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Home My WebLink AboutContract 47080-R1 4�. E, q CITY SECRETARY > CONTRACT NO.a q70 e IZ RECEIVED ``' NOV 3 0 2018 CITY OF FORT WORTH CITY of FORT WORTH REQUEST TO EXERCISE RENEWAL OPTION CITYSECRETARY City Secretary Contract No. 47080 November 19,2018 HUB International Texas, Inc. Scott Miller, Vice President 421 West Third Street, Suite 800 Fort Worth TX 76102 Re: REQUEST TO EXERCISE RENEWAL OPTION CSC No. 47080(the"Contract") Renewal Term: July 1, 2018 through June 30,2019 The above referenced Contract expired on June 30, 2018. Pursuant to the Contract, contract renewals are at the mutual agreement of the parties. This letter is to inform you that the City requests renewal of CSC No.47080 for a one-year(1)period beginning immediately upon the expiration of the current term and will end June 30,2019. All other terms and conditions of CSC 47080 remain unchanged. Please return three original signed copies of this agreement letter, along with a copy of your current insurance certification,to the address set forth below. If you have any questions concerning this Request for Contract Renewal, please contact me at the number below. Sincerely, Mailing Address: Sophia Gatewood Virginia Gomez City of Fort Worth Administrative Assistant HR/Risk Management Virginia.GomeZgfortworthtexas.gov 200 Texas Street 817-392-7405 Fort Worth, TX 76102 1 hereby acknowledge receipt of the Contract Renewal Notice for CSC No. 47080 for professional services to serve as the City's broker of record associated with the placement and administration of all property insurance, boiler and machinery insurance, environmental liability insurance, and other casualty insurance as needed. / �> By: Scott Miller, Vice President Date:_ !�-•�� -fid Printed Name d Title Signature J �1s. F 0 CITY OF FORT WQH: A TEST: Q Susan nis,Assistant City Manager J. VTfty Secretary f_ Date: I ?� l� M&C(if required) Approved Date: 4��R B. Ass' City Attorney OFFICIAL RECORD Jo CITY SECRETARY FT. WORTH,TX NOTICE OF CONTRACT RENEWAL PROFESSIONAL CONSULTING SERVICES Contract No. CSC No. 47080(the"Contract") Renewal Term No. 1: July 1,2018 to June 30,2019 RECOMMENDED BY: Mark J. Barta Assistant Human Resources Director Contract Compliance Manager: By signing, I acknowledge that I am the person responsible for the monitoring and administration of this contract, including ensuring all performance and reporting requirements. SphK-, I" 'b L ex rd a ewood Property &Casualty Manager OFFICIAL RECORD CITY SECRETARY FT. WORTH,TX 900 I ottoonvlocs 1 113 %,nen«:s tau I nunnv I C ACORD. CERTIFICATE OF LIABILITY INSURANCE 10/30/18�Yn THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER C NTAC NAME: _ HUB International Midwest Limited PHONE- 312 922-5000 FAX 866 748-9821 Professional Liability Department e A`o Ext• ac,No): 55 East Jackson Blvd ADDRESS:_ INSURER(S)AFFORDING COVERAGE i - NAIL R - Chicago,IL 60604 Allied V1�orld Insurance Com any -- 22730 INSURER A: p INSURED 1 INSURER B: Hub International Limited 300 North LaSalle St, 17th Floor INSURER C Chicago,IL 60654 •INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR -- - ...___.___ ._____ ADDLSUBR .__-_-_-_ _ ____...._-..__..._.__ __.._._.._POUCYEFF POLICY P -...... __..._.__ ____—..__------------ LTR TYPE OF INSURANCE EE77�� LIMITS __..INR VVQ POLICY NUMBER _MM/DINYYYY MWgDIYYYY _ _ GENERAL LIABILITY EACH OCCURRENCE 1$-71 COMMERCIAL GENERAL LIABILITY PREMISES EaE�mm. $ i I CLAIMS-MADE EIOCCUR MED EXP(Any one person) t$ PERSONAL&ADV INJURY $ _ j GENERAL AGGREGATE $ v GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG$ POLICY PECO?- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO iBODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ 'AUTOS AUTOS NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS I Per accident) Is - $ UMBRELLA LIABE-CLAJMS-MADE OCCUR EACH OCCURRENCE )s EXCESS UAB _ AGGREGATE $ DED RETENTION$ WORKERS COMPENSATION WC STATU OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE Y 1� E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? MIA — -- ---------- (Mandatory In NH) �-L.DISEASE-EA EMPLOYEE}$ If yes.describe under _ DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT ;$ A Ins Agents _ _�_ 0304-2450__- - �� `1 8512048 1-1TI512MI $10,000,000/410,000,000 E&O II I DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,N more space Is required) This coverage applies to all U.S.operations of Hub International Limited.HUB International Texas,Inc.,is an insured under Hub International Limited's master contract,dba Hub International Insurance Services,Hub International Personal Insurance,Wm.Rigg Co.,Hub International Rigg,Benefit Concepts,.Administration and Benefits Consultants,Benefit Administration Systems,Troy Davis Insurance,John D.Williams,JDW Insurance,EI Paso Insurance Agency,Risk&Insurance Management Consultants,The Rigg Group,Hub International Rigg,Hub International Texas Limited,Roeder&Moon The Roy Agency,Rigg Life Agency,Hub International Rigg,Benefits,Rigg Benefits&Financial Services and Concord Premium Finance,Tri-Star Insurance Professionals,Inc.,IPS Advisors,LLP,IPS Management,LLC,The Ward Agency CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE #S816985/M624,,713 ®1888-2010 ACORD CORPORATION.All rights reserved. ------e inw�nlnel L. �/�/�rlrl ...J..-t Ak^^nr%