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CORRESPONDENCE - RFP - 7220 WATER WW TREATMENT & SITE INFRASTRUCTURE DESIGN CONSTRUCTION CONTRACTOR (8)
DocuSign Envelope ID: 3939F694-1432-47F0-B8B4-6AFDA8A64242 City of Fort Collins �Pu.�nasmq June 18, 2014 Hydro Construction Company Inc Attn: Mr. James Eurich 301 E Lincoln Ave Fort Collins, CO 80524 Financial Services Purchasing Division 215 N. Mason St. 2"d Floor PO Box 580 Fort Collins, CO 80522 970.221.6775 970.221.6707-fax fcgov. com/purchasing RE: Renewal, 7220 Water Wastewater Treatment & Site Infrastructure Design Construction Contractor Dear Mr. Eurich: The City of Fort Collins wishes to extend the agreement term for the above captioned proposal per the existing terms and conditions. The term will be extended for one (1) additional year, June 1, 2014 through May 31, 2015. If the renewal is acceptable to your firm, please sign this letter in the space provided, include a current copy of insurance naming the City as an additional insured and return all documents to the City of Fort Collins, Purchasing Division, P. O. Box 580, Fort Collins, CO 80522, within the next fifteen days. If this extension is not agreeable with your firm, we ask that you send us a written notice stating that you do not wish to renew the contract and state the reason for non -renewal. Please contact Pat Johnson, Senior Buyer at (970) 221-6816 if you have any questions regarding this matter. Sincerely, DocuSigned by: E ..�.u� �d. d — A9D .0 CSCB45D... Gerry . aul Director of Purchasing and Risk Management DocuSigned by: �Iwt'^^' 6/23/2014 Signature Date (Please indicate your desire to renew 7220 by signing this letter and returning it to Purchasing Division within the next fifteen days.) GSP: jw Rev 02/2010 DocuSign Envelope ID: 3939F694-1432-47F0-B8B4-6AFDA8A64242 A�ORO° CERTIFICATE OF LIABILITY INSURANCE FDATE(MM/DDIYYYY) /31/2014 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). PRODUCER 1-303-534-4567 CONTACT NAME: IMA, Inc. - Colorado Division PHONE FAX A/C No Ext : A/C No): 1705 17th Street E-MAIL den am@imaco com ADDRESS: P rP• Suite 100 Denver, CO 80202 INSURER(S) AFFORDING COVERAGE NAIC# INSURED Hydro Construction Company, Inc. 301 East Lincoln Avenue Fort Collins, CO 80524 INSURERA: PHOENIX INS CO (Travelers) 25623 INSURER B : TRAVELERS PROP CAS CO OF AMER 25674 INSURERC: PINNACOL ASSUR 41190 INSURER E : COVERAGES CERTIFICATE NUMBER: 39096714 REVISION NUMBER: 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. INSR LTR TYPE OF INSURANCE ADDL SUBR NUMBER POLICPOLICY MM/DDYEFF APO/ pY EXP LIMITS A GENERAL LIABILITY DTC04E251248PHX14 04/01/1 04/01/15 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ 300,000 CLAIMS -MADE � OCCUR 4X MED EXP (Any one person) $ 10,000 Ded:$5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X PRO- CT LOC $ B AUTOMOBILE LIABILITY DT8104E216873TIL14 04 O1 1 04/01/15 COMBINED SINGLE LIMIT Ea accident 1,000,000 X BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ X NON -OWNED HIRED AUTOS AUTOS $ g X UMBRELLA LIAB X OCCUR DSMCUP4E216873TIL14 04/01/1 04/01/15 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 EXCESS LIAB CLAIMS -MADE DED I X I RETENTION $ 10, 000 $ C AND EMPLOYERS' LIABILITY Y / N WORKERS COMPENSATION ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N� N / A 2091550 04/01/1 04/01/15 T X TORYLIWC MITS OER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1 000 000 $ r DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) City of Fort Collins is included as Additional Insured on the General Liability Policy if required by written contract or agreement and with respect to work performed by Insured subject to the policy terms and conditions. CERTIFICATE HOLDER CANCELLATION RE: 7220 Water/Wastewater Treatment & Site Infrastructure Design/Construction Contractor. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 700 Wood Street AUTHORIZED REPRESENTATIVE Fort Collins, CO 80521-0000 USA © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD ryan23 39096714 Fri Jun 06 11:00:55 CDT 2014 SIMON, ANNE L & SIMON, RANDY 706 JACK PINE Pt LOVELAND, CO 80538-8101 Evidence of Insurance Motor Carrier Coverage Agent WELCH INSURANCF AGENCY INC (970)669-7259 05-D238-10 Policy Number: 05-1-C-7890757-7 Effective Date: 06/06/2014, 10:58 AM Central Time Expiration Date: 10/052014, 12:01 AM Central Time (Item #3) Vehicle Year Make/Model Vehicle ID 1997 FREIG FL 60 I FV3GFBD9VH839234 (Item N2) Coverages Coverage Limit/ Endorsement Premium Symbol Deductible Number Single Liability Limit 67 $500.000 Limit $121.00 Uninsured Motorist 67 $500,000 Per Person $33.00 Split Bodily Injury Uninsured Motorists Coverage Limits 67 $500000 Per Accident CA 2102 1106 Collision 67 $1,000 Deductible $48.00 Comprehensive 67 $1000 Deductible $32,00 Discounts (Reflected In Premiums). PREMIUM $234 00 Other Endorsements Attached To This Policy Endorsement Number Designated Insured For Covered Autos Liability Coverage CA 20 48 10 13 Colorado Changes - Concealment, Misrepresentation or Fraud IL 01 69 09 07 Colorado Changes - Cancellation and Nonrenewal IL 02 28 09 07 Nuclear Energy Liability Exclusion Endorsement (Broad Form) IL 00 2109 08 Colomdo Changes -Civil Union IL 01 25 11 13 RATE CLASS I6A TERRITORY 003 COST SYMBOL E PACKAGE -CD ADDITIONAL INSURED CITY OF FORT COLLINS PO BOX 580 FORT COLLINS, CO 80522-0580 LOAN NO. TERM 06 Agent A-622.1-A .44COR0", CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 1 6/9/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NO AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOE 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 condition 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). PRODUCER Heritage General Agency, Inc 6 Inverness Court East Suite 110 Englewood, CO 80112 INSURED C.T Daniel Boone Underwriters P"°"E 573-445-8441 PA%: 573-446-9112 E-MAIL 'PRODUCER INSURER(S) AFFORDING COVERAGE NAIC # Universal Lightguide Technology Distribution, Inc. 706 Jack Pine Place Loveland, CO 80538 I R A: Western Heritage Insurance Company INSURER B:— INSURER G: NHF: INSURE THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIO 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, EXCLUSION AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR ADOL SUBR POLICY EFF POLICY E%P LTR TYPE OF INSURANCE INSD wvD POLICY NUMBER (MM/DDIYYYY) (MM/DD/YYYY) LIMITS A GENERAL LIABILITY X COM MERCIAL GENERAL LIABILITY X SCP0971116 12/10/2013 12/10/2014 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $100, 000 MED PAY (Any one person) $1 ,000 CLAIMS MADE OCCUR PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: JECPROT X POLICY LOC PRODUCTS-COMP/OPAGG $1,000,000 $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE (Per accdent) $ HIRED AUTOS $ NON -OWNED AUTOS $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ GARAGE LIABILITY AUTO ONLY (Ea accident) $ ANY AUTO OTHER THAN (Ea accident) CW AUTO ONLY. (Aggregate) $ $ DESCRIPTION OF OPERATIONS / LOCATI NS I VEHICLE $ Communication Equipment Installation- Industrial or Commercial Certificate holder is additional insured City of Ft. Collins P.O. Box 580 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGE TS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE w11 — — nylna reaerveu. ACORD 25 (2009109) The ACORD name and logo are registered marks ur 6f ENDORSEMENT NO. 01 Western Heritage Insurance Company ATTACHED TO AND FORMING A PART OF ENDORSEMENT EFFECTIVE DATE POLICY NUMBER (12:01 A.M. STANDARD TIME 1 NAMED INSURED AGENT NO. SCP0971116 06/06/2014 UNIVERSAL LIGHTGUIDE TECHNOLOGY 05040 ( I ne aoove Intormatlon Is required only when this endorsement is issued subsequent to preparation of the policy.) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Additional insured interest of City of Ft. Collins is added per the attached WHI 21 0479 and WHI 21 0493 Additional Premium: Surplus Lines Tax: Total Additional Premiume: $50 $ 1.50 $51.50 All other Terms and Conditions of this Policy remain unchanged. / 06/09/2014 KMV AUTHORIZED REPRESENTATIVE DATE WHI 20-0106 (03/99) INSURED Western Heritage Insurance Company ATTACHED TO AND FORMING A PART OF ENDORSEMENT EFFECTIVE DATE POLICY NUMBER �12) :01 A.M. STANDARD TIME NAMED INSURED AGENT NO. SCP0971116 06/06/2014 UNIVERSAL LIGHTGUIDE TECHNOLOGY 05040 ( I ne above information is required only when this endorsement is issued subsequent to preparation of the policy.) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM SCHEDULE Name Of Additional Insured Person(s) Or Organization Location(s) Of Covered Operations CITY OF FT. COLLINS P.O. BOX 580 ALL JOBS BY UNIVERSAL LIGHTGUIDE TECHNOLOGY FORT COLLINS, CO 80522 DISTRUBUTION, INC. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. SECTION 11 - WHO IS AN INSURED is amended to include as an additional insured the person(s) or or- ganizations) shown in the Schedule, but only with re- spect to liability for "bodily injury," "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. B. With respect to the insurance afforded to these addi- tional insureds, the following additional exclusions apply: All other Terms and Conditions of this Policy remain unchanged. This insurance does not apply to "bodily injury" or "property damage" occurring after: That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontrac- tor engaged in performing operations for a principal part of the same project. AUTHORIZED REPRESENTATIVE J DATE WHI 21-0479 (02/05) INSURED cip Western Heritage Insurance Company ATTACHED TO AND FORMING A PART OF ENDORSEMENT EFFECTIVE DATE POLICY NUMBER 12:01 A.M. STANDARD TIME ( ) NAMED INSURED AGENT NO. SCP0971116 06/06/2014 UNIVERSAL LIGHTGUIDE TECHNOLOGY 05040 (The above information is required only when this endorsement is issued subsequent to preparation of the policy.) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LIMITED WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition (Section IV - COMMER- CIAL GENERAL LIABILITY CONDITIONS) is amended by the addition of the following: We waive any right of recovery we may have against an additional insured shown on form WHI 21-0479 or WHI 21-0516 but only with respect to liability for "bodily injury," "property damage" or "personal and advertis- ing injury" caused by. 1. The named insured's acts or omissions; or 2. The acts or omissions of those acting on the named insured's behalf; in the performance of the named insured's ongoing operations for the additional insured shown on form WHI 21-0479 or WHI 21-0516. All other Terms and Conditions of this Policy remain unchanged. AUTHORIZED REPRESENTATIVE DATE Includes copyrighted material of ISO Properties, Inc., with its permission. Copyright, ISO Properties, Inc., 1992, 2003 WHI 21-0493 (08-08) INSURED