HomeMy WebLinkAbout2013-019 Contract - Ashland Electric
Contract for GOODS AND SERVICES Less than $25,000
CITY OF CONTRACTOR: Ashland Electric, Inc.
ASHLAND CONTACT: Scott Richey
20 East Main Street
Ashland, Oregon 97520 ADDRESS: 136 N. Laurel Street, Ashland OR 97520
Telephone: 541/488-6002
Fax: 541/488-5311 TELEPHONE: 541-488-5754
DATE AGREEMENT PREPARED: December 14, 2012 FAX: 541-488-6623
BEGINNING DATE: December 18, 2012 COMPLETION DATE: January 14, 2013
COMPENSATION: $820.00 per proposal attached as Exhibit C.
GOODS AND SERVICES TO BE PROVIDED: Labor and materials to install new 100 amp residential service,
wiring for one (1) single pole switch, one (1) GFCI outlet and one (1) keyless fixture per proposal attached as
Exhibit C.
ADDITIONAL TERMS:
NOW THEREFORE, pursuant to AMC 2.50.090 and after consideration of the mutual covenants contained herein the
CITY AND CONTRACTOR AGREE as follows:
1. All Costs by Contractor: Contractor shall, provide all goods as specified above and shall at its own risk and
expense, perform any work described above and, unless otherwise specified, furnish all labor, equipment and
materials required for the proper performance of such work.
2. Qualified Work: Contractor has represented, and by entering into this contract now represents, that any personnel
assigned to the work required under this contract are fully qualified to perform the work 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. Contractor must also maintain a current City business license.
3.. Completion Date: Contractor shall provide all goods in accordance with the standards and specifications, no later
than the date indicated above and start performing the work under this contract by the beginning date indicated
above and complete the work by the completion date indicated above.
4. Compensation: City shall pay Contractor for the specified goods and for any work 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.
Compensation under this contract, including all costs and expenses of Contractor, is limited to $25,000.00, unless a
separate written contract is entered into by the City.
5. Ownership of Documents: All documents prepared by Contractor pursuant to this contract shall be the property of
City.
6. Statutory Requirements: ORS 279B.220, 279B.225, 279B.230, 2796.235, ORS Chapter 244 and ORS 670.600 are
made part of this contract.
7. Living Wage Requirements: If contractor is providing services under this contract and the amount of this contract
is $19,494 or more, Contractor 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 work under this contract. Contractor is also required to post the notice attached
hereto as Exhibit B predominantly in areas where it will be seen by all employees.
8. Indemnification: Contractor 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 Contractor (including but not limited
to, Contractor's employees, agents, and others designated by Contractor to perform work or services attendant to this
contract). Contractor 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.
9. Termination:
a. Mutual Consent. This contract may be terminated at any time by mutual consent of both parties.
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 Contractor, or at such later date as may be established b City under an of the following
Contract for Goods and Services Less than $25,000, Revised 06/30/2012, Page 1 of 5
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;
ii. 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 Contractor 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 Contractor 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.
1. Time is of the essence for Contractor's performance of each and every obligation and duty under
this contract. City by written notice to Contractor of default or breach, may at any time terminate
the whole or any part of this contract if Contractor 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, Contractor shall immediately cease all activities under
this contract, unless expressly directed otherwise by City in the notice of termination. Further, upon termination,
Contractor 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 Contractor for work performed prior to
the termination date if such work was performed in accordance with the Contract.
10. Independent Contractor Status: Contractor is an independent Contractor and not an employee of the City.
Contractor shall have the complete responsibility for the performance of this contract.
11. Non-discrimination Certification: The undersigned certifies that the undersigned Contractor has not discriminated
against minority, women or emerging small businesses enterprises in obtaining any required subcontracts.
Contractor further certifies that it shall not discriminate in the award of such subcontracts, if any. The Contractor
understands and acknowledges that it may be disqualified from bidding on this contract, including but not limited to
City discovery of a misrepresentation or sham regarding a subcontract or that the Bidder has violated any
requirement of ORS 279A.110 or the administrative rules implementing the Statute.
12. Asbestos Abatement License: If required under ORS 468A.710, Contractor or Subcontractor shall possess an
asbestos abatement license.
13. Assignment and Subcontracts: Contractor 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. Contractor 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.
14. Use of Recyclable Products: Contractor shall use recyclable products to the maximum extent economically feasible t
in the performance of the contract work set forth in this document.
15. Default. The Contractor shall be in default of this agreement if Contractor: commits any material breach or default of
any covenant, warranty, certification, or obligation it owes under the Contract; if it loses its QRF status pursuant to
the QRF Rules or loses any license, certificate or certification that is required to perform the work or to qualify as a
QRF if Contractor 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.
16. Insurance. Contractor 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. 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.
C. 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.
Contract for Goods and Services Less than $25,000, Revised 06/30/2012, Page 2 of 5 .f
d. Notice of cancellation or change. There shall be no cancellation, material change, reduction of limits or
intent not to renew the insurance coverage(s) without 30 days' written notice from the Contractor or its insurer(s) to
the City. I
e. Additional Insured/Certificates of Insurance. Contractor 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 Contractor's services to be provided under this Contract. As evidence of the insurance coverages
required by this Contract, the Contractor shall furnish acceptable insurance certificates prior to commencing work
under this contract. The contractor's insurance is primary and non-contributory. 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
Contractor shall be financially responsible for all pertinent deductibles, self-insured retentions and/or self-
insurance.
17. 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 Contractor 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. Contractor, 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.
18. 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.
CONTRACTOR, 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.
19. Nonappropriations 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. Contractor
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 Contractor, with no further
liability to Contractor.
20. Prior Approval Required Provision. Approval by the City of Ashland Council or the Public Contracting Officer is
required before any work may begin under this contract.
21. Certification. Contractor shall sign the certification attached hereto as Exhibit A and herein incorporated by
reference.
Contractor:: City of Ashland
By ~Qr/WVf 91p~heq By
Signature a Department Head
6!tAerin z° 1Rtc wu Afro ke-/kerl
Print Name Print Name
obi ci° I /q / ► 3
Title Date
W-9 One copy of a W-9 is to be submitted with
the signed contract. Purchase Order No. /
AP ,ROV D TO FORM
Signature (_~7
Contract for Goods and Services Less than $25,000, Revised 06/30/2012, Page 3 of%ate \
.i
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 j
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:
4
(1) I 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.
(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.
A- h)y"d Gbc; ~L 2, -2, S-12
Contractor (Date)
Contract for Goods and Services Less than $25,000, Revised 06/30/2012, Page 4 of 5
Dec 11 12 02:48p Kathy 541-488-5747 P.1
Ashland Electric, Inc.
136 N Laurel St..
Ashland, Or. 97520
Phone 541-488-5754
Fax 541-488-6623
ashlandelectricinc@ashlandnet.net
CCB 70562
December 7, 2012
TO: City of Ashland
JOB: Nevada Street plump house, Ashland, Or. 97520
The undersigned proposed to furnish all materials and perform all labor necessary
to complete: Installing new 100 amp residential all-in-one on outside of building. Inside
pump house wiring for 1 single pole swt outlet, I GFCI recp outlet and 1 keyless fixture.
Permit by us.
There will be one phase to completion. Any additional trips between these two
phases will be billed time and materials, including one way travel time.
Proposal will be good for 30 days only. Work needs to begin within 60 days of
date on proposal. Need a signed contract within 30 days of date on proposal.
All of the above work'is to be completed in a substantial and workmanlike
manner according to standard practices for the sum of $820.00. All charge orders/extras
are billed a 100% of whole price at completion of job.
Accounts due 10 days after billing. 2% charge after 30 days on unpaid balances.
Attorney fees and court cost will accrue at your expense if legal action is required for any
satisfaction of money due.
Any alteration or deviation from the above specifications involving extra cost of
materials or labor will be executed upon written/verbal for same and will become an extra
charge over the sum mentioned in this contract.
Contractor: Ashland Electric, Ina
By: Scott Richey
1~c~~h y~ ►~1(i 1Z-2- g-12.
Ashland Electric, Inc.
136 N. Laurel St.
Ashland, Or. 97520
Phone: 541-488-5754
Fax: 541-488-6623
ashlandelectricinc@ashlandnet.net
December 28, 2012
City of Ashland
90 N. Mountain St
Ashland, Or. 97520
Re: Workmans' Compensation
To Whom It May Concern:
Oregon Law mandates that if your company is a family owned business with each
Board of Director or employee owning 10% or more of the company you do not have to
carry workmans' compensation insurance on those employee's.
I have however enclosed disability insurance that our company carries on our
employee's for 24 hour protection.
If you need further clarification on our disability insurance policies, please let me
know and I will provide whatever you require.
Sincerely,
Katherine Richey
POLICY SCHEDULE
INSURED WILLIAM J RICHEY POLICY NUMBER PA02892700
136 N LAUREL ST
ASHLAND OR POLICY DATE 04-06-09
975201724
FIRST RENEWAL DATE 05-06-09
ANNUAL PREMIUM $694.16
a MODE MONTHLY PAC
} MODE PREMIUM $62.47
INITIAL ACCIDENT COVERAGE PRIMARY INSURED EFFECTIVE DATE
MONTHLY TOTAL DISABILITY BENEFIT $1,000.00* 04-06-09
MAXIMUM BENEFIT PERIOD LIFETIME
ELIMINATION PERIOD 7 DAYS
MAXIMUM SURGICAL BENEFIT $1,500.00 04-06-09
(SEE SCHEDULE IN RIDER)
r
EMERGENCY TREATMENT BENEFIT $50.00 04-06-09
INFLATION PROTECTION RIDER YES 04-06-09
WAIVER OF PREMIUM BENEFIT YES 04-06-09
RETURN OF PREMIUM RIDER YES 04-06-09
c
)
* TOTAL DISABILITY BENEFITS MAY END FOR TOTAL DISABILITY STARTING AFTER AGE 65
(SEE TOTAL DISABILITY RIDER)
1900 PAGE 3
POLICY SCHEDULE
INSURED CHARLES A RICHEY POLICY NUMBER PA02127240
196 CENTRAL AVE
ASHLAND OR POLICY DATE 02-01-02
97520
FIRST RENEWAL DATE 03-01-02
ANNUAL PREMIUM $669.10
MODE MONTHLY PAC
MODE PREMIUM $60.22
INITIAL ACCIDENT COVERAGE PRIMARY INSURED EFFECTIVE DATE
MONTHLY TOTAL DISABILITY BENEFIT $500.00* 02-01-02
MAXIMUM BENEFIT PERIOD 6 MONTHS
ELIMINATION PERIOD 0 DAYS
MONTHLY TOTAL DISABILITY BENEFIT $500.00* 11-01-02
MAXIMUM BENEFIT PERIOD LIFETIME
ELIMINATION PERIOD 7 DAYS
MAXIMUM SURGICAL BENEFIT $5,000.00 02-01-02
(SEE SCHEDULE IN RIDER)
EMERGENCY TREATMENT BENEFIT $25.00 02-01-02
INFLATION PROTECTION RIDER YES 02-01-02
WAIVER OF PREMIUM BENEFIT YES 02-01-02
J,.
RETURN OF PREMIUM RIDER YES 10-01-03
TOTAL DISABILITY BENEFITS MAY END FOR TOTAL DISABILITY STARTING AFTER AGE 65
(SEE TOTAL DISABILITY RIDER)
1900 PAGE 3
POLICY SCHEDULE
INSURED SCOTT A RICHEY POLICY,NUMBER PA02075390
382 ARNOS
TALENT OR POLICY DATE 10-12-01
97540
FIRST RENEWAL DATE 11-12-01
ANNUAL PREMIUM $784.46
MODE MONTHLY PAC
MODE PREMIUM $70.60
!INITIAL ACCIDENT COVERAGE PRIMARY INSURED EFFECTIVE DATE
MONTHLY TOTAL DISABILITY BENEFIT $1,000.00* 10-12-01
MAXIMUM BENEFIT PERIOD LIFETIME
ELIMINATION PERIOD 7 DAYS
MAXIMUM SURGICAL BENEFIT $5,000.00 10-12-01
(SEE SCHEDULE IN RIDER)
EMERGENCY TREATMENT BENEFIT $25.00 10-12-01
.INFLATION PROTECTION RIDER YES 10-12-01
WAIVER OF PREMIUM BENEFIT YES 10-12-01
RETURN OF PREMIUM RIDER YES 10-12-01
a
* TOTAL DISABILITY BENEFITS MAY END FOR TOTAL DISABILITY STARTING AFTER AGE 65
(SEE TOTAL DISABILITY RIDER) -
1900 PAGE 3
Jan. IU. LU13 IU:L0MIA r a r m e r s I10.g74y r. I
Commercial Certificate of Liability Insurance Aft FARM E R S
Agency Brian Gabaldon Issue Dare (MM/DD/YY) 01/10/13
Name 1361 Center Dr Sle 100 This certificate is issued as a mailer of information only and confers no rights
& Medford, OR 97501 upon the certificate holder. This certificale does not affirmatively or negatively
Address541-734-2300 amend, extend or alter the coverage afforded by the policies shown below.
St. 73 Dist.01 Agent 363 This certificate of insurance does not conslflute a contract between the issuing
insurer(s), authorized representative or producer, and the certificate holder.
Insured Ashland Electric, Inc. Companies Providing Coverage (NAIC
Name 136 N Laurel St Company Letter A Truck Insurance Exchange 21709
& Ashland, OR 97520 Company Letter B Farmers Insurance Exchange 21652
Address Company Letter C Mid-Century Insurance Company 21687
Company Letter D
Coverages -
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 b aid claims,
Co. Add'. Type of Insurance Policy Number Poaq E/feNre ptat/rsplradol Policc Limits
Lir. lnsrd. y Dale Onl/0DtM Dole(MM/DD/M y
C General Liability 605040512 09114/12 09114/13 Each Occurrence $2,000,000
Commercial General Liab.
_Buslnessownen Liability plama e-f'o Rented $ 100,000
y remisges (Ea. Occur)
Medical Expenses $ 5,000
Claims Made ny one person))
x Occurrence Personal & Adv. injury $ 2,000,000
General Aggregate Limit Applies: General Aggregate $ 4,000,000
. Per Location Prod./Comp. Ops. Aggr. $ 4,000,000
X Per Project
C Automobile Liability 6050405(2 09/14/12 09/14/(3 ~omb edSinleLimit $2,000,000
_Any Auto
-All Owned Autos Bodily Injury $
p
Scheduled Autos Bodily Inlury S
Hired Autos (Per acciddent)
Non-Owned Autos - Property Da age $
(leera cddent
Garage Liability Auto Only-Ea. Accident $
_ Any Auto Other Than Each Accident $
Auto Only
Aggrgate $
Umbrella Liability
Retention $ Limit $
Workers' Compensation and Statutory
Employers' LEabillry Each Accident $
Disease - Ea. Employee $
Disease - Policy Limit $
Description of Operations/Vehicles/Restrictions/Special Items:
Certificate Holder Cancellation
Should any of the above described policies be cancelled
Name CityofAshland before the expiration date thereof, notice will be delivered in
& 90 N. Mountain Ave accoZd nce,wl th o ' y ovislong.
Address Ashland, OR 97520 f
I
I
Authorized Representative
66-2492 10.11 CZ492201 PAGE 1 CF 2
I
Jan. IU. ZUIJ IU:20AM r a r m e r s 40.4jlfy r. 2
IMPORTANT
If the certificate holder is an additional Insured, the policy(ies) must be so endorsed. A statement on this
certificate does not confer rights to the certificate holder in lieu of such endorsement(s),
If subrogadon 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).
DISCLAIMER
The Commercial Certificate of Insurance on the reverse side of this form does not constitute a contract
between the issuing insurer, authorized representative or producer, and the certificate holder, nor does It
affirmatively or negatively amend, extend or alter the coverage afforded by any policies listed thereon.
INQUIRIES
The agent listed on this certificate of insurance will be happy to answer your questions. If, for any reason, you
wish to contact one of our companies directly, please write or call our service center:
Farmers Insurance (group of Companies
Attn: Customer Service
2245 Sequoia Dr.
Aurora, IL 60506
Phone; (877) 411-4249
S&249210.11 02492202 PAG120F2
Page
-I 1 Y C` EC DER 1 / 1
CITY OF
ASHLAND DATE - PO NUMBER
20 E MAIN ST. 1/9/2013 11387
ASHLAND, OR 97520
(541) 488-5300
VENDOR: 003340 SHIP TO: Ashland Electric Department
ASHLAND ELECTRIC (541) 488-5354
136 N LAUREL ST 90 N MOUNTAIN
ASHLAND, OR 97520 ASHLAND, OR 97520
FOB Point: Req. No.:
Terms: Net Dept:
Req. Del. Date: Contact: Dave Tvgerson
Special Inst: Confirming? No
:Quanta .Unit . Description Unit Price ' Ezf: Price
Labor and materials to install new 100 820.00
amp residential service. Wirinq for (1)
single pole switch. (1) GFI outlet, (1)
keyless fixture.
Location: Nevada Street Pump House
Contract for Goods and Services
Beqinninq date: December 18, 2012
Completion date: January 14, 2013
SUBTOTAL 820.00.
BILL To: Account Payable TAX
20 EAST MAIN ST FREIGHT 0.00
541-552-2010 TOTAL 820.00.
ASHLAND, OR 97520
.`Account Number_Projecf Number ,''Amount- i Account Number, Project Number Amount
E 675.08.17.00.70420 E 200823.999 820.00
~8
Auth I d5igna~ VENDORCOPY
FORM #3 CITY OF
ASHLAND
REQUISITION Date of request:
Required date for delivery:
Vendor Name 1121 0460 E/erb7e- SNC.
Address, City, State, Tip 1-76 /Y. L l4ZCA~Z- ST' 667/i0, DR . 97520
Contact Name & Telephone Number
Fax Number -541/-~IsR-57SL/ Cr,SI,/onc/elecfirle Gt3~7(4/)d/VC~NET
54I/-ZI88 -6623
SOURCING METHOD 5774ILT L91-[7E.- 12CGVYIpLe-T/ON DI977-F e
❑ Exempt from Competitive Bidding ❑ Emergency
❑ 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#
❑ 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 #4, Personal Services $5K to $75K Contract#
PERSONAL SERVICES ❑ Special Procurement Intergovernmental Agreement
$5.000 to $75,000 ❑ Form #g, Request for Approval ❑ Agency
❑ Less than $35,000, by direct appointment ❑ Written quote or proposal attached Date original contact approved by Council:
❑ (3) Written proposals attached Date approved by Council: (Date)
❑ Form #4, Personal Services $5K to $75K Valid until: Date
Description of SERVICES Total Cost
LF4E302 ~mr-i-TE2lGtl~ 7o ir/,Sr~KC New !00 /~nrP
Aes /elen l iaL S- c E: / o0
W/!r/%'7G FOR jl2 /oDLC SW/1z<f - C/~ d.~i-Fex- 0a7/,e7 -
S210.
GI !re leers frx tv.-
Item # Quantity Unit Description of MATERIALS Unit Price Total Cost
E_ ttl~C/f 07~ 8201
[Per attached quote/proposal TOTAL COST
$
Project Number 200 S. 23 Account Number 82-0' 0O
Account Number 675-063- 17-00.70LIZOO 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:
ITDirector Date Support -Yes/No
By signing this requisition form, l certify that the (34s public contracting requirements a been 56sfi~ .
Employee Signature: C'lfl Aa c CdQ4l(o (Sl Department Head Signature: `ry
Additional signatures (if applicable): (Equal to reer than $5,000)
Funds appropriated for current riscal year., YES / NO
Finance Director- (Equal to or greater than $5.060) Date
Comments:
i