HomeMy WebLinkAboutC19-088 Lewan TechnologyDocuSign Envelope ID: 57AE35EC-957F-403D-A602-1EA62807F256 LEWAN & A550GIATE5, INC. POBox 91LEWAN E N Denver, CO 8 80291-2728 www.LEWAN.com 1.888.LEWANI1 CUSTOM PRINT PROGRAM MONTHLY/eQUARTERLY ALBUQUERQUE SANTA FE BOULDER COLORADO SPRINGS DENVER FORT COLLINS GLENWOOD SPRINGS PUEBLO SILVERTHORNE CHEYENNE CUSTOMER NAME SHIP TO CUSTOMER BILL TO CUSTOMER AGREEMENT NUMBER Eagle County Government -Clerks Office EC05:16427 EC05:16427 SERVICEADDRESS BILLING ADDRESS INTERNAL USE ONLY 500 Broadway PO Box 850 BRANCH DIV CITY STATE ZIP CODE CITY STATE ZIP CODE Eagle CO 181631 Eagle CO 81631 PROGRAM TYPE RECEIVED DATE CUSTOMER KEY CONTACT PRINTED NAME CUSTOMER PHONE TERMS Regina O'Brien 970-328-8783 NET 30 DAYS WAC ENTERED EE# ENTERED DATE CUSTOMER METER CONTACT eMAIL ADDRESS CUSTOMER PURCHASE ORDER NUMBER regina.obrien@eaglecounty.us PROOF EE# LEWAN REPRESENTATIVE 1LEWAN REPRESENTATIVE 2 NO. Charles Huff Rachel Gonzalez PROOF DATE AGREEMENT PRICING: MINIMUM MINIMUM QTRLY/IMAGE BEGINNING MONTH IMAGE + ( COPIES X ) BILLING OVERAGE BASE RATE PRODUCT CODE /DESCRIPTION SERIAL NUMBER /LOCATION METER / MONTH / MONTH. CHARGE 1 [mono Prints ———--— — — — —— 1000 0.01500 15.00 .015 2 — — — — — — — — — — — BASE SUBTOTAL: o.00 SUBTOTAL: 15.00 SALES TAX CODE: SALES TAX TOTAL: RATE: PLUS EXCESS ESTIMATED TOTAL MINIMUM BILLING / BILLING CYCLE: 15.00 PER COPY/PRINT CHARGES AGREEMENT TERM: LEWAN IS COMMITTED TO PROVIDING EXCEPTIONAL CUSTOMER SUPPORT DURING THE TERM OF THIS EFFECTIVE START DATE OF THIS AGREEMENT: E CUSTOM PRINT PROGRAM. OBTAINING REAL-TIME TERM OF THIS AGREEMENT: ❑ 12 Mos ❑24 Mos ❑36 Mos ❑48 MOS ✓❑60 MOS AND ACCURATE DEVICE INFORMATION IS VITAL TO PROVIDING THIS LEVEL OF SUPPORT. INSTALLATION OF THE LEWAN 360MANAGER WILL ALSO ALLOW OEM TONER: AUTOMATED METER ACQUISITION, RESULTING IN ❑ CHECK IF THIS CONTRACT INCLUDES OEM TONER IMPROVED BILLING INTEGRITY. METER SUBMISSION METHOD (Select One): INVOICE OPTION: (CHOOSE ONLY ONE) NO, I agree to the ❑� YES, please install ❑360Manager ❑✓ BY INVOICE MAILED TO BILLING ADDRESS electronic meter (ABOVE) automated metering refusal fee ❑ BY SPREADSHEET WAILED TO AP DEPT AT app ❑ BY .PDF of INVOICE WAILED to AP DEPT SPECIAL INSTRUCTIONS: No annual increases throughout the term of this contract. TERMS AND CONDITIONS: Under this Custom Print Agreement (the "Agreement"), Lewan & Associates (the "Company') will provide Service and Supplies for all Products listed on this cover page and/or on Schedule A and/or on Schedule B (if attached and signed by both parties). A mutually executed Statement of Work may also be associated with this Agreement and, if so, is also hereby incorporated by reference. This Agreement bills base amounts each month and overages quarterly. This Agreement is two pages: this first page is referred to as the "Cover Page." The Terms and Conditions continue on a second page, the "Back Page," and are an integral part of this Agreement, which Customer, named above, hereby acknowledges having read and accepted. MPTAN (CE: DocuSigned by: Vt&i hams Le an 'SAW999 0848T C Ad.= 2 4nature Vicki Mares Jeff shroll CPP Manager Printed Name 3/14/2019 Date NOTE: COST PER PRINT AGREEMENT BECOMES EFFECTIVE ONLY AFTER SIGNED ACCEPTANCE BY CUSTOMER AND CPP MANAGER. REV 032018 Customer Printed Name County Manager Title 3/14/2019 Date DocuSign Envelope ID: 57AE35EC-957F-403D-A602-lEA62807F256 CUSTOM PRINT PROGRAM TERMS AND CONDITIONS 1. SERVICES. Throughout this Services Agreement (the "Agreement") the words "We," "Our," 'Us" and "Contractor" refer to Company. The words "You" "Your" and "County" refer to the Customer indicated on the reverse. This Agreement covers both the labor and materials for adjustments, repairs, and replacement of parts necessitated by normal use of the Equipment listed on the face of this Agreement ("Services"). Services do not include the following: (a) repairs due to (i) misuse, neglect, or abuse (including, without limitation, improper voltage or use of supplies that do not conform to the manufacturers' specifications), (ii) use of options, accessories, products, supplies not provided by Company; (iii) non -Company alterations, relocation, or service; and/or (iv) loss or damage resulting from accidents, fire, water, or theft; (b) maintenance requested outside Company's normal business hours or this Agreement, (c) relocation, (d) software or connected hardware, (e) hard drive replacement, (f) Thermal heads, process units, and fuser units for Facsimile Machines, (g) Thermal Heads and MICR Toner for Laser Printers, and parts and labor for all non -laser printers, and/or (h) parts for Scanners. Replacement parts may be new, reprocessed, or recovered. Supplies provided by Company are in accordance with the copy volumes set forth on the face of this Agreement and within the manufacturer's stated yields, and do not include staples. Supplies are to be used exclusively for the Equipment and remain Company property until consumed. You will return, or allow Company to retrieve, any unused supplies at the termination/expiration of this Agreement. You are responsible for the cost of excess supplies. You authorize Equipment to be connected to automatic meter reading software and/or device or, if we otherwise request, You will provide us with accurate meter readings for each item of Equipment when and by such means as we request. If You do not permit the Company to use automatic meter reading software and/or devices, Company may charge a monthly fee for manually performing meterreads. If You do not provide meter reads as required, Company may estimate the reading and bill accordingly. You shall provide adequate space and electrical service for the operation of the Equipment in accordance with UL and/or manufacturer's specifications. Supplies will be shipped via UPS Ground. Unless otherwise stated herein, Customer will be billed for shipping, including, but not limited to, UPS Ground, Overnight, and/or Messenger Service. Additional fees may be charged for Services provided outside Company's standard business hours or for computer/network issues and will be at Company hourly rates in effect at the time of Services. If, at any time during the Term of this Agreement, Customer upgrades, modifies, or adds equipment, Customer shall promptly notify Company and provide Company right of first refusal to provide Services for added equipment. Company maintains the right to inspect any upgrades and modifications to Equipment and/or additional equipment and, in its sole discretion, determine whether equipment is eligible for Services. If approved for Services, the Agreement will be amended to include such changes, including pricing modifications. Unless otherwise agreed to in writing, Customer remains solely responsible to secure any sensitive data and permanently delete such data from the internal media storage prior to removal of Equipment or termination of this Agreement. 2. TERM AND PAYMENT. Except as otherwise provided for herein, this Agreement is non -cancelable and will commence on the start date indicated on the face of this Agreement and remain in effect throughout the Tenn; and, unless notified in writing sixty (60) days prior to its expiration, this Agreement shall automatically renew for additional one (1) year periods. In the event the fees herein are included in Your lease payment, the Term shall run ooncunentlywith the lease agreement and be subject to the renewal provisions provided for therein. The meter count at installation or, in the case of owned printers, at assessment, will be used for meter/overages calculations. You agree to pay Company all amounts due in accordance with the payment terms set forth on the face of this Agreement or in accordance with the applicable lease agreement, and all other sums when due and payable. Any Minimum Monthly Payment entitles You to Services for a specific number and type (ie. black & white, color, scan) of Prints/Copies as identified on the face of this Agreement and will be billed in advance. In addition, You agree to pay the Overage Rate for each Print/Copy that exceeds the applicable number and type of Prints/Copies provided in the Minimum Monthly Payment which amount shall be billed in arrears and is payable as indicated on the face of this Agreement. A Print/Copy is defined as standard 8.5"x11" copy (larger size copies may register two meter clicks). No credit will be applied towards unused copies/prints. Your obligation to pay all sums when due shall be absolute and unconditional and is not subject to any abatement, offset, defense or counterclaim. Company has the right to withhold Services and supplies, without recourse, for any non-payment. Company retains the right to have all or some of the amounts due hereunder billed and/or collected by third parties. If Customer requires any specialized billing procedure or invoicing, Company reserves the right to bill an administrative fee not to exceed $100 per invoice. Notwithstanding the foregoing, the Contractor will bill Customer on a quarterly basis. The invoice shall be sent to Eagle County Clerk and Recorder Attn Karen Valas, PO Box 537, Eagle, Colorado 81631. 3. TAXES. Payments are exclusive of all state and local sales, use, excise, privilege and similar taxes. You will pay when due, either directly or to Us upon demand, all taxes, fines and penalties relating to this Agreement that are now or in the future assessed or levied. 4. SOFTWARE LICENSE. Company grants (and is hereby authorized by its licensor's to grant) you a non-exclusive, non -transferable license to use in the U.S.: (a) software and accompanying documentation ("Base Software") only with the Equipment with which it was delivered; and (b) Software that is set forth as a separate line item in this Agreement ("Application Software") (including its accompanying documentation), as applicable, for as long as you are current in the payment of all applicable software license fees. "Base Software" and "Application Software" are referred to collectively as "Licensed Software". You have no other rights and may not: (1) distribute, copy, modify, create derivatives of, decompile, or reverse engineer Licensed Software; (2) activate Licensed Software delivered with the Equipment in an inactivated state; or (3) allow others to engage in same. Titre to, and all intellectual property rights in, Licensed Software will reside solely with Company and/or its licensors (who will be considered third -party beneficiaries of this Section). Licensed Software may contain code capable of automatically disabling the Equipment. Disabling code may be activated if: (x) Company is denied access to periodically reset such code; (y) you are notified of a default under this Agreement; or (z) your license is terminated or expires. The Base Software license will terminate: (i) if you no longer use or possess the Equipment; or (ii) upon the expiration or termination of this Agreement, unless you have exercised your option to purchase the Equipment. Neither Company nor its licensors warrant that Licensed Software will be free from errors or that its operation will be uninterrupted. The foregoing terms do not apply to Diagnostic Software or to Licensed Softwareldocumentation accompanied by a clickwrap or shrinkwrap license agreement or otherwise made subject to a separate license agreement. 5. DIAGNOSTIC SOFTWARE. Software used to evaluate or maintain the Equipment ("Diagnostic Software") is included with the Equipment. Diagnostic Software is a valuable trade secret of Company, or its Licensors. Title to Diagnostic Software will remain with Company or its licensors. Company does not grant Customer any right to use Diagnostic Software, and Customer will not access, use, reproduce, distribute or disclose Diagnostic Software for any purpose (or allow third parties to do so). Customer will allow Company reasonable access to the Equipment to remove or disable Diagnostic Software if Customer is no longer receiving Service from Company, provided that any on-site access to Customer's facility will be during Customer's standard business hours. 6. SOFTWARE SUPPORT. Except for Products and/or Third Party Products identified as "No Svc.", Company (or a designated servicer) will provide the software support set forth below or in accordance with an attached statement of work ("Software Support"). For Base Software for Equipment, Software Support will be provided during the initial Term and any renewal period but in no event longer than 5 years after Company stops taking customer orders for the subject model of Equipment. For Application Software, Software Support will be provided as long as you are current in the payment of all applicable software license and support fees. Company will maintain a web -based or toll-free hotline during Company's standard working hours to report Licensed Software problems and answer Licensed Software -related questions. Company, either directly or with its vendors, will make reasonable efforts to: (a) assure that Licensed Software performs in material conformity with its user documentation; (b) provide available workarounds or patches to resolve Licensed Software performance problems; and (c) resolve coding errors for (i) the current Release and (ii) the previous Release fora period of 6 months after the current Release is made available to you. Company will not be required to provide Software Support if you have modified the Licensed Software. New releases of Licensed Software that primarily incorporate compliance updates and coding error fixes are designated as "Maintenance Releases" or "Updates". Maintenance Releases or Updates that Company may make available will be provided at no charge and must be implemented within six months. New releases of Licensed Software that include new content or functionality ("Feature Releases") will be subject to additional license fees at then -current pricing. Maintenance Releases, Updates and Feature Releases are collectively referred to as "Releases". Each Release will be considered Licensed Software governed by the Software License and Licensed Software Support provisions of this Agreement (unless otherwise noted). Implementation of a Release may require you to procure, at your expense, additional hardware and/or software from Company or another entity. Upon installation of a Release, you will return or destroy all prior Releases. For Third Party Software identified as "No Svc.", you shall enter into a support agreement with a Third Party Software vendor or its support services provider, who shall be solely responsible for the quality, timeliness and other terms and conditions of such support services. Company shall have no liability for the acts or omissions of such third party support services provider. 7. WARRANTY: You acknowledge that the Equipment covered by this Agreement was selected by You based upon Your own judgment. COMPANYMAKES NO REPRESENTATIONS OR WARRANTIES, EXPRESS OR IMPLIED, ORAL OR WRITTEN, INCLUDING, WITHOUT LIMITATION, IMPLIED WARRANTIES OF NON -INFRINGEMENT; IMPLIED WARRANTIES OF MERCHANTABILITY; OR FITNESS FOR A PARTICULAR PURPOSE, ALL OF WHICH ARE SPECIFICALLY AND UNRESERVEDLY EXCLUDED. 8. LIMITATION OF LIABILITY. In no event, shall Company be liable for any indirect, special, incidental, loss of profits, or punitive damages whether based in contract, tort, or any other legal theory and irrespective of whether Company has notice of the possibility of such damages. REV_032018 Page 1 of 2 DS Customer Initials Ps DocuSign Envelope ID: 57AE35EC-957F-4O3D-A6O2-1EA628O7F256 9. DEFAULT; REMEDIES; Any of the following events or conditions shall constitute an Event of Default under this Agreement: (a) failure to make payment when due of any indebtedness to Company or for the Equipment, whether or not arising under this Agreement, without notice or demand by Company; (b) breach by You of any obligation herein; or (c) if You cease doing business as a going concern. If You default, Company may : (1) require future Services, including supplies, be paid for in advance, (2) require You to immediately pay the amount of the remaining unpaid balance of the Agreement, (3) terminate any and all agreements with You, and/or (4) pursue any other remedy permitted at law or in equity. In the Event of Default, remaining payment amounts due will be calculated using the average of the last six months' billing or the amount set forth on the face of the Agreement, whichever is greater, multiplied by the remaining months of the Agreement. You agree that any delay or failure of Company to enforce its rights under this Agreement does not prevent Company from enforcing any such right at a later time. All of Company's rights and remedies survive the termination of this Agreement. In the event of a dispute arising out of this Agreement or the Equipment listed herein, should it prevail, Company shall be entitled to collection of its reasonable costs and attorneys' fees incurred in defending or enforcing this Agreement, whether or not litigation is commenced. 10. ASSIGNMENT: You may not sell, transfer, or assign this Agreement without the prior written consent of Company. Company may sell, assign or transfer this Agreement. 11. NOTICES: All notices required or permitted under this Agreement shall be by overnight courier or by registered mail to such party at the address set forth in this Agreement, or at such other address as such party may designate in writing from time to time. Any notice from Company to You shall be effective three days after it has been deposited in the mail, duly addressed, or one day if sent via overnight courier. 12. INDEMNIFICATION. Lewan 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 Lewan or any of its subcontractors hereunder; and Lewan 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 Lewan. This paragraph shall survive expiration or termination hereof. 13. FAX/ELECTRONIC EXECUTION. A fazed or electronically transmitted version of this Agreement may be considered the original and You will not have the right to challenge in court the authenticity or binding effect of any fazed or scanned copy or signature thereon. This Agreement may be signed in counterparts and all counterparts will be considered and constitute the same Agreement. 14. MISCELLANEOUS. (a) Choice of Law. This Agreement shall be governed by the laws of the state of Colorado (without regard to the conflict of laws or principles of such states); (b) intentionally omitted (c) Entire Agreement. This Agreement constitutes the entire agreement between the parties with regards to the Services herein and supersedes all prior agreements, proposals or negotiations, whether oral or written regarding the Services set forth herein; (d) Enforceability. If any provision of this Agreement is unenforceable, illegal or invalid, the remaining provisions will remain in full force and effect; (e) Amendments. This Agreement may not be amended or modified except by a writing signed by the parties; provided You agree that we are authorized, without notice to You, to supply missing information or correct obvious errors provided that such change does not materially alter Your obligations; (f) Force Majeure. Company shall not be responsible for delays or inability to provide Services caused directly or indirectly by strikes, accidents, climate conditions, parts availability, unsafe travel conditions, or other reasons beyond our control; (g) Company has the right to modify/correct any clerical errors. 15. 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 Lewan in respect of any period after December 31 of any year, without an appropriation therefor by County in accordance with a budget adopted by the Board of County Commissioners in compliance with Article 25, title 30 of the Colorado Revised Statutes, the Local Government Budget Law (C.R.S. 29-1-101 et. seq.) and the TABOR Amendment (Colorado Constitution, Article X, Sec. 20). 16. 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: REV_032018 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, personalladvertising 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. 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. ii. Contractors 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 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. 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. Page 2 of 2 DCS J Customer Initials P DocuSign Envelope ID: 57AE35EC-957F-403D-A602-1 EA62807F256 Page 1 of 2 R� RRR CERTIFICATE OF LIABILITY INSURANCE A`��� DATE (MM/DDIYYYY) 12/22/2018 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(les) 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 Willis of New York, Inc. c/o 26 Century Blvd P.O. Sox 305191 CONTACT NAME: PHONE 1-877-945-7378 FAX 1-888-467-2378 IC No Ext): AIC No WC, E-MAIL ADDRESS: certificates@willis.com INSURER(S) AFFORDING COVERAGE NAIC# Nashville, TN 372305191 USA INSURER A: ACE American Insurance Company 22667 INSURED Lewan & Associates, Inc. 1400 S. Colorado Blvd. INSURER B: Travelers Casualty and Surety Company 19038 INSURER C: Indemnity Insurance Company of North Ameri 43575 INSURER D: Denver, CO 80222 INSURER E : INSURER F: $ 2,000,000 COVERAGES CERTIFICATE NUMBER: W9590726 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DDIYYYY POLICY EXP MM/DDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE � OCCUR DAMAGE TO RENTED PREMISES Ea occurrence) $ 2,000,000 MED EXP (Any one person) $ A Y HDO G71230405 01/01/2019 01/01/2020 PERSONAL &ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 10,000,000 X POLICY F7 PRO- JECT F7LOC PRODUCTS - COMP/OPAGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 3,000,000 BODILY INJURY (Per person) $ X ANY AUTO A OWNED SCHEDULED AUTOS ONLY AUTOS Y ISA H2527975A 01/01/2019 01/01/2020 BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ B X UMBRELLALIAB X OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE Y ZUP-12P63747-19 01/01/2019 01/01/2020 DED X RETENTION $ 10, 000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? No (Mandatory in NH) NIA WLR C65437727 01/01/2019 01/01/2020 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1,000,000 $ A Workers Compensation and WLR 065437685 01/01/2019 01/01/2020 E.L. EACH ACCIDENT $1,000,000 Employers' Liability E.L. DISEASE -EA EMP $1,000,000 Per Statute E.L. DISEASE -POLICY $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) SEE ATTACHED CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Eagle County AUTHORIZED REPRESENTATIVE 500 Broadway Eagle, CO 81631 © 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD SR ID: 17269816 BATCH: 1000234 DocuSign Envelope ID: 57AE35EC-957F-403D-A602-1EA62807F256 AGENCY CUSTOMER ID: LOC #: ,a�oRo ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED Willis of New York, Inc. Lewan & Associates, Inc. 1400 S. Colorado Blvd. POLICY NUMBER Denver, CO 80222 See Page 1 CARRIER NAIC CODE See Page 1 See Page 1 EFFECTIVE DATE: See Page 1 kDDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Eagle County, its associated or affiliated entities, its successors and assigns, elected officials employees, agents and volunteers is/are an additional insured with respect to liability coverage as required by written contract or agreement with respect to sales and service of equipment and supplies by Lewan & Associates, Inc.. INSURER AFFORDING COVERAGE: ACE American Insurance Company NAIC#: 22667 POLICY NUMBER: SCE 065437764 EEE DATE: 01/01/2019 EXP DATE: 01/01/2020 TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT: Workers Compensation and E.L. EACH ACCIDENT $1,000,000 Employers' Liability E.L. DISEASE -EA EMP $1,000,000 Per Statute E.L. DISEASE -POLICY $1,000,000 ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SR ID: 17269816 BATCH: 1000234 CERT: W9590726 DocuSign Envelope ID: 57AE35EC-957F-403D-A602-1EA62807F256 POLICY NUMBER: HDO 671230405 Endorsement Number: 56 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations Any Owner, Lessee or Contractor whom you have All locations where you are performing ongoing agreed to include as an additional insured under a operations for such additional insured pursuant to any written contract, provided such contract was executed such written contract. prior to the date of loss. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or However: 2. That portion of "your work" out of which the injury or damage arises has been put to its 1. The insurance afforded to such additional intended use by any person or organization insured only applies to the extent permitted by other than another contractor or subcontractor law; and engaged in performing operations for a 2. If coverage provided to the additional insured is principal as a part of the same project. required by a contract or agreement, the C. With respect to the insurance afforded to these insurance afforded to such additional insured additional insureds, the following is added to will not be broader than that which you are Section III — Limits Of Insurance: required by the contract or agreement to provide for such additional insured. If coverage provided to the additional insured is required by a contract or agreement, the most we CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 DocuSign Envelope ID: 57AE35EC-957F-403D-A602-1EA62807F256 will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 04 13