 $90 $1,394 Task Subtotal $9,607 Total Hours 92.0 272.0 40.0 0.0 4.0 12.0 0.0 28.0 0.0 $101,195 $169,655 Total Cost $15,548 $42,704 $5,880 $0 $508 $1,272 $0 $2,548 $0 $101,195 $169,655 Page 1 P:\P\16009MRD\Final Contract\Phase 3\Mullberry Riverside Fees Phase 3.xlsx DocuSign Envelope ID: 32A51903-2D5A-489F-AA3F-A27B269EE8D7 BASE Tactical Disaster Recovery PROFESSIONAL LOSS CONSULTANTS To: Craig Jacobson Principal 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: April 20, 2018 RE: Mulberry Riverside Project City of Fort Collins, ICON Engineering 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 to ICON Engineering for the City of Fort Collins, Colorado. BASE Tactical has been engaged with the City of Fort Collins since January of 2018. During this time, BASE Tactical has been working to ensure all contract and procurement documentation is in place and in compliance with FEMA requirements. Going forward, BASE Tactical would be pleased to offer the following services. Acceptance of this proposal will authorize BASE to continue to provide grant administration consulting services as directed by the City of Fort Collins for the project, titled, Mulberry Riverside Project. The services that BASE will provide, may include the following activities and additional services as requested by client: • Provide general grant management assistance and strategies. • Submit Request for Reimbursement to state and federal agencies. 3860 Carr Street Wheat Ridge, CO 80033 (720) 788-2898 FAX (800) 862-4008 www.basetactical.com DocuSign Envelope ID: 32A51903-2D5A-489F-AA3F-A27B269EE8D7 • Review invoices, change orders and required weekly and monthly submittals. • Identify appropriate documentation and secure it from the contractor, City and / or State departments. • Preparation of draft correspondence to State and FEMA, as requested. • Assist in capturing and summarizing costs. • Attend meetings with Applicant, State, and FEMA, as necessary. • Review procurement and eligibility issues as they occur. • Work with client to resolve any disagreements with FEMA and provide support for appeals, if necessary. • When Applicant has completed the project, and has drawn down reimbursement for all eligible costs, assist in finalizing preparation for State and FEMA final inspections. • Preparation and completion of project closeout for the Mulberry Riverside Project 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 exclude federal standard mileage rates. 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 City of Fort Collins’ 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 Regional Program Manager BASE Tactical Disaster Recovery AGREED TO AND APPROVED BY BY (NAME): SIGNATURE: TITLE: DATE: DocuSign Envelope ID: 32A51903-2D5A-489F-AA3F-A27B269EE8D7 BASE Tactical Disaster Recovery Fee Schedule - City of Fort Collins Personnel Title Rate May-18 Jun-18 Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Jan-19 Feb-19 Mar-19 Total Hrs Total Cost John G. Levy Principle $450.00 1.5 1.5 1.5 1.5 1.5 1.5 0.5 0.5 0.5 0.5 0.5 11.5 $ 5,175.00 Katie P. Wolff Program Manager $214.00 40 40 40 40 40 30 30 30 25 25 10 350 $ 74,900.00 Amount Remaining with Current Agreement: ($6,261) Totals: $ 73,814.00 DocuSign Envelope ID: 32A51903-2D5A-489F-AA3F-A27B269EE8D7 2625 Redwing Road, Suite 160 Fort Collins, Colorado 80526 970.373.3195 www.LithosEng.com April 25th, 2018 Project No. 15026 ICON Engineering, Inc. 7000 South Yosemite Street, Suite 120 Centennial, Colorado 80112 Attention: Mr. Jacobson, PE, CFM Principal Regarding: Proposal for Mulberry-Riverside Storm Sewer Outfall Revised Outfall Design Fort Collins, Colorado Mr. Jacobson, Lithos Engineering (Lithos) is pleased to have the opportunity to provide this proposal to ICON Engineering (ICON) for the subject project. Project Understanding The Mulberry-Riverside Storm Sewer Outfall has been designed and the City of Fort Collins (City) plans to construct the project in 2018. Due to several issues including a deep layer of fill and soft, saturated soils near the design outfall foundation location, the outfall has recently been redesigned as a run-down, rip- rap slope from near the existing outfall location. We understand, ICON would like Lithos to verify slope stability for the redesigned outfall grading and geometry, make occasional site visits during construction to verify conditions, and attend project design meetings with the City. Proposed Scope of Services Based on our understanding of the project, Lithos proposes the following scope of services: Task – 1: Site Visit and Outfall Design Consulting  Lithos has completed a site visit and attended a design meeting to discuss outfall redesign alternatives based on new geotechnical information discovered during access road construction and test pit excavations. Task – 2: Slope Stability Modeling for Revised Outfall Design  Model and confirm slope geometries for up to three two-dimensional cross sections near the proposed outfall. o We have assumed cross-section geometry will be provided by ICON. o Reasonable soil strength parameters and subsurface layer geometry will be selected based on collected geotechnical data to date. We have assumed additional drilling, sample collection, and lab testing will not be conducted in support of slope stability verification. DocuSign Envelope ID: 32A51903-2D5A-489F-AA3F-A27B269EE8D7 ICON Engineering Mulberry-Riverside Storm Sewer Outfall Page 2 of 2 o Slope stability modeling will analyze both shear strength of the slope (large circular failure) and the impact of softer materials near the foundation elevation of the outfall (wedge/sliding failure). o If modeling produced factor of safety values from provided cross sections are insufficient, Lithos will work with ICON to regrade the site to produce acceptable slope stability. Task – 3: Construction Support  We will visit the site up to three times during construction to verify encountered subsurface conditions and to verify construction techniques to produce a stable slope as modeled during Task 1. Task – 4, Project Design Meetings  Lithos will attend project design meetings. We have assumed a total of 3 meetings will be attended to finalize the revised outfall design approach. We anticipate meetings to be held at the City. Fee Estimate Based on our proposed Scope of Services outlined above, we estimate a total fee for our services of $13,394. Lithos proposes to provide these services on a time and expense. We will perform these services in accordance with our existing contract with ICON for the City of Fort Collins. Closing We appreciate the opportunity to submit a proposal for this project and look forward to the opportunity to work with you and your team on this project. For this project, Mr. Dornfest will be your key contact and Project Manager. If you have any questions regarding the contents of this proposal, please contact the undersigned. Sincerely, Lithos Engineering Robin Dornfest, PG Lance Heyer, PE President Associate Attachments (1): Project Fee Estimate DocuSign Envelope ID: 32A51903-2D5A-489F-AA3F-A27B269EE8D7 Detailed Fee Estimate No. Phase President/ Senior Consultant Vice President/ Senior Associate Project Manager Senior Professional Professional Staff Professional 2 Staff Professional 1 Administrative Rate/Hr $ 185 $ 170 $ 145 $ 125 $ 95 $ 90 $ 80 $ 60 1 Site Visit and Outfall Design Consulting $ 1,816 2 Slope Stability Modeling for Revised Outfall Design 8 40 48 $ 6,480 3 Constrution Support 4 12 16 $ 2,240 4 Project Design Meetings 9 9 18 $ 2,790 Fee Schedule (18G Fort Collins) Total Hours Total Labor Labor Fees per Position $ 3,885 $ - $ - $ 7,625 $ - $ - $ - $ - 82 $ 13,326 No. Phase Driller Lab Testing Fees per Task Mileage $0.54/mi Per Diem Lodging Other Fees per Task 1 Site Visit and Outfall Design Consulting $ - $ - $ - $ - $ - 33.4 $ 18.2 2 Slope Stability Modeling for Revised Outfall Design $ - $ - $ - $ - $ - $ - 3 Constrution Support $ - $ - $ - $ - $ - 45 $ 25 4 Project Design Meetings $ - $ - $ - $ - $ - 45 $ 25 Subtotal $ - $ - $ - $ - $ - $ 49 $ - $ - $ - $ 67 Markup 0% $ - $ - $ - $ - $ - $ - $ - $ - $ - Total $ - $ - $ - $ - $ 49 $ - $ - $ - Total Subconsultants $ - Total Direct Costs $ 67 No. Phase 1 Site Visit and Outfall Design Consulting 2 Slope Stability Modeling for Revised Outfall Design 3 Constrution Support 4 Project Design Meetings Markup 0% Total Project Name: Mulberry Riverside Stormsewer Outfall - Revised Outfall Design Project Number: 15026 Date: 4/25/18 $ 67 $ - LABOR $ - $ - $ - $ 6,480 Client ICON Engineering Project Ft Collins Mulberry-Riverside LID Improvements Date 4/24/2018 Consultant: DHM Design Corporation Discipline: Landscape Architecture Services Tasks and Hours Principal I Sr Associate Senior Designer Irrigation Design Total 12 $ 1,800.00 SUBTOTAL $ 1,800.00 8 24 $ 3,600.00 1 4 $ 550.00 1 4 $ 550.00 6 4 $ 1,300.00 SUBTOTAL $ 6,000.00 Total Hours 28 36 0 0 $ 7,800.00 2017 Rate $ 150.00 $ 100.00 $ 80.00 $ 1.00 Total Labor Extended $ 4,200.00 $ 3,600.00 $ - $ - $ 7,800.00 Estimated Reimbursable Costs Total $ - Costs $ - Total Task Order $ 7,800.00 Tasks and Hours Principal I Sr Associate Senior Designer Clerical Total Total Hours 0 0 0 0 $ - 2017 Rate $ 150.00 $ 100.00 $ 80.00 $ 75.00 Total Labor Extended $ - $ - $ - $ - $ - Total Task Order $ - Respectfully, DHM Design Approved By: Mark Wilcox, PLA, ASLA Title: Principal Date: PM meetings in Ft Collins (2) Position Design Phase - Basic Services Project Management If you find the general scope and estimated costs presented in this proposal acceptable, please sign and return one copy as our authorization to proceed. We appreciate the opportunity to submit this proposal for your review. Position Additional Services Item DHM Estimated Expenses site details specifications team coordination (phone call coordination) landscape & irrigation plans Final Design DocuSign Envelope ID: 32A51903-2D5A-489F-AA3F-A27B269EE8D7 1 ERO Resources Corporation Proposed Scope of Work for Additional Ecological Services for the Mulberry Outfall Project Fort Collins, Colorado April 26, 2017 Background ICON Engineering, Inc. (Client), on behalf of the City of Fort Collins (City), has requested that ERO Resources Corporation (ERO) prepare a scope of work and fee estimate to assist with additional Clean Water Act (CWA) Section 404 permitting associated with the Mulberry outfall project located between Mulberry Street, Riverside Avenue, and the Poudre River within Fort Collins, Colorado (project area). It is anticipated that an amendment to the existing CWA Section 404 nationwide permit (NWP) authorization, Corps File No. NWO-2017-00606-DEN may be required for the project. Task 1. Amend Nationwide Permit Authorization ERO will work with the project team to amendment the existing NWP authorization for the project. The amendment will include a discussion of the purpose and need for the amendment, information on the design modifications provided by the Client, and a discussion on impacts to waters of the U.S. ERO will coordinate with the Client on what information ERO requires for the application. Typical information includes plan and profile views, cross sections, figures showing and quantifying impacts on jurisdictional areas, details, and background information on other approval requirements (e.g., those of the Federal Emergency Management Agency). Based on preliminary project information, ERO believes that less than 0.10 acre of wetlands would likely be impacted by the project and a compensatory wetland mitigation plan would not be required for the amendment. This task also includes items associated with project coordination such as team communication through emails and phone calls, project management, and quality assurance. ERO will attend up to two meetings with the Client in Fort Collins to discuss the project and permitting requirements. ERO will also ensure all documents and figures are reviewed for technical and editorial accuracy. Products • Draft amendment submittal in PDF format delivered to the Client via email. • Final amendment includes one hard copy mailed to the Corps and a PDF copy delivered to the Client via email. Assumptions • Client will provide ERO with an electronic and/or PDF construction plan set. • This scope of work does not include a compensatory wetland mitigation plan. Estimated Costs Tasks 1 will be completed on a time and materials basis for a cost not to exceed $4,000.00. DocuSign Envelope ID: 32A51903-2D5A-489F-AA3F-A27B269EE8D7 Mulberry Riverside ‐ Phase 3 PERIODS May‐18 June‐18 July‐18 Aug‐18 Sept‐18 Oct‐18 Nov‐18 Dec‐18 Jan‐19 Feb‐19 Mar‐19 A BID PROCEDURES 1. Attend Pre-bid Meeting 2. Attend Partnering Meeting 2. RFI's and Addendums 3. Submittal Review 4. Drawing Adjustments & Questions B CONSTRUCTION SERVICES - BID CONSTRACT PHASE 1. Weekly Progress Meetings (10 meetings) 2. Consultation with City & Owners Representative (6 hours weekly) 3. Base Tactical CCLOSEOUT 1. Punch List & walkthrough 3. LOMR Preparation D OUTFALL RESTORATION DESIGN 1. Project Meetings & Coordination (4 Meetings) 2. Riprap Rundown Hydraulic Calculations 3. Project Alternative Development 4. Final Design Plan Preparation 5. Geotechncial Review (Lithos) 6. Landscape Design (DHM) 7. Permitting Review (ERO) E OUTFALL RESTORATION CONSTRUCTION (4 Weeks) 1. Site Visits (6 Visits) 2. Observation Reports (6 Reports) 3. Closeout ACTIVITY Plan Duration DocuSign Envelope ID: 32A51903-2D5A-489F-AA3F-A27B269EE8D7 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: 32A51903-2D5A-489F-AA3F-A27B269EE8D7 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME: CONTACT (A/C, No): FAX E-MAIL ADDRESS: PRODUCER (A/C, No, Ext): PHONE INSURED COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ PROPERTY DAMAGE $ BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOS ONLY AUTOS NON-OWNED OWNED SCHEDULED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? 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 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 LIZB Beth Ficken 01/09/2018 ICONENG-01 A 34SBAPD8771 A 34SBAPD8771 B 4077567 A 34SBAPD8771 1,000,000 1,000,000 1,000,000 10,000 2,000,000 2,000,000 4,000,000 2,000,000 4,000,000 10,000 300,000 2,000,000 2,000,000 X X X X X X X X 01/30/2018 01/30/2019 01/30/2018 01/30/2019 02/01/2018 02/01/2019 01/30/2018 01/30/2019 Project: 8073 Engineering Services for Future Water, Wastewater & Stormwater Capital Improvements. The City, its officers, agents and employees shall be named as additional insureds on the General Liability and Automobile liability policies for any claims arising out of work performed under this Agreement. The insurance evidenced will not be cancelled, except after Certificate Holder Note: thirty (30) days written notice has been received by the City of Fort Collins. CCIG 5660 Greenwood Plaza Blvd. Suite 500 Greenwood Village, CO 80111 (720) 212-2050 (303) 799-0156 City of Fort Collins Attn: Ms Pat Johnson CPPB 700 Wood Street Fort Collins, CO 80521 ICON Engineering Inc Douglas Williams 7000 S Yosemite St #120 Centennial, CO 80112 The Hartford Insurance Group Pinnacol Assurance 22357 41190 X X BethF@thinkccig.com DocuSign Envelope ID: 32A51903-2D5A-489F-AA3F-A27B269EE8D7 (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT ER OTH- STATUTE PER (MM/DD/YYYY) LIMITS POLICY EXP (MM/DD/YYYY) POLICY EFF LTR TYPE OF INSURANCE POLICY NUMBER INSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB EACH OCCURRENCE $ AGGREGATE $ $ OCCUR CLAIMS-MADE DED RETENTION $ PRODUCTS - COMP/OP AGG $ GENERAL AGGREGATE $ PERSONAL & ADV INJURY $ MED EXP (Any one person) $ EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES (Ea occurrence) $ COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 1/24/2018 Hall & Company 19660 10th Ave NE Poulsbo WA 98370 Jim Ledbetter 360-626-2019 360-598-3703 jledbetter@hallandcompany.com RLI INSURANCE COMPANY 13056 732 Icon Engineering Inc 7000 S Yosemite Street, Suite 120 Centennial CO 80112 1478961862 A Professional Liab: Claims Made RDP0031478 1/30/2018 1/30/2019 $2,000,000 Per Claim $2,000,000 Aggregate Additional Insured Status is not available on Professional Liability Policy. 8073 Engineering Services for Future Water, Wastewater & Stormwater Capital Improvements. City of Fort Collins 700 Wood Street Fort Collins CO 80521 DocuSign Envelope ID: 32A51903-2D5A-489F-AA3F-A27B269EE8D7 $ 2,240 $ 2,790 SUBCONSULTANTS and DIRECT COSTS SUMMARY Labor Subconsultants Direct Costs Total $ - $ 25 $ 25 $ 6,480 $ 2,265 Labor Fees per Task Hours per Task $ 2,815 $ 1,816 $ - $ 18 $ 1,834 $ 13,326 $ - $ - $ - $ 13,394 DocuSign Envelope ID: 32A51903-2D5A-489F-AA3F-A27B269EE8D7