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HomeMy WebLinkAboutCORRESPONDENCE - RFP - 9048 EXECUTIVE SEARCH SERVICES ON-CALLNovember 16, 2020 Baker Tilly Virchow Krause, LLP Attn: Charles Rohre PO Box 78975 Milwaukee, WI 53278-8975 RE: Renewal, 9048 Executive Search Services On-Call Dear Mr. Rohre: The City of Fort Collins wishes to extend the agreement term for the above captioned proposal per the existing terms and conditions and the following: 1) The term will be extended for one (1) additional year, January 1, 2021 through December 31, 2021. If the renewal is acceptable to your firm, please sign this letter in the space provided and include a current copy of insurance certificate naming the City as an additional insured for General and Automotive Liability within the next fifteen (15) 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 Beth Diven, Buyer at (970) 221-6216 if you have any questions regarding this matter. Sincerely, Gerry S. Paul Director of Purchasing __________________________________________ ________________ Signature Date (Please indicate your desire to renew 9048 by signing this letter and returning it to Purchasing Division within the next fifteen days.) GSP:kr Financial Services Purchasing Division 215 N. Mason St. 2nd Floor PO Box 580 Fort Collins, CO 80522 970.221.6775 970.221.6707- fax fcgov.com/purchasing DocuSign Envelope ID: 26D87145-D6FF-4CFC-A0FA-2F6DFB944E7E 11/20/2020 Holder Identifier : 01/27/2020 7777777707070700077761616045571110767717016204447207442027772507300072640577046230130777051513167400307173114673675103071736774635777610767515063046661207364015570076130076727242035772000777777707000707007 7777777707070700073525677115456000732001517127003007032336353172000070233273520731110702223634217310007123337342072001071233362521730000702332725316200007133336352173001077756163351765540777777707000707007 Certificate No : 570080331278 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 01/27/2020 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. PRODUCER Aon Risk Services Northeast, Inc. New York NY Office One Liberty Plaza 165 Broadway, Suite 3201 New York NY 10006 USA PHONE (A/C. No. Ext): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # (312) 381-1000 INSURED INSURER A: National Fire Ins. Co. of Hartford 20478 INSURER B: The Continental Insurance Company 35289 INSURER C: Transportation Insurance Co. 20494 INSURER D: INSURER E: INSURER F: FAX (A/C. No.): (312) 381-7007 CONTACT NAME: Baker Tilly Virchow Krause, LLP Ten Terrace Court Madison WI 53718-2004 USA COVERAGES CERTIFICATE NUMBER: 570080331278 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. Limits shown are as requested POLICY EXP (MM/DD/YYYY) POLICY EFF (MM/DD/YYYY) SUBR WVD INSR LTR ADDL TYPE OF INSURANCE INSD POLICY NUMBER LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR POLICY LOC EACH OCCURRENCE DAMAGE TO RENTED 7KH$&25'QDPHDQGORJRDUHUHJLVWHUHGPDUNVRI$&25' &(57,),&$7(+2/'(5 ‹$&25'&25325$7,21$OOULJKWVUHVHUYHG $&25'  $87+25,=('5(35(6(17$7,9( &$1&(//$7,21 &(57,),&$7(2)/,$%,/,7<,1685$1&( '$7( 00''<<<< JECT LOC POLICY PRO- GEN'L AGGREGATE LIMIT APPLIES PER: CLAIMS-MADE OCCUR &200(5&,$/*(1(5$//,$%,/,7< 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 $ 80%5(//$/,$% EACH OCCURRENCE $ (;&(66/,$% '(6&5,37,212)23(5$7,216/2&$7,2169(+,&/(6 $&25'$GGLWLRQDO5HPDUNV6FKHGXOHPD\EHDWWDFKHGLIPRUHVSDFHLVUHTXLUHG ,165 /75 7<3(2),1685$1&( 32/,&<180%(5 32/,&<()) 00''<<<< 32/,&<(;3 00''<<<< /,0,76 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 0DQGDWRU\LQ1+ OFFICER/MEMBER EXCLUDED? :25.(56&203(16$7,21 $1'(03/2<(56 /,$%,/,7< <1 $87202%,/(/,$%,/,7< ANY AUTO ALL OWNED SCHEDULED HIRED AUTOS NON-OWNED AUTOS AUTOS AUTOS COMBINED SINGLE LIMIT BODILY INJURY (Per person) Holder Identifier : 11/23/2020 7777777707070700077761616045571110767717016204447207442027772507300072640577046230130777051513167400307537510673671103075336330631773210727111467406665207724055530076570076727242035772000777777707000707007 7777777707070700073525677115456000732010407137112107123337243062110070233373431721100713233735216211007123226342173110071322363531721000712232735317200107032226253073111077756163351765540777777707000707007 Certificate No : 570085015159 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 11/23/2020 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. PRODUCER Aon Risk Services Northeast, Inc. New York NY Office One Liberty Plaza 165 Broadway, Suite 3201 New York NY 10006 USA PHONE (A/C. No. Ext): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # (312) 381-1000 INSURED INSURER A: National Fire Ins. Co. of Hartford 20478 INSURER B: The Continental Insurance Company 35289 INSURER C: Transportation Insurance Co. 20494 INSURER D: INSURER E: INSURER F: FAX (A/C. No.): (312) 381-7007 CONTACT NAME: Baker Tilly US, LLP Ten Terrace Court Madison WI 53718-2004 USA COVERAGES CERTIFICATE NUMBER: 570085015159 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. Limits shown are as requested POLICY EXP (MM/DD/YYYY) POLICY EFF (MM/DD/YYYY) SUBR WVD INSR LTR ADDL TYPE OF INSURANCE INSD POLICY NUMBER LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR POLICY LOC EACH OCCURRENCE DAMAGE TO RENTED CNA PARAMOUNT General Liability Extension Endorsement 1. ADDITIONAL INSUREDS a. WHO IS AN INSURED is amended to include as an Insured any person or organization described in paragraphs A. through K. below whom a Named Insured is required to add as an additional insured on this Coverage Part under a written contract or written agreement, provided such contract or agreement: (1) is currently in effect or becomes effective during the term of this Coverage Part; and (2) was executed prior to: (a) the bodily injury or property damage; or (b) the offense that caused the personal and advertising injury, for which such additional insured seeks coverage. b. However, subject always to the terms and conditions of this policy, including the limits of insurance, the Insurer will not provide such additional insured with: (1) a higher limit of insurance than required by such contract or agreement; or (2) coverage broader than required by such contract or agreement, and in no event broader than that described by the applicable paragraph A. through K. below. Any coverage granted by this endorsement shall apply only to the extent permissible by law. A. Controlling Interest Any person or organization with a controlling interest in a Named Insured, but only with respect to such person or organization’s liability for bodily injury, property damage or personal and advertising injury arising out of: 1. such person or organization’s financial control of a Named Insured; or 2. premises such person or organization owns, maintains or controls while a Named Insured leases or occupies such premises; provided that the coverage granted by this paragraph does not apply to structural alterations, new construction or demolition operations performed by, on behalf of, or for such additional insured. B. Co-owner of Insured Premises A co-owner of a premises co-owned by a Named Insured and covered under this insurance but only with respect to such co-owner’s liability for bodily injury, property damage or personal and advertising injury as co-owner of such premises. C. Grantor of Franchise Any person or organization that has granted a franchise to a Named Insured, but only with respect to such person or organization’s liability for bodily injury, property damage or personal and advertising injury as grantor of a franchise to the Named Insured. D. Lessor of Equipment Any person or organization from whom a Named Insured leases equipment, but only with respect to liability for bodily injury, property damage or personal and advertising injury caused, in whole or in part, by the Named Insured’s maintenance, operation or use of such equipment, provided that the occurrence giving rise to such bodily injury, property damage or the offense giving rise to such personal and advertising injury takes place prior to the termination of such lease. CNA74879XX (1-15) Policy No: 6016751638 Page 2 of 13 Endorsement No: 8 Nat'l Fire Ins Co of Hartford Effective Date: 01/01/2020 Insured Name: BAKER TILLY VIRCHOW KRAUSE, LLP Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. CNA PARAMOUNT General Liability Extension Endorsement E. Lessor of Land Any person or organization from whom a Named Insured leases land but only with respect to liability for bodily injury, property damage or personal and advertising injury arising out of the ownership, maintenance or use of such land, provided that the occurrence giving rise to such bodily injury or property damage, or the offense giving rise to such personal and advertising injury, takes place prior to the termination of such lease. The coverage granted by this paragraph does not apply to structural alterations, new construction or demolition operations performed by, on behalf of, or for such additional insured. F. Lessor of Premises An owner or lessor of premises leased to the Named Insured, or such owner or lessor’s real estate manager, but only with respect to liability for bodily injury, property damage or personal and advertising injury arising out of the ownership, maintenance or use of such part of the premises leased to the Named Insured, and provided that the occurrence giving rise to such bodily injury, property damage or the offense giving rise to such personal and advertising injury takes place prior to the termination of such lease. The coverage granted by this paragraph does not apply to structural alterations, new construction or demolition operations performed by, on behalf of, or for such additional insured. G. Mortgagee, Assignee or Receiver A mortgagee, assignee or receiver of premises but only with respect to such mortgagee, assignee or receiver’s liability for bodily injury, property damage or personal and advertising injury arising out of the Named Insured’s ownership, maintenance, or use of a premises by a Named Insured. The coverage granted by this paragraph does not apply to structural alterations, new construction or demolition operations performed by, on behalf of, or for such additional insured. H. State or Governmental Agency or Subdivision or Political Subdivisions – Permits A state or governmental agency or subdivision or political subdivision that has issued a permit or authorization, but only with respect to such state or governmental agency or subdivision or political subdivision’s liability for bodily injury, property damage or personal and advertising injury arising out of: 1. the following hazards in connection with premises a Named Insured owns, rents, or controls and to which this insurance applies: a. the existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoistaway openings, sidewalk vaults, street banners, or decorations and similar exposures; or b. the construction, erection, or removal of elevators; or c. the ownership, maintenance or use of any elevators covered by this insurance; or 2. the permitted or authorized operations performed by a Named Insured or on a Named Insured’s behalf. The coverage granted by this paragraph does not apply to: a. Bodily injury, property damage or personal and advertising injury arising out of operations performed for the state or governmental agency or subdivision or political subdivision; or b. Bodily injury or property damage included within the products-completed operations hazard. With respect to this provision’s requirement that additional insured status must be requested under a written contract or agreement, the Insurer will treat as a written contract any governmental permit that requires the Named Insured to add the governmental entity as an additional insured. CNA74879XX (1-15) Policy No: 6016751638 Page 3 of 13 Endorsement No: 8 Nat'l Fire Ins Co of Hartford Effective Date: 01/01/2020 Insured Name: BAKER TILLY VIRCHOW KRAUSE, LLP Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. 50020003860167516381429 CNA PARAMOUNT General Liability Extension Endorsement I. Trade Show Event Lessor 1. With respect to a Named Insured’s participation in a trade show event as an exhibitor, presenter or displayer, any person or organization whom the Named Insured is required to include as an additional insured, but only with respect to such person or organization’s liability for bodily injury, property damage or personal and advertising injury caused by: a. the Named Insured’s acts or omissions; or b. the acts or omissions of those acting on the Named Insured’s behalf, in the performance of the Named Insured’s ongoing operations at the trade show event premises during the trade show event. 2. The coverage granted by this paragraph does not apply to bodily injury or property damage included within the products-completed operations hazard. J. Vendor Any person or organization but only with respect to such person or organization’s liability for bodily injury or property damage arising out of your products which are distributed or sold in the regular course of such person or organization's business, provided that: 1. The coverage granted by this paragraph does not apply to: a. bodily injury or property damage for which such person or organization is obligated to pay damages by reason of the assumption of liability in a contract or agreement unless such liability exists in the absence of the contract or agreement; b. any express warranty unauthorized by the Named Insured; c. any physical or chemical change in any product made intentionally by such person or organization; 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 any inspections, adjustments, tests or servicing that such person or organization 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 such person or organization’s premises in connection with the sale of a product; g. products which, after distribution or sale by the Named Insured, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for such person or organization; or h. bodily injury or property damage arising out of the sole negligence of such person or organization 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. above; or (2) such inspections, adjustments, tests or servicing as such person or organization has agreed with the Named Insured 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 Paragraph J. does not apply to any insured person or organization, from whom the Named Insured has acquired such products, nor to any ingredient, part or container, entering into, accompanying or containing such products. CNA74879XX (1-15) Policy No: 6016751638 Page 4 of 13 Endorsement No: 8 Nat'l Fire Ins Co of Hartford Effective Date: 01/01/2020 Insured Name: BAKER TILLY VIRCHOW KRAUSE, LLP Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. CNA PARAMOUNT General Liability Extension Endorsement 3. This Paragraph J. also does not apply: a. to any vendor specifically scheduled as an additional insured by endorsement to this Coverage Part; b. to any of your products for which coverage is excluded by endorsement to this Coverage Part; nor c. if bodily injury or property damage included within the products-completed operations hazard is excluded by endorsement to this Coverage Part. K. Other Person Or Organization Any person or organization who is not an additional insured under Paragraphs A. through J. above. Such additional insured is an Insured solely for bodily injury, property damage or personal and advertising injury for which such additional insured is liable because of the Named Insured’s acts or omissions. The coverage granted by this paragraph does not apply to any person or organization: 1. for bodily injury, property damage, or personal and advertising injury arising out of the rendering or failure to render any professional service; 2. for bodily injury or property damage included within the products-completed operations hazard; nor 3. who is specifically scheduled as an additional insured on another endorsement to this Coverage Part. 2. ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY TO ADDITIONAL INSURED’S INSURANCE A. The Other Insurance Condition in the COMMERCIAL GENERAL LIABILITY CONDITIONS Section is amended to add the following paragraph: If the Named Insured has agreed in writing in a contract or agreement that this insurance is primary and non- contributory relative to an additional insured's own insurance, then this insurance is primary, and the Insurer will not seek contribution from that other insurance. For the purpose of this Provision 2., the additional insured's own insurance means insurance on which the additional insured is a named insured. B. With respect to persons or organizations that qualify as additional insureds pursuant to paragraph 1.K. of this endorsement, the following sentence is added to the paragraph above: Otherwise, and notwithstanding anything to the contrary elsewhere in this Condition, the insurance provided to such person or organization is excess of any other insurance available to such person or organization. 3. BODILY INJURY – EXPANDED DEFINITION Under DEFINITIONS the definition of bodily injury is deleted and replaced by the following: Bodily injury means physical injury, sickness or disease sustained by a person, including death, humiliation, shock, mental anguish or mental injury sustained by that person at any time which results as a consequence of the physical injury, sickness or disease. 4. BROAD KNOWLEDGE OF OCCURRENCE/ NOTICE OF OCCURRENCE Under CONDITIONS, the condition entitled Duties in The Event of Occurrence, Offense, Claim or Suit is amended to add the following: A. BROAD KNOWLEDGE OF OCCURRENCE The Named Insured must give the Insurer or the Insurer’s authorized representative notice of an occurrence, offense or claim only when the occurrence, offense or claim is known to a natural person Named Insured, to a partner, executive officer, manager or member of a Named Insured, or to an employee designated by any of the above to give such notice. B. NOTICE OF OCCURRENCE CNA74879XX (1-15) Policy No: 6016751638 Page 5 of 13 Endorsement No: 8 Nat'l Fire Ins Co of Hartford Effective Date: 01/01/2020 Insured Name: BAKER TILLY VIRCHOW KRAUSE, LLP Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. 50020003860167516381430 Business Auto Policy Policy Endorsement EXTENDED COVERAGE - BA PLUS - FOR HIRED AND NON-OWNED AUTOS It is understood and agreed that this endorsement amends the BUSINESS AUTO COVERAGE FORM as follows. If any other endorsement attached to this policy amends any provision also amended by this endorsement, then that other endorsement controls with respect to such provision, and the changes made by this endorsement to such provision do not apply. TABLE OF CONTENTS I. AMENDMENTS TO LIABILITY COVERAGE A. Who Is An Insured 1. Majority Owned Corporations 2. Newly Acquired Organizations 3. Additional Insureds Required By Written Contracts 4. Employee-Hired Autos B. Increased Loss of Earnings Allowance C. Fellow Employee Coverage II. AMENDMENTS TO PHYSICAL DAMAGE COVERAGE A. Increased Loss of Use Expense B. Broadened Electronic Equipment Coverage III. AMENDMENTS TO BUSINESS AUTO CONDITIONS A. Knowledge of Accident or Loss B. Knowledge of Documents C. Waiver of Subrogation D. Unintentional Failure To Disclose Hazards E. Primary and Non-Contributory When Required By Contract IV. AMENDMENTS TO DEFINITIONS A. Broadened Bodily Injury A. 1. 2. I. AMENDMENTS TO LIABILITY COVERAGE Amendments to Who Is An Insured Under SECTION II – COVERED AUTOS LIABILITY COVERAGE, the paragraph entitled Who Is An Insured is amended to add the following: Majority Owned Corporations Any incorporated entity in which you own a majority of the voting stock on the inception date of this Coverage Form is an insured, but only if such entity is not an insured under any other liability “policy” that provides auto coverage. Newly Acquired Organizations BUA 6016751641 Endorsement No: 8; Page: 1 of 4 Policy Page: 43 of 59 Underwriting Company: Valley Forge Insurance Company, 151 N Franklin St, Chicago, IL 60606 Form No: CNA83700XX (10-2015) Endorsement Effective Date: Policy No: Endorsement Expiration Date: Policy Effective Date: 01/01/2020 © Copyright CNA All Rights Reserved. Business Auto Policy Policy Endorsement a. (1) (2) b. 3. 4. i. ii. B. C. A. B. 5. Any organization you newly acquire or form during the policy period, other than a limited liability company, partnership or joint venture, and in which you maintain majority ownership interest is an insured, but only if such organization is not an insured under any other liability “policy” that provides auto coverage. The insurance afforded by this provision: Is effective on the date of acquisition or formation of the organization, and applies until: The end of the policy period of this Coverage Form; or The next anniversary of this Coverage Form’s inception date, whichever is earlier; and Does not apply to bodily injury or property damage caused by an accident that occurred before you acquired or formed the organization. Additional Insureds Required By Written Contract Any person or organization that you are required by written contract to make an additional insured under this insurance is an insured, but only with respect to that person or organization’s legal liability for acts or omissions of a person who qualifies as an insured for Liability Coverage under SECTION II - WHO IS AN INSURED of this Coverage Form. Employee-Hired Autos Any employee of yours is an insured while operating with your permission an auto hired or rented under a contract in that employee’s name, while performing duties related to the conduct of your business. With respect to provisions A.1. and A.2. above, “policy” includes those policies that were in force on the inception date of this Coverage Form, but: Which are no longer in force; or Whose limits have been exhausted. Increased Loss of Earnings Allowance Under SECTION II – COVERED AUTOS LIABILITY COVERAGE, the paragraph entitled Coverage Extensions is amended under Supplementary Payment subparagraph (4) to delete the $250. a day limit for loss of earnings and replace it with a $500. a day limit. Fellow Employee Coverage Under SECTION II – COVERED AUTOS LIABILITY COVERAGE, the paragraph entitled Exclusions is amended to delete the exclusion entitled Fellow Employee. II. AMENDMENTS TO PHYSICAL DAMAGE COVERAGE Increased Loss of Use Expense Under SECTION III – PHYSICAL DAMAGE COVERAGE, the paragraph entitled Coverage Extensions is amended under Loss of Use Expenses to delete the maximum of $600., and replace it with a maximum of $800. Broadened Electronic Equipment Coverage Under SECTION III – PHYSICAL DAMAGE COVERAGE, the paragraph entitled Exclusions is amended to delete paragraphs 5.a through 5.d. in their entirety, and replace them with the following: Exclusions 4.c. and 4.d. above do not apply to loss to any electronic equipment that at the time of loss is: BUA 6016751641 Endorsement No: 8; Page: 2 of 4 Policy Page: 44 of 59 Underwriting Company: Valley Forge Insurance Company, 151 N Franklin St, Chicago, IL 60606 Form No: CNA83700XX (10-2015) Endorsement Effective Date: Business Auto Policy Policy Endorsement a. b. (1) (2) (3) III. A. (4) B. (6) C. D. E. Permanently installed in or upon a covered auto, nor to such equipment’s antennas or other accessories used with such equipment. A $100 deductible applies to this provision, and supersedes any otherwise applicable deductible; or Designed to be operated solely by use of the power from the auto’s electrical system and is: Removable from a housing unit which is permanently installed in or upon the covered auto; An integral part of the same unit housing any electronic equipment described in paragraphs a. or b.(1) above; or Necessary for the normal operation of the covered auto or the monitoring of the covered auto’s operating system. AMENDMENTS TO BUSINESS AUTO CONDITIONS Knowledge of Accident or Loss Under BUSINESS AUTO CONDITIONS, the Loss Condition entitled Duties In the Event of Accident, Claims, Suit, or Loss is amended to add the following subparagraph a.(4): If your employees know of an accident or loss, this will not mean that you have such knowledge until such accident or loss is known to a natural person Named Insured, to a partner, executive officer, manager or member of a Named Insured, or to an employee designated by any of the above to be your insurance manager. Knowledge of Documents Under BUSINESS AUTO CONDITIONS, the Loss Condition entitled Duties In the Event of Accident, Claims, Suit, or Loss is amended to add the following subparagraph b.(6): If your employees know of documents concerning a claim or suit, this will not mean that you have such knowledge until such documents are known to a natural person Named Insured, to a partner, executive officer, manager or member of a Named Insured, or to an employee designated by any of the above to be your insurance manager. Waiver of Subrogation Under BUSINESS AUTO CONDITIONS, the Loss Condition entitled Transfer Of Rights Of Recovery Against Others To Us is amended to add the following: We waive any right of recovery we may have, because of payments we make for injury or damage, against any person or organization for whom or which you are required by written contract or agreement to obtain this waiver from us. This injury or damage must arise out of your activities under a contract with that person or organization. You must agree to that requirement prior to an accident or loss. Unintentional Failure To Disclose Hazards Under BUSINESS AUTO CONDITIONS, the General Condition entitled Concealment, Misrepresentation or Fraud is amended to add the following: Your failure to disclose all hazards existing on the inception date of this Coverage Form shall not prejudice you with respect to the coverage provided by this insurance, provided such failure or omission is not intentional. Primary and Non-Contributory When Required By Contract Under BUSINESS AUTO CONDITIONS, the General Condition entitled Other Insurance is amended to add the following: BUA 6016751641 Endorsement No: 8; Page: 3 of 4 Policy Page: 45 of 59 Underwriting Company: Valley Forge Insurance Company, 151 N Franklin St, Chicago, IL 60606 Business Auto Policy Policy Endorsement IV. A. Notwithstanding provisions 5.a. through 5.d. above, the coverage provided by this Coverage Form shall be on a primary and non-contributory basis when required to be so by a written contract entered into prior to accident or loss. AMENDMENTS TO DEFINITIONS Broadened Bodily Injury Under DEFINITIONS, the definition of bodily injury is deleted and replaced by the following: Bodily injury means physical injury, sickness or disease sustained by a person, including death, mental anguish or mental injury sustained by that person which results as a consequence of the physical injury, sickness or disease. All other terms and conditions of the policy remain unchanged This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy. BUA 6016751641 Endorsement No: 8; Page: 4 of 4 Policy Page: 46 of 59 Underwriting Company: Valley Forge Insurance Company, 151 N Franklin St, Chicago, IL 60606 Form No: CNA83700XX (10-2015) Endorsement Effective Date: Policy No: Endorsement Expiration Date: Policy Effective Date: 01/01/2020 © Copyright CNA All Rights Reserved. Workers Compensation And Employers Liability Insurance Policy Endorsement TEXAS WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement applies only to the insurance provided by the policy because Texas is shown in Item 3.A. of the Information Page. We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule, but this waiver applies only with respect to bodily injury arising out of the operations described in the Schedule where you are required by a written contract to obtain this waiver from us. This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule. The premium for this endorsement is shown in the Schedule. Schedule 1. Specific Waiver Name of person or organization X Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. 2. Operations: All Texas Operations 3. Premium: The premium charge for this endorsement shall be 2% percent of the premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operations described. 4. Advance Premium: Refer to Schedule of Operations All other terms and conditions of the policy remain unchanged. This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective Date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy unless another expiration date is shown below. WC 6 16751624 Endorsement No: 103; Page: 1 of 1 Policy Page: 341 of 354 Underwriting Company: The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 Form No: WC 42 03 04 B (06-2014) Endorsement Effective Date: Policy No: Endorsement Expiration Date: Policy Effective Date: 01/01/2020 © Copyright 2014 National Council on Compensation Insurance, Inc. All Rights Reserved. Form No: CNA83700XX (10-2015) Endorsement Effective Date: Policy No: Endorsement Expiration Date: Policy Effective Date: 01/01/2020 © Copyright CNA All Rights Reserved. Policy No: Endorsement Expiration Date: Policy Effective Date: 01/01/2020 © Copyright CNA All Rights Reserved. PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG X X X GEN'L AGGREGATE LIMIT APPLIES PER: $1,000,000 $1,000,000 $5,000 $1,000,000 $2,000,000 $2,000,000 A 01/01/2020 01/01/2021 General Liability C6016751638 PRO- JECT OTHER: AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY SCHEDULED AUTOS HIRED AUTOS ONLY NON-OWNED AUTOS ONLY BODILY INJURY ( Per person) PROPERTY DAMAGE X X (Per accident) BODILY INJURY (Per accident) $1,000,000 A 01/01/2020 01/01/2021 Auto COMBINED SINGLE LIMIT (Ea accident) BUA 6016751641 EXCESS LIAB X OCCUR CLAIMS-MADE AGGREGATE EACH OCCURRENCE DED $1,000,000 $1,000,000 01/01/2020 Umbrella B UMBRELLA LIAB CUE 6016723001 01/01/2021 RETENTION X E.L. DISEASE-EA EMPLOYEE E.L. DISEASE-POLICY LIMIT E.L. EACH ACCIDENT $1,000,000 X OTH- ER B 01/01/2020 01/01/2021 PER STATUTE B WC 6 23746823 01/01/2020 01/01/2021 C WC643413436 01/01/2020 01/01/2021 $1,000,000 Y / N (Mandatory in NH) ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED? N / A N Workers Compensation WORKERS COMPENSATION AND EMPLOYERS' LIABILITY If yes, describe under DESCRIPTION OF OPERATIONS below $1,000,000 WC 6 16751624 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Poudre Fire Authority is added as Additional Insured as respects the General Liability and Automobile Liability as required per written contract. 30-day notice of cancellation except 10 days for non-payment. A waiver of subrogation in favor of Additional Insured as respect the Workers Compensation pursuant to a written contract. CERTIFICATE HOLDER CANCELLATION PoudreREPRESENTATIVE Fire Authority AUTHORIZED C/o City of Fort Collins Attn: Purchasing Department P.O. Box 580 Fort Collins, CO 80522 USA ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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. ,16' $''/ :9' 68%5 1$ $ $ (Ea accident) (Per accident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on Risk Services Northeast, Inc. One Liberty Plaza, 165 Broadway, Suite 3201 New York, N.Y. 10006 312-381-1000 312-381-7007 Columbia Casualty Company Baker Tilly US, LLP Ten Terrace Court Madison, WI 53718 Poudre Fire Authority C/o City of Fort Collins Attn: Purchasing Department P.O. Box 580 Fort Collins, CO 80522 USA Professional Liability Insurance ABF-188122608 01-Oct-20 01-Oct-21 Not less than US $1,000,000 per claim and in the annual aggregate. Aon Risk Services Northeast, Inc. A PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG X X X GEN'L AGGREGATE LIMIT APPLIES PER: $1,000,000 $1,000,000 $5,000 $1,000,000 $2,000,000 $2,000,000 A 01/01/2020 01/01/2021 General Liability C6016751638 PRO- JECT OTHER: AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY SCHEDULED AUTOS HIRED AUTOS ONLY NON-OWNED AUTOS ONLY BODILY INJURY ( Per person) PROPERTY DAMAGE X X (Per accident) BODILY INJURY (Per accident) $1,000,000 A 01/01/2020 01/01/2021 Auto COMBINED SINGLE LIMIT (Ea accident) BUA 6016751641 EXCESS LIAB OCCUR CLAIMS-MADE AGGREGATE EACH OCCURRENCE DED UMBRELLA LIAB RETENTION E.L. DISEASE-EA EMPLOYEE E.L. DISEASE-POLICY LIMIT E.L. EACH ACCIDENT $1,000,000 X OTH- ER B 01/01/2020 01/01/2021 PER STATUTE B WC 6 23746823 01/01/2020 01/01/2021 C WC 6 43413436 01/01/2020 01/01/2021 $1,000,000 Y / N (Mandatory in NH) ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED? N / A N Workers Compensation WORKERS COMPENSATION AND EMPLOYERS' LIABILITY If yes, describe under DESCRIPTION OF OPERATIONS below $1,000,000 WC 6 16751624 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins is added as Additional Insured as respects the General Liability and Automobile Liability as required per written contract. 30-day notice of cancellation except 10 days for non-payment. A waiver of subrogation in favor of Additional Insured as respect the Workers Compensation pursuant to a written contract. CERTIFICATE HOLDER CANCELLATION CityREPRESENTATIVE of Fort Collins AUTHORIZED Attn: Purchasing Department P.O. Box 580 Fort Collins, CO 80522 USA ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. DocuSign Envelope ID: 26D87145-D6FF-4CFC-A0FA-2F6DFB944E7E