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Home My WebLink About20051179.tiff AGREEMENT 2005 Crack Fill Project THIS AGREEMENT,made this 29 day of March 20°5 by and between Weld County, Colorado,hereinafter called"Owner"and Flat Coat Asphalt Specialists, L.L.C. Doingbusinessas (an individual,)or(a partnership,)or(a corporation)hereinafter called"Contractor". WITNESSETH: That for and in consideration of the payments and agreements hereinafter mentioned: 1. The Contractor will commence and complete the following:2005 Crack Fill Project described in the Invitation for Bids,Bid No.B0500066. 2. The Contractor will furnish all of the material,supplies,tools,equipment,labor and other services necessary for the construction and completion of the Project described herein. I 3. The Contractor will commence the work required by the Contract Documents within ten (10) calendar days after the date of the Notice to Proceed and will complete the 2005 Crack Fill Project within 30 calendar days unless the period for completion is extended otherwise by the Contract Documents. 4. The Contractor agrees to perform all of th W r described in the Contract Documents and comply with the terms therein for the sum of$ '' 0• U ,or as shown in the Bid Schedule. 5. The term"Contract Documents"means and includes the following: (A) Invitation for Bids (B) Instructions to Bidders (C) Bid Proposal (D) Bid Bond (E) Statement of Qualifications and Subcontractors (F) Required Project Forms (G) Agreement (H) Labor and Materials Payment Bond (I) Labor and Materials Payment Bond (1) Performance Bond (K) Notice of Award (L) Notice to Proceed (M) Change Order (N) Certificate of Substantial Completion (O) Lien Waiver (P) Notice of Acceptance (Q) Specifications prepared or'issued by the Weld County Public Works Department. • (R) Colorado Department of Transportation"Standard Specifications for Road and Bridge Construction" (S) Colorado Department of Transportation Standard Plans"M&S Standards" Addenda: No. ,dated ,20 No. ,dated ,20 6. The Owner will pay to the Contractor in the manner and at such times as set forth by the Contract Documents,or otherwise agreed upon in writing. E&o a 21 2005-1179 4/`(1/-CS (r) 3' 4-. 7. This Agreement shall be binding upon all parties hereto and their respective heirs,executors, administrator, successors,and assigns. S. Contract Appropriations: The Owner hereby states and affirms that the amount of money appropriated for this Contract is equal to or in excess of the Contract amount. No change order to this Contract requiring additional compensable work to be performed,which work causes the aggregate amount payable under the Contract to exceed the amount appropriated for the original Contract shall be issued by the Owner unless the Owner assures the Contractor,in writing,that lawful appropriations to cover the costs of the additional work has been nude or unless such work is covered under a remedy-granting provision contained in the Contract. IN WITNESS WHEREOF,the parties hereto have executed,or caused to be executed by their duly authorized officials,this , Agreement in three(3)copies each of which shall be deemed an original on the date fast above written. ACCEPTED BY: ORDERED BY: il THE BOARD OF WELD COUNTY COMMISSIONERS CONT OR 111 BY ' -1 ---)ji .BY William H. Jerke NAME Norman W DavisNAME __ gi (Please Type) managing member TITLE Chair .- TITLE. L APR 1 1 2005 ADDRS sS 601A Innovation L:atc_ Il Windsor, CO 80550 11 DI „ (SEAL) � /� �� ATTEST: , g rr� G`�� 186► 1! n L ��//(( ® filill � i�t(:aunty Cllr TO the Board / BY Chanda Davis-Perryman J D:puty L: rk to the Board (Please Type) Operations Manager TITLE I 1 77 I .Cl ..//7, Bond No. 104492626 PERFORMANCE BOND 2005 Crack Fill Project KNOW ALL MEN 13Y THE PRESENTS;that Flat Coat Asphalt Specialists, LLC (Name of Contractor) 601A Innovation Circle, Windsor, CO 80550 (Address of Contractor) Limited Liability Company _ _,hereinafter called Contractor,and A(Corporation,Partnership,or Individual) • Travelers Casualty and Surety Company of America n� _ (Name of Surety) Hartford, CT 06183 _— (Address of Surety) Hereinafter called surety, are held and firmly bound unto Weld oun,tx,Colorado,�,,,__.,_�, _ (Name of Owner) P.O.Box 758, 11.11 H Street,Greeley.Colorado 80632 (Address of Owner) hereinafter called Owner, in the penal sum of Seven thousand eight hundred ($ 7.810.00 ), in lawful money of the United States of America, for the payment of which sum Wa� arin'rt 14 to be made, we bind ourselves, successors and assigns,jointly and severally firmly by these presents. THE CONDITION OF THIS OBLIGATION is such that whereas, the Contractor entered into a Certain Contact with the Owner,dated the oCis' 1 day of t t heLI i t'tm 20 25 a copy of which is hereto attached and made a parr hereof for the construction of 2005 Crack Fill Projects described in the invitation for Bids, Bid No.B0500066. NOW THEREFORE,if the Contractor shall well,truly and faithfully perform its duties,all of the undertakings,covenants,terms, conditions,and agreements of said contract during the original term thereof,and any extensions thereof which maybe granted by the Owner, with or without notice to the Surety and during the one year guaranty period, and if he shall satisfy all claims and demands incurred under such contract,and shall fially indemnify and save harmless the Owner from all costs and damages which it may suffer by reason of failure to do so,and shall reimburse and repay the Owner all outlay and expense which the Owner may incur in making good any default then this obligation shall be void;otherwise to remain in force and effect. • PROVIDED,FURTHER,that the said Surety for value received hereby stipulates and agrees that no change,extension of time, alteration or addition to the terms of the contract or to the Work to be performed thereunder of the Specifications accompanying the same shall in any way affect its obligation on this Bond,and it does hereby waive notice of any such change,extension of time, alteration or addition to the terms of the contract or to the Work or to the Specificatons. PROVIDED,FURTHER,that nu final settlement between the Owner and the Contractor shall abridge the right of any beneficialy hereunder,whose claim may be unsatisfied. 24 PERFORMANCE BOND 2005 Crack Fill Pro jt IN WITNESS WHEREOF,this instrument is executed in five (5)counterparts,each one of Which shall be deemed an original, this 2_2 day of____ ,20_()4) Flat Co t As halt S eel li is LLC — .� C-, By 1-6 `0 tt 0111011th (Contractor)Secretary (SEAL) 601A Innovation Circle (Witness as to Contractor) (Address) L�/3;6/ c II/es ra%I 61 Windsor, CO 80550 �p� (Address) i� s iiulA c9 ?& 6/ ATTEST: I (S ^t ) KtRifyK Wi ness (SEAL) • Travelers Casualty and Surety Company . of America ___ MAJ. goL ByStlg ti _ CQora .s Winless a.s to ety Attorney-in-Fact Pe Rot a 70 3 7 d Hartford. CT 06183 (Address) (Address) . 4D j,G,yc L' 0 R'Dca7 - I NOTE: Date of Bond must not be prior to date of Contract. If Contractor is Partnership, all partners should execute iHei IMPORTANT: Surety companies executing Bonds mast appear on the TreasuryDcpartment's most current list(Circular f 7 amended) and be authorized to transact business in the State where the Projet:t is located. 25 Bond No. 104492626 LABOR&MATERIALS PAYMENT BOND 2005 Crack Fill Project KNOW ALL MEN BY THE PRESENTS;that Flat Coat Asphalt Specialists, LLC (Name of Contractor) ^' 601A Innovation Circle, Windsor, CO 80550 (Address of Contractor) Limited Liabilit Com any hereinafter called Contractor,and A(Corporation, Partnership,or Individual) Travelers Casualty and Surety Company of America (Name of Surety) Hartford, CT 06183 (Address of Surety) Hercinatter called surety, are held and firmly bound unto Weld County. Colorado (Name of Owner) 1111 H Street. P.O. Box 758, Greeley,Colorado 80632 (Address of Owner) Hereinafter called Owner, in the penal sum of Seven thousand eight hundred ten and 00/100 In lawful money of the United States of America,for thepayment Dollars,($ 7,810.00 successors and assigns,jointly and severally firmly by thee presents. whtch sum well and truly to be made, we bind ourselves, THE CONDITION OF THIS OBLIGATION is such that whereas,the Contractor entered into a Certain Contract with the Owner,dated the d G*\ day of }air C 1 )A copy of which is hereto attached and made a part hereof for the construction of: 20( 2005 Crack-Fill Projects described in the Invitation for Bids,Bid No. BID NUMBER NOW, THEREFORE", if the Contractor shall promptly make payment to all persons, fins, Subcontractors, and corporations furnishing materials for or performing labor in the prosecution of the Work provided for in such contract, and any authorized extension or modification thereof, including all amounts due for materials, lubricants, oil, gasoline, repairs on machinery, equipment and tools, consumed or used in connection with the construction of such Work, and all insurance premiums on said Work, and for all labor, performed in such Work whether by Subcontractor or otherwise, then this obligation shall be void,; otherwise to remain in full force and effect. PROVIDED,FURTHER,that the said Surety for value received hereby stipulates and agrees that no change, extension of time, alteration or addition to the terms of the contract or to the Work to be pe rfomacd thereunder of the Specifications accompanying the same shall in any way affect its obligation on this Bond,and it does hereby waive notice of any such change,extension of time, alteration or addition to the terms of the Contract or to the Work or to the Specifications. PROVIDED,FURTHER,that no final settlement between the Owner and the Contractor shall abridge the right of any beneficiary hereunder, whose claim may be unsatisfied. 26 I LABOR Sc MATERIALS PAYMENT BOND ' 2005 Crack Fill Protect IN WITNESS WHEREOF,this instrument is executed in five(5)counterparts,each one of which shall be deemed an origind I This day of Cirkr l rt 1 . 20 �-1. Flat C Asphalt-.... S eci ists, LLC _ j Co t:tor I C JL1 —� By __ id , (Contractor) Secretary r ' (SEAL) aid_ 601A Innovation Circle (Witness as t ontractor) , (Address) Coi 5 44 - Windsor, CO 80550 J1 Xl (Address) s,4Lai, C; ?c 5Ify .—_ ATTEST: ,. .‘, / / (Surety 'witness (SEAL.) Travelers Casualty and Surety Company of America (/� g� BV.- . A . - \Vimess as Surety Attorney-in-Fact 4)2____&2(,gf,i7 e Hartford, CT 06183 ______ (Address) (Address) terra- & a Co gas-a-7 NOTE: Date of Bond must not be prior to date of Contract. If Contactor i:;Partnership,all partners should execute Bond. IMPORTANT: Surety companies executing Bonds must appear on the Treasury Department's most current list(Circular 570 as amended) and be authorized to transact business in the State where the Project is located. 27 _ - TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA • TRAVELERS CASUALTY AND SURETY COMPANY FARMINGTON CASUALTY COMPANY Hartford, Connecticut 06183-9062 POWER OF ATTORNEY AND CERTIFICATE OF AUTHORITY OF ATTORNEY(S)-IN-FACT KNOW ALL PERSONS BY THESE PRESENTS, THAT TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY, corporations duly organized under the laws of the State of Connecticut, and having their principal offices in the City of Hartford, County of Hartford, State of Connecticut, (hereinafter the "Companies") hath made, constituted and appointed, and do by these presents make, constitute and appoint: Connie K Boston, Donald B. Martin, Chris S. Richmond, Darlene Krings, William C. Bensler, Kelly T. Urwiller, Russell J. Michels, Debra S. Morris, Diane F. Clementson, Valerie R Partridge, Penny R Burkard, of Greeley, Colorado, their true and lawful Attorney(s)-in-Fact, with full power and authority hereby conferred to sign, execute and acknowledge, at any place within the United States, the following instrument(s): by his/her sole signature and act, any and all bonds, recognizances, contracts of indemnity, and other writings obligatory in the nature of a bond, recognizance, or conditional undertaking and any and all consents incident thereto and to bind the Companies,thereby as fully and to the same extent as if the same were signed by the duly authorized officers of the Companies, and all the acts of said Attorney(s)-in-Fact,pursuant to the authority herein given,are hereby ratified and confirmed. This appointment is made under and by authority of the following Standing Resolutions of said Companies, which Resolutions are now in full force and effect: VOTED: That the Chairman,the President,any Vice Chairman,any Executive Vice President,any Senior Vice President,any Vice President,any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint Attorneys-in-Fact and Agents to act for and on behalf of the company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the Company's seal bonds,recognizances,contracts of indemnity,and other writings obligatory in the nature of a bond,recognizance,or conditional undertaking,and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her. VOTED: That the Chairman, the President, any Vice Chairman,any Executive Vice President,any Senior Vice President or any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company,provided that each such delegation is in writing and a copy thereof is filed in the office of the Secretary. VOTED: That any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance, or conditional undertaking shall be valid and binding upon the Company when(a)signed by the President,any Vice Chairman,any Executive Vice President,any Senior Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary,or(b)duly executed(under seal,if required)by one or more Attorneys-in-Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority. This Power of Attorney and Certificate of Authority is signed and sealed by facsimile (mechanical or printed)under and by authority of the following Standing Resolution voted by the Boards of Directors of TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY,which Resolution is now in full force and effect: VOTED: That the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President, any Vice President, any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to any power of attorney or to any certificate relating thereto appointing Resident Vice Presidents,Resident Assistant Secretaries or Attorneys-in-Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof,and any such power of attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding upon the Company in the future with respect to any bond or undertaking to which it is attached. (05-04)Unlimited IN WITNESS WHEREOF, TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY have caused this instrument to be signed by their Senior Vice President and their corporate seals to be hereto affixed this 1st day of December, 2004. STATE OF CONNECTICUT TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA TRAVELERS CASUALTY AND SURETY COMPANY }SS.Hartford FARMINGTON CASUALTY COMPANY COUNTY OF HARTFORD so,ryerrya NJ".1YAN° GASU,4 ga. o Ii:� S By e it S \%.ta s George W. Thompson wit •�`� .+•'p 6`" • "`� Senior Vice President On this 1st day of December, 2004 before me personally came GEORGE W. THOMPSON to me known, who, being by me duly sworn, did depose and say: that he/she is Senior Vice President of TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY, the corporations described in and which executed the above instrument; that he/she knows the seals of said corporations; that the seals affixed to the said instrument are such corporate seals; and that he/she executed the said instrument on behalf of the corporations by authority of his/her office under the Standing Resolutions thereof. C. tmtati.O- r My commission expires June 30, 2006 Notary Public `4`13O" Marie C.Tetreault CERTIFICATE I, the undersigned, Senior Vice President of TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY,stock corporations of the State of Connecticut, DO HEREBY CERTIFY that the foregoing and attached Power of Attorney and Certificate of Authority remains in full force and has not been revoked; and furthermore, that the Standing Resolutions of the Boards of Directors, as set forth in the Certificate of Authority,are now in force. Signed and Sealed at the Home Office of the Company, in the City of Hartford, State of Connecticut. Dated this day of yp , 20 . !'WEgrh, N0.,.iY Asa t, crew, f� i HARTFORD. i =(CIO a e CONK. r y' ; By •�t ``i o+j° `Nr''44. "�j' Peter Schwartz Senior Vice President GTR PAUL L TRAVELERS IMPORTANT DISCLOSURE NOTICE OF TERRORISM INSURANCE COVERAGE On November 26, 2002, President Bush signed into law the Terrorism Risk Insurance Act of 2002 (the "Act"). The Act establishes a short-term pro- gram under which the Federal Government will share in the payment of covered losses caused by certain acts of international terrorism. We are providing you with this notice to inform you of the key features of the Act, and to let you know what effect, if any, the Act will have on your premium. Under the Act, insurers are required to provide coverage for certain losses caused by international acts of terrorism as defined in the Act. The Act fur- ther provides that the Federal Government will pay a share of such losses. Specifically, the Federal Government will pay 90% of the amount of cov- ered losses caused by certain acts of terrorism which is in excess of an in- surer's statutorily established deductible for that year. The Act also caps the amount of terrorism-related losses for which the Federal Government or an insurer can be responsible at $100,000,000,000.00, provided that the insurer has met its deductible. Please note that passage of the Act does not result in any change in cov- erage under the attached policy or bond (or the policy or bond being quoted). Please also note that no separate additional premium charge has been made for the terrorism coverage required by the Act. The premium charge that is allocable to such coverage is inseparable from and imbed- ded in your overall premium, and is no more than one percent of your pre- mium. ILT-1,018(9/04) 04/06/2005 09:08 9706869423 FLAT COAT ASPHALT PAGE 01 Flat Coat 970-686-2448 Circle,Windsor, F x686-9423Toll Colorado Free 888-686-0315 Aspha lt Specialists Fax To: From: a' 84/.-L_a- Fax: ,. n y' Pages: LK --,. Phone: I /},�f ��g Date: 41 lX /V Re: — OP v . -- ❑ Urgent 0 For Review Cl Please Comment 0 Please Reply 0 Please Recycle • Comments: 04/06/2005 09:08 9706869423 FLAT COAT ASPHALT PAGE 02 04/01/2105 08;34 FLOOD FIND PEIOF;SOhN 4 9P6869423 NO.031 0001 ELM V ACORD,.. CERTIFICATE OF LIABILITY INSURANCE 04101105 Y) 0410110 " PR000CER THIS CERTIFICAT[?IS ISSUED AS A MATTER OF INFORMATION Flood&Peterson Insurance Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 4821 Wheaton Drivo HOLDER,THIS CERTIFICATE DOES NOT AMEND,EXTEND OR P O Box 270370 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Fort Collins,CO au527 INSURERS AFFORD/NO COVERAGE NAICN — 1M"1IN° nsuse%A, St.Paul Travelers Insurance Company •Flat Coat Asphalt Specialists,LLC 601-Ainnovation Drive INSURER B: PlnnacdAssurance Windsor.CO 80550 INBlRIEil c: --_- - RIBUm E: COVERAGES TM9 POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO TIE INSURED NAMED ABOVE:OF THE POLICY PERIOD INDICATED.NOTWITHSTANDING /WY REQUIREMENT.TERM OR CONDITION OF ANT CONTRACT OR OTTER DOCUMENT WITH RESPECT 10 WHICH 1 HIS CERTIFICATE MAY BE ISSUED OR FAA?PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT To All T4'.:TERMS.EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITa SHOWN MAY HAVE REEK REDUCED BY PAD CLApIMpS,x,,ry �� LTA IL5RE TYPE OF INSURANCE poucv NUMBER O tE v8 J! NYl p�LPR�ATON A I1P1YJ!4!IYDIYTI LRAT3 A GENERAL IAAwuTI DTCO719IA897T1LO 03103/05 03/03/08 EACH OCCURRENCE si 400,000 X 4 COMMERCIAL GENERAL LIABILITY DANnG RENTED wawa MADE UX DrcuR PREHPspA IPA I,>m...1 ) S300,000 —, MED EXF(Any lm,pew) 'S,QOO — +u._ PERSONAL&AM INJURY $1,000,000 GENERAL AGGREGATE S2AOOS00 DEaT.AGGI✓EO�AT�E LWJT APPLIES PER: PRODUCTS•COMPIOP AOG 32.00(1,000-1 POLICY 1 I JL I JFCp I I we A AUTOMOBILELW&MY. DT810719A897TTL0 — 03/03105 '0,3/003/06 X ANY auto OOOaM modem)prob BIGLEIWIT 11.000,000 ALL OWNED AVTOt — gCHEDULEDAIITDI BODILY INJURY X HIRED nMro$ BODIL(Per PL+',.pn) S INJURY X NONAwNED AUTOS (Per 1.et $ ^ P� I ROPER DAMAGE I $ GARAGE LIABILITY --- E �ANYAUTO AUTO ONLY-EA ACQOT S • OTHER THAN EA ACC $ ALTO ONLY- Aso S EXCESS/IAIBRELIA warrr — OCCUR O LT,eIMs MACE EACH OCCURRENCE S A0IGRBOATE G HDEDUCTIBLE $ RETENTION S CM • 44 S B TAKERS. sB u� THIN AND 4070439 06/01/04 06101/[15 L WBTATW Dm4' S ANY TORY LIMTSL I OFFICCERAOHDER EACLWcDT LITY DUTNE E.L.eAC'HACCIDENI 51 DOOIOOO ler CGPDE th & tAL PROVISIONS wee EL DISEASE.Ell EMPLOYEE x1,000,000 DINER ___ e.L.OISEASE•POLICY mar 31.000,000 ~- _ Gg(A—w423 OE EC IBPIIOm OR DRERA1701M ILOCATIONSIVEHICiJ I EzCLUNONB MIRED ET INDORSEMENT 1$plCIAL PROVIBNNJS Certificate holder is named as additional insured. Fit'A( gGt4-e F 4t Patewt, mt.-.AIti' o Ant (^4&rye�' �. .4 dal CERTIFICATE HOLDER OI,A,_ OI "' , CANCELLATION _ Weld COHnf..PDr SHDJLI ANYOE THE ABOVE OESCgBED POLICIES DA CANOELLED REPORE THE EITPIRADON ••t chasing DATE THEREOF,THE It$URIC.MEURER WILL, 1111 It Street LENGEMVOR I'Dlwt _30_ DAYS MITTEN PO Box 758 francs TOTNE cERMTCAYr HOLpr-R MANED TO THE 4ERY.RUT tyylRE TO 0090$NALL Gree hry IMrot ND DBURAhCN Cu IJABlLT'OF ANY MIND one TIE USURER,IILAGT ns OR ,CO 80632 AUTIOPIZPD REPRIS'NTIA-I VF ACORD 29(2007rW31 DT2 riadie4 'r P17-14-)S60%.1 .vA-'t✓r aa.0 A 1 .7NC. #3310796/M308330 NJS . A ACORD CORPORATION 19ss __ . 04/06/2005 09:08 9706869423 FLAT COAT ASPHALT PAGE 03 + 64%0172265 02:34 FLOOD AND PETERSON 4 9P6869423 143.031 D062 IMPORTANT If the Certificate holder Is an ADDITIONAL INSURED,the policy(es)must be endorsed. A statement on this certificate does not confer rights to the certificate holder in Sou of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form doea not constitute a contract between the issuing insurer(s), authorized represemative or producer,and thn certificate holder, nor does q affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACCIRo 25.5(2007/084 2 of 2 #8310798/14308320 Kit MEMORANDUM TO: Clerk to the Board DATE: April 6, 2005 • COLORADO FROM: Frank B. Hempen, Jr., P.E. Director of Public Works/County Engineer SUBJECT: Item for Chair's Signature Agreement with Flat Coat Asphalt Specialist, LLC for the 2005 Crack Fill Project. The appropriate documentation is attached. pc: Dean Dreher, Engineer Tech III M:AFrancieAAgenda-2.docM:AFrancleAAgenda-2.doc Hello