HomeMy WebLinkAbout2012-246 Contract - Kistler Small White Architects Contract for PERSONAL SERVICES less than $35,000
C I T Y OF CONSULTANT: Kistler Small and White
ASHLAND CONTACT: Jerome White
20 East Main Street
Ashland, Oregon 97520 ADDRESS: 545 A Street
Telephone: 541/488-6002
Fax: 541/488-5311 TELEPHONE: 541-488-,66d�8��
DATE AGREEMENT PREPARED: 8/22/12 FAX:
BEGINNING DATE: 8/27/2012 COMPLETION DATE: 1/1/13
COMPENSATION: Option 1 as per design fee proposal $7800.00
SERVICES TO BE PROVIDED: Work to be performed as stipulated sum plus reimbursable expenses noted in
design fee ro osal.
ADDITIONAL TERMS:
FINDINGS:
Pursuant to AMC 2.50.120, after reasonable inquiry and evaluation, the undersigned Department Head finds and
determines that: (1) the services to be acquired are personal services, (2) the City does not have adequate personnel nor
resources to perform the services; (3) the statement of work represents the department's plan for utilization of such
personal services, (4) the undersigned consultant has specialized experience, education, training and capability sufficient
to perform the quality, quantity and type of work requested in the scope of work within the time and financial constraints
provided; (5) the consultant's proposal will best serve the needs of the City; and (6) the compensation negotiated herein
is fair and reasonable.
NOW THEREFORE, in consideration of the mutual covenants contained herein the CITY AND CONSULTANT AGREE as
follows:
1. Findings/ Recitations. The findings and recitations set forth above are true and correct and are incorporated herein
by this reference.
2. All Costs by Consultant: Consultant shall, at its own risk and expense, perform the personal services described
above and, unless otherwise specified, furnish all labor, equipment and materials required for the proper performance
of such service.
3. Qualified Work: Consultant has represented, and by entering into this contract now represents, that all personnel
assigned to the work required under this contract are fully qualified to perform the service to which they will be
assigned in a skilled and worker-like manner and, if required to be registered, licensed or bonded by the State of
Oregon, are so registered, licensed and bonded.
4. Completion Date: Consultant shall start performing the service under this contract by the beginning date indicated
above and complete the service by the completion date indicated above.
5. Compensation: City shall pay Consultant for service performed, including costs and expenses, the sum specified
above. Payments shall be made within 30 days of the date of the invoice. Should the contract be prematurely
terminated, payments will be made for work completed and accepted to date of termination.
6. Ownership of Documents: All documents prepared by Consultant pursuant to this contract shall be the property of
City.
7. Statutory Requirements: ORS 279C.505, 279C.515, 279C.520 and 279C.530 are made part of this contract.
8. Living Wage Requirements: If the amount of this contract is $19,494 or more, Consultant is required to comply with
chapter 3.12 of the Ashland Municipal Code by paying a living wage, as defined in this chapter, to all employees
performing work under this contract and to any Subcontractor who performs 50% or more of the service work under
this contract. Consultant is also required to post the notice attached hereto as Exhibit B predominantly in areas where
it will be seen by all employees.
9. Indemnification: Consultant agrees to defend, indemnify and save City, its officers, employees and agents harmless
from any and all losses, claims, actions, costs, expenses,judgments, subrogations, or other damages resulting from
injury to any person (including injury resulting in death), or damage (including loss or destruction) to property, of
whatsoever nature arising out of or incident to the performance of this contract by Consultant(including but not
limited to, Consultant's employees, agents, and others designated by Consultant to perform work or services
attendant to this contract). Consultant shall not be held responsible for any losses, expenses, claims, subrogations,
actions, costs,judgments, or other damages, directly, solely, and proximately caused by the negligence of City.
10. Termination:
a. Mutual Consent. This contract may be terminated at any time by mutual consent of both parties.
Contract for Personal Services, Revised 06/3012012, Page 1 of 5
b. City's Convenience. This contract may be terminated at any time by City upon 30 days' notice in writing
and delivered by certified mail or in person.
C. For Cause. City may terminate or modify this contract, in whole or in part, effective upon delivery of
written notice to Consultant, or at such later date as may be established by City under any of the following
conditions:
i. If City funding from federal, state, county or other sources is not obtained and continued at levels
sufficient to allow for the purchase of the indicated quantity of services;
fl. If federal or state regulations or guidelines are modified, changed, or interpreted in such a way
that the services are no longer allowable or appropriate for purchase under this contract or are
no longer eligible for the funding proposed for payments authorized by this contract; or
iii. If any license or certificate required by law or regulation to be held by Consultant to provide the
services required by this contract is for any reason denied, revoked, suspended, or not renewed.
d. For Default or Breach.
i. Either City or Consultant may terminate this contract in the event of a breach of the contract by
the other. Prior to such termination the party seeking termination shall give to the other party
written notice of the breach and intent to terminate. If the party committing the breach has not
entirely cured the breach within 15 days of the date of the notice, or within such other period as
the party giving the notice may authorize or require, then the contract may be terminated at any
time thereafter by a written notice of termination by the party giving notice.
ii. Time is of the essence for Consultant's performance of each and every obligation and duty under
this contract. City by written notice to Consultant of default or breach may at any time terminate
the whole or any part of this contract if Consultant fails to provide services called for by this
contract within the time specified herein or in any extension thereof.
iii. The rights and remedies of City provided in this subsection (d) are not exclusive and are in
addition to any other rights and remedies provided by law or under this contract.
e. Obligation/Liability of Parties. Termination or modification of this contract pursuant to subsections a, b, or
c above shall be without prejudice to any obligations or liabilities of either party already accrued prior to such
termination or modification. However, upon receiving a notice of termination (regardless whether such notice is
given pursuant to subsections a, b', c or d of this section, Consultant shall immediately cease all activities under
this contract, unless expressly directed otherwise by City in.the notice of termination. Further, upon termination,
Consultant shall deliver to City all contract documents, information, works-in-progress and other property that are
or would be deliverables had the contract been completed. City shall pay Consultant for work performed prior to
the termination date if such work was performed in accordance with the Contract.
-11. Independent Contractor Status: Consultant is an independent contractor and not an employee of the City.
Consultant shall have the complete responsibility for the performance of this contract. Consultant shall provide
workers'compensation coverage as required in ORS Ch 656 for all persons employed to perform work pursuant to
this contract. Consultant is a subject employer that will comply with ORS 656.017.
12. Assignment and Subcontracts: Consultant shall not assign this contract or subcontract any portion of the work
without the written consent of City. Any attempted assignment or subcontract without written consent of City shall be
void. Consultant shall be fully responsible for the acts or omissions of any assigns or Subcontractors and of all
persons employed by them, and the approval by City of any assignment or subcontract shall not create any
contractual relation between the assignee or subcontractor and City.
13. Default. The Consultant shall be in default of this agreement if Consultant: commits any material breach or default
of any covenant, warranty, certification, or obligation it owes under the Contract; its QRF status pursuant to the QRF
Rules or loses any license, certificate or certification that is required to perform the Services or to qualify as a QRF if
consultant has qualified as a QRF for this agreement; institutes an action for relief in bankruptcy or has instituted
against it an action for insolvency; makes a general assignment for the benefit of creditors; or ceases doing business
on a regular basis of the type identified in its obligations under the Contract; or attempts to assign rights in, or
delegate duties under, the Contract.
14. Insurance. Consultant shall at its own expense provide the following insurance:
a. Worker's Compensation insurance in compliance with ORS 656.017, which requires subject employers to
provide Oregon workers' compensation coverage for all their subject workers
b. Professional Liability insurance with a combined single limit, or the equivalent, of not less than Enter one:
$200,000, $500,000, $1,000,000, $2,000,000 or Not Applicable for each claim, incident or occurrence. This is to
cover damages caused by error, omission or negligent acts related to the professional services to be provided
under this contract.
C. General Liability insurance with a combined single limit, or the equivalent, of not less than Enter one:
$200,000, $500,000, $1,000,000, $2,000,000 or Not Applicable for each occurrence for Bodily Injury and Property
Damage. It shall include contractual liability coverage for the indemnity provided under this contract.
d. Automobile Liability insurance with a combined single limit, or the equivalent, of not less than Enter one:
$200,000, $500,000, $1,000,000, or Not Applicable for each accident for Bodily Injury and Property Damage,
including coverage for owned, hired or non-owned vehicles, as applicable.
e. Notice of cancellation or change. There shall be no cancellation, material change, reduction of limits or
Contract for Personal Services, Revised 06/30/2012, Page 2 of 5
intent not to renew the insurance coverage(s)without 30 days' written notice from the Consultant or its insurer(s) to
they City.
f. Additional Insured/Certificates of Insurance. Consultant shall name The City of Ashland, Oregon, and its
elected officials, officers and employees as Additional Insureds on any insurance policies required herein but only
with respect to Consultant's services to be provided under this Contract. The consultant's insurance is primary and
non-contributory. As evidence of the insurance coverages required by this Contract, the Consultant shall furnish
acceptable insurance certificates prior to commencing work under this contract. The certificate will specify all of
the parties who are Additional Insureds. Insuring companies or entities are subject to the City's acceptance. If
requested, complete copies of insurance policies, trust agreements, etc. shall be provided to the City. The
Consultant shall be financially responsible for all pertinent deductibles, self-insured retentions and/or self-
insurance.
15. Governing Law; Jurisdiction; Venue: This contract shall be governed and construed in accordance with the laws
of the State of Oregon without resort to any jurisdiction's conflict of laws, rules or doctrines. Any claim, action, suit or
proceeding (collectively, "the claim") between the City (and/or any other or department of the State of Oregon) and
the Consultant that arises from or relates to this contract shall be brought and conducted solely and exclusively within
the Circuit Court of Jackson County for the State of Oregon. If, however, the claim must be brought in a federal
forum, then it shall be brought and conducted solely and exclusively within the United States District Court for the
District of Oregon filed in Jackson County, Oregon. Consultant, by the signature herein of its authorized
representative, hereby consents to the in personam jurisdiction of said courts. In no event shall this section be
construed as a waiver by City of any form of defense or immunity, based on the Eleventh Amendment to the United
States Constitution, or otherwise, from any claim or from the jurisdiction.
16. THIS CONTRACT AND ATTACHED EXHIBITS CONSTITUTE THE ENTIRE AGREEMENT BETWEEN THE
PARTIES. NO WAIVER, CONSENT, MODIFICATION OR CHANGE OF TERMS OF THIS CONTRACT SHALL
BIND EITHER PARTY UNLESS IN WRITING AND SIGNED BY BOTH PARTIES, SUCH WAIVER, CONSENT,
MODIFICATION OR CHANGE, IF MADE, SHALL BE EFFECTIVE ONLY IN THE SPECIFIC INSTANCE AND FOR
THE SPECIFIC PURPOSE GIVEN. THERE ARE NO UNDERSTANDINGS, AGREEMENTS, OR
REPRESENTATIONS, ORAL OR WRITTEN, NOT SPECIFIED HEREIN REGARDING THIS CONTRACT.
CONSULTANT, BY SIGNATURE OF ITS AUTHORIZED REPRESENTATIVE, HEREBY ACKNOWLEDGES THAT
HE/SHE HAS READ THIS CONTRACT, UNDERSTANDS IT, AND AGREES TO BE BOUND BY ITS TERMS AND
CONDITIONS.
17. Nona ppropriations Clause. Funds Available and Authorized: City has sufficient funds currently available and
authorized for expenditure to finance the costs of this contract within the City's fiscal year budget. Consultant
understands and agrees that City's payment of amounts under this contract attributable to work performed after the
last day of the current fiscal year is contingent on City appropriations, or other expenditure authority sufficient to allow
City in the exercise of its reasonable administrative discretion, to continue to make payments under this contract. In
the event City has insufficient appropriations, limitations or other expenditure authority, City may terminate this
contract without penalty or liability to City, effective upon the delivery of written notice to Consultant, with no further
liability to Consultant.
Certification. Consultant shall si n the certification attached hereto as Exhibit A and herein incor orated by reference.
Consultant: City of Ashla
By By
1 Signature Department Head
Print Name /Print Name
14-CIA (T E u5 8*2a I yZ_ 30b_
Title Date
W-9 One copy of a W-9 is to be submitted with ��
the signed contract. Purchase Order No.
Contract for Personal Services, Revised 06/30/2012, Page 3 of 5
EXHIBIT A
CERTIFICATIONS/REPRESENTATIONS: Contractor, under penalty of perjury, certifies that (a) the
number shown on the attached W-9 form is its correct taxpayer ID (or is waiting for the number to be
issued to it and (b) Contractor is not subject to backup withholding because (i) it is exempt from
backup withholding or (ii) it has not been notified by the Internal Revenue Service (IRS) that it is
subject to backup withholding as a result of a failure to report all interest or dividends, or (iii) the IRS
has notified it that it is no longer subject to backup withholding. Contractor further represents and
warrants to City that (a) it has the power and authority to enter into and perform the work, (b) the
Contract, when executed and delivered, shall be a valid and binding obligation of Contractor
enforceable in accordance with its terms, (c) the work under the Contract shall be performed in
accordance with the highest professional standards, and (d) Contractor is qualified, professionally
competent and duly licensed to perform the work. Contractor also certifies under penalty of perjury
that its business is not in violation of any Oregon tax laws, and it is a corporation authorized to act on
behalf of the entity designated above and authorized to do business in Oregon or is an independent
Contractor as defined in the contract documents, and has checked four or more of the following
criteria:
/ (1) 1 carry out the labor or services at a location separate from my residence or is in a
specific portion of my residence, set aside as the location of the business.
(2) Commercial advertising or business cards or a trade association membership are
purchased for the business.
(3) Telephone listing is used for the business separate from the personal residence listing.
(4) Labor or services are performed only pursuant to written contracts.
(5) Labor or services are performed for two or more different persons within a period of one
/ year.
r/ (6) 1 assume financial responsibility for defective workmanship or for service not provided
as evidenced by the ownership of performance bonds, warranties, errors and omission
insurance or liability insurance relating to the labor or services to be provided.
8 y9 2,
Contr t (Date)
Contract for Personal Services, Revised 06/30/2012, Page 4 of 5
{ i
� 545 A Street kistlersmalhvhite:com
Ashland,OR emal4kistlersmallwhite.com ° white
97520 541 488 8200
rc
May 8,2012
Mr. Bruce Dickens, Superintendent
Ashland Parks and Recreation
340 S. Pioneer
Ashland, Oregon
Re: Enders Memorial Shelter
Mr. Dickens,
Allan Goffe of ACE Engineering and Kistler Small&White Architects are pleased to provide you with this
summary of our preliminary investigations and a design fee proposal for the stabilization of the historic
Ashland Memorial Shelter in Lithia Park. Following is our summary and our fee proposal.
Summary of preliminary investigations:
1. The settling/racking of the structure appears due to the undermining of the slab at the creek side
adjacent to the constant flowing water spigot and is significant enough to warrant your concerns
and desire to stabilize and strengthen the shelter.
2. The existing slab and pad footings need to be removed and a new foundation needs to be
installed beneath the existing structure. A soils engineer(Marquess&Associates)was consulted
and informed us that a soils investigation prior to design is not feasible or necessary as access by
the required equipment to the critical area at the creek side is not possible. They recommended
that a soils investigation(site visit)be performed at the time of excavation to determine if the soil
is adequate to support the foundation as designed. On-site recommendations would be made by
the soils engineer at the time of excavation.
3. Consultation with two contractors familiar with the rehabilitation and new construction of timber
frame structures indicates that the existing lower support structure is sound,with some decay and
could remain with the removal of the decayed portions and installation of new and taller
foundation'pedestals'.
4. The lower(main)support structure, including the eight columns and eight interconnecting beams,
should be strengthened and tied together to stabilize the main structure and to resist lateral
loading to wind or seismic events.
5. The upper roof structure, including the log rafters,cross tie members, and center'king'post, do
not meet, and with the current members cannot be made to meet the current building code for
snow loading or lateral resistance.
6. Maintenance and repair of the upper roof members can be made that will not trigger a complete
upgrade to conform to current codes.
7. If the Parks Department desires to bring the upper roof structure into conformance with current
codes,the entire upper structure would need to be replaced with new'up'sized members, new
sheathing, and new structural connections between the members. Any replacement of these roof
members may have ramifications affecting the Historic status of the Shelter and would need to be
investigated prior to selecting this option(see Option 2 below).
1
ENDERS MEMORIAL SHELTER
Design Fee Proposal
5-8-12
Option 1 -Goals:
To stabilize the structure including a lateral (seismic)design for the lower main support structure, and
maintain the historic status of the shelter through the following actions:
1. Remove the existing concrete slab and pad footings.
2. Design new foundation system with perimeter concrete grade beam integral with a new concrete
slab.
3. Design new foundation support for existing wood columns with lateral(seismic)resisting system.
4. Design connections for perimeter beams supporting the upper roof structure. Connections to
include beam connections to the eight columns and a perimeter tie to connect beam to beam at
each column.
5. Remove and re-install existing Lithia Water fountain and re-plumb as required.
(Verify drain requirements: Can Lithia Water be discharged into creek if fountain is modified?)
6. Remove and replace the wood shake roofing. No work is to be performed on the upper roof
structure;the upper structure to remain as is. (Note: The upper roof structure cannot be made,
modified,or strengthened to meet current building codes for snow loading and lateral resistance
from wind or a seismic event)
Option 1—Process
1. Meet with the City of Ashland Parks Commission/Staff and the Historic Commission to clarify and
define goals of the work to be performed.
2. Contact the State Historic Preservation Office to determine requirements of design to maintain
the historic status of the structure.
3. Prepare summary of goals and present to City prior to beginning design work.
4. Prepare construction documents and specifications for the stabilization work.
5. Solicit bids from qualified General Contractors.
6. Review bids for construction and select winning bid.
Option 7 —Fees
Work is to be performed as a stipulated sum plus the cost of reimbursable expenses.
Architect $4,300.00
Structural Engineer 3$ ,500.00
$7,800.00
Option 2-Goals:
To stabilize the structure including a lateral(seismic)design for the lower main support structure,
replacement the upper roof structure to meet current codes for snow and lateral resistance,and maintain
the historic status of the shelter through the following actions:
1. Remove the existing concrete slab and pad footings.
2. Design new foundation system with perimeter concrete grade beam integral with anew concrete
slab.
3. Design new foundation support for existing wood columns with lateral(seismic)resisting system.
2
ENDERS MEMORIAL SHELTER
Design Fee Proposal
5-8-12
4. Design connections for perimeter beams supporting the upper roof structure. Connections to
include beam connections to the eight columns and a perimeter be to connect beam to beam at
each column.
5. Remove and re-install existing Lithia Water fountain and re-plumb as required.
(Verify drain requirements: Can Lithia Water be discharged into creek if fountain is modified?)
6. Remove and replace existing upper roof structure with log members sized and configured to
support current snow loads. Design connections for the replacement structure to meet current
code requirements. Extend roof overhang 12 inches plus or minus beyond distance of existing
overhang.
7. Remove and replace wood shake roofing.
Option 2—Process
1. Meet with the City of Ashland Parks Commission/Staff and the Historic Commission to clarify and
define goals of the work to be performed.
2. Contact the State Historic Preservation Office to determine requirements of design to maintain
the historic status of the structure.
3. Prepare summary of goals and present to City prior to beginning design work.
4. Prepare construction documents and specifications for the stabilization work.
5. Solicit bids from qualified General Contractors.
6. Review bids for construction and select winning bid.
Option 2—Fees(fees below are in addition to Option 1 fees)
Work is to be performed as a stipulated sum plus the cost of reimbursable expenses.
i
Architect $ 1,100.00
Structural Engineer $2,100.00
$3,200.00
Please note that we are not proposing a Design/Build scheme in this proposal as you requested. After
much discussion,we believe that it was in the best interest of the City to follow the typical Design-Bid-
Build process. Call me if you want to discuss this further.
Thank you for the opportunity to present you with this proposal.
Sincerely,
dme White
3
CERTIFICATE OF LIABILITY INSURANCE °ABE)29i 012
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 Indemnity Excess & Surplus NAME Julie Asher _
Agency, Inc. PHOee -r . (591) 857-0679 ac Na, 1541) 857-9883
1500 NW Bethany EMAIL asher®ashlandinsurance.com
Beaverton OR R 9 97006 Aoopeu: jasher@ashlandinsurance.com
AFFORDING COVERAGE HAKE
INSURERA: BEAZLEY INSURANCE COMPANY
INSURED KISTLER SMALL WHITE INSURERB:
ARCHITECTS
INSURER C:
545 A STREET INSURER D:
ASHLAND OR 97520
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 00036055 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
15R TYPE OF INSURANCE LIMITS
tip POLICY NUMBER MMIOM'YY MMIDDIY
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A X Professional V10074110301 10/27/2011 O/27/2012 $1,000,000 Per Claim
A X Liability V10079110301 10/27/2011 0/27/2012 $1,000,000 Aggregate
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Claims Made Policy
Deductible: $8,500
Retro Date: 10/27/2009
CERTIFICATE HOLDER CANCELLATION
City of Ashland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
20 East Main St THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Ashland OR 97520 ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHDRI EPRESEMAT ��aC��
®1888-2010 ACORD CORPORATION. All rights reserved.
ACORD 25(2010105). The ACORD name and logo are registered marks of ACORD
(OMNI7 CERTGOa-11080811203291436)
,acoR°m CERTIFICATE OF LIABILITY INSURANCE /12/2 0112 2
3/12/2
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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 terns 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 NAME, Certificate Department
Ross 6 Associates Insurance Services, Inc. PHONE (503)698-3833 11Fa. (503)698-3844
Oregon License# 812525 '"AIL .certificates @roes-ins.com -
9201 SE 91st Ave, Suite 220 INSURER(S) AFFORDING COVERAGE rulcE
Portland OR 97066. INSURERA:Sentinel Insurance Co. 11000
INSURED BlsuaeRB:U.S. Speciality Insurance
ACE Engineering LLC INSURER C:
PO BOX 231 INSURER D:
Ashland, OR 97520 INSURERE:
INSURER F:
COVERAGES CERTIFICATE NUMBER:20120316 BEN PL; 0514 REN GL REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
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IS PROFESSIONAL LIABILITY USS1222755 /16/2012 /16/2013 OED SS,reD' PER CLAIM $ 500,000
CLAIMS-MADE FORM RETRO 3/16/2004 AGGREGATE $ 1,000,000
DESCRPTION OF OPERATIONS/LOCATIONS I VEHICLES(AUa08 ACORD 101,AtltlNpnM Remarks ScBatlula,II mpn space Ic roapiretl)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Insured Copy ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
1 Tim Cockburn/DRD
ACORD 25(2010/05) ®1988-2010 ACORD CORPORATION. All rights reserved.
tN5n2R rxnnnc,m Th.annan �.d Innn ecnon
f Page 1 / 1
CITY RECORIDER
Ashland Park Commission DATE PO NUMBER ,
20 E MAIN ST. 10/3/2012 00160
ASHLAND, OR 97520 -
(541)488-5300 0.?(
VENDOR: 004061 SHIP TO:
KISTLER SMALL WHITE ARCHITECTS
545 A STREET
ASHLAND, OR 97520
FOB Point: - Req.No.:
Terms: net Dept:
Req.Del. Date: Contact: Bruce Dickens
Special Inst: Confirming? No
Quantity Unit - Description - Unit Price Ext.Price. .
Consultant, architecture, engineerinq 7,800.00
services, plus details as listed in
proposal for the repairs needed at the
Enders Shelter in Lithia Park.
Contract for Personal Services
Beqinninq date: 08/27/2012
Completion date: 01/01/2013
Insurance required/On file
SUBTOTAL 7,800.00
BILL TO: TAX 0.00
FREIGHT 0.00
TOTAL 7,800.00
Account Number - Project Number` Amount .-Account Number Project Number' Amounts
E 411.12.00.00.704200 E 000021.999 7,800.00
2-
Auth rized Signature VENDOR COPY
FORM #3 y�'.. - L��U t'��az�. `H LAN
"� AS D ITY OF
A r wes far a ��I�M f� , �rdet',f WI /
7
REQUISITION Date of request: kJ (Z
Required date for delivery: 2i
Vendor Name #
Address,City,State,Zip �}
Contact Name&Telephone Number
Fax Number
SOURCING METHOD
❑ Exempt from Competitive Bidding ❑ Emergencv
❑ Reason for exemption: ❑ Invitation to Bid (Copies on file) ❑ Form#13,Written findings and Authorization
❑ AMC 2.50 Date approved by Council: ❑ Written quote or proposal attached
❑ Written quote or proposal attached
❑ Small Procurement Cooperative Procurement
Less than$5,000 ❑ Request for Proposal (Copies on file) ❑ State of Oregon
❑ Direct Award Date approved by Council: Contract It
❑ Verbal/Written quote(s)or proposal(s) ❑ State of Washington
Intermediate Procurement ❑ Sole Source Contract#
GOODS&SERVICES ❑ Applicable Form(#5,6,7 or 8) ❑ Other government agency contract
$5,000 to$100,000 ❑ Written quote or proposal attached Agency
❑ (3)Written quotes attached ❑ Form 94, Personal Services$5K to$75K Contract It
PERSONAL SERVICES ❑ Special Procurement Intergovernmental Agreement
$5,000 to$75.000 ❑ Form#9,Request for Approval ❑ Agency
P Less than$35,000,by direct appointment ❑ Written quote or proposal attached Date original contract approved by Council:'
El (3)Written proposals attached Date approved by Council: (Date)
❑ Form 94, Personal Services$51K to$75K I Valid until: Date
Description of SERVICES Total Cost
(b"115GC I_k7w i r A-61 6> I kCht e— A)61 NCQkJn)6 t It d5 D-10� lls
l6'j�� uJ P'p 05/3( �lz V—�x<IR5 P-"el)
r* CA p Gfl,rG
Is
Item # Quantity Unit Description of MATERIALS Unit Price Total Cost
TOTAL,COST'!
❑ Per attached quotelproposal $
ProjectNumber � f-�� Account Number___-__-__•__•______
Account Number4(I d2-00-00•�a4gLC) Account Number___-__-__-__-______
'Expenditure must be charged to the appropriate account numbers for the Financials to accurately reflect the actual expenditures.
IT Director in collaboration with department to approve all hardware and software purchases:
IT Director Date Support-Yes/No
By signing this requisition form,I certify that the City's public contracting requirements have been all tied.
Employee Signature: V u N,�lGl Department Head Signature:
t" (Eq is to or greater than$5,000)
Additional signatures(if applicable):
Funds appropriated for current fiscal year 68 / NO
Finance Director-(Equaao orgre rlhan$5,000) Date
Comments:
Form#3-Requisition