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Home My WebLink About20233139.tiffConWac-F0:4+-Nlioo September 29, 2023 FACILITIES DEPARTMENT PHONE: (970) 400-2020 FAX: (970) 304-6532 WEBSITE: www.co.weld.co.us 1105 H STREET P.O. BOX 758 GREELEY, COLORADO 80632 To: Board of County Commissioners From: Toby Taylor Subject: 2023 Tree Removal & Replacement (B2300175) As advertised this bid is for removal and replacement of dead trees that also maybe a hazard this winter. The low bid is from Tiger Tree Inc. and meets the specifications. Therefore, the Facilities Department is recommending the award to Tiger Tree Inc. the amount of $29,100.0 0. If you have any questions, please contact me at extension 2023. Sincerely, Toby Taylor Director Con5e,r11- wcio— i0/z3/z3 ce,p be,) /ola3/a3 2023-3139 ��iD02S SERVICE AGREEMENT BETWEEN WELD COUNTY AND TIGERTREE, INC. 2023 TREE REMOVAL & REPLACEMENT THIS AGREEMENT is made and entered into this Z34ay of October , 2023, by and between the Board of Weld County Commissioners, on behalf of Facilities, hereinafter referred to as "County," and TigerTree, Inc., hereinafter referred to as "Contractor". WHEREAS, County requires an independent contractor to perform the services required by County and set forth in the attached Exhibits; and WHEREAS, Contractor is willing and has the specific ability to perform the required services at or below the cost set forth in the attached Exhibits; and WHEREAS, Contractor is authorized to do business in the State of Colorado and has the time, skill, expertise, and experience necessary to provide the equipment, materials and services as set forth below. NOW, THEREFORE, in consideration of the mutual promises and covenants contained herein, the parties hereto agree as follows: 1. Introduction. The terms of this Agreement are contained in the terms recited in this document and in the attached Exhibits, each of which forms an integral part of this Agreement and are incorporated herein. The parties each acknowledge and agree that this Agreement, including the attached Exhibits, define the performance obligations of Contractor and Contractor's willingness and ability to meet those requirements (the "Work"). If a conflict occurs between this Agreement and any Exhibit or other attached document, the terms of this Agreement shall control, and the remaining order of precedence shall based upon order of attachment. Exhibit A consists of County's Request for Bid (RFB) as set forth in Bid Package No. B2300175. Exhibit B consists of Contractor's Response to County's Request. 2. Service or Work. Contractor agrees to procure the materials, equipment and/or products necessary for the Work and agrees to diligently provide all services, labor, personnel and materials necessary to perform and complete the Work described in the attached Exhibits. Contractor shall further be responsible for the timely completion, and acknowledges that a failure to comply with the standards and requirements of Work within the time limits prescribed by County may result in County's decision to withhold payment or to terminate this Agreement. 3. Term. The term of this Agreement begins upon the date of the mutual execution of this Agreement, and ends one year later. Both of the parties to this Agreement understand and agree that the laws of the State of Colorado prohibit County from entering into Agreements which bind County for periods longer than one year. This Agreement may be extended upon mutual written agreement of the Parties. 02.5- 4.39 4. Termination; Breach; Cure. County may terminate this Agreement for its own convenience upon thirty (30) days written notice to Contractor. Due to the time needed for County to procure replacement services, Contractor may terminate this Agreement for its own convenience upon ninety (90) days written notice to County. Either Party may immediately terminate this Agreement upon material breach of the other party, however the breaching party shall have fifteen (15) days after receiving such notice to cure such breach. Upon termination, County shall take possession of all materials, equipment, tools and facilities owned by County which Contractor is using, by whatever method it deems expedient; and, Contractor shall deliver to County all completed or partially completed Work under this Agreement, together with all other items, materials and documents which have been paid for by County, and these items, materials and documents shall be the property of County. Upon termination of this Agreement by County, Contractor shall have no claim of any kind whatsoever against the County by reason of such termination or by reason of any act incidental thereto, except for compensation for work satisfactorily performed and/or materials described herein properly delivered. 5. Extension or Amendment. Any amendments or modifications to this agreement shall be in writing signed by both parties. No additional services or work performed by Contractor shall be the basis for additional compensation unless and until Contractor has obtained written authorization and acknowledgement by County for such additional services. 6. Compensation. Upon Contractor's successful completion of the Work, and County's acceptance of the same, County agrees to pay Contractor an amount not to exceed $29,100.00 as set forth in the Exhibits. No payment in excess of that set forth in the Exhibits will be made by County unless a Change Order authorizing such additional payment has been specifically approved by Weld County. If, at any time during the term or after termination or expiration of this Agreement, County reasonably determines that any payment made by County to Contractor was improper because the service for which payment was made did not perform as set forth in this Agreement, then upon written notice of such determination and request for reimbursement from County, Contractor shall forthwith return such payment(s) to County. Upon termination or expiration of this Agreement, unexpended funds advanced by County, if any, shall forthwith be returned to County. County will not withhold any taxes from monies paid to the Contractor hereunder and Contractor agrees to be solely responsible for the accurate reporting and payment of any taxes related to payments made pursuant to the terms of this Agreement. Unless expressly enumerated in the attached Exhibits, Contractor shall not be entitled to be paid for any other expenses (e.g. mileage). Notwithstanding anything to the contrary contained in this Agreement, County shall have no obligations under this Agreement after, nor shall any payments be made to Contractor in respect of any period after December 31 of any year, without an appropriation therefore 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). 7. Independent Contractor. Contractor agrees that it is an independent contractor and that Contractor's officers, agents or employees will not become employees of County, nor entitled to any employee benefits (including unemployment insurance or workers' compensation benefits) 2 from County as a result of the execution of this Agreement. Contractor shall be solely responsible for its acts and those of its agents and employees for all acts performed pursuant to this Agreement. 8. Subcontractors. Contractor acknowledges that County has entered into this Agreement in reliance upon the particular reputation and expertise of Contractor. Contractor shall not enter into any subcontractor agreements for the completion of the Work without County's prior written consent, which may be withheld in County's sole discretion. County shall have the right in its reasonable discretion to approve all personnel assigned to the Work during the performance of this Agreement and no personnel to whom County has an objection, in its reasonable discretion, shall be assigned to the Work. Contractor shall require each subcontractor, as approved by County and to the extent of the Work to be performed by the subcontractor, to be bound to Contractor by the terms of this Agreement, and to assume toward Contractor all the obligations and responsibilities which Contractor, by this Agreement, assumes toward County. County shall have the right (but not the obligation) to enforce the provisions of this Agreement against any subcontractor hired by Contractor and Contractor shall cooperate in such process. The Contractor shall be responsible for the acts and omissions of its agents, employees and subcontractors. 9. Warranty. Contractor warrants that the Work performed under this Agreement will be performed in a manner consistent with the standards governing such services and the provisions of this Agreement. Contractor further represents and warrants that all Work shall be performed by qualified personnel in a professional manner, consistent with industry standards, and that all services will conform to applicable specifications. 10. Acceptance of Services Not a Waiver. Upon completion of the Work, Contractor shall submit to County originals of all test results, reports, etc., generated during completion of this work. Acceptance by County of reports and incidental material(s) furnished under this Agreement shall not in any way relieve Contractor of responsibility for the quality and accuracy of the project. In no event shall any action by County hereunder constitute or be construed to be a waiver by County of any breach of this Agreement or default which may then exist on the part of Contractor, and County's action or inaction when any such breach or default exists shall not impair or prejudice any right or remedy available to County with respect to such breach or default. No assent, expressed or implied, to any breach of any one or more covenants, provisions or conditions of the Agreement shall be deemed or taken to be a waiver of any other breach. Acceptance by the County of, or payment for, the Work completed under this Agreement shall not be construed as a waiver of any of the County's rights under this Agreement or under the law generally. 11. Insurance. Contractor must secure, before the commencement of the Work, the following insurance covering all operations, goods, and services provided pursuant to this Agreement, and shall keep the required insurance coverage in force at all times during the term of the Agreement, or any extension thereof, and during any warranty period. For all coverages, Contractor's insurer shall waive subrogation rights against County. a. Types of Insurance. Workers' Compensation / Employer's Liability Insurance as required by state statute, covering all of the Contractor's employees acting within the course and scope of their 3 employment. The policy shall contain a waiver of subrogation against the County. This requirement shall not apply when a Contractor or subcontractor is exempt under Colorado Workers' Compensation Act., AND when such Contractor or subcontractor executes the appropriate sole proprietor waiver form. Commercial General Liability Insurance including public liability and property damage, covering all operations required by the Work. Such policy shall include minimum limits as follows: $1,000,000 each occurrence; $1,000,000 general aggregate; $1,000,000 Personal injury $5,000; Medical payment per person. Automobile Liability Insurance: Contractor shall maintain limits of $1,000,000 for bodily injury per person, $1,000,000 for bodily injury for each accident, and $1,000,000 for property damage applicable to all vehicles operating both on County property and elsewhere, for vehicles owned, hired, and non -owned vehicles used in the performance of this Contract. b. Proof of Insurance. Upon County's request, Contractor shall provide to County a certificate of insurance, a policy, or other proof of insurance as determined in County's sole discretion. County may require Contractor to provide a certificate of insurance naming Weld County, its elected officials, and its employees as an additional named insured. c. Subcontractor Insurance. Contractor hereby warrants that all subcontractors providing services under this Agreement have or will have the above described insurance prior to their commencement of the Work, or otherwise that they are covered by the Contractor's policies to the minimum limits as required herein. Contractor agrees to provide proof of insurance for all such subcontractors upon request by the County. d. No limitation of Liability. The insurance coverages specified in this Agreement are the minimum requirements, and these requirements do not decrease or limit the liability of Contractor. The County in no way warrants that the minimum limits contained herein are sufficient to protect the Contractor from liabilities that might arise out of the performance of the Work under by the Contractor, its agents, representatives, employees, or subcontractors. The Contractor shall assess its own risks and if it deems appropriate and/or prudent, maintain higher limits and/or broader coverages. The Contractor is not relieved of any liability or other obligations assumed or pursuant to the Contract by reason of its failure to obtain or maintain insurance in sufficient amounts, duration, or types. The Contractor shall maintain, at its own expense, any additional kinds or amounts of insurance that it may deem necessary to cover its obligations and liabilities under this Agreement. 12. Indemnity. The Contractor shall defend, indemnify and hold harmless County, its officers, agents, and employees, from and against any and all injury, loss, damage, liability, suits, actions, claims, or willful acts or omissions of any type or character arising out of the Work done in fulfillment of the terms of this Agreement or on account of any act, claim or amount arising or recovered under workers' compensation law or arising out of the failure of the Contractor to conform to any statutes, ordinances, regulation, judicial decision, or other law or court decree. The Contractor shall be fully responsible and liable for any and all injuries or damage received or 4 sustained by any person, persons, or property on account of its performance under this Agreement or its failure to comply with the provisions of the Agreement. It is agreed that the Contractor will be responsible for primary loss investigation, defense and judgment costs where this contract of indemnity applies. In consideration of the award of this contract, the Contractor agrees to waive all rights of subrogation against the County its associated and/or affiliated entities, successors, or assigns, its elected officials, trustees, employees, agents, and volunteers for losses arising from the work performed by the Contractor for the County. A failure to comply with this provision shall result in County's right to immediately terminate this Agreement. 13. Non -Assignment. Contractor may not assign or transfer this Agreement or any interest therein or claim thereunder, without the prior written approval of County. Any attempts by Contractor to assign or transfer its rights hereunder without such prior approval by County shall, at the option of County, automatically terminate this Agreement and all rights of Contractor hereunder. Such consent may be granted or denied at the sole and absolute discretion of County. 14. Examination of Records. To the extent required by law, the Contractor agrees that an duly authorized representative of County, including the County Auditor, shall have access to and the right to examine and audit any books, documents, papers and records of Contractor, involving all matters and/or transactions related to this Agreement. Contractor agrees to maintain these documents for three years from the date of the last payment received. 15. Interruptions. Neither party to this Agreement shall be liable to the other for delays in delivery or failure to deliver or otherwise to perform any obligation under this Agreement, where such failure is due to any cause beyond its reasonable control, including but not limited to Acts of God, fires, strikes, war, flood, earthquakes or Governmental actions. 16. Notices. All notices or other communications made by one party to the other concerning the terms and conditions of this contract shall be deemed delivered under the following circumstances: (a) personal service by a reputable courier service requiring signature for receipt; or (b) five (5) days following delivery to the United States Postal Service, postage prepaid addressed to a party at the address set forth in this contract; or (c) electronic transmission via email at the address set forth below, where a receipt or acknowledgment is required and received by the sending party; or Either party may change its notice address(es) by written notice to the other. Notice may be sent to: TO CONTRACTOR: Name: Jeffrey Smith Position: Address: 110 Howe Road Address: Laramie, WY 82070 E-mail: jeff@tigertreeinc.com Phone: 307-460-4767 5 TO COUNTY: Name: Toby Taylor Position: Facilities Director Address: 1105 H Street Address: Greeley, CO. 80632 E-mail: ttaylorna,weldgov.com Phone: 970-400-2021 17. Compliance with Law. Contractor shall strictly comply with all applicable federal and State laws, rules and regulations in effect or hereafter established, including without limitation, laws applicable to discrimination and unfair employment practices. 18. Non -Exclusive Agreement. This Agreement is nonexclusive and County may engage or use other Contractors or persons to perform services of the same or similar nature. 19. Entire Agreement/Modifications. This Agreement including the Exhibits attached hereto and incorporated herein, contains the entire agreement between the parties with respect to the subject matter contained in this Agreement. This instrument supersedes all prior negotiations, representations, and understandings or agreements with respect to the subject matter contained in this Agreement. This Agreement may be changed or supplemented only by a written instrument signed by both parties. 20. Fund Availability. Financial obligations of the County payable after the current fiscal year are contingent upon funds for that purpose being appropriated, budgeted and otherwise made available. Execution of this Agreement by County does not create an obligation on the part of County to expend funds not otherwise appropriated in each succeeding year. 21. Employee Financial Interest/Conflict of Interest — C.R.S. §§24-18-201 et seq. and §24- 50-507. The signatories to this Agreement state that to their knowledge, no employee of Weld County has any personal or beneficial interest whatsoever in the service or property which is the subject matter of this Agreement. 22. Survival of Termination. The obligations of the parties under this Agreement that by their nature would continue beyond expiration or termination of this Agreement (including, without limitation, the warranties, indemnification obligations, confidentiality and record keeping requirements) shall survive any such expiration or termination. 23. Severability. If any term or condition of this Agreement shall be held to be invalid, illegal, or unenforceable by a court of competent jurisdiction, this Agreement shall be construed and enforced without such provision, to the extent that this Agreement is then capable of execution within the original intent of the parties. 24. Governmental Immunity. No term or condition of this Agreement shall be construed or interpreted as a waiver, express or implied, of any of the immunities, rights, benefits, protections or other provisions, of the Colorado Governmental Immunity Act §§24-10-101 et seq., as applicable now or hereafter amended. 6 25. No Third Party Beneficiary. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties and nothing in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties receiving services or benefits under this Agreement shall be an incidental beneficiary only. 26. Board of County Commissioners of Weld County Approval. This Agreement shall not be valid until it has been approved by the Board of County Commissioners of Weld County, Colorado or its designee. 27. Choice of Law/Jurisdiction. Colorado law, and rules and regulations established pursuant thereto, shall be applied in the interpretation, execution, and enforcement of this Agreement. Any provision included or incorporated herein by reference which conflicts with said laws, rules and/or regulations shall be null and void. In the event of a legal dispute between the parties, Contractor agrees that the Weld County District Court shall have exclusive jurisdiction to resolve said dispute. 28. Attorney's Fees/Legal Costs. In the event of a dispute between County and Contractor concerning this Agreement, the parties agree that each party shall be responsible for the payment of attorney fees and/or legal costs incurred by or on its own behalf. 29. Binding Arbitration Prohibited. Weld County does not agree to binding arbitration by any extra judicial body or person. Any provision to the contrary in this Agreement or incorporated herein by reference shall be null and void. Acknowledgment. County and Contractor acknowledge that each has read this Agreement, understands it and agrees to be bound by its terms. Both parties further agree that this Agreement, with the attached Exhibits, is the complete and exclusive statement of agreement between the parties and supersedes all proposals or prior agreements, oral or written, and any other communications between the parties relating to the subject matter of this Agreement. 7 CONTRACTOR: TigerTree, Inc. By:' - Name: Jeffrey Smith Title: Owner 10/5/2023 Date of Signature WELD COUN Y: ATTEST: ddriLiA) col. ,�p.ok. BOARD OF COUNTY COMMISSIONERS Weld • nt Clerk to the oard WELD COUNTY, COLORADO okawar BY: _ ��•-�: _��I�i- �y:.11 Deputy Clerk t : oard �r v 1 ?Pita, Mike Freeman, Chair OCT 2 3 2 020,1-5 - 3/3y Location ft of Trees removed Trees to be added ID Size Coroner's - 1121 M Street, Greeley 1 Royal Star Magnolia 1 #10 Larch 2 #10 Gladiator Crabapple 3 tin Japanese Maple 4 #10 Dogleg East/ 3 Fort McNair Horse Chestnut 5 #15 Planning -1402 N 17th Street Eastern Redbud 6 1 5" Shingle Oak 7 2" Chinkapin Oak 8 2" Tulip Tree 9 15" Dogleg West/1551- Dispatch 2 Londond Planetree (or Sycamore) 10 2" Triumph Elm 11 2" Streetspire Oak 12 1 5" IT 4 American Liberty Elm 13 2" 1401 N 17th Aven Heritage Oak 14 2" Endowment Sugar Maple 15 2" Emerald Sunshine Elm 16 2" O Street 4 Thunderchild Crabapple 17 2" Spring Snow Crabapple 18 2" Indian Magic Crabapple 19 2" Red Baron Crabapple 20 2" 11 Are there any restrictions for work, i e Time of year, Day of week, time of day? Answer Time of year is fall No other restrictions 12 Are substitutions of trees being planted negotiable? Answer Only with Grounds Supervisor's approval 13 Will water be available on stie to water trees? Answer No Exhibit B SPECIFICATIONS AND/OR SCOPE OF WORK AND PROPOSED PRICING: TREE REMOVAL AND REPLACEMENT This bid is for tree removal and tree planting services located at various Weld County facilities. SCOPE The contractor shall: 1. Providing City of Greeley contractor license. 2. Obtaining right-of-way permits from the City of Greeley. 3. Obtaining public and private utility locates for work areas. 4. Coordinating with the Grounds Supervisor daily on job location and updates 5. Remove trees according to ISA standards. 6. Grind stumps to a depth of 24". 7. Select replacement trees that are free of pests and disease, has good canopy structure, and good root structure. 8. Plant proper trees according to maps and index provided. 9. Plant the trees according to ANSI 300 standards. a. Prune only broken, dead wood, and co -dominant leaders from canopy per industry best management practices. b. Slope sides of planting hole, scarify, and roughen sides prior to installing tree. c. Planting hole should be 2 times the size of the root ball to the slope and a total of 3 times the size of the root ball including the slope. d. Remove all of wire basket and burlap before planting. Remove excess soil away from root flare. e. Set top of root flare/flrst order roots at or 1 to 2" above finish grade. Trees planted without the root flare visible will be rejected. Prune adventitious roots on trunk. 10. Use 2023 Tree Removal Index (attached) as a sizing and species selection guide. 11. Stake the newly planted trees using the Double Stake Method. a. Use 12" nylon tree strap with grommets on guy wire placed horizontally over lateral branch or intertwine to prevent slippage. Do not twist straps tight around trunk. b. Use 6' steel post or wood stake with safety caps per specification. Set one post to windward side and other opposite. Other staking methods as approved. 12. Create a water ring around the newly planted trees. Form 2 high soil saucer around planting hole at outside of transition zone. 13. Apply mulch within tree ring to a minimum depth of 2 - 3 inches. a. Circle of shredded wood mulch, 2" - 3" deep and 4" to 6" away from trunk, 8' diameter or to outer edge of planting hole, whichever is greater. 14. Water the new trees immediately after planting. 15. Repair any damage to turf and irrigation done during the removal, grinding, and planting process. 16. This is not an all or none bid. BID REQUEST #82300175 Page 8 LOCATIONS Building Name Address Number of trees removed Trees Planted Price Coroner's 1121 M Street, Greeley 1 4 $2,600.00 Planning and Oil and Gas 1402 N. 17"' Street, Greeley 3 5 $6,300.00 Dispatch/Record 1551 N. 17'" Street, Greeley 2 3 $5,400.00 Information Technology 1401 N. 17th Street, Greeley 4 4 $9,600.00 Jail, Law Admin, Public Health 2110 O Street. Greeley 4 4 $5,200.00 FEE Provide your lump sum to provide this work. If there are additional items provide those total costs as well as a description. Lump Sum Total $ 29,100.00 Other (describe) $ 0.00 BID REQUEST #82300175 Page 9 BID SUBMITTAL INSTRUCTIONS: The following Items must be completed and submitted with your bid on or before the bid opening deadline of 10:00 AM on September 26. 2023: 1) Pages 8 thru 11 of the Bid Specifications and/or Scope of Work. 2) W9, if applicable.* 3) Any future Addenda must be completed. 4) All other items as requested in the Bid Specifications and/or Scope of Work. *A current W9 is required for new bidders. If you have previously worked with Weld County, only provide your W9 if there has been a change. Failure to include any of the above Items upon submittal of your bid may result In your bid being Incomplete and your bid being rejected. If there are any exclusions or contingencies submitted with your bid b may be disqualified. BID REQUEST #62300175 Page 10 The undersigned, by his or her signature, hereby acknowledges and represents that: 1. The bid proposed herein meets at of the conditions, specifications and special provisions set forth in the Request for Bid for Request No. 002300175. 2. The quotations set forth herein are exclusive of any federal excise taxes and all other state and local taxes. 3. He or she is authorized to bind the below -named bidder for the amount shown on the accompanying bid sheets. 4. The signed bid submitted, all of the documents of the Request for Bid contained herein (including, but not limited to, product specifications and scope of services), and the formal acceptance of the bid by Weld County, together constitutes a contract, with the contract date being the date of formal acceptance of the bid by Weld County. 5. Weld County reserves the right to reject any and all bids, to waive any informality in the bids, and to accept the bid that, in the opinion of the Board of County Commissioners, is to the best interests of Weld County. The bid(s) may be awarded to more than one vendor. FIRM TigerTree, Inc. BUSINESS ADDRESS 110 Howe Rd. CITY, STATE, ZIP CODE Laramie. WY 82070 TELEPHONE NO 307,460.4767 FAX TAX ID # 20-8658355 PRINTED NAME AND TITLE Jeffrey Smith SIGNATURE dGZ' E-MAIL jeff(a?.tigertreeinc.com DATE 9/22/2023 WELD COUNTY IS EXEMPT FROM COLORADO SALES TAXES. THE CERTIFICATE OF EXEMPTION NUMBER IS #98-03651.0000. YOU DO NOT NEED TO SEND BACK PAGE51- 7, ATTEST: BOARD OF COUNTY COMMISSIONERS Weld County Clerk to the Board WELD COUNTY, COLORADO BY: Deputy Clerk to the Board Mike Freeman, Chair APPROVED AS TO SUBSTANCE: Elected Official or Department Head Controller GS0323 BID REQUEST #B2300175 Page 11 Forth W-9 (Rev. November 2017) Oeparim t of the Tom fMernel Rarertue Service Request for Taxpayer identification Number and Certification ► t3o to www.bs.gov/FomM. for Instructions and trio latest Give Fonn to the requester. Do not tend t0 bite IRS. send 1 8 iii 1 1110 t Name (as shown on your Income tan return). Name b required on this line; do not leave tits fine bleak. TigerTree, Inc. 2 Business nemetdterepe►ded entity owns, if dlHeent from above 3 Check epproprlate bon for federal tax dassifioatlon o1 the person whose name is entered on line 1. Check following seven boxes. 0 Individual/sole proprietor or 0 C Corporation ❑e 3 Corporation ❑ Perfnenehip atnglrmember LLC 0 Limited Ilebiltty compwly. Erna the tax classification (C.C corporation, S=8 corporation, P-Pwtnwship) Note: Check the appropriate box in the line above for the tan classification of the sine -member ovmer. LLC if the LLC Is doweled as a single m rm er U.C that b dtsragarded from the owner unless the owner another disrergardedfrrom not a owned r ehoidol check the appegarded from the owner rropdate fbox for the tax classification ed. tax O Its owner. 0 Other (sae Instnnadone) ► only one of the ❑ Tru7Vastate S. 4 Exemptl00 certain eMhies, Instructions Exempt payee Exemption cods r arty) macaw to ea.. (codes apply only to not indivldusie; see on page 3): code (I7 any) from FATCA reporting Oo not check of the U.C is member LLD that n wv<o■aoun ore rr use 5 Address (number, sheet, and apt. or write no.) Sea inatruatbna. Howe Rd Requester's name end address (optional) City, state, and ZIP code Laramie, WY 82070 7 List account numbers) here (opibnai) • Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this is goner* your social security number (SSN). However, fora resident alien, sole proprietor, or disregarded entity,see the Instructions for Part I, later. For other I soxN7 oo,4y number I l ll — 1 entities, if o your employer klerHificffilon member (FJN). TIN, later. Note: lt the account is in more than one name, see the instructions for line 1. Also see What Name and Number To Give the Requester for guidelines on whose number to enter. or Employer iderrtlfleatfon number 2 0 8 6 5 8 3 5 5 •. Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my corset taxpayer identification number (or I am waiting fora number to be issued to me); and 2. I am not subject to backup withholding because: (a) I em exempt from backup withholding, or (b) I have not been notified by the internal Revenue Service (IRS) that t am subject to backup withholding as a result of a failure to report alt interest or dividends, or (c) the IRS has notified me that lam no longer subject to backup withholding; end 3. I em a U.S. cozen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this forth (it any) indicating thefI am exempt fran FNMA reporting is correct Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to air Individual netkement arrangement (InA), and generally. payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part Ii, later. �Qn :II= of 84^. U.s pawn ► General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. For the latest information about developments related to Form W-9 and its instructions, such as legislation enacted after they won published, go to 000.be.gov/For ON9. Purpose of Form An individual or entity (Form W-9 requester) who le required to file an information return with the IRS must obtain your correct taxpayer Identification number (TIN) which may be your social security number (SSN ), individual taxpayer Identlficatlon number (ITIN), adoption taxpayer Identification number (ATIN), or employer Identification number (EIN), to report on an Information return the amount paid to you, or other amount reportable on an Information return. Examples of infon aiion returns Include, but are not limited to, the following. • Form 1099-INT (Internet earned or paid) o.t.► 4/19/2022 • Form 1099-DIV (dividends, including those from stocks or mutual funds) • Form 1099-MISC (various types of income, prizes, awards, or gross proceeds) • Form 109943 (stock or mutual fund sales and certain other transactions by brokers) • Form 1099-S (proceeds from real estate transactions) • Form 1099-K (merchant card and third party network transactions) • Fern 1098 (home mortgage interest), 1098-E (student loan interest), 1038-T (tuition) • Form 1099-C (canceled debt) • Form 1089-A (acquisition or abandonment of secured property) Use Form W-9 only if you an a U.S. person (Including a resident alien), to provide your correct TIN. If you do not return Form W-9 to the sequester with a TIN, you might be subject to backup withholding. See What Is backup withholding, later. Cat. No. 10231X Fonn W-4 (Rev. 11-0017) TIGEINC-01 MELISSAWA A� O• CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 10/5/2023 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 Mountain West In & Fin Sery LLC Way 100 E Victory Craig, CO 81625 CONTACT NAME: (AIcPHONE FAX , No, E d): (970) 824-8185 (ac, No): (970) 824-8188 ADDRESS: INSURER(S) AFFORDING COVERAGE NAIL It INSURER A : The Cincinnati Specialty Underwriters Insurance Company 13037 INSURED TigerTree, Inc. dba TigerTree Land Management 110 Howe Rd Laramie, WY 82070 INSURER B: Cincinnati Insurance Company 10677 INSURER C : Pinnacol Assurance 41190 INSURER D: Progressive Insurance Company 24260 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLIO ES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TV LTR TYPE OF INSURANCE ADDL'NM INSD 'NM POLICY NUMBER POLICY EFF (MM/DD/YYYYI POLICY EXP (MM/DDIYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR X CSU0154717 7/31/2023 7/31/2024 EACH OCCURRENCE $ 1'000'000 DAMAGETORENTED PREMISES (Ea occurtence) $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT. AGGREGATE LIMIT APPLIES PER: X POLICY ❑ jE 0 LOC OTHER: PRODUCTS - COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY X AUTOS ONLY SCHEDULED X AUTOS X rTOS ONLY X ENP0585812 /EBA0585812 7/31/2023 7/31/2024 COMBINED SINGLE LIMIT IEa accident) 1,000,000 $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ (Pe gi entrAGE $ A UMBRELLA LIAR X EXCESS LIAR X OCCUR CLAIMS -MADE CSU0200653 7/31/2023 7/31/2024 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 $ DED I I RETENTION $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY y / N ANY PROPRIETOR/PARTNT EXECUTIVE 1/ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION 'COOPERATIONS below N / A 4141111 10/1/2023 10/1/2024 X I STATUTE I X I EORH EL. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 B D Equipment Floater Commercial Auto ENP0585812 /EBA0585812 971034325 7/31/2023 6/27/2023 7/31/2024 9/8/2023 Leased / Rented CSL 94,300 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate Holder is included as Additional Insured with respect to General Liability, including Ongoing Operations only, if required by written contract. Certificate Holder is included as Additional Insured w'th respect to Auto Liability, if required by written contract. A Waiver of Subrogation applies in favor of the additional insured with respect to General Liability, Auto Liability and Workers Compensation, if required by written contract. A 30 -day notice of cancellation, for other than non-payment of premium, apples to General Liability, Auto Liability and Workers Compensation. CERTIFICATE HOLDER CANCELLATION Weld County Colorado tY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1301 N 17th Ave Greeley, CO 80631 AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY CSGA 405 12 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU - OPERATIONS ONLY This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. SECTION II - WHO IS AN INSURED is amended to include as an additional insured any person or organization when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy, but only with respect to "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured. The written contract or agreement must be currently in effect or become effective during the term of this Coverage Part. The contract or agreement must be executed prior to the "bodily injury", "property damage" or "personal and advertising injury" to which this endorse- ment pertains. However: 1. The insurance afforded to such additional insured only applies to the extent permit- ted by law; and 2. If coverage provided to the additional in- sured is required by a contract or agree- ment, the insurance afforded to such ad- ditional insured will not be broader than that which you are required by the con- tract or agreement to provide for such ad- ditional insured. B. With respect to the insurance afforded to these additional insureds, the following addi- tional exdusions apply: This insurance does not apply to: CSGA 405 12 13 1. 2. 3. 4. 5. "Bodily injury", "property damage" or "per- sonal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineer- ing or surveying services, including: a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or draw- ings and specifications; or b. Supervisory, inspection, architectural or engineering activities. "Bodily injury" or "property damage" aris- ing out of "your work" for which a consoli- dated (wrap-up) insurance program has been provided by the prime contrac- tor/project manager or owner of the con- struction project in which you are involved. "Bodily injury", "property damage" or "per- sonal and advertising injury" to any em- ployee of you or to any obligation of the additional insured to indemnify another because of damages arising out of such injury. "Bodily injury", "property damage" or "per- sonal and advertising injury' for which the Named Insured is afforded no coverage under this policy of insurance. "Bodily injury", "property damage" or per- sonal and advertising injury" occurring af- ter: a. All work, induding materials, parts or equipment furnished in connection with such work, on the project to be performed by or on behalf of the ad- ditional insured has been completed; or Includes copyrighted material of ISO Properties, Inc., with its permission. Page 1 of 2 b. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaging in performing operations for a principal as part of the same pro- ject. C. With respect to the insurance afforded to these additional insureds, SECTION III - LIM- ITS OF INSURANCE is amended to include: The limits applicable to the additional insured are those specified in the written contract or agreement or in the Declarations of this Cov- erage Part, whichever is less. If no limits are specified in the written contract or agreement, the limits applicable to the additional insured are those specified in the Declarations of this Coverage Part. The limits of insurance are in- CSGA 405 12 13 clusive of and not in addition to the limits of in- surance shown in the Dedarations. D. With respect to the insurance afforded to these additional insureds, SECTION IV - COMMERCIAL GENERAL LIABILITY CON- DITIONS, 4. Other Insurance is amended to indude: Any coverage provided herein will be excess over any other valid and collectible insurance available to the additional insured whether primary, excess, contingent or on any other basis unless you have agreed in a written con- tract or written agreement executed prior to any loss that this insurance will be primary. This insurance will be noncontributory only if you have so agreed in a written contract or written agreement executed prior to any loss and this coverage is determined to be primary. Includes copyrighted material of ISO Properties, Inc., with its permission. Page 2 of 2 COMMERCIAL GENERAL LIABILITY CSGA 4087 12 12 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - PER CONTRACT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to Paragraph 8. Transfer of Rights of Recovery Against Others to Us of SECTION IV - CONDITIONS: If you have agreed, in a written contract or agreement, to provide a waiver of any right of recovery against a person or organization, we will waive any right of recovery we may have against that person or organization because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard". This waiver applies only to that person or organization for which you have agreed to in a written contract to provide said waiver. CSGA 4087 12 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CinciPlus® BUSINESS AUTO XC+® (EXPANDED COVERAGE PLUS) ENDORSEMENT This endorsement modifies insurance provided by the following: BUSINESS AUTO COVERAGE FORM With respect to the coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. A. Blanket Waiver of Subrogation SECTION IV - BUSINESS AUTO CONDI- TIONS, A. Loss Conditions, 5. Transfer of Rights of Recovery Against Others to Us is amended by the addition of the following: We waive any right of recovery we may have against any person or organization because of payments we make for "bodily injury" or "property damage" arising out of the operation of a covered "auto" when you have assumed liability for such "bodily injury" or "property damage" under an "insured contract", provid- ed the "bodily injury" or "property damage" oc- curs subsequent to the execution or the "in- sured contract". B. Noncontributory Insurance SECTION IV - BUSINESS AUTO CONDI- TIONS, B. General Conditions, 5. Other In- surance c. is deleted in its entirety and re- placed by the following: c. Regardless of the provisions of Par- agraph a. above, this Coverage Form's Liability Coverage is primary and we will not seek contribution from any other insurance for any lia- bitty assumed under an "insured contract" that requires liability to be assumed on a primary noncontributo- ry basis. C. Additional Insured by Contract SECTION II - LIABILITY COVERAGE, A. Coverage, 1. Who is an Insured is amended to include as an insured any person or organi- zation for whom you have agreed in a valid written contract to provide insurance as af- forded by this policy. This provision is limited to the scope of the valid written contract. AA 288 06 20 This provision does not apply unless the valid written contract has been: 1. Executed prior to the accident causing "bodily injury' or "property damage"; and 2. Is still in force at the time of the "accident" causing "bodily injury" or "property dam- age". D. Employee Hired Auto 1. Changes in Liability Coverage The following is added to the SECTION II - LIABILITY COVERAGE, A. Coverage, 1. Who is an Insured: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in that "employee's" name, with your permission, while performing duties related to the conduct of your business. 2. Changes in General Conditions SECTION IV - BUSINESS AUTO CON- DITIONS, B. General Conditions, 5. Other Insurance is deleted in its entirety and replaced by the following: b. For Hired Auto Physical Damage Coverage the following are deemed to be covered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in that individual "em- ployee's" name, with your per- mission, while performing duties related to the conduct of your business. Includes copyrighted material of ISO Properties, Inc., with its permission. Page 1 of 4 However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". E. Audio, Visual and Data Electronic Equip- ment SECTION III - PHYSICAL DAMAGE COV- ERAGE, C. Limit of Insurance is amended by adding the following: 4. The most we will pay for all "loss" to au- dio, visual or data electronic equipment and any accessories used with this equipment as a result of any one "acci- dent" is the lesser of a. The actual cash value of the dam- aged or stolen property as of the time of the "accident"; b. The cost of repairing or replacing the damaged or stolen property with oth- er property of like kind and quality; or c. $2,500. Provided the equipment, at the time of the "loss" is: a. Permanently installed in or upon the covered "auto" in a housing, opening or other location that is not normally used by the "auto" manufacturer for the installation of such equipment; b. Removable from a permanently in- stalled housing unit as described in Paragraph 2.a. above; or c. An integral part of such equipment. F. Who is an Insured -Amended SECTION II - LIABILITY COVERAGE, A. Coverage, 1. Who is an Insured is amended by adding the following: The following are "insureds": 1. Any subsidiary which is a legally incorpo- rated entity of which you own a financial interest of more than 50% of the voting stock on the effective date of this cover- age form. However, the insurance afforded by this provision does not apply to any subsidiary that is an "insured" under any other au- tomobile liability policy or would be an "in- sured" under such policy but for termina- tion of such policy or the exhaustion of such policy's limits of insurance. 2. Any organization that is newly acquired or formed by you and over which you main- tain majority ownership. The insurance provided by this provision: AA 288 06 20 a. Is effective on the date of acquisition or formation, and is afforded for 180 days after such date; b. Does not apply to "bodily injury" or "property damage" resulting from an "accident" that occurred before you acquired or formed the organization; c. Does not apply to any newly acquired or formed organization that is a joint venture or partnership; and d. Does not apply to an insured under any other automobile liability policy or would be an insured under such a policy but for the termination of such policy or the exhaustion of such poli- cy's limits of insurance. 3. Any of your "employees" while using a covered "auto" in your business or your personal affairs, provided you do not own, hire or borrow that "auto". G. Liability Coverage Extensions - Supple- mentary Payments - Higher Limits SECTION II - LIABILITY COVERAGE, A. Coverage, 2. Coverage Extensions, a. Sup- plementary Payments is amended by: 1. Replacing the $2,000 Limit of Insurance for bail bonds with $4,000 in (2); and 2. Replacing the $250 Limit of Insurance for reasonable expenses with $500 in (4). H. Amended Fellow Employee Exclusion SECTION II - LIABILITY COVERAGE, B. Ex- clusions, 5. Fellow Employee is modified as follows: Exdusion 5. Fellow Employee is deleted. I. Hired Auto - Physical Damage If hired "autos" are covered "autos" for Liability Coverage, then Comprehensive and Collision Physical Damage Coverages as provided un- der SECTION III - PHYSICAL DAMAGE COVERAGE of this Coverage Part are ex- tended to "autos" you hire, subject to the fol- lowing: 1. The most we will pay for "loss" to any hired "auto" is $50,000 or the actual cash value or cost to repair or replace, which- ever is the least, minus a deductible. 2. The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage, or $1,000, whichever is less. 3. Hired Auto - Physical Damage coverage is excess over any other collectible insur- ance. Includes copyrighted material of ISO Properties, Inc., with its permission. Page 2 of 4 4. Subject to the above limit, deductible, and excess provisions we will provide cover- age equal to the broadest coverage appli- cable to any covered "auto" you own in- sured under this policy. Coverage indudes loss of use of that hired au- to, provided it results from an "accident" for which you are legally liable and as a result of which a monetary loss is sustained by the leasing or rental concern. The most we will pay for any one "accident" is $3,000. If a limit for Hired Auto - Physical Damage is shown in the Schedule, then that limit replac- es, and is not added to, the $50,000 limit indi- cated above and the deductibles shown in the Schedule are applicable. J. Rental Reimbursement SECTION III - PHYSICAL DAMAGE COV- ERAGE is amended by adding the following: 1. We will pay for rental reimbursement ex- penses incurred by you for the rental of an "auto" because of a 'loss" to a covered "auto". Payment applies in addition to the otherwise applicable amount of each cov- erage you have on a covered "auto". No deductible applies to this coverage. 2. We will pay only for those expenses in- curred during the policy period beginning 24 hours after the "loss" and ending, re- gardless of the policys expiration, with the lesser of the following number of days: a. The number of days reasonably re- quired to repair the covered "auto". If "loss" is caused by theft, this number of days is added to the number of days it takes to locate the covered "auto" and return it to you; or b. 30 days. 3. Our payment is limited to the lesser of the following amounts: a. Necessary and actual expenses in- curred; or b. $50 per day. 4. This coverage does not apply while there are spare or reserve "autos" available to you for your operations. 5. We will pay under this coverage only that amount of your rental reimbursement ex- penses which is not already provided for under SECTION III - PHYSICAL DAM- AGE COVERAGE, A. Coverage, 4. Coverage Extensions. K. Transportation Expense - Higher Limits SECTION III - PHYSICAL DAMAGE COV- ERAGE, A. Coverage, 4. Coverage Exten- sions is amended by replacing $20 per day with $50 per day, and $600 maximum with $1,500 maximum in Extension a. Transpor- tation Expenses. L. Airbag Coverage SECTION III - PHYSICAL DAMAGE COV- ERAGE, B. Exclusions, 3.a. is amended by adding the following: However, the mechanical and electrical breakdown portion of this exdusion does not apply to the accidental discharge of an airbag. This coverage for airbags is excess over any other collectible insurance or warranty. M. Loan or Lease Gap Coverage 1. SECTION III - PHYSICAL DAMAGE COVERAGE, C. Limit of Insurance is deleted in its entirety and replaced by the following, but only for private passenger type "autos" with an original loan or lease, and only in the event of a "total loss" to such a private passenger type "auto": The most we will pay for "loss" in any one "accident" is the greater of: (1) The amount due under the terms of the lease or loan to which your covered private passenger type "auto" is subject, but will not include: (a) Overdue lease or loan pay- ments; (b) Financial penalties imposed under the lease due to high mileage, excessive use or abnormal wear and tear; (c) Security deposits not re- funded by the lessor; (d) Costs for extended warran- ties, Credit Life Insurance, Health, Accident or Disabil- ity Insurance purchased with the loan or lease; and (e) Carry-over balances from previous loans or leases, or (2) Actual cash value of the stolen or damaged property. b. An adjustment for depreciation and physical condition will be made in de- termining actual cash value at the time of "loss". AA 288 06 20 Includes copyrighted material of ISO Properties, Inc., with its permission. Page 3 of 4 2. SECTION V - DEFINITIONS is amended by adding the following, but only for the purposes of this Loan or Lease Gap Coverage: 'Total loss" means a "loss" in which the cost of repairs plus the salvage value ex- ceeds the actual cash value. N. Glass Repair - Waiver of Deductible SECTION III - PHYSICAL DAMAGE COV- ERAGE, D. Deductible is amended by adding the following: No deductible applies to glass damage if the glass is repaired in a manner acceptable to us rather than replaced. O. Duties in the Event of an Accident, Claim, Suit or Loss - Amended SECTION IV - BUSINESS AUTO CONDI- TIONS, A. Loss Conditions, 2. Duties in the Event of Accident, Claim, Suit or Loss, a. is amended by adding the following: This condition applies only when the "acci- dent" or "loss" is known to: 1. You, if you are an individual; 2. A partner, if you are a partnership; 3. An executive officer or insurance manag- er, if you are a corporation; or 4. A member or manager, if you are a lim- ited liability company. AA 288 06 20 P. Unintentional Failure to Disclose Hazards SECTION IV - BUSINESS AUTO CONDI- TIONS, B. General Conditions, 2. Conceal- ment, Misrepresentation or Fraud is amended by adding the following: However, if you unintentionally fail to disdose any hazards existing on the effective date of this Coverage Form, we will not deny cover- age under this Coverage Form because of such failure. Q. Mental Anguish Resulting from Bodily Inju- ry SECTION V - DEFINITIONS, C. "Bodily inju- ry" is deleted in its entirety and replaced by the following: "Bodily injury" means bodily injury, sickness or disease sustained by a person, induding men- tal anguish and death sustained by the same person that results from such bodily injury, sickness or disease. "Bodily injury" does not indude mental anguish or death that does not result from bodily injury, sickness or disease. R. Coverage for Certain Operations in Con- nection with Railroads With respect to the use of a covered "auto" in operations for or affecting a railroad: 1. SECTION V - DEFINITIONS, H. "Insured contract", 1.c. is deleted in its entirety and replaced by the following: c. An easement or license agreement; 2. SECTION V - DEFINITIONS, H. "Insured contract", 2.a. is deleted. Includes copyrighted material of ISO Properties, Inc., with its permission. Page 4 of 4 PINNIACOL ASSURANCE 7501 E. Lowry Blvd. Denver, CO 80230-7006 303.361.4000 / 800.873.7242 Pinnacol.com Tigertree Inc. 110 Howe Rd Laramie, WY 82070 ENDORSEMENT: Blanket Waiver of Subrogation NCCI #: WC000313B Policy #: 4141111 Mountain West Ins & Fin/Alamosa 100 E. Victory Way Craig, CO 81625 (719) 589-3606 We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. SCHEDULE To any person or organization when agreed to under a written contract or agreement, as defined above and with the insured, which is in effect and executed prior to any loss. Effective Date:October 1, 2022 Expires on: October 1, 2023 Pinnacol Assurance has issued this endorsement October 5, 2022 7501 E. Lowry Blvd Denver, CO 80230-7006 Page 1 of 1 P COLER - Underwriter 10/05/2022 13:10:18 4141111 80495958 359-B Ct Entity Information Entity Name* TIGER TREE INC Contract Name* 2023 TREE REMOVAL & REPLACEMENT Contract Status CTB REVIEW Contract Description* REMOVE AND REPLACE TREES Contract Description 2 Contract Type* CONTRACT Amount * $29,100.00 Renewable* NO Automatic Renewal Grant IGA Entity ID* @00037790 Department BUILDINGS AND GROUNDS Department Email CM- BuildingGrounds@weldgo v.com Department Head Email CM-BuildingGrounds- DeptHead@weldgov.com County Attorney GENERAL COUNTY ATTORNEY EMAIL County Attorney Email CM- COUNTYATTORNEY@WEL DGOV.COM Q New Entity? Contract ID 7460 Contract Lead * SGEESAMAN Contract Lead Email sgeesaman@co.weld.co.0 s;Iredfern@weldgov.com Parent Contract ID Requires Board Approval YES Department Project # Requested BOCC Agenda Due Date Date* 10/07/2023 10/11/2023 Will a work session with BOCC be required?* NO Does Contract require Purchasing Dept. to be included? YES Bid/RFP #* B2300175 If this is a renewal enter previous Contract ID If this is part of a MSA enter MSA Contract ID Note: the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts are not in OnBase Contract Dates Effective Date Termination Notice Period Contact Information Review Date* 12/31/2023 Committed Delivery Date Renewal Date Expiration Date* 12/31/2023 Contact Info Contact Name Contact Type Contact Email Contact Phone 1 Contact Phone 2 Purchasing Purchasing Approver Purchasing Approved Date CHERYL PATTELLI 10/16/2023 Approval Process Department Head Finance Approver Legal Counsel TOBY TAYLOR CHERYL PATTELLI BRUCE BARKER DH Approved Date Finance Approved Date Legal Counsel Approved Date 10/16/2023 10/16/2023 10/16/2023 Final Approval BOCC Approved Tyler Ref # AG 102323 BOCC Signed Date Originator SGEESAMAN BOCC Agenda Date 10/23/2023 Hello