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HomeMy WebLinkAboutC17-385 Northwest Colorado Council of GovernmentsAGREEMENT FOR SERVICES
BETWEEN EAGLE COUNTY, COLORADO
AND
NORTHWEST COLORADO COUNCIL OF GOVERNMENTS
THIS AGREEMENT ("Agreement"] is effective as of 11/20/2017 by and between
Northwest Colorado Council of Governments, a collaborative of local governmental entities (hereinafter
"Contractor") and Eagle County, Colorado, a body corporate and politic (hereinafter "County").
RECITALS
WHEREAS, the County, through its Department of Human Services ("DHS") works to promote the health, 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
health, safety and welfare; and
WHEREAS, Contractor will administer Non -Emergent Medical Transportation (NEMT) billing services through
Health First Colorado, Colorado's Medicaid program, (the "Project"); 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 I hereof; and
WHEREAS, this Agreement shall govern the relationship between Contractor and County in connection with the
services.
AGREEMENT
NOW, THEREFORE, in consideration of the foregoing and the following promises Contractor and County agree as
follows:
1. Services or Work. Contractor agrees to diligently provide all services, labor, personnel and materials
necessary to perform and complete the services or work described in ExhibitA ("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 furnish the Services January 1, 2018 through June 30, 2018 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. County's Representative. The Human Services Department's designee shall be Contractor's contact with
respect to this Agreement and performance of the Services.
C17-385
3. Term of the Agreement. This Agreement shall commence on January 1, 2018, and subject to the provisions
of paragraph 11 hereof, shall continue in full force and effect through the 30th day of dune, 2018.
4. Extension or Modification. This Agreement may be extended for up to three additional one year terms
upon written agreement of the parties. Any amendments or modifications shall be in writing signed by both parties.
No additional services or work performed by Contractor shall be the basis for additional compensation unless and
until Contractor has obtained written authorization and acknowledgement by County for such additional services in
accordance with County's internal policies. Accordingly, no course of conduct or dealings between the parties, nor
verbal change orders, express or implied acceptance of alterations or additions to the Services, and no claim that
County has been unjustly enriched by any additional services, whether or not there is in fact any such unjust
enrichment, shall be the basis of any increase in the compensation payable hereunder. In the event that written
authorization and acknowledgment by County for such additional services is not timely executed and issued in strict
accordance with this Agreement, Contractor's rights with respect to such additional services shall be deemed waived
and such failure shall result in non-payment for such additional services or work performed.
5. Compensation. County shall compensate Contractor for the performance of the Services in a sum
computed and payable as set forth in Exhibit A. The performance of the Services under this Agreement shall not
exceed $15,732. Contractor shall not be entitled to bill at overtime and/or double time rates for work done outside
of normal business hours unless specifically authorized in writing by County.
a. For reimbursement Contractor must submit invoices monthly. Invoices shall include a description
of the Services performed. If County 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 performed within thirty (30) days of receipt of a proper and accurate invoice from Contractor. All
invoices shall include detail regarding the hours spent, tasks performed, who performed each task and such other
detail as County may request_
All invoices must be mailed or delivered in-person to the following address to ensure proper payment.
Invoices sent by fax or e-mail will not be accepted.
Eagle County Department of Human Services
Business Office
550 Broadway
Post Office Box 660
Eagle, CO 81631
b. If, at any time during the term or after termination or expiration of this Agreement, County
reasonably determines that any payment made by County to Contractor was improper because the Services for
which payment was made were not performed as set forth in this Agreement, then upon written notice of such
determination and request for reimbursement from County, Contractor shall forthwith return such payment(s) to
County. Upon termination or expiration of this Agreement, unexpended funds advanced by County, if any, shall
forthwith be returned to County.
c. All funds received by Contractor 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. Contractor shall provide the County with progress reports upon County's request; or
Contractor shall furnish progress reports as more specifically set forth in the attached Exhibit A.
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Eagle County HHS General Services Final 5/14
d. County will not withhold any taxes from monies paid to the Contractor hereunder and Contractor
agrees to be solely responsible for the accurate reporting and payment of any taxes related to payments made
pursuant to the terms of this Agreement.
e. Notwithstanding anything to the contrary contained in this Agreement, County shall have no
obligations under this Agreement after, nor shall any payments be made to Contractor in respect of any period after
December 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-t-tOt et. seq.) and the TABOR Amendment (Colorado Constitution, Article X,
Sec. 20).
6. Subcontractors. Contractor acknowledges that County has entered into this Agreement in reliance upon the
particular reputation and expertise of Contractor. Contractor shall not enter into any subcontractor agreements for
the performance of any of the Services or additional services without County's prior written consent, which may be
withheld in County's sole discretion. County shall have the right in its reasonable discretion to approve all
personnel assigned to the subject Project during the performance of this Agreement and no personnel to whom
County has an objection, in its reasonable discretion, shall be assigned to the Project. Contractor shall require each
subcontractor, as approved by County and to the extent of the Services to be performed by the subcontractor, to be
bound to Contractor by the terms of this Agreement, and to assume toward Contractor all the obligations and
responsibilities which Contractor, by this Agreement, assumes toward County. County shall have the right (but not
the obligation) to enforce the provisions of this Agreement against any subcontractor hired by Contractor and
Contractor shall cooperate in such process. The Contractor shall be responsible for the acts and omissions of its
agents, employees and subcontractors.
7. Insurance. Contractor agrees to provide and maintain at Contractor's sole cost and expense, the following
insurance coverage with limits of liability not less than those stated below:
a. Types of Insurance.
Workers' Compensation insurance as required by law.
ii. intentionally omitted.
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 commercial general liability coverage and as set forth above shall be endorsed to
include Eagle County, its associated or affiliated entities, its successors and assigns, elected officials, employees,
agents and volunteers as additional insureds. A certificate of insurance consistent with the foregoing requirements is
attached hereto as Exhibit B.
ii. Contractor's certificates of insurance shall include subcontractors, if any as additional
insureds under its policies or Contractor shall furnish to County separate certificates and endorsements for each
subcontractor.
iii. The insurance provisions of this Agreement shall survive expiration or
3
Eagle County HHS General Services Final 5/14
termination hereof.
iv. The parties hereto understand and agree that the County is relying on, and does
not waive or intend to waive by any provision of this Agreement, the monetary limitations or rights, immunities and
protections provided by the Colorado Governmental Immunity Act, as from time to time amended, or otherwise
available to County, its affiliated entities, successors or assigns, its elected officials, employees, agents and
volunteers.
Contractor isnot entitled to workers' compensation benefits except as
provided by the Contractor, nor to unemployment insurance benefits unless unemployment compensation coverage
is provided by Contractor or some other entity. The Contractor is obligated to pay all federal and state income tax
on any moneys paid pursuant to this Agreement.
8. Indemnification. The Contractor shall indemnify and hold harmless County, and any of its officers, agents
and employees against any losses, claims, damages or liabilities for which County may become subject to insofar as
any such losses, claims, damages or liabilities arise out of, directly or indirectly, this Agreement, or are based upon
any performance or nonperformance by Contractor or any of its subcontractors hereunder; including claims for
bodily injury or personal injury including death or loss or damage to tangible or intangible property; and Contractor
shall reimburse County for reasonable attorney fees and costs, legal and other expenses incurred by County in
connection with investigating or defending any such loss, claim, damage, liability or action. This indemnification
shall not apply to claims by third parties against the County to the extent that County is liable to such third party for
such claims without regard to the involvement of the Contractor. This paragraph shall survive expiration or
termination hereof.
9. Ownership of Documents. All documents (including electronic files) and materials obtained during,
purchased or prepared in the performance of the Services shall remain the property of the County and are to be
delivered to County before final payment is made to Contractor or upon earlier termination of this Agreement.
10. Notice. Any notice required by this Agreement shall be deemed properly delivered when (i) personally
delivered, or (ii) when mailed in the United States mail, first class postage prepaid, or (iii) when delivered by FedEx
or other comparable courier service, charges prepaid, to the parties at their respective addresses listed below, or (iv)
when sent via facsimile so long as the sending party can provide facsimile machine or other confirmation showing
the date, time and receiving facsimile number for the transmission, or (v) when transmitted via e-mail with
confirmation of receipt. Either party may change its address for purposes of this paragraph by giving five (5) days
prior written notice of such change to the other party.
COUNTY:
Eagle County, Colorado
Attention: Kathleen Lyons
500 Broadway
Post Office Box 660
Eagle, CO 81631
Telephone: 970-328-8840
Facsimile: 855-846-075 t
E -Mail: Kathleen.lyons@eaglecounty.us
With a copy to:
Eagle County Attorney
500 Broadway
4
Eagle County HHS General Services Final 5/14
Post Office Box 850
Eagle, Co 81631
Telephone: 970-328-8685
Facsimile: 970-328-8699
E -Mail: atty@eaglecounty.us
CONTRACTOR:
Northwest Colorado Council of Governments
ATTN: Jon Stavney
249 Warren Ave.
Post Office Box 1607
Silverthorne, CO 80435
Telephone: 970-468-0295 ext 113
Facsimile: 970-468-1208
Email: jstavney@nwccog.org
11. Termination. County may terminate this Agreement, in whole or in part, at any time and for any reason,
with or without cause, and without penalty therefor with seven (7) calendar days' prior written notice to the
Contractor. Upon termination of this Agreement, Contractor shall immediately provide County with all documents
as defined in paragraph 9 hereof, in such format as County shall direct and shall return all County owned materials
and documents. County shall pay Contractor for Services satisfactorily performed to the date of termination.
12. Venue, Jurisdiction and Applicable Law. Any and all claims, disputes or controversies related to this
Agreement, or breach thereof, shall be litigated in the District Court for Eagle County, Colorado, which shall be the
sole and exclusive forum for such litigation. This Agreement shall be construed and interpreted under and shall be
governed by the laws of the State of Colorado.
13. Execution by Counterparts; Electronic Signatures. This Agreement may be executed in two or more
counterparts, each of which shall be deemed an original, but all of which shall constitute one and the same
instrument. The parties approve the use of electronic signatures for execution of this Agreement. Only the following
two forms of electronic signatures shall be permitted to bind the parties to this Agreement. (i) Electronic or
facsimile delivery of a fully executed copy of the signature page; (ii) the image of the signature of an authorized
signer inserted onto PDF format documents. All documents must be properly notarized, if applicable. All use of
electronic signatures shall be governed by the Uniform Electronic Transactions Act, C.R.S. 24-71.3401 to 121.
14. Other CQntract 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 County written notice of all conflicts, errors, or
discrepancies.
5
Eagle County HHS General Services Final 5/14
e. Contractor shall be responsible for the completeness and accuracy of the Services and shall
correct, at its sole expense, all significant errors and omissions in performance of the Services. The fact that the
County has accepted or approved the Services shall not relieve Contractor of any of its responsibilities. Contractor
shall perform the Services in a skillful, professional and competent manner and in accordance with the standard of
care, skill and diligence applicable to contractors performing similar services. Contractor represents and warrants
that it has the expertise and personnel necessary to properly perform the Services and shall comply with the highest
standards of customer service to the public. Contractor shall provide appropriate supervision to its employees to
ensure the Services are performed in accordance with this Agreement. In the event County finds these standards of
customer service are not being met by Contractor, County may terminate this Agreement, in whole or in part, upon
seven (7) days' notice to Contractor. This paragraph shall survive termination of this Agreement.
f. Contractor agrees to work in an expeditious manner, within the sound exercise of its judgment and
professional standards, in the performance of this Agreement. Time is of the essence with respect to this
Agreement.
g. This Agreement constitutes an agreement for performance of the Services by Contractor as an
independent contractor and not as an employee of County. Nothing contained in this Agreement shall be deemed to
create a relationship of employer-employee, master -servant, partnership, joint venture or any other relationship
between County and Contractor except that of independent contractor. Contractor shall have no authority to bind
County.
h. Contractor represents and warrants that at all times in the performance of the Services, Contractor
shall comply with any and all applicable laws, codes, rules and regulations.
i. This Agreement contains the entire agreement between the parties with respect to the subject
matter hereof and supersedes all other agreements or understanding between the parties with respect thereto.
j. Contractor shall not assign any portion of this Agreement without the prior written consent of the
County. Any attempt to assign this Agreement without such consent shall be void.
k. This Agreement shall be binding upon and shall inure to the benefit of the parties hereto and their
respective permitted assigns and successors in interest. Enforcement of this Agreement and all rights and obligations
hereunder are reserved solely for the parties, and not to any third party.
1. No failure or delay by either party in the exercise of any right hereunder shall constitute a waiver
thereof. No waiver of any breach shall be deemed a waiver of any preceding or succeeding breach.
In. The invalidity, illegality or unenforceability of any provision of this Agreement shall not affect the
validity or enforceability of any other provision hereof.
n. The signatories to this Agreement aver to their knowledge no employee of the County has any
personal or beneficial interest whatsoever in the Services or Property described in this Agreement. The Contractor
has no beneficial interest, direct or indirect, that would conflict in any manner or degree with the performance of the
Services and Contractor shall not employ any person having such known interests.
o. The Contractor, if a natural person eighteen (18) years of age or older, hereby swears and affirms
under penalty of perjury that he or she (i) is a citizen or otherwise lawfully present in the United States pursuant to
federal law, (ii) to the extent applicable shall comply with C.KS. 24-76.5-103 prior to the effective date of this
Agreement.
6
Eagle County HHS General Services Final 5/14
P. Contractor shall comply with the Civil Rights Act of 196 and Section 504, Rehabilitation Act of
1973, concerning discrimination on the basis of race, color, sex, age, religion, political beliefs, national origin or
handicap.
15. Prohibitions on Government Contracts.
As used in this Section 15, the term undocumented individual will refer to those individuals from foreign countries
not legally within the United States as set forth in C.R.S. 8-17.5-101, et. seq. If Contractor has any employees or
subcontractors, Contractor shall comply with C.RLS. 8-17.5-101, et. seq., and this Agreement. By execution of this
Agreement, Contractor certifies that it does not knowingly employ or contract with an undocumented individual
who will perform under this Agreement and that Contractor will participate in the E -verify Program or other
Department of Labor and Employment program ("Department Program") in order to confirm the eligibility of all
employees who are newly hired for employment to perform Services under this Agreement.
a. Contractor shall not:
Knowingly employ or contract with an undocumented individual to perform Services
under this Agreement; or
ii. Enter into a subcontract that fails to certify to Contractor that the subcontractor shall not
knowingly employ or contract with an undocumented individual to perform work under the public contract for
services.
b. Contractor has confirmed the employment eligibility of all employees who are newly hired for
employment to perform Services under this Agreement through participation in the E -Verify Program or Department
Program, as administered by the United States Department of Homeland Security. Information on applying for the
E -verify program can be found at:
htti)s://www.uscis.gov/e-verify
C. Contractor shall not use either the E -verify program or other Department Program procedures to
undertake pre-employment screening of job applicants while the public contract for services is being performed.
d. If Contractor obtains actual knowledge that a subcontractor performing work under the public
contract for services knowingly employs or contracts with an undocumented individual. Contractor shall be required
to:
Notify the subcontractor and County within three (3) days that Contractor has actual
knowledge that the subcontractor is employing or contracting with an undocumented individual; and
ii. Terminate the subcontract with the subcontractor if within three days of receiving the
notice required pursuant to subparagraph (i) of the paragraph (d) the subcontractor does not stop employing or
contracting with the undocumented individual; except that Contractor shall not terminate the contract with the
subcontractor if during such three (3) days the subcontractor provides information to establish that the subcontractor
has not knowingly employed or contracted with an undocumented individual.
C. Contractor shall comply with any reasonable request by the Department of Labor and Employment
made in the course of an investigation that the department is undertaking pursuant to its authority established in
C.R.S. 8-17.5-102(5).
7
Eagle County HHS General Services Final 5/14
If Contractor violates these prohibitions, County may terminate the Agreement for breach of
contract. If the Agreement is so terminated specifically for breach of this provision of this Agreement, Contractor
shall be liable for actual and consequential damages to County as required by law.
g. County will notify the Colorado Secretary of State if Contractor violates this provision of this
Agreement and County terminates the Agreement for such breach.
[Rest of page intentionally left Blank]
8
Eagle County HHS General Services Final 5/14
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
Lo
Bryan Treu, Interim County Manager
CONTRACTOR
By:
E��e,
Print Name: Jon Stavney
Title: Executive Director
9
Eagle County HHS General Services Final 5/14
SCOPE OF SERVICES, SCHEDULE, FEES
1. PURPOSE:
Eagle County Department of Human Services (ECDHS) provides a wide array of State & Federally -
mandated services to ensure the safety and stability of the most vulnerable populations in Eagle County.
ECDHS seeks to contract with Northwest Colorado Council of Governments (NWCCOG) to provide
services related to administration of the Non Emergent Medical Transportation (NEMT) component of
Health First Colorado, Colorado's Medicaid program. During the six month period, January 1, 2018
through June 30, 2018, NWCCOG will provide the services outlined below.
2. PROVIDER RESPONSIBILITIES:
Contractor will administer the Non Emergent Medical Transportation (NEMT) component of Health First
Colorado, Colorado's Medicaid program on behalf of the Eagle County Department of Human Services.
Responsibilities include:
a) Act as the NEMT Services Broker and facilitate the management of NEMT services through
Eagle County,
b) Approve, refer for transportation, verify receipt of services, bill for approved services, reimburse
transportation providers for approved Medicaid NEMT services and retain appropriate billing
records of said services through the Mountain Ride Transportation Resource Center,
c) Complete Prior Authorization (PAR) and eligibility determination prior to approval or denial of
services through its Mountain Ride Transportation Program,
d) Denial of services will be made in writing and delivered to the client and to the ECDHS with the
appropriate information concerning the reason for denial and "Client Right to Appeal" language
and instructions in the same language that is included on the back of all form claim denials sent
from the department's fiscal agent.
e) NEW claims reimbursement will be provided to transportation providers in a timely fashion not
to exceed 15 business days from receipt of claim from Health First Colorado.
f) Conduct program activities in compliance with all applicable Colorado law, rules and regulations
as outlined by Colorado Department of Health Care Policy and Financing and HIPPA Privacy
Practices, the Colorado Medicaid Privacy Practices standards, and as an authorized agent of Eagle
County Department of Human Services,
g) Maintain complete confidentiality of client records in accordance with all applicable County,
state and federal laws, rules and regulations,
h) Retain 15% of the transportation claims reimbursement paid to transportation providers (except
for Health First Colorado recipients, spouse or legal parent/guardian who provides transportation)
to cover administrative expenses associated with this service,
i) Retain on file appropriate Certification of Transportation Providers in accordance with the NEMT
Billing Program which includes copies of vehicle registrations, appropriate vehicle insurance, and
copy of valid driver's license for the vehicle operator.
j) Maintain and retain client records according to program regulations as outlined by Colorado
Department of Health Care Policy and Financing.
10
Eagle County HHS General Services Final 5/14
3. FEES AND COMPENSATION:
County shall pay Contractor in six monthly installments of $2,622 each. Total compensation is not to
exceed $15,732. Each installment will be paid upon receipt of an invoice and satisfactory completion of
Services performed for each monthly service period which begins on the lst of each month and ends on
the last calendar day of each month. A detailed report of tasks performed and activity progress and any
additional information requested by the County is due on or about the 15" of each month for services
provided the prior calendar month.
ii
Eagle County HHS General Services Final 5/14
EX-IIBIT B
INSURANCE CERTIFICATE
12
Eagle County HHS General Services Final 5/14
ACDRDT. CERTIFICATE OF LIABILITY INSURANCE
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A
2/20
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PRODUCER LIC #NIA I-303-757-5475
THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION
CIRSA
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
3685 Cherry Creek North Drive
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW,
INSURERS AFFORDING COVERAGE
-- ------ --- - -- ---------
INSURER A: CIRSA
- ----- - - •.--
Denver, CO 80209
INSURED
Northwest Colorado Council of Governments
INSURER B;
PO sox 234E
_......................._.
PER 50MAL&ADV INJURY
INSURER C
- .............................
Silnerthorne, CO 80498
INSURER D:
I
INSURER E:
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THE POLICIES OF INSURANCE LISTED 8ELOW 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 15 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES, AGGREGATE LIMITS SHO'R'N MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INTI: TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POEICY E7CPIRATIONDATE (M M fl) njYY1 LIMITS
A
GENERAL LIABILITY
LIAR 01-2917
O1lO1/17 D1j01/18
_FA(:H000IJRRENCE
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X COMMERCIAL GENERAL LIA31LITY
X CLAIMS MAGE i_..__.I OCCUR
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310,000,000
GENERAL AGGREG.ATES
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GEN'LAGGREGATE LIMITAPPLIESPEP:
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DESCRIPTION OF 0PERATIONS&O CATIONSNE HICIL ESIMLUSION 5 ADDED BY ENDORSEMENTIS PECIAL PROVISIONS
Certificate Halder is Additional Insured on Liability Policies if required by contract,
As per the requirements of the EGA between Eagle County and NWCCOG
re: the CDBG grant to fund the Northwest Loan Fund (HLF).
3 Huuil WrYRL lnSVK�yI IHiVKCIS Lt HrK: LH[V UCLI-AI IV
SHOULD ANY OF THE ABOVE 1)ESCRILIE D POLICIES BE CANCELLED 8EFORETHE EXPIRATION
Eagle County DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 38 DAYS WR17TEN
Seth Ayres -Oliver NOTTCE TO THE CERTIFICATE HOLbER NAMED TO THE LEFT, RUT FAILURE TO DD 5R SHALL
P.O. Bax 850 IMPOSE NO OBLIGATION OR LIABILITY OF ANY RIND UPON THE INSURER, ITS AGENTS DR
REPRESENTATIVES,
Eagle, CO 81631 AUTHORIZEDREPRESENTATIVE
DSA
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ACORDM CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD YY)
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
12/29/2017
PRODUCER LIC #N/A 1-303-757-5475
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
CIRSA
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
POLICY EXPIRATIONLTR
DATE (MM/DDIYYI
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
3665 Cherry Creek North Drive
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
INSURER A: CIRSA
Denver, CO 80209
INSURED
Northwest Colorado Council of Governments
FIRE DAMAGE (Any one fire) $ 10,000,000
INSURER B:
PO Box 2308
INSURER C:
Silverthorne, CO 80498
INSURER D:
INSURER E:
COVERAGES
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
POLICY EXPIRATIONLTR
DATE (MM/DDIYYI
LIMITS
A
GENERAL LIABILITY
LIAB 01-2018
01/01/18
01/01/19
EACH OCCURRENCE $ 10,000,000
FIRE DAMAGE (Any one fire) $ 10,000,000
X COMMERCIAL GENERAL LIABILITY
X CLAIMS MADE 71OCCUR
MED EXP (Any one person) $ 0
PERSONAL &ADV INJURY $10,000,000
X $10m POL E&O Aggregate
GENERAL AGGREGATE $
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG $ 10,000,000
POLICY 7 PRO LOC
A
AUTOMOBILE
X
LIABILITY
ANY AUTO
LIAB 01-2018
01/01/18
01/01/19
COMBINED SINGLE LIMIT $ 5,000,000
(Ea accident)
BODILY INJURY
(Per person) $
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per accident) $
HIRED AUTOS
NON -OWNED AUTOS
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT $
OTHER THAN EA ACC $
ANY AUTO
AUTO ONLY: AGG $
EXCESS LIABILITY
EACH OCCURRENCE $
OCCUR 7 CLAIMS MADE
AGGREGATE $
$
DEDUCTIBLE
$
RETENTION $
WORKERS COMPENSATION AND
STATUS OTH-
TORY LIMIT ER
OR
EMPLOYERS' LIABILITY
E.L. EACH ACCIDENT $
E.L. DISEASE - EA EMPLOYEE $
E.L. DISEASE - POLICY LIMIT $
OTHER
-7
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Proof of Liability Coverage for CDBG Grant.
The Northwest Loan Fund is covered under NWCCOG, for the same coverages and limits.
UtK I IFIUA It: HULUtK ADDITIONAL INSURED; INSURER LETTER: UANUtLLA I IUN
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
Eagle County DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Beth Ayres -Oliver IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
P.O. Box 850
REPRESENTATIVES.
Eagle, CO 81631 AUTHORIZED REPRESENTATIVE/ ��
USA � i«f �` _ ( 7
ACORD 25-S (7/97) Moniquef @ ACORD CORPORATION 1988
51792486