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2013-064 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 Rd., Medford, OR 97501 Telephone: 541/488-6002 Fax: 541/488-5311 TELEPHONE: 541-941-11329 DATE AGREEMENT PREPARED: 03/08/13 E-MAIL: tobester29@hotmail.com BEGINNING DATE: 03/08/2013 COMPLETION DATE: 03/22/2013 COMPENSATION: $3,500 per proposal attached as Exhibit C. GOODS AND SERVICES TO BE PROVIDED: Contractor to upgrade electric system at 841 Berwick Way easement, Ashland, OR. Work includes trenching and backfill to City of Ashland (COA) Electric Department's specifications, stump grinding and brush removal. PVC. conduit and conduit fittings will be provided by the City of Ashland. Ma of specs attached as Exhibit D. ADDITIONAL TERMS: Workers' Compensation is eing waived because the contractor has no employees and will be performing all the work himself. lAtl 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 279B.220, 27913.225, 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 art, effective upon delivery of Contract for Goods and Services Less than $25,000, Revised 06/30/2012, Page 1 of 6 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, 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 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 e, Contract for Goods and Services Less than $25,000, Revised 06/30/2012, Page 2 of 6 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 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 Stated 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. Contract for Goods and Services Less than $25,000, Revised 06/30/2012, Page 3 of 6 Contractor: City of Ashland BY BY Signature Department Head Print Name Print Name 0 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 4 of 6 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 wjth its terms, (c) the work under the Contract shall be performed in accordance with the highest professional standards, and (d) Contractor is qualified, professionally competent and duly licensed to perform the work. Contractor also certifies under penalty of perjury that its business is not in violation of any Oregon tax laws, and it is a corporation authorized to act on behalf of the entity designated above and authorized to do business in Oregon or is an independent Contractor as defined in the contract documents, and has checked four or more of the following criteria: (1) 1 carry out the labor or services at a location separate from my residence or is in a specific portion of my residence, set aside as the location of the business. (2) Commercial advertising or business cards or a trade association membership are purchased for the business. (3) Telephone listing is used for the business separate from the personal residence listing. (4) Labor or services are performed only pursuant to written contracts. (5) Labor or services are performed for two or more different persons within a period of one year. (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. -/-21 Contractor (Date) Contract for Goods and Services Less than $25,000, Revised 06/30/2012, Page 5 of 6 r T do M Excavation 1796 Thomas Rd Medford, OR 97501 Phone (541) 941-1329 Email:tobester29@hotmaii.com March 7m 2013 841 Beswick (Power Re-route) Equipment/Labor $1000.00 Rock/Sand $1200.00 Haul Away Dirt $800.00 Misc. $300.00 Stump Grind $200.00 Total $3,500.00 Thank You ® DATE (MM/OO/YYYY) VEHICLE OR EQUIPMENT CERTIFICATE OF INSURANCE 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 PHHCNN Est; 541 7721335 ac NO: 541 7720327 ' 1603 E Barnett Rd EMAIL C©l®J EMAIL S: OSCAR.RODRIGUEZ.QUJQ@STATEFARM.COM Medford OR 97504 PRODUCER <5 CUSTOMERID#: INSURER S) AFFORDING COVERAGE NAIC # INSURED INSURER A: State Farm Mutual Automobile Insurance Company 25178 MUNROE, TOBYM 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(ES) 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 DOCUMENT WITH 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 ADO'L POLICY EFFECTIVE POLICY EXPIRATION LTR wSRD TYPEOFINSURANCE POLICYNUMBER DATE(MMIDD/YYYY) DATE(MM/DD/YYYY) LIMITS :X ::[VEHICLE LIABILITY COMBINED SINGLE LIMB $ A 0715787-A26-37A 01/06/2013 07/0612013 BODILY INJURY (Per person) $ 250,000 .1 BODILY INJURY (Peraaitlenq $ 500,000 PROPERTY DAMAGE $ 250,000 GENERALLIABIUTY EACH OCCURENCE $ OCCURRENCE GENERAL AGGREGATE $ CLAIMS MADE $ INSR Loss POLICY EFFECTIVE POLICY EXPIRATION LTR PAYEE TYPEOFINSURANCE POLICYNUMBER DATE(MMIDD/YYYY) DATE(MMMONYYY) LIMITS/DEDUCTIBLE VEH COLLISION LOSS ❑ ACV ❑ AGREED AMT $ LIMIT ❑ ❑ STATED AMT $ DED VEH COMP VEH OTC ❑ ACV ❑ AGREED AMT $ LIMIT ❑ ❑ STATED AMT $ DED PROPERTY - ❑ ACV ❑ AGREED AMT $ LIMIT LBA BROAD ❑ RC ❑ STATED AMT $ OED ❑ 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 me policy(ies) listed herein by policy number(s). BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE ' A request has been submitted to add the ad6000al interest described tolow to me pMicy(les) DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. listed herein by of numbers.. VEHICLE /EQUIPMENT INTEREST: LEASED FINANCED DESCRIPTION OFTHE ADDITIONAL INTEREST NAME AND ADDRESS OF ADDITIONAL INTEREST X ADDITIONAL INSURED LOSS PAYEE CITY OF ASHLAND LENDER'S LOSS PAYEE ELECTRIC DEPARTMENT Lo ILEASE NUMBER 90 N MOUNTAIN AVE ASHLAND OR 97520 T RED REFIRE ATIVE ©1997-2010 A RD CORPORA N. All rights reserved. ACORD 23 (2010/05) The ACORD name and logo are registered marks of ACOR 1004361 142987 09-30-2011 Beecher Carlson 1/15/2013 10:25:39 AM PAGE 2/006 Fax Server a CERTIFICATE OF LIABILITY INSURANCE' 1/15/2 s. THIS.CERT1FICATE IS ISSUED AS A.MATTER. OF.INFORoA7iON ONLY At1O CONFERS NO RIGHTS UPON THE CER'DEIDATE~fIOCOCR. 'THIS CER"NFICA.TE DOES NOT AFFJHh1ATIVtLY OR tJEGATIVELY' A(AENO, ER-(END Oft AL'ltif; THE COVERAGE AFFORDED BY THE POLlC1E5 BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE AtONTRACT BETWEEN THE ISSUING INSUREAfB)• AUTHORIZED REPRESENTAT)VE OR PRODUCER,'ANp-THE CER*ICAT:E HOLDER. IMPORTANT: If the"certiflcafe holdei )s on.ADO1MONAL INBURED;"the po11Cy(ies)' must be ehdoisad. If-SUBROGATION IS WAIVED, sub)edto Ih¢ teirils ahd'conaliibns cfitim. pollcp, Geftalii.pg_IICIes'Ifiay rsqulfe an 91idJSSefhenL A 5i8{eiii¢(M'on[hl s' i5x[i0¢atlf do¢s flat Cdfltef lights fnahe. cartincale hoiden inficu of such endorsements) ?D71arry' Thompson pRowm. corAME N seecher Carlson insurance Agency LLC _?;OI`s ;.4541)772-1111 .:A,~„~ISazrT7z-3456 70T Millphy Ri! E .tarn "aho soriabeechercaazlson. com INSgR~tfr _5 p) Ff"DMBINp'CDYe"RALE'___ _ _ _NAK Medford. OR :97504" MURERA:Funezican Hallmark Sns Co of Z 3494 INSURED - 'I[FDRERS, . Toby. M'32Unr0e:, 'DU:: T M Excavation itduRESC: 1796 Thomas Rd. INSBRER D: INSURER E- - - Medford OR 97501 lrsORERF: COVERAGES CERTIFICATE:14UMBER:2012-33 Al REVrSION NUMBER: THIS .IS TO'-CERTIFY THAT THh P.OL!CIES OF INSURANCE LISTED BELOW HAVE BEEk t$SUE01'O THE INSURED NAMED ABOVE FOR THE POLICY.PERIOJ- INPIC,ATED:. NQTVVTttiST'ANL11Nff ANY REOUIREMENF. TERM OR CONDITION OF ANY CONTRACT OR OTHER 0OC.UNENT WITH RESPECT TO"WHk.":H' i}i15 CERTIFICATE MAY BE SSUEO OR MAY PERTAIN; THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN I5 SUBJECT 'TO ALL>THE'TERMS; EXCLUSIONS AND CONDITIONSOFSUCH POLICIES'. LIMq-5 SHOWN hWY HAVE BEEN REDUCED: BY PAIDCLAIMS: PDUCYFFF PDIJUE P. 014fB II I R iwp .djlNS4gmm a ( PUWJ4I BER MMIDDIWI N :GENEWIL LABILMV V E/6H.'vCDDP.F~`NCF $ 1.00)000 ih. CUMMERtVi GENER•W LWB:LITf' X :AAA'?=.!J F{1{ .100,00 A, :OPALS VU`_:Q,oC'CDP' GCLd37S9507 'inn/tut[ /'lU/2U1J MEO EYP-;MVCnF FS ti?nl 4 5',000 FERSDNAC"s a13'IiNDJRP s 1,.000., DOA GENERA. AGGREGAIE....S.. . 2 i:000.i 000 vENL.:Yf(E'iATG:NllT R~fJGSF=n: N.TD,CtG.'<03fl:JPOU'3.•3 2, DOD i000 y . x. T•O ICy AC S 1, MtlYrEV E'JIyL[JMI( aUTOribeU:E+.Kalm Eeir; wn:. - waYaxnbcOlt'=.iS ti~y:~aw F?rs:ni. s.. ALL UNM ED MNEDLL£D. FA:UILYNJI:RY !P9f b.L'Itl3YA0 5 N3ti.4'dAJED HRFDAL10s APTO-3 - UMBREII.ALA8: 0 EALH'OE gmENGE $ EitCESSUAE' C{AwtaAiAYe X'SGE'AT= C DEi: FEJI IoN' 3 AWEIJRSL0MPE11SAUT MCBTFTIY~ O(R- ANCEMpL0VJi6 LL\eRIN Y/N O°~II A'I! PROi.YIiTIX~PJR"IEUAkq'RyE C 6i~F h,GD NT S A MEFPrA~J.ER EY 10 NI E.L.GISEASC-E4:JiPLOY° S nre ?,mi nee uvflf GFB'LCRIMiON OF ~N ATftG hve , E:L. DI EIZZ Mt" "11 Y ~SLfaPTON.OfO>bRATroN3l LOLATION5I VERICL'e3 IA4icIALDIN'141 Addll" IRo,m,' C R dW ,Tlmci a 'irgu:iT - Gremii'al tiiiiility palaey ulalOdes P i.:navy C Nb onn7 .1 tclbu Dry "oriel GOn PAZ aad6r ew zuii T .97 B7: ID(1-} fattaChed)j 'w'here regnired by Fritten contract- This:" form.is.subjeat'ttl:Poliay ter:as:Conrlitions.s ' rXC1Y,sioms. ' CERTIFICATEHOLDER CANCELLATION (541)488'-5311 SHOULD ANY OF THEABOVE DESCRIBED POLICIES. SE CANCELLED' BEFORE. THE EMRATION OATE THEREOF, NOTICE' WILL BE: DELIVERED. IN. ADC,ORIDANCE WITH THE POLICY PROVISIONS City of: ishl'amd, Oregon,: its elected.. o££icals.,":o££icers and -employees 20 East Main Street. AUTHORIZED REPRESENTATIVE A9heind, OR 97620 ];airy' T1Yarnpson/LARRY. -t«c 4'a''<". AC.OR0.25(20f0/0,5): Q 1988.2440 ACORCYCORPORATION, All rights mocved-. TN5025h016a6!:Pi: The ACORQ name and logoaro-Pegister'ed marks ofACORO. Beecher Carlson 1/15/2013 10:25:39 AM PAGE 3/006 Fax Server (5) Vandalism and-ma!fdous mischief; or . (6) Theft. c. The following Is added. to. A.2. Property :Not` Covered of the BUILDING AND PERSONAL. PROPERTY COVERAGE FORM: r.: Properly -while stored or operated underground in connection with any mining operations. d; Tlie:following:i5added to:Papagraph:2:of13::Ezelusionsof. Ihe:CgUSE,SOF:G(3SS•SPECIAL FORHI: n; "WewillnotpayforlosS,ordama9e:causepbypuricturn,btov<outand.roaddalnage;tofresanq;tibosmounted cn uehldas .Nor✓eve , we:do pay for puncture, blowout of road damage caused by. asgediffed peril, . o. We will riot pay for loss caused by humidity, dampness, dryness or changes in-or extremes of temperature. p: We wilfnot.payfcrloss causedbythe.weightof aload whlch,.undertneoueratingconditiohsalthetimeof :a: loss, exceeds tne: registeretldiiting: rapabiry of any equipment.orrnachine. xl:. W.0 will not payfor loss~due to theftor:rtysterious dlsapp2arattcefi'om ariyyenieie or attached eonialner,:..We wl l! pay for loss:due.ta:bufglary When the . re are signs otforcible entry to a locked VehlGa orcontsiner, e. E:7..VatuatlonoftheBUILDING ANDPERSONAL PROPERTt'COVERAGE FORM Isdeleted andreptacedbythe following; 7. Valuation Wewllldetermine the:'va'tu$ of coveted proporty in the a?ehtbi loss or damage as_fcliows, a; At aviual cash: value at the 11me:of the loss:(wifh a deduction for depreciation) except as provided, in Paragraphs b. and,c. following. :b. Pairror:S,et. The value ofa lost or damaged ariidewhrch is pert bf, a pau or set is based ona,reasonable: proportion of'the.'value oflha entire pair or set. The loss:is not considered a total Posy of the pair or set. c. Loss fo parts. The.value of a lost or damaged partof. ah item that cor slsts of. several pacts When it is complete is based onfhe value of only the lost ordamaged part or the Cost to repair ortepiace it. 2. Recital Relmbpcsement In the event of loss b4 a.covered'peril to covered cbntrectois'. equipment thatyori own; we will reini iurse.you for your expense fowl similar equipmerit iRhi!e your equipment is inoperable. The. most we. yr ii re!itiburse you.for rental. reimbursetent:expenses is $1,000..We will eohtlhus to reimburse you for the rental of equipmenfafter tha:ezpiratlon date-ofIbis cavalrage pm,,ndedjhe Jos'; occurred:befora.file expiration date. We will hot reimbLoa Y66: , a. ifyou can continua or resume your operations with similar egUorri6ht that. is,avelfable to you at no additional. expense toym;; or b. For the rentafexpenaeof:anyoqulpmentunlessyou make every reasonable effbrtto repair, replace or rebuild the inoperable. equipment after the covered loss occurs-. 3. With respect to this AdditionafCoverage,Contractors Equipment Coverage,SecficnD.Deductible oftheBUILDING, AND PERSONAL.PROPERTY:COVERAGE FORM is deleted and replaced by:the following D.. Deductible Wewill hot.oay.foi'loss ordamage In anyona.occurrence.until the amount of loss ord2siage-ezceeds$500. W,..Wfl then pay the a iount:of Ioss.or darbz P Ili e$cess 6f.$500 up to the:applicable limit of rrisurarice. We will not reimburse yDii for the. rental of equipment until after 72. hours have passed since Ine C(1Va PA pmperly Was rendered lhoperable. After 72 hours :have passed; we wilt onlyrelmburse you for the rental expense that you. actually Incur: 1 h.e deductible of:$500 does not apply to rental reimbursement expenses. .General liability Additional Coverages The fallowing.Additlond Coverages Oro- added to'the: COMMERCIAL GENERAL LIABILITY COVERAGE FORM. A. Slanlcet`Add(tlotial Insured Covocage: 1. SECTION II=WHO IS ANINSUREDof the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is amended to lnctide as sri:insumd any'pFrson:or atganzatior:(refen'ed,to as Addnional G~isured) Wnrm youm'e:requiredfoa;id. asap: Additional Insured on this.policy under: a. A,,vMen;contract or agreement and b. Where acerfacateof insuranceshowtrlgthat person.ororganVatlonas an additional insured has been Issued; and .l}age:20 of 25 Induilas cumi gYk~d .afefialof Insuimnco SeMce,.Qf Inc. and '.MP 97 6710 t0 American:Assrdmfon al, In,wrasce Services, lrc., wilt rhea permission Beecher Carlson 1/15/2013 10:25:39 AM PAGE 4/006 Fax Server c. When the written contract or agreement and certificate ofinsumnce.arecurrently in effect or becoming in effect during the term :rife the policy and executed prior to the: `bodily :injury," "property damage": or "personal and. advertising injury" 2. The Insurance provided todhe.Additlonal Insuredis limited asfollows: t a. The Additional insured is onlyarl addrlional insured for; (i) "Bodily Injury"`property damage or `personal and advertising injurycdused in whole or (n: part byrisgigent: acts or.orhissLOnsoftbe:NamedInsure..d:oranyonedi.reGpyprindirectyen^ployed7y16 11Marn . insured;orfor whose: act. a NpMeo Irisu red. may tie tiaole. (f):Liability ahOng out of your ongoing.operatiorts for the Addition( Insured by or for you: A person's or organization's status: as an insufed:uridi;r this covetage ands:wnen: your Operations for Thal Insured eFe completed It. TnoLimitsoflnsuranz~papphcab.lztotheAddlticrralInsuredarethose speclfiedk1thewritten contradoragreement: but not moreahan the Limits of Insurance speelficd in the Peclarallphs for this. policy The LJmits of Insurance: applicable to fhe Addtional leisured are fridasive:of and: not.In:addition to the. Limits of Insuranceshow.ii in th"e. DeclardtidnsfortheNarri !Wnsured. 3, h1 addition to the other:exclUsions:applicable to Section I, Coverages A., B: and C: of the COMMERCIAL. GENERAL LIABILITY COVERAGE FORMAhe Insurance provided to the Additional Insured does notapplyto: a. "Prope(y damage" to: (1): Property owned, used, occupied by, loaned.or rented to:the.Additlonal Insured'(2) Properivin9hecare,custydyorcentrgloftfreAdditionallosure droverwhichthe.Addrtlgnafinsuredareforany purpose exercising physical control; or (3) "Your wolk performed.foitheAddillOnallnsured. b. "Bodily tnjury` "propertydamage; or "perscltal;and advertising ih)ury' arising outofan architects, engineefsror surveyor s rendering or failure to rendEk any professional survives lpryou, far the Addltiogal t.nsurzd or for others, ncluding but not limited to: (1). The preparing, approving-or: fallupetoprepare or approve'maps, draw ngs opinions, reports,.suiveys, charige: Herders, designs'or specification's; or , (2)::S ipe vsory,iilspection or engineering services.. c. "Bodily lnjury' or "property damage" occurring after. (1)' All work, including materials; parts oraquinmentfurnished in connection with:such.work;. on the.project (other than service, maintenance orrepafrs)to.beperformed.Uy,oron.behatfoflheadditfonalinsured af he siteof1he: :covered operations has:been completed; or (2). That portion of "your wort(" cut.of w?ilch Me Injury or damage arises has: been put to ils-lntended. use'byany .person or organization other than another contractor or subcontractor engaged in.performing.opera(ions fora principal as a part of the same project. 4.: SEGTIBN N --COM.IfIERCIAL~IiENERAL. LIABiLITY~CONDITlONS, Paragraph a.-6fher Insuranpe, is.amendedfoadd the:following subparagraph: d Additional Insured's Other Insurance As Excess Insurance To the extent required Jy Winsuwd contract:" Ibis insurance is pnmaryon behalf of the Additional Insured; and any: gthOlpsuintoce. rrtalntaihed bytbe Additiohai insured is, excess' and not cobtr biiiory:btilth this friswartm If the '9nsured,contrInt" does not. regaire thsprovision, 11hen Paragraph a, above will apply. B: Mobile Equipttten Broadenecl Coverage V.121.(1) of the COMMERCIAL GENERAL. LIABILITY COVERAGE FORM is: replaeed'.by the following: (1) Equigmentdesiglned:prinnarily:for:: (a) Snow Removal; (b): Road:maintenance, but not consvuctioil orresurfacing;:orr (c): Streeteleaning. Excepfdhe aboveprovisions du not apply to self propelled vehicles of less then 1.,000pounds gross vehicle-weight which are not intended for use. on a highway. C, Aggregate Limit Per Project. TheGeneral.AggregaIF Limit under SEC.TION.III -LIMITS OF1NSURANCE:of the COMMERCIAL: GENERAL. LIABILITY COVERAGE FORM applies separately to.eachofyour projects away from premises owned by or rented to you. MP 97.67 10 10 Indudas cawightad maleriaW Insuarim Services Once, Ina and Page 21 of 25: .A.merlcao:Assnualfonaf: Inimirance s iim% irz, with meir pami-S on Beecher Carlson 1/15/2013 10:25:39 AM PAGE 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 -.CONIIVIERdIAL GENERAL LIABILITY`COMOITIONS) is -amended byfhe addition. of the fnllnwing; We valve: anyrghtofrecoverywemay:haveagainst anyperon.ororganfzattpntowhom'yqu'pywritiencomracterwritten agreernenYtiavewaived your nwnriyfitgrre nvery:for.lpsscaersedkb ythatpergr~nprorgaaizatlonoecause of payments we make for Injury or damage arising. otitotyaur ortgolttg opprations or "yourwork" done under a wrhfen contract or:written. agreement with that person. ororganization ~and included in ifie "preducts.completeclltions hazard. This prov'iision does not apply unless ihe:written ~contracforwrittenagreement has been executed prior tothe "occurrence' or offense giving rise.to:tha `.bodilyinjury" or"properly damage:' e YoluntaryProperty.Damage Coverage 7;. Ye.wll,atYdUFregUeSt;pOy_bufpOtd?tend;anycalm for'properlydam3ge"to the proper ty otothersotherwiseexcip0ed under A.2.1,(4), (5) and (6) of the COIYM ERCIAL:GENERALL{ABILITY COVBRAGE"FORM proy ded.. that: a Such "propertydamage"takes:plarewhilesurhproperty.is:in your care, ruslodyoreantrol,orIsproperlyfolhers: liver whichyou, for' an y purpose, are ezercising.0r have exercised phys(cal colttrd; "and b. Such ",propady damage"' lakes place awayi om any premises you own, rent or Pease: and C. Such "property damage" takes plane wthin the 'coverage territory" and.during the policy term; and d. Such "propertydamage"takes :place-only during.your operations that are known to us, are scheduled on the- policy and for which a premium has been,charged. 2 The insurance under his additonal:coverage does.nof apply to"propertyAamage'"to.property a Herrl hyyeu for sefv¢rng repairs.... or sale aLpremises ow,ted,by, rented or!eaa . to:you; b. While being transported by or caused by the ownership, maintenance; operation, use, 'loading or unloading"-of arry "aulo," wafercraft.or aircraft; or c. Omed or occupied by or rerited to yon:. ;3 Deductible T his•odditional coverage will apply' only to that amount of any loss in each "occurrence" that exceeds $aiic. The terms of the policy with respect toyourduties in the event of "occurrence," claim oi- %uft"and the Companys right 10: i nvestlgate, negotiate andsetite any dal m or"shit"apply irraspective offlie application of. the:deductibie'amount:of $.500. WemayP.ayanyPart :orallofthe, ded'uctitileomountof$ 0.1ooffcotsettlementof'anyclaimor"s0it." Upon60flontion of theactiori taken, you, must prompNy in nrburse us for such part of.Lhe deductible amount as has bearv. paid by us, 4. Limits of Liability. The Limit of Liabilityforahls additionalcoverage shall not exceed $2;500?or'each "occurrence":and is the. limit of the CompanS?sliabilityforall damages on 'accountofeaehclalm;or"suit"covered herein. The annual aggregateLimitof Liabilityis $2,500 and is,, subject to the above provisions respecting each claim, the total limit of the Companys liability for all damages. 5. Settlement In the:event of loss covered by.this additional coverage,you shall, if requested by us, replace.the.properly or furnish the laborand materials necessarytor repairs thereto ai actual:cost to-you, excluding.prospective profit oroverhead:charges: of-anyrtaiure, Any property so paid foror replaced shiall, at our option, become the property of the Compa ny. Payment: hereundershall not'constltufe:an admission. of:Bab[lily ofyou or; exceptasstated herein, of the Company: Additional C . enditions: A Insurance Under Two Or:Nigre Coverages. The'fellowing is-added to Paragraph:C. Insurance under Two or'More. Coverages'of the.COMMERCIAL PROPERTY' CONDITIONS; lf.e:Cdverage Form.is attached to this pajicythat:provides a:limitforanycoverage provided bythis:endorsemeaty.theI,nit, shown In the SCHEDULE and the coverage pr-0vided by this endorsement are deleted and replacedby the limit-am coverage provided by.ihe:Coverage Form.. B. Limits Of insurance Regardless ofthe number of buildings at a location covered bythis endorsement, the most we will pay under this:Coverage: Enhancement endorsement inamy one occurrence is the applicable Limits of insurance shown lathe SCHEDULE onpage t of this endoi-serrenl. Page.22 of 25 Includes ror4Ti9Y3¢dmaierialof lnsu7nce Services dRce,, lna aM N1P 97 67 90 'io -Amerira]ausrualluah(:In1tir3ACe sweims, Irc., w0 me'v penoisston 13eergher Carlson 1/15/2013 10:25:39 AM PACE 6/006 Fax Server C. Deductibles . . . COV . ERAGE . . PROPERTY . The Deductible described. in section D. ofthe BUILDING . AND ND PERSONAL . . F . ORM:applies loeach of the Coverage Enhancements except as-shown below: - We will not pay for loss ondamage in anyone : occurrence until the amount of loss or damage exceeds:SSOD. We will then paythe amount of loss-or damagein excess of$50O-up to the-applicd6le Limit ofinsuranee tnr thefollrjMiig enhancements'. 1, Persohsl:Effects and Property of Others 2t Valuable Papers end Records: (ether than Electron CI031a) 3, PropperlyOff~Premises(I,n lading aplgpsarid Other Electronic Equiprrment) 4; Outdoor Property (Named Perils) 5. AccquntsReceiva5;e. 5. Property inTransif(lneiuding Laptops and Other. Eteetronic Equlpmen€) 7. FineAns b. Electronic Data .y. Water Back..UpandSump:Cyelflow 10, Employed Theft y and Securities 14. Mond 12.. rorgery or Alteration Nadeductible provisions apply to the following enhancements: 1. Fire Department Service Charge. I Arson Reward :3. Cleims Expenses. 4_ !riverroryor'AparaisalCost 5. Recharging, of Fire Extinguishers .6. Rental Reimbursement D: Addiflonal Deflnitlons: The folfcwing Additional Definitions apply lo. this endorse ment.only: "Bankibg Premtlies" means.the rntecio~ofthat p6dion of anyoulldirig occupied b:ya oahr<Irg lhstito, 6n orsimilarsafe depo'sitory.. - 2 'tfiusl less Income" mean s the.` a. Ne(.inGO€it@ (NEf:ProfiCorLpsg befo76 lnco(ne iaXes~ fhab4upUld:.hace SeEr earned had n014?ss odcurfEd':and " b. Coriiintringnnrmal operas ng ekpenses incurred, including payroll For manufacturing risks,. Net incomeindudes the net sales value. of production. - 3. '.Cilent' as used in Employee Theft Coveraga.meanseny entity for uihom"you;perferm services under a written agreement.. 4:. "Client"'as USed iYSCOlltract9l'S EgUIprtlent Coyerdgo n?Cons an mdrvid'uai,co)r)pgnyor-orgajizaticri With whom you have a .written cantractorworl orderfpr voucsewices for a.desrrlbed-oreffil and have bllled.for your services, S. "Employee"asuse;dinEmptoyeeTheftand.Manny.Arid Securities Coverages mean5:. a. "Emm,p'loyee" means; (1) Any natural. Pemba .{a)'Wnlle;io.youeseivlce.ocfor3ll:days:aiteitermirrationofsevice;! .(by Who you ournpensate directly by salary, wages or commissions:: and (c) Who you:have toe: right to direct and control,whlle performing services.forycu; (2): Anynaluraf pp. son;who:ls furnlshegtemporarlly:to you: (a) To substitute fora permanent "empfoyao" as defined in Faraf)raph (1) above; who is on leave; or. (b) To meet seasona€ orshorMerm work load corditioos; while: that persor s subject td:your dGection'and control and perfdrming.servces.fot you, ezduding;. however,:any 6uch.persbn~whiLe.having care and custody of property"outside:the "premises"; MP 97: 10 1O Indud6scamrigG3nd.rraierial of Insurzrso servicm co; Inc:arx3 Pago 23 of 25: fi eMa•1As5nuarionat. nsuww Serrlies, inc, with their permsston Page 1 / 1 Q!TY RECORDER OW. CITY O F ASH LAND DATE BO NUMBER_ 20 E MAIN ST. 3/20/2013 11495 ASHLAND, OR 97520 (541) 488-5300 00 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. Dale: Contact: Dave Tygerson - special Inst: Confirming? No -Quantity. Unit' - Description -Unit Price ExL Price . Contractor to trench, install PVC 3,500.00 conduit and fittings, backfill, includes stump qrindinq and brush removal. Per attached proposal. Location: 841 Beswick Way Contract for Goods and Services Beqinninq date: 03/0812013 Completion date: 03/2212013 Insurance required/On file SUBTOTAL 1500.00. BILL To: Account Payable TAX 0.00 20 EAST MAIN ST FREIGHT 0.00 541-552-2010 TOTAL 3,500.00 ASHLAND, OR 97520 Account Number , Project Number Amount _ Account Number". _ -Project Number --'Amount, E 690.11.18.00.70410 E 000341.999 1,750-00 E 691.02.47.00.70410 E 000268.120 1,750.00 /3 VENDOR COPY Author d Signature FORM#3 CITY OF mac;, "~I ,:L ASHLAND REQUISITION Date of request: 3-~ -!3 Required date for delivery: Vendor Name T/YI FxC~3~/a7/oN Address, City, State, Zip /79/o 7-/-/6/YIe2S Rd. rn nFnRd ,DR. 9750/ Contact Name & Telephone Number TO,B Y MMA/,Roe 19W - 9.5//- l3e2 9 Fax Number te)h esker .29 @ 110-t/ra i!.. ELYYI SOURCING METHOD ep~ */Oil/ ' .4T 3- -13 ❑ Exempt from Competitive Bidding ❑ Emergency ❑ Reason for exemption: ❑ InvitatioTto BidBid (Copies on file) ❑ Form 113, Witten findings and Authorization ❑ AMC 2.50 Date approved by Council: ❑ Written quote or proposal attached ❑ Written quote or proposal attached ❑ Small Procurement Less than $5,000 ❑ Request for Proposal (Copies PRW ` C7_ 'A/0 ❑ Direct Award Date approved by Council: - ~ 2 O ❑ Verballvidtten quote(s) or proposal(s) 000 -)-68 Intermediate Procurement ❑ Sole Source GOODS & SERVICES ❑ Applicable Form (#5,6,7 or 8) 5 00 to 100 000 ❑ Written quote or proposal attache (3) Written quotes attached ❑ Form #4, Personal Services $5K PERSONAL SERVICES ❑ Special Procurement $5,000 to $75,000 ❑ Form #9, Request for Approval ❑ Less than $35,000, by direct appointment ❑ Written quote or proposal attache ❑ (3) Written proposals attached Date approved by Council:. ❑ Form 94, Personal Services $5K to $75K Valid until: Date Description of SERVICES e $H/ 13E5uJfC! GC/~ E,SE/y/ENT Total Cost F' 7irC 6v67751vt ulzmao<e . t-rarvebl'99, 14W40 - T"b F/ec. DF_PT. ~Sjo~learionr5 6-7tj y/ rinel6l f 81eQ H rem0Vz24 $ 315-00. S-2) Item # Quantity Unit Description of MATERIALS Unit Price Total Cost 10W. CON01411t 7-0 Be e 13b (7/& OF ❑ Per attached quotelproposal MOTE : /Nyo/(F no &F SPG/7r' 561-To To BELOW TOTAL COST . 14MOW r- A0 & E/ec 01F/V' $ 31560 Project Number0003W-922 Account NumberQQ[-02-6TPV-70_NIOO\ Account Number690.//•[x-DO-70_y_/00 Account Number___-__-__-__•______&'7oj~~,f 45~; '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:. j)r UICL Tzlne -Sow Department Head Signature: (Equal to or greater than $5,lillg) City Administrator: lJ (Equal to or greater than $25,000) Funds appropriated for current fiscal year YES / NO Finance Director- (Equal to orgreaterthan $5,000) Date Comments: Form #3 - Requisition