Loading...
HomeMy WebLinkAbout20-31 Agmt with New IPT, Inc. St. Vrain Injection Well 03-11-2020RESOLUTION N0.20-31 A RESOLUTION OF THE BOARD OF TRUSTEES OF THE TOWN OF FIRESTONE, COLORADO, APPROVING A PROFESSIONAL SERVICES AGREEMENT BETWEEN THE TOWN OF FIRESTONE AND NEW IPT, INC., REGARDING THE ST. VRAIN WATER TREATMENT INJECTION WELL PROJECT WHEREAS, construction of the Town of Firestone's ("Town") St. Vrain Water Treatment Plant requires the design and construction of an injection well; and WHEREAS, the Town is thus in need of engineering services for the development of a drilling plan, on -site personnel to oversee, coordinate and direct drilling of the well and design of the injection pump facility, such duties referred to collectively as the St. Vrain Water Treatment Injection Well Project ("Project"); and WHEREAS, the Town requested proposals and selected New IPT, Inc., as the most qualified and responsive bidder to provide the required Project services. NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF TRUSTEES OF THE TOWN OF FIRESTONE, COLORADO: The Professional Services Agreement between the Town of Firestone and New IPT, Inc., for engineering services regarding the development, oversight, coordination of a drilling plan and facility design services for the St. Wain Water Treatment Injection Well Project, is approved in substantially the same form as the copy attached hereto and made a part of this resolution and the Mayor is authorized to execute the Agreement on behalf of the Town. INTRODUCED, READ AND ADOPTED thisl lth day of March, 2020. ATTEST: T�\N� '�Qh�UfVTY � C'ov Town Attorney 1 I�/ MUMI, L AGREEMENT FOR PROFESSIONAL SERVICES THIS AGREEMENT FOR PROFESSIONAL SERVICES (the "Agreement") is made and entered into this 11th day of March, 2020 (the "Effective Date"), by and between the Town of Firestone, a Colorado municipal corporation with an address of 151 Grant Avenue, P.O. Box 100, Firestone, Colorado 80520 (the "Town"), and New IPT, Inc., an independent contractor with a inci prpal place of business at 1707 Cole Blvd., Suite 200, Golden, Colorado 80401 ("Contractor") each a "Party" and collectively the "Parties"). WHEREAS, the Town requires professional services; and WHEREAS, Contractor has held itself out to the Town as having the requisite expertise and experience to perform the required professional services. NOW, THEREFORE, for the consideration hereinafter set forth, the receipt and sufficiency of which are hereby acknowledged, the Parties agree as follows; I. SCOPE OF SERVICES A. Contractor shall furnish all labor required for the complete and prompt execution and performance of all duties, obligations, and responsibilities which are described or reasonably implied from the Scope of Services set forth in Exhibit A, attached hereto and incorporated herein by this reference and known as; Schedule A). B. A change in the Scope of Services shall not be effective unless authorized as an amendment to this Agreement. If Contractor proceeds without such written authorization, Contractor shall be deemed to have waived any claim for additional compensation, including a claim based on the theory of unjust enrichment, quantum merit or implied contract. Except as expressly provided herein, no agent, employee, or representative of the Town is authorized to modify any term of this Agreement, either directly or implied by a course of action. II. TERM AND TERMINATION A. This Agreement shall commence on the Effective Date, and shall continue until Contractor completes the Scope of Services to the satisfaction of the Town, or until terminated as provided herein. B, Either Party may terminate this Agreement upon 30 days advance written notice. The Town shall pay Contractor for all work previously authorized and completed prior to the date of termination. If, however, Contractor has substantially or materially breached this Agreement, the Town shall have any remedy or right of set-off available at law and equity, III. COMPENSATION Inconsideration for the completion of the Scope of Services by Contractor, the Town shall pay Contractor $362,000.00, This amount shall include all fees, costs and expenses incurred by Contractor, and no additional amounts shall be paid by the Town for such fees, costs and expenses. Contractor may submit periodic invoices, which shall be paid by the Town within 30 days of receipt. IV. PROFESSIONAL RESPONSIBILITY A. Contractor hereby warrants that it is qualified to assume the responsibilities and render the services described herein and has all requisite corporate authority and professional licenses in good standing, required by law. The work performed by Contractor shall be in accordance with generally accepted professional practices and the level of competency presently maintained by other practicing professional firms in the same or similar type of work in the applicable community. The services to be performed by Contractor hereunder shall be done in compliance with applicable laws, ordinances, rules and regulations. B. The Town's review, approval or acceptance of, or payment for any services shall not be construed to operate as a waiver of any rights under this Agreement or of any cause of action arising out of the performance of this Agreement. C. Because the Town has hired Contractor for its professional expertise, Contractor agrees not to employ subcontractors to perform any work except as expressly set forth in the Scope of Services. V. OWNERSHIP Any materials, items, and work specified in the Scope of Services, and any and all related documentation and materials provided or developed by Contractor shall be exclusively owned by the Town. Contractor expressly acknowledges and agrees that all work performed under the Scope of Services constitutes a "work made for hire." To the extent, if at all, that it does not constitute a "work made for hire," Contractor hereby transfers, sells, and assigns to the Town all of its right, title, and interest in such work. The Town may, with respect to all or any portion of such work, use, publish, display, reproduce, distribute, destroy, alter, retouch, modify, adapt, translate, or change such work without providing notice to or receiving consent from Contractor. VI. INDEPENDENT CONTRACTOR Contractor is an independent contractor. Notwithstanding any other provision of this Agreement, all personnel assigned by Contractor to perform work under the terms of this Agreement shall be, and remain at all times, employees or agents of Contractor for all purposes. Contractor shall make no representation that it is a Town employee for any purposes. VII. INSURANCE A. Contractor agrees to procure and maintain, at its own cost, a policy or policies of insurance sufficient to insure against all liability, claims, demands, and other obligations assumed by Contractor pursuant to this Agreement. At a minimum, Contractor shall procure and maintain, and shall cause any subcontractor to procure and maintain, the insurance coverages listed below, with forms and insurers acceptable to the Town. 1. Worker's Compensation insurance as required bylaw. 2. Commercial General Liability insurance with minimum combined single limits of $1,000,000 each occurrence and $2,000,000 general aggregate. The policy shall be applicable to all premises and operations, and shall include coverage for bodily injury, broad form property damage, personal injury (including coverage for contractual and employee acts), blanket contractual, products, and completed operations. The policy shall contain a severability of interests provision, and shall include the Town and the Town's officers, employees, and contractors as additional insureds. No additional insured endorsement shall contain any exclusion for bodily injury or property damage arising from completed operations. 3. Professional liability insurance with minimum limits of $1,000,000 each claim and $2,000,000 general aggregate. B. Such insurance shall be in addition to any other insurance requirements imposed by law. The coverages afforded under the policies shall not be canceled, terminated or materially changed without at least 30 days prior written notice to the Town. In the case of any claims -made policy, the necessary retroactive dates and extended reporting periods shall be procured to maintain such continuous coverage. Any insurance carried by the Town, its officers, its employees or its contractors shall be excess and not contributory insurance to that provided by Contractor. Contractor shall be solely responsible for any deductible losses under any policy. C. Contractor shall provide to the Town a certificate of insurance as evidence that the required policies are in full force and effect. The certificate shall identify this Agreement. VIII. INDEMNIFICATION A. Contractor agrees to indemnify and hold harmless the Town and its officers, insurers, volunteers, representative, agents, employees, heirs and assigns from and against all claims, liability, damages, losses, expenses and demands, including attorney fees, on account of injury, loss, or damage, including without limitation claims arising from bodily injury, personal injury, sickness, disease, death, property loss or damage, or any other loss of any kind whatsoever, which arise out of or are in any manner connected with this Agreement if such injury, loss, or damage is caused in whole or in part by, the act, omission, error, professional error, mistake, negligence, or other fault of Contractor, any subcontractor of Contractor, or any officer, employee, representative, or agent of Contractor, or which arise out of a worker's compensation claim of any employee of Contractor or of any employee of any subcontractor of Contractor. Contractor's liability under this indemnification provision shall be to the fullest extent of, but shall not exceed, that amount represented by the degree or percentage of negligence or fault attributable to Contractor, any subcontractor of Contractor, or any officer, employee, representative, or agent of Contractor or of any subcontractor of Contractor. Be If Contractor is providing architectural, engineering, surveying or other design services under this Agreement, the extent of Contractor's obligation to indemnify and hold harmless the Town may be determined only after Contractor's liability or fault has been determined by adjudication, alternative dispute resolution or otherwise resolved by mutual agreement between the Parties, as provided by C.R.S. § 13-50.5-102(8)(c). C. Town to the extent permitted bylaw, agrees to indemnify and hold harmless Contractor and its officers, insurers, volunteers, representative, agents, employees, heirs and assigns from and against all claims, liability, damages, losses, expenses and demands, including attorney fees, on account of injury, loss, or damage, including without limitation claims arising from bodily injury, personal injury, sickness, disease, death, property loss or damage, or any other loss of any kind whatsoever, which arise out of or are in any manner connected with this Agreement if such injury, loss, or damage is caused in whole or in part by, the act, omission, error, professional error, mistake, negligence, or other fault of Town, any subcontractor of Town, or any officer, employee, representative, or agent of Town, or which arise out of a worker's compensation claim of any employee of Town or of any employee of any subcontractor of Town. Town's liability under this indemnification provision shall be to the fullest extent of, but shall not exceed, that amount represented by the degree or percentage of negligence or fault attributable to Town, any subcontractor of Town, or any officer, employee, representative, or agent of Town or of any subcontractor of Town. R. Notwithstanding any other provision in this agreement, Town to the extent permitted by law, agrees to defend, indemnify, hold harmless and release Contractor from and against all losses arising from or related to (1) damage to or impairment of a well or reservoir, regardless of fault, or (ii) the well site or operations thereon, including any pollution or discharges, spills, releases or the presence of wastes, petroleum or petroleum products (including crude oil or any fraction thereof), hazardous substances, pollutants and/or contaminants on, in, under, or from any property or equipment owned, operated, leased or provided by any member of company group, including, without limitation, any such losses arising out of, resulting from or alleged to have resulted from any drilling, extraction, hydraulic fracturing or other well -related activities, regardless of fault. E. Consequential damages. Neither party shall be liable to the other, and each party hereby waives and releases all claims against the other, for general, special, punitive, exemplary, indirect, incidental or consequential damages arising from or out of this agreement, including without limitation, loss of revenue, profit or use of capital, business interruptions, production delays, loss of product, resevoir loss or damage, losses resulting from failure to meet other contractual commitments or deadlines, and downtime of facilities, however same may be caused. IX. ILLEGAL ALIENS A. Certification. By entering into this Agreement, Contractor hereby certifies that, at the time of this certification, it does not knowingly employ or contract with an illegal alien who will perform work under this Agreement and that Contractor will participate in either the &Verify Program administered by the United States Department of Homeland Security and Social Security Administration or the Department Program administered by the Colorado Department of Labor and Employment to confirm the employment eligibility of all employees who are newly hired to perform work under this Agreement. Be Prohibited Acts. Contractor shall not knowingly employ or contract with an illegal alien to perform work under this Agreement, or enter into a contract with a subcontractor that fails to certify to Contractor that the subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this Agreement. C. Verification. 1. If Contractor has employees, Contractor has confirmed the employment eligibility of ail employees who are newly hired to perform work under this Agreement through participation in either the E-Verify Program or the Department Program, 2. Contractor shall not use the E-Verify Program or Department Program procedures to undertake pre -employment screening of job applicants while this Agreement is being performed. 3. If Contractor obtains actual knowledge that a subcontractor performing work under this Agreement knowingly employs or contracts with an illegal alien who is performing work under this Agreement, Contractor shall: notify the subcontractor and the Town within 3 days that Contractor has actual knowledge that the subcontractor is employing or contracting with an illegal alien who Is performing work under this Agreement; and terminate the subcontract with the subcontractor if within 3 days of receiving the notice required pursuant to subsection 1 hereof, the subcontractor does not stop employing or contracting with the illegal alien who is performing work under this Agreement; except that Contractor shall not terminate the subcontract if during such 3 days the subcontractor provides information to establish that the subcontractor has not knowingly employed or contracted with an illegal alien who is performing work under this Agreement. D. Duty to Comply with Investigations. Contractor shall comply with any reasonable request by the Colorado Department of Labor and Employment made in the course of an investigation conducted pursuant to C.R.S. § &17.5-102(5)(a) to ensure that Contractor is complying with the terms of this Agreement. E. Affidavits, If Contractor does not have employees, Contractor shall sign the "No Employee Affidavit" attached hereto. If Contractor wishes to verify the lawful presence of newly hired employees who perform work under the Agreement via the Department Program, Contractor shall sign the "Department Program Affidavit" attached hereto. X. MISCELLANEOUS A. Governing Law and Venue. This Agreement shall be governed by the laws of the State of Colorado, and any legal action concerning the provisions hereof shall be brought in Weld County, Colorado. B. No Waiver. Delays in enforcement or the waiver of any one or more defaults or breaches of this Agreement by the Town shall not constitute a waiver of any of the other terms or obligation of this Agreement. C. Integration, This Agreement constitutes the entire agreement between the Parties, superseding all prior oral or written communications. D. Third Parties. There are no intended third -party beneficiaries to this Agreement. E. Notice. Any notice under this Agreement shall be in writing, and shall be deemed sufficient when directly presented or sent pre -paid, first class United States Mail to the Party at the address set forth on the first page of this Agreement. F. Severability. If any provision of this Agreement is found by a court of competent jurisdiction to be unlawful or unenforceable for any reason, the remaining provisions hereof shall remain in full force and effect. G. Modification. This Agreement may only be modified upon written agreement of the Parties. H. Assignment. Neither this Agreement nor any of the rights or obligations of the Parties shall be assigned by either Party without the written consent of the other. I. Governmental Immunity. The Town and its officers; attorneys and employees, are relying on, and do not waive or intend to waive by any provision of this Agreement, the monetary limitations or any other rights, immunities or protections provided by the Colorado Governmental Immunity Act, C.R.S. § 24-10-101, et seq., as amended, or otherwise available to the Town and its officers, attorneys or employees. J. Rights and Remedies. The rights and remedies of the Town under this Agreement are in addition to any other rights and remedies provided by law. The expiration of this Agreement shall in no way limit the Town's legal or equitable remedies, or the period in which such remedies may be asserted, for work negligently or defectively performed. K. Subject to Annual Appropriation. Consistent with Article X, § 20 of the Colorado Constitution, any financial obligation of the Town not performed during the current fiscal year is subject to annual appropriation, shall extend only to monies currently appropriated, and shall not constitute a mandatory charge, requirement, debt or liability beyond the current fiscal year. L. Representative Authority. Each person signing this Agreement represents and warrants that he or she is duly authorized and has the legal capacity to execute the Agreement. IN WITNESS WHEREOF, the Parties have executed this Agreement as of the Effective Date, ATTEST: .� Koenig, Town Clerk AS TO F k� ��rO�.�N °'� � � �� � O � v,�rY'.,Go�o i, Town Attorney By: OF i Sindelar, Mayor IE� COLORADO Managing Director, Brian Ervine NO EMPLOYEE AFFIDAVIT To be completed only if Contractor has no employees 1. Check and complete one: ❑ I, , am Cl sole proprietor doing business as I do not currently employ any individuals. Should I employ any employees during the term of my Agreement with the Town of Firestone (the "Town"), I certify that I will comply with the lawful presence verification requirements outlined in that Agreement. Ce7� ❑ I, am the sole owner/memberishareholder of a [specify type of entity — i.e., corporation, limited liability company], that does not currently employ any individuals. Should I employ any individuals during the term of my Agreement with the Town, I certify that I will comply with the lawful presence verification requirements outlined in that Agreement. 2. Check one. ❑ I am a United States citizen or legal permanent resident. The Town must verify this statement by reviewing one of the following items: ■ A valid Colorado driver's license or a Colorado identification card; ■ A United States military card or a military dependent's identification card, ■ A United States Coast Guard Merchant Mariner card; ■ A Native American tribal document; ■ In the case of a resident of another state, the driver's license or state -issued identification card from the state of residence, if that state requires the applicant to prove lawful presence prior to the issuance of the identification card; or ■ Any other documents or combination of documents listed in the Town's "Acceptable Documents for Lawful Presence Verification" chart that prove both Contractor's citizenship/lawful presence and identity. OR ❑ I am otherwise lawfully present in the United States pursuant to federal law. Contractor must verify this statement through the federal Systematic Alien Verification of Entitlement ("SAVE') program, and provide such verification fo the Town. Signature Date DEPARTMENT PROGRAM AFFIDAVIT To be completed only if Contractor parlicfpates fn the Department of labor Lawful Presence Vercation Program public contractor under contract with the Town of Firestone (the "Town"), hereby affirm that: 1. I have examined or will examine the legal work status of all employees who are newly hired for employment to perform work under this public contract for services ("Agreement") with the Town within 20 days after such hiring date, 2. I have retained or will retain file copies of all documents required by 8 U.S.C. § 1324a, which verify the employment eligibility and identity of newly hired employees who perform work under this Agreement; and 3. I have not and will not alter or falsify the identification documents for my newly hired employees who perform work under this Agreement, Signature Date STATE OF COLORADO ) ss. COUNTY OF ) The foregoing instrument was subscribed, sworn to (or affirmed) before me this _ day of _, 2020, by as of My commission expires: (SEAL) Notary Public EXHIBIT A SCOPE OF SERVICES Contractor's Duties During the term of this Agreement, Contractor shall perform the following duties, as directed by the Town: • Schedule A Contractor's Deliverables In performance of the duties described above, Contractor shall deliver the following items to the Town, during the timeframes established by the Town: • As described in Schedule A Works Orders 2020-01 through 2020-05 SCHEDULE A (Attached to and made part of the Agreement between Town of Firestone and New IPT, Inc. dated March 11, 2020) IPT Project Name: Town of Firestone SWD #1, Task: Drilling Engineering (Work Order 2020-01) $175,000 in the 2020 budget Work Order 2020-1 is for the development of a detailed drilling plan, management of drilling logistics, and subsequent analysis as follows: Subpart O1: Development of a well Basis of Design (BOD) including offset well and bit analysis, expected days -vs -depth curve, detailed casing and cementing design, recommended vendor determination, expected performance analysis, determination of quality objectives, and determination of contractor key performance indicators (KPIs). This subpart also includes an authority -for -expenditure (AFE) and client meeting. Subpart 02: Drilling Engineering including issuance of request for quotes (RFQs), evaluation, and award. Additionally, this subpart includes review of any special issues arising during drilling. Subpart 03: Drilling Engineering Detailed Drilling Plan with operational procedures including detailed drilling fluids, cementing, bit program, emergency response plan, and wellhead and operational checklists. This subpart includes all documentation required for onsite operations. Subpart 04: Drill the Well on Paper (DWOP) meeting including all relevant contractors and the client, held approximately two weeks prior to moving in the drilling rig. Subpart O5: nsite Prespud Meeting, held on location just prior to spud. Subpart 05: Drilling Engineering End of Well Reports which includes consolidation of all reports and logs subsequent to drng, an as -built wellbore diagram, performance assessment of objectives, and KPIs. This subpart includes a client meeting to review. The budget for 2020-01 is $175,000 and is estimated to be incurred over the period from September 2020 through December 2020. The project will be billed twice a month beginning in September through December in $21,875 installments. IPT Project Name: Town of Firestone SWD #1, Task: Drilling and Completions Operations Management (Work Order 2020-02) $4,000 in the 2020 budget Work Order 2020-02 is for drilling and completions operations management including daily field support, morning calls, and operations engineering support. The budget for 2020-02 is $4,000 to be billed as a lump sum when the well is spudded. The spud date is anticipated to be in November 2020. IPT Project Name: Town of Firestone SWD #1, Task: Completion Engineering (Work Order 2020-03) $15,000 in the 2020 budget or Order number 2020-03 is for completions engineering work including development of completion programs, issuance of RFQs, evaluation and award, end of well report and as -built wellbore diagram. The budget for 2020-03 is $15,000 to be billed as a lump sum prior to the start of well completion operations. This project is anticipated to be completed by December 31, 2020. IPT Project Name: Town of Firestone SWD #l, Task: Drilling Wellsite Supervision (Work Order 2020-04) $78,000 in the 2020 budget Work Order 2020-04 is for drilling wellsite supervision with two on -site personnel to oversee, coordinate, and direct activities during the drilling of the well. The budget for 2020-04 is $78,000 to be billed at $3,900 per day. This project is anticipated to commence in November 2020 and be completed by the end of December 2020 and will be invoiced every two weeks. IPT Project Name: Town of Firestone SWD #1, Task: Injection Facility Design (Work Order 2020-05) $90,000 in the 2020 budget Work Order 2020-OS is for the injection pump facility design including design, RFQs, bid analysis, award, and final construction documents. This also includes costs of obtaining grading, excavating and stormwater plans necessary to obtain the relevant permits. The budget for 2020-05 is $90,000 to be billed at $225 per hour. This project will commence in March 2020 and go through December 2020 and will be invoiced every two weeks. The additional work orders below are fof• fiscal veal• 2021 and will require separate appf•oval by the Town of Firestone Board of Trc{stees. IPT Project Name: Town of Firestone SWD #1, Task: Facilities Commissioning (Work Order 2021-01) $5,000 in the 2021 budget Work Order 2021-01 is for engineering and field supervision necessary to monitor installation and commissioning of the injection pump facility. The budget for 2021-01 is $5,000 to be billed at $225 per hour. This project will be delivered during 2021 and invoiced every two weeks. IPT Project Name: Town of Firestone SWD #1, Task: Completion Supervision (Work Order 2021-02) $40,000 in the 2021 budget Work Order 2021-02 is for completions supervision with on -site personnel to oversee, coordinate and direct activities during the well completion. The budget for 2021-02 is $40,000 to be billed at $2,000 per day. This project is anticipated to commence in January 2021 and complete in May 2021 and will be invoiced every two weeks. DATE (MM/DD/YWY) CERTIFICATE OF LIABILITY INSURANCE 3/l/2021 3/10/2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Lockton Companies CONTACT 8110 E Union Avenue PHONE FAX A/C No Ext : A/C No): Suite 700 E-MAIL Denver CO 80237 ADDRESS: (303) 414-6000 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Liberty Mutual Fire Insurance Comnanv 23035 INSURED NeW 1PT, Ine. 1337799 1707 Cole Boulevard, Suite 200 Golden, CO 80401 COVERAGES WAyzr�zI wsuRER c :Indian Harbor Insurance Com an 36940 INSURER D : Lloyds of London 38253 CERTIFICATE NUMBER: 1 r;F3R179 E: RFVISInN NIIMRFR ------ ------ 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 INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYW POLICY EXP MM/DD/YYW LIMITS C X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR Y N US00083117LI20A 3/1/2020 3/1/2021 EACH OCCURRENCE $ 1 000000 DAMAGE TO RENTED PREMISES Ea occurrence $ 501000 X Deductible $50 000 MED EXP (Any one person) $ 5,000 X Cent Poll Lmt $ 1 M PERSONAL &ADV INJURY $ 1 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 210001000 X POLICY ❑ JECT LOC PRODUCTS - COMP/OP AGG $ 210005000 OTHER: $ A AUTOMOBILE LIABILITY N N AS2641445429020 3/l/2020 3/1/2021 COMBINED SINGLE LIMIT Ea accident $ 1 MON BODILY INJURY (Per person) $ XXXXXXX ANY AUTO I OWNED SCHED AUTOS ONLY AUTOSULED BODILY INJURY (Per accident) $ XXXXXXX HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $XXXXXXX $XXXXXXX C UMBRELLA LIAB N OCCUR N N US000831 I8L20A 3/1/2020 3/1/2021 EACH OCCURRENCE $ 710001000 X' EXCESS LIAB CLAIMS -MADE AGGREGATE $ 710001000 DED I I RETENTION $ $ XXXXXXX B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? N / A N WC7641445429010 3/1/2020 3/l/2021 X, PER STATUTE OTH- ER E.L. EACH ACCIDENT $ 1 NUN (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 11000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 D ProfLiab/Claims Made N N B0621PINTE008120 3/1/2020 3/l/2021 $1,000,000 Per Claim $2,000,000 Agg DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Town of Firestone, its officers, its employees and contractors are included as Additional Insured as respects General Liability if required by written contract. Where allowed by law and if required by written contract, General Liability insurance is primary and non-contributory subject to the terms and conditions of the policies carried. Professional Liability (various retroactive dates)- Limits below $IMM have a retro date of 12/31/1999 and Limits above $1MM has a retro date of 3/1/2011. CERTIFICATE HOLDER 16638179 Town of Firestone PO BOX 100 Firestone, CO 80520 151 Grant Avenue CANCELLA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHOR2ED ©1988-20 ACORD CORPU'i2ATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD