HomeMy WebLinkAbout20184164.tiffRESOLUTION
RE: APPROVE AGREEMENT FOR CHILD PROTECTION SERVICES AND AUTHORIZE
CHAIR TO SIGN - JULIE SCROGGINS, P.C.
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS, the Board has been presented with an Agreement for Child Protection
Services between the County of Weld, State of Colorado, by and through the Board of County
Commissioners of Weld County, on behalf of the Department of Human Services, and
Julie Scroggins, P.C., commencing November 1, 2018, and ending May 31, 2019, with further
terms and conditions being as stated in said agreement, and
WHEREAS, after review, the Board deems it advisable to approve said agreement, a copy
of which is attached hereto and incorporated herein by reference.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld
County, Colorado, that the Agreement for Child Protection Services between the County of Weld,
State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf
of the Department of Human Services, and Julie Scroggins, P.C., be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized
to sign said agreement.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 26th day of December, A.D., 2018, nunc pro tunc November 1, 2018.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
ATTEST: _46%6.
Weld County Clerk to the Board
BY:
Deputy CI
Steve Moreno, Chair
rbara Kirkmeyer Pro -T em
EXCUSED
Date of signature: 1/23/i
Sean P. Con ayy,�w/
a "°-c _
lie A. Cozad
ou ttorney
CC :Hso
2/14VA
Mike Freeman
2018-4164
HR0089
Cfbn4r-A.
PRIVILEGED AND CONFIDENTIAL
MEMORANDUM
DATE: December 18, 2018
TO: Board of County Commissioners — Pass -Around
FR: Judy A. Griego, Director, Human Services
RE: Child Protection Agreement for Services with Julie A. Scroggins,
Attorney at Law, P.C.
Please review and indicate if you would like a work session prior to placing this item on the Board's agenda.
Request Board Approval of the Department's Child Protection Agreement for Services with Julie A.
Scroggins, Attorney at Law, P.C. The major provisions of the Agreement are as follows:
Term
Service/Funding
Rate
November 1, 2018 -May 31,
2019
Mediation
Core/Other
$250.00/Hour (Inclusive of all
scheduling, preparation and post-
mediation requirements and
documentation.)
I do not recommend a Work Session. I recommend approval of this Agreement.
Approve Schedule
Recommendation Work Session
Sean P. Conway
Julie A. Cozad E L
Mike Freeman
Barbara Kirkmeyer, Pro -Tern V ot etya
Steve Moreno, Chair
Other/Continents:
Pass -Around Memorandum; December 18, 2018 - CMS 2277
i a/aCo
aO18'-ct1Cout
�coo8
Karla Ford
From:
Sent:
To:
Subject:
Yes, I approve
Julie Cozad
Wednesday, December 19, 2018 1:47 PM
Steve Moreno; Sean Conway; Barbara Kirkmeyer; Karla Ford
Re: PLEASE REPLY PA for Routing (Scroggins - CMS
From: Karla Ford
Sent: Wednesday, December 19, 2018 12:48:59 PM
To: Steve Moreno; Sean Conway; Barbara Kirkmeyer; Julie Cozad
Subject: PLEASE REPLY PA for Routing (Scroggins - CMS
This is number three of three that are urgent. Please reply via email if you approve recommendation. Once I get four, I
will send back to DHS. Thanks!
Karla Ford P.
Office Manager, Board of Weld County Commissioners
1150 0 Street, P.O. Box 758, Greeley, Colorado 80632
:: 970.336-7204 :: kford@weldgov,com :: www.weldgov.com
My working hours are Monday -Thursday 7:00a.m.-4:00 p.m.
Friday 7:00a.m. - Noon
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: Tobi Sullins
Sent: Wednesday, December 19, 2018 12:00 PM
To: Karla Ford <kford@weldgov.com>
Cc: CTB <CTB@co.weld.co.us>; Barb Connolly <bconnolly@weldgov.com>; Bruce Barker <bbarker@weldgov.com>;
Esther Gesick <egesick@weldgov.com>; HS Contract Management <HS_Contract_Management@co.weld.co.us>; Jamie
Ulrich <ulrichjj@weldgov.com>; Judy Griego <griegoja@weldgov.com>; Lennie Bottorff <bottorll@weldgov.com>
Subject: PA for Routing (Scroggins - CMS
Good afternoon, Karla
Please see attached PA for routing. Commissioner Freeman has initialed off.
This item is running through CMS (ID 2277) and is slated for the 12/26/18 Agenda.
Thank you, and have a blessed day!
1.
Karla Ford
From:
Sent:
To:
Cc:
Subject:
Barbara Kirkmeyer
Wednesday, December 19, 2018 2:35 PM
Julie Cozad
Steve Moreno; Sean Conway; Karla Ford
Re: PLEASE REPLY PA for Routing (Scroggins - CMS
Approve
Sent from my iPhone
On Dec 19, 2018, at 1:46 PM, Julie Cozad <lcozad@weldgov.com> wrote:
Yes, I approve
From: Karla Ford
Sent: Wednesday, December 19, 2018 12:48:59 PM
To: Steve Moreno; Sean Conway; Barbara Kirkmeyer; Julie Cozad
Subject: PLEASE REPLY PA for Routing (Scroggins - CMS
This is number three of three that are urgent. Please reply via email if you approve
recommendation. Once I get four, I will send back to DHS. Thanks!
Karla Ford 4,
Office Manager, Board of Weld County Commissioners
1150 0 Street, P.O. Box 758, Greeley, Colorado 80632
:: 970.336-7204 :: cfordaO.weldoov.com :: www.weldpov.com
My working hours are Monday -Thursday 7:00a.m.-4:00 p.m.
Friday 7:00a.m. - Noon
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: Tobi Cullins
Sent: Wednesday, December 19, 2018 12:00 PM
To: Karla Ford <kford@weldgov.com>
Cc: CTB <CTB@co.weld.co.us>; Barb Connolly <bconnollv{r welds ov.com>; Bruce Barker
<bbarker@weldgov.com>; Esther Gesick <egesickCr4weldkov. om>; HS Contract Management
<HS Contract Management@co.weld.co.us>; Jamie Ulrich <ulrichii@weldgov.corn>; Judy Griego
<RrieRoia(weldgov.com>; Lennie Bottorff <bottorIl@weldRov.corn>
Subject: PA for Routing (Scroggins - CMS
1
/o AA -17
CHILD PROTECTION AGREEMENT FOR SERVICES
BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES
AND JULIE A. SCROGGINSS, ATTORNEY AT LAW, P.C.
This Agreement, made and entered into thbday of , 2018, by and between the
Board of Weld County Commissioners, on behalf of the Weld County Department of Human Services, hereinafter
referred to as the "Department' and Julie A. Scroggins, Attorney at Law, P.C., hereinafter referred to as the
"Contractor".
The parties to this Agreement understand and agree that the provisions of this Agreement specifically
include the following documents: Exhibit A, Contractor's Information, Exhibit B, Scope of Services, and Exhibit C,
Payment Schedule. Each of these documents is attached hereto and incorporated herein by this reference.
WITNESSETH
WHEREAS, required approval, clearance, and coordination have been accomplished from and with
appropriate agencies; and
WHEREAS, the Colorado Department of Human Services has provided Core Services or other funding to
the Department for Mediation Services.
NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows:
1. Term
This agreement shall become effective on November 1. 2018 upon proper execution of this Agreement
and shall expire May 31, 2019, unless sooner terminated as provided herein.
2. Scope of Services
Services shall be provided by the Contractor to any person(s) eligible for services in compliance with
Exhibit A, Contractor's Information and Exhibit B, Scope of Services.
3. Referrals. Billing and Tracking
a. Contractor understands and will comply with all aspects of the referral authorization, billing and
tracking requirements as set forth by the Department. Failure to comply with all aspects may result
in a forfeiture of payment.
b. Contractor agrees to receive referrals for services through e-mail and will provide an identified e-
mail address prior to the start of this Agreement. Contractor acknowledges that services are not
authorized until the Contractor has received an authorized referral form from the Department.
Contractor further acknowledges that services provided prior to the authorized start date or outside
the scope of services on the referral form will not be eligible for reimbursement.
Contractor acknowledges that any and all modifications to an existing referral must be approved
through the Department's Resource Manager, Child Welfare Contract and Services Coordinator, or
through a Team Decision Making (TDM) meeting or Family Team Meeting (FTM). No other
Department staff or other party to the case may authorize services or modifications to services.
c. Contractor agrees to submit an itemized complete billing statement by the 7th of the month,
following the month of service, utilizing billing forms required by the Department.
2018-4164
1
d. Contractor agrees to submit a monthly report with the billing statement by the 7th of the month
following the month of service for each client receiving ongoing services. One-time services will be
verified through receipt of the completed product (ex. psychological evaluation, substance abuse
evaluation). Verification of Monitored Sobriety Services will be the test result.
Contractor will document in detail any and all observed or verbalized concerns regarding any child
whom the Contractor is working with under the Agreement. Areas of concern may include, but are
not limited to, any physical, emotional, educational or behavioral issues. Areas of concern should be
reported immediately to the caseworker AND on the required monthly report.
Monthly reports will be submitted through the Department's online reporting system, unless
otherwise directed or agreed to by the Department.
4. Payment
a. The Department and the Contractor agree that all benefits from private insurance and/or other
funding sources such as Medicaid (if Contractor is a Medicaid eligible provider) or Victim's
Compensation must be exhausted before Core Services or other Department funds can be accessed
for services. Exceptions to this Paragraph may include, if approved by the Department, the following:
i. The service being provided by the contractor is not a Medicaid eligible service;
ii. The service is not deemed medically necessary;
iii. The Court with jurisdiction over the case has ordered that a non -Medicaid provider
or service be used;
iv. A Medicaid provider is not available to provide the needed service;
v. Medicaid is exhausted for the needed service; or
vi. Medicaid denied service.
vil. The client is not eligible for Medicaid.
b. Payment shall be made in accordance with Exhibit A, Contractor's Information, Exhibit B, Scope
of Services, and Exhibit C, Payment Schedule, attached hereto and incorporated herein by reference,
so long as services are rendered satisfactorily and in accordance with the Agreement.
c. Payment pursuant to this Agreement, whether in whole or in part, is subject to, and contingent
upon, the continuing availability of said funds for the purposes hereof.
d. The Department may withhold reimbursement if Contractor has failed to comply with any part of
the Agreement, including the Financial Management requirements, program objectives, contractual
terms, or reporting requirements. In the event of forfeiture of reimbursement, Contractor may
appeal such circumstance in writing to the Director of Human Services. The decision of the Director
of Human Services shall be final.
5. Financial Management
At all times from the effective date of the Agreement until completion of the Agreement, Contractor shall
comply with the administrative requirements, cost principles and other requirements set forth in the
Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds
expended under this Agreement must conform to the Single Audit Act of 1984 and OMG Circular A-133.
6. Payment Method
Unless otherwise provided in Exhibit A, Contractor's Information, Exhibit B, Scope of Services, and Exhibit
C, Payment Schedule:
2
a. If services are funded through Core Services, Contractor agrees to accept reimbursement
through ACH direct deposit one time per month.
b. If Contractor is not currently set up with the State of Colorado to accept direct deposit,
Contractor agrees to complete and submit an ACH Form for Colorado Providers, which will be
provided by the Department. Contractor is solely responsible to submit the ACH Form to the State of
Colorado per the directions on the form. Failure to complete and submit this form in a timely and
accurate manner may result in a delay of payment.
c. Contractor agrees to accept payment through county warrant when funding source does not
allow for direct deposit.
7. Compliance with Applicable Laws
a. At all times during the performance of this Agreement, Contractor will strictly adhere to all
applicable Federal and State laws, order, and applicable standards, regulations, interpretations
and/or guidelines issued pursuant thereto. This includes protection of the confidentiality of all
applicant/recipient records, papers, documents, tapes and any other materials that have been or may
hereafter be established which relate to the Agreement. Contractor shall abide by all applicable laws
and regulations, including, but not limited to the following:
- Title VI of the Civil Rights Act of 1964, 42 U.S.C. Sections 2000d-1 Title VI of the Civil
Rights Act of 1964, 42 U.S.C. Sections 2000d-1 et. seq. and its implementing regulation, 45
C.F.R. Part 80 et. 2m; and
- all provisions of the Civil Rights Act of 1986 so that no person shall, on the grounds of
race, creed, color, sex, or national origin, be excluded from participation in, be denied the
benefits of, or be otherwise subjected to discrimination under the approved Agreement.
- Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. Section 794, and its
implementing regulations, 45 C.F.R. Part 84; and
- the Age Discrimination Act of 1975, 42 U.S.C. Section 6101 gt seo. and its
implementation regulations, 45 C.F.R. Part 91; and
Title VII of the Civil Rights Act of 1964; and
the Age Discrimination in Employment Act of 1967; and
the Equal Pay Act of 1963; and
the Education Amendments of 1972; and
Immigration Reform and Control Act of 1986, P.L. 99-603, 42 C.F.R. Part 2; and
- all regulations applicable to these laws prohibiting discrimination because of race, color,
national origin, sex, religion, and handicap, including Acquired Immune Deficiency Syndrome
(AIDS) or AIDS related conditions covered under Section 504 of the Rehabilitation Act of
1973, as amended, cited above. If necessary, Contractor and the Department will resist in
judicial proceedings any efforts to obtain access to client records except as permitted by 42
C.F.R. Part 2. 45 C.F.R. Part 74, Appendix G 9, which requires that affirmative steps be taken
to assure that small and minority businesses are utilized, when possible, as sources of
3
supplies, equipment, construction and services. This assurance is given in consideration of
and for the purpose of obtaining any all Federal and/or State financial assistance.
- Colorado Revised Statute (C.R.S.) 26-6-104, requiring criminal background record checks
for all employees, contractors and sub -contractors.
b. Contractor is further charged with the knowledge that any person who feels that s/he has been
discriminated against has the right to file a complaint either with the Colorado Department of Human
Services or with the United States Department of Health and Human Services, Office for Civil Rights.
c. Contractor assures that it will fully comply with all other applicable Federal and State laws which
may govern the ability of the Department to comply with the relevant funding requirements.
Contractor understands the source of funds to be accessed under the Agreement is Core Services.
d. Contractor assures and certifies that it and its principals:
- Are not presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from covered transaction by a Federal or State department or agency;
and
- have not, within a three-year period preceding this Agreement, been convicted of or
had a civil judgment rendered against them for commission of fraud or criminal offense in
connection with obtaining, attempting to obtain, or performing a public (Federal, State or
local) transaction or contract under public transaction; violation of federal or state antitrust
statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction
of records, making false statements, or receiving stolen property; and
- are not presently indicted for or otherwise criminally or civilly charged by a government
entity (federal, state or local) with commission of any of the offenses enumerated in this
certification; and
- have not, within a three-year period preceding this Agreement, had one or more public
transactions (federal, state, or local) terminated for cause or default.
e. Public Contracts for Services C.R.S. §8-17.5-101. Contract Professional certifies, warrants, and
agrees that it does not knowingly employ or contract with an illegal alien who will perform work under
this contract. Contract Professional 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(S)(c). Contract Professional 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 Contract Professional that the subcontractor shall not knowingly employ or contract with an illegal
alien to perform work under this Agreement. Contract Professional 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 Contract Professional obtains actual knowledge that a
subcontractor performing work under the public contract for services knowingly employs or contracts
with an illegal alien Contract Professional shall notify the subcontractor and County within three (3)
days that Contract Professional 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. Contract Professional 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. Contract
Professional shall comply with reasonable requests made in the course of an investigation, undertaken
4
pursuant to C.R.S. §8-17.5-102(5), by the Colorado Department of Labor and Employment. If Contract
Professional participates In the State of Colorado program, Contract Professional shall, within twenty
days after hiring a new employee to perform work under the contract, affirm that Contract Professional
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. Contract Professional 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 Contract
Professional 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, Contract Professional shall be
liable for actual and consequential damages.
f. Except where exempted by federal law and except as provided In C.R.S. § 24-76.5-103(3), if
Contract Professional receives federal or state funds under the contract, Contract Professional 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 Contract Professional 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.
8. Compliance with Child and Family Services Review
The Child and Family Services Review (CFSR) examines child welfare service outcomes in three areas;
Safety, Permanency and Well Being of families. For each outcome, data and performance indicators
measure each state's performance according to national standards and monitor progress over time.
Following the review, a Program Improvement Plan (PIP) will be implemented for the state to enhance
services to families.
Contractor agrees to continually strive for positive outcomes in the areas of Safety, Permanency and Well
Being. Contractor will ensure that any employee or subcontractor of Contractor providing services under
this Agreement will work towards positive outcomes in the aforementioned three areas as outlined under
the Child and Family Services Review (CFSR), and will address the aforementioned three areas when
completing monthly reports as required by Paragraph 3(d) of this Agreement.
9. Insurance Requirements
Contractor and Department agree that Weld County, the Board of County Commissioners of Weld County,
its officers and employees, shall not be held liable for injuries or damages caused by any negligent acts or
omissions of the Contractor, it subcontractor, or their employees, volunteers, or agents while performing
duties described in this Agreement. Contractor shall indemnify, defend and hold harmless Weld County,
the Board of County Commissioners of Weld County, its employees, volunteers and agents.
Contractor shall provide the liability insurances (including professional liability insurances where
necessary) and worker's compensation insurances for all its employees, volunteers, and agents engaged
in the performance of this Agreement which are required under Weld County's Request for Bid, and
required by the Colorado Worker's Compensation Act. Contractor shall provide the Department with the
acceptable evidence that such coverage is in effect within seven (7) days of the date of this Agreement.
At a minimum, Contractor shall procure, either personally or through its employer as applicable to the
Contractor's business, at its own expense, and maintain for the duration of the work, the following
insurance coverage. Weld County, State of Colorado, by and through the Board of County Commissioners
5
of Weld County, its employees and agents, shall be named as additional named insured on the insurance,
where permissible the insurance provider.
a. 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 alt 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 coverages specified in this
Agreement are the minimum requirements, and these requirements do not decrease or limit the
liability of Contractor/Contract Professional. Contractor/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.
b. Types of Insurance: Contractor/Contract Professional shall obtain, and maintain at all
times during the term of any Agreement, insurance in the following kinds and amounts:
i.Workers' Compensation Insurance as required by state statute, and Employer's Liability
insurance covering all of Contractor's Contract Professional's employees acting within
the course and scope of their employment. If Contractor is an Independent Contractor,
as defined by the Colorado Worker's Compensation Act, this requirement shall not apply.
Contractor must submit to the Department a Declaration of Independent Contractor
Status Form prior to the start of this agreement.
ii.Commercial General Liability Insurance written on ISO occurrence form CG 00 01 10/93
or equivalent, covering premises operations, fire damage, independent Contractors,
products and completed operations, blanket contractual liability, personal injury, and
advertising liability with minimum limits as follows:
$1,000,000 each occurrence;
$2,000,000 general aggregate;
$50,000 any one fire; and
$500,000 errors and omissions.
iii.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.
iv.Additional Provisions: Policies for all general liability, excess/umbrella liability, liquor
liability and pollution liability must provide the following:
6
If any aggregate limit is reduce by twenty-five percent (25%) or more
by paid or reserved claims, Contractor shall notify County within ten (10) days
and reinstate the aggregates required;
- Unlimited defense costs in excess of policy limits;
- Contractual liability covering the indemnification provisions of this
Agreement;
A severability of interests provision;
Waiver of exclusion for lawsuits by one insured against another;
A provision that coverage is primary; and
A provision that coverage is non-contributory with other coverage or
self-insurance provided by County.
v.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.
c. Contractors/Contract Professionals shall secure and deliver to County's Risk
Administrator ("Administrator") 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 Bid.
d. Proof of Insurance: Contractor/Contract Professional shall provide a copy of this
information to its Insurance agent or broker, and shall have its agent or broker provide proof of
Contractor/Contract Professional's required insurance. County reserves the right to require
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.
e. 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 as follows:
County of Weld
1150'O' Street
Greeley, Colorado 80631
f. Waiver of Subrogation: For all coverages, Contractor/Contract Professional's insurer
shall waive subrogation rights against County.
g. 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 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.
A provider of Professional Services (as defined in the Bid or RFP) shall provide the following
coverage:
Professional Liability: Contract Professional shall maintain limits of $1,000,000 for each claim, and
$2,000,000 aggregate limit for all claims.
10. Certification
Contractor certifies that, at the time of entering into this Agreement, it has currently in effect all
necessary licenses, approvals, insurance, etc., required to properly provide the services and/or supplies
covered by this Agreement. Copies of all necessary licenses shall be provided to the Department by the
Contractor prior to the start of any Agreement.
11. Training
Contractor may be required to attend training that the request of the Department specific to services
provided under this Agreement. The Department will not compensate the Contractor for said training in
the form of registration fees, time spent traveling to and from training, attending the training or any other
associated costs unless otherwise agreed to by the Department.
12. Subpoenas
Contractor will, on behalf of its employees and/or officers, accept any subpoena for testimony from the
Weld County Attorney's Office by e-mail and will return a waiver of services within 72 business hours. For
this purpose, Contractor will designate an e-mail address prior to the start of this Agreement. If the
Contractor receives a subpoena via e-mail but will only accept personal service, the Contractor will
contact the Weld County Attorney's Office immediately at 970-352-1551, x6503, and advise that the
subpoena must be personally served.
13. Monitoring and Evaluation
Contractor and the Department agree that monitoring and evaluation of the performance of this
Agreement shall be conducted by the Contractor and the Department. The results of the monitoring and
evaluation shall be provided to the Board of Weld County Commissioners, the Department and the
Contractor.
Contractor shall permit the Department, and any other duly authorized agent or governmental agency, to
monitor all activities conducted by the Contractor pursuant to the terms of this Agreement. As the
monitoring agency may in its sole discretion deem necessary or appropriate, such program data, special
analyses, on -site checking, formal audit examinations, or any other reasonable procedures. All such
monitoring shall be performed in a manner that will not unduly interfere with the work conducted under
this Agreement.
14. Modification of Agreement
All modifications to this Agreement shall be in writing and signed by both parties.
15. Remedies
The Director of Human Services or designee may exercise the following remedial actions should s/he find
the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial
failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by
the Contractor. These remedial actions are as follows:
8
- Withhold payment to the Contractor until the necessary services or corrections in
performance are satisfactorily completed.
- Deny payment or recover reimbursement for those services or deliverables, which have
not been performed and which due to circumstances caused by the Contractor cannot be
performed or if performed would be of no value to the Department. Denial of the amount
of payment shall be reasonably related to the amount of work or deliverables lost to the
Department.
- Incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation
shall be recovered from Contractor by deduction from subsequent payments under this
Agreement or other agreements between the Department and Contractor, or by the
Department as a debt due to the Department or otherwise as provided by law.
16. Representatives
For the purpose of this Agreement, the individuals identified below are hereby designated representatives
of the respective parties. Either party may from time to time designate in writing a new or substitute
representative(s).
For Department: For Contractor:
Heather Walker, Administrator Julie Scroggins. Attorney at Law
17. Notice
All notices required to be given by the parties hereunder shall be given by certified or registered mail to
the individuals at the addresses set forth below. Either party may from time to time designate in writing a
substitute person(s) or address to whom such notices shall be sent.
For Department: For Contractor:
Judy A. Griego, Director Julie Scroggins, Attorney at Law, P.C.
P.O. Box A 71011th Avenue, Suite 205
Greeley, CO 80632 Greeley, CO 80631
(970) 352-1551 (970) 353-0216
18. Litigation
Contractor shall promptly notify the Department in the event that Contractor learns of any actual
litigation in which it is a party defendant in a case that involves services provided under this Agreement.
Contractor, within five (5) calendar days after being served with a summons, complaint, or other pleading
which has been filed in any Federal or State court or administrative agency, shall deliver copies of such
document(s) to the Director of Human Services. The term "litigation" includes an assignment for the
benefit of creditors, and filings of bankruptcy, reorganization and/or foreclosure.
19. Termination
This Agreement may be terminated at any time by either party giving thirty (30) days written notice to the
individuals identified in paragraph 17. No portion of this Agreement shall be deemed to create an
obligation on the part of the County of Weld, State of Colorado, to expend funds not otherwise
appropriated in each succeeding year, as this Agreement is subject to the availability of funding.
Therefore, the Department may terminate this Agreement at any time if the source of funding for the
services made available to the Contractor is no longer available to the Department, or for any other
9
reason. Contractor reserves the right to suspend services to clients if funding is no longer available.
20. No Third -Party Beneficiary Enforcement
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.
21. 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 of §§24-10-101 et. sect., as applicable now or hereafter amended.
22. Partial Invalidity of Agreement
If any section, subsection, paragraph, sentence, clause, or phrase of this Agreement is for any reason held
or decided to be unconstitutional, such decision shall not affect the validity of the remaining portions.
The parties hereto declare that they would have entered into this Agreement and each and every section,
subsection, paragraph, sentence, clause, and phrase thereof irrespective of the fact that any one or more
sections, subsections, paragraphs, sentences, clauses, or phrases might be declared to be unconstitutional
or invalid.
23. Imoroorieties/Conflict of Interest
No officer, member or employee of Weld County and no member of their governing bodies shall have any
pecuniary interest, direct or indirect, in the approved Agreement or the proceeds thereof.
The Appearance of Conflict of Interest applies to the relationship of a Contractor with the Department
when the Contractor also maintains a relationship with a third party and the two relationships are in
opposition. In order to create the appearance of a conflict of interest, it is not necessary for the
Contractor to gain from knowledge of these opposing interests. It is only necessary that the Contractor
know that the two relationships are in opposition. During the term of the Agreement, Contractor shall
not enter into any third -party relationship that gives the appearance of creating a conflict of interest.
Upon learning of an existing appearance of a conflict of interest situation, Contractor shall submit to the
Department, a full disclosure statement setting forth the details that create the appearance of a conflict
of interest. Failure to promptly submit a disclosure statement required by this paragraph shall constitute
grounds for the Department's termination, for cause, of its Agreement with the Contractor.
Contractor certifies that Federal appropriated funds have not been paid or will be paid, by or on behalf of
Contractor, to any person for influencing or attempting to influence an officer or employee of an agency,
a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in
connection with the awarding of any Federal contract, the making of any Federal grant, the making of any
Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal,
amendment, or modification of an Federal contract, loan, grant, or cooperative agreement.
24. Storage. Availability and Retention of Records
Contractor agrees that authorized local, Federal, and State auditors and representatives shall, during
business hours, have access to inspect and copy records, and shall be allowed to monitor and review
10
through on -site visits, all activities related to this Agreement, supported with funds under this Agreement,
to ensure compliance with the terms of this Agreement. Contracting parties agree that monitoring and
evaluation of the performance of the Agreement shall be conducted by appropriate funding sources. The
results of the monitoring and evaluation activities shall be provided to the appropriate and interested
parties.
All such records, documents, communications, and other materials created pursuant or related to this
Agreement shall be maintained by the Contractor in a central location and shall be made available to the
Department upon its request, for a period of seven (7) years from the date of final payment under this
Agreement, or for such further period as may be necessary to resolve any matters which may be pending,
or until an audit has been completed with the following qualifications: If an audit by or on behalf of the
Federal and/or State government has begun but is not completed at the end of the seven (7) year period,
or if audit findings have not been resolved after a seven (7) period, the materials shall be retained until
the resolution of the audit finding.
25. Confidentiality of Records
Contractor shall protect the confidentiality of all applicant records and other materials that are
maintained in accordance with this Agreement except for purposes directly connected with the
administration of Child Protection. No information about or obtained from any applicant/recipient in
possession of Contractor shall be disclosed in a form identifiable with the applicant/recipient or a minor's
parent or guardian unless in accordance with the Contractor's written policy governing access to,
duplication and dissemination of, all such information, in any form, including social networks. Contractor
shall advise its employees, agents, and subcontractor, if any, that they are subject to these confidentiality
requirements.
Contractor shall provide its employees, agents, and subcontractors, if any, with a copy or written
explanation of these confidentiality requirements before access to confidential data is permitted.
Contractor shall have its employees, agents, and subcontractors, if any, sign a written confidentiality
agreement and shall provide a copy of such agreement to the Department, if requested.
26. Proprietary Information
Proprietary information for the purposes of this Agreement is information relating to a party's research,
development, trade secrets, business affairs, internal operations and management procedures and those
of its customers, clients or affiliates, but does not include information (1) lawfully obtained from third
parties, (2) that which is in the public domain, or (3) that which is developed independently. Neither
party shall use or disclose directly or indirectly without prior written authorization any proprietary
information concerning the other party obtained as a result of this Agreement. Any proprietary
information removed from the Department's site by the Contractor in the course of providing services
under this Agreement will be accorded at least the same precautions as are employed by the Contractor
for similar information in the course of its own business.
27. Independence of Contractor: Not an Employee of Weld County
Contract Professional agrees that it is an independent Contract Professional and that Contract
Professional'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. Contract Professional shall
perform its duties hereunder as an independent Contract Professional. Contract Professional shall be
solely responsible for its acts and those of its agents and employees for all acts performed pursuant to
this Agreement. Contract Professional, 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 Contract Professional or any of its agents or employees. Unemployment
11
insurance benefits will be available to Contract Professional and its employees and agents only if such
coverage is made available by Contract Professional or a third party. Contract Professional shall pay when
due all applicable employment taxes and income taxes and local head taxes (if applicable) incurred
pursuant to this Agreement. Contract Professional shall not have authorization, express or implied, to
bind County to any agreement, liability or understanding, except as expressly set forth in this Agreement.
Contract Professional 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 provide proof thereof
when requested to do so by County.
28. Entire Agreement
This Agreement, together with all attachments hereto, constitutes the entire understanding between the
parties with respect to the subject matter hereof, and may not be changed or modified except as state in
Paragraph 14 herein. This Agreement shall be binding upon the parties hereto, their successors, heirs,
legal representatives, and assigns. The Contractor and the Department may not assign any of its rights or
obligations hereunder without the prior consent of both parties.
29. Agreement Nonexclusive
This Agreement does not guarantee any work nor does it create an exclusive agreement for services.
30. Warranty
The Contractor warrants that services performed under this Agreement will be performed in a manner
consistent with the professional standards governing such services and the provisions of this Agreement.
The Contractor shall faithfully perform the work in accordance with the standards of care, skill, training,
diligence and judgment provided by highly competent individuals and entities that perform services of
a similar nature to those described in this Agreement including Exhibits A, B, and C.
31. Acceptance of Services Not a Waiver
Upon completion of the work, the Contractor shall submit to Department originals of all tests and results,
reports, etc., generated during completion of this work. Acceptance by Department of reports and
incidental rnaterial(s) furnished under this Agreement shall not in any way relieve the Contractor of
responsibility for the quality and accuracy of the services. In no event shall any action by the Department
hereunder constitute or be construed to be a waiver by the Department of any breach of covenant or
default which may then exist on the part of the Contractor, and the Department's action or inaction when
any such breach or default shall exist shall not impair or prejudice any right or remedy available to the
Department with respect to such breach or default; and 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 Department of, or payment for, any services performed
under this Agreement shall not be construed as a waiver of any of the Department's rights under this
Agreement or under the law generally.
32. Employee Financial Interest/Conflict of Interest. C.R.S. §124-18-201 et seq. and §24-50-507
The signatories to this Agreement aver 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. The Contractor has no interest and shall not acquire any interest direct or indirect, which
would in any manner or degree with the performance of the Contractor's services and the Contractor,
shall not employ any person having such known interests. During the term of this Agreement, the
Contractor shall not engage in any in any business or personal activities or practices or maintain any
12
relationships which actually conflict with or in any way appear to conflict with the full performance of Its
obligations under this Agreement. Failure by the Contractor to ensure compliance with this provision may
result, in the Department's sole discretion, in immediate termination of this Agreement. No employee of
the Contractor nor any member of the 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
Contract Professional's operations, or authorizes funding to the Contractor.
33. 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.
34. 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, Contract Professional agrees that the Weld County District Court shall have exdusive
jurisdiction to resolve said dispute.
35. Subcontractors
Contract Professional acknowledges that County has entered into this Agreement in reliance upon the
particular reputation and expertise of Contract Professional. Contract Professional 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.
36. Attorneys Fees/Legal Costs
In the event of a dispute between County and Contract Professional, 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.
37. Ownership
All work and information obtained by Contract Professional under this Agreement or individual work order
shall become or remain (as applicable), the property of County. In addition, all reports, documents, data,
plans, drawings, records and computer files generated by Contract Professional 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. Contract Professional shall not make use of such
material for purposes other than in connection with this Agreement without prior written approval of
County.
38. 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.
39. Severability
13
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.
IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and
year first above written.
COUNTY:
ATTEST:
,,,drifet) Jdto;,,k.
BOARD OF COUNTY COMMISSIONERS
Weld County Clerk to the Board WELD COUNTY, COLORADO
By:
Deputy Clerk to S e Bo: rd
14
Men -C
Steve Moreno, Chair
DEC 2 6 2018
CONTRACTOR:
Julie A. Scroggins, Attorney at Law, P.C.
710 11th Avenue, Suite 205
Greeley, Colorado 80631
(970) 353-0
By:
Date:
Juli A. Scroggins, = to - ey aw
ilrAF
ozo a
EXHIBIT A
CONTRACTOR'S INFORMATION
wccicuI W.V/N..V NOWA
Phone: (970) 353-0216 • Fax: (970) 353-4025
jscrogginstaw gmaiI.carn
To Whom It May Concern:
October 3, 2018
I am bidding on providing mediation services for the Weld County Department of Human
Services
I graduated from University of Colorado School of Law in May of 1983 and have been a
member of the Colorado Bar since October 1983.
When I was first admitted to the bar, I was an Associate with Thomas Aron, practicing in
the area of water law. Since that time I have worked in Risk Management for Monfort and then
Con Agra, served for two years as the municipal judge for the Town of Ault, and beginning in
November 1998, I joined the Greeley office of the firm of Brega & Winters practicing primarily
family law. In 2007, I became a partner of Winters, Hellerich, & Hughes, LLC, the successor
firm to the Greeley office of Brega & Winters. In June of 2014, I returned to my sole practice of
Julie A. Scroggins, Attorney at Law, P.C.
Since 1998, family law has been my primary practice. Both my corporation and my
practice are in good standing.
I currently do not have professional liability insurance. 1 or course had it with my former
firm when I had 4 partners, but since I went solo four years ago, I have not gotten any. I am
applying for it at this time. For the general liability insurance, we have requested an updated
Certificate of Liability but have not yet received it. I am enclosing our current policy and the
prior Certificate of Liability for this same policy endorsing Weld County.
I have participated in numerous mediations and family meetings in the course of my
work. In addition I have provided mediation services from time to time in the area of family law.
I have no doubt that I will be able to schedule and successfully provide requested mediation
services within a timely and professional manner. My office has the capacity to provide
mediation to larger family groups and their representatives and my staff is used to scheduling
and facilitating such events and timely providing notice of such.
I enjoy the practice of family law, believing it gives me an opportunity to help good
people going through tough times. From time to time my cases/clients have come within the
orbit of the Department of Human Services and I have helped 'de my clients thrgh those
cases.
Name License Status
SCROGGINS, JULIE A Active
&egi tratinn / Dar Number
13459
ti
Is in Private Practice
Yes
Carries Professional Liability
Insurance
No
(What does this mean? - Click Here for mere Isformadon)
(I&erch1PLI_Nofice.up)
Business Information
Fhoa
(970) 353-0216
Firm Name
Julie A Scroggins PC
Business Address
710 11th Avenue
Suite 205
Greeley, CO 80631
Admission Date: 10/31/1983
Fax
(970) 353-4025
1
There Is no public disciplinary history on file for this attorney within the state of Colorado.
ITEM 1. INSURED
Julie A. Scroggins, Attorney at Law P.C.
710 11th Ave
Greeley, CO 80631
ITEM 2. POLICY PERIOD: FROM: October 2, 2018 to
October 2, 2019 12:01 A.M. MOUNTAIN
STANDARD TIME
October 2, 2018
Policy #: 2501611
ITEM 3. A. Workers' Compensation Insurance: Part One of the policy applies to the
workers' compensation law of the states listed here:
COLORADO
Affinity/0
B. Employers Liability Insurance: Part Two of the policy applies to work in each
state listed in Item 3 A. The limits of our liability under part two are:
BODILY INJURY BY ACCIDENT $100,000 EACH ACCIDENT
BODILY INJURY BY DISEASE $100,000 EACH EMPLOYEE
BODILY INJURY BY DISEASE $500,000 POLICY LIMIT
C. Other States Insurance: Part Three of the policy applies to the states, if any,
listed here:
NONE
('lease contact us for information on coverage outside the state of Colorado)
D. This policy includes the attached endorsements and schedules:
414 Notification of Change in Ownership Endorsement
511 Other State Endorsement
CAT09 Catastrophe (Other than Certified Acts of
Terrorism)
TRPRA Terrorism Risk Insurance Program Reauthorization
Act of 2015
1 of 7 111,71201117:37:17 AM 2501011 Inauronca Policy Information Page P401 Coverage by Pinnace'
ITEM 4. We will determine the premium for this policy by our manuals of rules,
classifications, rates and rating plans. All Information required below is subject to
change by audit The statements of estimated advanced premium are also past of
this policy.
Coverage information for Julie A. Scroggins, Attorney at Law P.C.
Location: 710 11th Ave
Greeley, CO 80631
Period: 10/02/2018 -10/02/2019
Class
RT
Description
Emp
Payroll
Rate
Prem Charge
8820
EM
Attorney's Office
1.00
$42,000
$0.192000
$81
Total for Julie A. Scroggins, Attorney at Law
P.C.
$42,000
$81
Description
Period
Adjustment
Amount
Ratable Manual Premium
10/02/2018 - 10/0212019
$81
Designated Provider
Discount
10/02/2018 - 10/02/2019
.975
$2
Annual Policy Fee
10/02/2018 - 10/02/2019
$195
Terrorism Insurance
Coverage
10/02/2018 - 10/02/201.9
$2
Catastrophe Insurance
Coverage
10/02/2018 - 10/02/2019
$4
Net Estimated Annual
Premium
10/02/2018 - 10/02/2019
$280
2 of 7 10/2/2018 7:87:17 AM 2501611 Insurance Policy Information Pape P401 Coverage by Pihnac l
Julie A. Scroggins, Attorney at Law P.C.
710 11th Ave
Greeley, CO 80631
NCCI#WC000422B
Policy#: 2501611
ENDORSEMENT: Terrorism Risk Insurance Program Reauthorization Act Disclosure
Endorsement (WC 00 04 22 8)
This endorsement addresses the requirements of the Terrorism Risk Insurance Act of 2002 as amended
and extended by the Terrorism Risk Insurance Program Reauthorization Act of 2015. It serves to notify
you of certain limitations under the Act, and that your insurance carrier is charging premium for losses
that may occur in the event of an Act of Terrorism.
Your policy provides coverage for workers' compensation losses caused by Acts of Terrorism. including
workers' compensation benefit obligations dictated by state law. Coverage for such losses is still subject
to all terms. definitions, exclusions, and conditions in your policy, and any applicable federal and/or state
law, rules. or regulations.
Definitions
The definitions provided in this endorsement are based on and have the same meaning as the definitions
in the Act. If words or phrases not defined in this endorsement are defined in the Act, the definitions in
the Act will apply.
"Act" means the Terrorism Risk Insurance Act of 2002, which took effect on November 26, 2002, and
any amendments thereto, including any amendments resulting from the Terrorism Risk Insurance
Program Reauthorization Act of 2015.
"Act of Terrorism" means any act that is certified by the Secretary of the Treasury, in consultation with
the Secretary of Homeland Security, and the Attorney General of the United States as meeting all of the
following requirements:
a. The act is an act of terrorism.
b. The act is violent or dangerous to human life, propriety or infrastructure.
c. The act resulted in damage within the United States, or outside of the United States in the case
of the premises of United States missions or certain air carriers or vessels.
d. The act has been committed by an individual or individuals as part of an effort to coerce the
civilian population of the United States or to influence the policy or affect the conduct of the
United States Government by coercion.
"Insured Loss" means any loss resulting from an act of terrorism (and. except for Pennsylvania. including
an act of war, in the case of workers' compensation) that is covered by primary or excess property and
3 of 7 10/2/2018 7:37:17 AM 2501611 Insurance Policy information page P401 Coverage by Pinnemi
casualty Insurance issued by an insurer if the loss occurs in the United States or at the premises of United
States missions or to certain air carriers or vessels.
"Insurer Deductible" means, for the period beginning on January 1, 2015, and ending on December 31,
2020, an amount equal to 20% of our direct earned premiums, during the immediately preceding
calendar year.
Limitation of Liability
The Act limits our liability to you under this policy. If aggregate Insured Losses exceed
$100,000,000,000 to a calendar year and if we have met our Insurer Deductible, we are not liable for the
payment of any portion of the amount of insured Losses that exceeds $100,000,000,000; and for
aggregate Insured Losses up to $100,000,000,000, we will pay only a pro rata share of such Insured
Losses as determined by the Secretary of Treasury.
Policy Disclosure Notice
1. Insured Losses would be partially reimbursed by the United States Government If the aggregate
industry Insured Losses exceed:
a. $140,000,000, with respect to such Insured Losses occurring in calendar year 2017. the
United States Government would pay 83% of our Insured Losses that exceed our Insurer
Deductible.
b. $160,000,000, with respect to such Insured Losses occurring in calendar year 2018, the
United States Government would pay 82% of our Insured Losses that exceed our Insurer
Deductible.
c. $180,000,000, with respect to such insured Losses occurring in calendar year 2019, the
United States Government would pay 81% of our Insured Losses that exceed our Insurer
Deductible.
d. $200,000,000, with respect to such Insured Losses occurring in calendar year 2020, the
United States Government would pay 80% of our Insured Losses that exceed our insurer
Deductible.
State
CO
Schedule
Rate
$0.005
Effective Date: October 2, 2018
Pinnacol Assurance has issued this endorsement October 2, 2018.
Premium
$2
of 7 10(7/2028 737:17 AM 2501811 Insurance Policy Information Pogo P401 Coverage by Pirmscol
Julie A. Scroggins, Attorney at Law P.C.
710 11th Ave
Greeley, CO 80631
NCCI#WC00O421D
Policy#: 2501611
WORKERS' COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY
CATASTROPHE (OTHER THAN CERTIFIED ACTS OF TERRORISM) PREMIUM
ENDORSEMENT
This endorsement is notification that your insurance carrier is charging premium to cover the
losses that may occur in the event of a Catastrophe (other than Certified Acts of Terrorism) as
that term is defined below.
Your policy provides coverage for workers' compensation losses caused by a Catastrophe
(other than Certified Acts of Terrorism).
This premium charge does not provide funding for Certified Acts of Terrorism contemplated
under the Terrorism Risk Insurance Program Reauthorization Act Disclosure Endorsement (WC
00 04 22 B) attached to this policy.
For purposes of this endorsement, the following definitions apply:
Catastrophe (other than Certified Acts of Terrorism): Any single event, resulting from an
Earthquake, Nancertified Act of Terrorism, or Catastrophic Industrial Accident, which results in
aggregate workers' compensation losses in excess of $50 million.
Earthquake: The shaking and vibration at the surface of the earth resulting from underground
movement along a fault plane or from volcanic activity.
Noncertified Act of Terrorism: An event that is not certified as an Act of Terrorism by the
Secretary of Treasury pursuant to the Terrorism Risk Insurance Act of 2002 (as amended) but
that meets all the following criteria:
a. It is an act that is violent or dangerous to human life, property, or infrastructure.
b. The act results in damage within the United States, or outside the United States in the
case of the premises of the United States missions or air carriers or vessels as those
terms are defined in the Terrorism Risk Insurance Act of 2002 las amended); and
c. It is an act that has been committed by an individual or individuals as part of an effort to
coerce the civilian population of the United States or to influence the policy or affect the
conduct of the United States Government by coercion.
5 of 7 10/2/21318 7:87:17 AM 2501611 Insurance Policy Information Page P401 Coverage by Pinnecol
Catastrophic Industrial Accident A chemical release, large explosion, or small blast that is
localized in nature and affects workers in a small perimeter the size of a building.
The premium charge for the coverage your policy provides for workers' compensation losses
caused by a Catastrophe (other than Certified Acts of Terrorism) is shown in Item 4 of the
Information Page or in the Schedule below.
State
CO
Thank you for your business.
Pinnacol Assurance
Schedule
Rate
$0.010
Premium
$4
6 of 7 10/2/20113 7;37:17 AM 2501611 Insurance Policy Information Page P401 Coverage by Pinnacci
Julie A. Scroggins, Attorney at Law P.C.
710 11th Ave
Greeley, CO 80631
NCCI#WC000414
Pollcy#: 2501611
ENDORSEMENT: NOTIFICATION OF CHANGE IN OWNERSHIP ENDORSEMENT
Experience rating is mandatory for all eligible insureds. The experience rating
modification factor, if any, applicable to this policy, may change if there is
a change in your ownership or in that of one or more of the entities eligible
to be combined with you for experience rating purposes. Change in ownership
includes sales, purchases, other transfers, mergers, consolidations,
dissolutions, formations of a new entity and other changes provided for
in the applicable experience rating plan manual.
You must report any change in ownership to us in writing within 90 days of
such change. Failure to report such changes within this period may result
in revision of the experience rating modification factor used to determine
your premium.
7 of 7 10/2/2018 7:37:17 AM 2601611 Insurance Policy Information Page P401 Coverage by Plnnecal
I 111116.1 rlw v lucl, I Y i!1 .wumlq
PRIMARY CONTACT - FULL NAME
L 970 .a.. L__.
PHONE NUMBER
2
PRIMARY CONTACT - E-MAIL ADDRESS
710 nth Avenue, Ste 205
AGENCY MAIUNG ADDRESS
Christy Dixon
REFFERALCONTACT- FULL NAME
97(3 X333 -021G
REFERRAL CONTACT -PHONE NUMBER
Christy Dixon
BIWNG CONTACT- FULL NAME
97O :_353-4216
BILLING CONTACT- PHONE NUMBER
EXT,
Greeley
CITY
EXT.
PRIMARY CONTACT - TITLE
t 970
FAX NUMBER
AGENCY/PRACTICE WEB ADDRESS (IF APPUCABLE)
Le:al Assistant
REFERRAL CONTACT - TIRE
jsiawpc@grnail,com
LP
REFERRAL CONTACT - E-MAIL ADDRESS
Legal Assistant
BILLING CONTACT- TITLE
jslawpc@gmall.com�� _
BIWNG CONTACT- E-MAIL ADDRESS
I _
I certify that the services proposed for intended use by the Weld County Department of Human Services will meet
all the specifications it has so indicated in this bid form. I further affirm intention to enter into an agreement with
Weld County, on behalf of the Weld County Department of Human Services, and comply with all requirements of
the contract, if awarded_
The Board of Weld County Commissioners reserve the right to reject any or all bids, to waive any informality in the
bids, and to accept the bid, or part of a bid, that, in the opinion of the Board, is in the best interests of the Board and
of the County of Weld, State of Colorado. The Board of Weld County Commissioners shall give preference to
resident Weld County bidders in all cases where the bids are competitive in price and quality,
Signature of Authorized Representative:
Date of Signature:
B1800058
2. Program name or service type Mediator
being proposed:
3. Modalities, curriculum or tools that will be utilized in the delivery of the service.
To provide mediation services for the Department of Human Services, to help facilitate agreements
between family members for the benefit of the child/children.
4. Anticipated frequency of the service (ex. 4 hours/week).
As needed, hours of office operation — 8:00a.m. to 4:00 p.m., Monday through Friday.
5. Anticipated duration of the service (ex. 3-4 months).
Of duration requested by the Department, available 12 months/year for duration of contract.
6. Goals of the service.
Good faith agreements between family members and/or the Department.
7. Outcomes of service.
See above.
8. Target population for service.
Note: Please include age range, applicable genders, and any specific characteristics/traits/needs.
Parents and extended family of all ages and genders.
9. Service access. 710 11th Avenue, Ste 205, Greeley, Colorado, 80631- office based.
Note: if office -based, bidder should provide full physical addresses for all locations. if provided outside
the office, bidder should note home -based and/or community -based, and geographical area(s) bidder is
willing to travel to.
10. Languages service is available in. English
Note: Bidder should note the language and level of proficiency. Refer to
11. Medicaid eligibility of service. No
Note: if only a portion of the service is billable to Medicaid, bidder should note the specific portion.
12. Transportation of clients. No
Note: Bidder should provide the specific population eligible for transportation, the transportation
range or radius, and the specific starting point.
13. Rates of service. $250.00 per hour
Note: Bidder should include fee for service, staffing, mileage, and any other applicable costs bidder
would like considered. Rates must be an exact amount and must include the unit of cost (i.e., hour, day,
month, episode). Approximate rates or a range of rates for a service will not be accepted.
Bid No.: B1800058
T EXHIBIT D
pilcable staff who will manage and/or administer the proposed service. One Staff Data Sheet per proposed service. Bidder should not combine services.)
SERVICE
NAME:
�t Name
ulie A. Scroggins, Attorney at Law, P.C.
APPLICABLE STAFF MEMBER OR CONTRACTOR INFORMATION
Work#
Work Email
ie
970-353-0216 iscroeginslaw@amail.com
970-353-0216 Jslawpc@Rmail.com
risty
Education Degree ' Lic ensure]
Level Focus Credentials
DORA #
(If applicable)
Post Grad JD Law Colorado Bar
12th grade
This certificate is issued as a matter of information only end confers no(9on lbs Ca 940 to Holder.
9.
rights upon the Cate Hold
This certificate does not amend, extend or alter the coverage afforded by the policies listed below.
aiiva:lerskb ' -
This is to sway het policies of Insurance Weed below have been Issued to the Insured named above for Vaporer/ period Indicated.... • 1 r .. c
dhxaenant with respect to which this cerfecete may be Issued or may parkin, the fr usnca afforded by the poktee deawfbed reran Is� Me re r*, eadu lave orzonationof any =newt a ahhwr
Jac! terms, acdualohhq and oorndftlons death wades.
TYPE OF INSURANCEPOLICY DATE
POLICY NUMBER
Homeowners/
Mobllehomeowners Liability
WW1 Yr) ILMYr7
LIMITS OF LIABILITY
Bodily Irony and Property Damage
Each Om unarm
Boatownars Liability
Personal Umbrella Liability
Farm/Ranch Liability
Workers Compensation and
Employers Liability 1 -
General Liability
O Commerdal General
Liability (occurrence)
0
Businessowners Liability
Liquor Liability
Autorrwbib Liability
❑ Any Auto
❑ All Owned Autos
❑ Scheduled Autos
❑ Hired Auto
❑ Nonowned Autos
O
Excess liability
❑ Commercial Blanket Excess
O
Other (Miscellaneous Coverages)
05-X66837-01
07/09/2017
07/09/2018
Scaly Injury and Property Damps
Each Oocumeroa $
Badly Injury and Property Damage
Each Oce maraca $
Farm Libllay d Personal Liability
Each Occurrenoe
Fein Ei ptoyer's liability
Each Occurrence
Ststnfory
Era' Acddeet
Dlse Each E npbyee
Disease - Policy umlt $ ,000
Genera Applegate
Pro -CoopOpereaom Appreaata $ .000
Personal and *Meriting Injury $ ,000
,000
,000
$ ,000
$
$
,000
,000
.000
Each Oaumnae
Demeter to Premises Rayed to You $ 1000
Medical Expense (Any One Parson) $ 000
Each Occurrencett
Ap lleSciatt
$ ,000
Cananon Care crone
Aggrat ale Unit
Scaly Injury - ENO Person
Sealy Iriury - Each Accident
$ 1,000,000
$ 2,000,000
$
$
$
.000
,000
,000
.000
Property Damage
$ ADO
Beaty injury end Properly Demege Combined $ .000
Each oo iamnceJApaapam
DESCRIPTION OF OPERATIONS / WCATIDNS !VEHICLES I RESTRICTIONS I SPECIAL ITEMS
Weld County is named as additional insured
CERTIFICATE HOLDER'S NAME AND ADDRESS
Weld County
PO Box 1167
Greeley, CO 80632
don@donjanklow.00m
U-201 Ed. 5/00
.000
tVIhe Incleklual a partners ❑ Hpye
shown au Insured elected to
be covered under this policy. O Haw not
tFIs idr Done and end a
equal
included In piny appregeb.
CANCELLATION
0 Should any of the above dascrtbed petioles be Cancelled before the expiration deb
thereof. he company will endeavor to mail'( days) written notice to the C,er1ifeete
Holder named. but Mare to mall such node* shall Impost no °bipeton or liability of any kind
upon she company. Its agents or repreemrfaeves. '10 days urless dafemd minter of days
ahem,
U This chitties coverage on the date of issue only. Tithe above described poacher are -
subject to cancellation In conformity with their temps end by the laws of the state of leave.
DATE ISSUED
08/09/2017
AUnIORWZED REPRESENTATIVE
Less Ringk)ob, A.R.M.
Stock No. 00868 Rev. 7/02
- DECLARATIONS
- BUSINESSOWNERS COVERAGE FORM
- APPLICABLE FORMS AND ENDORSEMENTS
Notification of changes to the Businessowners Policy that occur during the policy term will be made using a change
endorsement that is issued by us and made a part of this policy. Whenever the sentence information required to complete
this Schedule, If not shown on this endorsement, wtl be shown in the Declarations' appears In an endorsement attached
to this policy. the sentence is changed to read:
Information required to complete this Schedule, if not shown on this endorsement, Al be shown in the Declaration or on a
change endorsement issued by us, and made a part of this policy.
Includes copyrighted material of Insurance Services Office, Inc.,
with is permission.
IPM) 01 0517
Pape 2 of 4 Stock No. 14744
NAMED DONALD JANRLOW
INSURED JAMES PEYTON
MICHAEL LAZAR
JULIE SCROGGINS
MAILING 710 11TH AVE STE 205
ADDRESS GREELEY, CO 80631-3200
POLICY PERIOD FROM 07-09-2018 TO 07-09-2019
12:01 A.M. Standard Time at your mailing address shown above.
FORM OF BUSINESS PARTNERSHIP
In return for the payment of the premium, and subject to all the terms of this policy, we agree with you to provide the insurance as stated in
this policy.
SECTION I PROPERTY
ALL PROPERTY COVERAGES ARE SUBJECT TO THE FOLLOWING:
COVERED CAUSES OF LOSS SPECIAL — RISK OF DIRECT PHYSICAL LOSS
COVERAGE LIMIT OF INSURANCE PREMIUM
OPTIONAL COVERAGE
EMPLOYEE DISHONESTY 810,000 $117.00
ADDITIONAL COVERAGE - HIGHER UNITS
FORGERY AND ALTERATION $10,000 $29.00
COVERAGE PROVIDED INSURANCE AT THE FOLLOWING DESCRIBED PREMISES ONLY FOR COVERAGES FOR WHICH A LIMIT OF INSURANCE
IS SHOWN UNLESS COVERAGE IS PROVIDED BY AN ENDORSEMENT.
DESCRIPTION OF PREMISES
PREMISES NO. 0001 BUILDING NO. 001
LOCATION 710 11TH AVE STE 205
GREELEY, CO 80631-3200
BUILDING INTEREST TENANT
PREDOMINANT OCCUPANCY ATTORNEY/ LAWYER OFFICE
CONSTRUCTION JOISTED MASONRY
CERTIFIED ACTS OF TERRORISM
POUCY PROPERTY DEDUCTIBLE $250
OTHER PROPERTY DEDUCTIBLES)
OPTIONAL COVERAGE/GLASS DEDUCTIBLE
AGENT 031-309
LESA RINGKJOB AGENCY, INC
375 E HORSETOOTH RD BLDG 6100
FORT COLLINS, CO 80525-6800
BPAF010517
$3.00
$300
PHONE PAGE 0001
970-223-0940 BRANCH UNATRE RENW
970-353-0032 ENTRY DATE 04-11-2018
INSURED Stock No. 15141
COVERAGE
BUSINESS PERSONAL PROPERTY
REPLACEMENT COST
AUTOMATIC INCREASE IN COVERAGE 4%
ADDITIONAL COVERAGE
BUSINESS INCOME
OPTIONAL COVERAGES
MONEY AND SECURITIES
INSIDE THE PREMISES
OUTSIDE THE PREMISES
LIMIT OF INSURANCE
$41,215
LIMIT OF INSURANCE
ACTUAL LOSS SUSTAINED
LIMIT OF INSURANCE
$10,000
$5,000
Property forms and endorsements applying to this premises and made part of this policy at time of issue:
Any endorsement followed by a state abbreviation will only apply to coverages within this state.
BP 85 17 09 15 BP 84 10 07 98 BP 85 11 12 08
TOTAL ADVANCE PROPERTY PREMIUM $323.00
Property forms and endorsements applying to ail premises end made part of this policy at tine of issue:
Any endorsement followed by a state abbreviation will only apply to coverages within this stale.
BP 06 01 01 07 BP 83 01 07 98 BP 83 02 01 07
PREMIUM
$138.00
PREMIUM
INCLUDED
PREMIUM
$36.00
INCLUDED
INCLUDED
SECTION II LIABILITY AND MEDICAL EXPENSES
Except for Damage To Premises Rented To You, each paid claim for the following coverages reduces the amount of Insurance we
provide during the applicable annual period Please refer to Section II Liability in the BUSINESSOWNERS COVERAGE FORM and any
attached endorsements.
COVERAGE
AGGREGATE LIMIT (OTHER THAN PRODUCTS COMPLETED OPERATIONS)
PRODUCTS -COMPLETED OPERATIONS AGGREGATE LIMIT
LIMIT OF INSURANCE
$2,000,000
$2,000,000
DAMAGE TO PREMISES RENTED TO YOU - ANY ONE PREMISES SEE BP 04 55
LIABILITY - EACH OCCURENCE LIMIT
PREM 0001 BLDG 001 MEDICAL EXPENSES - ANY ONE PERSON
LOCATION PREMIUM BASIS
PREMISES NO. 0001 BUILDING NO. 001
1000 SQUARE FOOTAGE
AGENT 031-309
LESA RINGKJOB AGENCY, INC
375 E HORSETOOTH RD BLDG 6100
FORT COLLINS, CO 80525-6800
BP AF 0'1 0017
$1,000,000
$5,000
RATE ADVANCE PREMIUM
$21.00
PHONE PAGE 0002
970-223-0940 BRANCH UNATRE RENW
970-353-0032 ENTRY DATE 04-11-2018
INSURED Stock No. 15141
CERTIFIED ACTS OF TERRORISM $1.00
APPUCABLE BUSINESS LIABILITY ENDORSEMENT CHAROES $94.00
TOTAL ADVANCE BUSINESS LIABILITY PREMIUM $116.00
Liability forms and endorsements applying to all premises and made part of this policy at time of issue:
Any endorsement followed by a state abbreviation will only apply to coverages within this state.
BP 04 37 07 02 BP 04 39 07 02 BP 04 48 01 06
BP 04 55 01 06 BP 04 93 01 06 BP 05 17 01 06
BP 10 05 07 02 BP 14 60 06 10 BP 15 04 05 14
BP 65 D4 07 10 BP 85 05 07 98C0 BP 85 10 07 98
BP 88 04 02 15 IL 75 26 12 05
BP 04 54 01 06
BP 05 77 01 06
BP 84 24 01 07
BP 85 12 01 06
TOTAL ADVANCE BUSINESS PREMIUM $439.00
This premium may be subject to adjustment.
Forms and endorsements applying to pmperty and liability at all premises and made part of this policy at time of Issue:
Any endorsement followed by a slate abbreviation will only apply to coverages within this state.
BP IN 01 01 06 BP 00 03 01 06 BP 01 81 11 13 BP 05 01 07 02
BP 05 15 01 15 BP 05 23 01 15 BP 05 38 01 15 BP 80 01 05 17
AUTHORIZED
REPRESENTATIVE
ta-,114er-s4C 4
5.al7far�
AGENT 031-309
LESA RINGHJOB AGENCY, INC
375 E HORSETOOTH RD BLDG 6100
FORT COLLINS, CO 80525-6800
BP AF 01 05 17
COUNTERSIGNED
LICENSED RESIDENT AGENT
PHONE PAGE 0003
970-223-0940 BRANCH UNATRE RENW
970-353-0032 ENTRY DATE 04-11-2018
INSURED Stook No. 15141
This endorsement modifies Insurance provided wider the following:
BUSINESSOWNERS COVERAGE FORM
A. Exclusion B.1.q. of Section II — Liability is replaced by the following:
This insurance does not apply to:
q. Access Or Disclosure Of Confidential Or Personal Information And Data -related Liability
(1) Damages, other than damages because of ipersonal and advertising injuryr', arising out of any access to or dsclosure of
any person's or organization's confiderulal or personal information, including patents, trade secrets, processing methods,
customer lists, financial information, credit card information, health information or any other type of nonpublic information; or
(2) Damages arising out of the loss of, loss of use of, damage to, corruption of, inabiity to access, or inability to manipulate
electronic data.
This exclusion applies even If damages are claimed for notification costs, credt monitoring expenses, forensic expenses, public
relations expenses or any other loss, cost or expense incurred by you or others arising out of that which is described In
Paragraph (1) or (2) above.
Hower, unless Paragraph (1) above applies, this exclusion does not apply to damages because of 'badly injury".
As used in this exclusion, electronic data means information, facts or computer programs stored as or on, created or used on,
or transmitted to or from computer software (includng systems and applications software), on hard or floppy diska, CD-ROMs,
tapes, drives, cells, data processing devices or any other repositories of computer software which me used with electronically
controlled equipment. The term computer programs, referred to in the foregoing description of electronic dais, means a set of
related electronic instructions which ciroct the operations and functions of a computer or device connected to It, which enable
the computer or device to receive, process, store, retrieve or sand data.
B. The following is added to Paragraph B.1.p. Personal And Advertising Injury Exclusion of Section II — Liability:
This Insurance does not apply to:
p. Personal And Advertising Injury
'Personal and adrertlaing injury":
Arising out of any access to or disclosure of any person's or organization's confidential or personal information, inducing
patents, trade secrets, processing methods, customer lists, financial information, credit card Information, health information or
any other type of nonpublic information.
This exclusion apples even if damages are claimed for notification costs, credt monitoring avenses, forensic expenses, public
relations expanses or any other loss, cost or expense Incurred by you or others arising out of any access to or diaciosure of any
person's or orgarizaicn's confidential or personal irtormaion.
BP 15 0406 14
O Insurance Services Office, Inc., 2013 Stock Nor. 38338
BUSINESBOWNERS COVERAGE FORM
A. Section II- Liability is amended as follows: The term
'spouse' Is replaced by the following:
Spouse or party to a chill union recognized under
Colorado
B. Section III - Common Policy Conditions is amended
as foikaws:
1. Paragraph A.2. Cancellation Is replaced by the
folowing:
2. If this policy has been In effect for less then 60
days, we may cancel this poky by mating or
delveting to the first Named insured written
notice of cancellation at least
a. 10 days before the effective date of
cancellation if we cancel for nonpayment
of premium; or
b. 30 days before the effective date of
cancellation If we cancel for any other
reason.
2. The following is added to Paragraph A.
Cancellation:
7. Cancellation of Policies in Effect for 60
Days or More
a. If this poky has been in effect for60 days
or more, or is a renewal of a policy we
issued, we may cancel this policy by
mailing through first-class mail to the first
Named Insured written notice of
carncellatiotx
(1) Inckrdng the actual reason, at least
10 days before the ef[eotive date of
cancellation, If we cancel for
nonpayment of premium; or
(2) At least 45 days before the effective
date of cancellation if we cancel for
any other reason
We may only cancel this policy based on
one or more of the folkaw kig reasons:
(1) Nonpayment of premium;
(2) A false statement knowingly made
by the insured on the application for
insurance; or
(8) A substantial change In the
exposure or risk other than that
indcated In the application and
underwritten as of the effective date of the poky Insured hasunless otified us of the
change andweaccept such change.
OP01 h 1113
3. Paragraph C. Concealment, fit:representation
Or Fraud is replaced by the following
C. Concealment, ifferepresentation Or Fraud
We MN not pay for any loos or damage in any
case of
1. Concealment or misrepresentation of a
material fact a
2. Fraud
Committed by you or any other insured at any
timeand relating to coverage under this poicy.
4. The following Paragraph is added and supersedes
any other provision to the contrary
NONREl1EWAL
If we decide not to renew this policy, we will mall
through first-class mail to the first Named insured
shown is the Declarations written no- Lice of the
norranewaf at least 45 days before the etrpiretion
date, or its anniversary date if it is a policy written
for a term of more than one year or with no fined
expiration data
If notice is malted, proof of mailing will be sufficient
proof of notice.
5. The following paragraph is added
INCREASE IN PRENIlM OR DECREASE IN
COVERAGE
We will not Increase the premium unilaterally or
decrease the coverage benefits on renewal of this
poicy unless we mail through first-class mall written
notice of our Intention, including the actual mason,
to the first Named Insureds last mailing address
known to us, at least 45 days before the effective
data
My decrease in coverage during the policy term
must be based on one or morn of the following
reasons:
a. Nonpayment of premium;
b. A false statement knowingly made by the
insured on the application for Insurance; or
c. A substantial change in the exposure or risk
other than that indeated in the application and
underwritten as of the effective date of the
policy unless the first Named Insured has
notified us of the change and we accept such
change.
If notice is mailed, proof of mailing will be
sufficient proof of notice.
o BO Propel, Inc., 2013
Stack No. NOV
This endorsement mo i es insurance provided under the following:
BUSINESSOWNERS COVERAGE FORM
SCHEDULE
Name Of Additional Insured Person(e) Or Organlzation(s):
THOMAS & TYLER LLC
WELD COUNTY
PO BOX 1167
GREELEY CO 80632
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
The following is added to Paragraph C. Who is An Insured In Section II — Liability:
3. My person(s) or orgara¢abon(s) shown in the Schedule is also an additional insured, but only with respect to liability for toddy injury',
'properly damage' or "personal and advertising injury caused, in whole or in part, by your acts or omissions or the acts or omissions of
those acting on your behalf in the performance of your ongoing operations or in connection with your premises owned by or rented to
you,
BP044B 5106
0 !SO Properties, Inc., 2004 Stock No.13799
This endorsement mantes insurance provided under the following:
BUSINESSOWNERS COVERAGE FORM
SCHEDULE
A. Premises: B. Lint Of Insurance Per Occurrence):
0001 BLDG. NO. 001 $100,000
Information required to complete this Schedule, If not shown above, will be shown in the Declarations.
With respect to the coverage pmvtded under Ns endorsement, Section II — Llabllily is amended es follows:
A. The final paragraph of B.1. Exclusions —Applicable To Business Liability Coverage Is deleted and replaced by the following.
With respect to the premises shown in the Schedule of this endorsement which are rented to you or temporarily occupied by you with
the permission of the owner, Exclusions c., d., e., g., h., k., l., m., n. and o. do not apply to "property damage".
B. Paragraph D.2. Liability And Medical Expenses Limits Of insurance is deleted and replaced by the following with respect to
damage to the premises shown in the Schedule of this endorsement
The most we will pay under this endorsement for the sum of all damages because of all "property damage' to premises while rented to
you or temporarily occupied by you with the pem iseian of the owner is the Limit of Insurance shown in the Schedule.
C. With respect to the premises shown In the Schedule of this endorsement, Paragraph D.3. is deleted.
8P045551OS
® ISO Properties, Inc., KU Stock It. 1383D
This endorsement modifies Insurance provided under the following:
BUSINESSOWNERS COVERAGE FORM
SCHEDULE'
Auxiliary
Auxiliary Buildings Business
Premises Building Building! Personal Property
No. No. Auxiliary Buildingl'Structure Description Structure Limit Limit
Information required to complete this Schedule, if not shown on this endorsement, will be shown in the Declarations.
BP 151112 Olt Inductee ccpyrighted material of Insurance Services Office, Inc_, with b permission.
Page 1 or 2
Stock No. 19 25
below, Auxiliary Buildngs Business Personal Property as
doodad under Paragraph d. below, or all for,
depending on whether a Limit of insurance is shown in the
Declarations for that type of property. Regardees of
whether coverage le shown in the Declarations for
Billings, Business Personal Property, Auxiliary
Buildfnge/Structures, Auxiliary Buildings Business
Personal Property, or all four, there is no coverage for
property described under Paragraph A.Z. Rgperly Not
Covered.
a. Buildng, means the described building shown in the
Declarations, Including:
(1) Completed addtione;
(2) Fixtures, including outdoor fixtures;
(3) Permanently metalled:
(a) Machinery', and
(b) Equipment;
(4) Your personal property In apartments, moms or
common areas finished by you as landorrl;
(5) Personal property owned by you that is used to
maintain ar service the described building or the
premises, holding:
(a) Fire extinguishing equipment;
(b) Outdoor furniture;
(c) Floor coverings; and
(d) Appliances used for refrigerating, ventilating,
cooking, dshwashing or laundering;
(6) If not coveted by other insurance:
(a) Additions under construction, alterations and
repars to the described building;
(b) Materials, equipment, supplies and temporary
structures, on or within 100 feet of the
described premises, used for making
additions, alterations or repairs to the
descxbed building.
b. Business Personal Property located In or on the
described building at the premises shown in the
Declarations or in the open (or in a vehicle) within 100
feet of the described premises, inc udng:
(1) Property you own that is used in your business;
(2) Property of others that is in your care, custody or
control, except as otherwise provided in Loss
Payment Property Loss Condition E.5.d.(3)(b)
(3) Tenant's improvements and betterments.
Improvements and betterments are fixtures,
alterations, installations or editions:
and
(5) Exterior buli ling glass, if you are a tenant and no
Unit of insurance is shown in the Declarations
for Building property. The glass must be owned
by you or In your care, custody or control.
a. Auxiliary Builcings/Struchne, meaning the auxiliary
buildingslstuotures described in the above Schedule
located at the premises shown in the Declarations,
including:
(1) Completed additions;
(14Fbdu;
(3) Pannanenily installed:
(a) Machinery; and
(b) Ecluipmenl;
(4) Personal property owned by you that Is used to
molntain or service the atodiiany buildings/
structures, inducing:
(a) Fl re extinguishing equipment;
(b) Floor coverings; and
(c) Appliances used for refrigerating, ventilating,
cooking, dishwashing or laundering;
(5) If not covered by other insurance:
(a) Additions under construction, alterations and
repairs to the auxiliary buildingslshuot Ira;
(b) Materials, equipment lea and temporary
structrras, on o r within 100 feet of the
auditory buildings/structures, used for making
additions, alterations or repairs to the auxiliary
buildngskbuctures.
d. Auxiliary Buildings Business Personal Property
located in or on the auditory buridingalstnxctures
described in the above Sahedtie located at the
premises shown in the Declarations, including:
(1) Property you own that Is used in your business;
(2) Property of others that is in your care, custody or
control, except as otherwise provided In Loss
Payment Property Loss Condition E.54.(3)(14;
(3) Leased personal property for which you have a
contractual msporaiblllly to ire, unless
otherwise provided for under Paragraph 1.b.(2).
B. The following is added to E.3., Property Loss Conditions —
Duties in the Event of Loss or Damage:
(10) Keep records of your property in such a way that we cart
accurately determine the amount of any loss.
BP 11112Oe Indices copyrighted materiel of insurance Services Office, inc., with its permission.
Page 2 of 2
Stock No.19225
.r r,ay.r..w • 1 . ...r s .rr— ..HY Mal V Ihinkf YGI\J%VG
PLEASE READ THE ENTIRE FORM CAREFULLY
This endorsement modifies insurance provided under the following:
BUSINESSOWNERS COVERAGE FORM
SCHEDULE
UMuI OF LIABILITY (INCLUDES COST OF DEFENSE):
Each insured Event Limit
Self�lflsu R lien citldes C of Dsfen
An ° One insu E t
Prior Kn,..e: 0710 1
Period: Yes Li
can Farnily Clal
For the purposes of the coverage provided by this endorsement,
Section II — LJahllity is amended as follows:
A The following is added to Paragraph A. Coverages:
1. WHAT IS COVERED
We will pay Loss amounts that an Insured is legally
obligated to pay on account of a Claim because of an
insured Event to which this endorsement applies.
However, the amount we will pay is limited as described
in the LIMIT OF UABIUTY and SELF INSURED
RE eNTION paragraphs of this endorsement
2. This endorsement applies only if:
a. A Claim is first made against an insured in
accordance WHEN COVERAGE IS PROVIDED in
this endorsement;
b. The Claim is reported in accordance with WHEN
COVERAGE IS PROVIDED and the Duties In the
event of a Claim Condition of this endorsement
c. A Claim is first made against an Insured In
accordance with WHERE COVERAGE IS
PROVIDED; and
3100,000
ill be shown in the Declarations
d. A Claim is first made against an Insured based
upon an Insured Event that first occurred on or
after the Retroactive Date set forth In the Schedule
of this endorsement
3. Defense. We have the right and duty to defend any
Claim for an Insured Event made or brought against
any Insured to which h this endorsement apples. We have
the right b choose counsel to du#end a Claim that we
are covering. We have no duty to provide other services
or take other actions. Our duty to defend any Claim
ends when the MIT OF UABIUTY that applies has
been exhausted, and in such event, the Named Insured
shell, upon notice from us, promptly take over control of
the Menu.
We have the right to investigate end to settle any Claim
for an Insured Event in the manner and to the extent
that we believe is proper, contingent upon the consent of
the Named insured as defined in this endorsement
This Includes the right to agree to poet a notice of
compliance, provided such notice does not contain an
admiseion of lability.
BP ea 04 0215 Includes copyrighted material of Insurarce Services Office, with its permission.
Page 1 of 7
Stock No. 35392
to you.
4. During the transfer of control. We agree to take
whatever steps are necessary to continue the defense of
any autstanc g Claim and avoid a default Judgment
during the transfer of control to you. If we do so, you
agree to pay reasonable menses that we ear for
taking such steps after the LIMB' OF UABIUTY is
exhausted
5. Duty to pay. We have the duty to pay any Loss (after
you pay the applicable seifinsuued retention) that results
from arty Claim for an Insured Event made or brought
against any Insured to which this policy applies. Our
duty to pay ends when the applicable LIMIT OF
LIABIUTY has been exhausted We will not pay more
than the amicable LIMIT OF LIABILITY.
We have the duty to pay Defense Costs incurred (after
you pay the applicable self -Insured retention) for the
defense of any Claim that is controlled by us. Any
payment of Defense Costs is Included In the LIMIT OF
LIABILITY, it is not In addition to the LIMIT OF
LIABILITY.
A. Recommended Settlements. As respects any Claim for
which we recommend that a settlement offer be
accepted but you do not give your consent to such
settlement, and the Claim later results in a judgment or
settlement in excess of the reconynended settlement,
ow liability for Loss on account of such Claim shall not
exceed the recommended settlement amout plus
Defense Cods incur ed as of the date we
recommended the settlement. This provision shall not
apply unless the total Loss, including the recommended
settlement, old exceed the applicable SELF
INSURED RETENTION amount
7. WHEN COVERAGE IS PROVIDED
This endorsement applies only to Claims arising cut of
an insured Event first made or brought during the Poky
Period and which are reported to us in accordance with
the notice provisions as set forth in E.1. Duties In the
Event of a Claim of this endorsement Claims are
considered to be that made when It le first served or
received by the Insured.
a. All Claims because of One Insured Event will be
considered to have been made or brought on the
date that the first of those Claims wee first node or
brought.
b. Limited Reporting Period
For the purposes of the coverage provided by this
endorsement, Limited Reporting Period means the
thirty (30) day period after the policy ends, during
which Claims because of insured Events which
happen or oonvnence during the Poky Period and
are reported in accordance with Paragraph A. and
Paragraph E. of this endorsement can be made.
PBS 040215
terms, you ahei have the right to buy an
Extended Reporting Period providing:
(a) An extended reporting g period of up to
thirty six (36) months from the end of the
Policy Period or
(b) The effective date of cancellation,,
whichever Is eerier, In exchange for yew
payment of an additional premium.
(2) The Extended Reporting Period will not be
enforced unless
(a) we receive a written request for It within
thirty (30) days after this endorsement Is
cancelled or non -renewed; nor
(b) will It take effect unless the additional
Premium is paid within thirty (30) days
after this endorsement is cancelled or
nor -renewed
The Extended Reporting Period is activated by checking
the appropriate box on the Schedule of this
endorsement Once that Premium is paid the Extended
Reporting Period may not be cancelled and the
additional Premium will be fully earned,
The additional premium for a 36 month Extended
Reporting Period will be two hundred percent (200%) of
the premium charged for the last Policy Period.
However, the Extended Reporting Period will not apply
to any Claim if other insurance you buy covers you or
would cover you if its limits of coverage had not been
exhausted.
Coverage under the Extended Reporting Period Is with
respect to Claims first made against an insured during
the Policy Period or Extended Reporting Period and first
reported by an Insured during the Extended Reporting
Period, provided always that Claims reported during the
Extended Reported Period are limited to Insured Events
which happen or commence before the original Policy
Period ends by either cancellation or non -renewal and
which am otherwise covered by this endorsement.
The UNIT OF UABIUTY that applies at the end of the
Policy Period is not renewed or increased and the Limits,
as sham in the Schedule of this endorsement, shall not
be increased In any way by the Limited Reporting Period
or the addition of the Extended Reporting Period.
8. If, during the Policy Period, any of the following changes
occur.
a. the acquisition of an Insured, or of all or
stthfantially all of its assets, by another entity, or
the merger or consolidetlon of an Insured into or
with another entity such that the Insured Is not the
surviving entity; or
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Stock No, 35392
change, but coverage with respect to such Insured will
cease with respect to Claims for Insured Events
committed after such change. Altar any such change,
this endorsement may not be cancelled and the entire
Premium for the endorsement will be deemed fully
earned.
9. WHERE COVERAGE IS PROVIDED
This endorsement covers Claims made and Insured
Events otxmrdsg anywhere in the United States of
America or its tarritodes.
B. For the purposes of the coverage provided by this
endorsement, the following is added to Section IL Liability
Paagraph B. Exclusions:
1. Worker's
CompensationERISAIFLSAINRLAIWARWCOBRAIO
BHA. This endorsement does not cover any Loss adeirgi
out of any Clabn alleging violation of any: I) worker's
compensation, dsabilty benefits or unemployment
compensation law, social security and other employment
benefits law; I) the Err byes Retirement Income
Security Act of 1974 Public Law 93.406; iii) the Fair
Labor Standards Act (except the Equal Pay Act); (iv) the
National Labor Relations Act; (v) the Worker Adpsbnent
and Retraining Notification Act (vi) the Consolidated
Omnibus gadget Reconciliation Act of 1985; (vi) the
Occupational Safety and Health Act (viii) any other
federal, state or local statute or law similar to any statute
or law described in (1) through (ve) of this exclusion;
provided, however, this exclusion shall not apply to any
Claim for any actual or alleged retalatory treatment of
the chimera on account of the claimant's exercise of
tights pursuant is such statute, law, rule or regulation.
2. Contractual Liability. This endorsement does not cover
any Loss based upon, editing out of, directly or Indirectly
in connection with, related to, or in any way involving
any Claim any Insured is obligated to pay by reason of
the aaeurption of anther's liability for an Insured
Event in a contract or agreement. This excluslon wll not
apply to liability for damages because at en Insured
Event that any Insured would have without the contract
or agreement
3. Consequential Loss. This endorsement does not cover
any Loss resulting from or attributable to any allegations
made by or solely for the benefit of a claimant's
domestic partner, spouse, child, parent, brother or sister.
4. Wage and Hour Law. This endorsement does not cover
any Loss arising out of a claim based upon, arising out
of, directly or I ndieclly in connection with, related to or in
any way alleging violation of any state or local wage and
hour low, however, in the event such Claim also alleges
an Insured Event otherwise covered by this
endorsement, notwithstanding the provisions of
Paragraph A.3. Defense, and subject to all other berme,
conditions and exclusion contained in this endorsement,
BP 8a 040216
or alleged wrongful termination of an Employee.
6. Fraud and Collusion. This endorsement does not cover
any Loss based upon, arising out of, directly or indirectly
in connection with, related to, or In any way Involving
any Claim alleging fraud, collusion, dishonest, criminal
or malicious acts by or at the dmctian of an insured.
Without limiting the foregdng, we el pay Defense
Costs incurred relating to allegations of fraud, collusion,
dishonest, criminal or malicious acts to defend an
innocent Insured named in such Claim so long as such
Claim also curtains allegations against that innocent
Insured involving an Insured Event otherwise covered
by this endorsement
7. Prior Knowledge. This endorsement does not cover any
Loss arising out of Insured Events of which any
insured who is a principal, partner, officer, director,
Uuetee, In-house counsel, Employee(s) within the
Human Resource or Risk Management department or
Employee(s) with personnel and risk management
responsibilities was aware by actual knowledge of the
facts or circumstances of such Insured Event prior to
the Prior Knowledge Date, as ailMi in the Schedule of
this endorsement
& Prior NoEce. This endorsement does not cover any
Loss arising out of Insured Events that have been the
subject of any notice given under any other policy prior
to the Inception date of this endorsement.
9. Retroactive Date This endorsement does not cover any
Loss arising out of any Insured Events that first
occured red before the Retroactive Date as set forth in the
Schedule of this endorsement For the purposes of this
exclusion, related Insured Events are excluded if the
first related Insured Event took place or is alleged to
have taken place prior to the Retroactive Date.
C. For the purposes of the coverage provided by this
endorsement Section IL Liability Paragraph B. Who Is An
Insured is amended to include as an insured:
1. Individual. If you are shown in the Declarations as an
Individual, you and your spouse are Insureds but only
for the conduct of a business of which you am the sole
ovmer.
2. Corporation. If you are storm in the Declarations as a
corporation or organization other than a per nersNp or
pint venture, you are en Insured. Your stockholders are
also Insureds, but only with respect to their liability as
your stockholders.
3. Partnership or Joint Venture. If you are shown in the
Declarations as a partnership or joint venture, you are an
Insured. Your partners or co -venturers and their
spouses are also Insureds, but only for the conduct of
your business.
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Stock No. 35392
shareholders am also insureds but only with respect to
the conduct of your business.
5. Employees. Your Employees, executive officers,
dreators and your trustees am insureds only for the
conduct of your business within the scope of their
employment. Your Employee's status as an Insured
will be determi ned as of the date of the Discrimination.
Harassment, Inappropriate Employment Conduct,
which caused an Insured Event.
6. Mergers and AcqubI@ons. My organization that you
newly acquire, form or merge with while this
endorsement is in effect that has less than 10% of the
total number of your Employees as of the inception date
of this endorsement shall be an Insured at the time of
such acquisition, merger or formation if you own at least fifty one percent to the expiration oflthe poll the Insured �Il�give us
written notice as to all such organizations. If you acquire,
form or merge with any organization that has more than
10% of the total number of your Employees as of the
inception date of this endorsement, such organization is
also an insured if you awn at least fifty one (51%) of it
provided, however, no such organization Is covered for
more than forty five (45) days or the remainder of the
Policy Period, whichever is less, from the date acquired,
merged or formed unless we agree to cover such
acquisition or newly formed organization within such
forty five (45) day period in consideration of an additional
Premium to be determined by us. Notwithstanding the
foregoing, any acquired or loomed organization Is neither
covered for Loss that results from an Insured Event
that happened or first commenced before the Insured
acquired or formed it; nor for Loss covered under any
other insurance.
This provision does not apply to a partnership or joint
venture. Nor does it apply to any organization once it is
shown in the Declarations.
T. Subsidiary. My organization more than 50% owned by
the Named Insured and listed In the Application shall be
an Insured.
D. For the purposes of the coverage provided by this
endorsement, Section IL Liability Paragraph D. Liability
And Medical Expanses Limits of insurance is replaced by
the following:
1. Umlt of Uabill y
a. The amount shown in the Schedule of this
endorsement as the 'Each Insured Event Limit' is
the most we will pay for Claims first made or
brought during the Policy Period for Loss that
results from any One Insured Event regardless of
the number of Claims.
HP 11640215
not in any way increase. For purposes of the LIMIT
OF LABILITY, any policy extension Is considered
to be pmt of and not in addition to the former Policy
Period.
2. Self Insured Retention
Our obligation to pay under this endorsement applies
only to armed amounts in excess of any Self Insured
Retention amount that the Insured must pay, as shown
in the Schedule of this endorsement, and the LIMIT OF
UABIUTY will not be reduced by the amount of such
Self Insured Retention.
The Self Insured Retention amount will apply separately
to each Claim made, however, it will only apply once to
all Claims arising out of any One Insured Event
regardless of the number of claimants who allege
damages.
If, prior to terminating or demoting an Employee the
Insured consults with and follows the advice of the EPL
hotline andtor a labor law attorney approved by our
Authorized Representatives, as shown in the Scheib)
of this endorsement, then the Insured's Self Insured
Retention is reduced by 50% In the event the Insured
faces a Claim involving such termination or demotion.
E. For the purposes of the coverage provided by the
endorsement, the folio ing are added to Paragraph E.
Liability And Medical Expenses General Conditions:
1. Duties in the event of a Claim
a. You must see to It that we or our Authorized
Representatives, as shown in the Schedule of this
endorsement, are notified as soon as practicable
but in no event more then thirty days (30) after any
Insured who is a principal, partner, officer, director,
trustee, in house counsel, Employee(s) within the
HR Risk Management department or Employee(s)
with personnel and risk management
reeponsibilWes, becomes aware that a Claim has
been made. Your notification should include:
(1) the identity of the person(s) alleging
Discrimination, Harassment, Inappropriate
Employment Conduct;
(2) the identity of any insured(s) who allegedly
committed the Discrimination, Harassment,
Inappropriate Employment Conduct;
(3) the identity of any witnesses to the alleged
Discrimination, Harassment, Inappropriate
Employment Conduct; and
the date(s) an Insured Event took place.
(4)
Includes copyrighted material or insurance Services Office, with its permission.
Page 4 of 7
Stock No. 35392
Representatives, as shown in the Schedule of
this endorsement, to obtain statements,
records and other information;
(3) co-operate with us or air Authorized
Representatives, as shown in the Schedule of
this endorsement, in the investigation or
defense of the Claim; and
(4) assist us or our Authorized Representatives.
as shown in the Schedule of this endorsement,
in the enforcement of any right against any
person or organization which may be liable to
an Insured because of Loss to which this
endorsement may also apply.
0. No Insured will, except at their own cost, voluntarily
make a payment, assume any obligation, or incur
any expense without our consent Subsequent
payments that are deemed by us as having been
prejudiced by any such voluntary be the sole responsibility
will also
lity of the Insured.
2. Report of a Potential Claim
Solely at an insured's option, an Insured may within
the Policy Period report an oral complaint by an
Employee, fanner Employee or applicant for
employment alleging Discrimination, Harassment
andlor Inappropriate Employment Conduct. If such
report Is received by us or our Authorized
Representatives, as shown in the Schedule of this
endorsement, within the Policy Period then any Claim
subsequently arising from such oral complaint will be
deemed to be made on the date such report was
received. Such report must include the identity of the
person(s) maldng the oral complaint in no went,
however, is an Insured entitled to owerage under this
endorsement based on a Laundry List Notification.
3. Legal Action Against Us
a. No person or organization has the right under this
endorsement
(1) to join us as a party or otherwise bring us into
a suit asking for damages from an Insured; or
(2) to sue us on this endorsement unless all of Its
terms have been fully complied with.
b. A poison or organization may sue us to recover on
an agreed Battlement or on final judgment against
an Insured obtained after an actual trial, but we will
not be liable for damages that are not payable
made the tams of this endorsement or that am in
excess of the amicable LIMIT OF 'mummy. An
agreed settlement means a settlement and release
of liability signed by us, an Insured and the
claimants legal representative.
F.
available to any insured. Nothing herein is intended to
make this endorsement subject to the terms, conditions
and imitations of any other insurance, and nothing
herein is intended to limit our or any tosireds right to
contribution or indemnity from any other party, insurer or
indemnitor.
5. Representations
By accepting this endorsement you agree:
a. The statements in the Policy Declarations and this
endorsement are accurate and complete;
b. Those statements are based upon representations
you made to us; and
c. We have issued this endorsement in reliance upon
your representations.
6. Transfer Of Rights Of Recovery Against Others to Us
if any insured has rights to recover all or part of any
payments we have made under this endorsement, those
rights are eansfened to us; the insured must do nothing
after a Loss to anpeir them. At our request, any Insured
will bring suitor transfer those rights to us and help us to
enforce them.
7. Bankruptcy
Banknote,/ or insolvency of any insured or of an
Insured's estate will not relieve us of our obligations
under this endorsement, except as excluded in
Paragraph B. of this endorsement
8. False Or Fraudulent Claims
If any Insured shall proffer any Claim knowing the same
to be false or fraudulent as regards amount or otherwise,
this endorsement will become void in Its entirety and all
coverage hereunder shall be forfeited.
For the purposes of the coverage provided by this
endorsement, the following is added to Section II. Llab*lty
Paragraph F. Liability And Medical Expenses Definitions:
1. Claim(s) means a written complaint or written charge
made against an Insured or a written demand made
against an Insured in which damages are alleged or
where specific charges of Discrimination, Harassment,
Inappropd a Employment Conduct are brought
Claim Includes a civil adlon, suit or adrfnnistrative
proceeding, to which any insured must submit or to
which any lamed submits with our consent.
But Claim shall not mean any labor or grievance
arbitration subject to a colective bergain'ung agreement;
or any complaint, writ or other proceeding in which en
Insured is alleged to have committed or engaged in a
criminal offense or violation of a federal, state of local
penal lane.
BPISN0215
Incnrdes copyrighted materiel of Inauranoe Services Office, with its permission
Pegs 5of7
Stock No. 353
rru nuve rug uuage won to rurnran any cons,
The following are not Defense Cods: costs Incurred by
any inured before notice Is provided to us; salaries and
expenses of your employees, includng In-house andlor
coverage attorneys, salaries and expenses of our
employees, or our in-house or coverage attorneys or the
fees and expenses of independent adjusters we tire.
3. Discrimination means lamination of the employment
relationship, a demotion, a failure or refusal to hire or
promote, denial of an employment benefit or the taldng
of any adverse or dfferential employment action
because of race, color, religion, age, sex, dsablity,
pregnancy, sexual orientation, national origin, or any
other basis prohibited by federal, state or local law
occurring on or after the Retroactive Date as shown in
the Schedcde of this endorsement.
This insurance cotters retaliation claims based on
unlawful dscriminafion occurring on or after the
Retroactive Date as shown on the Schedule of this
endorsement, except as excluded in Paragraph B. of
this endorsement.
4 Employee means an individual whose labor or service is
engaged by and drected by the Named Insured, or ay
covered entity. This Includes volunteers, part time,
seasonal and temporary Employees as well as any
individual employed in a supervisory, =medal or
confidential position. Independent contractors and
subcontractors are not Employees unless they are
dedc ated agents or representatives of an Insured.
Employees who are leased to another employer are not
Employees.
5. Harassment means unwelcome sexual or nonsexual
advances, requests for sexual or non -sexual favors or
other verbal, visual or physical conduct of a sexual or
non -sexual nature, where such harassment occurs on or
after the Retroactive Data as shown in the Scheduled of
this endorsement and Is based on a factor or category
prohibited by law (including sex, race, age, national
origin, disability, etc.), that (1) explicitly or Implicitly are
made a condition of employment, (2) are used as a basis
for employment decisions, or (3) create a work
environment that interferes with performance.
6. Inappropriate Employment Conduct means any of the
following occurring on or after the Retroactive Date as
shown in the Schedule of this endorsement
a. actual or constructive termination of an employment
relationship in a manner which is alleged to have
been against the law or wrongful or in breath of en
implied employment contract or breach of the
covenant of good faith and fair dealing in the
employment contract;
b. allegations of wrongful demotion, or wrongful
discipline;
&ability made by en Employee, a former
Employee or an applicant for employment which
arise from an Insured's employment decision to
hire, fire, promote or demote;
e. allegations of false imprisonment, detention or
malicious prosecution made by an Employee, a
former Employee or art applicant for employment
which arise from the insured's an employment
decision to hire, fire, promote or demote;
f. allegations of libel, slander, defamation of character
or any invasion of right of privacy math by an
Employee, a former Employee or an applicant for
errploym ant which arise hart an Insured's
employment decision to hire, fire, promote or
demote; or
other personal injury allegations made by an
Employee, a former Employee or an applicant for
employment which arise from an Insured's
employment decision to hire, fire, promote or
demote.
Inappropriate Employment Conduct shall not include
any allegations other than those sot forth above.
7. insured Event means actual or alleged acts of
Discrimination, Harassment, andlor Inappropriate
Employment Conduct, by an Insured against an
Employee or farrier Employee or applicant for
employment with an insured entity occurring on or after
die Retroactive Date as shown in the Schedule of this
endorsement. Insured Event shall not include Claims
for actual or alleged violation of any federal, state or
local wage and hour laws or regulations.
8. Laundry List Notification means any attempt by an
Insured to report multiple matters under this policy in a
summary fashion that does not comfy with Paragraph
E.1. Dulles In the event of a Claim or Paragraph Ei
Report of a Potential Claim. By way of example, a
Laundry List Notification may consist of a report by an
insured that lists purported potential claimants, either in
the absence of a Claim, Of in the absence of an oral
9. Loss means damages, judgments (including
prejudgment and poet judgment interest awarded against
an Insured on that part of any judgment paid by us),
settlements, we authorize or agree to, statutory attorney
fees and Defense Costs.
However, Loss does not include anything specifically
excluded in Paragraph B. of this endorsement, or arty of
the following:
a salary or wages of the Insured;
b. nowrxrneteiy relief (this provision does not apply to
Defense Costs where non -monetary relief is sought
for alleged Harassment, Diecdminatlon,
Inappropriate Employment Conduct;
g.
DP ore 040215
!nctudas copyrighted malerW of Insurance Services Office, with its permission.
Page 6 of 7
Stock No. 302
a. costs hound by an insured to modify or adapt any
balking or property in order to make such bulking
or property more accessible or accommodating to
any disabled person; costs associated with
eliminating non -essential duties from the job
desaiption of a disabled person; costs associated
with providing a dsabled person with reasonable
workplace accommodations; and costs associated
with lost produatlitty by an employer as the result of
making a reasonable workplace accommodation for
a dsabled person;
f. matters which may be deemed uninsurable
according to the law under which this policy is
construed
I. severance paymems or oongasans to make
paY► ts;
k. amounts that are sought or deemed to be owed
under partnership, stock or other ownersNp
agreements;
L fines, penalties and tame.
10. One Insured Event means (1) one or more catered
allegations of Discrimination, Harassment and/or
Inappropriate Employment Conduct which are related
by an unbroken chain of events or (2) class action or
multiple claimant or multiple plaintiff suits arising out of
related Insured Events.
11. Subsidiary means any organization more than 50%
owned by the Named Insured listed in the Application.
@P 6a 040210 Includes copyrighted mater1l at Insurance Swvkxs Ofrice, with its permission.
Page 7of7
Stock No. 35392
UM ueparauons. mum ors[ name° ensured Known in me declarations may continue mis policy tor Successive policy,
periods by paying the required premium on or before the effective date of each renewal policy period. If the premium
is not paid when due, this policy expires at the end of the last policy period for which the premium was paid.
The premium for each policy period will be based on our current rates and rules.
if this policy replaces coverage in other policies terminating at 12:00 Noon (standard time) on the inception date of
this policy, this policy shall be effective at 12:00 Noon (standard time) instead of at 12:01 A.M., Standard Time.
Includes copyrighted material of Insurance Services Office, Inc.,
will Its permission.
BP 80010517
Page 3 of 4
Stock No. 14744
While this policy is in force, each insured named in the Declarations is considered an owner or policyholder and a member
of the American Family Insurance Mutual Holding Company (AFMMHC) of Madison, Wisconsin. As a member, you are
entltled to one vote at all meetings either in person or by proxy. You can only cast one vote regardless of the number of
policies or coverage you purchased. If two or more persons quaff), as a member under a single policy, they am considered
one member for purposes of voting. The owner of a group policy will have one vote regardless of the number of persons
insured or coverage purchased. Fractional voting is not allowed. If you are a minor, any vote will be given to your parent or
legal guardian.
2. ANNUAL MEETINGS
The Annual Meetings am held at the Home Office: 6000 American Parkway, Madison, Wisconsin, on the first Tuesday of
March at 2:00 P.M. Central Standard Time. Notice in this policy shall be sufficient notification.
3. DIVIDENDS
It any dividends are declared, you will share in them according to law and under condltlons set by the Board of Directors.
This policy is signed at Madison, Wisconsin, on oar behalf by our President and Secretary. If it to required by law, it
is countersigned on the declarations by our authorized representative.
BP 80010517
ca)1144Le (-----C 141-----.-„
President Secretary
This is not a complete and valid contract without accompanying DECLARATIONS properly executed.
Page 4 of 4 Stock No.14744
BUSINESSOWNERS POLICY
Non -assessable policy Issued by
AMERICAN FAMILY MUTUAL INSURANCE COMPANY, S.I.
6000 American Pkwy
Madison WI 53783-0001
(608) 249-2111
Member of American Family Insurance Group
BP 80 01 0617 Stock No.14744
EXHIBIT B
SCOPE OF SERVICES
1. Contractor will provide Mediation services to Weld County families in Dependency and Neglect cases as
referred by the Department.
2. Contractor will accept calls directly from the Court for the purpose of scheduling mediations and will notify
the Department that mediation has been scheduled. The Department will provide the Contractor with a
formal referral authorizing the services to be billed to the Department.
3. Contractor agrees to be organized, responsive and to quickly and successfully schedule mediations.
4. Contractor is available Monday through Friday, 8:00 a.m. to 4:00 p.m.
5. Mediation sessions are generally scheduled for one (1) to two (2) hours in length; however, Contractor
can accommodate longer sessions up to one (1) day in length under special circumstances, with
Department approval.
6. Contractor will provide adequate, local and appropriately secure space for mediations to occur in.
7. Contractor agrees to bill for face-to-face mediation services only and further agrees that the rate reflected
in Exhibit C, Payment Schedule, is inclusive of all scheduling, preparation and post -mediation
requirements and documentation.
8. All mediation services will be provided by Julie Scroggins, Attorney at Law.
9. Goal/Outcome of Service: Good faith agreements between family members and/or Department.
10. Target Population: Parents and extended family of all ages and genders.
11. Service Access: All services will be provided at 710 11th Avenue, Suite 205, Greeley, Colorado 80631.
12. Language: English only.
13. Medicaid Eligibility: Services are not eligible for Medicaid.
14. Transportation: Contractor does not transport clients.
15. Contractor agrees to confirm upon receipt of a request and/or referral for mediation services that he does
not have any conflict of interest with any party to the mediation.
16. Contractor will submit documentation that notes the date and time of the mediation, participating
parties, and whether or not agreement or partial agreement was reached for each referral. This
documentation will be submitted with each monthly billing.
EXHIBIT C
PAYMENT SCHEDULE
1. Funding and Method of Payment
The Department agrees to reimburse the Contractor in consideration of the work and services performed
under this Agreement at the rate specific in Paragraph 2, below. The total amount to be paid to the
Contractor during the term of this Agreement shall be reported by the Department after May 31, 2019.
Expenses incurred by the Contractor prior to the term of this Agreement are not eligible Department
expenditures and shall not be reimbursed by the Department.
Payment pursuant to this Agreement, whether in whole or in part, is subject to and contingent upon the
continuing availability of said funds for the purposes hereof. In the event that said funds, or any part
thereof, become unavailable as determined by the Department, the Department may immediately
terminate the Agreement or amend it accordingly.
2. Fees for Services
$250.00 Hour (Inclusive of all scheduling, preparation and post -mediation requirements and
documentation.)
3. Submittal of Vouchers
Contractor shall prepare and submit monthly an itemized voucher, and monthly report if applicable,
certifying that services authorized were provided on the date(s) indicated and the charges were made
pursuant to the terms and conditions of Paragraph 3 and Exhibits A and B.
Contractor shall submit all monthly billing sand applicable reports to the Department by 7t1 day of the
month following the month the cost was incurred. Failure to submit by the aforementioned deadline
may result in forfeiture of payment.
a. For ongoing services, proof of services rendered shall be a Client Verification Form signed by the
client and a monthly report submitted in accordance with Paragraph 3(d) of this Agreement.
b. For one-time services, proof of services rendered shall be receipt of the completed product.
c. For Monitored Sobriety services, proof of services rendered shall be the test result.
REQUEST FOR BID
WELD COUNTY, COLORADO
1150 O STREET
GREELEY, CO 80631
DATE: NOVEMBER 19, 2018
BID NUMBER: B1800162
DESCRIPTION: STREAM GAGE FLOOD WARNING PROJECT
DEPARTMENT: OFFICE OF EMERGENCY MANAGMENT
MANDATORY PRE -BID CONFERENCE DATE: NOVEMBER 29, 2018
BID OPENING DATE: DECEMBER 6, 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:
WELD COUNTY STREAM GAGE FLOOD WARNING PROJECT.
A mandatory pre -bid conference will be held at 2:00PM., on _November 29th, 2018, at the Weld County
Administration Building. The Administration Building is located at 1150 O Street Greeley Co, 8063.
Bidders must participate and record their presence at the pre -bid conference to be allowed to submit bids.
Bids 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 December 6, 2018 (Weld County
Purchasing Time Clock).
PAGES 1 - 8 OF THIS REQUEST FOR BIDS CONTAIN GENERAL INFORMATION FOR THE REQUEST
NUMBER REFERRED TO ABOVE. NOT ALL OF THE INFORMATION CONTAINED IN PAGES 1-8 MAY BE
APPLICABLE FOR EVERY PURCHASE. BID SPECIFICS FOLLOW PAGE 8.
2. INVITATION TO BID:
Weld County requests bids for the above -listed merchandise, equipment, and/or services. Said
merchandise and/or equipment shall be delivered to the location(s) specified herein
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.
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.
Bid Delivery to Weld County - 2 methods:
1. Email. Emailed bids are preferred. Bids may be emailed to: bids@weIdg ov. com . 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.
BID REQUEST #B1800162 Page 1
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 be the bid of the individual signing. When requested by
the Weld County Controller/Purchasing Director, satisfactory evidence of the authority of the officer signing in
behalf of a corporation shall be furnished. A power of attorney must accompany the signature of anyone not
otherwise authorized to bind the Bidder. 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. 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.
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. 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. Bidders are expected to examine the conditions,
specifications, and all instructions contained herein, failure to do so will be at the bidders' risk.
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. It is also
understood that Weld County will give preference to suppliers from the State of Colorado, in accordance with
C.R.S. § 30-11-110 (when it is accepting bids for the purchase of any books, stationery, records, printing,
lithographing or other supplies for any officer of Weld County). 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.
In submitting the bid, the bidder agrees that 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), 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 RFB.
4. 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
BID REQUEST #61800162 Page 2
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.
5. GENERAL PROVISIONS:
A. Fund Availability: Financial obligations of 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 financial information of the bidder should be transmitted
separately from the main bid submittal, clearly denoting in red on the financial 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 attempt to contact the bidder in order to allow
the bidder to seek an appropriate court order preventing disclosure. Without such an order, Weld County will
release the requested information in accordance with CORA.
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
BID REQUEST #B1800162 Page 3
the successful bidder and its employees and agents only if such coverage is made available by the successful
bidder or a third party. The successful bidder shall pay when due all applicable employment taxes and
income taxes and local head taxes (if applicable) incurred pursuant to the contract. The successful bidder
shall not have authorization, express or implied, to bind Weld County to any agreement, liability or
understanding, except as expressly set forth in the contract. The successful bidder shall have the following
responsibilities with regard to workers' compensation and unemployment compensation insurance matters:
(a) provide and keep in force workers' compensation and unemployment compensation insurance in the
amounts required by law, and (b) provide proof thereof when requested to do so by Weld County.
E. Compliance with Law: The successful bidder shall strictly comply with all applicable federal and state
laws, rules and regulations in effect or hereafter established, including without limitation, laws applicable to
discrimination and unfair employment practices.
F. Choice of Law: Colorado law, and rules and regulations established pursuant thereto, shall be applied
in the interpretation, execution, and enforcement of the contract. Any provision included or incorporated
herein by reference which conflicts with said laws, rules and/or regulations shall be null and void.
G. No Third Party Beneficiary Enforcement: It is expressly understood and agreed that the
enforcement of the terms and conditions of the contract, and all rights of action relating to such enforcement,
shall be strictly reserved to the undersigned parties and nothing in the contract shall give or allow any claim or
right of action whatsoever by any other person not included in the contract. It is the express intention of the
undersigned parties that any entity other than the undersigned parties receiving services or benefits under the
contract shall be an incidental beneficiary only.
H. Attorney's Fees/Legal Costs: In the event of a dispute between Weld County and the successful
bidder, concerning the contract, the parties agree that Weld County shall not be liable to or responsible for the
payment of attorney fees and/or legal costs incurred by or on behalf of the successful bidder.
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 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.
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
BID REQUEST #61800162 Page 4
consent, which may be withheld in County's sole discretion. County shall have the right in its reasonable
discretion to approve all personnel assigned to the subject Project during the performance of this Agreement
and no personnel to whom County has an objection, in its reasonable discretion, shall be assigned to the
Project. The successful bidder shall require each subcontractor, as approved by County and to the extent of
the Services to be performed by the subcontractor, to be bound to the successful bidder by the terms of this
Agreement, and to assume toward the successful bidder all the obligations and responsibilities which the
successful bidder, by this Agreement, assumes toward County. County shall have the right (but not the
obligation) to enforce the provisions of this Agreement against any subcontractor hired by the successful
bidder and the successful bidder shall cooperate in such process. The successful bidder shall be responsible
for the acts and omissions of its agents, employees and subcontractors.
O. Warranty: The successful bidder warrants that services performed under this Agreement will be
performed in a manner consistent with the standards governing such services and the provisions of this
Agreement. The successful bidder 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.
The bidder warrants that the goods to be supplied shall be merchantable, of good quality, and free from defects,
whether patent or latent. The goods shall be sufficient for the purpose intended and conform to the minimum
specifications herein. The successful bidder shall warrant that he has title to the goods supplied and that the
goods are free and clear of all liens, encumbrances, and security interests.
Service Calls in the First One Year Period: The successful bidder shall bear all costs for mileage, travel time,
and service trucks used in the servicing (including repairs) of any of the goods to be purchased by Weld
County, Colorado, pursuant to this bid for as many service calls as are necessary for the first one (1) year
period after said goods are first supplied to Weld County.
Bidder shall submit with their bids the following information pertaining to the equipment upon which the bids
are submitted:
1. Detailed equipment specifications to include the warranty.
2. Descriptive literature.
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
BID REQUEST #61800162 Page 5
family shall serve on a County Board, committee or hold any such position which either by rule, practice or
action nominates, recommends, supervises the successful bidder's operations, or authorizes funding to the
successful bidder.
T. Severability: If any term or condition of this Agreement shall be held to be invalid, illegal, or
unenforceable by a court of competent jurisdiction, this Agreement shall be construed and enforced without
such provision, to the extent that this Agreement is then capable of execution within the original intent of the
parties.
U. Binding Arbitration Prohibited: Weld County does not agree to binding arbitration by any extra-
judicial body or person. Any provision to the contrary in the contract or incorporated herein by reference shall
be null and void.
V. 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.
W. Compensation Amount: Upon the successful bidder's successful completion of the service, 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 County's delegated
employee, or by formal resolution of the Weld
X. Taxes: 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. Contractor shall not be entitled to bill at overtime and/or double time
rates for work done outside of normal business hours unless specifically authorized in writing by County.
6. INSURANCE REQUIREMENTS:
Insurance and Indemnification. 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. 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 Contract Professional. Contract Professional shall be responsible for the payment of any
deductible or self -insured retention. County reserves the right to require 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 Professional. The County in no way warrants that the minimum limits
contained herein are sufficient to protect them from liabilities that might arise out of the performance of the
work under this Contract by the Contract Professional, its agents, representatives, employees, or
subcontractors. The Contract Professional shall assess its own risks and if it deems appropriate and/or
prudent, maintain higher limits and/or broader coverages. The Contract Professional 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 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.
BID REQUEST #B1800162
Page 6
The Contract Professional stipulates that it has met the insurance requirements identified herein. The
Contract Professional 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
Contract Professional and shall, without additional compensation, promptly remedy and correct any errors,
omissions, or other deficiencies.
INDEMNITY: The Contract Professional shall defend, indemnify and hold harmless County, its officers,
agents, and employees, from and against injury, loss damage, liability, suits, actions, or willful acts or
omissions of Contract Professional, 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 Contract Professional to conform to any
statutes, ordinances, regulation, law or court decree. The Contract Professional 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 Contract Professional in its 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 Contract Professional 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 Contract Professional 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 Contract Professional 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 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 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 Contract
Professional or subcontractor is exempt under Colorado Workers' Compensation Act., AND when such
Contract Professional or subcontractor executes the appropriate sole proprietor waiver form.
Commercial General Liability Insurance shall include bodily injury, property damage, and liability assumed
under the contract.
$1,000,000 each occurrence;
$1,000,000 general aggregate;
$1,000,000 Personal Advertising injury
Automobile Liability: 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.
Professional Liability (Errors and Omissions Liability)
The policy shall cover professional misconduct or lack of ordinary skill for those positions defined in
the Scope of Services of this contract. Contract Professional shall maintain limits for all claims covering
wrongful acts, errors and/or omissions, including design errors, if applicable, for damage sustained by reason
of or in the course of operations under this Contract resulting from professional services. In the event that the
professional liability insurance required by this Contract is written on a claims -made basis, Contract
Professional warrants that any retroactive date under the policy shall precede the effective date of this
Contract; and that either continuous coverage will be maintained or an extended discovery period will be
exercised for a period of two (2) years beginning at the time work under this Contract is completed.
BID REQUEST #B1800162
Page 7
Minimum Limits:
Per Loss
Aggregate
$ 1,000,000
$ 2,000,000
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 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, Contract Professional's insurer shall name County as an additional insured.
Waiver of Subrogation: For all coverages, Contract Professional's insurer shall waive subrogation rights
against County.
Subcontractors: All subcontractors, independent Contract Professionals, 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 Contract Professional. Contract Professional
shall include all such subcontractors, independent Contract Professionals, sub -vendors suppliers or other entities
as insureds under its policies or shall ensure that all subcontractors maintain the required coverages. Contract
Professional agrees to provide proof of insurance for all such subcontractors, independent Contract
Professionals, 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 REQUEST #B1800162 Page 8
SPECIFICATIONS AND/OR SCOPE OF WORK AND PROPOSED PRICING:
Background
On September 9, 2013, a slow -moving cold front stalled over Colorado, conflicting with warm humid air
from further south. The result produced heavy rain and catastrophic flooding along Colorado's Front
Range from Colorado Springs to Fort Collins. The situation intensified over September 11 and 12 as
rain continued and storm runoff began entering rivers, causing multiple surges far above typical levels.
The National Weather Service's Hydro -meteorological Design Studies Center stated in the Exceedance
Probability Analysis for the Colorado Flood Event Study: "The rarity of this event...shows how the
maximum rainfall amounts compared to corresponding precipitation frequency estimates for annual
exceedance probabilities from 50% to 0.1% for durations from 15 minutes to 7 days."
Weld County was heavily impacted by the overflow of the South Platte River, the Big Thompson River,
the Saint Vrain River, the (Cache La) Poudre River, and a series of minor tributaries during the
September 2013 flooding event. Flooding in Weld County affected a total of 7,121 parcels of land. Of
this number, 2,910 were residential properties, 355 parcels contained commercial properties, 62
parcels had been used as industrial service sites, and the remaining parcels served as either
agricultural properties or natural resources.
Existing stream gages currently delay readings by up to one hour and cannot be relied upon to provide
crucial information within an appropriate timeframe during a potential flood event. In the case of the
September floods, the stream gage information was received just before the rivers began to reach a
dangerously high level of flow and did not allow emergency services enough time to both properly warn
all citizens within close proximity of the waterways and initiate the established protocol for responding
to a flood hazard. This resulted in far less than desirable evacuation times for a large portion of the
local population, and to the confusion and congestion which naturally follows.
Scope of Work
Weld County, Colorado
The Weld County Office of Emergency Management is seeking proposals to install a series of ALERT
(Automated Local Evaluation in Real Time) radio telemetry stream gage warning system sensors within
Weld County and surrounding areas to serve as early warning systems for the purpose of notifying
citizens of impending flood hazards. This project is in coordination with the Division of Water Resources
and utilizing DRW gages. The newly installed stream gage equipment will provide real time stream data
allowing for a much quicker warning response service than those relied upon during the September
2013 flood subsequently declared by FEMA as disaster DR -4145.
The Contractor will be responsible for completing a telemetry study to ensure data from the selected
gaging stations can be received to the receiver locations. The Contractor is also responsible for
obtaining the FCC licenses for each ALERT gaging site.
The Contractor will be responsible for providing all grounding rods, concrete, antenna masts,
mounting accessories, etc. which are needed to install the monitoring equipment.
Current stream gage data is gathered from the Internet utilizing a number of existing gages operated
BID REQUEST #B1800162 Page 9
by the Colorado Division of Water Resources. While these systems do assist in providing the County
with river flow information, the time steps of each existing station are roughly one hour, meaning that
information is not typically relayed back to the County until one hour after the gage has performed the
reading. This is not sufficient for the citizens of Weld County who live within a flood hazard area because
this does not allow for a sufficient amount of time to evacuate to safety in a sudden flood.
All mitigation actions performed will provide a level of protection in line with the goals of the most
current NOAA National Weather Service Flood Warning Systems Manual. In order to ensure that the
citizens of Weld County will be provided with a higher level of safety, a total of six radio telemetry
stream gages will be installed along the major rivers and confluences in the southeastern portion of
the County. (See figure 1.1 below.) This area contains the highest number of persons per square
mile within the County and contains the City of Greeley, as well as a number of the County's local
government offices and buildings. Working with the DWR we are proposing six stream gages be co -
located with existing Colorado Division of Water Resources (DWR) stations which will assist in
providing the National Weather Service with more accurate and up-to-date data than existing gages
can offer.
Weld County requires the warning software be able to work on a "Cloud base system" to collect all of
the data and disseminate it to local emergency managers, public works employees, the National
Weather Service, and the general public. It is possible that a single repeater may be required in order
to ensure reliable and accurate data at the base/modem. Once the project has been completed and
closed out, Weld County will evaluate the need for an additional radio repeater and will install this with
local funding if necessary. Please see gage installation descriptions below for more information.
Project Locations
Each of the project sites are listed in the blow table with the Division of Water Resource gage Identifier.
For additional information see the attached MAP for location information.
Poudre River
Timnath Admin Gage
DWR
CLARIVCO
Poudre River
Fern Ave in E Greeley
DWR
CLAGRECO
Big Thompson
402 &I-25
DWR
BIGHILCO
Confluence Big Thompson and South Platte River
40.349983, -104.784966
DWR
BIGLASCO
Confluence St Vrain and South Platte River
CR 19.5 and St Vrain River
DWR
SVCPLACO
South Platte River
CR 53 Bridge and South Platte River
DWR
PLAKERCO
Weld County Project Management Contact
Weld County Office of Emergency Management will partner with appropriate county agencies, the
Colorado Department of Transportation and experts from the National Weather Service and will contract
with an experienced vendor who specializes in the installation and operation of ALERT flood warning
systems. The Weld Office of Emergency Management will manage the project, to include; contracting,
directing timelines and deliverables, process invoices and inspect for approved standards.
BID REQUEST #B1800162
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Timeline
The timeline for this project is March 31st 2019, Weld County received a grant through FEMA which
requires the project to be completed by the end of March 2019.
Specifications (all listed equipment are examples and not necessarily required brands, but similar
equipment is required)
Packaged Water Level/ Rainfall Station
ALERT2 Packaged Water Level Station
ALERT2 Radio Transceiver (spec. freq.) or comparable equipment
Rain gauge tipping bucket or similar equipment
Lightning Protection
Packaged Repeater
ALERT2 Packaged Repeater and associated equipment to support early warning for rivers
Cloud Based Software
Web access to information pertaining to rain fall gage, river height and warning alerting to County
Emergency Management personnel.
The selection process for a contractor will be based in qualifications and experience with installation
of stream gage warning equipment familiarity with Weld County and an understanding of current
early warning systems. Work experience with the Colorado Division of Water Resource and an
understanding of current warning systems in Boulder, Larimer and Adams Counties. Proposals
should include three references and examples of related projects. Utilizing best practices and
national standards for monitoring and warning.
Once a contractor is selected, the contractor shall provide a task completion schedule and indicate
the percentage of payment as tasks are completed that shall be made with a 5% retention until
completion.
BID REQUEST #B1800162
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* The successful vendor is required to sign a separate contract (a sample contract is included as a separate
attachment.)
PRICING:
TOTAL $:
ESTIMATED COMPLETION DATE:
DOES YOUR BID MEET OUR SPECS? YES OR NO (PLEASE SPECIFY)
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 proposal for Request No. #B1800162.
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 Proposal contained herein (including,
but not limited to, product specifications and scope of services), and the formal acceptance of the bid by Weld
County, together constitutes a contract, with the contract date being the date of formal acceptance of the bid
by Weld County.
5. Weld County reserves the right to reject any and all bids, to waive any informality in the bids, and to
accept the bid that, in the opinion of the Board of County Commissioners, is to the best interests of Weld
County. The bid(s) may be awarded to more than one vendor.
FIRM BY
(Please print)
BUSINESS
ADDRESS
DATE
CITY, STATE, ZIP CODE
TELEPHONE NO FAX TAX ID #
SIGNATURE
E-MAIL
**ALL BIDDERS SHALL PROVIDE A W-9 AT TIME OF BID OPENING**
(If not already on file)
WELD COUNTY IS EXEMPT FROM COLORADO SALES TAXES. THE CERTIFICATE OF EXEMPTION
NUMBER IS #98-03551-0000. YOU DO NOT NEED TO SEND BACK PAGES 1 - 8.
BID REQUEST #B1800162
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