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HomeMy WebLinkAboutBRUNCH BROS LLC - CONTRACT - RFP - 8281 DOWNTOWN CONCESSIONAIRESConcession Agreement- 8281 Downtown Concessionaires Page 1 of 9 DOWNTOWN CONCESSION AGREEMENT THIS AGREEMENT is made and entered into this day and year shown below, by and between THE CITY OF FORT COLLINS, COLORADO, a Municipal Corporation (City), and BRUNCH BROS LLC, a Colorado Limited Liability Company, (Concessionaire). WITNESSETH WHEREAS, the City Council passed Ordinance No. 36, 1994, establishing the Downtown Plan Area as a concession area for the sale of goods and services from outdoor locations; and WHEREAS, the City has established various concession locations in the Downtown Plan Area; and WHEREAS, the City agrees to grant to the Concessionaire and the Concessionaire accepts from the City a concession for outdoor vending at: SITE #2 for DAY use. NOW THEREFORE, in consideration of the mutual covenants and obligations herein expressed, the parties agree as follows: Section 1. Contract Documents The contract documents consist of this Agreement and Exhibits incorporated herein. These form the contract, and are incorporated herein by this reference. Section 2. Terms of the Agreement A. This Agreement shall be effective upon signing by all parties until May 31, 2019, 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 two (2) additional one year periods. Written notice of renewal shall be provided to the Concessionaire and mailed no later than thirty (30) days prior to contract end. Either party may terminate this Agreement without cause, by providing written notice to the other party of its intention to terminate at least thirty (30) days prior to the end of the then existing term. B. In the event that the concession location cannot be used because of improvements being made at the concession location, this Agreement may be suspended on thirty (30) days notice to the Concessionaire. The suspension shall continue until the improvements are completed or it is determined that the location can no longer be used as a concession site. The City will use a good faith effort to relocate the concession site if needed. Section 3. Concession Operations The City hereby grants Concessionaire a concession area for the use of the property described as: Site #2, as per Exhibit “A”- Site Map, for outdoor vending. The Concessionaire shall have the exclusive right to operate an outdoor vending concession with this area in accordance with the Agreement. DocuSign Envelope ID: CF32EEDF-CB3A-4B62-9236-BD6F308D714E Concession Agreement- 8281 Downtown Concessionaires Page 2 of 9 A. Independent Contractor: The services to be performed by the Concessionaire are those of an independent contractor and not as an employee of the City. The City shall not be responsible for withholding any portion of Concessionaire's compensation hereunder for the payment of FICA, Worker's Compensation or otherwise. B. Records: The Concessionaire shall keep adequate and proper business records of all expenses and receipts of the concession operations. At the request of the City, all such business records shall be made open and available for inspection and audit by the City of Fort Collins Treasury Division. C. Monetary Provision: The Concessionaire agrees to pay the City an amount equal to one hundred twenty dollars ($120) per site per year. The $120 annual fee is due immediately upon contract execution and at the time of subsequent contract extensions. D. Licenses: The Concessionaire shall obtain and pay for all licenses needed for the operation of the concession including, but not necessarily limited to, a County Health Department Food Services establishment inspection, City and State sales tax licenses. Any such licenses held specifically by the Concessionaire in connection with this Agreement shall be surrendered by the Concessionaire at the time of termination of this Agreement. E. Laws, Rules & Regulations: The operation of the concession granted under this Agreement shall, at all times, conform with all applicable Federal, State, and local laws and with all applicable rules and regulations adopted by the City or any of its Boards or Departments. F. Insurance/Indemnity: The Concessionaire shall indemnify, save and hold harmless the City from all claims and losses, including costs and reasonable attorney’s fees arising directly or indirectly out of the Concessionaire's use of the concession area or operation of the concession. The Concessionaire shall maintain insurance as specified within Exhibit “B”. The Concessionaire, before commencing services hereunder, shall submit to the City’s Purchasing Department, one (1) copy of a certificate evidencing the insurance coverage required from an insurance company acceptable to the City. G. Signage: All signs on the concession cart must be approved by the City. Signs may be displayed in or on the cart only unless additional signage is approved by City staff. H. Cart: The Concessionaire will be required to have a mobile cart, unless the site is designated for transportation related vending. The cart may not exceed the size of four (4) foot wide, ten (10) foot long and eight (8) foot high, excluding roof overhangs and wheels. The design and appearance of the cart must conform to the specifications described in Concessionaire’s proposal, unless otherwise agreed to in writing by the parties before the cart may be used at the concession area. The City reserves the right to approve any modifications, changes, or alternative cart. The cart is subject to inspection by City. The cart must be maintained and repaired to the City's satisfaction. The cart must be removed from the site when not in use. DocuSign Envelope ID: CF32EEDF-CB3A-4B62-9236-BD6F308D714E Concession Agreement- 8281 Downtown Concessionaires Page 3 of 9 I. Restrictions: Equipment such as tables, chairs, benches and displays not attached to the cart may not be used except for items and equipment authorized, in writing, by the City Representative. Merchandise must be restricted to the cart or appropriate storage containers if authorized. Vendor area must not exceed 10 X 10 feet, excepting only a tarp or other protective medium placed to protect underlying surface. Cart must be located in approved location on site and cannot impede pedestrian flow on the sidewalk. J. Cleanliness: Concessionaires shall be required to supply an acceptable trash receptacle to be removed from the concession site with all its contents and keep the designated area clean of all trash generated by the concession within a hundred (100) foot radius of the site. Food concessionaires must use a tarp under cart to minimize grease deposits and pay site cleaning fee. Concessionaire shall pay sixty Dollars ($60) per month cleaning fee for power washing of the site granted. The monthly cleaning fee for power washing of the site granted will be waived for the months of December, January and February. Cleaning fee subject to change during term of agreement based on frequency required with at least thirty (30) days notice to the Concessionaire. K. Sales Tax Returns: All sales tax returns and Concessionaire payments to the City associated with the concession operation must be filed by their due date. No assessment fees, penalties or interest will be waived by the City. L. Power Source: Propane shall be the only power source for mobile cart operations. Portable generators will not be permitted due to concerns regarding compatibility and noise. M. Stock: The Concessionaire shall maintain an adequate stock of supplies on hand for all occasions in order to supply the need of parties desiring to patronize the concession area. N. Hours: The Concessionaire must keep the concession area open for business as directed by the City. Days of operation shall be agreed to by both parties and the minimum hours of operation must be maintained. Concessionaire has sole rights to the concession area from 6:00 PM to 6:00 AM. Minimum of five (5) days of operation per week. Concessionaire is not required to operate on national holidays or holidays recognized by the City where City offices (except for emergency services offices) are closed. O. Inclement Weather: The Concessionaire shall not be required to operate the concession when it is raining, snowing, hailing, and abnormally windy or when the air temperature is below 50 degrees Fahrenheit. P. Product. The products authorized are as described in Concessionaire’s proposal and agreed to by the City. The City will not pre-authorize new products but does reserve the right to review any new products that may be added. This is to ensure that the new products meet the same quality as those proposed in the original Request for Proposal. DocuSign Envelope ID: CF32EEDF-CB3A-4B62-9236-BD6F308D714E Concession Agreement- 8281 Downtown Concessionaires Page 4 of 9 Q. Blackout Dates. Concessionaire will not be allowed to operate on granted site during the following special events in the downtown area: Old Town Car Show, Colorado Brewers’ Festival and New West Fest. Visit http://downtownfortcollins.com for event dates. Concessionaire may contact the Downtown Business Association (DBA) at (970) 484-6500 to receive an application for a site at these events. The DBA will work with Concessionaire regarding the location of the site and a discounted booth rate. Section 4. General Conditions A. The Concessionaire shall neither assign any of the rights nor delegate any of the duties under the provisions of this Agreement without having first obtained the written permission of the City. The Concessionaire shall not sublet any portion of the concession area or allow any other person to take possession of any portion of the concession areas without the written consent of the City. B. At the City’s sole discretion, vacant sites resulting from either no-bid or termination may be awarded by the City at any time or remain vacant. C. This Agreement may not be enlarged, modified or altered except in writing, signed by the parties as an amendment hereto. D. No waiver of any breach of this Agreement shall be held or construed to be a waiver of any subsequent breach thereof. E. It is expressly understood and agreed by and between the parties hereto that in the performance of the terms and conditions of this Agreement, time is of the essence. F. The location assigned is not transferable to another vendor or Concessionaire. G. Fixtures and Improvements: 1. The Concessionaire agrees that all auxiliary equipment needed to operate the Concession shall be installed at his/her expense. Prior to making any and all improvements on said premises, the Concessionaire agrees to obtain the approval of the appropriate City Department and shall supervise the construction of said improvements. 2. Upon the termination of this Agreement the Concessionaire shall remove any fixtures or improvements made by it to the concession area. However, the concession area must be restored to as good a condition as the premises were in at the time the Concessionaire took possession thereof. H. This Agreement shall be binding upon and inure to the benefit of the heirs, successors, and assigns of the parties hereto. DocuSign Envelope ID: CF32EEDF-CB3A-4B62-9236-BD6F308D714E Concession Agreement- 8281 Downtown Concessionaires Page 5 of 9 I. If either party must resort to legal action to enforce the terms of this Agreement, the prevailing party shall be awarded its costs and reasonable attorney's fees. J. Any notice required or desired to be given under this Agreement will be considered delivered to the other party upon hand delivery or upon its deposit in the United States mail, postage prepaid, sent by registered mail, addressed to the other party at the following address: K. Notwithstanding the time periods contained herein, either party may terminate this Agreement at any time without cause by providing written notice of termination to the other party. Such notice shall be delivered at least thirty (30) 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 above address. L. The Concessionaire’s conduct reflects directly on the City’s image, therefore the Concessionaire is required to uphold high standards of customer service, integrity and professional conduct and address customer complaints in a prompt and courteous manner. Concessionaire will also provide contact information to the City, updated as needed. Unacceptable conduct/behavior by the Concessionaire or Concessionaire’s staff may result in immediate or early termination of the Agreement. M. The City supports product variety and free market principles for all Concessionaires. Pursuant to this philosophy, the City may not restrict a Concessionaire’s site location and/or menu options due to the proximity of another Concessionaire offering similar/like items. Section 5. Default A. The Concessionaire shall be in default under the terms and conditions of this Agreement if the Concessionaire fails to cure the default within ten (10) days after written notice setting forth the nature of the default is delivered to the Concessionaire. B. In the event the default is not timely cured, the City may elect to (a) terminate this Agreement and seek damages; (b) treat the Agreement as continuing and require specific performance or (c) avail itself of any other remedy at law or equity. Section 6. Prohibition Against Employing Illegal Aliens Pursuant to Section 8-17.5-101, C.R.S., et. seq., Concessionaire represents and agrees that: A. As of the date of this Agreement: City: Concessionaire: City of Fort Collins Purchasing Division P.O. Box 580 Fort Collins, CO 80522 purchasing@fcgov.com Brunch Bros LLC Attn: Larry Rutledge 1115 W Swallow Road, Unit 7 Fort Collins, CO 80526 brunchbrosbbq@gmail.com DocuSign Envelope ID: CF32EEDF-CB3A-4B62-9236-BD6F308D714E Concession Agreement- 8281 Downtown Concessionaires Page 6 of 9 1. Concessionaire does not knowingly employ or contract with an illegal alien who will perform work under this Agreement; and 2. Concessionaire 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. Concessionaire 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. Concessionaire 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 Concessionaire obtains actual knowledge that a subcontractor performing work under this Agreement knowingly employs or contracts with an illegal alien, Concessionaire shall: 1. Notify such subcontractor and the City within three days that Concessionaire 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 Concessionaire 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. Concessionaire 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 Concessionaire 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, Concessionaire shall be liable for actual and consequential damages to the City arising out of Concessionaire’s violation of Subsection 8-17.5-102, C.R.S. G. The City will notify the Office of the Secretary of State if Concessionaire violates this provision of this Agreement and the City terminates the Agreement for such breach. DocuSign Envelope ID: CF32EEDF-CB3A-4B62-9236-BD6F308D714E Concession Agreement- 8281 Downtown Concessionaires Page 7 of 9 THE CITY OF FORT COLLINS, COLORADO By: Gerry Paul Purchasing Director DATE: ATTEST: APPROVED AS TO FORM: BRUNCH BROS LLC By: Printed: Date: DocuSign Envelope ID: CF32EEDF-CB3A-4B62-9236-BD6F308D714E 4/12/2018 Larry Akil Alano Rutledge Assistant City Attorney 4/17/2018 City Clerk Concession Agreement- 8281 Downtown Concessionaires Page 8 of 9 EXHIBIT A SITE MAP DocuSign Envelope ID: CF32EEDF-CB3A-4B62-9236-BD6F308D714E Concession Agreement- 8281 Downtown Concessionaires Page 9 of 9 EXHIBIT B 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 be cancelled or materially altered, except after ten (10) 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: CF32EEDF-CB3A-4B62-9236-BD6F308D714E 04/12/2018 Veracity Insurance Solutions, LLC. 260 South 2500 West, Suite 303 Pleasant Grove UT 84062 FLIP Program Support (888) 568-0548 info@fliprogram.com Great American Alliance Insurance Co. 26832 Brunch Bros LLC 7530 Back Stretch dr Wellington CO 80549 A x x x x PL1744427-F037235 11/01/2017 11/01/2018 1,000,000 300,000 5,000 1,000,000 2,000,000 2,000,000 Certificate holder had been added as additional insured regarding the above mentioned policy per attached Additional Insured-Vendors (CG 20 15 Ed. 04 13) City of Fort Collins P.O. Box 580 Fort Collins, CO 80522 DocuSign Envelope ID: CF32EEDF-CB3A-4B62-9236-BD6F308D714E PL1744427-F037235 CG 20 15 (Ed. 04 13) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - VENDORS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE FORM SCHEDULE Name of Additional Insured Person(s) or Organization(s) (Vendor) Your Products Any vendor of products covered by this policy but only for product defect claims where said vendor had no involvement in the creation of the alleged defect and there are not allegations of independent wrongdoing. All products of Named Insured Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. SECTION II – WHO IS AN INSURED is amended to include as an additional insured any person(s) or organization(s) (referred to throughout this endorsement as vendor) shown in the Schedule, but only with respect to "bodily injury" or "property damage" arising out of "your products" shown in t he Schedule which are distributed or sold in the regular course of the vendor's business. However: 1. the insurance afforded to such vendor only applies to the extent permitted by law; and 2. if coverage provided to the vendor is required by a contract or agreement, the insurance afforded to such vendor will not be broader than that which you are required by the contract or agreement to provide for such vendor. B. With respect to the insurance afforded to these vendors, the following additional exclusions apply: 1. The insurance afforded the vendor does not apply to: a. "bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; c. any express warranty unauthorized by you; c. any physical or chemical change in the product made intentionally by the vendor; Copyright, ISO Properties, Inc., 2012 CG 20 15 (Ed. 07/04) PRO (Page 1 of 2) DocuSign Envelope ID: CF32EEDF-CB3A-4B62-9236-BD6F308D714E d. repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; e. any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; f . demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; g. products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or h. "bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (1) the exceptions contained in subparagraphs d. or f. ; or (2) such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. 2. This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. C. With respect to the insurance afforded to these vendors, the following is added to SECTION III - LIMITS OF INSURANCE: If coverage provided to the vendor is required by a contract or agreement, the most we will pay on behalf of the vendor is the amount of insurance: 1. required by the contract or agreement; or 2. available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Copyright, ISO Properties, Inc., 2012 CG 20 15 (Ed. 04/13) (Page 2 of 2) DocuSign Envelope ID: CF32EEDF-CB3A-4B62-9236-BD6F308D714E 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? a CERTIFICATE OF EXEMPTION FROM STATUTORY WORKERS' COMPENSATION LAW AND ACKNOWLEDGEMENT OF RISK/HOLD u*l e , as an(w-n})/ member / partner / stockholder Proprietorship / Limited Liability Company I Partnership i .Corporation (circle one), with a principal address of /, t S Fo.* (nil;a (ogz b , ertfy to the City of Fort Collins, Colorado (the "City'') that the aforementioned business has no employees as defined by the Workers' Compensation Act of Colorado, C.R.S. SS 8-40-101, ef seg., (the "Act") other than those owners, members, partners, directors or other principals that have elected to be exempt from Workers' Compensation coverage in accordance with Colorado law. On behalf of said business and its officers, agents, insurers, heirs, legal representatives, successors and assigns (collectively the "Business"), I warrant that I have full authority to execute this Exhibit on behalf of the Business. t warrant I understand the requirements of the Act with respect to providing Workers' Compensation coverage for any employees of the Business. lf the Business's status changes in such a manner that requires Workers' Compensation lnsurance, the Business shall provide the City with a Certificate of lnsurance evidencing proof of Workers' Compensation lnsurance coverage and Employefs Liability Insurance coverage as required by the Agreement. The Business shall provide such Certificate of lnsurance prior to the employees' start of work for the Gity. On behalf of the Business, I acknowledge the Business may be contracting to engage in activities that involve a risk of personal injury, that the Business is capable of performing the activities, and that the Business shall take all necessary precautions to prevent injury. The Business does hereby waive, release and forever discharge and hold harmless the City, its officers, employees, agents and insurers from any and allliability, damages, claims, causes of action and demands with respect to any bodi$ injury, perconal injury, illness, or death that may result from the performance of the Agreement, either in law or equity, v*rether caused by the negligence or breach of contract of the City its officers, employees, agents and insurers or othenrise. The Business also understands that the City, its officers, employees, agents and insurers do not assume any responsibility for, or obligation to, provide the Business with flnancial assistance or other assistance, including but not limited to medical, health, or disability insurance in the event of any bodily injury, personal injury, illness or death The Business agrees to defend, indemnify, and hold harmless the City from any and all such claims. As an independent contractor, the Business acknowledges that neither the Business nor any person employed by or serving the Business is entitled to workers' compensation benefits from the City. The Business hereby waives any rights or claims to workers' compensation benefits from the City, and agrees to indemnify and hold the City harmless against any claims for such benefits by any officer, director, owner, employee, or servant of the Business or any other person claiming through the Business. By signing this Certificate, the Business acknowledges that it is responsible and liable for all work-related injuries, and further requests the City waive its requirement for evidence of Workers' Compensation lnsurance. HARMLESS AGREEMENT DocuSign Envelope ID: CF32EEDF-CB3A-4B62-9236-BD6F308D714E a BUSINESS: B.un.L', 8.o s LLC By: Printed: Title: Date: DocuSign Envelope ID: CF32EEDF-CB3A-4B62-9236-BD6F308D714E CERTIFICATE OF EXEMPTION FROM STATUTORY WORKERS' COMPENSATION LAW AND ACKNOWLEDGEMENT OF RISK/HOLD (Solecircle one) in 3 LCstockholder ,gg an owner / member (insert business /@ name)/ , a Proprietorship I / Partnersh principal address of (.^) tA , certify to the Cid of Fort Collins, (the "City") that the aforementioned business has no employees as defined by the Workers'Compensation Act of Colorado, C.R.S. SS 840-101, ef seg., (the "Act") other than those owners, members, partners, directors or other principals that have elected to be exempt from Workers' Compensation coverage in accordance with Colorado law. On behalf of said business and its officers, agents, insurers, heirs, legal representatives, successors and assigns (collectively the "Business"), I warrant that I have full authority to execute this Exhibit on behalf of the Business. I warrant I understand the requirements of the Act with respect to providing Workers' Compensation coverage for any employees of the Business. lf the Business's status changes in such a manner that requires Workers' Compensation lnsurance, the Business shall provide the City with a Certificate of lnsurance evidencing proof of Workers' Compensation lnsurance coverage and Employefs Liability lnsurance coverage as required by the Agreement. The Business shall provide such Certificate of lnsurance prior to the employees' start of work for the City. On behalf of the Business, I acknowledge the Business may be contracting to engage in activities that involve a risk of personal injury, that the Business is capable of performing the activities, and that the Business shall take all necessary precautions to prevent injury. The Business does hereby waive, release and forever discharge and hold harmless the City, its officers, employees, agents and insurers from any and all liability, damages, claims, causes of action and demands with respect to any bodily injury, personal injury, illness, or death that may result from the performance of the Agreement, either in law or equity, whether caused by the negligence or breach of contract of the City its officers, employees, agents and insurers or otherwise. The Business also understands that the City, its officers, employees, agents and insurers do not assume any responsibility for, or obligation to, provide the Business with financial assistance or other assistance, including but not limited to medical, health, or disability insurance in the event of any bodily injury, personal injury, illness or death The Business agrees to defend, indemnify, and hold harmless the City from any and all such claims. As an independent contractor, the Business acknowledges that neither the Business nor any person employed by or serving the Business is entitled to workers' compensation benefits from the City. The Business hereby waives any rights or claims to workers' compensation benefits from the City, and agrees to indemniff and hold the City harmless against any claims for such benefrts by any officer, director, owner, employee, or servant of the Business or any other person claiming through the Business. By signing this Certificate, the Business acknowledges that it is responsible and liable for all work-related injuries, and further requests the City waive its requirement for evidence of Workers' Compensation lnsurance. / Corooration (circle one). with a " r I CoLl tns iC o g0'fQ6 HARMLESS AGREEMENT DocuSign Envelope ID: CF32EEDF-CB3A-4B62-9236-BD6F308D714E BUSTNESS, B concl'r l3co s LL C Date: t't 4lr 7r I By: Printed: DocuSign Envelope ID: CF32EEDF-CB3A-4B62-9236-BD6F308D714E (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 FORT COLLINS, CO 80522 PO BOX 580 CITY OF FORT COLLINS PURCHASING DEPT. MOBILE FOOD SALES 500,000 A Y 51-716787-00 04/12/2018 04/12/2019 OWNERS INS CO 32700 FORT COLLINS CO 80526 1115 W SWALLOW RD UNIT 7 BRUNCH BROS., LLC bruce@wiainsurance.com 9702074000 Bruce Farrell Fort Collins CO 80525 4033 E. Boardwalk Drive, #200 FC- Welsh Insurance Agency Inc. 4/12/2018 DocuSign Envelope ID: CF32EEDF-CB3A-4B62-9236-BD6F308D714E