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Home My WebLink About20230170.tiffC,cyvcxdlftotocj1 December 21, 2022 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: 822 7th Street Parking Lots/Sidewalks Snow Removal A bid for the snow removal from the parking lots and sidewalks at 822 7th Street Greeley, CO was performed using the informal bid process for this season only and Landscapers of America, LLC was the low bidder and meets the requirements. Therefore, Facilities is recommending the award to Landscapers of America, LLC. in the amount of $1,100.00 for Full removal Services & $950.00 for Partial removal Services as defined in the exhibit. If you have any questions, please contact me at extension 2023. Sincerely, Toby Taylor Director Comer+ d4,-, um/ t3 2023-0170 8e10()Z5 Z5 SERVICE AGREEMENT BETWEEN WELD COUNTY AND LANDSCAPERS OF AMERICA, LLC 822 7TH STREET PARKING LOTS & SIDEWALKS SNOW REMOVAL THIS AGREEMENT is made and entered into this 21 day of DECEMBER, 2022, by and between the Board of Weld County Commissioners, on behalf of the Facilities Department, hereinafter referred to as "County," and Landscapers of America, LLC., hereinafter referred to as "Contractor". WHEREAS, County requires an independent contractor to perform the services required by County and set forth in the attached Exhibit; 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 Exhibit; 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 Exhibit, 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 Exhibit, 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 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 Exhibit. 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 4.greemf .m. 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. 010.23 - O / 70 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 $1.100.00 for Full Removal & 950.00 for Partial Removal as set forth in the Exhibit. No payment in excess of that set forth in the Exhibit 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 Exhibit, 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. Contractor shall not provide representations, warranties, or assurances as to the safety of chemical substances used while performing the services, provided that Contractor applies such substances properly and in accordance with applicable laws and regulations. 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. 3 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 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 4 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 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 5 Either party may change its notice address(es) by written notice to the other. Notice may be sent to: TO CONTRACTOR: Name: Christina Mendez Nava Position: Owner Address: 805 16th Street Suite A Address: Greeley, CO. 80631 E-mail: landscapersofamerica@gmail.com Phone: 970-673-8202 TO COUNTY: Name: Toby Taylor Position: Facilities Director Address: 1105 H Street Address: Greeley, CO. 80632 E-mail: ttaylortEtweldgov.com Phone: 970-400-2021 17. Compliance with Law. Contractor shall strictly comply with all applicable federal and State laws, rules and regulations in effector 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 Exhibit 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. 6 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. 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. Public Contracts for Services C.R.S. §8-17.5-101. Contractor certifies, warrants, and agrees that it does not knowingly employ or contract with an illegal alien who will perform work under this Agreement. Contractor will confirm the employment eligibility of all employees who are newly hired for employment in the United States to perform work under this Agreement, through participation in the E -Verify program or the State of Colorado program established pursuant to C.R.S. §8-17.5-102(5)(c). Contractor shall not enter into a contract with a subcontractor that fails to certify with Contractor that the subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this Agreement. Contractor shall not use E -Verify Program or State of Colorado program procedures to undertake pre -employment screening or job applicants while this Agreement is being performed. If Contractor obtains actual knowledge that a subcontractor performing work under this Agreement knowingly employs or contracts with an illegal alien Contractor shall notify the subcontractor and County within three (3) days that Contractor has actual knowledge that a subcontractor is employing or contracting with an illegal alien and shall terminate the subcontract if a subcontractor does not stop employing or contracting with the illegal alien within three (3) days of receiving notice. Contractor shall not terminate the subcontract if within three days the subcontractor provides information to establish that the subcontractor has not knowingly employed or contracted with an illegal alien. Contractor shall comply with reasonable requests made in the course of an investigation, undertaken 7 pursuant to C.R.S. §8-17.5-102(5), by the Colorado Department of Labor and Employment. If Contractor participates in the State of Colorado program, Contractor shall, within twenty days after hiring an new employee to perform work under the contract, affirm that Contractor has examined the legal work status of such employee, retained file copies of the documents, and not altered or falsified the identification documents for such employees. Contractor shall deliver to County, a written notarized affirmation that it has examined the legal work status of such employee, and shall comply with all of the other requirements of the State of Colorado program. If Contractor fails to comply with any requirement of this provision or of C.R.S. §8-17.5-101 et seq., County, may terminate this Agreement for breach, and if so terminated, Contractor shall be liable for actual and consequential damages. Except where exempted by federal law and except as provided in C.R.S. § 24-76.5-103(3), if Contractor receives federal or state funds under the contract, Contractor must confirm that any individual natural person eighteen (18) years of age or older is lawfully present in the United States pursuant to C.R.S. § 24-76.5-103(4), if such individual applies for public benefits provided under the contract. If Contractor operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it: (a) is a citizen of the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall produce one of the forms of identification required by C.R.S. § 24-76.5-101, et seq., and (c) shall produce one of the forms of identification required by C.R.S. § 24-76.5-103 prior to the effective date of the contract. 29. 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. 30. 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 Exhibit, 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. CONTRACTOR: Landscapers Of America, LLC By:/sL'09.Ve Name: is, ,4- /tki✓AE� A4 -1/4 - Title: O 0O wee. 'Date of Signature WELD COC1.� ATTEST: / Q ` BOARD OF COUNTY COMMISSIONERS Wel ' C . unty Clerk to t e Board WELD COUNTY, COLORADO Mike Freeman, Chair 9 JAN 1 1 2023 02o23 -o/70 Exhibit A SPECIFICATIONS AND/OR SCOPE OF WORK AND PROPOSED PRICING: PARKING LOTS SIDEWALK SNOW REMOVAL FOR 822 7`h STREET INFORMAL BID This bid is for the snow removal from two parking lots and sidewalks at the Weld County Property located at 822 7. StreenGreeley, CO. FULL REMOVAL SPECIFICATIONS 1. Snow shall be removed from parking lots and sidewalks each weekday (Monday through Friday). 2. Snow must be removed before 0700 hours each weekday of snowfall more than one inch in depth. 3. Snow is to be piled on the property at locations that do not Interfere with traffic flow. 4. Provide price below for FULL REMOVAL. PARTIAL REMOVAL SPECIFICATIONS 1. If snow continues through the day, Contractor is expected to return to site and remove snow from parking lots and sidewalks greater than one Inch in depth. 2. Contractor will coordinate arrival and departures with Facilities Department representative. 3. Contractor will not perform partial removals past S PM each weekday. 4. Contractor shall plow drive paths In parking lot. S. Removal of snow between parked cars is not required. 6. Snow Is to be piled on the property at locations that do not interfere with traffic flow. 7. Provide price below for PARTIAL REMOVAL. LOCATIONS 1. The locations for snow removal will be the following: a. The Annex Parking Lot at 922 7th Street. The Annex Lot is East of the building. b. The Gated Parking Lot at 822 7'h Street. The Gated lot is North of 7th Street. c. All sidewalks associated with the property and sidewalks adjacent to parking lots above. 2. The quoted price for FULL REMOVAL and PARTIAL REMOVAL will be for completing all of these at the same time. OTHER 1. Bid will be from January 1st, 2023 through May 1st, 2023. PRICING Provide pricing in spaces below for full removal and partial removal. FULL REMOVAL $ PARTIAL REMOVAL $ 950 The undersigned, by his or her signature, hereby acknowledges and represents that: 1. The quotations set forth herein are exclusive of any federal excise taxes and at other state and local taxes. 2. He or she is authorized to bind the below -named bidder for the amount shown on the accompanying bid sheets. FIRM, d -� ¢��-,�f 0 ;`fl/e- 1k ADDRESS 605 /&iVied U/, CITY, STATE, ZIP CODE &-7.8e42 49 / e (063/ TELEPHONE NO ("M2 -‘73-f& t,S- FAX#9b) 7,9,-,,w3 TAX ID # ‘1-7 91d8 F E. __ PRINTED NAME AND TITLE asAve6,-6,44,_ &me e — SIGNATURE E-MAIL I41Seat*isWain eieB2/. DATE j4'e- eel/Y.5; , aJJ2, - **ALL BIDDERS SHALL PROVIDE A W-9 WITH THE SUBMISSION OF THEIR BID•• Form W-9 (Rev, October 20181 In1Rove©rue ServiceVrY ri a 8 e a >g� � e Ip tn) Name (se shown on your Request for Taxpayer Identification Number and Certification ► do to www./rs.gov/FormW9 for instructions end the latest information, CRISTINA MENDEZ NAVA 2 Bus noes named 3rogarded entJty name, If cliff LANDSCAPERS OF AMERICA LLC Name is required on tin ; da net ieav Give Form to the requester. Do not send to the IRS. above 3 Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the following seven boxes, El Individual/sole proprietor or ❑ C Corporation ❑ S Corporation ❑ Partnership ❑ TrusVestate single -member LLc ❑ Limited liability company, Enter the tax classification (CUC thrporetion. 5=S eorponoyon, P.Pertndrehit ► Note: Gnedt the appropriefe box to the Ilse above far the lax claseificetfon of the single-mernbar o„mer, po not check LLC it the LLC Is Gessined es a singte-membef LLC that Is dixegarded from the owner unless the rnvner of the L'i iA another LLC that le not disregarded from the owner for U.s. federal tax purposes. Otherwise, a single -member LLC that Ha disregarded from the owner should check the appropriate box for the tax classification of its owner. Other tree instructions) ► a Rddr�s (nem street, and ap or Butte no.) See I 2280 1st AVE, LOT 52 6 City, state, and ZIP code GREELEY,CO, 80631 account number(s) here (op Taxpayer Went 4 Exemptions (codes apply only to certain entities, not Individuals; see Instructions an page 3); Exempt payee code (if env) Exemption from FATCA reporting code (i1 any) Raquasior's name and address ion Number (TIN Enter your TIN In the appropriate box. The TIN provided trust thatch the name given on line 1 to avoid backup withholding. For individuals, this Is generally your social security number (SON). However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part 1, toter. For other entlbee. Nis your employer (dentiflcatlon number (EIN). If you do not have a number, see How to get TIN, later. Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and Number To Glee the Requester for guidelines on whose number to enter. UM Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my correct 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 am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I ant subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3. I am a U.S. Citizen or other U.S. person (defined below); end 4. The FATCA code(e) entered on this form (If any) indicating that I em exempt from FATCA reporting is correct. Certification inefnwoane. You must cross out Item 2 above if you have been nott ied by the IRS that you are currently subject to backup withholding because you have felled to report a6 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 an individual retirement arrangement (IRA), 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 It, tater, Sign I Signature of Here u.s. person ► General Instruction Social or ty numb Employer Identification number 6 7 8 9 0 Section references are to the Internal Revenue Code unless otherwise noted. Future developments. For the latest information about developments related to Fenn W-9 and Its instructions, such as legislation enacted after they were published, go to www.lrs.gov/FormW9, Purpose of Form An individual or entity (Form W-9 requester) who is required to the an information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN). Individual taxpayer Identlficat on number (ITIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN), to report on an information return the amount peld to you, or other amount reportable on an Information return. Examples of information returns include, but are not limited to, the following. • Form 1099-INT (interest earned or paid) Date►�� o8 • Form 1099-DIV (dividends, including those from stocks or mutual funds) • Form 1099-MISC (various types of income, prizes, awards, or gross proceeds) • Form 1099-B (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) • Form 1098 (home mortgage Interest), 1098-E (student loan interest), 1098-T (tuition) • Form 1099-C (canceled debt) • Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you area U.S. person (including a resident alien), to provide your correct TIN. 11 you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding, later. Cat. No. 10231X Form W-9(Rev, io.aoini THE HARTFORD THE HARTFORD BUSINESS SERVICE CENTER 3600 WISEMAN BLVD SAN ANTONIO TX 78251 Weld County Government 1105 H Street Greeley CO 80631 Account Information: Policy Holder Details : Landscapers of America, LLC December 21, 2022 0, Contact Us Need Help? Chat online or call us at (866) 467-8730. We're here Monday - Friday. Enclosed please find a Certificate Of Insurance for the above referenced Policyholder. Please contact us if you have any questions or concerns. Sincerely, Your Hartford Service Team WLTR005 CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 12/21/2022 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 be endorsed. If SUBROGATIONIS 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 MADISON INSURANCE GROUP LLC 34340708 7600 E EASTMAN AVE STE 500 DENVER CO 80231 CONTACT NAME: PHONE (303)322-0800 FAX (a/c, No, Ext): (ac, No): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NA. INSURER A: Hartford Underwriters Insurance Company 30104 INSURED LANDSCAPERS OF AMERICA, LLC 2280 1ST AVE LOT 52 GREELEY CO 80631 INSURER B : INSURER C : INSURER D 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 POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE INSR SUER WVD POLICY POLICY NUMBER POLICY (MMIDD/YEFF FF POLICY EXP (MM/DD/Y YYYI LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 ICLAIMS-MADEOCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $1,000,000 X General Liability MED EXP (Any one person) $10,000 A X 34 SBM AH9DA3 10/06/2022 10/06/2023 PERSON, BADVINJURY $1,000,000 GENT. AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY E PRO' C LOC JECT PRODUCTS - COMP/OP AGG $2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) ANY AUTO BODILY INJURY (Per person) ALL OWNED AUTOS SCHEDULED _ AUTOS BODILY INJURY (Per accident) HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) A UMBRELLA LIAR EXCESS LIAB X OCCUR cuaMADIEs' 34 SBM AH9DA3 10/06/2022 10/06/2023 EACH OCCURRENCE $2,000,000 AGGREGATE $2,000,000 DEDI I RETENTION $ 10,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ( I IEORH STATUTE ANY Y/N E.L. EACH ACCIDENT PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? C N/ A E.L. DISEASE -EA EMPLOYEE (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT A Employment Practices Liability 34 SBM AH9DA3 10/06/2022 10/06/2023 Each Claim Limit $25,000 Insurance Annual Aggregate Limit $25,000 DESCRIPTION OF OPERATIONS/LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Those usual to the Insured's Operations. Waiver of Subrogation applies in favor of the Certificate Holder per the Business Liability Coverage Form SL0000, attached to this policy. CERTIFICATE HOLDER CANCELLATION Weld County Government SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 1105 H Street BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED Greeley CO 80631 IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATNE ...f' of Caa ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CAKE 12/21/2022 Ca₹:e markets., u:nr er riles and services pr,ic,es for Pirmacol Assurance. Policy # 2504412 Policy Name Landscapers of America LLC NCCI # WC000313 Insurer Cake Insure 7501 E. Lowry Blvd Denver, CO 80230 833.230.CAKE (2253) cakeinsure.com Endorsement: Waiver Of Subrogation 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 Weld County Government 1105 H Street GREELEY, CO 80631 Effective Date: 12/21/2022 Pinnacol Assurance has issued this endorsement on 12/21/2022 1 of 3 COISB 7501 E. Lowry Blvd, Denver, CO 80230 support@cakeinsure.com 833.230. CAKE (2253) A� L3° CERTIFICATE OF LIABILITY INSURANCE DATE WMIDDWYYY) 12/21/2022 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: B the certificate holder is an ADDITIONAL INSURED, the policy(Ies) must have ADDITIONAL INSURED provisions or be endorsed. B 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 Cake Insure 7501 E. Lowry Blvd Denver, CO 80230 CONTACT NAME: PHONE ( FAX ADDRE-MAIL support@cakeinsure.com INSURERS) AFFORDING COVERAGE MICA INSURER A: Pinnacol Assurance 41190 INSURED Landscapers of America LLC 2626 W 1st St Lot 263 Greeley, Colorado 80631 INSURER B : INSURER c : INSURER D: 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 POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. MR LTR TYPE OF INSURANCE ADOL SUER INgp lyyp POLICY NUMBER POLICY EFF gag= POLICY EXP DaYVDW1(YY17 LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE S DAMAGE TO RENTED PREMISES (Ea occurrence) S MED EXP (Any are person) S PERSONAL b ADV INJURY S GENL AGGREGATE LIMIT APPLIES PER: _ POLICY ❑ JPEC Ej LOC OTHER: GENERAL AGGREGATE S PRODUCTS - COMP/OP AGG $ S AUTOMOBI.ELIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY SCHEDULED _ AUTOS AUTOS ONLY AUTOS ONLY COMBWEDSINGLEUMIT (Ea aocidentl $ BODILY INJURY (Per person) S BODILY INJURY (Per accident) S PROPERTY DAMAGE (Per accident) $ UMBRELLA LIAR EXCESS LIAR CUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTIONS $ A WORKERS COMPENSATION AND EMPLOYERS' LABILITY Y / N MIYPROPRIETOR/PARTNER/EJ(ECUTIVE OFFICER1ME TER EXCLUOED4 Y� Pendebxy In NH) Hyes tlescribe under DES( RIPTION OF OPERATIONS bebw NIA 1 2504412 10/07/2022 10/07/2023 X I STATUTE ( !FR E.LEACHACCIDENT $ 500000 E.L. DISEASE - EA EMPLOYEE $ 500000 EL DISEASE - POLICY LIMIT $ 500000 DESCRIPTION OF OPERATIONS/LOCATIONS / VEHICLES (ACORD 101, Additions( Remsrka Schedule, may be attached H more apace la required) Unless otherwise stated in the policy provisions, coverage in Colorado only. Excluded from coverage: CRISTINA MENDEZ; SNOW REMOVAL CERTIFICATE HOLDER CANCELLATION Weld County Government 1105 H Street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN GREELEY, CO 80631 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORUED REPRESENTATIVE Cake Insure I ACORD 25 (2016/03) CO 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CERTIFICATE HOLDER COPY Weld County Government 1105 H Street GREELEY, CO 80631 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. 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 does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend, or alter the coverage afforded by the policies listed thereon. MENDEZCR01 FAUAD1 CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 12/23/2022 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 LSI Insurance Agency, Inc 401 Pointe Plaza Dr Unit B Windsor, CO 80550 CONTACT Adriana Carrillo NAME: PHONE FAX (A/c, Ne, Ex,: (970) 674-1151 (a/c, No: (970) 674-0501 S: _ INSURER(S) AFFORDING COVERAGE NAIL # INSURER : ProgreSSiVe INSURED Mendez Nava, Cristina/Landscapers of America LLC 2280 1st Avenue Lot #52 Greeley, CO 80631 INSURER B : INSURER C : INSURER D: 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. INSR LTR TYPE OF INSURANCE ADDL SUER INSD ',VC POLICY NUMBER POLICY EFF IMM/DDIYYYYI frig/0=1 EXP fMMIDD/YYYYI LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ❑ JECT LOC OTHER: GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ A AUTOMOBILE LIABILITY ANY AUTO OWNED AUTEO�S ONLY AUTOS ONLY SCHEDULED X AUTOpSyy� _ AUOTOS ONL� 962787455 10/29/2022 10/29/2023 COMBINED SINGLE LIMIT (Ea accident) 1,000,000 $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ (PeO5Ec T$ AMAGE $ UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y 1 N OFFICER/MEMBOER/EXCLUDED? ECUTIVE ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A I STATUTE I I EORH E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION Weld County 1105 H St Greeley, CO 80631 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Contract Form New Contract Request Entity Information Entity Name" Entity ID* LANDSCAPERS OF AMERICA LLC- O310046574 Contract Name" SNOW REMOVAL 822 7TH STREET Contract Status CTB REVIEW ❑ New Entity? Contract ID 6601 Contract Lead" SGEESAMAN Contract Lead Email sgeesarnan@cn,weld.co.us Contract Description" SNOW REMOVAL CONTRACT. $1,100.00 FULL REMOVAL $950.00 PARTIAL REMOVAL Contract Description 2 Contract Type" CONTRACT Amount • $1,100.00 Renewable" NO Automatic Renewal Parent Contract ID Requires Board Approval YES Department Project Department Requested BOCC Agenda Due Date BUILDINGS AND GROUNDS Date" 01%07/2023 01 /11%2023 Department Email CM- BuildingGroundsarweldgov.c om Department Head Email CM-BuildingGrounds- DeptHeadi0weldgov.com County Attorney GENERAL COUNTY ATTORNEY EMAIL County Attorney Email CM- COUNTYATTORNEYWWSLDG OV.COM Will a work session with BOCC be required?" NO Does Contract require Purchasing Dept. to be included? NO If this is a renewal enter previous Contract ID if this is part of a NSA enter NSA Contract ID Note the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts are not in OnBase Effective Date Review Date" 05,/01/202:3 Renewal Date Termination Notice Period Committed Delivery Date Expiration Date 05/01:2023 Contact Information Contact Info Contact Name Purchasing Contact Type Contact Email Contact Phone 1 Contact Phone 2 Purchasing Approver Purchasing Approved Date Approval Process Department Head TOBY TAYLOR DH Approved Date 01 ;`0412023 Final Approval BOCC Approved BOCC Signed Date BOCC Agenda Date 01 11,2023 Originator SGEESAMAN Finance Approver CHERYL PATTELLI Legal Counsel MATTHEW CONROY Finance Approved Date Legal Counsel Approved Date 01/05;2023 01'05:2023 Tyler Ref # AG 011123 Hello