HomeMy WebLinkAboutGE15-003 All Purpose Enterprises Inc. AGREEMENT FOR PROCUREMENT AND INSTALLATION SERVICES BETWEEN GOLDEN EAGLE ELDERLY HOUSING CORPORATION AND ALL PURPOSE ENTERPRISES,INC. THIS AGREEMENT("Agreement")is effective as of the 9 day of r rte/ ,2015 by and between All Purpose Enterprises,Inc.,a Colorado corporation(hereinafter"Contractor")and Golden Eagle Elderly Housing Corporation,a Colorado non-profit corporation(hereinafter"Golden Eagle"). RECITALS WHEREAS,Golden Eagle desires to hire Contractor for the demolition of the damaged concrete sidewalks and reinforcement and pouring of new concrete on the sidewalks(the"Project")at the Golden Eagle Senior Apartments located at 700 Broadway Street,Eagle,CO 81631 (the"Property");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 equipment,materials and installation services as set forth below in paragraph 1 hereof;and WHEREAS,this Agreement shall govern the relationship between Contractor and Golden Eagle in connection with the procurement of equipment,materials and services. AGREEMENT NOW,THEREFORE,in consideration of the foregoing and the following promises Contractor and Golden Eagle agree as follows: 1. Services or Work. Contractor agrees to procure the materials,equipment and/or products("Materials") necessary for the Project and agrees to diligently provide all services,labor,personnel and materials necessary to perform and complete the procurement and installation services described in Exhibit A("Services"or"Work") which is attached hereto and incorporated herein by reference.The Services shall be performed in accordance with the provisions and conditions of this Agreement. a. Contractor agrees to complete the Services no later than June 30,2015 and in accordance with the schedule established in Exhibit A. If no completion date is specified in Exhibit A,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 and the terms and conditions set forth in this Agreement,the terms and conditions set forth in this Agreement shall prevail. c. Golden Eagle shall have the right to inspect all Materials and Services. Inspection and acceptance shall not be unreasonably delayed or refused. 2. Golden Eagle's Representative. The Golden Eagle Maintenance Supervisor,Bill Wright,shall be Contractor's contact with respect to this Agreement and performance of the Services. 1 Golden Eagle Procurement and Installation Final 5/14 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 until the Services are completed to the satisfaction of Golden Eagle. 4. gxtension or Modification. 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 Golden Eagle for such additional services in accordance with Golden Eagle'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 Golden Eagle 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 Golden Eagle 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. ompensation Golden Eagle shall compensate Contractor for the Materials and performance of the Services in a sum computed and payable as set forth in Exhibit A. The Materials and performance of the Services under Agreement shall not exceed$8,250.00 with a discount to$7,250.00 if the Contractor is permitted to pour co ete for both sides of the sidewalk simultaneously. 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 Golden Eagle. a. Payment will be made for Materials and 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,tanks performed,who performed each task and such other detail as Golden Fagle may request. b. If,at any time during the term or after termination or expiration of this Agreement,Golden Eagle reasonably determines that any payment made by Golden Eagle to Contractor was improper because the Materials or Services ifor which payment was made were not provided or performed as set forth in this Agreement,then upon written notice of such determination and request for reimbursement from Golden Eagle,Contractor shall forthwith return such payment(s)to Golden Eagle. Upon termination or expiration of this Agreement,unexpended funds advanced by Golden Fngle,if any,shall forthwith be returned to Golden Eagle. c. Golden Eagle 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 putsuant to the terms of this Agreement. 6. Subcontractors. Contractor acknowledges that Golden Eagle 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 Golden Eagle's prior written consent,which may be withheld in Golden Eagle's sole discretion. Golden Fagle shall have the right in its reasonable discretion to approve all personnel assigned to the subject Project during the performance of this Agreem nt and no personnel to whom Golden Eagle has an objection,in its reasonable discretion,shall be assigned to the Project. Contractor shall require each subcontractor,as approved by Golden Eagle and to the extent of the Services 4o 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 Golden Eagle.Golden Eagle shall have the right(but not the obligation)to enforce the provisions of this 2 Golden Eagle Procurement and Installation Final 5/14 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. Auto coverage with limits of liability not less than$1,000,000 each accident combined bodily injury and property damage liability insurance,including coverage for owned,hired,and non-owned vehicles. 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 Golden Eagle,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 Golden Eagle 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 Golden Eagle 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 available to Golden Eagle,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 Golden Eagle,and any of its officers, agents and employees against any losses,claims,damages or liabilities for which Golden Eagle 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 Golden Eagle for reasonable attorney fees and costs,legal and other expenses incurred by Golden Eagle in connection with investigating or defending any such loss,claim,damage,liability or action. This 3 Golden Eagle Procurement and Installation Final 5/14 indemnification shall not apply to claims by third parties against Golden Eagle to the extent that Golden Eagle 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 Golden Eagle and are to be delivered to Golden Eagle before final payment is made to Contractor or upon earlier termination of this Agreement. Further,Contractor shall execute any bill of sale or other documents required by Golden Eagle to transfer title of the Materialk to Golden Eagle.Contractor shall provide copies of any instruction or operations or care manuals and shall further provide copies of any manufacturers warranties associated with the Materials. 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 seat 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. GOLDEN EAGLE: Attention:Jill Klosterman 500 Broadway Post Office Box 850 Eagle,CO 81631 Telepho4le:970-328-8773 Facsimile:970-328-8787 E-mail:Jill.klosterman@eaglecounty.us With a copy to: Eagle County Attorney 500 Broadway Post Office Box 850 Eagle,do 81631 Telephone:970-328-8685 Facsimile: 970-328-8699 E-mail:atty @eaglecounty.us CONTRACTOR: All Purpose Enterprises,Inc. P.O.Box 1212 Eagle,00 81631 Telephone:970-390-5747 11. Termination. Golden Eagle 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 Golden Eagle with all documents as defined in paragraph 9 hereof,in such format as Golden Eagle shall direct and shall return all Golden Eagle owned materials and documents.Golden Eagle shall pay Contractor for Services satisfactorily performed to the date of termination. 4 Golden Eagle Procurement and Installation Final 5/14 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 intended purpose and use of the Materials,nature and extent of the Services to be provided hereunder and the Property,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 Golden Eagle written notice of all conflicts,errors,or discrepancies. e. Contractor shall be responsible for 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 Golden Eagle has accepted or approved the Materials and/or 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 ensure the Services are performed in accordance with this Agreement. This paragraph shall survive termination of this Agreement. f. Contractor hereby represents and warrants that the Materials will be new and that it will perform the Services in a good and workmanlike manner and guarantees all Work against defects in materials or workmanship for a period of one(1)year from the date the Work is accepted by Golden Eagle,or such longer period as may be provided by the law or as otherwise agreed to by the parties. g. All guarantees and warranties of Materials furnished to Contractor or any subcontractor by any manufacturer or supplier are for the benefit of Golden Eagle. If any manufacturer or supplier of any Materials furnishes a guarantee or warrantee for a period longer than one(1)year,then Contractor's guarantee or warrantee shall extend for a like period as to such Materials. 5 Golden Eagle Procurement and Installation Final 5/14 1 !r. Contractor warrants that title to all Work and Materials shall pass to Golden Eagle either by incorporation into the Property or upon receipt by Contractor of payment from Golden Eagle(whichever occurs first)free and clear of all liens,claims,security interests or encumbrances. Contractor further warrants that Contractor(or any other person performing Work)purchased all Materials free and clear of all liens,claims,security interests Or encumbrances.Notwithstanding the foregoing,Contractor assumes all risk of loss with respect to the Material$until the Materials installed and Golden Eagle has inspected and approved the same. i. Within a reasonable time after receipt of written notice,Contractor shall correct at its own expense,)without cost to Golden Eagle,and without interruption to Golden Eagle: i. Any defects in Materials or workmanship which existed prior to or during the period of any guarflntee or warranty provided in this Agreement;and ii. Any damage to any other Work or property caused by such defects or the repairing of such defects. j. Guarantees and warranties shall not be construed to modify or limit any rights or actions Golden Eagle may otherwise have against Contractor in law or in equity. k. 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. I. This Agreement constitutes an agreement for performance of the Services by Contractor as an independent contractor and not as an employee of Golden Eagle. Nothing contained in this Agreement shall be deemed io create a relationship of employer-employee,master-servant,partnership,joint venture or any other relationship between Golden Engle and Contractor except that of independent contractor.Contractor shall have no authority to bind Golden Eagle. m. 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. n. This Agreement contains the entire agreement between the parties with respect to the subject matter hreof and supersedes all other agreements or understanding between the parties with respect thereto. o. Contractor shall not assign any portion of this Agreement without the prior written consent of the Golden Eagle. Any attempt to assign this Agreement without such consent shall be void. p. This Agreement shall be binding upon and shall inure to the benefit of the parties here to and their respecti a permitted assigns and successors in interest.Enforcement of this Agreement and all rights and obligations hereund r are reserved solely for the parties,and not to any third party. q. No failure or delay by either party in the exercise of any right hereunder shall constitute a waiver thereof. o waiver of any breach shall be deemed a waiver of any preceding or succeeding breach. r. The invalidity,illegality or unenforceability of any provision of this Agreement shall not affect the validity Or enforceability of any other provision hereof. 6 Golden Eagle Procurement and Installation Final 5/14 s. The signatories to this Agreement aver to their knowledge,no employee of Golden Eagle 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. t. 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 Contracts. a. As used in this Section 14,the term undocumented individual will refer to those individuals from foreign countries not legally in 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 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 contract for services. b. If Contractor obtains actual knowledge that a subcontractor performing work under the contract for services knowingly employs or contracts with an undocumented individual,Contractor shall be required to: i. Notify the subcontractor and Golden Eagle 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(3)days of receiving the notice required pursuant to subparagraph (i)of the paragraph 14(b)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. c. If Contractor violates these prohibitions,Golden Eagle 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 Golden Eagle. d. Golden Eagle may notify the Colorado Secretary of State if Contractor violates this provision of this Agreement and Golden Fagle terminates the Agreement for such breach. [Rest of page intentionally left blank] 7 Golden Eagle Procurement and Installation Final 5/14 IN WITNESS WHEREOF,the parties have executed this Agreement the day and year first set forth above. GOLDEN EAGLE ELDERLY HOUSING CORPORATION By: Jill Klo rman,Executive Director CONTRACTOR ALL OSE ENTERPRI ZL,INC. By: Cad/ Print Name: /Dl PG ir2 Title: ,re...(/` • 8 Golden Eagle Procurement and Installation Final 5/14 EXHBIT A SCOPE OF SERVICES,EQUIPMENT,SCHEDULE,FEES 9 Golden Eagle Procurement and Installation Final 5/14 All Purpose Enterprises,Inc. Proposal PO Box 1212 Proposal Date: Proposal# Eagle,CO 816131 Phone: 970.390.5747 11/6/2014 1836 Bill To: Golden Eagle Senior Apartments P 0 Box 850 Eagle,CO 81631 Project: Golden Eagle Apartments Description of work to be performed Est.Hours/Qty. Total Remove and replace approximately 4,000 sq.ft.of sidewalk 4,000.00 Remove and replace approximately 3,500 sq.ft.of sidewalk 3,500.00 Pump 750.00 *NOTE: $1,000 discount if both sides poured at the same time • This proposal is good for 30 days. Total $8,250.00 Payment to be made as follows: 50%prior to start of work. Balance due upon completion of work. Any alteration or deviation involving extra costs will become an extra charge over and above the estimate. Acceptance of Proposal The above prices,s),ecificatiions and conditions are satisfactory and are hereby accepted.You are authorized to do the work specified. Payment will be as outlined. Submitted by Date Accepted by Date EXHIBIT B INSURANCE CERTIFICATES 10 Golden Eagle Procurement and Installation Final 5/14 .��...1,4 ALLPU-1 OP ID:AK '`1�... .R° °- CERTIFICATE OF LIABILITY INSURANCE DATE( IDDRYYY) 04/0612015 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 pollcy(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 NAME: Angie Kriedeman Arrow Insurance Mgt-Avon �A x:970-949-5110 FAX 70 Benchmark Rd#103 I(ac,No):9T0�49-6306 P.O.Box 918 ADDRESS: Avon,CO 81620 Angle Krledeman INSURER(S)AFFORDING COVERAGE NAIC/ INSURER A:Acuity Insurance 14184 INSURED All Purp se Enterprises,Inc. INSURER 8:Pinnacol Assurance 41190 Carlos F vela PO Box 212 INSURER C Eagle,C 81631 INSURERD: INSURER E: 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 WM-I 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. I TYPE OF INSURANCE ADDL SUER POUCY EFF POLICY EXP LIMITS INSR WVD POLICY NUMBER (MIUDDIVYYY) (MMIDDWYYY) GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A COMMERCIAL GENERAL LIABILITY RENTED TY X PREMISES(Ea occurrence) $ 100,000 CLAIMS-MAD n OCCUR MED EXP(Any one person) $ 5,000 X Business Ow ors K86831 02/22/2015 02/22/2016 PERSONAL a ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE UIVWT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 —I POUCY n JE F7 LOC $ AUTOMOBILE LIABILI COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY(Per person) $ — ALL OWNED I SCHEDULED BODILY INJURY(Per accident) $AUTOS AUTOS NON-OWNED PROPERTY HIRED AUTOS AUTOS (PER ACCIDENT) $ _ — . $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB CLAIMS-MADE K86831 02/22/2015 02/22/2016 AGGREGATE $ 1,000,000 DED I X I RETE TION$ 0 $ WORKERS COMPENSA ON X I TORY LIMITS I x IOER AND EMPLOYERS'LIA ITY B ANY PROPRIETOR/PAR ER/EXECUTIVE IIN NIA 4122407 04101/2015 04/01/2016 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER DED9 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OP ATIONS below E.L.DISEASE-POLICY OMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEIICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Certificate Hold is listed as Additional Insured as respects to the General Liabilit for ongoing operations. ■ CERTIFICATE HOLDEIR CANCELLATION GOLDEAI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Golden Eagle Elderly Housing ACCORDANCE WITH THE POLICY PROVISIONS. Corpora on 700 Broa Way AUrNORIZEDREPRESENTATIVE PO Box 50 g1,A_o,, J1..A..44 ."..-Aa„ (Eagle, 81631 O 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD ADDITIONAL INSURED-OWNERS,LESSEES OR CONTRACTORS- CB-71915-13) AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU -PRIMARY This endorsement modifies insurance provided under This insurance does not apply to: the following: a. Bodily injury, property damage, personal BIS-PAK BUSINESS LIABILITY AND MEDICAL EX- and advertising injury arising out of the ren- PENSES COVERAGE FORM dering of, or the failure to render, any pro- 1. Who is An Insured is amended to include as fessional, architectural, engineering or sur- an additional insured: veying services, including: a. Any person or organization for whom you (1) The preparing, approving or failing to are performing operations when you and prepare or approve maps, shop draw- such person or organization have agreed in ings, opinions, reports, surveys, field or- writing In a contract or agreement that such ders, change orders or drawings and person or organization be added as addi- specifications; and tional Insured on your policy; and (2) Supervisory, inspection, architectural or b. Any other person or organization you are engineering activities, required to add as an additional insured b. Bodily injury or property damage occurring under the contract or agreement described after: in paragraph a above. (1) All work, Including materials, parts or Such person or organization is an insured only equipment furnished in connection with with respect to liability for bodily Injury, property such work,on the project(other than ser- damage or personal and advertising injury vice, maintenance or repairs) to be per- caused, in whole or in part, by: formed by or on behalf of the additional a. Your acts or omissions; or Insured(s) at the location of the covered b. The acts or omissions of those acting on operations has been completed;or your behalf; (2) That portion of your work out of which in the performance of your ongoing operations the Injury or damage arises has been for the additional insured. put to Its intended use by any person or organization other than another con- A person's or organization's status as an in- tractor or subcontractor engaged in per- sured under this endorsement ends when your forming operations for a principal as a operations for that insured are completed. part of the same project. 2. With respect to the insurance afforded to these 3. The insurance provided by this endorsement is additional insureds, the following additional ex- primary and noncontributory. clusions apply: EXCLUSION OF PUNITIVE DAMAGES RELATED TO A CERTIFIED ACT OF CB-7298(1-08) TERRORISM This endorsement modifies Insurance provided under be an act of terrorism pursuant to the federal the following: Terrorism Risk Insurance Act. The criteria con- BIS-PAK BUSINESS LIABILITY AND MEDICAL EX- tained in the Terrorism Risk Insurance Act for a PENSES COVERAGE FORM certified act of terrorism include the following: A. The following exclusion is added: 1. The act resulted in insured losses in excess This insurance does not apply to: of$5 million in the aggregate, attributable to Terror- TERRORISM PUNITIVE DAMAGES all types of insurance subject to the Terror- ism Risk Insurance Act; and Damages arising, directly or indirectly, out of a 2. The act is a violent act or an act that is certified act of terrorism that are awarded as dangerous to human life, property or infra- punitive damages. structure and Is committed by an individual B. The following definition is added: or individuals as part of an effort to coerce "Certified act of terrorism"means an act that is the civilian population of the United States certified by the Secretary of the Treasury, in or to influence the policy or affect the con- concurrence with the Secretary of State and duct of the United States Government by the Attorney General of the United States, to coercion. A CERTIFICATE OF LIABILITY INSURANCE DATE`M�°°""Y"' 04/23/2015 THIS CERTIFICATE I ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES OT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CER FICATE 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(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and condlH¢ns of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In I14u of such endorsement(s). PRODUCER I,, CONTACT NAME: Joe Mason(0750394) IA/ No.Ext): 970-242-0000 I ma.No): 970-242-0046 555 North Ave Dept 1 ADDRESS: mmason @farmersagent.com INSURER(S)AFFORDING COVERAGE NAIC'S Grand Junction CO 81501-7505 INSURER A: Truck Insurance Exchange 21709 INSURED INSURER B: Farmers Insurance Exchange 21652 ALL PURPOSE ENTERPRISE INC INSURER c: Mid Century Insurance Company 21687 PO BOX 1212 INSURERD: INSURER E: EAGLE CO 81631 INSURERF: • COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY T THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITH TANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE SSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CON ITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUER POUCY EFF POLICY EXP TYPE OF IN RANCE . LTR INSR WVD POLICY NUMBER (MMIDD/YYYYI IMMIDDIYYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LABILITY PREMISES SES(E c a ocurrence) _ $ CLAIMS-MADE', OCCUR MED EXP(My one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE UMIX APPLIES PER: PRODUCTS-COMP/OP AGG S POLICY JEC LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO 1 BODILY INJURY(Per person) $ 1,000,000 B A OWNED SCHEDULED Y 605818931 02/21/2015 02/21/2016 BODILY INJURY(Per accident) $ 1,000,000 AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ 1,000,000 HIRED AUTOS AUTOS (Per accident) MEDICAL $ 5,000 UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS UAB - CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'UABI'T'Tllmm•••.. TORY LIMITS ER ANY PROPRIETORIPART R/EXECUTIVE YIN NIA E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLII��DDED7 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ Eyes,descdbe under DESCRIPTION OF OPER4TIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATION/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If mom space Is required) 2008 FORD F250 SUPER;VIN.1FTSX21518EB05123 Golden Eagle Elderly H using Corporation,it's associated or affiliated entities,it's successors and assigns,elected officials,employees,agents and volunteers and additional insureds ender the automobile liability policies of insurance. CERTIFICATE HOLDEit CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE GOLDEN EAGLE ELDERLY HOUSING THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CORPORATION ACCORDANCE WITH THE POLICY PROVISIONS. 700 BROADWAY ST AUTHORIZED REPRESENTATIVE EAGLE CO 81631 JOE MASON A CORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. 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