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HomeMy WebLinkAbout2013-025 Contract - T&M Excavation Contract for GOODS AND SERVICES Less than $25,000 CITY OF CONTRACTOR: T & M Excavation ASHLAND CONTACT: Toby Munroe 20 East Main Street Ashland, Oregon 97520 ADDRESS: 1796 Thomas Road, Medford, OR 97501 Telephone: 541/488-6002 Fax: 541/488-5311 TELEPHONE: 541-941-1329 DATE AGREEMENT PREPARED: 01/09/2013 FAX: BEGINNING DATE: 01/10/2013 COMPLETION DATE: 01/25/2013 COMPENSATION: $700.00 per proposal attached as Exhibit C. GOODS AND SERVICES TO BE PROVIDED: Contractor to trench approximately 20-25' and install 4" PVC conduit, minimum depth 48", bury tape, cover with minimum one (1) foot sand, backfill, and clean-up per . proposal attached as Exhibit C. Location: Northwest corner of Peache Road and Hillview Drive ADDITIONAL TERMS: Workers' Compensation is in waived because the contractor has no employees and will be performing all the work himself. Contractor's initials 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 27913.220, 2796.225, 2796.230, 2798.235, 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 by City under any of the following conditions: Contract for Goods and Services Less than $25,000, Revised 06/30/2012, Page 1 of 5 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 parry 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 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 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. d. Notice of cancellation or change. There shall be no cancellation, material change, reduction of limits or Contract for Goods and Services Less than $25,000, Revised 06/30/2012, Page 2 of 5 intent not to renew the insurance coverage(s) without 30 days' written notice from the Contractor or its insurer(s) to the City. 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 /z, 'L By Signature D rtm n Head ~/Print Name Print Name b LAI"\ I-I~-13 Tie Date W-9 One copy of a W-9 is to be submitted with the signed contract. Purchase Order No. l Contract for Goods and Services Less than $25,000, 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: x (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. )0 (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. ontra or (Date) Contract for Goods and Services Less than $25,000, Revised 06/30/2012, Page 4 of 5 T do M Excavation 1796 Thomas Rd Medford, OR 97501 Phone (540-9414329 Email: tobester29nhotmail.com January 9`h 2013 Hil[view Dr and Peachey Power: Trenching 25R Backfill 1 ft Sand 4" Conduit Bury Tape Clean-up Total $700.00 Mary McClary. From: Mark Holden [holdenm@ashland.or.us] Sent: Friday, January 18, 2013 9:20 AM To: 'Dave Kanner'; 'Lee Tuneberg' Cc: 'Michael Ainsworth'; 'Dan Hendrix'; 'Warren DiNapoli'; 'Mary McClary' Subject: Delegation of Signature Authority Jan 19 to Jan 27, 2013 Warren DiNapoli is delegated my signature authority while I am out of the country from January 19th through Jan 27th, 2013. Regards, Mark Holden Director of Electric Utility, Telecom and IT City of Ashland eMail: mjholden(dashland.or,us phone: 541.552.2314 This email transmission is official business of the City of Ashland, and it is subject to Oregon Public Records Law for disclosure and retention. If you have received this message in error, please contact me at (541) 552-2314. Thank you. t A~ VEHICLE OR EQUIPMENT CERTIFICATE OF INSURANCE DATE(MMIDD/YYYY) January 14, 2013 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. This form is used to report coverages provided to a single specific vehicle or equipment. Do not use this form to report liability coverage provided to multiple vehicles under a single policy. Use ACORD 25 for that purpose. PRODUCER CONTACT NAME: OSCAR RODRIGUEZ Oscar Rodriguez, State Farms a/cNNe E,t, 541 7721335 ac No: 541 7720327 ~m1 1603 E Barnett Rd E-MAIL C®f¢r E-MAIL ADDRESS: OSCAR.RODRIGUEZ.QUJQ@STATEFARM.COM Medford OR 97504 PRODUCER CUSTOMER ID p: INSURERS AFFORDING COVERAGE NAIC N INSURED INSURER A: State Farm Mutual Automobile Insurance Company 25178 MUNROE, TOBY M INSURER B 1796 THOMAS RD INSURER C MEDFORD OR 97501-3846 INSURER D: INSURER E : DESCRIPTION OF VEHICLE OR EQUIPMENT YEAR MAKE/MANUFACTURER MODEL BODY TYPE VEHICLE IDENTIFICATION NUMBER 02 CHEVY K1500 PU 1GCEK19VX2Z265513 DESCRIPTION SERIAL NUMBER COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICY(IES) OF INSURANCE LISTED BELOW HAS/HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD(S) INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENTWITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICY(IES) DESCRIBED HEREIN IS/ARE SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICY(IES). INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE (MMMD/YYYY) DATE (MMMDIYYYY) LIMITS X VEHICLE LIABILITY COMBINED SINGLE LIMIT $ A 0715787-A26-37A 01/06/2013 07/0612013 BODILY INJURY (Par person) $ 250,000 BODILY INJURY (Per accident) $ 500,000 PROPERTY DAMAGE $ 250,000 GENERAL LIABILITY EACH OCCURENCE $ OCCURRENCE GENERAL AGGREGATE $ CLAIMS MADE $ INSR Loss POLICY EFFECTIVE POLICY EXPIRATION LTR PAYEE TYPE OF INSURANCE POLICY NUMBER DATE(MMMD/YYYY) DATE(MMMD/YYYY) LIMITS/DEDUCTIBLE VIER COLLISION LOSS ❑ ACV ❑ AGREED AMT It LIMIT ❑ ❑ STATED AMT $ DED VIER COMP VEH OTC ❑ ACV ❑ AGREED AMT $ LIMIT ❑ ❑ STATED AMT $ DED PROPERTY ❑ ACV ❑ AGREED AMT S LIMIT BASIC BROAD ❑ RC ❑ STATED AMT SPECIAL ❑ f DIED REMARKS (INCLUDING SPECIAL CONDITIONS / OTHER COVERAGES) (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) ADDITIONAL INTEREST CANCELLATION Select one of the following: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED X The additional interest described below has been added to the policyhes) listed herein by policy number(s). BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE A request has been submitted to add the additional interest desalbed below to the policy(us) DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. listed herein b li s VEHICLE/ EQUIPMENT I=T : LEASED FINANCED DESCRIPTION OF THE ADDITIONAL INTEREST NAME AND ADDRESS OF ADDITIONAL INTEREST X ADDITIONAL INSURED LOSS PAYEE CITY OF ASHLAND LENDER'S LOSS PAYEE ELECTRIC DEPARTMENT LO /LEASENUMBE 90 N MOUNTAIN AVE ' ASHLAND OR 97520 T ED REPRE N nvE ~ ©1997-2010 A RD CORPORA N. All rights reserved. ACORD 23 (2010105) The ACORD name and logo are registered marks of ACOR 1004361 142987 09-30-2011 Beecher Carlson 1/15/2013 10:25:39 AM PACE 2/006 Fax Server AL.I/RDA DAiEIYIWOOf Yf.: CERTIFICATE OF LIABILITY INSURANCE 1/15/2013 THIS-CERTIFICATE IS ISSUED .AS A MATTER OF ANFORMATON ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CEWFIFICATE. DOES NOT AFFIRMATIVELY OR.,NEGATIVELY' AMEND; EATEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE'S DOES NOT CONSTITUTE A' CONTRACT' BETWEEN THE ISSUING INSURER(SI, AUTHORIZED REPREsENTATVE OR PRODUCER,'AND, THE' CERTIFICATE HOLDER IMPORTANT:' If the ceni8cete holder Is an ADDITIONAL INSURED; The policy(ies) iiuist be endorsed. If SUBROGATION IS WANED, subjectto, the te1R15 siid COnfiltlenS dTthe DOllcy, teRaln.pollCleS'may feQUlfe an e110Df5emenL A statenterit'Gn this tertiflhate does not Cenw rtght3 to fhe. ceRlOcdte bolder In lieu of such endorsemenqc)i PRODUCER. c '.Larry' Thompson Beecher Carlson maurance Agency LLC P1t0f`'a (5Qi> 7.2p 1 ."X. N,,. (541)'+72-37us 70T Murphy Ptl E .leer-:the sorilbeechercarlson.com NSCRE7951-AFPORU&4 COVERAGE NR1GII Medford. OR 97504, INURE A'AMricaM Hallmark Ins: Co of TX: 3494 INSURED if OUR F C: Toby M Maaroe, "DBA: T 6 H Excavation irisiinsigc: 1196 Thomas Rd. INSUREA D: INSVRER E: Medford OR 97501 osuR_vgc: COVERAGES CERTIFICATENUMBER:2012-13 Al'Cert's REVISION NUMBER: THIS IS B'O-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 DOCUVENTWIT'H RESPECT TO VMk:H Iii75: CERTIFICATE MAYBE ,SUED OR MAY PERTAN; T1tE INSURANCE AFFORDED-DY THE POLICIES DESCRIBED HEREIN 16 SUBJECT TO AL. THE'TERMS, EXCLUSIONS AND CONDITIONS: CF SUCH POLICIES. LIMBS SHOWN MAY HAVE BEEN REDUCED BY PAIDCLAIMS. INSrt 1R 1YPEDFINSONANCE PCLSJYN EIER MMII~YET 11,11 tin Is '.0EEML LMILRY E/.Cn,iLOUP.PEN~ S l,,000, DOD X. a1M.tiPty: Oi:.raFFU LV91tIfv' i~eu1;[ -oi' q .100,000 A :(1,n MS CCIXIP' a('L43789107 710/2012 /t0/2U1J NEL•E:W (Nry P;...I 1 5,009 Psgsolia: S W+NJ R, 8 1, 000,000 G?NEw'•L_a36REG~I6.. i.. .2,:0_00;000 N'L'.40yIlE xr 611,7 P_F:--_ P1a'C-«=,CYae~r..-G~~1 2,000,000 Tl I.QC $ AVTOWBILELASIUr UIM NL~:InyLL uw. L1dY NITfl ECQILYWA'FY+Pff PQJS'.Di $ _ KL Gt4NED SCnEDLLE N,1?c ;4 Tos WDIq IN U Y cv ID3u1 $ H REJ.Atff06 N')ti 0144E:] YFK!T1 LWuHi: . K!TOS x ^riaaMl q DNBREU.A LIA&. OLv'UI;. _E?QYDCCLMCIENCE 4 EXCESS IJAE pIyIM AiADF rl:C.r<E Ai - q 1)FC Fc-E~l'i oN' 4 WOR✓05COMPENSAnON IBC e1I-TU Ufll- ANDEMPLOY_N6LABILIn' /N RIi T 0FPrU?AZETChPA4T r1:FR;ffWTYE el Eti.Y/ti CII`cNi 1 tNisOdHwyln dHl F_LDI'aFJ.SC"E9 cAlpl v1," f DF6GRIPIiOrt DFZNfiRTFfOn.Shm`a EL DI a~aE-J-YiJCY LP/IS $ ❑F.S PRONOFOPERATDNSILOCATIONSIVEHICLES IAkL'ah ACOftr)tOt Addil 'nlMmAi4 S duld;lhnei~ r •nqu~iNf Crneril Likbili Ey policy iiialudes' Prl:nary Y No -Contribucoryyroicor. per eodorseniont: DIP 91 67 10/10 (attached), where required by written 'co'ntract. This-form. is subject to policy terms:eond:itions.0 exclusions. CERTIFICATE HOLDER CANCELLATION..................................... (541)468-5311 . SHOVEDANY OF THE ATE THEREOF, NOTICE ISLL BE DELIVERED IN THE EXPIkATfO fON DATE HEREt~, N011dE-:WILL SE: nELIYERm II. City o£. Ilshland, ozegon',: its elected ACCORUANCEWITH THE POLICY.PROVISIONS - Officals, officers and employees 20 East Main Str*:et AVTHORHOREPRESENTATVE Ashalnd, OR 97526 Larry Thompson/LARRY ACORD 25 (2010105) Cn1988.2014ACORDCORPORATION, Allrights reserved- IN5025_^m 15! oi, Tne ACORD name and logo are registered marks of ACORD. Beecher Carlson 1/15/2013 10:25:39 AM PAGE 3/006 Fax Server (5) Vandalism :and.malicious mischief; or (6) Theft. c. The following is added. to. b2: Property Not Covered of the BUILDING AND PERSONAL. PROPERTY COVERAGE FORM: r. Property while stored or operated underground in connection with any milning operations. . . . . -SP . E I C . IAL . FO . RM: . OFGOSS . d; Tlie:fotlowing.is added to:Paragraph . :2:uf B:Ezeluslons gflhe:CAU3ES . n. W e will not pay for loss or damage caused by puncture; blowout and road damage to tires and tubes mounted on vehicles. However, we do pay for puncture, blowout at roaddamage caused by a specified peril. ,o. We will not pay, for loss caused byhumidity, dampness, dryness or changes in or extremes of temperature. P: We will not.pay for lass caused by the weight of a load which, under the operating conditions at the time of a! loss; exceeds the registered lif ing. capartlyef any equipment or machine. q:. We will rot pay.forloss:due to theft anayslerious disappearance from any vetiicie:erattached container:, We will pay for loss::due: taburglarywtientheree are signs of forcible entry to a locked vehicle or container. a. E.1-Valuation of the BUILDING AND PERSONAL PROPERTY COVERAGE FORM Is deiisted and replaced by the following:. 7. Valuation Wewill oeterminethe value.ot covered property in the oriental loss or damage as follows: a. At actual cash value at the Ilme:of the Ipss:(with a Jeductlon for depreciallonp except as provided in Paragraphs; b. and,cjollowing: :b.. Pair or Sat, The value ata lust ordaniaged article which is pert of a pairor set is based on a reasonable proportion of the value of the entire pair or set, The loss is not considered a total loss of the pair or set. C. Loss to Parts. The valueof a iost or iiamaged part of an item that consists of several parts wlhe i it is :complete is based on the value of only the Iosl or damaged part or fhe.cost to repair or reipiacc it. 2. Rental Reimbursement Iri the event of loss bya,covered. peril to covered contra i;trrs' equlonent Mal you own: we. Will :re6i iurse-you for your expense to cent similar equipmentwhile your equipment is inoperable. The. most we veil reimburse you.for rental. relmbursementexpensesis$1,000. We will continue to reimburse you for the rental ofequpmentafterthe:expiration daWof this coverage provided the loss occurred'.before.tne expiration date. We Will not reimburse your a. If you can continue or resume. your operations with sinniiar equipment that. is. available to you at no additional. expense to you; or b. For the rental expense of any:equipment uniess you make every.reasonableeffort to repair, replace or rebuild the inoperable equipment after the covered loss occurs. 3. With respect to this Additional Coverage, Contractors Equipment Coverage. Section D. Deductible of the BUILDING AND PERSONAL-PROPERTY:COVERAGE FORM is deleted and replaced by the following: D. Deductible Wiswil! hot payforlossordamage in anyone. occurrence until the amountof loss ordamageaezceeds$500. Wewill then any the amount of loss ortlamage in excess of.$500 up to the. applicable limit of insurance. We will not rP.imnurSe you-torlhe rn?ltal of equ7pmPnt:untilaftor 72: hcwrs nave passed since tna rnveriuf property was rendered inoperable. After 72 hours have passed; we will only reimburse you for the rentalt expense that you, actually incur, '*he-deductible of.S5W does not apply to rental reimbursement expenses. General Liability Additional Coverages Thc:following Additional Coverages are added to the COMMERCIAL (GENERAL LIABILITY COVERAGE FORM, A. Blankot'Addttional Insured Coverage 1. SECTION II-WNOISAN.INSUREDoiCOMMERCIAL GENERAL LIABILITY COVERAGE FORM isamended to include as an insured any person or organ 7ation (referred to as Additiorai insured) wlnorn you areTrequired to add asan Additional Insured on this policy under: a. A writtenconliart or agreement; and b. Where acertlflcateofInsuranceshowhgthatpersonororganlzallonasanadditionalInsuredhasbeenIssued:and - Page 20 of 25 Indudes coptr;ghtcd material of Insienrce Services Office, Inc. and MP 97 67 10 10 -ArnerirdTASSOUaIiUn aiansman~ 5enices, lrx., vnCt Rmec permisSnn ,Beecher Carlson 1/15/2013 10:25:39 AM PAGE 4/006 Fax Server c. When the written contract or agreement and certificate ofinsurance.arecurrently in effector becorning in effect during the term of the policy and executed prior to :the :'bodily :injury," "property damage;": or "personal and. advertising injury" 2. The Insurance provided to1he: Additional insured is limited as tolfows: a. The Additional lnsi red is only. an additional inured for; (1) "Bodily injury, "property damage,"or"personal and advertising njury'causedinwhole orinpail by:negligent -acts or emissions of theNamed Insured or anyone directly or indirectly employed by lhe:rjamed I nsured:or for :whose acts a Named Insured may be liable.: (2) :Liability arising out of your ongoing.operations for the Additional Insured by or for you: A person's or aganization's status as an insured under this coverage ends when your operations for that insured are completed. to. Th6Lifnits of lnsuran:v applicable to the Additional Insured wet6ose specified in thewritten contract oragreement but not moreahon the Limits of Insurance specified in the Declarations for this policy, The Urnits of Insurance: applicable to the Additional Insured are inclusive of and not in addition to the Limits of Insurance shown in the Declarations fortheNamed.lnsured. 3. In addition to_theother :exclusions applicable to Section I, Coverages A., B. and C. of the COMMERCIAL GENERAL LIABILITY COVERAGE FORM,!tne insurance provided to the Additional Insured does not apply to, a. "Property darnage" to: (1) Property owned,:used, occupied by, loaned or rented to the Additional Insured; (2) -Property in the care, custody or control of the Addiiii:inal Insured or over which the. Additional Insured are for any purpose exercising physical control; or (3) "Your, work".performedforthe Additional Insured. b. "Bodily injury." "property. damage," or "personal and advertising injury' arising outof an archltect's, engineer's: or surveyor's rentlenrig or failure to render any professional services fVryou, for theA[idilional Insured or for others, including, but notjimitodic: (1) The ;preparing, approving orfailure to.prepare orapprove.inaps, drawings; opinions, reports,surveys, change - -cdersi designs or specifications; or (2) Supervisory,inspectioi or engineering services.. c. "Bodily injury"or "property damage" occurring.after (1) :AII work, including materials; parts or equipment furnished in connection with such.work, on the project (other than service,. maintenance orrepa!rs) to.be performedby.ar on behalf of the additional insured M the site ofthe: :covered operations has:been completed; or (2): That ponlon of "your wont" out,of which the injury or damage arises has been put to its intended. use by any person or organization other than another contractor or subcontractor engaged in performing operations fora principal as a part of the same project. 4.: SECTION P7 COMMERCIALS GENERAL. LIABILITY CONDITIONS, Paragraph 4. Other Insurance, is.amended to add the following subparagraph: d. Additional Insured's Other. Insurance As Excess Insurance To the extent required by art lmsured contract" this insurance is pnmary,on behalf of the Addifional Insured; and any other insurance mainlained by the Additional insured is excess and not contributory with this insurance. If the "insured: contract" does not.require this provision, then Paragraph a. above will apply. B: Mobile Equipment Broadened Coverage V.12.f.(I) of Cie COMMERCIAL GENERAL LIABILITY COVERAGE. FORM is replaced by the-fol[owing: (1) Equipment designed:primarily for: (a) Snow Removal; (b) Road maintenance. but not constructonor resurfacing;. or (c). Street cleaning. Exceptlhe above provisions do not apply to self-propelled vehicles of lessthan 1,000. pounds gross vehicle-weight which are not intended for use on a highway. C. Aggregate Limit Per Project The General: Aggregate Limit under SECTION III - LIMITS OFINSURANCE rof the COMMERCIAL GENERAL LIABILITY COVERAGE FORM applies separately to each of your projects away from premises owned by or rented to you. .MP 97 67 10 10 Includes rorn ighwii material of Insumrm Services office, Inc. aril Page 21 of 25 -American Astt:daWn of Insurance Services, Inc., with their permisaan .Beecher Carlson 1/15/2013 10:25:39 AM PACE 5/006 Fax Server .D. Blanket Waiver Of Transfer Of Rights Of. Recovery Against Others To Us The Transfer Of Rights Of Recovery . Against Others To Us Condition (SECTION IV -.COMMERCIAL-GENERAL LIABILITY' CONDITIONS) is amended by the addition of the folloW rig; We wmlve:anv right of recoverywe mayhave aga;rist any person or organization to whom you bvwritten conVaQt or.writ en agreernem have w:yved your awn right or recovery for loss caused by that person or organization oerause of payments we make for Injury or damage arising outof.your ongoing operations or'yourvii done under a written conhBct pr :written agreement with that person or organization and irldLided in Ole-"products-comp~eled operations hazard." This proviisiondoes not apply unless the written contract orwhilenagreement has been executed prior to fie "occurrence" or offense giving rise to the `.bodily injury' or 'property damage:' E: voluntary Property Damage coverage 1. We.will,atycurrequest;pay:but not defend anyclalmfor"propem'.damage "Totheproperty ol others otherwiseexcluded underA.2.J.(4), (5) and (6) of the COMMERCIAL: GENERAL, LIABILITY COVERAGE FORM provided that: a. Such "property damage" takes place while such property. is in your care, custody or cnnirol,. or is properly of others: over which you, for any purpose, are exercising or have exercised physical contrG; and b. Such "loioperty dariiage"'takes place away from any premises you own, relit or lease: and C. Such "property damage"-takes plane Mirsinthe "coverage territory'and during the policy term; and d. Such "property :damage" takes place only during youroperations that are known to us, are scheduled on the policy and for which a premium has been charged. 2 The ihsusance under this adddionel:coverage does not apply to "propertydemage"ao property. a. Held hyyou fur servicing, repair;storage or sale at premises owned;by, rentedar,(easedi lo!yuu; b. While being transported byorc;ausedbythecswnership, maintenance, operation, use, -loading or unloading" of arty, "auto," waterc,afl.or aircraft; or c. Owned orccrupied byor renteddo you.. ;3 Deductible. This additional coverage will apply onlytothat amount of any loss in each "occurrence" thatexceeds $500. The terms of the policy with respect tcyourduties in the event.of"occurrence,"claim or "suit"and the Company's right to. investigate; negotiate and settle: any cla im or'sult"apply irrespective of the application of the deductible amount :of $500. We may paysny part or at of-the deductible amount of $500. to. effect settlement of shy ciai!n oi'suit." Upon notification of the action"taken, you.mtrst promptly re. nlburse us for such pan' of the deductible, amount as has been paid 6 us. d. Limits of Liability The Limit of Liability fort" additional coverage shall not exceed S2,500 for each "occurrence":and is the limit of the Company's liability for all damages on account of each claim:or"suit' covered herein. The annual aggregate Limit of Liability is $2,500 and is, subject to the a'oove provisions respecting each claim, the total limit of the Company's liability for at damages. 5. Settlement In the:eventof loss covered by this additional coverage, you shall, if requested by us, repiace]he.property orfurnish the laborand materials necessary for repairs thereto at. actual :cost to you, excluding prospedNe profit or overhead charges: of anynature. Any property so'paid far or replaced shall, at our option, becorne the properiyof Ins Company. Payment: hereunder shall not constitute: an admission: of:flab [lily of.you or, except as stated herein, of the -Company: Additional Conditions- A.. Insurance Under Two Or More C.overagos The following is added to Paragraph: C. Insurance under Two or More Coverages of the. COMMERCIAL PROPERTY CONDITIONS! If.a.Coverage Form. is attached to this policythat:provides a rmitfor anyc iverage provided by this :endorsement; the limit: shown in the SCHEDULE and the coverage provided by this endorsement are deleted and replaced by the limit and coverage provided bythe Coverage Farm.. B. Limits Of Insurance Regardless ofthe number of buildings at a location covered oythis endorsement, the mostwe will pay under this:Coverage. Enhancement endorsement inanyone occurrence is the applicable Limits of Insurance shown in the SCHEDULE on page 1 of this endorserent. Page 22 of 25 Includes cop iMgited mztMal of Ins=r" Swvicc t Office, Inc. and MP g7 671010 ArnCriCd] Astt:aation eF.lns~raa~ ServirES, !x., vnLh they permissnn Beecher Carlson 1/15/2013 10:25:39 AM PAGE 6/006 Fax Server C. Deductibles The Deductible described in section D. of the BUILDING AND PERSONAL PROPERTY COVERAGE FORM applies -to- each -ofthe Coverage Enhancements except as shown below: We will not pay for loss or:damage in any cne occurrence until the amount of loss or damage exceeds:5500. We will then pay the amount of loss or damage in excess oli up In the applicable Limit of Insurance forihe following emancernents: 1. Personal.Effects and Property of Others 2.. Valuable Papers and Records (Other than Electronic: Data) 3. Property Off7Premises (including Laptops aria Other Electronic Equipment) 4. Outdoorr Property (Named Perils) 5. Accounts Receivabie 6. Property in 1'ransit:(Inciuding Laptops. and Other. Electronic Equipment) -7. Fine.Ans Ill. Electronic-Data. 9. Water Back-Up. and:Sump. Overflow 19. Employee Theft 11, Money anti Securities 12.. Forgery or Alteration No. deductible provisions apply to the following enhancements: 1. Fire Department Service Charge 2. Arson Reward 3. Claims Expenses 4. !mientaryoiAppraisal Cost 5. Recharging of Fire Extinguishers .6. Rental Reimbursement 0. Additional Definitions: The following Additional Definitions apply to, this endorsement only, 1: "Banking Promises" mearathe interior of that portion of any building ociupied by a ban I king instituti on orsimilarsate depository.. 2. "Business Income" means the' a. Net, income (NotlProfit or Loss before income taxes) that would, have beer eanied had no loss occurred; and tiContinuing normal operat ng expenses incurred, including payroll. For manufacturing risks, Net Income includes the net sales value-of production. 3. ".Client' as used in Employee Theft Coverage: means any entity for whomyou;perform services under a written agreement:. 4. "Cllent`°asused inContractors Equipment Coverage means anlnVivid I uaf, company or organization with whom you nave a written contractor work order for your services fora described premises and have billed for yr),ur services 5. "Employee" as used in Employee Theft and Money And Securities Coverages means; a. "Employee" means; (11 Any natical. person: .(a) While: in your :service.ocfor 30:days :after -termination of. service, :,(b) Wheyoucompensatedirectly bysalary, _wooesorcommissions yand (c) Who you have the rgnt:to dreet and control.while performing servlces.for you, (2): Any.nanaai person.who. is furnished temporarily to you:: ,(a) 'To substitute. for a permanent "employee" as defined in. Paragraoh (1) above, who is on leave: or .(b) To meet seasonal; or short-term work load conditions; while that person is subject to. your direction and control and peifonnirg'servlces.toe you, excluding;. howevee,:any such.person while having care and custody of property outside the "premises"; MP 97 67 10 10 Indudes coMi4Wn d material of Insurance Services Office, inc. anti Page 23 of 25 American Asmouation of In"rance Saroms, inc., mtti thew perm, sRon t Y i ~Qr DER Pagel / 1 WP~ CITY OF T ASH LAN D DATE : I-PONUMBER' 20 E MAIN ST. 2/1/2013 11423 ASHLAND, OR 97520 (541) 488-5300 - ,l7Cr' VENDOR: 017558 SHIP TO: Ashland Electric Department T & M EXCAVATION (541) 488-5354 1796 THOMAS ROAD 90 N MOUNTAIN - MEDFORD, OR 97501 ASHLAND, OR 97520 FOB Point: Req. No.: Terms: Net Dept.: Req. Del. Date: Contact: Dave Tvgerson - Special Inst: Confirming? No. ...Quantity Unit - Description - - Unit Price , Ext. Price Contractor to trench and install 4" PVC 700.00 northwest corner of Peachy and Hillview Drive. Contract for Goods and Services Beginning date: 01/10/2013 Completion date: 01/25/2013 i i SUBTOTAL 700.00 BILL TO: Account Payable _ TAX 0.00 20.EAST MAIN ST FREIGHT 0.00 541-552-2010 TOTAL 700.00 ASHLAND, OR 97520 Account Number - Project Number Amount Account Number: Project Number.- "Amount - i E 690.11.18.00.70410 E 000326.999 700.00 LlIx ~ Author d Sim VENDOR COPY FURIVI#3 CITY OF ASHLAND REQUISITION Date of request: Required date for delivery: Vendor Name T ~ 07 5XCQ\ 6t-r7DA1 Address, City, State, Zap 1791n 'T7-10lwos ROAD miSOFOAO, 012. 976-01 Contact Name & Telephone Number -Mbq /7PUiy/ne Slyl. qNl.• 132 9 Fax Number /~rPLe-770a Dore SOURCING METHOD ❑ 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# ❑ VerbaVWritten 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 El Special Procurement Intergovernmental Agreement Agency $5.000 to $75.000 ❑ Form #0, Request for Approval ❑ ❑ Less than $35,000, by direct appointment ❑ Written quote or proposal attached Date original contract approved by Council: (Date) ❑ (3) Written proposals attached Date approved by Council: ❑ Form #4, Personal Services $5K to $75K Valid until: Date Description of SERVICES Total Cost r"6r-041_ 14-7-!0n/ 0r- y"f>ItG ~OCi47Fp e 7ft/= NlW CrJnR/er P~'~HEt/ RO. }~/-f~>Ivicw D/2tv.E- ,UUF-Prrs a A119" v - sgnr,o cover - ,dBclr-Fi%/ ~ CLaau-✓~. $ 700, Item # Quantity Unit Description of MATERIALS Unit Price Total Cost sE~ / {#C i eln/ r'o os'0 . 700- dLo TOTAL COST ❑ Per attached quote/proposal $ Project Number 00032 6-9`19 Account Number -------__700. Account Number(,QQ-LL-ZR-00-70y-l0O 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 satisfied Employee Signature: I~Qi AAiQ r Department Head Signature: (Equalto or greater than ,000) City Administrator: (Equal to or greater than $25,000) Funds appropriated for current fiscal year: YES / NO Finance Director- (Equal to or greater than $5,000) Date Comments: 9 .