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HomeMy WebLinkAbout2013-135 Contract - T&M Excavation Contract for 795 Park ST. 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: 541-941-1329 DATE AGREEMENT PREPARED: 03/08/13 E-MAIL: tobester29@hotmail.com BEGINNING DATE: 05/30/2013 COMPLETION DATE: 06/17/2013 COMPENSATION: 16,300.00 per proposal attached as Exhibit C. GOODS AND SERVICES TO BE PROVIDED: Contractor to excavate in order to install electrical conduits and an electrical vault in and around the apartment complex located at 795 Park Street, Ashland, OR as per attached quote, Exhibit C. Work includes installation of 3" schedule 40 PVC primary conduit from electric pole P-5158602 on the East side of Park St. to the new electrical vault. Install 3" schedule 40 PVC conduit from the existing electric transformer T-5158655 on the East side of Park St. to the new electrical vault. Also, re-feed existing transformer T-5158656 near the West end of the apartment complex parking lot with 3: schedule 40 PVC conduit from the new electrical vault. Cut, remove and replace a strip of asphalt in the street and in the parking lot to install these conduits. Haul and dispose of soils and asphalt removed, bed the new conduits with 12" of sand topped with burial tape as per the City of Ashland Electric Department requirements. Backfill the remainder of the trenches in the street with slurry as per the City of Ashland Engineering Department. Backfill the remainder of the trench in the parking lot with compacted minus crushed rock and repair any private utility lines encountered in the parking lot. The city of Ashland will provide the electrical vault and the excavation permit. PVC conduit and conduit fittings will be provided by the City of Ashland. Map of specs attached as Exhibit D. ADDITIONAL TERMS: Workers' Compensatio is being waived ause the contractor has no employees and will be performing al the work himself. (Contractor's initials) NOW THEREFORE, pursuant to AMC 2.50.090 and after consideration of the mutual covenants contained herein the CITY AND CONTRACTOR AGREE as follows: 1. All Costs by Contractor: Contractor shall, provide all goods as specified above and shall at its own risk and expense, perform any work described above and, unless otherwise specified, furnish all labor, equipment and materials required for the proper performance of such work. 2. Qualified Work: Contractor has represented, and by entering into this contract now represents, that any personnel assigned to the work required under this contract are fully qualified to perform the work to which they will be assigned in a skilled and worker-like manner and, if required to be registered, licensed or bonded by the State of Oregon, are so registered, licensed and bonded. Contractor must also maintain a current City business license. 3. Completion Date: Contractor shall provide all goods in accordance with the standards and specifications, no later than the date indicated above and start performing the work under this contract by the beginning date indicated above and complete the work by the completion date indicated above. 4. Compensation: City shall pay Contractor for the specified goods and for any work performed, including costs and expenses, the sum specified above. Payments shall be made within 30 days of the date of the invoice. Should the contract be prematurely terminated, payments will be made for work completed and accepted to date of termination. Compensation under this contract, including all costs and expenses of Contractor, is limited to $25,000.00, unless a separate written contract is entered into by the City. 5. Ownership of Documents: All documents prepared by Contractor pursuant to this contract shall be the property of City. 6. Statutory Requirements: ORS 279B.220, 2798.225, 2798.230, 2796.235, ORS Chapter 244 and ORS 670.600 are made part of this contract. 7. Living Wage Requirements: If contractor is providing services under this contract and the amount of this contract is $19,494 or more, Contractor is required to comply with chapter 3.12 of the Ashland Municipal Code by paying a living wage, as defined in this chapter, to all employees performing work under this contract and to any subcontractor who performs 50% or more of the work under this contract. Contractor is also required to post the notice attached Contract for Goods and Services Less than $25,000, Revised 06/30/2012, Page 1 of 6 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, 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 an covenant, warranty, certification, or obligation it owes under the Contract; if it loses its QRF status pursuant to Contract for Goods and Services Less than $25,000, Revised 06/30/2012, Page 2 of 6 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 Liab' ' nce with a combined single limit, or the equivalent, of not less than Enter one: $200,000, $500,000, 000,00 , $2,000,000 or Not Applicable for each occurrence for Bodily Injury and Property Damage. It shall include con ractual liability coverage for the indemnity provided under this contract. C. Au mo ille ' bilit insurance with a combined single limit, or the equivalent, of not less than Enter one: $200,00 $500,00 $1,000,000, or Not Applicable for each accident for Bodily Injury and Property Damage, including cove age 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 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. Contract for Goods and Services Less than $25,000, Revised 06/30/2012, Page 3 of 6 Contractor: City of Ashland By By L. &W~L= Signature Department Head zao ) ~/V Aank HeI'LN -Print Name Print Name a t.✓h ~2 iob3 / 13 Title Date W-9 One copy of a W-9 is to be submitted with l the signed contract. Purchase Order No. AP,R V FORM Date 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) if 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: t i (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) 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. ontractor (Date) Contract for Goods and Services Less than $25,000, Revised 06/30/2012, Page 5 of 6 Beecher Carlson 6/4/2013 3:07:31 PM PAGE 1/005 Fax Server t"5 7 BEECHER"r3~:ARLSON InsuianceAgency,LLC FAX TRANSMITTAL LAR51AE029BO7FO Date: 6/4/2013 3:06:56 PM Num of Pages: 5 (including cover) To: City of Ashland From: Larry Thompson Company: Direct Phone: (541)494-2657 Phone: Direct Fax: (541)772-3785 Fax: 5415522436 Email Address: larry.thompson@beechercarlson.com 3256 Hillcrest Park Drive. Medford, OR 97504 (541)772-1111 Main (541)772-3785 Fax CA License #OF09618 OR License #816307 WA License 9252204 Th!a.a -in Jn mnssal i, 1t ]anf:d. ar.; is rant-,cc. wain n r t c:.r 3 nr tnn it namod S you r.nt no iniceced w?Sp o; x n crizod I:.: iar it to th 6 Anj m ra 1 }cu a:u i ::~j 9dmxr q 2 o.i cr enF. n ci fhr 0."t n'4:3 ~En,T ;1 ~Cit11nC. i =PSe rneni 7 -h-, Incs n du .,-1SRIInnlnn r .as.: = rjl; rLG mr.'er iu.u.e 1 _ , „r I:I and ;m[u n . ori~'.cn,-( '..i r:'G transn 117ltvrs ,:i: hr J.S. Blau iil 09/02/2020 07:24 FAX ll1001 CERTIFICATE OF LIABILITY INSURANCE °06/03/20013" THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS . CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the cartificate holder is an ADDITIONAL INSURED, the policy(ias) must be endorsed. N SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an ando asmant A statement on this GeNflca$e does not confer rights to the "Mileate holder in lieu of such endorsement(s). PRODUCER STATE FARM INSURACE MANE: OSCAR RODRIGUEZ 011 a Ne: 1-772-0 27 OSCAR RODRIGUEZ-AGENT 1603 E BARNETT RD -ARRKM4. - O MEDFORD, OR 97504 D16UREi s AFFORDING COVERAGE NAIC0 MSURER A: State Farm MUIUSI AutomO0ft, Insurance Company 161ze INWOOD TOBY M MUNROE INSURER 6: 1795 THOMAS RD MBURERC: MEDFORD, OR 97501 NrSYRER D: 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. _ POLICT'NUMBCR POLICY EFF PNOUCY EXP Ulm IM$R TYPEOFINSURA-WE -AML GENERAL LIABILITY EACH OCCURRENCE 3 OAUA~ COMMERCIAL GENERAL LIABILITY PREM16E TO R VSFN^~`~I 3 CLAN64AADE r-1 OCCUR MEDFJLP(AMNOTTAMan) 3 PERSONAL 5 AW INJURY 3 GENERAL AGGREGATE $ GENT AGGREGATE LIMIT APPLIES PER'. PRODUCTS-COMPIOPAGG $ POLICY JFM 1-1 LOC 3 A AUTOMOBILE UAMW}Y y 071 5797-A26-376 07/2812077 D1RBI2014 axIMIM LIMIT 3 eOOLLY INJURY (per NmOn) $ 250,000 ANY AUTO x ALL OWNED SCHEDULED 6001LY INJURY (PO' MXIMIN) $ 500,000 AUTOS -11ROV DAMAGE NON-0O MNEO HIRED AUTOS AUTOS PaiulRMN $ 250,000+ UMBRELLALIAB OCCUR EACH OCCURRENCE 3 EXCFSb UAa CUIM$•MAOE AGGREGATE 3 DED RETENTION6 3 MVO otscompeRSATmN VVC STATIU. OTN. AND M"Ye", LIABILITY ANY PROPMETORIPARTNEROECUTIVE Y/❑M NIA E.L. EACH ACCIDENT 3 OFFICFJMEMSER EXCLUDED7 (MARYMry In NN) E.L. DISEASE - EA EMPLOYE i Ilya, -,INmRN E.L. DISEASE - POLICY LIMIT 3 MSCRIPTONOFOPETINTI DESCRIPTION OF OPERATION61 LOCATIONS I VENCLFS (AINm WORD let, ANSI RMOOMA SO M H. a MON 3PKY N1M IHwU CONSTRUCTIONIEXCAVATING CERTIFICATE HOLDER CANCELLATION CITY OF ASHLAND SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE FXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 90 MOUNTAIN ST ACCORDANCE WITH THE POLICY PROVISIONS. ASHLAND, OR 97520 AUTHORIZED REPRESENTATIVE ®1988.2010 O CORPORATION. All rights reserved. ACORD 25120101051 The ACORD name and logo are registered marks of ACORD 1002398 139020.2 12-22-2010 J Be6cher Carlson 6/4/2013 3:07:31 PM PAGE 2/005 Fax Server cATF4El!AC)GiY~Yr. CERTIFICATE OF LIABIUTY INSURANCE THIS CERTIRCATE.IS ISSUED AS 'A MATTER: Of INFORMATION ONLY AND COFFERS NO RIGNTa UPON THE CERTIFICATE HOLDER THIS- CERTIFK•ATE DOES NOT AFFIRNATLVELY OR'NEGATWELY AMEND, EXTEND DP, ALTER THE COVERAGE-AFFORDED BY THE POLICIES i BELOW. T;•d8 CERTIFICATE OF INSURANCE DOES-1407 CONSTITUTE A CONTRACT' BETWEEM. THE ISSUIVG,INSURERjS), AUTF.ORIZU0, REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT. R'he CerilBWte HOldef is an ADDITIONAL INSURED,( HirpoUty(pejmust Oeenddrsed; It SUBROO,ATION~IS WAIVED, ECt'iect to me twins 4m <t11011LM`S M Nis Policy.,-c iti politiAs..r.1w rpqutre an o idwsomt nt. 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Street AJ4Il NL[2J PTPI(f:$EYtq]Wr A-ablana.-6a -97326 Ta1'ry>Th'nmprnn fi,YRFY ~'U7 'fy':N3`i' .ACOR035( O1N89)' T1988-201OACCRDCORPORATION. AdIrlgtd roaerved. IN302;,^iigasj,eq Tne ACORO.name and logo:are registered marks OTACORD, i CCB Business Detail for License: 142905 Page 1 of 2 BUSINESS DETAIL FOR: TOBY MICHAEL MUNROE License: 142905 The business detail record includes business contact information and information about the business' bond, liability insurance, worker's compensation insurance, licensing category, business entity and other associated CCB licenses. License 142905 Number License Active Status: Date First 5/10/2000 Expiration: 5/10/2014 Licensed: Name: TOBY MICHAEL MUNROE Address: 1796 THOMAS RD MEDFORD OR 97501 Work (541) 941-1329 Phone: Entity Type: Sole Proprietor Class of Independent Exempt Contractor License Residential: RGC - General Contractor Endorsement: BUSINESS LICENSES & CERTIFICATIONS CERTIFIED LEAD-BASED PAINT RENOVATION CONTRACTOR (LBPR) LICENSE (IMPORTANTINFO) NO LEAD BASED PAINT RENOVATORS LICENSE All. contractors must have an active "License Status" for their CCB license to legally offer or perform any type of work on any structure. An active "LBPR Status" allows contractors with an active "License Status" to renovate specific structures that may contain lead-based paint. Click on the IMPORTANT INFO link above for more detail. ENERGY EFFICIENCY AND SUSTAINABLE TECHNOLOGY (EEAST) CERTIFICATION (IMPORTANT INFO) NO EEAST CERTIFICATION All contractors must have an active "License Status" for their CCB license to legally offer or perform any type of work on any structure. An active "EEAST Status" indicates the contractor has met specific https://ccbed.ccb. state.or.us/ccb_frames/consumer-info/business_detail.asp?license number... 6/3/2013 CCB Business Detail for License: 142905 Page 2 of 2 requirements to work on projects funded through the Energy Efficiency and Sustainable Technology program.'Click on the IMPORTANT INFO link above for more detail. OTHER BUSINESS. INFORMATION WORKERS' COMPENSATION INSURANCE INFORMATION Coverage Carrier Policy Number Employee Coverage None None Personal Election Coverage Ndne None LIABILITY INSURANCE INFORMATION (HISTORY) Insurance $1,000,000.00 Insurance Company: AMERICAN HALLMARK Amount: INSURANCE CO OF TEXAS Effective 5/10/2014 Through: CCB RESIDENTIAL BOND INFORMATION (HISTORY) Bond $20,000.00 Bonding Company: 27 - CONTRACTORS Amount: BONDING & INS CO Effective 5/10/2014 . Through: ASSOCIATED PEOPLE (INFO) PRESENT - RMI Owner MUNROE, TOBY MICHAEL PAST ASSUMED BUSINESS NAMES (INFO) PRESENT - T & M EXCAVATION PAST Cross-referenced CCB Licenses and Associated Records: No Records Found BACK https://ccbed.ccb.state.or.us/ccb_frames/consumer info/business_detail.asp?license number... 6/3/2013 ' ~ Xl-ht3~T C. T & M Excavation 1796 Thomas Rd Medford, OR 97501 Phone (541) 941-1329 Email:tobester29@hotmail.com June 6th 2013 List of Subs to be used on the 795 Park Street Project ' PConfident Staffing ~..~f~on Munroe Backhoe Service ANIountain View Paving Ld Inc Thank You ZIA a6 WCCE ap-L, tpoe immhs About Us Confident Staffing, Employee Leasing Page 1 of 1 About Us Confident Staffing offers a number of services ranging from temporary and temp-to-hire programs regionally to Direct Hire recruiting and placement services nationally. Our management team has an incredible wealth of experience and knowledge in human resources and staffing techniques - that helps find the best person for the job at the best company for the person. The matching process is the foundation of the services we provide. We pride ourselves on really understanding the needs and desires of our candidates, employees and our clients - so we are able to bring together the best, most qualified person with the best job available in their field at a company they will feel comfortable working for. Our client benefits from our matching process, by avoiding unnecessary turn-over and re-training costs. For Hourly Employees: CSI's temp-to-hire program is a fantastic way for both the employee and the client to look each other over, before committing to a long-term working relationship. For Salary Employees: CSI's Direct Hire service is an efficient and cost-effective tool that companies appreciate when seeking a highly skilled, knowledgeable and experienced professional. ■ Confident Staffing offers Nationwide recruiting & placement Direct Hire services. ■ Our skilled recruiting staff as well as our unique nationwide network of Recruiting & Placement professionals offers one of the strongest combinations of recruiting and placement services available. ■ Confident Staffing is an Oregon based, female owned corporation, that provides staffing services throughout Oregon. ■ Confident Staffing of Washington provides staffing services for the state of Washington. ■ Registered with the Small Business Association. ■ Registered CCR contractor in good standing for government and corporate contracts. Tax Benefits of doing business with Confident Staffing - 100% female owned business ©Copynght 2010 Confident Staffing. Inc. WI Rights Reserved. I Home I About Us I Client Service s Candidate Area l tgeyg I Contact Us http://www.confidentstaffing.com/about/ 6/7/2013 W/13 Roof of Crn age Search - Results Proof of Coverage Search - Results Employer: CONFIDENT STAFFING INC 2770 BIDDLE RD MEDFORD, OR 97504-4113 See all policies for this employer location Coverage Effective Policy Information 08/01/2012 to 08/012013 Insurer: DALLAS NATIONAL INSURANCE COMPANY Policy#:' WCOR14209 Policy Status:ACTNE Policy Holder: CONFIDENT STAFFING INC 2770 BIDDLE RD MEDFORD, OR 97504-4113 Covered Employer Locations Claims Processing Information Employer Dates Co%ered CONFIDENT STAFFING INC 08/012012 to 08/012013 CONFIDENT STAFFING INC 08/012012 to 081012013 531 NEE ST STE D GRANTS PASS OR CONFIDENT STAFFING INC 08/012012 to 08/012013 2770 BIDDLE RD MEDFORD OR Return to the search page Request Coverage Search Assistance Search hints: • The search return is proof of coverage for carrier4nsured, selftinsured, or worker leasing arrangements. Self-insurance was added in October 2011, eliminating the need for a separate search for that coverage and worker-leasing coverage is also included in the same search form. • The search tool is sensitive to exact spelling, based on the spelling used by the insurer, and considers only whole words. If you are unsure of a spelling or just want to search quickly, start the word.and then use a % sign as a wild card to complete the word. The %symbol must be the last entry if you are using it as a wild card for any particular word. • First, try searching with fewer words of the employer's legal name (perhapsjust one unique word or portion of a word ending in a %symbol). • If the screen shows too many results, then add another element such as the city or one known piece of the street address (even just the address number without the street name). • If the results are still too many, add another data element • If you use the back arrow to get back to the search page, click on the "Reset Search Fields" button to clear the form. Shortcut to this site: WorkCompCoverage.wcd.oregon.gov wcd cov search.liSt.results www4.cbs.state.or.us/exMcd/coindexcfm?B64=nZzV WZjFGcMjbslXaONTJFJmczVWda4ctZ2bIRWP4VWYONmI1J2cuIXZzNSPiZXdpNmbzVlcu9W1'11uPP... 1/1 CCB Business Detail for License: 121229 Pagel of 3 BUSINESS DETAIL FOR: RONALD LYNN MUNROE License: 121229 The business detail record includes business contact information and information about the business' bond, liability insurance, worker's compensation insurance, licensing category, business entity and other associated CCB licenses. License 121229 Number: License Active Status: Date First 3/17/1997 Expiration: 3/17/2014 Licensed: Name: RONALD LYNN MUNROE Address: 4624 WINNETKA RD WHITE CITY OR 97503 Work (541) 601-4076 Phone: Entity Type: Sole Proprietor Class of Independent Non-Exempt Contractor: License Residential: RGC - General Contractor Endorsement: Commercial: CGC2 - General Contractor 2 BUSINESS LICENSES & CERTIFICATIONS CERTIFIED LEAD-BASED PAINT RENOVATION CONTRACTOR (LBPR) LICENSE (IMPORTANT INFO) NO LEAD BASED PAINT RENOVATORS LICENSE All contractors must have an active "License Status" for their CCB license to legally offer or perform any type of work on any structure. An active "LBPR Status" allows contractors with an active "License Status" to renovate specific structures that may contain lead-based paint. Click on the IMPORTANT INFO link above for more detail. ENERGY EFFICIENCY AND SUSTAINABLE TECHNOLOGY (EEAST) CERTIFICATION (IMPORTANT INFO) NO EEAST CERTIFICATION All contractors must have an active "License Status" for their CCB license to legally offer or perform any type of work on any structure. An active "EEAST Status" indicates the contractor has met specific https://ccbed.ccb. state.or.us/ccb_frames/consumer info/business-... 6/7/2013 CCB Business Detail for License: 121229 Page 2 of 3 requirements to work on projects funded through the Energy Efficiency and Sustainable Technology program. Click on the IMPORTANT INFO link above for more detail. OTHER BUSINESS INFORMATION WORKERS' COMPENSATION INSURANCE INFORMATION Coverage Carrier Policy Number Employee Coverage SAIF CORP 963825 Personal Election Coverage None None LIABILITY INSURANCE INFORMATION (HISTORY) Insurance $1,000,000.00 Insurance Company: AMERICAN HALLMARK Amount: INSURANCE CO OF TEXAS Effective 2/11/2014 Through: CCB RESIDENTIAL BOND INFORMATION (HISTORY) Bond $20,000.00 Bonding Company: 153 - OLD REPUBLIC Amount: SURETY CO Effective 3/17/2014 Through: CCB COMMERCIAL BOND INFORMATION (HISTORY) Bond $20,000.00 Bonding Company: 153 - OLD REPUBLIC Amount: SURETY CO Effective 3/17/2014 Through: ASSOCIATED PEOPLE (INFO) PRESENT - RMI Owner MUNROE, RONALD LYNN PAST - Previous RONALD MUNROE BACKHOE SERVICE Name ASSUMED BUSINESS NAMES (INFO) PRESENT - RON MUNROE BACKHOE SERVICE https:Hccbed.ccb. state. or.us/ccb_frames/consumer_info/business_... 6/7/2013 CCB Business Detail for License: 121229 Page 3, of 3 PAST Cross-referenced CCB Licenses and Associated Records: No Records Found BACK https://ccbed. ccb. state.or. us/ccb_frames/consumer_info/business_... 6/7/2013 6/7/13 Roof of Coverage Search - Results Proof of Coverage Search - Results Employer: RON MUNROE 4624 WINNETKA RD WHITE CITY, OR 97503-3008 See all oolicies for this employer location Coverage Effective Policy Information 04/01/2013 to 04/01/2014 Insurer: SAIF CORPORATION Policy#: A963825160 Policy Status: ACTIVE Policy Holder: RON MUNROE 4624 WINNETKA RD WHITE CITY, OR 97503-3008 Covered Employer Locations Claims Processina Information Retum to the search page Request Coyeraae Search Assistance Search hints: • The search return is proof of coverage for carrierynsured, self4nsured, or worker leasing arrangements. Self-insurance was added in October 2011, eliminating the need for a separate search for that coverage and worker-leasing coverage is also included in the same search form. • The search tool is sensitive to exact spelling, based on the spelling used by the insurer, and considers only whole words. If you are unsure of a spelling or just want to search quickly, start the word and then use a % sign as a wild card to complete the word. The %symbol must be the last entry if you are using it as a wild card for any particular word. • First, try searching with fewer words of the employers legal name (perhapsjust one unique word or portion of a word ending in a %symbol). • If the screen shows too many results, then add another element such as the city or one known piece of the street address (even just the address number without the street name). • If the results are still too many, add another data element • If you use the back arrow to get back to the search page, click on the "Reset Search Fields" button to clear the form. Shortcut to this site: World;ompCoveraae.wed.oregon.gov wcd cov se arch. list. results wmk4.cbs.state.onus/e:A%cd/co,firdexcfrn?B64=nZzV WZjFGNjbslXaONTJFJmczVWdO)ctZ2blR WP4V WYONm11J2culXZzNSPi2XdpNrrtzV1 cu9V M 1VPP... 1/1 CCB Business Detail for License: 59920 Page 1. of 3 BUSINESS DETAIL FOR: MOUNTAIN VIEW PAVING INC License: 59920 The business detail record includes business contact information and information about the business' bond, liability insurance, worker's compensation insurance, licensing category, business entity and other associated CCB licenses. License 59920 Number License Active Status: Date First 4/25/1989 Expiration: 4/28/2015 Licensed: Name: MOUNTAIN VIEW PAVING INC Address: PO BOX 508 TALENT OR 97540 Work (541) 488-7745 Phone: Entity Type: Corporation Class of Independent Non-Exempt Contractor License Residential: RGC - General Contractor Endorsement: Commercial: CGC2 - General Contractor 2 BUSINESS LICENSES & CERTIFICATIONS CERTIFIED LEAD-BASED PAINT RENOVATION CONTRACTOR (LBPR) LICENSE (IMPORTANT INFO) NO LEAD BASED PAINT RENOVATORS LICENSE All contractors must have an active "License Status" for their CCB license to legally offer or perform any type of work on any structure. An active "LBPR Status" allows contractors with an active "License Status" to renovate specific structures that may contain lead-based paint. Click on the IMPORTANT INFO link above for more detail. ENERGY EFFICIENCY AND SUSTAINABLE TECHNOLOGY (EEAST) CERTIFICATION (IMPORTANT INFO) NO EEAST CERTIFICATION All contractors must have an active "License Status" for their CCB license to legally offer or perform any type of work on any structure. An active "EEAST Status" indicates the contractor has met specific https:Hccbed.ccb. state. or.us/ccb-frames/consumer-info/business-... 6/7/2013 CCB Business Detail for License: 59920 Page 2 of 3 requirements to work on projects funded through the Energy Efficiency and Sustainable Technology program. Click on the IMPORTANT INFO link above for more detail. OTHER BUSINESS INFORMATION WORKERS' COMPENSATION INSURANCE INFORMATION Coverage Carrier Policy Number Employee Coverage SAIF 495478 Personal Election Coverage None None LIABILITY INSURANCE INFORMATION (HISTORY) Insurance $1,000,000.00 Insurance Company: NORTH PACIFIC INS Amount: COMPANY Effective 9/25/2013 Through: CCB RESIDENTIAL BOND INFORMATION (HISTORY) Bond $20,000.00 Bonding Company: 429 - DEVELOPERS SURETY Amount: AND INDEMNITY COMPANY Effective 4/28/2015 Through: CCB COMMERCIAL BOND INFORMATION (HISTORY) Bond $20,000.00 Bonding Company: 429 - DEVELOPERS SURETY Amount: AND INDEMNITY COMPANY Effective 4/28/2015 Through: $30,000 PUBLIC WORKS BOND INFORMATION (INFO) Effective 5/8/2012 Effective Through: Until Cancelled From: Company DEVELOPERS SURETY AND INDEMNITY COMPANY Name: Exemption Expiration Date of the Exemption Disadvantaged Business Enterprise No DBE Exemption (DBE): Emerging Small Business Enterprise No ESB Exemption (ESB): https:Hccbed.ccb. state. or.us/ccb-frames/consumer-info/business-... 6/7/2013 CCB Business Detail for License: 59920 Page 3 of 3 Women Business Enterprise (WBE): No WBE Exemption Minority Business Enterprise (MBE): No MBE Exemption ASSOCIATED PEOPLE (INFO) PRESENT - Corporate MEYER, PAUL F Officer - RMI Owner MEYER, PAUL F - Changed MEYER, PAUL F Entity PAST ASSUMED BUSINESS NAMES (INFO) PRESENT PAST Cross-referenced CCB Licenses and Associated Records: No Records Found 1BACK https://ccbed.ccb. state.or.us/ccb_frames/consumer_info/business_... 6/7/2013 67113 Prod of Caerag a Search - Results Proof.of Coverage Search - Results Employer: MOUNTAIN VIEW PAVING INC 530 VALLEYVIEW TALENT, OR 97540 See all policies for this employer location Coverage Effective Policy Information 10/01/2012 to 10/012013 Insurer. SAIF CORPORATION Policy#: A496578160 Policy Status: ACTIVE Policy Holder: MOUNTAIN VIEW PAVING INC PO BOX 508 TALENT, OR 97540-0508 Covered Employer Locations Claims Processino Information Employer Dates Covered MOUNTAIN VIEW PAVING INC 10/01 2 01 2 to 10/01 2 01 3 530 VALLEY VIEW TALENT OR MOUNTAIN VIEW PAVING INC 10/012012 to 10/012013 PO BOX 508 TALENT OR Return to the search page Request Coverage Search Assistance Search hints: • The search return is proof of coverage for carriertinsured, self4nsured, or worker leasing arrangements Self-insurance was added in October 2011, eliminating the need for a separate search for that coverage and workeraeasing coverage is also included in the same search form. • The search tool is sensitive to exact spelling, based on the spelling used by the insurer, and considers only whole words If you are unsure of a spelling orjust want to search quickly, start the word and then use a % sign as a wild card to complete the word. The %symbol must be the last entry if you are using it as a wild card for any particular word. • First, try searching with fewer words of the employer's legal name (perhaps just one unique word or portion of a word ending in a %symbol). • If the screen shows too many results, then add another element such as the city or one known piece of the street address (even just the address number without the street name). • If the results are still too many, add another data element • If you use the back arrow to get back to the search page, click on the "Reset Search Fields" button to clear the form. Shortcut to this site: Work ComDCoyeraae.wcd.Oreaon aov wcd cov search.liSt.results wwM4.cbs.state.or.us/eAwd/caJindexcfm?B64=nZzVWZFGcMjbslXaONTJFJm VWdOx)ctZ2blRWP4VWYONrN1J2culXZzNSRZXdpNmbzVlcu9WY11UPP... 1/1 CCB Business Detail for License:. 35873 Pagel of 3 BUSINESS DETAIL FOR: LLAD INC License: 35873 The business detail record includes business contact information and information about the business' bond, liability insurance, worker's compensation insurance, licensing category, business entity and other associated CCB licenses. License 35873 N er: License Active Status: Date First 3/23/1982 Expiration: 5/8/2014 Licensed: Name: LLAD INC Address: PO BOX 516 MEDFORD OR 97501-0035 Work (541) 772-8271 Phone: Entity Type: Corporation Class of Independent Non-Exempt Contractor: I icenco Residential: RGC - General Contractor Endorsement: Commercial: CGC2 - General Contractor 2 BUSINESS LICENSES & CERTIFICATIONS CERTIFIED LEAD-BASED PAINT RENOVATION CONTRACTOR (LBPR) LICENSE (IMPORTANT INFO) NO LEAD BASED PAINT RENOVATORS LICENSE All contractors must have an active "License Status" for their CCB license to legally offer or perform any type of work on any structure. An active "LBPR Status" allows contractors with an active "License Status" to renovate specific structures that may contain lead-based paint. Click on the IMPORTANT INFO link above for more detail. ENERGY EFFICIENCY AND SUSTAINABLE TECHNOLOGY (EEAST) CERTIFICATION (IMPORTANT INFO) NO EEAST CERTIFICATION All contractors must have an active "License Status" for their CCB license to legally offer or perform any type of work on any structure. An active "EEAST Status" indicates the contractor has met specific https://ccbed. ccb. state. or. us/ccb_frames/consumer info/business-... 6/7/2013 CCB Business Detail for License: 35873 Page 2 of 3 requirements to work on projects funded through the Energy Efficiency and Sustainable Technology program. Click on the IMPORTANT INFO link above for more detail. OTHER BUSINESS INFORMATION WORKERS'COMPENSATION INSURANCE INFORMATION Coverage Carrier Policy Number Employee Coverage SAIF 744999 Personal Election Coverage None None LIABILITY INSURANCE INFORMATION (HISTORY) Insurance $1,000,000.00 Insurance Company: NORTH PACIFIC INS Amount: COMPANY Effective 3/8/2014 Through: CCB RESIDENTIAL BOND INFORMATION (HISTORY) Bond $20,000.00 Bonding Company: 1002 - AMERICAN Amount: CONTRACTORS INDEMNITY CO Effective 5/8/2014 Through: CCB COMMERCIAL BOND INFORMATION (HISTORY) Bond $20,000.00 Bonding Company: 1002 - AMERICAN Amount: CONTRACTORS INDEMNITY CO Effective 5/8/2014 Through: $30,000 PUBLIC WORKS BOND INFORMATION (INFO) Effective 2/11/2011 Effective Through: Until Cancelled From: Company PLATTE RIVER INSURANCE COMPANY Name: Exemption Expiration Date of the Exemption Disadvantaged Business Enterprise No DBE Exemption (DBE): https:Hccbed.ccb. state. or.us/ccb-frames/consumer-info/business-... 6/7/2013 CCB Business Detail for License: 35873 Page 3 of 3 Emerging Small Business Enterprise (ESB): No ESB Exemption Women Business Enterprise (WBE): No WBE Exemption Minority Business Enterprise (MBE): No MBE Exemption ASSOCIATED PEOPLE (INFO) PRESENT - Corporate FREEMAN, LARRY D Officer - Corporate HODGES, JANET Officer - RMI Owner FREEMAN, LARRY D PAST - Previous CAMPBELL, JOHN R "RICK" Name - Previous FISHER, JERRY Name - Previous FREEMAN, ANITA L Name - Previous FREEMAN, DIANE K Name - Previous PROBERT, DIANE R Name ASSUMED BUSINESS NAMES (INFO) PRESENT PAST Cross-referenced B Licenses and Associated Records: No Records Found BACK https:Hccbed.ccb. state. or.us/ccb_frames/consumer_info/business_... 6/7/2013 6r7/13 Proof of Coerag a Search - Results Proofof Coverage Search - Results Employer: LLAD INC 3003 GRIFFIN CREEK RD MEDFORD, OR 97501 See al_I_ policies for this employer location Coverage Effective Policy Information 10/01/2012to10/01/2013 Insurer: SAW CORPORATION Policy#: A744999160 Policy Status: ACTIVE Policy Holder: LLADINC PO BOX 516 MEDFORD, OR 97501-0035 Covered Emplowr Locations Claims Processing Information Employer Dates Coered LLAD INC 10/01/2012 to 90/012013 3003 GRIFFIN CREEK RD MEDFORD OR LLAD INC 01/31/2013 to 101012013 5555 N MEDFORD IND RD ' MEDFORD OR LLAD INC 10/01/2012 to 10/012013 PO BOX 516 MEDFORD OR Return to the search page Request Cmeraae Search Assistance Search hints: • The search return is proof of coverage for carrierrnsured, self4nsured, or worker leasing arrangements Self-insurance was added in October 2011, eliminating the need for a separate search for that coverage and worker-leasing coverage is also included in the same search form. • The search tool is sensitive to exact spelling, based on the spelling used by the insurer, and considers only whole words If you are unsure of a spelling orjust want to search quickly, start the word and then use a % sign as a wild card to complete the word. The %symbol must be the last entry if you are using it as a wild card for any particular word. • First, try searching with fewer words of the employer's legal name (perhapsjust one unique word or portion of a word ending in a %symbol). • If the screen shows too many results, then add another element such as the city or one known piece of the street address (even just the address number without the street name). • If the results are still too many, add another data element • If you use the back arrow to get back to the search page, click on the "Reset Search Fields" button to clear the form. Shortcut to this site: WorkCompCoveraae wcd oregon.aov wcd cov search.liSt.results wwwt.cbs.state.or.us/e>dwcd/coVindexcfm?B64=nZzV WZjFGcMjbslXaONTJFJmczV WdOxyctZ2bIR WP4V WYONm11J2cuIXZzNSPiZXdpNmbzVlcugVW l U PM... 1/1 •GXtkt~3rr C. a ' T drc M Excavation 1796 Thomas Rd Medford, OR 97501 Phone (541) 941-1329 P, m a i l: tobeste r29@ho tm a i l.com May 28th 2013 Park Street (New Power Service) Equipment/Labor. $10,640.00 Patch $1,600.00 Materials/Haul Off $4.060.00 Total S16,300.00 Thank You ~X I-h P rr o~ ¢ - v Vl C o n D w OJ rp m o rr+ n o N z m ~ `D ~ s r - - - - - - - - - - - - - - - - - - - - - - - - - - r------ I i ~ I rn I o I I, i J I ' \rnm wn C49. rn < in I ~y Cn o C © nm n0 r = i i cn cn d PARK ST ! T m i--- ~ ® N O J ~ L J/R ~ 00 O \ A O r I ~ I ~ I w, ~ A I wm I ~ Am C y I <"i, D O I I N ~m I' r~ , ~ <m m ' ° I' a ` A I I ' ~ I I I ' ~ ill rnD A N ` ' ' ~ I- - J O VL I ao . W L J O O ~ V7 J v N ~ N .o m m co \p - N---o------ Beecher Carlson 6/4/2013 3:07:31 PM PAGE 3/005 Fax Server s e: E.F. Veiloatimior the BUILDING AND PERSONAL PROPERTY COVERAGE FORMisdeletedaad(oplacedbytie. fok"'.g! 7. 'Valuation We will determine tle.volue of obteredptorxnty in the 'event of loss or. darnagc~ as follms:a. A€. actual cash value, at the tuna of the loss;;w M a de. v tim tot dopea<tim):e%capt.as ppmrided in Pare ;p!i%b:.and:e following. b. Pa-r or $et- The vahK, if a mst o-.7aT ad anr,;o:wpicH ~ pa p{ a pav or stiai:G ~sased ^r: a rea3onaE~e pt:pwrtion.of ;th•e va luc ofthr, onto pair oraot theMoss a not cmtw"red a total toss .t the pair or%rrL. :r Loss to Parts. Tho aaiue :if o lost or damagedpmn of an dorri that ennstctsof:severA par's whrnit;is uomple a is besed on the va uo of b0i tfre lost or dafnagad pdii or the cost ip rapcfr a replaceit. 1. Rental Revubursement in f:he event of loss'by.u covered peril to cove:ed contactors' egninmenftratyod ut~•l, v+a vjI,rjinbosq, you-for your, urense to 4eM,slrrilar egClofnprt while yow eQalpment w Inuicerabie. Tile most m 0. 'elmburse you :for re'ntal' fIP7~0 Re^ICTS C%„^erAi95 S S1,WO.:t!yE WIi,Cyn_~firlE10 reimhurse yDC fd'ahe reMii of equipmem aIICrthe egoragon 3ata of thi; coverage pravided the loss Dccdfrod tefore tse eyaration'date. -dQewo notremnburse you: a bycuinnconhnueoirestuneyouroperaborswil:~tsrm:tar:eciripfnen[!n suvailabletoyouwficadditional iigrcntie to yod; or b FCf the rental oyporiiM of any:rgirpmanividir+s you maaA every teascracieeffort tr i"Ir, oplroz or rotad the inoperable quipnientafter lhccmitrod loss occara.. 3 VA hrespect pr uusA Afit unal. Coverage. CglNrer-ti rs Equipment Coverage. Se on D; murlibla of this BULDING, AND PERSONAL PROPERTY COVERAGE, FORM rs delot d anti mrifaced ty the.to.lowing` D. Deductible Yvs k4f i notpavfnr toss or damage. at any ono occenence untiliffe atntwritof loss or dannage.exceads €500,\Nnwid then nay tho anmuitcf loss o- darmp in mess of 1500 upifo.(ha opprcablo limit of insutanoc, We'4A!notrif.Un. rrseyou€orLnE entAof-a mentuntl-atei bours havepigitted9,Fcet4eumuredp!ager!y`v;ai reydercdlnaparabt@._Aqe:72ildprshave,paS~eri;wskn'Iordyreimburseyouforttr renls's%pensethe, you actually I^ciir, 'rc Asollanln:crrmoa (mas nncanniym rrmtaI fambur5entam expense-. 6e'araf Lie fiilitir Additional Covuragas Thefo lawng AddiU'onal Covoragr are adiedto the COMMERCIAL GENERAL LIABILITY'COVERAGE FORM, A. 8lankat lF9Cdronai (rtturaC. COViiga 1. SECTION 11-111HO13 ANINWRED-ofthe.COMMERCIAL GENERAL uABILrrycovERAG€FORff.is-amendedto irwhtde-asaninsured .artypersonioeorgar illon(iolerraotoasAdcitonainsil'ed)whomyouareraguaedtoadiiasan ;4ddiucrlsl lilsur~d on !Irs po!wy mw'er. a, A •ririttern contractor ti&cment; ape, - b Mare :a corlificatE of insurance showing that erson 6, organisation as an addillonalinswe"as been impWandl C. VYtizn.tho Written cantract'oi a". ment and ceitficate of lhsurance are currently in effect or bocumirg. in a!fect' dCring,the ter,not[NE,{`oilb/ar:d exe.cuu:d primaihe'btx6lyiujurY arq~iiyUamapz;'ai"perusal atef mverCSNµj1gRt.y.,, .2. fno rlSirrariGa Pro'rrdedtittne.4F.diflruial insuiel is;jiinA.etl1 taeb3w5: a, `te AGdivopal insured is only anadcydonal Insuoid! for. Of "Boc*inrury'°rybpetydaniarje oc'persdnaland -dvei6enpN*fiy"caimedin w,noleorin partfoy:negliftem i oso.:ac.pmists redmntvlaorat±YOreilirr~tYeGrndirBetN mp!c*.biylheNamediftsufedfrfor :wfioso:a Naine Narrleo:irsutodmey~be ilatita. f21>'liatibly andfA out of your angoidg operations fcr'the Additional insured by :1r for you A prJSdn's u[' aganlzatlor's status as at, fnswod udder thl5 coveragP.ends wifn yopr cpiervtn!ts'or thatfnsur®d;off) co Plotii5t. . b: TYeurnitsoUesurailceapplicaM to theAddiuonailmmodarethose sa=cihedinthewlMonconVitct;ragieeme[tl br.".'.wt ~ino.e.ihan the t hints uf-;nsurance;specified in the Naatations for Sits poficy Tae Limits of-lase ante. Page.LOGr23 isiodeecorv-ignledrarprlaorIrmranStrkc GfW'Inc -xw P9P37611.VtR .>nrra~fsaoil2tlm~lr&~rxvr.'e'vcvrs: Irc.;~uArltr6 r:.rrrisu?n Bdecher Carlson 6/4/2013 3:07:31 PM PAGE 4/005 Fax Server a appliceble to the i0ditfomdInstired afe inclusive. of and :hol. in. aanit ir: to the Limts of lnsurance :ohown~jr+the. Declarations for the-Namodl)nsired:. 3. 3nxirdtlnnir.Ihc other caluaron. nppGi;e#gd:fo Setetion.i. Cavarrges A.. B.aridC.oFGne COMMERCIAL OENERAI: LAFIILITY COVERAGE FORM, ttm inswt nce provided to One Addiii6ral h aurea does not=aaply to:' a. 1Propeltydanrge" W, ' !pdoPa''!"f rAVncd:;-used, occupied bq;, loanodor ren:ed2c tha.Ardihan.f-fm:urea, (2I.procFrvi the cam. ars'o l or control cfthe Adclitmnatinsured or avsr}yhi.•n .ha Ad lien tlnsned arq foe anv purpose --wreising phvsieal control: or (3y 'Vnnr wet k%ierformA for the Additional Insured, b "Eludiiv in rV""piopol ty damag?>"nor "personM and adjo5sinrl i urv wising oat of an architacCS,, cr>? nspr'S.or' surve,yor f; rendering: or failure to render any'arofessio nal s9wIiIS' :ur you; rir the Adlditio fal Irpured dr:fel' o•;hor:S:. Including but not limilad to:' tit The.preparino. approving of failure to prepay of apprcva maps drawings, ooin)ons. rep Ats,survers. ohangis 'riders d?StgfDr SpP.ttfK'addr(5',~(N (81:.Suc8Nfsay, inSPeC: orl or enginEenng WKADS: c. 'Snaky injury; at 'property daraoo' occurring after:: . (i All. work Inciddmgmareriais;p9tisdreuuipmen+f5mimedinw5uc~ cr a h~uoh..chicahthe .orojeit(tithe than seMiz:mainten~txa o(tEpairs),to 6e_ porfolmed byor oh behalf of the additiohai:insured at the :siteof ho: rsriarad.operataniI has been cnmpfetedror - (Z iiiat portion of'Sour work" out of which the iryury:ordamage arises has been. putto b imerrided.use try' any fx=su•t or oyaintaaun other loan enodht!f cunt ecioror subcontraulor erigageu in w-funning operations Pori pincgral asa pair of tho "same preloct - 4. SECTION IV-COMMERCIAL GEYERALUABILITYCONDITIONS,f1rragraph4,.oihertnatrance,isatnendedto add the fotiiaing suopa ra;?iapti: d. AAsgtinnatinsttred°SOthdr3n5nnnna At$x'i:RSs insuianca To fire Won othcr;msurance rr iWamedlbyth Adiillonalinsured is excess andnot contobutorvwat, fib surar ifihoirisitred 3onttaCf anal. nol tcouiro thx provbian, then Pwagrap". a, above VAI anply.. : Mobile EquiprineMBf6adened:Coverage V. Z L(i i of tfo COMMERCIAL GENERAL.LIAEILITy COVERAGE FORM? rapkicoL b/ tne:fol!>r.+irt9 : (1) Enu7omer~icosrgned prima.wJ for; ia). $now Rernova; (b) Ruddrawatenance,,bulno; evitstaicsan o fieau taring;:or { )..SYex, craning. EKCap;-the..aSowprovisions.donoiaMijioseI propelled vc!ricles oi,~ess then-l OilO ooueds Er•oss ,r roar. iYEgliwlii h arc ratiMertced.fa(.:ze an a hiphwiY. C;..A9greg40, imlt'Per:prb*t . . The Geneal AggregateUmitnndal SECTION IN LIMITS OF INSURANCEof:thG GOMMERCIALGENERAL LIABILITY COVERAGE FORM apptesseparately-W each or:your'prolecls away from premise:: owned by or ranted tbyoll :D: Blanket VOan~ai'Of Transfer Of Rights Of Recovery Against Olheirs To Us the Transfer di Rigrtle of Recovery Against Others To UIs capdition (SEC130hl IV - C64MEXC14L GENERAL LIADILITY CONDMONit) is arnentIed.bythe addNioh:of the foltcrmrg:' We yawn Anyright of recovery we m y:riaw again! any porsarl or oigah2atio!t to whom you or w t on contract. or Written, agr(raticn Imvo*HIVtsf you{'%wn rgh.ar+'ec. tveiy for{oss.,,ausecl yNai fx;rso+ur uryunieaGunaeauusc of)rdymeMs,wc make for injuy o damaga using out of:youi oucong aparatona or 'Jour work' rlonb under a wi tton contract orwrituon FfgfFP.ni Cri: With char pertrxz nr; uigan Yatian aru3'inCiurled In IFii3 "pr(H1iiCt«mnt.9@'.r dries iunstwwri" This. pro\fs7ondaes qot=i~piy:U tes.,ths iwin6e:conUactotw:9Um agreemeriha5 ee9itersculac: jxi~)to tho'aceitrt~nce"o:off°6se giving rise totho 'bcdiiy injury"ar "prcpertydariia6e;' E. Polunta'ryPro;k ty pitrtage:Coiiimoe t. wowflf,atycurre0--,tpaybu,. notdefendanyclai~rnfir`pop..i:ydamage totfie.properyofolhersdtheijrs wIJded: under A,2401, (5) ar d(9) of Ih=COMMERCIAL GENERAL -4ABILTY COVERAGE FORM pr6vidsd:651: rAPeyF71DiD is iudeeagry98NVnaMraorIrsura~~.:ensre cffo Inca d paf)e2'I'o125 rtetx-,'saoriatlm0 !rN«ra+Ge.4r,'~+a, ire... "ktow;mrniieainn • Proposal S.O.S. Plumbing Inc. May 29, 2013 206 S. Pacific Hwy. Talent, Or 97540 Reference j 1321-56029 541 779-3472 541 488-2680 Fax 541-535-3964 SCOTT T Due Date: 6/28/2013 'Job Name: City of Ashland Electric Dept. 795 Park Street 20 E Main Electric Dept. 795 Park Street Ashland, OR 97520 Ashland 541488-5345 541488-6006 Specifications We Hereby Submit This proposal is for.. excavation work to install electrical conduits and an electrical vault in and around the apartment complex located at 795 Park Street. The scope of work will include: --Installing a new electrical vault behind the Park Street curb near the Southeast corner of the apartment complex parking lot --Installing one-3" Schedule 40 PVC conduit from electric pole P-5158602 on the East side of Park Street to the new electrical vault --Installing one-3" Schedule 40 PVC conduit from the existing electric transformer T-5158655 on the East side of Park Street to the new electrical vault --Re-feeding existing transformer T-5158656 near the West end of the apartment complex parking lot with one-3" Schedule 40 PVC conduit from the new electrical vault --Cutting, removing and replacing a strip of asphalt in the street and in the parking lot to install these conduits --Hauling away and disposing of soils and asphalt removed in the street and parking lot --Bedding the new conduits with 12" of sand topped with burial tape as per the City of Ashland Electric Department requirements --Backfilling the remainder of the trenches in the street with slurry as per the City Of Ashland Engineering Department --Backfilling the remainder of the trench in the parking lot with compacted 3/4" minus crushed rock --The repair of any private utility lines encountered in the parking lot NOTES: The electrical vault will be provided by the City of Ashland Electric Department --The Excavation Permit from the City of Ashland Engineering Department will be provided by the City of Ashland Electric Department We propose hereby to furnish material and labor - complete in accordance with the above specifications, for the sum of: $18,445.00 All material is guaranteed to be as specified. All work to be completed in a professional manner according to standard practices. Any alteration or deviation from above specifications involving extra costs will be executed only upon written orders and will become an extra charge over and above the estimate. All agreements contingent upon delays beyond our control. Purchaser agrees to pay all costs of collection, including attorneys fees. This proposal may be withdrawn by us if not accepted by the above due date . Authorized Acceptance Signature Signature Date a May Rock & Excavating, LLC ESTIMATE CCB#65636 USDOT#198930-80 PO Box 319 DATE ESTIMATE NO. Talent OR 97540 5/28/2013 523 NAME/ADDRESS City of Ashland Electric Department We now accept Attn: Dave Tigerson MasterCard, Visa & 90 N. Mountain Street Discover Card. Ashland OR 97520 PROJECT Park Street Elec-Upgrade DESCRIPTION QTY/HRS COST TOTAL City will supply electrical vaults/cabinet. 0.00 0.00 Electrical upgrade. 1 18,550.00 18,550.00 THANK YOU FOR YOUR BUSINESS. ESTIMATE IS GOOD FOR 30 DAYS FROM THE Total $18,550.00 ABOVE DATE. ITEMS NOT LISTED IN THIS PROPOSAL ARE CONSIDERED AN EXTRA AND SIGNATURE WILL BE BILLED @ T7ME & MATERIAL ROCK OR 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 mayrockil9@SmaiLcom * ~ w Dm Tyge From: Knute Parent [knuteparent@charter.netl Sent: Tuesday, May 28, 2013 7:13 AM To: davet@ashland.or.us Subject: Park Street Bid Dave, Thank you very much for the opportunity to bid on the job on Park Street. After reevaluating my schedule, it appears as though I will not be able to complete the job by the deadline required. I appologize for any inconvience this may cause you. Please continue to keep me in mind for future bid jobs and call or e-mail me if you have any questions. I truley appreciate it, thank you again. Knute Parent Owner/Operator Sky Bound Tree Service and Excavation, LLC CCB #189882 541-499-0077 Office 541-890-3386 Cell Page 1 / 1 • As H i,~M [b RECORD LR DATE PO NUMBER 6/4/2013 11619 20 E MAIN ST. ASHLAND, OR 97 97520 (541) 488-5300 VENDOR: 017558 SHIP TO: Ashland Electric Department T & M EXCAVATION (541) 488-5354 1796 THOMAS ROAD 90 N MOUNTAIN MEDFORD, OR 97501 ASHLAND, OR 97520 FOB Point: Req. No.: Terms: Net Dept.: Req. Del. Date: Contact: Dave Tygerson Special Inst: Confirming? No Quantity Unit Description Unit Price _ Ext. Price Installation of 3" PVC primary 16,300.00 conduiUvault (a795 Park Street, includes excavation and backfill. Contract for Goods and Services Beginning date: 05/3012013 Completion date: 06/17/2013 SUBTOTAL 16.300 00 BILL TO: Account Payable TAX 0.00 20 EAST MAIN ST FREIGHT 0.00 541-552-2010 TOTAL 16,300.00 ASHLAND, OR 97520 'Account Number'- Project Number , Amount Account Number.- _7, Project Number Amount' E 690.11.18.00.70410 E 000355.999 16,300.00 r VENDORCOPY I 1. Authorized Signature F+OiCA 0 CITY OF = ASHLAND REQUISITION Date of request: 5-30 - / 3 Required date for delivery: Vendor Name T f EAC'C Va770T/ Address, City, State, Zip /79& 7-ArrOrYt45 A4). /rlE1J6W, OR _ 975-0/ Contact Name & Telephone Number T0,8y MOA/ROE SH/-• 4L!/ • /329 Fax Number E' MA/C ft~6 a sTer Z 9 @ ~in7mai/ . C6/N 6 - / 7 - / 3 SOURCING METHOD O B D/4T~ /7- 13 ❑ Exempt from Competitive Bidding ❑ Emeritencv ❑ Reason for exemption: ❑ Invitation to Bid (Copies on file) ❑ Form #13, Written findings and Authorization ❑ AMC 2.50 Date approved by Council: ❑ Written quote or proposal attached ❑ Written quote or proposal attached ❑ Small Procurement Cooperative Procurement Less than $5,000 ❑ Request for Proposal (Copies on file) ❑ State of Oregon ❑ Direct Award Date approved by Council: - Contract# ❑ Verbal/Written quote(s) or proposal(s) ❑ State of Washington Intermediate Procurement ❑ Sole Source Contract# GOODS & SERVICES ❑ Applicable Form (#5,6, 7 or 8) ❑ Other government agency contract W 5 000 0 100 000 ❑ Written quote or proposal attached Agency 3) Written quotes and solicitation attached ❑ Form #4, Personal Services $5K to $75K Contract# PERSONAL SERVICES ❑ Special Procurement Intergovernmental Agreement $5,000 to $75.000 ❑ Form #9, Request for Approval ❑ Agency ❑ Less than $35,000, by direct appointment ❑ Written quote or proposal attached Date original contract approved by Council: ❑ (3) Written proposalsfWitten solicitation Date approved by Council: (Date) ❑ Form #4, Personal Services $5K to $75K Valid until: Date Description of SERVICES Total Cost /A(MW/1!4T/CW OF 3" PVC V121IYr02y Coy U/1' vJqULT ,F_XC0V147-10A1 - D~►c/tF~%/ - ~s ,o ER 1*tY14CJ,pd E/EerniesfL ttiayour..~n~v PropcLSft~ Gocsa-T/%o ~ /.3D~. 00 795 $ P~.etc sr. Lo Item # Quantity Unit Description of MATERIALS Unit Price Total Cost TOTAL COST. ❑ Per attached quote/proposal $ Project Number000355. ESQ Account Number 624 - J J-1$ CIO - 7oylo_6 ~t!v, 300. 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 bee satis ; Employee Signature: , I h, e x to n UnP)7b2. 0A_ Department Head Signature: LL---- (Equal to or greater than $5,000) City Administrator: (Equal to or greater than $25,000) Funds appropriated for current fiscal year: YES / NO Finance Director- (Equal to orgreater than S5,000) _ Date Comments: R CITY OF Foy #2 ^AS H LAN D REQUEST FOR PROPOSAL - PERSONAL SERVICES INTERMEDIATE PROCUREMENT Release date: May 22, 2013 Requested by (name/dept/telephone/fax/email): Dave Tygerson Electric Department Project Manager Tel: 541.552.2389 Fax: 541.552.2436 davet@ashland.or.us Proposals are due by (time/day/date):5/29/2013 @ 3:30PM Project Name: 795 Park Street Primary cable replacement Project completion required by (date): 6/17/2013 Preferred method of shipment for materials/equipment (if applicable): FOB Ashland -Freight Prepaid Proposals may be faxed, emailed or hand delivered. Proposers shall submit their proposal on their company letterhead. Informal email proposals and/or late proposals will not be accepted. Terms or discounts which are conditioned upon payment within a certain time will not be'considered for purposes of comparison of proposals. The successful proposer will be required to enter into a contract with the City for the services and provide insurance certificates in their own name for General Liability, Professional Liability, Automobile, and Workers' Compensation. Subcontracting will not be permitted. SCOPE OF SERVICES Excavation Project Location : 795 Park Street Excavation and installation of primary conduit and vault. To be installed per the City of Ashland Electric Department Standards and attached drawings and specifications. All Labor and material to be provided by contractor, Excluding 644-sect-ash vault & city excavation permit to be provided by City of Ashland Electric Dept. ) All work to be provided and installed by licensed Contractor. Mandatory pre-bid jobsite inspection scheduled for 9:00 AM Wednesday May 22nd. All bidders must be in attendance Located at 795 Park Street. Method ofAward: In accordance with AMC 2.50.120(C), personal services selection criteri6 shall include: 1. Specialized experience in the type ofwork to be performed,, 2. Capacity and capability to perform the work, including any Specialized services within the time limitations for the work; 3. Educational and professional record, including past record of performance on contracts with governmental agencies and private parties with respect to cost control, quality of work, ability to meet schedules, and contract administration where applicable; 4. Availability to perform the assignment and familiarity with the area in which the specific work is located, including knowledge ofdesigning or techniques peculiar to it, where applicable; 5. Cost ofthe services; and r 6. Any otherfactors relevant to the particular contract. In accordance with ORS 279B.070, Intermediate Procurement (4) Ifa contract is awarded, the contracting agency shall award the contract to the offeror whose quote or proposal will best serve the interests of the contracting. agency, taking into account price as well as considerations including, but not limited to, experience, expertise, product functionality, suitabiliryfor a particular purpose and contractor responsibility under ORS 279B.I10. - Form #2 - Intermediate Procurement, Request for Proposal, Personal Services, Page 1 of 1, 5/31/2013