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HomeMy WebLinkAboutC19-100 Personnel Safety EnterprisesDocuSign Envelope ID: B93BE29F-31DC-410C-8457-08993964F6D1
AGREEMENT FOR SERVICES
BETWEEN EAGLE COUNTY, COLORADO
AND
PERSONNEL SAFETY ENTERPRISES, INC
THIS AGREEMENT ("Agreement") is effective as of 4/2/2019 , by and between Personnel
Safety Enterprises, Inc. an Arizona corporation (hereinafter "Contractor") and Eagle County, Colorado, a body
corporate and politic (hereinafter "County").
RECITALS
WHEREAS, County desires to utilize Contractor provide and stock first aid cabinet supplies and other services as
requested for County owned -facilities (the "Properties"); and
WHEREAS, Contractor is authorized to do business in the State of Colorado and has the time, skill, expertise, and
experience necessary to provide the Services as defined below in paragraph 1 hereof; and
WHEREAS, this Agreement shall govern the relationship between Contractor and 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, including providing and stocking first aid cabinet supplies
and other services as requested by Eagle County, and as described in Exhibits A and B ("Services" or "Work")
which are attached hereto and incorporated herein by reference. The Services are to be completed two times per
year unless product use warrants the Services occur more often at specific facilities. This additional schedule shall
be determined during the normal scheduled Services and approved by the Facilities Manager. The Services shall be
performed in accordance with the provisions and conditions of this Agreement.
a. 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 Exhibits
A and B 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 Facilities Management Department's designee shall be Contractor's contact
with respect to this Agreement and performance of the Services.
3. Term of the Agreement. This Agreement shall commence upon the date first written above, and subject to
the provisions of paragraph 11 hereof, shall continue in full force and effect for a period of one year.
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.
DocuSign Envelope ID: B93BE29F-31DC-410C-8457-08993964F6D1
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 B. The performance of the Services under this Agreement shall not
exceed three thousand dollars ($3,000.00). In the event Contractor and County agree upon the need for additional
services beyond those described in Exhibit A, those services shall be billed at the rates as set forth in Exhibit B.
Prior to commencement of any additional Services at any Property or Properties, Contractor shall first provide
County with a written estimate which shall include an estimate of the labor, materials without any mark up and any
additional costs necessary to perform the Services at a particular Property or Properties. Each estimate must be
approved by County's Representative prior to commencement of the Services by Contractor and all rates shall be in
accordance with the fee schedule set forth in Exhibit B. Total compensation under this Agreement shall not exceed
four thousand ($4,000.00) without a written amendment to this Agreement. 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. 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.
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. 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.
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 Contractor 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).
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
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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. 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 C.
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
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.
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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; 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: Ron Siebert
3289 Cooley Mesa Road
Gypsum, CO 81637
Post Office Box 850
Eagle, CO 81631
Telephone: 970-328-8881
Facsimile: 970-328-3539
E -Mail: ron.siebert@eaglecounty.us
With a copy to:
Eagle County Attorney
500 Broadway
Post Office Box 850
Eagle, Co 81631
Telephone: 970-328-8685
Facsimile: 970-328-8699
E -Mail: atty@eaglecounty.us
CONTRACTOR:
Personnel Safety Enterprises, Inc.
3716 N. Eagle Mountain Drive
Flagstaff, AZ 86004
Telephone: 1-928-526-3131 x114
Facsimile: 1-928-526-2372
E -Mail: julie@personnelsafety.com
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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. 24-71.3-101 to 121.
14. Other Contract Requirements and Contractor Representations.
a. Contractor has familiarized itself with the nature and extent of the Services to be provided
hereunder and the Property, and with all local conditions, federal, state and local laws, ordinances, rules and
regulations that in any manner affect cost, progress, or performance of the Services.
b. Contractor will make, or cause to be made, examinations, investigations, and tests as he deems
necessary for the performance of the Services.
C. To the extent possible, Contractor has correlated the results of such observations, examinations,
investigations, tests, reports, and data with the terms and conditions of this Agreement.
d. To the extent possible, Contractor has given County written notice of all conflicts, errors, or
discrepancies.
e. Contractor shall be responsible for the completeness and accuracy of the Services and shall
correct, at its sole expense, all significant errors and omissions in performance of the Services. The fact that 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. 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.
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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.R.S. 24-76.5-103 prior to the effective date of this
Agreement.
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.R.S. 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:
i. Knowingly employ or contract with an undocumented individual to perform Services
under this Agreement; or
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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:
i. 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.
e. 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).
f. 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]
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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
DocuSign/Ied�� by:
By: S U,�'a
J %46emnty Manager
CONTRACTOR:
PERSONNEL SAFETY ENTERPRISES, INC
DocuSigned by:
By:
92C56777BFAD471...
Print Name:7ulie ]acobs
Title: office Manager
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DocuSign Envelope ID: B93BE29F-31DC-410C-8457-08993964F6D1
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ANS! ComplianCE
The American National Standards
Institute (ANSI) is a private
non-profit organization that
oversees the development of
voluntary consensus standards
for products, services, processes,
systems, and personnel in the
United States. The International
Safety Equipment Association
(ISEA) is a trade association of
manufacturers of personal
protective equipment and other
safety equipment. Together, they
established new standards for
workplace first aid kits known as,
Z308.1-2015 which was last
updated in 2009. The new
standards sets minimum
performance requirements for first
aid kits and their supplies that are
intended for use in various work
environments.
OSHA often refers employers
to the ANSI Z308.1 standard as a
best practices solution for
requirements if a company does
not have an infirmary.
Class A
ANSI/ISEA Z308.1-2015, Class A, Type I, II, III or IV First Aid Kit
This kit meets the ANSI/ISEA Z308.1-2015 standard as so d. It conta rs -' -s' a d p-od• •cts wh ch meet
performance specifications detailed in the standard at the be ow recu rec m m f . t vill continue to
be compliant only when maintained with products :hat mee: ti,e s:anda c at spec f ed quantities.
Required Minimum Fill
1 First Aid Guide
16 Adhesive Bandage 1 x 3 in.
1 E e S.( r .'.as. f oz total
1 Adhesive Tape 2.5 yd (total)
1 F rst A d Gi ce
10 Antibiotic Application 1/57 oz
6 Harc Sa- : zer 1 32 oz
10 Antiseptic 1/57 oz
2 pr Medica Exar G o\ es
1 Breathing Barrier
1 Roller Barcage 2 in. x 4 yd
1 Burn Dressing (gel soaked) 4 x 4 in.
1 Scissors
10 Burn Treatment 1/32 oz
2 Stene pad 3 3
1 Cold Pack 4 x 5 in.
2 Trauma pad 5 9 n.
2 Eye Covering w/ means of attachment 2.9 sq. in.
1 Tnangu a Bandage 40 x 40 x 56 in.
The described kit may be suitable for some businesses. However, the adequac, of t a contents for hazards of each
work environment should always be evaluated by competent personnel. Kits shou d be inspected frequently to ensure
the completeness and usability of all first aid supplies. Any supply beyond its marked expiration date should be discarded
and replaced. For a variety of operations, employers may find that additional first aid supplies and kits are needed.
Class B
ANSI/ISEA Z308.1-2015, Class B, Type I, II, 111 or IV First Aid Kit
This kit meets the ANSI/ISEA Z308.1-2015 standard as sold It contains first aid products which meet
performance specifications detailed in the standard at the below required minimum fill. It will continue to
be compliant only when maintained with products that meet the standard at specified quantities.
Required Minimum Fill
1 First Aid Guide
50 Adhesive Bandage 1 x 3 in.
10 Hand Sanitizer 1'32 oz
2 Adhesive Tape 2.5 yd (total)
4 pr Medical Exam Gloves
25 Antibiotic Application 1.57 oz
2 Roller Bandage 2 in. x 4 yd
50 Antiseptic 1/57 oz
1 Roller Bandage 4 in. x 4 yd
1 Breathing Barrier
1 Scissors
2 Burn Dressing (gel soaked) 4 x 4 in.
1 Splint
25 Burn Treatments/32 oz.
4 Sterile pad 3 x 3 in.
2 Cold Pack 4 x 5 in.
1 Tourniquet
2 Eye Covering w/ means of attachment 2.9 sq. in.
4 Trauma pad 5 x 9 in.
1 Eye/Skin Wash 4 fl. oz. total
2 Triangulai Bandage 40 x 40 x 56 in.
The described kit may be suitable for some businesses. However, the adequacy of the contents for hazards of each
work environment should always be evaluated by competent personnel. Kits should be inspected frequently to ensure
the completeness and usability of all first aid supplies. Any supply beyond its marked expiration date should be discarded
and replaced. For a variety of operations, employers may find that additional first aid supplies and kits are needed.
Class A first aid kits
are intended to provide
a basic range of products
to deal with most common
types of injuries
encountered in the work-
place including: major
wounds, minor wounds
(cuts and abrasions), minor
burns and eye injuries.
Class B kits are intended
to provide a broader
range and quantity of
supplies to deal with
injuries encountered in
more populated, complex
and/or high risk work-
place environments.
DocuSign Envelope ID: B93BE29F-31DC-410C-8457-08993964F6D1
PERSONNEL SAFETY
P+ ENTERPRISES
111111111IN
0 Keeping your workplaceI
Personnelsafety.com • 3716 N. Eagle Mountain Dr. • Flagstaff, AZ 86004 • Phone: 800-526-1232 • Fax: 928-526-2372
Eagle County - Facilities
3289 Cooley Mesa Rd
Gypsum, CO 81637
Dear Mr. Siebert,
January 10, 2019
Thank you for your interest in working with us. Personnel Safety Enterprises has provided van based first
aid, safety and training services since 1972. Please find attached a specialized price list generated
exclusively for Eagle County — Facilities. This price list is valid for one year.
Additionally, I would like to point out that:
There are no hidden service or delivery fees with us
We offer complementary injury prevention clinics for your staff; and
I live in Gypsum and will never use the weather, road conditions, or any other excuse to not
show up when you need me.
Looking forward to working with you!
Sincerely,
Bennett Pollack
First Aid & Safety Territory Manager
Mountain Communities
M: 970-773-0831
E: bennett@personnelsafety.com
Personnel Safety Enterprises, Inc.
3716 N. Eagle Mountain Drive
Flagstaff, AZ 86004
DocuSign Envelope ID: B93BE29F-31DC-410C-8457-08993964F6D1
PkPERSONNEL SAFETY
ENTERPRISES
E Keeping your workplaceI
Person nelsafety.com • 3716 N. Eagle Mountain Dr. • Flagstaff, AZ 86004 • Phone: 800-526-1232 • Fax: 928-526-2372
Eagle County Facilities - 2019 Price List
Part #
Description
Price
81586
LENS CLEANER TOWELETTES 120/BX
$18.11
MCRBK110
GLASSES, BEARKAT CLEAR LENS
$2.55
MCRBK112
GLASSES, BEARKAT GREY LENS PR
$2.55
22502
BURN SPRAY, PUMP 2 OZ
$6.89
24402
MF ANTISEPTIC SPRAY,PUMP 2 OZ
$6.89
51173
ANTISEPTIC, BIO -HAND SANITIZER 25/bx
$6.33
60433
CTN TIP APPLICATOR 3", NS, 100/VL
$3.74
60901
MEDI-RIP 2" X 5 YDS
$7.57
61101
TAPE, ADH TRI CUT, SYDS
$6.08
62301
ELASTIC TAPE, 1" x 5 YDS
$4.96
63101
MEDI-RIP 3" X 5 YDS
$10.29
64101
BLOODSTOPPER COMPRESS 5" X 9"
$4.93
64470
EYE PADS 4/UN
$5.57
65001
BNDG, TRIANGULAR 40" STER 1/UN
$3.91
66044
BURNAID DRESSING, 4X4
$14.92
66626
BURNJEL WATERIEL 6/UN
$9.78
69932
ELASTIC RLLR GAUZE N/S 2" X 4.5 YDS
$4.46
71401
FIRST AID HANDBOOK
$4.21
72401
ICE PACK, SMALL BOXED
$3.10
73699
GLOVES, DISPOSABLE, NITRILE, 2 PR/BX
$3.06
76512
SPLINTER OUT
$4.63
77101
SCISSORS, 4-1/2" WIRE
$2.76
77233
TWEEZER, DISP
$0,72
80201
CPR SHIELD, ECONOMY
$5.57
90233
MFP ANTACID, 100/BX
$13.05
90433
MFP NON-ASPRIN EXTRA STRNGTH 500MG, 100/BX
$15.85
90833
MFP IBUPROFEN, 100/BX
$14.92
91148
MFP PAIN ZAPPERS 250/BX
$24.10
91933
MFP SINUS PAIN & PRESSURE 100/BX
$16.36
93473
MFP TRI -ANTIBIOTIC OINT, 25/BX
$9.82
93618
MFP EYEWASH, 4 OZ
$7.44
100150
BNDG,WOVEN STRIP NON -LTX 7/8"x3" 50/BX
$7.10
100378
FLEXIBLE HW FINGERTIP 40/BX
$7.95
100578
BNDG, MFP HW WVN KNUCKLE 40/BX
$8.80
100673
BNDG, MFP HW WVN 2X3 WVN PATCH 25/BX
$8.63
102033
BNDG,DURA-STRIP NON -LTX 1" 100/BX
$6.99
103071
ANTISEPTIC, MFP WIPES (XL) 20/BX
$5.78
103150
ALCOHOL, MFP PREP PADS 50/BX
$6.08
103612
GAUZE PADS, 3" x 3", 10/BX
$4.89
MOO90033
SPLINT, SAM 9"
$7,74
DocuSign Envelope ID: B93BE29F-31DC-410C-8457-08993964F6D1
PERSSAF-01 AROMANELI
A�ORO CERTIFICATE OF LIABILITY INSURANCE
[DAOT.E(MMIDD/YYVY)
/18/2019
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
t this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER
CONTACT Angela ROmaneli0
The Mahoney Group - Show LowPHONE — FAX
1835 South Extension Road (A/c, No, Ext): (928) 537-4197 (A/c, No):(928) 537-4232
Mesa, AZ 85210 I E-MAIL
ADDRESS:
INSURERA • Gemini Insurance Company 110833
INSURED INSURER B: CENTRAL MUTUAL INSURANCE CO. 120230
Personnel Safety Enterprises I INSURER C: Cincinnati Insurance Company 110677
P.O. BOX 2487 I INSURER D
Flagstaff, AZ 86003 I
INSURER E: (
INSURER F: I
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT 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.
TYPE OF INSURANCE
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE X1 OCCUR
L AGGREGATE LIMIT APPLIES PER:
POLICY 1 PRO- F-1 LOC
—1 PRO-
JECT
AUTOMOBILE LIABILITY
)DLISUBR' POLICY EFF POLICY EXP
ISD WVD POLICY NUMBER IMMIDDIYYYYI I IMM/DDIYYYYI
I
X VNGP001481 03/03/2019 03/03/2020
X i BAP 9944538 02/02/2019 02/02/2020
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIIETgOERIPARTNER/EXECUTIVE
jMandatolry In NHI EXCLUDED? r N / A
If yes, describe under I
EXS 0523257 ' 02/02/2019 102/02/2020
LIM
LIMITS
,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
Eagle County its associated or affiliated entities , Its successors and assigns, elected officials employees agents and volunteers are additional insured
CERTIFICATE HOLDER
Eagle County
Po Box 850
Eagle, CO 81631-0850
ACORD 25 (2016/03)
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.
AUTHORIZED REPRESENTATIVE
I
©19888-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
ANY AUTO
X
AUTOS
I I SCHEDULED
X
I
AUOS ONLY
X I AUTOS ONLY
II
X I
UMBRELLA LIAR
X I OCCUR
—j
EXCESS LIAB
�01I CLAIMS -N
DED _[RETENTIONS
S
)DLISUBR' POLICY EFF POLICY EXP
ISD WVD POLICY NUMBER IMMIDDIYYYYI I IMM/DDIYYYYI
I
X VNGP001481 03/03/2019 03/03/2020
X i BAP 9944538 02/02/2019 02/02/2020
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIIETgOERIPARTNER/EXECUTIVE
jMandatolry In NHI EXCLUDED? r N / A
If yes, describe under I
EXS 0523257 ' 02/02/2019 102/02/2020
LIM
LIMITS
,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
Eagle County its associated or affiliated entities , Its successors and assigns, elected officials employees agents and volunteers are additional insured
CERTIFICATE HOLDER
Eagle County
Po Box 850
Eagle, CO 81631-0850
ACORD 25 (2016/03)
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.
AUTHORIZED REPRESENTATIVE
I
©19888-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
DocuSign Envelope ID: B93BE29F-31DC-410C-8457-08993964F6D1
,ac [ CERTIFICATE OF LIABILITY INSURANCE
DATE(MMIDDNYYY)
IADDLSUBR
I INSR
03/25/2019
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must 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
Applied Risk Services, Inc.
10825 Old Mill Rd
NAME:
PHONE FAx
(A/C. No,(877)234-4420 (A/C,No): (877)234-4421
Omaha, NE 68154
E-MAIL
ADDRESS:
(877)234-4420
PRODUCER
CUSTOMER ID#
INSURER(S) AFFORDING COVERAGE NAIC #
INSURED
INSURER A- California Insurance Co. 38865
Personnel Safety Enterprises, Inc.
dba Personnel Safety Enterprises, Inc.
INSURER B:
INSURER C:
PO BOX 2487
INSURER D:
Flagstaff, AZ 86003-2487
INSURER E:
CTL 1273 1522852
INSURER F:
I GEN'L AGGREGATE LIMIT APPLIES PER:
�j PRO-
I� POLICY jIJECT F7 LOC
COVERAGES CERTIFICATE NUMBER: REVICiON NUMRFR•
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
IADDLSUBR
I INSR
IWVD
POLICY NUMBER
POLICYEFF
MMIDD/YYYY
POLICYEXP
MM/DD/YYYYLIMITS
106468
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
'
CLAIMS MADE C OCCUR
7
_ EACH OCCL/RRENCE i $ _
DAMAGE TO RENTED
IS
- PREMES (Ea_eGcurrence) $
MED EXP fanv one person) ( $
PERSONAL 8 ADV INJURY $
GENERAL AGGREGATE $
PR D TS - COMP/OP A � $
$
I GEN'L AGGREGATE LIMIT APPLIES PER:
�j PRO-
I� POLICY jIJECT F7 LOC
AUTOMOBILE
LIABILITY
I
COMBINED SINGLE LIMIT
(Ea accident) $
]ANYAUTO
ALL OWNED AUTOS
BODILY INJURY Weir ers n) $
`—
ISCHEDULEDAUTOS
BODILY INJRY P r n $
HIRED AUTOS
INON•OWNEDAUTOS
PROPERTY DAMAGE
Per accident $
I $
I$
UM13RELLA LIAB I (OCCUR
EXCESS LIAB 71 CLAIMS MADE
�I
I�
I EACH OCCURRENCE I $
AGGREGATE $
DEDUCTIBLE
RETENTION $
$
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBEREXCLUDED? �
(Mandatory In NH)
If yes, describe under
SPECIAL PROVISIONS below
N I A
_TORY
I
_J
3 7- 5 4 4 4 2 3- O 1- 0 1
01/01/2019
X WC STATU- OTH-
LIMITS
01/01/2020 E.L. EACH ACCIDENT $ 1,0001000
E.L. DISEASE - EA EMPLOYEE! $ 1,000,000
I E.L. DISEASE - POLICY LIMIT I $ 1, 000,000
I
DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (Attach Acord 101, Additional Remarks Schedule, if more space Is required)
Re: Facility Services, Building 77 at 575 Pine Knoll Drive, Flagstaff, AZ 86011. Waiver of subrogation in favor of the State of
Arizona, its departments, agencies, boards, commissions, universities and its officers, officials, agents, and employees relative
to work performed under contract.
CER I iFiCA I t HOLUER CANCELLATION
State of Arizona, Arizona Board of Regents
and NAU
PO Box 4104
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED
IN ACCORDANCE WITH THE POLICY PROVISIONS.
Flagstaff, AZ 86011
AUTHORIZED REPRESENTATIVE
106468
AGORD 25 (2009109) ©1988-2009'ACORD CORPORATION. All rights reserved