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Home My WebLink About20195155.tiffeoyikAct 4-ga9;t. DEPARTMENT OF BUILDINGS AND GROUNDS PHONE: (970) 304-6531 FAX: (970) 304-6532 WEBSITE: www.co.weld.co.us 1105 H STREET P.O. BOX 758 GREELEY, COLORADO 80632 December 20, 2019 To: Board of County Commissioners From: Toby Taylor Subject: Missile Site Concrete Recommendation Repairs to specific areas of concrete at the Missile Site Park were pursued through the informal bid process. The low bid is from Trujillo Concrete and meets specifications. Therefore, Buildings & Grounds is recommending award to Trujillo Concrete. for $18,160.00. If you have any questions, please contact me at extension 2023. Sincerely, Toby Taylor Director den,m.1 a /a-023-, CG; `1P -AA -°'4"136. 2019-5155 g&0021 /p AGREEMENT FOR PROFESSIONAL SERVICES BETWEEN WELD COUNTY & TRUJILLO CONCRETE MISSILE SITE CONCRETE DRAINAGE REPAIR THIS AGREEMENT is made and entered into this 2. ( day of A)we. c 4&r , 201,, 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 Trujillo Concrete and Building whose address is 4331 W 14th Street Greeley, CO 80634, hereinafter referred to as "Contract Professional". WHEREAS, County requires an independent contractor to perform the services required by County and set forth in Exhibits A and B; and WHEREAS, Contractor is willing to perform and has the specific ability to perform the required 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 arc 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 Bare 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). The RFB contains all of the specific requirements of County. Exhibit B consists of Contractor's Response to County's Request for Bid. The Response confirms Contractor's obligations under this Agreement. 2. Service or Work. Contractor agrees to procure the materials, equipment and/or products necessary for the Project and agrees to diligently provide all services, labor, personnel and materials necessary to perform and complete the Project described in Exhibits A and B which is attached hereto and incorporated herein by reference. 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. 3. Term. The term of this Agreement begins upon the date of the execution of this Agreement 446,/9-50" 6&p0021 by County, and shall continue through and until Contractor's completion of the responsibilities described in Exhibits A and B. Both of the parties to this Agreement understand and agree that the laws of the State of Colorado prohibit County from entering into Agreements which bind County for periods longer than one year. Therefore, within the thirty (30) days preceding the anniversary date of this Agreement, County shall notify Contractor if it wishes to renew this Contract. 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. 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. 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. 6. Compensation/Contract Amount. Upon Contractor's continued successful completion of the work, and County's acceptance of the same, County agrees to pay an amount no greater than $18,160.00, 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 Weld County, 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 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. 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. 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. 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 the services performed under this Agreement will be performed in a manner consistent with the standards governing such services and the provisions of this Agreement. Contractor further represents and warrants that all services shall be performed by qualified personnel in a professional and workmanlike manner, consistent with industry standards, and that all services will conform to applicable specifications. 12. Acceptance of Services Not a Waiver. 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. Acceptance by the County of, or payment for, the services 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 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 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 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. This paragraph shall survive expiration or termination hereof. Types of Insurance: The Contractor/Contract Professional shall obtain, and maintain at all times during the term of any Agreement, insurance in the following kinds and amounts: Workers' Compensation Insurance as required by state statute, and Employer's Liability Insurance covering all of the Contractor's 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. Commercial General Liability Insurance with the minimum limits as follows: $1,000,000 each occurrence; $2,000,000 general aggregate; $2,000,000 products & completed operations aggregate; $1,000,000 personal advertising injury 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. 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 an duly authorized representative of County, including the County Auditor, shall have access to and the right to examine and audit any books, documents, papers and records of Contractor, involving all matters and/or transactions related to this Agreement. 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, 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, Toby Taylor, Weld County Director of Buildings and Grounds. Either party may change its notice address(es) by written notice to the other. Notification Information: Contractor: Trujillo Concrete and Building Attn: Mike Trujillo -owner Address: 4331 W. 14th St. Address: Greeley, CO 80634 E-mail: N/A Telephone: (970) 405-3760 County: Name: Toby Taylor Position: Director of Buildings and Grounds Address: 1105 H Street, Greeley, CO 80632 Address: PO Box 758 E-mail: ttaylor(weldgov.com Facsimile: 970.304.6532 18. Compliance with Law. Contractor shall strictly comply with all applicable federal and State laws, rules and regulations in effect or hereafter established, including without limitation, laws applicable to discrimination and unfair employment practices. 19. Non -Exclusive Agreement. This Agreement is nonexclusive and County may engage or use other Contractors or persons to perform services of the same or similar nature. 20. Entire Agreement/Modifications. This Agreement including the Exhibits attached hereto and incorporated herein, contains the entire agreement between the parties with respect to the subject matter contained in this Agreement. This instrument supersedes all prior negotiations, representations, and understandings or agreements with respect to the subject matter contained in this Agreement. This Agreement may be changed or supplemented only by a written instrument signed by both parties. 21. Fund Availability. Financial obligations of the County payable after the current fiscal year are contingent upon funds for that purpose being appropriated, budgeted and otherwise made available. Execution of this Agreement by County does not create an obligation on the part of County to expend funds not otherwise appropriated in each succeeding year. 22. Employee Financial Interest/Conflict of Interest — C.R.S. §§24-18-201 et seq. and §24- 50-507. The signatories to this Agreement state that to their knowledge, no employee of Weld County has any personal or beneficial interest whatsoever in the service or property which is the subject matter of this Agreement. 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 or 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 an new employee to perform work under the contract, affirm that Contractor has examined the legal work status of such employee, retained file copies of the documents, and not altered or falsified the identification documents for such employees. Contractor shall deliver to County, a written notarized affirmation that it has examined the legal work status of such employee, and shall comply with all of the other requirements of the State of Colorado program. If Contractor fails to comply with any requirement of this provision or of C.R.S. §8-17.5-101 et seq., County, may terminate this Agreement for breach, and if so terminated, Contractor shall be liable for actual and consequential damages. Except where exempted by federal law and except as provided in C.R.S. § 24-76.5-103(3), if Contractor receives federal or state funds under the contract, Contractor must confirm that any individual natural person eighteen (18) years of age or older is lawfully present in the United States pursuant to C.R.S. § 24-76.5-103(4), if such individual applies for public benefits provided under the contract. If Contractor operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it: (a) is a citizen of the United States or is otherwise lawfully present in the United States pursuant to federal law, (b) shall produce one of the forms of identification required by C.R.S. § 24-76.5-101, et seq., and (c) shall produce one of the forms of identification required by C.R.S. § 24-76.5-103 prior to the effective date of the contract. 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. I WITNESS WHEREOF, the parties hereto have signed this Agreement this 12t -r , 2012. CONTRACTOR: Truiillo Concrete and Building By: Name: Title: day of Date 021 /(%, Lr rae,Y`? \to WELD T: G..1I /W,/ �/• •K ATTEST: ,��jj'' Weld Cty lerk to the BY: Deputy Cler to th BOARD OF COUNTY COMMISSIONERS ELD COUNTY, OLORADO arbara Kirkmeye , Chair EC 2 3 2019 „a/9-5/65 Weld County Missile Site Concrete Repairs Exhibit A SCOPE OF WORK: This is a request for bid to provide site drainage improvements through selectively reconfiguring existing concrete flatwork and grades at the Weld County Missile Site Park located at 10611 CO - 257 Spur, Greeley, Colorado. The following is a list of major scope activities. 1. Add topping slabs with 3,500psi entrained concrete to low areas, enabling positive drainage away from site. 2. Field measurements and actual quantities will be the Contractor's responsibility. 3. Selective demolition of concrete may be required in some areas. 4. Hours for construction may occur between 7:00am — 3:30pm, Monday — Friday. Off - hours work is permitted when coordinated with the Owner. 5. A Weld County permit is not anticipated for this project. 6. Installation shall meet all applicable building codes. 7. Davis -Bacon and Buy American requirements are NOT required. S. Contractor parking, waste removal and material laydown outside the structure is limited. Contractor to coordinate minimum needs with Owner. 9. Weld County is a tax-exempt entity. 10. Contractor will be required to enter into a contract for this service. Total $ Start Date _ Finish Date LX. Trujillo Concrete and Building 4331 W 14th Street Road o Greeley, CO 80634 (970) 405-3760 or (970) 518-5730 Submitted to: Weld County- Attn: Sterling Phone: (970) 518-2808 Date: September Geesaman 30, 2019 Street: 1105 H Street Job Name: Missile Site Park City, State, and Zip Code: Greeley, CO Job Location: 10611 CO -257 Spur 80632 Architect: Job Phone: We hereby submit specifications and estimate for: Installation of: Forming, pouring, & finishing concrete. Cure for the concrete and competition of Inspections... • 10'x25'x8" • 8'x11'x8" • 5'x9'x6" • 7'x6'x6" • 7'x6'x6" • 4'x12'x6" • 7'x13'x6" • 7'x13'x6" + 9'x13'x6" • 13'x4'x6" • 10'x12'X6" • 4'x4'x6" Cap All Labor and Materials: $18,160.00 We Propose hereby to furnish materials and labor - completed in accordance with the above specifications for the sum of : Eighteen Thousand One Hundred and Sixty Dollars and Zero Cents ( $18,160.00). Authorized Signature: -i 60 Date: September 30th, 2019 `CCPR 1 . A aaa__`_ iJ CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 11/19/2019 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. H SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Cake Insure 1624 Market St, Ste 226, #63440 Denver, CO 80202-5926 CONTACT NAME: PHONE FAX (A/C, No. Ent: (A/C, Nol: E-MAIL supportcicakeinsure.com ADDRESS: INSURER(S)AFFORDINGCOVERAGE NAIL= INSURER A: Pinracol Assurance 41190 INSURED Trujillo Concrete LLC 4331 W 14th St Greeley, CO 80634 INSURERB: INSURERC: INSURER 0: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE INSSDD SUBR WV POLICY NUMBER (M�Ii/OD YYYY) (MM UCYD UMITS COMMERCIAL GENERAL LIABIUTY ( ° i EACH OCCURRENCE $ I DAMAGE TO RENTED L PREMISES (Ea occurrence) $ CLAIMS -MADE iI OCCUR r� MED EXP (Any one persons $ l PERSONAL & ADV INJURY $ I: ENERAL AGGREGATE $ GE AGGREGATE LIMIT APPLIES ! 'E T � PER: LOC PRODUCTS - COMP/OP AGG $ t $ AUTOMOBILE LIABILITY ANY AUTO OWNED ^ SCHEDULED AUTOS NON -OWNED AUTOS ONLY 4 ff i j COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ I BODILY INJURY (Per accident) $ I PROPERTY DAMAGE per accident) $ UMBRELLA LIAB EXCESS LIAB I OCCUR 1 CLAIMS -MADE i EACH OCCURRENCE $ I AGGREGATE $ I $ DEC RETENTION S A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETORlPARTNER/EXECUTIVE OFFICER/MEMBEREXCLUOED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y/N Y N/A= I 2502504 03/22/2019 a I X 1 PER I 0TH - STATUTE I ER '' E.L. EACH ACCIDENT $ 1,000,000 03/22/2020 i i E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 $ r � i DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, AddItIonal Remarks Schedule, may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION Weld County Government 1105 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 Shannon Lyle Quality and Compliance ACORD 25 (2016/03) tI 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD a002M00000vKmK5QAK CERTIFICATE HOLDER COPY Weld County Government IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. a OO2MOOOOOvKmK5QAK AC RIJ CERTIFICATE OF LIABILITY INSURANCE DA ilsrza�s ' 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 INSURERS), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER MIKE DEUTCHER STATE FARM 2324 23RD AVE. GREELEY, CO 60634 CONTACT NAME: PH970-330-1000 No. EMI; 970-330-1000 J FAX (ac, No?: 970-330-2222 E.MAILADDRE53: — INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: State Farm Mutual Automobile Insurance Company 25178 INSURED JERRY & JUNE TRUJILLO 4331 W 14TH STREET RD OREELEY,CO 80634-2400 INSURER B: INSURER c : INSURER 0 : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES_ LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INS° SUER WYE POLICY NUMBER POLICY EFF LMM104fYYYYt POLICY EXP troMIPDIYYYYI LIMITS COMMERCIAL GENERAL LIABILITY I EACH OCCURRENCE 5 CLAIMS -MADE I ! OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) S MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE ' $ PRODUCTS $ $ AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY SCHEDULED AUTOS NON -OWNED AUTOS ONLY 227 9924 —A02 -06C 07/02/2019 01/02/2020 01102/2020 07/02/2020 COaMBINdEDentSINGLE LIMIT {Eacci) BODILY INJURY (Per person) $ 1,000,000 BODILY INJURY (Per accident) $ 1,000,000 PROPERTY DAMAGE (Per accident) $ 1,000,000 $ i UMBRELLA LIAB EXCESSLIARCLAIMS-MADE _ OCCUR EACH OCCURRENCE S AGGREGATE , $ IDED , RETENTIONS I $ WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below YIN N IA r PER 1 6TH- STATUTE J ER E,L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE, $ E DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES IACORO 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION WELD COUNTY GOVERNMENT ACORD 26 (2016/03) 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 r, p U @1988.201$ ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 1001496 132849.12 03-18-2016 ACORD® CERTIFICATE OF LIABILITY INSURANCE `„. / DATE (MM/DD/YYYY) 11/18/2019 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 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 Kersey Insurance & Investments PO Box 555 Kersey CO 80644 CONTACT NAME: Nikki Michalik PaCNNo, Ext): 9703534660 I (A//CC, No): E-MAIL ADDRESS: insurance.com kerse ADDRESS: niklci@kerseyinsurance.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : SECURITY NAIL INS CO 19879 INSURED Trujillo Concrete Lie 4331 W 14th St Greeley CO 80634 INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE AUULSUOK INSD WVD POLICY NUMBER POLICY ❑I+F (MM/DD/YYYY) POLK.Y EXP (MM/DD/YYYY) LIMITS A K COMMERCIAL GENERAL LIABILITY NA167095000 03/29/2019 03/29/2020 EACH OCCURRENCE $ 1,000,000 PREMISES (Ea occurrence) $ 100,000 ICLAIMS -MADE x OCCUR MED EXP (My one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L x AGGREGATE POLICY OTHER: K LIMIT APPLIES PRO - JECT PER: LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ AUTOMOBILE - - LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY - - SCHEDULED AUTOS NON -OWNED AUTOS ONLY (,OMBINEU SINGLE LIMI I (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPER fY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAB - OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED I I RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y/ N N / A I PER STATUTE I I ERI H- E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Purchase Order P1800464 (Courthouse landscaping refresh) CERTIFICATE HOLDER CANCELLATION Weld County Dept of Buildings & Grounds 1105 H Street PO Box 758 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 MUri -S/n-M1e ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD QUOTE FORM Date 11-18-2019 Requested by_Toby Taylor Scope Of Work: Contractor Cost Missile Site Concrete Leveling Trujillo Concrete November/ December 2019 $18,160.00 RT Concrete November/ December 2019 $30,875.00 Foundations Inc. March 2020 $29,600.00 NOTES: Work Inclusions: This bid is for Leveling concrete areas at the Missile Site in order to prevent water from standing and seeping into the underground area. Work includes: 1. Preparing areas and installing material, concrete, mesh to level areas and allow for proper draining. 2. All work must be completed in a professional workmanship manner Contract Form New Contract Reques Entity Information Entity Name* TRUJILLO CONCRETE LLC Entity ID* @00041658 Contract Name* MISSILE SITE CONCRETE DRAINAGE REPAIR Contract Status CTB REVIEW New Entity? Contract ID 3292 Contract Lead* SGEESAMAN Contract Lead Email sgeesaman@co.weld.co.us Parent Contract ID Requires Board Approval YES Department Project # Contract Description* MISSILE SITE DRAINAGE IMPROVEMENTS BY SELECTIVELY RE -CONFIGURING CONCRETE FLATWORK. Contract Description 2 Contract Type* CONTRACT Amount* $18,160.00 Renewable* NO Automatic Renewal Grant EGA Department BUILDINGS AND GROUNDS Department Email CM- BuildingGrounds@weldgovco m Department Head Email ChMBuildingGrounds- DeptHead@weldgo+v.com County Attorney GENERAL COUNTY ATTORNEY EMAIL County Attorney Email CM- COUNTYATTORNEY@WELD GOV.COM Requested BOCC Agenda Date* 12/16/2019 Due Date 12/12/2019 Will a work session with BOCC be required?* NO Does Contract require Purchasing Dept. to be included? If this is a renewal enter previous Contract ID If this is part of a MSA enter MSA Contract ID Note: the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts are not in OnBase Contract Dates Effective Date Termination Notice Period Review Date* 03/30/2020 Renewal Date Committed Delivery Date Expiration Date* 03/30/2020 Contact Name Contact Type Contact Email Purchasing Purchasing Approver Approval Proces. Department Head TOBY TAYLOR OH Approved Date 12/13/2019 Final Approval 8OCC Approved 8OCC Signed Date BOCC Agenda Date Originator SGEESAMAN Contact Phone 1 Purchasing Approved Date Finance Approver BARB CONNOLLY Finance Approved Date 12/16/2019 Tyler Ref Legal Counsel BOB CHOATE Contact Phone 2 Legal Counsel Approved Date 12/17/2019 Submit Hello