HomeMy WebLinkAbout2013-045 Contract - May Rock & Excavating
Contract for GOODS AND SERVICES Less than $25,000
CITY OF CONTRACTOR: May Rock & Excavating
ASHLAND CONTACT: Dan May
20 East Main Street
Ashland, Oregon 97520 ADDRESS: PO Box 319, Talent, OR 97540
Telephone: 541/488-6002
Fax: 541/488-5311 TELEPHONE: 541-482-2289
DATE AGREEMENT PREPARED: 02114/13 FAX:
BEGINNING DATE: 02/18/2013 COMPLETION DATE: 03/22/2013
COMPENSATION: $8,210.00 per proposal attached as Exhibit C.
GOODS AND SERVICES TO BE PROVIDED: Contractor to install new 3" PVC Schedule 40 service conduits
run to residences located at 735 and 715 Glenwood. Contractor to cut, remove, dispose and replace all
asphalt, back fill with compacted %"minus, slurry backfill, remove and dispose of unacceptable and excess
excavated soils, road restoration per the City of Ashland's engineering standards. Conduit and conduit fittings
will be provided b the City of Ashland. Ma of specs attached as Exhibit D.
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, 2798.225, 2798.230, 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
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.
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
I 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 Liabilitv 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
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.
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 By \~)l
n to artment Head
Print Na a Print N me
Title Date
W-9 One copy of a W-9 is to be submitted with
the signed contract. Purchase Order No.
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:
(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
U purchased for the business.
t.l P? (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.
J (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.
3
-a o O
Contractor (Date)
Contract for Goods and Services Less than $25,000, Revised 06/30/2012, Page 4 of 5
b 12 13 05:04p Office Services 541-512-8892
May Rock & Excavating, LLC ESTIMATE
CCB#65636 USDOT#198930-80
PO BOX 319 DATE ESTIMATE NO.
Talent OR 97540
211212013 509
NAMEIADDRESS
City of Ashland Electric Deparment
Attn: Dave Tigerson We now accept
90 N. Mountain Street MasterCard, Visa &
Ashland OR 97520 Discover Card.
PROJECT
715 Glennwood Street
DESCRIPTION QTYIHRS COST TOTAL
Utility trenchin0ay condult/backfrll, re-asphalt the street 1 8,210-00 8,210.00
and labor.
WE APPRECIATE YOUR BUSINESS.
ESTIMATE IS GOOD FOR 30 DAYS FROM THE Total
ABOVE DATE. ITEMS NOT LISTED IN THIS $8,210.00
PROPOSAL ARE CONSIDERED AN EXTRA AND
WILL BE BILLED @ TIME & MATERIAL. ROCK OR SIGNATURE
OTHER MATERIAL THAT REQUIRE ROCK
BREAKING EQUIPMENT WILL ALSO BE @ TIME &
MATERIAL. ALL AGREEMENTS ARE CONTINGENT
UPON WEATHER OR DELAYS BEYOND
CONTROL. Phone # Fax # E-mail
541-482-2289 541-512-8892 mayrock319@gmaiI,ccm
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FEB-22-2013 FR1 10:51 AM LNW COML UW FAX NO. 918665851399 P. 01/01
Certificate of Insurance
THE
AND
ONLY
CERTIFICATE INSURANCE POLICY ANDUDOES NOT A END, EXTEND. OR ALTER THE CO R GE AF ORDED BY THE POLIO ES L STED. HOLDER. THIS CERT7FCATE IS NOT AN
ED ASA
IS ISS
THIS CERTIFICA
Libeity
This is to Certify that Northwest.
Memtaer Ur Liberty MintlA C W UP
Liberty Centre
KEN MAY AND DAN MAY 650 NE Holladay Street
PO 4555
MAY ROCK a EXCAVATING po&x:Rland, OR
OR 97208-4555
PO BOX 319
TALENT OR 97640-0319 Tel: 5032395800
1116dwLIIIIIIn111u1Illnupltllpjlbuullbluu1111 www.libertynorthwest.com
.
The insurance
is, at the date of the certificate, insured by the Company under the policy(les) listed below. aH by the fisted pDl oth:)
is subject to alt their terms, exclusions and conditions and is not altered by any requirement, term or condition ion of any con^ tact or Dtner
document with respect to which this Da,tificate may be issued.
EXPIRATION
TYPE OF POLICY DAT POLICY NUMBER LIMITS OF LVIBILITY
~
(OVERAGE AFFORDEP UNDER W.C. LAW _ OadERAOEAP ORDEO UNDER W.O. LAW
OF POLLolmW, STATES.
Of FOLLOWING STATES:
OR
WORKERS?
® COMPENSATION 7101/2012iW .4-1NC-0004541
(EMPLOYERS LIABILITY LIMITS EMPLOYERS LIAH ITY LIMITS
Eacn ddem $600,000 E6rn
Ad
e]en ecclderd
Oi6aa_e pe~lcy imir $500,000 OPee6d-Pelky wil
Disee64. $500,000 Ol6eA]e• each employee
empl0y0e
MARITIME COVERAOF•. FOLLOWING STATES' LIMIT OF UAR MARITIME COVERAGE
30nerdl AeareOete 3
GENERAL LIA&UTY
ler.
0 OORmamlai General ?wdun6 CanP10P6 A0glN.IB 5
Ll LION (=I enee) I P6160ml B AemdlMnp 01UN ;
I] Owner6 ON COnuO. I EOCn Oe:mrenm
P aecdre 3
Fire OOm+es (Amy en] ere)
McNcal E6Pdnne(AAYene P Mn) S
AUTOMOBILE LIABILITY $
13 Any AU6 I CSL
-M 9.41Y lnluty CO. Peron) $
All OnN* A
SOned.MO A-%O I BadllY In wry (Pm Actldmt) $
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NOn.ownedAWe I - I - _
cc] WTaye UwierY I DESCRIPTIONOFOPERATION5
OCATION(5) Of OPERATIO.vE L JOa R IIF A?PLICA]LE7
FAX 541-552-2436 BEFO
. THE ING
EREOF
DATE
CANCELLED
SHOULD 0.NY Of THE ABOVE DESCRIBED30POLICIE
NOTICE TO RTHEHCERTIFCATENHO DER HNAM D BELOW.( (BUT
COMPANY WILL ENDEAVOR TO MAIL
CANCELLATION'. FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY (+JD UPON THE COMPANY, OR
REPRESENTATIVES.
MAILED TO'. DiA
CITY OF ASHLAND IIINNN ,ll
ATTN MARY MCLARY Dexter Legg. ViceP1(Mident ndSecretary
90 N MOUNTAIN AVE
ASHLAND OR 97520-2014 DATEISSUED OFFICE
IldulndlLLnllllhNnldlldnnllllb11111ddluun111
From:Dena Leong Fax ID:WesternStatesIns2 Date:2/22/2013 1:26:35 PM Page: 2 of 2
MAYROCK-01 DLEONG
UA
'`~t`°RO* CERTIFICATE OF LIABILITY INSURANCE 2122/2013
THIS CERTIFICATE IS ISSUED AE A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the pGLcy, :-.a3ln pnlicies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
ACT Dena Leong
PRODUCER NAME
Medford Office PHONE
Pa _(541)779-1321 FuAXC NO: 541(779.9187
No
yneWest Insurance, inc. ^ ' .
38 North Central Ave. EMAIL Aooa$ss dleongQpaYnewest.com
Suite 10D
Medford, OR 97501 WSURERIS AFFORDING COVERAGE NAICR
INSURER As Liberty Northwest Ins Corp
INSURED
INSURER 0:
May Rock & Excavating LLC INSURER C:
Attn: Dan May
INS UaER D:
PO Box 319
Talent, OR 97540 INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADDLsUOa POLICT EFF POLICY EXP
LTR TYPE Of INSURANCE INSR YN01 POLM:Y NUMBER NM1o01YYYY) (MMrno YYYY) LIMITS
GEKERAL LMa1LTTY EACH OCCURRENCE $ 1,000,000
A X COMMERCML GENERA' _uBILIW I X 0041731125 1012612012 1012612013 PREMISES Ea oc¢ ante(AnYOre Perron) $ 100.000
CIAIMSM..ADE EXI OCCUR ME D ExP $ 5,000
PERSONAL 8 ADV INJURY $ 1,000,000
GENERAL AGGREGATE $ Z000001
GEWL AGGREGATE LIMIT AP PLIES PER I I PRODUCTS-COMPIDPAGG $ 2,000,Ooa
X POLICY PRO- LOC I $
AUTOMOBILE LMBILITY MEINmSINGLE LIMIT 1,000,00
D
Eaa¢im
A ANY AUTO IC04173125 1012612012 10/2612013 BODILY INJURY(Percemon) $
ALL OWNED CHEDULED BODILY INJURY (Per a¢Nenp $
AUTOS X ALTOS
NON-OW.UED PROPERTY DAMAGE $
X HIRED, UTOG lx AUTOS PER ACCIDENT
UMBRELLA LIAR OCCUR EACH OCCURRENCE $
E%CEES LMB
QAIM$MAOE AGGREGATE $
DED RETENTION$ I $
WORKERS COMPENSATION I WC STATU- DTH-
ANCEMPLOYERS'LIAaILRY YIN TORY LIMITS ER
ANY PROPRIETORIPARTNEPo2RECUTIVr _ E.L. EACH ACCIDENT $
OFFICERIMEMSER EXCLUDED' ~I NIA/ _
IMaMatOry I. NH) - E.L.DISEASE EAEMPLOYE $
rc yes.&,,Odte grader
DESCRIPTION OF OPERATIONS WOW EL. DISEASE POLICY LIMIT $
II
DESCRIPTON OF OPERAMNS I LOCATIONS I VEHICL_S 'AIOCK ACORD 101. AUdilional RomaMs Scnsdule. it mom spxo is oquoNI
City of Ashland it's agents, officers and employees Additional Insured per endrsement as respects all operations of the Named Insured
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Ashland THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Attn: Mary McClary ACCORDANCE WITH THE POLICY PROVISIONS.
Electric Dept
90 N. Mountain. St. AUTHORRED REPRESENTATIVE
Ashland. OR 97520 , /1& ^Q~.(ryyp,~
Q 1988.2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
1 WRECO DIER Page 1 / 1
CITY OF ! V
ASHLAND DATE PO NUMBER
. 20 E MAIN ST. 2/28/2013 11463
ASHLAND, OR 97520
(541) 488-5300
VENDOR: 005662 SHIP TO: Ashland Electric Department
MAY ROCK & EXCAVATING, LLC (541) 488-5354
P O BOX 319 90 N MOUNTAIN
TALENT, OR 97540 ASHLAND, OR 97520
FOB Point: Req. No.:
Terms: Net Dept.:
Req. Del. Date: Contact: David Tygerson
Special Inst: Confirming? No
Quantity. `Unit - Descri tiou - - - UAit Price - Ext. Price
Contractor to install new 3" PVC, Sch 8,210.00
40, service conduits to 735 Glenwood
and 715 Glenwood. Includes removal and
replacement of all asphalt. Per
attached quote. Materials will be
provided by the City.
Contract for Goods and Services
Beginning date: 02/18/2013
Completion date: 03/22/2013
i
I
i,
I
i
I
SUBTOTAL 8 210.00
BILL To: Account Payable TAX 0.00
20 EAST MAIN ST FREIGHT 0.00
541-552-2010 TOTAL 8,210.00 j
ASHLAND, OR 97520
Account Number Project Number Amount - Account Number. Project Number; Amount.--.,
E 690.11.18.00.70410 E 000333.999 8,210.00
I
VENDOR
A orized signature COPY
FORM #3 CITY OF
ASHLAND
REQUISITION Date of request:
Required date for delivery:
Vendor Name ROC/Vf ZF~ g7-11YG .
Address, City, State, Zip 13 OA" 3/ 9 T/~LFNT OR • 975h0
Contact Name & Telephone Number /0 6W.1-162 .2289 F.- 5141 -S/2 - 8892
Fax Number
ma yrDe,~r 3l9 @ aural%, com
o
3
SOURCING METHOD 57-*27- I247-f-_ Z ~ l3 CO LeT/ON fJfIT~ -37W-/
❑ Exempt from Competitive Bidding LP ❑ Emercincv ZZCjJ
❑ Reason for exemption: ❑ Invitation to Bid (Copies on ftle) ❑ 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 a SERVICES ❑ Applicable Form (#5,6, 7 or 8) ❑ Other government agency contract
5 00 to $100 000 ❑ Written quote or proposal attached Agency
(3) Written n 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 contract 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
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Item # Quantity Unit Description of MATERIALS . Unit Price Total Cost
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TOTAL COST
❑ Per attached quote/proposal $
Project Number po0313 00
Account Number6QQ-[[- 9.0-70Y/OtJ
Account Number 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 be n satist E
mployee Signature ~l JCt fQ rJl Department Head Signature: AAL
'Ju (Equ oorgreater thA $5,
City Administrator:
(Equal to or greater Cryan 25,000`
Funds appropriated for current fiscal year., O / NO . -a 3/r Ldi 3
Finance Director- (Equal to orgreaterthan S5.000) Date
Comments: