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Home My WebLink About20102439.tiff RESOLUTION RE: APPROVE NONEXCLUSIVE LICENSE AGREEMENT CONCERNING INSTALLATION OF IRRIGATION PIPE BENEATH COUNTY ROAD 62.5, BETWEEN COUNTY ROADS 49 AND 51, AND AUTHORIZE CHAIR TO SIGN - PRODUCERS FEEDLOT, LLC WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, the Board has been presented with a Nonexclusive License Agreement Concerning the Installation of Irrigation Pipe beneath County Road 62.5, between County Roads 49 and 51, between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Public Works, and Producers Feedlot, LLC, 30130 County Road 49, Greeley, Colorado 80631,with terms and conditions being as stated in said agreement, and WHEREAS, after review,the Board deems it advisable to approve said agreement, a copy of which is attached hereto and incorporated herein by reference. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado,that the Nonexclusive License Agreement Concerning the Installation of Irrigation Pipe beneath County Road 62.5, between County Roads 49 and 51, between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Public Works, and Producers Feedlot, LLC, be, and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said agreement. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 13th day of October, A.D., 2010. BOARD OF COUNTY COMMISSIONERS 11 Tv- ELD COUNTY, COLORADO ATTEST: SED 8' ;S\ as Rademacher hair Weld County Clerk to the Boar `fir /its ara Kirkmeye , Pro-Tem BY. k 11 9 �C��C �' . ,1. Dept Clerk t he Board Sean P.C -7 l O D M: iam F. arcia unty Attorney �� (- David E. Long Date of signature: II it (I0 2010-2439 I Ur Ili 40 Vra„ci� �C' PL). EG0062 lu�14110 II-3• ID MEMORANDUM WI`Dc. COLORADO TO: Clerk to the Board DATE: October 11, 2010 FROM: Josh Holbrook, Public Works SUBJECT: Agenda Item Nonexclusive License Agreement Concerning Installation of Irrigation Pipe beneath WCR 62.5 between WCR 49 and WCR 51 with Producers Feedlot, LLC to construct, operate, maintain, and repair the new irrigation pipe. Reference: Right-of-Way Permit No. RW 10-00342 attached. Enclosed are two original agreement. Please returned one signed original to Public Works pc: Janet Carter M:AFrancicWgendalosh.doe 2010-2439 NONEXCLUSIVE LICENSE AGREEMENT CONCERNING INSTALLATION OF IRRIGATION PIPE BENEATH WELD COUNTY ROAD 62.5 BETWEEN RD. 49 AND RD. 51 THIS NONEXCLUSIVE LICENSE AGREEMENT, made and entered into this j 3rtday of Oe.\obwr , 2010, by and between the Board of County Commissioners of Weld County, Colorado, (hereinafter "Licensor"), whose address is 915 Tenth Street, Greeley, Colorado 80631, and Producers Feedlot, LLC, (hereinafter "Licensee"), whose local address is 30130 WCR 49, Greeley, Colorado 80631. WITNESSETH: WHEREAS, Licensor is the owner of a public right-of-way located in Weld County, more particularly described on Exhibit A, (Legal Description), and Exhibit B, (Map), which are attached to this Agreement and incorporated herein by reference, (hereinafter referred to as "Property"), and WHEREAS, pursuant to Colorado Revised Statutes, (hereinafter referred to as "C.R.S."), § 38-5-101, Licensor has the authority to permit public and private utilities to locate their facilities along, across, upon and under said Property, and WHEREAS, Licensee desires to construct, operate, maintain, and repair a new irrigation pipe in, under, and/or along portions of the Property, as more particularly described on Exhibit C, (Legal Description), and WHEREAS, Licensor desires to grant Licensee a non-exclusive license (hereinafter referred to as "License"), to allow Licensee to construct, operate maintain, and repair the new irrigation pipe in, under, and/or along portions of the Property, NOW, THEREFORE, in consideration of the covenants contained herein and the agreements of the Licensee to be performed hereunder, and upon the conditions herein stated, Licensor does grant to Licensee with respect to such interest as Licensor may have in the Property, a non-exclusive License to construct, operate maintain, and repair a new irrigation pipe in, under, and/or along portions of the Property, subject to the following terms and conditions: 1. Licensors Limited Interest in Property. Licensor owns a limited interest in the Property and therefore, does not warrant the right-of-way by the issuance of this License. Licensee is responsible for determining the ownership of properties traversed by its lines, the location of all property boundary lines, and the ownership of all right-of-ways. Therefore, Licensee shall obtain from the fee title owner(s) of the Property or others having proprietary interests in the Property such authority or rights as Licensee may need, in addition to this License for Licensee's use of the Property. Licensee acknowledges and agrees that the authorization granted herein by Licensor is subject to Licensee's securing such authority or rights. I 11111111111111111111111��111111111111III11111IIIIVIII 372559 o?D01:28P Weld County, /b -07 v�Y 1 of 10 R 0.00 D 0.00 Steve Moreno Clerk& Recorder • 2. Licensor's Rights. The parties to the Agreement acknowledge and agree that the Property exists as a public right-of-way for the primary benefit of the travelling public, and that the rights granted herein to Licensee and to other public and private utilities and entities, are subject to the Licensor's rights and obligations to preserve and maintain the Property as such. A. Subject to the right granted herein to Licensee, Licensor reserves the remaining use of the Property for existing and future construction, operation, maintenance, repair, replacement relocation and abandonment of its own use and facilities. B. Licensor reserves the right to revoke this License at any time if Licensee fails to comply with the requirements of this Agreement. Should this Agreement be terminated for non-compliance by Licensee, any lines or facilities installed prior to the termination shall remain the responsibility of the Licensee and may be removed or maintained by Licensee at the sole discretion of Licensor. 3. Licensee's Responsibilities. Licensor's grant of the License herein is conditioned upon Licensee's compliance with the following requirements: A. A Traffic Control Plan (TCP) must be submitted and approved prior to Licensee's commencement of work. Licensee shall provide all necessary traffic control in accordance with the Manual on Uniform Traffic Control Devices (MUTCD). Flaggers shall be provided at any locations where normal signing is not capable of handling the safe and orderly flow of traffic. B. Inspection of the work performed in the Weld County right-of-way is required. Licensee will notify Weld County Public Works 24 hours prior to commencing any and all work. Final inspections are required. Weld County shall have the right to order Licensee to stop work anytime Weld County believes that a violation of this Agreement has occurred or if there is a danger to the public safety if the work continues. C. In the event any changes are made to the roadway or its appurtenances within the right-of-way that would necessitate removal or relocation of the irrigation pipe and electrical conduit installed or constructed herein, Licensee shall do so promptly at its own expense upon the request of the County. D. Licensee shall secure and maintain insurance policies that will protect itself, its subcontractors, and Weld County from claims for bodily injury, death, or property damage, which may arise from the installation and/or construction contemplated herein, or caused by the facilities which are installed and/or constructed as permitted herein. Weld County, Colorado, the Board of County Commissioners of the County of Weld, its officers and employees, must be named as an "Additional Named Insured" in all liability insurance policies. The following insurance policies are required and shall be delivered to the Weld County Public Works Department: 2 1IIt 11li11111IIII11 U III 111111/11111111111111III�� 3725590 10/15/2010 01:28P Weld County, CO 2 of 10 R 0.00 0 0.00 Steve Moreno Clerk& Recorder (i) Statutory Worker's Compensation. (ii) Contractor's public liability and property damage in the following sums: Bodily Injury: Property Damage: Each person $1,000,000 Each $1,000,000 accident Each $1,000,000 Aggregate $2,000,000 accident (iii) Automobile public liability and property damage in the following sums: Bodily Injury: Property Damage: Each person $1,000,000 Each $1,000,000 accident Each $1,000,000 accident E. Licensee shall be responsible for obtaining all other State, Federal, or Local permits that may be necessary for the work to be performed. F. If determined necessary by Licensor's Department of Public Works, Licensee shall provide a surety bond or other security for the total amount required to restore the right-of-way under which the projected irrigation pipe is to be installed or constructed, based upon current Licensor's contract prices for the performance of such work. Said security shall remain in effect for a period of two (2) years after acceptance of completed construction by Licensor. Whether or not covered by a bond, Licensee shall reimburse Licensor for any and all expenses incurred by Licensor within 2 years after completion of any work, as a result of, or related to, failure by Licensee to perform all installation, construction, maintenance or other work pursuant to this permit, in a workmanlike manner. G. Licensor's Department of Public Works shall have the authority to suspend work, wholly or in part, because of the failure of Licensee to properly execute the work in accordance with this Agreement. Notwithstanding the issuance of this License, Licensor reserves the right to make or to require Licensee to make any changes, additions, repairs or required relocation of any facilities within the dedicated rights-of- way at any time. Licensor further reserves the right to reconstruct, widen and/or maintain the road(s) or right(s)-of-way affected by this License Agreement, without compensating Licensee. Licensee shall relocate its facility upon notification from Licensor of such activities. H. Licensee shall report all emergency repairs to Weld County Public Works. Licensee shall utilize proper traffic control measures. 111111111 1411 11111111112111111111111 liii 3725590 10/15/2010 01:28P Weld County, CO 3 of 10 R 0.00 D 0.00 Steve Moreno Clerk& Recorder • I. Licensee or its contractor is responsible for locating all existing utilities which may conflict with their work. Contact the Utility Notification Center of Colorado at 811 or 1-800-922-1987 at least two days in advance of digging. Licensee must remove all utility locates such as flags and marker pins from the Property (right-of- way) once the construction is complete. J. No culverts, irrigation structures, drain lines, utility lines, or any other facilities within the right-of-way are to be cut or damaged. In the event Licensee damages an existing facility, Licensee shall first notify the owner and either immediately repair and replace the damaged facility or pay the owner to repair and replace the same in accordance with the desires of the owner. All damaged facilities are to be inspected by Licensor's Department of Public Works before being concealed in any manner. Drainage and barrow ditches are to be restored to original condition immediately after backfilling is completed. It is the duty of Licensee to anticipate all underground obstructions such as culverts, irrigation structures, drain lines, or utility lines. K. At the end of each day during the installation and construction Licensee shall observe the following requirements: (i) All materials shall be removed a minimum of ten feet (10') from outside edge of the road shoulder; (ii) All excavations upon the traveled portions of the right-of-way shall be back-filled in accordance with the Compaction requirements set forth below unless otherwise approved by Weld County; (iii) All traffic signs must be in place per the approved Traffic Control Plan or in accordance with the Manual on Uniform Traffic Control Devices or removed or covered if not applicable to nightly activities. L. No cleated or track equipment may work on or move over asphalt surfaces without mats. M. Licensee shall mark the site of the installation of the irrigation pipe with markers acceptable to Licensor. Licensee shall place Class 6 Road base. N. The installation of non-ferrous lines in any right-of-way shall require a suitable means to facilitate future line location, such as metallic warning tape installed above the line. O. Licensee shall preserve or replace all survey monuments or benchmarks at each work site. If such monuments or bench marks are destroyed, Licensee shall hire a Registered Land Surveyor to replace destroyed monuments or bench marks. If Licensee chooses to preserve such monuments or benchmarks, it shall also hire a Registered Land Surveyor to complete such preservation. P. All road borings shall be cased and will be at a minimum depth of 4 feet 11111111111111111111111III111111111111 III 1111111111111 3725590 10/15/2010 01:28P Weld County CO 4 of 10 R 0.00 0 0.00 Steve Moreno Ckler & Recorder below the lowest point of the right-of-way. All underground facilities that parallel the road centerline shall have a minimum of three (3) feet of ground cover. (See Section 4 for Fiber Optic exceptions.) Q. Compaction Requirements: (i) All compaction of backfills and road surfaces shall be compacted in accordance with the latest edition of the Colorado Department of Transportation's "Standard Specifications for Road and Bridge Construction" or Weld County Public Work Department's Design Criteria. (ii) All backfills located under an existing asphalt surface or under the asphalt not currently in place but will be as part of a new road construction, must be compacted using flow-fill cement in the upper three feet (3') of backfill. (iii) If any wet or non-compactable materials are produced from excavations, they shall be completely removed from the right-of-way and replaced with compactable materials. The right-of-way shall then be returned to the original grades and cross sections. Licensee shall have the authority to determine what materials shall be discarded and what materials shall be acceptable as replacement. (iv) On gravel roads where excavation is done in the road surfaces or excavation materials are stacked on the road surfaces, road base of 900 tons of 3/4 inch crushed gravel meeting the Colorado Highway Department specifications for Class 6 gravel per mile shall be spread over the road surfaces upon completion of the work. Shoulders on paved roads or barrow ditches where excavation is done shall require 300 tons per mile upon completion. These amounts are to coat the road surfaces and do not supersede any requirements within the permit. (v) Backfilling lifts greater than eight (8) inches, but not exceeding twelve (12) inches, shall be permitted providing that Licensee has suitable equipment to properly compact the depth of lift placed. Licensor shall determine if Licensee's equipment and the depth of backfill lift is appropriate. Ninety-five (95%) percent of a standard proctor shall be required at any trench depth or in replacement of any materials within the traveled portion of the right-of-way. Eighty-five (85%) percent of a standard proctor shall be required at any trench depth or in replacement of any materials off the traveled portions of the right-of- way. R. Licensee shall install manholes and other points of access to underground lines within the boundaries of the Property outside the normal wheel path of the roadway so that they do not obstruct maintenance operations within the rights-of-way. Licensee shall adjust access points, at its sole expense, when requested to do so by Licensor. S. Licensee's Obligations Regarding Surveys: (i) All surveying performed within the boundaries of the Property shall be conducted with proper safety equipment and advanced warning signs; (ii) Surveying permit holders can be issued an annual permit. I IIIIIIIIIII11111111 U1III lilt 11111111 3725590 10/15/2010 01:28P Weld Counly, CO 5 of 10 R 0.00 D 0.00 Steve Moreno Clerk& Recorder (iii) Any excavation within the boundaries of the Property will be backfilled with the same material or better than what was excavated. (iv) Licensor offers free monument boxes to Licensee to establish, upgrade or perpetuate the location of an aliquot corner of any section on a paved road. The boxes are located at Weld County Public Works Department. Licensee shall furnish the location of the section corners being preserved to the Surveying Section when obtaining monument boxes. (v) Licensee shall replace all lids on monument boxes when finished working for the day. If a lid is broken, a free replacement lid is available at Licensor's Public Works Department. T. Licensee's Obligations Regarding the Completion of Project: (i) Licensee shall place gravel on all surfaces where any damage has occurred to the road surface from equipment, trenching, or storage of material. Licensor shall determine the damaged areas, remedial work required, and timing of said work. (ii) Licensee shall complete road restoration including, but not limited to, clean-up (including utility markers), repair of damaged facilities, trench compaction, and replacement of gravel shall be kept within one (1) mile of new excavation. (iii) All disturbed portions of the right-of-way or damaged road surfaces are to be returned to their original condition prior to demobilizing. If the right of way is not returned to original conditions, Licensor may perform or contract such remedial work and Licensee shall pay for all work or forfeit its surety bond in order to pay for all work done. U. The upgrade and maintenance of the electrical conduit installed by Licensee, and all other improvements described in this Agreement, shall be at its own expense and without the aid or use of Licensor's funds. V. Project Special Provisions may be attached to the approved Right-of-Way Permit, which includes additional requirements. 4. Indemnification. Except for the negligence of Licensor, Licensee shall indemnify and save harmless Licensor, its successors, assigns, employees, and agents from any damage or loss sustained by them or any of them arising by reason of Licensee's negligence with respect to the upgrade and maintenance of the Property. 5. Hold Harmless. Except for the negligence of Licensor, Licensee agrees to protect Licensor and save and hold it harmless from any and all third party claims and damages that said upgrade and maintenance may directly or indirectly cause and hereby releases Licensor, its successors, assigns, employees, and agents from any and all claims and damages of whatsoever character to property owned by Licensee resulting from any act, either on the part of the Licensor or on the part of any third party. 1 111111 111111 11111 IIV)h1t1!it!)ItiII1 1111 V I II 3725590 10/15/2010 6 of 10 R 0.00 D 0.00 Steve Moreno Clerk& Recorder 6. No Assignment. Licensee shall not assign any or all of its rights under this Nonexclusive License Agreement without first obtaining written consent to such assignment from Licensee, which consent shall not be unreasonably withheld. However, in the event Licensee contracts with a third party contractor to perform the work associated with the installation of the Project, said contractor shall obtain the Right-of-Way Permit required by County. Following the issuance of the permit, with the County's written approval, Licensee may assign one or more of the responsibilities enumerated in Paragraph 3 above to said contractor. 7. Entire Agreement. The parties hereby agree that neither has made or authorized any agreement with respect to the subject matter of this instrument other than expressly set forth herein, and no oral representation, promise, or consideration different from the terms herein contained shall be binding on either party hereto, or its agents or employees. This Nonexclusive License Agreement embodies all agreements between the parties hereto and there are no promises, terms, conditions, or obligations referring to the subject matter whereof other than as contained herein. 8. Effect of Invalidity of Provision. If any term or provision of this Nonexclusive License Agreement, or the application thereof to any person or circumstances shall, to any extent, be held invalid or unenforceable, the remainder of this Nonexclusive License Agreement, or the application of such terms or provisions, to a person or circumstances other than those as to which it is held invalid or unenforceable, shall not be affected, and every other term and provision of this Nonexclusive License Agreement shall be deemed valid and enforceable to the extent permitted by law. 9. No Waiver of Immunity. No portion of this Nonexclusive License Agreement shall be deemed to constitute a waiver of any immunities the parties or their officers or employees may possess, nor shall any portion of this Nonexclusive License Agreement be deemed to have created a duty of care which did not previously exist with respect to any person not a party to this Nonexclusive License Agreement. 10. No Third Party Beneficiary. It is expressly understood and agreed that the enforcement of the terms and conditions of this Nonexclusive License Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties and nothing in this Nonexclusive License Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Nonexclusive License Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties receiving services or benefits under this Nonexclusive License Agreement shall be an incidental beneficiary only. It is mutually understood and agreed that this Nonexclusive License Agreement and all the terms and conditions hereof shall extend to and be binding upon the parties hereto, their successors, and assigns. I 11111111111111111111111 III 11111111111 III 11 Ill IIII 3725590 10/15/2010 01:28P 7 of 10 R 0.00 D 0.00 Steve Moreno Clerk& Recorder EXECUTED IN DUPLICATE the day and year first above written. Licensor: Elsa�` WELD COUNTY, COLORADO, by and through the BOARD OF COUNTY COMMISSIONERS OF WELD COUNTY, COLORADO ATTEST: Clerk to the Board °U SK By: I :i/�i,�1 r % � B . 1 putt' Clerk Ba ra Kirkmeyer, Chair ro-Tem 10/13/2010 Approves W ounty Attorney Licensee: Producers Feedlot, LLC. By: Title: SUBSCRIBED AND SWORN to before me this day of -, "eke,- , 2010. WITNESS my hand and official seal Notary Public My commission expires: MY C0MMI EXPIRES ; LAURA MARRS 10.1SSI0N92011 NOTARY PUBLIC i STATE OF COLORADO - -• 11111111111111111111111 III 111111 Ill III lilt MI dill 3725590 10115/2010 01:28P Weld County, 8 of 10 R 0.00 0 0.00 Steve Moreno Clerk& Recorder EXHIBIT A WELD COUNTY RIGHT-OF-WAY USE PERMIT Weld County Public Works Dept. Q C� Phone: (970)304-6496 1111 H Street y� After Hours: (970)356-4000 P.O. Box 758 Ea Emergency Services: (970)304-6500 x 2700 Greeley, CO 80632 G Inspection: (970)304-6480 B</C WOQ Permit Number: RW10-00342 Issuance of this permit binds applicant and its contractors to all requirements,provisions,and ordinances of Weld County,Colorado. A copy of this permit must be on site at all times during construction hours. Approved MUTCD traffic control/warning devices are required at all times. Permit Type: Standard Permit fee: $180.00 Project Name: USR#: n/a Application Date: 09/21/2010 Start date: 10/13/2010 Expiration date: 12/21/2010 Applicant Information: Contractor Information: Name: Mike Cervi Name: Simon Rodriguez Company: Producers Feedlot Company: Simon's Backhoe Service LLC Phone: 970-352-6500 Phone: 970-352-7820 Email: Heatherp@producersfeeedlot.com Email: Location: WCR: 62.5 Between: 49 And: 51 Address: Subivision: Legal: 31 I 6N / 64W Impacted Surface(s): ❑ Asphalt/Chip seal/RAP ZGravel O Treated Gravel El Outside Roadway O Other Use Type: ❑Communication O Electrical O Gas/Oil O Water Service O Sanitary Sewer p Irrigation ❑Storm Water ❑ Misc Classification of Work: O Abandonment ❑Misc.Occupation O Relocation O Potholing ❑Other o Maintenance O Culvert Installation O Road Improvements O Tree Trimming El New Service O Overhead Installation El Underground Installation O Surveying Description of ROW use: Excavate through 62.5 for 10" irrigation pipe. Restoration: ❑Asphalt(HMA) p Class 6 Road Base ❑Fugitive Dust Chemical p Compaction Testing ❑Mulching p Structural Fill O Flow Fill O Native Material El Reseeding ❑Erosion Control O Other Weekend Hours No Daily work hours are from DAYLIGHT to 1/2 HOUR BEFORE DARK Special Requirements License agreement, Pipe must be registered w/811 one call and marked appropriately for location purposes. 1 day road closure. Approved by: Weld County Public Works Date: 10/11/2010 I111111 11111 111111 111111III111111111111III 11111 1111 IIII Rev.July 2010 3725590 10/15/2010 01:28P Weld County, CO w0000tvooz Page 1 of 1 9 of 10 R 0.00 D 0.00 Steve Moreno Clerk& Recorder Sep. 21. 2010 1 : 07PM Produce EXHIBIT B No. 4966 ?. 0- I� oi} S . „ • uCrou/ wc, R 6g 1 _ ry W e- 5 to cs s C d U 3 C o 0. o a -cTh 4 � �...lc s � o ci3 • wc2 (09Iiy ry Gloss 1 11111111111111111111111 III 111111111111 III 111111 III 3725590 10/15/2010 01:28P Weld County, CO 10 of 10 R 0.00 D 0.00 Steve Moreno Clerk& Recorder Sep. 21. 2010 1 : 07PM Producers Fe EXHIBIT C No. 4966 P. 1 Weld County Public Works Department ,e (j/o '- 003 yc,2 .nAt 1111 H Street,PO Box 758 3� Greeley,CO 80632 1rIT Phone: 970-304.6496 Fax: 970-304-6497 it RIGHT-OF-WAY USE APPLICATION Applicant informal: _,, i Ate—.p Contractor Information: Business name: TI'Odku _r s.keeA_lr+ M—� Business name: S:miss.'ri{a&jfi+oc $nra/'e CAC Contact name: Contact name: c;, 0 orl r+ywra- Address: 3013 6 !MA 41? PO Box: Contact phone: 470-3.5-1-7170 (office) City:c»'eele-y State;La_Zip: R0I.3/ 910.302-11 12. (cell) Phone:179- 52'6SOo Fax: 9'10-95.2.6 Contact e-mail: E-mail; b6ffierteereol rsa-fertdi Com Permit type: Standard ✓ Annual",._„ Project name: USR#(if applicable): Location: WCR S19 and La%a. between and Address: Subdivision: Legal(Sec/twn/Rng):31 - /c N-WW Impacted surface(check all that apply): ❑Asphalt/Chip seal/RAP 13 Gravel 0 Treated Gravel 0 Outside roadway 0 Other Type of Use: ❑ Communications ❑ Electrical ID Gas/Oil ❑ Water service in Sanitary sewer 13?rrigation 0 Storm water ❑ Misc Classification of Work(check all that apply): ❑ Abandonment 0 Misc.occupation 0 Relocation ❑ Potholing ❑ Maintenance ❑ Culvert installation 0 Road improvements ❑ Tree trimming 2'New Service ❑ Overhead installation laiUnderground installation 0 Surveying 0 Other Planned Restoration(check all that apply): ❑ Asphalt(HMA) 0 Flow fill ❑ Compaction testing ❑ Erosion Control licsractural fill 0 Fugitive dust chemical ❑ Reseeding 0 Other • ass 6 road base ❑ Native material // ❑ Mulching /��x� Use and/or construction detail: pYl q ver'f+ e .,throu8 A lop'( 1/2 'COr in"�e 2'n c- Ppr would u t' Lc Stck Or' Irri94+,o., Submittals; 24'W Schedule lat4Contnetor Insurance ❑ Reseeding mix *required ❑ CTrafficcontrolplan 0 HMA mix design 0 Other 0--'Sketch/drawings of work ❑ Road base gradation/Classification a {; 1 �� r Requested Start date: J^/o End date:9-023-A0 Weekend hours requested: Yes_4o e Does project disturb more than one acre? No ✓ Yes CDPHE permit k ;U i SEP 2 1 2010 'r'� i Comments: u - I I 1 vlTYl D (F;CIIGI FY P1JBL;C\YOIRKS rIEPT l Applicant "` - Printed /yl i/_ A ' Signature: Name: ) P Date: , (Revised 5/2010) Sep. 21. 2010 1 :07PM Producers Fee EXHIBIT No. 4966 P. 2 In WELD COUNTY PUBLIC WORKS DEPARTMENT RIGHT-OF-WAY USE FEE SCHEDULE Agtandard Permit F1,= BI Annual Permit Let dmin,review and inspection $125.00 1)Admin,review,and inspection $250.00 2)"Admin,review,and no Inspection $75.00 (Ex:Surveying,Tree trimming) TOTAL: C)Road Bore fig Unit Quantity Minimum Fee Cost Road bore w/bore pit located in R.O.W. $75.00 Per location - Road bore w/bore pit located outside R.O.W. $25.00 Per location - I))Work within a Hard Surface Roadway ' Trench w/Structural fill or Flowable fill $2.00 SF $50.00 Test Hole/Pot Hole $20.00 Each - E)Work within a Gravel Roadway 11/� 'Trench w/Structural fill or Flowable fill $0.50 SF D O ki, Ft $20.00 Tt"e0 Test Hole/Pot Hole $10.00 Each - F)Work In R.O.W,Outside of Roadway Trenching/Plow or cable puller $0.20 LF $15.00 Test Hole/Pot Hole $10.00 Each - S)Now Appurtenance 3 sq/ft or less $25.00 Each - Greater than 3 sq/ft $150.00 Each - HI Abandonment Abandoning/retiring line In R.O.W. $75.00 Each - Subtotal of lines A-H: /`,C.,ac? )1*Working Prior to Permit Aooroval Subtotal x 2 Emergency repairs excluded is 00 TOTAL ,i)`Public Safety Violation $20000 K)Inspection Outside Normal Work Hours $50.00/hr 'As determined by Public Works .eeear For County Use Only A)Permit application _ G)New appurtenance B)Annual permit 14)Abandonment C)Road Bore I)Working prior to permit D)Work w/in a Hard surface roadway J)Public Safety Violation E)Work w/in a Gravel roadway K)Additional Inspection hours F)Work w/in FLOW,outside roadway TOTAL: Revised March,2010 Sep. 21. 2010N 1 : 07PMFAI producers 'eedlo'laace Ins. Group No. 4966 P. al/002 cw'+l CERTIFICATE OF LIABILITY INSURANCE °Pm NIT MTh worm 09/,7,0/10 TtCERTWICATE IS ISSUED MA MA'K'ER OF INFORMATION ONLY AND CONFERT3 NO RIGiHT8 UPON The CserinCAR HOLDER TES CERTIFICATE 00E8 NOT AFFIRMATIVELY OR NEGATIVELY AMEND.EXTEND OR ALTER THE COVERAGE AFFORDED BY WE POLICIES USLOW. TIIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN TNR,ISSUING INSURERIS1 AUTHORRED REPRESENTATIVE OR PROWCIR,AND WE CIS ITFlCATE MOWER- IMPORTANT:Nthe carttph holder If MIADMTIQNAL INSURED.do pWky(alp mane endorsed. 8SUBNOOAMION IS WAIYkb h trite the toms sea oonmdens ol the policy,ceimin policies may romans en endorsement A shdemant on this..UBtMO Cop not corder rights to the tannins isomer hi 111M of cuoh,o cnwnenK4 NSIIOEa �'puryAmEy�i-a.l f*w� Aeaaisaaaaa IfSSIZW1Ce GLOM* WC.Ne.aR5 1 .0e1-.. P 0 Box 478 a.m01. 101 B Math Street Miadsor Co 80550 WBTOMERID1 S»RD-1 Phone:970-674-8825 Pasts ST0-674-8826 I Anouosucays a _,. eroe IMAM MINIMA flea sato Mama=Capa.U1A 25127 s‘von'ialajkhoee Service, LIC MUMS:180O De Teed A POEM C: Greeley CO 80633 mein o: MUMS: MIERF: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: TI451310 Cara?THAT THE POLICES OP IIIBWOOiC OI Ma006WW-WWE BEEN ISSUED70THG 0 gire.0 NAMEDABOVEFCA THE p0130Y PER10C INDICATED.NOSY TNS7AN01NCMNVREQUIREMENT.TERM OR COMMON WARY CONTRACTOR one DOCuM@1rWOW*USPeerTO wesesTTIS cwourn re MAY IIi ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED EY THE P000M6 ogwao MEWS SUBJECT TO ALL THETERME. EXCLUSIONSNwD CONDTIICTS OF SUCH MUSES.LAMS SMDNNMAY HAVE MEN RP-OWED CEqY�PPTrAII 0111DSLAM�S. • TYPE OFamMAICe AMR,,Ikik WilD POLICY MEWLMEW _IleN OW° aeNYYY) Lin 0SHERALwserh• BACHOCCURRENE 51,000,000 A X COMMEROLODIIMMLISLJfY W2241695 12/2710819/21/10 PI A'rs8 5eNnne*i is00.000 T CLAIMIMma ❑Z MCA N e)tee Eves i 5/000 1 , solw.aWHOM 51,000.000 _ oaNN5wAA0ansaa 52,000,000 Mtn innnAn Pet PRDDUC75•CONPQPACO~$2.000.000 n nn nE.C or $ AIRONOMIL IManT MOM u`efr 11,000,000 Vs moms A 1: AM•AVTO ilP2241895 12/37/0912/27/10 afar KWAY(P„won) I _ALL OwNwwlat BCOILY MERV(w.MORN) $ .- SCHEDULED MACE P*0PERN WAGS5 �_HREDAUIOS (Pn.IaAed NCNOANIDANO$ i —. I IMMMLLALW ODOUR N/A EACHOCCURRENE 1 —mis Oa — q ADOAOGTa $ 9 0l000Tmt ✓RnNTON s i * woke=CogsnisoloN 4045169 04701/10 06/01/11 X ittigt i,I [Tr MOpY LY PLOTOMTADT TIN ANY MCPANTOR'PAk NERACOdR'V�--�MIA w WM El EACH ACCIOCST 5100,000 5L =UM* u e.L.COLOR-u*ARAM e 100,000 r P�q�eahe mac. DISI i.raw Lam tSO0,000 ...-� Ot54nP11CN CI0PGATIONe bylaw C.1. , CESCNr1ION ar0 MATISS,LEGROOM l YIH Clfs(ASP AaMS/N,ASSSsw eaa e5sb.dda NMO.op a$squirm° CERTIFICATE HOLDER CANCELLATION MILD ANY OF THE ABOVE DOOMED Malin CANDIED BEFORE WSSIWC07 7)E E P?ATION On TI 0P,NQTIR*ILL se muting IN ACOOMMCE 5111111W POLJCYPROVISIONI• Weld County Public Works Dept. MMEM EDI`E R(SE1rATNE 1111 II Street p J P.O. BOY 785 Ruch,....v_JwaAsocs,llarfe Arpelsv CO 40683 ©1988.2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD aims and lege are registered marks of ACORD Hello