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Home My WebLink About20211590.tiffCbn4'vcicf- U3JJ (09 Z-7 BOARD OF COUNTY COMMISSIONERS PASS -AROUND REVIEW PASS -AROUND TITLE: Weld County 2023 Slurry Seal Renewal DEPARTMENT: Weld County Public Works / Pavement Management PERSON REQUESTING: Joshua Holbrook DATE: 4.10.2023 Brief description of the problem/issue: The original agreement for the Slurry Seal contract has the option to be extended from one year to the next as permitted by the contract. This extension would be the third and final year of a possible three-year term limit. The contract also allows for yearly rate adjustments based upon the ENR Construction cost index, which shows an 4.93% increase (20 city avg.) for 2023 and the Denver -Aurora -Lakewood CPI which is a 6.28% increase. A-1 chip seal has requested an increase that ranges from 6.11% to 6.28% for different line items in the contract (see attached cost comparison sheet). A-1 Chip Seal was the lowest bidder in 2021 and Public Works has been satisfied with their work. Attached to this pass -around is a copy of the 2023 Fee Schedule and the cost comparison from 2022 to 2023. The total amount for the contract would be $1,003,313.32, we do not anticipate going over the budget amount for the contract. What options exist for the Board? (Include consequences, impacts, costs, etc. of options): The Board may request a work session to discuss this further. Recommendation: Staff recommends approval for the attached renewal with A-1 Chip Seal Perry L. Buck, Pro-Tem Mike Freeman, Chair Scott K. James Kevin Ross Lori Saine Approve Recommendation cc. Curtis Hall, Director of Public Works Duane Na bauer, Deputy Director Mona Wecdenkeller, Office Tech IV - Accts Payable/Receivable Attachments 2023 Fee Schedule 2022-2023 Cost comparison Can 7,--enk 5/s/ 23 Schedule Work Session e&P Pit-84-4-o �P�> %g/0t5 26Z(- 1510 EGA 00-19 Other/Comments: • Karla Ford From: Sent: To: Subject: yes Lori Saine Weld County Commission ,r, District 3 1150 O Street PO Box 758 Greeley CO 80632 Phone: 970-400-4205 Fax: 970-336-7233 Email: Isaine@weldgov.cc m Website: www.co.weld.cc.us In God We Trust Lori Saine Wednesday, April 12, 2023 11:06 AM Karla Ford RE: Please Reply - Pass -Around Weld County 2023 Slurry Seal Renewal Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosu -e. If you have received this communication in error, please immediately notify sender by return e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents of this commu iication or any attachments by anyone other than the named recipient is strictly prohibited. From: Karla Ford <kford @weld.gov> Sent: Wednesday, April 12, 2023 10:34 AM To: Lori Saine <Isaine@weld.gov> Subject: Please Reply - Fass-Around Weld County 2023 Slurry Seal Renewal Importance: High Please advise if you approve recommendation. Thank you! Karla Ford X Office Manager, Board of Wel l County Commissioners 1150 O Street, P.O. Box 758, 3reeley, Colorado 80632 :: 970.336-7204 :: kford(a�welc gov.com :: www.weldgov.com :: **please note my working hours are Monday -Thursday 7:00a.m.-5:00p.m.** 1 Ph CONTRACTOR: — CONTRACT AGREEMENT EXTENSION/RENEWAL BETWEEN THE WELD COUNTY DEPARTMENT OF PUBLIC WORKS AND A-1 CHIPSEAL. This Agreement Extension Renewal "Renewal" made and entered in g / ("Renewal"), into %3/41 day of 2023, by and between the Board of Weld County Commissioners, on behalf of the Weld County Department of Public Works, h reinafter referred to as the "Department", and A-1 Chipseal, hereinafter referred to as the "Contractor". WHEREAS the parties entered into an agreement (the "Original Agreement"), identified by the Weld County Clerk to the Board of County Commissioners as document No. 2021-1590, approved on August 2, 2021. WHEREAS the parties hereby agree to extend the term of the Original Agreement in accordance with the terms of the Original Agreement, which is incorporated by reference herein, as well as the terms provided herein. NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows: • The renewal Agreement will end on April 30, 2022. • The parties agree to extend the Agreement for an additional period, which will begin May 1, 2023, and will end on December 31, 2023 • The Renewal, together with the Agreement, constitutes the entire understanding between the parties. The following change is hereby made to the Contract Documents: 1. This extension will be the third year of a possible three-year contract 2. The 2022 Bid Schedule of the contact shall be replaced by the attached 2023 Bid Schedule, which is incorporated herein. 3. The contract price shall be modified to no more than $1,003,313.32 for the contract period between May 1, 2023, to December 31, 2023. • All other terms and conditions of the Original Agreement remain unchanged. IN,.•-•-.�••s WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the ,•mQrtt,�h,,inrIjyear first above written. O 4. :. %• •eggii /j 'L r- !; • J /♦`•_ • CAR \ ps-eci Oc g-cvhaniC WCAlt�S' C4r ort:0-e E'ea re_tar rirfed Name w Signature BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO Mike Freeman, Chair MAY ATTEST: Weld Co BY: „46,(4CrAA.411 Clerk to the Bo 11/09/1092 0 = O R Pk5,),9°: . "tie" e O•Wc2A ---/S 90 BID SCHEDULE 2023 Renewal Slurry Seal and Sand Seal Contract Item Number Description Unit Est. Quantity Unit Price Contract Bid 408 Place Rubberized Crack Filler & Traffic Control (Weld County to supply material) TON 32.50 $4, 632.27 $150,548.78 409 Slurry Seal SY 260,500 $2.78 $724,190.00 627 Pavement Marking Paint (Parking Lots) GAL 0 $231.90 $0.00 630 Signing and Traffic Control (Sub/Parking lot) EACH 2 $2,145.10 $4,290.20 630 Signing and Traffic Control (Slurry Seal) MILE 16.84 $4,927.40 $82,977.42 630 MHT and Traffic Control for Cdot intersections EACH 6 $5,217.82 $31,306.92 700 F/A Minor Contract Revisions F/A 1 $10,000.00 $10,000.00 Total: $1,003,313.32 * The successful vendor is required to sign a separate contract (a sample contract is included as a separate attachment.) BID NO. B2100100 Page - 1 - RECEIPT OF ADDENDA The undersigned acknowledges receipt of the following Addenda to the Invitation for Bids, Drawings, Specifications and other Contract Documents. Addendum No. N/A Date: By: Addendum No. N/A Date: By: Bidder agrees to perform all Work described in the Contract Documents for the unit prices as shown in the Bid Schedule_ Payment will be based on the Lump Sum price or the actual quantities fumished, installed or constructed. The undersigned, by his or her signature, hereby acknowledges and represents that: 1. The bid proposed herein meets all of the conditions, specifications and special provisions set firth in the request for bid for Request No. #62100100 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 proposal sheets. 4. The signed bid submitted, all of the documents of the Request for Bid contained herein (inclad-ng, 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. FIRM A-1 Chipseal Company BY Mike Starr BUSINESS ADDRESS 2505 East 74th Avenue (Please print) DATE 04/05/23 CITY, STATE, ZIP CODE Denver, CO 80229 TELEPHONE ND 720-540-8272 SIGNATURE ..,.� FAX 303-650-9669 TAX ID # 84-1216817 E-MAIL mstarr@asphaltrepair.com WELD COUNTY IS EXEMPT FROM COLORADO SALES TAXES. THE CERTIFICATE OF EXEMPTION NUMBER IS #98-03551-0000. BID NO. B2100100 Page - 2 - t Bond No. 30189332 PERFORMANCE BOND PROJECT: SLURRY SEAL AND SAND SEAL CONTRACT 2023 RENEWAL KNOW ALL MEN BY THE PRESENTS; that A-1 Chipseal Company (Name of Contractor) 2505 E. 74th Avenue, Denver, CO 80229 (Address of Contractor) Colorado hereinafter called Contractor, and a (Corporation, P 8HtIONAIK*01'rdI 1' *) Western Surety Company (Name of Surety) 151 N. Franklin Street, Chicago, IL 60606 (Address of Surety) hereinafter called surety, are held and firmly bound unto Weld County, Colorado (Name of Owner) P.O. Box 758, 1111 H Street, Greeley, Colorado 80632 (Address of Owner) hereinafter called Owner, in the penal sum of One Million Three Thousand Three Hundred Thirteen and 32/100 Dollars, ($ 1,003,313.32 ), in lawful money of the United States of America, for the payment of which sum well and truly to be made, we bind ourselves, successors and assigns, jointly and severally firmly by these presents. THE CONDITION OF THIS OBLIGATION is such that whereas, the Contractor entered into a certain Contract with the Owner, dated the day of , 2023, a copy of which is hereto attached and made a part hereof for the construction of: PROJECT: Slurry Seal Contract described in the Invitation for Bids, Bid No. B2100100 NOW THEREFORE, if the Contractor shall well, truly and faithfully perform its duties, all of the undertakings, covenants, terms, conditions, and agreements of said contract during the original term thereof, and any extensions thereof which may be granted by the Owner, with or without notice to the Surety and during the one year guaranty period, and if he shall satisfy all claims and demands incurred under such contract, and shall fully indemnify and save harmless the Owner from all costs and damages which it may suffer by reason of failure to do so, and shall reimburse and repay the Owner all outlay and expense which the Owner may incur in making good any default, then this obligation shall be void; otherwise to remain in force and effect. PROVIDED, FURTHER, that the said Surety for value received hereby stipulates and agrees that no change, extension of time, alteration or addition to the terms of the contract or to the Work to be performed thereunder of the Specifications accompanying the same shall in any way affect its obligation on this Bond, and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the contract or to the Work or to the Specifications. PROVIDED, FURTHER, that no final settlement between the Owner and the Contractor shall abridge the right of any beneficiary hereunder, whose claim may be unsatisfied. BID NO. B2100100 PERFORMANCE BOND PROJECT: SLURRY SEAL CONTRACT 2023 RENEWAL IN WITNESS WHEREOF, this instrument is executed in two (2) counterparts, each one of which shall be deemed an original, this 202 I vi E AL Et°449/1992 \C:9.[o ik?,9 • day of A-1 Chipseal Company Con o .._ae By ctor) Secretary ; r- , 61,9 zivat4 �resid.tv..F 2505 E. 74th Avenue (Witness as to Contractor) (Address) 2505 E. 74th Avenue (Address) Denver, CO 80229 ATTEST: N/A (Surety) Secretary (SEAL) Witness . to Surety 8055 E. Tufts Aye■ue, #1000 (Address) Denver, CO 80237 By _ Denver, CO 80229 Western Surety Company /Attorney -in -Fact Jody L. Anderson 151 N. Franklin Street (Address) Chicago, IL 60606 NOTE: Date o€ Bond must not be prior to date of Contract. If Contractor is Partnership, all partners should execute Bond. IMPORTANT: Surety companies executing Bonds must appear on the Treasury Department's most current list (Circular 570 as amended) and be authorized to transact business in the State where the Project is located. BID NO. B210011r00 Page-6- Bond No. 30189332 LABOR & MATERIALS PAYMENT BOND PROJECT: SLURRY SEAL CONTRACT 2023 RENEWAL KNOW ALL MEN BY THE PRESENTS; that A-1 Chipseal Company (Name of Contractor) 2505 E. 74th Avenue, Denver, CO 80229 (Address of Contractor) Colorado hereinafter called Contractor, and a (Corporation, latRA I9F0RMI ilMill6hBt) Western Surety Company (Name of Surety) 151 N. Franklin Street, Chicago, IL 60606 (Address of Surety) hereinafter called surety, are held and firmly bound unto Weld County, Colorado, P.O. Box 758, 1111 H Street, Greeley, Colorado 80632, hereinafter called Owner, in the penal sum of One Million Three Thousand Three Hundred Thirteen and 32/100 --- Dollars ($1.003.313.32 ), in lawful money of the United States of America, for the payment of which sum well and truly to be made, we bind ourselves, successors and assigns, jointly and severally firmly by these presents. THE CONDITION OF THIS OBLIGATION is such that whereas, the Contractor entered into a certain Contract with the Owner, dated the day of , 2023, a copy of which is hereto attached and made a part hereof for the construction of: PROJECT: Slurry Seal Contract 2023 Renewal described in the Invitation for Bids, Bid No. B2100100. NOW, THEREFORE, if the Contractor shall promptly make payment to all persons, firms, Subcontractors, and corporations furnishing materials for or performing labor in the prosecution of the Work provided for in such contract, and any authorized extension or modification thereof, including all amounts due for materials, lubricants, oil, gasoline, repairs on machinery, equipment and tools, consumed or used in connection with the construction of such Work, and all insurance premiums on said Work, and for all labor, performed in such Work whether by Subcontractor or otherwise, then this obligation shall be void,; otherwise to remain in full force and effect. PROVIDED, FURTHER, that the said Surety for value received hereby stipulates and agrees that no change, extension of time, alteration or addition to the terms of the contract or to the Work to be performed thereunder of the Specifications accompanying the same shall in any way affect its obligation on this Bond, and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the Contract or to the Work or to the Specifications. PROVIDED, FURTHER, that no final settlement between the Owner and the Contractor shall abridge the right of any beneficiary hereunder, whose claim may be unsatisfied. BID NO. B2100100 Page-7- itn : as In Contractor) LABOR & MATERIALS PAYMENT BOND IN WITNESS WHEREOF, this instrument is executed in two (2) counterparts, each one of which shall be deemed an original, this day of ,2023. A-1 Chips pl Company _ Contr 2 74th Avenue (Address) Denver, CO 80229 ATTEST: N/A (Surety) Secretary (SEAL) B Y bawvie t • & vr.a.L&i 1;eresZoia....* 2505 E. 74th Avenue (Address) Denver, CO 80229 Witness -s ' Surety 8055 E. Tufts Avenue, #1000 (Address) Western Surety Company By jIrail Attdd'' ey-i'rf-Fac J L. Anderson 151 N. Franklin Street (Address) Denver, CO 8023? Chicago, IL 60606 NOTE: Date of Bond must not be prior to date of Contract. If Contractor is Partnership, all partners should execute Band. IMPORTANT: Surety companies executing Bonds must appear on the Treasury Department's most current list (Circubr 570 as amended) and be authorized to transact business in the State where the Project is located. BID NO. B21001D0 Page-8- Western Surety Company POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY -IN -FACT Know All Men By These Presents, That WESTERN SURETY COMPANY, a South Dakota corporation, is a duly organized and existing corporation having its principal office in the City of Sioux Falls, and State of South Dakota, and that it does by virtue of the signature and seal herein affixed hereby make, constitute and appoint Jody L Anderson, Evan E Moody, Karen A Feggestad, Tina Marie Post, Bradley J Moody, Andrew J Waterbury, Elizabeth Ostblom, Individually of Denver, CO, its true and lawful Attomey(s)-in-Fact with full power and authority hereby conferred to sign, seal and execute for and on its behalf bonds, undertakings and other obligatory instruments of similar nature - In Unlimited Amounts - and to bind it thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of the corporation and all the acts of said Attorney, pursuant to the authority hereby given, arc hereby ratified and confirmed. This Power of Attorney is made and executed pursuant to and by authority of the By -Law printed on the reverse hereof, duly adopted, as indicated, by the shareholders of the corporation. In Witness Whereof, WESTERN SURETY COMPANY has caused these presents to be signed by its Vice President and its corporate seal to be hereto affixed on this 22nd day of December, 2021. WESTERN SURETY COMPANY aul T. Bruflat, Vice President State of South Dakota ss County of Minnehaha On this 22nd day of December, 2021, before me personally came Paul T. Bruflat, to me known, who, being by me duly sworn, did depose and say: that he resides in the City of Sioux Falls, State of South Dakota; that he is the Vice President of WESTERN SURETY COMPANY described in and which executed the above instrument; that he knows the seal of said corporation; that.the seal affixed to the said instrument is such corporate seal; that it was so affixed pursuant to authority given by the Board of Directors of said corporation and that he signed his name thereto pursuant to like authority, and acknowledges same to be the act and deed of said corporation. My commission expires March 2, 2026 M. BENT faiwzrams4 P2. de•ff M. Bent, Notary Public CERTIFICATE I, L. Nelson, Assistant Secretary of WESTERN SURETY COMPANY do hereby certify that the Power of Attorney hereinabove set forth is still in force, and further certify that the By -Law of the corporation printed on the reverse hereof is still in force. In testimony whereof I have hereunto subscribed my name and affixed the seal of the said corporation this day of WESTERN SURETY COMPANY Form F4280-7-2012 • 1Nelson, Assistant Secretary Go to www.cnasurety.com > Owner / Obligee Services > Validate Bond Coverage, if you want to verify bond authenticity. Authorizing By -Law ADOPTED BY THE SHAREHOLDERS OF WESTERN SURETY COMPANY This Power of Attorney is made and executed pursuant to and by authority of the following By -Law duly adopted by the shareholders of the Company. Section 7. Alt bonds, policies, undertakings, Powers of Attorney, or other obligations of the corporation shall be executed in the corporate name of the Company by the President, Secretary, and Assistant Secretary, Treasurer, or any Vice President, or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys in Fact or agents who shall have authority to issue bonds, policies, or undertakings in the name of the Company. The corporate seals nut necessary for the validity of any bonds, policies, undertakings, Powers of Attomey or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile. ACO OR CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 04/18/2023 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 po icy, 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 Moody Insurance Agency, Inc. 8055 East Tufts Avenue CONTACT Moody Insurance NAME: PP. No fit. (303) 824-6600 I ra , Noi: (303) 370-0118 lelc,ADOREss: certrequest@moodyins.com Suite 1000 INSURER(S) AFFORDING COVERAGE NAIC0 Denver CO 80237 INSURER A : Selective Insurance Co Of AM.. 12572 INSURED INSURER a : Plnnacol Assurance 41190 A-1 Chipseal Company, DBA: Rocky Mountain Pavement, LLC INsuRER C : Evanston Insurance Company 35378 2505 E. 74th Ave INSURER D : INSURER E : Denver CO 80229-6621 INSURER F : COVERAGES CERTIFICATE NUMBER: 23-24 Master 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 ADM SUBR INSD WVD POLICY NUMBER POLICY EFF alibi /yM POLICY EXP ADDOA,IP LIMITS A X COMMERCIAL GENERAL LiAttiLrry I CLAIMS•MADE El OCCUR S2501487 02/01/2023 02/01/2024 EACH OCCURRENCE S 1,000,000 PRAEM SES EaENoccunenoel O00,.° MED EXP Pm one person) S 15,000 RERSONALaAD, iNJURY $ 1,000,000 GENERAL AGGREGATE S 2,000,000 GEM. AGGREGATE LIMIT APPLIES PER: POLICY © Ter-- LOC OTHER: PRODUCTS • COMP/OPAGG S 2,000,000 S A AUTOMOBILE LIABILITY X ANY AUTO OWNED _ AUTOS ONLY HIRED AUTOS ONLY SCHEDULED AUTOS NON -OWNED AUTOS ONLY S2501487 02/01/2023 02/01/2024 1 O SINGLE LIMIT graxklenq (Ea a $ 1,000, 000 BODILY INJURY (Per person) S BODILY INJURY /Per amid.) S PROPERTY DAMAGE (Per aaklent) $ Uninsured motorist $ 1,000,000 A uMBRELLAUA5 EXCESS LIAR OCCUR CLAIMS -MADE S2501487 02/01/2023 02/01/2024 """'""'"" ""'y'" ""'' EACH OCCURRENCE S 10,000,000 AGGREGATE $ 10'000'000 DED I XI RETENTION $0 s B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY y / N ANY PROPRIETOR/PARTNEDREVEC'I' n OFFICERIMEMBER E%CLUDED7 (Mandatory In NH) II yes, describe under DESCRIPTION OF OPERATIONS below NIA 4055760 02/01/2023 02/01/2024 XI STATUTE I I ER Et...ACCIDENT $500,000 E.L. DISEASE - EA EMPLOYEE S 500,000 E.L. DISEASE - POLICY LIMIT S 500,000 C Pollution Liability CPLMOL114903 0O01/2023 02/01/2025 Each Occurrence Limit Aggregate Limit Deductible 55.000,000 $5,000,000 $10,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached K more space M required) RE: 2023 Renewal - Slurry Seal and Sand Seal CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Weld County ACCORDANCE WITH THE POLICY PROVISIONS. 1150 O Street Greeley I CO 80631 AUTHORIZED REPRESENTATIVE I4 �j/�( jr W/t� ��'1)" - `- U v 'i ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 00015073 LOC #: ACORO` ADDITIONAL REMARKS SCHEDULE Page of AGENCY Moody Insurance Agency, Inc. POLICY NUMBER CARRIER NAIL CODE NAMED INSURED A-1 Chipseal Company, DBA: Rocky Mountain Pavement, LLC EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance: Notes CONTRACTUAL LIABILITY APPLIES PER POLICY TERMS AND CONDITIONS Additional Named Insureds: A-1 Chipseal Company DBA Rocky Mountain Pavement, LLC Black Rock Material & Supply, Ll DBA Rocky Mountain Parking Lot Sewices Location Schedule: 2505 E. 74th Avenue, Denver, CG 80329 7231-35 Cole View, Colorado Spings, CO 80915 20 Monarch Lane, Pueblo, CO 811004 4690 Joliet Street, Demver, CO 6O22I 10800 Highway 90, Arvada CO 8040d Inland Marine Policy: Policy Number: S2501487 Policy Effective Dates: 2-1-2023 b 24-2024 Insurer: Selective Insurance Corroan, of America Total Combined Scheduled Contractor's Equipment Value: $8,139,068 Scheduled Contractor's Equipment Dsductible: $10,000 Leased & Rented Equipment Fran alters Limit: $1,000,000 General Liability Policy: General Liability Deductible: $2,030 CG 73 00 01/19 From Attached Includes: Blanket Additional Insured status app ies only to the extent provided in form CG 79 88 01/19. Blanket Waiver of Subrogation applies only to the extent provided in from CG 73 00 01/19. General Liability Policy is Primary and Non -Contributory only to the extent provided in form CG 79 88 01/19. Auto Liability Policy: Physical Damage Deductibles: Cempsehensive: $2,000, Collision: $2,000 CA 78 09 / From Attached Includes: Blanket Additional Insured status apples only to the extent provided in farm CA 78 09 11/17. Blanket Waiver of Subrogation applies only to the extent provided in from CA 78 09 11/17. Umbrella Policy: Umbrella Policy is on a foltow1) frnn oasis for underlying insurance coverages: General Liability, Automobile Liability, and Employers Liability. Additional insured status will followr wien required by written contract, including Primaryand Non-ContributoryStatus. Worker's Compensation Policy: 359-B Form Attached Includes: Blanket Waiver of Subrogation status applies when required by written contract. ' Please Note Hard Copies of Endorsement will not be sent out via mail. All Endorsements will only be sent electronically via email. Please send your email address to certrequest@meodlns.com for forms and future mailings" ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Commercial Automobile Extension COMMERCIAL AUTO CA78161117 SCHEDULE OF COVERAGE EXTENSIONS AND LIMITS OF INSURANCE This ElitePac Schedule is a summary of additional coverages, coverage modifications and corresponding Limits of Insurance that supplements the Business Auto Coverage Form. No coverage is provided by this summary. Refer to the actual endorsement for changes affecting your insurance protection. DESCRIPTION I- AMENDMENTS TO SECTION II - LIABILITY COVERAGE Newly Acquired Or Formed Organizations ' Coverage Extension Limited Liability Companies ( Coverage Extension Employees As Insureds Coverage Extension I Blanket Additional Insureds Coverage Extension Expenses For Bail Bonds And Loss Of Earnings Bail Bonds $3,000 Per "Accident" Loss Of Earnings $1,0O0 Per Day Employee Indemnification and Employer's Liability Amendment ! Coverage Extension Fellow Employee Coverage Coverage Extension Care, Custody Or Control Amendment $1,00O per "Accident"; $500 Deductible Per "Accident" AMENDMENTS TO SECTION III - PHYSICAL DAMAGE COVERAGE Towing And Labor Coverage Extension Private Passenger Auto, Social Service Van or Bus, Light Truck Medium, Heavy and Extra Heavy Trucks $75 Per Tow $150 Per Tow Glass Breakage Deductible Coverage Extension I Additional Transportation Expenses $60 per day up to a maximum of $1,800 Hired Auto Coverage Damage Physical y g g $75,000 per "loss" IIIIIIIIIIIIIII I II IIIIIIIIIIMI II Hired Auto Loss of Use Coverage Auto Loan/Lease Gap Coverage (Not Available in New York) $750 Per "Accident" Coverage Extension Personal Effects $5OO Per "Accident" Airbag Coverage Expanded Audio, Visual, And Data Electronic Equipment Coverage Comprehensive Deductible - Location Tracking Device Coverage Extension Coverage Extension Coverage Extension Physical Damage Limit Of Insurance Copyright, 2017 Selective Insurance Company of America. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. INSURED'S COPY Coverage Extension CA78161117 Page 1 of 2 DESCRIPTION AMENDMENTS 'O SECTION IV - BUSINESS AUTO CONDITIONS Duties In The Eveit Of Accident, Claim, Suit Or Loss Coverage Extension Waiver of Subrogation Multiple Deductibes Coverage Extension Coverage Extension Concealment, Mim'enresentation Or Fraud Coverage Extension Policy Period, Coverage Territory Coverage Extension Two Or More Coverage Forms Or Policies Issued By Us - Deductibles AMENDMENTS TO SECTION V - DEFINITIONS Coverage Extension Bodily Injury Including Mental Anguish (Not Applicable in New York) Coverage Territory Broadened Definition Broadened Definition Copyright, 2017 Selective Insurance Company of America. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. INSURED'S COPY CA78161117 Page 2 of 2 General Liability Extension Endorsement COMMERCIAL GENERAL LIABILITY CG 73 00 01 19 SUMMARY OF COVERAGES (including index) This is a summary of the various additional coverages and coverage modifications provided by this endorsement. No coverage is provided by this summary. Refer to the actual endorsement (Pages 3 -through -9) for changes affecting your insurance protection. auwra cwnaribu II I I I I IIII N I I UII O I II I INI II I II flI I II 111111119 DESCRIPTION Additional Insureds - Primary and Non -Contributory Provision Blanket Additional Insureds - As Required By Contract • Owners, Lessees or Contractors (includes Architects, Engineers or Surveyors • Lessors of Leased Equipment • Managers or Lessors of Premises • Mortgagees, Assignees and Receivers • Any Other person or organization other than a joint venture • Grantors of Permits Broad Form Vendors Coverage Page 7 Damage To Premises Rented To You (Including Fire, Lightning or Explosion) Page 3 Electronic Data Liability ($100,000) Page 4 Employee Definition Amended Page 9 Employees As Insureds Modified Page 5 Employer's Liability Exclusion Amended (Not applicable in New York) Page 3 Incidental Malpractice Exclusion modified Page 7 Knowledge of Occurrence, Claim, Suit or Loss Page 7 Liberalization Clause Page 8 Mental Anguish Amendment (Not applicable to New York) Page 9 Newly Formed or Acquired Organizations Page 5 Non -Owned Aircraft Page 3 Non -Owned Watercraft (under 60 feet) Page 3 Not -for-profit Members - as additional insureds Page 5 Personal And Advertising Injury - Discrimination Amendment (Not applicable in New York) Page 8 Products Amendment (Medical Payments) Page 4 Supplementary Payments Amended - Bail Bonds ($5,000) and Loss of Earnings ($1,000) Page 4 Two or More Coverage Parts or Policies Issued By Us Page 8 Unintentional Failure to Disclose Hazards Page 8 Waiver of Transfer of Rights of Recovery (subrogation) Page 8 When Two or More Coverage Parts of this Policy Apply to a Loss Page 3 Copyright, 2018 Selective Insurance Company of America. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. INSURED'S COPY PAGE FOUND Page 8 Page 5 CG 73 00 01 19 Page 1 of 9 THIS PAGE IS INTENTIONALLY LEFT BLANK. Copyright, 2018 Selective Insurance Company of America. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. INSURED'S COPY CG73000119 Page 2 of 9 General Liability Extension Endorsement COMMERCIAL GENERAL LIABILITY CG 73 00 01 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies the insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The SECTIONS of the Commercial General Liability Coverage Form identified in this endorsement will be amended as shown below. However, if (a) two or more Coverage Parts of this policy, or (b) two or more forms or endorsements within the same Coverage Part apply to a loss, coverage provision(s) with the broadest language will apply, unless specifically stated otherwise within the particular amendment covering that loss. With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. IIIIIIIIIIIIIIIIIIIIIIIIIlIIIIIlhIII IItIIIIIII COVERAGES - Amendments SECTION I - COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY EXCLUSIONS Employer's Liability Amendment (This provision is not applicable in the State of New York). The following is added to Exclusion e. Employer's Liability under COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions: This exclusion also does not apply to any "temporary worker". Non -Owned Aircraft, Auto or Watercraft A. Paragraph (2) of Exclusion g. Aircraft, Auto Or Watercraft under COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclus- ions is deleted in its entirety and replaced with the following: (2) A watercraft you do not own that is: (a) Less than 26 feet long and not being used to carry persons or property for a charge; or (b) At least 26 feet, but less than 60 feet long, and not being used to carry per- sons or property for a charge. Any person is an insured who uses or is responsible for the use of such water- craft with your expressed or implied consent. However, if the insured has any other valid and collectible insurance for "bodily injury" or "property damage" that would be covered under this provi- sion, or on any other basis, this cover- age is then excess, and subject to Condition 4. Other Insurance, b. Excess Insurance under SECTION IV • COM- MERCIAL GENERAL LIABILITY CONDI- TIONS. B. The following is added to Exclusion g. Aircraft, Auto Or Watercraft under COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions: This exclusion does not apply to: (6) Any aircraft, not owned or operated by any insured, which is hired, chartered or loaned with a paid crew. However, if the insured has any other valid and collectible insur- ance for "bodily injury" or "property dam- age" that would be covered under this provision, or on any other basis, this cover- age is then excess, and subject to Condition 4. Other Insurance, b. Excess Insurance under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS. Damage To Premises Rented to You A. The last paragraph of Paragraph 2. Exclusions under COVERAGE A BODILY INJURY AND PROPERTY DAMAGE is deleted in its entirety and replaced with the following: Exclusions c. through n. do not apply to damage by fire, lightning or explosion to premises rented to you or temporarily occupied by you with the permission of the owner. A separate limit of insurance applies to this coverage as described in SECTION III - LIMITS OF INSURANCE. Copyright, 2018 Selective Insurance Company of America. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. INSURED'S COPY CG 73 00 01 19 Page 3 of 9 B. Paragraph 6. under SECTION III - LIMITS OF INSURANCE is deleted in its entirety and replaced with the following: 6. Subject b Paragraph 5. above, the most we will pay under COVERAGE A for damages because of "property damage" to any one premises, while rented to you, or in the case of damage caused by fire, lightning or explosion, while rented to you or temporarily occupied by you with permission of the owner, for all such damage caused by fire, lightning or explosion proximately caused by the same event, whether such damage results from fire, lightning or explosion or any combination of the three, is the amount shown is the Declarations for the Damage To Prem ses Rented To You Limit. C. Paragraph a of Definition 9. "Insured contract" under SECTION V - DEFINITIONS is deleted in its entirety and replaced with the following: A contract bra lease of premises. However, that potion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning or explosion to premises while rented to you or temporarily occupied by you with the per- mission of the owner is not an "insured contract'; Electronic Data Liability A. Exclusion p. Access or Disclosure Of Confiden- tial Or Personal Information And Data -related Liability under COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions is deleted in its entirety and replaced by the following: p. Access or Disclosure Of Confidential Or Personal Information And Data -related Liability Damages arising out of: (1) Any access to or disclosure of any person's or organization's confidential or personal information, including patents, trade secrets, processing methods, customer lists, financial infor- mation, credit card information or any other type of nonpublic information; or (2) The loss of, loss of use of, damage to, corrLptbn of, inability to access, or inabiity to manipulate "electronic data" that does not result from physical injury to tangible property. This exclusion applies even if damages are claimed for notification costs, credit mon- itoring expenses, forensic expenses, public relations expenses or any other loss, cost or expense incurred by you or others arising out of that which is described in Paragraph (1) or (2) above. B. The following paragraph is added to SECTION III - LIMITS OF INSURANCE: Subject to 5. above, the most we will pay under COVERAGE A for "property damage" because of all loss of "electronic data" arising out of any one "occurrence" is a sub -limit of $100,000. SECTION I - COVERAGE C MEDICAL PAYMENTS EXCLUSIONS Any Insured Amendment Exclusion a. Any insured under COVERAGE C MEDICAL PAYMENTS, 2. Exclusions is deleted in its entirety and replaced with the following: a. Any Insured To any insured. This exclusion does not apply to: (1) "Not -for-profit members" ; (2) "Golfing facility" members who are not paid a fee, salary, or other compensation; or (3) "Volunteer workers". This exclusion exception does not apply if COVERAGE C MEDICAL PAYMENTS is excluded by another endorsement to this Coverage Part. Product Amendment Exclusion f. Products -Completed Operations Hazard under COVERAGE C MEDICAL PAYMENTS, 2. Exclusions is deleted in its entirety and replaced with the following: f. Products -Completed Operations Hazard Included within the "products -completed opera- tions hazard". This exclusion does not apply to "your products" sold for use or consumption on your premises, while such products are still on your premises. This exclusion exception, does not apply if COVERAGE C MEDICAL PAYMENTS is excluded by another endorsement to this Coverage Part. SECTION I - SUPPLEMENTARY PAYMENTS - COVERAGES A AND B Expenses For Bail Bonds And Loss Of Earnings A. Subparagraph 1.b. under SUPPLEMENTARY PAYMENTS - COVERAGES A AND B is deleted in its entirety and replaced with the following: b. Up to $5,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. Copyright, 2018 Selective Insurance Company of America. All rights reserved. Includes copyriglad material of Insurance Services Office, Inc., with its permission. INSURED'S COPY CG 73 00 01 19 Page 4 of 9 IIIIInIIiIlI I IIN 1IIIIIuIII11®III II I I a u B. Subparagraph 1.d. under SUPPLEMENTARY PAYMENTS - COVERAGES A AND B is deleted in its entirety and replaced with the following: d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or. "suit", including actual loss of earnings up to $1,000 a day because of time off from work. SECTION II - WHO IS AN INSURED - Amendments Not -for -Profit Organization Members The following paragraph is added to SECTION II - WHO IS AN SISURED: If you are an organization other than a partnership, joint venture, or a limited liability company, and you are a not -for-profit organization, the following are included as additional insureds: 1. Your officials; 2. Your trustees; 3. Your members; 4. Your board members; 5. Your commission members; 6. Your agency members; 7. Your insurance managers; 8. Your elective or appointed officers; and 9. Your "not -for-profit members". However only with respect to their liability for your activities or activities they perform on your behalf. Employees As Insureds Modified A. Subparagraph 2.a.(1Xa) under SECTION II - WHO IS AN INSURED does not apply to "bodily injury" to a "temporary worker" caused by a co - "employee" who is not a "temporary worker". B. Subparagraph 2.a.(2) under SECTION II - WHO IS AN INSURED does not apply to "property damage" to the property of a "temporary worker" or "volunteer worker" caused by a co - "employee" who is not a "temporary worker" or "volunteer worker". C. Subparagraph 2.a.(1Xd) under SECTION II - WHO IS AN INSURED does not apply to "bodily injury" caused by cardio-pulmonary resuscita- tion or first aid services administered by a co - "employee ". With respect to this provision only, Subparagraph (1) of Exclusion 2. e. Employer's Liability under SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY does not apply. Newly Formed Or Acquired Organizations A. Subparagraph 3.a. under SECTION II - WHO IS AN INSURED is deleted in its entirety and replaced with the following: a. Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier. However, COVERAGE A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organi- zation. B. The following paragraph is added to SECTION II - WHO IS AN INSURED, Paragraph 3: If you are engaged in the business of con- struction of dwellings three stories or less in height, or other buildings three stories or less in height and less than 25,000 square feet in area, you will also be an insured with respect to "your work" only, for the period of time described above, for your liability arising out of the conduct of any partnership or joint venture of which you are or were a member, even if that partnership or joint venture is not shown as a Named Insured. However, this provision only applies if you maintain or maintained an interest of at least fifty percent in that partnership or joint venture for the period of that partnership or joint venture. This provision does not apply to any partnership or joint venture that has been dissolved or otherwise ceased to function for more than thirty-six months. With respect to the insurance provided by this provision, Newly Formed or Acquired Organizations, the following is added to SECTION IV - COMMER- CIAL GENERAL LIABILITY, Paragraph 4. Other Insurance, Subparagraph b. Excess Insurance: The insurance provided by this provision, Newly Formed or Acquired Organizations, is excess over any other insurance available to the insured, whether primary, excess, contingent or on any other basis. (All other provisions of this section remain unchanged) Blanket Additional Insureds - As Required By Contract Subject to the Primary and Non -Contributory provi- sion set forth in this endorsement, SECTION It - WHO IS AN INSURED is amended to include as an additional insured: A. Owners, Lessees or Contractors/Architects, Engineers and Surveyors 1. Any person or organization for whom you are performing operations when you and such person or organization have agreed in a written contract, written agreement or written permit that such person or organi- zation be added as an additional insured on your commercial general liability policy; and Copyright, 2018 Selective Insurance Company of America. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. INSURED'S COPY CG 73 00 01 19 Page 5 of 9 2. Any oche- person or organization, including any arch tells, engineers or surveyors not engaged by you, whom you are required to add as an additional insured under your policy in fie contract or agreement in Paragrap, 1. above: Such person or organization is an additional insured only wish respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: a. Your acts or omissions; or b. The acts of omissions of those acting on your behalf; in the performance of your ongoing operations performed for the additional insured in Para- graph 1., above However, this irsurance does not apply to: "Bodily injury", 'property damage" or "personal and advertising injury" arising out of the render- ing of, or the fa lure to render, any professional architectural, engineering or surveying services by or for you, including: The preparing, approving, or failing to prepare or approve, maps, shop drawnge, opinions, reports, surveys, field orcers, change orders or drawings and s3e3ifications; and b. Supervisory, inspection, architectural or enginve-ing activities. Professional services do not include services within construdion means, methods, tech- niques, sequences and procedures employed by you in conne:tion with your operations in your capacity as a ccnstruction contractor. A person or organization's status as an additional insured under this endorsement ends when your operations for the person or organi- zation descried in Paragraph 1. above are completed. B. Other Additio•a insureds Any of the following persons or organizations with whom you have agreed in a written contract, writtei agreement or written permit that such persons or organizations be added as an additional insured on your commercial general liability policy: 1. Lessors of Leased Equipment Any person or organization from whom you lease equipment, but only with respect to liability for 'bodily injury", "property dam- age" or 'personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased tc you by such person or organi- zation. With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after the equipment lease expires. 2. Managers or Lessors of Premises Any person or organization from whom you lease premises, but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you. This insurance does not apply to any "occurrence" which takes place after you cease to be a tenant of that premises. 3. Mortgagees, Assignees or Receivers Any person or organization with respect to their liability as mortgagee, assignee or receiver and arising out of the ownership, maintenance or use of your premises. This insurance does not apply to any "occurrence" which takes place after the mortgage is satisfied, or the assignment or receivership ends. 4. Any Person or Organization Other Than A Joint Venture Any person or organization (other than a joint venture of which you are a member), but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts of omissions of those acting on your behalf in the performance of your ongoing operations or in connection with property owned by you. 5. State or Governmental Agency or Political Subdivision - Permits or Authorizations Any state or governmental agency or subdivision or political subdivision, but only with respect to: a. Operations performed by you or on your behalf for which the state or govern- mental agency or subdivision or political subdivision has issued a permit or authorization; or b. The following hazards for which the state or governmental agency or sub- division or political subdivision has issued a permit or authorization in connection with premises you own, rent or control and to which this insurance applies: Copyright, 2018 Setactive Insurance Company of America. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. INSURED'S COPY CG 73 00 01 19 Page 6 of 9 IIIIIfhIIIIIIIIIIIIINIIIIIIlIIIIIIlIII IINI (1) The existence, maintenance, repair, construction, erection or removal of advertising signs, awnings, cano- pies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners or decora- tions and similar exposures; (2) The construction, erection or re- moval of elevators; or (3) The ownership, maintenance or use of any elevators covered by this insurance. This insurance does not apply to: (a) "Bodily injury" or "property damage" arising out of opera- tions performed for the federal government, state or munici- pality; or (b) "Bodily injury" or "property damage" included within the "products -completed operations hazard". With respect to Paragraphs 2. through 4., this insurance does not apply to structural alterations, new construction or demolition operations performed by or on behalf of such person or organization. The provisions of this coverage extension do not apply unless the written contract or written agree- ment has been signed by the Named Insured or written permit issued prior to the "bodily injury" or "property damage" or "personal and advertising injury". Broad Form Vendors Coverage Subject to the Primary and Non -Contributory provision set forth in this endorsement, SECTION II - WHO IS AN INSURED is amended to include as an additional insured any person or organization (referred to below as vendor) for whom you have agreed in a written contract or written agreement to provide coverage as an additional insured under your policy. Such person or organization is an additional insured only with respect to "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's business. However, the insurance afforded the vendor does not apply to: a. "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement; however this exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; b. Any express warranty unauthorized by you; Any physical or chemical change in the product made intentionally by the vendor; d. Repackaging, unless unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business in connection with the sale of the product; or f. Products which, after distribution or sale by you, have been labeled or re -labeled or used as a container, part of ingredient of any other thing or substance by or for the vendor; however this insurance does not apply to any insured person or organization, from who you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. The provisions of this coverage extension do not apply unless the written contract or written agree- ment has been signed by the Named Insured prior to the "bodily injury" or "property damage". Incidental Malpractice Subparagraph 2.a.(1Xd) under SECTION II - WHO IS AN INSURED is deleted in its entirety and replaced with the following: (d) Arising out of his or her providing or failing to provide professional health care services. This does not apply to nurses, emergency medical technicians or paramedics if you are not in the business or occupation of providing any such professional services. This also does not apply to "bodily injury" caused by cardio-pulmonary resuscitation or first aid services administered by a co - "employee". This provision does not apply if you are a Social Service or Senior Living risk. SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS - Amendments Knowledge Of Occurrence, Claim, Suit Or Loss The following is added to Paragraph 2. Duties in the Event of Occurrence, Offense, Claim or Suit under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS: The requirements under this paragraph do not apply until after the "occurrence" or offense is known to: 1. You, if you are an individual; 2. A partner, if you are a partnership; Copyright, 2018 Selective Insurance Company of America. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. INSURED'S COPY CG 73 00 01 19 Page 7 of 9 3. An "executive officer" or insurance manager, if you are a coWcration; 4. Your membes, managers or insurance manager, if son are a limited liability company; or 5. Your elected sr appointed officials, officers, members, trafees, board members, commis- sion members, agency members, or your administrator o" your insurance manager if you are an organization other than a partnership, joint venture, or limited liability company. Primary and Non -Contributory Provision The following is added to Paragraph 4. Other insur- ance, b. Excess insurance under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS: This insurance is p'imary to and we will not seek contribution from any other insurance available to an additional insured under this policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in a written contract, written agreement o- written permit that this insurance would be pr'rnary and would not seek contri- bution from wry other insurance available to the additional insured. Unintentional Fai Utz To Disclose Hazards The following is added to Paragraph 6. Representations urder SECTION IV - COMMERCIAL GENERAL LIABIUTT CONDITIONS: However, if you should unintentionally fail to disclose any ex"etiig hazards in your representa- tions to us at the inception date of the policy, or during the policy period in connection with any additional hazards we shall not deny coverage under this Coverage Part based upon such failure to disclose hazards Waiver Of Transfer Of Rights Of Recovery The following is added to Paragraph 8. Transfer of Rights Of Recoserp Against Others To Us under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS: We will waive any right of recovery we may have against a person a' organization because of pay- ments we make for "bodily injury" or "property damage" arising od of your ongoing operations or "your work" done under a written contract or written agreement and included in the "products -completed operations hazard", if: 1. You have agreed to waive any right of recovery against that seson or organization in a written contract or w-ittrrn agreement; 2. Such person or organization is an additional insured on Kw -policy; or 3. You have assumed the liability of that person or organization in that same contract, and it is an "insured contract". The section above only applies to that person or organization identified above, and only if the "bodily injury" or "property damage" occurs subsequent to the execution of the written contract or written agreement. Liberalization The following condition is added to SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS: If we revise this Coverage Part to provide more coverage without additional premium charge, sub- ject to our filed company rules, your policy will automatically provide the additional coverage as of the day the revision is effective in your state. Two or More Coverage Parts or Policies Issued By Us (This provision is not Applicable in the state of New York or Wisconsin). The following condition is added to SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS: It is our intention that the various coverage parts or policies issued to you by us, or any company affiliated with us, do not provide any duplication or overlap of coverage. We have exercised diligence to draft our coverage parts and policies to reflect this intention. However, if the facts and circumstances that will respond to any claim or "suit" give rise to actual or claimed duplication or overlap of coverage between the various coverage parts or policies issued to you by us or any company affiliated with us, the limit of insurance under all such coverage parts or policies combined shall not exceed the highest applicable limit under this coverage, or any one of the other coverage forms or policies. This condition does not apply to any Excess or Umbrella policy issued by us specifically to apply as excess insurance over this coverage part or policy to which this coverage part is attached. SECTION V - DEFINITIONS Discrimination (This provision does not apply in New York). A. The following is added to Definition 14. "Per- sonal and advertising injury": "Personal and advertising injury" also means "discrimination" that results in injury to the feelings or reputation of a natural person, how- ever only if such "discrimination" or humiliation is: 1. Not done by or at the direction of: a. The insured; or Copyright, 2018 Selective Insurance Company of America. All rights reserved. Includes copyriglted material of Insurance Services Office, Inc., with its permission. INSURED'S COPY CG 73 00 01 19 Page 8 of 9 IIIIIIIII IIIIIIIIIIIIIIIII1IIIIINIIII IIIII IIIII b. Anyone considered an insured under SECTION II - WHO IS AN INSURED; 2. Not done intentionally to cause harm to another person. 3. Not directly or indirectly related to the em- ployment, prospective employment or termi- nation of employment of any person or persons by any insured. 4. Not arising out of any "advertisement" by the insured. B. The following definition is added to SECTION V - DEFINITIONS: "Discrimination" means: a. Any act or conduct that would be considered discrimination under any applicable federal, state, or local statute, ordinance or law; b. Any act or conduct that results in disparate treatment of, or has disparate impact on, a person, because of that person's race, religion, gender, sexual orientation, age, disability or physical impairment; or c. Any act or conduct characterized or inter- preted as discrimination by a person based on that person's race, religion, gender, sexual orientation, age, disability or physi- cal impairment. It does not include acts or conduct character- ized or interpreted as sexual intimidation or sexual harassment, or intimidation or harass- ment based on a person's gender. Electronic Data The following definition is added to SECTION V - DEFINITIONS: "Electronic data" means information, facts or programs stored as or on, created or used on, or transmitted to or from computer software, including systems and applications software, hard or floppy disks, CD-ROMS, tapes, drives, cell, data pro- cessing devices or any other media which are used with electronically controlled equipment. For the purpose of the Electronic Data Liability coverage provided by this endorsement, Definition 17. "Prop- erty damage" is deleted in its entirety and replaced by the following: 17. "Property damage" means: a. Physical injury to tangible property, includ- ing all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it; or b. Loss of, loss of use of, damage to, corruption of, inability to access, or inability to properly manipulate "electronic data", re- sulting from physical injury to tangible property. All such loss of "electronic data" shall be deemed to occur at the time of the "occurrence" that caused it. For the purpose of the Electronic Data Liability coverage provided by this endorsement, "electronic data" is not tangible property. Employee Amendment Definition 5. "Employee" under SECTION V - DEFINI- TIONS is deleted in its entirety and replaced by the fallowing: 5. "Employee" includes a "leased worker", or a "temporary worker". If you are a School, "Employee" also includes a student teacher. Golfing Facility The following definition is added to SECTION V - DEFINITIONS: "Golfing facility" means a golf course, golf club, driving range, or miniature golf course. Mental Anguish Amendment (This provision does not apply in New York). Definition 3. "Bodily injury" under SECTION V - DEFINITIONS is deleted in its entirety and replaced with the following: 3. "Bodily injury" means bodily injury, sickness or disease sustained by a person, including death resulting from any of these at any time. This includes mental anguish resulting from any bodily injury, sickness or disease sustained by a person. (In New York, mental anguish has been determined to be "bodily injury"). Not -for-profit Member The following definition is added to SECTION V - DEFINITIONS: "Not -for-profit member" means a person who is a member of a not -for-profit organization, including clubs and churches, who receives no financial or other compensation. Copyright, 2018 Selective Insurance Company of America. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. INSURED'S COPY CG 73 00 01 19 Page 9 of 9 P/NN/IOL ASSURANCE A-1 Chipseal Company dba Rocky Mounta Rocky Mountain Pavement LLC 2505 E 74th Ave Denver, CO 80229 ENDORSEMENT: Blanket Waiver of Subrogation 7501 E. Lowry Blvd. Denver, CO 80230-7006 303.361.4000 / 800.873.7242 Pinnacol.com NCCI #: WC000313B Policy #: 4055760 Moody Insurance Agency Inc 8055 E. Tufts Ave Ste 1000 Denver, CO 80237 (303) 824-6600 We have the rig -it b recover our payments from anyone liable for an injury covered by this policy. We will not enforce our righ- against the person or organization named in the Schedule. This agreement applies only to the extent that you pedorm 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 will- tl'm insured, which is in effect and executed prior to any loss. Effective Date:=earuary 1, 2023 Expires on: February 1, 2024 Pinnacol Assuerie has issued this endorsement January 23, 2023 7501 E. Lowry Blvd Denver, CO 80230-7006 Page 1 of 1 P DORSEYR - Underwriter 01/23/2023 14:55:32 4055760 80992082 359-B WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - BLANKET BASIS (WAIVER OF SUBROGATION) COMMERCIAL UMBRELLA LIABILITY CXL 456 06 22 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL UMBRELLA LIABILITY COVERAGE PART A. The following is added to Paragraph M. Transfer Of Rights Of Recovery Against Others To Us under SECTION IV - CONDITIONS: We will waive any right of recovery against a person or organization because of payments we make under this Commercial Umbrella Liability Coverage Part. This waiver applies only if the insured has agreed in a written contractor written agreement to: 1. Either: a. Waive any right of recovery against that person or organization; or b. Assume the liability of that person or organization pursuant to a written contract or written agreement that qualifies as an "insured contract"; 2. And: a. Include such person or organization as an additional insured on your Commercial Umbrella Liability Coverage Part; and b. The "underlying insurance" contains a substantially similar waiver of recovery rights. Such waiver by us applies only to the person or organization identified above and only to the extent that the insured has waived its right of recovery against such person or organization prior to loss. B. The following Definition is added to SECTION V - DEFINITIONS: "Insured contract" means: a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract"; b. A sidetrack agreement; c. Any easement or license agreement, except in connection with construction or demolition operations on or within 50 feet of a railroad; d. An obligation, as required by ordinance, to indemnify a municipality, except in connection with work for a municipality; e. An elevator maintenance agreement; f. That part of any other contract or agreement pertaining to your business (including an indemnification of a municipality in connection with work performed for a municipality) under which you assume the tort liability of another party to pay for "bodily injury" or "property damage" to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f. does not include that part of any contract or agreement: (1) That indemnifies a railroad for "bodily injury" or "property damage" arising out of construction or demolition operations, within 50 feet of any railroad property and affecting any railroad bridge or trestle, tracks, roadbeds, tunnel, underpass or crossing; (2) That indemnifies an architect, engineer or surveyor for injury or damage arising out of: (a) Preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (b) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or damage; or (3) Under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the insured's rendering or failure to render professional services, including those listed in (2) above and supervisory, inspection, architectural or engineering activities. Copyright, 2021 Selective Insurance Company of America. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. INSURED'S COPY CXL 456 06 22 Page 1 of 1 OTHER INSURANCE CONDITION FOR ADDITIONAL INSUREDS - NON-CONTRIBUTORY - BLANKET BASIS COMMERCIAL UMBRELLA LIABILITY CXL 449 0617 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 00000FS 2501487 346 This endorsement modifies insurance provided under the following: COMMERCIAL UMBRELLA LIABILITY COVERAGE PART The following is added in SECTION IV - CONDITIONS, Paragraph H. Other Insurance: With respect to each additional insured under SECTION II, WHO IS AN INSURED, Paragraph A.5., this insurance is (i) excess over any "underlying policy", and (ii) primary to, and we will not seek contribution from, any other insurance providing coverage to any such additional insured whether primary or excess. However, we will not waive our right to seek contribution from other insurance unless: a. The addtianal insured is a Named Insured under such other insurance; b. The addhianal insured is included as an additional insured on an "underlying policy"; c. You have agreed in a written contract, written agreement or written permit that this insurance would be primary b and/or would not seek contribution from any other insurance provided to the additional insured; and d. The writbn contract or written agreement has been executed (executed means signed by the Named Insured) or written permit issued prior to the "bodily injury" or "property damage" or "personal and advertising injury". The most we will pay on behalf of the additional insured is the amount of insurance required by the written contract, written agreement at- written permit, less any amounts payable by any "underlying insurance", subject to SECTION III - LIMITS OF INSURANCE. This provision is included within and does not act to increase the Limits of Insurance stated in the Declarations. Copyright, 2016 Selective Insurance Company of America. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. INSURED'S COPY CXL 449 0617 Page 1 of 1 ElitePac® Commercial Automobile Extension COMMERCIAL AUTO CA 78 09 11 17 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Business Auto Coverage Form apply unless modified by the endorsement. 00000FS 2501487 249 AMENDMENTS TO SECTION II - LIABILITY COVERAGE A. If this policy provides Auto Liability coverage for Owned Autos, the following extensions are applicable accordingly: NEWLY ACQUIRED OR FORMED ORGANIZATIONS The following is added to SECTION II, A.1. - Who Is An Insured: Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no similar insurance available to that organization. However: 1. Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier; 2. Coverage does not apply to "bodily injury" or "property damage" resulting from an "accident" that occurred before you acquired or formed the organization. No person or organization is an "insured" with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations. EXPENSES FOR BAIL BONDS AND LOSS OF EARNINGS Paragraphs (2) and (4) of SECTION II, A.2.a. - Supplementary Payments are deleted in their entirety and replaced with the following: (2) Up to the Limit of Insurance shown on the ElitePac Schedule for the cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" covered under this policy. We do not have to fumish these bonds. (4) All reasonable expenses incurred by the "insured" at our request. This includes actual loss of earnings because of time off from work, which we will pay up to the Limit of Insurance shown on the ElitePac Schedule. EMPLOYEE INDEMNIFICATION AND EMPLOYER'S LIABILITY AMENDMENT The following is added to SECTION II, B.4. - Exclusions: This exclusion does not apply to a "volunteer worker" who is not entitled to workers compensation, disability or unemployment compensation benefits. FELLOW EMPLOYEE COVERAGE The Fellow Employee Exclusion, SECTION II, B.5. - is deleted in its entirety. CARE, CUSTODY OR CONTROL AMENDMENT The following is added to SECTION II, B.6. - Exclusions: This exclusion does not apply to property owned by anyone other than an "insured", subject to the following: 1. The most we will pay under this exception for any one "accident" is the Limit of Insurance stated in the ElitePac Schedule; and 2. A per "accident" deductible as stated in the ElitePac Schedule applies to this exception. B. If this policy provides Auto Liability coverage for Owned Autos or Non -Owned Autos, the following extension is applicable accordingly: LIMITED LIABILITY COMPANIES The following is added to SECTION II, A.1. - Who Is An Insured: If you are a limited liability company, your members and managers are "insureds" while using a covered "auto" you don't own, hire or borrow during the course of their duties for you. BLANKET ADDITIONAL INSUREDS - As Required By Contract The following is added to SECTION II, A.1. - Who Is An Insured: Copyright, 2017 Selective Insurance Company of America. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. INSURED'S COPY CA 78 09 11 17 Page 1 of 5 Any person or organization whom you have agreed in a written contract, written agreement or written permit that such person or organization be added as an additional "insured" on your policy. Such person or organization is an additional "insured" only with respect to liabiity for "bodily injury" or "property damage" caused, in whole or in part, by your ownership, mairtesance or use of a covered "auto". This coverage steal be primary and non-contributory with respect b the additional "insured". This provision only espies if: 1. It is required in the written contract, written agreement or written permit identified in this section; 2. It is permitted by law; and 3. The written ccntract or written agreement has been executed (executed means signed by a named insured or written permit issued prior to the "bodily iejuwr" or "property damage". C. If this policy provides Auto Liability coverage for Non -Owned Asks, the following extension is applicable accordingly: EMPLOYEES AS NSUREDS If this policy provides Auto Liability coverage for Non -Owned Autos, the following is added to SECTION II, A.t -Who Is An Insured: Any "employee" of -yours is an "insured" while using a covered "auto' you don't own, hire or borrow in your business or year personal affairs. An "employee" cf yours is an "insured" while operating an "auto" hired or rented under a contract or agreement it that "employee's" name with your permission, whie performing duties related to the conduct of your business. AMENDMENTS TO SECTION III - PHYSICAL DAMAGE COVERAGE If this policy provides Comprehensive, Specified Causes of Loss or Collision coverage, the following extensions are applicable br those "autos" for which Comprehensive, Specfied Causes of Loss or Collision coverage is purchased. TOWING AND LABOR SECTION III, A.2. - Towing is deleted in its entirety and replaced with the folbvang: We will pay all reasonable towing and labor costs up to the maximum Limit of Insurance shown on the ElitePac Schedule per tow Each time a covered "Private Passenger Auto", "Social Service Van or Bus" or "Light Truck" is disabled and up to the maximum Limit of Insurance per tow each time a covered "Medium Truck", "Heavy Truck" or "Extra Heavy Truck" is disabled. For labor charges to be eligible for reimbursement the labor must be performed at the place of disablement. This coverage extension does not apply to Emergency Services Organizations and Governmental Entities. GLASS BREAKAGE DEDUCTIBLE The following is added to SECTION III, A.3. - Glass Breakage - Hitting A Bird Or Animal - Falling Objects or Missiles: If damaged glass is repaired rather than replaced, no deductible will apply for such repair. This extension does not apply to Emergency Services Organizations and Governmental Entities. ADDITIONAL TRANSPORTATION EXPENSES SECTION III, A.4.a. - Transportation Expenses is deleted in its entirety and replaced with the following: We will pay up to the maximum Limit of Insurance shown on the ElitePac Schedule for temporary transportation expenses that you incur because of any "loss" to a covered "auto", but only if the covered "auto" carries the coverages and meets the requirements described in 1. or 2. below: 1. We will pay temporary transportation expenses for total theft of a covered "auto". We will only pay for such expenses incurred during the period beginning 24 hours after the theft and ending, regardless of the policy's expiration, when the covered "auto" is returned to use or we pay for its "loss". 2. For "loss" other than total theft of a covered "auto" under Comprehensive or Specified Causes of Loss Coverage, or for any "loss" under Collision Coverage to a covered "auto", we will only pay for those temporary transportation expenses incurred during the policy period beginning 24 hours after the "loss" and ending, regardless of the policy's expiration, with the lesser of the number of days reasonably required to repair or replace the covered "auto" or 30 days. Paragraph 2. of this extension does not apply while there are spare or reserve "autos" available to you for your operations. This coverage extension does not apply to Emergency Services Organizations and Governmental Entities. HIRED AUTO PHYSICAL DAMAGE COVERAGE The following is added to SECTION III, A.4. - Coverage Extensions: Physical Damage coverage is hereby extended to apply to Physical Damage "loss" to "autos" leased, hired, rented or borrowed without a driver. We will provide coverage equal to the broadest coverage available to any covered "auto" shown in the Declarations. But, the most we will pay for "loss" to each "auto" under this coverage extension is the lesser of: Copyright, 2017 Selective Insurance Company of America. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. INSURED'S COPY CA 78 09 11 17 Page 2 of 5 00000FS 2501487 251 1. The Limit of Insurance stated in the ElitePac Schedule; or 2. The actual cash value of the damaged or stolen property as of the time of the "lose; or 3. The actual cost of repairing or replacing the damaged or stolen property with other property of like kind and quality. A part is of like kind and quality when it is of equal or better condition than the pre -accident part. We will use the original equipment from the manufacturer when: (a) The operational safety of the vehicle might otherwise be impaired; (b) Reasonable and diligent efforts to locate the appropriate rebuilt, aftermarket or used part have been unsuccessful; or (c) A new original equipment part of like kind and quality is available and will result in the lowest overall repair cost. For each leased, hired, rented or borrowed "auto" our obligation to pay "losses" will be reduced by a deductible equal to the highest deductible applicable to any owned "auto" for that coverage. No deductible will be applied to "losses" caused by fire or lightning. SECTION IV, B.5. Other Insurance Condition, Paragraph 5.b. is deleted in its entirety and replaced by the following: 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 or agreement in that "employee's" name, with your permission, while performing duties related to the conduct of your business. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". This coverage extension does not apply to Emergency Services Organizations and Governmental Entities. HIRED AUTO LOSS OF USE COVERAGE The following is added to SECTION III, A.4. - Coverage Extensions: We will pay expenses for which you are legally responsible to pay up to the Limit of Insurance shown on the ElitePac Schedule per "accident" for loss of use of a leased, hired, rented or borrowed "auto" if it results from an "accident". This coverage extension does not apply to Emergency Services Organizations, Governmental Entities, and Schools. AUTO LOAN/LEASE GAP COVERAGE (Not Applicable in New York) The following is added to SECTION III, A.4. - Coverage Extensions: In the event of a total "loss" to a covered "auto" we will pay any unpaid amount due on the lease or loan for a covered "auto", less: 1. The amount paid under the Physical Damage Coverage Section of the policy; and 2. Any: a. Overdue lease/loan payments at the time of "loss"; b. Financial penalties imposed under a lease for excessive use, abnormal wear and tear, high mileage or similar charges; c. Security deposits not refunded by the lessor or financial institution; d. Costs for extended warranties, credit life, health, accident, or disability insurance purchased with the loan or lease; and e. Carry-over balances from previous leases or loans. You are responsible for the deductible applicable to the "loss" for the covered "auto". PERSONAL EFFECTS The following is added to SECTION III, A.4. - Coverage Extensions: If this policy provides Comprehensive Coverage for a covered "auto" you own and that covered "auto" is stolen, we will pay up to the Limit of Insurance shown on the ElitePac Schedule, without application of a deductible, for lost personal effects that were in the covered "auto" at the time of theft. Personal effects do not include jewelry, tools, money, or securities. This coverage is excess over any other collectible insurance. AIRBAG COVERAGE The following is added to SECTION III, B.3.a. - Exclusions: Mechanical breakdown does not include the accidental discharge of an airbag. This coverage extension does not apply to Emergency Services Organizations and Governmental Entities. EXPANDED AUDIO, VISUAL, AND DATA ELECTRONIC EQUIPMENT COVERAGE SECTION III, B.4. - Exclusions This exclusion does not apply to the following: 1. Global positioning systems; 2. "Telematic devices"; or 3. Electronic equipment that reproduces, receives or transmits visual or data signals and accessories used with such equipment, provided such equipment is: Copyright, 2017 Selective Insurance Company of America. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. INSURED'S COPY CA78091117 Page 3 of 5 a. Permanently installed in or upon the covered "auto" at the time of the "loss"; b. Removable f©m a housing unit that is permanently installed in the covered "auto" at the time of the loss"; c. Designed to be solely operated by use of power from the "auto's" electrical system; or d. Designed tc be used solely in or upon the covered "aub"_ For each covered "Ices' to such equipment, a deductible of $50 shall apply unless the deductible otherwise applicable to such eau oment is less than $50, at which point the lower deductible, if any, will apply. COMPREHENSIVE DEDUCTIBLE - LOCATION TRACKING DEVICE The following is added io SECTION III, D. - Deductible: Any Comprehensive Overage Deductible shown in the Declarations will be educed by 50% for any "loss" caused by theft if thy covered "auto" is equipped with a location tracking deyioe and that device was the sole method used to recover the "auto". PHYSICAL DAMAGE LIMIT OF INSURANCE SECTION III, C. - Limit Of Insurance is deleted in its entirety and replacec with the following: The most we will pay fm a "loss" in any one "accident" is the lesser of: 1. The actual cash alue of the damaged or stolen property as of the tine of the "loss"; or 2. The cost of repairig or replacing the damaged or stolen property wits other property of like kind and quality. This coverage extersien does not apply to Emergency Services Organizationsand Governmental Entities. AMENDMENTS TO SECTION IV - BUSINESS AUTO CONDITIONS DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS The following is addhdto SECTION IV, A.2.a. - Duties In The Event Of Accident, Claim, Suit Or Loss: The notice requirements for reporting "accident" claim, "suit" or "loss" information to us, including provisions related to the subsequent investigation of such "accident", claim, "suit' or "loss" do not apply until the "accident", claim, "suit" or "loss" is known to: 1. You, if you are al individual; 2. A partner, if you are a partnership; 3. An executive officer or insurance manager, if you are a corporation; 4. Your members, managers or insurance manager, if you are a limited liability company; 5. Your elected or appointed officials, trustees, board members or your insurance manager, if you are an organization other than a partnership, joint venture or limited liability company. But, this section does not amend the provisions relating to notification of police or protection or examination of the property that was subject to the "loss". WAIVER OF SUBROGATION SECTION IV, A.5. - Transfer Of Rights Of Recovery Against Others To Us is deleted in its entirety and replaced with 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" resulting from the ownership, maintenance or use of a covered "auto" but only when you have assumed liability for such "bodily injury" or "property damage" in an "insured contract". In all other circumstances, if a person or organization to or for whom we make payment under this Coverage Form has rights to recover damages from another, those rights are transferred to us. MULTIPLE DEDUCTIBLES The following is added to SECTION IV, A. - Loss Conditions: If a "loss" from one event involves two or more covered "autos" and coverage under Comprehensive or Specified Causes of Loss applies, only the highest applicable deductible will be applied. CONCEALMENT, MISREPRESENTATION OR FRAUD The following is added to SECTION IV, B.2. - Concealment, Misrepresentation Or Fraud: If you should unintentionally fail to disclose any existing hazards in your representations to us prior to the inception date of the policy or during the policy period in connection with any newly discovered hazards, we will not deny coverage under this Coverage Form based upon such failure. POLICY PERIOD, COVERAGE TERRITORY SECTION IV, B.7. - Policy Period, Coverage Territory is deleted in its entirety and replaced with the following: Under this Coverage Form, we cover "accidents" and "losses" occurring: a. During the policy period shown in the Declarations; and b. Within the "Coverage Territory". Copyright, 2017 Sdertive Insurance Company of America. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. INSURED'S COPY CA 78 09 11 17 Page 4 of 5 00000FS 2501487 253 We also cover "loss" to or "accidents" involving a covered "auto" while being transported between any of these places. TWO OR MORE COVERAGE FORMS OR POLICIES ISSUED BY US - DEDUCTIBLES The following is added to SECTION IV, B.8. - Two Or More Coverage Forms Or Policies Issued By Us: If a "loss" covered under this Coverage Form also involves a "loss" to other property resulting from the same "accident" that is covered under this policy or another policy issued by us or any member company of ours, only the highest applicable deductible will be applied. AMENDMENTS TO SECTION V - DEFINITIONS BODILY INJURY INCLUDING MENTAL ANGUISH (Not Applicable in New York) The definition of bodily injury is deleted in its entirety and replaced by the following: "Bodily injury" means bodily injury, sickness, or disease sustained by a person, including death resulting from any of these. "Bodily injury" includes mental anguish resulting from bodily injury, sickness or disease sustained by a person. ADDITIONS TO SECTION V - DEFINITIONS COVERAGE TERRITORY "Coverage Territory" means: 1. The United States of America (including its territories and possessions), Canada and Puerto Rico; and 2. Anywhere in the world, except for any country or jurisdiction that is subject to trade or other economic sanction or embargo by the United States of America, if a covered "auto" is leased, hired, rented, or borrowed without a driver for a period of 30 days or less, and the insured's responsibility to pay "damages" is determined in a "suit" on the merits in and under the substantive law of the United States of America (including its territories and possessions), Puerto Rico, or Canada, or in a settlement we agree to. If we are prevented by law, or otherwise, from defending the "insured" in a "suit" brought in a location described in Paragraph 2, above, the insured will conduct a defense of that "suit". We will reimburse the "insured" for the reasonable and necessary expenses incurred for the defense of any such "suit" seeking damages to which this insurance applies, and that we would have paid had we been able to exercise our right and duty to defend. EXTRA HEAVY TRUCK "Extra Heavy Truck" means a truck with a gross vehicle weight rating of 45,001 pounds or more. HEAVY TRUCK "Heavy Truck" means a truck with a gross vehicle weight rating of 20,001 pounds to 45,000 pounds. LIGHT TRUCK "Light Truck" means a truck with a gross vehicle weight rating of 10,000 pounds or less. MEDIUM TRUCK "Medium Truck" means a truck with a gross vehicle weight rating of 10,001 pounds to 20,000 pounds. PRIVATE PASSENGER AUTO "Private Passenger Auto" means a four-wheel "auto" of the private passenger or station wagon type. A pickup, panel truck or van not used for business is included within the definition of a "private passenger auto". SOCIAL SERVICE VAN OR BUS "Social Service Van or Bus" means a van or bus used by a government entity, civic, charitable or social service organization to provide transportation to clients incidental to the social services sponsored by the organization, including special trips and outings. TELEMATIC DEVICE "Telematic Device" includes devices designed for the collection and dissemination of data for the purpose of monitoring vehicle and/or driver performance. This includes Global Positioning System technology, wireless safety communications and automatic driving assistance systems, all integrated with computers and mobile communications technology in automotive navigation systems. VOLUNTEER WORKER "Volunteer worker" means a person who performs business duties for you, for no financial or other compensation. Copyright, 2017 Selective Insurance Company of America. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. INSURED'S COPY CA78091117 Page 5 of 5 VV��N a.tVa�■�� .a ac��aaU V�� vv� •�Va. Y��Y .101. 10.41. General Liability Extended ElitePac® Endorsement COMMERCIAL GENERAL LIABILITY CG79880119 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. II IIIIMIIlNII I I III M I II IIIIIIII II1III I II uI IN 1. BLANKET ADDITIONAL INSUREDS Ongoing Operations SECTION I - WHO B AN INSURED is amended to include as an additional insured: 1. Any person or organization for whom you are performing operations when you and such person or organization have agreed in a written contract, written agreement or written permit that such person or organization be added as an additional insured on your commercial general liability policy; and 2. Any other person or organization, in- cluding any architects, engineers or surveyors not engaged by you, whom you are required to add as an additional insured under your policy in the contract or agreement in Paragraph 1. above; Such person or organization is an additional insured only with respect to liability arising out of your ongoing operations performed under that contract, agreement, or permit when that contract, agreement, or permit requires the additional insured be added with respect to liability arising out of your ongoing operations. If the written contract, written agreement, or written peirnit does not require that the additional insured be added with respect to liability arising out of your ongoing opera- tions, then such person or organization is an additional insured only with respect to "bodily injury", "property damage" or "per- sonal and advertising injury" caused in whole or in part by your ongoing operations performei Linder that contract, agreement, or permit b. Completed Operations SECTION II - WHO IS AN INSURED is amended to include as an additional insured: 1. Any person or organization for whom you are performing or have performed operations when you and such person or organization have agreed in a written contract, written agreement or written permit that such person or organization be added as an additional insured on your commercial general liability policy; and 2. Any other person or organization, in- cluding any architects, engineers or surveyors not engaged by you, whom you are required to add as an additional insured under your policy in the contract or agreement in Paragraph 1. above; Such person or organization is an additional insured only with respect to their liability arising out of "your work" performed under that contract, agreement, or permit and included in the "products -completed opera- tions hazard" when that contract, agree- ment, or permit requires the additional insured be added with respect to liability arising out of "your work" performed under that contract, agreement, or permit and included in the "products -completed opera- tions hazard". Copyright, 2018 Selective Insurance Company of America. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. INSURED'S COPY CG 79 88 01 19 Page 1 of 3 If the written contract, written agreement, or written permit does not require that the additional insured be added with respect to liability arising out of "your work" performed under that contract, agreement, or permit and included in the "products -completed operations hazard", then such person or organization is an additional insured only with respect to liability for "bodily injury", "property damage" or "personal and adver- tising injury" caused, in whole or in part, by "your work" performed under that contract, agreement, or permit and included in the "products -completed operations hazard". The coverages provided in Paragraphs a. and b. do not apply unless the written contract or written agreement has been signed by the Named Insured or written permit issued prior to the "bodily injury", "property damage" or "personal and adver- tising injury". d. Exclusions (1) With respect to the insurance afforded to additional insureds under a. Ongoing Operations the following is added to 2. Exclusions under SECTION I —COVER- AGE A — BODILY INJURY AND PROP- ERTY DAMAGE LIABILITY: This insurance does not apply to "bodily injury", "property damage", or "personal and advertising injury" occurring after: (a) All work, including materials, parts or equipment furnished in connec- tion with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the site of the covered operations has been completed; or (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 sub- contractor engaged in performing operations for a principal as a part of the same project. (2) With respect to the insurance afforded to these additional insureds under a. Ongoing Operations and b. Completed Operations, the following is added to 2. Exclusions under SECTION I — COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY: This insurance does not apply to: "Bodily injury", "property damage", or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, in- cluding: (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, architec- tural or engineering activities. Conditions With respect to the insurance afforded to these additional insureds under a. Ongoing Operations and b. Completed Operations the following is added to Paragraph 4. Other Insurance, a. Primary Insurance under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDMONS: This insurance is primary and will not contribute with any other insurance available to an additional insured under this coverage part provided that: (1) The additional insured is a Named Insured under such other insurance. (2) You have agreed in a written contract, written agreement or written permit to include that additional insured on your General Liability policy on a primary and/or non-contributory basis. 2. PROPERTY DAMAGE CARE, CUSTODY OR CONTROL The following is added to Exclusion j. under SECTION I — COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY: Paragraphs (4) and (5) do not apply for the limited purpose of providing the coverage and sub -limits of liability as set forth below. We will pay those sums that the insured becomes legally obligated to pay as damages arising out of "property damage" to: (1) Personal property in the care, custody or control of the insured; and Copyright, 2018 Selective Insurance Company of America. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. INSURED'S COPY CG 79 88 01 19 Page 2 of 3 II I I I IU I I II I I IIII N I II I IUI II I I I I I I 1111 1111111 (2) That part cular part of real property on which you or any contractors or subcontractors working directly or indirectly on your behalf are performing operations, if the "property damage" arises out of those operations. The most we will pay under (1) and (2) above in any one "ocourience" or for all damages during any one policy period is a sub -limit of $100,000. These limits are included in and not in addition to the Limits of Insurance shown in the Declara- tions of the Conanercial General Liability Policy. Our right and duty to defend the insured against any "suit" for damages under (1) and (2) above ends when we Nave used up the applicable sub - limit of liabilty in the payment of judgments or settlements under it. 3. OTHER INSURANCE AMENDMENT -SUPPLE- MENTAL COVERAGE FOR INSURED'S INVOLVE- MENT IN A CONSOLIDATED (WRAP-UP) INSUR- ANCE PROGRAM OR SIMILAR PROJECT The following is added to SECTION IV - COMMERCIAL GENERAL LIABILITY CONDI- TIONS, Paragraph 4. Other Insurance b. Excess Insurance (1)a): (v) That is covered by a consolidated (wrap-up) or similar insurance program provided by the prime contractor/project manager or owner of the construction project in which you are involved for your ongoing operations or operations included within the "products - completed operations hazard", unless such consolidated (wrap-up) or similar program is specifically excluded from coverage on this policy. 4. FELLOW EMPLOYEE EXTENSION Under SECTION N - WHO IS AN INSURED Para- graphs 2.a. ani 2.a. (1) are replaced by the following: Your "volunteer workers" only while per- forming duties related to the conduct of your business, or your "employees", other than either your "executive officers" (if you are an organizat on other than a partnership, joint venture, or limited liability company) or your managers (P you are a limited liability com- pany), but only for acts within the scope of their empioyrent by you or while performing duties related to the conduct of your busi- ness. The Employers Liability exclusion (SECTION I COVERAGES; COVERAGE A, exclusion e.) does not apply to this provision. However, none of these "employees" or "volunteer workers" are insureds for: (1) "Bodily injury" or "personal and adver- tising injury": (a) Arising out of his or her providing or failing to provide professional health care services. 5. CONTRACTUAL LIABILITY (RAILROADS) Definition 9. Insured Contract is amended as fol- lows: Paragraph c. is deleted in its entirety and replaced with the following: Any easement or license agreement; Paragraph f,(1) is deleted in its entirety. 6. CONTRACTUAL LIABILITY AMENDMENT — (PERSONAL AND ADVERTISING INJURY) If it is required in a written contract, written agreement or written permit with the insured that any contractual liability exclusion for Personal Injury be removed from the policy, then Exclu- sion e. Contractual Liability under COVERAGE B PERSONAL AND ADVERTISING INJURY, 2. Exclusions is deleted in its entirety and replaced with the following: e. Contractual Liability "Personal and advertising Injury" for which the insured has assumed liability in a contract or agreement arising out of an "advertisement". This exclusion does not apply to liability for damages that the insured would have in the absence of the contract or agreement. 7. WAIVER OF GOVERNMENTAL IMMUNITY We will waive, both in the adjustment of claims and in the defense of "suits" against the insured, any governmental immunity of the insured, unless the insured requests in writing that we not do so. Waiver of immunity as a defense will not subject us to liability for any portion of a claim or judgment in excess of the applicable limit of insurance. 8. DAMAGE TO PREMISES RENTED TO YOU The Limit of Insurance for Damage To Premises Rented To You is increased to $1,000,000. Copyright, 2018 Selective Insurance Company of America. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. INSURED'S COPY CG 79 88 01 19 Page 3 of 3 NOTICE OF RENEWAL Project: 2023 Slurry Seal Renewal To: Mike Starr Al Chipseal Company 2505 E 74th Ave, Denver CO 80229 Project Description: 2023 Slurry Seal Contract renewal, Original Bid No. B2100100 You are hereby notified that your renewal rates have been accepted and the estimated budget for 2023 is $1,003,313.32. You are required by the Instructions to Bidders to execute the Renewal Agreement, Bonds and furnish the required Certificates of Insurance within ten (10) calendar days from the date of this Notice to you. You are required to return an acknowledged copy of this Notice of Renewal to the Owner. Dated this 17 day of April 2023. Weld County, Colorado, Owner By Joshua J. Holbrook, Pavement Management Supervisor ACCEPTANCE OF NOTICE Receipt of the above Notice of Award is hereby acknowledged by A-1 Chipseal Co. Stephanie Wallis Title: Corporate Secretary (Contractor) BID NO # B2100100 Page 1 Ent ation New Con, Entity Name* A-1 CHIPSEAL CO Entity ID* O00022694 Contract Name* WELD COUNTY 2023 SLURRY SEAL RENEWAL Contract Status CT6 REVIEW ❑ New Entity? Contract ID 6927 Contract Lead* JHOLBROOK Contract Lead Email JholbrookAco.weld.cs.us Parent Contract ID Requires Board Approval YES Department Project Contract Description* THE PROJECT IN GENERAL CONSISTS OF APPLYING BITUMINOUS SEAL COAT TO PAVED ROADS, Contract Description 2 Contract Type* CONTRACT Amount* 51,003,313.32 Renewable* YES Automatic Renewal Grant IGA Department PUBLIC WORKS Department Email CM- PublicWorks@weldgov.com Department Head Email CM-PublicWorks- DeptHeadC'weldgov.com County Attorney GENERAL COUNTY ATTORNEY EMAIL County Attorney Email CM- COUNTYATTORNEY-AWELDG OV.COM If this is a renewal enter previous Contract ID 20211590 If this is part of a MSA enter MSA Contract ID Requested BOCC Agenda Date. 05 ?08; 2023 Due Date 05104;2023 Will a work session with BOCC be required?* NO Does Contract require Purchasing Dept. to be included? YES Bid/RFPi* 62100100 Note: the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts are not in OnPase Effective Date Review Date 01102/2024 Renewal Date* 01 :'.31,='2024 Contra Termination Notice Period Committed Delivery Date Expiration Date Contact lnfortnal Contact Info Contact Name Purchasing Purchasing ov CHERYL PATTELLI Approval Procesx Department Head .CURTIS HALL DH Approved Date 05/02/2023 Final Approval BQCC Approved BOCC Signed Date BOCC Agenda Date 05 0812O23 Originator JHOLBROOK Contact Type Contact Email Finance Approver CHERYL PATTELLI Contact Phone 1 Purchasing 05/02/2023 Finance Approved Date 05/0212023 Tyler Ref I AG 050823 d Legal Counsel BRUCE BARKER Contact Phone 2 Legal Counsel Approved Date 05./02, 2023 CbrrivGCq- IDalon BOARD OF COUNTY COMMISSIONERS PASS -AROUND REVIEW PASS -AROUND TITLE: Weld County 2022 Slurry Seal Renewal DEPARTMENT: Weld County Public Works / Pavement Management PERSON REQUESTING: Joshua Holbrook DATE: 6.6.2022 Brief description of the problem/issue: The original agreement for the Slurry Seal contract has the option to be extended from one year to the next as permitted by the contract. This extension would be the second year of a three-year term limit. The contract also allows for yearly rate adjustments based upon the ENR Construction cost index, which shows an 8.0% increase for 2022 and the Denver -Aurora -Lakewood ClP which is a 9.1% increase. A-1 chip seal has requested an increase of 9.1% for the traffic control and crack seal line items and a 23% increase for the slurry seal line item. The attached documents show a 54% increase from 2021 (bid year) to 2022 for the CQS-1hp slurry seal oil supplied by Suncor. A-1 chip seal shared their contract pricing for their oil supply in 2021 and 2022 season which reflects their price increase for the slurry seal line item. A-1 Chip Seal was the lowest bidder in 2021 and Public Works has been satisfied with their work. Attached to this pass -around is a copy of the 2022 Fee Schedule(s), a cost comparison from 2021 to 2022 and contracted pricing from SUNCOR for the CQS-1 hp. The total amount of $824,842.77 is within the 2022 budget. What options exist for the Board? (Include consequences, impacts, costs, etc. of options): The Board may request a work session to discuss this further. Recommendation: Staff recommends approval for the attached renewal for A-1 Chip Seal. Perry L. Buck Mike Freeman, Pro-Tem Scott K. James, Chair Steve Moreno Lori Seine Attachments 2022 Fee Schedule 2021-2022 Cost comparison 2021-2022 Oil cost increase Letter from A-1 Chip Seal CC: Jay McDonald, Director of Public Works Curtis Hall, Deputy Director Approve Schedule Recommendation Work Session Other/Comments: Coivr)-)- -Neda ce-` ov I v z Z v„pix 20ZI- 15g0 CONTRACT AGREEMENT EXTENSION/RENEWAL BETWEEN THE WELD COUNTY DEPARTMENT OF PUBLIC WORKS AND A-1 CHIPSEAL. This Agreement Extension/Renewal ("Renewal"), made and entered into I I�day of &4j I 2022, by and between the Board of Weld County Commissioners, on behalf of the Weld County Department of Public Works, fidreinafter referred to as the "Department", and A-1 Chipseal, hereinafter referred to as the "Contractor". WHEREAS the parties entered into an agreement on August 2, 2021 (the "Original Agreement"), identified as document Bff2100100. WHEREAS the parties hereby agree to extend the term of the Original Agreement in accordance with the terms of the Original Agreement, which is incorporated by reference herein, as well as the terms provided herein. NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows: • The renewal Agreement will end on August 1, 2022. • The parties agree to extend the Agreement for an additional period, which will begin August 2, 2022, and will end on April 30. 2023. • The Renewal, together with the Agreement, constitutes the entire understanding between the parties. The following change is hereby made to the Contract Documents: 1. This extension will be the second year of a possible three-year contract 2, The 2021 Bid Schedule of the contact shall be replaced by the attached 2022 Bid Schedule, which is incorporated herein. • All other terms and conditions of the Original Agreement remain unchanged. IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year fi CONTRACTOR: ATTEST: ddry,.) �I Weld C. y Clerk to the Boar BY: BOARD OF COUNTY COMMISSIONERS WELD QOUNTY, COLORADO Sco James, Chair 'JUL 1 12022 o�Do2/- /5Q0 BID SCHEDULE 2022 Renewal Slurry Seal and Sand Seal Contract Item Number Description Unit Est. Quantity Unit Price Contract Bid 408 Place Rubberized Crack Filler & Traffic Control (Weld County to supply material) TON 19.5 $4358.55 $84,991.73 409 Slurry Seal SY 240,620 $2 . 62 $630,424.40 627 Pavement Marking Paint (Parking Lots) GAL 35.73 $218 . 20 $7,796.28 630 Signing and Traffic Control (Sub/Parking lot) EACH 5 $2018.35 $10,091.75 630 Signing and Traffic Control (Slurry Seal" MILE 13.35 $4636.75 $61,900.61 630 MHT and Traffic Control for Cdot intersections EACH 4 $4909.50 $19,638.00 700 F/A Minor Contract Revisions F/A 1 $10,000.00 $10,000.00 Total: $824,842.77 * The successful vendor is required to sign a separate contract (a sample contract is included as a separate attachment.) BID NO. B2100100 Page -1- RECEIPT OF ADDENDA The undersigned acknowledges receipt of the following Addenda to the Invitation for Bids, Drawings, Specifications and other Contract Documents. Addendum No. None Date: By: Addendum No. None Date: By: Bidder agrees to perform all Work described in the Contract Documents for the unit prices as shown in the Bid Schedule. Payment will be based on the Lump Sum price or the actual quantities furnished, installed or constructed. The undersigned, by his or her signature, hereby acknowledges and represents that: 1. The bid proposed herein meets all of the conditions, specifications and special provisions set forth in the request for bid for Request No. #82100100 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 proposal 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. FIRM A-1 Chipseal Company BY Mike Starr (Please print) BUSINESS 2505 E. 74th Avenue ADDRESS DATE 5/26/22 CITY, STATE, ZIP CODE Denver, CO 80229 TELEPHONE NO 720-540-8272 FAX 303-650-9669 SIGNATURE ,,.A ,4 Jk-- TAX ID# 84-1216817 E-MAIL mstarr@asphaltrepair.com WELD COUNTY IS EXEMPT FROM COLORADO SALES TAXES. THE CERTIFICATE OF EXEMPTION NUMBER IS #98-03551-0000. BID NO. 52100100 Page - 2 - Bond No. 30162635 PERFORMANCE BOND PROJECT: SLURRY SEAL CONTRACT 2022 KNOW ALL MEN BY THE PRESENTS; that A-i Chipseal Company (Name of Contractor) 2505 E. 74th Avenue, Denver, CO 80229 (Address of Contractor) CO , hereinafter called Contractor, and a (Corporation, Pantnevship,-ur-tRdividual4 Western Surety Company (Name of Surety) 151 N. Franklin Street, Chicago, IL 60606 (Address of Surety) hereinafter called surety, are held and firmly bound unto Weld County, Colorado (Name of Owner) P.O. Box 758, 1111 H Street, Greeley, Colorado 80632 (Address of Owner) hereinafter called Owner, in the penal sum of Eight Hundred Twenty Four* Dollars, ($ 824,842.77 in lawful money of the United States of America, for the payment of which sum well and truly to be made, we bind ourselves, successors and assigns, jointly and severally firmly by these presents. *Thousand Eight Hundred Forty Two and 77/100 --- THE CONDITION OF THIS OBLIGATION is such that whereas, the Contractor entered into a certain Contract with the Owner, dated the day of , 202.1, a copy of which is hereto attached and made a part hereof for the construction of: 2022 PROJECT: Slurry seal and Sand seal contract described in the Invitation for Bids, Bid No. 62100100 NOW THEREFORE, if the Contractor shall well, truly and faithfully perform its duties, all of the undertakings, covenants, terms, conditions, and agreements of said contract during the original term thereof, and any extensions thereof which may be granted by the Owner, with or without notice to the Surety and during the one year guaranty period, and if he shall satisfy all claims and demands incurred under such contract, and shall fully indemnify and save harmless the Owner from all costs and damages which it may suffer by reason of failure to do so, and shall reimburse and repay the Owner all outlay and expense which the Owner may incur in making good any default, then this obligation shall be void; otherwise to remain in force and effect. PROVIDED, FURTHER, that the said Surety for value received hereby stipulates and agrees that no change, extension of time, alteration or addition to the terms of the contract or to the Work to be performed thereunder of the Specifications accompanying the same shall in any way affect its obligation on this Bond, and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the contract or to the Work or to the Specifications. PROVIDED, FURTHER, that no final settlement between the Owner and the Contractor shall abridge the right of any beneficiary hereunder, whose claim may be unsatisfied. BID NO. B2100100 Page - 36 - PERFORMANCE BOND PROJECT: SLURRY SEAL CONTRACT 2022 IN WITNESS WHEREOF, this instrument is executed in two (2) counterparts, each one of which shall be deemed an original, this day of 2 tf 1?visllbjs� 14: Frz Ai 1 (1Tf o)i 992 tractor) Secretary A-1 Chipseal Company By ,Contracto 2505 E. 74th Avenue (Witness as to Contractor) (Address) 2505 E. 74th Avenue (Address) Denver, CO 80229 ATTEST: N/A (Surety) Secretary (SEAL) Wit`s as to Surety 8055 E. Tufts Avenue, #1000 (Address) Denver, CO 80237 Denver, CO 80229 Western Surety Company By ('-'()Yea/1/1)(t A orney-in-Fact Jody L. Anderson 151 N. Franklin Street (Address) Chicago, IL 60606 NOTE: Date of Bond must not be prior to date of Contract. If Contractor is Partnership, all partners should execute Bond. IMPORTANT: Surety companies executing Bonds must appear on the Treasury Department's most current list (Circular 570 as amended) and be authorized to transact business in the State where the Project is located. BID NO. B2100100 Page - 38 - Bond No. 30162635 LABOR & MATERIALS PAYMENT BOND PROJECT: SLURRY SEAL CONTRACT 2022 KNOW ALL MEN BY THE PRESENTS; that A-1 Chipseal Company (Name of Contractor) 2505 E. 74th Avenue, Denver, CO 80229 (Address of Contractor) CO hereinafter called Contractor, and a (Corporation, Parr-iershivor Individual) Western Surety Company (Name of Surety) 151 N. Franklin Street, Chicago, IL 60606 (Address of Surety) hereinafter called surety, are held and firmly bound unto Weld County, Colorado, P.O. Box 758, 1111 H Street, Greeley, Colorado 80632, hereinafter called Owner, in the penal sum of Eight Hundred Twenty Four Thousand Eight Hundred Forty Two and 77/100 --- Dollars ($ 824,842.77 ), in lawful money of the United States of America, for the payment of which sum well and truly to be made, we bind ourselves, successors and assigns, jointly and severally firmly by these presents. THE CONDITION OF THIS OBLIGATION is such that whereas, the Contractor entered into a certain Contract with the Owner, dated the day of , 2©24-, a copy of which is hereto attached and made a part hereof for the construction of: 2022 PROJECT: Slurry Seal Contract z4 described in the Invitation for Bids, Bid No. B2100100. NOW, THEREFORE, if the Contractor shall promptly make payment to all persons, firms, Subcontractors, and corporations furnishing materials for or performing labor in the prosecution of the Work provided for in such contract, and any authorized extension or modification thereof, including all amounts due for materials, lubricants, oil, gasoline, repairs on machinery, equipment and tools, consumed or used in connection with the construction of such Work, and all insurance premiums on said Work, and for all labor, performed in such Work whether by Subcontractor or otherwise, then this obligation shall be void,; otherwise to remain in full force and effect. PROVIDED, FURTHER, that the said Surety for value received hereby stipulates and agrees that no change, extension of time, alteration or addition to the terms of the contract or to the Work to be performed thereunder of the Specifications accompanying the same shall in any way affect its obligation on this Bond, and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the Contract or to the Work or to the Specifications. PROVIDED, FURTHER, that no final settlement between the Owner and the Contractor shall abridge the right of any beneficiary hereunder, whose claim may be unsatisfied. RIM BID NO. B2100100 Page - 39 - LABOR & MATERIALS PAYMENT BOND 1 _ 2505 E. 74th Avenue IN WITNESS WHEREOF, this instrument is executed in two (2) counterparts, each one of which shall be deemed an original, this day of 2022 . A-1 Chipseal Company I;Contractor) Secretary ss as to Contractor) (Address) Denver, CO 80229 ATTEST: N/A (Surety) Secretary (SEAL) acto By 2505 E. 74th Avenue (Address) Denver, CO 80229 Witnes o Surety 8055 E. Tufts Avenue, #1000 (Address) Denver, CO 80237 Western Surety Company By`4,/b,de,DL. Anderson 151 N. Franklin Street (Address) Chicago, IL 60606 NOTE: Date of Bond must not be prior to date of Contract. If Contractor is Partnership, all partners should execute Bond. IMPORTANT: Surety companies executing Bonds must appear on the Treasury Department's most current list (Circular 570 as amended) and be authorized to transact business in the State where the Project is located. BID NO. B2100100 Page - 40 - Western Surety Company POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY -IN -FACT Know All Men By These Presents, That WESTERN SURETY COMPANY, a South Dakota corporation, is a duly organized and existing corporation having its principal office in the City of Sioux Falls, and State of South Dakota, and that it does by virtue of the signature and seal herein affixed hereby make, constitute and appoint Jody L Anderson, Evan E Moody, Karen A Feggestad, Tina Marie Post, Bradley J Moody, Andrew J Waterbury, Elizabeth Ostblom, Individually of Denver, CO, its true and lawful Attorney(s)-in-Fact with full power and authority hereby conferred to sign, seal and execute for and on its behalf bonds, undertakings and other obligatory instruments of similar nature - In Unlimited Amounts - and to bind it thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of the corporation and all the acts of said Attorney, pursuant to the authority hereby given, are hereby ratified and confirmed. This Power of Attorney is made and executed pursuant to and by authority of the By -Law printed on the reverse hereof, duly adopted, as indicated, by the shareholders of the corporation. In Witness Whereof, WESTERN SURETY COMPANY has caused these presents to be signed by its Vice President and its corporate seal to be hereto affixed on this 22nd day of December, 2021. WESTERN SURETY COMPANY aul T. Bruflat, Vice President State of South Dakota ss County of Minnchaha On this 22nd day of December, 2021, before me personally came Paul T. Bruflat, to me known, who, being by me duly sworn, did depose and say: that he resides in the City of Sioux Falls, State of South Dakota; that he is the Vice President of WESTERN SURETY COMPANY described in and which executed the above instrument; that he knows the seal of said corporation; that the seal affixed to the said instrument is such corporate seal; that it was so affixed pursuant to authority given by the Board of Directors of said corporation and that he signed his name thereto pursuant to like authority, and acknowledges same to be the act and deed of said corporation. My commission expires March 2, 2026 S M. BENT ..pp!!gqrioruiv vusue��qq; fta 7�souni uxKomcr i CERTIFICATE 122, 46‘?',IL' M. Bent, Notary Public I, L. Nelson, Assistant Secretary of WESTERN SURETY COMPANY do hereby certify that the Power of Attorney hereinabove set forth is still in force, and further certify that the By -Law of the corporation printed on the reverse hereof is still in force. In testimony whereof I have hereunto subscribed my name and affixed the seal of the said corporation this day of .0sETYc IfiAA Form F4280-7.2012 WESTERN SURETY COMPANY L. Nelson, Assistant Secretary Go to www.cnasurety.com > Owner / Obligee Services > Validate Bond Coverage, if you want to verify bond authenticity. Authorizing By -Lass ADOPTED BY THE SHAREHOLDERS OF WESTERN SURETY COMPANY This Power of Attorney is made and executed pursuant to and by authority of the following By -Law duly adopted by the shareholders of the Company. Section 7. All bonds, policies, undertakings, Powers of Attorney, or other obligations of the corporation shall be executed in the corporate name of the Company by the President, Secretary, and Assistant Secretary, Treasurer, or any Vice President, or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys in Fact or agents who shall have authority to issue bonds, policies, or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile. ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) os/22/zoz2 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 Moody Insurance Agency, Inc. CONTACT Moody Insurance Agency NAME: PHONEo, Ext): ( (303) 824-6600 I AXArc. No): () 303 370-0118 8055 East Tufts Avenue 85506SS: cerirequest@moodyins.com ADDRE Suite 1000 INSURER(S) AFFORDING COVERAGE NAIL # Denver CO 80237 INSURER A : Selective Insurance Co of America 12572 INSURED INSURER B: Pinnacol Assurance 41190 A-1 Chipseal Company, DBA: Rocky Mountain Pavement, LLC INSURER C : Evanston Insurance Company 35378 2505 E. 74th Ave INSURER D : INSURER E : Denver CO 60229 INSURER F : COVERAGES CERTIFICATE NUMBER: 22/23 Master 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. TV LTR TYPE OF INSURANCE ADDL SUER INSR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/D AY' ) LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR Y S2501487 02/01/2022 02/01/2023 EACH OCCURRENCE $ 1.000.000 DAMAGE TO RENTED PREMISES IEa oecurtence) S 300,000 MED EXP (Any one person) $ WAD pERsoNAL BAov INJURY $ 1,000,000 EMLAGGREGATE LIMIT APPLIESPER: _ POLICY D JECT PRD LOC OTHER: GENERAL AGGREGATE $ 2,000,000 '0000018 -0081:81086 2,000,000 $ A AUTOMOBILE LIABILITY x ANY AUTO OWNED ONLY WAS HIRED _ AUTOS ONLY SCHEDULED itTOS NON•OWNED _ AUTOS ONLY S2501487 02/01/2022 02/01/2023 COMBINED SINGLE LIMIT (Ea aaklent) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) A X UMBRELLA LIAR EXCESS LIAR X OCCUR CLAIMS -MADE S2501487 02/01/2022 02/01/2023 EACH OCCURRENCE $ 10.000,000 AGGREGATE $ 10,000,000 DED I XI RETENTION $ D $ B WORKERS COMPENSATION EMPLOYERS' LIABILITY ANY PROPRiETOR/PARTNER/EXECUTIVE Y/ N (Mandatory in N ) EXCLUDED? a (Mandatory in NH) If yes, desuibe under DESCRIPTION OF OPERATIONS below N / A 4055760 02/01/2022 02/01/2023 XI STATUTEI ER STATUTE E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 E.L. DISEASE - POLICY LIMIT $ 500,000 C Pollution Liability CPLMOL105319 02/01/2021 02/01/2023 Each Occurrence Limit Aggregate Limit Deductible $5,000,000 $5,000,000 $10,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It more apace Is required) [Job #: B#2100100 Job Type: ] RE: Slurry Seal and Sand Seal Contract Board of County Commissioners of Weld County, Colorado, its officers, and employees are named as additional insured per written contract. CERTIFICATE HOLDER CANCELLATI Weld County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1150 "O" Street AUTHORIZED REPRESENTATIVE Greeley CO 80632 '- cic&}( k, 44 ,t-)cv " ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: LOC ft: ACG ADDITIONAL REMARKS SCHEDULE Page of AGENCY Moody Insurance Agency, Inc. POLICY NUMBER CARRIER INAIL CODE NAMED INSURED A-1 Chipseal Company, DBA: Rocky Mountain Pavement, LLC EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance: Notes CONTRACTUAL LIABILITY APPLIES PER POLICY TERMS AND CONDITIONS Additional Named Insureds: A-1 Chipseal Company DBA Rocky Mountain Pavement, LLC Black Rock Material & Supply, LLC Location Schedule: 2505 E. 74th Avenue, Denver, CO 80229 7231 Cole VW, Colorado Springs, CO 80915 752O & 7560 Space Village Avenue, Colorado Springs, CO 80929 1100 Harlem, Pueblo CO 81001 10800 Highway 90, Arvada CO 80007 Inland Marine Policy: Policy Number: S2501487 Policy Effective Dates: 2-1-2022 to 2-1-2023 Insurer: Selective Insurance Company of America Total Combined Scheduled Contractor's Equipment Value: $6,893,372 Scheduled Contractor's Equipment Deductible: $10,000 Leased & Rented Equipment From Others Limit: $1,000,000 General Liability Policy: General Liability Deductible: $2,000 CG 73 00 01/19 From Attached Includes: Blanket Additional Insured status applies only to the extent provided in form CG 79 88 01/19. Blanket Waiver of Subrogation applies only to the extent provided in from CG 73 00 01/19. General Liability Policy is Primary and Non -Contributory only to the extent provided in form CG 79 88 01/19. Auto Liability Policy: Physical Damage Deductibles: Comprehensive: $2,500, Collision: $2,500 CA 78 09 / From Attached Includes: Blanket Additional Insured status applies only to the extent provided in form CA 78 0911/17. Blanket Waiver of Subrogation applies only to the extent provided in from CA 78 09 11/17. Umbrella Policy: Umbrella Policy is on a follow/) form basis for underlying insurance coverages: General Liability, Automobile Liability, and Employers Liability. Additional insured status will follow when required by written contract, including Primary and Non -Contributory Status. Worker's Compensation Policy: 359-B Form Attached Includes: Blanket Waiver of Subrogation status applies when required by written contract. "Please Note Hard Copies of Endorsement will not be sent out via mail. All Endorsements will only be sent electronically via email. Please send your email address to certrequest@moodylns.com for forms and future mailings" ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD PINN II COL ASSURANCE A-1 Chipseal Company dba Rocky Mounta Rocky Mountain Pavement LLC 2505 E 74th Ave Denver, CO 80229 ENDORSEMENT: Blanket Waiver of Subrogation 7501 E. Lowry Blvd. Denver, CO 80230-7006 303.361.4000 / 800.873.7242 Pinnacol.com NCCI #: WC000313B Policy #: 4055760 Moody Insurance Agency Inc 8055 E. Tufts Ave Ste 1000 Denver, CO 80237 (303) 824-6600 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 contractor agreement, as defined above and with the insured, which is in effect and executed prior to any loss. Effective Date:February 1, 2022 Expires on: February 1, 2023 Pinnacol Assurance has issued this endorsement January 26, 2022 7501 E. Lowry Blvd Denver, CO 80230-7006 Page 1 of 1 P DORSEYR - Underwriter 01/26/2022 12:59:30 4055760 59270663 359-B Contracting, Installation, Service and Repair General Liability Extended ElitePac® Endorsement COMMERCIAL GENERAL LIABILITY CG 79 88 01 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. 1. BLANKET ADDITIONAL INSUREDS Ongoing Operations SECTION II - WHO IS AN INSURED is amended to include as an additional insured: 1. Any person or organization for whom you are performing operations when you and such person or organization have agreed in a written contract, written agreement or written permit that such person or organization be added as an additional insured on your commercial general liability policy; and 2. Any other person or organization, including any architects, engineers or surveyors not engaged by you, whom you are required to add as an additional insured under your policy in the contract or agreement in Paragraph 1. above; Such person or organization is an additional insured only with respect to liability arising out of your ongoing operations performed under that contract, agreement, or permit when that contract, agreement, or permit requires the additional insured be added with respect to liability arising out of your ongoing operations. If the written contract, written agreement, or written permit does not require that the additional insured be added with respect to liability arising out of your ongoing operations, then such person or organization is an additional insured only with respect to "bodily injury", "property damage" or "personal and advertising injury" caused in whole or in part by your ongoing operations performed under that contract, agreement, or permit. b. Completed Operations SECTION II - WHO IS AN INSURED is amended to include as an additional insured: 1. Any person or organization for whom you are performing or have performed operations when you and such person or organization have agreed in a written contract, written agreement or written permit that such person or organization be added as an additional insured on your commercial general liability policy; and 2. Any other person or organization, including any architects, engineers or surveyors not engaged by you, whom you are required to add as an additional insured under your policy in the contract or agreement in Paragraph 1. above; Such person or organization is an additional insured only with respect to their liability arising out of "your work" performed under that contract, agreement, or permit and included in the "products -completed operations hazard" when that contract, agreement, or permit requires the additional insured be added with respect to liability arising out of "your work" performed under that contract, agreement, or permit and included in the "products -completed operations hazard". Copyright, 2018 Selective Insurance Company of America. All rights reserved. CG 79 88 01 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 3 c. d. If the written contract, written agreement, or written permit does not require that the additional insured be added with respect to liability arising out of "your work" performed under that contract, agreement, or permit and included in the "products -completed operations hazard", then such person or organization is an additional insured only with respect to liability for "bodily injury", "property damage" or 'personal and advertising injury" caused, in whole or in part, by "your work" performed under that contract, agreement, or permit and included in the "products -completed operations hazard". The coverages provided in Paragraphs a. and b. do not apply unless the written contractor written agreement has been signed by the Named Insured or written permit issued prior to the 'bodily injury", "property damage" or "personal and advertising injury". Exclusions (1) With respect to the insurance afforded to additional insureds under a. Ongoing Operations the following is added to 2. Exclusions under SECTION I — COVER- AGE A— BODILY INJURY AND PROP- ERTY DAMAGE LIABILITY: This insurance does not apply to "bodily injury", "property damage", or "personal and advertising injury" occurring after: (a) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the site of the covered operations has been completed; or (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 contrac- tor or subcontractor engaged in perform- ing operations for a principal as a part of the same project. (2) With respect to the insurance afforded to these additional insureds under a. Ongoing Operations and b. Completed Operations, the following is added to 2. Exclusions under SECTION I — COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY: This insurance does not apply to: "Bodily injury", "property damage", or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering 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 drawings and specifications; or (b) Supervisory, inspection, architectural or engineering activities. Conditions With respect to the insurance afforded to these additional insureds under a. Ongoing Operations and b. Completed Operations the following is added to Paragraph 4. Other Insurance, a. Primary Insurance under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS: This insurance is primary and will not contribute with any other insurance available to an additional insured under this coverage part provided that: (1) The additional insured is a Named Insured under such other insurance. (2) You have agreed in a written contract, written agreement or written permit to include that additional insured on your General Liability policy on a primary and/or non-contributory basis. 2. PROPERTY DAMAGE CARE, CUSTODY OR CONTROL The following is added to Exclusion j. under SECTION I — COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY: Paragraphs (4) and (5) do not apply for the limited purpose of providing the coverage and sub -limits of liability as set forth below. We will pay those sums that the insured becomes legally obligated to pay as damages arising out of "property damage" to: (1) Personal property in the care, custody or control of the insured; and Copyright, 2018 Selective Insurance Company of America. All rights reserved. CG 79 88 01 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 3 (2) That particular part of real property on which you or any contractors or subcontractors working directly or indirectly on your behalf are performing operations, if the "property damage" arises out of those operations. The most we will pay under (1) and (2) above in any one "occurrence" or for all damages during any one policy period is a sub -limit of $100,000. These limits are included in and not in addition to the Limits of Insurance shown in the Declarations of the Commercial General Liability Policy. Our right and duty to defend the insured against any "suit" for damages under (1) and (2) above ends when we have used up the applicable sub -limit of liability in the payment of judgments or settlements under it. 3. OTHER INSURANCE AMENDMENT - SUPPLE- MENTAL COVERAGE FOR INSURED'S INVOLVE- MENT IN A CONSOLIDATED (WRAP-UP) IN SUR- ANCE PROGRAM OR SIMILAR PROJECT The following is added to SECTION IV - COMMERCIAL GENERAL LIABILITY CONDI- TIONS, Paragraph 4. Other Insurance b. Excess Insurance (1)(a): (v) That is covered by a consolidated (wrap-up) or similar insurance program provided by the prime contractor/project manager or owner of the construction project in which you are involved for your ongoing operations or operations included within the "products -completed operations hazard", unless such consolidated (wrap-up) or similar program is specifically excluded from coverage on this policy. 4. FELLOW EMPLOYEE EXTENSION Under SECTION II - WHO IS AN INSURED Para- graphs 2.a. and 2.a. (1) are replaced by the following: Your "volunteer workers" only while performing duties related to the conduct of your business, or your "employees", other than either your "executive officers" (if you are an organization other than a partnership, joint venture, or limited liability company) or your managers (if you are a limited liability company), but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. The Employers Liability exclusion (SECTION I - COVERAGES; COVERAGE A, exclusion e.) does not apply to this provision. However, none of these "employees" or "volunteer workers" are insureds for: (1) "Bodily injury" or "personal and advertising injury": (a) Arising out of his or her providing or failing to provide professional health care services. 5. CONTRACTUAL LIABILITY (RAILROADS) Definition 9. Insured Contract is amended as fol- lows: Paragraph c. is deleted in its entirety and replaced with the following: Any easement or license agreement; Paragraph f.(1) is deleted in its entirety. 6. CONTRACTUAL LIABILITY AMENDMENT — (PERSONAL AND ADVERTISING INJURY) If it is required in a written contract, written agreement or written permit with the insured that any contractual liability exclusion for Personal Injury be removed from the policy, then Exclusion e. Contractual Liability under COVERAGE B PERSONAL AND ADVERTISING INJURY, 2. Exclusions is deleted in its entirety and replaced with the following: e. Contractual Liability "Personal and advertising Injury" for which the insured has assumed liability in a contract or agreement arising out of an "advertisement". This exclusion does not apply to liability for damages that the insured would have in the absence of the contract or agreement" 7. WAIVER OF GOVERNMENTAL IMMUNITY We will waive, both in the adjustment of claims and in the defense of "suits" against the insured, any governmental immunity of the insured, unless the insured requests in writing that we not do so. Waiver of immunity as a defense will not subject us to liability for any portion of a claim or judgment in excess of the applicable limit of insurance. 8. DAMAGE TO PREMISES RENTED TO YOU The Limit of Insurance for Damage To Premises Rented To You is increased to $1,000,000. Copyright, 2018 Selective Insurance Company of America. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. CG 79 88 01 19 Page 3 of 3 ElitePac® Commercial Automobile Extension COMMERCIAL AUTO CA 78 09 11 17 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Business Auto Coverage Form apply unless modified by the endorsement. AMENDMENTS TO SECTION II - LIABILITY COVER- AGE A. If this policy provides Auto Liability coverage for Owned Autos, the following extensions are applica- ble accordingly: NEWLY ACQUIRED OR FORMED ORGANIZA- TIONS The following is added to SECTION II, A.1. - Who Is An Insured: Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no similar insurance available to that organi- zation. However: 1. Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier; 2. Coverage does not apply to "bodily injury" or "property damage" resulting from an "accident" that occurred before you acquired or formed the organization. No person or organization is an "insured" with re- spect to the conduct of any current or past partner- ship, joint venture or limited liability company that is not shown as a Named Insured in the Declarations. EXPENSES FOR BAIL BONDS AND LOSS OF EARNINGS Paragraphs (2) and (4) of SECTION II, A.2.a. - Supplementary Payments are deleted in their entirety and replaced with the following: (2) Up to the Limit of Insurance shown on the ElitePac Schedule for the cost of bail bonds (in- cluding bonds for related traffic law violations) required because of an "accident" covered under this policy. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the "insured" at our request. This includes actual loss of earnings because of time off from work, which we will pay up to the Limit of Insurance shown on the ElitePac Schedule. EMPLOYEE INDEMNIFICATION AND EMPLOY- ER'S LIABILITY AMENDMENT The following is added to SECTION II, B.4. - Exclusions: This exclusion does not apply to a "volunteer work- er" who is not entitled to workers compensation, disability or unemployment compensation benefits. FELLOW EMPLOYEE COVERAGE The Fellow Employee Exclusion, SECTION II, B.5. - is deleted in its entirety. CARE, CUSTODY OR CONTROL AMENDMENT The following is added to SECTION II, B.6. - Exclusions: This exclusion does not apply to property owned by anyone other than an "insured", subject to the follow- ing: 1. The most we will pay under this exception for any one "accident" is the Limit of Insurance stat- ed in the ElitePac Schedule; and 2. A per "accident" deductible as stated in the ElitePac Schedule applies to this exception. B. If this policy provides Auto Liability coverage for Owned Autos or Non -Owned Autos, the following extension is applicable accordingly: LIMITED LIABILITY COMPANIES The following is added to SECTION II, A.1. - Who Is An Insured: If you are a limited liability company, your members and managers are "insureds" while using a covered "auto" you don't own, hire or borrow during the course of their duties for you. BLANKET ADDITIONAL INSUREDS - As Required By Contract The following is added to SECTION II, Al,. - Who Is An Insured: Copyright, 2017 Selective Insurance Company of America. All rights reserved. CA 78 09 11 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 5 Any person or organization whom you have agreed in a written contract, written agreement or written permit that such person or organization be added as an additional "insured" on your policy. Such person or organization is an additional "insured" only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by your owner- ship, maintenance or use of a covered "auto". This coverage shall be primary and non-contributory with respect to the additional "insured". This provision only applies if: 1. It is required in the written contract, written agreement or written permit identified in this sec- tion; 2. It is permitted by law; and 3. The written contract or written agreement has been executed (executed means signed by a named insured) or written permit issued prior to the "bodily injury" or "property damage". C. If this policy provides Auto Liability coverage for Non - Owned Autos, the following extension is applicable accordingly: EMPLOYEES AS INSUREDS If this policy provides Auto Liability coverage for Non -Owned Autos, the following is added to SECTION II, A.1. - Who is An Insured: Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow in your business or your personal affairs. An "employee" of yours is an "insured" while operat- ing an "auto" hired or rented under a contract or agreement in that "employee's" name with your per- mission, while performing duties related to the con- duct of your business. AMENDMENTS TO SECTION III - PHYSICAL DAMAGE COVERAGE If this policy provides Comprehensive, Specified Causes of Loss or Collision coverage, the following extensions are applicable for those "autos" for which Comprehen- sive, Specified Causes of Loss or Collision coverage is purchased: TOWING AND LABOR SECTION III, A.2. - Towing is deleted in its entirety and replaced with the following: We will pay all reasonable towing and labor costs up to the maximum Limit of Insurance shown on the ElitePac Schedule per tow each time a covered "Private Passen- ger Auto", "Social Service Van or Bus" or "Light Truck" is disabled and up to the maximum Limit of Insurance per tow each time a covered "Medium Truck", "Heavy Truck" or "Extra Heavy Truck" is disabled. For labor charges to be eligible for reimbursement the labor must be performed at the place of disablement. This coverage extension does not apply to Emergency Services Organizations and Governmental Entities. GLASS BREAKAGE DEDUCTIBLE The following is added to SECTION III, A.3. - Glass Breakage - Hitting A Bird Or Animal - Falling Objects or Missiles: If damaged glass is repaired rather than replaced, no deductible will apply for such repair. This extension does not apply to Emergency Services Organizations and Governmental Entities. ADDITIONAL TRANSPORTATION EXPENSES SEC- TION III, A.4.a. - Transportation Expenses is deleted in its entirety and replaced with the following: We will pay up to the maximum Limit of Insurance shown on the ElitePac Schedule for temporary transportation expenses that you incur because of any "loss" to a cov- ered "auto", but only if the covered "auto" carries the coverages and meets the requirements described in 1. or 2. below: 1. We will pay temporary transportation expenses for total theft of a covered "auto". We will only pay for such expenses incurred during the period beginning 24 hours after the theft and ending, regardless of the policy's expiration, when the covered "auto" is re- turned to use or we pay for its "loss". 2. For "loss" other than total theft of a covered "auto" under Comprehensive or Specified Causes of Loss Coverage, or for any "loss" under Collision Coverage to a covered "auto", we will only pay for those tem- porary transportation expenses incurred during the policy period beginning 24 hours after the "loss" and ending, regardless of the policy's expiration, with the lesser of the number of days reasonably required to repair or replace the covered "auto" or 30 days. Paragraph 2. of this extension does not apply while there are spare or reserve "autos" available to you for your operations. This coverage extension does not apply to Emergency Services Organizations and Governmental Entities. HIRED AUTO PHYSICAL DAMAGE COVERAGE The following is added to SECTION III, A.4. - Coverage Extensions: Physical Damage coverage is hereby extended to apply to Physical Damage "loss" to "autos' leased, hired, rent- ed or borrowed without a driver. We will provide cover- age equal to the broadest coverage available to any covered "auto" shown in the Declarations. But, the most we will pay for "loss" to each "auto" under this coverage extension is the lesser of: Copyright, 2017 Selective Insurance Company of America. All rights reserved. CA 78 09 11 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 5 1. The Limit of Insurance stated in the ElitePac Sched- ule; or 2. The actual cash value of the damaged or stolen property as of the time of the "loss"; or 3. The actual cost of repairing or replacing the dam- aged or stolen property with other property of like kind and quality. A part is of like kind and quality when it is of equal or better condition than the pre - accident part. We will use the original equipment from the manufacturer when: (a) The operational safety of the vehicle might otherwise be impaired; (b) Reasonable and diligent efforts to locate the appropriate rebuilt, aftermarket or used part have been unsuccessful; or (c) A new original equipment part of like kind and quality is available and will result in the lowest overall repair cost. For each leased, hired, rented or borrowed "auto" our obligation to pay "losses" will be reduced by a deductible equal to the highest deductible applicable to any owned "auto" for that coverage. No deductible wilt be applied to "losses" caused by fire or lightning. SECTION IV, B.5. Other Insurance Condition, Para- graph 5.b, is deleted in its entirety and replaced by the following: For Hired Auto Physical Damage Coverage, the follow- ing 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 "em- ployee" under a contract or agreement in that "employee's" name, with your permission, while performing duties related to the conduct of your business. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". This coverage extension does not apply to Emergency Services Organizations and Governmental Entities. HIRED AUTO LOSS OF USE COVERAGE The following is added to SECTION III, A.4. - Coverage Extensions: We will pay expenses for which you are legally responsi- ble to pay up to the Limit of Insurance shown on the ElitePac Schedule per "accident" for loss of use of a leased, hired, rented or borrowed "auto" if it results from an "accident". This coverage extension does not apply to Emergency Services Organizations, Governmental Entities, and Schools. AUTO LOAN/LEASE GAP COVERAGE (Not Applica- ble in New York) The following is added to SECTION III, A.4. - Coverage Extensions: In the event of a total "loss" to a covered "auto" we will pay any unpaid amount due on the lease or loan for a covered "auto", less: 1. The amount paid under the Physical Damage Cover- age Section of the policy; and 2. Any: a. Overdue lease/loan payments at the time of "loss"; b. Financial penalties imposed under a lease for excessive use, abnormal wear and tear, high mileage or similar charges; c. Security deposits not refunded by the lessor or financial institution; d. Costs for extended warranties, credit life, health, accident, or disability insurance purchased with the loan or lease; and e. Carry-over balances from previous leases or loans. You are responsible for the deductible applicable to the "loss" for the covered "auto". PERSONAL EFFECTS The following is added to SECTION III, A.4. - Coverage Extensions: If this policy provides Comprehensive Coverage for a covered "auto" you own and that covered "auto" is stolen, we will pay up to the Limit of Insurance shown on the ElitePac Schedule, without application of a deducti- ble, for lost personal effects that were in the covered "auto" at the time of theft. Personal effects do not include jewelry, tools, money, or securities. This coverage is excess over any other collectible insurance. AIRBAG COVERAGE The following is added to SECTION III, B.3.a. - Exclu- sions: Mechanical breakdown does not include the accidental discharge of an airbag. This coverage extension does not apply to Emergency Services Organizations and Governmental Entities. EXPANDED AUDIO, VISUAL, AND DATA ELEC- TRONIC EQUIPMENT COVERAGE SECTION III, B.4. - Exclusions This exclusion does not apply to the following: 1. Global positioning systems; 2. "Telematic devices"; or 3. Electronic equipment that reproduces, receives or transmits visual or data signals and accessories used with such equipment, provided such equipment is: Copyright, 2017 Selective Insurance Company of America. All rights reserved. CA 78 09 11 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 5 a. Permanently installed in or upon the covered "auto" at the time of the "loss"; b. Removable from a housing unit that is perma- nently installed in the covered "auto" at the time of the "loss"; c. Designed to be solely operated by use of power from the "auto's" electrical system; or d. Designed to be used solely in or upon the covered "auto". For each covered "loss" to such equipment, a deductible of $50 shall apply, unless the deductible otherwise appli- cable to such equipment is less than $50, at which point the lower deductible, if any, will apply. COMPREHENSIVE DEDUCTIBLE - LOCATION TRACKING DEVICE The following is added to SECTION III, D. - Deductible: Any Comprehensive Coverage Deductible shown in the Declarations will be reduced by 50% for any "loss" caused by theft if the covered "auto" is equipped with a location tracking device and that device was the sole method used to recover the "auto". PHYSICAL DAMAGE LIMIT OF INSURANCE SECTION III, C. - Limit Of Insurance is deleted in its entirety and replaced with the following: The most we will pay for a "loss" in any one "accident" is the lesser of: 1. The actual cash value of the damaged or stolen property as of the time of the "loss"; or 2. The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality. This coverage extension does not apply to Emergency Services Organizations and Governmental Entities. AMENDMENTS TO SECTION IV - BUSINESS AUTO CONDITIONS DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS The following is added to SECTION IV, A.2.a. - Duties In The Event Of Accident, Claim, Suit Or Loss: The notice requirements for reporting "accident" claim, "suit" or "loss" information to us, including provisions related to the subsequent investigation of such "acci- dent", claim, "suit" or "loss" do not apply until the "accident", claim, "suit" 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 manager, if you are a corporation; 4. Your members, managers or insurance manager, if you are a limited liability company; 5. Your elected or appointed officials, trustees, board members or your insurance manager, if you are an organization other than a partnership, joint venture or limited liability company. But, this section does not amend the provisions relating to notification of police or protection or examination of the property that was subject to the "loss". WAIVER OF SUBROGATION SECTION IV, A.5. - Transfer Of Rights Of Recovery Against Others To Us is deleted in its entirety and replaced with 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" resulting from the ownership, maintenance or use of a covered "auto" but only when you have assumed liability for such "bodily injury' or "property damage" in an "insured con- tract". In all other circumstances, if a person or organiza- tion to or for whom we make payment under this Cover- age Form has rights to recover damages from another, those rights are transferred to us. MULTIPLE DEDUCTIBLES The following is added to SECTION IV, A. - Loss Conditions: If a "loss" from one event involves two or more covered "autos" and coverage under Comprehensive or Specified Causes of Loss applies, only the highest applicable deductible will be applied. CONCEALMENT, MISREPRESENTATION OR FRAUD The following is added to SECTION IV, B.2. - Conceal- ment, Misrepresentation Or Fraud: If you should unintentionally fail to disclose any existing hazards in your representations to us prior to the incep- tion date of the policy or during the policy period in connection with any newly discovered hazards, we will not deny coverage under this Coverage Form based upon such failure. POLICY PERIOD, COVERAGE TERRITORY SECTION IV, B.7. - Policy Period, Coverage Territory is deleted in its entirety and replaced with the following: Under this Coverage Form, we cover "accidents" and "losses" occurring: a. During the policy period shown in the Declarations; and b. Within the "Coverage Territory". Copyright, 2017 Selective Insurance Company of America. All rights reserved. CA 78 09 11 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 5 We also cover "loss" to or "accidents" involving a cov- ered "auto" while being transported between any of these places. TWO OR MORE COVERAGE FORMS OR POLICIES ISSUED BY US - DEDUCTIBLES The following is added to SECTION IV, B.8. - Two Or More Coverage Forms Or Policies Issued By Us: If a "loss" covered under this Coverage Form also in- volves a "loss" to other property resulting from the same "accident" that is covered under this policy or another policy issued by us or any member company of ours, only the highest applicable deductible will be applied. AMENDMENTS TO SECTION V - DEFINITIONS BODILY INJURY INCLUDING MENTAL ANGUISH (Not Applicable in New York) The definition of bodily injury is deleted in its entirety and replaced by the following: "Bodily injury" means bodily injury, sickness, or disease sustained by a person, including death resulting from any of these. "Bodily injury" includes mental anguish resulting from bodily injury, sickness or disease sus- tained by a person. ADDITIONS TO SECTION V - DEFINITIONS COVERAGE TERRITORY "Coverage Territory" means: 1. The United States of America (including its territories and possessions), Canada and Puerto Rico; and 2. Anywhere in the world, except for any country or jurisdiction that is subject to trade or other economic sanction or embargo by the United States of America, if a covered "auto" is leased, hired, rented, or borrowed without a driver for a period of 30 days or less, and the insured's responsibility to pay "dam- ages" is determined in a "suit" on the merits in and under the substantive law of the United States of America (including its territories and possessions), Puerto Rico, or Canada, or in a settlement we agree to. If we are prevented by law, or otherwise, from defending the "insured" in a "suit" brought in a location described in Paragraph 2. above, the insured will conduct a defense of that "suit". We will reimburse the "insured" for the rea- sonable and necessary expenses incurred for the de- fense of any such "suit" seeking damages to which this insurance applies, and that we would have paid had we been able to exercise our right and duty to defend. EXTRA HEAVY TRUCK "Extra Heavy Truck" means a truck with a gross vehicle weight rating of 45,001 pounds or more. HEAVY TRUCK "Heavy Truck" means a truck with a gross vehicle weight rating of 20,001 pounds to 45,000 pounds. LIGHT TRUCK "Light Truck" means a truck with a gross vehicle weight rating of 10,000 pounds or less. MEDIUM TRUCK "Medium Truck" means a truck with a gross vehicle weight rating of 10,001 pounds to 20,000 pounds. PRIVATE PASSENGER AUTO "Private Passenger Auto" means a four-wheel "auto" of the private passenger or station wagon type. A pickup, panel truck or van not used for business is included within the definition of a "private passenger auto". SOCIAL SERVICE VAN OR BUS "Social Service Van or Bus" means a van or bus used by a government entity, civic, charitable or social service organization to provide transportation to clients inci- dental to the social services sponsored by the organiza- tion, including special trips and outings. TELEMATIC DEVICE "Telewatic Device" includes devices designed for the collection and dissemination of data for the purpose of monitoring vehicle and/or driver performance. This in- cludes Global Positioning System technology, wireless safety communications and automatic driving assistance systems, all integrated with computers and mobile com- munications technology in automotive navigation sys- tems. VOLUNTEER WORKER "Volunteer worker" means a person who performs busi- ness duties for you, for no financial or other compensa- tion. Copyright, 2017 Selective Insurance Company of America. All rights reserved. CA 78 09 11 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 5 General Liability Extension Endorsement COMMERCIAL GENERAL LIABILITY CG 73 00 01 19 SUMMARY OF COVERAGES (including index) This is a summary of the various additional coverages and coverage modifications provided by this endorsement. No coverage is provided by this summary. Refer to the actual endorsement (Pages 3 -through -9) for changes affecting your insurance protection. DESCRIPTION Additional Insureds - Primary and Non -Contributory Provision Blanket Additional Insureds - As Required By Contract • Owners, Lessees or Contractors (includes Architects, Engineers or Surveyors • Lessors of Leased Equipment • Managers or Lessors of Premises • Mortgagees, Assignees and Receivers • Any Other person or organization other than a joint venture • Grantors of Permits • Broad Form Vendors Coverage Damage To Premises Rented To You (Including Fire, Lightning or Explosion) Electronic Data Liability ($100,000) Employee Definition Amended Employees As Insureds Modified Employer's Liability Exclusion Amended (Not applicable in New York) Incidental Malpractice Exclusion modified Knowledge of Occurrence, Claim, Suit or Loss Liberalization Clause Mental Anguish Amendment (Not applicable to New York) Newly Formed or Acquired Organizations Non -Owned Aircraft Non -Owned Watercraft (under 60 feet) Not -for-profit Members - as additional insureds Personal And Advertising Injury - Discrimination Amendment (Not applicable in New York) Products Amendment (Medical Payments) Supplementary Payments Amended - Bail Bonds ($5,000) and Loss of Earnings ($1,000) Two or More Coverage Parts or Policies Issued By Us Unintentional Failure to Disclose Hazards Waiver of Transfer of Rights of Recovery (subrogation) When Two or More Coverage Parts of this Policy Apply to a Loss PAGE FOUND Page 8 Page 5 Page 7 Page 3 Page 4 Page 9 Page 5 Page 3 Page 7 Page 7 Page 8 Page 9 Page 5 Page 3 Page 3 Page 5 Page 8 Page 4 Page 4 Page 8 Page 8 Page 8 Page 3 Copyright, 2018 Selective Insurance Company of America. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. INSURED'S COPY CG 73 00 01 19 Page 1 of 9 THIS PAGE IS INTENTIONALLY LEFT BLANK. Copyright, 2018 Selective Insurance Company of America. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. INSURED'S COPY CG 73 00 01 19 Page 2 of 9 a.��acr ...- General Liability Extension Endorsement COMMERCIAL GENERAL LIABILITY CG 73 00 01 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies the insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The SECTIONS of the Commercial General Liability Coverage Form identified in this endorsement will be amended as shown below. However, if (a) two or more Coverage Parts of this policy, or (b) two or more forms or endorsements within the same Coverage Part apply to a loss, coverage provision(s) with the broadest language will apply, unless specifically stated otherwise within the particular amendment covering that loss. With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. IIIIIIIIIIIIIlIIIIIIIIIIIIIIIII IIIIIIIill COVERAGES - Amendments SECTION I - COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY EXCLUSIONS Employer's Liability Amendment (This provision is not applicable in the State of New York). The following is added to Exclusion e. Employer's Liability under COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions: This exclusion also does not apply to any "temporary worker". Non -Owned Aircraft, Auto or Watercraft A. Paragraph (2) of Exclusion g. Aircraft, Auto Or Watercraft under COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclus- ions is deleted in its entirety and replaced with the following: (2) A watercraft you do not own that is: (a) Less than 26 feet long and not being used to carry persons or property for a charge; or (b) At least 26 feet, but less than 60 feet long, and not being used to carry per- sons or property for a charge. Any person is an insured who uses or is responsible for the use of such water- craft with your expressed or implied consent. However, if the insured has any other valid and collectible insurance for "bodily injury" or "property damage" that would be covered under this provi- sion, or on any other basis, this cover- age is then excess, and subject to Condition 4. Other Insurance, b. Excess Insurance under SECTION IV - COM- MERCIAL GENERAL LIABLITY CONDI- TIONS. B. The following is added to Exclusion g. Aircraft, Auto Or Watercraft under COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions: This exclusion does not apply to: (6) Any aircraft, not owned or operated by any insured, which is hired, chartered or loaned with a paid crew. However, if the insured has any other valid and collectible insur- ance for "bodily injury" or "property dam- age" that would be covered under this provision, or on any other basis, this cover- age is then excess, and subject to Condition 4. Other Insurance, b. Excess Insurance under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS. Damage To Premises Rented to You A. The last paragraph of Paragraph 2. Exclusions under COVERAGE A BODILY INJURY AND PROPERTY DAMAGE is deleted in its entirety and replaced with the following: Exclusions c. through n. do not apply to damage by fire, lightning or explosion to premises rented to you or temporarily occupied by you with the permission of the owner. A separate limit of insurance applies to this coverage as described in SECTION III - LIMITS OF INSURANCE. Copyright, 2018 Selective Insurance Company of America. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. INSURED'S COPY CG 73 00 01 19 Page 3 of 9 B. Paragraph 6. under SECTION III - LIMITS OF INSURANCE is deleted in its entirety and replaced with the following: 6. Subject to Paragraph 5. above, the most we will pay under COVERAGE A for damages because of "properly damage" to any one premises, while rented to you, or in the case of damage caused by fire, lightning or explosion, while rented to you or temporarily occupied by you with permission of the owner, for all such damage caused by fire, lightning or explosion proximately caused by the same event, whether such damage results from fire, lightning or explosion or any combination of the three, is the amount shown in the Declarations for the Damage To Premises Rented To You Limit. C. Paragraph a. of Definition 9. "Insured contract" under SECTION V - DEFINITIONS is deleted in its entirety and replaced with the following: a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning or explosion to premises while rented to you or temporarily occupied by you with the per- mission of the owner is not an "insured contract"; Electronic Data Liability A. Exclusion p. Access or Disclosure Of Confiden- tial Or Personal Information And Data -related Liability under COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions is deleted in its entirety and replaced by the following: P. Access or Disclosure Of Confidential Or Personal Information And Data -related Liability Damages arising out of: (1) Any access to or disclosure of any person's or organization's confidential or personal information, including patents, trade secrets, processing methods, customer lists, financial infor- mation, credit card information or any other type of nonpublic information; or (2) The loss of, loss of use of, damage to, corruption of, inability to access, or inability to manipulate "electronic data" that does not result from physical injury to tangible property. This exclusion applies even if damages are claimed for notification costs, credit mon- itoring expenses, forensic expenses, public relations expenses or any other loss, cost or expense incurred by you or others arising out of that which is described in Paragraph (1) or (2) above. B. The following paragraph is added to SECTION III - LIMITS OF INSURANCE: Subject to 5. above, the most we will pay under COVERAGE A for "property damage" because of all loss of "electronic data" arising out of any one "occurrence" is a sub -limit of $100,000. SECTION I - COVERAGE C MEDICAL PAYMENTS EXCLUSIONS Any Insured Amendment Exclusion a. Any Insured under COVERAGE C MEDICAL PAYMENTS, 2. Exclusions is deleted in its entirety and replaced with the following: a. Any Insured To any insured. This exclusion does not apply to: (1) "Not -for-profit members"; (2) "Golfing facility" members who are not paid a fee, salary, or other compensation; or (3) "Volunteer workers". This exclusion exception does not apply if COVERAGE C MEDICAL PAYMENTS is excluded by another endorsement to this Coverage Part. Product Amendment Exclusion f. Products -Completed Operations Hazard under COVERAGE C MEDICAL PAYMENTS, 2. Exclusions is deleted in its entirety and replaced with the following: f. Products -Completed Operations Hazard Included within the "products -completed opera- tions hazard". This exclusion does not apply to "your products" sold for use or consumption on your premises, while such products are still on your premises. This exclusion exception, does not apply if COVERAGE C MEDICAL PAYMENTS is excluded by another endorsement to this Coverage Part. SECTION I - SUPPLEMENTARY PAYMENTS - COVERAGES A AND B Expenses For Bail Bonds And Loss Of Earnings A. Subparagraph 1.b. under SUPPLEMENTARY PAYMENTS - COVERAGES A AND B is deleted in its entirety and replaced with the following: b. Up to $5,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. Copyright, 2016 Selective Insurance Company of America. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. INSURED'S COPY CG 73 00 01 19 Page 4 of 9 B. Subparagraph 1.d. under SUPPLEMENTARY PAYMENTS - COVERAGES A AND B is deleted in its entirety and replaced with the following: d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $1,000 a day because of time off from work. SECTION II - WHO IS AN INSURED - Amendments Not -for -Profit Organization Members The following paragraph is added to SECTION II - WHO IS AN INSURED: If you are an organization other than a partnership, joint venture, or a limited liability company, and you are a not -for-profit organization, the following are included as additional insureds: 1. Your officials; 2. Your trustees; 3. Your members; 4. Your board members; 5. Your commission members; 6. Your agency members; 7. Your insurance managers; 8. Your elective or appointed officers; and 9. Your "not -for-profit members". However only with respect to their liability for your activities or activities they perform on your behalf. Employees As Insureds Modified A. Subparagraph 2.a.(1fa) under SECTION II - WHO IS AN INSURED does not apply to "bodily injury" to a "temporary worker" caused by a co - "employee" who is not a "temporary worker". B. Subparagraph 2.a.(2) under SECTION II - WHO IS AN INSURED does not apply to "property damage" to the property of a "temporary worker" or "volunteer worker" caused by a co - "employee" who is not a "temporary worker" or "volunteer worker". C. Subparagraph 2.a.(1Xd) under SECTION II - WHO IS AN INSURED does not apply to "bodily injury" caused by cardio-pulmonary resuscita- tion or first aid services administered by a co - "employee ". With respect to this provision only, Subparagraph (1) of Exclusion 2. e. Employer's Liability under SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY does not apply. Newly Formed Or Acquired Organizations A. Subparagraph 3.a. under SECTION II - WHO IS AN INSURED is deleted in its entirety and replaced with the following: a. Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier. However, COVERAGE A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organi- zation. B. The following paragraph is added to SECTION II - WHO IS AN INSURED, Paragraph 3: If you are engaged in the business of con- struction of dwellings three stories or less in height, or other buildings three stories or less in height and less than 25,000 square feet in area, you will also be an insured with respect to "your work" only, for the period of time described above, for your liability arising out of the conduct of any partnership or joint venture of which you are or were a member, even if that partnership or joint venture is not shown as a Named Insured. However, this provision only applies if you maintain or maintained an interest of at least fifty percent in that partnership or joint venture for the period of that partnership or joint venture. This provision does not apply to any partnership or joint venture that has been dissolved or otherwise ceased to function for more than thirty-six months. With respect to the insurance provided by this provision, Newly Formed or Acquired Organizations, the following is added to SECTION IV - COMMER- CIAL GENERAL LIABILITY, Paragraph 4. Other Insurance, Subparagraph b. Excess Insurance: The insurance provided by this provision, Newly Formed or Acquired Organizations, is excess over any other insurance available to the insured, whether primary, excess, contingent or on any other basis. (All other provisions of this section remain unchanged) Blanket Additional Insureds - As Required By Contract Subject to the Primary and Non -Contributory provi- sion set forth in this endorsement, SECTION II - WHO IS AN INSURED is amended to include as an additional insured: A. Owners, Lessees or Contractors/Architects, Engineers and Surveyors 1. Any person or organization for whom you are performing operations when you and such person or organization have agreed in a written contract, written agreement or written permit that such person or organi- zation be added as an additional insured on your commercial general liability policy; and Copyright, 2018 Selective Insurance Company of America. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. INSURED'S COPY CG 73 00 01 19 Page 5 of 9 2. Any other person or organization, including any architects, engineers or surveyors not engaged by you, whom you are required to add as an additional insured under your policy in the contract or agreement in Paragraph 1. above: Such person or organization is an additional insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in pad, by: a. Your acts or omissions; or b. The acts of omissions of those acting on your behalf; in the performance of your ongoing operations performed for the additional insured in Para- graph 1., above. However, this insurance does not apply to: "Bodily injury", "property damage" or "personal and advertising injury" arising out of the render- ing of, or the failure to render, any professional architectural, engineering or surveying services by or for you, including: a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and b. Supervisory, inspection, architectural or engineering activities. Professional services do not include services within construction means, methods, tech- niques, sequences and procedures employed by you in connection with your operations in your capacity as a construction contractor. A person or organization's status as an additional insured under this endorsement ends when your operations for the person or organi- zation described in Paragraph 1. above are completed. B. Other Additional Insureds Any of the following persons or organizations with whom you have agreed in a written contract, written agreement or written permit that such persons or organizations be added as an additional insured on your commercial general liability policy: 1. Lessors of Leased Equipment Any person or organization from whom you lease equipment, but only with respect to liability for "bodily injury", "property dam- age" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person or organi- zation. With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after the equipment lease expires. 2. Managers or Lessors of Premises Any person or organization from whom you lease premises, but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you. This insurance does not apply to any "occurrence" which takes place after you cease to be a tenant of that premises. 3. Mortgagees, Assignees or Receivers Any person or organization with respect to their liability as mortgagee, assignee or receiver and arising out of the ownership, maintenance or use of your premises. This insurance does not apply to any "occurrence" which takes place after the mortgage is satisfied, or the assignment or receivership ends. 4. Any Person or Organization Other Than A Joint Venture Any person or organization (other than a joint venture of which you are a member), but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts of omissions of those acting on your behalf in the performance of your ongoing operations or in connection with property owned by you. 5. State or Governmental Agency or Political Subdivision - Permits or Authorizations Any state or governmental agency or subdivision or political subdivision, but only with respect to: Operations performed by you or on your behalf for which the state or govern- mental agency or subdivision or political subdivision has issued a permit or authorization; or b. The following hazards for which the state or governmental agency or sub- division or political subdivision has issued a permit or authorization in connection with premises you own, rent or control and to which this insurance applies: Copyright, 2018 Selective Insurance Company of America. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. INSURED'S COPY CG 73 00 01 19 Page 6 of 9 I,iii I II IIIIII IIIIIu,IIIIIII Uiii ii I (1) The existence, maintenance, repair, construction, erection or removal of advertising signs, awnings, cano- pies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners or decora- tions and similar exposures; (2) The construction, erection or re- moval of elevators; or (3) The ownership, maintenance or use of any elevators covered by this insurance. This insurance does not apply to: (a) "Bodily injury" or "property damage" arising out of opera- tions performed for the federal government, state or munici- pality; or (b) "Bodily injury" or "property damage" included within the "products -completed operations hazard". With respect to Paragraphs 2. through 4., this insurance does not apply to structural alterations, new construction or demolition operations performed by or on behalf of such person or organization. The provisions of this coverage extension do not apply unless the written contract or written agree- ment has been signed by the Named Insured or written permit issued prior to the "bodily injury" or "property damage" or "personal and advertising injury". Broad Form Vendors Coverage Subject to the Primary and Non -Contributory provision set forth in this endorsement, SECTION II - WHO IS AN INSURED is amended to include as an additional insured any person or organization (referred to below as vendor) for whom you have agreed in a written contract or written agreement to provide coverage as an additional insured under your policy. Such person or organization is an additional insured only with respect to "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's business. However, the insurance afforded the vendor does not apply to: a. "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement; however this exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; b. Any express warranty unauthorized by you; Any physical or chemical change in the product made intentionally by the vendor; d. Repackaging, unless unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business in connection with the sale of the product; or f. Products which, after distribution or sale by you, have been labeled or re -labeled or used as a container, part of ingredient of any other thing or substance by or for the vendor; however this insurance does not apply to any insured person or organization, from who you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. The provisions of this coverage extension do not apply unless the written contract or written agree- ment has been signed by the Named Insured prior to the "bodily injury" or "property damage". Incidental Malpractice Subparagraph 2.a.(1Xd) under SECTION II - WHO IS AN INSURED is deleted in its entirety and replaced with the following: (d) Arising out of his or her providing or failing to provide professional health care services. This does not apply to nurses, emergency medical technicians or paramedics if you are not in the business or occupation of providing any such professional services. This also does not apply to "bodily injury" caused by cardio-pulmonary resuscitation or first aid services administered by a co - "employee". This provision does not apply if you are a Social Service or Senior Living risk. SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS - Amendments Knowledge Of Occurrence, Claim, Suit Or Loss The following is added to Paragraph 2. Duties in the Event of Occurrence, Offense, Claim or Suit under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS: The requirements under this paragraph do not apply until after the "occurrence" or offense is known to: 1. You, if you are an individual; 2. A partner, if you are a partnership; Copyright, 2018 Selective Insurance Company of America. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. INSURED'S COPY CG 73 00 01 19 Page 7 of 9 3. An "executive officer" or insurance manager, if you are a corporation; 4. Your members, managers or insurance manager, if you are a limited liability company; or 5. Your elected or appointed officials, officers, members, trustees, board members, commis- sion members, agency members, or your administrator or your insurance manager if you are an organization other than a partnership, joint venture, or limited liability company. Primary and Non -Contributory Provision The following is added to Paragraph 4. Other Insur- ance, b. Excess Insurance under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS: This insurance is primary to and we will not seek contribution from any other insurance available to an additional insured under this policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in a written contract, written agreement or written permit that this insurance would be primary and would not seek contri- bution from any other insurance available to the additional insured. Unintentional Failure To Disclose Hazards The following is added to Paragraph 6. Representations under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS: However, if you should unintentionally fail to disclose any existing hazards in your representa- tions to us at the inception date of the policy, or during the policy period in connection with any additional hazards, we shall not deny coverage under this Coverage Part based upon such failure to disclose hazards. Waiver Of Transfer Of Rights Of Recovery The following is added to Paragraph 8. Transfer of Rights Of Recovery Against Others To Us under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS: We will waive any right of recovery we may have against a person or organization because of pay- ments we make for "bodily injury" or "property damage" arising out of your ongoing operations or "your work" done under a written contract or written agreement and included in the "products -completed operations hazard", if: 1. You have agreed to waive any right of recovery against that person or organization in a written contract or written agreement; 2. Such person or organization is an additional insured on your policy; or 3. You have assumed the liability of that person or organization in that same contract, and it is an "insured contract". The section above only applies to that person or organization identified above, and only if the "bodily injury" or "property damage" occurs subsequent to the execution of the written contract or written agreement. Liberalization The following condition is added to SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS: If we revise this Coverage Part to provide more coverage without additional premium charge, sub- ject to our filed company rules, your policy will automatically pro'vide the additional coverage as of the day the revision is effective in your state. Two or More Coverage Parts or Policies Issued By Us (This provision is not Applicable in the state of New York or Wisconsin). The following condition is added to SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS: It is our intention that the various coverage parts or policies issued to you by us, or any company affiliated with us, do not provide any duplication or overlap of coverage. We have exercised diligence to draft our coverage parts and policies to reflect this intention. However, if the facts and circumstances that will respond to any claim or "suit" give rise to actual or claimed duplication or overlap of coverage between the various coverage parts or policies issued to you by us or any company affiliated with us, the limit of insurance under all such coverage parts or policies combined shall not exceed the highest applicable limit under this coverage, or any one of the other coverage forms or policies. This condition does not apply to any Excess or Umbrella policy issued by us specifically to apply as excess insurance over this coverage part or policy to which this coverage part is attached. SECTION V - DEFINITIONS Discrimination (This provision does not apply in New York). A. The following is added to Definition 14. "Per- sonal and advertising injury": "Personal and advertising injury" also means "discrimination" that results in injury to the feelings or reputation of a natural person, how- ever only if such "discrimination" or humiliation is: 1. Not done by or at the direction of: a. The insured; or Copyright, 2018 Selective Insurance Company of America. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. INSURED'S COPY CG 73 00 01 19 Page 8 of 9 21101)OF\ .111417154 IIIIIIIuIIIIIINIIIIIIIIIIIII IIIII II b. Anyone considered an insured under SECTION II - WHO IS AN INSURED; 2. Not done intentionally to cause harm to another person. 3. Not directly or indirectly related to the em- ployment, prospective employment or termi- nation of employment of any person or persons by any insured. 4. Not arising out of any "advertisement" by the insured. B. The following definition is added to SECTION V - DEFINITIONS: "Discrimination" means: Any act or conduct that would be considered discrimination under any applicable federal, state, or local statute, ordinance or law; b. Any act or conduct that results in disparate treatment of, or has disparate impact on, a person, because of that person's race, religion, gender, sexual orientation, age, disability or physical impairment; or Any act or conduct characterized or inter- preted as discrimination by a person based on that person's race, religion, gender, sexual orientation, age, disability or physi- cal impairment. It does not include acts or conduct character- ized or interpreted as sexual intimidation or sexual harassment, or intimidation or harass- ment based on a person's gender. Electronic Data The following definition is added to SECTION V - DEFINITIONS: "Electronic data" means information, facts or programs stored as or on, created or used on, or transmitted to or from computer software, including systems and applications software, hard or floppy disks, CD-ROMS, tapes, drives, cell, data pro- cessing devices or any other media which are used with electronically controlled equipment. For the purpose of the Electronic Data Liability coverage provided by this endorsement, Definition 17. "Prop- erty damage" is deleted in its entirety and replaced by the following: 17. "Property damage" means: a. Physical injury to tangible property, includ- ing all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it; or b. Loss of, loss of use of, damage to, corruption of, inability to access, or inability to properly manipulate "electronic data", re- sulting from physical injury to tangible property. All such loss of "electronic data" shall be deemed to occur at the time of the "occurrence" that caused it. For the purpose. of the Electronic Data Liability coverage provided by this endorsement, "electronic data" is not tangible property. Employee Amendment Definition 5. "Employee" under SECTION V - DEFINI- TIONS is deleted in its entirety and replaced by the following: 5. "Employee" includes a "leased worker", or a "temporary worker". If you are a School, "Employee" also includes a student teacher. Golfing Facility The following definition is added to SECTION V - DEFINITIONS: "Golfing facility" means a golf course, golf club, driving range, or miniature golf course. Mental Anguish Amendment (This provision does not apply in New York). Definition 3. "Bodily injury" under SECTION V - DEFINITIONS is deleted in its entirety and replaced with the following: 3. "Bodily injury" means bodily injury, sickness or disease sustained by a person, including death resulting from any of these at any time. This includes mental anguish resulting from any bodily injury, sickness or disease sustained by a person. (In New York, mental anguish has been determined to be "bodily injury"). Not -for-profit Member The following definition is added to SECTION V - DEFINITIONS: "Not -for-profit member" means a person who is a member of a not -for-profit organization, including clubs and churches, who receives no financial or other compensation. Copyright, 2018 Selective Insurance Company of America. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. INSURED'S COPY CG 73 00 01 19 Page 9 of 9 Contract Form New Contract Request Entity Information Entity Name* A-1 CHIPSEAL CO Contract Name* 2022 SLURRY SEAL CONTRACT RENEWAL Contract Status CTB REVIEW Entity ID* OO0022694 Contract ID 6098 Contract Lead* JHOLBROOK ❑ New Entity? Parent Contract ID 5095 Requires Board Approval YES Contract Lead Email Department Project # Jholbrook:Qco.weld.co.us AN -9 Contract Description * THE PROJECT IN GENERAL CONSISTS OF APPLYING BITUMINOUS SEAL COAT TO PAVED ROADS. Contract Description 2 Contract Type* RENEWAL Amount* 9824,842.77 Renewable * YES Automatic Renewal Grant ICA Department PUBLIC WORKS Department Email CM- PublicWorksl weldgov.com Department Head Email CM-PublicWorks- DeptHead.veldgov.com County Attorney GENERAL COUNTY ATTORNEY EMAIL County Attorney Email CM- COU NTYATTO R N EY YWELDG OV.COM If this is a renewal enter previous Contract ID 5095 If this is part of a NSA enter MSA Contract ID Requested BOCC Agenda Date* 07'05:'2022 Due Date 07,02;2022 Will a work session with BOCC be required?* NO Does Contract require Purchasing Dept. to be included? Note: the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts are no On Base Contract Dates Effective Date Review Date* 01 16 2021 Renewal Date* 04 30 2023 Termination Notice Period Committed Delivery Date Expiration Date Contact Information Contact Info Contact Name Contact Type Contact Email Contact Phone 1 Contact Phone 2 Purchasing Purchasing Approver Purchasing Approved Date Approval Process Department Head finance Approver Legal Counsel .CURT1S HALL CHERYL PATTELLI BRUCE BARKER DH Approved Date Finance Approved Date Legal Counsel Approved Date 07'06;2022 07 07 2022 07`07:2022 Final Approval BOCC Approved Tyler Ref # AC 071 122 BOCC Signed Date BOCC Agenda Date 07 1 1 2022 Originator JHOLBROOK WELD COUNTY AGREEMENT FOR CONSTRUCTION SERVICES BETWEEN WELD COUNTY & A-1 CHIPSEAL COMPANY 2021 SLURRY SEAL CONTRACT THIS AGREEMENT is made and entered into thi day of , 2Q, 1, by and between the County of Weld, a body corporate and politic of the State of Colorado, b nd through its Board of County Commissioners, whose address is 1150 "O" Street, Greeley, Colorado 0631 hereinafter referred to as "County," and A-1 Chipseal Company, a corporation, who whose address is 2505 E. 74'h Avenue Denver, CO 80229, hereinafter referred to as "Contractor". and WHEREAS, Various Weld County Roads need Maintenance, (hereinafter referred to as the "Project'), WHEREAS, in the interests of public health, safety and welfare, it is necessary to undertake the maintenance of these roads, and WHEREAS, County requires an independent contract construction professional to perform the construction services required by County and set forth in Exhibit A and B WHEREAS, Contractor is willing to perform and has the specific ability to perform the required Construction Services at or below the cost set forth in Exhibit B. 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 Exhibits A and B, each of which forms an integral part of this Agreement. Exhibits A and B are specifically incorporated herein by this reference. County and Contractor acknowledge and agree that this Agreement, including specifically Exhibits A and B, define the performance obligations of Contractor and Contractor's willingness and ability to meet those requirements. Exhibit A consists of County's Request for Bid (RFB) as set forth in "Bid Package No. BB2100100". The RFP contains all of the specific requirements of County. Exhibit B consists of Contractor's Response to County's Request for Bid. The Response confirms Contractor's obligations under this Agreement. 2. Service or Work. Contractor agrees to procure the materials, equipment and/or products necessary for the Project and agrees to diligently provide all services, labor, personnel and materials necessary to perform and complete the Project described in Exhibit A which is attached hereto and incorporated herein by reference. Contractor shall coordinate with, the Weld County Director of Public Works or other designated supervisory personnel, (the "Manager"), to perform the services described on attached Exhibits A and B. Contractor shall faithfully perform the work in accordance with the standards of professional care, skill, training, diligence and judgment provided by highly competent Contractors performing construction services of a similar nature to those 1- O2,x1 2cb2/ —/690 64-o(27 described in this Agreement. Contractor shall further be responsible for the timely completion, and acknowledges that a failure to comply with the standards and requirements of Exhibits A and B within the time limits prescribed by County may result in County's decision to withhold payment or to terminate this Agreement. In its sole discretion, the County, by the Director of the Department of Public Works or his or her designee, may extend the time for the Contractor to complete the service or work, by not more than thirty (30) days. Such extension shall not increase the compensation to be paid to the Contractor nor change any other term herein. 3. Term. The term of this Agreement begins upon the date of the execution of this Agreement by County, and shall continue through and until Contractor's completion of the responsibilities described in Exhibits A and B. 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. Therefore, within the thirty (30) days preceding the anniversary date of this Agreement, County shall notify Contractor if it wishes to renew this Contract. Allowable annual percentage increase will be based on both the ENR construction cost index and the Denver, Aurora, Lakewood Consumer Price Index. 4. Termination. County has the right to terminate this Agreement, with or without cause on thirty (30) days written notice. Furthermore, this Agreement may be terminated at any time without notice upon a material breach of the terms of the Agreement. However, nothing herein shall be construed as giving Contractor the right to provide materials (or services) under this Agreement beyond the time when such materials (or services) become unsatisfactory to the County. If this Agreement is terminated by County, Contractor shall be compensated for, and such compensation shall be limited to, (1) the sum of the amounts contained in invoices which it has submitted and which have been approved by the County; (2) the reasonable value to County of the materials which Contractor provided prior to the date of the termination notice, but which had not yet been approved for payment; and (3) the cost of any work which the County approves in writing which it determines is needed to accomplish an orderly termination of the work. County shall be entitled to the use of all material generated pursuant to this Agreement upon termination. 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 drawings, drafts or other documents it has completed or partially completed 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. Copies of work product incomplete at the time of termination shall be marked "DRAFT -INCOMPLETE." 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 Modification. 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. Accordingly, no claim that the County has been unjustly enriched by any additional services, whether or not there is in fact any such unjust enrichment, shall be the basis of any increase in the compensation payable hereunder. 6. Compensation/Contract Amount. Upon Contractor's successful completion of the construction of the Project, and County's acceptance of the same, County agrees to pay an amount no greater than $969,452.51, which is the bid set forth in Exhibit B. Contractor acknowledges no payment in excess of that amount will be made by County unless a "change order" authorizing such additional payment has been specifically approved by the Director of Weld County Public Works, or by formal resolution of the Weld County Board of County Commissioners, as required pursuant to the Weld County Code. Any other provision of this Agreement notwithstanding, in no event shall County be liable for payment for services rendered and expenses incurred by Contractor under the terms of this Agreement for any amount in excess of the sum of the bid amount set forth in Exhibit B. Contactor acknowledges that any work it performs beyond that specifically authorized by County is performed at Contractor's risk and without authorization under this Agreement. County shall not be liable for the payment of taxes, late charges or pereliiies of any nature other than the compensation stated herein. 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. 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 from County as a result of the execution of this Agreement. Contractor shall perform its duties hereunder as an independent Contractor. Contractor shall be solely responsible for its acts and those of its agents and employees for all acts performed pursuant to this Agreement. Contractor, its employees and agents are not entitled to unemployment insurance or workers' compensation benefits through County and County shall not pay for or otherwise provide such coverage for Contractor or any of its agents or employees. Contractor shall pay when due all applicable employment taxes and income taxes and local head taxes (if applicable) incurred pursuant to this Agreement. Contractor shall not have authorization, express or implied, to bind County to any agreement, liability or understanding, except as expressly set forth in this Agreement. 8. Subcontractors. Contractor acknowledges that County has entered into this Agreement in reliance upon the paricular reputation and expertise of Contractor. Contractor shall not enter into any subcontractor agreements for the completion of this Project without County's prior written consent, which may L withheld in County's sole discretion. County shall have the right in its reasonable discretion to approve all personnel assigned to the subject Project during the performance of this Agreement and no personnel to whom County has an objection, in its reasonable discretion, shall be assigned to the Project. Contractor shall require each subcontractor, as approved by County and to the extent of the Services 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. Ownership. All work and information obtained by Contractor under this Agreement or individual work order shall become or remain (as applicable), the property of County. In addition, all reports, data, plans, drawings, records and computer files generated by Contractor in relation to this Agreement and all reports, test results and all other tangible materials obtained and/or produced in connection with the performance of this Agreement, whether or not such materials are in completed form, shall at all times be considered the property of the County. Contractor shall not make use of such material for purposes other than in connection with this Agreement without prior written approval of County. 10. Confidentiality. Confidential financial information of Contractor should be transmitted separately from the main bid submittal, clearly denoting in red on the financial information at the top the word, "CONFIDENTIAL." However, Contractor is advised that as a public entity, Weld County must comply with the provisions of C.R.S. 24-72-201, et seq., with regard to public records, and cannot guarantee the confidentiality of all documents. Contractor agrees to keep confidential all of County's confidential information. Contractor agrees not to sell, assign, distribute, or disclose any such confidential information to any other person or entity without seeking written permission from the County. Contractor agrees to advise its employees, agents, and consultants, of the confidential and proprietary nature of this confidential information and of the restrictions imposed by this agreement. 11. Warranty. Contractor warrants that construction services performed under this Agreement will be performed in a manner consistent with the professional construction standards governing such services and the provisions of this Agreement. Contractor further represents and warrants that all construction services shall be performed by qualified personnel in a professional and workmanlike manner, consistent with industry standards, and that all construction services will conform to applicable specifications. In addition to the foregoing warranties, Contractor is aware that all work performed on this Project pursuant to this Agreement is subject to a one year warranty period during which Contractor must correct any failures or deficiencies caused by contractor's workmanship or performance. This warranty shall commence on the date of County's final inspection and acceptance of the Project. 12. 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, incidental material(s), and structures furnished under this Agreement shall not in any way relieve Contractor of responsibility for the quality and accuracy of the construction 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 shall exist 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 construction 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. 13. Insurance and Indemnification. General Requirements: Contractors/Contract Professionals must secure, at or before the time of execution of any agreement or commencement of any work, the following insurance covering all operations, goods or services provided pursuant to this request. Contractors/Contract Professionals 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. The required insurance shall be underwritten by an insurer licensed to do business in Colorado and rated by A.M. Best Company as "A"VIII or better. Each policy shall contain a valid provision or endorsement stating "Should any of the above - described policies by canceled or should any coverage be reduced before the expiration date thereof, the issuing company shall send written notice to the Weld County Director of General Services by certified mail, return receipt requested. Such written notice shall be sent thirty (30) days prior to such cancellation or reduction unless due to non-payment of premiums for which notice shall be sent ten (10) days prior. If any policy is in excess of a deductible or self -insured retention, County must be notified by the Contractor/Contract Professional. Contractor/Contract Professional shall be responsible for the payment of any deductible or self -insured retention. County reserves the right to require Contractor/Contract Professional to provide a bond, at no cost to County, in the amount of the deductible or self -insured retention to guarantee payment of claims. The insurance coverage's specified in this Agreement are the minimum requirements, and these requirements do not decrease or limit the liability of Contractor/Contract Professional. 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 this Contract by the Contractor, its agents, representatives, employees, or subcontractors. 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. Any modification to these requirements must be made in writing by Weld County. The Contractor stipulates that it has met the insurance requirements identified herein. The Contractor shall be responsible for the professional quality, technical accuracy, and quantity of all construction services provided, the timely delivery of said services, and the coordination of all services rendered by the Contractor and shall, without additional compensation, promptly remedy and correct any errors, omissions, or other deficiencies. Indemnity: The Contractor shall defend, indemnify and hold harmless County, its officers, agents, and employees, from and against injury, loss damage, liability, suits, actions, or claims of any type or character arising out of the work done in fulfillment of the terms of this Contract 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, 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, or on account of or in consequence of neglect of the Contractor in its construction methods or procedures; or in its provisions of the materials required herein, or from any claims or amounts arising or recovered under the Worker's Compensation Act, or other law, ordinance, order, or decree. This paragraph shall survive expiration or termination hereof. 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. Types of Insurance: The Contractor/Contract Professional shall obtain, and maintain at all times during the term of any Agreement, insurance in the following kinds and amounts: Workers' Compensation Insurance as required by state statute, and Employer's Liability Insurance covering all of the Contractor's Contract Professional's employees acting within the course and scope of their employment. 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. Minimum Limits: Coverage A (Workers' Compensation) Coverage B (Employers Liability) Statutory $ 500,000 $ 500,000 $ 500,000 Commercial General Liability Insurance written on ISO occurrence form CG 00 01 equivalent, covering premises operations, explosions, collapse and underground hazard, personal advertising injury, fire damage, independent Contractors, products and completed operations, blanket contractual liability, personal injury, and liability assumed under an insured contract. The policy shall be endorsed to include 1) the Additional Insured Endorsements CG 2010 (or equivalent), 2) CG 2037 Additional Insured for products/completed operations, and 3) the Designated Construction Projects General Aggregate Endorsement CG 2503. The policy shall be endorsed to include the following additional insured language on the additional insured endorsements specified above: "Weld County, its subsidiary, parent, associated and/or affiliated entities, successors, or assigns, its elected officials, trustees, employees, agents, and volunteers named as an additional insured with respect to liability and defense of suits arising out of the activities performed by, or on behalf of the Contractor, including completed operations" and the minimum limits must be as follows: $1,000,000 each occurrence; $2,000,000 general aggregate; $2,000,000 products and completed operations aggregate; $1,000,000 Personal Advertising injury $50,000 any one fire; and $500,000 errors and omissions. $5,000 Medical payment one person Automobile Liability: Contractor/Contract Professional 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. For all general liability, excess/umbrella liability, liquor liability, pollution liability and professional liability policies, if the policy is a claims -made policy, the retroactive date must be on or before the contract date or the first date when any goods or services were provided to County, whichever is earlier. Contractors/Contract Professionals shall secure and deliver to the County at or before the time of execution of this Agreement, and shall keep in force at all times during the term of the Agreement as the same may be extended as herein provided, a commercial general liability insurance policy, including public liability and property damage, in form and company acceptable to and approved by said Administrator, covering all operations hereunder set forth in the related Bid or Request for Proposal. Proof of Insurance: County reserves the right to require the Contractor/Contract Professional to provide a certificate of insurance, a policy, or other proof of insurance as required by the County's Risk Administrator in his sole discretion. Additional Insureds: For general liability, excess/umbrella liability, pollution legal liability, liquor liability, and inland marine, Contractor/Contract Professional's insurer shall name County as an additional insured. Waiver of Subrogation: For all coverages, Contractor/Contract Professional's insurer shall waive subrogation rights against County. Subcontractors: All subcontractors, subcontractors, independent Contractors, sub -vendors, suppliers or other entities providing goods or services required by this Agreement shall be subject to all of the requirements herein and shall procure and maintain the same coverage's required of Contractor/Contract Professional. Contractor/Contract Professional shall include all such subcontractors, independent Contractors, sub -vendors suppliers or other entities as insureds under its policies or shall ensure that all subcontractors maintain the required coverages. Contractor/Contract Professional agrees to provide proof of insurance for all such subcontractors, independent Contractors, sub -vendors suppliers or other entities upon request by the County. 14. 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. 15. Examination of Records. To the extent required by law, the Contractor agrees that any 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. The Contractor agrees to maintain these documents for three years from the date of the last payment received. 16. 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. 17. Notices. County may designate, prior to commencement of work, its project representative ("County Representative") who', shall make, within the scope of his or her authority, and all necessary and proper decisions with reference to the project. All requests for contract interpretations, change orders, and other clarification or instruction shall be directed to County Representative. The County Representative for purposes of this Agreement is hereby identified as, Director of Weld County Department of Public Works, or his designee. All notices or other communications (including annual maintenance 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 by the sending party; or d) transmission via facsimile, at the number set forth below, where a receipt or acknowledgment is required by the sending party. Either party may change its notice address(es) by written notice to the other. Notification Information: Contractor: A-1 Chipseal Company Attn.: Daniel J. Gryzmala, President Address: 2505 E. 74th Avenue Denver, Co 80229 Facsimile: (303) 464.9267 County: Name: Joshua J. Holbrook Position: Pavement Management Supervisor Address: 1111 H street, Greeley CO 80632 E-mail: Jholbrook@weldgov.com Facsimile: (970)400.3744 18. 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. 19. 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. 20. 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. 21. 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. 22. Employee Financial Interest/Conflict of Interest — C.R.S. §§24-18-201 et seq. and §24-50-507. The signatories to this Agreement agree 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. County has no interest and shall not acquire any interest direct or indirect, that would in any manner or degree interfere with the performance of Contractor's services and Contractor shall not employ any person having such known interests. During the term of this Agreement, Contractor shall not engage in any in any business or personal activities or practices or maintain any relationships which actually conflicts with or in any way appear to conflict with the full performance of its obligations under this Agreement. Failure by Contractor to ensure compliance with this provision may result, in County's sole discretion, in immediate termination of this Agreement. No employee of Contractor nor any member of Contractor's family shall serve on a County Board, committee or hold any such position which either by rule, practice or action nominates, recommends, supervises Contractor's operations, or authorizes funding to Contractor. 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 tie parties. 24. Governmental Immunity. No term or condition of this contract 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 ofthis 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 contract. 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 of the State of Colorado program established pursuant to C.R.S. §8-17.5- 102(5)(c). Contractor shall not knowingly employ or contract with an illegal alien to perform work under this Agreement or 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 the public contract for services 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 contract 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 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 a 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. Official Engineering Publications: Contractor acknowledges and agrees that the Colorado Department of Transportation "Standard Specifications for Road and Bridge Construction" and the Colorado Department of Transportation Standard Plans "M & S Standards" establish the requirements for all work performed by Contractor under this Agreement, and Contractor agrees to meet or exceed all standards set by these publications. Contractor further acknowledger and agrees that a failure to meet the standards set by these publications may result in withholding by County of some or all of the Contract Amount. 30. Attorneys 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. 31. 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. 32. Public Contracts for Services C.R.S. §8-17-101. For public contracts in excess of $500,000 annually, or for public contracts for road or bridge construction in excess of $50,000, Contractor certifies, warrants, and agrees that Colorado labor shall be employed to perform at least eighty percent of the work under this Contract. "Colorado labor" means any person who is a resident of the state of Colorado at the time of the public works project, who can provide a valid Colorado driver's license, a valid Colorado state -issued photo identification, or documentation that he or she has resided in Colorado for the last thirty days. The County, in its sole discretion, may waive the eighty percent requirement if there is reasonable evidence to demonstrate insufficient Colorado labor is available to perform the work, and this requirement would create an undue burden that would substantially prevent the work from proceeding to completion. This section shall not apply to any project which is funded in whole or in part with federal funds, or where otherwise contrary to federal law. 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 A and B, 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. j r7-- IN WI NESS WHEREOF, the parties hereto have signed this Agreement this 'T day of CONTACTOR: £ By: Name: •,. , Title: , 20A. a . �qeN»rs�� y p h��s a �t 1 Co`ji RP• AR .a ' • GNL� '��te ex- •P.r i% . . /09/1932 i = OR. ., WELD COU ATTEST: Weld 'ou tv lerk to th- = •ard BY: Deputy CI T to t BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO Steve Moreno, Chair 'AUG 0 2 2021 02,0W- /590 b.xnibit A BID REQUEST NO. B2100100 WELD COUNTY DEPARTMENT OF PUBLIC WORKS CONTRACT BID DOCUMENTS AND SPECIFICATIONS FOR PROJECT: SLURRY SEAL CINT CT 2021 (With Renewal Options for 2020/2021) May 2021 Weld County Public Works Pavement Management Division P.O. Box 758 1111 H Street Greeley, Colorado 80632 970-304-6496 BID NO. B2100100 Page - 1- TABLE OF CONTENTS The following checked forms and provisions take precedence over plan drawings and supplement the most current edition cf the Colorado Department of Transportation "Standard Specifications for Road and Bridge Construction" (Standard Specifications) which is to be used to administer the construction of this project. BIDDING REQUIREMENTS: *All Bidders must submit these forms with their Bid. Notice to Bidders 3 Invitation for Bids 4 Instructions to Bidders 4-14 Bid Proposal 15-16 * Bid Schedule 17-18 * Bid Bond 19-20 * IRS Form W-9 21 *Statement of Qualifications and Subcontractors 22-25 WELD COUNTY CONTRACT FORMS: **Low Bidder must submit these forms prior to Contract Award. **Notice of Award 26 **Sample Agreement 27-37 **Performance Bond 38 **Labor and Materials Payment Bond 39-40 N otice to Proceed 41 Certificate of Substantial completion 42 Lien Waiver 43-45 N otice of Acceptance 46 WELD COUNTY PROJECT SPECIAL PROVISIONS: Special Provisions Index 47 Project Special Provisions 48-80 Appendix: Estimated Quantities .82-83 Project Location Map 84-87 61J' X. T&Il tifr 4 NNSl OLZBESEMESSIM BID NO. B2100100 Page - 2 - REQUEST FOR BID WELD COUNTY, COLORADO 1150 O STREET GREELEY, CO 80631 DATE: May 27, 2021 BID NUMBER: 82100100 DESCRIPTION: 2021 Slurry Seal Contract BID OPENING DATE: June 16, 2021 1. NOTICE TO BIDDERS: The Board of County Commissioners of Weld County, Colorado, by and through its Controller/Purchasing Director (collectively referred to herein as, "Weld County"), wishes to purchase the following: 2021 Slurry Seal and Sand Seal Contract The project in general consists of applying bituminous seal coat to paved surfacing. Bids for the above stated merchandise, equipment, and/or services will be received until 10:00 AM on JUNE 16, 2021 (Weld County Purchasing Time Clock). Due to COMM -1 , the bbd opening he heM vii a ,,ibl icrosoft Teams Conference C , N. join, C2 the phone number and enter the Conference _D provioie b&o ,y: Due to COVID-19, instead of an "in -person" bid opening, the submitted proposals will be read over a Microsoft Teams Conference Call on JUNE 16 , 2021 at 10:30 AM (MDT). To join, call the phone number and enter the Conference ID provide below: Phone N Im a r (721.) 439=5261 Conference The Contractor services will be requested by the County on an as -needed basis by issuing individual Internal Accounting forms (lAs) (aka "work order"). For each IA, the County will provide basic project information so the Contractor can prepare a detailed scope of work and cost estimate. The IA will be signed by both Weld County and the Contractor. This is an on -call construction services agreement. There is no guarantee that the County will need or utilize the services of the Contractor in any given year. There is no retainer paid by the County. The Contractor understands and agrees that there are no guarantees of specific tasks or quantities of services associated with the construction services agreement. The Contractor may or may not perform the erosion control and seeding services as circumstances require. Furthermore, the County is in no way obligated to utilize the Contractor in every applicable situation encountered. The construction services agreement shall commence on the date the Agreement is signed by the Board of County Commissioners and shall continue in full force until December 31, 2021. At the option of the County, the agreement may be extended for up to two additional one-year periods beginning on January 1 and ending on December 31. If the agreement is renewed, the Consultant will have the opportunity to revise the contract fee schedule in accordance with the "U.S. Bureau of Labor Statistics Consumer Price Index for Denver, Aurora, Lakewood, All Items, All Urban Consumers, Seasonally Unadjusted" or its successor index. PAGES 1 - 12 OF THIS REQUEST FOR BIDS CONTAIN GENERAL INFORMATION FOR THE REQUEST NUMBER REFERRED TO ABOVE. NOT ALL OF THE INFORMATION CONTAINED IN BID NO. B2100100 Page - 3 - PA ES1— MAY BE APPLICABLE F ERY PURCHASE. B D SPECiF&CS LL'W PAGE 120 20 IN eld C services. Li b I ITATION TO ==ID: my requests bids f: r the purchase of the above -listed merchandise, equipment, and/or ids shah include any and all charges for freight, delivery, containers, packaging, less all taxes eind discunts, arind shall, in every way, be the total n t price which the bidder will expect thr W id Cunty t pay if awarded the bid. PJlerchndise and/or equipment shall be delivered to the locations) specified herein. r Information concerning this request can be und on the BidNet Direct w bsite at www.bidnetdirect.com. Weld County Governren is a member of BidNet Direct. BidNet Direct is an on-line notification system which is being utilized by mu tiple non- prfit and governmenta entities. Participating entities post their bids, quotes, proposa s, addendums, and ;irds of this one centralized system. Bid Delivery to Weld County. 1. Email. Due tai, the Coronavirus (C•V1t-19), emailed 7 Ns are required. zios r ay b emailed to bids ►,weldgov.com; however, if your bid exceeds 25MB please upload your bid t https://www.bidnetdirect.com. The maximum file size to upload to BidNet is 500 MB. P format is requiired. Emailed bids must include the following statement on the email: "I hereby Mve my right to a sealed bid". An email confirmation will be sent when we receive your bid/proposal. Please call Purchasing at 970-400-4223 or 4222 with any questions. 3. INSTRUCTION `. TO BIDDERS: INTRODUCTORY INFORMATION Bids shall be typewritten or written in ink on forms prepared by the Weld County Purchasing Department. Each bid must give the full business address .f bidder and be signed by him with his usual signature. Bids by partnerships must furnish the full names of all partners and must be signed with the partnership name by one of the members of the partnership or by an authorbzed representative, foil- wed by the signature and title of the person signing. Bids by corporations must be signed with the legal name of the corps ration, followed by the name f the state f the incorporation and by the signature and title of the president, secretary, or other person authorized to bind it in the matter. The name of each person signing shall also be typed or printed below the signature. A bid by a person ho affixes to {pis signature the word "president," "secretary," "agent," or other title without disclosing his principal, may be held to the bid of the individual signing. When requested by the Weld County Controller/Purchasing Direct., satisfactory evidence of the authority of the officer signing in behalf of corpor tion shall be furnished. All corrections or erasures shall be initialed by the person signing the bid. All bidders sha I agree to c.mply with all of the conditions, requirements, specifications, and/or instructions f this big as stated or implied herein. All designations and prices stall be fully and clearly set forth. All blank spaces in the bid forms shall be suitably filltd in. 4 Bids may be withdrawn upon written request to and approval of the Weld County Controller/Purchasing Directo; said request being received from the withdrawing bidder prior tthe time fixed for award. Negligence or the part of a bidder in preparing the bid confers no right fo: the withdraal of the bid after it h s b -gin awarded. YJ Late or unsigned bids shall not be accepted or considered. it is the respc lnsibility of the bidder t. ensure that the bid arrives in the Weld County Purchasing Department on or prior to the time indicated BID NO. B2100100 IL-%%7EISMEggelatun5gfir..: • u r'� ae ,.'� u`,a"i%'aztiii Page-4- in Section 1., entitled, "Notice to Bidders." Bids received prior to the time of opening will be kept unopened in a secure place. No responsibility will attach to the Weld County Controller/Purchasing Director for the premature opening of a bid not properly addressed and identified. In accordance with Section 14-9(3) of the Weld County Home Rule Charter, Weld County will give preference to resident Weld County bidders in all cases where said bids are competitive in price and quality. Weld County reserves the right to reject any and all bids, to waive any informality in the bids, to award the bid to multiple vendors, 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. Terms Defined: Terms used in these instructions to Bidders and elsewhere throughout the Contract Documents are defined in the General Provisions, CDOT, Standard Specification for Road and Bridge Construction, Section 101 and project special provisions. Qualification of Bidders: Qualification statements, attached with this document, are required to be completed by Bidders. If requested by Weld County, a Statement of Qualifications will be completed for the Subcontractors listed by the Contractor within 72 hours of the request. Failure to submit qualifications may be cause for rejection of Bids. The Owner shall consider the following criteria in evaluating the Bidder's qualifications following the opening of Bids: Experience and performance records on similar work. Ability to complete the Work within the Contract Time. Familiarization with the Work: Before submitting his Bid, each prospective Bidder shall familiarize himself with the Work, the site where the Work is to be performed, local labor conditions and all local, state and federal laws, ordinances, rules, regulations and other factors affecting performance of the Work. He shall carefully correlate his observations with requirements of the Contract Documents and Drawings and otherwise satisfy himself of the expense and difficulties attending performance of the Work. The submission of a Bid will constitute an incontrovertible representation by the Bidder that he has complied with every requirement of this paragraph. Interpretation of Contract Documents to Prospective Bidders: Any prospective Bidder who discovers ambiguities or is in doubt as to the true meaning of any part of the Contract Documents or Drawings shall make a request to the Engineer for an interpretation thereof. Interpretations will be made only by Addenda, duly issued, and copies of each Addendum will be mailed or delivered to each Contract Document holder of record. Unless approved by the Controller/Purchasing Director, no interpretation Addenda will be issued within the last seven (7) days before the date set for opening of Bids. The Bidder shall be solely responsible for any interpretation of the Contract Documents or Drawings other than by duly issued Addenda. Preparation of the Bid: Bidders are required to use the Proposal Forms which are included in this package and on the basis indicated in the Bid Forms. The Bid Proposal must be filled out completely, in detail, and signed by the Bidder. Bids by partnerships must be executed in the partnership name and signed by a partner. His title must appear under his signature and the official address of the partnership must be shown below the signature. Bids by corporations must be executed in the corporate name by the president or a vice president (or other corporate officer accompanied by evidence of authority to sign) and the corporate seal shall be affixed and attested by the secretary or an assistant secretary. The corporate address and state of incorporation shall be shown below the signature. Names of all persons signing must be printed below their signatures. A power of attorney must accompany the signature of anyone not otherwise authorized to bind the Bidder. BID NO. B2100100 Page - 5 - Modification or Withdrawal of Bid: Bids may be modified or withdrawn by an appropriate document duly executed in the manner that a Bid must be executed, and delivered to the place where Bids are to be submitted at any time prior to the final time set for receiving Bids. Bidders may modify or withdraw Bids by electronic communication at any time prior to the time set for receiving Bids provided the instruction is positively identified. Any electronic modification should not reveal the amended Bid price, but should provide only the addition, subtraction or modification. A duly executed document confirming the electronic modification shall be submitted within three days after Bids are opened. The Controler/Pkxchasing Dicta'may at her sole discretion, release any Bid at any time. 4. AWARD AND EXECUTION OF CONTRACT Basis of Award: Only irm Bids will be considered. The award of the Contract, if it is awarded, will be to the lowest responsible b dder whose Bid compares favorably upon evaluation with other Bids. We I d County intends to award the Contract to the lowest responsible Bidder within the limits of funds available and to best serve its interests. The County reserves the right to waive informalities and/or irregularities and to reject any or all bids. Evaluation of Bids: The evaluation of Bids will include consideration of Subcontractors and suppliers. All Bidders shall submit a I st of all Subcontractors he expects to use in the Work with the Bid. The experience statement wii h pertinent information on similar Projects shall be furnished with the name of each Subcontractor proposed to perform work on the project. The use of Subcontractors listed by the Bidder and accepted by unty prior to the Notice of Award will be required in the performance of the Work. All Bidders shall ubmit with their Bid a list of the suppliers as indicated in the Bid Forms. Contract Execution: Th successful Bidder shall be required to execute the Contract and to furnish the Performance Bond, Labor & Materials Payment Bond and Certificate of Insurance within ten (10) calendar days of recap of the Notice of Award. The Certificate of Insurance shall name Weld County as additional i sured. Failure to execute the contract and furnish the required paperwork within the time frame me tioned above shall be just cause for the annulment of the Award and, in the event of such annulment, he Award may then be made to another Bidder, or the County may reject all Bids or call for other Bids. Tfi County, within ten (10) days of receipt of acceptable Performance Bid, Labor & Materials Payment Bond, and signed Contract from the successful Bidder will issue the Notice to Proceed. In submitting the bid, t e bidder agrees that the signed bid submitted, all of the documents of the Request for Propo I contained herein (including, but not limited to, product specifications and scope of services), the successful bidder's response, and the formal acceptance of the bid by Weld County, toget er constitutes a contract, with the contract date being the date of formal acceptance of the bid y Weld County. The County may require a separate contract, which if required, has been ma e a part of this RFB. 5. PERFORMANCE, LABOR, MATERIAL AND PAYMENT BOND The successful Bidder Payment Bond in the a covering the faithful pelo Bonds shall be execute authorized to do bus Ine; Bidder shall deliver the Bc hall be required to execute the Performance Bond and Labor & Materials nount of 100% of the Contract plus the value of the force account items, mance of the Contract and the payment of all obligations arising there -under. The i on the forms included with the Contract Documents by a surety company s in the State of Colorado and acceptable as surety to Weld County. The nds to the Owner not later than the date of execution of the Contract. 6. INDIRECT COSTS BID NO. B2100100 Page - 6 - Governmental Fees: The cost of all construction licenses, building and other permits, and governmental inspections required by public authorities for performing the Work, which are applicable at the time Bids are opened and which are not specified to be obtained by the County, shall be included in the Bid price. Royalties: The cost of all royalties and license fees on equipment and materials to be furnished and incorporated in the Work shall be included in the Bid price. Utilities: Unless otherwise specified, the Bidder shall include in his Bid the cost of all electrical, water, sani ry, gas, telephone, and similar facilities and services required by him in performing the Work. Cash Allowances: The Bidder shall include in his Bid such sums as he deems proper for overhead costs and profits on account of cash allowances named in the Bid Documents. 7. SITE CONDITIONS Familiarization with the Site: The prospective Bidder shall by careful examination, satisfy himself of the following: Nature and location of the site where the Work is to be performed. Character, quality, and quantity of surface and subsurface materials, water, structures and utilities to be encountered. Character of construction equipment and facilities needed for performance of the Work. General local conditions. Availability of lands as set forth in the General Conditions. Access to the Site: The Bidder shall carefully review the Drawings and the Project Special Conditions for provisions concerning access to the site during performance of the Work. The Bidder shall carefully review the locations of the site where the work is to be performed. The Bidder shall make all arrangements, as deemed necessary, for access to property outside of County Right of Way, prior to beginning the work. 8. SUCCESSFUL BIDDER HIRING PRACTICES - ILLEGAL ALIENS Successful bidder certifies, warrants, and agrees that it does not knowingly employ or contract with an illegal alien who will perform work under this contract. Successful bidder 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). Successful bidder shall not knowingly employ or contract with an illegal alien to perform work under this Agreement or enter into a contract with a subcontractor that fails to certify with Successful bidder that the subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this Agreement. Successful bidder 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 Successful bidder obtains actual knowledge that a subcontractor performing work under the public contract for services knowingly employs or contracts with an illegal alien Successful bidder shall notify the subcontractor and County within three (3) days that Successful bidder 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. Successful bidder BID NO. B2100100 Page - 7 - shall not terminate the contract if within three days the subcontractor provides information to establish that the subcontractor has not knowingly employed or contracted with an illegal alien. Successful bidder shall comply with reasonable requests made in the course of an investigation, undertaken pursuant to C.R.S. §8-17.5-102(5), by the Colorado Department of Labor and Employment. If Successful bidder participates in the State of Colorado program, Successful bidder shall, within twenty days after hiring a new employee to perform work under the contract, affirm that Successful bidder has examined the legal work status of such employee, retained file copies of the documents, and not altered or falsified the identification documents Ifor such employees. Successful bidder 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 Successful bidder 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, Successful bidder 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 Successful bidder receives federal or state funds under the contract, Successful bidder 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 Successful bidder 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 tp 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. 9. GENERAL PROVISIONS A. Fund Availability Financial obligations of the Weld County payable after the current fiscal year are contingent upon fund for that purpose being appropriated, budgeted and otherwise made available. By acceptance f the bid, Weld County does not warrant that funds will be available to fund the contract beyond the c rrent fiscal year. B. Confidential Info mation: Confidential information of the bidder should be transmitted separately from the main id submittal, clearly denoting in red on the information at the top the word, "CONFIDENTIAL." Howe er, the successful bidder is advised that as a public entity, Weld County must comply with the provision of C.R.S. 24-72-201, et seq., the Colorado Open Records Act (CORA), with regard to public records, nd cannot guarantee the confidentiality of all documents. If Weld County receives a CORA request for bid information marked "CONFIDENTIAL", staff will withhold any information which is clearly marked CONFIDENTIAL and submitted separately. Weld County staff will not be responsible for red cting or identifying Confidential information which is included within the body of the bid and not separat ly identified. C. Governmental Immunity: No term or condition of the contract shall be construed or interpreted as a waiver, express or ir%plied, of any of the immunities, rights, benefits, protections or other provisions, of the Colora 4 o Governmental Immunity Act §§24-10-101 et seq., as applicable now or hereafter amended. D. Independent Con ractor: The successful bidder shall perform its duties hereunder as an independent contractor and not as an employee. He or she shall be solely responsible for its acts and those of its agents and employees for all acts performed pursuant to the contract. Neither the successful bidder nor any agent or employee thereof shall be deemed to be an agent or employee of BID NO. B2100100 Page - 8 - Weld County. The successful bidder and its employees and agents are not entitled to unemployment insurance or workers' compensation benefits through Weld County and Weld County shall not pay for or otherwise provide such coverage for the successful bidder or any of its agents or employees. Unemployment insurance benefits will be available to the successful bidder and its employees and agents only if such coverage is made available by the successful bidder or a third party. The successful bidder shall pay when due all applicable employment taxes and income taxes and local head taxes (if applicable) incurred pursuant to the contract. The successful bidder shall not have authorization, express or implied, to bind Weld County to any agreement, liability or understanding, except as expressly set forth in the contract. The successful bidder shall have the following responsibilities with regard to workers' compensation and unemployment compensation insurance matters: (a) provide and keep in force workers' compensation and unemployment compensation insurance in the amounts required by law, and (b) provide proof thereof when requested to do so by Weld County. E. Compliance with Law: The successful bidder 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. F. Choice of Law: Colorado law, and rules and regulations established pursuant thereto, shall be applied in the interpretation, execution, and enforcement of the contract. Any provision included or incorporated herein by reference which conflicts with said laws, rules and/or regulations shall be null and void. G. No Third -Party Beneficiary Enforcement: It is expressly understood and agreed that the enforcement of the terms and conditions of the contract, and all rights of action relating to such enforcement, shall be strictly reserved to the undersigned parties and nothing in the contract shall give or allow any claim or right of action whatsoever by any other person not included in the contract. It is the express intention of the undersigned parties that any entity other than the undersigned parties receiving services or benefits under the contract shall be an incidental beneficiary only. H. Attorney's Fees/Legal Costs: In the event of a dispute between Weld County and the successful bidder, concerning the contract, the parties agree that Weld County shall not be liable to or responsible for the payment of attorney fees and/or legal costs incurred by or on behalf of the successful bidder. Disadvantaged Business Enterprises: Weld County assures that disadvantaged business enterprises will be afforded full opportunity to submit bids in response to all invitations and will not be discriminated against on the grounds of race, color, national origin, sex, age, or disability in consideration for an award. J. Procurement and Performance: The successful bidder agrees to procure the materials, equipment and/or products necessary for the project and agrees to diligently provide all services, labor, personnel and materials necessary to perform and complete the project. The successful bidder shall faithfully perform the work in accordance with the standards of professional care, skill, training, diligence and judgment provided by highly competent contractors performing construction services of a similar nature to those described in this Agreement. The successful bidder shall further be responsible for the timely completion, and acknowledges that a failure to comply with the standards and requirements outlined in the Bid within the time limits prescribed by County may result in County's decision to withhold payment or to terminate this Agreement. K. Term: The term of this Agreement begins upon the date of the execution of this Agreement by County, BID NO. B2100100 Page - 9 - and shall continue through and until successful bidder's completion of the responsibilities described in the Bid. L. Termination: County has the right to terminate this Agreement, with or without cause on thirty (30) days written notice. Furthermore, this Agreement may be terminated at any time without notice upon a material breach of the terms of the Agreement. M. Extension or Modification: Any amendments or modifications to this agreement shall be in writing signed by both parties. No additional services or work performed by the successful bidder shall be the basis for additional compensation unless and until the successful bidder has obtained written authorization and acknowledgement by County for such additional services. Accordingly, no claim that the County has been unjustly enriched by any additional services, whether or not there is in fact any such unjust enrichment, shall be the basis of any increase in the compensation payable hereunder. In the event that written authorization and acknowledgment by the County for such additional services is not timely executed and issued in strict accordance with this Agreement, The successful bidder's rights with respect to such additional services shall be deemed waived and such failure shall result in non- payment for such additional services or work performed. N. Subcontractors: The successful bidder acknowledges that County has entered into this Agreement in reliance upon the particular reputation and expertise of the successful bidder. The successful bidder shall not enter into any subcontractor agreements for the completion of this Project 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 subject Project during the performance of this Agreement and no personnel to whom County has an objection, in its reasonable discretion, shall be assigned to the Project. The successful bidder shall require each subcontractor, as approved by County and to the extent of the Services to be performed by the subcontractor, to be bound to the successful bidder by the terms of this Agreement, and to assume toward the successful bidder all the obligations and responsibilities which the successful bidder, 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 the successful bidder and the successful bidder shall cooperate in such process. The successful bidder shall be responsible for the acts and omissions of its agents, employees and subcontractors. 0. Warranty. Contractor warrants that construction services performed under this Agreement will be performed in a manner consistent with the professional construction standards governing such services and the provisions of this Agreement. Contractor further represents and warrants that all construction services shall be performed by qualified personnel in a professional and workmanlike manner, consistent with industry standards, and that all construction services will conform to applicable specifications. In addition to the foregoing warranties, Contractor is aware that all work performed on this Project pursuant to this Agreement is subject to a one year warranty period during which Contractor must correct any failures or deficiencies caused by contractor's workmanship or performance. This warranty shall commence on the date of County's final inspection and acceptance of the Project. P. Non -Assignment. The successful bidder may not assign or transfer this Agreement or any interest therein or claim thereunder, without the prior written approval of County. Any attempts by the successful bidder 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 the successful bidder hereunder. Such consent may be granted or denied at the sole and absolute discretion of County. Q. 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 BID NO. B2100100 Page -10 - to any cause beyond its reasonable control, including but not limited to Acts of God, fires, strikes, war, flood, earthquakes or Governmental actions. R. 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. S. Employee Financial Interest/Conflict of Interest — C.R.S. §§24-18-201 et seq. and §24-50- 507. The signatories to this Agreement agree 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. County has no interest and shall not acquire any interest direct or indirect, that would in any manner or degree interfere with the performance of the successful bidder's services and the successful bidder shall not employ any person having such known interests. During the term of this Agreement, the successful bidder shall not engage in any in any business or personal activities or practices or maintain any relationships which actually conflicts with or in any way appear to conflict with the full performance of its obligations under this Agreement. Failure by the successful bidder to ensure compliance with this provision may result, in County's sole discretion, in immediate termination of this Agreement. No employee of the successful bidder nor any member of the successful bidder's family shall serve on a County Board, committee or hold any such position which either by rule, practice or action nominates, recommends, supervises the successful bidder's operations, or authorizes funding to the successful bidder. T. 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. U. 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. V. Compensation Amount. Upon the successful bidder's successful completion of the construction of the Project, and County's acceptance of the same, County agrees to pay an amount no greater than the amount of the accepted bid. The successful bidder acknowledges no payment in excess of that amount will be made by County unless a "change order" authorizing such additional payment has been specifically approved by the Director of Weld County Public Works, or by formal resolution of the Weld County Board of County Commissioners, as required pursuant to the Weld County Code. County will not withhold any taxes from monies paid to the successful bidder hereunder and the successful bidder 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 10. INSURANCE REQUIREMENTS General Requirements: Successful bidders/Contract Professionals must secure, at or before the time of execution of any agreement or commencement of any work, the following insurance covering all operations, goods or services provided pursuant to this request. Successful bidders/Contract Professionals 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. The required insurance shall be underwritten by an insurer licensed to do business in Colorado and rated by A.M. Best Company as "A" VIII or better. Each policy shall contain a valid provision or endorsement stating "Should any of the above -described policies by canceled or should any coverage be reduced before the expiration date thereof, the issuing company shall send written notice to the Weld County Controller/Purchasing Director by certified mail, return receipt requested. Such written notice shall be sent thirty (30) days prior BID NO. B2100100 Page - 11 - to such cancellation or reduction unless due to non-payment of premiums for which notice shall be sent ten (10) days prior. If any policy is in excess of a deductible or self -insured retention, County must be notified by the Successful bidder/Contract Professional. Successful bidder/Contract Professional shall be responsible for the payment of any deductible or self -insured retention. County reserves the right to require Successful bidder/Contract Professional to provide a bond, at no cost to County, in the amount of the deductible or self -insured retention to guarantee payment of claims. The insurance coverages specified in this Agreement are the minimum requirements, and these requirements do not decrease or limit the liability of Successful bidder/Contract Professional. The County in no way warrants that the minimum limits contained herein are sufficient to protect the Successful bidder from liabilities that might arise out of the performance of the work under this Contract by the Successful bidder, its agents, representatives, employees, or subcontractors. The successful bidder shall assess its own risks and if it deems appropriate and/or prudent, maintain higher limits and/or broader coverages. The successful bidder 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 successful bidder/Contract Professional 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. Any modification to these requirements must be made in writing by Weld County. The successful bidder stipulates that it has met the insurance requirements identified herein. The successful bidder shall be responsible for the professional quality, technical accuracy, and quantity of all construction services provided, the timely delivery of said services, and the coordination of all services rendered by the successful bidder and shall, without additional compensation, promptly remedy and correct any errors, omissions, or other deficiencies. INDEMNITY: The successful bidder shall defend, indemnify and hold harmless County, its officers, agents, and employees, from and against injury, loss damage, liability, suits, actions, or claims of any type or character arising out of the work done in fulfillment of the terms of this Contract or on account of any act, claim or amount arising or recovered under workers' compensation law or arising out of the failure of the successful bidder to conform to any statutes, ordinances, regulation, law or court decree. The successful bidder 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, or on account of or in consequence of neglect of The successful bidder in its construction methods or procedures; or in its provisions of the materials required herein, or from any claims or amounts arising or recovered under the Worker's Compensation Act, or other law, ordinance, order, or decree. This paragraph shall survive expiration or termination hereof. It is agreed that the successful bidder 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 successful bidder 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 successful bidder for the County. A failure to comply with this provision shall result in County's right to immediately terminate this Agreement. Types of Insurance: The successful bidder/Contract Professional shall obtain, and maintain at all times during the term of any Agreement, insurance in the following kinds and amounts: Workers' Compensation Insurance as required by state statute, and Employer's Liability Insurance covering all of the successful bidder's Contract Professional's employees acting within the course and scope of their employment. Policy shall contain a waiver of subrogation against the County. This requirement shall not apply when a successful bidder or subcontractor is exempt under Colorado BID NO. B2100100 Page -12 - Workers' Compensation Act., AND when such successful bidder or subcontractor executes the appropriate sole proprietor waiver form. Minimum Limits: Coverage A (Workers' Compensation) Coverage B (Employers Liability) Statutory $ 500,000 $ 500,000 $ 500,000 Commercial General Liability Insurance written on ISO occurrence form CG 00 01 10/93 or equivalent, covering premises operations, explosions, collapse and underground hazard, personal advertising injury, fire damage, independent Contractors, products and completed operations, blanket contractual liability, personal injury, liability assumed under an insured contract (including defense costs assumed under contract, designated construction projects(s) general aggregate limit, ISO CG 2503 or equivalent additional insured —owners, lessees or successful bidders endorsement, ISO Form 2010 or equivalent, additional insured —owners, lessees or successful bidders endorsement, ISO CG 2037 or equivalent, the policy shall be endorsed to include the following additional insured language on the additional insured endorsements specified above: "Weld County, its subsidiary, parent, associated and/or affiliated entities, successors, or assigns, its elected officials, trustees, employees, agents, and volunteers named as an additional insured with respect to liability and defense of suits arising out of the activities performed by, or on behalf of the Successful bidder, including completed operations" and the minimum limits must be as follows: $1,000,000 each occurrence; $2,000,000 general aggregate; $2,000,000 products and completed operations aggregate; $1,000,000 Personal Advertising injury $50,000 any one fire; and $500,000 errors and omissions. $5,000 Medical payments one person Automobile Liability: Successful bidder/Contract Professional 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. For all general liability, excess/umbrella liability, liquor liability, pollution liability and professional liability policies, if the policy is a claims -made policy, the retroactive date must be on or before the contract date or the first date when any goods or services were provided to County, whichever is earlier. Successful bidders/Contract Professionals shall secure and deliver to the County at or before the time of execution of this Agreement, and shall keep in force at all times during the term of the Agreement as the same may be extended as herein provided, a commercial general liability insurance policy, including public liability and property damage, in form and company acceptable to and approved by said Administrator, covering all operations hereunder set forth in the related Bid or Request for Proposal. Proof of Insurance: County reserves the right to require the successful bidder/Contract Professional to provide a certificate of insurance, a policy, or other proof of insurance as required by the County's Risk Administrator in his sole discretion. BID NO. B2100100 Page -13 - Additional Insureds: For general liability, excess/umbrella liability, pollution legal liability, liquor liability, and inland marine, Successful bidder/Contract Professional's insurer shall name County as an additional insured. Waiver of Subrogation: For all coverages, Successful bidder/Contract Professional's insurer shall waive subrogation rights against County. Subcontractors: All subcontractors, subcontractors, independent contractors, sub -vendors, suppliers or other entities providing goods or services required by this Agreement shall be subject to all of the requirements herein and shall procure and maintain the same coverages required of Successful bidder/Contract Professional. Successful bidder/Contract Professional shall include all such subcontractors, independent contractors, sub -vendors suppliers or other entities as insureds under its policies or shall ensure that all subcontractors maintain the required coverages. Successful bidder/Contract Professional agrees to provide proof of insurance for all such subcontractors, independent contractors, sub -vendors suppliers or other entities upon request by the County. The terms of this Agreement are contained in the terms recited in this Request for Bid and in the Response to the Bid each of which forms an integral part of this Agreement. Those documents are specifically incorporated herein by this reference. BID NO. B2100100 Page -14 - BID PROPOSAL To: Weld County Purchasing Department P.O. Box 758, 1150 "O" Street Greeley, Colorado 80632 Attention: Rob Turf, Director of General Services Bid Proposal for: Slurry Seal and Sand Seal Contract PROPOSAL Pursuant to and in full compliance with all Contract Documents the undersigned Bidder hereby proposes to furnish all labor and materials and to perform all Work required for the complete and prompt execution of everything described or shown in or reasonably implied from the Bidding Documents, including the Drawings and Specifications, for the Work above indicated for the monies indicated below which includes all State, County and local taxes normally payable with respect to such Work. The amounts stated include all allowances for profit and overhead, taxes, fees and permits, transportation, services, tools and equipment, labor and materials and other incidental costs. The Bidder and all Sub -Bidders shall include in their bid all Sales and Use Tax if applicable. State of Colorado and Weld County tax shall not be included. Upon application, the State of Colorado Department of Revenue shall issue to a Bidder or Sub -Bidder a Certificate or Certificates of Exemption indicating that the purchase of construction or building materials is for a purpose stated in Section 39-26-114, CRS, and is free from Colorado State Sales Tax. EXAMINATION OF DOCUMENTS AND SITE The Bidder has carefully examined the Bidding Documents, including the Drawings and Specifications, and has examined the site of the Work, so as to fully appraise themselves of the conditions at the site and to gain a clear understanding of the Work to be executed and is thoroughly familiar with all local, state and federal laws, ordinances, rules, regulations and other factors affecting performance of the Work. PROPOSAL GUARANTEE This Bid Proposal is accompanied by the required Bid Bond of five percent (5%) based upon the Total Cost of all items required to be Bid. Weld County, Colorado is authorized to hold said Bid Bond for a period of not more than sixty (60) days after the opening of the Bids for the Work indicated, unless the undersigned Bidder is awarded the Contract within said period, in which event the Owner may retain said Bid Bond until the undersigned Bidder has executed the required Agreement and furnished the required Performance Bond, Labor & Materials Payment Bond, and Certificates of Insurance. TIME OF COMPLETION The Bidder agrees to make their best effort to complete the entire Project as soon as possible and within the time specified in the Project Special Conditions after the issuance of the Notice to Proceed subject to the CDOT Standard Specifications for Road and Bridge Construction, Section 108. EXECUTION OF DOCUMENTS The Bidder understands that if this Bid Proposal is accepted, they must execute the required Agreement and furnish the required Performance Bond, Labor & Materials Payment Bond and Insurance Certificates within ten (10) days from the date of Notice of Award. BID NO. B2100100 Page -15 - METHOD OF AWARD The Owner reserves the right to reject any Bid from any Bidder whom the Owner deems is unfit or unqualified to complete the Work as specified regardless of the amount of the Bid. It is understood by the Bidder how Bids shall be awarded and that should the cost of the Bid exceed budgeted funds, the Owner reserves the right to reject any or all Bids or portions of Work Bid or the use of any of the methods stated in the Instructions to Bidders to obtain the most advantageous Bid price. All bids will be reviewed by the Owner and Engineer. All mathematics will be checked and the correct total used for determining the low bidder. BID NO. B2100100 Page -16 - BID SCHEDULE 2021 Slurry Seal and Sand Seal Contract Item Description Unit Est. Quantity Unit Price Contract Bid Number 408 Place Rubberized Crack Filler & Traffic Control (Weld County to supply material) TON 10.50 409 Slurry Seal SY 418,030 627 Pavement Marking Paint (Parking Lots) GAL 0 630 Signing and Traffic Control (Sub/Parking lot) EACH 2 630 Signing and Traffic Control (Slurry Seal) MILE 24 630 MHT and Traffic Control for Cdot intersections EACH 4 700 F/A Minor Contract Revisions F/A 1 $10,000.00 $10,000.00 Total: * The successful vendor is required to sign a separate contract (a sample contract is included as a separate attachment.) BID NO. B2100100 Page - 17 - RECEIPT OF ADDENDA The undersigned acknoWledges receipt of the following Addenda to the Invitation for Bids, Drawings, Specifications and other Contract Documents. Addendum No. Date: By: Addendum No. Date: By: Bidder agrees to perform all Work described in the Contract Documents for the unit prices as shown in the Bid Schedule. Payment will be based on the Lump Sum price or the actual quantities furnished, installed or constructed. The undersigned, by hia or her signature, hereby acknowledges and represents that: 1. The bid proposed herein meets all of the conditions, specifications and special provisions set forth in the request for bid for Request No. #B2100100 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 a thorized to bind the below -named bidder for the amount shown on the accompanying' proposal 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. FIRM BY (Please print) BUSINESS ADDRESS CITY, STATE, ZIP CODE DATE TELEPHONE NO FAX TAX ID # SIGNATURE E-MAIL WELD COUNTY IS EXEMPT FROM COLORADO SALES TAXES. THE CERTIFICATE OF EXEMPTION NUMBER IS #98-03551-0000. BID NO. B2100100 Page -18 - BID BOND PROJECTS: Slurry Seal contract 2021 KNOW ALL MEN BY THESE PRESENTS, that as Principal, and as Surety, are hereby held and firmly bound unto Weld County, Colorado (hereinafter called the "Owner") in the penal sum of Dollars ($ ), lawful money of the United States of America, for the payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly to these presents. THE CONDITION OF THIS OBLIGATION IS SUCH, that whereas the Principal has submitted the accompanying Bid dated , 2021 for the PROJECTS: Slurry Seal Contract as set out in the accompanying Bid. WHEREAS, the Owner has required as a condition for receiving said Bid that the principal deposit with the Owner either a certified check equivalent to not less than five percent (5%) of the amount of said Bid or in lieu thereof furnish a Bid Bond for said amount conditioned such that in the event of failure to execute the proposed Contract for such construction if the Contract is to be awarded to him, that said sum be paid immediately to the Owner as liquidated damages and not as a penalty for the principal's failure to perform. NOW THEREFORE, if the principal shall, within the period specified therefore: A. On the attached prescribed forms presented to him for signature, enter into a written Contract with the Owner in accordance with his Bid as accepted, and give a Performance Bond with good and sufficient sureties, as may be required upon the forms prescribed by the Owner for the faithful performance and the proper fulfillment of said Contract, or B. Withdraw said Bid within the time specified, or C. Pay to the Owner the sum determined upon herein as liquidated damages, and not as a penalty, then this obligation shall be void and of no effect, otherwise to remain in full force and effect. IN WITNESS WHEREOF, the above parties have executed this instrument under their several seals this day of 2021 the name and corporate seal of each corporate party being hereto affixed and these presents duly signed by its undersigned representative pursuant to authority of its governing board. Principal Address ATTEST: By: ATTEST: By: By: Surety Address BID NO. B2100100 Page -19 - INSTRUCTIONS The full firm name and residence of each individual party to the bond must be inserted in the first paragraph. If the principal is a partnership, the full name of all partners must be inserted in the first paragraph which must recite that they are partners composing the partnership (to be named), and all partners must execute the bond as individuals. The state of incorporation of each corporate party to the bond must be inserted in the first paragraph and the bond must be executed under the corporate seal of said party attested by its secretary or other authorized officer. Power of Attorney must accompany this bond when signed by other than an officer of either the principal or surety. A standard printed bond form may be used in lieu of the foregoing form provided that the security stipulations protecting the Owner are not in any way reduced by use of such standard printed bond form. BID NO. B2100100 Page - 20 - Form W-9 (Rev. August 2013) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification Give Form to the requester. Do not send to the IRS. Print or type See Specific Instructions on page 2. Name (as shown on your income tax return) Business name/disregarded entity name, rf different from above Check appropriate box for federal tax classification: ❑ Individual/sole proprietor E C Corporation ❑ S Corporation ❑ Partnership ❑ ❑ Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership) ❑ Other (see instructions) ► Trust/estate ► Exemptions Exempt payee Exemption code (if any) (see instructions): code (it any) from FATCA reporting Address (number, street, and apt ar suite no.) Requester's name and address (optional) City, state, and ZIP code List account number(s) here (optional) Part I Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on the "Name" line to avoid backup withholding. For individuals, this is your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3. Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose number to enter. Social security number Employer identification number Part II 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 for a 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 am 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), and 4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA 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 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 on page 3. Sign Here Signature of U.S. person ► Date ► General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. The IRS has created a page on IRS.gov for information about Form W-9, at www.irs.govlw9. Information about any future developments affecting Form W-9 (such as legislation enacted after we release it) will be posted on that page. Purpose of Form A person who is required to file an information retun with the IRS must obtain your correct taxpayer identification number (11N) to report, for example, income paid to you, payments made to you in settlement of payment card and third party network transactions, real estate transactions, mortgage interest you paid, acquisition or abandonment of secured property, cancellation of debt, or contributions you made to an IRA. Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN to the person requesting it (the requester) and, when applicable, to: 1. Certify that the TIN you are giving is correct (or you are waiting for a number to be issued), 2. Certify that you are not subject to backup withholding, or 3. Claim exemption from backup withholding if you are a U.S. exempt payee. It applicable, you are also certifying that as a U.S. person, your allocable share of any partnership income from a U.S. trade or business is not subject to the withholding tax on foreign partners' share of effectively connected income, and 4. Certify that FATCA code(s) entered on this form (if any) indicating that you are exempt from the FATCA reporting, is correct. Note. If you are a U.S. person and a requester gives you a form other than Form W-9 to request your TIN, you must use the requester's form if it is substantially similar to this Form W-9. Definition of a U.S. person. For federal tax purposes, you are considered a U.S. person if you are: • An individual who is a U.S. citizen or U.S. resident alien, • A partnership, corporation, company, or association created or organized in the United States or under the laws of the United States, • An estate (other than a foreign estate), or • A domestic trust (as defined in Regulations section 301.7701-7). Special rules for partnerships. Partnerships that conduct a trade or business in the United States are generally required to pay a withholding tax under section 1446 on any foreign partners' share of effectively connected taxable income from such business. Further, in certain cases where a Form W-9 has not been received, the rules under section 1446 require a partnership to presume that a partner is a foreign person, and pay the section 1446 withholding tax. Therefore, if you are a U.S. person that is a partner in a partnership conducting a trade or business in the United States, provide Form W-9 to the partnership to establish your U.S. status and avoid section 1446 withholding on you share of partnership income. Cat. No. 10231X Form W-9 (Rev. 8-2013) BID NO. B2100100 Page - 21- STATEMENT OF QUALIFICATIONS AND SUBCONTRACTORS DATE OF THIS STATEMENT: All questions herein must be answered by all bidders and the information given must be legible, clear in meaning and comprehensive. The bidder will not be given the opportunity to further explain or defend any answers beyond the time that this statement is submitted with the bid. This statement must be notarized. Questions may be answered on separate attached sheets if necessary. The Bidder may attach and submit any additional information which is believed to be pertinent to this bid. Failure to complete this form pursuant to the directions herein may be cause for rejection of the bid. All bidders are reminded that a contract for the work described in the Contract Documents will be awarded to the lowest reliable, responsible and qualified bidder as determined by the County. The County reserves the right to waive informalities and/or irregularities and to reject any or all bids. 1. Name of Bidder (Company or Firm): 2. Permanent main office address: Phone Number: Fax Number: 3. Year Company was organized: 4. Number of years this Company has been engaged similar construction: Under what firm, company or trade names has this company been engaged in this type of construction, how long under each name and how long has each company been bonding work? 5. List all projects that the Company has under contract at the present time. Show the contract amount and the anticipated date of completion for each: 6. List all contracts which were not completed by the contracted and completion date. Include the project description and state the number of days beyond the contract completion date. 7. List all contracts within the last 3 years for which liquidated damages were assessed or may be assessed. BID NO. B2100100 Page - 22 - 8. List all contracts within the last 3 years during which or after which the Company filed a protest with the owner. 9. List all contracts within the last 3 years during which or after which any of the Company's subcontractors or suppliers filed a verified statement of claim with the owner or failed to provide the Company with a lien waiver upon request. 10. Has any owner, as party to any of the Company's contracts within the last 3 years, contacted the Company's bonding company concerning late completion of the project, poor performance on the project, etc., or attempted to have the performance bond invoked? If yes, explain in detail. 11. Describe all contracts that the Company failed to complete. 12. Describe all contracts on which the Company defaulted or from which the Company was terminated. 13. List all or a maximum of three (3) of the most recent projects, similar to the project described in these Contract Documents, which the Company has successfully completed within the last 5 years or are under construction at the present time. List the project name, location, project superintendent, owner's representative and phone number, date completed and contract amount for each project. Project Name: Location: Supt: Owner's Representative: Phone: Completion Date: Contract Amount: BID NO. B2100100 Page - 23 - Project Name: Location: Supt: Owner's Representative: Phone: Completion Date: Contract Amount: Project Name: Location: Supt: Owner's Representative: Phone: Completion Date: Contract Amount: 14. List all of the subcontractors the Company intends to use under this contract, the work that each subcontractor will do and the percentage of the Company's bid that each contractor's work comprises. IF REQUESTED, THOSE CONTRACTORS BEING FURTHER CONSIDERED FOR AWARD SHALL FURNISH, WITHIN 24 HOURS AFTER THE BID OPENING, A SEPARATE STATEMENT OF QUALIFICATIONS COMPLETED BY EACH SUBCONTRACTOR WHO WILL PERFORM 15% OR MORE OF THE WORK. SUBCONTRACTOR WORK DESCRIPTION % OF WORK 15. List the principal members of the company who will be involved with this project, including the superintendent, foreman, project manager, etc. NAME YRS. PERTINENT TITLE EXPERIENCE 16. List all lawsuits previously filed against or currently pending against you, the Company or any officers of the Company. BID NO. B2100100 Page - 24 - The undersigned hereby swears and affirms that the information contained herein is complete and true and further, hereby authorizes and requests any person, company, firm or corporation to furnish any information requested by the County of Weld in verification of the recitals comprising this Statement of Qualifications and Subcontractors. Dated this day of , 2021. Bidder: Company By: Signature Name: (Please Type) Title: NOTARY County of ) ) ss. State of ) being duly sworn, deposes and says that he is of, (Title) and that the answers to the foregoing questions (Company Name) and all statements therein contained are true and correct. Subscribed and sworn before me this day of, 2021. (SEAL) Commission Expires Notary Public BID NO. B2100100 Page - 25 - NOTICE OF AWARD PROJECT: SLURRY SEAL CONTRACT 2021 To: Project Description: The project in general consists of performing the crack seal in the subdivisions and parking lots and seal coat work for the 2021 construction season. The contract is a one year commitment with the option of renewal for up to two additional years. The project, 2021 Slurry seal and Sand Seal, in general consists of: -Crack sealing 10.5 tons in parking lots. (County to supply material) -Slurry Seal 418,030 SY This project is not subject to Federal or State contract requirements. The Owner has considered the Bid submitted by you for the above described Work in response to its Invitation for Bids and Instructions to Bidders. You are hereby notified that your Bid has been accepted in the amount of $ or as shown in the Bid Schedule. You are required by the Instructions to Bidders to execute the Agreement and furnish the required Performance Bond, Payment Bond and Certificates of Insurance within ten (10) calendar days from the date of this Notice to you. If you fail to execute said Agreement and to furnish said Bonds within ten (10) days from the date of this Notice, said Owner will be entitled to consider all your rights arising out of the Owner's acceptance of your bid as abandoned. The Owner will be entitled to such other rights as may be granted by law. You are required to return, an acknowledged copy of this Notice of Award to the Owner. Dated this day of June, 2021 Weld County, Colorado, Owner By: Josh Holbrook, Pavement Management Supervisor ACCEPTANCE OF NOTICE Receipt of the above Notice of Award is hereby acknowledged by (Contractor) Dated this day of , 2021 By: Title: BID NO. B2100100 Page - 26 - SAMPLE WELD COUNTY AGREEMENT FOR CONSTRUCTION SERVICES BETWEEN WELD COUNTY & Slurry Seal Contract 2021 THIS AGREEMENT is made and entered into this _ day of , 2021, by and between the County of Weld, a body corporate and politic of the State of Colorado, by and through its Board of County Commissioners, whose address is 1150 "O" Street, Greeley, Colorado 80631 hereinafter referred to as "County," and , [an individual], [a limited liability partnership] [a limited liability company] [a corporation], who whose address is , hereinafter referred to as "Contractor". WHEREAS, Various Weld County Roads need Maintenance, (hereinafter referred to as the "Project"), and WHEREAS, in the interests of public health, safety and welfare, it is necessary to undertake the maintenance of these roads, and WHEREAS, County requires an independent contract construction professional to perform the construction services required by County and set forth in Exhibit A and B WHEREAS, Contractor is willing to perform and has the specific ability to perform the required Construction Services at or below the cost set forth in Exhibit B: 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 Exhibits A and B, each of which forms an integral part of this Agreement. Exhibits A and B are specifically incorporated herein by this reference. County and Contractor acknowledge and agree that this Agreement, including specifically Exhibits A and B, define the performance obligations of Contractor and Contractor's willingness and ability to meet those requirements. Exhibit A consists of County's Request for Bid (RFB) as set forth in "Bid Package No. B2100100". The RFP contains all the specific requirements of County. Exhibit B consists of Contractor's Response to County's Request for Bid. The Response confirms Contractor's obligations under this Agreement. 2. Service or Work. Contractor agrees to procure the materials, equipment and/or products necessary for the Project and agrees to diligently provide all services, labor, personnel and materials necessary to perform and complete the Project described in Exhibit A, which is attached hereto and incorporated herein by reference. Contractor shall coordinate with, the Weld County Director of Public Works or other designated supervisory personnel, (the "Manager"), to perform the services described on attached Exhibits A and B. Contractor shall faithfully perform BID NO. B2100100 Page - 27 - the work in accordance with the standards of professional care, skill, training, diligence and judgment provided by highly competent Contractors performing construction services of a similar nature to those described in this Agreement. Contractor shall further be responsible for the timely completion, and acknowledges that a failure to comply with the standards and requirements of Exhibits A and B within the time limits prescribed by County may result in County's decision to withhold payment or to terminate this Agreement. In its sole discretion, the County, by the Director of the Department of Public Works or his or her designee, may extend the time for the Contractor to complete the service or work, by not more than thirty (30) days. Such extension shall not increase the compensation to be paid to the Contractor nor change any other term herein. 3. Term. The term of this Agreement begins upon the date of the execution of this Agreement by County, and shal continue through and until Contractor's completion of the responsibilities described in Exhibits A and B. Both 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. Therefore, within the thirty (30) days preceding the anniversary date of this Agreement, County shall notify Contractor if it wishes to renew this Contract. 4. Termination. County has the right to terminate this Agreement, with or without cause on thirty (30) days written notice. Furthermore, this Agreement may be terminated at any time without notice upon a material breach of the terms of the Agreement. However, nothing herein shall be construed as giving Contractor the right to provide materials (or services) under this Agreement beyond the time when such materials (or services) become unsatisfactory to the County. If this Agreement is terminated by County, Contractor shall be compensated for, and such compensation shall be limited to, (1) the sum of the amounts contained in invoices which it has submitted and which have been approved by the County; (2) the reasonable value to County of the materials which Contractor provided prior to the date of the termination notice, but which had not yet been approved for payment; and (3) the cost of any work which the County approves in writing which it determines is needed to accomplish an orderly termination of the work. County shall be entitled to the use of all material generated pursuant to this Agreement upon termination. 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 drawings, drafts or other documents it has completed or partially completed 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. Copies of work product incomplete at the time of termination shall be marked "DRAFT -I NCOMPLETE." 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 Modification. 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. Accordingly, no claim that the County has been unjustly enriched by any additional services, whether or not there is in fact any such unjust enrichment, shall be the basis of any increase in the compensation payable hereunder. BID NO. B2100100 Page - 28 - 6. Compensation/Contract Amount. Upon Contractor's successful completion of the construction of the Project, and County's acceptance of the same, County agrees to pay an amount no greater than $ , which is the bid set forth in Exhibit B. Contractor acknowledges no payment in excess of that amount will be made by County unless a "change order" authorizing such additional payment has been specifically approved by the Director of Weld County Public Works, or by formal resolution of the Weld County Board of County Commissioners, as required pursuant to the Weld County Code. Any other provision of this Agreement notwithstanding, in no event shall County be liable for payment for services rendered and expenses incurred by Contractor under the terms of this Agreement for any amount in excess of the sum of the bid amount set forth in Exhibit B. Contactor acknowledges that any work it performs beyond that specifically authorized by County is performed at Contractor's risk and without authorization under this Agreement. County shall not be liable for the payment of taxes, late charges or penalties of any nature other than the compensation stated herein. 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. 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 from County as a result of the execution of this Agreement. Contractor shall perform its duties hereunder as an independent Contractor. Contractor shall be solely responsible for its acts and those of its agents and employees for all acts performed pursuant to this Agreement. Contractor, its employees and agents are not entitled to unemployment insurance or workers' compensation benefits through County and County shall not pay for or otherwise provide such coverage for Contractor or any of its agents or employees. Contractor shall pay when due all applicable employment taxes and income taxes and local head taxes (if applicable) incurred pursuant to this Agreement. Contractor shall not have authorization, express or implied, to bind County to any agreement, liability or understanding, except as expressly set forth in 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 this Project 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 subject Project during the performance of this Agreement and no personnel to whom County has an objection, in its reasonable discretion, shall be assigned to the Project. Contractor shall require each subcontractor, as approved by County and to the extent of the Services 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 BID NO. B2100100 Page - 29 - such process. The Contractor shall be responsible for the acts and omissions of its agents, employees and subcontractors. 9. Ownership. All work and information obtained by Contractor under this Agreement or individual work order shall become or remain (as applicable), the property of County. In addition, all reports, data, plans, drawngs, records and computer files generated by Contractor in relation to this Agreement and all reports, test results and all other tangible materials obtained and/or produced in connection with the performance of this Agreement, whether or not such materials are in completed form, shall at all times be considered the property of the County. Contractor shall not make use of such material for purposes other than in connection with this Agreement without prior written approval of County. 10. Confidentiality. Confidential financial information of Contractor should be transmitted separately from the main bid submittal, clearly denoting in red on the financial information at the top the word, "CONFIDENTIAL." However, Contractor is advised that as a public entity, Weld County must comply with the provisions of C.R.S. 24-72-201, et seq., with regard to public records, and cannot guarantee the confidentiality of all documents. Contractor agrees to keep confidential all of County's confidential information. Contractor agrees not to sell, assign, distribute, or disclose any such confidential information to any other person or entity without seeking written permission from the County. Contractor agrees to advise its employees, agents, and consultants, of the confidential and proprietary nature of this confidential information and of the restrictions imposed by this agreement. 11. Warranty. Contractor warrants that construction services performed under this Agreement will be performed in a manner consistent with the professional construction standards governing such services and the provisions of this Agreement. Contractor further represents and warrants that all construction services shall be performed by qualified personnel in a professional and workmanlike manner, consistent with industry standards, and that all construction services will conform to applicable specifications. In addition to the foregoing warranties, Contractor is aware that all work performed on this Project pursuant to this Agreement is subject to a one-year warranty period during which Contractor must correct any failures or deficiencies caused by contractor's workmanship or performance. This warranty shall commence on the date of County's final inspection and acceptance of the Project. 12. 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, incidental material(s), and structures furnished under this Agreement shall not in any way relieve Contractor of responsibility for the quality and accuracy of the construction 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 shall exist 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 construction 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. 13. Insurance and Indemnification. General Requirements: Contractors/Contract Professionals must secure, at or before the time BID NO. B2100100 Page - 30 - of execution of any agreement or commencement of any work, the following insurance covering all operations, goods or services provided pursuant to this request. Contractors/Contract Professionals 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. The required insurance shall be underwritten by an insurer licensed to do business in Colorado and rated by A.M. Best Company as "A"VIII or better. Each policy shall contain a valid provision or endorsement stating "Should any of the above -described policies by canceled or should any coverage be reduced before the expiration date thereof, the issuing company shall send written notice to the Weld County Director of General Services by certified mail, return receipt requested. Such written notice shall be sent thirty (30) days prior to such cancellation or reduction unless due to non-payment of premiums for which notice shall be sent ten (10) days prior. If any policy is in excess of a deductible or self -insured retention, County must be notified by the Contractor/Contract Professional. Contractor/Contract Professional shall be responsible for the payment of any deductible or self - insured retention. County reserves the right to require Contractor/Contract Professional to provide a bond, at no cost to County, in the amount of the deductible or self -insured retention to guarantee payment of claims. The insurance coverage's specified in this Agreement are the minimum requirements, and these requirements do not decrease or limit the liability of Contractor/Contract Professional. 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 this Contract by the Contractor, its agents, representatives, employees, or subcontractors. 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. Any modification to these requirements must be made in writing by Weld County. The Contractor stipulates that it has met the insurance requirements identified herein. The Contractor shall be responsible for the professional quality, technical accuracy, and quantity of all construction services provided, the timely delivery of said services, and the coordination of all services rendered by the Contractor and shall, without additional compensation, promptly remedy and correct any errors, omissions, or other deficiencies. Indemnity: The Contractor shall defend, indemnify and hold harmless County, its officers, agents, and employees, from and against injury, loss damage, liability, suits, actions, or claims of any type or character arising out of the work done in fulfillment of the terms of this Contract 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, 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, or on account of or in consequence of neglect of the Contractor in its construction methods or procedures; or in its provisions of the materials required herein, or from any claims or amounts arising or recovered under the Worker's Compensation Act, or other law, ordinance, order, or decree. This paragraph shall survive expiration or termination hereof. 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. Types of Insurance: The Contractor/Contract Professional shall obtain, and maintain at all times during the term of any Agreement, insurance in the following kinds and amounts: BID NO. B2100100 Page - 31- Workers' Compensation Insurance as required by state statute, and Employer's Liability Insurance coverin all of the Contractor's Contract Professional's employees acting within the course and scope of their employment. Policy shall contain a waiver of subrogation against the County. This req irement shall not apply when a Contractor or subcontractor is exempt under Colorado Workers' Compensation Act., AND when such Contractor or subcontractor executes the appropriate so e proprietor waiver form. Minimum Limits: Coverage A (Workers' Compensation) Cdverage B (Employers Liability) Statutory $ 500,000 $ 500,000 $ 500,000 Commercial General Liability Insurance written on ISO occurrence form CG 00 01 equivalent, covering premises operations, explosions, collapse and underground hazard, personal advertising injury, fire damage, independent Contractors, products and completed operations, blanket contractual liability personal injury, and liability assumed under an insured contract. The policy shall be endorsed to include 1) the Additional Insured Endorsements CG 2010 (or equivalent), 2) CG 2037 Additional Insured for products/completed operations, and 3) the Designated Construction Projects General Aggregate Endorsement CG 2503. The policy shall be endorsed to include the following additional insured language on the additional insured endorsements specified above: 'Weld County, its subsidiary, parent, associated and/or affiliated entities, successors, or assigns, its elected officials, trustees, employees, agents, and volunteers named as an additional insured with respect to liability and defense of suits arising out of the activities performed by, or on behalf of the Contractor, including completed operations" and the minimum limits must be as follows: $1,000,000 each occurrence; $2,000,000 general aggregate; $2,000,000 products and completed operations aggregate; $1,000,000 personal Advertising injury $50,000 any bne fire; and $500,000 errrs and omissions. $5,000 Medi al payment one person Automobile Liability: Contractor/Contract Professional shall maintain limits of $1,000,000 for bodily injury per person, $ ,000, 000 for bodily injury for each accident, and $1,000,000 for property damage applicable to all v icles operating both on County property and elsewhere, for vehicles owned, hired, and non -ow ed vehicles used in the performance of this Contract. For all general professional liability before the contrac whichever is earlier liability, excess/umbrella liability, liquor liability, pollution liability and policies, if the policy is a claims -made policy, the retroactive date must be on or date or the first date when any goods or services were provided to County, Contractors/Contract Professionals shall secure and deliver to the County at or before the time of execution of this Agreement, and shall keep in force at all times during the term of the Agreement as the same may be extended as herein provided, a commercial general liability insurance policy, including public liability and property damage, in form and company acceptable BID NO. B2100100 Page - 32 - to and approved by said Administrator, covering all operations hereunder set forth in the related Bid or Request for Proposal. Proof of Insurance: County reserves the right to require the Contractor/Contract Professional to provide a certificate of insurance, a policy, or other proof of insurance as required by the County's Risk Administrator in his sole discretion. Additional Insureds: For general liability, excess/umbrella liability, pollution legal liability, liquor liability, and inland marine, Contractor/Contract Professional's insurer shall name County as an additional insured. Waiver of Subrogation: For all coverages, Contractor/Contract Professional's insurer shall waive subrogation rights against County. Subcontractors: All subcontractors, subcontractors, independent Contractors, sub -vendors, suppliers or other entities providing goods or services required by this Agreement shall be subject to all of the requirements herein and shall procure and maintain the same coverage's required of Contractor/Contract Professional. Contractor/Contract Professional shall include all such subcontractors, independent Contractors, sub -vendors suppliers or other entities as insureds under its policies or shall ensure that all subcontractors maintain the required coverages. Contractor/Contract Professional agrees to provide proof of insurance for all such subcontractors, independent Contractors, sub -vendors suppliers or other entities upon request by the County. 14. 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. 15. Examination of Records. To the extent required by law, the Contractor agrees that any 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. The Contractor agrees to maintain these documents for three years from the date of the last payment received. 16. 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. 17. Notices. County may designate, prior to commencement of work, its project representative ("County Representative") who shall make, within the scope of his or her authority, and all necessary and proper decisions with reference to the project. All requests for contract interpretations, change orders, and other clarification or instruction shall be directed to County Representative. The County Representative for purposes of this Agreement is hereby identified as, Director of Weld County Department of Public Works, or his designee. All notices or other communications (including annual maintenance 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 BID NO. B2100100 Page - 33 - 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 by the sending party; or d) transmission via facsimile, at the number set forth below, where a receipt or acknowledgment is required by the sending party. Either party may change its notice address(es) by written notice to the other. Notification Information: Contractor: Attn.: President, Address: Address: E-mail: Facsimile: With copy to: Name: Position: Address: Address: E-mail: Facsimile: County: Name: Position: Address: Address: E-mail: Facsimile: 18. 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. 19. Non -Exclusive A reement. This Agreement is nonexclusive and County may engage or use other Contractors r persons to perform services of the same or similar nature. 20. 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. 21. Fund Availability. Financial obligations of the County payable after the current fiscal year are BID NO. B2100100 Page - 34 - 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. 22. Employee Financial Interest/Conflict of Interest — C.R.S. §§24-18-201 et seq. and §24-50- 507. The signatories to this Agreement agree 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. County has no interest and shall not acquire any interest direct or indirect, that would in any manner or degree interfere with the performance of Contractor's services and Contractor shall not employ any person having such known interests. During the term of this Agreement, Contractor shall not engage in any in any business or personal activities or practices or maintain any relationships which actually conflicts with or in any way appear to conflict with the full performance of its obligations under this Agreement. Failure by Contractor to ensure compliance with this provision may result, in County's sole discretion, in immediate termination of this Agreement. No employee of Contractor nor any member of Contractor's family shall serve on a County Board, committee or hold any such position which either by rule, practice or action nominates, recommends, supervises Contractor's operations, or authorizes funding to Contractor. 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 contract 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 contract. 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 of the State of Colorado program established pursuant to C.R.S. §8-17.5- 102(5)(c). Contractor shall not knowingly employ or contract with an illegal alien to perform work BID NO. B2100100 Page - 35 - under this Agreement or 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 the public contract for services 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 contract 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 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 a 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. Official Engineering Publications: Contractor acknowledges and agrees that the Colorado Department of Transportation "Standard Specifications for Road and Bridge Construction" and the Colorado Department of Transportation Standard Plans "M & S Standards" establish the requirements for ail work performed by Contractor under this Agreement, and Contractor agrees to meet or exceed all standards set by these publications. Contractor further acknowledger and agrees that a failure to meet the standards set by these publications may result in withholding by County of some or all of the Contract Amount. 30. Attorneys 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. 31. 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. 32. Public Contracts for Services C.R.S. §8-17-101. For public contracts in excess of $500,000 annually, or for public contracts for road or bridge construction in excess of $50,000, Contractor certifies, warrants, and agrees that Colorado labor shall be employed to perform at least eighty BID NO. B2100100 Page - 36 - percent of the work under this Contract. "Colorado labor" means any person who is a resident of the state of Colorado at the time of the public works project, who can provide a valid Colorado driver's license, a valid Colorado state -issued photo identification, or documentation that he or she has resided in Colorado for the last thirty days. The County, in its sole discretion, may waive the eighty percent requirement if there is reasonable evidence to demonstrate insufficient Colorado labor is available to perform the work, and this requirement would create an undue burden that would substantially prevent the work from proceeding to completion. This section shall not apply to any project which is funded in whole or in part with federal funds, or where otherwise contrary to federal law. 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 A and B, 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. IN WITNESS WHEREOF, the parties hereto have signed this Agreement this day of , 2021. CONTRACTOR: By: Date Name: Title: WELD COUNTY: ATTEST: Weld County Clerk to the Board BY: BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO Deputy Clerk to the Board Steve Moreno, Chair BID NO. B2100100 Page - 37 - PERFORMANCE BOND PROJECT: SLURRY SEAL CONTRACT 2021 IN WITNESS WHEREOF this instrument is executed in two (2) counterparts, each one of which shall be deemed a original, this day of 2018. Contractor By (Contractor) . ecretary (SEAL) (Witness i3s to Contractor) (Address) (Address) ATTEST: (Surety) Secretary (SEAL) Witness as to Surety (Address) By Attorney -in -Fact (Address) NOTE: Date of Bond must not be prior to date of Contract. If Contractor is Partnership, all partners should execute Bond. IMPORTANT: Surety companies executing Bonds must appear on the Treasury Department's most current list (Circular 570 as amended) and be authorized to transact business in the State where the Project is located. BID NO. B2100100 Page - 38 - LABOR & MATERIALS PAYMENT BOND PROJECT: SLURRY SEAL CONTRACT 2021 KNOW ALL MEN BY THE PRESENTS; that (Name of Contractor) (Address of Contractor) hereinafter called Contractor, and a (Corporation, Partnership, or Individual) (Name of Surety) (Address of Surety) hereinafter called surety, are held and firmly bound unto Weld County, Colorado, P.O. Box 758, 1111 H Street, Greeley, Colorado 80632, hereinafter called Owner, in the penal sum of Dollars ($ ), in lawful money of the United States of America, for the payment of which sum well and truly to be made, we bind ourselves, successors and assigns, jointly and severally firmly by these presents. THE CONDITION OF THIS OBLIGATION is such that whereas, the Contractor entered into a certain Contract with the Owner, dated the day of , 2021, a copy of which is hereto attached and made a part hereof for the construction of: PROJECT: Slurry Seal Contract 2021 described in the Invitation for Bids, Bid No. B2100100. NOW, THEREFORE, if the Contractor shall promptly make payment to all persons, firms, Subcontractors, and corporations furnishing materials for or performing labor in the prosecution of the Work provided for in such contract, and any authorized extension or modification thereof, including all amounts due for materials, lubricants, oil, gasoline, repairs on machinery, equipment and tools, consumed or used in connection with the construction of such Work, and all insurance premiums on said Work, and for all labor, performed in such Work whether by Subcontractor or otherwise, then this obligation shall be void,; otherwise to remain in full force and effect. PROVIDED, FURTHER, that the said Surety for value received hereby stipulates and agrees that no change, extension of time, alteration or addition to the terms of the contract or to the Work to be performed thereunder of the Specifications accompanying the same shall in any way affect its obligation on this Bond, and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the Contract or to the Work or to the Specifications. PROVIDED, FURTHER, that no final settlement between the Owner and the Contractor shall abridge the right of any beneficiary hereunder, whose claim may be unsatisfied. BID NO. B2100100 Page - 39 - LABOR & MATERIALS PAYMENT BOND IN WITNESS WHEREOF, this instrument is executed in two (2) counterparts, each one of which shall be deemed an original, this day of ,2021. Contractor By (Contractor) Secretary (SEAL) (Witness as to Contractor) (Address) (Address) ATTEST: (Surety) Secretary (SEAL) By Witness as to Surety Attorney -in -Fact (Address) (Address) NOTE: Date of Bond must not be prior to date of Contract. If Contractor is Partnership, all partners should execute Bond. IMPORTANT: Surety companies executing Bonds must appear on the Treasury Department's most current list (Circular 570 as amended) and be authorized to transact business in the State where the Project is located. BID N0. B2100100 Page - 40 - NOTICE TO PROCEED PROJECT: SLURRY SEAL CONTRACT 2021 To: Date: PROJECT: SLURRY SEAL CONTRACT 2021 described in the Invitation for Bids, Bid No. B2100100. You are hereby notified to commence Work in accordance with the Agreement dated . The date of completion of all Work is therefore Weld County, Colorado, Owner By Josh Holbrook, Pavement Management Supervisor ACCEPTANCE OF NOTICE Receipt of the above Notice to Proceed is hereby acknowledged by: (Contractor) Dated this day of , 2021. By Title BID NO. B2100100 Page - 41- CERTIFICATE OF SUBSTANTIAL COMPLETION PROJECT: SLURRY SEAL CONTRACT 2021 Owner's Project No: _ Engineer's Project No: Project: Slurry seal contract described in the Invitation for Bids, Bid No. B2100100 Contractor Contract For Contract Date This Certificate of S bstantial Completion applies to all Work under the Contract Documents except for the following specified parts thereof: The Work to which this Certificate applies has been inspected by authorized representatives of the Owner, Contractor and Engineer, and that Work is hereby declared to be substantially complete in accordance with the Contract Documents on Date of Substantial Completion A list of items to be completed or corrected may be attached hereto. This list may not be all-inclusive, and the failure to include an item in it does not alter the responsibility of the Contractor to complete all the Work in accordance with the Contract Documents. The items in the list shall be completed or corrected by the Contractor within 30 days of the above date of Substantial Completion. To be effective, this form must be signed by the Owner, the Engineer, and the Contractor. Owner: Date: Engineer: Date: Contractor: Date: BID NO. B2100100 Page 42 LIEN WAIVER Slurry Seal/Sand Seal Contract TO: Weld County Public Works Attn: Joshua Holbrook P.O. Box 758 Greeley, Colorado 80632 Gentlemen: For a valuable consideration paid by the Board of County Commissioners of Weld County, the receipt and sufficiency of which is hereby acknowledged, the undersigned hereby, releases unto Weld County and to its heirs, executors, administrators or assigns, all rights of the undersigned to claim a mechanic's lien for material heretofore furnished for use in and for labor heretofore performed upon the construction, alteration, addition to or repair of the structures or improvements described in the Contract Documents as: Project: Slurry Seal Contract 2021 described in the Invitation for Bids, Bid No. B2100100 Contractor: (If no legal description is shown following the description of Project, we acknowledge that the foregoing is an adequate description of the real properties and improvements inasmuch as the foregoing is the description given in the Contract Documents which govern the performance of the Work for which consideration has been received.) In executing this release, we certify that all claims for labor, or materials, or both, furnished or performed on our behalf by our material suppliers or subcontractors have been paid or that satisfactory arrangement for payment has been made. We agree to defend Weld County from any and all claims on the part of our material suppliers, laborers, employees, servants and agents or subcontractors arising from our Work on the Project, and we further agree to reimburse the Board of County Commissioners of Weld County for any and all costs, including reasonable attorney fees, which they may incur as a result of such claims. Contractor By: Title: Date: STATE OF ) ) ss. COUNTY OF ) The foregoing instrument was acknowledged before me this day of 2021, by My commission expires: Notary Public BID NO #B2100100 Page 43 FINAL LIEN WAIVER PROJECT: SLURRY SEAL CONTRACT 2021 To All Whom It May Concern: WHEREAS, he undersigned has been employed by (A) to furnish labor and materials for (B) work, under a contract (C) for the improvement of the premises described as (D) County of State of of which is the Owner. NOW, THEREFORE, this day of , 2021, for and in consideration of the sum of (E) Dollars paid simultaneously herewith, the receipt whereof is hereby acknowledged by the undersigned, the undersigned does hereby waive and release any lien rights to, or claim of lien with respect to and on said above described premises, and the improvements thereon, and on the monies or other considerations due or to become due from the Owner, on account of labor, services, material, fixtures, apparatus or machinery heretofore or which may hereafter be furnished by the undersigned to or for the above described premises by virtue of said contract. (Affix Corporate seal here) (SEAL) (F) (SEAL) (Name of sole ownership, corporation or partnership) (Signature of Authorized Representative) Title: BID NO #B2100100 Page 44 INSTRUCTIONS FOR FINAL WAIVER (A) Person or firm with whom you agreed to furnish either labor, or services, or materials, or both. (B) Fill in nature and extent of work; strike the word labor or the word materials if not in your contract. (C) If you have more than one contract on the same premises, describe the contract by number if available, date and extent of work. (D) Furnish an accurate enough description of the improvement and location of the premises so that it can be distinguished from any other property. (E) Amount shown should be the amount actually received and equal to total amount of contract as adjusted. (F) If waiver is for a corporation, corporate name should be used, corporate seal affixed and title of officer signing waiver should be set forth; if waiver is for a partnership, the partnership name should be used, partner should sign and designate himself as partner. BID NO #B2100100 Page 45 NOTICE OF ACCEPTANCE PROJECT: SLURRY SEAL CONTRACT TO: Date: RE: Slurry Seal Contract 2021 described in the Invitation for Bids, Bid No. B2100100 This is to inform you that the above referenced job, has been satisfactorily completed in accordance with the Contract Documents and is hereby accepted. Final payment will follow the 30 -day advertisement period and will be made on or about Final acceptance does not relieve the Contractor of the minimum one (1) year guarantee on all work and materials incorporated into this Project. Such guarantee shall begin on the date of this acceptance. Weld County, Colorado, Owner By: Joshua Holbrook, Pavement Management Supervisor BID NO #B2100100 Page 46 TECHNICAL PROVISIONS FOR THE WELD COUNTY PUBLIC WORKS DEPARTMENT The Colorado Department of Transportation, Standard Specifications for Road and Bridge Construction, are the guidelines for the construction standards of this project. The following special provisions supplement or modify the Standard Specifications and take precedence over the Standard Specifications and plans. When specifications or special provisions contain both English units and SI units, the (English) units apply and are the specification requirement. PROJECT SPECIAL PROVISIONS Index Pages Commencement and Completion of Work Revision of Section 101 -Definition of Terms Revision of Section 104 -Scope of Work Revision of Section 105 -Control of Work Revision of Section 106 -Control of Material Revision of Section 107 -Legal Relations and Responsibility to Public Revision of Section 108 -Prosecution and Progress Revision of Section 109 -Measurement and Payment Revision of Section 408 -Joint and Crack Sealant Revision of Section 409 -Sand Seal Revision of Section 409 -Slurry Seal Revision of Section 627 -Pavement Marking Revision of Section 630 -Construction Zone Traffic Control Revision of Section 712 -Water Force Account Items / Basis of payment (May 2018) (May 2018) (May 2018) (May 2018) (May 2018) (May 2018) (May 2018) (May 2018) (May 2018) (May 2018) (May 2018) (May 2018) (May 2018) (May 2018) (May 2018) STANDARD SPECIAL PROVISIONS Page 49 50 51 52-54 55 56 57 58 59-61 62-65 66-73 74-75 76-78 79 80 BID NO #B2100100 Page 47 NOTICE TO BIDDERS The proposal guaranty shall be a certified check, cashier's check, or bid bond in the amount of five percent (5%) of the Contractor's total bid. Pursuant to subsections 102.04 and 102.05, it is recommended that bidders on this project review the work site and plan details. Information regarding the project may be obtained from the following listed authorized representatives. Joshua Holbrook, Pavement Management Supervisor Weld County Public Works Department 1111 H Street Greeley, CO 80632 Office Phone: 970.304.6496, ext. 3744 The above referenced individual is the only representative with authority to provide any information, clarification, or interpretation regarding the plans, specifications, and any other contract documents or requirements. BID NO #B2100100 Page 48 COMMENCEMENT AND COMPLETION OF WORK The Contractor shall commence the work under the Contract as required in the "Notice to Proceed" and will complete all work within 80 Calendar Days unless the period for completion is extended otherwise by the County. If construction continues beyond the Contract time period or the time as extended, the Contractor will be assessed liquidated damages as stated hereafter. BID NO #B2100100 Page 49 1 REVISION OF SECTION 101 DEFINITION OF TERMS Technical Specifications related to construction materials and methods for the work required under this contract shall consist of the "Colorado Department of Transportation, Standard Specifications for Road and Bridge Construction" dated 2017. Where the Project Special Provisions and the CDOT Specifications contradict one another, the more stringent specification shall apply. Certain terms utilized in the Specifications referred to in the paragraph above shall be interpreted to have different meanings within the scope of this Contract. A summary of redefinitions follows: Subsection 101.10 "CDOT Resident Engineer" shall mean an employee designated as such by the Weld County Public Works Department. Subsection 101.28: "Department" shall mean the Weld County Public Works Department. Subsection 101.29: "Chief Engineer" shall mean the Weld County Public Works Director or designated representative. Subsection 101.36: Holidays recognized by Weld County are: New Year's Day Washington/Lincoln Day Memorial Day Independence Day Labor Day Veterans Day Thanksgiving Christmas Subsection 101.37: "Inspector" shall mean an employee designated as such by the Weld County Public Works Department. Subsection 101.48: "CDOT project personnel" shall mean personnel designated as such by the Weld County Public Works Department. Subsection 101.51 "Project Engineer" shall mean an employee designated as such by the Weld County Public Works Department. Subsection 101.58: "Region Transportation Director" shall mean Weld County Public Works Director or designated representative. Subsection 101.65: Roadway prism defined as toe of slope to toe of slope. Subsection 101.76: "State" shall mean Weld County. All references to State, CDOT, and the Department of Transportation shall be defined as Weld County acting directly or through its duly authorized representative or agent. END OF SECTION BID NO #B2100100 Page 50 1 REVISION OF SECTION 104 SCOPE OF WORK Subsection 104.02(c) shall be revised as follows: When the character of the work as altered differs materially in kind or nature from that involved or included in the original proposed construction. Subsection 104.07 paragraph 4, starting with "Net cost savings..." shall be revised as follows: Net cost savings on VECPs shall be split equally between the Contractor and Weld County as determined in the Basis of Payment section of this specification. VECPs shall be submitted prior to the start of construction activities relating to the VECP. Subsection 104.07(d)(2) shall be deleted and replaced as follows: 2. For all VECPs, the incentive payment shall be calculated as follows: (gross cost of deleted work) — (gross cost of added work) = (gross savings) (gross savings) — (Contractor's engineering costs) — (Weld County's engineering costs) = (net savings) Contractor's total incentive = (net savings)/2 Lost opportunity shall not be considered part of the calculations. The Contractor's engineering costs will be reimbursable only for outside consultant costs that are verified by certified billings. Weld County's engineering costs shall be actual consultant costs billed to Weld County and extraordinary in-house personnel labor costs. These labor costs will be calculated at the fixed amount of $100.00 per hour per employee. Project personnel assigned to the field office or who work on the project on a regular basis shall not be included in Weld County's portion of the costs. END SECTION BID NO #B2100100 Page 51 1 REVISION OF SECTION 105 CONTROL OF WORK Section 105 of the Standard Specifications is hereby revised for the project as follows: Subsection 105.01 the provisions regarding Authority of the Engineer shall include the following: Weld County has the authority by written order to suspend the Work wholly or in part for the reasons delineated in the Contract Documents. All employees shall have the skill and experience and any licenses or certifications required to perform the Work assigned to them. If the County determines in its sole discretion that any Person employed by the Contractor or by any Subcontractor is not performing the Work properly and skillfully, then, at the written request of the County, the Contractor or such Subcontractor shall remove such Person and such Person shall not be re-employed on the Project without the prior written approval of the County. If the Contractor or the Subcontractor fails to remove such Person(s) or fails to furnish skilled and experienced personnel for the proper performance of the Work, then the County may, in its sole discretion, suspend the affected portion of the Work by delivery of written notice of such suspension to the Contractor. Such suspension shall in no way relieve the Contractor of any obligation contained in the Contract Documents or entitle the Contractor to a Change Order. Weld County in its sole discretion may require the Contractor to replace project management staff (Project Manager, Superintendent, Project Engineer, etc.) for any reason. This will also apply to all of the Contractor's subcontractors. At the written request of the County, the Contractor or such Subcontractor shall remove such Person and such Person shall not be re-employed on the Project without the prior written approval of the County. If the Contractor or the Subcontractor fails to remove such Person(s), then the County may, in its sole discretion, suspend the affected portion of the Work by delivery of written notice of such suspension to the Contractor. Such suspension shall in no way relieve the Contractor of any obligation contained in the Contract Documents or entitle the Contractor to a Change Order. Subsection 105.02 the provisions regarding Plans, Shop Drawings, Working Drawings, other Submittals and Construction Drawings shall include the following: Provisions regarding plans, shop drawings, working drawings and construction documents are set forth in the Contract Documents. Subsection 105.03 the provisions regarding conformity to the Contract are revised as follows: When the Engineer or Weld County finds the Materials furnished, Work performed, or the finished product are not in conformity with the Contract Documents, and Weld County determines, in its sole discretion, that it has resulted in an inferior or unsatisfactory product, the Work or Materials shall be removed and replaced or otherwise corrected by and at the expense of the Contractor. Materials will be sampled and tested by the Contractor in accordance with the sampling and testing schedules and procedures contained in the Contract Documents. The quantity represented by five consecutive random samples will constitute a lot whenever production schedules and Material continuity permit. The Engineer may establish a lot consisting of the quantity represented by any number of consecutive random samples from one to seven inclusive when it is necessary to represent short production runs, significant Material changes, or other unusual characteristics of the Work. Tests that are determined to have sampling or testing errors will not be used. The Contractor will not have the option of accepting a price reduction in lieu of producing Material that complies with the Contract Documents. Continued production of nonconforming Material will not be permitted. Material, which is obviously defective, may be isolated and rejected by Weld County without regard to sampling sequence or location within a lot. Rejected material shall be removed at the Contractor's expense. BID NO #B2100100 Page 52 2 REVISION OF SECTION 105 CONTROL OF WORK Subsection 105.09 shall be revised as follows: Delete subsections 105.09 (and replace with the following: These specifications, the supplemental specifications, the plans, special provisions, and all supplementary documents are essential parts of the Contract, and a requirement occurring in one is as binding as though occurring in all. They are intended to be complementary and to describe and provide for a complete work. In the event of a discrepancy, the order of precedence is as follows: (a) Contract Documents including Exhibits, Addenda, and Appendices (b) Special Provisions I. Weld County Project Special Provisions ii. Weld County Standard Special Provisions iii. CDOT Project Special Provisions iv. CDOT Standard Special Provisions (c) CDOT Standard Specifications (d) Plans Detailed Plans ii. Standard Plans iii. Calculated dimensions will govern over scaled dimensions Notwithstanding the foregoing, in the event of conflicting requirements involving any requirement within the Contract Documents, the County shall have the right to determine, in its sole discretion, which requirement(s) apply. The Contractor shall request the County's determination respecting the order of precedence among conflicting provisions promptly upon becoming aware of any such conflict. The Contractor shall not take advantage of any apparent error or omission in the Contract. Should it appear that the work to be done or any matter relative thereto is not sufficiently detailed or explained in the Contract Documents, the Contractor shall immediately notify the Project Manager in writing for further written explanations as may be necessary and shall conform to the explanation provided. The Contractor shall promptly notify the Project Manager of all error which it may discover in the Contract Documents, and shall obtain specific instructions in writing regarding any such error before proceeding with the work affected thereby. The Project Manager will make corrections and interpretations as necessary to fulfill the intent of the Contract. The fact that the Contract Documents omit or mis-describe any details of any work which is necessary to carry out the intent of the Contract Documents, that are customarily performed under similar circumstances, shall not relieve the Contractor from performing such omitted work or mis-described details of the work, and they shall be performed as if fully and correctly set forth and described in the Contract Documents, without entitlement to a change order except as specifically allowed. Subsection 105.22 shall be revised as follows: The Colorado Department of Transportation (CDOT) will not participate in the resolution process for any claims filed by the Contractor. Weld County will be the responsible party to such claims. Subsection 105.24 is amended as follows: Delete all references to CDOT and replace with Weld County. Delete: The venue for all unresolved disputes with an aggregate value $25,000 or less shall be the County Court for the City and County of Denver. Replace with: The venue for all unresolved disputes with an aggregate value $25,000 or less shall be the County Court for Weld County. BID NO #B2100100 Page 53 3 REVISION OF SECTION 105 CONTROL OF WORK Subsection 105.24(c) is amended as follows: Delete: Division of Audit, 4201 E. Arkansas Ave, Denver, Co. 80222 Replace with: Weld County Board of Commissioners, 1150 O Street, Greeley, Co. 80632 Subsection 105.24(f) is amended as follows: In the third paragraph delete "the City and County of Denver" Replace with: "Weld County" In the fourth paragraph delete "Denver District Court" Replace with: "Weld County District Court" END OF SECTION BID NO #B2100100 Page 54 1 REVISION OF SECTION 106 CONTROL OF MATERIAL/SORAGE OF MATERIALS Subsection 106.08 shall be revised to include the following: When The Inspector inspects the material the following conditions will be met: The Inspector shall have the cooperation and assistance of the Contractor and the materials producer. Weld County reserves the right to select random samples from the job in progress for retesting. All materials delivered to the pre -approved staging area will have a representative sample and bill of lading available along with a certificate of specification compliance for the Inspector. Those materials sampled and tested after delivery on the project or after incorporation into the work that do not meet the requirements of the contract will be rejected. Slurry Seal: Precautions shall be taken to ensure that stockpiles are carefully mixed just prior to use to ensure uniform distribution of the moisture, and that they do not become contaminated with over -sized rock, clay, silt, or excessive amounts of moisture. To eliminate oversized aggregate, the material shall be screened at the load site immediately prior to use. Costs for the screen will not be measured or paid for separately, but shall be considered incidental to the work. The stockpile shall be kept in areas that drain readily. Segregation of the aggregate will not be permitted. The contractor shall exercise care in the selection of stockpile locations. The stockpile should be located so as to minimize impacts to existing traffic and local residents. Under no circumstances shall stockpiles be located creating hazardous conditions for the traveling public. It is the sole responsibility of the contractor to locate stockpile sites. Stockpile and staging areas are to be provided to the engineer prior to starting work. Storage: The Contractor shall provide suitable storage facilities for the asphalt emulsion, using containers equipped to prevent water from entering the emulsion. If necessary, suitable heat shall be provided to prevent freezing. END OF SECTION BID NO #B2100100 Page 55 1 REVISION OF SECTION 107 LEGAL RELATIONS AND RESPONSIBILITY TO PUBLIC Section 107 of the Standard Specifications is hereby revised for the project as follows: Subsection 107.01 shall include the following after the first paragraph: Failure to comply with all contractual obligations may lead to the suspension, debarment or both of the Contractor as stipulated in the "Rules". Subsection 107.06 shall be revised to include the following: The Contractor and any subcontractor shall not require any laborer or mechanic employed in performance of the Contract to work in surroundings or under working conditions which are unsanitary, hazardous, or dangerous to his health or safety, as determined under construction safety and health standards (Rules and Regulations of the Federal Occupational Safety and Health Act of 1970 (OSHA) and as amended). All facilities and work conditions shall comply with the Colorado and Local Health Department Regulations and with OSHA requirements. Subsection 107.15 shall be revised to include the following: For this project, the insurance certificates shall name Weld County (Weld) and as additionally insured parties. Subsection 107.17 — Delete the third paragraph beginning with "Loss, injury, or damage to the work..." and replace with the following: Loss, injury, or damage to the work due to unforeseeable causes beyond the control of and without fault or negligence of the Contractor, including but not restricted to acts of God, such as flood, earthquake, tornado, or other cataclysmic phenomenon or nature shall be restored by the Contractor at no cost to the County. Subsection 107.19 shall be revised to include the following: The Contractor shall be required to obtain permission to conduct any work, store materials or stockpiles, or park any construction equipment or vehicles on private property. The Contractor shall conduct their work within the right-of-way and easement boundaries shown on the Contract Drawings. If working in the County right-of-way, the Contractor shall obtain a right-of-way permit from the Public Works Right -of -Way Permitting Technician, 970- 304-6496. END OF SECTION BID NO #B2100100 Page 56 1 REVISION OF SECTION 108 PROSECUTION AND PROGRESS Section 108 of the Standard Specifications is hereby revised for this project as follows: Subsection 108.03(b) shall include the following after the first paragraph: The Bar Chart or Initial Schedule shall be submitted at least 10 working days prior to the start of the work. The Engineer's review of the Schedule will not exceed two working days. Work shall not begin until the Schedule is accepted in writing, unless otherwise approved by the Engineer. Delete the second paragraph starting with "The Contractor shall not carry on construction..." in subsection 108.08 and replace with the following: The Contractor shall not carry on construction operations on Saturdays, Sundays, or holidays unless previously arranged and approved by the Project Manager and Inspector Supervisor. The Contractor shall not perform construction operations on any three or four -day holiday weekend without prior written approval. Requests for weekend construction operations shall be presented in writing to the Project Manager and Inspector Supervisor no later than Wednesday at 5 p.m. prior to the weekend in which the work will be performed. Written requests received after the deadline will be reviewed on a case by case basis. The Project Manager and Inspector Supervisor are not required to provide written approval for weekend inspectable construction operations requests. In the event, the weekend construction operations involve inspectable work (operations requiring a construction inspector), the Contractor shall provide a credit on the next pay application to the County. The amount credited shall be $200.00 for the first 4 hours and $50.00 per hour per day thereafter for each Inspector required to perform inspections on the inspectable work. This requirement will be waived when the County requires weekend work on parking lots. Construction operations shall stop at 5 p.m. the day before the start of the holiday weekend. Construction operations may resume after the holiday weekend has passed. The Contractor shall only make emergency repairs and provide proper protection of the work and the traveling public on the holiday weekend days. Delete subsection 108.08(a)(2), and replace with the following: Calendar Day Contract. When the work is on a calendar day basis, one calendar day of contract time will be assessed for each calendar day from the date that Contract time starts. Calendar Day Contracts have been adjusted prior to bid advertisement to account for no work on Saturdays, Sundays, and holidays by increasing the calendar days by the appropriate number of days. As stated in subsection 108.08, no inspectable construction operations shall occur on Saturdays, Sundays, and holidays unless prior approval has been granted. No weather days or less than full time charges days will be granted in this contract. In subsection 108.09 delete the schedule of liquidated damages and replace with the following: Original Contract Amount ($) Liquidated Damages per Calendar Day ($) From More Than To and Includiinn � � _ >fx� !� �` dam. , � ' �� a�� l1 � ��, xwG``' �.K'��;S, ;�. �. ., .. Ya:�b ,,. . , . , . � ✓ ,.� . �.. .. a IA 150,000 150,000 500,000 1,000 1,000,00.0 2,000,000 2,300 . ✓ `Wa^pi uA.�i'..v�'ti'��'.0 G �H6 ft . , vn � •�`1'.siiaa4.,f.ebd ,r,,._ ,� b � . ,�..al e, , . . t ? , ≥Y�...st✓..r +�K4 ski. 2i`�.:¢. .p � £ , . �. .u."i� �> �� 7.... �Bt nY. %"�b.: 4� 4,000,000 10,000,000 5,800 ,.. ., w*srn` .., p h ., s �T hereof . ✓ r E r 10,000,000 i.5µ x + .k�, r -. -i . , ,. lid .n i�w `3 43„K �x �. ... �. { END OF SECTION BID NO #B2100100 Page 57 1 REVISION OF SECTION 109 MEASUREMENT AND PAYMENT Section 109 of the Standard Specifications is hereby revised for the project as follows: Subsection 109.06(a) — Delete the second sentence beginning with "The amount retained ", and replace with the following: The amount retained will be 10% of the value of the completed work, to a maximum of 5% of the contract amount. No retainage shall be released prior to Final Acceptance. In Subsection 109.07 — Delete and replace with the following: Partial monthly payments to the Contractor for completed work will include payment only for materials actually incorporated in the work unless otherwise approved by the Engineer. END OF SECTION BID NO #B2100100 Page 58 1 REVISION OF SECTION 408 JOINT AND CRACK SEALANT Crack Fill: Section 408.02 of the Standard Specifications is hereby revised for this project as follows: Weld County will supply the crack fill material for this contract. Specifications below are for information only. Material specifications and references in the plans are in accordance with the State Department of Highways, Division of Highways, State of Colorado, Standard Specifications for Road and Bridge Construction, 2017. The Contractor will submit asphalt mix formulas and aggregate in writing prior to job start. State Highway mix formulas and aggregate tests on the materials to be used are acceptable. Material Specification Hot Pour Rubberized Asphalt Crack Filler. Crack filler material shall be hot pour polymer rubberized asphalt crack filler and shall not contain vulcanized or reclaimed rubber. Crack filler material shall meet or exceed the following requirements. Material shall be tested in accordance to ASTM D-5329. Samples shall be prepared and heated in accordance to ASTM D-5167. Cone Penetration: The average of three determinations, when tested at 77EF for five (5) sec. at 150 grams total moving weight, will not exceed 90 DMM. Resilience: The average of three determinations when tested at 77EF for twenty (20) sec. will be a minimum of 60%. Flow: Material shall be tested in accordance to ASTM D-3407, Flow shall not exceed 3 mm. after 5 hours. Softening Point: Material shall have a minimum softening point 190EF (93.3 DC), ASTM D36. Tensile Strength Adhesion: Conduct test in accordance with ASTM D-3406, Section 4.7 Tensile Adhesion @ 77F; except that sealant specimens shall be cured 4 hours (not 7 days). Minimum extension is 500%. Ductility: A standard specimen shall be capable of being pulled a minimum of 30 cm at 1 cm/min at 39.2DF (4DC) (State of Utah Test). Force Ductility: The standard specimen shall not exceed a force of 4 pounds maximum during the specified elongation rate of 1 cm/min at 39.2DF (4DC). (State of Utah Test). Flexibility: A (1/8" x 1" x 6") specimen of the product conditioned to-16.6DF (-27DC)for one hour shall be capable of being bent to a 90D angle over a 1 - 1/8 inch (28.6mm) mandrell in 2 seconds without cracking. (State of Utah Test). Viscosity: Material shall have a viscosity of 1700CP maximum at 300DF (148.9DC), as determined by the Brookfield viscosity test method, SC4-27 spindle, 20 rpm. Incubate the specimen in the sample chamber and thermosel unit for 15 minutes prior to conducting the test. Report the result as the average of three. Use readings taken at 15, 30, and 45 minutes. BID NO #B2100100 Page 59 2 REVISION OF SECTION 408 JOINT AND CRACK SEALANT Delete Section 408.03 and Replace with the Following: Visible thermal cracking six (6) feet or more between cracks or as directed by the inspector shall be cleaned and sealed. Immediately prior to sealing the crack and surface area for a least six (6) inches on both sides of the cracks(s) shall be cleaned of foreign matter, vegetation, and loosened particles with a HCA (hot compressed air) heat lance. In the event that the hot air lance is not able to clean and preheat the crack without over heating the surface it will be necessary for the contractor to use other means to remove debris from the crack. Adequate cleaning is determined by a darkening of the surface at least two inches in width, centered on the crack. Where dirt is still being retained on the un-melted (un-darkened) surface, the darkened width may be expanded to match the sealant configuration or as directed by the inspector. The heat lance shall meet the following requirements: temperature of heated air at exit orifice minimum of 2,500E F. Velocity of existing heated air minimum of 1,800 fps. Direct flame dryers shall not be used. The band shall have a minimum thickness of 1/32 inch and a maximum thickness of 3/32 inch. A wipe zone flush with the pavement surface shall extend for a minimum of one-half (%") inch to a maximum of one (1) inch on either side of the band (see drawing Band-Aid Configuration page 38). The band shall be centered on the crack. Where traffic or construction activities may cause tracking or pull-out of the sealant material, the Contractor shall sand the sealant as it is placed, or as directed by the inspector. Only silica sand or approved materials will be allowed, and shoulder dirt or gravel will not be used. Sealant material picked up or pulled out shall be replaced at contractor expense. Any damage to the traveling public resulting from sealant application or sealant pull-out shall be paid for the Contractor. The contractor shall repair all damaged work areas to their original condition prior to construction. Damaged areas will be repaired prior to moving to the next section. Cleaning and Sealing shall extend across the full width of the bituminous surfacing including paved shoulders, or as directed by the Engineer. Sealing shall be done only when the cracks are clean, dry, and preheated and only upon inspection and approval of the Engineer. Equipment: Sealant placement shall use circulating hot oil heat transfer for heating the product (sealant machines). No direct heat transfer units (tar pots) shall be used. Maximum product tank capacity of sealant placement equipment shall not exceed 500 gallons. Alternate equipment shall be approved by theinspector. Temperature Control: Sealant manufacturer's instructions on application temperature shall be observed. The Contractor's sealant unit shall have available at all times, an operating ASTM 11-F thermometer with an intact mercury column or a certified, calibrated digital pyrometer, electronic thermometer, or equivalent direct reading temperature measurement device capable of reading within +-5❑F from 200❑F to 600❑F. A log of product tank temperatures shall be recorded at one, +-10 minute intervals, and kept available for inspection by the Engineer. Project tank temperatures shall be taken with one of the certified calibrated devices described. Temperature gauge readings are not acceptable. Material that has been overheated in excess of 30°F above the manufacturer's recommended maximum temperature for one (1) hour, or 60°F for 2 hour, shall be wasted at the Contractor's expense. The Contractor will replace wasted material with only approved material of like kind and quality. The material shall not be placed if the temperature at the wand tip is below the manufacturer's recommended application temperature. BID NO #B2100100 Page 60 3 REVISION OF SECTION 408 JOINT AND CRACK SEALANT Crack Fill Detail 1/2" to 1" a 1/32 3/32 1/2" to 1" a a a a s a a ° a a a a o a a a a ° a a a as 8 a a a Delete Section 408.05 and replace with the following: Crack Fill: This item in this contract includes all equipment, traffic control, signing and blotter material is to be bid and paid for by Unit Price per ton of filler; complete in place and ready for use. Crack sealing shall be measured by the ton of material used. The county will supply crack fill material for the job. The measured quantity shall include the blended mixture and dissolvable liner. The inspector at the contractor's expense may require the weighing of equipment for determination of actual quantities of material used. PAY ITEM PAY UNIT Crack Fill (Material Supplied by Weld County) TON END OF SECTION BID NO #B2100100 Page 61 1 REVISION OF SECTION 409 SAND SEAL Sand Seal: Section 409 of the Standard Specifications is hereby revised for this project as follows: Application Rates The contractor will supply daily run sheets showing material usage, time and duration of area covered, quantity of each application, and location of work. The contents and sealer/sand slurry mix shall be closely monitored to assure maximum cured film thickness. Two (2) applications are to be applied. The first coat should be allowed to dry to the touch 3 hours prior to the second application. Sealer shall contain three to five (3-5) lbs. clean, graded silica sand per gallon. Bulk sand and witnessed by inspector. Contractor will supply mixture data for specific tank size used. The rate of application shall be approximately (11.1-13.3) square yards per gallon based on mixed and applied. Sealer Specification A. SURFACE PREPARATION each application, coverage of this approximately 1 - shall be weighed material properly 1. All vegetation shall be removed from all surfaces to be sealed. 2. All surfaces to be sealed shall be thoroughly cleaned to remove all foreign debris (dirt, silt, gravel, etc.) using mechanically powered forced -air sweeper and steel bristle hand brooms. 3. Mud areas shall be scraped and thoroughly scrub -washed as necessary to assure proper adhesion of sealer. 4. Oil spots shall be removed. It may be necessary to apply a degreasing agent and then scrape or scrub the area to remove excess oil. B. SEALER APPLICATION 1. Sealer shall be applied strictly according to manufacturer's specifications 2. All sealer/sand emulsion shall be homogenous. Materials shall be kept in adequate suspension at all times during application by constant agitation. 3. All sealer/sand mix shall be uniformly applied utilizing techniques to fill voids and hairline cracks. There shall be no puddles or pin holes in finish coating. 4. All work shall be done using specialized seal coating equipment. Handwork will be allowed only in areas inaccessible to equipment or to accommodate neat, trim work at curb -lines. A dedicated effort shall be made to protect sidewalks, curbs, and concrete aprons and all other no asphalt surfaces from spills, footprints, or tire marks. Over spray or tracked areas will be removed at contractor's expense. 5. Sealer shall not be applied when ambient temperature is below 60 degrees, or falling, or when rain is imminent. 6. Sealed areas shall be barricaded from traffic and may be re -opened in no less than 24 hours. BID NO #B2100100 Page 62 2 REVISION OF SECTION 409 SAND SEAL Asphalt Emulsion Sand Seal: 1. MODIFIED ASPHALT EMULSION PHYSICAL PROPERTIES: Particle Charge Cationic (With 3-5 lbs aggregate per gal) Color (wet) Brown Color (dry) Flat Black Penetration Base Asphalt 30-50 Specific Gravity 1.18 Min Polymer/Asphalt Ratio 2% min. Asphalt Cement to be polymerized before emulsification not post added latex. 2. AGGREGATE: Use washed dry silica sand or boiler slag, free of dust, trash, clay, organic materials or other contaminants. Sand added to 300 to 500 lbs per 100 gals of Modified Asphalt Emulsion. 3. WATER: Use water for mixing that is potable and free of harmful soluble salts. Water temperature needs to be at least 50 degrees Fahrenheit. Water added at 15% to 25% of Modified Asphalt Emulsion Concentrate. 4. OIL SPOT PRIMER: Must be compatible with Modified Asphalt Emulsion and be applied per manufacturer's recommendations. 5. The seal coat material must meet or exceed the requirements to Federal Specification R -P 355-D, and have the typical properties: Product Data Water, % Non Volatiles, % Ash Non Volatiles, Specific Gravity 25 Degrees C. Drying Time Minimum 15 47-53% 30-60 1.18 Min. 8 Hr. Max Maximum 25 52.1 40 1.21 PASS IIXTURE CHART PER 100 GAL OF MODIFIED ASPHALT EMULSION Application Modified Asphalt Emulsion Concentrate Water Aggregate Formula Rate of Mix per Application /Square Yard /Square Yard Gallons Gallons LBS Min.Gal. Max.Gals 1st Spray Coat 100 15-25 300-500 0.11 0.13 2nd Spray Coat 100 15-25 300-500 0.11 0.13 Additional coats may be added following the same spec for high traffic areas. BID NO #B2100100 Page 63 3 REVISION OF SECTION 409 SAND SEAL EQUIPMENT: 1. Use application equipment that is capable of applying the material at required coverage rates evenly over the entire surface. To ensure this, equip all spray units with a pumping distribution system using positive displacement pumps. 2. The mixing part of the application equipment must be the tank type with a mechanically -powered, full -sweep mixer capable of homogeneously mixing the entire contents of the tank. 3. Use of hand squeegee or brush application is to be restricted to places not accessible to the mechanized equipment or to accommodate neat trip work at curbs, etc. Material that is applied by hand is to meet the same standards as that applied by machine. 4. Perform a water -break -free test to confirm that the surface oils have degraded and dissipated. (Cast one gallon of clean water out over the surface. The water should sheet out and wet the surface uniformly without crawling or showing oil rings.) If asphalt does not pass this test, additional time must be allowed for extra curing and retesting prior to sealing. 5. Cleaning: Clean as detail above. 6. Oil Spot Priming: As needed, see above. MIXING & APPLICATION OF MODIFIED ASPHALT EMULSION SEALER MIXING: 1. Blend the Asphalt Emulsion mixture in the equipment described above. The mixing must produce a smooth homogeneous mixture of uniform consistency. (Consultant asphalt emulsion supplier for its recommended order of addition of the ingredients.) During the entire mixing and application process, not breaking, segregating or hardening of the emulsion, nor bailing or lumping of the sand is to be permitted. 2. Small additional incremerts of water may be needed to provide a workable consistency, but in no case is the water content to exceed the specified amount. 3. A staging area will be agreed to at the pre construction conference that will satisfy Weld County of quantity usage and product proportion. 4. A traffic control plan must be submitted at the pre construction meeting for review prior to construction. Removal and Replacement of Curb Stops Some parking lots may require removal of curb stops to complete sealing and pavement marking operations. This work will not be paid for separately but will be subsidiary to item 409 Sand Seal. BID NO #B2100100 Page 64 4 REVISION OF SECTION 409 SAND SEAL Section 409.04 of the Standard Specifications is hereby revised for this project as follows: No product shall be applied: When there is any danger the finished product will freeze before it cures completely. In the period following a rain while puddles of water remain on the surface to be coated. Sand Seals that cure by evaporation shall not be laid during periods of abnormally high humidity, or when rain may fall within eight (8) hours. Sand Seal shall not be laid during periods of high humidity above 45%. Sealer should not be applied unless pavement temperature is at least 50° degrees Fahrenheit and the air temperature is 60° Fahrenheit and rising, and no freezing temperatures are expected for at least 24 hours. Section 409.09 of the Standard Specifications is hereby revised for this project as follows: The accepted quantities of sand seal will be paid for at the contract price per square yard PAY ITEM PAY UNIT Sand Seal Square Yard END OF SECTION BID NO #B2100100 Page 65 1 REVISION OF SECTION 409 SLURRY SEAL Slurry Seal Section 409 of the Standard Specifications is hereby revised for this project as follows: Asphalt Emulsion: The emulsified asphalt shall conform to the requirements listed below for type CQS-IhL except that the residual asphalt shall constitute at least 60% of the emulsion by weight. CQS-1 hL CATIONIC QUICK SETTING EMULSIFIED ASPHALT WITH 3% LATEX POLYMER CQS-1 hL shall be an emulsified blend of asphalt, water, styrene -butadiene rubber (SBR) latex and emulsifiers. The emulsion shall be pumpable and suitable for use in slurry seal mixing and spreading equipment and suitable for application through a distributor truck. The emulsion shall contain a minimum of three percent (3.0%) by weight of styrene -butadiene rubber (SBR) polymer solids based on weight of residual asphalt. The polymer shall be added as SBR latex by high shear mixing by co -milling or post -milling. The emulsified asphalt shall conform to the following requirements: Tests on Emulsion: Viscosity, Saybolt Furol, 77°F, s Storage stability test, 24-h, %A Particle charge test Sieve test, %A DistillationB: Residue, % Min. Max. Test Method 20 50 ASTM D88 1 ASTM D244 (' 82 to 88) positive ASTM D244 ( ' 28 to 33) 0.1 ASTM D244 (' 58 to 63) 60 ASTM D244 (' 11 to 15) Tests on residue from oven evaporation test (ASTM D244 21 to 27)8: Penetration, 77°F, 100g, 5s Ductility, 77°F, 5 cm/min cm Solubility in trichloroethyene, % Elastic recovery, 77°F, 1 Dcm, 1h, % 40 90 ASTM D5 40 ASTM D113 97.5 ASTM D2042 40 ASTM D6084 A. This test requirement on representative samples is waived if successful application of the material has been achieved in the field. B. Distillation to 500°F (D244 ' 11 to 15) shall be the reference method for percent distillate and percent residue. Residue by evaporation at 325°F (D244 ' 21 to 27) shall be the reference method to obtain material for tests on residue. Residue from distillation shall not be used for tests on residue due to polymer degradation at 500°F. Aggregate: RECOMMENDED SLURRY SEAL AGGREGATE SPECIFICATION The aggregate shall coisist of natural or manufactured sand, slag, crusher fines, and others or a combination thereof. Smooth textured sand of less than 1.25% water absorption shall not exceed 50% of the total combined aggregate. The aggregate shall be clean and free from organic matter, other deleterious substances, and clay balls and shall meet the following requrements: BID NO #B2100100 Page 66 2 REVISION OF SECTION 409 SLURRY SEAL Aggregate will be sampled per CP 30 (4.3.3.3 Sampling Tube) Materials finer than No. 200 sieve will be determined by washing. Sieve Size 3/8 No. 4 No. 8 No. 16 No. 30 No. 50 No. 100 No. 200 Percent Passing Stockpile Tolerance 100 90-100 65-90 45-70 30-50 18-30 10-21 5-15 Oversize granular material and/or presence of clay balls will require the project to be stopped. Screening through a #4 screen will be required prior to delivery to the slurry machine. If clay balls are present, the aggregate may not be used. Resistance to Degradation Soundness of Aggregate Sand Equivalent Value (ASTM C131) (ASTM C88) (ASTM D2419A) 60 minimum 25% maximum loss 15% maximum loss The reference method for preparation of the sample shall be as follows: The aggregate shall be oven dried at 140°F to a constant weight and allowed to cool to room temperature. Two percent (2.0%) of water based on weight of the aggregate shall be mixed with the aggregate and the aggregate -water mixture shall be sealed in a moisture proof and water proof container for a minimum of 24 hours. Complete using ASTM D2419 Procedure B. Mineral fillers such as Portland cement, limestone dust, lime, and fly ash shall be considered as part of the blended aggregate, and shall be used in the amount required. They shall meet the gradation requirements of AASHTO M17. Mineral fillers shall be used for one or more of the following reasons only: to improve the gradation of the aggregate; to control the time of break of the emulsion; to provide improved stability and workability of the slurry; or to increase the durability of the cured slurry. The total aggregate, including mineral filler, shall conform to the following gradation when tested by AASHTO T27. Mix Design General: Before work commences, the Contractor shall submit a mix design, signed and stamped by a Professional Engineer, covering the specific materials to be used on the project. This design shall be prepared by an independent laboratory qualified in slurry seal mix design and testing. Once the materials are selected, no substitution will be permitted unless first tested and approved by the laboratory preparing the mix design. Mix Design: The qualified laboratory shall develop the job mix design and present certified test results to the County Inspector. Compatibility of the aggregate and emulsion shall be verified by the mix design. All component materials used in the mix design shall representative of the material proposed by the Contractor for use on the project. AGGREGATE: Unit Weight of Aggregate from 0 to 5% moisture by Rodding Procedure (ASTM C29) Soundness of Aggregate (ASTM C88) - aggregate supplier report accepted Resistance to Degradation by Los Angeles Machine (ASTM C131) - aggregate supplier report accepted BID NO #B2100100 Page 67 3 REVISION OF SECTION 409 SLURRY SEAL Gradation of Aggregate, with Materials finer than No. 200 sieve by wash (ASTM C136 and ASTM C117) Sand Equivalent Value of Ag regate with 2% moisture content (ASTM D2419 modified) Determination of height of la gest aggregate particle retained on #4 sieve EMULSION: Viscosity, SSF, 770r, s (ASTM D5) Storage Stability Te1st, 24h, % (ASTM D244) Particle Charge Test (ASTM D244) Sieve Test, % (ASTM D244) Residue, % (ASTM D244) Polymer Content, % (Supplir Certification) Penetration of Residue, 77°F, 5s, 100g, dmm (ASTM D113) Ductility of Residue, 77°F, 5am/min, cm (ASTM D113) Solubility of Residue in Trich oroethylene, c1/0 (ASTM D2042) Elastic Recovery of Residue, 77°F, 1 hr, 10cm, % (ASTM D6084) Specifications: The Owner shall review the design mix and all materials and methods prior to use. The component materials shall be within the following limits. Residual Asphalt 7.5% to 13 5% by dry weight of aggregate Mineral Filler 0% to 3% by dry weight of aggregate Additive As required to provide the specified properties Water As required to produce proper mix consistency Laboratory Testing: Sources of all materials shall be selected and identified by the Contractor. All materials shall be pretested by the Contractor, at his expense, by a qualified laboratory as to their suitability for use in slurry and conformance with project specifications. Laboratory Report: The labor their values to those requirec mixture. Test Pu Slurry S Excess Wet Strii Compati Quick S Wet Tra Mixing tests must pass a Using job aggregate tory report will show the results of tests performed on the individual materials, comparing by this Specification. The report will provide the following information on the slurry seal pose al Consistency asphalt ping Test �ility t Emulsion k Abrasion Method Spec ISSA T106 2-3 cm ISSA T109 50 gms/sq ft. max. ISSA T114 Pass ISSA T115 *Pass ISSA T102 **Pass (6 day soak)ISSA T100 75 gms/sq ft. max. the maximum expected air temperature. BID NO #B2100100 Page 68 4 REVISION OF SECTION 409 SLURRY SEAL The laboratory shall further report the quantitative effects of moisture content on the unit weight of the aggregate (bulking effect). The laboratory report must clearly show the proportions of aggregate, mineral filler (min. and max.), water (min. and max.), additive(s) (usage), and asphalt based on the dry aggregate weight. A complete laboratory analysis and test report accompanied by abraded and unabraded slurry test samples shall be submitted by the Contractor a minimum of 2 weeks prior to use. The County Inspector shall be allowed to observe all testing. The County Inspector will perform testing on materials and mix design proposed for the project. This testing will be at the County's expense. The Contractor shall supply material samples as needed at no expense to the County. In addition to the tests shown above, the Owner shall use Schulze -Breuer -Ruck compatibility, methylene blue, cohesion, loaded wheel, and other tests it deems necessary to verify the quality of the slurry and its components. BID NO #B2100100 Page 69 5 REVISION OF SECTION 409 SLURRY SEAL Section 409.05 of the Standard Specifications is hereby revised for this project as follows: Equipment: All equipment, tools, and machines used in the performance of this work shall be maintained in satisfactory working order at all times. Any equipment found to be defective and potentially affecting the quality of the paving shall be replaced. Slurry Mixing Equipment: he slurry mixing machine shall be a double shafted continuous flow mixing unit, capable of delivering accurate pre- determined proportions of aggregate, water, and asphalt emulsion to a revolving spiraled multi blade mixer tank, and of discharging the thoroughly mixed product on a continuous basis. The aggregate shall be pre -wetted immediately prior to mixing with the emulsion. The mixing unit shall be capable of thoroughly blending all ingredients together without violent action. The mixing machine shall be equipped with suitable means of accurately metering each individual material being fed into the mixer. The units shall be equipped with approved devices so that the machine can be accurately calibrated and the quantities of materials used during any one period estimated. The mixing machine shall be equipped with a water pressure system capable of misting all the tires where they contact the pavement. The system is to be activated when ambient temperatures are over 90E F or when directed by the Engineer. A fog type spray bar adequate for completely fogging the surface with up to 0.05 to 0.10 gallons per square yard (depending on conditions and as directed by the Engineer), immediately ahead of the spreading equipment. The machine shall be capable of mixing materials at preset proportions regardless of the speed of the machine engine, and without changing machine settings. Slurry Spreading Equipment: The surfacing mixture shall be spread uniformly by means of a mechanical type spreader box attached Ito the mixer, equipped with paddles to agitate and spread the materials throughout the box. A front seal shall be provided to insure no loss of the mixture at the road contact point. The rear seal shall act as final strike off and shall be adjustable. The mixture shall be spread to fill cracks and minor surface irregularities and leave a uniform skid resistant application of material on the surface. The spreader box and rear strike off shall be so designated and operated that a uniform consistency is achieved to produce a free flow of material to the rear strike off. The longitudinal joint where two passes join shall be neat appearing, uniform, and lapped. All excess material shall be removed from the job site prior to opening the road. The spreader box shall have suitable means provided to side shift the box to compensate for variations in pavement width, longitudinal alignment, and pavement geometry. Proportioning Devices: Individual volume or weight controls for proportioning each material to be added to the mix, i.e., aggregate, mineral filler, emulsified asphalt, and water shall be provided and properly marked. These proportioning devices are usually revolution counters, gate valves, or similar devices and are used in material calibration and determining the materials output at any time. Joints: Longitudinal joint overlap shall not exceed six inches over the previously placed slurry unless approved by County Inspector. Only burlap overlap drags will be permitted. Other types of drags will be permitted only with consent of the County Inspector. When burlap drags are used, they must be kept relatively clean, free of excessive build up, tears, and replaced a minimum of twice daily or at the discretion of the County Inspector. Quality Control: The Contrf actor will assist the County Inspector in taking samples of the aggregate and asphalt emulsion used in the project at the Project Managers discretion. Gradation and sand equivalent tests may be run on the aggregate and residual asphalt content tests on the emulsion. Test results will be compared to specifications. Initial tests will be run at the expense of the County. BID NO #B2100100 Page 70 6 REVISION OF SECTION 409 SLURRY SEAL Slurry Seal: Samples of the material may be taken directly from the mixing unit(s). Consistency and residual asphalt content tests may be made on the samples and compared to the specifications. Initial tests will be run at the expense of the Owner. The County Inspector may use the recorders and measuring facilities of the unit to determine application rates, asphalt emulsion content, mineral filler, and additive. Hand Work: Approved methods shall be agreed upon at pre -construction meeting for hand work. Lutes and squeegees shall be used to spread slurry in areas not accessible to the slurry mixer. Care shall be exercised to leave a pleasing appearance. Noncompliance,: If any two successive tests fail on the stockpile material, the job shall be stopped. If any two successive tests on the mix from the same machine fail, the use of the machine shall be suspended. It will be the responsibility of the Contractor, at his own expense, to prove to the County Inspector that the problems have been corrected and that the machine is working properly. Finish: No streaks, such as those caused by oversized aggregate, will be left in the finished surface. No ripples or chatter marks will be allowed. If these conditions develop, the job will be stopped until the Contractor proves to the County Inspector that the situation has been corrected. After the lay -down work is completed and before final acceptance by the County Inspector: spot application of slurry seal material may be required to correct any deficiencies such as streaking. Scuff marks, tire tracks, gaps, etc. to improve the ride quality and overall appearance. Slurry seal material required to repair deficiencies due to unsatisfactory workmanship shall not be paid for but shall be placed entirely at the Contractors expense. Section 409.04 of the Standard Specifications is hereby revised for this project as follows: No product shall be applied: When there is any danger the finished product will freeze before it cures completely. In the period following a rain while puddles of water remain on the surface to be coated. Slurries that cure by evaporation shall not be laid during periods of abnormally high humidity, or when rain may fall within four (4) hours. Slurries shall not be laid during periods of high humidity above 45%. Ambient temperature should be 50°F and rising, pavement surface temperature should be 65*F and rising. BID NO #B2100100 Page 71 7 REVISION OF SECTION 409 SLURRY SEAL Section 409.07 of the Standard Specifications is hereby revised for this project as follows: Applying Slurry Seal: Daily reports shall be furnished by the Contractor to be used as a check for application rates and composition of the slurry mix. The amount of asphalt emulsion to be blended with the aggregate shall be determined in the laboratory, subject to final adjustment in the field to allow for absorption by the existing surface. The amount of water added must be controlled accurately to insure production of a readily spreadable, yet completely stable slurry. Proper water content shall be determined by an appropriate consistency test on freshly made slurry using T-106 procedures. The slurry shall be a homogenous mixture, sufficiently stable during the entire mixing - spreading period that the emulsion does not break; that there is no segregation of fines from the coarser aggregate and the liquid portion of the mix does not float to the surface. Total time of mixing, from introduction of emulsion to spreading shall be 2 minutes or less. The weight of dry aggregate applied per unit area shall be 18 lbs./Sq. Yd. The Contractor shall place a test strip of 60 square yards in the area designated by the County Inspector. The test section shall be placed using the same equipment and methods to be used on the job. Slurry mixtures placed in test strips shall conform to design mix with minor variations to obtain crack fillings bond to pavement, and desired skid resistant texture. In the event materials do not meet the requirements for fluidity, non -segregation, or surface texture, a new job mix shall be formulated and tested. Work shall not proceed before approval of a design mix and acceptance following the placing of a test strip. Proportions of the material components to be used will be identified in the mix design. Minimum application rates are: Dry Aggregate Spread Rate % Mineral Filler* % Asphalt Emulsion* *by dry weight of aggregate = 18 lbs./Sq.Yd. =0-1.00% = 8.0% Application rates will be set to match the approved mix design. The range of acceptable application rates will be set to within plus or minus 1 pound of the application rates above. If daily checks indicate that the average application rates were below the minimum application rates, the final payment for individual roads will be reduced as shown below: Amount Below Minimum Application Rate, Aggregate, Emulsion or Mineral Filler 1-3% 3-5% 5-7% 7-10% 10%+ Percent Reduction in Final Payment for Aggregate, Emulsion or Mineral Filler 10% 15% 20% To be negotiated No pay The Owner will continually be checking quantities. The Contractor is encouraged to also check quantities with run sheets to avoid the penalties described above. Responsibility for ensuring proper spread rates and material proportions is solely the Contractors. The Contractor will be required to test sections on each project or sections where surface conditions change, in order to determine the appropriate rates and to calibrate equipment. The testing will be done at the direction of the Engineer. BID NO #B2100100 Page 72 8 REVISION OF SECTION 409 SLURRY SEAL Section 409.09 of the Standard Specifications is hereby revised for this project as follows: The accepted quantities of slurry seal will be paid for at the contract price per square yard PAY ITEM PAY UNIT Slurry Seal Square Yard END OF SECTION BID NO #B2100100 Page 73 1 REVISION OF SECTION 627 PAVEMENT MARKINGS Section 627.10 of the Standard Specifications is to include the following: Temporary pavement markings will be placed by contractor. The 4" wide by 12" long retro reflective adhesive tape will be placed at 75' intervals at the measured center of the roadway. Temporary marking tape is required prior to leaving job each day when existing pavement markings have been covered entirely or even partially. Under no circumstances will a road be left overnight without centerline delineation. Payment will not be made separately but shall be subsidiary to item 409 Slurry Seal. Section 627.04 shall be Evised to include the following: Contractor grade acrylic paint for striping in parking lots and epoxy pavement markings for roadway work. NOTE: Application rate for pavement markings is to be placed @ 1 Gal. / 89-93 SF SUBMITTALS A. Product Data 1. Submit manufacturer's printed Product Data Sheets. PROJECT/SITE CONDITIONS A. ENVIRONMENTAL REQUIREMENTS 1. Apply marking paint in dry weather when pavement and atmospheric temperatures are fifty (50) degrees F. or above (or mfg. Specification) and are anticipated to remain above fifty (50) degrees F. for four (4) hours after completing application. PART 2 PRODUCTS EQUIPMENT A. Commercial compressed air spray striping machine capable of applying an even coating at the manufacturer's recommended thickness in an even width across the stripe. Dr B. Commercial airless spray striping machine capable of applying an even coating at the manufacturer's recommended thickness in an even width across the stripe. EXAMINATION A. Inspect existing pavement surfaces for conditions and defects that will adversely affect quality of work, and which cannot be put into an acceptable condition through normal preparatory work as specified. B. Do not place marking over unsound pavements. If these conditions exist, notify Engineer. C. Starting installation constitutes contractor's acceptance of surface as suitable for installation. PREPARATION A. Provide qualified technician to supervise equipment and application of marking. Layout markings using guide lines, templates and forms. Stencils and templates shall be professionally made to industry standards. "Free hand" painting of arrows, symbols, or wording shall not be allowed. B. Thoroughly clean surfaces free of dirt, sand, gravel, oil and other foreign matter. C. Protect adjacent curbs, walks, fences, and other items from receiving paint. D. [Verify that any new pavement coating has been accepted by Engineer and has cured a minimum of twenty four (24) hours under good drying conditions. APPLICATION A. Apply marking paint at a rate of one (1) gallon per three to four hundred (300-400) lineal feet of four (4) inch wide stripes. (Or to mfg. specification) B. Apply stripes straight and even in accordance with schedules. BID NO #B2100100 Page 74 PROTECTION A. Barricade marked areas during installation and until the marking paint is dried and ready for traffic. NOTE: ALL HANDICAP MARKINGS WILL NEED TO BE UPDATED TO CURRENT ADA COMPLIANT. Glass beads shall conform to AASHTO M-247, Type 1 and should be silicon treated. Removal and Replacement of Curb Stops Some parking lots may require removal of curb stops to complete sealing and pavement marking operations. This work will not be paid for separately but will be subsidiary to item 627 Pavement Marking Paint. Section 627.13 of the Standard Specifications is hereby revised for this project as follows: The accepted quantities of pavement marking paint will be paid for at the contract price per gallon. PAY ITEM PAY UNIT Pavement Marking Paint GALLON END OF SECTION BID NO #B2100100 Page 75 1 REVISION OF SECTION 630 CONSTRUCTION ZONE TRAFFIC CONTROL Subsection 630.10 shall be revised to include: Traffic control through the construction areas is the responsibility of the Contractor. For all locations, a Traffic Control Plan shall be prepared. The Traffic Control Plans shall be submitted for approval to the Engineer by 8:00 a.m., two working days prior to the commencement of work. (Note: Traffic Control Plans for work done on Monday and Tuesday shall be submitted the previous Friday by 8:00 a.m.) Full road closure is prohibited. All plans shall be delivered to County Engineering, 1111 H Street. Facsimiles of plans shall not be allowed. No phase of the construction shall start until the Traffic Control Plan has been approved. Failure to have an approved Traffic Control Plan shall constitute cause for the County to stop work, as well as the Contractor's forfeiture of payment for all work and materials at that location, with no adjustment in the contract time. All costs associated with Traffic Control Plan review will not be measured or paid for separately, but shall be considered incidental to the Work. The Traffic Control Plan shall include, as a minimum, the following: (1) A diagram which shows proposed locations of sign placement, including advance construction signs (if not previously approved) and speed limit signs; method, length and time duration for lane closures, and location of flag persons. (2) A tabulation of all traffic control devices shown on the detailed diagram including, but not limited to: construction signs; vertical panel; vertical panel with light; Type I, Type II, and Type III barricades; cones; drum channelizimg devices; advance warning flashing or sequencing arrow panel. Certain traffic control devices may be used for more than one operation or phase. However, all devices required for any particular phase must be detailed and tabulated for each phase. (3) (4) Parking Restrictbns to be in effect (Subdivision work and Parking Lots) Number of flaggers to be used. Subsection 630.11 shal be revised as follows: Traffic Control Management shall be performed by a Traffic Control Supervisor (TCS). The TCS(s) shall possess a current American Traffic Safety Services Association (ATSSA) certification as a Worksite Traffic Control Supervisor or Colorado Contractor's Association (CCA) certification as a Traffic Control Supervisor. (Proof of certification shall be presented to the county when requested by a county representative, for each TCS utilized on this project.) One TCS shall be desig.ated as the Head TCS. The Head TCS shall have a minimum of one year experience as a certified TCS. Quaifications shall be submitted to the Engineer for approval a minimum of one week prior to commencement of the work. It is the intent of the specifications that the Head TCS be the same throughout the project. If the Head TCS is to be replaced during the project, the Engineer shall be given a minimum of one (1) weeks notice and qualifications shall be submitted for approval for the replacement. The TCS will not paid separately but shall be included in bid unit cost for traffic control. The TCS's duties shall include, but not be limited to: Preparing, revising and submitting Traffic Control Plans as required. (Review fees will not be measured or paid for separately, but shall be considered incidental to the Work.) Direct supervision of project flaggers. Coordinating all taffic control related operations, including those of the Subcontractors and suppliers. BID NO #B2100100 Page 76 2 REVISION OF SECTION 630 CONSTRUCTION ZONE TRAFFIC CONTROL (4) Coordinating project activities with appropriate police and fire control agencies, Transport, school districts and other affected agencies and parties prior to construction. Typed hand delivered notification to all businesses and residents at least 24 hours prior to construction. (The notification of residents and businesses may be accomplished by a representative of the TCS.) (5) Maintaining a project traffic control diary which shall become part of the County's project records. (6) Inspecting traffic control devices on every calendar day for the duration of the project. (7) Insuring that traffic control devices are functioning as required. (8) Overseeing all requirements covered by the plans and specifications which contribute to the convenience, safety and orderly movement of traffic. (9) Flagging. (10) Setting up traffic control devices. Traffic control management shall be maintained on a 24 hour per day basis if necessary. The Contractor shall make arrangements so that the Traffic Control Supervisor or their approved representative will be available on every working day, "on call" at all times and available upon the Engineer's request at other than normal working hours. All costs associated with "on call" service, excluding actual hours worked, shall be included in the contract unit price for Traffic Control. Subdivisions and Parking Lots Only: Notification of residents and businesses shall be the responsibility of the TCS or Contractor and shall consist of distributing letters indicating the nature of the work to be completed, any special instructions to the residents (i.e. limits on lawn watering during and prior to sealing operations, etc.), the dates and times of the work, and the parking and access restrictions that will apply. Letters shall be submitted with the Traffic Control Plans for approval. Approved letters shall be distributed a minimum of 24 hours prior to the commencement of work. The cost for preparing and distributing the letters shall be included in the bid unit cost for traffic control. BID NO #B2100100 Page 77 3 REVISION OF SECTION 630 CONSTRUCTION ZONE TRAFFIC CONTROL Section 630.14 of the Standard Specifications is hereby revised for this project as follows: The Contractor shall install, move and maintain signs that shall be in compliance with the Manual on Uniform Traffic Control Devices. The Contractor shall also provide certified flaggers for the possible need to control local traffic during construction. See signing diagram. Slurry Seal The Contractor shall also provide certified flaggers and a pilot car. For slurry sealing, a signing drawing with instructions is provided on the following pages. The pilot car will be used to guide traffic, at low speeds, between flag men, and around the construction area. If the sign, cones, or flag pylons are not present, the Engineer or inspector may stop construction and all equipment will be removed from the roadway until signs or cones are placed. See signing diagram. NOTE: There are several proiect locations that will require multiple passes with the slurry machine. It will be necessary to use special considerations for traffic control because of the wider section being sealed. The cost for traffic control at these locations will be included in the bid item for traffic control. Traffic holding times shall be less than 5 minutes unless prior approval is given by inspector. Section 630.18 of the Standard Specifications is hereby revised for this project as follows: Accepted quantities of signing and traffic control for slurry seal will be paid for by total miles. Accepted quantities of signing and traffic control for sand seal will be paid for at each location. Accepted quantities of traffic control for CDOT intersections will be paid for at each location. PAY ITEM Signing and Traffic Control (Slurry Seal) Signing and Traffic Control (Sand Seal) Singing and Traffic Control (CDOT Intersections) END OF SECTION PAY UNIT MILE EACH EACH BID NO #B2100100 Page 78 1 REVISION OF SECTION 712.01 WATER Section 712.01 of the Standard Specifications is hereby revised for this project as follows: Water used in construction shall be obtained and paid for by the Contractor with the cost incorporated in the unit price bid. All water used for construction shall be potable. END OF SECTION BID NO #B2100100 Page 79 1 FORCE ACCOUNT ITEMS DESCRIPTION This special provision contains the County's estimate for force account items included in the Contract. The estimate amounts marked with an asterisk will be added to the total bid to determine the amount of the performance and payments bonds. Force Account work shall be performed as directed by the Engineer. BASIS OF PAYMENT Payment will be made in accordance with subsection 109.04. Payment will constitute full compensation for all work necessary to complete the item. Force account work valued at $5,000 or less, that must be performed by a licensed journeyman in order to comply with federal, state, or local codes, may be paid for after receipt of an itemized statement endorsed by the Contractor. Force Account Item Estimated Quantity F/A Minor Contract Revisions F/A Amount $5,000 F/A Minor Contract Revisions — This work consists of minor work authorized and approved by the Engineer, which is not included in the contract drawings or specifications, and is necessary to accomplish the scope of work for this contract. END OF SECTION BID NO #B2100100 Page 80 APPENDIX VICINITY MAP & DETAILS: Estimated Quantities 82-83 Project location Maps 84-87 BID NO #B2100100 Page 81 TOTALS FOR ROAD: Wield t�/'Y e�oi1in ' -luny Seal 2021 41 C.R 8 23 CR 20 East Bound 'dirt CR 26 Patrick St CR 18 (E0P) CR 59 1 CR 61 CR 50 1HW 34 CR23.5 ; CR25 990'N. of CR 32 13 West of CR 34 13 East of CR 34 1,170' N. of CR 34 19 18 1 24 74 27 29 74 43 12,933.00 8,888.00 10,352.00 10,471.00 5,663.00 4,563.00 2,536.00 5,510.00 1,080.00 1.68 1.96 1.98 1.07 0.86 26.001 1,480.00 0.28 24.00 15,820.00 3.00 32.00 5,650.00 24.00 15,600.00 2.95 25.00 21,200.00 4.02 23.06 690.00. 162.00 590.00 65.40 114.00 242.00 27.00 130.00 327.00 10435.00 5,738.00 6,400.00 37,252.00 24,770.89 29,217.56 31,032.56 16,781.18 13339.00 7,326.22 2.6,352.78 8,858.00 10,675.56 42,186.67 20,088.89 41,600.00 58,888.89 368,37018 Sand* Knolls Sandy Knolls CR 53 l End Davis Rd Intersection Intersect Intersect Davis Road 54.25 End Ranch Eggs 25.00 0.00 25.00 2595 0 760 0.49 0.14 944 90.00 78.00 22.00 7,29833 78.00 2,139.11 9,515A4 CR 4 CR 7 End I 22.00 2675 0.51 . 100.001 m..... �. �.�.r.... 6,63829 175th Ave CR 7 End J 22.00 .2135 0A0 21.001 314.00 5,553.89 Johnson Lane CR 7 l End 22.00 2642 0.50 37.00 d 6,495.22 Lowell Lane CR7 End 22.00 2632 0.50 32.00 6,465,78 CR 7 Mainline 2,635' S. of CR 6=5.00 1 5396 1.02 ; 14,988.89 2.660' N of Cif 2 Totals: 2.93 23.06 Totals: 40,142.67 418,028.29 BID NO #B2100100 Page 82 Crack F/LI ?021 LOCATION of PROJECT ROAD From Crack Fill To (Tons) Sandy Knolls Sub 1.50 Ranch Eggs Sub 6.00 Indian Head Sub 3.00 .�� l., d' a 'i i' , J- ., . , .1.1 .,. i ..ri;$.1,9k' �t^�s .rt o's"•' h. lt,.,,+k'•.'c'...z ..,fdt, ,f 1 _ , .. _ .. �9, � y., . L 7 xEv.,. ,,. < '.Y+, .,. ,.,Y YY.•_., _ .. .....&:�e a.�+.:.....rv.'.asK• . v�.x ,t°de<?. "t.t 0,4Wr:./ira:*1° ISA^?:4400S4 47;fin:5stitr4F:: Li3*.k:5: J:�.:4.�,5,;lrfiwl ;�.+i -.�-.#: �'1?f ✓�#,;A,G �: /,il-.S1',iZY:' � �.7r:f. 1, w.i d�1t:?<C f'L e-l.'A�ii x'.t., 2. .4: ..z.'/f r +�ti 1?'i9'P,•:rf �.. :'71�(. C/2.s.; •:: /Y� #K L''i •i';M1 ...,-,I :. .,. .i ;r.!t..�,." .^sic ?fTi: z�"�s "� .s:r..>(?�f`.�e�.,• BID NO #B2100100 Page 83 WCR 74fr. WCR27to WCR29 WCR 23.5 to WCR 25 SSSSSSS MSS SS s t I 6 l OUSTS I 23 25 wg_31--33-35 t3 yWC�t�._��,;� yr+ Ada _ MEM WCR 1fr. SH66toWCR 38 - -5 7w JI _ _. I I -11- 1.3--1.5 FIRESTONE /VCR 18 to WCR 24 ' .11 FREDERICK GILCREST I r I A _� I r _�.. __1_ 1--4- -1,-I I i I 1-7-1.9 21 23 251 /y 7 2-9- -31- -33 $5- -37 - 39- i J.. • N,'4 WCR 13 and WCR 34 Intersection 1 I 1 I 1 ; - - 76- 60 8 8 6 4-- I I I-.52 - I I I I L. I I ' 2t7:53.--55-§7-49-61-63--65-67"69-7-1- -7: WCR 74 fr. WCR 43 to WCR I I I , It �-a-I WCR 61 fr. WCR 50 to SH 34Cer— _ 50 WCR 5ofr. WCR 59to WCR 61 ` 46- - )14 II { I L r L_ _ 7. CL's:. J I I jp-ibcPine Ranch Eggs Subiivision I w Slurry Seal 0 I I I 4-1-43 WCR 19 fr. WCR 26to SH66 SUMP I 1 I I e 1 _L I I - --42--I- --� 1 l - -I 40- - - - - �-- --1 I 45 47-i-51 53 55 57 59 61 63 65 67 69 71 7 36- - - ' 34 I 32 r I 3I0 I 28 I 26 24 WCR 23 fr. WCR 18 to VCR 20.0 2 I 2 —r BRIGHTON I L I .jam.. r • d. . —r - -I- I --p KEEN ESBURG II { 20 18 I r --r -I --I I I I I. I I r .L J I J I I �..-.w ,.a.., Sandy Knolls Subdivision --1 WCR 18 fr. Patrick St. to WCR 37 I saaal Si-- 2.5 5 10 Miles I j rdiF I I I —r - I _1- 34 I I _Y_i'_.+ -�-- I I - I I I I I I I -�� -I—. WCR 41 fr. WCR8toSH52 U-- 1 r I Sandy Knoll Estates 0 0.03 0.06 0.09 0A2 Milos C�Y'�YOAJWffenso =YMW NT MW.:A M Ir1U'.v<^°: Subdivison Snow Route a Main Snow Route City Limits —111-1MI H;ghways Paved Gravel Map Produced By: Weld County GIS September 2012 Zone: 5 1 BID NO. B2100100 Page 85 vitT pg,r-isi migrant igivn. Zo .._1 "' ,;.: :x ::,:.S _s2t. -_ot C —M— .L4t.: .r: —a..... xis..— .. 0 0 012 0.1E: 0.21 ism Subdivison Snow Route rim Highways Main Snow Route ® Paved City Limits B ® W Gravel Map Produced By: VVe&d County GIS September 2012 BID NO #B2100100 Slaar Page 86 Indianhead Zone: 7 to rot S -111 ..litt-1 fl BF_EU l.. 321_t■i iEE- _1 i 0 0.03 0.06 0.09 0 12 Mites a.. s a ant -150fliar_la . __En___Jur><isr.J..,3na s = fl 1 r:a `s liETOU.. s:E I s3:t:fit[ _ ' -yam ..Bit a -m .0: -14. IIIIIIIIIIII Subdivison Snow Route Highways iiss Main Snow Route ..- Paved City Limits 'ae nom Gravel Map Produced By: Weld County GIS September 2012 I BID NO #B2100100 Page 87 BID REQUEST NO. B2100100 WELD COUNTY DEPARTMENT OF PUBLIC WORKS CONTRACT BID DOCUMENTS AND SPECIFICATIONS FOR PROJECT: SLURRY SEAL CONTRACT 2021 (With Renewal Options for 2020/2021) _ ... D.+ `f 4...DNL. LMai. Anpmj C, May 2021 Weld County Public Works Pavement Management Division P.O. Box 758 1111 H Street Greeley, Colorado 80632 970-304-6496 BID NO. B2100100 Page - 1 - BID SCHEDULE 2021 Slurry Seal and Sand Seal Contract Item Description Unit Est. Quantity Unit Price Contract Bid Number 408 Place Rubberized Crack Filler & Traffic Control (Weld County to supply material) TON 10.50 409 Slurry Seal SY 380,777 627 Pavement Marking Paint (Parking Lots) GAL 0 630 Signing and Traffic Control (Sub/Parking lot) EACH 2 630 Signing and Traffic Control (Slurry Seal) MILE 21 630 MHT and Traffic Control for Cdot intersections EACH 3 700 F/A Minor Contract Revisions F/A 1 $10,000.00 $10,000.00 Total: * The successful vendor is required to sign a separate contract (a sample contract is included as a separate attachment.) BID NO. B2100100 Page - 17 - RECEIPT OF ADDENDA The undersigned acknowledges receipt of the following Addenda to the Invitation for Bids, Drawings, Specifications and other Contract Documents. Addendum No. Addendum No. Date: By: Date: By: Bidder agrees to perform all Work described in the Contract Documents for the unit prices as shown in the Bid Schedule. Payment will be based on the Lump Sum price or the actual quantities furnished, installed or constructed. The undersigned, by his or her signature, hereby acknowledges and represents that: 1. The bid proposed herein meets all of the conditions, specifications and special provisions set forth in the request for bid for Request No. #B2100100 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 proposal sheets. 4. The signed bic 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. FIRM BY BUSINESS ADDRESS (Please print) CITY, STATE, ZIP CODE DATE TELEPHONE NO FAX TAX ID # SIGNATURE E-MAIL WELD COUNTY IS EXEIt PT FROM COLORADO SALES TAXES. THE CERTIFICATE OF EXEMPTION NUMBER IF #98-03551-0000. rszrg P BID NO. B2100100 Page- 18- 20.61 3 51 24.00 15,600.00 2.95 66 38 25.00 21,200.00 4.02 Subdivisions 2595 a 0.49 90.00 53 End 25.00 'sect Intersect 0.00 0 T 78.00 ._ 25 End 25.00 760 0.14 28.00 0.64 t. 7 22.00 2675 0.51 100.00 End t. 7 22.00 2135 0.40 21.00 End 17 22.00 2642 0.50 37.00 End 7 22.00 2632 0.50 32.00 End of CR 2 2,635' S. of CR 6 25.00 5396 1.02 2.93 Totals: 20.61 13 15 17 e WCR 74 fr. WCR 27 to WCR 29 anmvo..rr nxn vr=v..a.,<+nu.ua ..ur�ulattra snrexx.. WCR 23.5 to WCR 25 1 t I 1 I I 23 25': 19---31--33--35 43 I I IMP I _ — WCR 1 fr SH 66 to WCR 38 Y I I _a L — I I + I i I I 1 i I - "'� -7-6- IA 1 A e_.,.=e I I4� I I I I I --L- L--r-7-z- 1 I I I I .�L_ I_t_7®_- I i =68 I -66 - I - 64- --�- 62 I I I i i 1 1 --I--1-_s- I 1 i -5.3-5 5-5-7-5 9-61-6-3-65 -6 7/ 1 60 8 taI I I I 5&g i spat 1 I I I WCR 61 fr. WCR 50 to SH 34 50 ' -- 1 16_ WCR 50 fr. WCR 59 to WCR 61 I 44 I I 1 I '•VILV LV-7 �' 1 I eepop,IIF �. m,.1. - .,. _,_t.___ — —, I I _ 1- _ .L _ _ -� - - �-- - �- I I 1 _ —5 I 7,,,j Al 1.3-1-5-17 19 21 23 251 2,7 29- -31- -33 35737-39- .41-43 as IS �_ 'CR 18 to WCR 24 . i=3 _ I - -J 1 — .nw.a - - a Y a I I- -tjj WCR 13 and WCR 34 Intersection I I I FREDERICK DACONO .14 '!'SIIY.^idNID^! iJCtif Nom.' raattillaSSA LUSL.Casta.- ir -4 I I -Y Ian I U ns M _ _ n — - _^ = -talTri •xmam. • -. 4 -L WCR 19 fr. WCR 26 to SH 66 I ... I 4: I- WCR 74 fr. WCR 43 t' Sandy Knolls Sub' I I J I 1 I 'I I I I I -y-----42-L- + --{ I 1 I 1 i -I- -{ 40- - - - - 4- - -E 1 I I 45 47 - 51 53 55 57 59 61 63 65 67 1 I I I 36-------, I I i ' 34 I ' 32---- 90 18 I 26 ef:WCR 23 fr. WCR 18 to WCR 20.2 I 24 - � a 2 Ranch Eggs Subdivision I I I - -1 I� FORT LUPTON I BRIGHTON 1 aT I - - I I 20 I I KEENESBURG I' - I I r -r- - i I I i WCR 18 fr. Patrick St. to WCR 37 I I J 1 I r --I- -- --�- I I I I I I I I 1 b- I __- I I I I I I I I A /1'0 44 fr- l A /f' D S2_f_r, c u_ &.") VV\JI \ -r/ 11. VV VI \ V tV Cr t iz I I 4f.. is 11 AIAW.F Q�eT�E- 4, N A LARAMIE �� r CAHHIB..iiL Rose Everett From: Sent: To: e Cc: Subject: Attachments: Follow Up Flag: Flag Status: Stephanie Wallis <swallis@a-1chipseal.com> Wednesday, June 16, 2021 8:52 AM bids Mike Starr; Josh Krueger; Danny Gryzmala BID ENCLOSED - Slurry Seal & Sand Seal Contract A-1 CHIPSEAL CO. Weld County BID - A-1 Chipseal Co..pdf Follow up Flagged Caution: This email originated from outside of Weld County Government. Do not click links or open attachments unless you recognize the sender and know the content is safe. BID ENCLOSED Weld County Slurry Seal & Sand Seal Contract BIDS 10:00 AM, June 16, 2021 I hereby waive my right to a sealed bid. Respectfully Submitted By: A-1 Chipseal Co. 2505 E. 74th Ave. Denver, CO 80229 303-464-9267 Questions concerning the bid should be directed to Mike Starr mstarrhaitrepair ncom Stephanie Wallis Controller & Office Manager A-1 Chipseal & Rocky Mountain Pavement 720-540-8264 (office) 303-464-9261 (fax) swallis@a-1chjpsealcom, hsw;1/www. a ichipsealcorn http://www.asphaltrepair.com A -ONE Roc KY MOUNTAIN PAVE MENT This communication, together with any attachments hereto or links contained herein, is for the sole use of the intended recipient (s) and may contain information that is confidential or legally protected. If you are not the intended recipient, you are hereby notified that any review, disclosure, copying, dissemination, distribution or use of this communication is strictly prohibited. If you have received this communication in error, please 1 notify the sender immediately by return e-mail message and delete the original and all copies of the communication, along with any attachments hereto or links herein, from your system. 2 BID PROPOSAL To: Weld County Purchasing Department P.O. Box 758, 1150 "O" Street Greeley, Colorado 80632 Attention: Rob Turf, Director of General Services Bid Proposal for: Slurry Seal and Sand Seal Contract PROPOSAL Pursuant to and in full compliance with all Contract Documents the undersigned Bidder hereby proposes to furnish all labor and materials and to perform all Work required for the complete and prompt execution of everything described or shown in or reasonably implied from the Bidding Documents, including the Drawings and Specifications, for the Work above indicated for the monies indicated below which includes all State, County and local taxes normally payable with respect to such Work. The amounts stated include all allowances for profit and overhead, taxes, fees and permits, transportation, services, tools and equipment, labor and materials and other incidental costs. The Bidder and all Sub -Bidders shall include in their bid all Sales and Use Tax if applicable. State of Colorado and Weld County tax shall not be included. Upon application, the State of Colorado Department of Revenue shall issue to a Bidder or Sub -Bidder a Certificate or Certificates of Exemption indicating that the purchase of construction or building materials is for a purpose stated in Section 39-26-114, CRS, and is free from Colorado State Sales Tax. EXAMINATION OF DOCUMENTS AND SITE The Bidder has carefully examined the Bidding Documents, including the Drawings and Specifications, and has examined the site of the Work, so as to fully appraise themselves of the conditions at the site and to gain a clear understanding of the Work to be executed and is thoroughly familiar with all local, state and federal laws, ordinances, rules, regulations and other factors affecting performance of the Work. PROPOSAL GUARANTEE This Bid Proposal is accompanied by the required Bid Bond of five percent (5%) based upon the Total Cost of all items required to be Bid. Weld County, Colorado is authorized to hold said Bid Bond for a period of not more than sixty (60) days after the opening of the Bids for the Work indicated, unless the undersigned Bidder is awarded the Contract within said period, in which event the Owner may retain said Bid Bond until the undersigned Bidder has executed the required Agreement and furnished the required Performance Bond, Labor & Materials Payment Bond, and Certificates of Insurance. TIME OF COMPLETION The Bidder agrees to make their best effort to complete the entire Project as soon as possible and within the time specified in the Project Special Conditions after the issuance of the Notice to Proceed subject to the CDOT Standard Specifications for Road and Bridge Construction, Section 108. EXECUTION OF DOCUMENTS The Bidder understands that if this Bid Proposal is accepted, they must execute the required Agreement and furnish the required Performance Bond, Labor & Materials Payment Bond and Insurance Certificates within ten (10) days from the date of Notice of Award. BID NO. B2100100 Page - 15 - METHOD OF AWARD The Owner reserves the light to reject any Bid from any Bidder whom the Owner deems is unfit or unqualified to complete the Work as specified regardless of the amount of the Bid. It is understood by the Bidder how Bids shall be awarded and that should the cost of the Bid exceed budgeted funds, the Owner reserves the right to reject any or all Bids or portions of Work Bid or the use of any of the methods stated in the Instructions to Bidders to obtain the most advantageous Bid price. All bids will be reviewed by the Owner and Engineer. All mathematics will be checked and the correct total used for determining the low bidder. BID NO. B2100100 Page -16 - BID SCHEDULE 2021 Slurry Seal and Sand Seal Contract Item Description Unit Est. Quantity Unit Price Contract Bid Number 408 Place Rubberized Crack Filler & Traffic Control (Weld County to supply material) TON 10.50 3,995.00 41,947.50 409 Slurry Seal SY 418,030 2.13 890,403.90 627 Pavement Marking Paint (Parking Lots) GAL 0 200.00 0.00 630 Signing and Traffic Control (Sub/Parking lot) EACH 2 1,850.00 3,700.00 630 Signing and Traffic Control (Slurry Seal) MILE 24 4,250.00 102,000.00 630 MHT and Traffic Control for Cdot intersections EACH 4 4,500.00 18,000.00 700 F/A Minor Contract Revisions F/A 1 $10,000.00 $10,000.00 Total: 1,066,051.40 * The successful vendor is required to sign a separate contract (a sample contract is included as a separate attachment.) BID NO. B2100100 Page - 17 - RECEIPT OF ADDENDA The undersigned acknowledges receipt of the following Addenda to the Invitation for Bids, Drawings, Specifications and other Contract Documents. NONE Addendum No. Addendum No. Date: By: Date: By: Bidder agrees to perform all Work described in the Contract Documents for the unit prices as shown in the Bid Schedule. Payment will be based on the Lump Sum price or the actual quantities furnished, installed or constructed. The undersigned, by his or her signature, hereby acknowledges and represents that: 1. The bid proposed herein meets all of the conditions, specifications and special provisions set forth in the request for bid for Request No. #B2100100 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 proposal 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. FIRM A-1 Chipseal Co. BY Daniel J. Gryzmala (Please print) BUSINESS ADDRESS 2505 E. 74th Ave. CITY, STATE, ZIP CODE Denver, CO 80229 DATE 6/16/2021 TELEPHONE NO 303-464-9267 SIGNATURE FAX 303-464-9261 TAX ID # 84-1216817 E-MAIL dgryzmala@a-lchipseal.com WELD COUNTY IS EXEMPT FROM COLORADO SALES TAXES. THE CERTIFICATE OF EXEMPTION NUMBER IS #98-03551-0000. BID NO. B2100100 Page -18 - BID BOND PROJECTS: Slurry Seal contract 2021 KNOW ALL MEN BY THESE PRESENTS, that A-1 Chipseal Company, a CO Corp as Principal, and as Surety, are hereby held and firmly bound unto Weld County, Colorado (hereinafter called the "Owner") in the penal sum of Five Percent of Amount Bid-- Dollars ($ 5°l0 ), lawful money of the United States of America, for the payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly to these presents *Western Surety Company, a SD Corp THE CONDITION OF THIS OBLIGATION IS SUCH, that whereas the Principal has submitted the accompanying Bid dated June 16th 2021 for the PROJECTS: Slurry Seal Contract as set out in the accompanying Bid. WHEREAS, the Owner has required as a condition for receiving said Bid that the principal deposit with the Owner either a certified check equivalent to not less than five percent (5%) of the amount of said Bid or in lieu thereof furnish a Bid Bond for said amount conditioned such that in the event of failure to execute the proposed Contract for such construction if the Contract is to be awarded to him, that said sum be paid immediately to the Owner as liquidated damages and not as a penalty for the principal's failure to perform NOW THEREFORE, if the principal shall, within the period specified therefore: A On the attached prescribed forms presented to him for signature, enter into a written Contract with the Owner in accordance with his Bid as accepted, and give a Performance Bond with good and sufficient sureties, as may be required upon the forms prescribed by the Owner for the faithful performance and the proper fulfillment of said Contract, or B Withdraw said Bid within the time specified, or C Pay to the Owner the sum determined upon herein as liquidated damages, and not as a penalty, then this obligation shall be void and of no effect, otherwise to remain in full force and effect_ IN WITNESS WHEREOF, the above parties have executed this instrument under their several seals this 16th day of June 2021 the name and corporate seal of each corporate party being hereto affixed and these presents duly signed by its undersigned representative pursuant to authority of its governing board. Principal Ai Chipseal Company ATTEST By. Stephanie Wallis, Corporate Secretary ATTEST By Address 2505 E. 74th Avenue Denver, CO 80229 By: Surety WesternSurety Company 151 N. Franklin Street Address Chicago, I..60606 By:_ Eliza eth S *m, Attorney -In -Fact cQ'��r Co t.• osPOq,1T;;• SEAL 11/09/1992 ,'•�C©tORR4� It BID NO. B2100100 Page 19 INSTRUCTIONS The full firm name and paragraph esidence of each individual party to the bond must be inserted in the first If the principal is a partnership, the full name of all partners must be inserted in the first paragraph which must recite that they are partners composing the partnership (to be named), and all partners must execute the bond as individuals. The state of incorporation of each corporate party to the bond must be inserted in the first paragraph and the bond must be executed under the corporate seal of said party attested by its secretary or other authorized officer. Power of Attorney must accompany this bond when signed by other than an officer of either the principal or surety. A standard printed bond form may be used in lieu of the foregoing form provided that the security stipulations protecting the Owner are not in any way reduced by use of such standard printed bond form. BID NO. B2100100 Page - 20 Western 5urety Company POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY -IN -FACT Knorr All Mco By These Presents, That WESTERN SURE1'r' COMPANY, a South Dakota corporation, is a duly organized and existing corporation haling to principa office in the City of Sioux Falls, and State of South Dakota. and that it does by urine of the signature and seal herein affixed hereby make, constitute and appoint Jody L Anderson, Evan E Moody, Karen A Feggestad, Bradley J Moody, Tina Marie Post, Elizabeth Ostblom, Individually of Denser, CO. its true and lawful Attorncyts)•un-Fact with full power and authority hereby conferred to sigr.. seal and execute for and on its beh:'f hum's undertakings and other obligatory instnimcnts of similar nature - In Unlimited Amounts - and to hind it thereby as fully and to the same extent as it stk.' rnshl,menti were signed by a duly authnrt,ed officer of the corporation and all the arts of said Attorney, pursuant to the authority hereby given arc hereby ratified and confirmed This Power of Attorney is made and executed pursuant to and by attr' oriay 01 the By law printed on the reverse lie:tot duly adopted. as indi.ated by the shareholders of the corporation In Witness Whereof, WESTERN SURETY COMPANY has caused these presents us be signed by its \'ice President and its corporate seal to be hereto affixed on this 228th day of March. .020 WESTERN SURETY COMPANY State of South Dakota County of Minneliaha ss 47 044 mss. St AN •,- J 4144 er0 ail T Brufiat. Vice President On this Nth day of March, 2020. before me personally came Paul 1 Ilruflat, to me known, who, being by me duly sworn, did depose and say that he resides in the City of Sioux Falls. State of South Dakota. that he is the Vice President of WESI ERN SURETY COMPANY described in and which executed the abuse instrument that he knows the seal of said corporation, that the seal affixed to the said instrument is such corporate seal that it was so affixed pursuant to authority given by the Board of Directors of said corporation and that he signed his name thereto pursuant to like authority, and acknowledges sonic to he the act and deed of Said corporation My commission expires lune 21 21121 J MOHR ,moo` MOW, GOWN OAgt VUM c CERTIFICATE: .1 Mohr, Notary Public I. Nelson, Assistant Secretary of WESTERN SURETY COMPANY do hereby certify that the Power of Attouwy heicinaliose set froth is still in force, and further certify that the II) -1 ass of the corporation pr rued on the nacrue hereof is still in force In testimony whereof I base hereunto subscribed my name and affixed the seal of the said corporation this I bah dry of lune, 2021 WESTERN SURETY COMPANY L Neisori Assistant Sc* reran Porn, I..a CI0.7.?ul2 Go to www.cnasuret,y.com > Owner / Obligee Services > Validate Bond Coverage, if you want to verify bond authenticity. AuIhori'ing, fi%-f ate AD( )V 1 ED BY TI IF SHAREHOLDERS OF WESTERN SI_iRI 1 t" (_•( )MPi\N' uxi rtr_iac;I pii i Uir I„ ,iiiii h: ;tutlmni ,tI tY;r �nll,�.; in�� f�v I „„ rltsly ,t�lnrt t! i)V 01 ,hareholdcr, of th ( larsp:tnc tirrlum 7 All >ha!1 He exeitrit•,I ut rite c�nl,��r,trc n.uur ul the ( Sc( rei,rr' I IL',iICI ti iii l ;;u I'rc-r;lei;t , : t' ,ti H Grit.; rri,i\ lie I'ib'>i�I�III ,niv ' I.: fic.rdcr; tip, n ili\ .ui. „!_tnr c, ICI in I!tr fr:j iir<; nr,tt Appoint Attnrn;•v; u. Ile ~hail lt,uc .0011011k tt i„u: h_ iul- pt,li,ic, i i uatletr i rhea rr tiie Want<' el the {:uuylanv fire cnrhni,ite :cal H nt,+ necc�,ar} Iii tie_ candit�, ,it i'otser. ,iil;;,•r irhiig.aiur; i t the eorh,rwiu�ir 1 nc i,gnature i l an; sut h u(t,eer and ;orpnr.tte priiitc,l by I i:iir�il, Forni ■ -9 hies August 2013) Depaitnr.nl otrlxe T,easey InteirA Revenue Ser:tce Request for Taxpayer Identification Number and Certification Give Form to the requester. Do not send to the IRS. Nana. tax , tlenyn on Your Income tax latuln! A-1 Chipseal Co. business tuuntthleitt19 u.hnl ex16h dame. it Jltt•hvral !run abOxe m rn a m 0 G N O �V O 2 C n U !F City, state, and /IN code !:heck appropriate box for federal lax classde:atimr Indi.ndtr.iUxnle Popnelo i_� U COIpu, tltxl %� S Corpurahwn ;j Partnership IiusVeslal, 1 nmled liatxhty canpany Forer hie, lax riassdicaton (C C rxxlxnahun S S aapoaton, Pr..partnership)► Olhq (se,; iI ist eau ern ► Address number, street, and apt ra state no ) 2505 E. 74th Ave. Denver, CO 80229 List account number(s)here OA:Mrxlet{ F mounts'''. (see rnsirucluns) Exempt payer code (n any) Exemption luau FA I CA tepnrtin)t erste Id Any) Requester's name and address (ny,itixual Part I Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box The TIN provided must match the name given on the `Name" line to avoid backup withholding For individuals, this is your social security number (SSN) However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3 For other entities, it is your employer identification number (EIN) tf you do not have a number, see How to get a TIN on page 3 Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose number to enter Social security number Employer idenbSeetion number 8'4 ' _1 2 1 6 8;1 7, Part II 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 for a 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 am subject to backup withholding as a result of a failure to report all interest or dividends, or (e) 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), and 4 The FATCA code(s) entered on this form (if any) indicating that I am exempt Certification instructions. You must cross out item 2 above if you have been because you have failed to report all interest and dividends on your tax return interest paid, acquisition or abandonment of secured property, cancellation of generally, payments other than interest and dividends, you are not required to instructions on page 3 Sign Here Signature of US. parson ► from FATCA reporting is correct notified by the IRS that you are currently subject to backup withholding For real estate transactions, item 2 does not apply For mortgage debt, contributions to an individual retirement arrangement (IRA), and sign the certification, but you must provide your correct TIN See the oat.. 6/16/2021 General Instructions Seetuxn telernrlcas are to the Internal Revenue Code iniless otherwise nole,I Future developments the IRS has created a page on IRS gov for information abort F one NJ t), at stuns as yov/ivy Iniixnralax, about any future developments afta;6ng Funn W D Sach a s legislation enacted attr we release ib will by ptwleni on (teat page Purpose of Form A person who is required to file an information return with the IRS must obtalrl you correct taxpayer idenhAlratirxi nunibix (I IN) to repot. ha example, income paid to yell, payments made to you In settlement n1 payment card and third party network transactions, real estate 6ansacliorns, mortgage interest you paid. acgtasili n or abandonment of secured property, cancellation of debt. or contributions you merle to an IRA Use I am W 0 only if you are a 1.I S person (uuludaxl a nnident alum), In provide your crxrea 1IN to the person requesting it (the rugosle9 and. when applicable, In 1 Cei tidy that the I IN you are giving is correct Ira you are waiting to a number to be issued) 2 Certify that you ate not uabiera to backup withhiAduxg. o 3 Claim exemplum' hum backup withholding it you ate a U.S exempt paws' II applicable, you are atso certifyrog tidal as a 1J S perscnn, your allocable sham nl any partnership income hunt a 11S. trade or business is not subject to the withholding but on foreign partners' share of eler6veiy connected unco )e, and 4 Certify lila) FATI A code(s) entered on this trm lit any) indicating that y,xi are exempt Iron the I Al CA rerxxhng, IS correct Note. If you are. a I1 S person and a requester gives yin, a trim other than Farm W-9 to reque-st your TRN, you must use the requester's form it it is substantially similar to this roam W n Definition of a U.S. person For federal tax purposes you are considered a l I S person d you are: • An individual who is a tI S ❑ lizen or US iesrdent atian • A partnership, cgprxalilxi, Ctxllpiny, Of aS501:nlliiei healed ar neganize'l in the United Stales of undo tie lams of the United Stales • An estate (other than a loliagn estate), or • A ,domestic trust his defined in Regulations se,twit 301 7701 7) Special rules for partnerships. Partnerships that induct a Trade or business in the United States are generally required to pay a wnhhdding tax under section 1446 inn any lot ergo parlrslts' share al etlecllvely connected taxable income Irony such business Further, in certain cases where a Firm W fa has not been received the riles under section 1446 require a partnership to presume that a partner L: a toreulrn p tson, and pay the section 1.146 withholding lax Ihereloe, it your ale a II S person that is a partner in a partnership conducting a bade o business in the United States, pnovidc Form W 9 tax the partnership to establish your US status and avoid section 1.146 vnlhhdring On yore share ul partnership income Cat No t0231X Form W-9 (Rev 6 2013) BID NO. B2100100 Page - 21- STATEMENT OF QUALIFICATIONS AND SUBCO TRACTORS DATE OF THIS STATEMEN 6/16/2021 All questions herein must be answered by all bidders and the information given must be legible, clear in meaning and comprehensive. The bidder will not be given the opportunity to further explain or defend any answers beyond the time that this statement is submitted with the bid. This statement must be notarized. Questions may be answered on separate atta?hed sheets if necessary. The Bidder may attach and submit any additional information which is believed to be pertinent to this bid. Failure to complete this form pursuant to the directions herein may be cause for rejection of the bid. All bidders are reminded that a contract for the work described in the Contract Documents will be awarded to the lowest reliable, responsible and qualified bidder as determined by the County. The County reserves the right to waive informalities and/or irregularities and to reject any or all bids. 7 , Name of Bidder (Company or Firm): I, 2. Permanent main offic A-1 Chipseal Co,. address: 2505 E 74th Ave., Denver, CO 80229 Phone Number: 303-464-9267 Fax Number: 303-464-9251 3 Year Company was organized: 1992 rronwrnrernerrvegn 4 Number of years this Company has been engaged similar construction; 28 Under what firm, company or trade names has this company been engaged in this type of construction, how long under each name and how long has each company been bonding work? 24 A-1 Chipseal Company 24 Years Rocky Mountain Pavement 11 Years List all projects that the Company has under contract at the present time. Show the contract amount and the anticipated date o completion for each See Attached 1 _\ nahrealaxgkear >1 6. List all contracts which were not completed by the contracted and completion date. Include the project description and state the number of days beyond the contract completion date. None 7 List all contracts within the last 3 years for which liquidated damages were assessed or may be assessed. None BID NO. B2100100 r-v+.cmvncmmr+.+e¢a�..wacmarvM`viw.nnmmmm..n..vnewvxnl .WM'?\NYY.A(9Y12S{O �.seW9erau ia3Lierurise Yw %aarwaawx.; �y,y \. -PAP -w AA 3 ._.._,_...___....__ _..�,.�,.. Page - 22 - Contracts in Progress tad Updated 6/15/7021 • a 11259 Brighton 2020 Street Project City0f13riti ttl�tl 71 SOerth 4th A9+ ► righton, COSO�t Sill Mien (303) 655-IQ1$ Chip Seal, Slurry Seal, Asphalt, Crack Seal, Concrete, Hot Chip Seal 99% $ 3,202,015.00 5 3,202,015.00 06/30/21 11460 Dish Network C11xh PO BOA kngtewuod. fl•ute r(143t fiely.•oortr 6422 CO 30155 Pen 4324246.. Infrared, Asphalt 94% 5 127 738 00 4 $ 127,738 00 06/15/21 11468 South Parking Lot Paving Nutley & Nterf y, Irk 619 Av41110n CtrOt I<03vn and.CO805343 iylor Waller 7191 49943250 Asphalt 8935 5 214,861.26 • S 214,861 26 06/15/21 ` 11475 Buckley AFB-CRWU 20-1034 Oljfonniis 0iiersified Sery LLC 411 S. Non St Citlorjt&.Sprss, CO 80903 Tun► %Users (7194 640`942 Slurry Seal 0% 5 146,939 30 5 156,939 30 06/30/21 11483 Boulder %lay Real Coate COMM 10. C/o 80,vider#/4flv.y-Meal Estate 13ttltrfNrr, CO 803(4 fo11411 1fy (3631444.41.33 Asphalt, Crack Seal, Seal Coat 75% $ 67,016.99 5 67,016.99 07/31/21 11487 Jordan's Building Center Iordan 5ui=dxng Center 5000 Ward Rt1, Wheat Ridge„. CO $0033 1 i(Ti (3011421.1484 Infrared, Asphalt. Crack Seat Seal Coat 92% $ 86,388 76 5 86,388 76 06/30/21 i. 11510 faystone Condos 1 it Property St tv�<te% 1630 5. College Avt. Foil COMMi CO SOS2S Surlwan MtC'urc (910) 2244445 Infrared, Asphalt 0% . - 5 66,091.99 s 5 66,091 99 07/15/21' 11513 Nob Hill KC & A.s1ociates 10t%WSan 2uirrs Way 4210 t.rttre ton, CO $0127 tin) White (3011 933..6279 Asphalt 1% $ 59,562 54 $ 59,562 54 06/30/21 11523 Holy Rosary Catholic Church holy Rotiry Catholic Palish 4 Pearl St Demon., C 04216 bather Pro* atra (303) x97'1.962 Asphalt 0% fr t $ 62,059 00 $ 62,059 00 t 08/30/21 11534 `larimer County tansrlt r County $)Q BOX 1.19X8 Fort t:ut'Ens, CU 402211411 970) 49&8724 Chip Seal, Slurry Seal. Asphalt r 49% a $ 92,706 30 5 92,706 30 06/30/21 11535 Wheat Ridge 2021 Crackseat City of Wheal Ridge /50(7 V'at, 29th Me, Meat R(d, t*. +CO SOO331 OW ntt Oubbei (3.0311 475.1_",43 Crack Seal 95% i $ 115,400,00 5 115,400..00 06/30/21, 11540 Canon City C.+ty of Canon-C4y 128 Main 5t€eft Canon City, COS1215 Adam ism -astir (719)169-9011 Chip Seal, Crack Seal 2% 5 326,472 139 r 5 326,972 89 07/31/21 11542 Coto Springs 2021 Crackseal Cnyof Colorado $ itiisc$t PO Box 152'5 . MC ?40 Cutorat a $pn g.s. CO 8091S Kathryn tenfigltoo 4/t91385.68t3 Crack Seal 73% $ 417,959.25 5 417,959 25 A E 06/30/21 11546 City of Broomfield Ehoumliehi, lurlin {30)) City of tftoomtcld CtneO sCa,nbesDrwr CO 80020 Mundt - 4&4 5fs7`.* Chip Seal, Slurry Seal, Asphalt, Crack Seal, Concrete, Hot Chip Seal 1% 5 3.544,870 05 5 3,544,870 05 10/31/21 I 11547 I COOT Region 4 Overlay Project Colorado Dept,. of 1'rpnspcxt. 4/0141, Atyicano, flow 158 Draw, CO 60211 flick 1/201 99 S557 ... _ Chip Seal, Asphalt Patching 14% ' _ $ 1,726,505.86 : 5 1,726,505.86 07/31/21 11552 Loveland 2021 Chipseal Project City of tbvt~I41isl1 Chip 500 Foul thu4 I Qscl4nd, CO 30437 13rflher :lmseier ,AP Oro, 361-flit3 Seal 33% $ 715,000 01 S 715,000 01 06/30/21 11557 Office Building 39.39 150 Of Da (243) GrOUp LtC Infrared, 5 Oniecla St ,230 ell CO:80230 rold tt ll1 9330254 Asphalt, Seal Coat 99% $ 111,411 00 $ 111,411 00 06/15/21 11568 Chelsea HOA Co4w3clo 261.0 Debra (1031 Dri e:1.y M3nagemtrnt Infrared, S Patsktrr Rond.Suitr 105 ttfOra, CO1 14 V ury 611.6401 Asphalt 0% $ 70,996 76 S 70,996 76 81115/?1 • • .t, • s Per4Rnt i.. Cwrent Contact Contracts in Progress WI Updated 6/15/2021 10_110 PrOkaliafrrc Percent Cam$tle = Coe tact Arr uunt t_ spntircI CO +ptcliOrt Ditr Clarion* Contract Amount Oticripaoriftwrof Work cummmaJnforrrlat) 11570 Westminster 2021 Chipseal City Of Westminster t&S7S West 88th Ave Afle:sWO01ttl:ef, CO 80030 (tub f ;414e4e 1.7"P WI' 10 gbyt (304 658;2522 Chip Seal, Hot Chip Sea 1% S 420,890.75 5 420,890:.75 09/30/21 11580 Wieler Road Maintenance Meier Stint Ma ntenance Slurry Sea . Asphalt, Crack Seal 18% 5 51"94398 $ 51,943,98 08/30/21 2'2.61 Miter Rd Evergreen, CO Ice $lerneyer 3014.6744257 11585 Hob Nob Pet Care/Dunkin Donuts kWh, EEC infrared, Asphalt 1% $ 91,633.30 $ 91,633 30 07/15/21 «.2 Rolf 1`O Dam lelitffrtt ra, CO *0126 Stow Mstrtis j3031917-7):20, 1 1588 City of Fort Morgan City of ton Mafia Chip Seal (,)% $ 93,425 54 $ 93,425 54 08/30/21 P 0 Out 1t)t) Fon Mevg,m . CO 80701 Ill' Curt.% 970k 542-39S' of Fort Collins City of;art r`'.olri nt Chip Seal, Slurry Seal 8% 5 1,798,562.21 5 1,798,562 21 10/31/21 11589 ;City 281 N. College Ave. 8522 Fart 0)1;40. W80522 Stan Welch .• Firixoce Debbie 0 (970) 416-2091 11590 City of Louisville ADC'Conttructi.nn Co , RC Chip Seal, Slurry Seal 0% s• 431,555-3S S 431,555 35 09/15/21 14802 W 44ttl Avi tinldoR, CO 80.403 Ow* y:trry (103) 219,6611 11593 City of Centennial CItyofCerg trtttsai Slurry Seal, Crack Seal, Seal Coat 1% S 578,987 59 $ 578,98759 09/15/21' 1303 t:.Arapahoe Rd Ctrnt VISA CO PM 12 10th an: { J3)) 7544459 w Greenwood Village City ofG.*'itt twoodVillage Chip Seal, Slurry Seal, Crack Seal 1% 5 660.022 55 5 660,022 55 07/20/21 11596 60$0 C Q4e1xc4, St Cs&ndfwood Village, CO 08011 F IttrPre attainment • i 001L1234251 i 11597 City of Montrose City of Montratm Slurry Seal 2% $ 318,400.24 I $ 318,400 24 07/25/21 43.3 5 f'ir;t51roraf i MontrOsw, CO &1:402 �f /� /�'1 y q:yy� fty�.on Cushttios { 9(211.10:1485 , 11606 Muley Park HOA ' Muli y 0..114€ Uttdowners Assoc Chip Seal, Asphalt Patchirg 0% 5 149,879 44 • $ 149,879 44 . 07/15/21 Eagievscw R4 fort CoHini, CO 80526 ftdy Sttytht' (1031246-6619 , . u �. Muller State Park Sell Coat 5ctx;#harts, Inc Slurry Seat 0% $ 187,536 45 $ 187,536.45 , 06/30/21 11607 PO TICK 6091i1. Cal*r4c10 Sprint*, CO 80960 tl4v4.1 Warm J303) &41-0292. 11608 City of Arvada City 01 Arvada Chlp Seal, Slurry Seal 0% 5 698,879 17 ' s 698,879 17 07/15/21 P.O 8u.a 13101 At vdd a, CD 8000111101 Chr.,topit*r YaAty (7.20108 -?130 of Littleton City ui 1,wttirtut't 'Asphalt, Slurry Seal 0% 5 529,515.00 $ 529,515 00 06/30/21 11609 City 2255 W tient_Atte t.itttetcn, CO 3 0165 ldreltt 1hst{on 1305)195-P%. 11610 City of Aurora City otAutor.). Chip Seal 3% $ 1,950,995 29 5 1,950,995 29 07/31/21 1,1140 t .Mind Ave Auryr.4, (0 8011 Kt 4u* Girt -go f10.1) 326 $.708 + 11612 Adams County Adam%County a CrackSrb31 096 5 887,461,40 5 887,461 40 10/31/21 44305 Adorns Cuuiuy Parkway Irt$,tltoti, CO *14111 xt £Unit) 120) 521.0512 11617 City of Brighton City of ttrich.tort Infrared, Asphalt 1% 5 3,321,849 51 5 3,371,849 51 12/31/21 Alile Couch 4th Ave lugh1or. Cf340'y01 8111 Allen (303) GSS-2O3h 11618 Buell Mansion H0A Buell Manson Fctafes Property Slurry Seal 0% $ 91.,932 73 $ 91,932 73 10/31/21 Orvr►yn M.t $tat; n bertyr Has uil134e., CO 80113 i'4wce 114r6ulitta 151y 49S-12:53 '. 11619 Noorwood Snopping Center $14rtir Mxrwe114 Slurry Seal 10% 5 131,622 20 5 131,622 20 10/31/21 '2475 w'.rrldttrf P1 (ciictr4cdo Sporio, CO 80915 Marc ►t,:nson 6 r 19) :191 9693 Contracts in Progress last Updated 6/15/7021 tobjtio 11622 Pruitt -1 Hamar Csaatcratt.hif0rTration Dr ptIonf;yprr of Work Yuan Conract* Contract ArnOunt Current Contract Amount Itspttte Corpt+term 041e faith Presbyterian Church Fakh Pretbriertin Church 11371 E A#1ttlrrd3 A o Autotal, CO 80012 0 - Crack Seal 0% $ 206,373 26 $ 206,373.26 ' 07/31/21 1162S Columbine mem S¢draga Colurnti+rte ti Stroage 8431 S_ Co':stut*.vntel Divide Rd t.rt1leto", CO 8012 7 Millltrife (103) 9.I. -.3s3 'Asphalt, Infrared, Concrete, Crack Seal y _ 0% $ 71,903 49 S 11,903 49 08/15/21 11626 -tiniv of Cola -Boulder University- o-f,Colo fuu'thar tow 4tklertt (f7 SO2LICB Boulder CO 303 Accounts Payable (303) 3151346 Asphalt, Crack Seal, Infrared 15% $ 136,895 76 $ 136,89515 08/15/21 116?9 City of Longmont City of horrg'nflnt 150 t n(satk Street Longmont CO 80501 Akira .tertkins OOP Cryf-814t Chip Seal, Slurry Sea- 1% $ 710,830 37 $ 710,830 37 08/20/21 E 11631 Town of Windsor Yawn of `,tirt.,sdull 101 Walnut Wirs,4tor, CO 80'550 Brills flown 970) 686,7476 Chip Seai, Slurry Seal 1% $ 488,278 98 $ 488,278,98 08/30/21 11645 Ranch Meadow Condominiums Ctnekt-d43t OTC t/a MS', i-LC Virstm r+sier-CO800203200 111019:x44126 Slurry Seal 0% $ 81,392 64 $ 81,392.64 06/30/21 11655 All American Mini Storage AB Arntrdcarl Mini Storaga! 130 S tiodand St Lakewood, 06180 26 Atntrz;c.a .Saticoy -at c3O3) 8354714 Crack Seal, Infrared, Slurry Seal 0% $ 57,909 99 5 57,909.99 07/31/21 11665 City of Lafayette Martyr Matfett ]-'Jorthe►n 1800N rahRcra4 Fort Collins, CO 805.21 cagy Steele Clink Seal OK S 105,630.00 $ 105,630 00 - 07/31/21 11666 'City of Colorado Springs Ctt'y of Colorado Spiny PO 80.ie MS"- - MC 240 fl*)r;ade, S4trutgk CO $0915 t(allityn Livingston 1 1.9) 38S-6.813 Chip Seal 1 $ 1,568,164.61 $ 1,568,164 61 r 09/30/21, 11674 Mill Run HOA Chalet `ownhoeftes c/4 Advance H0A Mgmt, Inc f)enVer, CO 801)7 f'3TU,t $1';-4031 Infrared, Asphalt W 096 5 64,710 00 5 64.110 00 07/31/21 11681 Lowry Community Master Assoc Quality PavingCanttaitants .120 8ax Z078 8 Wheat rbldge: CO,WG34 Jarrett Weit11 19701361-252S Chip Seal, Slurry Seal, Asphalt, Crack 5 0% $ 6543L&) $ 65,831.60 1 09/30/21 11686 5ust/Rpr Airfield Pavements PtramidPaving 3075 tanketi Road Culorzdo 5prsnji, CO W904E. 51140b- €edttard (7191214,15W Crack Seal 0% 5 53,470 01 5 53,470 01 08/30/21 11693 2021 Annual Pavement Rehab lrslrtralt4tgnvwCtnst, Fits 11351 5 tutoan Way teAlennials, CO X3117 Anthony Wiarda 14006298 62 Crack Seal 0% $ 176,497.51 5 176,497 51 09/30/21 11697 Castle Pines Metro District M4.,tro aat'rir, Lit no Bran 601 llenderiOn. CO 80640 Cnati Anesna (10.33{ Wilk 1.7)1 $tti*ryr Seal 0% 5 119,530.46 I, 5 119,530 46 07/31/71 11699 City of Wray City of Vlrary 745 W 4th St Wray. CO IWJMe ferry alit hatl e14,0) 6301062 Chip Seal 0% $ 74,999.99 - 5 14,999.99 08/15/21 11701 take Front HOA Cermledidel,31 OTC c/o St$r, tit W4ttminstrr.. C0100201100 I pop y.t 42111 Asphalt- Crack Seal, Infrared, Slurry Seal we 0% 5 75,433 27 $ 75,433 27 07/15/21 11702 Bucking Horse Apartments Madiso44panrtteftrWroutt 384J Wt it Chester. Pike 141rrittort Str ate„ i A 140 1 . 9441 Crack Seal, Seal Coat ON + $ 54,115 24 $ 54,115 24 1 07/15/21 , 11708 4c/13)144 Town of Erie Town of Lilt P 0 So. 7§D Eric, CO S0SIG Frank Mcilweun 30.3)9762136.3 Crack Sra1 0% 5 249,899;99 : 5 219,899.99 . 1 10/31/2.1 . 5 11.921,454 83 5 _27,97i .454.33 i List all contracts within the last 3 years during which or after which the company filed a protest with the owner. None List all contracts with n the last 3 years during which or after which any of the Company's subcontractors or suppliers filed a verified statement of claim with the owner or failed to provide the Company with a lien waiver upon request. None 10. Has any owner, as party to any of the Company's contracts within the last 3 years, contacted the Company's boncing company concerning late completion of the project, poor perrormance on the project, etc., or attempted to have the performance bond invoked? If yes, explain in detail. No 11 Describe all contracts that the Company failed to complete. None 12. Describe all contracts on which the Company defaulted or from which the Company was terminated. None toraiothilliSasaaviesailamtasi 13. List all or a maximum of three (3) of the most recent projects, similar to the project described in these Contract Documents, which the Company has successfully completed within the last 5 years or are under construction at the present time. List the project name, location, project superintendent, owner's representative and phone number, date completed and contract amount for each project. Project Name: Aurora 20.0 Surface Treatment Program Location: Aurora CO Owner's Representative: Raul Griego Completion Date: BID NO. B2100100 12/8/2020 Supt: Rogelio Contreras Phone:: 303-326-8213 Contract Amount: 2,752,356.67 asgaggrari Page - 23 Project Name: 2020 Slurry Seal Program Location: Weld County Supt: Rogelio Contreras Owner's Representative: Josh Holbrook Phone: 970-304-6496 Completion Date: 8/19/2020 Contract Amount: 912,630.03 Project Name: City of Brighton 2020 Street Preservation Project Location: Brighton, CO Supt: Rogelio Contreras Owner's Representative: Chris Montoya Phone: 303-655-2037 Completion Date: 5/31/2021 Contract Amount: 3,148,642.19 14. List all of the subcontractors the Company intends to use under this contract, the work that each subcontractor will do and the percentage of the Company's bid that each contractor's work comprises. IF REQUESTED, THOSE CONTRACTORS BEING FURTHER CONSIDERED FOR A ft ' D SHALL FURNISH, WITHIN 24 HOURS AFTER THE Ire OPENING, SEP _�* ATE STATEMENT OF QUALIFICATIONS COMPLETED BY EACH SUBCONTRACTOR WHO WILL PERFORM 15% OR MORE OF THE WORK. SUBCONTRACTOR None WORK DESCRIPTION % OF WORK 15. List the principal members of the company who will be involved with this project, including the superintendent, foreman, project manager, etc. NAME Rogelio Contreras Martinez Mike Starr Jairo Vasquez TITLE YRS. PERTINENT EXPERIENCE Superintendent 26 Sales Manager 28 Foreman 8 16. List all lawsuits previously filed against or currently pending against you, the Company or any officers of the Company. None m .:,44..‘424.12... BID NO. 82100100 Page - 24 The undersigned hereby s further, hereby authorizes requested by the County of Subcontractors. Dated this 16th NOTARY County of State of years and affirms that the information contained herein is complete and true and nd requests any person, company, firm or corporation to furnish any information Weld in verification of the recitals comprising this Statement of Qualifications and ,,r t = -4, re • Ct i t 'a j SEAL k~ r .! t R a}y y 11109/1992 .y x 3 I S day of June Bidder: A-1 Chipseal Co. ,2021. ByY Name: Company Signature Daniel J. Gryzmala Title: President (Please Type) )ss. deposes and says that he is /-74 CA42,sal (kJ (Company Name) eush9b (Title) being duly sworn, of, and that the answers to the foregoing questions and all statements therein contained are true and correct. Subscribed and sworn before me this Oda fsttsi tepi-h day of, !%21 (SEAL) Li -a -.Do(a Commission Expires BID NO. B2100100 Notary Public STEPHANIE WALLIS Notary Public ttsState of Colorado Notary ID # 2005401 2221 Ay Commission Expires 04-02-2025 Page - 25 - -17":71r4"9' MEMO RANDUM TO: Curtis Hall, Deputy Director DATE: July 6, 2021 FROM: Joshua Holbrook, Pavement Management Supervisor SUBJECT: Continuance Letter for the 2021 Slurry Seal Contract Bid No. B2100100 — Move award to 7.12.2021 One bid for the 2021 Slurry Seal Contract was received and opened on June 16, 2021. The bid was submitted by A-1 Chip Seal based out of Denver, Colorado for an amount of $1,066,051.40. The bid is over the 2021 budget amount, so Public Works is requesting a continuance for the award until July 12, 2021. This week Public Works will determine which projects to remove from the contract to remain within the budget. pc: Jay McDonald, Director Rob Turf, Purchasing Manager Rose Everett, Purchasing Mona Weidenkeller, Office Tech IV / Payable / Receivable M:\Maintenance Contracts\Slurry Seal -Sand Seal-Rejuvenator\2018\Contract Doc's\Bids BED REQUEST NO2 B2100100 WELD COUNTY DEPARTMENT OF PUBLIC WORKS CONTRACT BID DOCUMENTS AND SPECIFICATIONS FOR PROJECT: SLURRY SEAL CONTRACT 2021 (With Renewal Options for 2020/2021) May 2021 Weld County Public Works Pavement Management Division P.O. Box 758 1 111 H Street Greeley, Colorado 80632 970-304-6496 BID NO. 82100100 Page - 1 - BID SCHEDULE 2021 Slurry Seal and Sand Seal Contract Item Number 408 409 627 630 630 630 700 Description Place Rubberized Crack Filler & Traffic Control (Weld County to supply material) Unit Est. Quantity TON 10.50 Slurry Seal E SY 380,777 Pavement Marking Paint (Parking Lots) Signing and Traffic Control (dub/Parking lot) Signing and Traffic Control (Slurry Seal) GAL EACH MILE MHT and Traffic Control for Cdot EACH intersections F/A Minor Contract Revisions F/A 0 2 21 3 1 Unit Price 3,995.00 2.13 200.00 1,850.00 4,250.00 4,500.00 $10,000.00 Total: Contract Bid 41,94150 811,055.01 0.00 3,700.00 89/250.00 13,500.00 $10,000.00 959,452.51 * The successful vendor is required to sign a separate contract (a sample contract is included as a separate attachment.) BID NO. B2100100 Page - 17 RECEIPT OF ADDENDA The undersigned acknowledges receipt of the following Addenda to the Invitation for Bids, Drawings, Specifications and other Contract Documents. Addendum No. Date: By: Addendum No. Date: By: Bidder agrees to perform all Work described in the Contract Documents for the unit prices as shown in the Bid Schedule. Payment will be based on the Lump Sum price or the actual quantities furnished, installed or constructed. The undersigned, by his or her signature, hereby acknowledges and represents that: 1. The bid proposed herein meets all of the conditions, specifications and special provisions set forth in' the request for bid for Request No. #B21 00100 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 proposal 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. FIRM A-1 Chipseal Co. BUSINESS ADDRESS 2505 E 74th Ave., BY Daniel is Gryzmala (Please print) DATE 7/8/2021 CITY, STATE, ZIP CODE Denver, Co 80229 TELEPHONE NO 303-` 64-9267 r FAX 303-464-9261 SIGNATURE r TAX ID # 84-1216817 E-MAIL mstarr@asphaltrepair.com WELD COUNTY IS EXEMPT FROM COLORADO SALES TAXES. THE CERTIFICATE OF EXEMPTION NUMBER IS #98=03551-0000. BID NO. B2100100 Page - 18 - Weld County Slurry Seal 1021 LOCATION of`f'KOJi:t."1` ROAD From l u Width ti Length (t) `'"' "i ADIYL Bridges SQ. YDS. Because Of: win,. Approaches Widen Ar<as Radii 4} CR S SH52 25.99 12,933.00. 2-44 310.09 69'0 327.00 377252.00 23 CR 20 East Bound (dirt) 25.00 8,888.00 1.68 82.00 24,770.89 CR 18 (BOP) 19 CR 26 SH66 25.00 10,352.00 10,471.00 1.96 120.00 342.00 29,217.56 18 Patrick St 26.00 1.98 162.00 590.00 31.00 31,032.56 CR 37 50 CR 59 CR 61 26.00 5,663.00 1.07. 65.40 114.00 242.00 16,781.18 61 CR 50 HW 34 26.00 4,563.00 0.86 27.00 130.00 13,339.00 54 a CR 23.5 CR 25 26.00 2,536.00 0.48 m i 7,326.22 13 990' N. of CR 32 34 26.00 5,510.00 1.04 10,435.00 26,352.78 8 858.00 r 1,170' N. of CR 13 West of CR 34 26.00 1,080.00 0.20 5,738.00 13 East of CR 34 _ 26.00 1,480.00 0.28 6,400.00 10,675.56 19 18 24 24.00 15,820.00 3.00 42,186.67 74 27 29 32.00 5,650.00 L07 20,088.89 74 43 51 24.00 15,600.00 2.95 41,600.00 1 SH 66 38 25.00 21 200.00 4.02 58 888.89 TOTALS FOR ROAD: 20.61 331,118.18 Subdivisions Sandy Knolls Sandy Knolls CR 53 End 25.00 2595 0A9 90.00 7 298.33 Davis Rd Intersection Intersect Intersect 0.00 0 78.00 78.00 Davis Road 54.25 End 25.00 760 0.14. 28.00 2,139.11 0.64 Ranch Eggs 9,515.44 CR 7 - End 22.00 F 2675 0.51_ 100.00_ 6,638.89; CR 4 _ 175th Ave CR 7 End 22.00 2135 0.40, 21.00 314.00 5,553.89 Johnson Lane End 22.00 2642 0.50 37.00 6,495.22 CR 7 Lowell Lane End 22.00 2632 0.50 32.00 6,465.78 CR 7 CR 7 Mainline 2,660' N of CR 2 _ 2,635' S. of CR 6 _ 25.00 5396 L02, 14,988.89 Totals: 2.93 20.61 Totals: 40,142.67 380,776.29 i 3 15 4- WCR74fr. WCR 27tnWCR 29 r I +_ WCR 54 fr. WCR 23.5 to WCR 25 4 WCR 19 fr. WCR 18 to WCR 24 '' �Leg�'end�r Seal Yd 2021 Stuffy Seal I Fanch Eggs Subdivision N S E i I A I I I s —— r --------e I I 1 I I a I �__— - -I__ I _-I_..L- I I I I i 4wcRelfr. WCR 50 to SH 34 " WCR 50 fr. WCR 59 to WCR 61 WCR 19 f . WCR 26 to SF! 66 ..... dmip :IS IL WCR 23 fr. WCR 18 to WCR 20.2 0 2.5 5 I I I I 10 Mdes i l I I 46 94 1 22 f_— I r I 3 a 1 e 1a C. J. s ¢a , rataiczat* aaSrachfd 1 , a> ari•Or aw,L,.wi n' a I I I I I Sandy Knolls Subdivision 2021 Weld County Slurry Seal Location Map LARAMIE ( KIMBALL TO: Curtis Hall, Deputy Director DATE: July 7, 2021 FROM: Joshua Holbrook, Pavement Management Supervisor SUBJECT: Recommendation Letter for the 2021 Slurry Seal Contract Bid No. B2100100 One bid for the 2021 Slurry Seal Contract was received and opened on June 16, 2021. The bid was submitted by A-1 Chipseal based out of Denver, Colorado for the amount of $1,066,051.40. The bid is over the 2021 budget amount, so Public Works removed WCR 41 from WCR 8 to SH 52 from the Slurry Seal Contract and added it to the 2021 Chip Seal Program. It is staff's recommendation to award the project to A-1 Chipseal for a total amount of $969,452.51, which is within the 2021 budget for the contracted slurry seal contract. Work is expected to begin in late July and end in late September. Attachments: 2021 Bid Tab pc: Jay McDonald, Director Rob Turf, Purchasing Manager Rose Everett, Purchasing Mona Weidenkeller, Office Tech IV / Payable / Receivable A:\Maintenance Contracts S irr\ Seal -Sand Seal-Rcjuuvenak r',2t1 18\Contract Doc's\ F3ids BID REQUEST NO. B2100100 2021 SEAL COAT PROGRAM BID TAB IIEM N© DESCRIPTION UNIT PLAN QUANTITY UNIT PRICE COST py: 408 PLACE RUBBERIZED CRACK FILLER & TRAFFIC CONTROL (Weld County to supply material) TON 11 $3,995.00 $41,947.50 409 SLURRY SEAL SQYD 380,777 $2.13 $811,055.01 627 PAVEMENT MARKINGS (Parking lot only) GAL 0 $200.00 $0.00 630 SIGNING & TRAFFIC (Sand Seal) PER LOCATION 2 $1,850.00 $3,700.00 630 SIGNING & TRAFFIC (Slurry Seal) MILE 21 $4,250.00 $89,250.00 630 MHT & TRAFFIC CONTROL FOR CDOT INTERSECTIONS EACH 3 $4,500.00 $13,500.00 700 F/A MINOR CONTRACT REVISIONS 1 $10,000.00 $969,452.51 *No Errors PLACE RUBBERIZED CRACK FILLER & TRAFFIC CONTROL (Weld County to supply material) TON 11 $3,995.00 $41,947.50 SLURRY SEAL SQYD 380,777 $2.13 $811,055.01 PAVEMENT MARKINGS (Parking lot only) GAL 0 $200.00 $0.00 SIGNING & TRAFFIC (Sand Seal) PER LOCATION 2 $1,850.00 $3,700.00 SIGNING & TRAFFIC (Slurry Seal) MILE 21 $4,250.00 $89,250.00 MHT & TRAFFIC CONTROL FOR CDOT INTERSECTIONS EACH 3 $4,500.00 $13,500.00 F/A MINOR CONTRACT REVISIONS 1 $10,000.00 $969,452.51 *No Errors NOTICE OF AWARD PROJECT: SLURRY SEAL CONTRACT 2021 To: Mike Star A-1 Chipseal Compary 2505 E. 74th Ave. Denver, CO 80229 Project Description: The project in general consists of performing the crack seal in the subdivisions and parking lots and seal coat work for the 2021 ccnstruction season. The contract is a one year commitment with the option of renewal for up to two add tional years. The project, 2021 Slurry seal and Sand Seal, in general consists of: -Crack sealing 10.5 tons in parking lots. (County to supply material) -Slurry Seal 380,777 SY This project is not subject to Federal or State contract requirements. The Owner has considered the Bid submitted by you for the above described Work in response to its Invitation for Bids and Instructions to Bidders. You are hereby notified that your Bid has been accepted in the amount of $969,452.51 or as shown in the Bid Schedule. You are required by the Instructions to Bidders to execute the Agreement and furnish the required Performance Bond, Payment Bond and Certificates of Insurance within ten (10) calendar days from the date of this Notice to you. If you fail to execute said Agreement and to furnish said Bonds within ten (10) days from the date of this Notice, said Owner will be entitled to consider all your rights arising out of the Owner's acceptance of your bid as abandoned. The Owner will be entitled to such other rights as may be granted by law. You are required to return an acknowledged copy of this Notice of Award to the Owner. Dated this 16th day of July, 2021 Weld County, Colorado, Owner By: Josh Holbrook, Pavement Management Supervisor ACCEPTANCE OF NOTICE Receipt of the above Notice of Award is hereby acknowledged by A-1 Chipseal Co. (Contractor) Dated this 16th day of July , 2021 By: Title: President Daniel J. Gryzmala BID NO. B2100100 Page - 26 - Bond No. 30130984 PERFORMANCE BOND PROJECT: SLURRY SEAL CONTRACT 2021 KNOW ALL MEN BY THE PRESENTS; that A-1 Chipseal Company (Name of Contractor) 2505 E. 74th Avenue, Denver, CO 80229 (Address of Contractor) Colorado , hereinafter called Contractor, and a (Corporation, FOINXIOVII0p00002dittd04 I) Western Surety Company (Name of Surety) 151 N. Franklin Street, Chicago, IL 60606 (Address of Surety) hereinafter called surety, are held and firmly bound unto Weld County, Colorado (Name of Owner) P.O. Box 758, 1111 H Street, Greeley, Colorado 80632 (Address of Owner) hereinafter called Owner, in the penal sum of Nine Hundred Sixty Nine* Dollars, ($ 969,452.51 ), in lawful money of the United States of America, for the payment of which sum well and truly to be made, we bind ourselves, successors and assigns, jointly and severally firmly by these presents. *Thousand Four Hundred Fifty Two and 51/100 --- THE CONDITION OF THIS OBLIGATION is such that whereas, the Contractor entered into a certain Contract with the Owner, dated the day of , 2021, a copy of which is hereto attached and made a part hereof for the construction of: PROJECT: Slurry seal and Sand seal contract described in the Invitation for Bids, Bid No. 82100100 NOW THEREFORE, if the Contractor shall well, truly and faithfully perform its duties, all of the undertakings, covenants, terms, conditions, and agreements of said contract during the original term thereof, and any extensions thereof which may be granted by the Owner, with or without notice to the Surety and during the one year guaranty period, and if he shall satisfy all claims and demands incurred under such contract, and shall fully indemnify and save harmless the Owner from all costs and damages which it may suffer by reason of failure to do so, and shall reimburse and repay the Owner all outlay and expense which the Owner may incur in making good any default, then this obligation shall be void; otherwise to remain in force and effect. PROVIDED, FURTHER, that the said Surety for value received hereby stipulates and agrees that no change, extension of time, alteration or addition to the terms of the contract or to the Work to be performed thereunder of the Specifications accompanying the same shall in any way affect its obligation on this Bond, and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the contract or to the Work or to the Specifications. PROVIDED, FURTHER, that no final settlement between the Owner and the Contractor shall abridge the right of any beneficiary hereunder, whose claim may be unsatisfied. BID NO. B2100100 Page - 36 - Bond No. 30130984 PERFORMANCE BOND PROJECT: SLURRY SEAL CONTRACT 2021 IN WITNESS WHEREOF, this instrument is executed in two (2) counterparts, each one of which shall be deemed an original, this day of 2021 oP ', Contractor s O ':%teptla Ns 2 4 (�). ,." :Z a 11/09/1932 : I �c�<ORA�O': • 1 (Witness as to Contractor) 2505 E. 74th Avenue (Address) Denver, CO 80229 ATTEST: Western Surety Company (SEAL) Witness as to Surety (Surety) lgeoretary 8055 E Tufts Avenue, Suite 1000 A-1 Chipseal Company Contractor 2505 E. 74th Avenue (Address) Denver, CO 80229 By y -in -Fact Elizabeth Ostblom 151 N. Franklin Street (Address) (Address) Denver, CO 80237 Chicago, IL 60606 NOTE: Date of Bond must not be prior to date of Contract. If Contractor is Partnership, all partners should execute Bond. IMPORTANT: Surety companies executing Bonds must appear on the Treasury Department's most current list (Circular 570 as amended) and be authorized to transact business in the State where the Project is located. BID NO. B2100100 Page - 38 - Bond No. 30130984 LABOR & MATERIALS PAYMENT BOND PROJECT: SLURRY SEAL CONTRACT 2021 KNOW ALL MEN BY THE PRESENTS; that A-1 Chipseal Company (Name of Contractor) 2505 E. 74th Avenue, Denver, CO 80229 (Address of Contractor) Colorado hereinafter called Contractor, and a (Corporation, F4i141ernett*N(t4 ottita94t ) Western Surety Company (Name of Surety) 151 N. Franklin Street, Chicago, IL 60606 (Address of Surety) hereinafter called surety, are held and firmly bound unto Weld County, Colorado, P.O. Box 758, 1111 H Street, Greeley, Colorado 80632, hereinafter called Owner, in the penal sum of Nine Hundred Sixty -Nine Thousand, Four Hundred Fifty -Two and 51/100 -- Dollars ($ 969,452.51 -- ), in lawful money of the United States of America, for the payment of which sum well and truly to be made, we bind ourselves, successors and assigns, jointly and severally firmly by these presents. THE CONDITION OF THIS OBLIGATION is such that whereas, the Contractor entered into a certain Contract with the Owner, dated the day of , 2021, a copy of which is hereto attached and made a part hereof for the construction of: PROJECT: Slurry Seal Contract 2021 described in the Invitation for Bids, Bid No. B2100100. NOW, THEREFORE, if the Contractor shall promptly make payment to all persons, firms, Subcontractors, and corporations furnishing materials for or performing labor in the prosecution of the Work provided for in such contract, and any authorized extension or modification thereof, including all amounts due for materials, lubricants, oil, gasoline, repairs on machinery, equipment and tools, consumed or used in connection with the construction of such Work, and all insurance premiums on said Work, and for all labor, performed in such Work whether by Subcontractor or otherwise, then this obligation shall be void,; otherwise to remain in full force and effect. PROVIDED, FURTHER, that the said Surety for value received hereby stipulates and agrees that no change, extension of time, alteration or addition to the terms of the contract or to the Work to be performed thereunder of the Specifications accompanying the same shall in any way affect its obligation on this Bond, and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the Contract or to the Work or to the Specifications. PROVIDED, FURTHER, that no final settlement between the Owner and the Contractor shall abridge the right of any beneficiary hereunder, whose claim may be unsatisfied. BID NO. B2100100 Page - 39 - LABOR & MATERIALS PAYMENT BOND IN WITNESS WHEREOF, deemed an original, this instrument is executed in two (2) counterparts, each one of which shall be this day of ,2021. Contractor) Secretary • ess as to Contractor) 2505 E. 74th Avenue (Address) Denver, CO 80229 ATTEST: Western Surety Company (SEAL) (Surety) Somberly A-1 Chipseal Company Contractor 2505 E. 74th Avenue (Address) Denver, CO 80229 By Witness as to Surety Attorney- - act Elizabeth Ostblom 8055 E Tufts Avenue, Sub ite 1000 (Address) Denver, CO 80237 151 N. Franklin Street (Address) Chicago, IL 60606 NOTE: Date of Bond mu not be prior to date of Contract. If Contractor is Partnership, all partners should execute Bond. IMPORTANT: Surety co panies executing Bonds must appear on the Treasury Department's most current list (Circular 570 s amended) and be authorized to transact business in the State where the Project is located. BID NO. B2100100 Page - 40 - Western Surety Company POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY -IN -FACT Know All Men By These Presents, That WESTERN SURETY COMPANY, a South Dakota corporation, is a duly organized and existing corporation having its principal office in the City of Sioux Falls, and State of South Dakota, and that it does by virtue of the signature and seal herein affixed hereby make, constitute and appoint Jody L Anderson, Evan E Moody, Karen A Feggestad, Bradley J Moody, Tina Marie Post, Elizabeth Ostblom, Individually of Denver, CO, its true and lawful Attomey(s)-in-Fact with full power and authority hereby conferred to sign, seal and execute for and on its behalf bonds, undertakings and other obligatory instruments of similar nature - In Unlimited Amounts - and to bind it thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of the corporation and all the acts of said Attorney, pursuant to the authority hereby given, arc hereby ratified and confirmed. This Power of Attorney is made and executed pursuant to and by authority of the By -Law printed on the reverse hereof, duly adopted, as indicated, by the shareholders of the corporation. In Witness Whereof, WESTERN SURETY COMPANY has caused these presents to be signed by its Vice President and its corporate seal to be hereto affixed on this 28th day of March, 2020. State of South Dakota County of Minnehaha } ss WESTERN SURETY COMPANY aul T. Bruflat, Vice President T. Vice President On this 28th day of March, 2020, before me personally came Paul T. Bruflat, to me known, who, being by me duly sworn, did depose and say: that he resides in the City of Sioux Falls, State of South Dakota; that he is the Vice President of WESTERN SURETY COMPANY described in and which executed the above instrument; that he knows the seal of said corporation; that the seal affixed to the said instrument is such corporate seal; that it was so affixed pursuant to authority given by the Board of Directors of said corporation and that he signed his name thereto pursuant to like authority, and acknowledges same to be the act and deed of said corporation. My commission expires June 23, 2021 J. MOLAR NOUN PLEIUC CERTIFICATE J. Mohr, Notary Public I, L. Nelson, Assistant Secretary of WESTERN SURETY COMPANY do hereby certify that the Power of Attorney hereinabove set forth is still in force, and further certify that the By -Law of the corporation printed -on the reverse hereof is still in force. In testimony whereof I have hereunto subscribed my name and affixed the seal of the said corporation this day of WESTERN SURETY COMPANY 94111—Inits/ L. Nelson, Assistant Secretary Form F4280-7-2012 Go to www.cnasurety.com > Owner / Obligee Services > Validate Bond Coverage, if you want to verify bond authenticity. Authorizing By -Law ADOPTED BY THE SH REHOLDERS OF WESTERN SURETY COMPANY This Power of Attorney is ma a and executed pursuant to and by authority of the following By -Law duly adopted by the shareholders of the Company. Section 7. All bonds, policies, undertakings, Powers of Attorney, or other obligations of the corporation shall be executed in the corporate name of the Company by the President, Secretary, and Assistant Secretary, Treasurer, or any Vice President, or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys in Fact or agents who shall have authority to issue bonds, policies, or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile. A� o® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDrYYYI) 07/19/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. OR ALTER THE COVERAGE AFFORDED BY THE POLICIES THIS BETWEEN THE ISSUING INSURER(S), AUTHORIZED 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 Moody Insurance Agency, Inc. 8055 East Tufts Avenue Suite 1000 Denver CO 80237 CONTACT Jane Smith NAME: PHONE (303) 824-6600 FAXi vac, No, (303) 370-0118 o. DRESS: jane.smith@moodyins.com AD INSURER(S) AFFORDING COVERAGE NAIC $ INSURER A: Phoenix Insurance Company 25623 INSURED A-1 Chipseal Company, DBA: Rocky Mountain Pavement, LLC 2505 E. 74th Ave Denver CO 80229 INSURER B : Travelers Indemnity Company 25658 INSURER c : Travelers Prop Cas Co of America 25674 INSURER D : Pinnacol Assurance 41190 INSURER E : Evanston Insurance Company 35378 INSURER F : COVERAGES CERTIFICATE NUMBER: 21-22 Master 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 AWL INSD SUER WVD POLICY NUMBER POLICY EFF IMM/DD/YYYY) POLICY EXP (MMIDDIYYYY) LIMITS A X COMMERCIAL GENERAL UABIUTY ICLAIMS -MADE © OCCUR Y DTCO0J730005PHX21 02/01/2021 02/01/2022 EACH OCCURRENCE $ 1,000,000 AGE TO RENTED PREMISES Ea occurrence) $D300,000 MED EXP (My one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000'000 GENt AGGREGATE X LIMIT APPLIES PER JECT LOC GENERALAGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2.000,000 $ B AUTOMOBILE _ X — LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY ^ — SCHEDULED AUTOS NON -OWNED AUTOS ONLY 8103L4051972126G 02/01/2021 02/01/2022 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ C X UMBRELLA LIAB EXCESS UAB X OCCUR CLAIMS -MADE CUP9R5157362126 02/01/2021 02/01/2022 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 $ DED I XI RETENTION $ 10.000 D WORKERS COMPENSATION EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below YN N NIA 4055760 02/01/2021 02/01/2022 •...0.1 PER I I OTH- /0.I STATUTE ER ER E.L. EACH ACCIDENT $ 500,000 El. DISEASE - EA EMPLOYEE s 500,000 E.L. DISEASE - POLICY LIMIT 500,000 $ E Pollution Liability CPLMOL105277 02/01/2021 02/01/2022 Each Occurrence Limit Aggregate Limit Deductible $5,000,000 $5,000,000 $10,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) RE: 2021 Slurry seal and Sand Seal CERTIFICATE HOLDER CANCELLATION Weld County 1111 H Street Greeley CO 80632 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 140,114 Wa IV e,,ncv( ACORD 25 (2016/03) ® 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 00015073 LOC #: ACORD ADDITIONAL REMARKS SCHEDULE Page of AGENCY Moody Insurance Agency, Inc. NAMED INSURED A-1 Chipseal Company, DBA: Rocky Mountain Pavement, LLC POUCY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance: Notes CONTRACTUAL LIABILITY APPLIES PER POUCY TERMS AND CONDITIONS Additional Named Insureds: A-1 Chipseal Company DBA Rocky Mountain Pavement, LLC Black Rock Material & Supply, LLC Location Schedule: 2505 E. 74th Avenue, Denver, CO 80229 2505 E. 64th Avenue, Denver, CO 80229 5575 E. Bijou, Colorado Springs, CO 80916 7520 & 7560 Space Village Avenue, Colorado Springs, CO 80929 10800 Highway 90, Arvada, CO 80007 General Liability Policy: Separation of Insureds Clause applies. General Liability Deductible: $2,500 CG D3 16 02/19 From Attached Includes: Blanket Additional Insured status applies only to the extent provided in form CG D3 16 02/19. Blanket Waiver of Subrogation applies only to the extent provided in from CG D3 16 02/19. General Liability Policy is Primary and Non -Contributory only to the extent provided in form CG D3 16 02/19. CG D2 46 04/19 From Attached Includes: Blanket Additional Insured status applies only to the extent provided in form CG D2 46 04/19. General Liability Policy is Primary and Non -Contributory only to the extent provided in form CG D2 46 04/19. CG D2 11 01/04 From Attached Includes: General Liability Policy has a Per Project Aggregate which applies only to the extent provided in form CG D2 11 01/04. Auto Liability Policy: Scheduled Auto Physical Damage Deductibles: Comprehensive: $10,000, Collision: $10,000 Hired / Non -Owned Vehicle Liability Limit: $1,000,00 Hired Car Physical Damage Deductibles: Comprehensive: $2,500, Collision: $2,500 CA T3 53 / From Attached Includes: Blanket Additional Insured status applies only to the extent provided in form CA T3 53 02/15. Blanket Waiver of Subrogation applies only to the extent provided in from CA T3 53 02/15. CA T4 74 / Form Attached Includes: Primary and Non-contributory Coverage applies only to the extent provided in form CA T4 74 02/16. Inland Marine Policy: Policy Number: 6308R645096TIL21 Policy Effective Dates: 2-1-2021 to 2-1-2022 Insurer: Travelers Property Casualty Company of America NAIC #: 25674 Total Combined Scheduled Contractor's Equipment Value: $7,607,748 Scheduled Contractor's Equipment Deductible: $10,000 Leased & Rented Equipment From Others Limit: $1,000,000 Leased & Rented Equipment To Others Limit $25,000 Leased & Rented Equipment Deductible: $5,000 Motor Truck Cargo Coverage Deductible: $2,500 Umbrella Policy: Separation of Insureds clause applies. Umbrella Policy is on a follow form basis for underlying insurance coverages: General Liability, Automobile Liability, and Employers Liability. Additional insured status will follow when required by written contract, including Primary and Non -Contributory Status. Worker's Compensation Policy: 359-B Form Attached Includes: Blanket Waiver of Subrogation status applies when required by written contract. "Please Note Hard Copies of Endorsement will not be sent out via mail. All Endorsements will only be sent electronically via email. Please send your email address to certrequest@moodyins.corn for forms and future mailings" ACORD 101 (2008/01) ® 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: DT-CO-0J730005-PHX-19 COMMERCIAL GENERAL LIABILITY ISSUE DATE: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY DESIGNATED PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Project(s): EACH "PROJECT" FOR WHICH YOU HAVE AGREED, IN A WRITTEN CONTRACT WHICH IS IN EFFECT DURING THIS POLICY PERIOD, TO PROVIDE A SEPARATE GENERAL AGGREGATE LIMIT; PROVIDED THAT THE CONTRACT IS SIGNED AND EXECUTED BY YOU BEFORE THE "BODILY INJURY" OR "PROPERTY DAMAGE" OCCURS. A. For all sums which the insured becomes legally obligated to pay as damages caused by "occur- rences" under COVERAGE A. (SECTION I), and for all medical expenses caused by accidents un- der COVERAGE C (SECTION I), which can be attributed only to operations at a single desig- nated "project" shown in the Schedule above: 1. A separate Designated Project General Ag- gregate Limit applies to each designated "pro- ject", and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations, unless separate Designated Project General Aggregate(s) are sched- uled above. 2. The Designated Project General Aggregate Limit is the most we will pay for the sum of all damages under COVERAGE A., except damages because of "bodily injury" or "prop- erty damage" included in the "products - completed operations hazard", and for medi- cal expenses under COVERAGE C, regard- less of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". Designated Project General Aggregate(s): GENERAL AGGREGATE LIMIT SHOWN ON THE DECLARATIONS. 3. Any payments made under COVERAGE A. for damages or under COVERAGE C. for medical expenses shall reduce the Desig- nated Project General Aggregate Limit for that designated "project". Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they re- duce any other Designated Project General Aggregate Limit for any other designated "project" shown in the Schedule above. 4. The limits shown in the Declarations for Each Occurrence, Damage To Premises Rented To You and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated Project General Ag- gregate Limit. B. For all sums which the insured becomes legally obligated to pay as damages caused by "occur- rences" under COVERAGE A. (SECTION I), and for all medical expenses caused by accidents un- der COVERAGE C. (SECTION I), which cannot be attributed only to operations at a single desig- nated "project" shown in the Schedule above: CG D211 01 04 Copyright, The Travelers Indemnity Company, 2004 Page 1 of 2 COMMERCIAL GENE AL LIABILITY 1. Any payments made under COVERAGE A. for damages or under COVERAGE C. for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products -Completed Operations Ag- gregate Limit, whichever is applicable; and 2. Such payments shall not reduce any Desig- nated Project General Aggregate Limit. C. Part 2. of SECTION III - LIMITS OF INSURANCE is deleted and replaced by the following: 2. The General Aggregate Limit is the most we will pay for the sum of: a. Damages under Coverage B; and b. Damages from "occurrences" under COVERAGE A (SECTION I) and for all medical expenses caused by accidents under COVERAGE C (SECTION I) which cannot be attributed only to operations at a single designated "project" shown in the SCHEDULE above. D. When coverage for liability arising out of the "products -completed operations hazard" is pro- vided, any payments for damages because of "bodily injury" or "property damage" included in the "products -completed operations hazard" will reduce the Products -Completed Operations Ag- gregate Limit, and not reduce the General Aggre- gate Limit nor the Designated Project General Aggregate Limit. E. For the purposes of this endorsement the Defini- tions Section is amended by the addition of the following definition: "Project" means an area away from premises owned by or rented to you at which you are per- forming operations pursuant to a contract or agreement. For the purposes of determining the applicable aggregate limit of insurance, each "project" that includes premises involving the same or connecting lots, or premises whose con- nection is interrupted only by a street, roadway, waterway or right-of-way of a railroad shall be considered a single "project". F. The provisions of SECTION III - LIMITS OF INSURANCE not otherwise modified by this en- dorsement shall continue to apply as stipulated. Page 2 of 2 Copyright, The Travelers Indemnity Company, 2004 CG D2 11 01 04 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. BROAD FORM NAMED INSURED B. BLANKET ADDITIONAL INSURED C. EMPLOYEE HIRED AUTO D. EMPLOYEES AS INSURED E. SUPPLEMENTARY PAYMENTS - INCREASED LIMITS F. HIRED AUTO - LIMITED WORLDWIDE COV- ERAGE - INDEMNITY BASIS G. WAIVER OF DEDUCTIBLE - GLASS PROVISIONS A. BROAD FORM NAMED INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II - COVERED AUTOS LIABILITY COVERAGE: Any organization you newly acquire or form dur- ing the policy period over which you maintain 50% or more ownership interest and that is not separately insured for Business Auto Coverage. Coverage under this provision is afforded only un- til the 180th day after you acquire or form the or- ganization or the end of the policy period, which- ever is earlier. B. BLANKET ADDITIONAL INSURED The following is added to Paragraph c. in A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to be named as an addi- tional insured is an "insured" for Covered Autos Liability Coverage, but only for damages to which H. HIRED AUTO PHYSICAL DAMAGE - LOSS OF USE - INCREASED LIMIT I. PHYSICAL DAMAGE - TRANSPORTATION EXPENSES - INCREASED LIMIT J. PERSONAL PROPERTY K. AIRBAGS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS M. BLANKET WAIVER OF SUBROGATION N. UNINTENTIONAL ERRORS OR OMISSIONS C. this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Section II. EMPLOYEE HIRED AUTO 1. The following is added to Paragraph A.1., Who Is An Insured, of SECTION II - COV- ERED AUTOS LIABILITY COVERAGE: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your busi- ness. 2. The following replaces Paragraph b. in B.5., Other Insurance, of SECTION IV - BUSI- NESS AUTO CONDITIONS: b. For Hired Auto Physical Damage Cover- age, the following are deemed to be cov- ered "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 an "employee's" name, with your CA T3 53 0215 2015 The Travelers Indemnity Company. All rights reserved. Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission. COMMERCIAL AUTO permission, while performing duties related to the conduct of your busi- ness. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". D. EMPLOYEES AS INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any "employee" of yours is an "insured" while us- ing a covered "alto' you don't own, hire or borrow in your business or your personal affairs. E. SUPPLEMENTARY PAYMENTS - INCREASED LIMITS 1. The following replaces Paragraph A.2.a.(2), of SECTION II - COVERED AUTOS LIABIL- ITY COVERAGE: (2) Up to $3,000 for cost of bail bonds (in- cluding bonds for related traffic law viola- tions) required because of an "accident" we cover. We do not have to furnish these bonds. 2. The following replaces Paragraph A.2.a.(4), of SECTION II COVERED AUTOS LIABIL- ITY COVERAGE: (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day be- cause of time off from work. F. HIRED AUTO — LIMITED WORLDWIDE COV- ERAGE — INDEMNITY BASIS The following replaces Subparagraph (5) in Para- graph B.7., Policy Period, Coverage Territory, of SECTION IV - BUSINESS AUTO CONDI- TIONS: (5) Anywhere in t4 world, except any country or jurisdiction whie any trade sanction, em- bargo, or similar regulation imposed by the United States of America applies to and pro- hibits the transaction of business with or within such country or jurisdiction, for Cov- ered Autos Liability Coverage for any covered "auto" that yot, lease, hire, rent or borrow without a driver for a period of 30 days or less and that is not an "auto" you lease, hire, rent or borrow fro any of your "employees", partners (if you are a partnership), members (if you are a limited liability company) or members of th 'r households. (a) With respect to any claim made or "suit" brought outside the United States of America, the territories and possessions of the United States of America, Puerto Rico and Canada: (i) You must arrange to defend the "in- sured" against, and investigate or set- tle any such claim or "suit" and keep us advised of all proceedings and ac- tions. (ii) Neither you nor any other involved "insured" will make any settlement without our consent. (iii) We may, at our discretion, participate in defending the "insured" against, or in the settlement of, any claim or "suit". (iv) We will reimburse the "insured" for sums that the "insured" legally must pay as damages because of "bodily injury" or "property damage" to which this insurance applies, that the "in- sured" pays with our consent, but only up to the limit described in Para- graph C., Limits Of Insurance, of SECTION II — COVERED AUTOS LIABILITY COVERAGE. (v) We will reimburse the "insured" for the reasonable expenses incurred with our consent for your investiga- tion of such claims and your defense of the "insured" against any such "suit", but only up to and included within the limit described in Para- graph C., Limits Of Insurance, of SECTION II - COVERED AUTOS LIABILITY COVERAGE, and not in addition to such limit. Our duty to make such payments ends when we have used up the applicable limit of insurance in payments for damages, settlements or defense expenses. (b) This insurance is excess over any valid and collectible other insurance available to the "insured" whether primary, excess, contingent or on any other basis. (c) This insurance is not a substitute for re- quired or compulsory insurance in any country outside the United States, its ter- ritories and possessions, Puerto Rico and Canada. Page 2 of 4 @ 2015 The Travelers Indemnity Company. All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc. with its permission. COMMERCIAL AUTO You agree to maintain all required or compulsory insurance in any such coun- try up to the minimum limits required by local law. Your failure to comply with compulsory insurance requirements will not invalidate the coverage afforded by this policy, but we will only be liable to the same extent we would have been liable had you complied with the compulsory in- surance requirements. (d) It is understood that we are not an admit- ted or authorized insurer outside the United States of America, its territories and possessions, Puerto Rico and Can- ada. We assume no responsibility for the furnishing of certificates of insurance, or for compliance in any way with the laws of other countries relating to insurance. G. WAIVER OF DEDUCTIBLE — GLASS The following is added to Paragraph D., Deducti- ble, of SECTION III - PHYSICAL DAMAGE COVERAGE: No deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced. H. HIRED AUTO PHYSICAL DAMAGE - LOSS OF USE - INCREASED LIMIT The following replaces the last sentence of Para- graph A.4.b., Loss Of Use Expenses, of SEC- TION III - PHYSICAL DAMAGE COVERAGE: However, the most we will pay for any expenses for loss of use is $65 per day, to a maximum of $750 for any one "accident". I. PHYSICAL DAMAGE - TRANSPORTATION EXPENSES - INCREASED LIMIT The following replaces the first sentence in Para- graph A.4.a., Transportation Expenses, of SECTION III - PHYSICAL DAMAGE COVER- AGE: We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense in- curred by you because of the total theft of a cov- ered "auto" of the private passenger type. J. PERSONAL PROPERTY The following is added to Paragraph A.4., Cover- age Extensions, of SECTION III - PHYSICAL DAMAGE COVERAGE: Personal Property We will pay up to $400 for "loss" to wearing ap- parel and other personal property which is: (1) Owned by an "insured"; and (2) In or on your covered "auto". This coverage applies only in the event of a total theft of your covered "auto". No deductibles apply to this Personal Property coverage. K. AIRBAGS The following is added to Paragraph B.3., Exclu- sions, of SECTION III - PHYSICAL DAMAGE COVERAGE: Exclusion 3.a. does not apply to "loss" to one or more airbags in a covered "auto" you own that in- flate due to a cause other than a cause of "loss" set forth in Paragraphs A.1.b. and A.1.c., but only: a. If that "auto" is a covered "auto" for Compre- hensive Coverage under this policy; b. The airbags are not covered under any war- ranty; and c. The airbags were not intentionally inflated. We will pay up to a maximum of $1,000 for any one "loss". L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS The following is added to Paragraph A.2.a., of SECTION IV - BUSINESS AUTO CONDITIONS: Your duty to give us or our authorized representa- tive prompt notice of the "accident" or "loss" ap- plies only when the "accident" or "loss" is known to: (a) You (if you are an individual); (b) A partner (if you are a partnership); (c) A member (if you are a limited liability com- pany); (d) An executive officer, director or insurance manager (if you are a corporation or other or- ganization); or (e) Any "employee" authorized by you to give no- tice of the "accident" or "loss". M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A.5., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV - BUSINESS AUTO CONDI- TIONS: 5. Transfer Of Rights Of Recovery Against Others To Us We waive any right of recovery we may have against any person or organization to the ex- tent required of you by a written contract signed and executed prior to any "accident" or "loss", provided that the "accident" or "loss" arises out of operations contemplated by CA T3 53 0215 ® 2015 The Travelers Indemnity Company. All rights reserved. Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission. COMMERCIAL AUTO such contract. The waiver applies only to the person or organization designated in such contract. N. UNINTENTIONAL ERRORS OR OMISSIONS The following is added to Paragraph B.2., Con- cealment, Misrepresentation, Or Fraud, of SECTION IV - BUSINESS AUTO CONDITIONS: Page 4 of 4 The unintentional omission of, or unintentional error in, any information given by you shall not prejudice your rights under this insurance. How- ever this provision does not affect our right to col- lect additional premium or exercise our right of cancellation or non -renewal. ® 2015 The Travelers Indemnity Company. All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc. with its permission. COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY WITH OTHER INSURANCE This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM PROVISIONS 1. The following is added to Paragraph A.1.c., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: This includes any person or organization who you are required under a written contract or agreement between you and that person or organization, that is signed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to name as an additional insured for Covered Autos Liability Coverage, but only for damages to which this insurance applies and only to the extent of that person's or organization's liability for the conduct of another "insured". CA T4 74 0216 2. The following is added to Paragraph B.5., Other Insurance of SECTION IV — BUSINESS AUTO CONDITIONS: Regardless of the provisions of paragraph a. and paragraph d. of this part 5. Other Insurance, this insurance is primary to and non-contributory with applicable other insurance under which an additional insured person or organization is the first named insured when the written contract or agreement between you and that person or organization, that is signed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, requires this insurance to be primary and non-contributory. ® 2016 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission. COMMERCIAL GENERAL LIABILITY THIS ENDORS ENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED (Includes Products -Completed Operations If Required By Contract) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS The following is added to SECTION II — WHO IS AN INSURED: Any person or organization that you agree in a written contract or agreement to include as an additional insured on this Coverage Part is an insured, but only: a. With respect to liability for "bodily injury" or "property damage" that occurs, or for "personal injury" caused by an offense that is committed, subsequent to the signing of that contract or agreement and while, that part of the contract or agreement is in effect; and b. If, and only to the extent that, such injury or damage is caused by, acts or omissions of you or your subcontractor in the performance of "your work" to which the written contract or agreement applies. Such person or organization does not qualify as an additional insured with respect to the independent acts or omissions of such person or organization. The insurance provided to such additional insured is subject to the following provisions: a. If the Limits of Insurance of this Coverage Part shown in the Dedartions exceed the minimum limits required by the written contract or agreement, the insurance provided to the additional insured ill be limited to such minimum required li its. For the purposes of determining whether this limitation applies, the minimum limits requir d by the written contract or agreement will be sidered to include the minimum limits of ny Umbrella or Excess liability coverage r quired for the additional insured by that writt n contract or agreement. This provision will of increase the limits of insurance described in Section III — Limits Of Insurance. b. The insurance proded to such additional insured does not appl to: (1) Any "bodily injury", "property damage" or "personal injury" arising out of the providing, or failure to provide, any professional architectural, engineering or surveying services, including: (a) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders or change orders, or the preparing, approving, or failing to prepare or approve, drawings and specifications; and (b) Supervisory, inspection, architectural or engineering activities. (2) Any "bodily injury' or "property damage" caused by "your work" and included in the "products -completed operations hazard" unless the written contract or agreement specifically requires you to provide such coverage for that additional insured during the policy period. c. The additional insured must comply with the following duties: (1) Give us written notice as soon as practicable of an "occurrence" or an offense which may result in a claim. To the extent possible, such notice should include: (a) How, when and where the "occurrence" or offense took place; (b) The names and addresses of any injured persons and witnesses; and (c) The nature and location of any injury or damage arising out of the "occurrence" or offense. (2) If a claim is made or "suit" is brought against the additional insured: CG D2 46 0419 © 2018 The Travelers Indemnity Company. All rights reserved. Page 1 of 2 COMMERCIAL GENERAL LIABILITY (a) Immediately record the specifics of the claim or "suit" and the date received; and (b) Notify us as soon as practicable and see to it that we receive written notice of the claim or "suit' as soon as practicable. (3) Immediately send us copies of all legal papers received in connection with the claim or "suit", cooperate with us in the investigation or settlement of the claim or defense against the "suit', and otherwise comply with all policy conditions. (4) Tender the defense and indemnity of any claim or "suit' to any provider of other insurance which would cover such additional insured for a loss we cover. However, this condition does not affect whether the insurance provided to such additional insured is primary to other insurance available to such additional insured which covers that person or organization as a named insured as described in Paragraph 4., Other Insurance, of Section IV — Commercial General Liability Conditions. Page 2 of 2 © 2018 The Travelers Indemnity Company. All rights reserved. CG D2 46 04 19 COMMERCIAL GENERAL LIABILITY THIS ENDORSE ENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. XTEND ENDORSEMENT FOR CONTRACTORS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to this Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general coverage description only. Read all the provisions of this endorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. Who Is An Insured — Unnamed Subsidiaries B. Blanket Additional Insured — Governmental Entities — Permits Or Authorizations Relating To Operations PROVISIONS A. WHO IS AN INSURED - UNNAMED SUBSIDIARIES The following is added to SECTION II - WHO IS AN INSURED: Any of your subsidiaries, other than a partnership, joint venture or limited liability company, that is not shown as a Named Insured in the Declarations is a Named Insured if: a. You are the sole owner of, or maintain an ownership interest of more than 50% in, such subsidiary on the first day of the policy period; and b. Such subsidiary is not an insured under similar other insurance. No such subsidiary is an insured for "bodily injury' or "property damage" that occurred, or "personal and advertising injury caused by an offense committed: a. Before you maintained an ownership interest of more than 50% in such subsidiary; or b. After the date, if an that you no longe interest of more tha during the policy period maintain an ownership 50% in such subsidiary. For purposes of Paragraph 1. of Section II — Who Is An Insured, each such subsidiary will be deemed to be designated in the Declarations as: C. D. E. F. Incidental Medical Malpractice Blanket Waiver Of Subrogation Contractual Liability — Railroads Damage To Premises Rented To You a. An organization other than a partnership, joint venture or limited liability company; or b. A trust; as indicated in its name or the documents that govern its structure. B. BLANKET ADDRIONAL INSURED - GOVERNMENTAL ENTITIES - PERMITS OR AUTHORIZATIONS RELATING TO OPERATIONS The following is added to SECTION II - WHO IS AN INSURED: Any governmental entity that has issued a permit or authorization with respect to operations performed by you or on your behalf and that you are required by any ordinance, law, building code or written contract or agreement to include as an additional insured on this Coverage Part is an insured, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" arising out of such operations. The insurance provided to such governmental entity does not apply to: a. Any "bodily injury', "property damage" or "personal and advertising injury" arising out of operations performed for the governmental entity; or b. Any "bodily injury' or "property damage" included in the "products -completed operations hazard". CG D3 16 02 19 © 2017 The Travelers Indemnity Company. All rights reserved. Page 1 of 3 Includes copyrighted material of Insurance Services Office, Inc., with its permission. COMMERCIAL GENERAL LIABILITY C. INCIDENTAL MEDICAL MALPRACTICE 1. The following replaces Paragraph b. of the definition of "occurrence" in the DEFINITIONS Section: b. An act or omission committed in providing or failing to provide "incidental medical services", first aid or "Good Samaritan services" to a person, unless you are in the business or occupation of providing professional health care services. 2. The following replaces the last paragraph of Paragraph 2.a.(1) of SECTION II - WHO IS AN INSURED: Unless you are in the business or occupation of providing professional health care services, Paragraphs (1)(a), (b), (c) and (d) above do not apply to "bodily injury" arising out of providing or failing to provide: (a) "Incidental medical services" by any of your "employees" who is a nurse, nurse assistant, emergency medical technician or paramedic; or (b) First aid or "Good Samaritan services" by any of your "employees" or "volunteer workers", other than an employed or volunteer doctor. Any such "employees" or "volunteer workers" providing or failing to provide first aid or "Good Samaritan services" during their work hours for you will be deemed to be acting within the scope of their employment by you or performing duties related to the conduct of your business. 3. The following replaces the last sentence of Paragraph 5. of SECTION III - LIMITS OF INSURANCE: For the purposes of determining the applicable Each Occurrence Limit, all related acts or omissions committed in providing or failing to provide "incidental medical services", first aid or "Good Samaritan services" to any one person will be deemed to be one "occurrence". 4. The following exdusion is added to Paragraph 2., Exclusions, of SECTION I - COVERAGES - COVERAGE A - BODILY INJURY AND PROPERTY DAMAGE LIABILITY: Sale Of Pharmaceuticals "Bodily injury' or "property damage" arising out of the violation of a penal statute or ordinance relating to the sale of pharmaceuticals committed by, or with the knowledge or consent of, the insured. 5. The following is added to the DEFINITIONS Section: "Incidental medical services" means: a. Medical, surgical, dental, laboratory, x-ray or nursing service or treatment, advice or instruction, or the related furnishing of food or beverages; or b. The furnishing or dispensing of drugs or medical, dental, or surgical supplies or appliances. 6. The following is added to Paragraph 4.b., Excess Insurance, of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS: This insurance is excess over any valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to any of your "employees" for "bodily injury" that arises out of providing or failing to provide "incidental medical services" to any person to the extent not subject to Paragraph 2.a.(1) of Section II — Who Is An Insured. D. BLANKET WAIVER OF SUBROGATION The following is added to Paragraph 8., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS: If the insured has agreed in a contract or agreement to waive that insured's right of recovery against any person or organization, we waive our right of recovery against such person or organization, but only for payments we make because of: a. "Bodily injury" or "property damage" that occurs; or b. "Personal and advertising injury" caused by an offense that is committed; subsequent to the execution of the contract or agreement. E. CONTRACTUAL LIABILITY — RAILROADS 1. The following replaces Paragraph C. of the definition of "insured contract" in the DEFINITIONS Section: c. Any easement or license agreement; Page 2 of 3 © 2017 The Travelers Indemnity Company. All rights reserved. CG D3 16 02 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. COMMERCIAL GENERAL LIABILITY 2. Paragraph f.(1) of the definition of "insured contract' in the EFINITIONS Section is deleted. F. DAMAGE TO PREMIS S RENTED TO YOU The following replaces the definition of "premises damage" in the DEFINITIONS Section: "Premises damage" means "property damage" to: CGD3160219 a. Any premises while rented to you or temporarily occupied by you with permission of the owner; or b. The contents of any premises while such premises is rented to you, if you rent such premises for a period of seven or fewer consecutive days. © 2017 The Travelers Indemnity Company. All rights reserved. Incl4des copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 3 P1NN/ICOL ASSURANCE A-1 Chipseal Company dba Rocky Mounta Rocky Mountain Pavement LLC 2505 E 74th Ave Denver, CO 80229 ENDORSEMENT: Blanket Waiver of Subrogation 7501 E. Lowry Blvd. Denver, CO 80230-7006 303.361.4000 / 800.873.7242 Pinnacol.com NCCI #: WC000313B Policy #: 4055760 Moody Insurance Agency Inc 8055 E. Tufts Ave Ste 1000 Denver, CO 80237 (303) 824-6600 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:February 1, 2021 Expires on: February 1, 2022 Pinnacol Assurance has issued this endorsement January 28, 2021 7501 E. Lowry Blvd Denver, CO 80230-7006 Page 1 of 1 P DORSEYR - Underwriter 01/28/2021 12:01:59 4055760 57288629 359-B Contract Form New Contract Request trty Information Entity Name* A-1 CHIPSEAL CO Contract Name* SLURRY SEAL CONTRACT 2021 Contract Status CT6 REVIEW Entity ID* a 4JO022694 ❑ New Entity? Contract ID 5095 Contract Lead* JHOLEROOK Contract Lead Email Jholbrook@co.weld.co.us Parent Contract ID Requires Board Approval YES Department Project # Contract Description* THIS PROEJCT IN GENERAL CONSISTS OF PERFORMING CRACK SEAL (10.5 TONS) IN SUBDIVISIONS AND PARKING LOTS AND SEAL COAT (SLURRY SEAL) ON MAIN LINE ROADWAYS (380,777 SY) Contract Description 2 Contract Type AGREEMENT Amount* $969,452.51 Renewable YES Automatic Renewal ICA CM- PublicWorks@weldgov.com Department Head Email CM-PublicWorks- DeptHead .weldgov.com County Attorney GENERAL COUNTY AI I ORNEY EMAIL Attorney Email CM - CO NTYA i I ORNEYItWELDG OV. .OM If this is a renewal enter previous Contract ID If this is part of a MSA enter MSA contract ID Note: the Previous Contract Numbe On Base Contract Dates Effective Date Requested BOCC Agenda Date* 0802,2021 Due Date 07,'291 2021 Will a work session with BOCC be required?* NO Does Contract require Purchasing Dept. to be included? NO r and Master Services Agreement Number should be left blank if those contracts are not in Review Date* 02:01 ?2022 Renewal Date* 04,'01 ,'2021 Termination Notice Period Contact Information Contact Info Contact Name Contact Type Purchasing Approval Process Department Head JAY MCDONALD OH Approved Date 07J27/2021 Final Approval BOCC Approved BOCC Signed Date BOCC Agenda Date 08,/02;2021 Originator JHOLEROOK Contact Email Co Finance Approver CHRIS D'OViDlO Purchasing r, Date Legal Counsel BOB CHOATE Contact Phone 2 Finance Approved Date Legal Counsel Approved Date 07i28,2021 07J28e2021 Tyler Ref AG 080221 MEMORANDUM TO: Curtis Hall, Deputy Director DATE: July 7, 2021 FROM: Joshua Holbrook, Pavement Management Supervisor SUBJECT: Recommendation Letter for the 2021 Slurry Seal Contract Bid No. B2100100 One bid for the 2021 Slurry Seal Contract was received and opened on June 16, 2021. The bid was submitted by A-1 Chipseal based out of Denver, Colorado for the amount of $1,066,051.40. The bid is over the 2021 budget amount, so Public Works removed WCR 41 from WCR 8 to SH 52 from the Slurry Seal Contract and added it to the 2021 Chip Seal Program. It is staff's recommendation to award the project to A-1 Chipseal for a total amount of $969,452.51, which is within the 2021 budget for the slurry seal contract. Work is expected to begin in late July and end in late September. Attachments: 2021 Bid Tab pc: Jay McDonald, Director Rob Turf, Purchasing Manager Rose Everett, Purchasing Mona Weidenkeller, Office Tech IV / Payable / Receivable t 2- M:\Maintenance Contracts\Slurry Seal -Sand Seal-Rejuvenator\2018\Contract Doc's\Bids oeca1- /590 ��0�9 BID REQUEST NO. B2100100 2021 SEAL COAT PROGRAM BID TAB IEM 'NO DESCRIPTION UNIT QUANTITY UNIT PRICE COST A-1 Chip Seal 408 PLACE RUBBERIZED CRACK FILLER & TRAFFIC CONTROL (Weld County to supply material) TON 11 $3,995.00 $41,947.50 409 SLURRY SEAL SQYD 380,777 $2.13 $811,055.01 627 PAVEMENT MARKINGS (Parking lot only) GAL 0 $200.00 $0.00 630 SIGNING & TRAFFIC (Sand Seal) PER LOCATION 2 $1,850.00 $3,700.00 630 SIGNING & TRAFFIC (Slurry Seal) MILE 21 $4,250.00 $89,250.00 630 MHT & TRAFFIC CONTROL FOR CDOT INTERSECTIONS EACH 3 $4,500.00 $13,500.00 700 F/A MINOR CONTRACT REVISIONS 1 $10,000.00 $969,452.51 *No Errors DATE OF BID: JUNE 16, 2021 REQUEST FOR: 2.21 SLURRY SEL DEPARTMENT: PUBLIC WORKS DEPT BID NO: #6210 1 0 PRESENT DATE: JUNE 21, 2021 APPROVAL DATE: JULY 7, 2021 VENDO A-1 CHIPSEAL CO 2505 E. 74H AVENUE DE \IER CO 80229 WELD COUNTY PURCHASING 1150 O Street Room 107, Greeley CO 80631 E -Mail: reverett@weldgou.com E-mail: cmpeters@weldgov.com Phone: (970) 400-4222 & 400-4223 Fax: (970) 304-6434 (MOVE TO JULY 12, 2021) PUBLIC VV RKS WILL REVIEW THE BIDS. TOTAL PRICE $1,066,051040 aocv � 1 54,007 MEMORANDUM TO: Curtis Hall, Deputy Director DATE: July 6, 2021 FROM: Joshua Holbrook, Pavement Management Supervisor SUBJECT: Continuance Letter for the 2021 Slurry Seal Contract Bid No. B2100100 — Move award to 7.12.2021 One bid for the 2021 Slurry Seal Contract was received and opened on June 16, 2021. The bid was submitted by A-1 Chip Seal based out of Denver, Colorado for an amount of $1,066,051.40. The bid is over the 2021 budget amount, so Public Works is requesting a continuance for the award until July 12, 2021. This week Public Works will determine which projects to remove from the contract to remain within the budget. pc: Jay McDonald, Director Rob Turf, Purchasing Manager Rose Everett, Purchasing Mona Weidenkeller, Office Tech IV / Payable / Receivable 1/7 M:\Maintenance Contracts \Slurry Seal -Sand Seal-Rejuvenator\7D18\Contract Doc's\Bids 0200u -1590 C=Goo79 DATE OF BID: JUNE 16, 2021 REQUEST FOR: 2021 SLURRY SEAL DEPARTMENT: PUBLIC WORKS DEPT BID NO: #62100100 PRESENT DATE: JUNE 21, 2021 APPROVAL DATE: JULY 7, 2021 VENDOR A-1 CHIPSEAL CO 2505 E. 74H AVENUE DENVER CO 80229 PUBLIC WORKS WILL REVIEW THE BIDS. C3Cof WELD COUNTY PURCHASING 1150 O Street Room 107, Greeley CO 80631 E -Mail: reverett(a�weldgov.com E-mail: cmpeters(n�weldgov.com Phone: (970) 400-4222 & 400-4223 Fax: (970) 304-6434 TOTAL PRICE $1,066,051.40 2021-1590 Ed&CO 7c1 Hello