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HomeMy WebLinkAboutLC16-014 Fred's Plumbing and HeatingAGREEMENT FOR SERVICES BETWEEN LAKE CREEK VILLAGE LLC AND FRED’S PLUMBING AND HEATING SERVICE, INC. THIS AGREEMENT (“Agreement”) is effective as of the _______day of ______________, 20___ by and between Fred’s Plumbing and Heating Service, Inc., an incorporated Colorado Plumbing and Heating company (hereinafter “Contractor”) and Lake Creek Village LLC, a Colorado limited liability company (hereinafter “LCV”). RECITALS WHEREAS, LCV desires to have Contractor install a new boiler for the residents of Building 24 (the “Project”) at the Lake Creek Village Apartments at 4923 Lake Creek Village Drive, Edwards, CO 81632, (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 Services as defined below in paragraph 1 hereof; and WHEREAS, this Agreement shall govern the relationship between Contractor and LCV in connection with the Services. AGREEMENT NOW, THEREFORE, in consideration of the foregoing and the following promises Contractor and LCV agree as follows: 1. Services or Work. Contractor agrees to diligently provide all services, labor, personnel and materials necessary to perform and complete the installation services or work described in Exhibit A (“Services” or “Work”) which is attached hereto and incorporated herein by reference. The Contractor further agrees to install the materials necessary for the Project as detailed in Exhibit B, 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 furnish the Services no later than November 30, 2016 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. 2. LCV’s Representative. The Maintenance Supervisor, William Wright, the Housing 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 through the 30th day of November, 2016. DocuSign Envelope ID: FA041C94-549B-4A58-B382-50F08C210043     LC16-013 2 LCV General Services Final 5/14 4. Extension 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 LCV for such additional services in accordance with LCV’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 LCV 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 LCV 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. LCV shall compensate Contractor for the performance of the Services in a sum computed and payable as set forth in Exhibit A. The performance of the Services under this Agreement shall not exceed $ shall not exceed $9,759.44 for the High Efficiency Lochinvar WHN285 Boiler and Lochinvar SIT119 Indirect Water heater install including labor.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 LCV. 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 LCV may request. b. If, at any time during the term or after termination or expiration of this Agreement, LCV reasonably determines that any payment made by LCV 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 LCV, Contractor shall forthwith return such payment(s) to LCV. Upon termination or expiration of this Agreement, unexpended funds advanced by LCV, if any, shall forthwith be returned to LCV. c. LCV 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. 6. Subcontractors. Contractor acknowledges that LCV 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 LCV’s prior written consent, which may be withheld in LCV’s sole discretion. LCV shall have the right in its reasonable discretion to approve all personnel assigned to the subject Project during the performance of this Agreement and no personnel to whom LCV has an objection, in its reasonable discretion, shall be assigned to the Project. Contractor shall require each subcontractor, as approved by LCV 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 LCV. LCV 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. DocuSign Envelope ID: FA041C94-549B-4A58-B382-50F08C210043 3 LCV General Services Final 5/14 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 LCV, 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 C. ii. Contractor’s certificates of insurance shall include subcontractors, if any as additional insureds under its policies or Contractor shall furnish to LCV 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 LCV 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 LCV, 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 LCV, and any of its officers, agents and employees against any losses, claims, damages or liabilities for which LCV 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 LCV for reasonable attorney fees and costs, legal and other expenses incurred by LCV 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 LCV to the extent that LCV 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 LCV and are to be delivered to LCV before final payment is made to Contractor or upon earlier termination of this Agreement. DocuSign Envelope ID: FA041C94-549B-4A58-B382-50F08C210043 4 LCV General Services Final 5/14 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. LCV: Attention: Jill Klosterman 500 Broadway Post Office Box 850 Eagle, CO 81631 Telephone: 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, Co 81631 Telephone: 970-328-8685 Facsimile: 970-328-8699 E-mail: atty@eaglecounty.us CONTRACTOR: Fred’s Plumbing and Heating Service, Inc. Attn: Fred Espinoza PO Box 5396 Eagle, CO 81631 Telephone: 970-328-1095 Facsimile: 970-328-1418 E-mail: fredespinoza1972@gmail.com 11. Termination. LCV 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 LCV with all documents as defined in paragraph 9 hereof, in such format as LCV shall direct and shall return all LCV owned materials and documents. LCV 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 DocuSign Envelope ID: FA041C94-549B-4A58-B382-50F08C210043 5 LCV General Services Final 5/14 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, 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 LCV 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 LCV 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 ensure the Services are performed in accordance with this Agreement. This paragraph shall survive termination of this Agreement. f. Contractor hereby represents and warrants the proper installation of the materials necessary for the Project and 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 LCV, or such longer period as may be provided by the law or as otherwise agreed to by the parties. g. 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. h. This Agreement constitutes an agreement for performance of the Services by Contractor as an independent contractor and not as an employee of LCV. 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 LCV and Contractor except that of independent contractor. Contractor shall have no authority to bind LCV. i. 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. DocuSign Envelope ID: FA041C94-549B-4A58-B382-50F08C210043 6 LCV General Services Final 5/14 j. 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. k. Contractor shall not assign any portion of this Agreement without the prior written consent of LCV. Any attempt to assign this Agreement without such consent shall be void. l. 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. m. 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. n. The invalidity, illegality or unenforceability of any provision of this Agreement shall not affect the validity or enforceability of any other provision hereof. o. The signatories to this Agreement aver to their knowledge, no employee of LCV 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. p. 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 15, 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 LCV 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. DocuSign Envelope ID: FA041C94-549B-4A58-B382-50F08C210043 7 LCV General Services Final 5/14 c. If Contractor violates these prohibitions, LCV 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 LCV. d. LCV may notify the Colorado Secretary of State if Contractor violates this provision of this Agreement and LCV terminates the Agreement for such breach. [Rest of page intentionally left blank] DocuSign Envelope ID: FA041C94-549B-4A58-B382-50F08C210043 8 LCV General Services Final 5/14 IN WITNESS WHEREOF, the parties have executed this Agreement the day and year first set forth above. Lake Creek Village LLC By and through Eagle County Housing and Development Authority, its sole member By: _______________________ Jill Klosterman, Executive Director CONTRACTOR: By:________________________________ Print Name:__________________________ Title: ______________________________ DocuSign Envelope ID: FA041C94-549B-4A58-B382-50F08C210043      9 LCV General Services Final 5/14 EXHIBIT A BOILER INSTALL PRICING WITH LABOR DocuSign Envelope ID: FA041C94-549B-4A58-B382-50F08C210043 Fred’s Plumbing & Heating Service, Inc. PO Box 5396 Eagle, CO 81631 970-328-1095 Customer: Lake Creek Village Job Name: BR16-189 Date: September 19, 2016 Contact: Bill Wright Company/Owner: Eagle County Housing Boilers & Indirect Water Heater Installation Building #24 Job Site Address: 4923 Lake Creek Village Drive Building #24 Edwards, CO 81632 Fred’s Plumbing & Heating Service, Inc. is pleased to offer you the Base Price of $9,759.44 for the work listed below: x File & Pay For Eagle County Building Permit x Protect and clean areas where work being performed as needed x Drain Existing Boiler System & Water Heater x Remove and dispose of existing Boiler and water heater along with the pumps, and all pipes and wiring associated with the boiler x Install 1 High Efficiency Lochinvar WHN285 Boiler to replace existing x Install 1 Lochinvar SIT119 Indirect Water Heater to replace existing x Install all new cold and hot water piping needed for the installation new water heater x Install new isolation valves for the water heater x Install one new domestic expansion tank to the new boiler system x Install the proper connections to the water heater (Misc. fittings, low voltage wiring) x Refill and purge new water heater x System to be flue and piped according to the manufacturer’s specifications x Install a new Grundfos pump for the system x Install insulated copper piping for the primary piping to the boiler system x Install new ball valves as needed to the new boiler system Exhibit A DocuSign Envelope ID: FA041C94-549B-4A58-B382-50F08C210043 x Install new Honeywell Zone Valves to replace existing x Install a condensate neutralization kit, condensate pipe and perform the piping x Install new gas connection for the boiler x Install Glycol with Furnox inhibitor to the new boiler system x Test the system for correct operation x Clean Boiler Area as Best as Possible The above shall constitute “the Work.” *WARRANTY ON WORKMANSHIP IS FOR A PERIOD OF 2 YEARS* Excluded Are The Following Items From The Base Price: ¾Patching and repairs to all floors, walls, ceiling and chases. ¾Testing, abatement or disposal of lead paint, asbestos, or other hazardous materials ¾BOILER< WATER HEATER OR ANY MATERIAL; All Material will Provided by the Customer ¾Any concrete demo or disposal and Any interior or exterior excavation ¾Supplying or installation of any other material not listed above. DocuSign Envelope ID: FA041C94-549B-4A58-B382-50F08C210043 10 LCV General Services Final 5/14 EXHIBIT B PARTS LIST DocuSign Envelope ID: FA041C94-549B-4A58-B382-50F08C210043 Exhibit B DocuSign Envelope ID: FA041C94-549B-4A58-B382-50F08C210043 DocuSign Envelope ID: FA041C94-549B-4A58-B382-50F08C210043 DocuSign Envelope ID: FA041C94-549B-4A58-B382-50F08C210043 DocuSign Envelope ID: FA041C94-549B-4A58-B382-50F08C210043 DocuSign Envelope ID: FA041C94-549B-4A58-B382-50F08C210043 DocuSign Envelope ID: FA041C94-549B-4A58-B382-50F08C210043 11 LCV General Services Final 5/14 EXHIBIT C INSURANCE CERTIFICATE DocuSign Envelope ID: FA041C94-549B-4A58-B382-50F08C210043 ANY PROPRIETOR/PARTNER/EXECUTIVEOFFICER/MEMBER EXCLUDED? INSR ADDL SUBRLTR INSD WVD PRODUCER CONTACTNAME: FAXPHONE(A/C, No):(A/C, No, Ext): E-MAILADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY) (MM/DD/YYYY) AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATIONAND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE EACH OCCURRENCE $ DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT OTHER:$ COMBINED SINGLE LIMIT $(Ea accident) ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY (Per accident) $AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $AUTOS ONLY AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE CLAIMS-MADE AGGREGATE $ DED RETENTION $ PER OTH-STATUTE ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03) CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) $ $ $ $ $ The ACORD name and logo are registered marks of ACORD 10/6/2016 (970) 328-2324 19879 Fred's Plumbing and Heating, Inc. PO Box 5396 Eagle, CO 81631 31755 41190 A 1,000,000 X NA110379700 03/11/2016 03/11/2017 100,000 5,000 2,000,000 1,000,000B X BAP2422057 03/10/2016 03/10/2017 C 4181461 04/01/2016 04/01/2017 1,000,000 1,000,000 1,000,000 Additional insured Lake Creek Village LLC., 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. Lake Creek Village, LLC 4923 Lake Creek Village Edwards, CO 81632 FREDPLU-01 PATTY Hood Insurance Agency850 Chambers Ave, Ste 5 Eagle, CO 81631 Patty Jackson-Hood/Hood Ins Agency hoodinsurance@centurylink.net Security National Insurance Co State Auto Insurance Co. Pinnacol Assurance X X X X Exhibit C DocuSign Envelope ID: FA041C94-549B-4A58-B382-50F08C210043