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HomeMy WebLinkAboutC14-392 Spectrum Interiors, LLC AGREEMENT FOR ON-CALL SERVICES BETWEEN EAGLE COUNTY,COLORADO AND SPECTRUM INTERIORS,LLC THIS AGREEMENT("Agreement")is effective as of the LG' 1--day of October,2014 by and between Spectrum Interiors LLC a Colorado limited liability company(hereinafter"Contractor"))and Eagle County,Col rado a bod y corporate and politic(hereinafter"County"). RECITALS WHEREAS,County desires to contract for on-call or as needed construction and repair services for Eagle County owned properties(the"Properties");and WHEREAS,Contractor is authorized to do business in the State of Colorado and has the time,skill,expertise,and experience necessary to provide the Services as defined below in paragraph 1 hereof;and WHEREAS,this Agreement shall govern the relationship between Contractor and County in connection with the Services. AGREEMENT NOW,THEREFORE,in consideration of the foregoing and the following promises Contractor and County agree as follows: 1. Services or Work. Contractor agrees to diligently provide all services,labor,personnel and materials necessary to perform and complete the on-call services or work at the rates set forth in Exhibit A and in accordance with a formal proposal for each on-call service to be provided by Contractor and approved by County in writing ("Services"or"Work").Exhibit A is attached hereto and incorporated herein by reference.The Services shall be performed in accordance with the provisions and conditions of this Agreement and shall include the provision of materials("materials")of County's choice,the installation of said materials,and the replacement and repair of the Properties.Installation services shall include removal and disposal of existing materials and replacement with the purchased materials. a. Contractor agrees to furnish the Services in accordance with the schedule established in each proposal approved by County. If no completion date is specified,then Contractor agrees to furnish the Services in a timely and expeditious manner consistent with the applicable standard of care. By signing below,Contractor represents that it has the expertise and personnel necessary to properly and timely perform the Services. b. In the event of any conflict or inconsistency between the terms and conditions set forth in Exhibit A any formal proposal received from Contractor and the terms and conditions set forth in this Agreement,the terms and conditions set forth in this Agreement shall prevail. c. County shall have the right to inspect all Work and materials prior to acceptance.Inspection and acceptance shall not be unreasonably delayed or refused.In the event County does not accept the materials for any reason in its sole discretion,then Contractor shall upon County's request and at no charge or cost to County i)take the materials back,ii)exchange,or iii)repair the materials. 2. County's Representative. The Facilities Management Department's designee shall be Contractor's contact with respect to this Agreement and performance of the Services. 3. Term of the Agreement. This Agreement shall commence upon the date first written above,and subject to the provisions of paragraph 11 hereof,shall continue in full force and effect for a period of one year. 4. Extension or Modification. This Agreement may be extended for up to three,additional one year terms upon written agreement of the parties.Any amendments or modifications shall be in writing signed by both parties. No additional services or work performed by Contractor shall be the basis for additional'compensation unless and until Contractor has obtained written authorization and acknowledgement by County for such additional services in accordance with County's internal policies. Accordingly,no course of conduct or dealings between the parties,nor verbal change orders,express or implied acceptance of alterations or additions to the Services,and no claim that County has been unjustly enriched by any additional services,whether or not there is in fact any such unjust enrichment,shall be the basis of any increase in the compensation payable hereunder.In the event that written authorization and acknowledgment by County for such additional services is not timely executed and issued in strict accordance with this Agreement,Contractor's rights with respect to such additional services shall be deemed waived and such failure shall result in non-payment for such additional services or work performed. 5. Compensation. County shall compensate Contractor for the performance of the Services in accordance with the fee schedule set forth in Exhibit A plus the cost of the materials selected by the County. Prior to commencement of Services at any Property or Properties,Contractor shall first provide County with a written estimate which shall include an estimate of the labor,materials without any mark up and any additional costs necessary to perform the Services at a particular Property or Properties. Each estimate must be approved by County's Representative prior to commencement of the Services by Contractor and all rates shall be in accordance with the fee schedule set forth in Exhibit A. Total compensation for each individual Service under this Agreement shall not exceed twenty five thousand dollars($25,000)and the Total Compensation under this Agreement shall not exceed one hundred thousand dollars($100,000)without a written amendment executed by the Parties. Contractor shall not be entitled to bill at overtime and/or double time rates for work done outside of normal business hours unless specifically authorized in writing by County. a. Payment will be made for Services satisfactorily performed within thirty(30)days of receipt of a proper and accurate invoice from Contractor. All invoices shall include detail regarding the hours spent,tasks performed,who performed each task and such other detail as County may request. b. If,at any time during the term or after termination or expiration of this Agreement,County reasonably determines that any payment made by County to Contractor was improper because the Services for which payment was made were not performed as set forth in this Agreement,then upon written notice of such determination and request for reimbursement from County,Contractor shall forthwith return such payment(s)to County. Upon termination or expiration of this Agreement,unexpended funds advanced by County,if any,shall forthwith be returned to County. c. 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. d. 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 of any year,without an appropriation therefor 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 2 G:\MAINTENANCE\Service Agreements\Contractor\2014\Spectrum Interiors FINAL.docx Government Budget Law(C.R.S. 29-1-101 et. seq.)and the TABOR Amendment(Colorado Constitution,Article X, Sec.20). 6. Subcontractors. 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 subcontractor agreements for the performance of any of the Services or additional services 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 Services during the performance of this Agreement and no personnel to whom County has an objection,in its reasonable discretion,shall be assigned to the Project. Contractor shall require each subcontractor,as approved by County and to the extent of the Services to be performed by the subcontractor,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. County shall have the right(but not the obligation)to enforce the provisions of this Agreement against any subcontractor hired by Contractor and Contractor shall cooperate in such process.The Contractor shall be responsible for the acts and omissions of its agents,employees and subcontractors. 7. Insurance. Contractor agrees to provide and maintain at Contractor's sole cost and expense,the following insurance coverage with limits of liability not less than those stated below: a. Types of Insurance. i. Workers' Compensation insurance as required by law. ii. The parties acknowledge that there will be limited driving,if any,in connection with the performance of the Services. As a result,auto coverage may be provided through a personal insurance policy covering the driver and vehicle. A copy of such coverage shall be provided as part of Exhibit B. iii. Commercial General Liability coverage to include premises and operations, personal/advertising injury,products/completed operations,broad form property damage with limits of liability not less than$1,000,000 per occurrence and$1,000,000 aggregate limits. b. Other Requirements. i. The automobile and commercial general liability coverage shall be endorsed to include Eagle County,its associated or affiliated entities,its successors and assigns,elected officials,employees,agents and volunteers as additional insureds.A certificate of insurance consistent with the foregoing requirements is attached hereto as Exhibit B. ii. Contractor's certificates of insurance shall include subcontractors,if any as additional insureds under its policies or Contractor shall furnish to County separate certificates and endorsements for each subcontractor. iii. The insurance provisions of this Agreement shall survive expiration or termination hereof. iv. The parties hereto understand and agree that the County is relying on,and does not waive or intend to waive by any provision of this Agreement,the monetary limitations or rights,immunities and protections provided by the Colorado Governmental Immunity Act,as from time to time amended,or otherwise 3 G:\MAINTENANCE\Service Agreements\Contractor\2014\Spectrum Interiors FINAL.docx available to County,its affiliated entities,successors or assigns,its elected officials,employees,agents and volunteers. v. Contractor is not entitled to workers' compensation benefits except as provided by the Contractor,nor to unemployment insurance benefits unless unemployment compensation coverage is provided by Contractor or some other entity. The Contractor is obligated to pay all federal and state income tax on any moneys paid pursuant to this Agreement. 8. Indemnification. 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 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 reasonable 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 County is liable to such third party for such claims without regard to the involvement of the Contractor. This paragraph shall survive expiration or termination hereof. 9. Ownership of Documents. All documents(including electronic files)and materials 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. 10. Notice. Any notice required by this Agreement shall be deemed properly delivered when(i)personally delivered,or(ii)when mailed in the United States mail,first class postage prepaid,or(iii)when delivered by FedEx or other comparable courier service,charges prepaid,to the parties at their respective addresses listed below,or(iv) when sent via facsimile so long as the sending party can provide facsimile machine or other confirmation showing the date,time and receiving facsimile number for the transmission,or(v)when transmitted via e-mail with confirmation of receipt. Either party may change its address for purposes of this paragraph by giving five(5)days prior written notice of such change to the other party. COUNTY: Eagle County,Colorado Attention:Ron Siebert 590 Broadway Post Office Box 850 Eagle,CO 81631 Telephone: 970-328-8881 Facsimile: 970-328-8782 E-Mail:ron.siebert@eaglecounty.us With a copy to: Eagle County Attorney 500 Broadway Post Office Box 850 Eagle,Co 81631 Telephone: 970-328-8685 Facsimile: 970-328-8699 E-Mail: atty @eaglecounty.us 4 G:\MAINTENANCE\Service Agreements\Contractor\2014\Spectrum Interiors FINAL.docx CONTRACTOR: Spectrum Interiors LLC. P.O.Box 1604 Gypsum, Colorado 81637 Telephone: 970-471-0893 Facsimile: 970-524-7696 E-Mail: spectruminteriorsllc @gmail.com 11. Termination. County may terminate this Agreement,in whole or in part,at any time and for any reason, with or without cause,and without penalty therefor with seven(7)calendar days'prior written notice to the Contractor. Upon termination of this Agreement,Contractor shall immediately provide County with all documents as defined in paragraph 9 hereof,in such format as County shall direct and shall return all County owned materials and documents. County shall pay Contractor for Services satisfactorily performed to the date of termination. 12. Venue,Jurisdiction and Applicable Law. Any and all claims,disputes or controversies related to this Agreement,or breach thereof,shall be litigated in the District Court for Eagle County,Colorado,which shall be the sole and exclusive forum for such litigation. This Agreement shall be construed and interpreted under and shall be governed by the laws of the State of Colorado. 13. Execution by Counterparts;Electronic Signatures. This Agreement may be executed in two or more counterparts,each of which shall be deemed an original,but all of which shall constitute one and the same instrument. The parties approve the use of electronic signatures for execution of this Agreement. Only the following two forms of electronic signatures shall be permitted to bind the parties to this Agreement: (i) Electronic or facsimile delivery of a fully executed copy of the signature page; (ii) the image of the signature of an authorized signer inserted onto PDF format documents. All documents must be properly notarized,if applicable. All use of electronic signatures shall be governed by the Uniform Electronic Transactions Act,C.R.S.24-71.3-101 to 121. 14. Other Contract Requirements and Contractor Representations. a. Contractor has familiarized itself with the nature and extent of the Services to be provided hereunder and the Property or Properties,and with all local conditions,federal,state and local laws,ordinances, rules and regulations that in any manner affect cost,progress,or performance of the Services. b. Contractor will make,or cause to be made,examinations,investigations,and tests as he deems necessary for the performance of the Services. c. To the extent possible,Contractor has correlated the results of such observations,examinations, investigations,tests,reports,and data with the terms and conditions of this Agreement. d. To the extent possible,Contractor has given County written notice of all conflicts,errors,or discrepancies. e. Contractor shall be responsible for the completeness and accuracy of the Services and shall correct,at its sole expense,all significant errors and omissions in performance of the Services. The fact that the County has accepted or approved the Services shall not relieve Contractor of any of its responsibilities. Contractor shall perform the Services in a skillful,professional and competent manner and in accordance with the standard of care,skill and diligence applicable to contractors performing similar services. Contractor represents and warrants that it has the expertise and personnel necessary to properly perform the Services and shall comply with the highest standards of customer service to the public. Contractor shall provide appropriate supervision to its employees to 5 G:\MAINTENANCE\Service Agreements\Contractor\2014\Spectrum Interiors FINAL does ensure the Services are performed in accordance with this Agreement.This paragraph shall survive termination of this Agreement. f. Contractor agrees to work in an expeditious manner,within the sound exercise of its judgment and professional standards,in the performance of this Agreement. Time is of the essence with respect to this Agreement. g. This Agreement constitutes an agreement for performance of the Services by Contractor as an independent contractor and not as an employee of County. Nothing contained in this Agreement shall be deemed to create a relationship of employer-employee,master-servant,partnership,joint venture or any other relationship between County and Contractor except that of independent contractor. Contractor shall have no authority to bind County. h. Contractor represents and warrants that at all times in the performance of the Services,Contractor shall comply with any and all applicable laws,codes,rules and regulations. i. This Agreement contains the entire agreement between the parties with respect to the subject matter hereof and supersedes all other agreements or understanding between the parties with respect thereto. j. Contractor shall not assign any portion of this Agreement without the prior written consent of the County. Any attempt to assign this Agreement without such consent shall be void. k. This Agreement shall be binding upon and shall inure to the benefit of the parties hereto and their respective permitted assigns and successors in interest.Enforcement of this Agreement and all rights and obligations hereunder are reserved solely for the parties,and not to any third party. 1. No failure or delay by either party in the exercise of any right hereunder shall constitute a waiver thereof. No waiver of any breach shall be deemed a waiver of any preceding or succeeding breach. m. The invalidity,illegality or unenforceability of any provision of this Agreement shall not affect the validity or enforceability of any other provision hereof. n. The signatories to this Agreement aver to their knowledge no employee of the County has any personal or beneficial interest whatsoever in the Services or Property described in this Agreement.The Contractor has no beneficial interest,direct or indirect,that would conflict in any manner or degree with the performance of the Services and Contractor shall not employ any person having such known interests. o. The Contractor,if a natural person eighteen(18)years of age or older,hereby swears and affirms under penalty of perjury that he or she(i)is a citizen or otherwise lawfully present in the United States pursuant to federal law,(ii)to the extent applicable shall comply with C.R.S. 24-76.5-103 prior to the effective date of this Agreement. 15. Prohibitions on Government Contracts. As used in this Section 15,the term undocumented individual will refer to those individuals from foreign countries not legally within the United States as set forth in C.R.S. 8-17.5-101,et. seq. If Contractor has any employees or subcontractors,Contractor shall comply with C.R.S. 8-17.5-101,et. seq.,and this Agreement. By execution of this Agreement,Contractor certifies that it does not knowingly employ or contract with an undocumented individual who will perform under this Agreement and that Contractor will participate in the E-verify 6 G:\MAINTENANCE\Service Agreements\Contractor\2014\Spectrum Interiors FINAL.docx 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 Agreement. a. Contractor shall not: i. Knowingly employ or contract with an undocumented individual to perform Services under this Agreement;or ii. Enter into a subcontract that fails to certify to Contractor that the subcontractor shall not knowingly employ or contract with an undocumented individual to perform work under the public contract for services. b. Contractor has confirmed the employment eligibility of all employees who are newly hired for employment to perform Services under this Agreement 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 c. 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. d. If Contractor obtains actual knowledge that a subcontractor performing work under the public contract for services knowingly employs or contracts with an undocumented individual,Contractor shall be required to: i. Notify the subcontractor and County within three (3) days that Contractor has actual knowledge that the subcontractor is employing or contracting with an undocumented individual; 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 undocumented individual; except that Contractor shall not terminate the contract with the subcontractor if during such three(3)days the subcontractor provides information to establish that the subcontractor has not knowingly employed or contracted with an undocumented individual. e. 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). f. If Contractor violates these prohibitions, County may terminate the Agreement for breach of contract. If the Agreement is so terminated specifically for breach of this provision of this Agreement, Contractor shall be liable for actual and consequential damages to County as required by law. g. County will notify the Colorado Secretary of State if Contractor violates this provision of this Agreement and County terminates the Agreement for such breach. [REST OF PAGE INTENTIONALLY LEFT BLANK] 7 G:\MAINTENANCE\Service Agreements\Contractor\2014\Spectrum Interiors FINAL.docx IN WITNESS WHEREOF,the parties have executed this Agreement the day and year first set forth above. COUNTY OF EAGLE,STATE OF COLORADO,By and Through Its BOARD OF COUN ' C ii MMISSIONERS 'ci ilL d, eoe..„11i. H.Ryan,Chairm, v Attest: m By: •. *OW Teak J. Simonton,Cl k to the Board CONTRACTO'• Spectrum • ors,LLC B ,,,, : ,4 Print ■ e. la n ,4/ ,,�;/1 i •tle: OU)V1fJ (((�l�! 8 G:\MAINTENANCE\Service Agreements\Contractor\2014\Spectrum Interiors FINALdocx SPECTRUM INTERIORS, LLC CONTRACTOR WORK/PRICE SUBMITTAL Type of Work In-House Subcontract $/hr (Please Check One) Exterior Carpentry/Trim Siding X 45 Trim X 45 Framing X 45 Interior Drywall Framing X 45 Hanging X 45 Finish/Texture X 45 Paint X 45 Tile Demo X 45 Floor Leveling X 45 Floor Tile Installation X 45 Wall Tile Installation X 45 Ceiling Grid and Tiles Installation of Both X 45 Interior Trim Trim Installation X 65 Door/Window Installation X 65 General Labor Rate 45 Demo Labor Rate 30 Markup Materials 0% Subcontract Work 10% Insurance Yes No Can provide required Insurance as provided in attached document X EXHIBIT it A • ® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 7/14/2014 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 James McGalliard Alpine Insurance Agency of Edwards, Inc. PHONE No.Ezt). (970)926-1717 x102 I A/C.Na):(970)926-1722 0225 Main Street, 0-205 E-MAIL ADDRESS: ames @AIAEdwards.com P.O. Box 2240 INSURER(S)AFFORDINGCOVERAGE NAIC# Edwards CO 81632 INsuRERA:Peerless Indemnity Ins CO 18333 INSURED INSURER B:Pinnacol Assurance Spectrum Interiors, LLC. INSURER C: PO Box 1604 INSURERD: INSURER E: Gypsum CO 81637-1604 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1441611760 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 INSR WVD POLICY NUMBER (MM/DD/YYYY) IMM/DD/YYYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES(Eaoccurrence) $ 300,000 A (CLAIMS-MADE © OCCUR X HKS55986948 4/3/2014 4/3/2015 MED EXP(Any one person) $ 15,000 PERSONAL&ADV INJURY_ $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 ii POLICY Ti 1 n LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) _5 _ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED —SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS ( ) — HIRED AUTOS NON-OWNED PROPERTY DAMAGE _ AUTOS (Peraccident) _ $ $ UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ ` EXCESS LIAB CLAIMS-MADE AGGREGATE _ $ DED I I RETENTION$ $ (f B WORKERS COMPENSATION WC STATU- I 10TH- AND EMPLOYERS'LIABILITY Y/1 X TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? I N/A (Mandatory In NH) 4150895 9/1/2013 9/1/2014 E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS f VEHICLES(Attach ACORD 101,AdditIonal Remarks Schedule,If more space Is required) Eagle County, its associated or affiliated entities, its successors and assigns, elected officals, employees, agents and volunteers are automatically listed as Additional Insured IF such status is required in a written contract with the Named Insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Eagle County Government ACCORDANCE WITH THE POLICY PROVISIONS. PO BOX 850 EAGLE, CO 81631 AUTHORIZED REPRESENTATIVE James McGalliard/JDM ACORD 25(2010/05) ©1888-2010 ACORD CORPORATION. -; 'EXHIBIT INS025(201005).01 The ACORD name and logo are registered marks of ACORD Ctiv, I 'Dec Page View-Alan Alpin Page 1 of 2 Alan Alpin Basic Policy Information Policy#: 12838924-9 Term: 06/27/2014- 12/27/2014 Tran Date: 06/27/2014 Tran Type: Renew policy Tran Description: DNLD/Renew policy Policy Type: Private Passenger Auto Business Unit: Division: Division one Department: Eagle- Dept One Primary Service Group: Account Executive:James McGalliard,James @AIAEdwards.com Account Representative: Holly Webster, Holly@alaedwards.com Parent Company: Progressive Insurance Company Writing Company: Progressive Preferred Insurance CO Bill Method/Pay Plan: Direct bill Current Policy Premium: $986.50 Full Term Premium: $986.50 First Named Insured Name: ALAN ALPIN Firm Name: DBA: Dec Name: ALAN ALPIN Address: PO BOX 1604 GYPSUM CO 81637 Business: (970)471-0893 Residence: (970)471-0893 Cell: Fax: Email: Additional Interests Name Type Address Phone Fax Email Interest In Payor Loan/Ref# Description Rank AIR ACADEMY Loss P.O. BOX 62910,COLORADO SPRING, Veh#0001 FCU payee CO,80962 Remarks DIAMOND MEMBERSHIP TOTAL CASH=$000000265.75 UNPD BAL=$000000720.75 EARN PREM=$000000986.50; 9610,06/06; 4884, 10/08; Z445 CO,09/13; Z538, 10/08; Z792 CO, 08/09; 6255,07/11 Lines of Business Private Passenger Auto CLASSIC MIDDLE MARKET Veh #0001 Company Veh #0001: 2003, FORD, F350, Vehicle Premium: $986.50 1FTSW31F73EB03855, 02 Coverages Coverage Limit 1 Limit 2 Ded Type/Amt Stated Amount Premium Bodily injury limit(s) 50,000 100,000 $240.00 Property damage-single limit 50,000 0 $166.00 Uninsured Motorist Liab/BI 50,000 100,000 $53.00 Medical payments 5,000 $35.00 Coverage Options Option Type: PR Comprehensive 500 $176.00 Collision 500 $288.00 OPEXP $28.00 NP4 SD5 Theft Prevention Authority Charge $0.50 Rating Information https://www.ams360.com/v801212/Customer/Policy_Dec_View Printer.aspx?Custld=3clfbef6-3457-4fa... 7/16/2014 Dec Page View-Alan Alpin Page 2 of 2 Territory: 31 Performance: Age Group: Odometer: Symbol: FD Annual Miles: Col Symbol: Comp Symbol: Usage: Pleasure Passive Retraint: Miles One Way: Airbag: Multi Car: Anti-Lock Brakes: Car Pool: Anti-Theft Device: Reg State: CO Anti-Theft%: Garaged: Drivers Driver Lic Good Dry Stdnt Ovr Good Mat # Name DOB Lic# State RelationStatusStdnt Train 100 Dry Dry SSN 0001 ALPIN 10/01/19691 Insured Accidents Violations Med Pay Amt Driver# Violation Description Occ Date Cony Date BI Amt Paid PD Amt Paid Paid 0001 At fault ASW-ACCIDENT 08/20/2012 accident WAIVED 0001 Speeding SPD-SPEEDING 12/08/2012 Usage of Governing Owner of Veh# Year Make Model Driver Usage Driver Used Most Vehicle 0001 2003 FORD F350 ALAN ALPIN Y Y It https://www.ams360.com/v801212/Customer/Policy_Dec_View Printer.aspx?Custld=3clfbef6-3457-4fa... 7/16/2014