HomeMy WebLinkAboutbocc.con.137.2010CLERK'S CHECK LIST
FOR CONTRACTS SUBMITTED TO CLERK AND RECORDER FOR
SCANNING/ARCHIVING
CONTRACT #: 137-2010
ORIGINATING DEPARTMENT/DIVISION: Airport
CONTACT PERSON: David Ulane PHONE #: 970-429-2853
PROJECT NAME: Airfield Pavement Crack Sealing
^ BOCC AGENDA ITEM
(Requires BOCC Signature)
CHECK PROCUREMENT TYPE:
~STAFF AUTHORIZED SIGNATURE
(per Revised Procurement Code 7/2005)
^None ^Informal ~Formal ^Sole Source ^Emergency ^State Bid ^
^Compliance with House Bills 06-1343 and 07-1073 (Under $10,000, Letters of Engagement, etc.)
CHECK CONTRACT TYPE:
DOLLAR AMOUNT: $70,622.00 BUDGET LINE ITEM/LEDGER NUMBER:
404.25.00000.82869
^Services/Maintenance ^Employment (for county employees)
^License/Use ^Intergovernmental Agreement (Requires BOCC Action)
^Lease ^Non-Profit
~Construction ^Quasi-Public
^Goods, Equipment, Supplies ^Grant Agreements (Requires BOCC Action)
^Other (e.g. revenue) ^Change Order/Contract Amendment
CONTRACTOR/BUSINESS:Maxwell Asphalt, Ina Complete Legal of Name of Business
Maxwell Asphalt, Inc..
Contract Execution Date:05/12/2010 Contract End Date: 6/20/2010
Automatic Renewal ^Yes ~No Term of Contract: OS/12/2010-6/20/2010
All Contracts should be proofed for the following: ~
/ ~No Pages Missing 1 3 ~ (~
/^If a Page is Left Intentionally Blank -Note on Page ~
/ ~Page numbered consecutively
/ ~All Signatures Affixed
/ ~All Dates Filled In
/ ~All Other Blanks Filled In
/ ~All E~ibits Attached
/~HB 06-1343 and 07-1073 Legislation Included in RFP and/or Contract
/ ^All Legal Descriptions Attached (if appropriate)
/ ^Notice of Award/Proceed Attached (if appropriate)
/ ^Warranty, if applicable
^Special Instructions for Finance Department:
~Sent to Clerk and Recorder for Scanning/Archiving
~Authorized Staff Person's Name: David Ulane
BY CHECKING ABOVE AND ENTERING NAME, THE AUTHORIZED STAFF
PERSON INDICATES THAT THE ATTACHED DOCUMENT HAS BEEN PROOFED
AND READY FOR SCANNING.
NOTE: CLERK' S OFFICE WILL KEEP ORIGINAL DOCUMENTS IN COMPLIANCE
WITH COLORADO STATE ARCHNES RETAINAGE SCHEDULE.
13~t ~o~o
yoy . ZS.~ 91y1~. $?AO~
CONTRACT AGREEMENT
Aspen-Pitkin County Airport
Aspen, Colorado
Jviation, Inc. Project No. ASE LOC-10-01
ST
THIS AGREEMENT, made and entered into this ~ day of 3~1~J'c~ , 20 ~
by and between Pitkin County Board of County Commissioners, Party of the First Part,
hereinafter referred to as the "Owner", and Maxwell Asphalt, Inc., Party of the Second Part,
hereinafter referred to as the "Contractor;' for the construction of airport improvements
including
Schedule I- Existing Airfield Pavement Crack Sealing
and other incidental work at the Aspen-Pitkul County Airport.
WITNESSETH:
ARTICLE 1. It is hereby mutually agreed that for and in consideration of the payments as
provided for herein to the Contractor by the Owner, the said Contractor shall furnish all labor,
equipment, and material and shall perform all work necessary to complete the improvements in
a good and substantial manner of the highest quality, ready for use, and in strict accordance
with this Contract, a copy of which is filed pursuant to law in the office of the legal
representative of the Owner.
ARTICLE 2. It is hereby further agreed that in consideration of the faithful performance of the
work by the Contractor, the Owner shall pay the Contractor the compensation due hun/her by
reason of said faithful performance of the work, at stated intervals and in the amount certified
by the Engineer, in accordance with the provisions of thi.s Contract.
ARTICLE 3. It is hereby further agreed that, at the completion of the work and its acceptance
by the Owner, all sums due the Contractor by reason of his faithful performance of the work,
taking into consideration additions to or deductions from the Contract price by reason of
alterations or modifications of the original Contract or by reason of "Extra Work" authorized
under this Contract, or by reason of Owner's right to deduct for liquidated damages and other
damages as provided for in the Contract Documents, will be paid the Contractor by the Owner
after said completion and acceptance.
ARTICLE 4. It is hereby further agreed that any references herein to the "Contract" shall mean
"Contract Documents° as the same as defined in Paragraph 10-13, Section 10 of the General
Provisions and consisting of the Invitation for Bid, Instruction to Bidders, all issued Addenda,
Proposal, Statement of Qualifications, Anticipated Sub-Contracts, Form of Proposal Guaranty,
Notice of Award, Contract Agreement, Performance & Payment bonds, Notice to Proceed,
Notice of Contractor's Settlement, Wage Rates, General Provisions, Special Provisions, Plans,
Technical Specifications, attached appendices and all documents incorporated by reference.
Said "Contract Documents" are made a part of the Contract as if set out at length herein. Said
Contract Agreement is limited to the items in the proposal as signed by the Contractor and
included in the Contract Documents.
ARTICLE 5. The Contractor agrees to perform all the work described in the Contract
Documents for the unit prices and lump sums as submitted in the Bid, taking into consideration
additions to or deductions from the Total Bid by reason of alterations or modifications of the
original quantities or by reason of "Extra Work" authorized under this Agreement in
accordance with the provisions of the Contract Documents.
ARTICLE 6. The Contractor agrees to commence work within ten (10) calendar days after the
receipt of a notice to proceed and the Contractor further agrees to complete said work within 15
Working days for Schedule I and 7 Working Days for Schedule II (concurrently with
Schedule I) after the start of construction. All work on this project will be completed by June 15,
2010. If work is not completed by this date, remaining work items will be delayed for
completion until the fall of 2010. Extensions of the Contract time may only be permitted upon
execution of a farmal modification to the Contract Agreement in writing as approved by the
Owner. Liquidated damages shall be assessed in the amounts specified in General Provisions
section 80-08, as described and specified in Special Provisions Part C Paragraph 19. In the event
of an inconsistency in the Contract Documents regarding the amount of liquidated damages to
be assessed, the amounts set forth in General Provisions section 80-08 shall control.
The total estimated cost for Jviation, Inc. Project No. ASE LOC-10-01, Schedule I- Existing
Airfield Pavement Crack Sealing thereof to be
Thirty two thousand, seven hundred and fifty dollars ($32,750.00) (See attached memo)
IN WITNESS WHEREOF, the Party of the First Part and the Party of the Second Part,
respectively, have caused this Agreement to be duly executed in day and year first herein
written in five (5) copies, all of which for all intents and purposes shall be considered as the
original.
CONTRAC'TOR, Pa of the Se nd Part
^ Y 1I l r4,~-
~~ f _ _" _
By: "...F~
~--~~-~ .
(Office or Position of Signer)
OWNE e First Part
_.~
By: 'D*~t~ ~l~wr~
As~ : ~ra~a•+ c~cE.c.rc~
(Oftice or Position of Signer)
(SEAL)
ATTEST:
(Office or Position of Signer)
~
(Office or Position of Signer)
Bond No. 346CSZZ8708
LABOR AND MATERIAL PAYMENT BOND
KNOW ALL MEN BY THESE PRESENTS:
That the Contractor, Maxwell Asphalt, Inc. , as Principal and hereinafter called "Principal", and
Hartford Fire Insurance Com a~nv, as Surety and hereinafter called "Surety," a corporation organized and
existing under the laws of Connecticut , are held and firmly bound unto the Pitkin
County Board of County Commissioners, and to all subcontractors and any others who have
supplied or furnished or shall supply or furnish materials, rental machinery, tools, or
equipment actually used in the performance of the hereinafter identified Contract, or who have
performed or shall perform labor in the performance of or in connection with said Contract,
hereinafter called "Obligees" in the sum of ~ Dollars ($ 32,750.00 ) together with
interest at the rate of eight per cent (8%) per annum on all payments becoming due in
accordance with said Contract, from the time such payments shall become due until such
payment shall be made, for the payment of which, well and truly made to the Obligees, the
Principal and the Surety bind themselves, their heirs, executors, administrators, successors and
assigns, jointly and severally, firmly, by these presents.
WHEREAS, the Principal and the Pitkin County Board of Coun {~ ommissioners have
ay 12,'20~0
entered into a certain Contract, hereinafter called "Contract," datec~ for the construction
of a PROJECT described as Aspen-Pitkin County Airport, which Contract is hereby by reference
made a part hereof; Jviation, Inc. Project No. ASE LOC-10-01
NOW, THEREFORE, THE CONDTTION OF THIS OBLIGATION is such that if the
Principal and the Surety shall fully indemnify and save harmless the Pitkin County Board of
County Commissioners from and against any and all costs and damages, including patent
infringements, which either may suffer by reason of any failure or failures of the Principal
prompfly and faithfully to perform all terms and conditions of said Contract and shall fully
reimburse and repay the Pitkin County Board of County Commissioners all outlay and expense
which the Pitkin County Board of County Commissioners may incur in making good any such
failure or failures, and further, if the Principal and his subcontractors shall duly and promptly
pay for any and all labor, materials, team hire, sustenance, provisions, provender, rental
machinery, tools, or equipment and other supplies which have been or shall be used or
consumed by said Principal or his subcontractors in the performance of the work of said
Contract, and if said Principal shall duly and promptly pay all his subcontractors the sums due
them for any and all materials, rental machinery, tools, or equipment and labor that have been
or shall be furnished, supplied, performed or used in connection with performance of said
Contract, and shall also fully indemnify and save harmless the Pitkin County Board of County
Commissioners to the extent of any and all expenditures which either or both of them may be
required to make by reason of any failures or defaults by the Principal or any subcontractor in
connection with such payments; then this obligation shall be null and void, otherwise it shall
remain in full force and effect.
It is expressly understood and agreed that any alterations which may be made in the
terms of said Contract or in the work to be done under said Contract, or any extension(s) of time
for the performance of the Contract, or any forbearance on the part of either the Pitkin County
Board of County Commissioners or the Principal to any of the others, shall not, in any way
release the Principal and the Surety, or either of them, their heirs, executors, administrators,
3
successors or assigns from their liability hereunder, notice to the Surety of any such alteration,
extension or forbearance being hereby waived.
Any conditions legally required to be included in a payment bond on this contract, including
but not lixnited to those set out in the Pitkin County Home Rule Charter or Procurement Code,
are included herein by reference.
The Surety agrees that, in the event that the Contractor fails to make payment of the obligations
covered by this bond, it will do so and, further, that within forty-five (45) days of receiving, at
the address given below, a claim here under stating the amount claimed and the basis for the
claim in reasonable detail, it (a) will send an answer to the claimant, with a copy to the Owner,
stating the amounts that are undisputed and the basis for challenging any amounts that are
disputed and (b) will pay any amounts that are undisputed. The amount of this bond shall be
reduced by and to the extent of any payment of payments made in good faith hereunder.
While this bond is in force, it may be sued on at the instance of any party to whom any such
payment is due, in the name of the Owner, to the use of such party. The Owner shall not be
liable for the payment of any costs or expenses of any such suit.
No suit shall be commenced or pursued here under other than in a state court of competent
jurisdiction in Pitkin County, Colorado.
IN WTI'NESS WHEREOF, the Principal and the Surety have executed this Bond, this the
1st day of June , 20 10 .
SIGNATURE OF PRINCIPAL (as applicable)
A. Individual, partnership or joint venture
B. Cor ation
Attest. -~
Secretary (affix seal)
SIGNATURE OF SURETY
(Signature of sole proprie or or general a er)
,
Name of Corporate rincipal
By
Name and address of Corporate Surety
Hartford Fire Insurance Company
PO Box 57100, Salt Lake City, UT 84157
By (seal)
Attorney in Fact (attach power of attorney)
John Schlichte, Attorney in Fact
~
ACCEPTANCE BY
The foregoing bond is approved.
Date 6 •1-Z01~ , By
The foregoing bond is in due form according to law and i d.
Date I~ •1•Ze1~ , gy
THIS BOND MUST BE ACCOMPANIED BY A POWER OF ATTORNEY, EFFECTIVELY
DATED. This bond is issued simultaneousl~ with another bond conditioned for the full and faithful
performance of the contract.
~
Bond No. 34BCSZZ8708
PERFORMANCE BOND
KNOW ALL MEN BY THESE PRESENTS, That Maxwell Asahalt. Inc.
as Principal, hereinafter called Contractor, and
Hartford Fire Insurance Company as Surety, licensed to do business as such
in the State of Colorado, hereby bind themselves and their respective heirs, executors,
administrators, successors, and assigns, unto Pitkin County Board of County Commissioners,
Aspen, Colorado, as Obligee, hereinafter called Owner, in the penal sum of
Thirty Two Thousand Seven Hundred Fifty Dollars
Dollars ($ 32,750.00 ) for
the payment whereof Contractor and Surety bind themselves, their heirs, executors,
administrators, successors and assigns, jointly and severally, by these presents.
WHEREAS,
Contractor has by written agreement dated May 12 , 2p 10 entered
into a contract with Pitkin County Board of County Commissioners for
Thirty Two Thousand Seven Hundred Fifty , Dollars ($ 32,750.00 ) which contr'act,
including any present or future amendment thereto, is incorporated herein by reference and is
hereinafter referred to as the Contract.
NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION is such that, if the Contractor
shall promptly and faithfully perform said Contract including all duly authorized changes
thereto, according to all the terms thereof, including those under which Contractor agrees to
pay legally required wage rates including the prevailing hourly rate of wages in the locality, as
determined by the Department of Labor and Industrial Relations or by final judicial
determination, for each craft or type of workman required to execute the contract, and, further,
shall defend, indemnify and hold the Owner harmless from all damages, loss and expense
occasioned by any failure whatsoever of said Contractor and Surety to fully comply with and
carry out each and every requirement of the contract, then this obligation shall be void;
otherwise it shall remain in full force and effect.
In the event that Contractor shall be and is declared by the Owner to be in default under the
Contract, the Owner having performed its obligations thereunder, the Surety may promptly
remedy the default, or shall promptly
1) Complete the contract in accordance with its terms and conditions, or
2) Obtain a bid or bids for completing the Contract in accordance with its terms and conditions,
and upon determination by Surety of the lowest responsible bidder, or, if the Owner elects,
upon determination by the Owner and the Surety jointly of the lowest responsible bidder,
arrange for a contract between such bidder and the Owner , and make available as Work
progresses (even though there should be a default or a succession of defaults under the contract
or contracts of completion arranged under this paragraph) sufficient funds to pay the cost of
completion less the balance of the contract price; but not exceeding, including other costs and
damages for which the Surety may be liable here under, the penal sum of the bond. The term
"balance of the contract price", as used in this paragraph, shall mean the total amount payable ~
by the Owner to Contractor under the Contract and any amendments thereto, disbursed at the
rate provided in the original contract, less the amount properly paid by the Owner to the
Contractor. If the completion contract provides for more rapid payment than the Contract, then
Surety shall advance such sums as are needed to make payment as provided in the completion
contract and shall recover it from the Owner when payment from the Owner is due.
WAIVER. The said surety, for value received, hereby expressly agrees that no change,
extension of time, alteration or addition to the terms of the contract or to the work to be
performed thereunder, shall in any wise affect the obligations of this bond; and it does hereby
waive notice of any such change, extension of time, or alteration or addition to the terms of the
contract or the work to be performed thereunder.
IN WITNESS WHEREOF, the above parties have executed this instrument the 1st day of
June ,2010
SIGNATURE OF PRINCIPAL ~as applicable)
A. individual, partnership or joint venture
B. Cor ation
r
Atte .
Secre ary (affix se
SIGNATURE OF SURETY
ACCEPTANCE BY
The forego' n is a proved.
Date
Hartford Fire Insurance Comaanv
PO Box 57100, Salt Lake City, UT 84157
By h
orney in act (attach power o ttorney)
John Schlichte, Attorney in Fact
~"sr
By ~ •~ ~-zer o
The fore o' ' in due form according to law and is approved.
Date By ~-!•ZOt~p
~
Name and address of Corporate Surety
Direct Inquiries/Claims to:
POWER OF ATTORNEY P.o. B X" 0 6 Op S~ORDENUE
HARTFORD, CONNECTICUT 06115
call: 888-266-3488 or fax: 860-757-5835
KNOW ALL PERSONS BY THESE PRESENTS THAT: Agency Code: 34-477223 & 59-305342
X~ Hartford Fire Insurance Company, a corpora6on duly organized unc~r the laws ofthe State of Connecticut
X~ Hartford Casualty InsuranCe Company, a corporation duly orgamzed under the laws of the State of hdiana
X~ Hartford Accident and Indemnity Company, a corporation duly organized under the laws ofthe State of Connecticut
0 Hartford Underwriters Insurance Company, a corporation duly organized under the laws ofthe State of Connecticut
~ Twin City Fire Insurance Company, a corporation duly organizedunder the laws of the State of India~a
~ Hartford Insurance Company of Illinois, a corporation duly organized under the laws ofthe State ofIllinois
~ Hartford Insurance Company of the Midwest, a corporation duly organized under the laws of the State of Indiana
~ Hartford InsuranCe Company of the Southeast, a corporation duly organized under the laws ofthe State of Florida
having their home o~ce in Hartford, Connecticut, (hereinafter collectively referred to as the "Companies") do hereby make, constitute and appoint,
up to the amount of unlimited:
John D. Schlichte, Brian Rueckert, Michael J. Wade, Delia Zeeh, Kim Cooksey, Kimberly Payton
of
Salt Lake City, UT
their true and lawful Attorney(s)-in-Fact, each in their separate capacity if more than one is named above, to sign its name as surety(ies) only as
delineated above by ~, and to execute, seal and acknowledge any and all bonds, undertakings, contracts and other written instruments in the
nature thereof, on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and
executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law.
In Witness Whereof, and as authorized by a Resolution of the Board of Directors of the Companies on January 22, 2004 the Companies
have caused these presents to be signed by its Assistant Vice President and its corporate seals to be hereto affixed, duly attested by its Assistant
Secretary. Further, pursuant to Resolution of the Board of Directors of the Companies, the Companies hereby unambiguously affirm that they are
and will be bound by any mechanically applied signatures applied to this Power of Attorney.
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o ~r~Ms~ .° ~wa.~e.fii`f a ~O~r "~~~ L _ ~'~j~p~W~'~r~o`y;° '~T w~i
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i~7`?il,=~
Scott Sadowsky, Assistant Secretary
STATE OF CONNECTICUT
~ ss. Hartford
COUNTY OF HARTFORD
M. Ross Fisher, Assistant Vice President
On this 3rd day of March, 2008, before me personally came M. Ross Fisher, to me known, who being by me duly sworn, did depose and
say: that he resides in the County of Hartford, State of Connecticut; that he is the Assistant Vice President of the Companies, the corporations
described in and which executed the above instrument; that he knows the seals of the said corporations; that the seals affixed to the said
instrument are such corporate seals; that they were so affixed by authority of the Boards of Directors of said corporations and that he signed his
name thereto by like authority.
t~.o~
~~ ~~~~/~.
~~~~ • Scott E. Paseka
Notary Public
CERTIFICATE My Commission Expires October 31, 2012
I, the undersigned, Assistant Vice President of the Companies, DO HEREBY CERTIFY th t the above and foregoing is a true and correct
copy of the Power of Attorney executed by said Companies, which is still in full force effective as o~~,~{~Q (~'~~ (~
Signed and sealed at the City of Hartford.
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Gary W. Stumper, Assistant Vice President
~~~~~F
May 28, 2010
ASPENlPITKW COUNTY
130 SOUTH GALENA ST.
ASPEN CO 81611
CERTIFICATE OF INSURANCE
This will certify that:
MAXWELL ASPHALT INC
PO BOX 585
BOUNTIFUL UT 84011
Policy Number 1674538
has an active Workers Compensation and Employers Liability policy in
accordance with the provisions of the Utah Workers Compensation Act
for the period 6/20/2009 to 6/20/2010 at 12:01 A.M.
If the policy is cancelled prior to the policy expiration date of
6/20/2010 you will be notified.
Employer's Liability:
Each Accident: 500,000
Disease - Policy Limit: 500,000
Each Employee: 500,000
Job Reference:
(A job-site location is the only valid entry in this section. Any other
language or representation is invalid and in no way extends or alters
the coverage issued.)
ASPEN/PITKIN COUNTY AIRPORT
CRACK SEALING PROJECT
This certificate does not amend, extend, or alter the coverage afforded by the policy.
Workers Compensation Fund - 392 East 6400 South - Salt Lake City, Utah 84107 - 800-446-COMP - www.wcfgroup.com
ACORD CERTIFICATE OF LIABILITY INSURANCE OPID CB DATE(MM/DD/YYW)
-MAXASI 05 27 10
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
The Presidio Group, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND
EXTEND OR
5295 South 300 West #550 ,
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Salt Lake City UT 84107
Phone: 801-924-1400 Fax: 801-924-1441 INSURERS AFFORDING COVERAGE NAIC #
INSURED
INSURERA: Colorado Casualty Insurance
Q178'rj
INSURER B: Indian Harbor Snsurance Co.
M3XW211 Asphalt IIIC. INSURERC: rrat~l onion Fire xna. co. rTa 19445
650 S. Delon $t .
Salt Lake Ci~y UT 84104 INSURER D:
INSURER E:
C:UVtKACitS
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY DATE MM/DD/YY LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1~ OOO ~ OOO
B X COMMERCIALGENERALLIABILITY ESG002216203 OZ~OZ~ZO OZ~O1~~.1 PREMISES(Eaoccurence) $ZOO~OOO
CLAIMS MADE ~ OCCUR MED EXP (My one person) $ S~ OOO
PERSONAL 8 ADV INJURY $ 1
OOO
OOO
~
~
GENERAIAGGREGATE $ 2
OOO
OOO
GEN'L AGGREGATE LIMIT APPLIES PER:
PR PRODUCTS - COMP/OP AGG ~
~
$ 2~ OOO ~ OO O
O-
POLICY ][
JECT LOC
AU TOMOBILE LIABILITY
A
X
ANYAUTO
BA2572025
Q2~Q1~],Q
~2~~1~11 COMBINED SINGLE LIMIT
(Eaaccident) $]. OOO OOO
r i
ALL OWNED AUTOS
BODILY INJURY
$
SCHEDULED AUTOS (Per person)
HIRED AUTOS
BODILY INJURY $
NON-OWNED AUTOS (Per accident)
PR
OPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
ANY AUTO EA ACC
OTHER THAN $
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 3~ OOO ~ OOO
C X OCCUR ~ CLAIMS MADE BE044062788 OZ~OZ~1.O OI.~OZ~ZS. AGGREGATE $ 3~ OOO ~ OOO
s
DEDUCTIBLE $
X RETENTION $ Z O~ O O O $
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY TORY LIMITS ER
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED?
If yes
describe under E.L. DISEASE - EA EMPLOYEE $
,
SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $
OTHER
A Property CBP2572028 02/O1/10 02/O1/11 Off prem $35,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Subject to the terms and conditions of the policy.
~a
JOB: Aspen-Pitkin County Airport, Jviation, Inc. Project No. ASE LOC-10-O1
CERTIFICATE HOLDER CANCELLATION
Aspen / Pitkin County
County Soard of Commissioners
130 S. Galena St.
Aspen CO 81611
ASPEPIT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOP
DATE 7HEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3O DAYS WRITTEN
NOTICE TO THE CERTIFICATE FIOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
^""^" `~ ~"""'°v~ U AGORD CORPORATI~N 1988
07/01/2010 I0:28 FdX 3038800835
l~f1X~~lL ~d~lfi~~
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21. XXI. ~'~m~~nc~ ~:th i~a~~ i 06 343 end Ho 1 ~ 7
~1002
A. In compliance with Hous~ Bill 4b-13~3 au~c1 Hause Bi1107-]~73 ~mmending litle ~
of the Colaraclo lteviscd ~eat~abaY1 As~mbly of h~ ~tat~ of C 1lorado, tha ont~aCtD~hal n01:
far Serv-ces, enacted by
t. Knowingly ernploy or contrac! with an illcgal t~lien to ptrform work undcr
this cvntract ot;
2. Entor into a contr~ct with a sut~c4ntractor that fall~ to certify to tho
ContracWr that the subcantractor ~i~~ n~t knowingly ernploy or contract
with an illcg~! alien to ptrform work under thi~ eontrnot.
B. In complia~nc~ witb Housc Biil Ob-1343 and i-~ousc Bii1 U~-1073 omscted hy th~
Qenar~l AssGmbly of the Stat~ of Colorado:
1. Thn Contracior has confirmed or attempted to eonfirm the employmeM
cli~ibil~ty nf all employe~ who are nawty hit~ed for enlployment ln the Elnitad 3tates
through participation in the Hns~~c Pilat Progr~m [ere~tod in Public Law 208~ 104th
Congress, or its aucco~sor and expanc~ in Public I.aw t 56,1 Q~~' Congress, or its
succc~or, th~t is udminixtcred by thc United Stfi~tca Dcpertmettt of f~Iomeland SeourityJ
~nd, if the Contracwr }s not acccpted inta tho ~~sic Pilot Progrsm prior to entering intc~
thia eontract, thc Contraator ~ha11 ~pply to pertiic~te in the Basla Pilot Pragrsm every
three months unti3 the Contractor ~~ eecepted or this co~tract h~ been completed,
whiehover is oArlior. Thia provfsion ~a~l not ba raquirad cu effee#ive }f tha ~3aaic Pilot
Program is discontinucd.
2. The Gontractor shatl be prohibited fl~am uaing B~ic P~lot Progr~-
proce~3ures to und~rtska pre-employment sareening of job ~pplicaasts whito this contrr~ct
is beiag pc:rformed.
3, If thc Contr4ctor obt~i~s Actuat k~owledgc that a~ubca~tractar perPorming
work under this contra~t knowingly omploys or contr~otn wlth an ~tlcgal ~lien, the
Contraotor shall be roqu~red ta:
e. Notify the ~ttbQVntracWr and the Cuunty within thrce days thet thc
Contr~ctor has aclua! knowledge that thc subcontractor is employing or
contracting with an illegal a.lien; and
b. '1'~rminate thc subcnntract wlth the ~ubcontractor i~'within thrca
d~ys a~receivin~ thc nt~tico reqaired pursu~nt to ~ttbparegra~ (s} oFthis
psr~graph (3) the sabcontractor does nat atop en~playittg or contr~ctir~; with tho
illogel aliens; cxoept that the Contractor ah~li nat t~artt~iraste tha cuntr~ot with the
subec~ntraator if during e+x:h three days the subcontr~or provldca informalion ta
a~ta,blish that the subcontraGtor h~a not knpwin~ly emp#oysd or contractcd vv~th ~n
itlcYal aliec~.
~l
OT/01/201Q 10:19 fiAX 3096800895
~ 003
4. The Cantxa~tor shait com~ly with any rtasan~ble re,quest i~y th~
Department of Labor and Employment made in the coar~a of en investi~tion t~at the
Ucp~rtment of Labar snd L~mploy~nnent is unclcrtaking pursusnt ta tt~e authority est~bliatiec~
in Subsec:tian (S) ofC.R.S. § 8-17.5-102.
IN WI'CNEBS WHER~OF, the ~arti~s have cxecuted th~s contt~et as of the datc first set out
harein above.
~ ~.~E ~ .
,~
By:
Titlc ~-,.~¢,•~c~ ~-(,u iti; 7~ 1.~ ! 4
Datc
BQARD oF Y COMlvIISTnNERB 4F
By:
Authorized Sl Dgtc
~Y.
Fletcher, County Manager
CbUNTY,COLORADU:
`N