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Home My WebLink About20181689.tiffein+ract ZC) BOARD OF COUNTY COMMISSIONERS T'(0 5 PASS -AROUND REVIEW PASS -AROUND TITLE: Weld County 2020 Renewal for Slurry and Sand Seal DEPARTMENT: Weld County Public Works DATE: 4.4.2020 PERSON REQUESTING: Joshua Holbrook Brief description of the problem/issue: The Current contract for Slurry and Sand Seal between Weld County and A-1 Chipseal is nearing expiration. The contract allows for yearly extensions and possible rate adjustments. Per the contract, the allowable rate adjustments are based upon the yearly percent change (+/-) from the Denver/Boulder/Greeley Consumer Price Index (CPI), which has been changed to the Denver -Aurora -Lakewood Consumer Price Index. The Denver - Aurora -Lakewood CPI has a 1.924% increase for this year. A-1 Chipseal is requesting a 1.924% cost increase for 2020. This extension would be the third year of a possible three-year term limit. Attached to this pass around is a draft copy of the contract extension/renewal, the 2020 Bid Schedule, and cost comparison from 2019 to 2020. The budgeted amount for 2020 is $1,000,000. A-1 Chipseal was low bid and awarded this contract in 2018, Public Works has been satisfied with their work. 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 2020 renewal for A-1 Chipseal. Approve Recommendation Mike Freeman, Chair Scott K. James Barbara Kirkmeyer Steve Moreno, Pro-Tem Kevin D. Ross Attachments: Draft 2019 Contract Extension/Renewal 2020 Rate Schedule 2019-2020 cost comparison Cc: Jay McDonald, Director of Public Works Elizabeth Relford, Deputy Director Curtis Hall, Deputy Director Don Dunker, County Engineer c2ftfl+OVLQLLt OS(a7(..0 a0 Schedule Work Session ©r\base osra?rao Other/Comments: O0M- ICa€S9 EC,o015 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 1 day of April, 2020, by and between the Board of Weld County Commissioners, on behalf of the Weld County Department of Public Works, hereinafter referred to as the "Department", and A-1 Chipseal, hereinafter referred to as the "Contractor". WHEREAS the parties entered into an agreement on June 28, 2018 (the "Original Agreement"), identified as document B#1800070 / 2018-1689 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 March 31, 2020. • The parties agree to extend the Agreement for an additional period, which will begin April 1, 2020, and will end on December 31, 2020. • 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 and final year of a possible three-year contract 2. The 2019 Bid Schedule of the contact shall be replaced by the attached 2020 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 first above written. CONTRACTOR: A-1 Chipseal Co. Daniel J. Gryzmala, President Printed Name Signature G, 9"°• f! @off •• opP0R47:••o <i SEAL x 11/09/1992 ATTEST: d,„ettA,84) �1• Weld County Clerk to the Board BY BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO Mike Freeman, Chair MAY 2 7 2020 0018'-16531 BID SCHEDULE 2020 Slurry Seal and Sand Seal Contract (B1800070) Item Description Unit Est. Quantity Unit Price Contract Bid Number 408 Place Rubberized Crack Filler & Traffic Control (Weld County to supply material) Ton 15 $3664.77 $54,971.55 409 Sand Seal SQ 0 $ 0 . 0 0 409 Slurry Seal SQ 429,311 $1. 90 $815,690.90 614 Signing and Traffic (Sand Seal and Crack Fill) Per Location 2 $261 . 77 $523.54 614 Signing and Traffic (Slurry Seal) Mile 26 $2094 . 15 $54,447.90 627 Pavement Markings (Parking lot only) Gal. 20 $118 . 84 $2,376.80 630 MHT and Traffic Control for CDOT intersections Each 6 $2355 . 92 $14,135.52 700 F/A Minor Contract Revisions F/A 1 $25,000 $25,000 Total: $967,146.21 FIRM A-1 Chipseal Company BY Mike Starr (Please print) BUSINESS 2505 East 74th Avenue ADDRESS DATE 4/27/20 CITY, STATE, ZIP CODE Denver, CO 80229 TELEPHONE NO 303-464-9267 FAX 303-464-9261 SIGNATURE 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. 2019 vs. 2020 percent change for Slurry Seal and Sand Seal 2019 Cost 2020 Cost Item Item Description Unit Unit Cost Unit Unit Cost % Increase 408 Place rack Fill / WC to supply material ton $ 3,595.59 ton $ 3,664.77 1.924% 409 Sand Seal SY $ 1.39 SY $ 1.39 0.000% 409 Slurry Seal SY $ 1.86 SY $ 1.90 1.924% 614 Traffic & Signing for Sand Seal Per Location $ 256.83 Per Location $ 261.77 1.924% 614 Traffic & Signing for Slurry Seal Mile $ 2,054.62 Mile $ 2,094.15 1.924% 627 Pavement marking Gal $ 116.60 Gal. $ 118.84 1.924% 630 MHT and traffic Control for cdot intersection Each $ 2,311.45 Ton $ 2,355.92 1.924% Denver -Aurora -Lakewood (used to be Denver -boulder -Greeley CPI) =1.924% Percent Avg. Increase 2020 1.924% Weld County Slur!)' Seal 2020 Rom) 1) LOCATION of PROJECT From I , w idh t i ► Length (ft) Length (miles) Bridg. s AMYL SQ. YDS. Radii Because Of: Approaches Widen Areas TOTAL Square Yards 83rd Ave/64.5 O ST _2.230' West of CR 27 25.00 5.697.00 1.08 3.727 00 19,552.00 35 East 'T' Intersection of AA & 35 SH 392 26.00 5.660.00 1.07 220.00 56.00 1.048.00 17.675.11 72 SH 257 19 25.50 5.300.00 1.00 177.00 797.00 15.990.67 105 SH 14 390 26.50 20.849 00 3.95 373.00 3.132.00 1.61 1.00 66.504 72 390 104 118 26.50 43.070 (10 8.16 2,454.00 129.271.22 13 1.194' North of CR 34 CR 38 24.50 9,394.00 1.78 1.567.00 27.139.56 35 2.625' North of 74 (Eaton CL) 1.723' North of CR 80 (Ault CL) 24 00 15.200.00 2.88 170.00 40,703.33 39 66 SH 392 24.50 5.364.00 1.02 197.00 14.799.00 67 68 SH 392 26.50 11,128.00 2.11 190.00 92.00 33.047.78 TOTALS FOR ROAD: 23.04 364,683.39 Subdivisions Sierra Acres Miles Radii Approaches Widen Areas Square Yards Bravo Point CR 27 Cul de sac 24.00 1,118.00 0.21 2.121.00 5.102.33 Bravo Point Cul do Sac Cul de sac 135.00 830.00 965.00 TOTAL 0.25 6,067.33 Idaho Creel. Miles Radii Approaches Widen Areas Square Yards Idaho Creek Pkwy CR 7.5 Idaho Creek Park 50.00 547 0.10 154.00 3,192.89 Forester PI Upper Ridge Rd E of S bound Turn 40.00 485 0.09 64.00 2.219.56 Forester PI North Widend E/S turn North Widend E/S turn 46.00 190 0.04 971.11 Forester PI N side Widend E/S turn S side E/S widend turn 40.00 390 0.07 77.00 1.810.33 Forester PI S widend N/E turn S widend N/E turn 46.00 198 0.04 1.012.00 Forester PI S widend N/E turn Lower Ridge Road 40.00 473 0.09 69.00 2.171.22 Durango PI Lower Ridge Rd Upper Ridge Rd 40 00 2305 0.44 116.00 10.360.44 Butte Dr Lower Ridge Rd Upper Ridge Rd 40.00 2785 0.53 12.377 78 Corner Butte Dr Lower Ridge Road 46.00 181 0.03 '125.1 I Lower Ridge Rd Butte Dr W bound Corner 40.00 400 0.08 1.777,78 Corner N Lower Ridge Rd W Lower Ridge Rd 46.00 205 0.04 1.047.78 W bound Lower ridge rd S/W Corner S/E Corner 40.00 202 0.04 897.78 Corner Lower Ridge Rd Lower Highland Rd 46.00 178 0.03 909.78 Lower Highland Rd Corner Forester PI 40.00 74 0.01 328.89 Lower Highland Rd Forester PI Durango PI 40.00 144 0.03 640.00 Lower Highland Rd Durango PI Butte Dr 40.00 144 0.03 64000 Corner Butte Dr Upper Ridge Rd 46.00 194 0.04 9'4 .56 Upper Ridge Rd North Corner S. Corner 40.00 391 0.07 1.7:7.78 SE Corner Upper Ridge Upper Ridge Rd Upper Ridge Rd 46.00 187 0.04 I 955 78 Upper Ridge Rd Upper Ridge Rd corner upper highland 40.00 198 0.04 880.00 Corner Upper Ridge Rd Upper Highland Rd 46.00 178 0.03 909.78 Upper Highland Rd Corner Forester PI 40.00 65 0.01 288.89 Upper Highland Rd Forester PI Durango PI 40.00 144 0.03 640.00 Upper Highland Rd Durango PI Butte Dr 40.00 144 0.03 640.00 Upper Highland Rd Butte Dr Stagecoach Sd S 40.00 89 0.01 85.50 481.06 Idaho Creek Radius's I.00 2353 0.45 261.39 TOTAL: 2.44 49,068.67 Parkin(' Lots Island Grove Overflow SQ YDS TOTAL '74, l is t 'TOTAL: -,. '4 3.1x1 Oil and Gas/Sign Shop SQ YDS TOTAL I.74M DO TOTAL: 1,748.00 Slurry Seal Totals Total Miles 25.73 Total Project SY 429,310.39 2020 PARKING LOT SURRY SEAL & CRACK FILL LOCATION MAP Weld County PW 1111 H St. Greeley, CO 80631 970-304-6497 Legend Greeley ------ Highway ea Island Grove Overflow Paved die Oil & Gas / Sign Shop - - - - Gravel Other Municipal. Paved L_ _ Municipal, Gravel CountyBoundary frr SITES: 83rd Ave./CR 64.5 fr O ST to 2,230' East of CR 27 WCR 35 fr East "T" Intersection of AA & CR 35 to SH 392 WCR 72 fr SH 257 to CR 19 WCR 105 fr SH 14 to CR 390 WCR 390 fr CR 104 to CR 118 WCR 13 fr 1,194' North of CR 34 to CR 38 WCR 35 fr 2,625' North of CR 74 (Eaton CL) to 1,723' North of CR 80 (Ault CL) WCR 39 fr CR 66 to SH 392 WCR 67 fr CR 68 to SH 392 2020 Map 1 85 95 105 I —I I 100 90 80 I I L I 1 I 1 I 1 1 1 I I I 1 L I a ---— L — ——-- L —I.- 1 I I I I _I I I I I I I I I a 1 I I — 1 I 1 1 L___1 I 1 1 1 I 1 I I I I L L . - 1 I 1 I I I L_-- I I I I I 1 I I I I 1 I I I I I IL_ _L_L—I_-L_ I I I I 1/4.___L. I. I I I 1 I 1 _J • I ) I I I I t 1 I ' — 1 . - I I I I I I - L___L_L_1 I 1 I I 1 L_L_L_L_L_ I I I I 1 1 L_L_L_ _L_L. 1 1 1 1 1 1 _1 le_ 1 1• I A L I 1 1 t 1 1 1 1 1 1 I --�-L- 1 _-__.r. 1 -L WCR 72 fr. SH 257 to CR 19 "Pa 1 I - -i- - [WCR 35fr. AAtoSH392L 60 I - _ _ • I I L I 1 .1 -- I. ✓ 1 1 ens ,. _ I I I _L II 1 1 I 1 1 I I t 1 -- I t 1 1 WCR390fr. CR 104 to CR 118 1 I t L_ 1 1 I 1 I L _ 1 1 1 1 I I I 1 1 I L I I 1 1 1 1 I I I I _L LL L I I I I I I L 1 I 1 I I I I I I 1 L iv/ I I ..... L -L_ -_L.-; -I- 1 I 1 1 1 L r _ _ I S - I I I ,L- - -• I I a a 1 WCR 105 fr. SH 14 to CR 390 1 1 L I 1 1 __I _1 I I I WCR 35 fr. North of CR 74 to North of CR 80 _L 1 I 1 1 I I I I I I I_y_ I I I 1 L_ _ I I 1 -�._I-J- 1 1 1 WCR 39 fr. CR 66 to SH 392 l I t L_ l I I I I I 1 Greeley - WC Public Works 151-1—Errir 83rd Ave/ WCR 64.5 fr. "O ST" to West of CR 27 l E- - 1 1 I L 1 L -- L 1 I I I 1 I I L_L_f.- I L_ a L 1 l WCR 13 fr. North of CR 34 to CR 381_ I CEO ti T L —L_1 I I I I I I I I L_ 1 1 I I -- I _ p 1 1 I a L _L _1 I I 1 1 I I I I I 1 _ _L _1 1 -r 1 I 1 l 1 1 1 1 1 WCR 67 fr. CR 68 to SH 392 L, 1 L --_1_ __—L _.._ _ soar 1 I I I I I I I 1 a a I I PO L —L —L —L_1 1 a a 1 l l ! 1 1 1 1 I I L L— L---i—L—L--_L I I I I I L_L_L—L — I I 1 1 1 1 L—_.4._L—L_L t 1 I 1 1 1 I I I 1 1 1 _L_ L__ I • r I I L 1 1 1 1 1 I I I I I I 1 I I 1 I I I I I I I I 1.1 1 I I I L I I I e L 1 1 1 1 I t 1 1! • • • • • • 1 • L —I I —. 1 1 I 1 I L 1 1 1 L L 1 1 1 I 105 70 -� 60 S alb I 1 1 I 1 a I L L I 1 ......1 I 1 1 I L _ L_L-1 I 1 1 1 I 1 1 I I I ! 1 l ! I I I I I L _L__.L I I a 1. 1 I _1 I I L__ —I I I I —I I I I J I L I I I I 1 L "...__L---L—_—L.. 1 I I 1 I 50 30 20 10 2020 ROADS SURRY SEAL LOCATION MAP Weld County PW 1111 H St. Greeley, CO 80631 970-304-6497 Legend Greeley am WCR 390 fr CR 104 to CR 118 83rd Ave./64.5 fr O Street to CR 25 ammi VCR 13 fr CR 34 to CR 38 WCR 35 fr AA to SH 392 alma WCR 35 fr CR 74 to CR 80 WCR72frSH257toCR 19 isPWCR39frCR66toSH392 WCR 105frSH 14 toWCR390 ama WCR 67 fr CR 68 to SH 392 Other n-- Highway Paved - - - - Gravel Municipal, Paved 18 61 I Municipal, Gravel l _l CountyBoundary WCR 741 I i I, , t - ' SITES: Sierra Acres a 0" 4.c ° �-� 1 I I _ _ 1 I WCR72 L - - -- - - -- - - -- "• -"- - I _ _ I ---- I WCR 43 I I 1 WCR 45 4-----r---• I I I I I I Idaho 2020 Creek MapiLPaS'-.kc I 1 N I I I R70 �---I----t (Y 1 t c -LONGS - I I OLIVE I 1 PEAK IR 68 .5 ` Sierra Acres _.R0AD O�'� l�•� STREET $ I 8 —-- w in i� CC :__ 04 Greeley - WC Public Works44, t WCR 64.5 3 �csi! Z `c I.; WCR 64 pa VI II •• �• �'. ��1 ----i _ . , ...± - - 0 Z �F51 II `n r� sft Z> ?, .- Elm Q I C STREET CC In Iry WCR r 62 !� ;i > �, .. ' .. 4th 41 cv Q rSt Z `� t 1 Z m > 1 .c Q �. r to R N LL Q • 1 60':�� - 1 _ U r.:. E 16th St m 1 :. <.2 <1 83 LAW) k, — - W m" m • CO `` 1t .Q 1 . . «. i -- . 1 I in I �� w r.`' t '� 37th St ' i- w ten) WCR545' WCR 54r _ Arrowhead —I Arro+rvh tri Q ' > Or V'"� I Ir�� 1�Q , 5WCR 25 31 52.--' ' ' i WCR52� ' I m>- I 17.111). y I --L--- -- L- °�� — ,- t.•! cc ---beta-+ tli , MpO rI�G er z -TODD , L3 WCR 50 I --- 1 n < Dell R "� O VIt�iAVENUE d I U ; 3 �� I WCR 48.5 73 W %� 0 � oo, ' HLij w foi .591 _ . ' / ��` ST,Q�I,y Qr � i F!' ' '* I ce _ WCR 48 - - ‘ 1 Q -__-, - WCR I < t I � I __ 46.5 U 85 ' I� --nen I W 3 -_L L WCR 46 ------- 1 Z Z I Ww I - t__. =J . L I.v -- • , - I I^ ;U 1 3 1 I 1r> _Q I I N Iix I� 1 I / I , I i' I�tn I O> %Ai I>el WCR 44 1 1 , i I I I 1 ---' se — - - -;f1 C� 0a0h S -- I u%. - I ; I I ' ,' / I I 1 1 1 I 1 I 1 1 1 ^1 -- -- --- - -- � -- - ---------L--- 1 , I I /+ WCR ---r- 40.5 I i ,t°f , I �' I c 1 et # (.) I 1 I 1 1 I 1 1 I----1 I 1 I I I 1 , I -25 L---- (-___ I 1WCR40-' --L ..3 S_C__ __j__---L-- ,�` 4/ 19O 'let. I _______ I ' I _L_ I ICCto tri h I - WCR-r - 1 38.5 i I 1 - -% I I I N_ �� L WCR 38 1 1 ' 1 I 1 L_ ' WCR _ I -- f ------------ ars I .- $0 -I' ---- Gi "'�-- , , , I ��L 1 ' ks'p I I ,/WCR36' - - - _F_ , - 1 , �' I I 1 ----L----L----' _1. 1 I 1 1 _es* 9 O 34.7 ---- r - L - I I I 1 1K I 1 1 itct tb �O� '(�,$• li 1 �� y WCR 34' O ' + _ r 11' 11 1 1 ei.i, �..�.-+.'++ ! it' i - j alt_ ; i F.- 1 ( 1 r I a 1 — i. I �/ I I i WCR 32 -- STAGFCOACH ROAD � I I I - JIi' , - - es g - AAV ,—H I i,l 25 •�� d Y IJt,• I { I` e 'II 30 ir WCR CEDARAV'T� Jfc€ocuvt?_ U 1 Cr r ►1 ' 1'�� ihiiI1 I 0 I11� WCR28 AV; ,I . 1FIR 1�,U I .,��, �� • I.25' t� $.'"'.:C ` IVY AV, �._ IItI I( : WCR 26 L ....veto • — A(�e -• BUTTE DRIVEil •_.:... is. ,• . RQ�. , r }i , :.- a t-25.1 .�.—_� - _ � . IL WCR 24 .....v#'. - Lt *'_i' a Ili<n ii LU In , ...ter. In 3 6 I N zz 5 ' �' Idaho Creek , - - - - �. ' WCR 22 I i 1 WCR 20.5 --o AZ% ----- In WCR20 / I Q� mt I I i K . I , 1 2020 Weld County PW ...... , ;- �sb .-n "" le S, 5 ----------1.M..... 1. , j _ >~ SUBDIVISION SURRY SEAL IS.- E W IL -� Greeley, CO 80631 � I 970-304-6497 .. LOCATION MAP C o u S- y- -• 71 14 Le end 39 r—_"�__'" Greeley -�-'- ' Highway Municipal, Gravel 57; _ a 1" 34 ' a Idaho Creek Paved CountyBoundary 60 1 J i!, lemrl. Sierra Acres - - - - Gravel 11 Other 52 Municipal, Paved 79 s Bond No 30099996 PERFORMANCE BOND PROJECT* SLURRY SEAL AND SAND SEAL CONTRACT 2018 KNOW ALL MEN BY THE PRESENTS, that A-1 Chipseal Company 2505 E 74th Avenue, Denver, CO 80229 (Name of Contractor) I (Address of Contractor) CO Corporation , hereinafter called Contractor, and a (Corporation, Partnership, or Individual) Western Surety Company (Name of Surety) 151 N Franklin Street, Chicago, IL 60606 (Address of Surety) hereinafter called surety, are held and firmly bound unto Weld County, Colorado (Name of Owner) P 0 Box 758, 1111 H Street, Greeley, Colorado 80632 (Address of Owner) hereinafter called Owner, in the penal sum of Nine Hundred Sixty Seven Thousand'Dollars, ($ 967,146 21 ) 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 One Hundred Forty Six and 21/100 --- THE CONDITION OF THIS OBLIGATION is such that whereas, the Contractor entered into a certain Contract with the Owner, dated the 1st day of April, 2020 , Mc10, 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 B1800070 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 B1800070 Page - 37 - PERFORMANCE BOND PROJECT: SLURRY SEAL AND SAND SEAL CONTRACT 2018 IN WITNESS WHEREOF, this instrument is executed in two (2) counterparts, each one of which shall be deemed an original, this "�c,,!(Contra or) Secretary t i ^ C sE'Ar)'StAL Y �, • s Denver, CO 80229 13th day of May, 2020 By Jdwu1 I Q L ks- 2505 E. 74th Avenue (Witness as to Contractor) (Address) Denver, CO 80229 ATTEST: N/A (SEAL) (Surety) Secretary 0,< / CZ iG( e 4) By Witness as to urety 8055 E. Tufts Avenue, #1000 (Address) Denver, CO 80237 West gm mpany Elizabei Ostblotnttorney-in-Fact 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. B1800070 Page - 38 - Bond No. 30099996 LABOR & MATERIALS PAYMENT BOND PROJECT: SLURRY SEAL AND SAND SEAL CONTRACT 2018 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 Corporation , hereinafter called Contractor, and a (Corporation, Partnership, or 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 (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 Seven Thousand One Hundred Forty Six and 21/100 --- Dollars($ 967,146.21 ), 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 1st day of April, 2020 , EOb'8, 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. B1800070. 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. B1800070 Page - 39 - 8055 E. Tufts Avenue, #1000 (Address) Denver, CO 80237 LABOR & MATERIALS PAYMENT BOND PROJECT: SLURRY SEAL AND SAND SEAL CONTRACT IN WITNESS WHEREOF, this instrument is executed in two (2) counterparts, each one of which shall be deemed an original, this 13th I day of May, 2020 A-1 Chi Company Contractor • (f/ (eontractor) Secretary : ,....• cg" P turf,. Q (SE P.s 11/09/1902 cOCORA0.'. %. Aitne o Contractor) 2505 E. 74th Avenue (Address) Denver, CO 80229 ATTEST: N/A (SEAL) (Surety) Secretary We ttAtCi l..-1/ / fit.- ate -c\-) By _ tness as o Su ety , O Attorney -in -Fact Elizabeth Ostblom 151 N. Franklin Street , By j/9O1/a aIlerj 2505 E. 74th Avenue (Address) Denver, CO 80229 (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. B1800070 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, Brbdley J Moody, Tina Marie Post, 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 28th day of March, 2020. State of South Dakota County ofMinnehaha } SS WESTERN SURETY COMPANY Paul T. Bruflat, Vice President On this 28th day of March, 2020, before me personally came Paul T. Bru tat, 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 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 13th day of May, 2020. la VitA..,‘,247 M. Form F4280-7-2012 WESTERN SURETY COMPANY sc)T 2461-1771.." L. Nelson, Assistant Secretary Go to www.cnasuretv.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. 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. ACORN® CERTIFICATE OF LIABILITY INSURANCE `,,./ DATE (MM/UD!YYYY) 05/13/2020 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 H the certificate holder Is an ADDITIONAL INSURED, the policy(tes) 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 Suite 1000 Denver CO 80237 C NAME: Peter Foley, CIC (PHONE Extt: (303) 624-6600 I 1 i No): (303) 370-0118 E'Md� peter.foley@moodyins.com ADDRESS: INSURERS) AFFORDING COVERAGE NAIL # INSURERA: 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 INSURERS Illinois Union Insurance Company 27960 INSURER F : COVERAGES CERTIFICATE NUMBER: 20-21 Master • 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 CONTRACTOR 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 TYPE OF INSURANCE AUDI. wvBp POLICY NUMBER (MMIDDIVYYY) (MIDA/L DIYYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1.000,000 CLAIMS -MADE ix OCCUR DAMAGE TO RENTED PREMISES (Ea occunancol $ 300,000 MED EXP (Any one Pelson) 3 10,000 A COOJ730005PHX20 02/01/2020 02/01/2021 PERSONAL&ADVINJUHY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2'000.000 lPOLICY �X�f j ri LOC PRODUCTS - COMP/OP AGG $ 2,000:000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Eaacciden6 $ 1,000,000 X ANY AUTO BODILY INJURY (Per personl $ B ,^ OWNED AUTOS ONLY - SCHEDULED AUTOS 8103L4051971ND2026G 02/01/2020 02/01/2021 BODILY INJURY (Per ecciden0 $ X HIRE❑ AUTOS ONLY �/ •••-•AUTOS NON -OWNED ONLY PROPERTY DAMAGE (Per accident) $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10. 000,000 C EXCESS LIAB CLAIMS -MADE CUP2J3100432026 02/01/2020 02/01/2021 AGGREGATE $ 10,000,000 DED ( XI RETENTION $ 10,000 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY �/ P ER 0TH /�� STATUTEII ER D ANY PROPRIETOR/PARTNER/EXECUTIVE V! N N I NIA 4055760 02/01/2020 02/01/2021 Et EACH ACCIDENT 500,000 $ OFFICEPJMEMBER EXCLUDED? (Mandatory In NH) J E -L. DISEASE EA EMPLOYEE $ 500,000 II yes, describe under DESCRIPTION OF OPERA: IONS below E.L DISEASE - POLICY LIMIT $ 500,000 E Pollution Liability CPYG27165825008 02;01/2020 02/01/2021 Per Pollution Condition Aggregate Limit Deductible $5,000,000 $5,000,000 $25,000 DESCRIPTION OF OPERATIONS / LOCATIONS ! VEHICLES (AGGRO 101, Additional Remarks Schedule, may be altached If more space Is required) [Job It: B1800070 Job Type: ) RE: 2020 Slurry Seal Contract Renewal 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 Moolq ',t'L �.�VIX lX. �.-' �J1�AK,oevo 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 ACCO I J LOC #: ADDITIONAL REMARKS SCHEDULE Page of AGENCY Moody Insurance Agency, Inc. NAMED INSURED A-1 Chipseal Company, DBA: Rocky Mountain Pavement, LLC POLICY 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 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 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 11/11 From Attached Includes: Blanket Additional Insured status applies only to the extent provided in form CG D3 16 11/11. Blanket Waiver of Subrogation applies only to the extent provided in from CG 03 16 11/11. General Liability Policy is Primary and Non -Contributory only to the extent provided in form CG D3 16 11/11. CG 02 46 08105 From Attached Includes: Blanket Additional Insured status applies only to the extent provided in form CG D2 46 08/05. General Liability Policy is Primary and Non -Contributory only to the extent provided in form CG D2 46 08/05. 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: $2,000, Collision: $2,000 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: IH4D79782201 Policy Effective Dates: 2-1-2020 to 2-1.2021 Insurer: Hanover Insurance Company NAIC #: 22292 Total Combined Scheduled Contractor's Equipment Value: $6,272,440 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: $2,500 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.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 GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED (CONTRACTORS) This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. WHO IS AN INSURED - (Section II) is amended to include any person or organization that you agree in a 'Written contract requiring insurance" to include as an additional insured on this Cover- age Part, but: a) Only with respect to liability for "bodily injury", "property damage" or "personal injury"; and b) If, and only to the extent that, the 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 requiring insurance" applies. The person or organization does not qualify as an additional insured with respect to the independent acts or omissions of such person or organization. 2. The insurance provided to the additional insured by this endorsement is limited as follows: a) In the event that the Limits of Insurance of this Coverage Part shown in the Declarations exceed the limits of liability required by the "written contract requiring insurance", the in- surance provided to the additional insured shall be limited to the limits of liability re- quired by that "written contract requiring in- surance". This endorsement shall not in- crease the limits of insurance described in Section III — Limits Of Insurance b) The insurance provided to the additional in- sured does not apply to "bodily injury", "prop- erty damage" or "personal injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or sur- veying services, including: i. The preparing, approving, or failing to prepare or approve, maps, shop draw- ings, opinions, reports, surveys, field or- ders or change orders, or the preparing, approving, or failing to prepare or ap- prove, drawings and specifications; and ii. Supervisory, inspection, architectural or engineering activities c) The insurance provided to the additional in- sured does not apply to "bodily injury" or "property damage" caused by "your work" and included in the "products -completed op- erations hazard" unless the "written contract requiring insurance" specifically requires you to provide such coverage for that additional insured, and then the insurance provided to the additional insured applies only to such "bodily injury" or "property damage" that oc- curs before the end of the period of time for which the "written contract requiring insur- ance" requires you to provide such coverage or the end of the policy period, whichever is earlier. 3. The insurance provided to the additional insured by this endorsement is excess over any valid and collectible "other insurance", whether primary, excess, contingent or on any other basis, that is available to the additional insured for a loss we cover under this endorsement However, if the 'Written contract requiring insurance" specifically requires that this insurance apply on a primary basis or a primary and non-contributory basis, this insurance is primary to "other insurance" available to the additional insured which covers that person or organization as a named insured for such loss, and we will not share with that "other insurance" But the insurance provided to the additional insured by this endorsement still is excess over any valid and collectible "other in- surance", whether primary, excess, contingent or on any other basis, that is available to the addi- tional insured when that person or organization is an additional insured under such "other insur- ance" 4. As a condition of coverage provided to the additional insured by this endorsement a) The additional insured must give us written notice as soon as practicable of an "occur- rence" or an offense which may result in a claim. To the extent possible, such notice should include: CG D2460805 © 2005 The St. Paul Travelers Companies, Inc Page 1 of 2 COMMERCIAL GENERAL LIABILITY i. How, when and where the "occurrence" or offense took place; ii. The names and addresses of any injured persons and witnesses; and iii. The nature and location of any injury or damage arising out of the "occurrence" or offense. b) If a claim is made or "suit" is brought against the additional insured, the additional insured must: i. Immediately record the specifics of the claim or "suit" and the date received; and il. Notify us as soon as practicable. The additional insured must see to it that we receive written notice of the claim or "suit' as soon as practicable. c) The additional insured must 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 d) The additional insured must tender the de- fense and indemnity of any claim or "suit" to Page 2 of 2 any provider Cif "other insurance" which would cover the additional insured for a loss we cover under this endorsement. However, this condition does not affect whether the insur- ance provided to the additional insured by this endorsement is primary to "other insur- ance" available to the additional insured which covers that person or organization as a named insured as described in paragraph 3. above. 5. The following definition is added to SECTION V. - DEFINITIONS: 'Written contract requiring insurance" means that part of any written contract or agreement under which you are required to include a person or organization as an additional in- sured on this Coverage Part, provided that the "bodily injury" and "property damage" oc- curs and the "personal injury" is caused by an offense committed: a. After the signing and execution of the contract or agreement by you; b. While that part of the contract or agreement is in effect; and c. Before the end of the policy period. © 2005 The St. Paul Travelers Companies, Inc. CG D2 46 08 05 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS XTEND ENDORSEMENT 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 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. Aircraft Chartered With Pilot B. Damage To Premises Rented To You C. Increased Supplementary Payments D. Incidental Medical Malpractice E. Who Is An Insured — Newly Acquired Or Formed Organizations F. Who Is An Insured — Broadened Named Insured — Unnamed Subsidiaries G. .Blanket Additional Insured — Owners, Managers Or Lessors Of Premises PROVISIONS A. AIRCRAFT CHARTERED WITH PILOT The following is added to Exclusion g., Aircraft, Auto Or Watercraft, in Paragraph 2. of SECTION I - COVERAGES — COVERAGE A BODILY IN- JURY AND PROPERTY DAMAGE LIABILITY: This exclusion does not apply to an aircraft that is: (a) Chartered with a pilot to any insured; (b) Not owned by any insured; and (c) Not being used to carry any person or prop- erty for a charge. B. DAMAGE TO PREMISES RENTED TO YOU 1. The first paragraph of the exceptions in Ex- clusion j., Damage To Property, in Para- graph 2. of SECTION I — COVERAGES — COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY is deleted. 2. The following replaces the last paragraph of Paragraph 2., Exclusions, of SECTION I - COVERAGES — COVERAGE A. BODILY H. Blanket Additional Insured — Lessors Of Leased Equipment I. Blanket Additional Insured — States Or Political Subdivisions — Permits J. Knowledge And Notice Of Occurrence Or Offense K. Unintentional Omission L. Blanket Waiver Of Subrogation M. Amended Bodily Injury Definition N. Contractual Liability — Railroads INJURY AND PROPERTY DAMAGE LI- ABILITY: Exclusions c. and g. through n. do not apply to "premises damage". Exclusion f.(1)(a) does not apply to "premises damage" caused by: a. Fire; b. Explosion; c. Lightning; d. Smoke resulting from such fire, explosion, or lightning; or e. Water; unless Exclusion 1. of Section I — Coverage A — Bodily Injury And Property Damage Liability is replaced by another endorsement to this Coverage Part that has Exclusion — All Pollu- tion Injury Or Damage or Total Pollution Ex- clusion in its title. A separate limit of insurance applies to "premises damage" as described in Para- graph 6. of SECTION Ili - LIMITS OF IN- SURANCE. CG D3 16 11 11 O 2011 The Travelers Indemnity Company. All rights reserved. Page 1 of 6 COMMERCIAL GENERAL LIABILITY ate. 0= OZ'S O goiMMENNM 001014 3. The following replaces Paragraph 6. of SEC- TION III - LIMITS OF INSURANCE: Subject to 5. above, the Damage To Prem- ises Rented To You Limit is the most we will pay under Coverage A fcir damages because of "premises damage" to any one premises. The Damage To Premises Rented To You Limit will apply to all "property damage" proximately caused by the same "occur- rence", whether such damage results from: fire; explosion; lightning; smoke resulting from such fire, explosion, or lightning; or water; or any combination of any of these causes. The Damage To Premises Rented To You Limit will be: • a. The amount shown for the Damage To Premises Rented To You Limit on the Declarations of this Coverage Part; or b. $300,000 if no amount is shown for the Damage To Premises Rented To You Limit on the Declarations of this Coverage Part. 4. The following replaces Paragraph a. of the definition of "insured contract" in the DEFINI- TIONS Section: • a. A contract for a lease of premises. How- ever, that portion of the contract for a lease of premises that indemnifies any person or organization for "premises damage" is not an "insured contract"; 5. • The following is added to the DEFINITIONS Section: "Premises damage" means "property dam- age" to: a. Any premises while rented to you or tem- porarily 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. 6. The following replaces Paragraph 4.b.(1)(b) of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: (b) That is insurance for "premises damage"; or 7. Paragraph 4.b.(1)(c) of SECTION IV - COMMERCIAL GENERAL LIABILITY CON- DITIONS is deleted. Page 2 of 6 C. INCREASED SUPPLEMENTARY PAYMENTS 1. The following replaces Paragraph 1.b. of SUPPLEMENTARY PAYMENTS - COVER- AGES A AND B of SECTION I — COVER- AGE: b. Up to $2,500 for the cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to fur- nish these bonds. 2. The following replaces Paragraph 1.d. of SUPPLEMENTARY PAYMENTS — COVER- AGES A AND B of SECTION I — COVER- AGES: 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 $500 a day because of time off from work. D. INCIDENTAL MEDICAL MALPRACTICE 1. The following is added to the definition of "oc- currence" in the DEFINITIONS Section: "Occurrence" also means art act or omission committed in providing or failing to provide "incidental medical services", first aid or "Good Samaritan services" to a person. 2. The following is added to Paragraph 2.a.(1) of SECTION II — WHO IS AN INSURED: Paragraph (1)(d) above does not apply to "bodily injury" arising out of providing or fail- ing to provide: (i) "Incidental medical services" by any of your "employees" who is a nurse practi- tioner, registered nurse, licensed practical nurse, nurse assistant, emergency medi- cal technician or paramedic; or (ii) First aid or "Good Samaritan services" by any of your "employees" or "volunteer workers", other than an employed or vol- unteer doctor. Any such "employees" or "volunteer workers" providing or failing to provide first aid or "Good Samaritan ser- vices" 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 busi- ness. © 2011 The Travelers Indemnity Company. All rights reserved, CG D3 16 11 11 COMMERCIAL GENERAL LIABILITY 3. The following is added to Paragraph 5. of SECTION III - LIMITS OF INSURANCE: For the purposes of determining the applica- ble Each Occurrence Limit, all related acts or omissions cimmitted in providing or failing to provide "incidental medical services", first aid or "Good Samaritan services" to any one per- son will be deemed to be one "occurrence". 4. The following exclusion is added to Para- graph 2., Exclusions, of SECTION I - COV- ERAGES - COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY: Sale Of Pharmaceuticals "Bodily injury" or "property damage" arising out of the willful violation of a penal statute or ordinance relating to the sale of pharmaceuti-' cats 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. "Good Samaritan services" means any emer- gency medical services for which no compen- sation is demanded or received. 6. The following is added to Paragraph 4.b., Ex- cess Insurance, of SECTION IV — COM- MERCIAL GENERAL LIABILITY CONDI- TIONS: The insurance is excess over any valid and collectible other insurance available to the in- sured, whether primary, excess, contingent or on any other basis, that is available to any of your "employees" or "volunteer workers" for "bodily injury" that arises out of providing or failing to provide "incidental medical ser- vices", first aid or "Good Samaritan services" to any person to the extent not subject to Paragraph 2.a.(1) of Section II — Who Is An Insured. E. WHO IS AN INSURED - NEWLY ACQUIRED OR FORMED ORGANIZATIONS The following replaces Paragraph 4. of SECTION II - WHO IS AN INSURED: 4. Any organization you newly acquire or form, other than a partnership, joint venture or lim- ited liability company, of which you are the sole owner or in which you maintain the ma- jority ownership interest, will qualify as a Named Insured if there is no other insurance which provides similar coverage to that or- ganization. However: a. Coverage under this provision is afforded only: (1) Until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier, if you do not report such organization in writing to us within 180 days after you acquire or form it; or (2) Until the end of the policy period, when that date is later than 180 days after you acquire or form such organization, if you report such organization in writing to us within 180 days after you acquire or form it, and we agree in writing that it will con- tinue to be a Named Insured until the end of the policy period; b. Coverage A does not apply to "bodily injury" or "properly damage" that occurred before you acquired or formed the organization; and c. Coverage B does not apply to "personal in- jury" or "advertising injury" arising out of an offense committed before you acquired or formed the organization. F. WHO IS AN INSURED - BROADENED NAMED 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 Declara- tions is a Named Insured if you maintain an own- ership interest of more than 50% in such subsidi- ary on the first day of the policy period. No such subsidiary is an insured for "bodily injury" or "property damage" that occurred, or "personal injury" or "advertising injury" caused by an of- fense committed after the date, if any, during the policy period, that you no longer maintain an ownership interest of more than 50% in such sub- sidiary. CG D3 16 11 11 O2011 The Travelers Indemnity Company. All rights reserved. Page 3 of 6 COMMERCIAL GENERAL LIABILITY oT 0= os 0= 0= swomm G. BLANKET ADDITIONAL INSURED - OWNERS, MANAGERS OR LESSORS OF PREMISES The following is added to SECTION II — WHO IS AN INSURED: Any 'person or organization that is a premises owner, manager or lessor and that you have agreed in a written contract or agreement to in- clude as an additional insured on this Coverage Part is an insured, but only with respect to liability for "bodily injury", "properly damage", "personal injury" or "advertising injury" that: a. Is "bodily injury" or "property damage" that occurs, or is "personal injury" or "advertising injury" caused by an offense that is commit- ted, subsequent to the execution of that con- tract or agreement; and b. Arises out of the ownership, maintenance or use of that part of any premises leased to you. The insurance provided to such premises owner, manager or lessor is subject to the following pro- visions: a. The limits of insurance provided to such premises owner, manager or lessor will be the minimum limits which you agreed to pro- vide in the written contract or agreement, or the limits shown on the Declarations, which- ever are less. b. The insurance provided to such premises owner, manager or lessor does not apply to: (1) Any "bodily injury" or "property damage" that occurs, or "personal injury" or "adver- tising injury" caused by an offense that is committed, after you cease to be a tenant in that premises; or (2) Structural alterations, new construction or demolition operations performed by or on behalf of such premises owner, lessor or manager. c. The insurance provided to such premises owner, manager or lessor is excess over any valid and collectible other insurance available to such premises owner, manager or lessor, whether primary, excess, contingent or on any other basis, unless you have agreed in the written contract or agreement that this in- surance must be primary to, or non- contributory with, such other insurance, in which case this insurance will be primary to, and non-contributory with, such other insur- ance. Page 4 of 6 H. BLANKET ADDITIONAL INSURED - LESSORS OF LEASED EQUIPMENT The following is added to SECTION II — WHO IS AN INSURED: Any persIon or organization that is an equipment lessor and that you have agreed in a written con- tract or agreement to include as an insured on this Coverage Part is an insured, but only with re- spect to liability for "bodily injury", "property dam- age", "personal injury" or "advertising injury" that: a. Is "bodily injury" or "property damage" that occurs, or is "personal injury" or "advertising injury" caused by an offense that is commit- ted, subsequent to the execution of that con- tract or agreement; and b. Is caused, in whole or in part, by your acts or omissions in the maintenance, operation or use of equipment leased to you by such equipment lessor. The insurance provided to such equipment lessor is subject to the following provisions: a. The limits of insurance provided to such equipment lessor will be the minimum limits which you agreed to provide in the written contract or agreement, or the limits shown on the Declarations, whichever are less. b. The insurance provided to such equipment lessor does not apply to any "bodily injury" or "property damage" that occurs, or "personal injury" or "advertising injury" caused by an of- fense that is committed, after the equipment lease expires. c. The insurance provided to such equipment lessor is excess over any valid and collectible other insurance available to such equipment lessor, whether primary, excess, contingent or on any other basis, unless you have agreed in the written contract or agreement that this insurance must be primary to, or non-contributory with, such other insurance, in which case this insurance will be primary to, and non-contributory with, such other in- surance. I. BLANKET ADDITIONAL INSURED - STATES OR POLITICAL SUBDIVISIONS - PERMITS The following is added to SECTION II - WHO IS AN INSURED: Any state or political subdivision that has issued a permit in connection with operations performed by you or on your behalf and that you are required 2011 The Travelers Indemnity Company. All rights reserved. CG D3 16 11 11 001915 COMMERCIAL GENERAL LIABILITY by any ordinance, law or building code to include as an additional insured on this Coverage Part is an insured, but only with respect to liability for "bodily injury", "property damage", "personal in- jury" or "advertising injury" arising out of such op- erations. The insurance provided to such state or political subdivision does not apply to: a. Any "bodily injury," "property damage? "per- sonal injury" or "advertising injury" arising out of operations performed for that state or po- litical subdivision; or b. Any "bodily injury" or "property damage" in- cluded in the "products -completed operations hazard". J. KNOWLEDGE AND NOTICE OF OCCUR- RENCE OR OFFENSE The following is added to Paragraph 2., Duties In The Event of Occurrence, Offense, Claim or Suit, of SECTION IV — COMMERCIAL GEN- ERAL LIABILITY CONDITIONS: e. The following provisions apply to Paragraph a. above, but only for the purposes of the in- surance provided under this Coverage Part to you or any insured listed in Paragraph 1. or 2. of Section II — Who Is An Insured: (1) Notice to us of such "occurrence" or of- fense must be given as soon as practica- ble only after the "occurrence" or offense is known by you (if you are an individual), any of your partners or members who is an individual (if you are a partnership or joint venture), any of your managers who is an individual (if you are a limited liability company), any of your "executive offi- cers" or directors (if you are an organiza- tion other than a partnership, joint venture or limited liability company) or any "em- ployee" authorized by you to give notice of an "occurrence" or offense. (2) If you are a partnership, joint venture or limited liability company, and none of your partners, joint venture members or man- agers are individuals, notice to us of such "occurrence" or offense must be given as soon as practicable only after the "occur- rence" or offense is known by: (a) Any individual who is: (i) A partner or member of any part- nership or joint venture; (3) (ii) A manager of any limited liability company; or (ill) An executive officer or director of any other organization; that is your partner, joint venture member or manager; or (b) Any "employee" authorized by such partnership, joint venture, limited li- ability company or other organization to give notice of an "occurrence" or offense. Notice to us of such "occurrence" or of an offense will be deemed to be given as soon as practicable if it is given in good faith as soon as practicable to your work- ers' compensation insurer. This applies only if you subsequently give notice to us of the "occurrence" or offense as soon as practicable after any of the persons de- scribed in Paragraphs e. (1) or (2) above discovers that the "occurrence" or offense may result in sums to which the insurance provided under this Coverage Part may apply. However, if this Coverage Part includes an en- dorsement that provides limited coverage for "bodily injury" or "property damage" or pollution costs arising out of a discharge, release or es- cape of "pollutants" which contains a requirement that the discharge, release or escape of "pollut- ants" must be reported to us within a specific number of days after its abrupt commencement, this Paragraph e. does not affect that require- ment. K. UNINTENTIONAL OMISSION The following is added to Paragraph 6., Repre- sentations, of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS: The unintentional omission of, or unintentional error in, any information provided by you which we relied upon in issuing this policy will not preju- dice your rights under this insurance. However, this provision does not affect our right to collect additional premium or to exercise our rights of cancellation or nonrenewal in accordance with applicable insurance laws or regulations. L. 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 LI- ABILITY CONDITIONS: CG D3 16 11 11 O2011 The Travelers Indemnity Company. All rights reserved. Page 5 of 6 COMMERCIAL GENERAL LIABILITY If the insured has agreed in a contract or agree- ment to waive that insured's right of recovery against any person or organization, we waive our right of recovery against such person or organiza- tion, but only for payments we make becaule of: a. "Bodily injury" or "property damage" that oc- curs; or b. "Personal injury" or "advertising injury" caused by an offense that is committed; subsequent to the execution of that contract or agreement. M. AMENDED BODILY INJURY DEFINITION The following replaces the definition of "bodily injury" in the DEFINITIONS Section: IMMO IMMWM Y=ME 0= �� r� 0= Wf AI= Page 6 of 6 001010 3. "Bodily injury" means bodily injury, mental anguish, mental injury, shock, fright, disability, humiliation, sickness or disease sustained by a person, including death resulting from any of these at any time. N. CONTRACTUAL LIABILITY — RAILROADS 1. The following replaces Paragraph c. of the definition of "insured contract" in the DEFINI- TIONS Section: c. Any easement or license agreement; 2. Paragraph f.(1) of the definition of "insured contract" in the DEFINITIONS Section is de- leted. ® 2011 The Travelers Indemnity Company. All rights reserved. CG D3 16 11 11 POLICY NUMBER: DT-CO-0J730005-PHX-19 COMMERCIAL GENERAL LIABILITY ISSUE DATE: THIS ENDORSEMENT CI1ANGES 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. b. c. Insureds; Claims made or "suits" brought; or Persons or organizations making claims or bringing "suits". CG D2 11 01 04 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: Copyright, The Travelers Indemnity Company, 2004 Page 1 of 2 COMMERCIAL GENERAL 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 - Page 2 of 2 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. Copyright, The Travelers Indemnity Company, 2004 CG D2 11 01 04 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 02 16 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. PINNIACOL 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 Polio #: 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, 2020 Expires on: February 1, 2021 Pinnacol Assurance has issued this endorsement February 3, 2020 7501 E. Lowry Blvd Denver, CO 80230-7006 Page 1 of 1 P ISA - 02/03/2020 18:32:14 4055760 55462875 359-B 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 02 15 © 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 ofr 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 "auto" 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 the world, except any country or jurisdiction while 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 you 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 from any of your "employees", partners (if you are a partnership), members (if you are a limited liability company) or members of their households. (a) With respect to any claim made or "suit" brought outside the United Stags 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 CA T3 53 02 15 (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 ©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 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. OD 2015 The Travelers Indemnity Company. All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc. with its permission. NOTICE OF RENEWAL Project: 2020 Slurry Seal Renewal To: Mike Starr Al Chipseal Company 2505 E 74th Ave, Denver CO 80229 Project Description: 2020 Slurry Seal Contract renewal, Bid No. B1800070 You are hereby notified that your renewal rates have been accepted and the estimated budget for 2020 is $967,146.21. 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 25 day of May 2020. Weld County, Colorado, Owner By Joshua J. Holbrook, Construction Inspection Supervisor ACCEPTANCE OF NOTICE Receipt of the above Notice of Award is hereby acknowledged by (Contractor) Dated this 14 day of May , 2020. By: _ Title: Daniel J. Gryzmala , SEAL ':.'� 11/09/1992 J President BID NO # B1800070 Page 1 Contract Form New Contract Request Entity Information Entity Name* A-1 CHIPSEAL CO Contract Name* Entity ID* @00022694 Contract ID WELD COUNTY 2020 RENEWAL. FOR SLURRY SEAL AND 3665 SAND SEAL CONTRACT Contract Status CTB REVIEW Contract Lead* JHOLBROOK New Entity? Parent Contract ID Requires Board Approval YES Contract Lead Email Department Project # Jholbrook@co.weld.co co.us Contract Description* SLURRY SEAL 26 MILES OF ROADWAY, CRACK FILL AND SLURRY TWO PARKING LOTS AND TWO SUBDIVISIONS. Contract Description 2 Contract Type* RENEWAL Amount * $967,146.21 Renewable* NO Automatic Renewal Grant IGA Department PUBLIC WORKS Department Email CM- PublicWorks@weldgov.com Department Head Email CM-PublicWorks- DeptHead@weldgov.com County Attorney BOB CHOATE County Attorney Email BCHOATE@CO.WELD.CO US Requested BOCC Agenda Date* 05/27/2020 Due Date 05,/23/2020 Will a work session with BOCC be required?* NO Does Contract require Purchasing Dept. to be included? YES Bid/RFP#* B1800070 If this is a renewal enter previous Contract ID If this is part of a MSA enter MSA Contract ID Note: the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts are not in OnBase Contract Dates Effective Date Review Date* Renewal Date 01/08/2021 Termination Notice Period Committed Delivery Date Expiration Date * 12/3112020 Contact Information Contact Info Contact Name Contact Type Contact Email Contact Phone 1 Contact Phone 2 Purchasing Purchasing Approver CONSENT Approval Process Department Head JAY MCDONALD DH Approved Date 05/21/2020 Final Approval BOCC Approved BOCC Signed Date BOCC Agenda Date 05/27/2020 Originator JHOLBROOK Finance Approver CONSENT Purchasing Approved Date 05'21/2020 Finance Approved Date 05/21/2020 Tyler Ref I AG 052720 Legal Counsel CONSENT Legal Counsel Approved Date 05/21f2020 Submit OA &bald ► 0219 a BOARD OF COUNTY COMMISSIONERS PASS -AROUND REVIEW PASS -AROUND TITLE: Weld County 2019 Renewal for Slurry and Sand Seal DEPARTMENT: Weld County Public Works DATE: 4.15.19 PERSON REQUESTING: Joshua Holbrook Brief description of the problem/issue: The Current contract for Slurry and Sand Seal between Weld County and A-1 Chipseal is nearing expiration. The contract allows for yearly extensions and possible rate adjustments. Per the contract, the allowable rate adjustments arc based upon the yearly percent change (+/-) from the Denver/Boulder/Greeley Consumer Price Index (CPI), which has been changed to the Denver -Aurora -Lakewood Consumer Price Index. The Denver - Aurora -Lakewood CPI has a 2.731% increase for this year. A -I Chipseal is requesting a 2.69% cost increase for 2019. This extension would be the second year of a possible three-year term limit. Attached to this pass around is a copy of the contract extension/renewal, the 2019 Bid Schedule, and cost comparison from 2018 to 2019. The budgeted amount for 2019 is $1,000,000. A-1 Chipseal was low bid and awarded this contract in 2018, Public Works has been satisfied with their work. 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 2019 renewal for A-1 Chipseal. Approve Recommendation Work Session Schedule Sean P. Conway Mike Freeman, Pro -Tern Scott K. James Barbara Kirkmeyer, Chair Steve Moreno r4,1 Attachments: 20I9 Contract Ifxtension/Renewal 2019 Rate Schedule 2018-2019 cost comparison Cc: Jay McDonald, Director of Public Works Elizabeth Relford, Deputy Director Curtis Flail, Deputy Director Don Dunker, County Engineer ArrioL. c� - aa. 19 Other/Comments: you, tie,-*/c,e) ceAa/LI).4,4-6/0k)) 0201-- "ay 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 27 day of June. 2019by and between the Board of Weld County Commissioners, on behalf of the Weld County Department of Public Works, hereinafter referred to as the "Department", and A-1 Chipseal, hereinafter referred to as the "Contractor". WHEREAS the parties entered into an agreement on June 28, 2018 (the "Original Agreement"), identified as document B#1800070 / 2018-1 /oi9 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 Original Agreement will end on June 27, 2019. • The parties agree to extend the Agreement for an additional period, which will begin June 28, 2019, and will end on March 31, 2020. • 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 of a possible three-year contract 2. The 2018 Bid Schedule of the contact shall be replaced by the attached 2019 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 first above written. CONTRACTOR: A-1 Chipseal Co. Daniel J. Gryzmal Printed Name Signature \peat C G' '% � op �'�°�'"s G• QR. R,q1 SE=AL .. s 11/09/1992 t 1 • cps .700 rr.►ib ATTEST: did G•�� Weld 'ou , lerk to the B; . r. � rri BY: /��_ Deputy Cl'rk to t g oy BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO Mike Freeman, Chair Pro —Tern APR 2 2D19 oZo /$ 41'7 BID SCHEDULE 2019 Slurry Seal and Sand Seal Contract (81800070) Item Description Unit Est. Quantity Unit Price Contract Bid Number 408 Place Rubberized Crack Filler & Traffic Control (Weld County to supply material) Ton 4.5 3595.59 16,180.16 409 Sand Seal SQ 0 1.39 409 Slurry Seal SQ 464,311 1.86 863,618.46 614 Signing and Traffic (Sand Seal and Crack Fill) Per Location 3 256.83 770.49 614 Signing and Traffic (Slurry Seal) Mile 30 2054.62 61,638.60 627 Pavement Markings (Parking lot only) Gal. 12 116.60 1,399.20 630 MHT and Traffic Control for CDOT intersections Each 1 2311.45 2,311.45 700 F/A Minor Contract Revisions F/A 1 $10,000 $10,000 Total: 955,918.36 FIRM A-1 Chipseal Co BUSINESS ADDRESS 2505 E. 74th Ave By Daniel J. Gryzmala, President CITY, STATE, ZIP CODE Denver, CO 80229 (Please print) DATE 04/02/2019 ,`. -j JrvFI w r .„, ... c)SkPOR4, m " 'Q. SEAL • ATELEPH0NE NO 303-464-9267 / FAX 303-464-9261 TAX ID # 84-1216817 - 11/09/1992 `�' ` E-MAIL v SIGNATURE mstarr@a-1chipseal.com l'•` ..'c9ICaNAO5'� WELD COUNTY IS EXEMPT FROM COLORADO SALES TAXES. THE CERTIFICATE OF EXEMPTION NUMBER IS #98- 03551-0000. 2018 vs. 2019 percent change for Slurry Seal and Sand Seal 2018 Cost 2019 Cost Item Item Description Unit Unit Cost Unit Unit Cost % Increase 408 Place rack Fill / WC to supply material ton $ 3,500.00 ton $ 3,595.59 2.66% 409 Sand Seal SY $ 1.350 SY $ 1.39 2.88% 409 Slurry Seal SY $ 1.81 SY $ 1.86 2.69% 614 Traffic & Signing for Sand Seal Per Location $ 250.00 Per Location $ 256.83 2.66% 614 Traffic & Signing for Slurry Seal Mile $ 2,000.00 Mile $ 2,054.62 2.66% 627 Pavement marking Gal $ 113.50 Gal. $ 116.60 2.66% 630 MHT and traffic Control for cdot intersection Each $ 2,250.00 Ton $ 2,311.45 2.66% Denver -Aurora -Lakewood (used to be Denver -boulder -Greeley CPI) = 2.731% Percent Avg. Increase 2019 2.69% Nate Gibson From: Bob Choate Sent: Thursday, April 11, 2019 9:55 AM To: Josh Holbrook; Rob Turf Cc: Nate Gibson Subject: RE: 2019 renewal agreement for Slurry and sand seal (Contractor is A-1 chip seal) This is fine with me. Thanks, Bob Choate Assistant Weld County Attorney (970) 400-4393 From: Josh Holbrook Sent: Thursday, April 11, 2019 9:33 AM To: Bob Choate <bchoate@weldgov.com>; Rob Turf <rturf@weldgov.com> Cc: Nate Gibson <ngibson@weldgov.com> Subject: 2019 renewal agreement for Slurry and sand seal (Contractor is A-1 chip seal) Good morning Rob and Bob, I have one more for you today. If you could please review the attached 2019 contract extension for the Slurry and sand seal contract with A-1 chip seal. I have attached the Contract Extension, 2019 submitted bid schedule, 2019 vs 2018 cost increase, pass around and the 2018 contract documents. This renewal would be the second year of a possible three term. The terms for the renewal are on page 2 of the attached agreement from 2018. Please let me know if you have any questions. Thank you. Joshua Holbrook Construction Inspection Supervisor Department of Public Works 1111 H Street, Greeley CO 80632-0758 tel: 970.304.6496 Cell: 970.301.2622 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 disclosure. 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 communication or any attachments by anyone other than the named recipient is strictly prohibited. 1 Nate Gibson From: Rob Turf Sent: Thursday, April 11, 2019 9:47 AM To: Josh Holbrook; Bob Choate Cc: Nate Gibson Subject: RE: 2019 renewal agreement for Slurry and sand seal (Contractor is A-1 chip seal) Looks good. Also below CPI. Best, Rob Turf Title: Purchasing Manager Department: Purchasing Address: 1150 "0" Street Greeley, CO 80631 tel: 970-400-4216 fax: 970-336-7226 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 disclosure. 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 communication or any attachments by anyone other than the named recipient is strictly prohibited. From: Josh Holbrook Sent: Thursday, April 11, 2019 9:33 AM To: Bob Choate <bchoate@weldgov.com>; Rob Turf <rturf@weldgov.com> Cc: Nate Gibson <ngibson@weldgov.com> Subject: 2019 renewal agreement for Slurry and sand seal (Contractor is A-1 chip seal) Good morning Rob and Bob, I have one more for you today. If you could please review the attached 2019 contract extension for the Slurry and sand seal contract with A-1 chip seal. I have attached the Contract Extension, 2019 submitted bid schedule, 2019 vs 2018 cost increase, pass around and the 2018 contract documents. This renewal would be the second year of a possible three term. The terms for the renewal are on page 2 of the attached agreement from 2018. Please let me know if you have any questions. 1 Bond No. 30066374 PERFORMANCE BOND PROJECT: SLURRY SEAL AND SAND SEAL CONTRACT 2019 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 Corporation , hereinafter called Contractor, and a (Corporation, Partnership, or 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 (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 Fifty Five ousand* Dollars, ($ 955,918.36 ), 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. *Nine Hundred Eighteen and 36/100 -- THE CONDITION OF THIS OBLIGATION is such that whereas, the Contractor entered into a certain Contract with the Owner, dated the 27th day of June , 2019, 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. 81800070 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. B1800070 Page - 37 - (SEAL) PERFORMANCE BOND PROJECT: SLURRY SEAL AND SAND SEAL CONTRACT 2019 IN WITNESS WHEREOF, this instrument is executed in two (2) counterparts, each one of which shall be deemed an original, this A-ipseal Company ._ 27th (Contractor) Secretares"e•ttw ".i ,t,. Daniel J. Gryz� -! a, President Stephanie Wallis {� cJ (7� ee =Q. By day of June l s • 11/u; 15g2 (Witness asto4ContictorJ• (Address) 2505 E. 74th Avenue 2019. 2505 E. 74th Avenue (Address) Denver, CO 80229 ATTEST: N/A (Surety) Secretary (SEAL) WItnesstasTi Surety 8055 E. Tufts Avenue, #1000 (Address) Denver, CO 80237 Denver, CO 80229 Wester urety``Company Attorney -in -Fact aren A. Feggestad 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. B1800070 Page - 38 - Bond No. 30066374 LABOR & MATERIALS PAYMENT BOND PROJECT: SLURRY SEAL AND SAND SEAL CONTRACT 2019 KNOW ALL MEN BY THE PRESENTS; that A-1 Chipseal Company (Name of Contractor) 2505 E. 74th Avenue (Address of Contractor) Denver, CO 80229, a CO Corporation hereinafter called Contractor, and a (Corporation, Partnership, or 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 (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 Fifty Five Thousand Nine Hundred Eighteen and 36/100 --- Dollars($ 955,918.36 ), 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 27th day of June , 2019, 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. B1800070. 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. B1800070 Page - 39 - LABOR & MATERIALS PAYMENT BOND PROJECT: SLURRY SEAL AND SAND SEAL CONTRACT IN WITNESS WHEREOF, this instrument is executed in two (2) counterparts, each one of which shall be deemed an original, this 27th day of , 2019. pseal Company ,° .. .� • (ContracftiriSecretary • '-.°/>) tk. Stephanie Wallis : • c. , 0' 4 •,. ) .. ..,:.1i 11/09/1992 1 (SEP.1_) cO 9CORAQ (Witness as to Contractor" 2505 E. 74th Avenue (Address) Denver, CO 80229 ATTEST: N/A (Surety) Secretary (SEAL) (Address) Denver, CO 80237 By By June Daniel J. Gry President 2505 E. 74th Avenue (Address) Denver, CO 80229 Wester Surety Company 8055 E. Tufts Avenue, #1000 151 N. Franklin Street Attorney -in -Fact Karen A. Feggestad (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. ME_ NASBP WOW* MeOttltt4140, MOODY INSURANCE AGENCY, INC. 8055 East Tufts Avenue, Suite 1000 DENVER, COLORADO 80237 PHONE: (303) 824.6600 BID NO. B1800070 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, Ashlea Mc Caughey, 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 4th day of January, 2019. State of South Dakota County of Minnchaha } SS WESTERN SURETY COMPANY aul T. Brutlat, Vice President On this 4th day of January, 2019, 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 CERTIFICATE t;47-)9A11/L') J. Mohr, Notary Public 1, 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 nted on the reveirzysi is still in force. In testimogiy her I have hereunto subscribed my name and affixed the seal of the said corporation thisCr day o-� p0Agf •ftle Or, WESTERN SURETY COMPANY 630 L. Nelson, Assistant Secretary Form F4280-7-2012 Go to www.cnasuretvcom > Owner / Obligee Services > Validate Bond Coverage, if you want to verify bond authenticity. ACORL7°' CERTIFICATE OF LIABILITY INSURANCE `....,--- DATE (MM DDIVYYY) 04/15/2019 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 Suite 1000 Denver CO 80237 CONTACT Deanna Zahn, ACSR NAME: PHONE (303) 824-6600 I FAX (303) 370-0118 (c No Ez11; (A/C, NO EAFI�k ADDRESS: deanna.zahn@moodyins.com INSURER(S) AFFORDING COVERAGE NAIC A 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 Co 25658 INSURER C : Pinnacol Assurance 41190 INSURER D : Illinois Union Insurance Company 27960 INSURER S : INSURER F : COVERAGES CERTIFICATE NUMBER: 19-20 Master 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. JLIR TYPE OF INSURANCE INSP WVD POLICY NUMBER POLICY YV {MM/DDIYYYY) POLICY EXP 0,04/00tYYM LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y DTCOOJ730005PHX19 02/01/2019 02/01/2020 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occuncncal $ 300,000 MED EXP Any one person) $ 10,000 PERSONAL 8ADVINJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES X, JECT PER: LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS-COMPIDPAGG $ 2,000,000 $ B AUTOMOBILE X XHIRED LIABILITY ANY AUTO OWNED AUTOS ONLY AUTOS ONLY .-- ^ X SCHEDULED AUTOS NON -OWNED AUTOS ONLY Y DT8103L405197TIL19 02/01/2019 02/01/2020 COMBINED SINGLE LIMIT (Es accklenli $ 1,000,000 BODILY INJURY (Por person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Par accidonl) $ $ B X UMBRELLA LIAR EXCESS LIAR X OCCUR CLAIMS -MADE Y Y CUP2J3100431926 02/01/2019 02/01/2020 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 DED 1 XI RETENTION 1 10,000 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) II yes, describe under DESCRIPTION OF OPERATIONS below YYN N/A Y 4055760 02/01/2019 02/01/2020 �/ PER OTH- XI STATUTE I I ER E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 El. DISEASE - POLICY LIMIT $ 500,000 D Pollution Liability CPYG27165825007 02/01/2019 02/01/2020 Per Pollution Condition Aggregate Limit Deductible 5,000,000 5,000,000 25,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached II more space Is required) RE: Renewal 2019 - Slurry Seal and Sand Seal Contract 2018 B#1800070/2018-1934 CERTIFICATE HOLDER CANCELLATION Weld County 1111 H Street Greeley CO 80532 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZEDREPRESENTATIVE 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 #: ACOR[I AGENCY Moody Insurance Agency, Inc. NAMED INSURED A-1 Chipseal Company, DBA: Rocky Mountain Pavement, LLC POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE, ADDITIONAL REMARKS SCHEDULE Page of ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: FORM TITLE: : Notes Employment Related Practices Liability Prior and Pending Proceeding Date: 6-4-2009 Employment Related Practices Liability Continuity Date: 6-4-2009 Employee Theft Limit: $500,000 Employee Theft Deductible: $5,000 ER ISA Fidelity Limit: $500,000 Forgery or Alteration Limit: $500,000 Forgery or Alteration Deductible: $5,000 Crime Premises Coverage Limit: $500,000 Crime Premises Coverage Deductible: $5,000 Crime Transit Coverage Limit: $500,000 Crime Transit Coverage Deductible: $5,000 Computer Fraud Limit: $500,000 Computer Fraud Deductible: $5,000 Computer Program and Electronic Data Restoration Expense Limit: $50,000 Funds Transfer Fraud Limit: $500,000 Funds Transfer Fraud Deductible: $5,000 Credit, Debit or Charge Card Fraud Limit: $500,000 Credit, Debit or Charge Card Fraud Deductible: $5,000 Money Orders and Counterfeit Money Limit: $500,000 Money Orders and Counterfeit Money Deductible: $5,000 Personal Accounts Protection — Forgery or Alteration Limit: $25,000 Personal Accounts Protection — Forgery or Alteration Deductible: $1,000 Personal Accounts Protection — Identity Fraud Reimbursement Limit: $25,000 Personal Accounts Protection — Identity Fraud Reimbursement Deductible: $1,000 Investigation Expense Limit: $50,000 Fiduciary Liability Aggregate Limit: $1,000,000 Fiduciary Liability Compliance Resolution Coverage Limit: $250,000 Fiduciary Liability ERISA Section 502 Penalties Limit: $100,000 Fiduciary Liability HIPPA Penalties Limit: $100,000 Fiduciary Liability Prior and Pending Proceeding Date: 6-4-2009 Fiduciary Liability Continuity Date: 6-4-2009 Directors & Officers Liability Aggregate Limit: $1,000,000 Directors & Officers Liability Additional Limit of Liability for Executives Limit: $1,000,000 Directors & Officers Liability Security Holder Derivative Demand Investigation Limit: $250,000 Directors & Officers Liability Security Holder Derivative Demand Investigation Retention: $5,000 Directors & Officers Individual Non -Indemnified Liability Retention: $0 Directors & Officers Individual Indemnified Liability Retention: $5,000 Directors & Officers Corporate Entity Liability Retention: $5,000 Directors & Officers Prior and Pending Proceeding Date: 6-4-2009 Cyber Liability Package Policy: Policy Number: RPSP0585449M Policy Effective Dates: 2-1-2019 to 2-1.2020 Insurer: BCS Insurance Company NAIC #: 38245 Policy Aggregate Limit: $1,000,000 Privacy Liability (Including Employee Privacy) Limit of Liability: $1,000,000 Privacy Liability (Including Employee Privacy) Deductible: $5,000 Privacy Regulatory Claims Coverage Limit of Liability: $1,000,000 Privacy Regulatory Claims Coverage Retention: $5,000 Security Breach Response Coverage Limit of Liability: $1,000,000 Security Breach Response Retention: $5,000 Security Liability Limit of Liability: $1,000,000 Security Liability Retention: $5,000 Multimedia Liability Limit of Liability: $1,000,00 Multimedia Liability Retention: $5,000 Cyber Extortion Limit of Liability: $1,000,000 Cyber Extortion Retention: $5,000 Business Income and Digital Asset Restoration Limit of Liability: $1,000,000 Business Income and Digital Asset Restoration Retention: $5,000 / 8 Hour Waiting Period PCI DSS Assessment Limit of Liability: $1,000,000 PCI DSS Assessment Retention: $5,000 Electronic Fraud — Telephone Hacking Limit of Liability: $100,000 Electronic Fraud —Telephone Hacking Retention: $5,000 Electronic Fraud — Funds Transfer Fraud Limit of Liability: $100,000 ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: LOC #: ACG ADDITIONAL REMARKS SCHEDULE Page of AGENCY Moody Insurance Agency, Inc. NAMED INSURED A-1 Chipseal Company, DBA: Rocky Mountain Pavement, LLC POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: FORM TITLE: : Notes Electronic Fraud - Funds Transfer Fraud Retention: $5,000 Cyber Liability Retroactive Date: Full Prior Acts 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: Deductible: $16,000 359-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.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 AGENCY CUSTOMER ID: LOC #: ACORD ADDITIONAL REMARKS SCHEDULE Page of AGENCY Moody Insurance Agency, Inc, NAMED INSURED A-1 Chipseal Company, DBA: Rocky Mountain Pavement, LLC POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: FORM TITLE: 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 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 Employee Benefits Liability Occurrence Limit: $1,000,000 Employee Benefits Liability Aggregate Limit: $2,000,000 Employee Benefits Liability Retroactive Date: 10-1-2010 CG D3 1611/11 From Attached Includes: Blanket Additional Insured status applies only to the extent provided in form CG O3 16 11/11. Blanket Waiver of Subrogation applies only to the extent provided in from CG D3 16 11/11. General Liability Policy is Primary and Non -Contributory only to the extent provided in form CG D3 16 11/11. CG D2 46 08/05 From Attached Includes: Blanket Additional Insured status applies only to the extent provided in form CG D2 46 08/05. General Liability Policy is Primary and Non -Contributory only to the extent provided in form CG D2 46 08/05. 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: $2,000, Collision: $2,000 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, Inland Marine Policy: Policy Number: RH4A61994704 Policy Effective Dates: 5-1.2019 to 5-1-2020 Insurer: Hanover Insurance Company NAIC #: 22292 Total Combined Scheduled Contractor's Equipment Value: $5,966,449 Scheduled Contractor's Equipment Deductible: $10,000 Unscheduled Contractor's Equipment Aggregate Limit: $100,000 Unscheduled Contractor's Equipment Maximum Per Any One Item Limit: $5,000 Unscheduled Contractor's Equipment Deductible: $2,500 Leased & Rented Equipment From Others Limit: $1,000,000 Leased & Rented Equipment To Others Limit: $25,000 Leased & Rented Equipment Deductible: $2,500 Electronic Data Processing Hardware Equipment (2505 E. 74th Ave) Limit: $102,668 Electronic Data Processing Extra Expense (2505 E. 74th Ave) Limit: $25,000 Electronic Data Processing Equipment Deductible: $1,000 Motor Truck Cargo Coverage Limit: $300,000 Motor Truck Cargo Coverage Deductible: $2,500 Management Liability Package Policy: Policy Number: LH4D15946803 Policy Effective Dates: 2-1-20191a 2-1-2021 Insurer: The Hanover Insurance Company NAIC #: 22292 Employment Related Practices Liability Aggregate Limit: $1,000,000 Employment Related Practices Liability Occurrence Limit: $1,000,000 Employment Related Practices Liability Retention: $10,000 ACORD 101 (2008(01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED (CONTRACTORS) This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. WHO IS AN INSURED - (Section II) is amended to include any person or organization that you agree in a "written contract requiring insurance" to include as an additional insured on this Cover- age Part. but: a) Only with respect to liability for "bodily injury", "property damage" or "personal injuryand b) If, and only to the extent that, the 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 requiring insurance" applies, The person or organization does not qualify as an additional insured with respect to the independent acts or omissions of such person or organization. 2. The insurance provided to the additional insured by this endorsement is limited as follows: a) In the event that the Limits of Insurance of this Coverage Part shown in the Declarations exceed the limits of liability required by the "written contract requiring insurance", the in- surance provided to the additional insured shall be limited to the limits of liability re- quired by that 'Written contract requiring in- surance" This endorsement shall not in- crease the limits of insurance described in Section III — Limits Of Insurance b) The insurance provided to the additional in- sured does not apply to "bodily injury", "prop- erty damage" or "personal injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or sur- veying services, including: i. The preparing, approving, or failing to prepare or approve, maps, shop draw- ings, opinions, reports, surveys, field or- ders or change orders, or the preparing, approving, or failing to prepare or ap- prove. drawings and specifications; and ii. Supervisory, inspection, architectural or engineering activities c) The insurance provided to the additional in- sured does not apply to "bodily injury" or "property damage" caused by "your work" and included in the "products -completed op- erations hazard" unless the "written contract requiring insurance" specifically requires you to provide such coverage for that additional insured, and then the insurance provided to the additional insured applies only to such "bodily injury" or "property damage" that oc- curs before the end of the period of time for which the "written contract requiring insur- ance" requires you to provide such coverage or the end of the policy period, whichever is earlier 3. The insurance provided to the additional insured by this endorsement is excess over any valid and collectible "other insurance", whether primary, excess, contingent or on any other basis, that is available to the additional insured for a loss we cover under this endorsement However, if the "written contract requiring insurance" specifically requires that this insurance apply on a primary basis or a primary and non-contributory basis, this insurance is primary to "other insurance" available to the additional insured which covers that person or organization as a named insured for such loss, and we will not share with that "other insurance" But the insurance provided to the additional insured by this endorsement still is excess over any valid and collectible "other in- surance", whether primary, excess, contingent or on any other basis, that is available to the addi- tional insured when that person or organization is an additional insured under such "other insur- ance" 4. As a condition of coverage provided to the additional insured by this endorsement: a) The additional insured must give us written notice as soon as practicable of an "occur- rence" or an offense which may result in a claim To the extent possible, such notice should include: CG D2460805 2005 The St Paul Travelers Companies, Inc Page 1 of 2 COMMERCIAL GENERAL LIABILITY i. How, when and where the "occurrence" or offense took place; ii. The names and addresses of any injured persons and witnesses; and iii. The nature and location of any injury or damage arising out of the "occurrence" or offense b) If a claim is made or "suit" is brought against the additional insured, the additional insured must: i. Immediately record the specifics of the claim or "suit" and the date received; and il. Notify us as soon as practicable. The additional insured must see to it that we receive written notice of the claim or "suit" as soon as practicable. c) The additional insured must 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 d) The additional insured must tender the de- fense and indemnity of any claim or "suit" to Page 2 of 2 any provider of "other insurance" which would cover the additional insured for a loss we cover under this endorsement. However, this condition does not affect whether the insur- ance provided to the additional insured by this endorsement is primary to "other insur- ance" available to the additional insured which covers that person or organization as a named insured as described in paragraph 3. above. 5. The following definition is added to SECTION V. - DEFINITIONS: 'Written contract requiring insurance" means that part of any written contract or agreement under which you are required to include a person or organization as an additional in- sured on this Coverage Part, provided that the "bodily injury" and "property damage" oc- curs and the "personal injury" is caused by an offense committed: a. After the signing and execution of the contract or agreement by you; b. While that part of the contract or agreement is in effect; and c. Before the end of the policy period 2005 The St. Paul Travelers Companies, Inc CG D2 46 08 05 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS XTEND ENDORSEMENT 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 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. Aircraft Chartered With Pilot B. Damage To Premises Rented To You C. Increased Supplementary Payments D. Incidental Medical Malpractice E. Who Is An Insured — Newly Acquired Or Formed Organizations F. Who Is An Insured — Broadened Named Insured — Unnamed Subsidiaries G. .Blanket Additional Insured — Owners, Managers Or Lessors Of Premises PROVISIONS A. AIRCRAFT CHARTERED WITH PILOT The following is added to Exclusion g., Aircraft, Auto Or Watercraft, in Paragraph 2. of SECTION I - COVERAGES — COVERAGE A BODILY IN- JURY AND PROPERTY DAMAGE LIABILITY: This exclusion does not apply to an aircraft that is: (a) Chartered with a pilot to any insured; (b) Not owned by any insured; and (c) Not being used to carry any person or prop- erty for a charge. B. DAMAGE TO PREMISES RENTED TO YOU 1. The first paragraph of the exceptions in Ex- clusion j., Damage To Property, in Para- graph 2. of SECTION I — COVERAGES — COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY is deleted. 2. The following replaces the fast paragraph of Paragraph 2., Exclusions, of SECTION I - COVERAGES — COVERAGE A. BODILY H. Blanket Additional Insured — Lessors Of Leased Equipment I. Blanket Additional Insured — States Or Political Subdivisions — Permits J. Knowledge And Notice Of Occurrence Or Offense K. Unintentional Omission L. Blanket Waiver Of Subrogation M. Amended Bodily Injury Definition N. Contractual Liability — Railroads INJURY AND PROPERTY DAMAGE LI- ABILITY: Exclusions c. and g. through n. do not apply to "premises damage". Exclusion f.(1)(a) does not apply to "premises damage" caused by: a. Fire; b. Explosion; c. Lightning; d. Smoke resulting from such fire, explosion, or lightning; or e. Water; unless Exclusion f. of Section I — Coverage A — Bodily Injury And Property Damage Liability is replaced by another endorsement to this Coverage Part that has Exclusion — All Pollu- tion Injury Or Damage or Total Pollution Ex- clusion in its title. A separate limit of insurance applies to "premises damage" as described in Para- graph 6. of SECTION III - LIMITS OF IN- SURANCE. CG D3 16 11 11 O 2011 The Travelers Indemnity Company. All rights reserved. Page 1 of 6 COMMERCIAL GENERAL LIABILITY NOMMIO a- - ar� Out= ON of OMMEm ginee o- 001014 3. The following replaces Paragraph 6. of SEC- TION III - LIMITS OF INSURANCE: Subject to 5. above, the Damage To Prem- ises Rented To You Limit is the most we will pay under Coverage A for damages because of "premises damage" to any one premises. The Damage To Premises Rented To You Limit will apply to all "property damage" proximately caused by the same "occur- rence", whether such damage results from: fire; explosion; lightning; smoke resulting from such fire, explosion, or lightning; or water; or any combination of any of these causes. The Damage To Premises Rented To You Limit will be: • a. The amount shown for the Damage To Premises Rented To You Limit on the Declarations of this Coverage Part; or b. $300,000 if no amount is shown for the Damage To Premises Rented To You Limit on the Declarations of this Coverage Part. 4, The following replaces Paragraph a. of the definition of "insured contract" in the DEFINI- TIONS Section: a. A contract for a lease of premises. How- ever, that portion of the contract for a lease of premises that indemnifies any person or organization for "premises damage" is not an "insured contract"; 5. The following is added to the DEFINITIONS Section: "Premises damage" means "property dam- age" to: a. Any premises while rented to you or tem- porarily 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. 6. The following replaces Paragraph 4.b.(1)(b) of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS: (b) That is insurance for "premises damage"; or 7. Paragraph 4.b.(1)(c) of SECTION IV — COMMERCIAL GENERAL LIABILITY CON- DITIONS is deleted. Page 2 of 6 C. INCREASED SUPPLEMENTARY PAYMENTS 1. The following replaces Paragraph 1.b. of SUPPLEMENTARY PAYMENTS - COVER- AGES A AND B of SECTION I — COVER- AGE: b. Up to $2,500 for the cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to fur- nish these bonds. 2. The following replaces Paragraph 1.d. of SUPPLEMENTARY PAYMENTS - COVER- AGES A AND B of SECTION I - COVER- AGES: 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 $500 a day because of time off from work. D. INCIDENTAL MEDICAL MALPRACTICE 1. The following is added to the definition of "oc- currence" in the DEFINITIONS Section: "Occurrence" also means an act or omission committed in providing or failing to provide "incidental medical services", first aid or "Good Samaritan services" to a person. 2. The following is added to Paragraph 2.a.(1) of SECTION II - WHO IS AN INSURED: Paragraph (1)(d) above does not apply to "bodily injury" arising out of providing or fail- ing to provide: (i) "Incidental medical services" by any of your "employees" who is a nurse practi- tioner, registered nurse, licensed practical nurse, nurse assistant, emergency medi- cal technician or paramedic; or (ii) First aid or "Good Samaritan services" by any of your "employees" or "volunteer workers", other than an employed or vol- unteer doctor. Any such "employees" or "volunteer workers" providing or failing to provide first aid or "Good Samaritan ser- vices" 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 busi- ness. © 2011 The Travelers Indemnity Company. All rights reserved. CG D3 16 11 11 COMMERCIAL GENERAL LIABILITY 3. The following is added to Paragraph 5. of SECTION III - LIMITS OF INSURANCE: For the purposes of determining the applica- ble 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 per- son will be deemed to be one "occurrence". 4. The following exclusion is added to Para- graph 2., Exclusions, of SECTION I - COV- ERAGES - COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY: Sale Of Pharmaceuticals "Bodily injury" or "property damage" arising out of the willful violation of a penal statute or ordinance relating to the sale of pharmaceuti cats 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. "Good Samaritan services" means any emer- gency medical services for which no compen- sation is demanded or received. 6. The following is added to Paragraph 4.b., Ex- cess Insurance, of SECTION IV — COM- MERCIAL GENERAL LIABILITY CONDI- TIONS: The insurance is excess over any valid and collectible other insurance available to the in- sured, whether primary, excess, contingent or on any other basis, that is available to any of your "employees" or "volunteer workers" for "bodily injury" that arises out of providing or failing to provide "incidental medical ser- vices", first aid or "Good Samaritan services" to any person to the extent not subject to Paragraph 2.a.(1) of Section II — Who Is An Insured. E. WHO IS AN INSURED - NEWLY ACQUIRED OR FORMED ORGANIZATIONS The following replaces Paragraph 4. of SECTION II - WHO IS AN INSURED: 4. Any organization you newly acquire or form, other than a partnership, joint venture or lim- ited liability company, of which you are the sole owner or in which you maintain the ma- jority ownership interest, will qualify as a Named Insured if there is no other insurance which provides similar coverage to that or- ganization. However: a. Coverage under this provision is afforded only: (1) Until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier, if you do not report such organization in writing to us within 180 days after you acquire or form it; or (2) Until the end of the policy period, when that date is later than 180 days after you acquire or form such organization, if you report such organization in writing to us within 180 days after you acquire or form it, and we agree in writing that it will con- tinue to be a Named Insured until the end of the policy period; b. Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization; and c. Coverage B does not apply to "personal in- jury" or "advertising injury" arising out of an offense committed before you acquired or formed the organization. F. WHO IS AN INSURED — BROADENED NAMED 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 Declara- tions is a Named Insured if you maintain an own- ership interest of more than 50% in such subsidi- ary on the first day of the policy period. No such subsidiary is an insured for "bodily injury" or "property damage" that occurred, or "personal injury" or "advertising injury" caused by an of- fense committed after the date, if any, during the policy period, that you no longer maintain an ownership interest of more than 50% in such sub- sidiary. CG O3 16 11 11 © 2011 The Travelers Indemnity Company. All rights reserved. Page 3 of 6 COMMERCIAL GENERAL LIABILITY O= oinia o= elmenwo 0= 0= oil 001816 G. BLANKET ADDITIONAL INSURED - OWNERS, MANAGERS OR LESSORS OF PREMISES The following is added to SECTION II — WHO IS AN INSURED: Any person or organization that is a premises owner, manager or lessor and that you have agreed in a written contract or agreement to in- clude as an additional insured on this Coverage Part is an insured, but only with respect to liability for "bodily injury", "property damage", "personal injury" or "advertising injury" that: a. Is "bodily injury" or "property damage" that occurs, or is "personal injury" or "advertising injury" caused by an offense that is commit- ted, subsequent to the execution of that con- tract or agreement; and b. Arises out of the ownership, maintenance or use of that part of any premises leased to you. The insurance provided to such premises owner, manager or lessor is subject to the following pro- visions: a. The limits of insurance provided to such premises owner, manager or lessor will be the minimum limits which you agreed to pro- vide in the written contract or agreement, or the limits shown on the Declarations, which- ever are less. b. The insurance provided to such premises owner, manager or lessor does not apply to: (1) Any "bodily injury" or "property damage" that occurs, or "personal injury" or "adver- tising injury" caused by an offense that is committed, after you cease to be a tenant in that premises; or (2) Structural alterations, new construction or demolition operations performed by or on behalf of such premises owner, lessor or manager. c. The insurance provided to such premises owner, manager or lessor is excess over any valid and collectible other insurance available to such premises owner, manager or lessor, whether primary, excess, contingent or on any other basis, unless you have agreed in the written contract or agreement that this in- surance must be primary to, or non- contributory with, such other insurance, in which case this insurance will be primary to, and non-contributory with, such other insur- ance. Page 4 of 6 H. BLANKET ADDITIONAL INSURED — LESSORS OF LEASED EQUIPMENT The following is added to SECTION II — WHO IS AN INSURED: Any person or organization that is an equipment lessor and that you have agreed in a written con- tract or agreement to include as an insured on this Coverage Part is an insured, but only with re- spect to liability for "bodily injury", "property dam- age", "personal injury" or "advertising injury" that: a. Is "bodily injury" or "property damage" that occurs, or is "personal injury" or "advertising injury" caused by an offense that is commit- ted, subsequent to the execution of that con- tract or agreement; and b. Is caused, in whole or in part, by your acts or omissions in the maintenance, operation or use of equipment leased to you by such equipment lessor. The insurance provided to such equipment lessor is subject to the following provisions: a. , The limits of insurance provided to such equipment lessor will be the minimum limits which you agreed 10 provide in the written contract or agreement, or the limits shown on the Declarations, whichever are less. b. The insurance provided to such equipment lessor does not apply to any "bodily injury" or "property damage" that occurs, or "personal injury" or "advertising injury" caused by an of- fense that is committed, after the equipment lease expires. c. The insurance provided to such equipment lessor is excess over any valid and collectible other insurance available to such equipment lessor, whether primary, excess, contingent or on any other basis, unless you have agreed in the written contract or agreement that this insurance must be primary to, or non-contributory with, such other insurance, in which case this insurance will be primary to, and non-contributory with, such other in- surance. I. BLANKET ADDITIONAL INSURED - STATES OR POLITICAL SUBDIVISIONS - PERMITS The following is added to SECTION II - WHO IS AN INSURED: Any state or political subdivision that has issued a permit in connection with operations performed by you or on your behalf and that you are required O2011 The Travelers Indemnity Company. All rights reserved. CG D3 16 1111 COMMERCIAL GENERAL LIABILITY by any ordinance, law or building code to include as an additional insured on this Coverage Part is an insured, but only with respect to liability for "bodily injury", "property damage", "personal in- jury" or "advertising injury" arising out of such op- erations. The insurance provided to such state or political subdivision does not apply to: a. Any "bodily injury," "property damage," "per- sonal injury" or "advertising injury" arising out of operations performed for that state or po- litical subdivision; or b. Any "bodily injury" or "property damage" in- cluded in the "products -completed operations hazard". J. KNOWLEDGE AND NOTICE OF OCCUR- RENCE OR OFFENSE The following is added to Paragraph 2., Duties In The Event of Occurrence, Offense, Claim or Suit, of SECTION IV - COMMERCIAL GEN- ERAL LIABILITY CONDITIONS: e. The following provisions apply to Paragraph a. above, but only for the purposes of the in- surance provided under this Coverage Part to you or any insured listed in Paragraph 1. or 2. of Section II — Who Is An Insured: (1) Notice to us of such "occurrence" or of- fense must be given as soon as practica- ble only after the "occurrence" or offense is known by you (if you are an individual), any of your partners or members who is an individual (if you are a partnership or joint venture), any of your managers who is an individual (if you are a limited liability company), any of your "executive offi- cers" or directors (if you are an organiza- tion other than a partnership, joint venture or limited liability company) or any "em- ployee" authorized by you to give notice of an "occurrence" or offense. (2) If you are a partnership, joint venture or limited liability company, and none of your partners, joint venture members or man- agers are individuals, notice to us of such "occurrence" or offense must be given as soon as practicable only after the "occur- rence" or offense is known by: (a) Any individual who is: (i) A partner or member of any part- nership or joint venture; (3) (ii) A manager of any limited liability company; or (iii) An executive officer or director of any other organization; that is your partner, joint venture member or manager; or (b) Any "employee" authorized by such partnership, joint venture, limited li- ability company or other organization to give notice of an "occurrence" or offense. Notice to us of such "occurrence" or of an offense will be deemed to be given as soon as practicable if it is given in good faith as soon as practicable to your work- ers' compensation insurer. This applies only if you subsequently give notice to us of the "occurrence" or offense as soon as practicable after any of the persons de- scribed in Paragraphs e. (1) or (2) above discovers that the "occurrence" or offense may result in sums to which the insurance provided under this Coverage Part may apply. However, if this Coverage Part includes an en- dorsement that provides limited coverage for "bodily injury" or "property damage" or pollution costs arising out of a discharge, release or es- cape of "pollutants" which contains a requirement that the discharge, release or escape of "pollut- ants" must be reported to us within a specific number of days after its abrupt commencement, this Paragraph e. does not affect that require- ment. K. UNINTENTIONAL OMISSION The following is added to Paragraph 6., Repre- sentations, of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS: The unintentional omission of, or unintentional error in, any information provided by you which we relied upon in issuing this policy will not preju- dice your rights under this insurance. However, this provision does not affect our right to collect additional premium or to exercise our rights of cancellation or nonrenewal in accordance with applicable insurance laws or regulations. L. 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 LI- ABILITY CONDITIONS: CGD3161111 © 2011 The Travelers Indemnity Company. All rights reserved. Page 5 of 6 COMMERCIAL GENERAL LIABILITY If the insured has agreed in a contract or agree- ment to waive that insured's right of recovery against any person or organization, we waive our right of recovery against such person or organiza- tion, but only for payments we make because of: a. "Bodily injury" or "property damage" that oc- curs; or b. "Personal injury" or "advertising injury" caused by an offense that is committed; subsequent to the execution of that contract or agreement. M. AMENDED BODILY INJURY DEFINITION The following replaces the definition of "bodily injury" in the DEFINITIONS Section: Page 6 of 6 001018 3. "Bodily injury" means bodily injury, mental anguish, mental injury, shock, fright, disability, humiliation, sickness or disease sustained by a person, including death resulting from any of these at any time. N. CONTRACTUAL LIABILITY— RAILROADS 1. The following replaces Paragraph c. of the definition of "insured contract" in the DEFINI- TIONS Section: c. Any easement or license agreement; 2. Paragraph f.(1) of the definition of "insured contract" in the DEFINITIONS Section is de- leted. m 2011 The Travelers Indemnity Company. All rights reserved. CG D3 16 11 11 PIN11Vi1COL 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:January 7, 2019 Expires on: February 1, 2020 Pinnacol Assurance has issued this endorsement January 7, 2019 7501 E. Lowry Blvd Denver, CO 80230-7006 Page 1 of 1 P DORSEYR - Underwriter 01/07/2019 15:43:36 4055760 53048995 359-B 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 02 15 © 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 "auto" 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 the world, except any country or jurisdiction while 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 you 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 from any of your "employees", partners (if you are a partnership), members (if you are a limited liability company) or members of their households. Page 2 of 4 (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. CO 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 CAT3530215 © 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. Includes copyrighted material of Insurance Services Office, Inc. with its permission. CA T3 53 02 15 WELD COUNTY AGREEMENT FOR CONSTRUCTION SERVICES BETWEEN WELD COUNTY & A-1 Chioseal Company 2018 Slurry Seal and Sand Seal Contract THIS AGREEMENT is made and entered into this 28 day of June, 2018, 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 A-1 Chipseal Company, a corporation, whose address is 2505 E. 74th Avenue Denver, CO 80229 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. B1800070". 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 er/e6P Cia o2o/F` /6'g 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 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 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 Denver, Boulder, Greeley Consumer Price Index and the ENR Construction Cost 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 $944,065.50, 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 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. Tvves 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 Coun : Name: Joshua J. Holbrook Position: Construction Inspection Supervisor Address: 1111 H Street, Greeley CO 80632 E-mail: jholbrook(weldgov.com Facsimile: 1.970.301.2622 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. Trade Secrets and other Confidential Information: Weld County discourages bidders from submitting confidential information, including trade secrets, that cannot be disclosed to the public. If necessary, confidential information of the bidder shall be transmitted separately from the main bid submittal, clearly denoting in red on the information at the top the word, "CONFIDENTIAL." However, the successful bidder is advised that as a public entity, Weld County must comply with the provisions of C.R.S. 24-72-201, et seq., the Colorado Open Records Act (CORA), with regard to public records, and cannot guarantee the confidentiality of all documents. The bidder is responsible for ensuring that all information contained within the confidential portion of the submittal is exempt from disclosure pursuant to C.R.S. 24-72-204(3)(a)(IV) (Trade secrets, privileged information, and confidential commercial, financial, geological, or geophysical data). If Weld County receives a CORA request for bid information marked "CONFIDENTIAL", staff will review the confidential materials to determine whether any of them may be withheld from disclosure pursuant to CORA, and disclose those portions staff determines are not protected from disclosure. Weld County staff will not be responsible for redacting or identifying Confidential information which is included within the body of the bid and not separately identified. Any document which is incorporated as an exhibit into any contract executed by the County shall be a public document regardless of whether it is marked as confidential. 23. 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. Contractor 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. 24. 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. 25. 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. 26. 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. 27. 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. 28. 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. 29. 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. 30. Official Engineering Publications_ Contractor acknowledges and agrees that the Colorado Department of Transportation "Standard Specifications for Road and Bridge Construction", the Colorado Department of Transportation Standard Plans "M & S Standards" and the Colorado Department of Transportation "Field Materials Manual" 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. 31. 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. 32. 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. 33. 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. IN WITNESS WHEREOF, the parties hereto have signed this Agreement this 28 day of June , 2018. CONTRACTOR: A-1 Chipse c mpan By: Name: Daniel J Title: President Date WELD TOUR G: � ATTEST: ; BOARD OF COUNTY COMMISSIONERS Weld oJn Clerk to the : •ard WELD COUNTY, COLORADO BY: Deputy Moreno, Chair JUL 0 9 2018 ,cif -1 6Pp EXHIBIT A BID REQUEST NO. B1800070 WELD COUNTY DEPARTMENT OF PUBLIC WORKS CONTRACT BID DOCUMENTS AND SPECIFICATIONS FOR PROJECT: SLURRY SEAL AND SAND SEAL CONTRACT 2018 (With Renewal Options for 2019/2020) May 2018 Weld County Public Works Division of Engineering P.O. Box 758 1 1 1 1 H Street Greeley, Colorado 80632 970-304-6496 BID NO. B1800070 Page - 1- TABLE OF CONTENTS The following checked forms and provisions take precedence over plan drawings and supplement the 2017 edition of 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 *AII Bidders must submit these forms with their Bid Notice to Bidders 3 Invitation for Bids 3 Instructions to Bidders 4-13 Bid Proposal 14-15 *Bid Schedule 16-17 *Bid Bond 18-19 *IRS Form W-9 20 *Statement of Qualifications and Subcontractors 21-24 WELD COUNTY CONTRACT FORMS **Low Bidder must submit these forms prior to Contract Award **Notice of Award **Sample Agreement **Performance Bond **Labor and Materials Payment Bond Notice to Proceed Certificate of Substantial completion Lien Waiver Notice of Acceptance WELD COUNTY PROJECT SPECIAL PROVISIONS Special Provisions Index Project Special Provisions Appendix Estimated Quantities Project Location Map 25 26-36 37 38-39 40 41 42-44 45 46 47-79 81-82 83-85 BID NO B1800070 Page - 2 - REQUEST FOR BID WELD COUNTY, COLORADO 1150 O STREET GREELEY, CO 80631 DATE: May 9, 2017 BID NUMBER: B1800070 DESCRIPTION: 2018 Slurry Seal and Sand Seal Contract BID OPENING DATE: May 29, 2018 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: 2018 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 at the Office of the Weld County Purchasing Department in the Weld County Administrative Building. 1150 O Street Room #107 Greeley CO 80631 until: 10:00 AM on May 29, 2018. (Weld County Purchasing Time Clock) PAGES 1 - 15 OF THIS REQUEST FOR BIDS CONTAIN GENERAL INFORMATION FOR THE REQUEST NUMBER REFERRED TO ABOVE. NOT ALL OF THE INFORMATION CONTAINED IN PAGES 1 - 15 MAY BE APPLICABLE FOR EVERY PURCHASE. 2. INVITATION TO BID: Weld County requests bids for the purchase of the above -listed merchandise. equipment. and/or services. Bids shall include any and all charges for freight, delivery. containers, packaging, less all taxes and discounts, and shall, in every way, be the total net price which the bidder will expect the Weld County to pay if awarded the bid. Merchandise and/or equipment shall be delivered to the location(s) specified herein. You can find information concerning this request at two locations: On the Weld County Purchasing website at http://www.co.weld.co.us/Departments/Purchasing/index.html located under "Current Requests". And, on the Bidnet Direct website at www.bidnetdirect.com. Weld County Government is a member of BidNet Direct. BidNet Direct is an on-line notification system which is being utilized by multiple non-profit and governmental entities. Participating entities post their bids. quotes. proposals, addendums, and awards on this one centralized system. $id Delivery to Weld County - 2 methods: 1. Email. Emailed bids are preferred. Bids may be emailed to: bids @ w e I d g o v . c o m . Emailed bids must include the following statement on the email: "I hereby waive my right to a sealed bid". An email confirmation will be sent when we receive your bid/proposal. If more than one copy of the bid is requested, you must submit/mail hard copies of the bid proposal. BED NO. B1800070 Page - 3 - 2 Mail or Hand Delivery Mailed (or hand delivered) bids should be sent in a sealed envelope with the bid title and bid number on it Please address to Weld County Purchasing Department, 1150 O Street, Room #107 Greeley, CO 80631 Please call Purchasing at 970-400-4222 or 4223 if you have any questions 3 INSTRUCTIONS 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 of 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 authorized representative, followed by the signature and title of the person signing Bids by corporations must be signed with the legal name of the corporation, followed by the name of the state of 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 who affixes to his 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 Director, satisfactory evidence of the authority of the officer signing on behalf of a corporation shall be furnished All corrections or erasures shall be initialed by the person signing the bid All bidders shall agree to comply with all of the conditions, requirements, specifications, and/or instructions of this bid as stated or implied herein All designations and prices shall be fully and clearly set forth All blank spaces in the bid forms shall be suitably filled in Bids may be withdrawn upon written request to and approval of the Weld County Controller/Purchasing Director, said request being received from the withdrawing bidder prior to the time fixed for award Negligence on the part of a bidder in preparing the bid confers no right for the withdrawal of the bid after it has been awarded Late or unsigned bids shall not be accepted or considered It is the responsibility of the bidder to ensure that the bid arrives in the Weld County Purchasing Department on or prior to the time indicated 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 BID NO B1800070 Page - 4 - 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 Bidderthat 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. 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 ControlerlPur hasingDrectormay at her sole discretion, release any Bid at any time. 4. AWARD AND EXECUTION OF CONTRACT Basis of Award: Only firm Bids will be considered. The award of the Contract, if it is awarded, will be to the lowest responsible bidder 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 list of all Subcontractors he expects to use in the Work with the Bid. The experience statement with 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 County prior to the Notice of Award will be required in the performance of the BID NO. B1800070 Page - 5 - Work. All Bidders shall submit with their Bid a list of the suppliers as indicated in the Bid Forms. Contract Execution: The 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 receipt of the Notice of Award. The Certificate of Insurance shall name Weld County as additional insured. Failure to execute the contract and furnish the required paperwork within the time frame mentioned above shall be just cause for the annulment of the Award and, in the event of such annulment, the Award may then be made to another Bidder, or the County may reject all Bids or call for other Bids. The 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, the bidder agrees that the signed bid submitted, all of the documents of the Request for Proposal 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, together constitutes a contract, with the contract date being the date of formal acceptance of the bid by Weld County. The County may require a separate contract, which if required, has been made a part of this RFP. 5. PERFORMANCE, LABOR, MATERIAL AND PAYMENT BOND The successful Bidder shall be required to execute the Performance Bond and Labor & Materials Payment Bond in the amount of 100% of the Contract plus the value of the force account items, covering the faithful performance of the Contract and the payment of all obligations arising there -under. The Bonds shall be executed on the forms included with the Contract Documents by a surety company authorized to do business in the State of Colorado and acceptable as surety to Weld County. The Bidder shall deliver the Bonds to the Owner not later than the date of execution of the Contract. 6. INDIRECT COSTS 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, sanitary, 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. BID NO. B1800070 Page - 6 - 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 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 for 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 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. BID NO. B1800070 Page - 7 - 9. GENERAL PROVISIONS A. Fund Availability: Financial obligations of the Weld County payable after the current fiscal year are contingent upon funds for that purpose being appropriated, budgeted and otherwise made available. By acceptance of the bid, Weld County does not warrant that funds will be available to fund the contract beyond the current fiscal year. B. Confidential Information: Confidential information of the bidder should be transmitted separately from the main bid submittal, clearly denoting in red on the information at the top the word, "CONFIDENTIAL." However, the successful bidder is advised that as a public entity, Weld County must comply with the provisions of C.R.S. 24-72-201, et seq., the Colorado Open Records Act (CORA), with regard to public records, and 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 redacting or identifying Confidential information which is included within the body of the bid and not separately identified. C. Governmental Immunity: No term or condition of the 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. D. Independent Contractor: 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 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 BID NO. B1800070 Page - 8 - 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. I. 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, 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 BID NO. B1800070 Page - 9 - 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 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 BID NO. B1800070 Page - 10 - 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 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 BID NO. B1800070 Page - 11- 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 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 BID NO. B1800070 Page - 12 - 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. 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. B1800070 Page - 13 - 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. B1800070 Page - 14 - 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. B1800070 Page -15 - BID SCHEDULE 2018 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 5 409 Sand Seal SY 19,100 409 Slurry Seal SY 457,000 627 Pavement Marking Paint (Parking Lots) GAL 23 630 Signing and Traffic Control (Sand Seal) EACH 4 630 Signing and Traffic Control (Slurry Seal) MILE 28 630 MHT and Traffic Control for Cdot intersections EACH 4 700 F/A Minor Contract Revisions F/A 1 $5,000.00 $5,000.00 Total: * The successful vendor is required to sign a separate contract (a sample contract is included as a separate attachment.) BID NO. B1800070 Page - 16 - 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. #B1800070. 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 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. B1800070 Page - 17 - BID BOND PROJECTS: Slurry Seal and Sand Seal contract 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 , 2018 for the PROJECTS: Slurry Seal and Sand 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 2018 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. B1800070 Page - 18 - 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. B1800070 Page - 19 - lam w_9 (Rev August 2013) Department of the Trexwy Internal Rt.,•erwe Service Request for Taxpayer Identification Number and Certification Give Form to the requester. Do not send to the IRS. Name (as shown on yore unaiw, tax whin) Eke:Mess name/lur:,laulerl entity nano.+. if different front aitwe le • Check approptiale bier for federal tax da.swlicati n: MIntl eidraatsole proprietor I C Corporation 7'i I rotted kabdity company. Fnter the tax dassih.ati n (C=f: cot potation. SoS corporation Y=p xinexshp) ► C Other (acv.; eistiu:tiais)► Address (number. street, and apt. or state no.) City. state. and ZIP code S Ccxporahat ' ! Yarieasiap _j Trrwt/estate £xertptwns (see instructions): Fxempt layers rude (if any) Exemption from f ATCA reporting nixie (it any) Requester's name and address (optional) I ist account hinttrer(S) hero (optional) IZIO Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on the "Name- line I Soci& secrrfty number 1 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 I I - entities, it is your employer identification number (FIN) If you do not have a number, see Now to get a TIN on page 3. Note. tf the account is in more than one name. see the chart on page 4 for guidelines on whose number to enter. Employer identificaton 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 I signadre of Here U.B. parson► Dale► General Instructions Srn:tion reference_, are to the Internal Revenue Cole orders otherwise noted. Fuhne developments. the IRS has created a page on IRS.gov to adorn -ratan about Form W-9, at wr.v.en.yo» /vA.. Intrxmataxr about any future devvk.pments affecbny Fo,.,, W-4 (such as leyrsiatien enacted aver we release it) dl be posted on that page. Purpose of Form A person who is required to file an info matron return with the IRS must obtain yen correct taxpayer idenbircahatixntber (I IN) torcport, to example, Income paid to you, payments made to you in settlement of payment card and Thad party network transactions. real estate transactions. mortgage interest you paid, acquisition or abandonment of secured property, cancellation of debt. or conbibotiorr you mate to an IRA 1 he. l aan W 9 rally d you at. -.a I IS. p:rsai rur:kudlxJ .I n.n.4rd 'deryto provide your correct I IN to the p v :an rcyu".tetr' li IYho ney01,414•14 .at•1. -; hrr, apple able lo. 1 c:,•dit\ heat lie IN ,rai ate ,x r t I•. ..(lltr,o.i lox v�u,, ri,. ,:.xtln,l ha r ,a.oiu-i I44 to rv,.wri). (.441111`4 that oar. it, lull vdrp,.I' a tt,,,itr> dNnddn.r <r a t.6tai vxigaitxt tt<xn b,t*. k,4 rtl-d'ed•lun,i If4 oil At, . Vrni,l pi, It .444Mc,d.k elnr .err,. rku...ridonnith.d.nali.S frl•an porn alt,,. 'ld, ,,..t acv par lrlm.txl,In,axn. h,14.1 .II , fra,k-ax m>r ,the."iInn tlr' wrtlrhoiding tax on toreryrt partners' stare of etfeclively connected inrxxne. and 4 Certify that FATCA codes) entered on this form Of any) indicating that you are exempt from the 1 A I CA reporting, is correct. Note. It yam are a 11.5. person mil a requreaer grvrs yen a torn other than font W 9 to request your I IN, you must use the requester's form If It is substantially •:nwlar to tfx.s fuua W -it Dafniuon of a U.S.. person. Fr* federal tax purposes. you are considered a U.S. prom i4 yntr atr.: • Air rxlrvrrhrai who is a l lS. citizen a Its resident ate-rn. • A pax hire.shp, t:apxatirat axxnpaity, tit assa:rahcrt rxeatad or crq'amred it the I loft Static on lit Or, tilt laws of then t krlai States. • An rytate rntttir tilde 4 karogn nst:de) or • A •1<rrrr-.sh.: hint (as defnied in Regiaatuxts sec:hat 301.1701- 7). Speoal rules for partnerships. Parirwrsixps that crnoh x;i a Ira nie nrt txnxw.ss n the titrte•I State, .ins ,teneially cogimed to luay a withholding tax orate, sachet Lnii- on xrl, kc«nln paitir•rc sty,,- tut eife ,inv.•iy ,axrwr_ter.l taxable ktcixne horn „,iI - (rbel n, ... rt x , ,h-i, W9 hi,'. 'lift t ran 11,.. In de, -.,r,ri.,r v.••. nail t.t+lt+rw•, I;ixe a paehr.vrf tip I.+premarr- that a parlour ns a Ax• nor, itt4r•.<r,..x 441 p.ry 110 44 c, ;lost 1 i-16 ;;rtl'u>hlun, tax ttwrotav It vale ar? a I I .`. 1. 'rv'au lion i• a p'arlrwv Ira a parin.'rw'hr< rich ni't,r I.1 a Iran il- In benow•O' ri Si' Itl--.I , tat,,, pn«1,In f rim 44 9 to ill 1%adns rhp h, -:. 1, ,1, yivx I l S '.1.a1w'. .flI anvil I I.Iri allttixd,tin,i ix,•;<>Il stnarr- m1 parlitenaxii rir:uinit Al r4I,r ....!, f xtli Yt-9', BID NO. B1800070 Page - 20 - 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. B1800070 Page - 21 - 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. B1800070 Page - 22 - 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. B1800070 Page - 23 - 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 , 2018. 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, 2018. (SEAL) Commission Expires Notary Public BID NO. B1800070 Page - 24 - NOTICE OF AWARD PROJECT: SLURRY SEAL AND SAND SEAL 2018 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 2018 construction season. The contract is a one year commitment with the option of renewal for up to two additional years. The project, 2018 Slurry seal and Sand Seal, in general consists of: - Crack sealing 5 tons in parking lots. (County to supply material) - Sand Seal 19,027 SY -Slurry Seal 456,996 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 , 2018 Weld County, Colorado, Owner By: Josh Holbrook, Construction Inspection Supervisor ACCEPTANCE OF NOTICE Receipt of the above Notice of Award is hereby acknowledged by (Contractor) Dated this day of , 2018 By: Title: BID NO. B1800070 Page - 25 - SAMPLE WELD COUNTY AGREEMENT FOR CONSTRUCTION SERVICES BETWEEN WELD COUNTY & 2018 Slurry Seal and Sand Seal Contract THIS AGREEMENT is made and entered into this day of , 2018, 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. B1800070". 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. B1800070 Page - 26 - 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 shall 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 -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. BID NO. B1800070 Page - 27 - 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. B1800070 Page - 28 - 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 BID NO. B1800070 Page - 29 - 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. B1800070 Page - 30 - 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 injuryforeach 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 BID NO. B1800070 Page - 31- 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. B1800070 Page - 32 - 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 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 BID NO. B1800070 Page - 33 - 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. B1800070 Page - 34 - 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 BID NO. B1800070 Page - 35 - 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 , 2018. 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. B1800070 Page - 36 - PERFORMANCE BOND PROJECT: SLURRY SEAL AND SAND SEAL 2018 IN WITNESS WHEREOF, this instrument is executed in two (2) counterparts, each one of which shall be deemed an original, this day of 2018. 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 NO. B1800070 Page - 37 - LABOR & MATERIALS PAYMENT BOND PROJECT: SLURRY SEAL AND SAND SEAL 2018 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 , 2018, a copy of which is hereto attached and made a part hereof for the construction of: PROJECT: Erosion Control and Revegetation Services for 2018 described in the Invitation for Bids, Bid No. B1800076. 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. B1800070 Page - 38 - 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 ,2018. 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 NO. B1800070 Page - 39 - NOTICE TO PROCEED PROJECT: SLURRY SEAL AND SAND SEAL 2018 To: Date: PROJECT: SLURRY SEAL AND SAND SEAL 2018 described in the Invitation for Bids, Bid No. B1800070. 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, Construction Inspection Supervisor ACCEPTANCE OF NOTICE Receipt of the above Notice to Proceed is hereby acknowledged by: (Contractor) Dated this day of , 2018. By Title BID NO. B1800070 Page - 40 - CERTIFICATE OF SUBSTANTIAL COMPLETION PROJECT: SLURRY SEAL AND SAND SEAL 2018 Owner's Project No: Engineer's Project No: Project: Slurry seal and Sand seal contract described in the Invitation for Bids, Bid No. B1800070 Contractor Contract For Contract Date This Certificate of Substantial 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. B1800070 Page 41 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/Sand Contract 2018 described in the Invitation for Bids, Bid No. B1800070 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 2018, by My commission expires: Notary Public BID NO #B1800070 Page 42 FINAL LIEN WAIVER PROJECT: SLURRY SEAL AND SAND SEAL 2018 To All Whom It May Concern: WHEREAS, the undersigned has been employed by (A) 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. to NOW, THEREFORE, this day of , 2018, 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 #B1800070 Page 43 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 #B1800070 Page 44 NOTICE OF ACCEPTANCE PROJECT: SLURRY SEAL AND SAND SEAL 2018 TO: Date: RE: Slurry Seal/Sand Seal Contract 2018 described in the Invitation for Bids, Bid No. B1800070 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, Construction Inspection Supervisor BID NO #B1800070 Page 45 TECHNICAL PROVISIONS FOR THE WELD COUNTY PUBLIC WORKS DEPARTMENT The Colorado Department of Transportation, 2017 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 (May 2018) Revision of Section 101 -Definition of Terms (May 2018) Revision of Section 104 -Scope of Work (May 2018) Revision of Section 105 -Control of Work (May 2018) Revision of Section 106 -Control of Material (May 2018) Revision of Section 107 -Legal Relations and Responsibility to Public (May 2018) Revision of Section 108 -Prosecution and Progress (May 2018) Revision of Section 109 -Measurement and Payment (May 2018) Revision of Section 408 -Joint and Crack Sealant (May 2018) Revision of Section 409 -Sand Seal (May 2018) Revision of Section 409 -Slurry Seal (May 2018) Revision of Section 627 -Pavement Marking (May 2018) Revision of Section 630 -Construction Zone Traffic Control (May 2018) Revision of Section 712 -Water (May 2018) Force Account Items / Basis of payment (May 2018) STANDARD SPECIAL PROVISIONS Pa4e 48 49 50 51-53 54 55 56 57 58-60 61-64 65-72 73-74 75-77 78 79 CDOT Standard Special Provisions applicable to this contract can be found at: https://www.codot.gov/business/desig nsu pport/cdot-construction-specifications/2017-construction-standard- specs/rev-ssp BID NO #B1800070 Page 46 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, Inspection Supervisor Weld County Public Works Department 1111 H Street Greeley, CO 80632 Office Phone: 970.304.6496, ext. 3734 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 #B1800070 Page 47 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 #B1800070 Page 48 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 #B1800070 Page 49 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 #B1800070 Page 50 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 #B1800070 Page 51 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 #B1800070 Page 52 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 #B1800070 Page 53 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 #B1800070 Page 54 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 #B1800070 Page 55 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 $50.00 per hour per day thereafter for each Inspector required to perform inspections on the inspectable work. This requirement will be waived when the County requires weekend work on parking lots. Construction operations shall stop at 5 p.m. the day before the start of the holiday weekend. Construction operations may resume after the holiday weekend has passed. The Contractor shall only make emergency repairs and provide proper protection of the work and the traveling public on the holiday weekend days. Delete subsection 108.08(a)(2), and replace with the following: Calendar Day Contract. When the work is on a calendar day basis, one calendar day of contract time will be assessed for each calendar day from the date that Contract time starts. Calendar Day Contracts have been adjusted prior to bid advertisement to account for no work on Saturdays, Sundays, and holidays by increasing the calendar days by the appropriate number of days. As stated in subsection 108.08, no inspectable construction operations shall occur on Saturdays, Sundays, and holidays unless prior approval has been granted. No weather days or less than full time charges days will be granted in this contract. In subsection 108.09 delete the schedule of liquidated damages and replace with the following: Original Contract Amount ($) From More Than To and Including 500,000 2,000,000 10,000,000 Liquidated Damages per Calendar Day ($) END OF SECTION BID NO #B1800070 Page 56 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 #B1800070 Page 57 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 #B1800070 Page 58 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 2,500SF. 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 (W) 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 +-5CF from 200❑F to 6007F. 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 #B1800070 Page 59 3 REVISION OF SECTION 408 JOINT AND CRACK SEALANT Crack Fill Detail 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 #B1800070 Page 60 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 each application, area covered, quantity of each application, and location of work. The contents and coverage of this 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 approximately 1- 3 hours prior to the second application. Sealer shall contain three to five (3-5) lbs. clean, graded silica sand per gallon. Bulk sand shall be weighed 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 material properly mixed and applied. Sealer Specification A. SURFACE PREPARATION 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 #B1800070 Page 61 2 REVISION OF SECTION 409 SAND SEAL Asphalt Emulsion Sand Seal: 1. MODIFIED ASPHALT EMULSION PHYSICAL PROPERTIES: Particle Charge (With 3-5 lbs aggregate per gal) Color (wet) Color (dry) Penetration Base Asphalt Specific Gravity Polymer/Asphalt Ratio Cationic Brown Flat Black 30-50 1.18 Min 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 1IXTURE 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 #B1800070 Page 62 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 increments 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 #B1800070 Page 63 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 #B1800070 Page 64 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)B: Penetration, 77°F, 100g, 5s 40 90 ASTM D5 Ductility, 77°F, 5 cm/min, cm 40 ASTM D113 Solubility in trichloroethylene, % 97.5 ASTM D2042 Elastic recovery, 77°F, 10cm, 1h, % 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. Aqq regate: RECOMMENDED SLURRY SEAL AGGREGATE SPECIFICATION The aggregate shall consist 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 requirements: BID NO #B1800070 Page 65 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 #B1800070 Page 66 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 Aggregate with 2% moisture content (ASTM D2419 modified) Determination of height of largest aggregate particle retained on #4 sieve EMULSION: Viscosity, SSF, 77°F, s (ASTM D5) Storage Stability Test, 24h, % (ASTM D244) Particle Charge Test (ASTM D244) Sieve Test, % (ASTM D244) Residue, % (ASTM D244) Polymer Content, % (Supplier Certification) Penetration of Residue, 77°F, 5s, 100g, dmm (ASTM D113) Ductility of Residue, 77°F, 5cm/min, cm (ASTM D113) Solubility of Residue in Trichloroethylene, % (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 Additive Water 0% to 3% by dry weight of aggregate As required to provide the specified properties 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 laboratory report will show the results of tests performed on the individual materials, comparing their values to those required by this Specification. The report will provide the following information on the slurry seal mixture. Test Purpose Slurry Seal Consistency Excess Asphalt Wet Stripping Test Compatibility Quick Set Emulsion Wet Track Abrasion MethodSpec ISSA T106 2-3 cm ISSA T109 50 gms/sq ft. max. ISSA T114 Pass ISSA T115 *Pass ISSA 1102 **Pass (6 day soak)ISSA T100 75 gms/sq ft. max. * Mixing tests must pass at the maximum expected air temperature. ** Using job aggregate BID NO #B1800070 Page 67 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 #B1800070 Page 68 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: The 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 to 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 Contractor 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 #B1800070 Page 69 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 #B1800070 Page 70 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 #B1800070 Page 71 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 #B1800070 Page 72 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 revised 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. Or 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 #B1800070 Page 73 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 Pavement Marking Paint END OF SECTION PAY UNIT GALLON BID NO #B1800070 Page 74 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 channelizing 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) Number of flaggers to be used. (4) Parking Restrictions to be in effect (Subdivision work and Parking Lots) Subsection 630.11 shall 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 designated as the Head TCS. The Head TCS shall have a minimum of one year experience as a certified TCS. Qualifications 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: (1) 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.) (2) Direct supervision of project flaggers. (3) Coordinating all traffic control related operations, including those of the Subcontractors and suppliers. BID NO #B1800070 Page 75 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.) Maintaining a project traffic control diary which shall become part of the County's project records. Inspecting traffic control devices on every calendar day for the duration of the project. Insuring that traffic control devices are functioning as required. Overseeing all requirements covered by the plans and specifications which contribute to the convenience, safety and orderly movement of traffic. Flagging. 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 #B1800070 Page 76 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 project 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 PAY UNIT Signing and Traffic Control (Slurry Seal) Signing and Traffic Control (Sand Seal) Singing and Traffic Control (CDOT Intersections) END OF SECTION MILE EACH EACH BID NO #B1800070 Page 77 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 #B1800070 Page 78 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 #B1800070 Page 79 APPENDIX VICINITY MAP & DETAILS: Estimated Quantities 81-82 Project location Maps 83-85 BID NO #B1800070 Page 80 0L000818# ON Q18 Weld County SlurrySeal 2018 � LOCATION of PROJECT ,. Width t11 I cnAWLgi1; AL SQ. YDS. Because Ofi t t 111, Length ROAD From to i (II) ; ��ai l es ► Bridges Radii Approaches Widened Areas 1' ' 18 2t! 1 25.00 5.327.00 1.01 - - - 14,917.22 17 54 i Iatstu 'sn CI, 25.50 14.601.0(1 2.77 488.89 - 195.83 - 42.(154.22 19 2 10.25 25.00 '_2,972.00 4.35 116.60 - - 1,520.22 65.447.93 2 3 CO 392 RR Tracks 24.50 4. t 30.00 0.7K 97.22 - - 1.052.72 ;92. ,1 43 3+a 32 25.0► 5,168.00 0.98 - - 14, 355.56 a : 44 Kersey C'L. _' #.50 26,626.00 :.).04 � - 'c 62 >> ; l t �!" l.� f -, 4 - , c;,1 ij 390 305 95 26.50 24,102.00 4,56 } - 2.21119 73.178,19 12if. 11-25 frontageRI) US 85 >5.00 11.331.00 7,83 - 1 10.89 33.118.11 149.766.33 E 4111 ST RD. 11'SSSFnnil4oRD CI Il . DE SAC I 34.10 542.00 0 10 51.11 . -V 2,947,26 SUBDIV ISO\S PHEASANT ('REST ESTATES I Pltc:, ,►►t t rest Click J 4 f C t DI > A�_ ?2 50 1.11S 00 U.2? 1 1 46 I - �.. Kse `47 4.521 9? HIRE StireIRD TOTAL: 100 .CUL DE SAC 1 24.00 I h46.00 146,883,00 0.12 + 27:82 765.21 145.11 1 I 242.22 I 6,828.89 -i 980.00 , 37.960.39 2,847.78 456.995.32 1 Weld Couniv Sand Seal 2018 LOC XI1ON of PR( ),fECT TOTAL , BUILDING APPLICATION SY -" PARKING LOTS Chase Rink Ea`t Sand Seal 2,0 9.53 Greei Sh p\ \lotto Pool Sand Scat7301. 0 ��rl�irii`tr:rti�}n fltlC'C Z�4'alkiri Trail Sand `c:.il 1,7`%�.+:�t) .�._., . Administration 1 t)+C.`t,` Parking Lot (Main) Santa seal 7,260.46 TO ' 19,02659 Weld County Pavement Marking 2018 L_OC'ATION of Pk( ).in "I TOTAL BUILDING GAL PARKING LOTS Chase Bank East 2.37 GroCL\ Shops N 1 r E-' �t,,, 4d 2.67 \dniitii'tlration B( )t_ L P:ir-kin2 Lot (Main) 17.73 TOTAL: 22 . 77 Weld County Crack Fill 2018 " PARKING LOTS LOCATION Tons Chas:: Bank !:rat I ( 4eelc) Shop,- %toter Pool 2 \dministration 1R0CC Parking lot (Main) 2 TOTAL: 5' BID NO #B1800070 Page 82 1 I 120 — ..—r ..d.— •.•.. L T .. 1 I , r 1 I __.Y_A' -L ; I 1 1 , I I ' t 1 I T + I 1 i I I I 1 I ► sI , I1 I 1— ------1 -- I I 1 T 1 110 1--r--1----÷I I 1 1 + 1 I + I I I I . I---1 Ir--I-1----i F---- --I i I 1 I I I I I I 1 -I -I- -I i I I -1 I I J_. --�.�J I I I.__t-•• ...e.,.11_-i ; L -I I 1—' "W_f--r_L4—I 1 ; 1- -- +- ---F4— F+ —1---) �-- -, _) 1 ��-F'1—•}-+ I 1 ' I"1 �— -- — I 1 ''� -i I— ( s I L"1 r A .. I __ I 1 1 1 1 I 1 -, _I I I \ el+, r' = I I 1 j 1 I .,. • i 1 -4 'f - mil. I 1 , I 1 ,• 1 41 I 1 ! BID NO. B1800070 Page 83 ;tv C R 133 ACR '90 W CR 88 I = 5.246 feet Pheasant Crest Estates Shire PUD BID NO #H1800070 Page 84 Weld County BOCC Parking Lot Weld County Walking Path Weld County Motor Pool Parking Lot Chase Bank East Parking Lot BID NO #B1800070 Page 85 EXHIBIT B Christie Peters From Sent: To Cc Subject Attachments Stephanie Wallis <swallis@a-lchipseal corn> Tuesday, May 29, 2018 9 02 AM bids John Johnson, Mike Starr BID ENCLOSED - B1800070 - 2018 Slurry Seal and Sand Seal Contract 20180529095455 pdf I hereby waive my right to a sealed bid BID ENCLOSED BID NO B1800070 DESCRIPTION 2018 Slurry Seal and Sand Seal Contract BID OPENING DATE 5/29/2018 @ 10 00 AM Thank you for the opportunity Stephanie Wallis Controller & Office Manager A-1 Chipseal & Rocky Mountain Pavement 720-540-8264 (office) 303-464-9261 (fax) swallis@a-lchipseal corn http //www a-lchipseal corn http //www asphaltrepair corn G; -ONE; PAVE 1 ENT ROCKY MOUNTAIN 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 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 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, B1800070 Page - 14 - 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. B1800070 Page -15 - BID SCHEDULE 2018 Slurry Seal and Sand Seal Contract Item Description Unit Est. Quantity Unit Price Contract Bid Number 408 409 Place Rubberized Crack Filler & Traffic Control (Weld County to supply material) TON 5 3,500.00 17,500.00 Sand Seal SY 19,100 457,000 1.35 25,785.00 409 Slurry Seal SY 1.81 827,170.00 627 Pavement Marking Paint (Parking Lots) GAL 23 113.50 2,610.50 630 Signing and Traffic Control (Sand Seal) EACH 4 250.00 1,000.00 630 Signing and Traffic Control (Slurry Seal) MILE 28 2,000.00 56,000.00 630 MHT and Traffic Control for Cdot intersections EACH 4 2,250.00 9,000.00 700 F/A Minor Contract Revisions F/A 1 $5,000.00 $5,000.00 Total: 944,065.50 * The successful vendor is required to sign a separate contract (a sample contract is included as a separate attachment.) BID NO. B1800070 Page - 16 - 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. 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. #61800070. 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. Daniel J. Gryzmala BUSINESS ADDRESS 2505 E. 74th Ave. CITY, STATE, ZIP CODE Denver, CO 80229 BY (Please print) DATE TELEPHONE NO 303-464-9267 FAX 303-464-9261 TAX ID #, 84-1216817 n . SIGNATURE E-MAIL 11//i992 iiohnson@a-ichipseal.cgr . C *•:-.4OR PQ�' if O�� WELD COUNTY IS EXEMPT FROM COLORADO SALES TAXES. THE CERTIFICATE OF EXEMPTION NUMBER IS #98-03551-0000. BID NO. B1800070 Page -17 - BID BOND PROJECTS: Slurry Seal and Sand Seal contract 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%), lawful money of the United States of America, for the payment of which sum well and truly to be made, wel bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly to these presents. *Western Surety Company THE CONDITION OF THIS OBLIGATION IS SUCH, that whereas the Principal has submitted the accompanying Bid dated _ __. May 29th , 2018 for the PROJECTS: Slurry Seal and Sand 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 8. 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 _29th day of . May 2018 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 A-1 ChlpsealCompany_ ATTE By _ phani=W Allis, Secretary BID NO. B1800070 Address 2505 E. 74th Avenue Delver, CO 8 By Daniel ). Gryzmata, President Surety_ Western Surety Company Address 33 Wabash Avenue, Ctaicaeo, IL 6O804 n A. Feggestad, Attorney- n- act Fags -18 - MOODY INSURANCE AGENCY, INC. 8055 East Tufts Avenue, Suite 1000 DENVER, COLORADO 80237 PHONE: (303) 824.66110 INSTRUCTIONS The full firm name and residence of each individual party to the bond must be inserted in the first paragraph. lithe 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. 0180-60-70 Page -19 - Western Surety Company POWER OF AT'T'ORNEY APPOINTING INDIVIDUAL ATTORNEY -IN -FACT Know All Men lty'These Presents, That WEN'ft-;RN SURETY COMPANY, a South Dakota corporation, is a duly organized acrd 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, Ashlea Mc Caughey, Individually of Denver, CO, its true and lawful .Attontey(s1-in-Fact with full power and authority hereby conferred to sign, seal and execute for and on its behalf bands, 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 instnunents were signed by a duly authorized officer of ittc 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 fly-l.aw 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 it:; corporate seat hr he hereto affixed on this 24th day of April, 2(118. WESTERN SURETY COMPANY 'aul T. Bruflat, Vice President State of South Dakota ss County of Ivf;nnchaha On this 24th day of April, 20)8, hefore ore personally came Paul T. Brrdlat, 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 wusTERN SURETY COMPANY daunt ibed 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 he the act and deed of said corporation. )sly' cumtnissiott expires June 23, 2021 J. MOHR 4°T oteoutlit K CERTIFICATE J. Mohr, Notary Public I, T. Nelson, Assistant Secretary of WESTERN 5;MIRE;I'Y COMPANY do hereby certify that the Power of Attorney hereinabove set forth is still in force. and ft rthar certify that the Hy I- w of :he ;orpor iron r int id on he reverse hero 1. .% still in To •c. In test knoll whereof htlaue hereunto subscribed / sty more iris) affixed the seal of the said col —potation tht day of lJy WESTERN SURETY COMPANY Enna ('4280-7-7.(112 Go to www.cnasurety.com > Owner / Obligee Services > Validate Bond Coverage, if you want to verify bond authenticity. —4— L. Ndsun, Assistant Sec«aary 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, B1800070 Page -19 - lam ■ -9 (Flat A1151it 2m:y hewed Rownliq$:”...II Request for Taxpayer Identification Number and Certification Give Form to the requester, no not send to the IRS. Name C!"ipseal Co. I„tl.n, l.4arpur•n 0.mn•Ntkleg;a,)e.l .unty 11.01la. d lktl..mrl Wail .,1411., Cheuk epprly.lak, box ht I.vl,r.) lux doveJfir tlinir �r n Inrlrverlln llc.0o 711 r,p.t;M.i �. i (; f:nlpr tone. `I tocrplYunol I� f'arba' f-ep Li T,n.Ur0'lei, (._� l Imend h:.ulliry eomlory `nlra the lax rlacullr.Ilnw (C -C crr}x+ritten, 5=S frlpaaoaY�, 1+-Iral lnrecrulr) ► �ilax tsw rlreatt7Mxtr}► Mdreee Inumbee, street, and apt or cute no.) 2505 E 74th Ave. C ily, etA5S +eel %e' rinda Denver, CO 80229 t sl rn };1/ell lepetm(s) het 64.to uwa xemplIons (see II) uucliuluy, F.:empn payer: x1110 (if wily) Lxearplrrrl 1111111 Alt:A aril lllrg r,xk, (el •enyi Part I Taxpayer Identification Number (TIN)gigot _.I al _ Eyour TIN In the appropriate boz The providedTIN provided must match iha name gluon m the "Noma" Imo � Soda number to evad hookup withholding For indlvrdtlals, this Is yrxlr social security number (SSN). However, fora _ I resident alien, ado propdietot, cr dlslepardvd entity. sae 11U Pad I Instructions on page 3. For other entitles. It In yore employer ii 00$ licatlon number MIN)x you do not have a number, wee Now to gel a t._. _ I. TIN on page 3 Note. II the account le in more than one name, see the chart on Rage 4 to guidelines on whose number to enter. I kinployor Ilex lnlneNllun number 8 4 1 2 116 8 1 7i Part II Certification Under penalties of perjury. I certify (hat: 1. The number shown on thin form Is my correct taxpayer ident(fIcatia1 cumber (or I am waiting fora number to be issued to me), and 2. I am not subject to backup withholding because. (a) t am exempt from backup withholding, or Ib) I have nut boon notified by Iho Internal Revenue Service (IRS) that I am sub)ect to backup wilt holding ns a result of a failure to r aport all interest or dividends. C. (c) the kid has notifed mr, (hot I am on longer sub)act tc hackun withholding, and 3 I am a U.S. citizen or other U S. persQll (Jelned below), end 4. The FA1 CA code(s) entered on this form (d any) Indicating that I am exempt from FATCA renorting is correct. Certilloallon Instructions. You must cross out item 2 above it you 11306 been notified by the IPS that you are currently suoloct to backup withholding because you have failed to retest all interest and dhfdenj15. n your tax return For real estate transactions, 'tem 2 does not apply. For mortgage ,...-.. -. debt, con ..--_ an ,_- ..r... -r recr.,ment arrangement (IRA), and lto sign the certification. but you must crovide yoth correct TIN. See the infant pad, ocquiertioel salon' O1 genre ly, paylnente olt' Instructions on page 3 Sign signets.. at Here u•s,tlror.an► General Instructions C m;llnll iMahllIC at ire to the Mlolnal 04)1.11,0 Creltl 11111(1..,,Nlrr wlxl 11110,1, stuture ibekeemmetits Ilk. 111$ hag r'I,1.41.1 n paw In (ItS ,N Ira ndlaet.du•I dlrall Flare W n. re *WAY iri.rvrr/t al. grrl.nlitiral AIWA It any MoMnn dw.ai„anrolla .aw:nrgg Firm W -w pod. a. tododlllr tr .i,a.arrv1 alit. ,vr,,,,l.r.w III we 4.. (xw4W al flt.41 pane. Purpose of Form A prom Abe IS raM/e,l tattle all attnrnahal oaten web the 31th nlu•,t obtain vote .:Mll,,t Inyrlaty ,kweMneinro me,dxv 711M t., I.yva1. II.. lrxl1nida•, 411 Ialx15,011 to you, paylntvfl•, ma.fu torrid el seta.:ment aN pnynernl Cant :tilt 1111,1 psity eatwlak IIenmstem. tvei eslet.•• IlalverK a.rn,. Iune Nil to Ill, 4.nt teat pail. eogU''.IWr1 .v .b.I41au1x4n at swaged aged p40tlllrty. 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Inn l*.*1 rar•rtr, .1, Par IUM•. texlel !ecea/ ides 0+111110 n pal Inalatkip If. 711!•VIniv lint n )HnMk'a or a M..dtk/p141.a1.111111 Ir,Wltnl ra.r,Mrl. 14.1,1 w.Udx44Mu,, lax fir. tar..,,.1 yue 4010 I I.S.14(11111 Pia 14. pwlnw ..I II INII II elIdvp c.lnit4.IIl ly x wt,1,. ro 011111lows ter .he 1 M,1111.1 Me1.r., 51(/1410 1',.111 W )1 10 IN) µlllunrbp l0 asL,ldral. yea 11.5 rd.•nl-f will nunkl1,t:/erl I.btl0anadnertir i wt tint slime rd pinllwtrdgt enxnp. Cal No, 10d91k Foul W-9 (P110.3.20(1) BID NO. B1800070 Page - 20 - STATEMENT OF QUALIFICATIONS AND SUBCONTRACTORS DATE OF THIS STATEMENT: 5/29/18 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 A-1 Chipseal Co. (Company or Firm): 2505 E 74th Ave., Denver, CO 80229 2. Permanent main office address: Phone Number: 303-464-9267 303-464-9261 Fax Number. 1992 3. Year Company was organized: 4. Number of years this Company has been engaged similar construction: 26 Years 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? 22 Years A-1 Chipseal Co. 22 Years 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: See Attached 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. N/A 7. List all contracts within the last 3 years for which liquidated damages were assessed or may be assessed. NONE BID NO, B1800070 Page - 21 - 8. List all contracts within the last 3 years during which or after which the Company filed a protest with the owner. NONE 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. NONE 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. 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 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: Weld County 2017 Slurry and Sand Seal Location: Various Locations within the County Supt: Luis Ortega Owner's Representative: Josh Holbrook Phone: 970-304-6496 Completion Date: 8/20/17 Contract Amount: 950K BID NO. B1800070 Page - 22 - Project Name: City of Broomfield 2017 Pavement Preservation Program Location: Various locations within the city Supt: Terry Horton Owner's Representative: Les Weilacher Phone: 303-464-5675 Completion Date: 12/5/17 Contract Amount: 2.2MM Project Name: _ City of Aurora 2017 Surface Treatment Program Luis Ortega Location: Various locations within the city Supt: & Scott Vogl Owner's Representative: Raul Griego Phone:303-326-8213 Completion Date: 11/10/2017 Contract Amount: 2.9MM 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 American Sign Co. Rocky Mountain Parking Lot Services WORK DESCRIPTION Traffic Control Striping % OF WORK 5% .02% 15. List the principal members of the company who will be involved with this project, including the superintendent, foreman, project manager, etc. NAME Luis Ortega Dana Turner TITLE Superintendent YRS. PERTINENT EXPERIENCE 22 Years Foreman 11 Years Rogelio Contreras - Lopez Foreman 4 Years 16. List all lawsuits previously filed against or currently pending against you, the Company or any officers of the Company. None BID N0, B1800070 Page - 23 - 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 29th day of May , 2018. a.1" L,. NOTARY Bidder:' A-1 Chipseal Co. Corn n By: Signature Danie J. Gryzmala • c�CO.... Name: (Please Type) -450000. Title: President Adams County of ss. State Colorado of Daniel J. Gryzmala being duly sworn, deposes and says that he is President of, (Title) and that the answers to the foregoing questions A-1 Chipseal Co. (Company Name) and all statements therein contained are true and correct. Subscribed and sworn before me this 29th May day of, 2018. STEPHANIE WALLIS NOTARY PUBLIC MIA1 )F C'",.LORADO NOTARY ID 20054012221' MY COMMISSION EXPIRES MARCH 28, 2021 3/28/2021 Commission Expires BID NO. B1800070 Page - 24 - Contracts in Progress Last Updated 5/29/2018 job_no 10287 Project Name City of Aurora Customer Information City of Aurora. 15740 E 32nd Ave Aurora, CO 80011 Raul Griego (303) 326-8208 Contract Amount $ 2,436,601.38 Current Contract Amount $ 2,436,601.38 Expected Completion Date 06/30/18 10296 CDOT - Chipseal Colorado Dept. of Transport. 4201 E. Arkansas Room 158 Denver, CO 80222 Rick (720) 299-5552 $ 976,099.32 $ 976,099.32 05/31/18 10304 Colorado Springs Chipseal City of Colorado Springs PO Box 1575 - MC 240 Colorado Springs, CO 80915 Bob Syme (719) 385-6813 $ 2,015,159.19 $ 2,015,159.19 09/30/18 10309 Colorado Springs Crackseal City of Colorado Springs PO Box 1575 - MC 240 Colorado Springs, CO 80915 Bob Syme (719) 385-6813 $ 798,911.10 $ 798,911.10 10/31/18 10313 N.I.S.T. Paving Project Site Work Solutions 3931 Holly Street Unit B Denver, CO 80207 0- $ 271,354.00 $ 271,354.00 06/30/18 10315 City of Westminster City of Westminster 6575 West 88th Ave. Westminster, CO 80030 Barb - Finance A/P NET 30 days (303) 658-2522 $ 767,702.81 $ 767,702.81 06/30/18 10316 City of Westminster - Slurry City of Westminster 6575 West 88th Ave. Westminster, CO 80030 Barb - Finance A/P NET 30 days (303) 658-2522 $ 305,036.40 $ 305,036.40 09/30/18 Contracts in Progress Last Updated 5/29/2018 job no 10317 Project Name Adams County - Customer Information Contract Amount $ 718,639.23 Current Contract Amount, $ 718,639.23 Expected Completion Date 06/15/18 Adams County 4430 S. Adams County Parkway Brighton, CO 806018212 Liz Estrada (720) 523-6052 10318 Town of Parker Town of Parker 20120 E Mainstreet Parker; C0,8013.8 Ron Martinet (303) 805-3163 $ 1,780,327.91 $ 1,780,327.91 08/31/18 10319 Loveland Chipseal Project City of Loveland 500 East Third Loveland, CO 80537 Heather Ramseier - AP (970) 962-2310 $ 1,032,544.30 $ 1,032,544.30 06/30/18 10323 Louisville 2018 Street Project APC Construction Co., LLC 14802 W 44th Ave. Golden, CO 80403 Chris Yarry (303) 279-6611 $ 429,8.40.78 $ 429,840.78 05/31/18 10341 Brighton 2018 St Pres. Proj City of Brighton 22 South 4th Ave Brighton, CO 80601 Bill Allen (303)655-2036 $ 1,577,971.21 $ 1,577,971.21 05/31/18 10350 Salida 2018 Resurfacing Proj City of Salida 448 E. 1st Ave Suite 112 Salida, CO 81201 David Lady (719) 239-0048 $ 281,347.89 $ 281,347.89 i 07/31/18 , 10354 Broomfield 2018 Street Project City of Broomfield One DesCombes Drive Broomfield, CO 80020 Les Weilacher (303) 464-5675 $ 2,891,822.38 $ 2,891,822.38 09/30/18 Contracts in Progress Last Updated 5/29/2018 job_no 10355 Project Name CDOT-R5 FY18 Crackseal Proj Customer Information Colorado Dept. of Transport. 4201 E. Arkansas Room 158 Denver, CO 80222 Rick (720) 299-5552 _ Contract Amount $ 301,529.00 Current Contract Amount $ 301,529:00' Expected Completion Date 08/31/18 10377 Ft Collins 2018 Surface Prog City of Fort Collins 281 N. College Ave. Fort Collins, CO 80522 Stan Welsch - Finance Debbie D (970) 416-2091 $ 2,213,463.61 $ 2,213,463.61 07/31/18 10408 City of Canon City City of Canon City 128 Main Street Canon City, CO 81215 Adam Lancaster (719) 269-9011 $ 374,999.34 $ 374,999.34 08/31/18 10447 2018 Chipseal Project City of Longmont 350 Kimbark Street Longmont, CO 80501 Alden Jenkins (303) 651-8567 $ 577,273.36 $ 577,273.36 06/30/18 10466 City of Boulder 2018 Program City of Boulder 1739 Broadway Boulder, CO 80302 Rod Rindal (303)489-7759 $ 400,519.91 $ 400,519.91 12/31/18 $ 20,151,143.12 $ 20,151,143.12 Bond No. 30041202 PERFORMANCE BOND PROJECT: SLURRY SEAL AND SAND SEAL CONTRACT 2018 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 Corporation (Corporation, Partnership, or Individual) Western Surety Company , hereinafter called Contractor, and a (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.Q. Box 758, 1111 H Street, Greeley, Colorado 80632 (Address of Owner) hereinafter called Owner, in the penal sum of Nine Hundred Forty Four Thousand* Dollars, ($ 944,065.50 ), 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. Sixty Five Dollars and 50/100 -- THE CONDITION OF THIS OBLIGATION is such that whereas, the Contractor entered into a certain Contract with the Owner, dated the day of , 2018, 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. B1800070 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. 81800070 Page - 37 - PERFORMANCE BOND PROJECT: SLURRY SEAL AND SAND SEAL CONTRACT 2018 IN WITNESS WHEREOF, this instrument is executed in two (2) counterparts, each one of which shall be deemed an original, this A-1 al Compa (Contractor) Secretary Stephanie Wallis (SEAL) (Witness as to Contractor) 2505 E. 74th Avenue (Address) Denver, CO 80229 ATTEST: N/A (Surety) Secretary (SEAL) Witness ajto Surety 8500 E. Tufts Avenue, #1000 (Address) Denver, CO 80237 By day of 2018. Daniel J. G zmat-. resident 2505 E. 74th Avenue (Address) Denver, CO 80229 Western Surety Company Surety Attorney -in -Fa Karen A. Feggestad 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. B 1800070 Page - 38 - Bond No. 30041202 LABOR & MATERIALS PAYMENT BOND PROJECT: SLURRY SEAL AND SAND SEAL CONTRACT 2018 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 Corporation (Corporation, Partnership, or Individual) Western Surety Company , hereinafter called Contractor, and a (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 Forty Four Thousand Sixty Five Dollars and 50/100 --- Dollars($ 944,065.50 ), 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 , 2018, 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. 81800070. 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. B1800070 Page - 39 LABOR & MATERIALS PAYMENT BOND PROJECT: SLURRY SEAL AND SAND SEAL CONTRACT IN WITNESS WHEREOF, this instrument is executed in two (2) counterparts, each one of which shall be deemed an original, this day of , 2018. (Contractor) Secretary Stephanie Wallis (SEAL) (Witness as to Contractor) 2505 E. 74th Avenue (Address) Denver, CO 80229 ATTEST: N/A (Surety) Secretary (SEAL) Witness as to'Sure y 8055 E. Tufts Avenue, #1000 (Address) Denver, CO 80237 By Dan'" . GryzPresident 2505 E. 74th Avenue (Address) Denver, CO 80229 Western Surety Company Surety Attorney-i Karen A. Feggestad 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. MEMBER MOODY INSURANCE AGENCY, INC. 8055 East Tufts Avenue, Suite 1000 DEN% ER, COLORADO 80237 PHONE: (303) 824-6600 BID NO. B 1800070 Page 4 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, Ashlea Mc Caughey, 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 hind 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 he hereto affixed on this 24th day of April, 2018. State of South Dakota County of Minnehaha ss WESTERN SURETY COMPANY wI T. Bruflat, Vice President On this 24th day of April, 2018, before me personally came Paul T. Brullat, 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 CERTIFICATE )-77)7244f1A) 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 2414"."1"./ I. Nelson, Assistant Secretary I-,,rr, P428(r -)r) I, Go to www.cnasurety.com > Owner / Obligee Services > Validate Bond Coverage, if you want to verify bond authenticity. ARLI C CERTIFICATE OF LIABILITY INSURANCE DATE (M/sY) o18 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 pollcy(les) must 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 CONTACT Deanna Zahn, ACSR NAME: Moody Insurance Agency, Inc. - ((NG, No, Exl): (303)824-6600 oic,No: (303) 370-0118 8055 East Tufts Avenue AODRE-MAIEes:deanna.zahn@moodyins.com Suite 1000 INSURER(S) AFFORDING COVERAGE NAIL 8 Denver CO 80237 INSURER A :Phoenix Insurance Company 25623 INSURED INSURER a :Travelers Prop Cas Co of America 25674 A-1 Chipaeal Company, DEA: Rocky Mountain Pavement, INsuRERc:Pinnacol Assurance 41190 2505 E. 74th Ave INSURERD:11linois Union Insurance Company 27960 INSURER E:AGCS Marine Ins Co 22837 Denver CO 80229 INSURER F' COVERAGES CERTIFICATE NUMBER:18-19 w/ from 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 TYPE OF INSURANCE ADM SUER POLICY EFF POLICY EXP LIMITS LTftlean WW1 POLICY NUMBER IM�DDJYYYYI rMM100'YYYY1 X COMMERCIAL GENERAL LIABILITY A CLAIMS -MADE X OCCUR GENT AGGREGATE LIMIT APPLIES PER: POLICY X Ine7 LOC OTHER: EACH OCCURRENCE $ 1,000,000 NTED DTCO0J30005PHX18 DAMAGETO{ a snare anal $ 300,000 X Y Additional Insured Statue 2/1/2018 2/1/2019 mu) oP(Any one person) $ 10,000 Applies Only To The Extent PERSONAL E AOV INJURY $ 1,000,000 Provided in Forms GENERAL AGGREGATE $ 2,000,000 CC D3 16 11/11 & PRODUCTS - COMP/OP AGG S 2,000,000 CG 02 46 08/05 $ AUTOMOBILE LIABILITY X ANY AUTO a ALL OWNED SCHEDULED AUTOS AUTOS X X NON -OWNED HIRED AUTOS AUTOS COMBINED SINGLE LIMIT $ 1,000,000 rEa accident) BODILY INJURY (Per oersen) $ y D28100,730005=18 2/1/2018 2/1/2019 BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ (Per accident) CertyuahoalvesCelEstorn Dad, $ 2, 000 X UMBRELLA LIAR X OCCUR a EXCESS UAB CLAIMS -MADE DED X RETENTIONS 10,000 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10, 000, 000 X Y CUP2J3100431826 2/1/2018 2/1/2019 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETORiPARTNERIEXECLITIVE OFFICERIMEMBER EXCLUDED? C (Mandatory In NN) II yes, _ _describe Ittder DESCRIPTION OF OPERATIONS below OTM UTE ER X ;MUTE E.L. EACH ACCIDENT $ 500, 000 N/A Y 4055760 2/1/2018 2/1/2019 EL- DISEASE - EA EMPLOYEE $ 500, 000 ill). DISEASE - POLICY LIMIT $ 500, 000 D Pollution Liability E Motor Truck Cargo CPYG27165825006 2/1/2018 2/1/2019 Limit per occurenceiaggregate 5,000,000 M1193038133 2/1/2018 2/1/2019 Limit. 100,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Addltlonal Remarks Schedule, may be attached It more space Is required) RE: 2018 Slurry Seal and Sand Seal Contract Weld County, its subsidiary, parent, associated and/or affiliated entities, successors, or assigns, its elected officials, trustees, employees, agents, and volunteers are included as additional insured with respect to General Liability, including On -going and Completed Operations, and Umbrella Liability as required by written contract. A Waiver of Subrogation in favor of the additional insured applies with respect to General, Automobile, and Umbrella Liability, and Worker's Compensation. CERTIFICATE HOLDER CANCELLATION Weld County 1150 "0" Street Greeley, CO 80631 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE D Zahn, ACSR/DANFLI oC..l./.lJt �tia'1K.a L.ilrl/i„1� ACORD 25 (2014/01) INS025 (201401) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED (CONTRACTORS) This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. WHO IS AN INSURED - (Section Ii) is amended to include any person or organization that you agree in a "written contract requiring insurance" to include as an additional insured on this Cover- age Part but a) Only with respect to liability for "bodily injury "property damage" or "personal injury"; and b) If, and only to the extent that, the 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 requiring insurance" applies The person or organization does not qualify as an additional insured with respect to the independent acts or omissions of such person or organization 2. The insurance provided to the additional insured by this endorsement is limited as follows. a) In the event that the Limits of Insurance of this Coverage Part shown in the Declarations exceed the limits of liability required by the Written contract requiring insurance", the in- surance provided to the additional insured shall be limited to the limits of liability re- quired by that "written contract requiring in- surance" This endorsement shall not in- crease the limits of insurance described in Section III — Limits Of Insurance b) The insurance provided to the additional in- sured does not apply to "bodily injury", "prop- erty damage" or "personal injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or sur- veying services, including i. The preparing, approving, or failing to prepare or approve. maps, shop draw- ings, opinions, reports, surveys, field or- ders or change orders, or the preparing, approving, or failing to prepare or ap- prove, drawings and specifications. and ii. Supervisory, inspection, architectural or engineering activities. c) The insurance provided to the additional in- sured does not apply to "bodily injury" or "property damage" caused by "your work" and included in the "products -completed op- erations hazard" unless the 'written contract requiring insurance" specifically requires you to provide such coverage for that additional insured, and then the insurance provided to the additional insured applies only to such "bodily injury" or "property damage" that oc- curs before the end of the period of time for which the 'Written contract requiring insur- ance" requires you to provide such coverage or the end of the policy period, whichever is earlier 3. The insurance provided to the additional insured by this endorsement is excess over any valid and collectible "other insurance". whether primary excess, contingent or on any other basis, that is available to the additional insured for a loss we cover under this endorsement However, if the "written contract requiring insurance" specifically requires that this insurance apply on a primary basis or a primary and non-contributory basis. this insurance is primary to "other insurance" available to the additional insured which covers that person or organization as a named insured for such loss, and we will not share with that "other insurance" But the insurance provided to the additional insured by this endorsement still is excess over any valid and collectible "other in- surance", whether primary, excess, contingent or on any other basis, that is avaiiable to the addi- tional insured when that person or organization is an additional insured under such "other insur- ance" 4. As a condition of coverage provided to the additional insured by this endorsement a) The additional insured must give us written notice as soon as practicable of an "occur- rence" or an offense which may result in a claim To the extent possible such notice should include CG D2 46 08 06 © 2005 The St Paul Travelers Companies, Inc Page 1 of 2 COMMERCIAL GENERAL LIABILITY i. How, when and where the "occurrence" or offense took place, ii. The names and addresses of any injured persons and witnesses; and iii. The nature and location of any injury or damage arising out of the "occurrence" or offense b) If a claim is made or "suit" is brought against the additional insured, the additional insured must: i. Immediately record the specifics of the claim or "suit" and the date received; and ii. Notify us as soon as practicable The additional insured must see to it that we receive written notice of the claim or "suit' as soon as practicable. c) The additional insured must 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 d) The additional insured must tender the de- fense and indemnity of any claim or "suit" to Page 2 of 2 any provider of "other insurance" which would cover the additional insured for a loss we cover under this endorsement However, this condition does not affect whether the insur- ance provided to the additional insured by this endorsement is primary to "other insur- ance" available to the additional insured which covers that person or organization as a named insured as described in paragraph 3. above 5. The following definition is added to SECTION V - DEFINITIONS "Written contract requiring insurance" means that part of any written contract or agreement under which you are required to include a person or organization as an additional in- sured on this Coverage Part, provided that the "bodily injury" and "property damage" oc- curs and the "personal injury" is caused by an offense committed a. After the signing and execution of the contract or agreement by you: b. While that part of the contract or agreement is in effect: and c. Before the end of the policy period to 2005 The St. Paul Travelers Companies inc CG O2 46 08 05 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS XTEND ENDORSEMENT 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 10 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 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. Aircraft Chartered With Pilot B. Damage To Premises Rented To You C. Increased Supplementary Payments D. Incidental Medical Malpractice E. Who Is An Insured — Newly Acquired Or Formed Organizations F. Who Is An Insured — Broadened Named Insured — Unnamed Subsidiaries G. .Blanket Additional Insured — Owners, Managers Or Lessors Of Premises PROVISIONS A. AIRCRAFT CHARTERED WITH PILOT The following is added to Exclusion g., Aircraft, Auto Or Watercraft, in Paragraph 2. of SECTION I - COVERAGES — COVERAGE A BODILY IN- JURY AND PROPERTY DAMAGE LIABILITY: This exclusion does not apply to an aircraft that is: (a) Chartered with a pilot to any insured; (b) Not owned by any insured; and (c) Not being used to carry any person or prop- erty for a charge. B. DAMAGE TO PREMISES RENTED TO YOU 1. The first paragraph of the exceptions in Ex- clusion j., Damage To Property, in Para- graph 2. of SECTION I — COVERAGES — COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY is deleted. 2. The following replaces the last paragraph of Paragraph 2., Exclusions, of SECTION I — COVERAGES — COVERAGE A. BODILY H. Blanket Additional Insured — Lessors Of Leased Equipment I. Blanket Additional Insured — States Or Political Subdivisions — Permits J. Knowledge And Notice Of Occurrence Or Offense K. Unintentional Omission L. Blanket Waiver Of Subrogation M. Amended Bodily Injury Definition N. Contractual Liability — Railroads INJURY AND PROPERTY DAMAGE LI- ABILITY: Exclusions c. and g. through n. do not apply to "premises damage". Exclusion f.(1)(a) does not apply to "premises damage" caused by: a. Fire; b. Explosion; c. Lightning; d. Smoke resulting from such fire, explosion, or lightning; or e. Water; unless Exclusion f. of Section I — Coverage A — Bodily Injury And Property Damage Liability is replaced by another endorsement to this Coverage Part that has Exclusion — All Pollu- tion Injury Or Damage or Total Pollution Ex- clusion in its title. A separate limit of insurance applies to "premises damage" as described In Para- graph 6, of SECTION III — LIMITS OF IN- SURANCE. CG D3 16 11 11 O 2011 The Travelers Indemnity Company. All rights reserved. Page 1 of 6 COMMERCIAL GENERAL LIABILITY d= oats vi owig oMINIC mos o AMOK iii 3. The following replaces Paragraph 6. of SEC- TION III - LIMITS OF INSURANCE: Subject to 5. above, the Damage To Prem- ises Rented To You Limit is the most we will pay under Coverage A for damages because of "premises damage" to any one premises. The Damage To Premises Rented To You Limit will apply to alt "property damage" proximately caused by the same "occur- rence", whether such damage results from: fire; explosion; lightning; smoke resulting from such fire, explosion, or lightning; or water; or any combination of any of these causes. The Damage To Premises Rented To You Limit will be: • a. The amount shown for the Damage To Premises Rented To You Limit on the Declarations of this Coverage Part; or b. $300,000 if no amount is shown for the Damage To Premises Rented To You Limit on the Declarations of this Coverage Part. 4. The following replaces Paragraph a. of the definition of "insured contract" in the DEFINI- TIONS Section: a. A contract for a lease of premises. How- ever, that portion of the contract for a lease of premises that indemnifies any person or organization for "premises damage" is not an "insured contract"; 5. The following is added to the DEFINITIONS Section: "Premises damage" means "property dam- age" to: a. Any premises while rented to you or tem- porarily 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. 6. The following replaces Paragraph 4.b.(1)(b) of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS: (b) That is insurance for "premises damage"; or 7. Paragraph 4.b.(1)(c) of SECTION IV — COMMERCIAL GENERAL LIABILITY CON- DITIONS is deleted. Page 2of8 C. INCREASED SUPPLEMENTARY PAYMENTS 1. The following replaces Paragraph 1.b. of SUPPLEMENTARY PAYMENTS - COVER- AGES A AND B of SECTION I — COVER- AGE: b. Up to $2,500 for the cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to fur- nish these bonds. 2. The following replaces Paragraph 1.d. of SUPPLEMENTARY PAYMENTS — COVER- AGES A AND B of SECTION I - COVER- AGES: 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 $500 a day because of time off from work. D. INCIDENTAL MEDICAL MALPRACTICE 1. The following is added to the definition of "oc- currence" in the DEFINITIONS Section: "Occurrence" also means an act or omission committed in providing or failing to provide "incidental medical services", first aid or "Good Samaritan services" to a person. 2. The following is added to Paragraph 2-a.(1) of SECTION II - WHO IS AN INSURED: Paragraph (1)(d) above does not apply to "bodily injury" arising out of providing or fall- ing to provide: (i) "Incidental medical services" by any of your "employees" who is a nurse practi- tioner, registered nurse, licensed practical nurse, nurse assistant, emergency medi- cal technician or paramedic; or (ii) First aid or "Good Samaritan services" by any of your "employees" or "volunteer workers", other than an employed or vol- unteer doctor. Any such "employees" or "volunteer workers" providing or failing to provide first aid or "Good Samaritan ser- vices" 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 busi- ness. © 2011 The Travelers Indemnity Company. All rights reserved. CG D3 16 11 11 001914 COMMERCIAL GENERAL LIABILITY 3. The following is added to Paragraph 5. of SECTION III - LIMITS OF INSURANCE: For the purposes of determining the applica- ble 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 per- son will be deemed to be one "occurrence". 4. The following exclusion is added to Para- graph 2., Exclusions, of SECTION I - COV- ERAGES - COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY: Sale Of Pharmaceuticals "Bodily injury" or "property damage" arising out of the willful violation of a penal statute or ordinance relating to the sale of pharmaceuti cals 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. "Good Samaritan services" means any emer- gency medical services for which no compen- sation is demanded or received. 6. The following is added to Paragraph 4.b., Ex- cess Insurance, of SECTION IV - COM- MERCIAL GENERAL LIABILITY CONDI- TIONS: The insurance is excess over any valid and collectible other insurance available to the in- sured, whether primary, excess, contingent or on any other basis, that is available to any of your "employees" or "volunteer workers" for "bodily injury" that arises out of providing or failing to provide "incidental medical ser- vices", first aid or "Good Samaritan services" to any person to the extent not subject to Paragraph 2.a.(1) of Section II — Who Is An insured. E. WHO IS AN INSURED — NEWLY ACQUIRED OR FORMED ORGANIZATIONS The following replaces Paragraph 4. of SECTION iI - WHO IS AN INSURED: 4. Any organization you newly acquire or form, other than a partnership, joint venture or lim- ited liability company, of which you are the sole owner or in which you maintain the ma- jority ownership interest, will qualify as a Named Insured if there is no other insurance which provides similar coverage to that or- ganization. However: a. Coverage under this provision is afforded only: (1) Until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier, if you do not report such organization in writing to us within 180 days after you acquire or form it; or 42) Until the end of the policy period, when that date is later than 180 days after you acquire or form such organization, if you report such organization in writing to us within 180 days after you acquire or form it, and we agree in writing that it will con- tinue to be a Named insured until the end of the policy period; b. Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization; and c. Coverage B does not apply to "personal in- jury" or "advertising injury" arising out of an offense committed before you acquired or formed the organization. F. WHO IS AN INSURED - BROADENED NAMED 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 Declara- tions is a Named Insured if you maintain an own- ership interest of more than 50% in such subsidi- ary on the first day of the policy period. No such subsidiary is an insured for "bodily injury" or "property damage" that occurred, or "personal Injury" or "advertising injury" caused by an of- fense committed after the date, if any, during the policy period, that you no longer maintain an ownership interest of more than 50% in such sub.- sidiary. CGD3161111 © 2011 The Travelers Indemnity Company. All rights reserved. Page 3 of 6 COMMERCIAL GENERAL LIABILITY .sue mos mow JIM » 0= mem 0111114 G. BLANKET ADDITIONAL INSURED — OWNERS, MANAGERS OR LESSORS OF PREMISES The following Is added to SECTION II — WHO IS AN INSURED: Any person or organization that is a premises owner, manager or lessor and that you have agreed in a written contract or agreement to in- clude as an additional insured on this Coverage Part is an insured, but only with respect to liability for "bodily injury", "property damage", "personal injury" or"advertising injury" that: a. Is "bodily injury" or "property damage" that occurs, or is "personal injury" or "advertising injury" caused by an offense that is commit- ted, subsequent to the execution of that con- tract or agreement; and b. Arises out of the ownership, maintenance or use of that part of any premises leased to you. The insurance provided to such premises owner, manager or lessor is subject to the following pro- visions: a. The limits of insurance provided to such premises owner, manager or lessor will be the minimum limits which you agreed to pro- vide in the written contract or agreement, or the limits shown on the Declarations, which- ever are less, b. The insurance provided to such premises owner, manager or lessor does not apply to: (1) Any "bodily injury" or "property damage" that occurs, or "personal injury" or "adver- tising injury" caused by an offense that is committed, after you cease to be a tenant in that premises; or (2) Structural alterations, new construction or demolition operations performed by or on behalf of such premises owner, lessor or manager. c. The insurance provided to such premises owner, manager or lessor is excess over any valid and collectible other insurance available to such premises owner, manager or lessor, whether primary, excess, contingent or on any other basis, unless you have agreed in the written contract or agreement that this in- surance must be primary to, or non- contributory with, such other insurance, in which case this insurance will be primary to, and non-contributory with, such other insur- ance. Page 4 of 6 H. BLANKET ADDITIONAL INSURED - LESSORS OF LEASED EQUIPMENT The following is added to SECTION II — WHO IS AN INSURED: Any person or organization that is an equipment lessor and that you have agreed in a written con- tract or agreement to include as an insured on this Coverage Part is an insured, but only with re- spect to liability for "bodily injury", "property dam- age", "personal injury" or "advertising injury" that: a. Is "bodily injury" or "property damage" that occurs, or is "personal injury" or "advertising injury" caused by an offense that is commit- ted, subsequent to the execution of that con- tract or agreement; and b. Is caused, in whole or in part, by your acts or omissions in the maintenance, operation or use of equipment leased to you by such equipment lessor. The insurance provided to such equipment lessor is subject to the following provisions: a. The limits of insurance provided to such equipment lessor will be the minimum limits which you agreed to provide in the written contract or agreement, or the limits shown on the Declarations, whichever are less. b. The insurance provided to such equipment lessor does not apply to any "bodily injury" or "property damage" that occurs, or "personal injury" or "advertising injury" caused by an of- fense that is committed, after the equipment lease expires. c. The insurance provided to such equipment lessor is excess over any valid and collectible other insurance available to such equipment lessor, whether primary, excess, contingent or on any other basis, unless you have agreed in the written contract or agreement that this insurance must be primary to, or non-contributory with, such other insurance, in which case this insurance will be primary to, and non-contributory with, such other In- surance. I. BLANKET ADDITIONAL INSURED — STATES OR POLITICAL SUBDIVISIONS — PERMITS The following is added to SECTION II — WHO IS AN INSURED: Any state or political subdivision that has issued a permit in connection with operations performed by you or on your behalf and that you are required O 2011 The Travelers Indemnity Company. All rights reserved CG D3 16 11 11 001916 COMMERCIAL GENERAL LIABILITY by any ordinance, law or building code to include as an additional insured on this Coverage Part is an insured, but only with respect to liability for "bodily injury", "property damage", "personal in- jury" or "advertising injury" arising out of such op- erations. The insurance provided to such state or political subdivision does not apply to: a. Any "bodily injury," "property damage," "per- sonal injury" or "advertising injury" arising out of operations performed for that state or po- litical subdivision; or b. Any "bodily injury" or "property damage" in- cluded in the "products -completed operations hazard". J. KNOWLEDGE AND NOTICE OF OCCUR- RENCE OR OFFENSE The following is added to Paragraph 2., Duties In The Event of Occurrence, Offense, Claim or Suit, of SECTION IV - COMMERCIAL GEN- ERAL LIABILITY CONDITIONS: e. The following provisions apply to Paragraph a. above, but only for the purposes of the in- . surance provided under this Coverage Part to you or any insured listed in Paragraph 1. or 2. of Section II — Who Is An Insured: (1) Notice to us of such "occurrence" or of- fense must be given as soon as practica- ble only after the "occurrence" or offense is known by you (if you are an individual), any of your partners or members who is an individual (if you are a partnership or joint venture), any of your managers who is an individual (if you are a limited liability company), any of your "executive offi- cers" or directors (if you are an organiza- tion other than a partnership, joint venture or limited liability company) or any "em- ployee" authorized by you to give notice of an "occurrence" or offense. (2) If you are a partnership, joint venture or limited liability company, and none of your partners, joint venture members or man- agers are individuals, notice to us of such "occurrence" or offense must be given as soon as practicable only after the "occur- rence" or offense is known by: (a) Any individual who is: (i) A partner or member of any part- nership or joint venture; (3) (ii) A manager of any limited liability company; or (iii) An executive officer or director of any other organization; that is your partner, joint venture member or manager; or (b) Any "employee" authorized by such partnership, joint venture, limited li- ability company or other organization to give notice of an "occurrence" or offense. Notice to us of such "occurrence" or of an offense will be deemed to be given as soon as practicable if it is given in good faith as soon as practicable to your work- ers' compensation insurer. This applies only if you subsequently give notice to us of the "occurrence" or offense as soon as practicable after any of the persons de- scribed in Paragraphs e. (1) or (2) above discovers that the "occurrence" or offense may result in sums to which the insurance provided under this Coverage Part may apply. However, if this Coverage Part includes an en- dorsement that provides limited coverage for "bodily injury" or "property damage" or pollution costs arising out of a discharge, release or es- cape of "pollutants" which contains a requirement that the discharge, release or escape of "pollut- ants" must be reported to us within a specific number of days after its abrupt commencement, this Paragraph e. does not affect that require- ment. K. UNINTENTIONAL OMISSION The following is added to Paragraph 6., Repre- sentations, of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS: The unintentional omission of, or unintentional error in, any information provided by you which we relied upon in issuing this policy will not preju- dice your rights under this insurance. However, this provision does not affect our right to collect additional premium or to exercise our rights of cancellation or nonrenewal in accordance with applicable insurance laws or regulations. L. 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 LI- ABILITY CONDITIONS: CG D3 16 11 11 © 2011 The Travelers Indemnity Company. All rights reserved Page 5 of 6 COMMERCIAL GENERAL LIABILITY If the insured has agreed in a contract or agree- ment to waive that insured's right of recovery against any person or organization, we waive our right of recovery against such person or organiza- tion, but only for payments we make because of: a. "Bodily injury" or "property damage" that oc- curs; or b. "Personal injury" or "advertising injury" caused by an offense that is committed; subsequent to the execution of that contract or agreement. M. AMENDED BODILY INJURY DEFINITION The following replaces the definition of "bodily injury" in the DEFINITIONS Section: 0= CCSCEE o= OmerirMEM Z MEM a_ e= a� .a Page 6 of 6 3. "Bodily injury" means bodily injury, mental anguish, mental injury, shock, fright, disability, humiliation, sickness or disease sustained by a person, including death resulting from any of these at any time. N. CONTRACTUAL LIABILITY — RAILROADS 1. The following replaces Paragraph c. of the definition of "insured contract" in the DEFINI- TIONS Section: c. Any easement or license agreement; 2. Paragraph f.(1) of the definition of "insured contract" in the DEFINITIONS Section is de- leted. © 2011 The Travelers Indemnity Company. All rights reserved. CG D3 16 11 11 001010 POLICY NUMBER: DTCOOJ73000517PHX 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 hmit 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. b. c. Insureds; Claims made or "suits" brought; or Persons or organizations making claims or bringing "suits". CG D2 11 01 04 Designated Project General Aggregate(s): GENERAL AGGRE GATE 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: Copyright, The Travelers Indemnity Company, 2004 Page 1 of 2 COMMERCIAL GENERAL 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- • s mmwmm o= t!r I Page 2 of 2 00102 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. 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 With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by the endorsement. 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 COVERAGE - 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 — LIABILITY COV- ERAGE: 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 - 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 H. HIRED AUTO PHYSICAL DAMAGE - LOSS OF USE - INCREASED LIMIT I. PHYSICAL DAMAGE - TRANSPORTATION EXPENSES - INCREASED LIMIT J. PERSONAL EFFECTS K. AIRBAGS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS M. BLANKET WAIVER OF SUBROGATION N. UNINTENTIONAL ERRORS OR OMISSIONS 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 Liability Cover- age, but only for damages to which this insurance applies and only to the extent that person or or- ganization qualifies as an "insured" under the Who Is An Insured provision contained in Section II. C. EMPLOYEE HIRED AUTO 1. The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — LI- ABILITY COVERAGE: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in that "employee's" name, with your permission, while performing duties related to the conduct of your busi- ness. CA T3 53 06 09 © 2009 The Travelers Companies, Inc. Page 1 of 4 Includes the copyrighted material of Insurance Services Office, Inc. with its permission. COMMERCIAL AUTO 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 that individual "employee's" name, with your permission, while perform- ing 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". D. EMPLOYEES AS INSURED The following is added to Paragraph AA., Who Is An Insured, of SECTION II — LIABILITY COV- ERAGE: Any "employee" of yours is an "insured" while us- ing a covered "auto" 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 — LIABILITY 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 — LIABILITY 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 e. in Para- graph 8.7., Policy Term, Coverage Territory, of SECTION IV - BUSINESS AUTO CONDITIONS: e. Anywhere in the world, except any country or jurisdiction while any trade sanction, em- bargo, or similar regulation imposed by the Page 2 of 4 United States of America applies to and pro- hibits the transaction of business with or within such country or jurisdiction, for Liability Coverage for any covered "auto" that you 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 from any of your "employees", partners (if you are a partnership), members (if you are a limited liability company) or members of their house- holds. (1) 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: (a) You must arrange to defend the "insured" against, and investigate or settle any such claim or "suit" and keep us advised of all pro- ceedings and actions. (b) Neither you nor any other in- volved "insured" will make any settlement without our consent. (c) We may, at our discretion, par- ticipate in defending the "insured" against, or in the settlement of, any claim or "suit". (d) We will reimburse the "insured": (I) For sums that the "insured" legally must pay as damages because of "bodily injury" or "property damage" to which this insurance applies, that the "insured" pays with our consent, but only up to the limit described in Paragraph C., Limit Of Insurance, of SECTION H — LIABILITY COVERAGE; (Ii) For the reasonable expenses incurred with our consent for your investigation of such claims and your defense of the "insured" against any such "suit", but only up to and included within the limit de- scribed in Paragraph C., Limit Of Insurance, of SECTION II — LIABILITY COVERAGE, © 2009 The Travelers Companies, Inc. CA T3 53 06 09 Includes the copyrighted material of Insurance Services Office, Inc. with its permission. COMMERCIAL AUTO 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. (2) This insurance is excess over any valid and collectible other insurance available to the "insured" whether primary, excess contingent or on any other basis. 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. 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. (4) 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". (3) CA T3 53 06 09 I. PHYSICAL DAMAGE - TRANSPORTATION EXPENSES - INCREASED LIMIT The following replaces the first sentence in Para- graph A.4,a., Transportation Expenses, of SEC- TION III — PHYSICAL DAMAGE COVERAGE: 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 EFFECTS The following is added to Paragraph A.4., Cover- age Extensions, of SECTION III - PHYSICAL DAMAGE COVERAGE: Personal Effects We will pay up to $400 for "loss" to wearing ap- parel and other personal effects which are: (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 Effects 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); © 2009 The Travelers Companies, Inc. Page 3 of 4 Includes the copyrighted material of Insurance Services Office, Inc. with its permission. COMMERCIAL AUTO (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 - Page 4 of 4 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 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: 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. © 2009 The Travelers Companies, Inc. CA T3 53 06 09 Includes the copyrighted material of Insurance Services Office, Inc. with its permission. PINNACOL 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:January 26, 2018 Expires on: February 1, 2019 Pinnacol Assurance has issued this endorsement January 26, 2018 750" E Lowry Blvd Denver, CO 80230-7006 Page 1 of + P PIEHLA ineerwriter 26;2 X18 08 25 2 4055760 50847>>42 359-B UMBRELLA THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS This endorsement modifies insurance provided under the following: COMMERCIAL EXCESS LIABILITY (UMBRELLA) INSURANCE The following is added to Paragraph 11., OUR RIGHT TO RECOVER FROM OTHERS., of SECTION IV — 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: UM 04 88 07 08 a. "Bodily injury" or "property damage" caused by an "occurrence" that takes place; or b. "Personal injury" or "advertising injury" caused by an "offense" that is committed; subsequent to the execution of the contract or agree- ment. © 2008 The Travelers Companies, Inc. Page 1 of 1 Includes the copyrighted material of Insurance Services Office, Inc. with its permission UMBRELLA (3) Any statute, ordinance or regulation relat- ing to the sale, gift, distribution or use of alcoholic beverages. This exclusion applies only if you are in the business of manufacturing, distributing, sell- ing, serving or furnishing alcoholic beverages. . This exclusion does not apply to "bodily in- jury" or "property damage" to which any policy of "underlying insurance" listed in the SCHEDULE OF UNDERLYING INSURANCE of the DECLARATIONS of this insurance, or any renewal or replacement thereof, applies or would apply but for the exhaustion of its limits of liability. Coverage provided will follow the same provisions, terms, definitions, ex- clusions, limitations and conditions of the pol- icy(ies) of "underlying insurance" listed in the SCHEDULE OF UNDERLYING INSURANCE of the DECLARATIONS of this insurance. SECTION II - WHO IS AN INSURED. 1. If you are designated in the Declarations as: a. An individual, you and your spouse are insur- eds, but only with respect to the conduct of a business of which you are the sole owner. b. A partnership or joint venture, you are an in- sured. Your members, your partners, and their spouses are also insureds, but only with respect to the conduct of your business. c. A limited liability company, you are an in- sured. Your members are also insureds, but only with respect to the conduct of your busi- ness. Your managers are insureds, but only with respect to their duties as your managers. d. An organization other than a partnership, joint venture or limited liability company, you are an insured. e. A trust, you are an insured. Your trustees are also insureds, but only with respect to their duties as trustees. 2. Each of the following is also an insured: a. As respects the "auto hazard": (1) Anyone using an "auto" you own, hire or borrow including any person or organiza- tion legally responsible for such use pro- vided it is with your permission; and (2) Any of your executive officers, directors, partners, employees or stockholders, op- erating an "auto" you do not own, hire or Page 6 of 13 borrow while it is being used in your busi- ness. None of the following is an insured under (1) or (2) above: (a) Any person employed by or engaged in the duties of an auto sales agency, repair shop, service station, storage garage or public parking place that you do not operate; (b) The owner or lessee of any "auto" hired by or for you or loaned to you, and any agent or employee of such owner or lessee. b. Except as respects the "auto hazard": (1) Your executive officers, employees, direc- tors or stockholders while acting within the scope of their duties; and (2) Any person or organization while acting as real estate manager for you. c. Any organization you newly acquire or form, other than a partnership or joint venture, and over which you maintain ownership or major- ity interest, will be deemed to be a Named In- sured. However, coverage does not apply to: (1) "Bodily injury" or "property damage" that occurred before you acquired or formed the organization; and (2) "Personal injury" or "advertising injury" arising out of an "offense" committed be- fore you acquired or formed the organiza- tion. d. Any person or organization having proper temporary custody of your property if you die, but only: (1) With respect to liability arising out of the maintenance or use of that property; and (2) Until your legal representative has been appointed. e. Your legal representative if you die, but only with respect to duties as such. That represen- tative will have all your rights and duties un- der this insurance. f. Any other person or organization insured un- der any policy of the "underlying insurance" listed in the SCHEDULE OF UNDERLYING INSURANCE of the DECLARATIONS of this insurance for whom you have agreed in a written contract executed prior to loss to pro- vide insurance. This insurance is subject to all Copyright, The Travelers Indemnity Company, 2003 UM 00 01 11.03 UMBRELLA the limitations upon coverage under such pol- icy of "underlying insurance", and, the limits of insurance afforded to such person or or- ganization will be: (I) The difference between the "underlying insurance" limits and the minimum limits of insurance which you agreed to provide; or (ii) The limits of insurance of this policy whichever is less. If the minimum limits of insurance you agreed to provide such person or organization in a written contract are wholly within the "underly- ing insurance", this policy shall not apply. No person or organization is an insured with re- spect to the conduct of any current or past part- nership or joint venture that is not shown as a Named Insured in the Declarations. No person is an insured as respects "bodily in- jury" to a fellow employee unless insurance for such liability is afforded by the "underlying insur- ance". SECTION III - LIMITS OF INSURANCE. 1. The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay re- gardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". 2. The Products -Completed Operations Aggregate Limit is the most we will pay under Coverage A for damages because of injury and damage in- cluded in the "products -completed operations hazard". 3. The General Aggregate Limit is the most we will pay for damages under Coverage A and Cover- age B, except: a. Damages because of injury and damage in- cluded in the "products -completed operations hazard"; and b. Damages because of injury and damage in- cluded in the "auto hazard". 4. Subject to 3. above, the Personal and Advertising Injury Limit is the most we will pay under Cover- age B for the sum of all damages because of all "personal injury" and all "advertising injury" sus- tained by any one person or organization. Non cumulation of Personal and Advertising In- jury Limit — If "personal injury" and/or "advertising injury" is sustained by any one person or organi- zation during the policy period and during the pol- icy period of one or more prior and/or future poli- cies that include a COMMERCIAL EXCESS LIABILITY (UMBRELLA) INSURANCE policy for the insured issued by us or any affiliated insur- ance company, the amount we will pay is limited. This policy's Personal and Advertising Injury Limit will be reduced by the amount of each payment made by us and any affiliated insurance company under the other policies because of such "per- sonal injury" and/or "advertising injury". 5. Subject to 2. or 3. above, whichever applies, the Each Occurrence Limit is the most we will pay for the sum of damages under Coverage A because of all "bodily injury" and "property damage" arising out of any one "occurrence". Non cumulation of Each Occurrence Limit — If one "occurrence" causes "bodily injury" and/or "prop- erty damage" during the policy period and during the policy period of one or more prior and/or fu- ture policies that include a COMMERCIAL EX- CESS LIABILITY (UMBRELLA) INSURANCE policy for the insured issued by us or any affiliated insurance company, the amount we will pay is limited. This policy's Each Occurrence Limit will be reduced by the amount of each payment made by us and any affiliated insurance company under the other policies because of such "occurrence". To determine the limit of our liability, all "bodily injury" and "property damage" arising out of continuous or repeated exposure to the same general conditions shall be considered one "occurrence". The limits of this insurance apply separately to each consecutive annual period and to any remaining period of less than 12 months. The policy period begins with the effective date shown in the Declara- tions. If the policy period is extended after issuance for an additional period of less than 12 months, the additional period will be deemed part of the last preceding period. SECTION IV — CONDITIONS. 1. APPEALS. a. If the insured or the insured's "underlying in- surer" elects not to appeal a judgment which exceeds the "applicable underlying limit", we may do so. b. If we do, we will pay all costs of the appeal. We will also pay all costs on appeals related UM 00 01 11 03 Copyright, The Travelers Indemnity Company, 2003 Page 7 of 13 NOTICE OF AWARD PROJECT: SLURRY SEAL AND SAND SEAL 2018 To: John Johnson A-1 Chipseal Company 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 2018 construction season. The contract is a one year commitment with the option of renewal for up to two additional years. The project, 2018 Slurry seal and Sand Seal, in general consists of: -Crack sealing 5 tons in parking lots. (County to supply material) -Sand Seal 19,100 SY -Slurry Seal 457,000 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 $944,065.50 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 13th day of June, 2018 Weld County, Colorado, Ovyner By: I/ Josh Holbrook, Construction Inspection Supervisor ACCEPTANCE OF NOTICE Receipt of the above Notice of Award is hereby acknowledged by i p5QAI C'0 Dated tii \10( By: day of (Contractor) .-11)JAL mac. Title: --Pc-e6k a , 2018 BID NO. B1801 070 Page - 25 - MEMORANDUM TO: Jay McDonald, Public Works Director DATE: May 29, 2018 FROM: Joshua Holbrook, Construction Inspection Supervisor SUBJECT: Recommendation Letter for the 2018 Slurry Seal and Sand Seal Contract Bid No. B 1800070 Bids were received and opened on May 29, 2018 for the 2018 Slurry Seal and Sand Seal Contract. Two bids were received for the project, and the amounts ranged from $944,065.50 to $1,220,087.00. The lowest bid was submitted by A-1 Chipseal & Rocky Mountain Pavement of Denver, CO. Therefore, it is staff's recommendation to award the project to A-1 Chipseal & Rocky Mountain Pavement for a total amount of $944,065.50. This amount is within the 20].8 allotted budget for Slurry and Sand Seal. Work is expected to begin in July and remain in effect for the allotted contract time of 84 days. Please sign below if you agree with staff's recommendation X Jay McDonald Public Works Director Attachments: 2018 bid tab pc: Rob Turf, Purchasing Manager Elizabeth Relford, Deputy Director Curtis Hall, Deputy Director Don Dunker, County Engineer Rose Everett, Purchasing Mona Weidenkeller, Office Tech IV / Payable / Receivable M:\Maintenance Contracts\Slurry Seal -Sand Seal-Rejuvenator\20I8\Contract Doc's\Bids goIS- ICoac? e&0075 BID REQUEST NO. B1800070 2018 SEAL COAT PROGRAM BID TAB INO DESCRIPTION UNIT FLAN QUANTITY UNIT PRICE COST UNIT PRICE COST -.. .. A-1 Chip Seal .. ..... - -� Vanes Brothers 408 PLACE RUBBERIZED CRACK FILLER & TRAFFIC CONTROL (Weld County to supply material) TON 5 $3,500.00 $17,500.00 $4,700.00 $23,500.00 409 SAND SEAL SQYD 19,100 $1.35 $25,785.00 $1.35 $25,785.00 409 SLURRY SEAL SQYD 457,000 $1.81 $827,170.00 $2.32 $1,060,240.00 627 PAVEMENT MARKINGS (Parking lot only) GAL 23 $113.50 $2,610.50 $94.00 $2,162.00 630 SIGNING & TRAFFIC (Sand Seal) PER LOCATION 4 $250.00 $1,000.00 $2,700.00 $10,800.00 630 SIGNING & TRAFFIC (Slurry Seal) MILE 28 $2,000.00 $56,000.00 $2,950.00 $82,600.00 630 MHT & TRAFFIC CONTROL FOR CDOT INTERSECTIONS EACH 4 $2,250.00 $9,000.00 $2,500.00 $10,000.00 700 F/A MINOR CONTRACT REVISIONS 1 $5,000.00 $5,000.00 944,065.50 'No Errors 'No Errors DATE OF BID: MAY 29, 2018 REQUEST FOR: SLURRY SEAL & SAND SEAL DEPARTMENT: PUBLIC WORKS DEPT BID NO: #B1800070 PRESENT DATE: MAY 30, 2018 APPROVAL DATE: JUNE 13, 2018 VENDOR A-1 CHIPSEAL CO 2505 E. 74TH AVENUE DENVER CO 80229 VANCE BROTHERS INC 380 W. 62ND AVENUE DENVER CO 80216 PUBLIC WORKS WILL REVIEW THE BIDS. WELD COUNTY PURCHASING 1150 O Street Room 107, Greeley CO 80631 E -Mail: reverett(c�weldgov.com E-mail: cmpeters(a weldgov.com Phone: (970) 400-4222 & 400-4223 Fax: (970) 304-6434 TOTAL PRICE $ 944,065.50 $1,220,087.00 0208- 1lpg9 /3D Hello