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WHC FTC LLC DBA ZTRIP - CONTRACT - RFP - 7612 PARATRANSIT SERVICES
ASSIGNMENT OF CONTRACT Shamrock Taxi of Fort Collins, Inc., as Assignor, and WHC FTC, LLC dba zTrip, as Assignee, are parties transferring Paratransit Services under City of Fort Collins RFP No. 7612 from Shamrock Taxi of Fort Collins, Inc. to WHC FTC, LLC dba zTrip (hereinafter, the “Agreement"). Assignment Shamrock Taxi of Fort Collins, Inc, as Assignor, hereby assigns, transfers, and conveys unto WHC FTC, LLC dba zTrip, as Assignee, all rights, title, and interest of the Assignor in and to the Agreement. Assignor hereby agrees to continue to be liable for work as provided in the Agreement, and any other obligations related to this work as determined in the Agreement; and Assignee hereby accepts the assignment and agrees to be bound by all of the terms and conditions of the Agreement including all obligations, duties, responsibilities, and liabilities thereunder. Assignee shall maintain insurance coverage naming the City as an additionally insured of the type and with the limits specified and provide evidence at the time of Assignment execution. Electronic signatures are binding on the parties. This Assignment may be signed in counterparts. IN WITNESS WHEREOF, the parties hereto have executed this Assignment as of the day and year below. ASSIGNOR COMPANY: SHAMROCK TAXI OF FORT COLLINS, INC. By: ___________________________ Printed: Title: ASSIGNEE COMPANY: WHC FTC, LLC dba zTrip By: ___________________________ Printed: Title: CONSENT The City hereby consents to the assignment of the Agreement to WHC FTC, LLC dba zTrip, but by this consent the City does not hereby release Shamrock Taxi of Fort Collins, Inc. from its continuing obligations for work pursuant to the Agreement. Dated Effective: 6/15/2018 CITY OF FORT COLLINS, COLORADO By: Gerry Paul Director of Purchasing DocuSign Envelope ID: 5AADF035-FC8B-438B-87BE-AEA419A22BD8 Dwight Kines Regional Vice President Bill George CEO 06/19/2018 Lammel & Associates, LLC 775 Ridge Lake Blvd., Suite 105 Memphis, TN 38120 Joe Lammel (901)614-0100 jlammel@lammelassociates.com 00000000-13261 2 WHC FTC, LLC dba zTrip 1833 E. Mulberry St., Unit A Fort Collins, CO 80524 Paratransit Insurance Company, a Mutual Risk Rete 44130 A Y N PG 1158 17 06/15/2018 10/22/2018 X 1,000,000* *$975,000 Combined Single Limit excess of a $25,000 Retained Limit per Accident. City of Fort Collins, its officers, agents, and employees are included as Additional Insured with respect to the Automobile Liability policy as required by written contract. City of Fort Collins Attn: Craig Dublin P.O Box 580 Fort Collins, CO 80522 (WJL) Printed by WJL on June 19, 2018 at 11:26AM ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? INSR ADDL SUBR LTR INSD WVD DATE (MM/DD/YYYY) 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 TYPE OF INSURANCE POLICY EFF POLICY EXP LIMITS (MM/DD/YYYY) (MM/DD/YYYY) 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 $ DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO- LOC PRODUCTS - COMP/OP AGG $ JECT OTHER: $ 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 PRO- POLICY 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) A Y X 500,000 500,000 500,000 Y APP-0005111 06/21/2018 06/21/2019 Cake Insure 1624 Market St, Ste 226, #63440 Denver, CO 80202-5926 WHC FTC, LLC 1300 LYDIA AVE KANSAS CITY, MO 64106 support@cakeinsure.com Pinnacol Assurance 41190 Foothills Gateway Shuttle Troy Coleman Quality and Compliance a004100000kyjOxAAI 6/20/2018 City of Ft. Collins P.O. Box 580 Ft. Collins, CO 80522 wmgeorge@ztrip.com DocuSign Envelope ID: 295BDF6F-5AADF035-2656-FC8B-4C58-438B-9035-87BE-BEDDE1AD037C AEA419A22BD8 BODILY INJURY (Per accident) PROPERTY DAMAGE $ $ $ $ THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSD ADDL WVD SUBR N / A $ $ (Ea accident) (Per accident) OTHER: THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: INSURED PHONE (A/C, No, Ext): PRODUCER ADDRESS: E-MAIL FAX (A/C, No): CONTACT NAME: NAIC # INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : INSURER(S) AFFORDING COVERAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INS025 (201401) 6/21/2018 Twin Lakes Insurance Agency 2641 NE McBaine Drive Lee's Summit MO 64064 Sue Falter, CIC, CISR (816)525-2125 (816)525-4049 suef@twinlakesins.com WHC FTC, LLC 1833 East Mulberry St Ft Collins MO 80524 Covington Specialty Insurance CL1862108785 A X X X X VBA623699 6/13/2018 6/13/2019 1,000,000 100,000 5,000 1,000,000 2,000,000 2,000,000 The Certificate Holder and all other parties required under a written contract are named as additional insured with respects to liability. Mark Smith/SR City of Fort Collins Craig Dublin PO Box 580 Fort Collins, CO 80522 DocuSign Envelope ID: 295BDF6F-5AADF035-2656-FC8B-4C58-438B-9035-87BE-BEDDE1AD037C AEA419A22BD8 COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS 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 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD CERTIFICATE OF LIABILITY INSURANCE DocuSign Envelope ID: 295BDF6F-5AADF035-2656-FC8B-4C58-438B-9035-87BE-BEDDE1AD037C AEA419A22BD8