No preview available
HomeMy WebLinkAboutC16-058 Solutions Counseling CenterAGREEMENT FOR PROFESSIONAL SERVICES BETWEEN EAGLE COLTNTY, COLORADO AND SOLUTIONS COUNSELING CENTER, LLC THIS AGREEMENT("Agreement") is effective as ofthe a\ - Oay of fa\:. . 2016 by and between Solutions Counseling Center, LLC aColorado limited liability company (hereinafter ooConsultant" or "Contractor") and Eagle County, Colorado, a body corporate and politic (hereinafter "Countt'l. RECITALS WHEREAS, the County, through its Department of Health and Human Services ("IIHS") works to promote the healtlr, safety and welfare of County residents of all ages; and WHEREAS, the County uses outside providers and professionals to enhance the ability of County to promote such healttu safety and welfare; and WHEREAS, County desires to hire Consultant to perform the Services defined below in paragraph WHEREAS, Consultant is ar*horized to do business in the State of Colorado and has the time, skill, expertise, and experience necessary to provide the Services; and WHEREAS, this Agreement shall govern the relationship between Consultant and County in connection with the Services. AGREEMENT NOW, THEREFORE, in consideration of the foregoingand the following promises Consultant and County agree as follows: L Seryices. Consultant agrees to diligentty provide all services, labor, personnel and materials flecessary to perform and complete the services described in Exhibit A ("Services") which is attaehed hereto and inconporated herein by reference. The Services shall be performed in accordance with the provisions and conditions ofthis Agreement' a. Consultant agrees to furnish the Services in accordsnce withthe schedule established in Exhibit A. If no completion date is speoified in Exhibit A, then Consultant agrees to finnishthe Services in a timely and expeditious manner consistent with the applicable standard of care. By sigping below Consultant represents that it has the expertise and personnel necessary to properly and timely perform the Services. Eagle County Commissioners' Office C16-058 b. ln the event ofany conflict or inconsistency between the terrns and conditions set forth in Exhibit 4 and the terms and conditions set forth in this Ageemenl the terms and conditions set forth in this Agreement shall prevail. .. c. Consultant agrees that it will not enter into any consulting or other arrangements with ttitrO parties that will conflict in any manner with the Services. 2. County's.Represe.nt{Sve. The Protection Manager for Children, Family & Adult Services Department's designee shall be Consultant's contact with respect to this Agreement and perforrnance of the Services. 3. Tefm of lhe Aereefi.rSnt. This Agreement shall commence upon ttre date first written above, and subject to the provisions ofparagraph 1 I hereo{, shall continue in full force and effect through the 3 I *t day of May,2017. 4. Extension or Modific?tion. This Agreement may not be amended or supplemented" nor may any obligations hereunder be waived except by agreemer* signed by both parties. No additiornl services or work performed by Consultant shall be the basis for additional compensation unless and until Consultant has obtained witten authorization and acknowledgement by County for such additional services in aocordance with County's inlernal policies. Accordingly, no course of conduct or dealingp betweenthe parties, nor verbal change orders, expr€ss or implied acceptance ofalterafions or additions to the Services, and no claim that County has been unjustly snriched by any additional services, whether or not there is in fact any such u4just enrichment, shall be the basis ofany 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 Consultant'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 Consultant for the performance of the Services in a sum computed and payable as set forth in Exhibil A. The performance of the Services under this Agreement shall not exceed $101000.00. Contractor shall not be entitled to bill at overtime andlor double time rates for work done outside of normal business hours unless specifically authorized in writing by County. a. For reimbursement Contractor must submit invoices monthly. lnvoices shall include a description of $ervices performed. If Counfy is not satisfied with the completeness of a submitted invoice, County may request Contractor to either revise the invoice or provide additional information. Payment will be made for Services satisfactorily perfumed within thirly (30) days of receipt of a proper and accurate invoice. All invoices shall include detail regarding the hours spent tasks performed" who performed each task and such other detail as Cour$y may request. All invoices must be mailed or delivered in-person to the following address to enswe prop€r payment" Invgjcps sent by.fax or e-mail will not be acgepted 2 Eaels Courry HHS ProfServ Final 5ll4 Eagle County Health and Human Services Business Office 550 Broadway Post Office Box 660 Eagle, CO 81631 b- Any out-of-pocket expenses to be incurred by Consultant and reimbursed by County shall be identified on Exhibit A. Out-of-pocket expenses will be reimbursed without any additional mark*up thereon and are included in the not to exceed contract amount set forth above. Out-of-pocket expenses shall not include any payment of salaries, bonuses or other compensation to personnel of Consultant. Consultant shall not be reimbursed for expenses that are not set forth on Exhibit A untess specifically approved in writing by County. c. I{ prior to payment of compensation or reimbursement for Services but after submission to County of a request therefore by Contractor, County reasonably determines that payment as requested would be improper because the Services were not perfonmed as prescribed by the provisions of this Agreement, the County shall have no obligation to make such payment. If, at any time after or duringthe term or ater termination or expiration of this Agreemen! County reasonably determines that any payment theretofore paid 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 reimbwsement from County, Consultant shall forthwithreturn such paymen(s) to Counfy. Upon termination or expiration of this Agreement, unexpended funds advanced by County, if any, shall forthwith be retumed to Countv. d. All funds received by Conhactor under this Agreement shall be or have been expended solely for the purpose for which granted, and any funds not so expended, including funds lost or diverted for other purposes, shall be returned to County. Conkactor shall provide the County with progress repofis upon County's request; or Contractor shall furnish progress reports as more specifically set forth in the attached Exhibit A. e- County will not withhold any taxes fiom monies paid to the Consultant hereunder and Consultant agrees to be solely responsible for the accurate reporting and payment ofany taxes related to payments made pursuant to the terms ofthis Agreement. f. 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 Consultant 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 Comrnissioners in compliance with Article 25,trtle 30 of the Colorado Revised Statutes, the Local Government Budget Law (C.R.S. 2g-l-l0l et. seq.) and the TABOR Amendment (Colorado Constitutiorq Article X, Sec. 20). 6' Sub-consultants. Consultant acknowledges that County has entered intothis Agreement in reliance upon the particular reprdation and expertise ofConsultant. Consultant shall not enter into any sub-consultant agreements for the performance of any of the Services or additional services without 3 Eagle Courty HHS ProfServ Final 5/14 County's prior written consenq which rnay be wittiheld in County's sole dissretion. County shall have the right in its reasonable discretion to approve all personnel assigred to tlre subject project drring the perforrnance of this Agreement and no personnel to whom County has an objection, in its reasonable discretioq shall be assigned to the project. Consultant shall require each sub-consultant as approved by County and to the extent ofthe Services to be performed by the sub-constrltan! to be bound to Consultant by the terms ofthis Agreement, and to assume toward Consultant all the obligations and responsibilities which Consultanl by this Agreement, assumes toward County. County shall have the right (but nd the obligation) to enforce the provisions ofthis Agreement against any sub-consultant hired by Consultant and Consultant shall cooperate in such process. The Contractor shall be responsible for the acts and ornissions ofits agents, employees and sub-consultants or sub-conkactors. 7. Instrance. Consultant agrees to provide and maintain at Consultant's sols cost and expense, tlre following insurance cover&ge with limits of liability not less than those stated below: Types oflnsurance. Workers' Compensation insurance as required by law. Auto coverage as required by law. iii" Commercial General Liability coverage to include premises and operations, personal/advertising i4iury, products/completed operations, broad form property damage with limits of liability not less than $1,000,000 Fr occunence and $2,000,000 aggregate lirnie. This policy shall be endorsed to include coverage for physical/sexual abuse and molestation- iv. Professional liability insurame with prior acts cov€rage for all Services required hereunder, in a form and with an insurer or insurers satisfactory to County, with limits of liability of not less than $ I ,000,000 per claim and $2,000,000 in the aggregate. In the event the professional liability insurance is on a claims-made basis, Consultant wir$ants that any retroactive date under the policy shall precede tlre effsctive date of this Agreement. Continuom coverage will be maintained during any applicable statute of limitations for the Services. v. Intentionally Omitted. b.Other Requirements. The commercial general liability coverage and such other coverage as indicated above shall be endorsedto include Eagle County, its associated or affiliated entities, its successors and assigns, elected officials, employees, agents and volunteers as additional insureds. ii. Consultant's certificates ofinsurance shall include sub-consultants as additional insureds under its policies or Consultant shall finnish to County separate certificates and endorsernents for each sub-consultant. All coverage(s) for sub-consultants shall be subject to the same minimum requirements identified above. Consultant and sub-consultants, if any, shall maintain the foregoing 4 Eagle Cou$y HHS ProfServ Final 5/14 il. coverage in effect until the Services are completed. In addition, all such policies shall be kept in force by Consullant and its sub-consultants until the applicable statute of limitations for the Services has expired. iii' Insurance shall be placed with insurers duly licensed or authorized to do business in the state of colorado and with an "A.M. Best'rating of not less than A-vIl. iv- Consultant's insurance coverage shall be prirnary and non-contributory with respect to all other available sources" Consullant,s policy shall s6ntai, a waiver ofsubrogation against Eagle Counfy. v- All policies must contain an endorsement affording an unqualified thirfy (30) days' notice ofcancellation to coun8 in the event ofcancellation ofcoverage. All insurers must be licensed or approved to do business within the state of Colorado and all policies must be written on a per occuyence basis unless otherwise provided herein. vii. Consultant's certificate ofinsurance evidencing all required coverage(s) is attached hereto as Exhibit B. Upon request, Consultant shall provide a copy ofthe actual insurance poliey and/or required endorsements required under this Agreement within {ive (5) business days of a written request from County, and herebyauthorizes Consultant's broker" without further notice and authorization by Consultant, to immediately comply with any written request of County for a complete copy ofthe policy. viii. Consultant shall advise County in the event the general aggregate or other aggregate limits are reduced below the required per occurrence limit. Consultant, at its own expense, will reinstate the aggregate limits to comply with the minimum limits and shall fumish Countv a new certificate of imurance showing such coverage. ix- If Consultant fails to secure and maintain the insurance required by this Agreement and provide satisfactory evidence thereof to County, Counfy shall be entitled to immediately terminate th is Agreement. x. termination hereof, The imurance provisions of this Agreement shall survive expiration or xi- The parties hereto understand and agree that the County is relying ory and does not waive or intend to waive by any provision ofthis Agreemeng the monetary limitations or rights, immunities and protections provided by the Colorado Governmental Immunity Act, as from time to time amended, or otherwise available to County, its affiliated entities, successors or assigns, its elected officials, employees, agents and volunteers. consultant is not entitled to workers' compensation benefits except as 5 Eagle Courty HHS ProfServFinal 5i 14 xll. provided by the Consultant, nor to unemployment insurance benefits unless unemployment compensation coverage is provided by Consulftnt or somo other entity. The Consultant is obligated to pay all fEderal and state income tax on any moneys paid pursuant to this Agreement. 8. Indemnification The Consultant shall indemnifu and hold harmless County, and any of its officers, agents and ernployees against any losses, clairnso damages or liabilities for which County may become subject to insofar as any such losses, claims, damages or liabilities arise or* of, directly or indirectly, this Agreement, or are based upon any performance or nonperformance by Consultant or any of its sub-consultants hereunder including claims for bodily injtny or personal injury including deatll or loss or damage to tangible or intangible property; and Consultant shall reimburse Counfy for reasonable attorney fees and costs, legal and other exp€nses incurred by County in coryrection with investipting or defending any such loss, clairn, damage, liability or action, This indernnification 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 Consultant. This paragraph shall survive expiration or termination hereof. 9. Ownership of Documents. All documents prepared by Consultant in connection with the Services shall become property of Cotrrty. Consultant shall execute written assignments to County of all rights (including common law, statutory, and other rigtrts, including copyrights) to the same as County shall from time to time request" For purposes of this paragraph, the term'"doouments'n shall mean and include all reports, plans, studies, tape or other electronic recordings, drawings, skefches, estimatesn data sheets, maps and work sheets produccd, or prepared by or for Consultant (including any employee or subcontractor in connection with the performance ofthe Services and additional services under this Agreement). 10. Noticc. 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 prepat{ 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 parly can provide facsimile machins or other confimation showing the date, time and receiving facsimile number for the trarnmission, or (v) when transmitted via e-mail with confirmation of receipt. Either parly may change its address for purposes ofthis paragraph by giving five (5) days prior written notice ofsuch change to the other party. COUNTY: Eagle County, Colorado Attention: Kendra Kleinschmidt, LCSW 500 Broadway Post Of{ice Box 660 Eagle, CO 81631 Telephone : 91 A ^328-8827 Facsimile: 855-848-8E26 E-Mail: Kendra"Schle@eaglecounty.us 6 Bagle Cour*y fIHS Prof Serv Fiml 5/14 with a copy to: Eagle County Attomey 500 Broadway Post Office Box 850 Eagle, Co 81631 Telephone: 970-328-8685 Facsimile: 97 0-328-9699 E-Mai 1: atry@eaglecounty.us CONSULTANT: Solutions Counseling Center, LLC Jean Becker-Sullivan, M.A.. NCC 97 Sunlight Drive DillorL CO E0435 Phone: 97A-406-1547 jean@eanbeckersulli van. corn 1l' Termination- County may terminate this Agreement, in whole or in part, at any time and for any reasorl with or without cause, and without penalty therefor with seven (Z) calendar days, pnor written notice to the Consultant" Upon termination of this Agreemen! Consultant shall immediately provioe county with all documents as defined in paragraph t hereo{ in such format as County shall direct and shall retum all County owned materials and documents. County shall pay Consultant for Services satisfactorily performed to the date of termination. 12. Venue. Jrnisdiction and Appliqablg Lpw. Any and all claims, disputes or controversies related to this Agreement or breach thereof, shall be litigated in the District Court for Eagle Cornrty, 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 tbe laws ofthe state ofcolorado. 13, This Agreement may be executed in two or mole counterparts, each of which shall be deemed an original, but all of which shall constitute one and the same instrument' The parties approve t}te use of electronic signatrnes 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 ofthe signature page; (ii) the image of the sigrrature 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 Efectronic Transactions Act, C.R.S. 24-71.3-l0t to l2l. 14. Other Contract Requirements. a' In rendering the Services hereunder, Contractor shall comply with the highest standards of customer service to the public. Contractor shall provide appropria|e supervision of its employees to ersure the maintenance ofthese high standards ofcustomer service and professionalism are maintained. The performance of such obligation shall be determined at the sole discretion of County- In the event 7 Eagle County IIHS ProfServ Final 5/14 County finds these standards of customer service are not being met by Coutractor, County may terminate this Agreement, in whole or in part, upon soven (7) days' notice to Contractor. b. Consultant shall be responsible for the completeness and accuacy of the Services, including all supporting data or other documsnts Fepared or compiled in perfbrmance of the Services, and shall eorrec! at its sole expsnse, all significant errors and omissions therein. The fact that the County has accepted or approved the Servicbs shall not relieve Consultant ofany ofits responsibilities. Consultant shall perform the Services in a skillful, professional and cornpetent manner and in accordance with the standard of care, skill and diligence applicable to Consultants performing similar services. This paragraph shall survive termination of this Agreement" c. Consultant reprssents and warrants that it has the expertise and personnel necessary to properly perform the Services and covenants that its professional personnel are duly licensed to perform the Services within Colorado. d. Consultant agrees to work in an expeditious manner, within the sound exercise of its judgment and professional standards, inthe performance of this Agreement. Time is oftlre essence with respeet to this Agreernent. e. Ttris Agreement constitutes an agreement for performance ofthe Services by Consultant 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 Consultant excep that of independent confactror. Consultant shall havs no authority to bind County. f, Consultant represents and warrants that at all times in the performance of the Services" Consultant shall comply with any and all applicable federal and state laws, codes, rules and regulations. g. Contractor shall comply with the Civil Rights Act of 1964 and Section 504, Rehabilitation Ac't of 1973, concerning discriminalion on the basis of race, color, se& age, religion, political belieft, national origin or handicap. h, This Agreement cor$ains the entire agreement between the parties with respect to the subject matter hereof and supersedes all other agreements or undersknding between the parties with respect thereto. i. Consultant shall not assign any portion of this Agreement without the prior written consent ofthe County. Any attempt to assign this Agreement without such consent shall be void. j. This Agreernent shall be binding upon and shall inure to the benefit ofthe parties hereto and their respective permitted assigns and successors in interest. Enforcement ofthis Agreement arrd all rights and obligations hereunder are reserved solely for the parties, and not to any third parry. 8 Eaglc Cotlrty HHS ProfSery Final 5/14 k. No failure or delay by either parly 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. l. The invalidity, illegality or unenforceability of any provision ofthis Agreement shall not affect the validity or enforceability ofany other provision hereof. m. Comultant shall maintain for a minimum of tfuee years, adequate financial and other records for reporting to County. Consultant shall be subject to financial audit by federal, state or county auditors or their designees. Consultant authorizes such audits and inspections ofrecords during normal business hours, upon 48 hours' notice to Consultant. Consultant shall firlly cooperate during such audit or inspections. 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 Consultant has no beneficial interesf direct or indirect, that would conflict in any manner or degree with the performance of the Services and Consultant shall not employ any person having such known interests. o. The Consultant, if,a natural person eighteen (18) years ofage 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.RS. z4-76.5-rc3 prior to the effective date ofthis Agreement. 15. Prohibitions on Government Contracts. As used in this Section 15, the term undocumented individual will refer to those individuals from foreign counties not legally within the United States as set forth in C.R.S. 8-i7.5,101, et. s€q. If Consultant has any employees or subcontractors, Consultant shall comply with C.R.S. 8-17.5-101, et. seq., and this Agreement. By execution of this Agreemen! Consultant certifies that it does not knowingly employ or contact with an undocumented individual who will perform under this Agreement and that Consultant will participate in the E-veri& Program or other Department of Labor and Employment program f'Departnrent Program') in order to confirm the eligibility of all employes who are newly hired for employment to perform Services under this Agreement. Consultant 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 Consultant that th€ subcontractor shall not knowingly employ or conkact with an undocumented individual to perform work under the public contract for services. I Eagle Courry HHS Profserv Final 5/14 b. Consultant has confirmed the employrnent eligibility of all employees who are newly hired for employment to perform Services tmder this Agreement through participation in the E-Verifu hogram or Department Progranu as administered by the United States Department ofHomeland Security. Information on applying for the E-verify program can be found at: http:/lwww.dhs.govlxpreyprotlprogr"aryslgc*I t 85?2 l 678 i 50.shtrn c. Consultant shall not use either the E-verify program or other Deprtment Program procedures to undertake pre-employment screening ofjob applicar$s while the public contraot for services is being performed. d. If Consultant obtains actual knowledge that a subcontractor perfbrming work under the public contract for services knowingly employs or confacts with an undocumented individual, Consultanl shall be required to: i. Nofify the subcontractot and County within three (3) days that Consultant 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 Consultant 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. Consultant 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 pwsuant to its authority established in C.R- S. 8- I 7.5- I 02(5). f. If Consultant violates these prohibitions, County may terminate the Agreement for breach of contract. If the Agreement is so terminated specifically far breach of this provision of this Agreement, Consultant shall be liable for actual and consequential damages to Counf as required by law. g. County will notify the Colorado Secretary of State if Corsultant violates this provision of this Agreement and County terrninates the Agreement for such breach. I Fffir tr PAGE rNrEVnChFrLY LEFr H,ANK 10 Eagle Courty HIIS ProfSarv Firnl 5lI4 IN wlTNESs WHEREOF, the parties have executed this Agreement the day and year first set forth above. COLINTY OF EACLE, STATE OF COLORADO, By and Through lts coI_]NTy MANAGER riue: O L"l u€A e.:lelroos C*"&rkrf C-fntU\, l-LC COUNSELINGCENTE& LLC: PrintName: -\ p q rr fSarKpl * S,.r/liUan 71 Eagle Courty HHS ProfServ Final 5/14 EXHIBITA SCOPE OF SERVICES, SCHEDULE, FEES Solutions Counseling Center, LLC Jean Becker-Sullivan, M.A., llCC jean@jeanbeckersul livan.com bpeof $rvim Office Location 124 Main Street-Suite 205, Dillon, CO 80435. Mental Fblth Snvies: Providing individual & group therapy" Utilizing an integrative approach that includes building rapport and utilizing CBT and Solution Focused therapies. My approach empowers clients to explore, gain insight, and take action. Extensive experience working with adolescents who are experiencing social problems, truancy, or delinquency. n lndividual Therapy for Adults or Youth 10 - 18 D GroupTherapy hrent Rlucation & &pport *rvim Experience wo*ing with parents who seek to improve ability to co-parent. The Cooperative Co-parenting program can be used for traditional families as well as non- traditional families" Some examples include: biological parent / biological parent, adoptive parent / biological parent, step-parent / biological parent. Experience also working with adolescent parents to provide parenting coaching based on child developmental models and also life skills including: vocational, emancipation, and communication. n Group - Cooperative Co-Parenting {8 week group} E Life Skills Support n Parent Coaching / Mentoring DomdicMolenceTreatment Srvices: Experience responding to crisis situations involving domestic violence and providing on-going support, and safety planning. Experience also working with adolescents who experience trauma as a result of exposure to parental domestic violence. n lndividualTherapy I Group Therapy SJpervisd Vi$tation $rvies Received training fronr the Supervised Visitation Network. Experienced in providing the following: Therapeutic Supervised Visit, Supervised Visit, & Monitored Visits, for families experiencing divorce or families requiring supervised visits for extended family members, n On-Site (rny office) il In the comrnunity (some limitations apply) In$rane: SeAttdred 72 Eagle Courry HHS Prof Serv Finl 5i 14 Rates: Individual Therapy {or couple) $ ZS.OO t hour Group Therapy $ 45.00 / hour cooperative co-parenting Group $ 47s.00 per person (20 hours includes workbook) 5upervised Visitation S 45,00 / hour Case Managemenh $35.00 Qher Ocnsiderations: I am currently a Licensed Professional counselor candidate, registered with DORA. Submission for LPC will be mailed to DORA this week. Currently, I am working under supervision from Jane Fineberg, Lcsw. I also work at CASA of the Continental Divide part time. Because of Dual Relationships, I am only able to accept cases that are not also cASA cases. 13 Eagle County HIIS ProfServ Final 5/14 t4 Eagle County HHS Prof Serv Fiml 5/14 a^'ORD"ACOR'. t' ,/- .CERTIFICATE OF LIABILITY INSURANCE OATE (MM/DD/YYYY) 02t23t2016 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 CERTTFTCATE OF INSURANCE DOES NOT CONSTTTUTE A CONTRACT BETWEEN THE |SSU|NG TNSURER(S), AUTHORTZED REPRESENTATIVE OR PRODUCER. AND THE CERTIFICATE HOLDER. IMPORTANT: lf the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. lf SUBROGATION lS 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 Mark Martin-Williams(0707266) 130 Ski Hiil Rd Breckenridqe CO 80424-7368 ixilii'' Marie Hipple lilP\E^ =-.,. 970-453-7190 | fiI "^,. 970-315-0170 E-MAILADDRESS: mmarlin4(i)farmersanent enm INSURER(S) AFFORDING COVERAGE NAIC # tNsuRER A: Truck Insurance Exchanqe 21709 INSURED SOLUTIONS COUNSELING CENT LLC 97 SUNLIGHT DR DTLLON CO 80435 tNsuRERB: Farmers Insurance Exchange 21652 tNsuRER c , Mid Centurv Insurance Companv 21687 INSURER D : INSI IPFP F . INSURER F : COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE \uut INSP POLICY NUMBER POLICY EFF .MM/DD/YYYYI POLICY EXP rMM/DD/YYYVI LIMITS X "or"a*",ol GENERAL LrABrLrrY l l"ro,r.-"oo= [Xlo".r*-T-606232312 05t01t2015 05t01t2016 EACH OCCURRENCE $ 1,000,000 IJAMAGE IO REN IED PREMISES (Ea occurrence)s 1,000,000 MED EXP (Anv one Derson)$ 10,000 PERSONAL & ADV INJURY __.J GENERAL AGGREGATE 2,000,000 X ,or,"" fl F"o; fl .o" PRODUCTS - COMP/OP AGG s 2,000,000 AU'].OMOBILE L|ABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON-OWNED AUTOS GOMtsINED SINGLE LIMII aFe ecci.lentl BODILY INJURY (Per person) BODILY INJURY (Per accident)o PROPERTY DAMAGE(Per accident)J J UMBRELLA LIAB EXCESS LI,AB OCCUR CLAII\,{S-MADE EACH OCCURRENCE D AGGREGATE $ DED | *.r=r'o"s $ WORKERS COMPENSATION AND EMPLOYERS'LtABtLtTY Y/ N ANY PROPRIETOR,/PARTNERYEXECUTIVE T- OFFICER/MEMBER EXCLUDED? L(Mandatory in NH) lf yes, describe under DESCRIPTION OF OPERATIONS below N/A I wcsTATU- | OTH. E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEI D E,L, DISEASE. POLICY LIMIT DESCRIPTIONOFOPERATIONS/LOCATIONS/VEHICLES (AttachACORDl0l,AdditionalRemarksSchedule,ifmorespaceisrequired) Eagle County Government, and its associated or affiliated entities, its successors and assigns, elected officials, employees, agents and volunteers are Additional Insureds under the commercial general liability and automobile liability policies of insurance. CERTIFICATE HOLDER @ 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEL]VERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Eagle County Government PO Box 660 Eagle, CO 81631 AUTHORIZED REPRESENTATIVE Marie Hipple ACORD 25 (2010/0s) C"raifi.rae of Liability Insu rance State of Colorado Named Insured(s): Vehicle: Jean Becker-Sullivan David Sullivan 201 4Jeep Grand Cherokee 4D 4X4 Lar & r.*l^y.5*s Policy Number: 1 89894401 Effective: 2/ 1 /2016 Expiration: 8/1/2016 KEEPWITHVEHICLE VIN : 1 C4RJ FAG0EC422262 Registered Owner(s): Jean Becker-Sullivan NA|C Number:21652 YourAgent:MarkA Martin-Williams PO Box 7368 Breckenridge , CO 80424 Agent Phone:(970) 453-7 190 KEEP TH IS CERTIFICATE IN YOUR VEH ICLE AT ALt TIM ES. Farmers Insurance Exchange, Woodland Hills, California, an authorized Colorado Insurer, certifies that it has issued to the Named Insured a motor vehicle liability policy meeting the requirements of the Motor Vehicle Financial Responsibility Law and that said policy is in effect between the Effective Date and the Expiration Date identified above. The said motor vehicle liability policy insures the described vehicle(s). IMPORTANT: The coverage provided by this policy does not apply to the operation of any vehicle by a person named here. NOTAPPLICABLE READ CAREFULLY PENALTY: Any person who fails to comply with the Colorado Compulsory Insurance Law is subject to a class 1 traffic penalty. IMPORTANT: The coverage provided by this policy does not apply to ( 1) the operation of any vehicle by a person excluded from coverage by endorsement to this policy, and (2) any person who entrusts a vehicle to a person excluded from coverage. WHAT TO DO IN CASE OF AN ACCIDENT: Contact Farmers Claim Department Call us 24-hours a day at (80O) 435-7764 Para Espahol, llame al (877)732-5266 Obtain the following information: 1. Name, address, and phone numberof each driver, passenger and witness. 2. Driver's license number, vehicle description and license plate numbers. 3. Vehicle damage and accident scene photos. 4. Nameof Insurancecompanyand policynumberforeach vehicle. 5. Report the accident to the proper authorities. 6. Do notadmitfault - an investigation may later reveal you were not responsible for the accident. Visit www.farmers.com to learn more about claim self-service options. lt's quick, convenient and always open! See policy for octuol coverqge longuoge. 2s-9003 9-14 Certificate of Liability Insurance State of Colorado FARME INSURANCE Policy Number: I 89894401 Effective: 2/ 1/2O16 Expiration: 8/1/2O16 KEEPWITHVEHICLE RS Namedlnsured(s): JeanBecker-Sullivan David Sullivan Vehicle: 2010 Buick Lacrosse 4D 4Wd Cxl VIN: 1 G4GD5GG7AF1 63855 Registered Owner(s): Jean Becker-Su llivan NAfC Number:21652 YourAgent: Mark A Martin-Williams PO Box 7368 Breckenridge , CO 80424 Agent Phone : (97 0) 453 -7 1 90 KEEP TH IS CERTIFICATE IN YOU R VEH ICLE AT ALL TIM ES. Farmers Insurance Exchange, Woodland Hills, California, an authorized Colorado lnsurer, certifies that it has issued to the Named Insured a motor vehicle liability policy meeting the requirements of the Motor Vehicle Financial Responsibility Law and that said policy is in effect between the Effective Date and the Expiration Date identified above. The said motor vehicle liability policy insures the described vehicle(s). IMPORTANT: The coverage provided by this policy does not apply to the operation of any vehicle by a person named here. NOTAPPLICABLE READ CAREFULLY PENALTY: Any person who fails to comply with the Colorado Compulsory Insurance Law is subject to a class 1 traffic penalty. IMPORTANT: The coverage provided by this policy does not apply to ( 1 ) the operation of any vehicle by a person excluded from coverage by endorsement to this policy, and (2) any person who entrusts a vehicle to a person excluded from coverage. WHATTO DO IN CASE OFAN Contact Farmers Claim Department Call us 24-hours a day at (800) 435-7764 Para Espafrol, lfame al (877)732-5266 Obtain the following information: 1. Name, address, and phone number of each driver, passenger and witness. 2. Driver's license number, vehicle description and license plate numbers. 3. Vehicle damage and accident scene photos. 4. Name of Insurancecompanyand policy numberforeach vehicle. 5. Report the accident to the proper authorities. 6. Do not admit fault - an investigation may later reveal you were not responsible for the accident. Visit www.farmers.com to learn more about claim self-service options. lt's quick, convenient and always open! See policy for octuol coveroge longuage. 2s-9003 9-14