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HomeMy WebLinkAboutCORRESPONDENCE - RFP - 7526 FLEXIBLE SPENDING ACCOUNT ADMINISTRATOR (3)October 28, 2016 ASIFlex Attn: John Riddick asi@asiflex.com 201 West Broadway Bldg 4 Suite C Columbia, MO 65203 RE: Renewal, 7526 - Flexible Spending Account Administrator Dear Mr. Riddick: 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, 2017 through December 31, 2017. 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 Jill Wilson, 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 7526 by signing this letter and returning it to Purchasing Division within the next fifteen days.) GSP:jg 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: 6B5F58D4-C1B1-4BC1-A6F6-241F6A5C414C 11/7/2016 CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 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 CONTACT NAME: PHONE FAX (A/C, No, Ext): (A/C, No): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY 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: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY STATUTE ER Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N / A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Includes copyrighted material of Insurance GA 472 10 01 Services Office, Inc., with its permission. Page 1 of 2 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AUTOMATIC ADDITIONAL INSURED - WHEN REQUIRED IN CONTRACT OR AGREEMENT WITH YOU This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. SECTION II - WHO IS AN INSURED, 2. is amended to include: e. Any person or organization, hereinafter referred to as ADDITIONAL INSURED: (1) Who or which is not specifically named as an additional insured un- der any other provision of, or en- dorsement added to, this Coverage Part; and (2) For whom you are required to add as an additional insured on this Cover- age Part under: (1) A written contract or agreement; or (2) An oral agreement or contract where a certificate of insurance showing that person or organization as an additional insured has been issued; but only with respect to liability arising out of "your work" performed for that addi- tional insured by you or on your behalf. A person or organization's status as an in- sured under this endorsement continues for only the period of time required by the written contract or agreement, but in no event beyond the expiration date of this Coverage Part. If there is no written con- tract or agreement, or if no period of time is required by the written contract or agreement, a person or organization's status as an insured under this endorse- ment ends when your operations for that insured are completed. 2. SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS is amended to in- clude: 1. Automatic Additional Insured Provision The written or oral contract or agreement must be currently in effect or become ef- fective during the term of this Coverage Part. The contract or agreement also must be executed prior to the "bodily in- jury", "property damage" or "personal and advertising injury" to which this endorse- ment pertains. 2. Conformance to Specific Written Con- tract or Agreement If a written contract or agreement be- tween you and the additional insured specifies that coverage for the additional insured: a. Be provided by the Insurance Serv- ices Office additional insured form Includes copyrighted material of Insurance GA 472 10 01 Services Office, Inc., with its permission. Page 2 of 2 4. The following are added to SECTION I - COVERAGES, COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions and SECTION I - COVERAGES, COVERAGE B. PERSONAL AND ADVERTISING INJURY LIABILITY, 2. Exclusions: The insurance provided to the additional in- sured does not apply to: a. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the: (1) Rendering of, or failure to render, any professional architectural, engi- neering or surveying services, in- cluding: (a) The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and (b) Supervisory, inspection, archi- tectural or engineering activities; (2) Sole negligence or willful misconduct of, or for defects in design furnished by, the additional insured or its "em- ployees". b. "Bodily injury" or "property damage" aris- ing out of "your work" included in the "products-completed operations hazard". c. "Bodily injury" or "property damage" aris- ing out of "your work" for which a consoli- dated (wrap-up) insurance program has been provided by the prime contractor / project manager or owner of the con- struction project in which you are in- volved. 5. SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, 5. Other Insurance is amended to include: a. Where required by a written contract or agreement, this insurance is primary and / or noncontributory as respects any other insurance policy issued to the additional insured, and such other insurance policy shall be excess and / or noncontributing, whichever applies, with this insurance. b. Any insurance provided by this endorse- ment shall be primary to other insurance available to the additional insured except: (1) As otherwise provided in SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, 5. Other Insurance, b. Excess Insurance; or (2) For any other valid and collectible in- surance available to the additional insured as an additional insured by AA 4004 03 06 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Endorsement Effective: Policy Number: Named Insured: Countersigned by: (Authorized Representative) The person or organization named in the following schedule is an "insured" to the extent of their liability for the conduct of another "insured" as provided in SECTION II - LIABILITY COVERAGE, A. Coverage, 1. Who is an Insured, Paragraph c. Schedule Additional Insured Address: 11-16-2016 EBA 013 47 15 APPLICATION SOFTWARE INC CITY OF FORT COLLINS PO BOX 580 FORT COLLINS, CO 80522-0580 attachment of an endorsement to another insurance policy that is writ- ten on an excess basis. In such case, the coverage provided under this endorsement shall also be ex- cess. number CG 20 10 or CG 20 37 (where edition specified); or b. Include coverage for completed op- erations; or c. Include coverage for "your work"; and where the limits or coverage pro- vided to the additional insured is more re- strictive than was specifically required in that written contract or agreement, the terms of Paragraphs 3., 4.a.(2) and / or 4.b., or any combination thereof, of this endorsement shall be interpreted as pro- viding the limits or coverage required by the terms of the written contract or agreement, but only to the extent that such limits or coverage is included within the terms of the Coverage Part to which this endorsement is attached. If, how- ever, the written contract or agreement specifies the Insurance Services Office additional insured form number CG 20 10 but does not specify which edition, or specifies an edition that does not exist, Paragraphs 3. and 4.a.(2) of this en- dorsement shall not apply and Paragraph 4.b. of this endorsement shall apply. 3. SECTION III - LIMITS OF INSURANCE is amended to include: The limits applicable to the additional insured are those specified in the written contract or agreement or in the Declarations of this Cov- erage Part, whichever are less. If no limits are specified in the written contract or agreement, or if there is no written contract or agreement, the limits applicable to the additional insured are those specified in the Declarations of this Coverage Part. The limits of insurance are in- clusive of and not in addition to the limits of insurance shown in the Declarations. ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD APPLI-1 OP ID: JC 11/16/2016 Jessica Coleman The Insurance Group, Inc. 200 East Southampton Drive Columbia, MO 65203 Charles W. Digges, Jr., CIC 573-875-4800 573-875-4514 jcoleman@theinsurancegrp.com Cincinnati Insurance Company 10677 Application Software, Inc Travelers Property Casualty Co 25674 John Riddick P O Box 6044 Columbia, MO 65205 Chubb Group of Ins. Co. 41386 A X 1,000,000 X X EPP 0134715 03/09/2016 01/01/2019 500,000 5,000 X EBL 1,000,000 2,000,000 2,000,000 Emp Ben. 1,000,000 1,000,000 A X EBA 0134715 03/09/2016 01/01/2017 X X X X 2,000,000 A EPP 0134715 03/09/2016 01/01/2019 2,000,000 X 0 X B 6JUB9981M73615 10/11/2016 10/11/2017 1,000,000 1,000,000 1,000,000 C Professional Liab 82247584 01/01/2016 01/01/2017 Occurence 5,000,000 C Cyber Liab 82259819 01/01/2016 01/01/2017 Aggregate 5,000,000 Automatic Additional Insured on General Liability when required by written contract, but only to extent provided in policy form GA427. Designated Additional Insured on Auto Liability, but only to extent provided in policy form GA4004. City of Fort Collins Purchasing Department PO Box 580 Fort Collins, CO 80522