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HomeMy WebLinkAboutC17-421 National Car Charging LLCAGREEMENT FOR EQUIPMENT AND/OR MATERIALS BETWEEN
EAGLE COUNTY, COLORADO
AND
NATIONAL CAR CHARGING LLC
THIS AGREEMENT ("Agreement") is effective as of the ____1 2/18/2017 ___ by and between National
Car Charging LLC a limited liability company (hereinafter "Vendor") and Eagle County, Colorado, a body
corporate and politic (hereinafter "County").
1:7*410F-11W
WHEREAS, Eagle County will purchase two (2) electric vehicle charging stations and related products for use by
county staff and general public, and
WHEREAS, Vendor is authorized to do business in the State of Colorado and has the time, skill, expertise, and
experience necessary to provide the equipment and/or materials as set forth below in paragraph 1 hereof; and
WHEREAS, this Agreement shall govern the relationship between Vendor and County in connection with the
procurement of equipment and/or materials.
AGREEMENT
NOW, THEREFORE, in consideration of the foregoing and the following promises Vendor and County agree as
follows:
1. Equipment. Vendor agrees to procure the two electric vehicle charging stations and related products
(collectively the "Equipment") described in Exhibit A which is attached hereto and incorporated herein by reference.
The Equipment shall be provided in accordance with the provisions and conditions of this Agreement.
a. Vendor agrees to furnish the Equipment no later than June 30, 2018 and in accordance with the
schedule established in Exhibit A. If no date is specified in Exhibit A, then Vendor agrees to furnish the Equipment
in a timely and expeditious manner. By signing below, Vendor represents that it has the expertise and personnel
necessary to properly and timely provide the Equipment.
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. County shall have the right to inspect all Equipment. Inspection and acceptance shall not be
unreasonably delayed or refused. In the event County does not accept the Equipment for any reason in its sole
discretion, then Vendor shall upon County's request and at no charge to County:
i. take the Equipment back;
ii, exchange the Equipment; or
iii, repair the Equipment.
2. County's Representative. The Sustainable Communities Department's designee shall be Vendor's contact
with respect to this Agreement.
C17-421
3. Term of the Agreement. This Agreement shall commence upon the date first written above, and subject to
the provisions of paragraph t0 hereof, shall continue in full force and effect through the 30th day of June, 2018.
4. Extension or Modification. Any amendments or modifications shall be in writing signed by both parties.
No additional Equipment shall be provided by Vendor unless and until Vendor has obtained written authorization
and acknowledgement by County for such additional equipment in accordance with County's internal policies.
Accordingly, no course of conduct or dealings between the parties, nor verbal change orders, express or implied
acceptance of alterations or additions to the Equipment, and no claim that County has been unjustly enriched by any
Equipment, whether or not there is in fact any such unjust enrichment, shall be the basis of any increase in the
compensation payable hereunder. In the event that written authorization and acknowledgment by County for such
additional equipment is not timely executed and issued in strict accordance with this Agreement, Vendor's rights
with respect to such additional equipment shall be deemed waived and such failure shall result in non-payment for
such additional equipment.
5. Compensation. County shall compensate Vendor for the Equipment in a sum computed and payable as set
forth in Exhibit A. The Equipment under this Agreement shall not exceed $12,827.00.
a. Payment will be made for Equipment satisfactorily delivered and accepted by County within thirty
(30) days of receipt of a proper and accurate invoice from Vendor. All invoices shall include detail regarding the
Equipment and such other detail as County may request.
b. If, at any time during the term or after termination or expiration of this Agreement, County
reasonably determines that any payment made by County to Vendor was improper because the Equipment for which
payment was made were not provided as set forth in this Agreement, then upon written notice of such determination
and request for reimbursement from County, Vendor shall forthwith return such payment(s) to County. Upon
termination or expiration of this Agreement, unexpended funds advanced by County, if any, shall forthwith be
returned to County.
C. County will not withhold any taxes from monies paid to the Vendor hereunder and Vendor agrees
to be solely responsible for the accurate reporting and payment of any taxes related to payments made pursuant to
the terms of this Agreement.
d. Notwithstanding anything to the contrary contained in this Agreement, County shall have no
obligations under this Agreement after, nor shall any payments be made to Vendor in respect of any period after
December 3 t of any year, without an appropriation therefor by County in accordance with a budget adopted by the
Board of County Commissioners in compliance with Article 25, title 30 of the Colorado Revised Statutes, the Local
Government Budget Law (C.R.S. 29-1-tOt et. seq.) and the TABOR Amendment (Colorado Constitution, Article X,
Sec. 20).
b. Insurance. Vendor agrees to provide and maintain at Vendor's sole cost and expense, the following
insurance coverage with limits of liability not less than those stated below:
a. Types of Insurance.
Workers' Compensation insurance as required by law.
2
Eagle County Materials and Equipment Agreement 5114
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
Eagle County, its associated or affiliated entities, its successors and assigns, elected officials, employees, agents and
volunteers as additional insureds. A certificate of insurance consistent with the foregoing requirements is attached
hereto as Exhibit B.
ii. The insurance provisions of this Agreement shall survive expiration or termination
hereof.
iii. The parties hereto understand and agree that the County is relying on, and does not waive
or intend to waive by any provision of this Agreement, the monetary limitations or rights, immunities and
protections provided by the Colorado Governmental Immunity Act, as from time to time amended, or otherwise
available to County, its affiliated entities, successors or assigns, its elected officials, employees, agents and
volunteers.
iv. Vendor is not entitled to workers' compensation benefits except as provided by the
Vendor, nor to unemployment insurance benefits unless unemployment compensation coverage is provided by
Vendor or some other entity. The Vendor is obligated to pay all federal and state income tax on any moneys paid
pursuant to this Agreement.
7. Indemnification. The Vendor shall indemnify and hold harmless County, and any of its officers, agents and
employees against any losses, claims, damages or liabilities for which County may become subject to insofar as any
such losses, claims, damages or liabilities arise out of, directly or indirectly, this Agreement, or are based upon any
performance or nonperformance by Vendor or any of its subcontractors hereunder; and Vendor shall reimburse
County for reasonable attorney fees and costs, legal and other expenses incurred by County in connection with
investigating or defending any such loss, claim, damage, liability or action. This indemnification shall not apply to
claims by third parties against the County to the extent that County is liable to such third party for such claims
without regard to the involvement of the Vendor. This paragraph shall survive expiration or termination hereof.
8. Documents. Vendor shall execute any bill of sale or other documents required by County to transfer title
of the Equipment to County. Vendor shall provide copies of any instruction or operations manuals and shall further
provide copies of any manufacturers warranties associated with the Equipment.
9. 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 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.
3
Eagle County Materials and Equipment Agreement 5114
COUNTY:
Eagle County, Colorado
Attention: John Gitchell
500 Broadway
Post Office Box 850
Eagle, CO 81631
Telephone: 970-328-8766
E-mail: John.Citchell@eaglecounty.us
With a copy to:
Eagle County Attorney
500 Broadway
Post Office Box 850
Eagle, Co 81631
Telephone: 970-38-8685
Facsimile: 970-328-8699
E -Mail: atty@eaglecounty.us
VENDOR:
National Car Charging LLC
Attention: Jim Burness
209 Kalamath St., Suite 3
Denver, CO 80223
Telephone: (866) 996-6387
E -Mail: jburness@nationalcarcharging.com
10. Termination. County may terminate this Agreement, in whole or in part, at any time and for any reason,
with or without cause, and without penalty therefor with seven (7) calendar days' prior written notice to the Vendor.
Upon termination of this Agreement, Vendor shall immediately provide County with all documents as defined in
paragraph 8 hereof, in such format as County shall direct and shall return all County owned materials and documents
in the possession of Vendor, if any. County shall pay Vendor for Equipment satisfactorily inspected and accepted to
the date of termination.
It. 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.
12. 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.
13. Other Contract Requirements and Vendor Representations.
4
Eagle County Materials and Equipment Agreement 5114
a. Vendor has familiarized itself with the intended purpose and use of the Equipment to be provided
hereunder, the intended use of such Equipment by County, and with all local conditions, federal, state and local
laws, ordinances, rules and regulations that in any manner affect cost, progress, or Equipment.
b. Vendor will make, or cause to be made, examinations, investigations, and tests as he deems
necessary for the performance of this Agreement.
C. The fact that the County has accepted or approved the Equipment shall not relieve Vendor of any
of its responsibilities. Vendor represents and warrants that it has the expertise and personnel necessary to properly
perform the terms of this Agreement. Vendor shall provide appropriate supervision to its employees to ensure the
performance in accordance with this Agreement. Vendor will provide the Equipment in a skillful, professional and
competent manner and in accordance with the standard of care applicable to vendors supplying similar equipment.
d. Vendor warrants merchantability and fitness of the Equipment for its intended use and purpose.
C. Vendor hereby represents and warrants that the Equipment will be new and guarantees all
Equipment against defects for a period of one (1) year from the date the Equipment is accepted by County, or such
longer period as may be provided by the law or as otherwise agreed to by the parties.
f. All guarantees and warranties of Equipment furnished to Vendor by any manufacturer or supplier
are for the benefit of County. If any manufacturer or supplier of any Equipment furnishes a guarantee or warrantee
for a period longer than one (1) year, then Vendor's guarantee or warrantee shall extend for a like period as to such
Equipment.
g. Vendor warrants that title to all Equipment shall pass to County either by incorporation into the
County facility or upon receipt by Vendor of payment from County (whichever occurs first) free and clear of all
liens, claims, security interests or encumbrances. Vendor further warrants that Vendor (or any other person
performing Work) purchased all Equipment free and clear of all liens, claims, security interests or encumbrances.
Notwithstanding the foregoing, Vendor assumes all risk of loss with respect to the Equipment until County has
inspected and approved the same.
h. Within a reasonable time after receipt of written notice, Vendor shall correct at its own expense,
without cost to County, and without interruption to County:
i. Any defects in Equipment which existed prior to or during the period of any guarantee or
warranty provided in this Agreement; and
ii. Any damage to any property caused by such defects or the repairing of such defects.
i. Guarantees and warranties shall not be construed to modify or limit any rights or actions County
may otherwise have against Vendor in law or in equity.
j. Vendor 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.
k. This Agreement constitutes an agreement for performance by Contractor as an independent
Contractor and not as an employee of County. Nothing contained in this Agreement shall be deemed to create a
5
Eagle County Materials and Equipment Agreement 5114
relationship of employer-employee, master -servant, partnership, ,joint venture or any other relationship between
County and Vendor except that of independent Vendor. Vendor shall have no authority to bind County.
1. Vendor represents and warrants that at all times in the performance of the Agreement, Vendor
shall comply with any and all applicable laws, codes, rules and regulations.
in. 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.
n. Vendor shall not assign any portion of this Agreement without the prior written consent of the
County. Any attempt to assign this Agreement without such consent shall be void.
o. 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.
p. 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.
q. The invalidity, illegality or unenforceability of any provision of this Agreement shall not affect the
validity or enforceability of any other provision hereof.
r. The signatories to this Agreement aver to their knowledge no employee of the County has any
personal or beneficial interest whatsoever in the Equipment described in this Agreement. The Vendor has no
beneficial interest, direct or indirect, that would conflict in any manner or degree with the performance of the
Agreement and Vendor shall not employ any person having such known interests.
S. The Vendor, 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. 24-76.5403 prior to the effective date of this
Agreement.
14. Prohibitions on Government Contracts.
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. 5-17.5-101, et. seq. If Vendor has any employees or
subcontractors, Vendor shall comply with C.R.S. 8-17.5-101, et. seq., and this Agreement. By execution of this
Agreement, Vendor certifies that it does not knowingly employ or contract with an undocumented individual who
will perform under this Agreement and that Vendor will participate in the E -verify Program or other Department of
Labor and Employment program ("Department Program") in order to confirm the eligibility of all employees who
are newly hired for employment to perform Services under this Agreement.
a. Vendor shall not:
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 Vendor that the subcontractor shall not
knowingly employ or contract with an undocumented individual to perform work under the public contract for
services.
6
Eagle County Materials and Equipment Agreement 5114
b. Vendor has confirmed the employment eligibility of all employees who are newly hired for
employment to perform Services under this Agreement through participation in the E -Verify Program or Department
Program, as administered by the United States Department of Homeland Security. Information on applying for the
E -verify program can be found at:
https://www.uscis.gov/e-verify
C. Vendor shall not use either the E -verify program or other Department Program procedures to
undertake pre-employment screening of job applicants while the public contract for services is being performed.
d. If Vendor obtains actual knowledge that a subcontractor performing work under the public
contract for services knowingly employs or contracts with an undocumented individual, Vendor shall be required to:
i. Notify the subcontractor and County within three (3) days that Vendor 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 Vendor 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. Vendor shall comply with any reasonable request by the Department of Labor and Employment
made in the course of an investigation that the department is undertaking pursuant to its authority established in
C.R.S. 8-17.5-102(5).
f. If Vendor violates these prohibitions, County may terminate the Agreement for breach of contract.
If the Agreement is so terminated specifically for breach of this provision of this Agreement, Vendor shall be liable
for actual and consequential damages to County as required by law.
g. County will notify the Colorado Secretary of State if Vendor violates this provision of this
Agreement and County terminates the Agreement for such breach.
[REST OF PAGE INTENTIONALLY LEFT BLANK]
7
Eagle County Materials and Equipment Agreement 5114
IN WITNESS WHEREOF, the parties have executed this Agreement the day and year first set forth above.
COUNTY OF EAGLE, STATE OF COLORADO, By and
Through Its COUNTY MANAGER
By:
Kelly Collier, Deputy County Manager
�r�nrnrzu
By: ----------
Print Name: Jim Burness
C
Title: EO/GM
Eagle County Materials and Equipment Agreement 5/14
SCOPE OF SERVICES AND EQUIPMENT, SCHEDULE, FEES
Eagle County Materials and Equipment Agreement 5114
National Car Charging LLC
209 Kalamath St., Suite 3
Denver, CO 80223
(866)996-6387
info@ national carch arg i ng. cam
www.nationalcarcharging.com
ADDRESS
John Gitchell
Eagle County Government
John Gitchell
Eagle County Government
PO Box 179
500 Broadway
Eagle, CO 81631 USA
EXHIBIT A
SHIP TO
John Gitchell
Eagle County Government
John Gitchell
Eagle County Government
500 Broadway
PO Box 179
Eagle, CO 81 631-01 79
USA
SHIP VIA P.D. NUMBER
FedEx Ground Non/post-grant quote
6114►i
CT4021-GW1
ChargePoint dual bollard gateway with cord
management
CTSW-SAS-COMM-3 upgrade
Upgrade of COMM -1 tokens to COMM -3
Discount
ChargePoint trade-in promotion (includes station,
COMM -1, and Site Validation
CT4021
ChargePoint dual bollard non -gateway with cord
management
CPCLD-COMMERCIAL-3
Plan includes Secure Network Connection, On-going
Station Software updates, Station Inventory, 24x7 Driver
Support, Host Support, Session Data and Analytics,
Fleet Vehicle Management and Integration, Fleet Access
Control, Valet Dashboard, Power Management (Circuit,
Panel, Site Sharing), Scheduled Charging, Driver Access
Control, Pricing and Automatic Funds Collection, Waitlist,
Videos (on supported hardware). Price is per port.
Activation
Activation on the ChargePoint network
CT4000-SITEVALI D
New site validation by ChargePoint national installer (by
service panel)
CT4000-ASSURE2
CT4000 Series 2 -year Assure Plan (incl. parts and labor
warranty, monitoring, etc.)
NATIONAL
CARCHARGING
ESTIMATE # 1853
DATE 10/18/2017
SALES REP
JDB
{QTY RATE AMOUNT
1 7,210.00 7,210.QQT
2 425.00
850.00T
1 -4,635.00
-4,635.00T
1 5,356.00
5,356.00T
2 705.00
1,410.0aT
2 0.00
0.00
1 0.00
0.00
2 1,163.00
2,326.00
Installer MUST be ChargePoint certified ($19.95 at www.chargepointuniversity.com).
Warranty is VOIDED If installer refuses to get certified.
EXHIBIT A
IILM QIY
Sales Tax
Sales Tax calculated by AvaTax on Fri 08 Dec 19:47:39
UTC 2017
1 j Anchor bolts not included SUBTOTAL
2) Quote assumes buyer is exempt from sales tax. TAX (09I6)
3) Shorter warranty and software terms available. SHIPPING
4) Installer/client responsible for ensuring adequate TOTAL
cellular coverage at install site.
Accepted By
Accepted Date
RAIL AMOUN f
12,517.00
0.00
310.00
$12,827.00
Installer MUST be ChargePoint certified ($19.95 at www.chargepointuniversity.com).
Warranty is VOIDED If installer refuses to get certified.
EX-IIBIT B
INSURANCE CERTIFICATES
10
Eagle County Materials and Equipment Agreement 5114
AC"CWR ~ 1511 ts CERTIFICATE OF LIABILITY INSURANCE
(MM:DoyyYy)
rl
CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
2:11:2017
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: ff 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).
PRODUCER
CONTACT NAME: Susan Skinner
Arrowhead General Insurance Agency, Inc-
PAHONE Ext , (866)631.6555 x4531 S 11,N1): (888)221.0051
ADDRESS: sskinner@arrowheadgrp.com
8000 E. Maplewood Ave
INSURER(S)AFFOR DING COVERAGE NAIC R
Suite 350
INSURERA: Phoenix Ins. Co. (The) 25623
Greenwood Village CO 80111
INSURED
INSURER B : Hartford Aocident and Indemnity 22357
National Car Charging LLC
INSURERC: Travelers Indemnity Co. (The) 25658
INSURER D: Markel Insurance Company 38970
209 Kalamath St
INSURER E:
Ste 3
INSURER F:
Denver CO 80223
COVERAGES CERTIFICATE NUMBER: 17.18 Master AH 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSION SAN1) CONDITIONS OF SUCH POLICIES. OMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAI MS-
INSR
LTR
TYPE OF INSURANCE
ADULSUOR
INSD
WVD
POLICY NUMBER
POLICY EFF
(MM+DDIYYYY)
POLICY EXP
(MWDDIYYYY)
LIMITS
Eagle CO 81631
X COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE $ 1'000'000
CLAIMS -MADE � OCCUR
PREM SES Ea occu RENTED DAMAGE TO nce $ 300'000
MED EXP (Anyone person) $ 5,000
PERSONAL&ADV INJURY $ 1'000'000
A
Y
Y
68086873437
64/08/2017
04/08/2018
GEN'L AGG REGATE LIMITAPPLIES PER:
GENERALAGGREGATE $ 2'000'000
POLICY FIJE T F LDC
PRODUCTS-COMPIOPAGG $ 2,000,000
Contractors Al Schedule $
OTHER:
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT $ 1,000,000
Ea accidern
X
BODILY INJURY (Per person) $
ANYAUTD
B
OWNED SCHEDULED
AUTOSONLY AUTOS
Y
Y
34UECVT9521
04/15/2017
04/15/2018
BOD I LY I NJ U RY (Pe r accide nt) $
PROPERTY DAMAGE $
Peraccidern
HIRED NON -OWNED
AUTOSONLY AUTOSONLY
Underinsured motorist $ 1,000,000
X
UMBRELLA LIABOCCUR
EACH OCCURRENCE $ 1'000'000
AGGREGATE $ 1'000'000
C
EXCESS LIAB
CLAIMS -MADE
CUPOJ645474
04!0812017
04!0812018
DED I X1 RETENTION $ 51000
$
D
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETORIPARTNEFL'EXECUTIVE
OFFICERIMEMBER EXCLUDED? Y
(Mandatory In NH)
N 1 A
MWC004$517.05
04!17!2017
04/17/2018
/\ PER STATUTE OERH
E. L. EACH ACCIDENT $ 1,000,000
E. L. DISEASE -EA EMPLOYEE $ 1'000'000
Ifyes. describe under
DESCRIPTION0F0PERATION Sbelow
E. L. DISEASE - POLICY LIMIT $ 1,000,000
DESCRIPTION of OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached IF more space is required)
Eagle County, its associated or affiliated entities, its sucessors and assigns, elected officials, employees, agents and volunteers are
included as additional insured as respects to general liability where required by written contract. This form is subject to policy terms,
conditions, and exclusions.
CERTIFICATE HOLDER CANCELLATION
01988-2DIS ACORD CORPORATION. All rights reserved.
ACORD 25 (2016.'03) The ACORD name and logo are registered marks of ACORD
SHOULDANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Eagle County, Colorado
ACCORDANCE WITH THE POLICY PROVISIONS.
500 Broadway
AUTHORIZED REPRESENTATIVE
Post Office Box 850
Eagle CO 81631
[� 1
01988-2DIS ACORD CORPORATION. All rights reserved.
ACORD 25 (2016.'03) The ACORD name and logo are registered marks of ACORD