HomeMy WebLinkAbout2013-043 Contract - Adroit Construction
Contract for GOODS AND SERVICES Less than $25,000
C I T Y OF CONTRACTOR: Adroit Construction Company, Inc.
ASHLAND CONTACT: William J. Chmelir
20 East Main Street
Ashland, Oregon 97520 ADDRESS: PO Box 609, Ashland, OR 97520
Telephone: 541/488-6002
Fax: 541/488-5311 TELEPHONE: 541-482-4098
DATE AGREEMENT PREPARED: 02/20/2012 FAX: 541-482-4218
BEGINNING DATE: 02/21/2013 COMPLETION DATE: 03/01/2013
COMPENSATION: $7.460.00 per proposal attached as Exhibit C.
GOODS AND SERVICES TO BE PROVIDED: Removal of shade structure located at the north side of the
pool at Hunter Park 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, 279B.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:
i. If City funding from federal, state, count or other sources is not obtained and continued at levels
Contract for Goods and Services Less than $25,000, Revised 06/30/2012, Page 1 of 5
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 owh 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 Li di rance with a combined single limit, or the equivalent, of not less than Enter one:
$200,000, $500,00k$1,000,009 $2,000,000 or Not Applicable for each occurrence for Bodily Injury and Property
Damage. It shall inclu a actual liability coverage for the indemnity provided under this contract.
C. Automobile 'abili ' uurance with a combined single limit, or the equivalent, of not less than Enter one:
$200,000, $500,000, 1w,000,000 ~r Not Applicable for each accident for Bodily Injury and Property Damage,
including coverage for one fired or non-owned vehicles, as applicable.
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 insurers to
Contract for Goods and Services Less than $25,000, Revised 06/30/2012, Page 2 of 5
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. 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. 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.
1. fication. Contractor shall sign the certification attached hereto as Exhibit A and herein incorporated by
refere e.
ontractor City of Ashl n
. J~7G rr~ By
Signature \ artment Head
Print Name Print Name
Gcv ~lz~~~ .
Title Date
W-9 One copy of a W-9 is to be submitted with r/ i5
the signed contract. Purchase Order No. (J/
Contract for Goods and Services Less than $25,000, Revised 06/3012012, 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) 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) I 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.
- t
2-0
Contractor (Date)
Contract for Goods and Services Less than $25,000, Revised 06130/2012, Page 4 of 5
XIS
adroit
CONSTRUCTION CO., INC.
February 13, 2013
Jeff McFarland
Ashland Parks & Recreation
340 S. Pioneer Street
Ashland, OR 97520
Subject: Shade Structure Demolition at Hunter Park
Jeff,
Thank you for taking the time to meet with me the other day. Based upon our site meeting
and your description of the removal of the shade structure located at the north side of the pool at
Hunter Park, I am pleased to present the following scope of work description and cost proposal:
Work Description:
1) Demolish shade structure and solar apparatus on its roof except for the section above the
existing storage shed.
2) Remove shade structure posts and their buried concrete bases and backfill the void.
3) Finish exposed end of remaining structure left over the existing shed with salvaged material
from demolition.
4) Dispose of all demolished debris.
5) City will roll up adjacent chain link fence out of the way during construction
The work described above includes all labor, material, equipment, clean up, insurance and supervision
for a complete and finished project. The total proposed cost of the work is $7,460.00 payable upon
completion of the work. It is understood that the work will need to be completed during normal
business hours between 7:00 AM and 5:00 PM. Excludes permits and work not specifically identified
above.
Sincerely,
William J. Chmelir, P.E.
Warranty and Closeout Manager
Adroit Construction Co., Inc.
ADROIT CONSTRUCTION CO., INC. I;
P.0. Box 609, Ashland, Oregon 97520 • 5414824098 • Fax: 541-0824218
OREGON NO. 44384, CALIFORNIA NO. 454960B
'c
,aco CERTIFICATE OF LIABILITY INSURANCE DATE (MM D°
2/20/2013
13
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(les) 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 endorsements .
PRODUCER CONTACT Susan Wilson, AAI, AIC
NAME:
Beecher Carlson Insurance Agency LLC (5Q1)772-1111 FAC No: (541)]12-3'185
707 Murphy Rd PHONE.susan.wilson@beechercarlson. com
INSURERS AFFORDING COVERAGE NAIC t
Medford OR 97504 INSURERA:Valle Forge Insurance Co 0508
INSURED INSURERS Continental Insurance Company 5289
ADROIT CONSTRUCTION CO INC INSURERCSeibert Insurance Underwriters
PO BOX 609 INSURERO SAIF 2412
INSURERE:CO1uDlbia Casualty II
ASHLAND OR 97520 INSURER F:
COVERAGES CERTIFICATE NUMBER:CL1222813031 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 MAYHAVE BEEN REDUCED BY PAID CLAIMS.
ILTR TYPE OF INSURANCE ADM SWR POLICY NLP.ISER MMICorrVYYY MMIDDIYVYP LIMITS 1= Jffla GENERAL LIABILITY
EACH OCC=URRENCE 4 1,000,000
X COMMERCIAL GENERAL LIABILITY PREMISES Be occunenca $ 300,000
A CLAIMS MADE ❑X OCCUR X 020534090 /1/2012 /1/2013 MED EXP(Any one person) $ 5,000
PERSONAL B ADV INJURY $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
GENL AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP ASS $ 2,000,000
POLICY X PRO- F LOT 3
AUTOMOBILE LIABILITY Eea SINGLE FINED LIMIT
000en1 11000,000
B X ANY AUTO BODILY ll, URY(Perperson) $
AALL OSWN-D AUTOSULED X 020534106 /1/2012 /1/2013 BODILY INJURY Ber eminent) 3
NON-OaM1ED PROPERTY DAMAGE
X HIRED AUTOS X AUTOS Perac dent $
Pdkdon Liataiv $
UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 15, 000, 000
C X EXCESSLIAB CLAIMSMADE AGGREGATE $ 15,000,000
DED X RETENTIONS 0 XCSF1901064 /1/2012 /1/2013 3
D WORKERSCOMPENSATION Vvr STgTU- OTH-
ANDEMPLOYERS'LIABILITY YIN T RY
ANY PROPRIETORIPAATNERE>ECUTIVE E. L. EACH ACCIDENT $ 500,000
OFFICERIMEMBER EXCLUDED? N/A
(Mandatory in NH) 10619 0/1/2012 0/1/2013 E.L. DISEASE - EA EMPLOYE $ 500,000
DII Es. deemed under
SCRIPTION OF OPERATIONS be law EL. DISEASE - POLICY LIMIT $ 500,000
E Professional Liability PB254097995 /1/2012 11/2013 Limn 2,000,000
Deductible: 15,000
DESCRIPTION OF OPERATIONS 1 LOCAT DNS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, IT more space Ia required)
Re: Hunter Park Project, Ashland, OR. General Liability Policy includes Blanket Additional Insured and
Primary/Non-Contributory Coverage as required by written contract per endorsement G-160331-C (attached).
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS.
Kari Olson, Purchasing Representative
90 N Mountain Avenue AUTHORIZED REPRESENTATIVE
Ashland, OR 97520
S Wilson, AAI, AIC/SU c~YaLw.v t~ • J'ti'
ACORD 25 (2010105) O 1988-2010 ACORD CORPORATION. All rights reserved.
INS025(201005)01 The ACORD name and logo are registered marks of ACORD
C/VA (Ed. 10//10)
(Ed. 1
10)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -
WITH PRODUCTS-COMPLETED OPERATIONS COVERAGE
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE (OPTIONAL)
Name of Additional Insured Persons Or Organizations
(As required by "written contract" per Paragraph A. below.)
Locations of Covered Operations
(As per the "written contract," provided the location is within the "coverage territory" of this Coverage Part.)
A. Section II - Who Is An Insured is amended to include 2. We will not provide the additional insured any
as an additional insured: broader coverage or any higher limit of insurance
1. Any person or organization whom you are than the least that is:
required by 'written contract" to add as an a. Required by the "written contract";
additional insured on this Coverage Part; and b. Described in 8.1. above; or
2. The particular person or organization, if any, c. Afforded to you under this scheduled above. y policy.
B. The insurance provided to the additional insured is 3. This insurance is excess of all other insurance
e limited as follows: available to the additional insured whether on a
primary, excess, contingent or any other basis.
1. The person or organization is an additional But if required by the "written contract," this
insured only with respect to liability for "bodily insurance will be primary and non-contributory
$ injury," damage," or
$ "property "personal and relative to insurance on which the additional
p advertising injury" caused in whole or in part by: insured is a Named Insured.
a. Your acts or omissions; or 4. The insurance provided to the additional insured
b. The acts or omissions of those acting on your does not apply to "bodily injury," "property
behalf damage," or personal and advertising injury
arising out of:
in the performance of your ongoing operations a. The rendering of, or the failure to render, any
specified in the "written contract"; or professional architectural, engineering, or
c. "Your work" that is specified in the 'written surveying services, including:
contract" but only for "bodily injury" or
property damage" included in the "products- (1) The preparng, approving, or failing to
prepare or approve maps, shop drawings,
completed operations hazard," and only if: opinions, reports, surveys, field orders,
(1) The "written contract" requires you to change orders or drawings and
provide the additional insured such specifications; and
coverage; and (2) Supervisory, inspection, architectural or
(2) This Coverage Part provides such engineering activities; or
coverage.
G-140331-C Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 1 of 2
(Ed. 10/10)
1
G-140331-C
(Ed. 10/10)
b. Any premises or work for which the additional We have no duty to defend or indemnify an
insured is specifically listed as an additional additional insured under this endorsement until we
insured on another endorsement attached to receive from the additional insured written notice
this Coverage Part. of a claim or "suit"
C. SECTION IV - COMMERCIAL GENERAL LIABILITY 2. With respect only to the insurance provided by this
CONDITIONS is amended as follows: endorsement, the first sentence of Paragraph 4.a.
1. The Duties In The Event of Occurrence, of the Other Insurance Condition is deleted and
Offense, Claim or Suit condition is amended to replaced with the following:
add the following additional conditions applicable 4. Other Insurance
to the additional insured: a. Primary Insurance
An additional insured under this endorsement will
as soon as practicable: This insurance is primary and non-
contributory except when rendered
(1) Give us written notice of an "occurrence" or excess by endorsement G-140331-C, or
an offense which may result in a claim or when Paragraph b. below applies.
"suit" under this insurance, and of any claim
or "suit" that does result; D. Only for the purpose of the insurance provided by this
endorsement, SECTION V - DEFINITIONS is
(2) Except as provided in Paragraph B.3 of this amended to add the following definition:
endorsement, agree to make available any
other insurance the additional insured has for "Written contract" means a written contract or written
a loss we cover under this Coverage Part; agreement that requires you to make a person or
organization an additional insured on this Coverage
(3) Send us copies of all legal papers received, Part, provided the contract or agreement:
and otherwise cooperate with us in the 1. Is currently in effect or becomes effective during
claim or "suit"; and the term of this policy; and
(4) Tender the defense and indemnity of any 2. Was executed prior to:
claim or "suit" to any other insurer or self a. The "bodily injury" or "property damage"; or
insurer whose policy or program applies to a
loss we cover under this Coverage Part. But I The offense that caused the "personal and
if the "written contract" requires this insurance advertising injury"
to be primary and noncontributory, this for which the additional insured seeks coverage
provision (4) does not apply to insurance on under this Coverage Part.
which the additional insured is a Named
Insured.
G-140331-C Includes copyrighted material of Insurance services Office, Inc., with its permission Page 2 of 2
(Ed. 10/10)
Page 1 / 1
I
Ashland Park Commis on~~®tt~+ DATE PO NUMBER
20 E MAIN ST. 2/22/2013 00197
ASHLAND, OR 97520
(541) 488-5300
VENDOR: 004135 SHIP TO:
ADROIT CONSTRUCTION INC
PO BOX 609
ASHLAND, OR 97520
FOB Point: Req. No.:
Terms: net Dept.:
Req. Del. Date: Contact: Bruce Dickens
Special Inst: Confirming? NO
' Quantify', Unit bescri tion . - - Unit Price Ext. Price
Demolish shade structure per attached 7,460.00
proposal dated 02/13/2013.
Contract for Goods and Services
Beginning date: 02/21/2013
Completion date: 03/01/2013
SUBTOTAL 7,460.00
BILL TO: TAX 0.00
FREIGHT 0.00
TOTAL 7,460.00
Account Numtier' - Project Number - Amount Account Number Project Number! Amount
E 411.12.00.00.70420 E 000024.999 7,460.00
Z
574 VENDOR COPY
Authorized nature
CITY OF
A rel ueai for a Pur:-base Order ~1SH LAN D
REQUISITION Date of request:
Required date for delivery: y e+;
Vendor Name It
Address, City, State, Zip P0, JKOA 609, IltjrT ludi~«+ V-620
Contact Name & Telephone Number 5yj_ y;L- Hz18
Fax Number
SOURCING METHOD
❑ Exempt from Competitive Bidding ❑ Emeroencv
❑ Reason for exempfion: ❑ 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 #
❑ VerballWritten quote(s) or proposal(s) ❑ Slate of Washington
Intermediate Procurement ~~u F El Sole Source Contrail #
GOODS & SERVICES ❑ Applicable Form (#5,6, 7 or 8) ❑ Other government agency contract
5 00 100 000 v joe' Written quote or proposal attached Agency
D?❑ Form A, Personal Services $5K to $75K Contract #
3 )Wntten quo attached /
PER NAL SE CES ❑ Special Procurement Intergovernmental Agreement
5 000 75 0 ❑ Form #g, Request for Approval ❑ Agency
Date original contract approved by Council:
❑ Les n $35,000, by direct appointment ❑ Written quote or proposal attached (Date)
(3) en proposals attached Date approved by Council:
n n#4, ersonal Services $5K to $75K Valid until: Date
scriptio of SERVICES D O Total Cost
tmol, / - t r I^Laa, Salrr 2f An/l:" 1 : yh'/4 /s.lm:c L Sfhr.Yrr z
r/s r'nllb-lrie'Cl'cc'n<rr.J~~,.h sa.,r~6z:.E~~l, Qis reof[cll;i" G,ta0,ezq'fo~
alt-S//ruc/~u`t,-r:,h ev:,e(, ~ over 5 'x`jL !1o U(~ Ne•I-a;heJ w; f1+ .1 $ q6o. ~ .
Lti as~0 amys 1V~' 41&,, L; ;-e * we, cAa;„ /;nK fekee 7'n .,rife <rnrss,
Item # Quantity Unit Description of MATERIALS Unit Price Total Cost
TOTAL COST
09 Per attached quotelproposal $
Project Number (W0-L4Account Number
Account Number___-__-__-__-______
Account NumberqL(
'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,) certify that the City's public contracting requirements have b~el satisfied.
Employee Signature: Department Head Signature:
(Equal to or greater than $5,000)
City Administrator:
(Equal to or greater than $25,000)
Funds appropriated for current fiscal year., / NO A~- 1-. , z-1"~ J
Finance Director- (Equal to fearer than $5,000) Date
Comments:
Form #3 - Requisition