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HomeMy WebLinkAboutContract 42889-R1 ' MY SE09TAW CONTRACT NO. CITY OF FORT WORTH p�t�' JC; �lu �pi!i�!4 " REQUEST TO EXERCISE RENEWAL OPTION I' � iber 30,2015 Buxton 2651 Polaris Drive Fort Worth,TX 76137 Re: REQUEST TO EXERCISE RENEWAL OPTION Contract No. CSC No. 42889 (the"Contract") Renewal Term January 1,2016 through December 31,2016 The above referenced Contract expires on December 31,2016. Pursuant to the Contract,renewals are at the mutual agreement of the parties. This letter is to inform you that the City requests renewal of CSC No.42889 for an additional one year period,which will begin immediately upon the expiration of the current term and will end on December 31, 2016. All other terms and conditions of CSC No.42889 remain unchanged. Please return your signed agreement letter,along with a copy of your current insurance certificate,to the address set forth below. Please log onto BuySpeed Online at http://fortworthtexas.gov/purchasing to insure that your company information is correct and up-to-date. If you have any questions concerning this Request for Contract Renewal, please contact me at the telephone number listed below. Sincerely yours, Eryck Walker, Senior Buyer FMS,Purchasing Division 817.392.6610 I hereby acknowledge receipt of the Contract Renewal Notice for CSC No 42889 for a one year period ending on December 31,2016. By: Davi8 GAover, CFO Date: 1%/30/15 Printed Name and T'tl FOP Signature a q CITY OF FORT WORTH: ATEST: Susan-Aianig,Assistant City Manager / Mary J.Kayser,City e " Date: M&C No. CITY SECRE"(400' w`T. WORTH, ,r Page 2 of 2 Class-Item 961-02 5 Ad hoc services HR $225.00 $0.00 LN/FY/Account Code Dollar Amount Class-Item 961-02 6 Direct Mail Services-Consultant fee shall be$0.10 per name,per mailing list with a EA $0.00 $0.00 minimum order amount of$1,000.00. LN/FY/Account Code Dollar Amount TOTAL: $0.00 APPROVED: Rev.20091027 By: Eryck Walker Phone#: (817)392-6610 BUYER Client#:66735 18BUXTOCOM ACORD., CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 05/01/2015 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 CONTACT NAME: Wortham Insurance&Risk Mgmt. PHONE 817 336-3030 FAX 817 336-8257 1600 West Seventh Street E-MAIL Ext: a/c,No Fort Worth,TX 76102-2505 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC If INSURERA:National Fire Insurance Co of H 20478 INSURED INSURER B:Continental Casualty Company 20443 Buxton Company 2651 S.Polaris Drive INSURER C:Scottsdale Insurance Company 41297 Fort Worth,TX 76137 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DD MM/DD/YYYY A GENERAL LIABILITY 5088174785 5/03/2015 05/03/2016 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $300,000 CLAIMS-MADE 4 OCCUR MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY PRO LOC $ JECT A AUTOMOBILE LIABILITY 5088174821 510312015 05/031201 COMBINED SINGLE LIMIT 1 s 000 r 000 Ea accident $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PR IX HIRED AUTOS X OPERTY DAMAGE $ AUTOS Per accident $ B X UMBRELLA LIAB X OCCUR 5088174740 5103/2015 05/031201 EACH OCCURRENCE $5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 DED I X RETENTION$10 000 $ A WORKERS COMPENSATION WC2093007771 5/0312015 05/03/201 X WC Y LIMIT OTH- AND EMPLOYERS'LIABILITY O L S I ER YIN ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? � N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 C Errors& EKS3142774 11/11/2014 11/11/2015 3,000,000 each claim Ommissions 3,000,000 aggregate Retention 25,000 each claim DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) CG2010 07/04 Additional Insured-Owners,Lessees or Contractors-Scheduled Person or Organization by the manuscript endorsement G56015B 11/91 G147167B99 12/06 General Liability Extension Endorsement. CG2404 05/09 Waiver of Transfer of Rights of Recovery Against Others to Us SCA23500D 10/11 Extended Coverage Endorsement-BA PLUS (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION For Information Only 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 ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 2 The ACORD name and logo are registered marks of ACORD #S543932/M543931 180AS