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HomeMy WebLinkAboutC19-103 Ewing TruckingDocuSign Envelope ID: 0312991 F-CF1 1-48D5-l38A7-E4l325302C7A0
AGREEMENT FOR THE DELIVERY OF GRAVEL BETWEEN
EAGLE COUNTY, COLORADO
AND
EWING TRUCKING AND CONSTRUCTION, LLC
THIS AGREEMENT ("Agreement") is effective as of 4/2/2019 , by and between Ewing
Trucking and Construction, LLC, a Colorado limited liability company (hereinafter "Vendor") and Eagle County,
Colorado, a body corporate and politic (hereinafter "County").
RECITALS
WHEREAS, County desires to retain Vendor to deliver road base/gravel for its various County roads from Vendor;
and
WHEREAS, Vendor agrees to deliver to County 3/4" to 1 ''/z" CDOT spec base (the "Materials") as more specifically
provided in Vendor's bid; and
WHEREAS, Vendor is authorized to do business in the State of Colorado and has the time, skill, expertise, and
experience necessary to provide the Materials and/or materials as set forth below in paragraph 1 hereof; and
WHEREAS, this Agreement shall govern the relationship between Vendor and County in connection with the
delivery of Materials.
AGREEMENT
NOW, THEREFORE, in consideration of the foregoing and the following promises Vendor and County agree as
follows:
1. Materials. Vendor shall deliver 3/4" to 1 '/z" CDOT spec base as requested by County from time to time
during the period commencing April 1, 2019 and ending October 3, 2019 and as more specifically provided in
Vendor's bid, which is attached hereto as Exhibit A and incorporated herein by reference. The 3/4" to 1 '/z" CDOT
spec base is hereinafter referred to as the "Materials" and delivery of the Materials is hereinafter referred to as the
"Services." During the term of this Agreement, County may contact the Vendor from time to time, to schedule
delivery of the Materials. Vendor shall be able to perform the Services as requested and as set forth in Exhibit A.
The services shall be provided in accordance with the provisions and conditions of this Agreement.
a. Vendor agrees to deliver the Materials from April 1, 2019 through October 3, 2019 and in
accordance with the schedule established in Exhibit A. If no date is specified in Exhibit A, then Vendor agrees to
furnish the Materials in a timely and expeditious manner. By signing below, Vendor represents that it has the
expertise and personnel necessary to properly and timely provide the Materials.
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.
DocuSign Envelope ID: 0312991 F-CF1 1-48D5-l38A7-E4l325302C7A0
d. Liquidated Damages: County and Vendor recognize that time is of the essence of this Agreement
and that County will suffer financial loss if the Services are not available as specified in paragraph 1. They also
recognize the delays, expense, and difficulties involved in proving a legal or arbitration preceding the actual loss
suffered by County if the Services are not available on time. Accordingly, instead of requiring such proof, County
and Vendor agree that as liquidated damages for delay (but not as a penalty) Vendor shall pay County Three
Hundred dollars ($300.00) for each day the Materials are not available as set forth in Exhibit A.
2. County's Representative. The Eagle County Road & Bridge Director or his designee shall be Vendor's
contact with respect to this Agreement.
3. Term of the Agreement. This Agreement shall commence upon the date first written above, and subject to
the provisions of paragraph 10 hereof, shall continue in full force and effect through the 3rd day of October, 2019.
4. Extension or Modification. Any amendments or modifications shall be in writing signed by both parties.
No additional Materials shall be provided by Vendor unless and until Vendor has obtained written authorization and
acknowledgement by County for such additional Materials 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 Materials, and no claim that County has been unjustly enriched by any
Materials, 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 Materials is not timely executed and issued in strict accordance with this Agreement, Vendor's rights with
respect to such additional Materials shall be deemed waived and such failure shall result in non-payment for such
additional Materials.
5. Compensation. County shall compensate Vendor for the Materials in a sum computed and payable as set
forth in Exhibit A. The Materials under this Agreement shall not exceed $125,675.91.
a. Payment will be made for Materials satisfactorily delivered and accepted by County within thirty
(30) days of receipt of a proper and accurate invoice from Vendor. All invoices shall include detail regarding the
Materials and such other detail as County may request.
b. If, at any time during the term or after termination or expiration of this Agreement, County
reasonably determines that any payment made by County to Vendor was improper because the Materials for which
payment was made were not provided as set forth in this Agreement, then upon written notice of such determination
and request for reimbursement from County, Vendor shall forthwith return such payment(s) to County. Upon
termination or expiration of this Agreement, unexpended funds advanced by County, if any, shall forthwith be
returned to County.
C. County will not withhold any taxes from monies paid to the Vendor hereunder and Vendor agrees
to be solely responsible for the accurate reporting and payment of any taxes related to payments made pursuant to
the terms of this Agreement.
d. Notwithstanding anything to the contrary contained in this Agreement, County shall have no
obligations under this Agreement after, nor shall any payments be made to Vendor in respect of any period after
December 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).
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Eagle County Materials and Materials Agreement 5/14
DocuSign Envelope ID: 0312991F-CF11-48D5-B8A7-E4B25302C7A0
Insurance. Vendor agrees to provide and maintain at Vendor's sole cost and expense, the following
insurance coverage with limits of liability not less than those stated below:
a. Types of Insurance.
Workers' Compensation insurance as required by law.
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.
The automobile and commercial general liability coverage shall be endorsed to include
Eagle County, its associated or affiliated entities, its successors and assigns, elected officials, employees, agents and
volunteers as additional insureds. A certificate of insurance consistent with the foregoing requirements is attached
hereto as Exhibit B.
ii. The insurance provisions of this Agreement shall survive expiration or
termination hereof.
iii. The parties hereto understand and agree that the County is relying on, and does
not waive or intend to waive by any provision of this Agreement, the monetary limitations or rights, immunities and
protections provided by the Colorado Governmental Immunity Act, as from time to time amended, or otherwise
available to County, its affiliated entities, successors or assigns, its elected officials, employees, agents and
volunteers.
iv. Vendor is not entitled to workers' compensation benefits except as
provided by the Vendor, nor to unemployment insurance benefits unless unemployment compensation coverage is
provided by Vendor or some other entity. The Vendor is obligated to pay all federal and state income tax on any
moneys paid pursuant to this Agreement.
7. Indemnification. The Vendor shall indemnify and hold harmless County, and any of its officers, agents and
employees against any losses, claims, damages or liabilities for which County may become subject to insofar as any
such losses, claims, damages or liabilities arise out of, directly or indirectly, this Agreement, or are based upon any
performance or nonperformance by Vendor or any of its subcontractors hereunder; and Vendor shall reimburse
County for reasonable attorney fees and costs, legal and other expenses incurred by County in connection with
investigating or defending any such loss, claim, damage, liability or action. This indemnification shall not apply to
claims by third parties against the County to the extent that County is liable to such third party for such claims
without regard to the involvement of the Vendor. This paragraph shall survive expiration or termination hereof.
8. Documents. Vendor shall execute any bill of sale or other documents required by County to transfer title
of the Materials to County. Vendor shall provide copies of any instruction or operations manuals and shall further
provide copies of any manufacturers warranties associated with the Materials.
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Eagle County Materials and Materials Agreement 5/14
DocuSign Envelope ID: 0312991 F-CF1 1-48D5-l38A7-E4l325302C7A0
9. Notice. Any notice required by this Agreement shall be deemed properly delivered when (i) personally
delivered, or (ii) when mailed in the United States mail, first class postage prepaid, or (iii) when delivered by FedEx
or other comparable courier service, charges prepaid, to the parties at their respective addresses listed below, or (iv)
when 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: Road & Bridge Department
Post Office Box 250
Eagle, CO 81631
Telephone: 970-328-3540
Facsimile: 970-328-3546
With a copy to:
Eagle County Attorney
500 Broadway
Post Office Box 850
Eagle, Co 81631
Telephone: 970-38-8685
Facsimile: 970-328-8699
E -Mail: atty@eaglecounty.us
VENDOR:
Ewing Trucking and Construction, LLC
28 2nd Street Unit 212
Post Office Box 2303
Edwards, CO. 81632
Telephone: 970-926-2770
Facsimile: 970-926-4736
E-mail: bartgewingtrucking.com
10. Termination. County may terminate this Agreement, in whole or in part, at any time and for any reason,
with or without cause, and without penalty therefor with seven (7) calendar days' prior written notice to the Vendor.
Upon termination of this Agreement, Vendor shall immediately provide County with all documents as defined in
paragraph 8 hereof, in such format as County shall direct and shall return all County owned materials and documents
in the possession of Vendor, if any. County shall pay Vendor for Materials satisfactorily inspected and accepted to
the date of termination.
11. Venue, Jurisdiction and Applicable Law. Any and all claims, disputes or controversies related to this
Agreement, or breach thereof, shall be litigated in the District Court for Eagle County, Colorado, which shall be the
sole and exclusive forum for such litigation. This Agreement shall be construed and interpreted under and shall be
governed by the laws of the State of Colorado.
12. Execution by Counterparts; Electronic Signatures. This Agreement may be executed in two or more
counterparts, each of which shall be deemed an original, but all of which shall constitute one and the same
instrument. The parties approve the use of electronic signatures for execution of this Agreement. Only the following
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Eagle County Materials and Materials Agreement 5/14
DocuSign Envelope ID: 0312991F-CF11-48D5-B8A7-E4B25302C7A0
two forms of electronic signatures shall be permitted to bind the parties to this Agreement: (i) Electronic or
facsimile delivery of a fully executed copy of the signature page; (ii) the image of the signature of an authorized
signer inserted onto PDF format documents. All documents must be properly notarized, if applicable. All use of
electronic signatures shall be governed by the Uniform Electronic Transactions Act, C.R.S. 24-71.3-101 to 121.
13. Other Contract Requirements and Vendor Representations.
a. Vendor has familiarized itself with the intended purpose and use of the Materials to be provided
hereunder, the intended use of such Materials by County, and with all local conditions, federal, state and local laws,
ordinances, rules and regulations that in any manner affect cost, progress, or Materials.
b. Vendor will make, or cause to be made, examinations, investigations, and tests as he deems
necessary for the performance of this Agreement.
C. The fact that the County has accepted or approved the Materials shall not relieve Vendor of any of
its responsibilities. Vendor represents and warrants that it has the expertise and personnel necessary to properly
perform the terms of this Agreement. Vendor shall provide appropriate supervision to its employees to ensure the
performance in accordance with this Agreement. Vendor will provide the Materials in a skillful, professional and
competent manner and in accordance with the standard of care applicable to vendors supplying similar Materials.
d. Vendor warrants merchantability and fitness of the Materials for its intended use and purpose.
e. Vendor hereby represents and warrants that the Materials will be new and guarantees all Materials
against defects for a period of one (1) year from the date the Materials is accepted by County, or such longer period
as may be provided by the law or as otherwise agreed to by the parties.
f All guarantees and warranties of Materials furnished to Vendor by any manufacturer or supplier
are for the benefit of County. If any manufacturer or supplier of any Materials furnishes a guarantee or warrantee
for a period longer than one (1) year, then Vendor's guarantee or warrantee shall extend for a like period as to such
Materials.
g. Vendor warrants that title to all Materials shall pass to County either by incorporation into the
County facility or upon receipt by Vendor of payment from County (whichever occurs first) free and clear of all
liens, claims, security interests or encumbrances. Vendor further warrants that Vendor (or any other person
performing Work) purchased all Materials free and clear of all liens, claims, security interests or encumbrances.
Notwithstanding the foregoing, Vendor assumes all risk of loss with respect to the Materials until County has
inspected and approved the same.
h. Within a reasonable time after receipt of written notice, Vendor shall correct at its own expense,
without cost to County, and without interruption to County:
i. Any defects in Materials which existed prior to or during the period of any guarantee or
warranty provided in this Agreement; and
ii. Any damage to any property caused by such defects or the repairing of such defects.
i. Guarantees and warranties shall not be construed to modify or limit any rights or actions County
may otherwise have against Vendor in law or in equity.
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Eagle County Materials and Materials Agreement 5/14
DocuSign Envelope ID: 0312991F-CF11-48D5-l38A7-E4l325302C7A0
j. Vendor agrees to work in an expeditious manner, within the sound exercise of its judgment and
professional standards, in the performance of this Agreement. Time is of the essence with respect to this
Agreement.
k. This Agreement constitutes an agreement for performance by Contractor as an independent
Contractor and not as an employee of County. Nothing contained in this Agreement shall be deemed to create a
relationship of employer-employee, master -servant, partnership, joint venture or any other relationship between
County and Vendor except that of independent Vendor. Vendor shall have no authority to bind County.
1. Vendor represents and warrants that at all times in the performance of the Agreement, Vendor
shall comply with any and all applicable laws, codes, rules and regulations.
in. This Agreement contains the entire agreement between the parties with respect to the subject
matter hereof and supersedes all other agreements or understanding between the parties with respect thereto.
n. Vendor shall not assign any portion of this Agreement without the prior written consent of the
County. Any attempt to assign this Agreement without such consent shall be void.
o. This Agreement shall be binding upon and shall inure to the benefit of the parties hereto and their
respective permitted assigns and successors in interest. Enforcement of this Agreement and all rights and obligations
hereunder are reserved solely for the parties, and not to any third party.
P. No failure or delay by either party in the exercise of any right hereunder shall constitute a waiver
thereof. No waiver of any breach shall be deemed a waiver of any preceding or succeeding breach.
q. The invalidity, illegality or unenforceability of any provision of this Agreement shall not affect the
validity or enforceability of any other provision hereof.
r. The signatories to this Agreement aver to their knowledge no employee of the County has any
personal or beneficial interest whatsoever in the Materials described in this Agreement. The Vendor has no
beneficial interest, direct or indirect, that would conflict in any manner or degree with the performance of the
Agreement and Vendor shall not employ any person having such known interests.
S. The Vendor, if a natural person eighteen (18) years of age or older, hereby swears and affirms
under penalty of perjury that he or she (i) is a citizen or otherwise lawfully present in the United States pursuant to
federal law, (ii) to the extent applicable shall comply with C.R.S. 24-76.5-103 prior to the effective date of this
Agreement.
14. Prohibitions on Government Contracts.
As used in this Section 14, the term undocumented individual will refer to those individuals from foreign
countries not legally in the United States as set forth in C.R.S. 8-17.5-101, et. seq. If Vendor has any employees or
subcontractors, Vendor shall comply with C.R.S. 8-17.5-101, et. seq., and this Agreement. By execution of this
Agreement, Vendor certifies that it does not knowingly employ or contract with an undocumented individual who
will perform under this Agreement and that Vendor will participate in the E -verify Program or other Department of
Labor and Employment program ("Department Program") in order to confirm the eligibility of all employees who
are newly hired for employment to perform Services under this Agreement.
a. Vendor shall not:
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Eagle County Materials and Materials Agreement 5/14
DocuSign Envelope ID: 0312991F-CF11-48D5-l38A7-E4l325302C7A0
i. Knowingly employ or contract with an undocumented individual to perform Services
under this Agreement; or
ii. Enter into a subcontract that fails to certify to Vendor that the subcontractor shall not
knowingly employ or contract with an undocumented individual to perform work under the public contract for
services.
b. Vendor has confirmed the employment eligibility of all employees who are newly hired for
employment to perform Services under this Agreement through participation in the E -Verify Program or Department
Program, as administered by the United States Department of Homeland Security. Information on applying for the
E -verify program can be found at:
https://www.uscis.gov/e-verify
C. Vendor shall not use either the E -verify program or other Department Program procedures to
undertake pre-employment screening of job applicants while the public contract for services is being performed.
d. If Vendor obtains actual knowledge that a subcontractor performing work under the public
contract for services knowingly employs or contracts with an undocumented individual, Vendor shall be required to:
i. Notify the subcontractor and County within three (3) days that Vendor has actual
knowledge that the subcontractor is employing or contracting with an undocumented individual; and
ii. Terminate the subcontract with the subcontractor if within three days of receiving the
notice required pursuant to subparagraph (i) of the paragraph (d) the subcontractor does not stop employing or
contracting with the undocumented individual; except that Vendor shall not terminate the contract with the
subcontractor if during such three (3) days the subcontractor provides information to establish that the subcontractor
has not knowingly employed or contracted with an undocumented individual.
e. Vendor shall comply with any reasonable request by the Department of Labor and Employment
made in the course of an investigation that the department is undertaking pursuant to its authority established in
C.R.S. 8-17.5-102(5).
f If Vendor violates these prohibitions, County may terminate the Agreement for breach of contract.
If the Agreement is so terminated specifically for breach of this provision of this Agreement, Vendor shall be liable
for actual and consequential damages to County as required by law.
g. County will notify the Colorado Secretary of State if Vendor violates this provision of this
Agreement and County terminates the Agreement for such breach.
[REST OF PAGE INTENTIONALL Y LEFT BLANK]
7
Eagle County Materials and Materials Agreement 5/14
DocuSign Envelope ID: 0312991 F-CF1 1-48D5-l38A7-E4l325302C7A0
IN WITNESS WHEREOF, the parties have executed this Agreement the day and year first set forth above.
Attest:
DuSigned by:,¢,,�
By: �;" OL'UviUA,
Re 4ZW�,6Perk to the Board
COUNTY OF EAGLE, STATE OF COLORADO, By and
Through Its BOARD OF COUNTY COMMISSIONERS
DocuSigned by:
By: 5
"AMeQmacuey, Chair
VENDOR:
DocuSigned by:
By 26a� ewa "j
AOAKBOEODDC43D...
Title: Manager
8
Eagle County Materials and Materials Agreement 5/14
DocuSign Envelope ID: 0312991 F-CF1 1-48D5-l38A7-E4l325302C7A0
EXHIBIT A
SCOPE OF SERVICES AND MATERIALS, SCHEDULE, FEES
Eagle County Materials and Materials Agreement 5/14
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EXHIBIT B
INSURANCE CERTIFICATES
10
Eagle County Materials and Materials Agreement 5/14
DocuSign Envelope ID: 0312991F-CF11-48D5-B8A7-E4B25302C7A0
/
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
A� " CERTIFICATE OF LIABILITY INSURANCE
DATE (MMIDD/YYYY)
INSR
LTR
12/17/2018
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(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER
CONTACT Tonya Raymond
NAME:
Moody -Valley Insurance Agency
(970) 248-8300 FA (970) 242-1894
�CONN0
/CO. No :
Ext):
E-MAIL tonya.raymond@moodyins.com
ADDRESS:
760 Horizon Drive, Suite 302
CLAIMS -MADE FX OCCUR
INSURER(S) AFFORDING COVERAGE NAIC #
INSURERA: Cincinnati Insurance Company 10677
Grand Junction CO 81506
INSURED
INSURER B: Plnnacol Assurance 41190
INSURER C :
Ewing Trucking and Construction, LLC.
INSURER D:
PO Box 2303
INSURER E:
INSURER F:
Edwards CO 81632
COVERAGES CERTIFICATE NUMBER: 19-20 Master Cert 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 INSURANCEADDLSUBR
INSD
WVD
POLICY NUMBER
POLICY EFF
MM/DD/YYYY
POLICY EXP
MM/DD/YYYY
LIMITS
X COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE $ 1,000,000
CLAIMS -MADE FX OCCUR
DAMAGE TO
PREM SES Ea oNcE ante $ 100,000
MED EXP (Any one person) $ 5,000
PERSONAL &ADV INJURY $ 1,000,000
A
Y
EPP0171971
01/01/2019
01/01/2020
GEN-LAGGREGATE LIMITAPPLIES PER:
GENERAL AGGREGATE $ 2,000,000
PRO
X JECT LOC
PRODUCTS-COMP/OPAGG $POLICY 2,000,000
$
OTHER:
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT $ 1,000,000
Ea accident
BODILY INJURY (Per person) $
X
ANYAUTO
A
OWNED SCHEDULED
AUTOS ONLY AUTOS
Y
EPP0171971
01/01/2019
01/01/2020
BODILY INJURY (Per accident) $
PROPERTY DAMAGE $
Per accident
HIRED HNON-OWNED
AUTOS ONLY AUTOS ONLY
Medical payments $ 5,000
X
UMBRELLA LIAB
X
OCCUR
EACH OCCURRENCE $ 2,000,000
AGGREGATE $ 2,000,000
A
EXCESS LAB
CLAIMS -MADE
EPP0171971
01/01/2019
01/01/2020
DED I X1 RETENTION $ 10,000
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y/ N
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBEREXCLUDED?
(Mandatory in NH)
NIA
1856142
01/01/2019
01/01/2020
PER STATUTE ETH
X1
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
Leased & Rented Equipment
EPP0171971
01/01/2019
01/01/2020
Limit/ACV/$500 Ded $75,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Eagle County Government, its associated or affiliated entities, its successors and assigns, elected officials, employees, agents and volunteers are Additional
Insureds under the commercial general liability and automobile liability policies of insurance.
CERTIFICATE HOLDER CANCELLATION
@ 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Eagle County Government
ACCORDANCE WITH THE POLICY PROVISIONS.
500 Broadway
AUTHORIZED REPRESENTATIVE
Eagle CO 81631
Ayt
@ 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
DocuSign Envelope ID: 0312991F-CF11-48D5-B8A7-E4B25302C7A0
AGENCY CUSTOMER ID:
LOC #:
A4'O1?V ADDITIONAL REMARKS SCHEDULE
Page of
AGENCY
Moody -Valley Insurance Agency
NAMED INSURED
Ewing Trucking and Construction, LLC.
POLICY NUMBER
CARRIER
NAIC CODE
EFFECTIVE DATE:
ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: FORM TITLE: : Notes
CONTRACTUAL LIABILITY APPLIES PER POLICY TERMS AND CONDITIONS
Motor Truck Cargo, Cincinnati Insurance Company, NAIC code 10677, EPP0171971, 01/01/2019 to 01/01/2020, $500,000, $1,000 Deductible.
General Liability:
Blanket Additional Insured status applies only to the extent provided in form GA 233 0917 and GA472 0917 when required by written contract.
Blanket Waiver of Subrogation applies only to the extent provided in form GA 233 0917 when required by written contract.
Primary and Non -Contributory status only to the extent provided in form GA 233 0917 and GA472 0917 when required by written contract.
Per Project General Aggregate applies only to the extent provided in form GA 233 0917 when required by written contract.
Contractor's Limited Pollution Liability, $1,000,000 Each Pollution Incident and $1,000,000 Pollution Liability Aggregate, $3,000 Per Claim Deductible.
Auto Liability:
Blanket Additional Insured status applies only to the extent provided in form AA 4171 1105 when required by written contract.
Blanket Waiver of Subrogation applies only to the extent provided in form AA 4172 0909 when required by written contract.
Primary and Non -Contributory status only to the extent provided in form AA 101 0306 when required by written contract.
Pollution Liability Broadened Coverage, form AA 4012 0306, $25,000 Per Accident and $25,000 Per Aggregate, $500 Deductible per Accident
Umbrella Liability:
Umbrella Liability policy is on a follow form basis for the following underlying insurance coverages: General Liability, Automobile Liability, and Employers
Liability. Additional insured status will follow when required by written contract including Primary and Non -Contributory status when required by written
is Compensation:
From Attached Includes Blanket Waiver of Subrogation. Status applies when required by written contract.
IMPORTANT:
The policy forms referenced will be sent via email only. To obtain copies, please send your request with the email address to certrequestgj@moodyins.com.
ACORD 101 (2008/01) @ 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD