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Home My WebLink About992246.tiff Client# : 12574 FISME ACORDTM CERTIFICATE OF LIABILITY INSURANCE 08/25/99 PRODUCER - THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Flood & Peterson Insurance-Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 4821 Wheaton Drive HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P O Box 270370 Fort Collins, CO 80527 ' - INSURERS AFFORDING COVERAGE INSURED INSURER A:ST PAUL FIRE & MARINE INSURANCE CC Fisher Mechanical — INSURERB.FREMONT INDEMNITY COMPANY 2305 W. 9th Street - - -- -_- INSURER : Greeley, CO 80631 D INSURER D: INSURER E: COVERAGES THE POUCIES 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 AFFOR]ED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I NTR POLICY EFFECTIVE POLICY EXPIRATION TYPE OF INSURANCE POLICY NUMBER DATE(MMJ I)/YYI DATE(MM/DD/YT) LIMITS A GENERAL LIABILITY 1BFS00000378664 08/25/99 08/25/00 EACH OCCURRENCE $500000 X I COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any one l ire)$50,000 1 CLAIMS MADE XJ OCCUR MED EXP(Any one person) L$5, QQQ PERSONAL BADV INJURY $500, 000 GENERALAGGREGATE $1, 000 L 000 GEN'L AGGREGATE LIMIT APPLIESPER:'', PRODUCTS-COMP/OP AGO $1 000, 000 POLICY I PROT LOC JFC A AUTOMOBILE LIABILITY BFA00000378665 08/25/99 08/25/00 COMBINED SINGLELIMIT $500, 000 X ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY (Per accident) $ X NON-OWNED AUTOS PROPERTY DAMAGE (Per accident) GARAGE LIABILITY - AUTO ONLY-EA ACCIDENT $ ANY AUTOI OTHER THAN EA ACC $ AUTO ONLY: AGG $ A EXCESS LIABILITY 'iBFS00000378664 08/25/99 ! 08/25/00 EACH OCCURRENCE $1, 000, 000 X OCCUR CLAIMS MADE: AGGREGATE $1_, 000, 000 DEDUCTIBLE $ R TENTIONWORKERS $10000 8 / / .IOfiYLIMTS1t- B WORKERS COMPENSATION AND j'v-032755-oi 08/25/99 0�/ 2S 0C X I [omit _ EMPLOYERS'LIABILITY E.L.EACH ACCIDENT ;$100, 000 E.L.DISEASE-EAEMPLOYEE$100, 000 E.L.DISEASE-POLICY LIMIT$500 , 000 OTHER DESCRIPTION OF OPERATIONSILOCATIONSI VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER ADDmONALINSURED;INSURER LETTER CANCELLATION SHOULD ANYOFTHE ABOVE DESCRIBEDPOUCESBE CANCELLED BEFORE THE EXPIRATION Weld County, Colorado DATE THEREOF,THE ISSUING INSURER WILL EN DEAVORTO MAIL3 0_DAYSWRITLEN NOTICE TOTHE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DOSOSHALL c/o Board of County IMPOSE NO OS LIGATION OR LIABILITY OFANYKIND UPIDN THE INSURER,RS AGENTS OR Commissioners P.O. Box 758 REPRESENTATIVES. Greeley, CO 80632 AUTHORIZED REPRESENTATIVE PO OO1+ f7 t1son InSU4anc€ , Inc ACORD25-S(7/9711 o 2 #M136034 JAS C6% Q4 A 5f- 3O -99 992246 ACOR& CERTIFICATE OF LIABILITY INSURANCE DATE(,WODIYY) 7/26!1999 ' PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND O Riedman Corporation HOLDER. THIS C CERTIFICATE DOES NOT AMEND, EXTENDCA OR P.O. Box 2226 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Fort Collins, CO 80522-2226 COMPANIES AFFORDING COVERAGE (970) 482-7747 COMPANY A CNA INSURED . COMPANY FLAT COAT ASPHALT B "` SPECIALISTS AC COMPANYMPANv 3710 GOODELL LANE C FT COLLINS CO 80526 COMPANY .Nr I D CAMERAGES 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. UNITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION UNITS LTR DATE(MWDDIYY) DATE(MMRIDArY) A GENERAL uABILm B1 74807322 03/03/99 03/03/00 GENERAL AGGREGATE YlOOD,BOB X COMMERCIAL GENERAL LIABILITY j PRODUCTS-COMPICP AGG $2.000.000 CLAIMS MADE I X OCCUR PERSONAL&ADV INJURY $1.000.000 OWNER".)8 CONTRACTORS PROT EACH OCCURRENCE $1.000.000 FIRE DAMAGE(My one fire) $58,000 MED EN,'(My one person) SS 000 -- A AUTOMOBILE LIABILITY 91 74807336 03/03/99 03/03/00 COMBINED SINGLE LIMB $500,000 X ANY AUTO ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) S AL HIRED AUTOS BODILY INJURY - NON-OWNED AUTOS (Per accidenp $ PROPERTY DAMAGE S GARAGE LIABILITY `AUTO ONLY-EA ACCIDENT ANY AUTO OTHER THAN AUTO ONLY': EACH ACCIDENT S AGGREGATE $ I EXCESS LIABILITY EACH OCCURRENCE $ I UMBRELLA FORM AGGREGATE $ _ OTHER THAN UMBRELLA FORM : $ WORKERS COMPENSATION AND WC Y STATU MID- 01W EMPLOYERS' LIABILITY TOR CIE ER _ EL EACH ACCIDENT S THE PROPRIETOR/ INCL EL DISEASE-POLICY LIMIT S_ PARTNERSEXE:CUTIVE -- OFFICERS ME: EXCL .• EL DISEASE-EA EMPLOYEE IS OTHER I i DESCRIPTION OF OPERATIONS'LOCAT1ONSIVEHICLELSPECIAL ITEMS RE: BID- 1999 SEALCOAT PROJECT CERTIFICATE HOLDER CANCELLATION : SHOULD ANY OF THE ABOVE DESCRIBED POLICIES SE CANCELLED BEFORE THE WELD COUNTY EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL ATTN: PURCHASING DEPARTMENT 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, PO BOX 758 BUT FAILURE TO RAIL SUCH NOTICE SHALL IMPOSE MO OBLIGATION OR LIABILITY GREELEY CO 80632 OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPTIE/� f]�S♦1'E nr•nvn e-C rl, I9 G�4_ c.)`.1 j 1 "^) r' npnn, • .,i.,, .-.,^ PAYMENT BOND Bond # 50 74 88 KNOW LL MEN BY THESE PRESENTS : That . _flat Coat Asphalt Specialists TS,C Name of Contractor _. _Eel A Innovation Circle _Windcnr, en 80550 .--- -.- Address of Contractor a Limited Liability Company hereinafter called Principal, and Corporation, Partnership or Individual Old Republic Surety Company Name of Surety PO Box 1976. Des Moines, TA>. 50306 Address of Surety hereinafter called Surety, are held and firmly bound unto THE BOARD OF WE:: COUNT" CONT7_SSICNERs, 915 10th Street, Greeley, Colorado 50632, hereinafty: called County, in the penal sum of: ___Eo.ta Six Thousand and 00/100** Dollars ($ 46.000.00** • in lawful money of the United States, for the payment of which sum well and truly to be made, we bind ourselves, successors, and assigns, jointly and severall firmly by these presents. TNF rC,9r,: CN OF THIS OBLIGATION is such that whereas, the Principal entered ;. .., a certain Contract with the County, dated the 16 day of August , 1999 a -op-' of which is attached and made apart hereof for the construction of • 1999 SEAL_CaAT PROJECT NOw, THEREFORE, if the Principal shall during the entire length of said Contract: and a extension thereof promptly make payment to all persons, from:;, subcon^raccors, and corporation furnishing materials for or performing labor the prosecution of the work provided for in such Contract, and any authorize .site.nn or. or modification thereof, including all amounts due for materials lubrloants, oil, gasoline, coal and coke, repairs on machiuecy, equ_pmenn and cools consumed or used in connection with the construction of such work, and at- insurance premiums on said work, and for all labor, performed in such wo:'a whether subcontractor or otherwise, then this obligation shall be void; other•wnr Cc retail. Lull :urce and effect . PROVIZED. FURTHER, that the said Surety, for value received hereby stipulates and agree: :hat no change, extension of time, alteration or addition to the terms of the Contract or to the work to be peLLurmed thereunder or the s•p eni f.ic..iun accompanying the same shall in any way affect its obligation on time, alteration or adr. con to the terms of the Contract or tc the work or to the specification; . PROVIDED. F:IRTHER, that a final settlement between the County and the Contractor snali abridge the right of any beneficiary hereunder, whose claim may be unsatisfied. :N aiTNFcc wHEREnF, this instrument is executed in ___1 (number) counterpart: . each of which shall be deemed an orlyinal. thin t 7lyd day cC , 1999. Princ ATTEST: _ EY --- — - Norm Davis Principal Secretary (SEAL) 601 A Innovation Circle - -- Windcor. CO ROS50 _ w .ness as co Principal Address Address Old Republic Surety Company Surety ATTEST irness as to Su Vey Attorney-in-sac Diana R. Vigil Address Address — PO Box 2226 PO Box 2226 Fort Collins, CO 80522 _ Fort Collins, CO 80522 _ NOTE: Date of bond must not be prior to date of Contract. If Ccntractcc , s a partnership, all partners should execute bond. :MbCiTANT: Surety companies executing bonds must appear on the Treasury Department ' s most current list Icirtu_ar 570 as amended) and `.; authorized to transact business in the state where the pei.J)ect: located. 23 PERPCRMANCE BONE Bond# 50 74 88 KNOW ALL MEN EY THESE PRESENTS : That Flat Coat Asphalt Specialists , LLC Name of Contractor .. _ 601 A Innovation Circle, Windsor, CO 80550 Address of Contractor • a TiniYed Liability Company _ hereinafter called Principal, and Corporation, Partnership, or Individual 0Jd Republic Surety Company Name of Surety PO Box 1976, Des Moines, IA 50306 Address of Surety hereinafter called Surety, are held and firmly bound unto THE BOARD OF wEL:: COUNTY COMMISSIONERS, 915 10th Street . Greeley, Colorado 90632 , herecnat: , called County, in the penal num of _ For,t_Six Thousand and 00/100** Dollars ($ 46.000.00**__....__! in lawful money of the United States, for the payment of which sum well and t. .. to be made, we bind ourselves. successors, and assigns, jointly and severally �m1c my rhese presents . THE CONDITION CF THIS OBLIGATION is such that whereas, the Principal entered inrc. a certa'.n Contract with the County, dated the 16 day efAugust • 19.99.. a copy 7f which is attached and made apart hereof for the construction of . 1999 SEAL COAT PROJECT NOW, TWEPEFORE, if the Principal shall well, truly and faithfully perform its duties. all the undertaking, covenants, terms, conditions, and agreements of saiu Contract during the oricinal term thereof, and any extensions thereof which as • •, be granted by the County, with or without notice to the Surety and during the one year guarantee period, and if he shall satisfy all claims and demands incurred under ', :ca Contract, and shall fully indemnify and save harmless the County f.7- all costs and damages which it may suffer by reason, of failure to de so, and shall reimburse and repay the County all outlay and expense which the County may :hour ._ making good any default, then this obligation shall be void: to remav: in tu_1 torte and effect . 20 PROVIDED. FURTHER, that the said Surety, for value received hereby stipulates and agrees ihat no change, extension of time, alteration or addition cc the terms o.. the Contract or to work to be performed thereunder or the specificatichc accompanying she same shall in any ways affect its obligation on this bond, a::ci iu .,lce., hereby waive notice of any such change, extension of time, alteration Or addtt_cc: to the terms cE the Contract of the work or to the speeslications PROvTDEC, :FURTHER, that no final settlement between the County and the Contractor sal tcr.dae the right of any beneficiary hereunder, whose claim may 1,- unsat:cfied. IN W:vMESS WHEREOF, this instrument is executed in 3rd day .,_ _August _. __, 19 99 • / ATTEST .Fla eo '!st. TIC Principal L?rincipal Secretary By / ' • — ? �S) Norm Davis (SEAL) 601 A Innovation Circle ___ _ Windsor_ CO .80550 'A:.tness as tc Principal Address Address ATTEST ,.:rety Secretary (SEA rn F4s as to Suety Attorney-in-Fac Diana R. Vigil Address Address PO Box 2226 PO Box 2226 Fort Collins, CO 80522 Fort Collins, CO 80522 NOTE Date of bond must net be prior to date of Contract. If Contractor : . a partnership, a_1 partners should execute bond. ::".PCfl NT: Eouroty compauies executing bonds must appear nn the Treasury- Department's most current list (c_rcular 570 as amended( and ha authorized to transact business in the state where the proie�.:t located. 21 - list'**** _ - I *. OLD REPUBLIC Ili, •**** Surety Company POWER OF ATTORNEY • KtNOW ALL MEN BY THESE PRESENTS: That OLD REPUBLIC SURETY•C0MPANY, a Wisconsin stock insurance corporation, • does make, constitute and.appoint: -. - DAVID , PARKER.,. RCiDERT L. PONEL.L, DALE E. EBERHAFD, DIANA. #:. . VIGIL, i._ti:z ._ F"ORT COLLINS, CO - • • its true and lawful Attorneys)-in-Fact,with full power and authority for and on behalf of the company as surety,to execute and deliver and affix-the seat of the - __ company thereto(ifa seal is required),bonds,undertakings,recognizances or other written obligations in the nature thereof,(other than bail bonds,bank depository- bonds,mortgage deficiency bonds, mortgage guaranty bonds,guarantees of installmenl paper and note guaranty-bonds,self-insurance workers.compensation bonds guaranteeing payment of benefits,asbestos abatement contract bonds,waste management bonds,hazardous waste re mediationbonds or black king bonds) .as•follows: _ _. . ALL. WRITTEN INSTRUMENTS IN AN AMOUNT NOT TO EXCEED AN AGGREGATE -OF :. -- ONE MILLION DOLLARS ($1 ,000,000) __ _ : - - - • FOR AN E:SINGL .. .-- .: OP_L I GA T I ON, REGARDLESS ARDLESS OF THE NUMBER OF INSTRUMENTS ISSUED FOK THE OE LIGATION-;I GAT I ON and to bind OLD REPUBLIC SURETY COMPANY thereby, and all of the arts of said.Attorneys-in-Fact,pursuant to these presents, are . -- .ratified and confirmed. This document is not valid untess printed on colored background and is multi-colored. This appointment is made _- • under and by authority of-the board of directors at a special meeting held on February 18,1982.This Power.of Attorney is signedtand sealed:' '-: : • . by facsimile under and by the authority of the following resolutions adopted by the board of directors of the CLD REPUBLIC SURETY - • -COMPANY on February 18, 1982. .. • - RESOLVED that the president, any vice president, or assistant vice president in conjunction with the secretary or any assistant secretary, may appoint attorneys-in-fact or agents with authority as defined or;limited in the instrument evidencing the appointment- in each case, for and on behalf of the company to execute and deliver and affix the seal of the company to-bonds, undertakings,: - ' recognizances, and suretyship obligations of all kinds; and said officers may remove any such attorney-in-fact or agent:and revoke : any Power of Attorney previously granted to such person. RESOLVED FURTHER that any bond, undertaking,recognizance or suretyship obligation shall be valid and binding upon the Company - _ - (i) when signed by the president,any vice president or assistant vice president,and attested and sealed(if a seal be required)by any secretary orass+start;: ::.: . secretary; secret or _ - (ii) when signed by the presidert,any vice president or assistant vice president,secretary or:assi tent secretary,and countarsigned and sealer if a:seat •r -- • be required)by C.duty authorized attorney-in-fact or agent:or • -• (iii), when duty executed and settled(it a seal be required) by one or more attorrieyt} -fact or agents pursuant to and within:the limits:of the eethority.,- •• . = evidenced by the Power of Attorney issued by the company to such person or persons _ _ - - _ RESOLVED FURTHER that the signature of any authorized officer and the seal el the company may be-affixed by facsimile to any Power Attorney or = _ . • certification thereof authorizing the execution and delivery of any bond,undertaking,recognizance.or other suretyship-obligations of the compete l-such = • - signature and seal when so used shall have the same force and effect as though!lineally affixed. • ='= - IN WITNESS WHEREOF,O F ,UBLIC SU �y COMPANY has caused,tt presents to be signed by its proper officer,and tit :- • L_❑❑ - corporate seal to be affixed this____..—.._day of —_--_.-.__._ -_ . _ OLD REPUBLIC SURETY COMPANY / ---c) a co-� + / Z�$ . :�Msiet`nt-Secretyy .;, •- / rr ident . •S_TATE:OF WISCONSIN, COUNTY OF WAUKESHA- SS 44,'"s °y - 1 F'TH I;;AY 1• ''-�" JAMES E. LEE On this — day of . _ • • , personally came before me, and )DAVID G. MENZE:t_-to me known to be the individuals and officers of.the OLD REPUBLIC SURETY COMPANY who executed the above iristrJment, and they each acknowledged the execution of the same, and being by me duly sworn, did severally dispose and say; that they are the said officers of the corporation aforesaid, and that the seal affixed to the above instrument is the seal of the corporation. - and that said corporate seal and-:heir signatures as such officers were duly affixed and subscribed to the said irstrument by the authority- of the board of directors of said corporation. �,. • . .• •. t*. NotaryPiWic � \'2`‘"+n►' Jt 02! 113 .:oo:i. • •...as„„ My commission expires: .__.--_____ — - .__ CERTIFICATE .t,the undersigned, assistant secretary of the OLD REPUBLIC SURETY COMPANY, a Wisconsin corporation, CERTIFY that the - .; " foregoing and attached Power of Attorney remains in full force and has not been revoked;and furthermore,-that the Resolutions of the board. .cif-direetors set forth in the Power of Attorney, are now in force. • moo. Signed and sealed at the City of Brookfield,WI this 23rd day of _— _August,_ l 9eg SEA1L� A414 a, 6'itr4 — rotaryL1‘44.ere".111. : RIEDt4AN'. .CO i}t^I?_"►� !'�f:ON i THIS DOCUMENT IS NOT VALID UNLESS PRINTED ON COLORED BACKGROUND AND IS MULTI-COLORED - Hello