Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
HomeMy WebLinkAboutC12-063 Ace Equipment & Supply Company AGREEMENT BETWEEN EAGLE COUNTY AND ACE EQUIPMENT & SUPPLY COMPANY
THIS AGREEMENT is made this OILL day of �: ' , 2012, by and between Eagle County
( "County "), and, Ace Equipment & Supply Company ( "Contractor "), a Colorado corporation with a principal
place of business at 9660 Dallas Street, Henderson, Colorado 80640.
WHEREAS, County desires to inspect and maintain the vehicle lifts at the Maintenance Service Center (the
"Facility ").
WHEREAS, Contractor is authorized to do business in the State of Colorado, has experience and expertise
necessary to provide said product and/or services to County; and
WHEREAS, County and Contractor intend by this Agreement to set forth the scope of the responsibilities of
Contractor in connection with the services and related terms and conditions to govern the relationship between
Contractor and County in connection with this Agreement.
NOW, THEREFORE, in consideration of the foregoing premises and the following promises, County and
Contractor agree as follows:
ARTICLE 1 WORK
1.1 Contractor agrees to provide all services, labor, personnel and materials to perform and complete the
inspection and minor site repair services set forth in Exhibit A (hereinafter "Services" or "Work ") which is
attached hereto and incorporated by this reference. Contractor and will use its expertise, skill to perform the
Services.
ARTICLE 2 — COUNTY'S REPRESENTATIVE
2.1 The Facilities Management Department designee, shall be Contractor's contact with respect to this
Agreement and the performance of the Services.
ARTICLE 3 — TERM OF AGREEMENT
3.1 This Agreement shall commence upon execution of this Agreement by both parties, and, subject to the
provisions of Article 11 hereof, shall continue in full force and effect until the Services are satisfactorily
completed in accordance with the terms of this Agreement.
3.2 The term of this Agreement may be extended for up to three additional term years or modified and the
scope of Services may be changed upon a written amendment to this Agreement signed by both parties.
ARTICLE 4 — COMPENSATION
4.1 For the Services to be provided hereunder, County will pay Contractor two thousand five hundred fifty
dollars ($2,550.00). In the event Contractor and County agree upon the need for additional maintenance or
repair services beyond the lift inspections described in Exhibit A, those services shall be billed at a rate of $105
per hour, plus material costs. Total compensation under this Agreement shall not exceed seven thousand five
hundred fifty dollars ($7,550) without a written amendment to this Agreement. In the event of any conflict
between the contents of this Agreement and Exhibit A, this Agreement shall control.
4.2 Payment will be made for Services satisfactorily performed within thirty (30) days of receipt of a proper
and accurate invoice from Contractor respecting the Services. The invoice shall include a description of
1
services performed. Upon request, Contractor shall provide County with such other supporting information as
County may request.
4.3 County will not withhold any taxes from monies paid to the Contractor hereunder and Contractor agrees
to be solely responsible for the accurate reporting and payment of any taxes related to payments made pursuant
to the terms of this Agreement.
4.4 Notwithstanding anything to the contrary contained in this Agreement, no charges shall be made to the
County nor shall any payment be made to the Contractor in excess of the amount for any Services done without
the written approval in accordance with a budget adopted by the Board in accordance with provisions of the
Colorado Revised Statutes. Moreover, the parties agree that the County is a governmental entity and that all
obligations beyond the current fiscal year are subject to funds being budgeted and appropriated.
ARTICLE 5 CONTRACTOR'S REPRESENTATIONS
In order to induce County to enter into this Agreement, Contractor makes the following representations:
5.1 Contractor has familiarized itself with the nature and extent of the Services to be provided hereunder,
the Facility, and with all local conditions, and federal, state, and local laws, ordinances, rules and regulations
that in any manner affect cost, progress, or performance of the Services.
5.2 Contractor will make, or cause to be made, examinations, investigations, and tests as he deems
necessary for the performance of the Services.
5.4 To the extent possible, Contractor has correlated the results of all such observations, examinations,
investigations, tests, reports, and data with the terms and conditions of this Agreement.
5.5 To the extent possible Contractor, has given County written notice of all conflicts, errors, or
discrepancies that he has discovered in the Agreement.
5.6 Contractor will be responsible for provision of the Services and shall perform the Services m a skillful,
professional and competent manner and in accordance with the standard of care, skill and diligence applicable
to lift maintenance and repair. Further, in rendering the Services, Contractor shall comply with the highest
standards of customer service to the public. Contractor shall provide appropriate supervision of its employees
to ensure the Services are performed in accordance with this Agreement.
ARTICLE 6 — ENTIRE AGREEMENT
6.1 This Agreement represents the entire Agreement between the parties hereto. There are no Contract
Documents other than this Agreement and Exhibits A and B. The Agreement may only be altered, amended, or
repealed in writing.
ARTICLE 7 — MISCELLANEOUS
7.1 No assignment by a party hereto of any rights under, or interests in the Agreement will be binding on
another party hereto without the written consent of the party sought to be bound; and specifically, but without
limitation, moneys that may become due and moneys that are due may not be assigned without such consent
(except to the extent that the effect of this restriction may be limited by law), and unless specifically stated to
the contrary in any written consent to an assignment, no assignment will release or discharge the assignor from
any duty or responsibility under the Agreement.
2
7.2 County and Contractor each binds itself, its partners, successors, assigns and legal representatives to the
other party hereto, in respect to all covenants, agreements, and obligations contained in this Agreement.
7.3 Notwithstanding anything to the contrary contained in this Agreement, County shall have no obligations
under this Agreement after, nor shall any payments be made to Contractor in respect of any period after
December 31 without an appropriation therefore by County in accordance with a budget adopted by the Board
of County Commissioners in compliance with Article 25, Title 30 of the Colorado Revised Statutes, the Local
Government Budget Law (C.R.S. § 29 -1 -101 et seq.) and the TABOR Amendment (Colorado Constitution,
Article X, Sec. 20).
7.4 Provision Mandated by C.R.S. § 8- 17.5 -101 et seq. PROHIBITIONS ON PUBLIC CONTRACT FOR
SERVICES
7.4.1 If Contractor has any employees or subcontractors, Contractor shall comply with C.R.S. § 8- 17.5 -101, et
seq., regarding Illegal Aliens — Public Contracts for Services, and this Contract. By execution of this Contract,
Contractor certifies that it does not knowingly employ or contract with an illegal alien who will perform under
this Contract and that Contractor will participate in the E -verify Program or other Department of Labor and
Employment program ( "Department Program ") in order to confirm the eligibility of all employees who are
newly hired for employment to perform Services under this Contract.
7.4.2 Contractor shall not:
(i) Knowingly employ or contract with an illegal alien to perform work under this contract for
services; or
(ii) Enter into a contract with a subcontractor that fails to certify to the Contractor that the
subcontractor shall not knowingly employ or contract with an illegal alien to perform work under
the public contract for services.
7.4.3 Contractor has confirmed the employment eligibility of all employees who are newly hired for
employment to perform work under this Contract through participation in the E -verify Program or Department
Program, as administered by the United States Department of Homeland Security. Information on applying for
the E -verify program can be found at:
http: / /www.dhs.gov /xprevprot/programs /gc 1185221678150.shtm
7.4.4 The Contractor shall not use either the E -verify program or other Department Program procedures to
undertake pre - employment screening of job applicants while the public contract for services is being performed.
7.4.5 If the Contractor obtains actual knowledge that a subcontractor performing work under the public
contract for services knowingly employs or contracts with an illegal alien, the Contractor shall be required to:
(i) Notify the subcontractor and the County within three days that the Contractor has actual
knowledge that the subcontractor is employing or contracting with an illegal alien; and
(ii) Terminate the subcontract with the subcontractor if within three days of receiving the notice
required pursuant to subparagraph (i) of the paragraph (D) the subcontractor does not stop
employing or contracting with the illegal alien; except that the Contractor 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.
3
7.4.6 The Contractor shall comply with any reasonable request by the Department of Labor and Employment
made in the course of an investigation that the department is undertaking pursuant to its authority established in
C.R.S. § 8 -17.5- 102(5).
7.4.7 If a Contractor violates these prohibitions, the County may terminate the contract for a breach of the
contract. If the contract is so terminated specifically for a breach of this provision of this Contract, the
Contractor shall be liable for actual and consequential damages to the County as required by law.
7.4.8 The County will notify the office of the Colorado Secretary of State if Contractor violates this provision
of this Contract and the County terminates the Contract for such breach.
7.5 Invalidity or unenforceability of any provision of this Agreement shall not affect the other provisions
hereof, and this Agreement shall be construed as if such invalid or unenforceable provision was omitted.
7.6 Contractor acknowledges that County has entered into this Agreement in reliance upon the particular
reputation and expertise of Contractor. Contractor shall not enter into any sub - consultant or sub - contractor
agreements for the performance of any of the Services or without County's prior written consent, which may be
withheld in County's sole discretion. County shall have the right in its reasonable discretion to approve all
personnel assigned to perform the Work and no personnel to whom County has an objection, in its reasonable
discretion, shall be assigned. Contractor shall require each sub - consultant or sub - contractor, as approved by
County and to the extent of the Services to be performed by the sub - consultant or sub - contractor, to be bound to
Contractor by the terms of this Agreement, and to assume toward Contractor all the obligations and
responsibilities which Contractor, by this Agreement, assumes toward County.
ARTICLE 8 - JURISDICTION AND VENUE:
8.1 This Agreement shall be interpreted in accordance with the laws of the State of Colorado and the parties
hereby agree to submit to the jurisdiction of the courts thereof. Venue shall be in the Fifth Judicial District for
the State of Colorado.
8.2 In the event of litigation between the parties hereto regarding the interpretation of this Agreement, or the
obligations, duties or rights of the parties hereunder, or if suit otherwise is brought to recover damages for
breach of this Agreement, or an action be brought for injunction or specific performance, then and in such
events, the prevailing party shall recover all reasonable costs incurred with regard to such litigation, including
reasonable attorney's fees.
ARTICLE 9 - INDEMNIFICATION:
9.1 The Contractor shall indemnify and hold harmless County and any of its officers, agents and employees
against any losses, claims, damages or liabilities for which County or any of its officers, agents, or employees
may become subject to, insofar as any such losses, claims, damages or liabilities arise out of, directly or
indirectly, this Agreement, or are based upon any performance or nonperformance by Contractor or any of its
subcontractors hereunder; and Contractor shall reimburse County for any and all attorney fees and costs, legal
and other expenses incurred by County in connection with investigating or defending any such loss, claim,
damage, liability or action. This indemnification shall not apply to claims by third parties against the County to
the extent that the County is solely liable to such third party for such claims without regard to the involvement
of the Contractor.
4
ARTICLE 10 - OWNERSHIP OF DOCUMENTS AND MATERIALS:
10.1 All documents (including electronic files) and materials which are obtained during, purchased or
prepared in the performance of the Services shall remain the property of the County and are to be delivered to
County before final payment is made to Contractor or upon earlier termination of this Agreement.
ARTICLE 11 - TERMINATION:
11.1 County may terminate this Agreement, in whole or in part, for any reason, at any time, with or without
cause. Any such termination shall be effected by delivery to Contractor of a written notice of termination
specifying the date upon which termination becomes effective. In such event, Contractor shall be compensated
for all Services satisfactorily completed up to the date of termination for such Services.
ARTICLE 12 — NOTICE
12.1 Any notice required under this Agreement shall be personally delivered, mailed in the United States
mail, first class postage prepaid, or sent via facsimile provided an original is also promptly delivered to the
appropriate party at the following addresses:
The County: Eagle County Facilities Management
P.O. Box 850
Eagle, Colorado 81631
(970) 328 -8786 (p)
(970) 328 -8899 (f)
and a copy to: Eagle County Attorney
P.O. Box 850
Eagle, Colorado 81631
(970) 328 -8685 (p)
(970) 328 -8699 (f)
The Contractor: Ace Equipment & Supply Company
9660 Dallas Street
Henderson, CO 80640
(303) 288 -2916 (p)
(303) 288 -5609 (f)
12.2 Notices shall be deemed given on the date of delivery; on the date a FAX is transmitted and confirmed
received or, if transmitted after normal business hours, on the next business day after transmission, provided
that a paper copy is mailed the same date; or three days after the date of deposit, first class postage prepaid, in
an official depositary of the U.S. Postal Service.
ARTICLE 13 — INDEPENDENT CONTRACTOR
13.1 It is expressly acknowledged and understood by the parties hereto that nothing contained in this
Agreement shall result in, or be construed as establishing, an employment relationship between County and
Contractor or County and Contractor's employees. Contractor and its employees shall be, and shall perform as,
independent contractors. No officer, agent, subcontractor, employee, or servant of Contractor shall be, or shall
be deemed to be, the employee, agent or servant of County. Contractor shall be solely and entirely responsible
for the means and methods to carry out the Services under this Agreement and for Contractor's acts and for the
acts of its officers, agents, employees, and servants during the performance of this Agreement. Neither
5
Contractor nor its officers, agents, subcontractors, employees or servants may represent, act, purport to act or be
deemed the agent, representative, employee or servant of County.
ARTICLE 14 — INSURANCE REOUIREMENTS
14.1 At all times during the term of this Agreement, Contractor shall maintain insurance on its own behalf in
the following minimum amounts:
14.1.1 Workmen's Compensation, disability benefits, and other similar employee benefit acts, with coverage
and in amounts as required by the laws of the State of Colorado.
14.1.2 Comprehensive Automobile Insurance shall be carried in the amount of $1,000,000 for bodily injury and
$1,000,000 for property damage, each occurrence. All liability and property damage insurance required
hereunder shall be Comprehensive General and Automobile Bodily Injury and Property Damage form of policy.
14.1.3 Comprehensive liability and property damage insurance issued to and covering Contractor and any
subcontractor with respect to all Work performed under this Agreement and shall also name County as an
additional insured, in the following minimum amounts:
Bodily Injury Liability:
Each Person: $1,000,000
Each Accident or Occurrence: $1,000,000
Property Damage Liability:
Each Accident or Occurrence: $1,000,000
14.2 Contractor shall purchase and maintain such insurance as required above and the certificate of insurance
is attached hereto as Exhibit B.
/ /Signature page to follow //
6
IN WITNESS WHEREOF, the parties hereto have executed this Agreement the day and year first above
written.
COUNTY OF EAGLE, STATE OF
COLORADO, by its County Manager
By:
Keith Montag
CONTRACTOR:
Ace Equip, ent & Supply Company
B g' / ' i s , /11/ /r �
ler
Title; P 6/ .V7
CONTRACTOR IS REQUIRED TO HAVE ITS SIGNATURE NOTARIZED
STATE OFr z,z, )
�,,/' ) ss.
COUNTY OF�d:.f ,�/� 9'
The foregoing instrument was acknowledged before me byligii,'r ,,Q & )QC; , of
4, this 30 `.day of vl i u.c. , 2012.
My c • i f A ,. -
•.,?
0g6
7
•
CC' "lee Egaittmott & Se404 eo
9660 DALLAS STREET — HENDERSON, CO 80640
800 - 435 -4266 / 303 - 288 -2916 / 303 - 288 -5609 (FAX)
Serving the Rocky Mountain Region Since 1949
QUOTATION / SALES CONTRACT
TO: DATE: January 26, 2012
Eagle County Facilities Management QUOTE #: 12 -012602LB
3289 Cooley Mesa Road TERMS: Net 30
Gypsum, CO 81637 F.O.B.: Eagle, CO
DELIVERY: As Req'd
VALID FOR: Per Contract
ATTN: Ron Siebert, Facilities P.M.
RE: Lift Inspections PHONE: 970 - 328 -8881
FAX: 970 -328 -3539
EMAIL: Ron.siebertteaglecounty.us
WE ARE PLEASED TO QUOTE YOU AS FOLLOWS:
ITEM DESCRIPTION QTY UNIT UNIT PRICE TOTAL
Semi- annual Lift Inspection, includes:
(4) Heavy duty @ $150.00 /ea.
(2) Light Duty @ $75.00 /ea.
1 (1) Trip Charge @ $525.00 /ea. 2 LS $1,275.00 $2,550.00
NOTE: PRICES QUOTED INCLUDE DISCOUNT FOR CASH (NON - CREDIT CARD) TOTAL $2,550.00
COMMENTS: Semi - annual lift inspection includes lift inspections and minor onsite repairs/adjustments
at time of inspection.
Additional maintenance or repair services beyond those described above, will be billed at a rate of $105.00 per
hour, plus material costs.
Any alteration or deviation from the above specifics will become an extra charge over and above the estimate. Units quoted from stock are offered
subject to prior sale. Prices quoted do not include any state or local taxes and such taxes (If any) shall be paid by the purchaser in
addition to the quoted price. All deposits are non - refundable. Delivery quoted is based on the date of this quotation and subject to any delay
encountered in receiving a firm order and to other factors beyond our control. Warranty on above listed material, including new machines, parts
and supplies, is limited to that as provided by the manufacturers, copies of which are available upon request. It is understood that the seller shall
not be held responsible for any accident or damage resulting directly or indirectly from the above material and /or equipment. In the event of non-
payment of all or part of the amount due to Ace Equipment, Ace Equipment shall be entitled to payment of its attorneys fees and costs incurred in
the collection process, together with interest at the rate of 18% per annum from and after the payment due date. It is expressly agreed that any
property fumished by Ace Equipment, shall be and remains personal property, and the ownership and title to same is hereby retained by Ace
Equipment, and shall not pass to the purchaser, until total charges for labor, services, materials and equipment have been paid. Fax signatures
shall operate the same as original documents. These terms are applicable to all initial and subsequent work. It is understood that there are no
verbal agreements or understandings, which in any manner conflict with the written terms of this quotation.
AUTHORIZATION
Submitted By: Lawrence G. Booco Accepted By:
Signature: Signature:
Title: Pres. Title: Mania
Date: 01/26/2012 Date:
•
ACORD CERTIFICATE OF LIABILITY INSURANCE DA". (MMIDWYY)
' INSURANCE 01/27/12
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
FEDERATED MUTUAL INSURANCE COMPANY HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Home Office: P.O. Box 328 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Owatonna, MN 55060 COMPANIES AFFORDING COVERAGE
Phone: 1-888-333-4949
iArlY FEDERATED MUTUAL INSURANCE COMPANY OR
A FEDERATED SERVICE INSURANCE COMPANY
INSURED 302-610-1
ACE EQUIPMENT & SUPPLY CO INC
9660 DALLAS ST
HENDERSON CO 80640 COMT
12()MITANY
------
COVERAGES
H !S is 10 CERTIFY THAT 111E 0011CIES Of INSURANCE LISTED 8110W HAVE BEEN ISSUED 10 THE INSURED NAMED ABOVE' FOR THL POLICY PERIOD
INDICATED, NO T1-VITHS1ANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICFI THIS
C1 1111E1CA TE MAY BE ISSUED 00 MAY PERTAIN, 1 INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN. 10 SUBJECT 10 Al I THE TERMS,
1XCI USIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY fAID CLAIMS
CO POLICY EFFECTIVE , POLICY EXPIRATION
TYPE OF INSURANCE POLICY NUMBER IMIT S
LI R DATE (MM/DOTYY DA E IMMTDDIYYT
GIN! HAL LIABILI I Y 'TT .,T). 1,1)1 T T 2,000,000
X Lii1101 I)", .1)T "): . - 1) T01 2,000,000
A AIM!, VA, X 640793 03/01/11 03/01/12 1.11,F 1.000,000
, `. 01 S I 1
I' • 100,000
Ai' Y r,r 5,000
AUTOMOBILE LIABILI I Y
X C 1,000,000
A 640793 03/01/11 03/01/12
X
X
' •
0000111 101311 117
I 'it 1. AL.1C 111
1,11.1
ACt
001-11 1,0
I XCI SS L !ABM 1 Y FACT , L ) VT"! ") 2,000.000
A X I A ,P(.1 640796 03/01/11 03/01/12 .'.c,6» 2,000,000
, 1 1 I IAN ,) T TTiTm
001-103 130 COMPENSA I ION AND
L MP) 003 RS LIABILITY
1 Comp
1
of SCRIP rioN ()PIRA 1 ONS,LOCA 1 IONS.VEHICI IS SPECIAI ITEMS S
I CERTIFICATE HOLDER CANCELLATION
EAGLE COUNTY FACI L 1 IES 36 SHOULD ANY OF 1111 ABOVE DESCRIBI 11 POT ICI( S CANCELJED 131 TOM 1111
I
MANAGEMENT I XPIRAIION DAIL I HEREOF. THE ISSUING COMPANY WILL ENDEAVOR 10 MAll
3289 COOLEY MESA RD 10 DAYS WRI I 1113 NO 1101 TO 131 Cl HIll 0011 001 DER NAMED 10 111-1 ELI I
GYPSUM CO 81637 BUT FAILURE 10 MAR SUCH NO EICI SHAI I IMPOSE NO OBLIGATION OR 1101311 II
OF ANY KIND UPON 1341 COMPANY. 10 0GEN1S OR REPRESFN t A I IVI S
AU T HORIIED REPRESENT AT !VI
,
ACORD 25-$ (1/95) 0 AC OR EMBIT
• 1 •
• • . 1i;) •
ACORD., CERTIFICATE OF LIABILITY INSURANCE DATE(MM /DD/YYYY)
01/27/2012
PRODUCER
Pinnacol Assurance THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY
7501 E Lowry Blvd AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
Denver, CO 80230 -7006 CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE
COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Pinnacol Assurance 41190
Ace Equipment & Supply Co Inc
9660 Dallas Street INSURER B:
Henderson, CO 80640 -8451 INSURER C:
INSURER D:
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDNG
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMMENT 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 ADD'L POLICY EFFECTIVE POLICY EXPIRATION
LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE(MM /DDIYYYY) DATE(MMIDD/YYYY) LIMITS
GENERAL LIABILITY EACH OCCURRENCE —
COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED
1 CLAIMS MADE El OCCUR PREMISES _
MED EXP(Any one person)
_ PERSONAL & ADV INJURY
GEN'L AGGREGATE LIMIT APPLIERS PER: GENERAL AGGREGATE
POLICY PROJECT LOC
PRODUCTS - COMP/OP AGG
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
ANY AUTO (Ea Accident) _
ALL OWNED AUTOS BODILY INJURY
SCHEDULED AUTOS (Per person)
HIRED AUTOS BODILY INJURY
NON -OWNED AUTOS (Per accident)
PROPERTY DAMAGE
(Per accident)
_ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT
_ ANY AUTO OTHER THAN EA ACC
AUTO ONLY: AGG
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE _
OCCUR 111 CLAIMS MADE AGGREGATE
DEDUCTIBLE _
RETENTION $ I I
WORKERS COMPENSATION AND X WC STATU- I OTHER
—
A EMPLOYER'S LIABILITY LLLJJJ
ANY PROPRIETOR/PARTNER /EXECUTIVE 4087727 01/01/2012 01/01/2013 TORYLIMITS
E.L EACH ACCIDENT $1,000,000
OFFICER/MEMBER EXCLUDED?
E.L DISEASE - EA EMPLOYEE $1,000,000
If yes, please descdbe under SPECIAL PROVISIONS below
E.L DISEASE - POLICY LIMIT $1,000,000
OTHER
DESCRIPTION OF OPERATIONS /LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS
CERTIFICATE HOLDER CANCELLATION
1360334 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Eagle County Facilities Management THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
Attn: Ron Siebert MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
3289 Cooley Mesa Road LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
Gypsum, CO 81637 LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
Sean Vis
ACORD 25(2001/08) Underwriter ACORD CORPORATION 1988