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HomeMy WebLinkAbout580065 EMPLOYMENT MATTERS LLC - CONTRACT - SOLE SOURCE - EMPLOYMENT MATTERS LLCProfessional Services Agreement – Work Order Type SS 2017 – Workplace Investigations Page 1 of 11 PROFESSIONAL SERVICES AGREEMENT WORK ORDER TYPE THIS AGREEMENT (the “Agreement”) made and entered into the day and year set forth below by and between THE CITY OF FORT COLLINS, COLORADO, a Municipal Corporation, hereinafter referred to as the "City" and EMPLOYMENT MATTERS LLC and FLYNN INVESTIGATION GROUP (“EMFIG”), 2373 Central Park Blvd., Suite 100, Denver, CO 80238 hereinafter referred to as the "Professional". WITNESSETH: In consideration of the mutual covenants and obligations herein expressed, it is agreed by and between the parties hereto as follows: 1. Scope of Services. The Professional agrees to provide services in accordance with any project Work Orders issued by the City to conduct neutral and objective investigations of matters considered confidential and subject to any applicable privilege or protection from disclosure. A blank sample of a work order is attached hereto as Exhibit "A", consisting of one (1) page and is incorporated herein by this reference. The City reserves the right to independently bid any project rather than issuing a Work Order to the Professional for the same pursuant to this Agreement. The term “Work” as used in this Agreement shall include the services and deliverables contained in Exhibit A and any Work Orders issued by the City. 2. General Scope of Work. a. The Work to be performed under this Agreement includes, but is not limited to, the performance of neutral and objective investigations of matters considered confidential and subject to any applicable privilege or protection from disclosure. The investigations will include witness interviews, document reviews, and written reports. The Professional will develop a record of allegations and relevant evidence to enable the City with support of its legal counsel to make informed decisions regarding the circumstances, including potential remedial action. This material will be presented in a written report (the “Investigation Report”) that details and summarizes the process, procedures, and information involved. Typically, the Investigation Report is provided approximately one (1) week after the conclusion of interviews. b. The City and its legal advisors will determine the scope of each investigation in collaboration with the Professional. All participants are informed of the investigator’s purpose in this process, which is to conduct an appropriate investigation – one that is prompt, impartial, and thorough. Within investigation scope, it is understood and agreed that the City and its representatives will support the investigator’s purpose by providing reasonable access to individuals and evidence at the investigator’s independent discretion. City and Professional DocuSign Envelope ID: 2D66D7BB-0221-4CF9-AB3A-B739A595D0D6 Professional Services Agreement – Work Order Type SS 2017 – Workplace Investigations Page 2 of 11 representatives will take steps to address communication concerning any investigation, to the extent possible, verbally. Participants will be asked to assist the investigator in drafting individual summary statements intended to represent individual perspectives regarding the relevant scope of issues. All participants are informed by the Professional of expectations of confidentiality as appropriate, the City’s prohibition against retaliation for initiating the investigation or participating in the investigation, and the City’s expectation that he or she provide complete and truthful information using a form provided by the City. Interviews conclude with the participant’s opportunity to modify his or her summary statement to support accuracy and veracity as attested to by his or her signature. The City will assist the Professional in the scheduling/coordinating of the interviews. 3. The Work Schedule. The services to be performed pursuant to this Agreement shall be performed in accordance with the Work Schedule stated on each Work Order. 4. Time of Commencement and Completion of Services. The services to be performed pursuant to this Agreement shall be initiated as specified on each Work Order. Time is of the essence. Any extensions of any time limit must be agreed upon in writing by the parties hereto. 5. Contract Period. This Agreement shall commence on February 7, 2017, and shall continue in full force and effect until February 6, 2018, 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 four (4) additional one year periods. Renewals and pricing changes shall be negotiated by and agreed to by both parties. Written notice of renewal shall be provided to the Professional and mailed no later than thirty (30) days prior to contract end. 6. Early Termination by City/Notice. Notwithstanding the time periods contained herein, the City may terminate this Agreement at any time without cause by providing written notice of termination to the Professional. Such notice shall be delivered at least fifteen (15) 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 following address: Professional: City: Copy to: Employment Matters LLC Attn: Mark J. Flynn 2373 Central Park Blvd., Suite 100 Denver, CO 802338 City of Fort Collins Attn: Chief Human Resources Officer PO Box 580 Fort Collins, CO 80522 City of Fort Collins Attn: Purchasing Dept. PO Box 580 Fort Collins, CO 80522 In the event of any such early termination by the City, the Professional shall be paid for services rendered prior to the date of termination subject only to the satisfactory DocuSign Envelope ID: 2D66D7BB-0221-4CF9-AB3A-B739A595D0D6 Professional Services Agreement – Work Order Type SS 2017 – Workplace Investigations Page 3 of 11 performance of the Professional's obligations under this Agreement. Such payment shall be the Professional's sole right and remedy for such termination. 7. Work Quality, Document Ownership and Insurance. a. The Professional shall be responsible for the professional quality, accuracy, timely completion and the coordination of all Work rendered by the Professional. b. In the course of performing any Work hereunder, the Professional may prepare or revise documents that are transmitted electronically to the City or at the City’s written direction certain third parties. The Professional will not be responsible and shall have no liability for any consequences whatsoever arising out of or resulting from a document that is modified by the City or a third party after it has left the Professional’s control. c. All documents, electronic communications or other tangible evidence obtained by the Professional in the course of all Work under this Agreement is deemed the property of the City. All documents, materials, notes or electronic materials created by Professional during any investigation performed hereunder will be provided to the City or its designated legal counsel upon completion. d. All City-supplied materials and all investigation materials and reports (“City Material”) are the property of the City. The City is entitled, upon written request, to any files in Professional’s possession relating to any Work performed under this Agreement, and other documents reasonably necessary to the City’s representation, subject to Professional’s right to make copies of any files withdrawn by the City. e. The Professional’s document retention policy is to destroy files ten (10) years after the matter is closed, unless the City makes other prior arrangements with the Professional. The City is obligated to keep the Professional informed of current address/contact information for as long as the Professional retains materials related to any City Work Order. After ten (10) years, consistent with all applicable rules of professional conduct, the Professional will destroy City files without further notice unless the City instructs the Professional to return such files to the City at or before that time. f. The Professional shall indemnify, save and hold harmless the City its officers and employees, in accordance with Colorado law, from all damages whatsoever claimed by third parties against the City and for the City's costs and reasonable attorney’s fees arising directly or indirectly out of the Professional's negligent performance of any of the services furnished under this Agreement. g. The Professional shall maintain insurance in accordance with Exhibit B, consisting of one (1) page, attached hereto and incorporated herein. The Professional shall notify the City immediately in writing in the event the required DocuSign Envelope ID: 2D66D7BB-0221-4CF9-AB3A-B739A595D0D6 Professional Services Agreement – Work Order Type SS 2017 – Workplace Investigations Page 4 of 11 insurance coverage is no longer in place. The Professional’s obligation pursuant to this section shall continue during the entire period that any liability may arise and these obligations shall survive the expiration or termination of this Agreement. Nothing in this section shall limit any greater obligation imposed upon the Professional by law. h. The Professional will treat as strictly confidential all information and evidence related to any investigation performed hereunder. The Professional will not disclose information or evidence related to any City Work to any third party, unless requested in writing by the City or is compelled to do so by legal process. The Professional will promptly notify the City and/or its legal counsel of any third party request of demand for such confidential information. The Professional shall adhere to the provisions of Exhibit C - Confidentiality, consisting of one (1) page, attached hereto and incorporated herein by this reference. 8. Conflicts of Interest. An important issue continually analyzed by the Professional during any client engagement is whether an ethical conflict of interest is created by the Professional’s performance of work under any City Work Order. In the event either the City or the Professional become aware of a potential conflict at any time, the parties agree to collaborate to identify and resolve any concerns in accordance with the Rules of Professional Conduct. 9. Compensation. In consideration of services to be performed pursuant to this Agreement, the City agrees to pay the Professional on a time and reimbursable direct cost basis as follows: a. The hourly rate for the Work including, but not limited to, document reviews, interview preparation, conducting and documenting interviews, and preparing Investigation Reports is $200 per hour. b. The hourly rate for investigator’s travel time for up to two hours in a day is $100 per hour, after which the investigation hourly rate of $200 per hour applies. c. Where the Professional’s participation is later sought or required in the course of litigation, administrative process or other appeal, the City will be billed at the investigation hourly rate of $200 per hour. d. The City agrees to be billed directly for all Work under this Agreement and agrees to make payment of all undisputed invoices within thirty (30) days of receipt. Where the duration of any Work Order exceeds one (1) calendar month, the Professional may invoice monthly for Work performed. 10. City Representative. The City will designate, prior to commencement of the Work, its project representative who shall make, within the scope of his or her authority, all necessary and proper decisions with reference to the project. All requests for contract interpretations, change orders, and other clarification or instruction shall be directed to the DocuSign Envelope ID: 2D66D7BB-0221-4CF9-AB3A-B739A595D0D6 Professional Services Agreement – Work Order Type SS 2017 – Workplace Investigations Page 5 of 11 City Representative. 11. Independent Contractor. The services to be performed by the Professional are those of an independent contractor and not of an employee of the City of Fort Collins. The City shall not be responsible for withholding any portion of the Professional's compensation hereunder for the payment of FICA, Workers' Compensation, other taxes or benefits or for any other purpose. 12. Subcontractors. The Professional may not subcontract any of the Work set forth in the Exhibit A, Statement of Work without the prior written consent of the city, which shall not be unreasonably withheld. If any of the Work is subcontracted hereunder (with the consent of the City), then the following provisions shall apply: (a) the subcontractor must be a reputable, qualified firm with an established record of successful performance in its respective trade performing identical or substantially similar work, (b) the subcontractor will be required to comply with all applicable terms of this Agreement, (c) the subcontract will not create any contractual relationship between any such subcontractor and the City, nor will it obligate the City to pay or see to the payment of any subcontractor, and (d) the Work of the subcontractor will be subject to inspection by the City to the same extent as the Work of the Professional. The Professional shall require all subcontractors performing Work hereunder to maintain insurance coverage naming the City as an additional insured under this Agreement of the type and with the limits specified within Exhibit B, consisting of one (1) page attached hereto and incorporated herein by this reference. The Professional shall maintain a copy of each subcontract’s certificate evidencing the required insurance. Upon request, the Professional shall promptly provide the City with a copy of such certificate(s). 13. Personal Services. It is understood that the City enters into this Agreement based on the special abilities of the Professional and that this Agreement shall be considered as an agreement for personal services. Accordingly, the Professional shall neither assign any responsibilities nor delegate any duties arising under this Agreement without the prior written consent of the City. 14. Acceptance Not Waiver. The City's approval of drawings, designs, plans, specifications, reports, and incidental work or materials furnished hereunder shall not in any way relieve the Professional of responsibility for the quality or technical accuracy of the Work. The City's approval or acceptance of, or payment for, any of the services shall not be construed to operate as a waiver of any rights or benefits provided to the City under this Agreement. 15. Default. Each and every term and condition hereof shall be deemed to be a material element of this Agreement. In the event either party should fail or refuse to perform according to the terms of this Agreement, such party may be declared in default. DocuSign Envelope ID: 2D66D7BB-0221-4CF9-AB3A-B739A595D0D6 Professional Services Agreement – Work Order Type SS 2017 – Workplace Investigations Page 6 of 11 16. Remedies. In the event a party has been declared in default, such defaulting party shall be allowed a period of ten (10) days within which to cure said default. In the event the default remains uncorrected, the party declaring default may elect to (a) terminate the Agreement and seek damages; (b) treat the Agreement as continuing and require specific performance; or (c) avail himself of any other remedy at law or equity. If the non- defaulting party commences legal or equitable actions against the defaulting party, the defaulting party shall be liable to the non-defaulting party for the non-defaulting party's reasonable attorney fees and costs incurred because of the default. 17. Binding Effect. This writing, together with the exhibits hereto, constitutes the entire Agreement between the parties and shall be binding upon said parties, their officers, employees, agents and assigns and shall inure to the benefit of the respective survivors, heirs, personal representatives, successors and assigns of said parties. 18. Law/Severability. The laws of the State of Colorado shall govern the construction, interpretation, execution and enforcement of this Agreement. In the event any provision of this Agreement shall be held invalid or unenforceable by any court of competent jurisdiction, such holding shall not invalidate or render unenforceable any other provision of this Agreement. 19. Prohibition Against Employing Illegal Aliens. Pursuant to Section 8-17.5-101, C.R.S., et. seq., the Professional represents and agrees that: a. As of the date of this Agreement: 1. The Professional does not knowingly employ or contract with an illegal alien who will perform work under this Agreement; and 2. The Professional 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. The Professional 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. The Professional 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 the Professional obtains actual knowledge that a subcontractor performing work under this Agreement knowingly employs or contracts with an illegal alien, the Professional shall: DocuSign Envelope ID: 2D66D7BB-0221-4CF9-AB3A-B739A595D0D6 Professional Services Agreement – Work Order Type SS 2017 – Workplace Investigations Page 7 of 11 1. Notify such subcontractor and the City within three days that the Professional 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 the Professional 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. The Professional 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 the Professional 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, the Professional shall be liable for actual and consequential damages to the City arising out of the Professional’s violation of Subsection 8-17.5-102, C.R.S. g. The City will notify the Office of the Secretary of State if Professional violates this provision of this Agreement and the City terminates the Agreement for such breach. 20. Order of Precedence. In the event of a conflict between the Agreement and any Work Order, the terms of this Agreement shall take precedence. DocuSign Envelope ID: 2D66D7BB-0221-4CF9-AB3A-B739A595D0D6 Professional Services Agreement – Work Order Type SS 2017 – Workplace Investigations Page 8 of 11 THE CITY OF FORT COLLINS, COLORADO By: Gerry Paul Purchasing Director Date: ATTEST: APPROVED AS TO FORM: EMPLOYMENT MATTERS LLC FLYNN INVESTIGATIONS GROUP By: Printed: Title: CORPORATE PRESIDENT OR VICE PRESIDENT Date: DocuSign Envelope ID: 2D66D7BB-0221-4CF9-AB3A-B739A595D0D6 2/7/2017 Mark Flynn Corporate President Assistant City Attorney 2/7/2017 City Clerk Professional Services Agreement – Work Order Type SS 2017 – Workplace Investigations Page 9 of 11 EXHIBIT A WORK ORDER FORM PURSUANT TO AN AGREEMENT BETWEEN THE CITY OF FORT COLLINS AND DATED: Work Order Number: Purchase Order Number: Project Title: Commencement Date: Completion Date: Maximum Fee: (time and reimbursable direct costs): Project Description: Scope of Services: The Professional agrees to perform the services identified above and on the attached forms in accordance with the terms and conditions contained herein and in the Professional Services Agreement between the parties. In the event of a conflict between or ambiguity in the terms of the Professional Services Agreement and this Work Order (including the attached forms) the Professional Services Agreement shall control. The attached forms consisting of ___ (_) pages are hereby accepted and incorporated herein, by this reference, and Notice to Proceed is hereby given. PROFESSIONAL By:_______________________________ Date:_____________________________ CITY OF FORT COLLINS By:_________________________________ Project Manager Date: ______________________________ By: _______________________________ Gerry Paul Purchasing Director (over $60,000.00) Date: ____________________________ DocuSign Envelope ID: 2D66D7BB-0221-4CF9-AB3A-B739A595D0D6 Professional Services Agreement – Work Order Type SS 2017 – Workplace Investigations Page 10 of 11 EXHIBIT B INSURANCE REQUIREMENTS 1. The Professional 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 Professional 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 reduce coverage or limits and will not be cancelled, except after thirty (30) 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 Professional, 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 Professional under this Agreement. The City, its officers, agents and employees shall be named as additional insureds on the Professional '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 Professional shall maintain during the life of this Agreement for all of the Professional'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 Professional 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 Professional 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: 2D66D7BB-0221-4CF9-AB3A-B739A595D0D6 Professional Services Agreement – Work Order Type SS 2017 – Workplace Investigations Page 11 of 11 EXHIBIT C CONFIDENTIALITY IN CONNECTION WITH SERVICES provided to the City of Fort Collins (the “City”) pursuant to this Agreement (the “Agreement”), the Professional hereby acknowledges that it has been informed that the City has established policies and procedures with regard to the handling of confidential information and other sensitive materials. In consideration of access to certain information, data and material (hereinafter individually and collectively, regardless of nature, referred to as “information”) that are the property of and/or relate to the City or its employees, customers or suppliers, which access is related to the performance of services that the Professional has agreed to perform, the Professional hereby acknowledges and agrees as follows: That information that has or will come into its possession or knowledge in connection with the performance of services for the City may be confidential and/or proprietary. The Professional agrees to treat as confidential (a) all information that is owned by the City, or that relates to the business of the City, or that is used by the City in carrying on business, (b) all information obtained by Professional through or as part of its work for the City, and (c) all information that is proprietary to a third party (including but not limited to customers and suppliers of the City). The Professional shall not disclose any such information to any person except as authorized by the City representative. Further, the Professional shall not use such information to obtain any economic or other benefit for itself, or any third party, except as specifically authorized by the City. The foregoing to the contrary notwithstanding, the Professional understands that it shall have no obligation under this Agreement with respect to information and material that is required by law, regulation or court order to be disclosed, provided that the request for such disclosure is proper and the disclosure does not exceed that which is required. In the event of any disclosure, the Professional shall furnish a copy of this Agreement to anyone to whom it is required to make such disclosure and shall promptly advise the City in writing of each such disclosure. In the event that the Professional ceases to perform services for the City, or the City so requests for any reason, the Professional shall promptly return to the City any and all information described hereinabove, including all copies, notes and/or summaries (handwritten or mechanically produced) thereof, in its possession or control or as to which it otherwise has access. The Professional understands and agrees that the City’s remedies at law for a breach of the Professional’s obligations under this Confidentiality Agreement may be inadequate and that the City shall, in the event of any such breach, be entitled to seek equitable relief (including without limitation preliminary and permanent injunctive relief and specific performance) in addition to all other remedies provided hereunder or available at law. DocuSign Envelope ID: 2D66D7BB-0221-4CF9-AB3A-B739A595D0D6 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 POLICY PRO- 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) 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) 2/7/2017 ISU Insurance Services of Colorado, Inc. 950 17th Street, Suite 1000 Denver CO 80202-2819 Jennifer Wilke (303)534-2133 (303)892-5579 jwilke@isuinsurance.com Employment Matters, LLC 8937 E. 35th Avenue Denver CO 80238 Liberty Mutual 41785 Ohio Security Insurance Company Pinnacol Assurance Co 41190 Hiscox CL1711113239 A X X X BKS56654251 11/9/2016 11/9/2017 1,000,000 300,000 15,000 1,000,000 2,000,000 2,000,000 Hired Auto 1,000,000 B X X BAS56654251 5/20/2016 5/20/2016 1,000,000 C 4183236 6/1/2016 6/1/2017 1,000,000 1,000,000 1,000,000 D Professional Liability MPL157320115 5/20/2016 5/20/2017 1,000,000 Jennifer Wilke/JW City of Fort Collins 215 North Mason Street Fort Collins, CO 80524 DocuSign Envelope ID: 2D66D7BB-0221-4CF9-AB3A-B739A595D0D6